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At least 559 records · Page 31Linked to original sources
PubMed2006

Basal cell adenoma of the parotid gland: MR imaging findings with pathologic correlation.

BACKGROUND AND PURPOSE: Basal cell adenomas (BCAs) are rare tumors of the parotid gland. Only a few case reports describing MR imaging features of BCA have been published. The aim of this study was to describe and characterize the MR findings of BCAs of the parotid gland. MATERIALS AND METHODS: We retrospectively reviewed MR images of BCA with pathologic correlation in 8 cases (2 men and 6 women; age range, 52-82 years) collected between January 1992 and August 2004 from our pathologic data base. All MR images were retrospectively evaluated with respect to the marginal morphology, signal intensity (SI), and enhancement behavior by 2 experienced radiologists. RESULTS: On pathologic examination, 5 tumors were solid type, 2 were trabecular type, and 1 was membranous type. All of the tumors were well circumscribed with smooth contours. Cystic changes were seen in 4 cases. On T1-weighted images (T1WI), 7 tumors showed homogeneously low SI equal to muscle and one showed heterogeneously low SI. On T2-weighted images (T2WI), all of them showed slightly lower SI than that of surrounding parotid tissue. On gadolinium-enhanced T1WI, 6 tumors demonstrated moderate enhancement and one demonstrated strong enhancement (membranous type). Dynamic studies were performed in 4 cases. All showed rapid and prolonged enhancement. CONCLUSION: MR imaging findings of BCA were well-defined and smooth marginal morphologies, relatively low SI on both T11W and T2WI, and rapid and prolonged enhancement on dynamic study. Although BCAs are rare, they should be suspected when a tumor shows all of the characteristics noted here.

Adenoma↗
PubMed1990

[Three-dimensional imaging of the carpus].

Since 1987, the authors have developed three-dimensional (3D) imaging of carpus. This reconstruction based on 30 CT scans of the carpus is a new approach to imaging and allows spatial visualisation of the complex shapes of the carpal skeleton from all angles and views. The development of this technique should lead to a better understanding of the intimate physiology of the carpus and should allow the development of a real simulator of the wrist for precise planning of surgical procedures (osteotomy, intracarpal arthrodeses, etc.). It also helps to elucidate complex pathological images which are not always easy to interpret on CT scans.

Carpal Bones↗
PubMedDate not supplied

Comparison of CT, MRI and CT during arterial portography in the detection of malignant hepatic lesions.

BACKGROUND/AIMS: A prospective study was performed to compare the sensitivities of computed tomography, magnetic resonance imaging and CTAP (CT during arterial portography) in the detection of focal malignant hepatic lesions. METHODOLOGY: Twenty-eight (28) patients with primary and secondary hepatic malignant tumors were evaluated. All of these patients underwent hepatic resection and a lesion-to-lesion imaging-pathological analysis was performed. RESULTS: The overall sensitivities were 53% for CT, 66% for MRI sequences and 88% for CTAP. For lesions smaller than 1 cm the sensitivities were 6% for CT, 17% for MRI and 72% for CTAP. The combination of CTAP and MRI yielded an overall detection rate of 93%. The difference between the sensitivity of CTAP and that of the other two imaging techniques was statistically significant (P < 0.04) according to the McNemar test. CTAP demonstrated four false-positive lesions, two of which were correctly characterized by MRI and one by CT. In 6 patients (21.4%) the surgical plan was modified after CTAP. CONCLUSIONS: We conclude that, CTAP has the highest sensitivity and should be part of the preoperative examination. In some instances, the addition of MR imaging must be considered a helpful adjuvant. Both techniques should be considered complementary in the preoperative diagnostic algorithm.

Adult↗
PubMed2004

Gallbladder and biliary tract carcinoma: A comprehensive update, Part 2.

Gallbladder carcinoma and carcinoma of the bile ducts are relatively rare cancers in the United States. These cancers are often diagnosed in an advanced stage due to their nonspecific symptomatology and until recently have been associated with a dismal prognosis. Recent advances in imaging and surgical techniques along with emerging options in palliative chemotherapy have improved the outlook in these cancers. While complete surgical resection remains the only hope of cure in both these cancers, palliative biliary decompression and chemotherapy result in substantial improvement in quality of life. Part 1 of this review, which appeared in last month's issue, provided a relevant and comprehensive update of molecular pathology, imaging modalities, and surgical care. In part 2, we examine palliative care and systemic therapy in gallbladder and biliary tract carcinomas, as well as the use of liver transplantation in the treatment of cholangiocarcinomas. These strategies are of relevance to internists as well as oncologists caring for these patients.

