Magnetic resonance imaging of intracranial hemorrhage

The appearance and evolution of intracranial hemorrhage as detected by magnetic resonance (MR) imaging is complex. This article outlines the underlying physiology of hemorrhagic masses in order to explain their complex appearance. The MR appearance of intraparenchymal (benign and neoplastic) and extraparenchymal intracranial hemorrhage is described.     

Magnetic resonance imaging of intracranial venous angiomas

Magnetic resonance imagings (MRI) were made of intracranial venous angioma (six angiographically proved, four presumed). All draining veins were identified as a linear or a small round structure with a flow void. The stellate configuration was observed in seven of the ten patients. In two of the ten, the associated intraparenchymal hematoma was evident. Increased intensity of adjacent parenchyma on T2-weighted images was detected in four of ten patients, and a decreased intensity on the T1-weighted images was noted in three of eight. Thus, MRI is a pertinent diagnostic modality for evaluating intracranial venous angioma. Angiography does not seem to be required for confirmation in patients with typical MR findings.     

Magnetic resonance imaging of intracranial epidermoid tumours

Epidermoid tumours are rare lesions within the skull which are usually found in a cerebellopontine angle. In the computed tomography (CT) literature, they have been described as well-defined lesions of low density which seldom show calcification or tissue enhancement. We have recently encountered three intracranial epidermoids, which appeared to exhibit uniform findings on low field strength magnetic resonance (MR) of moderate signal intensity in the T1-weighted images and a bright signal (increased T2) in the T2-weighted sequences. It may be possible to predict accurately the presence of an epidermoid tumour when this particular configuration of findings is present.     

Magnetic resonance imaging of sacrococcygeal tumors

Five sacral tumors, 2 chordomas, 2 chondro- and/or osteosarcomas and one metastasis were examined with magnetic resonance imaging (MRI). The tumor delineation was excellent in all cases, and in several respects superior to CT. The signal pattern from the chordoma differed considerably from the other tumors suggesting a potential for tumor differentiation with MRI.     

Magnetic resonance imaging of orbital tumors

This contribution provides an overview of diseases of eye and orbit and their appearance on magnetic resonance imaging. In recent years the diagnosis of eye and orbit pathology has profited significantly from increasingly sophisticated technical developments in the field of tomographic methods. Due to the small size of the examination area the improvement in spatial resolution and soft tissue contrast leads to an increase in image quality. In most clinical questions concerning eye and orbit pathologies magnetic resonance imaging is superior to computed tomography and should be early performed.     

Magnetic resonance imaging in primary bone tumors

MRI plays a major role in the evaluation and treatment planning of bone tumors. It should be used following plain films and before biopsy. The MR appearance of most tumors is nonspecific; however, the entire extent of the tumor and its relationship to adjacent structures can be determined at MRI providing a road map for the surgeon. The role of dynamic enhancement is evolving and has not yet been determined.     

Magnetic resonance imaging techniques in children

A method of scanning children using magnetic resonance imaging (MRI) is described. Besides detailing ways to keep the patient comfortable and relaxed, which also allows for better resolution, the authors point out the necessity to plan objectives before beginning the MRI study.     

Magnetic resonance imaging of soft tissue tumors

This article outlines the ability of MR imaging in staging, grading, tissue characterization, and posttherapeutic surveillance of soft tissue tumors. Well-known staging parameters, such as extent, relationship with adjacent structures, and detection of intralesional necrosis, are used in the MR protocol for locoregional staging. Bone scintigraphy and high-resolution CT scan of the lungs are best methods for ruling out metastatic spread. A variety of (solitary or combinations of) grading parameters are described in the radiological literature. The role of MR imaging is to afford recognition of these lesions that need further aggressive work-up, excluding all others. Despite controversial reports, the definite role of MR imaging in grading of soft tissue tumors seems to become established. As for grading, a lot of individual imaging characteristics used for tissue characterization have low sensitivity, but combinations of parameters (age, site, signal intensities) are more useful and often allow to predict a specific diagnosis or to narrow down the list of differential diagnoses. Local recurrences of soft tissue tumors are frequent and can be detected accurately by an easy-to-use MR algorithm.     

