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PubMed2006

Space occupying lesions of parotid gland. Comparative diagnostic imaging and pathological analysis of echo color/power Doppler and of magnetic resonance imaging.

Aim of the study was to evaluate the role of echo color/power Doppler and magnetic resonance imaging in the diagnosis of space occupying parotid lesions, in the attempt to establish criteria for differential diagnosis between benign and malignant types. The study population comprised 49 patients (23 male, 26 female), age range 30-85 years, with a space occupying lesion of the parotid gland. Each lesion was carefully studied with ultrasound integrated with colour/power doppler and magnetic resonance imaging; patients were then submitted to echo-guided needle-biopsy and surgical excision. A preliminary evaluation by means of ultrasound revealed the site, size of lesion, echostructure and borders. Echo colour/power Doppler and magnetic resonance imaging can play a very important role both in diagnosis and pre-operative surgical planning of parotid lesions, although cost and availability, the former to be recommended vs. magnetic resonance imaging, which is poorly accessible, expensive, and not always accepted by the patients.

Adult↗
PubMed1994

Hypertrophic olivary degeneration: MR imaging and pathologic findings.

PURPOSE: To assess magnetic resonance (MR) imaging findings of hypertrophic olivary degeneration (HOD) due to hemorrhage and correlate them with pathologic findings. MATERIALS AND METHODS: MR imaging was performed in 11 patients--eight with pontine tegmental hemorrhages (THs) and three with cerebellar hemorrhages in the dentate nuclei. The interval from hemorrhagic ictus to the MR studies was 3 weeks to 49 months. Pathologic specimens came from a woman who died of brain stem hemorrhage. RESULTS: Involvement of the central tegmental tract produced ipsilateral HOD; that of the dentate nucleus or superior cerebellar peduncle produced contralateral HOD. Bilateral olivary changes occurred only when the TH also involved the superior cerebellar peduncle. In bilateral THs, HOD was limited to the dominant bleeding side because of the lateral position of the central tegmental tract. Hyperintense areas of the oliva appeared 3 weeks after ictus. Hypertrophy appeared after 5-15 months. Microscopically, vacuolar degeneration of neurons and hypertrophy of astrocytes with gliosis were seen. CONCLUSION: MR images may depict very early neuronal changes in the oliva and are well correlated with pathologic staging.

Adult↗
PubMed1990

[A study of MRI diagnosis for rheumatoid arthritis in the knee joint--imaging and pathologic correlation].

We performed MR (magnetic resonance) imaging of 25 knee joints in 20 patients with rheumatoid arthritis (RA) before synovectomy and the findings were compared with the pathological specimens. When based on the findings on T2-weighted images of the examined joints, the degree of joint involvement by RA could be divided into four stages: stage 1 in which only joint effusion was present; stage 2 in which synovial thickening, lower in signal intensity than joint effusion, was present; stage 3 in which cartilage destruction was present; stage 4 in which apparent bone destruction was present. There were eleven joints which appeared unremarkable on conventional X-ray films but three of them were at stage 2 and six at stage 3. In conclusion, MR imaging is of help in diagnosis of early involvement of the knee joints by RA.

Adult↗
PubMed1997

Adenoma malignum: MR imaging and pathologic study.

PURPOSE: To evaluate the clinical, pathologic, and magnetic resonance (MR) imaging findings in adenoma malignum, a rare variant of uterine cervical adenocarcinoma. MATERIALS AND METHODS: Medical records of all patients (n = 7) with adenoma malignum of the uterine cervix diagnosed pathologically between 1988 and 1996 were retrospectively reviewed. Unenhanced T1-weighted and T2-weighted images and gadolinium-enhanced T1-weighted MR images were evaluated, and findings were correlated with gross pathologic and microscopic features. RESULTS: In five of seven patients, enlargement of the cervix was seen. All lesions were detected as multiple cystic lesions that extended from the endocervical gland to the deep stroma of the cervix. They appeared isointense (n = 5) or slightly hyperintense (n = 2) relative to the uterus on T1-weighted images and markedly hyperintense relative to the uterus on T2-weighted images. Solid portions of variable size were seen between cystic lesions, and both the multiple cystic component and the solid portion were most apparent on the gadolinium-enhanced T1-weighted images. Microscopic parametrial invasion was seen in two patients but was not detected at MR imaging. CONCLUSION: Adenoma malignum was depicted on MR images as a multicystic mass with solid portions located in the deep cervical stroma. Gadolinium enhancement helped identify the solid portion of the tumor.

