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PubMedDate not supplied

Imaging and pathological correlation of soft-tissue chondroma: a serial five-case study and literature review.

The imaging findings (X-ray and MRI) and patterns of calcification of five patients with pathologically proven soft-tissue chondroma were correlated with histopathology. The size ranged from 0.5 to 3 cm. Four showed calcifications: curvilinear, punctuate, mixed curvilinear, and punctuate patterns, and the other one with a dystrophic or homogenous dense pattern showed hypointensity on T1- and T2-weighted MR imaging. Histopathology showed hyaline cartilage with nests of chondrocytes in the lacunae. Soft-tissue chondroma is a rare, benign soft-tissue tumor. It should be differentiated from other soft-tissue masses, especially malignancy.

Adolescent↗
PubMed1990

Repopulation of marrow after transplantation: MR imaging with pathologic correlation.

Sixty-seven magnetic resonance (MR) studies of the lumbar spine were performed in 15 patients with bone marrow transplants, and the appearance of marrow regeneration on MR images was correlated with results of bone marrow biopsy and pathologic examination. After transplantation, T1-weighted MR images of vertebral marrow showed a characteristic band pattern consisting of a peripheral zone of intermediate signal intensity and a central zone of bright signal intensity. Reciprocal changes were identified on short inversion time inversion recovery images. At histologic examination the central zone corresponded to fatty marrow; the peripheral zone corresponded to a zone of regenerating hematopoietic cells. Posttransplantation T1 and T2 relaxation times of the entire vertebral marrow were calculated from the spin-echo images; no statistically significant trends in relaxation times were noted. Knowledge of the normal MR pattern of marrow regeneration after transplantation may be useful in screening for residual marrow disease, determining marrow engraftment, and differentiating marrow repopulation with normal versus malignant cells.

Adolescent↗
PubMed1990

Mosaic pattern of encapsulated hepatocellular carcinoma: correlation of magnetic resonance imaging and pathology.

Internal architecture of an encapsulated hepatocellular carcinoma (HCC) was studied with magnetic resonance imaging and histologic correlation. The capsule of HCC showed low intensity relative to liver on both T1- and T2-weighted images. The T1-weighted images were superior to the T2-weighted images in delineating the capsule of HCC. The tumor showed a mosaic pattern, which was a configuration composed of multiple compartments of different intensities, reflecting viable tumor nodules and a necrotic portion. Viable tumor nodules, composed of trabeculae of polygonal cells resembling the normal liver cell with well-formed sinusoids, showed low intensity relative to liver on T1-weighted images and high intensity on T2-weighted images. The necrotic portion, composed of coagulation of amorphous, thick eosinophilic material without hemorrhage or inflammatory reaction, showed low intensity relative to liver on both T1- and T2-weighted images. The T2-weighted images were superior to the T1-weighted images in demonstrating the mosaic pattern of HCC.

Adult↗
PubMed1994

Central (interior) osteophytes of the distal femur. Imaging and pathologic findings.

RATIONALE AND OBJECTIVES: To characterize central osteophytes (COs) of the distal femur, imaging features that enable their differentiation from intra-articular bodies were identified, and the frequency of overlying articular cartilage abnormalities was determined. METHODS: The authors inspected 133 distal femoral specimens and retrospectively reviewed knee radiographs of 48 symptomatic patients and magnetic resonance images of 60 symptomatic patients for presence of COs. The location and imaging features of COs, and their association with marginal osteophytes (MOs), were recorded. Articular cartilage abnormalities, if any, were documented in patients who underwent magnetic resonance imaging. RESULTS: Specimen analysis showed a 41% prevalence of COs, 95% association of COs with MOs, and predominance of large COs in the medial femoral condyle (81%). Radiographic analysis revealed a 9.8% prevalence of COs in the distal femur. Magnetic resonance images demonstrated a 14.3% prevalence of COs, with the majority (73%) accompanied by an overlying cartilage that had abnormal signal intensity or morphology, or both. CONCLUSIONS: Central osteophytes are a common finding in the distal femur. Based on their location and cortical continuity with the underlying bone, most COs can be differentiated from intra-articular bodies.

Adult↗
PubMed1998

An experimental high-resolution MR coil for the imaging of pathological findings in the post mortem brain stem.

PURPOSE: The purpose of this study was to evaluate the potential of an experimental coil using a whole-body MR unit to delineate pathological changes within formalin-fixed human brain stems. MATERIAL, METHODS, AND RESULTS: The MR images of 9 brain stems were compared with gross anatomy and corresponding histological sections. The resolution of the images was high enough to depict areas of clinically relevant pathological alterations.

Brain Diseases↗
PubMed1997

Acute myocardial infarction followed by technetium-99m-sestamibi SPECT imaging and pathologic correlation.

