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PubMedDate not supplied

Malignant transformation of pelvic endometriosis: MR imaging findings and pathologic correlation.

Malignant transformation is a rare complication of endometriosis. Endometriosis-associated ovarian cancers are seen more often in younger women than are ovarian cancers without endometriosis, and early detection is important to improve the prognosis and preserve fertility. However, normal decidual change of the ectopic endometrium in an endometrioma during pregnancy must be differentiated from malignant transformation. The finding that is most important for a diagnosis of malignant change is the presence of one or more contrast material-enhanced mural nodules within a cystic mass at magnetic resonance (MR) imaging. Dynamic subtraction MR imaging is useful in depicting small contrast-enhanced nodules within the hyperintense endometrioma on T1-weighted images. Intracystic coagulate may mimic a mural nodule; the absence of contrast enhancement is the diagnostic clue to its benignity. Enlargement of the endometrioma and the disappearance of shading within the mass on T2-weighted images are suggestive of malignant transformation.

Endometrial Neoplasms↗
PubMed2004

The carpal tunnel: ultrasound display of normal imaging anatomy and pathology.

Ultrasound successfully displays the normal anatomy and pathology of the median nerve in the carpal tunnel. This article reviews the sonographic characteristics of carpal tunnel anatomy, including the superficially situated median nerve, the contained tendons and vessels, and the boundary-forming fibro-osseous landmarks. It emphasizes ultrasound evaluation of the median nerve and the criteria for diagnosis of compressive neuropathy in carpal tunnel syndrome. The techniques for performing sonography for carpal tunnel syndrome are detailed. Ultrasonic imaging is more comfortable for patients, less time-consuming, and less expensive than MR imaging, and achieves equal accuracy in skilled hands.

Bone Diseases↗
PubMed2006

Primary pulmonary primitive neuroectodermal tumor: CT and skeletal scintigraphic image features with pathologic correlation (2006: 6b).

We describe a rare case of a primitive neuroectodermal tumor (PNET) originating in the lung of a 28-year-old woman. A lung mass was detected incidentally on a chest radiograph taken before a Caesarian delivery. The chest P-A view showed a well-defined, lobulated mass in the right lower lobe with a small pleural effusion on the right. A thoracic CT with contrast enhancement showed a lobulated, heterogeneous, enhanced mass of approximately 9.2 x 8.4 x 6.3 cm with inner amorphous calcifications in the right lower lobe and a small right pleural effusion. A right lower lobectomy was performed 1 month after delivery. The pathology report was a primary pulmonary PNET with focal visceral pleural involvement.

Adult↗
PubMedDate not supplied

Benign versus malignant hepatic nodules: MR imaging findings with pathologic correlation.

According to the currently used nomenclature, there are only two types of hepatocellular nodular lesions: regenerative lesions and dysplastic or neoplastic lesions. Regenerative nodules include monoacinar regenerative nodules, multiacinar regenerative nodules, cirrhotic nodules, segmental or lobar hyperplasia, and focal nodular hyperplasia. Dysplastic or neoplastic nodules include hepatocellular adenoma, dysplastic foci, dysplastic nodules, and hepatocellular carcinoma (HCC). Many of these types of hepatic nodules play a role in the de novo and stepwise carcinogenesis of HCC, which comprises the following steps: regenerative nodule, low-grade dysplastic nodule, high-grade dysplastic nodule, small HCC, and large HCC. State-of-the-art magnetic resonance (MR) imaging facilitates detection and characterization in most cases of hepatic nodules. State-of-the-art MR imaging includes single-shot fast spin-echo imaging, in-phase and opposed-phase T1-weighted gradient-echo imaging, T2-weighted fast spin-echo imaging with fat saturation, and two-dimensional or three-dimensional dynamic multiphase contrast material-enhanced imaging.

Carcinoma, Hepatocellular↗
PubMed2006

Impaired cognitive functions in mild traumatic brain injury patients with normal and pathologic magnetic resonance imaging.

