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PubMedDate not supplied

Basal ganglia: anatomy, pathology, and imaging characteristics.

Several cases of bilateral basal ganglia lesions seen in magnetic resonance imaging initiated a review of the anatomy, pathology, and differential diagnoses of this region. There are a variety of disease entities that present as symmetrical basal ganglia abnormalities. Although these findings may not indicate a specific diagnosis, knowledge of the characteristics of diseases that affect this area can limit the differential considerations. Clinical information is often essential for narrowing the possible pathology that can be found here. The purpose of this article is to review the anatomy of the basal ganglia, the pathologies, clinical histories, and imaging characteristics that can cause bilateral basal ganglia lesions.

Basal Ganglia↗
PubMed1996

Choroid plexus histoplasmoma: clinical, pathologic, and imaging findings.

Histoplasmosis of the choroid plexus has not previously been described. We report its occurrence, as well as its clinical, pathologic, and imaging characteristics in one case. Clinically, our patient's choroid plexus lesion produced encephalopathy and third nerve palsy. On imaging it appeared as a hemorrhage or calcification. Cerebrospinal fluid studies were consistent with a chronic meningeal process uncomplicated by hemorrhage. Stereotactic biopsy of the choroid plexus was required to establish the diagnosis of cerebral histoplasmosis. Pathologic examination also revealed prominent abnormal calcification, which permitted the lesion of masquerade as a hemorrhage on computed tomographic and magnetic resonance images.

Biopsy↗
PubMed2005

Comparison of ultrahigh- and standard-resolution optical coherence tomography for imaging macular pathology.

OBJECTIVE: To compare ultrahigh-resolution optical coherence tomography (UHR OCT) with standard-resolution OCT for imaging macular diseases, develop baselines for interpreting OCT images, and identify situations where UHR OCT can provide additional information on disease morphology. DESIGN: Cross-sectional study. PARTICIPANTS: One thousand two eyes of 555 patients with different macular diseases including macular hole, macular edema, central serous chorioretinopathy, age-related macular degeneration (AMD), choroidal neovascularization, epiretinal membrane, retinal pigment epithelium (RPE) detachment, and retinitis pigmentosa. METHODS: A UHR ophthalmic OCT system that achieves 3-microm axial image resolution was developed for imaging in the ophthalmology clinic. Comparative studies were performed with both UHR OCT and standard 10-microm-resolution OCT. Standard scanning protocols of 6 radial 6-mm scans through the fovea were obtained with both systems. Ultrahigh-resolution OCT and standard-resolution OCT images were correlated with standard ophthalmic examination techniques (dilated ophthalmoscopy, fluorescein angiography, indocyanine green angiograms) to assess morphological information contained in the images. MAIN OUTCOME MEASURES: Ultrahigh-resolution and standard-resolution OCT images of macular pathologies. RESULTS: Correlations of UHR OCT images, standard-resolution images, fundus examination, and/or fluorescein angiography were demonstrated in full-thickness macular hole, central serous chorioretinopathy, macular edema, AMD, RPE detachment, epiretinal membrane, vitreal macular traction, and retinitis pigmentosa. Ultrahigh-resolution OCT and standard-resolution OCT exhibited comparable performance in differentiating thicker retinal layers, such as the retinal nerve fiber, inner and outer plexiform, and inner and outer nuclear. Ultrahigh-resolution OCT had improved performance differentiating finer structures or structures with lower contrast, such as the ganglion cell layer and external limiting membrane. Ultrahigh-resolution OCT confirmed the interpretation of features, such as the boundary between the photoreceptor inner and outer segments, which is also visible in standard-resolution OCT. The improved resolution of UHR OCT is especially advantageous in assessing photoreceptor morphology. CONCLUSIONS: Ultrahigh-resolution OCT enhances the visualization of intraretinal architectural morphology relative to standard-resolution OCT. Ultrahigh-resolution OCT images can provide a baseline for defining the interpretation of standard-resolution images, thus enhancing the clinical utility of standard OCT imaging. In addition, UHR OCT can provide additional information on macular disease morphology that promises to improve understanding of disease progression and management.

Adult↗
PubMed1991

Hepatic colorectal metastases: correlation of MR imaging and pathologic appearance.