Antineoplastic Combined Chemotherapy Protocols↗
PubMed1993

In search of optimum chest radiography techniques.

A nation-wide study of chest radiography in Sweden had previously revealed a large variation in the physical and technical factors involved, in particular the radiation dose. In this study the image quality could not be assessed unambiguously. The aim of the present study was to try to establish a correlation between visual grading of radiographs and physical and technical factors in order to find the optimum chest X-ray system. The physical and technical performance of 24 chest units was evaluated. Radiographs were taken of an anthropomorphic chest phantom supplied with test structures simulating various pathologies. Image quality was assessed by visual grading analysis of the radiographs. The physical and technical parameters of the units rated best were used to exemplify good radiographic practice. The results were in agreement with the recommendations issued by the Commission of the European Communities (CEC). It was also shown that low radiation dose is compatible with high-quality radiographic imaging of the chest.

Humans↗
PubMed2001

Dementia with Lewy bodies: diagnosis and management.

OBJECTIVE: To summarize the clinical, pathological, imaging and treatment aspects of dementia with Lewy bodies (DLB). METHOD: Review of literature (MEDLINE). RESULTS: DLB is the second most common form of degenerative dementia, accounting for up to 20% of cases in the elderly. It is characterized by fluctuating cognitive impairment, spontaneous parkinsonism and recurrent visual hallucinations. Consensus clinical criteria have been published and have been shown to have high specificity, but they may still lack sensitivity. Pathologically, DLB may be classified as a Lewy body (LB) disorder and/or as an alpha-synucleinopathy. It is probable that a spectrum of LB disorders exists with the clinical features reflecting the distribution and severity of pathology. Although both DLB and Alzheimer's disease (AD) show a reduction in pre-synaptic cholinergic transmission from the basal forebrain, in DLB there are also deficits in cholinergic transmission from brain stem nuclei. Post-synaptic cortical muscarinic receptors are more functionally intact in DLB suggesting potential responsiveness to cholinergic enhancement. Neuroimaging findings indicate a relative preservation of medial temporal lobe structures in DLB but similar distribution of white matter changes on MRI compared with AD. Defects in nigrostriatal dopamine pathways in DLB have been demonstrated with functional neuroimaging using ligands highlighting pre- and post-synaptic dopaminergic systems. Preliminary studies also indicate subtle differences in perfusion patterns on SPECT with a greater degree of occipital hypoperfusion in DLB compared with AD. Accurate diagnosis of DLB is clinically important as the management of psychosis and behavioural disturbances is complicated by sensitivity to neuroleptic medication. There is accumulating evidence to suggest that DLB may be particularly amenable to cholinergic enhancers. The clinical management of DLB is considered using a four step approach: making a diagnosis; identification of problem symptoms; appropriate non-pharmacological interventions; and pharmacological interventions. CONCLUSIONS: Consensus criteria for probable DLB have high specificity-a positive clinical diagnosis is likely to be correct. Treatment choices must consider effects upon motor, cognitive and psychiatric symptoms. Non-pharmacological management is an essential first step, as is reduction or withdrawal of drugs with potential adverse effects. Neuroleptic sensitivity reactions appear less likely to occur with the newer atypical antipsychotics. Cholinesterase inhibitors have been shown in open-label studies and one placebo RCT to be well tolerated and effective in treating cognitive and psychiatric symptoms in DLB. They may become first-line treatments.

Aged↗
PubMed1999

Three-dimensional video analysis of facial movements: a new method to assess the quantity and quality of the smile.