INTRODUCTION: Mild traumatic brain injury (MTBI) is a common neurological (neurotraumatological) diagnosis. As well as different subjective symptoms, many patients develop neuropsychological dysfunction with objective impairment of attention, memory and certain executive functions. Magnetic resonance imaging (MRI) is not routinely used in MTBI patients despite its proven greater sensitivity and specificity in comparison with computed tomography (CT). METHODS: The patient group consisted of 30 persons with MTBI and the control group consisted of 30 sex- and age-matched healthy volunteers. Both groups underwent neurological examination, neuropsychological testing (including the Postconcussion Symptoms Scale questionnaire, PCSS) and brain MRI (the patient group within 96 h after injury). RESULTS: The analyzed groups did not differ significantly in terms of sex, age, or level or duration of education. MRI pathological findings (traumatic and nonspecific) were present in nine patients. Traumatic lesions were found in seven patients. Nonspecific white matter lesions were found in five healthy controls. There were significant differences between MTBI patients and controls in terms of subjective symptoms (PCSS) and selected neuropsychological tests. Statistically significant neuropsychological differences were found between MTBI patients with true traumatic lesions and MTBI patients with nonspecific lesions. CONCLUSION: There is evidence that MTBI patients with true traumatic MRI lesions are neuropsychologically different from MTBI patients with nonspecific MRI lesions or normal brain MRI. These results support the hypothesis that some acute MTBI signs and symptoms have a real organic basis which can be detected by selected new MRI modalities.

Adult↗
PubMed1995

Three-dimensional high-frequency ultrasonic parameter imaging of anterior segment pathology.

PURPOSE: High-frequency ultrasound allows high-resolution imaging of anterior segment anatomy and pathology. Acoustic echo data, however, contain information relating to the microanatomic structure of the interrogated tissue which is not evident in B-mode images. The aim of this study is to develop imaging techniques to demonstrate and quantify the distribution of acoustic scattering properties in ocular tissues in three dimensions. METHODS: A tumor of the iris and a hyphema were scanned using a 50-MHz ultrasound probe mounted on a computer-controlled two-axis positioning system. Scan data from sequential parallel planes were used to make three-dimensional reconstructions. Digital signal processing and a mathematical model of acoustic backscatter then were used to represent the effective size and acoustic concentration of scattering elements using a false color representation superimposed on B-mode images. RESULTS: Three-dimensional reconstructions improved appreciation of the size and extent of pathology and allowed computation of tissue volumes. Parameter images demonstrated distinctive differences between diffuse and organized blood and allowed quantification of tumor scattering properties. CONCLUSIONS: Three-dimensional imaging of the anterior segment with high-frequency ultrasound allows construction of perspective images, which adds to the already significant clinical use of individual high-resolution B-mode images. Acoustic backscatter properties determined by tissue microstructure can be computed from echo data and represented in false color in three-dimensional reconstructions.

Anterior Eye Segment↗
PubMed1996

[Role of magnetic resonance imaging in liver pathology].

The increasingly common use of ultrasound examination of the liver has led to increased detection of hepatic tumours, showing a hitherto unsuspected prevalence. Improved techniques in MRI, such as dynamic sequences and new contrast media, are ameliorating the detection and characterization of the lesions, in particular with regard to computed tomography. In addition, since MRI is more sensitive to different components than in computed tomography, it permits better study of diffuse diseases such as haemochromatosis or fatty infiltration, particularly in pseudotumoural forms. The continuing progress in system improvement makes MRI an excellent method for diagnosis of bile duct disorders, especially in case of obstruction.

Biliary Tract Diseases↗
PubMed2005

Four cases of solid pseudopapillary tumors of pancreas: imaging findings and pathological correlations.

OBJECTIVE: Solid pseudopapillary tumor of the pancreas (SPTP tumor) is a rare pancreatic neoplasm with low malignant potential, which usually affects female patients in the second or third decades of life. It is a non-functional, slow-growing neoplasm that very often reaches considerable size before the first symptoms appear. Symptomatology is frequently related to tumor size. Surgical excision is usually curative in most cases. Infrequently the tumor can appear in male patients or in aged women, which can make the diagnosis more difficult. Some patients develop liver metastases in the follow-up that can be resected. Our purpose is to review the radiological and pathological findings of SPTP with emphasis on these infrequent cases. SUBJECTS AND METHODS: The medical records and radiological findings of patients who underwent surgery for SPTP between 2000 and 2005 were retrospectively reviewed. Study eligibility required that patients had undergone surgical resection and that a SPTP had been pathologically proved. RESULTS: Four cases of solid pseudopapillary tumor of the pancreas were diagnosed and treated in our institution in the study period. Two of the patients, developed on follow-up liver metastases, and peritoneal, hepatic, and nodal metastases, respectively. CONCLUSION: Solid pseudopapillary tumors are well-encapsulated neoplasms that usually have a good prognosis after surgical excision. A malignant behavior is uncommon and in this case lymph node involvement, hepatic metastases and occasionally peritoneal invasion may also occur. Resection of liver metastases can prolong the long-term survival of the patients.