Adenocarcinoma↗
PubMed1997

Fractures of the hands and feet in child abuse: imaging and pathologic features.

PURPOSE: To determine the imaging and histopathologic appearance of fractures of the hands and feet in abused infants. MATERIALS AND METHODS: The imaging findings in 11 abused infants with fractures of the hands and feet were examined retrospectively. All 11 infants underwent skeletal surveys; five infants also underwent nuclear bone scanning. Postmortem radiographs of the specimen and histopathologic data were available in two infants. RESULTS: A total of 22 fractures were noted. Six infants had fractures of the hands: six metacarpal and nine proximal phalangeal fractures. Five infants had fractures of the feet: six metatarsal fractures and one proximal phalangeal fracture. Torus fractures predominated, and these patterns were confirmed at the histologic examinations. These morphologic features were consistent with a mechanism of forced hyperextension. Oblique views of the hands and follow-up skeletal surveys aided in detection of these injuries. Four of six metatarsal fractures involved the first ray. Seven patients had three or more additional fractures that involved the long bones of the upper and lower extremities, and seven patients had additional fractures of the ipsilateral extremity. CONCLUSION: Fractures of the hands and feet are subtle but important injuries in abused infants. Well-collimated, high-detail radiographs of the hands and feet should be included in the skeletal survey performed for suspected child abuse.

Child Abuse↗
PubMedDate not supplied

Intracranial neurenteric cysts: imaging and pathology spectrum.

BACKGROUND AND PURPOSE: Intracranial neurenteric (NE) cysts are rare congenital lesions that may be mistaken for other, more common non-neoplastic cysts as well as cystic neoplasms. We delineate the imaging spectrum, pathologic findings, and differential diagnosis of NE cysts. METHODS: History, imaging, surgical and pathologic findings were analyzed retrospectively in 18 patients with intracranial NE cysts. Fifteen were surgically proved cases; 3 exhibited classic imaging findings and are being followed clinically. RESULTS: Thirteen cysts were located in the posterior fossa; 12 of 13 were extra-axial. Size varied from 1.2 x 0.8 x 0.6 cm to 3.4 x 3 x 2.5 cm. Five were supratentorial, measuring from 7 x 5 x 3 to 9 x 6 x 7 cm. All were frontal and off the midline. Seven of 18 patients had CT scans. Cysts varied widely in attenuation. None enhanced. Eighteen of 18 had MR images. Sixteen of 18 were hyperintense, and 2 were isointense to CSF on T1-weighted imaging. Sixteen of 18 were hyperintense on T2-weighted imaging. All cysts were hyperintense to CSF on fluid-attenuated inversion recovery (FLAIR) sequences. Diffusion imaging was performed on 2 patients. One case showed mild restriction. Mild posterior rim enhancement was seen in 5 cases at the site where the cyst adhered to brain parenchyma. CONCLUSION: The imaging spectrum for NE cysts is broader than previously reported. Intracranial NE cysts should be considered in the differential diagnosis for intracranial extra axial cystic lesions both above and below the tentorium.

Adolescent↗
PubMed1994

Renal parenchymal abnormalities associated with renal vein thrombosis: correlation between MR imaging and pathologic findings in rabbits.

