Imaging Findings of Localized Lymphoid Hyperplasia of the Pancreas: a Case Report

We report here on a case of localized lymphoid hyperplasia of the pancreas in a 70-year-old man which manifested as double lesions (uncinate process and tail) in the organ. The lesions were incidentally detected as hypoechoic lesions on ultrasonography and they appeared as delayed enhancing lesions on the contrast-enhanced dynamic CT and MRI. Total pancreatectomy was performed, because malignant tumor could not be excluded according to the preoperative imaging studies and the endoscopic ultrasound-guided biopsy failed. Pathology revealed localized lymphoid hyperplasia. The patient had an uneventful postoperative course. He has been alive for 18 months after surgery.     

Primary Hepatic Amyloidosis: Report of an Unusual Case Presenting as a Mass

Hepatic involvement of amyloidosis is common. Diffuse infiltration with hepatomegaly is a usual radiologic finding of hepatic amyloidosis. To our knowledge, this is the first case of amyloidosis involving the liver that presented as a mass.     

正常胰腺快速MR成像序列的比较研究

目的选择最适当的胰腺快速ＭＲ成像序列。材料与方法对２０例胰腺正常者行六种快速ＭＲ成像序列检查,其中包括四种快速自旋回波序列（ＴＳＥ—Ｔ１ＷＩ、Ｔ１ＦＳ、Ｔ２ＷＩ、Ｔ２ＦＳ）和二种梯度回波序列（ＧＲＥ—ＴＦＥ、ＦＦＥ）,然后对所得图像进行定量、定性分析。结果定量分析表明,Ｔ１ＦＳ有最高的胰腺信噪比。定性分析表明,Ｔ１ＷＩ显示脾静脉最好,且能同时清楚显示肠系膜上血管、门静脉和腹腔动脉。Ｔ１ＦＳ的伪影最少,且能同时清楚显示胰——十二指肠分界、胰一胃分界及肠系膜上静脉。Ｔ２ＷＩ的图像质量及对胰一十二指肠分界显示最好,且能同时清楚显示胆总管、肠系膜上血管、门静脉和腹腔动脉。Ｔ２ＦＳ显示胆总管最好,显示胰一十二指肠分界的能力同Ｔ２ＷＩ,同时能清楚显示门静脉。ＴＦＥ和ＦＦＥ无明显的优点。六个序列中任何一个,均不能使正常胰管成像。结论在正常胰腺快速ＭＲ成像序列中,Ｔ１ＦＳ和Ｔ２ＷＩ优于其它序列。     

胰腺内分泌肿瘤的MRI诊断

目的 探讨MRI在胰腺内分泌肿瘤诊断中韵价值。资料与方法 15例胰腺内分泌肿瘤患者均行MRI检查。扫描序列包括SE T1WI、FS T1WI、FSE T2WI、FMPSPGR平扫及动态增强扫描。结果 15例患者共16个病灶。多数肿瘤呈长T1（9／15）长T2（11／15）信号,FS T1WI及FMPSPGR平扫序列多为低信号（分别为8／11和13／16）,且显示肿瘤较常规SE T1WI更清晰,动态增强后肿瘤可有多种强化方式,8个动脉期中度或明显均匀强化,门脉和延迟期有所下降但仍高于周围正常胰腺实质;2个动脉期边缘结节样强化,进行性向中心填充;2个表现为均匀轻中度强化;2个呈均一渐进性强化;2个明显囊变,囊变区无强化,周围呈持续环状强化。动态增强扫描不仅有助于肿瘤的检出、定性,而且可以了解血管受累程度及有无肝脏、淋巴结转移。结论 MRI多序列扫描及动态增强扫描对胰内分泌肿瘤诊断具有较高价值。     

Laryngeal amyloidosis with laryngocele: MRI and CT

A case of laryngeal amyloidosis associated with a laryngocele is reported. Preoperative CT showed diffuse thickening of the epiglottis, aryepiglottic folds and false vocal cords with well-defined calcific foci. MRI revealed contrast enhancement and increased signal intensity on T2-weighted images. Received: 7 February 1997 Accepted: 14 October 1997     

