[show abstract][hide abstract] ABSTRACT: Myelolipomas are rare benign tumours composed of adipose tissue and haematopoietic cells that are typically found in adrenal glands but have also appeared in extra-adrenal sites. Distinguishing between extra-adrenal myelolipomas and malignant tumours, such as liposarcomas, is crucial to avoid an invasive procedure. To this end, we present a comprehensive report of the CT imaging characteristics of a pathologically proven bilateral extra-adrenal perirenal myelolipoma.
The British journal of radiology 10/2010; 83(994):e198-9. · 2.11 Impact Factor
[show abstract][hide abstract] ABSTRACT: To determine the frequency of asymptomatic incidental Bochdalek hernias in adults, using multidetector computed tomography (MDCT), and to ascertain any possible relationship between Bochdalek hernia and age, gender, or body mass index (BMI).
Seven hundred and forty-eight abdominal, and 602 chest MDCT scans, which had been performed for a variety of reasons on 1350 adults, were investigated retrospectively. Location and size of Bochdalek hernias seen on these scans were correlated with age, gender, and BMI. On the basis of BMI, patients with Bochdalek hernia were classified as group A (BMI < 25) and group B (BMI > or =25).
A total of 171 Bochdalek hernias were identified in 142 of 1350 patients, ranging in age from 25 to 90 years (median age, 57.2), representing a prevalence of 10.5%. Sixty leftsided unilateral Bochdalek hernias (42.2%), 53 (37.4%) rightsided unilateral Bochdalek hernias, and 29 (20.4%) bilateral Bochdalek hernias were detected. Forty-five (31.6%) were categorized as small, 82 (57.8%) were medium-sized, and 15 (10.5%) were large. BMI was < 25 in 62 patients (43.7%), and > or =25 in 80 patients (56.3%). Fourteen patients (9.9%) were young adults, while 86 (60.6%) were middle aged, and 42 (29.6%) were elderly. No statistically significant relationship was found between dimensions or hernia locations and age, gender, or BMI of patients with Bochdalek hernia.
In view of the high prevalence of Bochdalek hernia in our study (10.5%), the multiplanar and reconstruction features of MDCT seem to facilitate the diagnosis of asymptomatic incidental Bochdalek hernia. No relationship was found between asymptomatic incidental Bochdalek hernia and age, gender, or BMI in adults.
[show abstract][hide abstract] ABSTRACT: The purpose of this study was to describe the computed tomography (CT) findings of pancreatic lipomas of 9 cases, with emphasis to diagnostic challenges.
Between March 2006 and April 2008, 9 patients with pancreatic lipomas that were diagnosed by CT were reviewed in the present study. Clinical data and CT features of these 9 cases were retrospectively analysed. The patient population included 5 men and 4 women, aged 42-81 years (mean age, 65.8 years). The patients were followed up for at least 2 years with control CTs.
In all 9 cases, a well-bordered nodular fat density lesion was incidentally detected in the pancreas. Four of the lesions had a lobulated contour, and 2 of them had septations. Two of the lipomas were located in the head, 3 in the neck, 3 in the corpus, and 1 in the tail. The CT densitometric values were between -90 and -120 HU, with a mean value of -106 HU. No pancreatic or biliary dilatation or compression to the adjacent structures was seen. All the cases had control CTs, and the lipomas remained unchanged during the follow-up period. Histopathologic confirmation of the diagnosis was not planned for the cases.
Lipomas are rarely encountered in the pancreas. They often are diagnosed coincidentally as small, well-circumscribed, encapsulated, homogeneous, mature adipose masses on imaging studies. Imaging follow-up strategy or histopathologic confirmation is not necessary in asymptomatic patients.
Canadian Association of Radiologists Journal 03/2010; 61(3):156-61. · 0.43 Impact Factor
[show abstract][hide abstract] ABSTRACT: A case of primary primitive neuroectodermal tumor (PNET) of the chest wall in an adolescent is presented with imaging findings including 18F-fluorodeoxyglucose (18F-FDG) positron-emission computed tomography (PET-CT). To date, radiological description of the PNET of the chest wall has mainly been carried out by radiographic analysis, computed tomography (CT), and magnetic resonance imaging (MRI). We demonstrated that 18F-FDG PET-CT visualizes the active focus of glucose metabolism of PNET of the chest wall and is effective for the preoperative evaluation of patients with this tumor.