OBJECTIVE: The purpose of this study was to correlate abnormalities of the renal parenchyma seen on MR images with pathologic findings in rabbits with acute thrombosis of the renal vein. MATERIALS AND METHODS: MR images were obtained in 21 rabbits before and 1 hr to 2 weeks after ligation of the renal vein. MR findings were correlated with pathologic findings. RESULTS: The cross-sectional area of the kidney was 1.7, 1.8, 1.9, 2.2, 1.3, and 1.0 times of its initial size at 1 hr, 3 hr, 1 day, 3 days, 1 week, and 2 weeks, respectively, after ligation of the renal vein. Corticomedullary contrast on T1-weighted images decreased persistently from 1 hr to 2 weeks after ligation. Between 1 hr and 1 week after ligation, T2-weighted images showed a layer with low signal intensity that was correlated with medullary congestion and hemorrhage on pathologic specimens. CONCLUSION: MR images show a layer with low signal intensity in the renal medulla that probably represents medullary congestion and hemorrhage of the kidney in rabbits with acute thrombosis of the renal vein.

Adult↗
PubMed2000

Infantile fibromatosis in childhood: findings on MR imaging and pathologic correlation.

AIM: The objective of this study was to analyse the MR imaging findings of infantile fibromatosis of childhood and to correlate them with histopathological features. MATERIALS AND METHODS: Seven patients with histologically proven infantile fibromatosis were included in this study. The findings on MR images were retrospectively evaluated and then correlated with the pathological features. Findings on MR imaging evaluated included signal intensity, extent of hyperintense area on T2-weighted images, margins of the lesion, the degree and pattern of enhancement and the presence of fatty tissue. Pathological features evaluated included cellularity, collagenization, and myxoid change. A five point scale was used for the evaluation of the extent of hyperintense area on MR imaging, and each of pathological features. RESULTS: On T1-weighted images, the lesions were iso-intense in two patients; iso- and hypointense in three; and iso-, hypo- and hyperintense in two. On T2-weighted images, iso-, hypo- and hyperintense areas were mixed in all patients, the hyperintense area being the largest portion of the lesion. The margins of the lesions were infiltrative in four patients (57%), smooth in two (29%) and mixed in one (14%). Enhancement was marked in five patients (72%) and diffuse in five (71%). Regardless of the hyperintense signal intensity on T2-weighted images, the grades of each pathologic feature were variable. CONCLUSION: Infantile fibromatosis on MR imaging causes an enhancing mass, that is largely hyperintense on T2-weighted images. Areas of high signal intensity on T2-weighted images corresponded to variable grades of cellularity, collagenization, or myxoid change.

Child↗
PubMed1998

Nonossifying fibroma: characteristics at MR imaging with pathologic correlation.

PURPOSE: To correlate the findings of nonossifying fibroma at magnetic resonance (MR) imaging with those at pathologic examination. MATERIALS AND METHODS: In 19 patients (age range, 8-25 years; mean age, 14 years) with pathologically proved nonossifying fibroma, MR images were analyzed for signal intensity and patterns of contrast enhancement. Findings at MR imaging and biopsy were correlated. RESULTS: On T1-weighted images, all nonossifying fibromas had low signal intensity compared with that of skeletal muscle. On T2-weighted images, 15 lesions (79%) were hypointense and four (21%) were hyperintense. On gadolinium-enhanced images, intense contrast enhancement was seen throughout 15 lesions (heterogeneous pattern in 12 and homogeneous in three) and in the margins and septa in four. Extensive hypercellular fibrous tissue and hemosiderin seen at pathologic examination were depicted with low signal intensity on T2-weighted MR images. CONCLUSION: The distinguishing features of nonossifying fibroma included hypointensity and septation on T2-weighted images. Signal intensity on T1- and T2-weighted MR images and the patterns of contrast enhancement were dependent on the amounts of hypercellular fibrous tissue, hemosiderin, hemorrhage, collagen, foamy histiocytes, and bone trabeculae.

Adolescent↗
PubMed1989

Cerebral tuberous sclerosis: postmortem magnetic resonance imaging and pathologic anatomy.