The results of neuromuscular reconstructions of the paralyzed face are difficult to assess. Very sophisticated methods are necessary to measure the motor deficits of facial paralysis or the functional recovery in the face. The aim of this development was a relatively simple system for data acquisition, which is easy to handle and which makes it relatively cheap to delegate data acquisition to centers all over the world, which will not be able to derive a data analysis on their own, but will send their data to a center with specialized equipment. A complex mirror system was developed to get three different views of the face at the same time on the video screen. At each investigation, a digital video is taken from a calibration grid and from standardized facial movements of the patient. Secondary analysis of the digital videofilm is made possible at any time later on by the support of a computer program, which calculates distances and movements three-dimensionally from the frontal image and the right and left mirror images. Pathologies of the mimic movements can be identified as well as improvements after surgical procedures by this system. The significant advantage is the possibility to watch the same movement on the video which is under study and to apply any kind of study later on. Taking the video needs only a few minutes, and fatigue of the patient's mimic system is prevented. Measurements usually at the endpoints of the movements give excellent information on the quantity of the movement or the degree of the facial palsy, whereas the video itself is very informative regarding the quality of the smile. Specific computer software was developed for standardized three-dimensional analysis of the video-documented facial movements and for data presentation. There are options like two-dimensional graphs of single moving points in the face or three-dimensional graphs of the movements of all measured points at the same time during a standardized facial movement. By a comparison of the right- and left-sided alterations of specific distances between two points during the facial movements, the degree of normal symmetry or pathologic asymmetry is quantified. This system is more suitable for detailed scientific multicenter studies than any other system previously established. A very sensitive instrument for exact evaluation of mimic function is now available.

Calibration↗
PubMed2006

[Detection of unknown primary tumor in a patient with cerebellar metastasis using FDG PET-CT: case report].

Identification of unknown primary tumors in patients with brain metastasis is a continued diagnostic challenge. Several clinical reports have suggested that 18F-flouorodeoxyglucose positron emission tomography (FDG PET) is useful for detecting them. PET has incomparable abilities to determine the metabolic activity of tissues. But it needs the assistance of higher-resolution, anatomic information. CT is the easiest and highest-resolution tomographic modality to be integrated into PET imaging. Because of this, the market for PET devices has shifted so dramatically toward PET-CT. We report a case to show that FDG PET-CT was able to detect an unknown primary tumor. A 75-year-old female underwent resection of a left cerebellar tumor. The histological diagnosis was adenocarcinoma metastasis. Conventional systemic evaluation (chest radiography, chest and abdomen CT, abdominal sonography, and so on) did not show any pathologic image. FDG PET-CT was then carried out. A hypermetabolic focus was revealed in the left hilum. In conclusion, from now on, FDG PET-CT will be considered as the first diagnostic process for patients presenting brain metastasis with an unknown primary tumor.

Aged↗
PubMed2003

Primary intraspinal mesenchymal chondrosarcoma: a case report and literature review.

Mesenchymal chondrosarcomas are rare malignant tumors of the bone and soft tissue. Extraskeletal mesenchymal chondrosarcomas, especially those that arise in the central nervous system, are even rarer. Most of those described were intracranially located, with only a very few cases having been reported in an intraspinal region. Therapeutic experience with primary spinal mesenchymal chondrosarcomas is also extremely limited. We report on a case of a 21-year-old man with back pain and bilateral progressive weakness and numbness of the lower extremities. A T1-weighted magnetic resonance image revealed a hypointense tumor located at the T8 level. The tumor was completely excised through a posterior approach. Microscopic examination and immunohistochemical studies confirmed the diagnosis of mesenchymal chondrosarcoma. Spinal irradiation and chemotherapy were also administered for prevention of local recurrence and metastasis. The patient has been symptom-free for 1 year after surgery. Herein, we review the 22 cases of primary intraspinal mesenchymal chondrosarcomas in the literature and discuss their clinical presentations, pathology, imaging studies, treatments, and outcomes.

Adult↗
PubMed2003

Digital imaging guidelines for pathology: a proposal for general and academic use.

Digital imaging is an inexpensive and widely available tool that is used by most pathologists in patient reports, education, publication, diagnosis, and data archival. Its popularity is due, in part, to the ease of modifying, storing, enhancing, and annotating images. Since digital manipulation is essentially undetectable in the final product, it poses the potential risk for fraudulent manipulation and heightens the possibility of unintentional misrepresentation. In an attempt to ensure a high degree of uniformity and quality, and to create a professional standardization amongst pathologists, digital imaging guidelines are proposed for use in general and academic practice.

Education, Medical↗
PubMed2003

Relationship between the imaging features and pathologic alteration in hepatoma of rats.

AIM: The imaging features of MRI and DSA, using the models of implanted and induced hepatoma, were investigated in rats. METHODS: CBRH3 cancer cells were implanted for different liver site of rat liver and the diethylnitrosoamine was given orally to rats in order to induce liver cancer. Both experimental groups were detected by magnetic resonance imaging (MRI), digital subtraction angiography (DSA) and morphologic assay. RESULTS: Hypointensity on T1WI and homogenous high signal intensity on T2WI in MRI, and ring-like abnormal stain on DSA were found in implanted cancer. Induced cancers appeared as homogeneous or heterogeneous hypointensity on T1WI (10 cases), and equal or slight high intensity on T2WI (8 cases), but some as hypointensity on T2WI (2 cases). CONCLUSION: The imaging features of implanted cancers were similar to that of human liver metastases. Therefore, it could serve as an experimental model of human liver metastatic tumor. The imaging feature of induced cancers, whereas, were similar to that of human primary liver cancer. It could be use as an experimental model of human primary liver cancer.