[show abstract][hide abstract] ABSTRACT: Behçet disease (BD) is a chronic multisystemic inflammatory disorder, mainly characterized by recurrent oral and genital ulcers, skin lesions, and uveitis. Large vein thrombosis in BD is unusual; when present, it is most frequently seen in the inferior or superior vena cava (SVC). The authors describe an unusual hepatic pseudolesion caused by abnormal focal enhancement through collateral pathways to the liver in two BD patients with SVC occlusion on three-dimensional multi-detector computed tomography, using volume rendering and maximum intensity projection techniques. BD should be suspected in patients presenting a focal increased hepatic enhancement area with collaterals caused by occlusion of the SVC without evidence of a hypercoagulable state or malignant mediastinal or thoracic venous inlet obstruction.
[show abstract][hide abstract] ABSTRACT: Persistent trigeminal artery variants are described as cerebellar arteries that directly originate from the precavernous segment of the internal carotid artery. This has been observed in 0.18% of cerebral catheter angiograms. On the other hand, a persistent trigeminal artery variant feeding both the anterior inferior cerebellar artery and the posterior inferior cerebellar artery territory is very rare. We present this uncommon anomalous artery along with digital subtraction angiography findings and discuss its clinical significance in light of the literature.
[show abstract][hide abstract] ABSTRACT: Uterus didelphys with obstructed hemivagina and ipsilateral renal agenesis is a rare and specific entity referred to as Herlyn-Werner-Wunderlich syndrome. It usually presents after menarche with remittent pelvic pain and a palpable pelvic mass due to hematocolpos. It rarely presents with primary infertility in early adulthood. In this report, a case of Herlyn-Werner-Wunderlich syndrome with primary infertility in a young woman is described with MR imaging findings.
European Radiology 06/2009; 19(5):1306-8. · 3.55 Impact Factor
[show abstract][hide abstract] ABSTRACT: The aim of this study was to investigate dynamic contrast-enhanced MRI (DCE-MRI) for the noninvasive measurement of bladder cancer angiogenesis by correlation with microvessel density, histologic grade, and tumor staging, and to predict the outcome of local recurrence.
Twenty-four patients with bladder cancer were examined using DCE-MRI. Hemodynamic parameters obtained by DCE-MRI included peak time enhancement in the first minute (E(max/1)) after contrast administration, second minute (E(max/2)), third minute (E(max/3)), fourth minute (E(max/4)), and fifth minute (E(max/5)), and the steepest slope. Microvessel density was identified by immunostaining of endothelial cells using FVIII-related antigen. The Mann-Whitney U test, multivariate discriminant analysis, Spearman's correlation coefficient, and analysis of variance were used for statistical analysis.
Correlation was seen between DCE-MRI parameters (E(max/1) and steepest slope) and microvessel density (p < 0.05). E(max/1) and steepest slope were found to have a statistically significant correlation with histologic grade (p < 0.05 and p < 0.01, respectively). A significant difference was seen between groups of patients with and without local recurrence with regard to two of the DCE-MRI parameters (p < 0.05 for E(max/1) and E(max/2)).
The contrast enhancement patterns on DCE-MRI are influenced by tumor angiogenesis, as reflected by elevated microvessel density expression. Therefore, they are valuable indicators for assessing tumor angiogenic activity and tumor neovascularization in bladder cancers.
American Journal of Roentgenology 05/2009; 192(4):949-55. · 2.90 Impact Factor
[show abstract][hide abstract] ABSTRACT: A 31-year-old female with a history of ovarian cancer underwent an F-18 fluorodeoxyglucose (FDG) positron emission tomography-computed tomography (PET-CT) scan. The PET-CT demonstrated focal nodular uptake in the subcutaneous tissue of the back adjacent to the paraspinal muscles. Color Doppler ultrasonography examination demonstrated a vascular solid mass. The patient underwent biopsy followed by excision. The pathologic diagnosis was dermatofibroma. Although benign, dermatofibromas can have intense FDG uptake.
[show abstract][hide abstract] ABSTRACT: We describe a case of hydatid disease as a rare cause of pelvic pain. Although the involvement of pelvic bones makes diagnosis challenging, characteristic imaging findings of the cysts in the other tissues highly suggest the diagnosis of hydatid disease.
European Radiology 09/2008; 18(8):1757-9. · 3.55 Impact Factor
[show abstract][hide abstract] ABSTRACT: We present an adult patient with anomalies of congenital short and annular pancreas, gallbladder agenesis and splenic malrotation. The patient presented with symptoms typical of the two pancreatic malformations and is the only reported case with these malformations reported in the English imaging literature.
The British journal of radiology 08/2008; 81(968):e204-6. · 2.11 Impact Factor
[show abstract][hide abstract] ABSTRACT: We report a case of hypothenar hammer syndrome following a single severe blunt trauma in a 24-year-old man with a painful pulsatile mass, numbness in the fourth and fifth fingers, and intolerance to cold. The gray-scale and color Doppler sonographic findings are presented with correlation with MRI.
Journal of Clinical Ultrasound 03/2008; 36(2):98-100. · 0.70 Impact Factor