We conducted postmortem magnetic resonance imaging (MRI) studies of five brains from patients with a clinical and pathologic diagnosis of tuberous sclerosis. Areas of prolonged T1 and T2 relaxation could easily be identified within the white matter subjacent to the cortical tubers despite formalin fixation and storage. The signal changes were identical to those reported in living patients with the disease. The detection of cortical tubers by MRI in two patients who were 34 and 35 years of age, respectively, at the time of death suggests that the signal changes on MRI are less affected by aging than are the low-attenuation changes on computed tomography, which are rarely identified in patients older than 27 years of age. Once the changes caused by fixation of tissues are considered, postmortem MRI is a viable investigative tool in studying tuberous sclerosis and other diseases, and it seems to correlate well with the MRI findings in living patients, as well as the gross and histopathologic changes seen at autopsy.

Adolescent↗
PubMed1994

Rectal tumor stage: correlation of endorectal MR imaging and pathologic findings.

PURPOSE: To develop magnetic resonance (MR) imaging criteria for staging rectal cancer. MATERIALS AND METHODS: Thirty-six patients with rectal tumors underwent MR imaging with an endorectal surface coil. MR images were compared with specimens from the resected tumor. RESULTS: Rectal wall layers were reliably demonstrated. The MR imaging-determined tumor stage agreed with pathologic findings in 81% of cases. A retrospective review found the integrity of the rectal wall layers at the lesion center an accurate criterion for interpreting the local extent of the lesion. Lymph nodes as small as 2 mm were demonstrated. Although sensitive for demonstrating perirectal adenopathy, MR imaging had a specificity of only 72% for N1 disease. CONCLUSION: Endorectal surface coil MR imaging shows promise for staging rectal lesions. Additional studies are necessary to further establish criteria for interpreting the images.

Humans↗
PubMed2001

Grey matter abnormalities in multiple sclerosis: proton magnetic resonance spectroscopic imaging.

Pathologically defined abnormalities in the cortical gray matter (GM) are well described in multiple sclerosis (MS) but are infrequently seen by conventional magnetic resonance imaging (MRI). We systematically evaluated 52 relapsing-remitting MS patients and 20 normal volunteers with high resolution MRI and short echo proton magnetic resonance spectroscopic imaging (MRSI). Individual tissue contributions to the spectroscopic voxels were estimated based on MRI that incorporated both CSF suppression and magnetization transfer, or double inversion images in which both CSF and GM were suppressed. Strong resonances in the 0.8 to 1.5 p.p.m. spectral region were observed in 13 MS patients. Image segmentation based on the MRI characteristics of tissues contributing to the spectroscopic voxels showed that these additional peaks originated mainly from GM. The presence of these additional peaks suggests that the normal appearance GM on MRI, is biochemically abnormal in a substantial proportion of relapsing-remitting MS patients.

Adult↗
PubMed1993

Budd-Chiari syndrome: imaging with pathologic correlation.

We retrospectively evaluated 21 patients with Budd-Chiari syndrome who underwent liver transplant. The pathological findings were correlated with imaging studies that included computed tomography (CT) in all cases, sonography in 20, and magnetic resonance (MR) in 15. Pathological features of Budd-Chiari syndrome in subacute or chronic form, such as parenchymal fibrosis, hemorrhage, and congestion, were found in all resected livers. These occurred usually in conjunction with restricted hepatic veins due to thrombosis or fibrosis with partially recanalized lumen. The status of hepatic veins was correctly assessed and correlated with pathology in 13 of 20 patients who had sonograms, in 12 of 15 patients who had MR, and in nine of 18 patients with contrast-enhanced CT scans. Patency of the inferior vena cava was well seen by all three modalities; parenchymal abnormalities were best visible on CT (19 of 21), while ascites, caudate lobe enlargement and collateral vessels were best detected with MR or CT. We conclude that each imaging modality offers certain values and limitations in the assessment of vascular or parenchymal findings in Budd-Chiari syndrome.

Adolescent↗
PubMed1997

Undifferentiated (embryonal) sarcoma of the liver: pathologic basis of imaging findings in 28 cases.