Alkylating Agents↗
PubMed2007

Neuroradiologic characteristics of astroblastoma.

INTRODUCTION: Astroblastoma is a rare glial tumor of uncertain origin. Only a few scattered case reports and one small case series have described the radiologic appearance of this uncommon tumor. Many features previously identified are similar to those of other primary malignant brain tumors. We report the largest imaging series to date and further delineate the CT and MRI features of astroblastoma. We identify those features that may be useful in distinguishing astroblastoma from other neoplasms. METHODS: The radiologic images, pathology reports, and clinical information of 12 patients with pathology-confirmed astroblastoma were retrospectively reviewed. CT and MRI findings including location, morphology, signal intensity, and presence and patterns of enhancement were tabulated. RESULTS: Patients ranged in age from 0 (newborn) to 50 years with a mean of 20 years at the time of initial diagnosis. A striking female preponderance (11:1) was found. All tumors were supratentorial. There were multiple intratumoral cysts in 7 (58%) of the 12 patients. Nine (75%) showed strong rim enhancement and 3 (25%) showed no rim enhancement. CONCLUSION: The imaging features of astroblastoma are identified in 12 previously unreported cases. Distinguishing features that can be used to narrow the differential diagnosis with more common primary brain neoplasms reflect a combination of age, anatomic location, and specific imaging findings such as demarcation, heterogeneous tumor enhancement, rim enhancement, and a multicystic "bubbly" appearance. Intraventricular location, intratumoral hemorrhage with a fluid-fluid level, and dural "tails" are less common but important additions to the imaging spectrum.

Adolescent↗
PubMed2003

Extratemporal hypometabolism on FDG PET in temporal lobe epilepsy as a predictor of seizure outcome after temporal lobectomy.

We investigated the relationship between the presence of extratemporal hypometabolism on fluorine-18 fluorodeoxyglucose positron emission tomography (FDG PET) and seizure outcome after temporal lobectomy in patients with medically intractable temporal lobe epilepsy (TLE). In 47 patients with intractable unilateral mesial TLE, regional metabolic changes on FDG PET images obtained during the 2 months preceding anterior temporal lobectomy were compared with postoperative seizure outcome. Postoperative seizure outcome was evaluated with a mean follow-up period of 6.1+/-0.6 years (range 5.2-7.2 years). Forty-two (89%) of the 47 patients achieved a good postoperative seizure outcome (Engel class I or II). All patients had hypometabolism in the temporal cortex ipsilateral to the epileptogenic region on FDG PET scans. Fourteen (78%) of the 18 patients with hypometabolism only in the ipsilateral temporal cortex were completely seizure free (Engel class Ia) after surgery. In contrast, five (45%) of the 11 patients with extratemporal cortical hypometabolism confined to the ipsilateral cerebral hemisphere and only four (22%) of the 18 patients with hypometabolism in the contralateral cerebral cortex were completely seizure free after surgery. The postoperative seizure-free rates were significantly different across the three groups of patients with different cortical metabolic patterns ( P<0.005). Furthermore, all of the nine patients with a non-class I outcome (Engel class II-IV) had extratemporal (including contralateral temporal) cortical hypometabolism. Thalamic hypometabolism was noted in 20 (43%) of the 47 patients (ipsilateral in 12, bilateral in 8). Sixteen (59%) of the 27 patients with normal thalamic metabolism were completely seizure free after surgery, while only seven (35%) of the 20 patients with thalamic hypometabolism became completely seizure free ( P<0.05). Multivariate analysis revealed that among variables including clinical, EEG, magnetic resonance imaging, pathological and FDG PET metabolic findings, only cortical metabolic pattern was an independent factor for the prediction of postoperative seizure outcome ( P<0.005). It is concluded that extratemporal cortical hypometabolism outside the seizure focus, in particular hypometabolism in the contralateral cerebral cortex, may be associated with a poorer postoperative seizure outcome in TLE and may represent underlying pathology that is potentially epileptogenic. Thalamic hypometabolism, which was associated, but not independently, with a higher likelihood of postoperative seizures, may be secondary to extratemporal or temporal pathology.