Magnetic resonance imaging of myxoid containing tumors

Myxoid tissue forms part of many benign and malignant soft-tissue tumors. The advent of percutaneous needle biopsy has made it important to be aware of the diagnostic implications of biopsy samples containing myxoid tissue. To determine whether the magnetic resonance imaging (MRI) characteristics could help establish the diagnosis, we compared the MR images of 11 tumors containing myxoid tissue with the resected tumor tissue. In our small series of these rare tumors, the MRI characteristics allowed differentiation of intramuscular myxomas from malignant neoplasms containing myxoid tissue. Intramuscular myxomas meet the following conditions: (a) they are well circumscribed; (b) they arise within muscle; (c) T₁-weighted images demonstrate uniform, decreased signal intensity; (d) T₂-weighted images demonstrate uniform increased signal intensity; (e) contrast-enhanced images exhibit an inhomogeneous increase in signal intensity. If any of these conditions is not met, then a malignancy containing myxoid tissue should be suspected.     

Magnetic resonance imaging of small nasopharyngeal tumors

Magnetic resonance (MR) images of 9 patients with a small nasopharyngeal tumor were examined, and among them three cases were evaluated with Gd-DTPA enhancement technique. All cases showed no asymmetry of parapharyngeal space, but they presented neck lymph nodes swelling. These cases were proved malignant by surgical procedures and the blind biopsy. MR findings of levator and tensor veli palatini muscles and retropharyngeal lymph nodes were retrospectively evaluated in correlation with endoscopic examination and biopsy. In six cases among 9 patients, MR images demonstrated tumors on the lateral wall of nasopharynx. Infiltration of levator veli palatini muscle was an especially important earlier sign of nasopharyngeal tumor invasion because the levator veli palatini muscle belongs to the intrapharyngeal muscle group. Endoscopic examination could not reveal any abnormal lesion in three cases among these 6 cases. No definite signal intensity difference between tumor and pharyngeal mucosa was shown on both T1 and T2 weighted images. But the normal pharyngeal mucosa had demonstrated higher intensity than tumor with Gd-DTPA administration. So the enhanced nasopharyngeal MR imaging made the clear intensity difference between tumor and muscle tissue. It was the conclusion that MR imaging was superior to X-CT in detecting small nasopharyngeal tumor.     

Magnetic resonance imaging of head and neck tumors

Magnetic resonance imaging (MRI) provides several advantages over computed tomography (CT) in the evaluation of head and neck region tumors. The improved soft-tissue contrast among normal and abnormal tissues provided by MRI now permits the exact delineation of tumor margins in the nasopharynx, oropharynx, and skull base regions. In addition, the ability to depict cross-sectional anatomy and pathology in three planes without intravenous contrast, patient manipulation, or ionizing irradiation is a distinct advantage of MRI over CT scanning. Drawbacks of MRI include the detection of subtle osseous abnormalities, patient motion, and artifacts introduced by ferromagnetic dental appliances. These drawbacks appear minimal when compared to the benefits of improved soft-tissue contrast and the ability to image exact tumor volumes.     

Magnetic resonance imaging of intracranial neoplasms at 0.02 tesla

Sixty-five patients with single or multiple intracranial neoplasms were examined with an MR imager operating at 0.02 tesla. In 56 patients the diagnosis was histologically confirmed. All patients had an abnormal CT finding. MR images were positive in 59 cases, while the lesion remained undetected or equivocal in 6 cases (2 pituitary adenomas and 4 meningiomas). The MR signal intensity of several meningiomas was equal to that of normal brain tissue. Some astrocytomas were better delineated on MRI than on CT. For the study of pituitary lesions, the spatial resolution was unsatisfactory. The ultralow field MR imager was found to be sensitive for the detection of other intracranial neoplasms.     

Magnetic resonance imaging of extraabdominal desmoid tumors.

The authors describe the MR appearance of extra-abdominal desmoid in three patients, with longitudinal follow-up during a period of up to 29 months in two of them. For the MR examinations various pulse sequences, including spin-echo and gradient-echo sequences, were used. Both non-enhanced and Gd-DTPA contrast enhanced studies were made. We found gradient-echo T2*-weighted sequences best suited for the detection of extra-abdominal desmoids. Best correlation between MR features and histologic findings was obtained on spin-echo T2- and contrast enhanced T1-weighted studies. Although preliminary, our results suggest that MRI might predict evolution of extra-abdominal desmoids by providing data about cellularity and relative amount of mucoid matrix of the lesions.     

Magnetic resonance imaging of primary malignant bone tumors

The authors report a retrospective study that suggests that MRI may be superior to CT for the preoperative evaluation of bone tumors.     

Magnetic resonance imaging of primary malignant bone tumors

The authors find that MRI yields more useful information in a single study than CT, Tc scanning or angiography; they use it as the primary local staging procedure in malignant bone tumors.