Adult↗
PubMed1994

Cystic renal cell carcinoma. Imaging findings with pathologic correlation.

Twenty-seven cystic renal cell carcinomas (RCC) in 23 patients were analyzed radiologically and histologically. They were classified into 4 histopathologic growth patterns: a) multilocular (n = 15, 9 with macrocystic and 6 with microcystic components); b) unilocular (n = 3); c) cystic necrosis (n = 9); and d) tumors originating in the wall of a simple cyst (n = 0). Macrocystic multilocular RCC showed multiloculated configuration on ultrasound and contrast enhanced CT. Angiography revealed neovascularity peripherally or within the tumor (7/9 tumors). Microcystic multilocular RCC did not fulfill the criterion for a cystic mass on ultrasound: they were irregularly hyperechoic. There was little enhancement on postcontrast CT and only slight neovascularity on angiography. Unilocular RCC showed a cystic mass with an irregular wall or mural nodules on ultrasound and contrast enhanced CT. Necrotic RCC showed various sonographic findings from anechoic to irregular echoic. The appearance on CT varied from cystic with mural nodules to a multiloculated or irregular architecture. Neovascularity was seen in the periphery in 8 of 9 tumors. Clinically, this type seemed to be the most aggressive.

Adult↗
PubMed2005

Angiosarcoma of the spleen: imaging characteristics in 12 patients.

PURPOSE: To retrospectively review clinical, pathologic, and imaging features of angiosarcoma of the spleen in 12 patients. MATERIALS AND METHODS: Institutional review board approval was obtained, and informed consent was not required. Records of 12 cases of proved angiosarcoma of the spleen were accessed from the files of the Armed Forces Institute of Pathology. Clinical, pathologic, and imaging findings were reviewed. Presenting signs and symptoms were recorded, and the pathologist confirmed the diagnosis and determined gross and microscopic morphologic findings in each spleen. Radiologists reviewed available images to determine the size of the spleen and mass, amount of splenic involvement by the tumor (if enhanced at computed tomography [CT] and magnetic resonance [MR] imaging), and amount of nonviable tumor determined as decreased echogenicity at ultrasonography (US) and lack of enhancement at CT and MR imaging. Imaging and pathologic findings were compared. Five US, 10 CT, three MR, and two angiographic images were reviewed by two experienced abdominal radiologists. RESULTS: There were seven men and five women (age range, 36-86 years; mean, 55 years). The most common symptom was upper abdominal pain in eight (67%) patients: Pain was acute for 24 hours prior to admission in one patient and chronic (range, 1-6 months) in seven patients. At imaging, the spleen was enlarged (>12 cm in length) in nine patients. The most common finding, seen in seven (58%) patients, was a complex mass or masses in an enlarged spleen. Four of these patients had evidence of metastases and one had intraperitoneal hemorrhage. Two patients had solitary hypervascular tumors and liver metastases. One patient had a normal-sized spleen with multiple lesions that ranged 2-3 cm in size, as well as metastases to the spine. The 11th patient had two small lesions, with small calcifications in the periphery of one lesion. The 12th patient had intraabdominal hemorrhage around the spleen and no obvious mass at CT. Tumor necrosis was confirmed at histologic evaluation in nine patients. CONCLUSION: The most common clinical finding was upper abdominal pain. Angiosarcoma of the spleen could be suggested in the majority of cases (83%) by using the imaging features of splenic mass with evidence of metastatic disease.

Adult↗
PubMed2002

[Image quality and detection of pathology by ultrasound: comparison of B-mode ultrasound with photopic imaging and tissue harmonic imaging alone and in combination].