Adolescent↗
PubMedDate not supplied

MRI findings of a case of uterine tumor resembling ovarian sex-cord tumors coexisting with endometrial adenoacanthoma.

A case of uterine tumor resembling ovarian sex-cord tumors is reported. MRI was performed for the staging of the endometrial adenoacanthoma diagnosed by biopsy. A well-defined, slightly hyperintense mass with central hypointensity was noted in the myometrium on T2-weighted images. Pathological diagnosis of the myometrial mass was uterine tumor resembling ovarian sex-cord tumors. The central hypointense area was a leiomyomatous component. Adenoacanthoma was also confirmed. These features of coexisting tumors correlated well with the MRI findings.

Adult↗
PubMedDate not supplied

Subacute necrotizing myelopathy: MR imaging in four pathologically proved cases.

This report describes the MR and correlative imaging findings of four histologically proved cases of subacute necrotizing myelopathy in which there was no evidence of a spinal dural arteriovenous fistula. Subacute necrotizing myelopathy is characterized clinically by progressive motor and sensory deterioration, and pathologically by necrosis in the spinal cord. Initial MR imaging showed focal enlargement of the spinal cord and nonspecific T1 and T2 lengthening. Rimlike enhancement was demonstrated in one case. Clinically, steroid therapy failed in all four patients. Follow-up MR scans showed two slightly enlarged lesions, one stable thoracolumbar lesion, and atrophy of a cervical lesion. Open spinal cord biopsies revealed foci of necrosis and abnormal parenchymal vessels with thickened hyalinized walls. A prolonged course distinguishes subacute necrotizing myelopathy from acute transverse myelitis, but the clinical course and imaging appearance are similar to those of intramedullary tumor. Rimlike rather than solid contrast enhancement may be a distinguishing feature. In the absence of a demonstrable spinal dural arteriovenous fistula, the radiologic differentiation of subacute necrotizing myelopathy from tumor is probably impossible, and biopsy establishes the correct diagnosis.

Acute Disease↗
PubMed1997

Warthin's tumor of the parotid gland with extension into the parapharyngeal space.

A case of Warthin's tumor of the parotid gland which extensively extended into the parapharyngeal space is presented. The tumor border against the parotid gland was ill-defined but the border towards the parapharyngeal structures was clear. Solid portions of the tumor appeared hypointense relative to the gland on both unenhanced T1- and T2-weighted MR images without fat suppression, whereas cystic portions appeared hypointense on T2-weighted images and hyperintense on unenhanced T1-weighted images. Pathologic study showed that the ill-defined margin was caused by inflammation and cystic material consisted of highly proteinaceous material. We concluded that the atypical extension into the parapharyngeal space of the tumor was caused by its location in the deep lobe of the parotid gland and its bulky size.

Adenolymphoma↗
PubMed1986

Real light scatter in the human crystalline lens.

A comparison is made between the luminances of slit-lamp images of the normal human lens in frontal view with plane polarized light, when one ocular is provided with an analyzer and the other with variable neutral density filters, the light source being polarized perpendicularly to the direction of the analyzer. The amount of extinguished light is significantly larger as seen in the former, and rises systematically with age. The effect of varying the spectral composition of the illumination is also examined. What is conventionally referred to as scattered light appears to be made up of at least two separate components. The effect which this may have for our interpretation of pathological images is discussed.

Adult↗
PubMed2004

Congenital formation of an intraspinal osseous vertebral ring causing spinal cord compression.

STUDY DESIGN: A unique case of the congenital formation of an intraspinal osseous vertebral ring causing spinal cord compression is reported. OBJECTIVES: To our knowledge, such an osseous ring has not yet been described. The authors detail the clinical presentation, imaging, and treatment of the intraspinal osseous ring. SUMMARY OF BACKGROUND DATA: There are two traditional categories of congenital vertebral anomalies, that of failure of formation and of segmentation. The authors propose that this ring may not fit into either of these categories and may represent a new category of failure of migration. METHODS AND RESULTS: Surgical decompression using a costotransversectomy approach was performed. Adequate decompression the spinal cord was achieved. Anterior and posterior fusions with instrumentation were used to stabilize the spinal cord. CONCLUSIONS: An intraspinal osseous vertebral ring is a unique anomaly that, to our knowledge, has not been reported to date. The authors discuss the pathology, imaging, and treatment of this unique condition.

Child↗