胰腺损伤的MRI诊断

目的:总结胰腺损伤的MR征象,评价MRI在胰腺损伤诊断中的作用。材料和方法:回顾性分析5例急性闭合性腹部外伤伴胰腺损伤患者的MRI表现。其中男性3例,女性2例,年龄14-52岁,平均33.60±15.34岁。MRI检查用GE 1.5T超导全身磁共振机,相控阵列线圈,包括T_1WI、T_2WI及MRCP等序列。结果:胰腺损伤的MRI表现有:①胰腺肿大(2例);②胰腺断裂(4例);③主胰管断裂(4例);④胰腺内出血(1例);⑤胰周改变:5例均有胰周被膜和肾旁前筋膜增厚,胰周、肾旁间隙广泛积液;⑥假性囊肿形成(2例)。结论:胰腺损伤具有较特征的MR表现,结合临床,可以明确诊断。     

Groove pancreatitis: a diagnostic challenge

Groove pancreatitis is a distinct form of chronic pancreatitis characterized by inflammation and fibrous tissue formation, affecting the groove area between the head of the pancreas, the duodenum and the common bile duct. It is manifested on imaging by a sheet-like mass in the groove area near the minor papilla. Thickening of the duodenal wall and cystic transformation in the duodenal wall also represent common imaging features. Pathogenesis is still unclear, and clinical presentation is not specific. Endoscopic ultrasonography (EUS), computed tomography (CT) and magnetic resonance imaging (MRI) demonstrate imaging findings consistent with the disease in typical cases, but specific diagnosis is challenging in a number of patients where biopsy is required. The disease may mimic pancreatic, common bile duct or duodenal wall cancer that requires prompt and excessive surgical intervention, as opposed to groove pancreatitis where initial conservative treatment is suggested. The clinical, histopathological and radiological features on cross-sectional imaging of this entity are discussed in this review, and differential diagnostic clues are given.     

Unilateral hyperplasia of a cervical spinous process as a rare congenital variant of the spine

Congenital variants of the cervical spine may mimic traumatic lesions and may cause recurrent episodes of pain. We report a 24-year-old female patient with chronic neck pain who had marked unilateral hyperplasia of the spinous process of the seventh cervical vertebra. CT and MRI clearly depicted the abnormality and, furthermore, ruled out posttraumatic spinal changes. To our knowledge, our case is the first patient reported with this rare congenital variant diagnosed by cross-sectional imaging.     

Invasive aspergillosis presenting as a cavernous sinus mass in immuno competent individuals; report of 3 cases

Aspergillosis of the cavernous sinus is rare, especially in immuno competent individuals. We report three such cases secondary to paranasal sinus aspergillosis, with imaging findings. Received: 26 March 1998/Accepted: 28 January 1999     

Imaging by multiple modalities of patients with a carotidynia syndrome

The purpose of this article is to familiarize readers with the clinical syndrome of carotidynia. In the past, the International Headache Society (IHS) described idiopathic carotidynia as a diagnostic entity consisting of a self-limiting neck pain syndrome and tenderness over the carotid bifurcation without structural abnormality and then recently removed it from its classification. Although the clinical criteria of carotidynia in the former classification of the IHS included the absence of structural abnormality, several publications have demonstrated associated radiological findings and have described the usefulness of radiological investigations in diagnosing this syndrome. In this paper, we report four additional cases with a carotidynia clinical syndrome (according to the former classification) and the presence of abnormal soft tissue infiltration surrounding the symptomatic carotid artery as demonstrated by multiple imaging modalities, without any other underlying cause for the carotid pain syndrome. Our findings support the hypothesis that carotidynia could be a distinct disease entity, possibly caused by inflammation.     

“Eraseroma” as a cause of rhinolith: CT and MRI in a child

We report a 5-year old girl with progressive difficulty in breathing through the nose whose clinical diagnosis was nasal tumour. CT showed a calcified nodular mass and MRI a nonspecific nodular lesion in the right nasal cavity. The radiological suspicion was a rhinolith. The operative specimen showed that an eraser from a pencil was the primary source. We underline the rarity of this entity and the important role of radiological studies in preoperative recognition. Received: 25 February 1997 Accepted: 26 February 1997     

Imaging of liver transplantation

Liver transplantation (LT) is the treatment of choice for end-stage chronic liver disease, fulminant liver failure and early stage hepatocellular carcinoma. As discussed in this review, state-of-the-art imaging modalities including ultrasonography (US), computed tomography (CT) and magnetic resonance imaging (MRI) play a pivotal role in the selection of patients and donors, as well as in early detection of those complications at risk of impairing graft function and/or survival. We also illustrate main imaging findings related to the wide spectrum of clinical problems raised by LT.     

