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ABSTRACT: To investigate the use of magnetic resonance imaging in the detection of metastatic tumors involving the discovertebral junction of the spine in cadaveric specimens and patients, with histologic findings as the reference standard.
Magnetic resonance imaging studies were performed on 30 DVJs in 10 cadavers with documented metastatic bone disease. Anatomic sectioning and histologic evaluations were performed, and anatomic slices were correlated with the magnetic resonance images. For clinical study, magnetic resonance imaging examinations in three patients with vertebral metastasis were reviewed.
On magnetic resonance imaging, the signal intensity characteristics of vertebral body metastases were variable. Magnetic resonance imaging failed to detect metastatic foci invading the cartilaginous endplates. On microscopic examination, infiltration of the discovertebral junction by tumorous tissue was found in 11 (69%) of the 16 discovertebral junctions that had an irregular contour, and in 5 (31%) disrupted discovertebral junctions. In three specimens and three patients, microscopic examination revealed tumor metastasis to the intervertebral disc. In no specimen magnetic resonance imaging afforded depiction of discal invasion by tumor.
Our results lend further support to the theory that metastatic tumors can invade the cartilaginous endplate through defects in its substance, allowing direct contact of tumor and disc. Minimal tumor invasion of the discovertebral junction may not be identified at magnetic resonance imaging or gross anatomic inspection, or both, because small metastatic foci may be obscured by abnormalities in the morphology of the cartilaginous endplate.
Joint, bone, spine: revue du rhumatisme 11/2008; 76(1):50-6. · 2.25 Impact Factor
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Masaki Hara,
Yasunori Matsuzaki,
Tetsuya Shimizu,
Masaki Tomita,
Takanori Ayabe,
Yusuke Enomoto,
Shunsuke Wada,
Hiroyuki Tanaka,
Hiroaki Kataoka, Kazuki Nabeshima,
Toshio Onitsuka
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ABSTRACT: We report on a 42-year-old woman with malignant peripheral nerve sheath tumor (MPNST) arising from the cervical sympathetic nerve. A collar incision and partial sternotomy were performed at the second intercostal space. The mass was spindle shaped and connected to the sympathetic trunk on the cranial and caudal sides, and it compressed the left carotid sheath on the median side. After the patient's uneventful recovery from surgery, adjuvant radiotherapy was administered to the area of resection. The patient remains well 5 years after surgery with no evidence of recurrence.
Annals of thoracic and cardiovascular surgery: official journal of the Association of Thoracic and Cardiovascular Surgeons of Asia 09/2008; 14(4):246-8. · 0.69 Impact Factor
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ABSTRACT: The objective of this study was to describe the computed tomographic (CT) features of myofibroblastic inflammatory tumor of the lung with histopathologic correlation. The medical records and imaging studies of eight patients with pathologically proven myofibroblastic inflammatory tumor of the lung were reviewed. On radiographs and CT images, a poorly circumscribed mass or nodule was evident in five patients (six lesions), and a well-circumscribed lesion was evident in three patients (three lesions). Seven lesions were peripheral and two were centrally located. At CT, five lesions were of heterogeneous attenuation and four homogeneous. Increased perilesional parenchymal abnormalities, which were caused by peribronchial inflammatory infiltrates, were observed in three cases. The predominant histopathologic feature was organizing pneumonia type in three cases, lymphoplasmacytic type in three cases, and both organizing pneumonia and lymphoplasmacytic type in two cases. Variable degree of fibrous histiocytoma type was observed in all cases. The imaging characteristics of myofibroblastic inflammatory tumor of the lung are variable and nonspecific. The authors conclude that most cases appear as solitary, peripheral lesions with a predilection for the lower lobes. Associated findings may include perilesional inflammatory changes. Because myofibroblastic inflammatory tumor cannot be reliably differentiated from other pulmonary lesions based solely on the imaging appearance diagnostic biopsy is mandatory. Interpretation of the imaging findings combined with the histopathologic features of disease may help make correct diagnosis.