Results of magnetic resonance (MR) imaging examinations for 76 patients with proved colorectal metastases to the liver were retrospectively reviewed. Signal intensity and morphologic patterns of 157 lesions were scored. The morphologic patterns were correlated with the histologic material obtained at segmental hepatic resections or excisional biopsies in 33 patients. In 154 lesions (98%) colorectal metastases to the liver were found to be hyperintense on MR images acquired with a long repetition time/echo time; in 77 lesions (49%) central low-signal-intensity changes were seen. Virtually all larger lesions demonstrated areas of low signal intensity within the tumor. These areas were found to reflect histologic findings of coagulative necrosis and desmoplasia within the tumor. Peripheral hyperintense halos around central hypointense areas encompassed the growing tumor margin and variable degrees of cell necrosis. Hypointense peripheral rims, which correspond to abnormalities of surrounding hepatic parenchyma, were seen in 40 lesions (25%). This sign should not be assumed to represent the fibrous pseudocapsule of primary hepatic malignancy. No correlation between tumor grade (differentiation) and tumor morphology was observed.

Adenocarcinoma↗
PubMed2000

Leigh syndrome in a 3-year-old boy with unusual brain MR imaging and pathologic findings.

We report unusual MR serial imaging and electron microscopy findings in a 3-year-old boy who had Leigh syndrome with cytochrome-c oxidase (cox) deficiency. The MR imaging findings included periventricular white matter involvement, posteroanterior progression, and extension through the corpus callosum and internal capsule; however, no basal ganglia or brain stem abnormality was found, which was suggestive of leukodystrophy. The most noteworthy findings were the cystic foci with contrast enhancement in the affected white matter.

Child, Preschool↗
PubMed2005

Identification of vulnerable atherosclerotic plaque using IVUS-based thermal strain imaging.

Pathology and autopsy studies have demonstrated that sudden disruption of vulnerable atherosclerotic plaque is responsible for most acute coronary syndromes. These plaques are characterized by a lipid-rich core with abundant inflammatory cells and a thin fibrous cap. Thermal strain imaging (TSI) using intravascular ultrasound (IVUS) has been proposed for high-risk arterial plaque detection, in which image contrast results from the temperature dependence of sound speed. It has the potential to distinguish a lipid-laden lesion from the arterial vascular wall due to its strong contrast between water-bearing and lipid-bearing tissue. Initial simulations indicate plaque identification is possible for a 1 degrees C temperature rise. A phantom experiment using an IVUS imaging array further supports the concept, and results agree reasonably well with prediction.

Animals↗
PubMed1998

A comparison between magnetic resonance imaging and pathologic findings in patients with disc displacement.

PURPOSE: This study compared the magnetic resonance imaging (MRI) and pathologic findings in patients with disc displacement without perforation. PATIENTS AND METHODS: Eleven patients and 30 asymptomatic volunteers underwent MRI using the three-dimensional (3D) fast imaging with a steady precession sequence (FISP) acquisition technique. The 11 patients (11 joints) then underwent discectomy, and the pathologic and MRI findings were compared. RESULTS: MRI (FISP-3D) examination of the temporomandibular joint in 11 patients (11 joints) showed low signal intensity in the anterior band and the intermediate zone of the disc, and high signal intensity in the posterior band of the disc and retrodiscal tissue. On microscopic examination, the anterior band and intermediate zone of the disc were found to consist of dense collagenous bundles showing mild hyaline degeneration. Myxomatous degeneration was seen in the posterior band of the disc (11 joints), and edematous change was seen in the retrodiscal tissues (seven joints). CONCLUSIONS: Pathologic changes in the disc and the retrodiscal tissues are accurately depicted by FISP-3D.

Adult↗
PubMedDate not supplied

Cerebral changes and cerebrospinal fluid beta-amyloid in Alzheimer's disease: a study with quantitative magnetic resonance imaging.

Pathological and biochemical studies indicate that beta-amyloid (betaA4) deposition is a hallmark in the pathogenesis of Alzheimer's disease (AD). Neuroimaging studies demonstrate that the respective cerebral changes primarily strike the temporal lobe and the amygdala-hippocampus complex and may be reliably assessed using quantitative magnetic resonance imaging (MRI). Therefore one may expect that reduced betaA4-levels are significantly correlated with measures of the temporal lobe rather than global cerebral atrophy in AD patients. To test this hypothesis in a clinical study, cerebrospinal fluid concentrations of total betaA4 and its major C-terminal variations betaA4 1-40 and betaA4 1-42 were compared with cerebral changes as assessed by quantitative magnetic resonance imaging (MRI). Significantly (P< 0.05) reduced betaA4 1-40 and betaA4 1-42 levels were found in the AD patients (17 female; six male; AD/NINCDS-ADRDA-criteria) in comparison to the patients with major depression (seven female; two male; DSM-III-R). Within the AD group, betaA4 and betaA4 1-42 levels were significantly correlated with the volume of the temporal lobes (r= 0.46 and r= 0.48, respectively) but none of the other volumetric measures. These findings indicate that changes in cerebral betaA4 levels contribute to temporal lobe atrophy in AD and support the possibility that betaA4 is central to the etiology of AD.

