MR imaging features of uterine adenomyomas

Background

To evaluate the magnetic resonance (MR) imaging features of uterine adenomyoma in comparison with histopathologic findings.

Materials and methods

MR images of seven patients who had surgically proven uterine adenomyoma were retrospectively reviewed by two radiologists in consensus regarding the morphologic appearance, including tumor size, location, margin, presence of concomitant adenomyosis, presence and signal intensity of cavity within tumor, and signal intensity and enhancement pattern of solid portion of tumor. MR imaging findings were correlated with histopathologic findings.

Results

Tumor location was submucosal in three cases, subserosal in two, and mixed mural/subserosal in two. All tumors were well circumscribed on T2-weighted images and contrast-enhanced fat-suppressed T1-weighted images. In six cases, well defined cavities of high signal intensity, which reflected hemorrhagic cavities pathologically, were demonstrated within the tumors on T1-weighted images. Concomitant adenomyosis was observed in five cases. Solid portion of all tumors except hemorrhagic cavities exhibited iso-signal intensity on T1-weighted images, various signal intensity on T2-weighted images, and homogeneous enhancement on contrast-enhanced fat-suppressed T1-weighted images in five cases.

Conclusion

When MR imaging shows a well circumscribed mass with hemorrhagic cavities of high signal intensity on T1-weighted images and concomitant adenomyosis in the uterus, adenomyoma should be considered in the differential diagnosis.     

Comparison of MR imaging features of uterine neuroendocrine carcinoma and uterine malignant lymphoma

Purpose

We retrospectively investigated the characteristic magnetic resonance (MR) imaging findings of uterine neuroendocrine carcinoma (UNEC) compared to those of uterine malignant lymphoma (UML).

Methods

Nine consecutive female patients with UNEC and 5 female patients with UML participated in this study. MR imaging features were evaluated retrospectively.

Results

On MR imaging, seven of 9 UNEC lesions and no UML lesions showed an exophytic growth pattern. All 9 UNEC lesions and no UML lesions showed a growth pattern along the surface of the endocervix or endometrium. Only 1 UNEC lesion and all 5 UML lesions showed diffuse enlargement of the uterus. No UNEC lesions and all 5 UML lesions showed a multinodular shape. These findings showed significant differences between lesions. Findings for margin, endophytic growth pattern, signal intensity, and homogeneity on T2-weighted and T1-weighted imaging did not differ significantly between lesion types. Apparent diffusion coefficient was significantly lower for UML lesions than for UNEC lesions, but was quite low for both types. Local invasion to surrounding tissues was more frequent in UML lesions than in UNEC lesions. There was no significant difference in the frequency of lymphadenopathy between two entities.

Conclusions

UNEC lesions tended to show an exophytic growth pattern and growth along the surface of the endocervix or endometrium, even when diffuse enlargement of the uterus was present, while all UML lesions showed a multinodular shape and diffuse enlargement of the uterus without thickening of the cervical epithelium and endometrium.

     

Cirrhosis: MR imaging features

The intent of this article is to provide a comprehensive review of MR imaging findings of cirrhosis and discusses clinical implications. Areas of focus include: (1) Morphologic changes of the liver in advanced cirrhosis and in early cirrhosis, (2) the frequency and imaging spectrum of intra- and extrahepatic changes in cirrhosis such as regenerative nodules, nodular liver surface, hepatic iron deposition, fibrosis, dilation of right inferior phrenic artery, gastrointestinal wall thickening, and portal hypertension, (3) serial MR findings of clinically progressive cirrhosis, (4) newly described MR sign of cirrhosis (an expanded gallbladder fossa sign), and (5) complications after liver transplantation. Understanding these MR features related to cirrhosis is helpful in clinical MR practice.     

Paraovarian cyst: MR imaging features

BACKGROUND: Paraovarian cysts are common intrapelvic neoplasms, but the magnetic resonance (MR) findings of paraovarian cyst have never been reported. We investigated the spectrum of MR imaging features of paraovarian cyst. METHODS: MR images of 18 paraovarian cysts in 16 patients were reviewed retrospectively. MR images were evaluated for the size and location of paraovarian cysts, single or multicystic, signal intensity on T1- and T2-weighted images, and visualization of the normal ovary on the affected side. RESULTS: The normal ovary of the affected side was recognized in 13 lesions. Four of these 13 cysts were separated from the ipsilateral ovary. In seven cysts, the normal ovary was abutted by cysts but maintained its shape. In two cysts, the beak sign was recognized at the interface between the cyst and the ovary. Most other MR features were nonspecific. CONCLUSION: Most paraovarian cysts were homogeneous cystic masses near the ipsilateral round ligament and the uterus. Demonstration of a normal ipsilateral ovary close to, but separated from, the adnexal cyst may be an important MR finding for the diagnosis of paraovarian cysts.     