A 79-yr-old man received thrombolytic therapy for acute myocardial infarction after injection with 99mTc-sestamibi and died shortly thereafter. Postmortem in situ SPECT imaging of the heart was performed. The heart was then removed and sectioned into short-axis slices, which were placed directly on the SPECT camera face for imaging, and examined by routine gross and microscopic pathologic methods. Pathologic findings were consistent with a small acute inferoseptal myocardial infarction, as demonstrated on both SPECT imaging of the intact heart and imaging of the heart slices. This case report provides further evidence of the validity of SPECT sestamibi imaging for the determination of myocardium at risk during acute myocardial infarction.

Aged↗
PubMed1997

Septum-like structures in lipoma and liposarcoma: MR imaging and pathologic correlation.

OBJECTIVE: To investigate the septum-like structures in predominantly lipomatous tumors, by correlating fat-suppressed MR images with histopathologic findings. DESIGN AND PATIENTS: The MR findings of three cases of well-differentiated liposarcoma (atypical lipoma), one case of lipoma-like component of dedifferentiated liposarcoma, and nine cases of lipoma were analyzed. T1-, T2-, and fat-suppressed T1-weighted images after Gd-DTPA administration were obtained. Surgical specimens from five patients (four with liposarcoma and one with lipoma) were also scanned with a MR unit, and compared with the pathologic findings. RESULTS AND CONCLUSIONS: Enhancement features of lipoma and liposarcoma were well visualized on fat-suppressed T1-weighted images after Gd-DTPA administration. The septum-like structures of liposarcoma are thick and enhanced considerably, while septa of lipoma are thin and enhanced only slightly. Pathologically, the septum-like structures of liposarcoma contained muscle fibers and the septa of lipoma represented fibrous capsule. Identification of well-enhanced septa in a predominantly lipomatous tumor helps to differentiate malignant tumors from lipomas. As the septum-like structures of liposarcoma contain a skeletal muscle component the tumor might need more extensive surgical procedures including resection of adjacent muscles.

Aged↗
PubMed2002

Thymic lesions and myasthenia gravis. Diagnosis based on mediastinal imaging and pathological findings.

PURPOSE: To achieve a better understanding of the role of CT and MR imaging in the study of the mediastinum in patients with myasthenia gravis (MG). MATERIAL AND METHODS: Mediastinal CT and MR findings were correlated with the histopathological results in 104 thymectomized MG patients. RESULTS: CT was performed in 104 patients; in 11 of them, MR was also carried out. 44 patients had hyperplasia at histology. On CT, thymic hyperplasia was confirmed in 16 cases, thymoma was diagnosed in 10 and a normal thymus in 18 (sensitivity 36%, specificity 95%). Of 52 patients with thymoma at histology, CT showed thymoma in 46, hyperplasia in 1, and normal thymus in 5. CT showed 88.5% sensitivity and 77% specificity for thymoma. In 10 patients with invasive thymoma, CT was indiscriminate, while invasiveness was detected in 7 cases at MR (70% sensitivity) and at CT in 1 case. Both CT and MR detected tumor recurrence in 5 cases, but the exact localization and degree of invasion were best defined by MR. CONCLUSION: In MG patients CT is a sensitive, specific and efficient modality for detecting thymoma, but is less so for detecting thymic hyperplasia. MR was shown to be accurate in detecting invasive thymoma both preoperatively and in postoperative follow-up.

Adolescent↗
PubMed1998

Patterns of framework invasion in patients with laryngeal cancer: correlation of in vitro magnetic resonance imaging and pathological findings.

Total laryngectomy for laryngeal squamous cell carcinoma means a drastic change in the way of living for a patient. New surgical techniques such as laser surgery attempt to save the voice. To be oncologically correct, an accurate assessment of the tumor extent is necessary. Imaging is especially important in determining tumor extent in the regions where conventional and endoscopic ENT examinations are less accurate. Correlations of CT, in vivo MRI and pathological findings after surgery have demonstrated that MRI is more sensitive than CT, but that it overestimates the degree of cartilage invasion. Cartilage invasion is believed to be a contraindication to radiation therapy and voice-sparing surgery. In a prospective study, Gd-enhanced in vitro MRI of 10 total laryngectomy specimens was correlated with subsequent pathological examination. Good correlation of the anatomical relationships of the tumor between the in vitro images and gross pathology were found. Important is the absence of false negatives in our study, indicating that cartilage invasion can be ruled out when a normal signal intensity on in vitro MRI of the cartilage is seen. This has important oncological implications for partial voice-sparing laryngeal surgery.

Aged↗
PubMed2007

Reversible encephalopathy associated with cholesterol embolism syndrome: magnetic resonance imaging and pathological findings.