Aged↗
PubMed1998

Distinguishing silent lacunar infarction from enlarged Virchow-Robin spaces: a magnetic resonance imaging and pathological study.

We studied clinicopathological correlations between magnetic resonance imaging (MRI) appearances of postmortem brains and pathological findings in 12 patients to identify simple criteria with which to distinguish lacunar infarctions from enlarged Virchow-Robin spaces. In vivo MRI was also available for 6 of the 12 patients. We focused on small, silent, focal lesions including lacunar infarctions and enlarged Virchow-Robin spaces that were confirmed pathologically. From a total of 114 lesions, enlarged Virchow-Robin spaces were most often found in the basal ganglia and had a round or linear shape. Lacunar infarctions also were most frequent in the basal ganglia, but 47% of these were wedge-shaped. In the pathological studies, excluding lesions from the lower basal ganglia region, enlarged Virchow-Robin spaces were usually smaller than 2 x 1 mm. The shapes and sizes of the lesions determined by MRI (in vivo and postmortem) concurred with the pathological findings, except that on MRI the lesions appeared to be about 1 mm larger than found in the pathological study. When lesions from the lower basal ganglia and the brain stem regions are excluded, the sensitivity and specificity for discriminating enlarged Virchow-Robin spaces from lacunar infarctions are optimal when their size is 2 x 1 mm or less in the pathological study (79%/75%, respectively), 2 x 2 mm or less in both of the MRI studies: postmortem (81%/90%), and in vivo (86%/91%). In conclusion, we were able to differentiate most lacunar infarctions from enlarged Virchow-Robin spaces on MRI on the basis of their location, shape and size. We stress that size is the most important factor used to discriminate these lesions on MRI.

Aged↗
PubMed2002

Epithelioid sarcoma: clinical, MR imaging and pathologic findings.

OBJECTIVE: To report and describe the MR imaging features of eight new cases of this rare soft tissue sarcoma and correlate them with the clinical and histologic findings. DESIGN AND PATIENTS. Retrospective analysis was carried out for the MR imaging characteristics and histologic findings of eight patients with pathologically proven epithelioid sarcoma and the literature was reviewed. Findings were correlated in each case with the patient's clinical presentation and eventual outcome. RESULTS: The patients, whose primary tumors ranged from 2.5 cm to 19 cm in maximum dimension, were 1 to 90 years of age. Tumors involved the extremities ( n=5), the scalp ( n=2) and the paraspinal muscles ( n=1). Five tumors presented as well-defined, frequently painful, deeply situated masses and three as subcutaneous nodules or cutaneous ulcers with no palpable mass. Four patients had associated regional lymphadenopathy and one had distant metastases at diagnosis. MR imaging showed tumor infiltration of adjacent tissues in seven patients. Signal characteristics reflected varying degrees of cellularity, and the presence of necrosis, hemorrhage, fibrosis, hyalinization and inflammation. Bone marrow involvement was demonstrated in one patient. Clinical outcomes were generally poor. CONCLUSIONS: Epithelioid sarcoma is an aggressive soft tissue sarcoma with a varied clinical presentation, growth pattern, MR signal characteristics and histologic picture. The tumor favors the distal extremities and is commonly infiltrative and accompanied by enlarged regional lymph nodes. This neoplasm may present as an intramuscular mass but should also be suspected in patients with ulcerating cutaneous nodules with or without regional lymphadenopathy.

Adult↗
PubMed2004

[Ocular adnexal mucosa-associated lymphoid tissue lymphoma: a pathological and imaging study].