PURPOSE: To determine the accuracy of photopic imaging (PI) in detecting pathology by ultrasound (US) and to assess the image quality in direct comparison with conventional B-mode ultrasound and tissue harmonic imaging (THI). MATERIAL AND METHODS: Fifty-two patients underwent US examination, among them 29 patients for abdominal assessment and 23 for otolaryngological assessment. A total of 208 freeze frames, 52 B-mode scans each with and without THI and 52 B-mode scans each with and without PI, were assessed by three readers, who determined the presence of pathology on a scale of 1 (definitely abnormal) to 5 (definitely normal). All 52 patients underwent US follow-up within six weeks. The results were confirmed by CT in 30 patients and by histology in five cases. Image quality and different color encodings of each technique were rated on a ranking scale of 1 (optimal) to 4 (poor). The different US techniques were compared in terms of image quality, diagnostic accuracy, and color encoding using McNemar's test and ROC analysis. RESULTS: The results for image quality were as follows: B-scan 3.9; THI 1.9; PI 2.8; and THI plus PI 1.5 (each p < 0.05). The following AUCs (Area under Curve, presence of pathology) were calculated: 0.925, 0.990, and 0.990 for B-mode US, THI, and PI, respectively (not significant), and 0.994 for THI plus PI (significant compared to B-mode scan). The different color encodings were rated as follows: reddish brown 1.6, gray 1.9, blue 3.1, and green 3.6 (each p < 0.05). CONCLUSION: For ultrasound examinations, PI in combination with THI improves the image quality and conspicuity of pathology.

Abdomen↗
PubMed2005

Evaluation of posterior tibial pathology: comparison of sonography and MR imaging.

OBJECTIVE: To compare the results of sonographic (US) and magnetic resonance (MR) imaging in detecting pathology of the posterior tibial tendon (PTT) in patients with PTT dysfunction. DESIGN: Twenty-two ankles that were clinically suspected by the orthopedic surgeon to have PTT dysfunction were evaluated with US (10 MHz linear-array transducer) and 1.5 T MR examinations within the same day. The US and MR studies were conducted and interpreted by two sonologists and two musculoskeletal radiologists who were masked to the results of the other study. Four patients had bilateral studies. Classic clinical findings were utilized as a standard reference in staging PTT dysfunction. PATIENTS: Eighteen women (mean age 61 years, age range 39-86 years). RESULTS: Based on a commonly accepted staging system for PTT dysfunction, 6 ankles were classified as stage I, 11 ankles as stage II, and 5 ankles as stage III. All stage I ankles were interpreted as having an intact PTT by both MR imaging and US. In the stage II and III tendons, MR imaging demonstrated PTT tears in 12 of 22 examinations, including 11 partial tears and 1 complete tear. US demonstrated PTT tears in 8 of 22 examinations, including 8 partial tears and no complete tears. The findings of US and MR imaging were consistent in 17 of 22 cases (77%). The five inconsistencies were as follows: in 4 cases, US reported tendinosis when MR imaging interpreted partial tears (no change in management); in one case, US diagnosed a partial tear when MR reported a complete tear of the PTT (no change in management because the clinical findings were more consistent with a partial tear). CONCLUSIONS: In this study, US and MR imaging of the PTT were concordant in the majority of cases. US was slightly less sensitive than MR imaging for PTT pathology, but these discrepancies did not affect clinical management.

Adult↗
PubMedDate not supplied

Tongue cancer: correlation of MR imaging and sonography with pathology.

Ten patients with tongue cancer underwent both MR imaging and sonography. In seven of these patients, pathologic findings from glossectomies were correlated with MR and sonographic results. MR images of resected specimens also were obtained in two patients, and relaxation time was calculated in one of these patients. MR images (5- to 7-mm thick slices) were obtained by using a 0.1-T resistive magnet with a 128 x 256 acquisition matrix. MR and sonography had almost the same sensitivity for detecting primary-site tongue cancer. However, in the three patients with extraorgan spread of tumor, MR was superior, showing three of three cases, compared with sonography, which showed extraorgan spread in only one of the three cases. Although MR failed in one patient to differentiate postradiation scar tissue from tumor, because of similar relaxation time of both, this imaging technique proved to be an important adjunct to the physical examination in the staging of tongue cancer.

Adult↗
PubMed1993

Diagnosis of pathology of the temporomandibular joint. Clinical and imaging perspectives.