We describe a patient found to have acute diffuse and reversible encephalopathy on magnetic resonance imaging (MRI) associated with cholesterol emboli syndrome (CES). The initial MRI showed extensive white matter, basal ganglia and cortical damage without evidence of brain infarction. Dramatic clinical and MRI improvement was observed with corticosteroids. Pathologically, cholesterol crystal emboli were found in the lumen of skin and brain arteries and were associated with varying degrees of inflammation of the arteriole wall. This case suggests that CES may be responsible for extensive, acute and reversible encephalopathy underlined by an inflammation of brain arteries.

Acute Disease↗
PubMed1990

Skoptic syndrome: the treatment of an obsessional gender dysphoria with lithium carbonate and psychotherapy.

Cases of body image pathology are often misdiagnosed. Recognition of the obsessional annoyance with body image, especially with primary and secondary sex characteristics (skoptic syndrome), is important in making a differential diagnosis with other psychiatric and gender identity disorders. We have reported the successful use of lithium carbonate in treating two cases of skoptic syndrome. The initial low dosage (600 mg./day) resulted in dramatic reversal of obsessional thoughts of self-mutilization and self-castration. Increased dosages (900 mg./day) are still well below those usually used for manic-depressive illness. Our choice of lithium carbonate was prompted by our experience in successfully treating other forms of sexually related dysphorias at low doses, its ability to act rapidly, and the minimal side effects. These changes have been dramatic and lasting. In addition, there was marked lessening of dysthymia and intense anhedonia manifested by severe isolation, listlessness, and apathy. We believe that these cases are important to report in order that psychotherapists make better differential diagnoses of psychiatric disorders related to body image pathology and gender identity disorders. We also feel it is important to report a medication which was found effective in reducing the threat of self-mutilating behavior and making patients more receptive to psychotherapy. These cases increase our understanding of sexually obsessive and compulsive drives and some methods which have been found efficacious in reducing these symptoms.

Body Image↗
PubMed2005

Correlation of magnetic resonance imaging and pathologic size of infiltrating lobular carcinoma of the breast.

BACKGROUND: Determining the extent of infiltrating lobular carcinoma (ILCA) in the breast is difficult. This study was designed to determine if the size of ILCA on magnetic resonance imaging (MRI) correlated with final pathology. METHODS: Retrospective study of patients between 1998 and 2004, who were evaluated for extent of ILCA prior to definitive treatment, was conducted. Demographic data and radiology and pathology results were obtained. Spearman correlation coefficient was used. RESULTS: Twenty-nine patients (median age 62 years) had MRI of breast. Fourteen patients (48%) had contralateral MRIs; 13 (45%) normal; 1 (8%) prompted core biopsy; 6 of 13 patients underwent contralateral mastectomies, which were benign. The distribution of tumor size was: T1 = 15 (52%); T2 = 7 (24%); T3 = 5 (17%); T4 = 2 (7%). Spearman correlation coefficient between tumor size on ultrasound and MRI with pathology was .19 (P = .5) and .88 (P < .001), respectively. CONCLUSION: MRI provided superior correlation between tumor size and pathology.

Aged↗
PubMed1995

Osteoarthritis staging: comparison between magnetic resonance imaging, gross pathology and histopathology in the rhesus macaque.

Although osteoarthritis (OA) is the most common cause of articular skeletal disability in humans, assessing progression (staging) with noninvasive methods remains a major clinical problem. Using the rhesus macaque animal model, the objective of this study was to compare OA staging by noninvasive magnetic resonance imaging (MRI) against gross pathology and histopathology. Right knee joints from 18 rhesus macaques were used in this study. Using a four-point ordinal scale for each of the above-mentioned modalities, the lateral and medial femoral condyle and tibial plateau of each knee joint was independently scored for OA severity, i.e. normal, mild OA, moderate OA and severe OA. Correlation between each staging system was performed using Stuart's Tau-c correlation coefficient. By our criteria, MRI staging correlated as well with gross pathology (tau = 0.75) and histopathology (tau = 0.80) as did gross pathology with histopathology (tau = 0.78). Our study shows that MRI is a promising noninvasive modality to evaluate the severity of OA. MRI appears to be sensitive for demarcating the presence and extent of focal OA cartilage lesions. However, at this time, while MRI is sensitive for detecting OA change it cannot distinguish between certain lesions such as superficial cartilage matrix fibrillation and hypertrophy both of which show elevated signal intensity.

Animals↗
PubMed1995

Parkinsonism and dilatation of the perivascular spaces (état criblé) of the striatum: a clinical, magnetic resonance imaging, and pathological study.