PURPOSE: To analyze the relationship of the pathological and clinical features of patients with ocular adnexal mucosa-associated lymphoid tissue (MALT) type lymphoma, and to provide a suggestion of preoperative diagnosis and treatment of MALT lymphoma. METHODS: To analyze the clinical, imaging and histopathologic features of 20 cases (25 eyes) of MALT lymphoma retrospectively in the department of ophthalmology. RESULTS: Among the 20 cases (25 eyes), 18 cases (21 eyes)were located in the orbit, and 2 cases (4 eyes) were at conjunctiva. MALT lymphoma had typical characters in CT, MRI and B scan imaging, Histopathological examination showed that all of the 20 cases (25 eyes) were B cell lymphoma. Monoclonal immunophenotype of 21 eyes were positive, 15 eyes kappa positive, 6 eyes lambda positive. 15 eyes CD45RA positive, 18 CD45RO low positive, 23 eyes CD20 positive and 24 eyes CD3 negative. CONCLUSION: Patients with primary ocular adnexal MALT lymphoma had a similar pathological morphology with other locus. Through imaging we could get a preoperative diagnosis.

Adolescent↗
PubMed2004

Skull base chordoid meningioma: imaging features and pathology.

The clinical, imaging and pathological features of a skull base chordoid meningioma (CM) are described. The huge tumour resulted in obstructive hydrocephalus and partial erosion of the clivus such that a chordoma was suspected. The lesion's MRI findings were similar to those of a meningioma. Light microscopic, immunohistochemistry and ultrastructural features were diagnostic of CM. Chordoid meningioma is a rare subtype of meningioma and has a great tendency to recur should surgical resection be incomplete.

Choroid Neoplasms↗
PubMed2005

[The effect of body position changes on lung function, lung CT imaging and pathology in an oleic acid-induced acute lung injury model].

OBJECTIVE: To study the effect of body position changes on lung mechanics, oxygenation, CT images and pathology in an oleic acid-induced acute lung injury (ALI) model. METHODS: The study groups consisted of one control group and three experimental groups in which the rabbits were put on supine, prone and rotation, respectively. The changes of partial pressure of arterial oxygen (PaO(2)), lung mechanics in the course of the experiment, as well as lung CT and pathology were observed and analyzed. RESULTS: PaO(2) and lung compliance of the prone and the rotation rabbits were higher than those of the supine rabbits [(158 +/- 51) mm Hg, (166 +/- 37) mm Hg, (87 +/- 24) mm Hg; (2.8 +/- 0.9) ml/cm H(2)O, (2.6 +/- 0.7) ml/cm H(2)O, (1.6 +/- 0.5) ml/cm H(2)O, respectively, all P < 0.05], while intrapulmonary shunt was significantly less in the prone and the rotation groups. The airway peak inspiration pressure of the rotation rabbits was higher than that of the prone rabbits [(20 +/- 2) cm H(2)O, (16 +/- 2) cm H(2)O, P < 0.05]. PaO(2) was positively correlated to the lung compliance and negatively correlated to the intrapulmonary shunt. Oleic acid-induced ALI lung CT was divided into dependent region and nondependent region, and the CT changes of the two regions were rapid after position change. The distribution of lung edema was affected by gravitation. CONCLUSIONS: Prone and rotation positions can improve oxygenation in this ALI model. Continuous rotation can relieve the extent of compressive lung collapse which occurs in ALI.

Animals↗
PubMed2005

Acute blood-brain barrier opening in experimentally induced focal cerebral ischemia is preferentially identified by quantitative magnetization transfer imaging.

Pathologic changes in brain tissue during and after stroke may lead to injury of the blood-brain barrier (BBB) and subsequent hemorrhagic transformation (HT). In a rat model of HT, the apparent diffusion coefficient of water, cerebral blood flow, relaxation times, T(1) and T(2), and magnetization transfer (MT) related parameters (T(1sat), K(for) and the MT ratio) were repetitively measured during 3 h of focal ischemia and 2 h of reperfusion (n = 8). Areas of BBB opening were identified by sequential assay of the transcapillary influx of Gd-diethylenetriaminepentaacetic acid (Gd-DTPA) by MRI and (14)C-alpha-aminoisobutyric acid (AIB) by quantitative autoradiography. Ischemia-injured regions of interest were identified from the MRI data and divided into those with and without BBB opening. Of the several MRI parameters measured, the T(1sat) in the caudate-putamen and preoptic area during ischemia and the first 2 h of reperfusion correlated best with the regional pattern of BBB opening observed thereafter. These data suggest that an ipsilateral/contralateral T(1sat) ratio > 1.6 demarcates leakage of small molecules such as Gd-DTPA and AIB across the BBB. As to clinical relevance, the quantitation of MT parameters in acute stroke may enable the early detection of areas of BBB opening and potential HT.

Acute Disease↗
PubMed1988

Thyroid masses: MR imaging and pathologic correlation.