Computerized Medical Imaging and Graphics 01/2008; 31(8):607-13. · 1.47 Impact Factor
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ABSTRACT: The purpose of this study was to describe the normal anatomy and abnormalities of the lumbar intervertebral disk with sonography in cadaveric specimens and to correlate the sonographic findings with pathologic findings.
Sonographic imaging with both 4.5- and 10-MHz linear array transducers was performed on 35 lumbar intervertebral disks in 13 human cadaveric spines. The cadaveric specimens were sectioned for anatomic and histopathologic evaluation. Findings on anatomic sections were correlated with the findings on corresponding sonographic images with respect to the sonographic appearance of disk components in 30 intervertebral disks.
High-resolution sonography with a 10-MHz frequency transducer enabled distinction of the nucleus pulposus from the annulus fibrosus and assessment of the echogenic characteristics of these structures. Sonography showed numerous fine linear echoes in the outer portion of the intervertebral disk in 26 (87%) of 30 specimens, which corresponded to the normal concentric arrangement of the fibers in the periphery of the annulus fibrosus. Amorphous areas of low echogenicity in the inner portion of the annulus fibrosus (n = 14, 47%) correlated with degenerative changes of the disk on corresponding microscopic sections. The nucleus pulposus appeared relatively isoechoic (n = 5, 17%) or hyperechoic (n = 4, 13%) to the annulus fibrosus. In degenerative disks (n = 21, 70%), the nucleus pulposus showed decreased echogenicity, and differentiation between the nucleus pulposus and annulus fibrosus was difficult.
High-resolution sonography is a simple imaging method that can show the normal lumbar intervertebral disk and degenerative changes in appropriate subjects. High-resolution sonography proves superior to conventional sonography for evaluation of the lumbar intervertebral disk.
Journal of ultrasound in medicine: official journal of the American Institute of Ultrasound in Medicine 05/2005; 24(4):489-99. · 1.25 Impact Factor
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ABSTRACT: Minute pulmonary meningothelial-like nodules (MPMNs), previously known as minute pulmonary chemodectomas, are relatively rare lesions. They are small (1-3 mm) and often multiple. Pathologically, they represent an interstitial nodular proliferation of small oval or spindle-shape cells arranged in a "zellenballen" nesting pattern. The function and origin of the cells are unknown. These nodules are associated with specific conditions, including thromboembolism, cardiac disease, and malignancy. We describe a patient with MPMNs and adenocarcinoma of the lung in whom HRCT showed tiny (1-3 mm in diameter) nodules of ground-glass attenuation.
Journal of Thoracic Imaging 08/2002; 17(3):227-9. · 0.98 Impact Factor
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ABSTRACT: The purpose of this work was to describe the MR appearance of cartilaginous endplates (CEPs) with close anatomic correlation in cadavers derived from elderly subjects.
High-resolution MRI was performed on five cadaveric lumbar spines, and a total of 48 CEPs were studied with T1-weighted spin echo, T2-weighted fast spin echo, and fat-suppressed 3D spoiled GRASS gradient echo (SPGR) MR images. All specimens underwent anatomic sectioning, and gross anatomic findings were correlated with those of MRI.
Conventional MR images allowed gross morphologic evaluation of the integrity of the CEPs and demonstrated cartilaginous nodes. In all specimens, fat-suppressed 3D-SPGR images invariably improved visualization of the fine anatomic structures at the diskovertebral junction (p < 0.01). Various morphologic abnormalities of the CEPs demonstrated on MR images, including thinning, irregularity, erosions, cartilaginous defects, and Schmorl nodes, were confirmed on anatomic inspection.
Results in our study indicate that MRI may delineate the normal anatomy of CEPs and demonstrate morphologic changes occurring at the diskovertebral junction. Dedicated high-resolution technique and fat-suppressed 3D-SPGR images may significantly improve the diagnostic capabilities of MRI of this particular anatomic region.
Journal of Computer Assisted Tomography 26(6):933-40. · 1.22 Impact Factor