Case report. Transient nonketotic hyperglycinaemia: ultrasound, CT and MRI

We report a case of transient nonketotic hyperglycinaemia in which radiography correlated closely with clinical and biochemical findings. Only 5 patients have been previously described with this transient form of nonketotic hyperglycinaemia. Among the radiographic findings, thinning of the corpus callosum is the most characteristic. Received: 26 June 1996 Accepted: 29 November 1996     

Castleman's disease of the axilla mimicking metastasis

Castleman's disease is an unusual inflammatory lymphoproliferative disorder of unknown cause. It most commonly occurs in the mediastinum but rarely in the axillary lymph nodes. We report a case of localized axillary Castleman's disease mimicking metastasis as the patient had a palpable malignant mass in the breast, described by ultrasonography, color Doppler ultrasonography, contrast-enhanced CT, and dynamic enhanced breast MR images.     

甲状腺癌的影像学诊断进展

目前甲状腺癌主要的影像学诊断方法是电子计算机体层摄影(CT)、磁共振成像(MRI)及超声(US)等。这些检查方法既有各自独特的优势,也有相应不足。CT对甲状腺癌内钙化的发现明显优于MRI,对肿瘤侵犯相邻结构的显示MRI优于CT;超声检查由于其操作简单、价格适宜,已成为诊断原发性甲状腺癌的首选指标;MRI诊断甲状腺癌的敏感性较高,同时MRS还可以在分子水平上反映病变。本文将甲状腺癌影像学诊断进展情况综述如下。     

¿Están indicadas las pruebas de imagen urgentes en el manejo de la pancreatitis aguda?

Acute pancreatitis is a common emergency within abdominal disease. It is accepted that two of three conditions must be fulfilled for its diagnosis: characteristic clinical presentation, characteristic laboratory findings, and/or characteristic diagnostic imaging findings. The first two conditions are the most often used, probably for reasons of efficiency and frequency. Nevertheless, the need for imaging studies is sometimes a source of conflict. For this reason, we decided to review the current evidence regarding the indication of urgent imaging tests in the management of acute pancreatitis.     

MRI对胰腺癌胰周血管侵犯的手术可切除性评价

目的对胰腺癌胰周血管侵犯判断的最佳序列进行评价,并探讨MRI判断胰腺癌胰周血管侵犯的敏感性、特异性及准确性。资料与方法搜集22例经手术病理证实的胰腺癌病例,所有患者均行平扫的SET1WI、FSE T2WI、SE T1WI＋FS序列扫描,同时行动态增强GRE（DCE FMPSPGR）序列的三期扫描。对该22例患者术前胰周血管侵犯情况进行回顾性分析：（1）按照肿瘤对周围血管侵犯的程度,采用0～3级的等级法进行术前盲法评分,统计血管侵犯及无侵犯的支数,并同手术结果对照。分析0～3各级别对于血管侵犯与否判断其敏感性。（2）统计SE T1WI及DCE FMPSPGR两序列分别及结合起来评价胰周血管侵犯敏感性、特异性、阳性预测值、阴性预测值及准确性。结果22例患者7段共154支血管中,术中发现51支有侵犯,103支无侵犯。其中WE T1WI术前诊断45支受侵．109支无侵犯,漏诊6支,误诊3支。DCEFMPSPCR诊断43支受侵．111支正常,漏诊8支,误诊2支。WE T1WI和DCE FMPSPGR分别及两者相结合判断血管受侵的敏感性、特异性、阳性预测值、阴性预测值及准确性分别为：88．2％、97％、93．8％、94．3％、94．2％;84．3％、98．0％、95．5％、92．7％、93．5％;92．1％、98．0％、95．9％、96．2％、96．1％。结论MRI判断胰周血管侵犯的敏感性为92．1％,特异性为98．0％,诊断准确性96．1％。以SE T1WI和DCE FMPSPGR两序列较优,两者结合起来可以提高判断的准确性。     

Osteoblastoma in a lumbar vertebral body

We report a young man with low back pain suspected to have a disc protrusion. Imaging suggested a tumour of the dorsal portion of the fifth lumbar vertebral body. Operation suggested a giant-cell tumour and subsequent histology showed an osteoblastoma. All typical imaging features of osteoblastoma are demonstrated in this rather uncommon location. Contrast-enhancing bone-marrow oedema on MRI, with mild enhancement of the tumour, together with the CT appearances were the clues to the diagnosis. Received: 11 December 1997 Accepted: 3 September 1998