The authors explored the capability of high-field-strength surface coil magnetic resonance (MR) imaging in disclosing the gross pathologic characteristics of thyroid masses (especially pseudocapsular and hemorrhagic degeneration). Twenty-four patients were examined, including 12 with papillary carcinoma, eight with adenoma, and four with adenomatous goiter. All patients underwent surgery within 2 days after MR imaging. Specimens were cut and correlated directly with MR images. The appearance of the pseudocapsule was classified into four types: A, intact and even thickness around the tumor; B, only partially present or even absent; C, intact but with uneven thickness; D, partially destroyed by tumor. MR imaging findings corresponded precisely with those of gross pathologic examination in all cases but four of adenoma. Type A pseudocapsules were found only in adenoma and type D only in papillary carcinoma. Although the number of cases in the series was limited, the authors conclude that MR images reflect gross pathologic findings well and that some characteristic findings are suggestive of benign or malignant disease.

Adenoma↗
PubMed1995

Correlation of MR imaging and pathologic findings in athletes undergoing surgery for chronic patellar tendinitis.

OBJECTIVE: Jumper's knee, or chronic patellar tendinitis, can be a source of considerable pain in athletes. The changes that occur with shearing of the tendinous fibers from repeated microtrauma can progress to significant degeneration and increase the risk of tendon rupture. In order to better understand this phenomenon, a correlative study relating the MR imaging and pathologic findings was performed. SUBJECTS AND METHODS: Nine high-performance athletes 18-22 years old (mean age, 20 years) underwent operation of 11 knees for long-standing jumper's knee. The average period of symptoms was 3 years (range, 2 to 6 years). MR knee examinations were performed before surgery in all athletes. The symptoms, MR findings, and pathological findings were correlated. RESULTS: There was focal thickening in the proximal one third of the patellar tendon (range, 9-16 mm; mean, 12 mm) in all 11 knees, involving the medial portion of the tendon in 10 and the center in one. On proton-density-weighted MR images, all knees demonstrated a focus of abnormal signal intensity in the proximal one third of the patellar tendon. On T2-weighted MR images, 10 knees demonstrated abnormal signal intensity; eight were isointense to that seen on proton-density-weighted images, and two were relatively hyperintense. Ten tendons demonstrated a poorly defined posterior margin. Pathologically, the areas of abnormal signal intensity corresponded to tissue containing tenocyte hyperplasia, prominent angiogenesis with endothelial hyperplasia, loss of longitudinal collagenous architecture, and microtears with collagen fiber separation. Hyaline degeneration was present in specimens from every patient. CONCLUSION: In athletes with chronic patellar tendinitis, areas of abnormal signal intensity on MR imaging corresponded to degenerative pathologic changes consistent with angiofibroblastic tendinosis. In nearly all patients, the tendon thickening occurred eccentrically. Disproportionate medial tendon thickening may be related to unequal tensile forces across the knee joint, resulting in greater stress on the medial portion of the extensor mechanism of the knee.

Adolescent↗
PubMed2007

Uterine smooth-muscle tumors with unusual growth patterns: imaging with pathologic correlation.

OBJECTIVE: This essay illustrates the salient features of variant smooth-muscle tumors on multiple imaging techniques with correlative pathology. We describe how recognition of these features allows the radiologist to distinguish a uterine leiomyoma variant from the classic fibroid or a leiomyosarcoma. Finally, we highlight the role of the radiologist in triaging these patients to surgical versus medical management and in surgical planning. CONCLUSION: Parasitic leiomyoma, intravenous leiomyomatosis, disseminated peritoneal leiomyomatosis, and benign metastasizing leiomyoma show key features on multiple imaging techniques that correlate with pathology findings. In the appropriate clinical setting, the radiologist should include these unusual lesions in the broader differential diagnosis of smooth-muscle tumors and, in certain cases, aid in surgical planning.

Adult↗
PubMed1990

Magnetic resonance imaging of pathologic conditions of the Achilles tendon.

The advent of magnetic resonance imaging (MRI) has improved imaging of the Achilles tendon. Various pathologic conditions of the Achilles tendon and their MRI characteristics are described. The superior resolution of the tendon provided by MRI can aid in the diagnosis of Achilles tendon disorders, which include complete or partial rupture of the tendon as well as postoperative assessment of tendinous healing, tendinitis and tenosynovitis, and various tumors of the Achilles tendon.

Achilles Tendon↗