Two men, 89 and 83 years of age, presented with predominantly axial parkinsonian signs. In both cases, magnetic resonance imaging of the brain showed numerous small foci, delineating the striatum. The lesions had the same signal as cerebral spinal fluid in both T1 and T2 sequences. Postmortem examination of the brain showed numerous lacunes due to dilatation of the perivascular spaces, frequently associated with alterations of the surrounding brain parenchyma. Typical changes of Parkinson's disease were associated in one case. Such vascular changes may produce, or modify, a parkinsonian syndrome.

Aged↗
PubMed1999

Spinal osteoblastoma: CT and MR imaging with pathological correlation.

OBJECTIVES: To illustrate the CT and MRI features of spinal osteoblastomas and correlate the imaging with histological findings. DESIGN: In a retrospective review the CT and MRI features of spinal osteoblastomas with respect to mineralisation, signal intensity (SI), adjacent reactive changes, enhancement following gadolinium-DTPA (5 cases) and adjacent soft tissue masses were compared and correlated with the histological findings including the degree of osteoid formation and matrix mineralisation, vascularity and surrounding reactive changes in bone and soft tissue. PATIENTS: Eleven patients (7 males and 4 females; age range 8-43 years, mean age 19.5 years) with 12 osteoblastomas (1 patient suffered a recurrence) were studied. RESULTS: All lesions showed classical features on CT with varying degrees of matrix mineralisation, whereas MRI identified mineralisation in only eight of 12 cases. MRI showed low signal intensity of the lesion on both T1- and T2-weighted sequences in several cases in the absence of heavy mineralisation. In these cases, histological examination revealed diffuse osteoid production by the tumour. All patients given gadolinium showed enhancement within the tumour on MRI. Reactive bone marrow changes were identified on MRI in 10 cases, and in five of these the changes were at multiple levels. An adjacent soft tissue mass was demonstrated in five cases, but extraosseous tumour was present histologically in only two of these. CONCLUSIONS: The MRI appearances of spinal osteoblastomas are varied and show no characteristic features. MRI may also overestimate the extent of the lesion due to extensive reactive changes and adjacent soft tissue masses. CT should continue to be the investigation of choice for the characterisation and local staging of suspected spinal osteoblastomas.

Adolescent↗
PubMed2006

Intracranial cysts: radiologic-pathologic correlation and imaging approach.

Cysts and cystic-appearing intracranial masses have a broad imaging and pathologic spectra. The authors review the pathologic findings, origin, radiologic appearance, and differential diagnosis of many different intracranial cysts. A diagnostic algorithm based on most common anatomic locations is presented that helps narrow the differential diagnosis.

Algorithms↗
PubMed1990

Patellar cartilage lesions: in vitro detection and staging with MR imaging and pathologic correlation.

Fourteen freshly disarticulated knee specimens were studied to assess the usefulness of magnetic resonance (MR) imaging in the detection and correct staging of patellar chondral lesions. Axial and sagittal images were obtained; T1-weighted spin-echo sequences were found satisfactory for defining cartilage morphology. Specimens were sectioned and examined grossly for cartilage changes such as softening, blistering, fibrillation, fissuring, and frank subchondral bone exposure. In a side-by-side comparison, all lesions classified grossly in the Shahriaree system as stage II or higher showed MR changes. Stage I changes could not be identified in disarticulated specimens. Stage III lesions showed cartilage irregularity (ulceration) or a loss of the normal, sharply defined margin between coapted cartilage, which represented "crabmeat" fibrillation. Stage IV lesions showed ulceration to bone, sometimes with subchondral bone changes. In this in vitro, preliminary study, MR imaging was found to be an accurate means for detecting and staging moderate and advanced patellar cartilage lesions.

Adult↗
PubMed1997

[An autopsy case of amyotrophic lateral screlosis (ALS): magnetic resonance imaging and pathological findings of the pyramidal tract].

A 59-year-old woman was diagnosed as amyotrophic lateral screlosis (ALS) on the basis of neurological and electromyographical findings, and died after about 4 years course. Magnetic resonance imaging (MRI) on coronal planes through the internal capsule revealed high signal area almost limited to the pyramidal tract; the high signal area was more restricted in proton weighted imaging than in T2 weighted imaging. Histological lesion of the precentral gyrus was slight, while loss of myelinated fibers in the posterior limb of the internal capsule was remarkable. Extent of the pathological lesion in the posterior limb of the internal capsule well corresponded to the high signal area in proton weighted imaging. Comparison of the pyramidal tract pathology in the corona radiata and the internal capsule in Klüver-Barrera preparations with the MRI findings obtained 2 years and 8 months before the autopsy suggests us that the T2 weighted imaging of ALS brains may detect involvement of the pyramidal tract as early as or even earlier than histological changes become manifest.

Amyotrophic Lateral Sclerosis↗