The pathologic conditions that involve the TMJ are similar to those conditions that involve other joints in the body. Therefore, many of the radiologic characteristics of these diseases are also similar. Nevertheless, because the articular surface of the condyle is an important site of mandibular growth, leading to secondary facial asymmetries when damaged in young patients, this possibility must be considered when evaluating the radiographic changes. It also is important to understand that functionally the TMJs act as a single unit and that any alteration in function caused by a pathologic process on one side can lead to disturbed function on the opposite side. Such dysfunction can cause degenerative changes that must be distinguished from the primary disease. Finally, some of the conditions that involve the TMJ can produce rather similar radiographic changes. In these instances, an understanding of the associated clinical findings can be helpful in making a more accurate radiographic diagnosis.

Ankylosis↗
PubMed2006

Bacterial cholangitis/cholangiohepatitis with or without concurrent cholecystitis in four dogs.

OBJECTIVES: To evaluate the clinical, clinical pathology, diagnostic imaging, microbiological and pathological features of cholangitis/cholangiohepatitis in the dog. METHODS: The study design was a retrospective review of cases of bacterial cholangitis/cholangiohepatitis presented to the University of Bristol during the period 1995 to 2000. The diagnosis was made based on hepatic histopathological findings and positive bile culture results. RESULTS: Four dogs met the inclusion criteria. Common presenting signs included anorexia (n=4), jaundice (n=4), vomiting (n=4) and pyrexia (n=2). All four dogs had a leucocytosis or neutrophilia reported at some time in their history along with serum bilirubin elevation. In addition, serum alkaline phosphatase and alanine transaminase activity was increased in all of the dogs in which it was measured both before and at the time of referral. In general, the diagnostic imaging findings were non-specific. Organisms cultured from bile aspirates were Escherichia coli (n=3), Clostridium species (n=2) and a faecal Streptococcus species (n=1). Two cases resolved with medical treatment alone; two with concurrent cholecystitis required cholecystectomy. Following surgery, both of these cases showed a resolution of clinical signs. CLINICAL SIGNIFICANCE: This report highlights the fact that bacterial cholangitis/cholangiohepatitis with or without concurrent cholecystitis should be considered as a potential differential in dogs presenting with signs referable to biliary tract disease.

Alkaline Phosphatase↗
PubMed1996

[Bronchiolitis obliterans with organizing pneumonia (BOOP). Clinical aspects, pathology and radiologic images].

Bronchiolitis obliterans with organizing pneumonia (BOOP) is a clinicopathological syndrome of unknown etiology. Histopathologically, it is characterized by plugs of fibroplastic connective tissue within respiratory bronchioles, mononuclear cell infiltrates in parenchyma adjacent to the affected bronchioles and foam cells within alveolar air-spaces. The disease usually presents as a subacute illness with complete resolution. A subset of BOOP, however, is associated with a fulminant course and a high lethality due to respiratory failure. Early diagnosis and therapy are mandatory. Chest radiography, computed tomography (CT), bronchoalveolar lavage (BAL) and open lung biopsy are the primary diagnostic techniques. Radiographically, BOOP is characterized by patchy areas of consolidation that are usually bilateral, peripheral and often migratory. In some cases small, round opacities may be observed as the only abnormality. CT can show the pattern of ground glass opacities, areas of airspace consolidation and small, round opacities, while considerable fibrotic change is usually not seen. A reticular roentgenographic pattern, fibrotic changes mainly in subpleural location at CT, lack of lymphocytosis in BAL fluid and histological features of usual interstitial pneumonitis and BOOP in biopsy specimens are all considered risk factors for a fatal outcome.

Adult↗
PubMedDate not supplied

Large retroperitoneal hibernoma in an adult male: CT imaging findings with pathologic correlation.

Hibernoma is a rare benign tumor consisting primarily of brown fatty tissue. It is usually seen in locations where normal brown adipose tissue is found in fetuses and infants such as the periscapular or interscapular region, the neck, the axilla, the thorax, and, more rarely, the retroperitoneum. We report the computed tomographic findings and pathologic features of a large retroperitoneal hibernoma discovered in an adult male. Radiologists and surgeons should be aware that hibernoma should be included in the differential diagnosis of a large fatty retroperitoneal soft tissue tumor.

Adult↗