下肢平滑肌肉瘤超声误诊为神经鞘瘤1例

患者男,83岁,发现左大腿内侧无痛性肿物半年.查体:左大腿中段内侧触及4 cm×3 cm椭圆形肿块,质硬,边界清,同定,无压痛,左下肢无浮肿.超声:左大腿内侧肌肉层探及椭圆形实性低回声团(图1),大小4.38 cm×2.06cm,边界清,形态规则,内部回声均匀,与股动、静脉紧贴,股浅动脉局部受压,血流信号不丰富.术前诊断:神经鞘瘤.行左大腿包块切除术,术中见肿块质脆、较硬、色白.术后病理:肿瘤细胞呈浸润性生长,核可见异型性,有瘤巨细胞,低度恶性(图2).病理诊断:高分化平滑肌肉瘤.临床诊断:左大腿平滑肌肉瘤.术后半个月行放疗,随访期间无复发.     

原发性下腔静脉平滑肌肉瘤1例

患者男,66岁,右上腹部阵发性疼痛1年,伴有腰部放射痛.查体:右上腹轻度压痛,无肌紧张及反跳痛,未触及包块,腹部移动性浊音阴性,无腹壁静脉曲张,无下肢肿胀.实验室检查未见明显异常.CT:平扫约平肾门水平下腔静脉及其周围见团块样软组织密度影,约7.8 cm×6.2 cm×10.3 cm,CT值29～40 HU,与下腔静脉、十二指肠水平段及邻近腹主动脉分界欠清(图1A);增强扫描见下腔静脉限局性增粗,长约8.6 cm,局部可见7.5cm×5.6 cm软组织密度肿块影向腔内及腔外生长,实质明显不均匀强化,液化坏死部分末见强化;病变包绕部分腹主动脉,与右肾、右肾动脉、右侧输尿管、右侧腰大肌分界清楚,与十二指肠水平段紧邻(图1B、C),其远侧下腔静脉对比剂充盈欠佳.诊断为下腔静脉恶性肿瘤,行下腔静脉肿瘤切除+右侧肾脏切除术.术后病理诊断:下腔静脉平滑肌肉瘤(图2).免疫组化:Des(+),Ki-67(20十),SMA(+),Caldesmon(+),CD117(-).     

MR imaging of primary uterine lymphoma

Primary malignant lymphoma of the uterus is a rare disease. We present the MR findings in three cases where the uterus was the initial site. MR findings were retrospectively evaluated. Although the intact junctional zone is a specific finding for lymphoma, diffuse enlargement of the uterus and relatively homogeneous signal intensity on MR imaging in spite of large tumor size are helpful for diagnosing uterine lymphoma. Received: 14 March 1996/Accepted: 22 March 1996     

MR imaging of malignant uterine disease

The role of MR imaging in the diagnosis and management of patients who have uterine malignancy continues to evolve. MR imaging has been shown to be effective for preoperative characterization and staging of endometrial and cervical carcinoma, and for the evaluation of posttreatment changes and recurrent disease. Because of its potential to provide detailed information about local extent and metastatic disease, MR imaging has enormous potential to help triage patients to appropriate treatment groups and provide imaging surveillance after therapy. This article reviews the MR imaging technique and the imaging characteristics of malignant disease of the uterine corpus and cervix.     

MR imaging of benign uterine disease

MR provides excellent depiction of the female pelvic anatomy and has become the imaging modality of choice for the accurate diagnosis of numerous benign gynecologic conditions. Detection and characterization of leiomyomata and adenomyosis is performed routinely at many centers, and MR plays an important role in stratifying patients into appropriate treatment options. MR imaging is also uniquely well suited to the evaluation of gynecologic conditions that occur during pregnancy and in the postpartum period. This article describes MR protocols and the typical findings of various benign conditions of the uterine corpus and cervix, including congenital anomalies, leiomyomas, adenomyosis, and complications related to pregnancy.     

原发性颅内外沟通平滑肌肉瘤1例

患者女,74岁,1年前摔伤后出现右额部皮下血肿并进行性增大,无头晕、头痛、恶心、呕吐;既往高血压10年余.入院查体:神志清,右额部触及7 cm×7 cm肿块,整体质软、部分基底部稍硬,触之略有波动感,无压痛,移动度差.实验室检查未见明显异常.     

儿童巨大腔外型胃平滑肌肉瘤1例

患儿女,9岁10个月,面色苍白16月余,加重伴乏力3个月;10个月前出现中上腹明显腹痛,持续数十分钟自行缓解,外院诊断为营养性缺铁性贫血,经输血治疗后贫血有所改善.3个月前上述症状加重并出现黑便2次.入院超声检查;右中上腹实质性肿块,位于肝左叶内侧及胰腺前方,其内血供丰富,肝脏略大,实质回声不均质,肝左叶内散在分布低回声结节.     

微囊型脑膜瘤磁共振成像的特点

目的：探讨微囊型脑膜瘤ＭＲＩ的特点,从而提高对本病的认识及与其它颅内肿瘤的鉴别诊断水平,材料与方法：回顾性分析１０例微型型脑膜瘤的ＭＲＩ平扫及增强扫描所见,并与手术病理结果做对照。结果：１０例中,ＭＲＩ平扫呈明显长Ｔ１长Ｔ２者８例,稍长Ｔ１长Ｔ２者２例,且信号不均匀;．增强扫描６例呈地不均匀强化,４例呈蜂窝状强化,８例可见脑膜尾征。