PURPOSE: To correlate the imaging and pathologic features of undifferentiated (embryonal) sarcoma (UES) and account for the discrepancy between the solid appearance at ultrasound (US) and the almost cystlike appearance at computed tomography (CT) and magnetic resonance (MR) imaging. MATERIALS AND METHODS: The clinical, pathologic, and imaging findings in 28 patients (age range, 3-49 years) with pathologically proved UES were retrospectively reviewed. All patients underwent at least one cross-sectional imaging study to include CT (27 patients), US (21 patients), and MR imaging (six patients). Tumor size, gross morphology (n = 27), histologic features, and proportion of solid and cystlike components were evaluated and correlated to the imaging findings. RESULTS: The mean transverse diameter of the tumors was 14 cm (range, 10-25 cm). At gross examination, the tumors were predominantly solid (mean, 83% of tumor volume), and pathologic and US findings were concordant. Conversely, CT scans showed low attenuation (approximately that of water) in 88% of the tumor volume and T2-weighted MR images showed high signal intensity (approximately equal to that of cerebrospinal fluid) in 89% of the tumor volume. CONCLUSION: UES shows a misleading cystlike appearance at CT and MR imaging compared with US and pathologic findings. In a child or young adult with a liver tumor, this finding is useful in making a prospective diagnosis and avoiding misguided attempts at drainage.

Adolescent↗
PubMed2006

Can [18F]-fluorodeoxyglucose standardized uptake values of PET imaging predict pathologic extrathyroid invasion of thyroid papillary microcarcinomas?

OBJECTIVE: To evaluate the hypothesis that the [F]-fluorodeoxyglucose (FDG) standardized uptake values (SUVs) of positron emission tomographic (PET) imaging can predict pathologic extrathyroid invasion of thyroid papillary microcarcinomas (TPMC) DESIGN: Prospective clinical study. METHOD: From 2004 to 2005, 44 consecutive patients with TPMC (< or =1 cm), confirmed by ultrasonography and aspiration cytology, had FDG PET scans performed. Among them, 66 tumor foci in 41 patients were confirmed to be of less than 1 cm in diameter by the final surgical pathology report. According to the microcarcinoma tumor focus, prediction of pathologic extrathyroid invasion, by clinical variables including sonographic findings and SUVs from PET imaging, was evaluated by the univariate and multivariate logistic regression analysis. RESULTS: : Univariate analysis showed that the tumor site attached to the thyroid capsule and the SUVs of PET imaging could predict pathologic extrathyroid invasion. However, the tumor site attached to thyroid capsule and an age older than 45 were significant predictors by multivariate analysis (P = .001 and P = .036). SUVs from PET imaging were only correlated with the size of tumor (P < 0.001). CONCLUSION: The SUVs from FDG PET imaging alone cannot predict the pathologic extrathyroid invasion in patients with TPMC. However, the ultrasonographic findings, such as tumor site, provide better information about the extrathyroid invasion of TPMC tumor foci.

Adult↗
PubMed2004

Diffusion-weighted MR imaging and pathologic findings in adult cerebellar medulloblastoma.

UNLABELLED: OBJECTIVES, MATERIALS AND METHODS: The authors present the diffusion-weighted MR imaging and pathologic findings in two adult patients with cerebellar medulloblastoma. RESULTS: Both presented with a vermian mass of the posterior fossa with low signal on SE T1 weighted images, and moderate enhancement of the mass after gadolinium injection. The tumors were of high intensity on diffusion-weighted images with low ADC value. The ADC values (x10(-3) mm2/s) were respectively 0.60 +/- 0.06 and 0.59+/-0.11 (tumor), and 0.65 +/- 0.04 and 0.67 +/- 0.07 (cerebellar white matter). Tumors were highly cellular and composed of densely packed small round cells with hyperchromatic nuclei and scanty cytoplasm. CONCLUSION: diffusion-weighted MR imaging may be useful for the diagnosis of cerebellar medulloblastoma, due to their high cellularity and high nuclear-to-cytoplasmic ratio.

Adult↗