European Journal of Radiology Extra最新文献

Introduction

Intracranial germ cell tumors (GCT) are extremely rare brain neoplasms, with imaging characteristics being often non-specific. Considering such imaging limitation in establishing their exact histology, the aim of this paper is to integrate conventional, physiologic and metabolic magnetic resonance imaging (MRI) with histology of these tumors, with the goal of proposing some new insights that could aid in their diagnosis.

Materials and methods

We have retrospectively analyzed preoperative imaging findings in 9 patients with histology proven intracranial germ cell tumors. In all patients conventional magnetic resonance imaging in conjunction with diffusion-weighted imaging (DWI) and proton magnetic resonance spectroscopy (MRS) was performed.

Results

Based on imaging characteristics on conventional sequences germinoma cannot be differentiated from nongerminoma. DWI offered the potential for differentiation of germinomas from non-germinomas since solid part of germinomas demonstrated restricted diffusion with ADC values under 1.0 × 10⁻³ mm²/s, whereas nongerminoma showed elevated diffusion with ADC values above 1.3 × 10⁻³ mm²/s. Short echo MRS demonstrated characteristic spectra in germinomas: increased Cho, decreased NAA and prominent broad lipid resonances.

Conclusion

DWI and MRS imaging findings provide additional information that can facilitate evaluation of intracranial germ cell tumors.

The demand for minimally invasive cosmetic procedures is increasing. Injectable hyaluronic acid is an effective and well tolerated procedure that can be used for breast augmentation and provides predictable long-lasting results if administered appropriately in the correct tissue plane. Concerns already exist regarding the effect of Macrolane™ on breast cancer screening, and we raise a new concern about the need for imaging for its safe administration. We present three cases referred to our centre in the last 2 years with complications associated with Macrolane™ injection, possibly from injection into an incorrect tissue plane. Complications included breast pain, haematoma, cellulitis and abscess formation. We suggest that such aesthetic procedures should be carried out under ultrasound guidance to ensure administration into the correct site, potentially avoiding such complications.

Stafne's bone defects (SBDs) are asymptomatic radiolucent lingual/buccal bone lesions of the lower jaw and are frequently caused by soft tissue inclusion. SBDs located on the buccal ramus of the mandible are the rarest variant. To date, only one case involving the buccal ramus has been reported in the PubMed Database (National Library of Medicine) including both clinical cases and archaeological specimens. Advanced imaging techniques are useful in diagnosing these types of lesions in order to avoid unnecessary surgery. In the case described, the radiolucency in the condylar neck appeared to be developmental in origin and was later shown by computed tomography to be related to salivary gland tissue of the parotid gland.

Moyamoya disease is a chronic occlusive cerebrovascular disease affecting young patients. Its association with systemic lupus erythematosus (SLE) has not been well established though had been reported. Their similar acute neurological presentations can lead to diagnostic dilemma. We present a young Chinese female with known SLE initially presenting with unilateral moyamoya phenomenon, subsequently progressed to typical bilateral moyamoya disease 5 years later. We also compare various clinical parameters with other reported cases in past literatures.

Cobb syndrome is a rare illness that combines vascular skin nevus and spinal vascular malformation at the same metamere.

We report the case of a 34-year old man that presented a light low back pain, a slowly progressive paraparesis and abnormal urinary sphincter functioning. MR imaging of the thoracic spine depicted an intramedular arteriovenous malformation. Spinal angiography confirmed these findings. The arteriovenous malformation also affected the chestwall bones and muscles with the same metameric distribution as the intramedular lesion. Due to these findings Cobb syndrome was suspected and in a second physical examination a skin angioma was noted on the patient's back. He was treated with corticosteroids and endovascular coiling and his symptoms rapidly improved.

Although pathophysiology of this syndrome is poorly understood and the correct management remains unknown, endovascular treatment has become the first choice for spinal arteriovenous malformations. We believe that combined treatment with corticosteroids and endovascular embolization is an effective procedure to alleviate symptoms and to minimize morbidity.

Fallopian tube torsion is a rare occurrence, which generally presents in the reproductive age group. The clinical and imaging features are usually non-specific and misdiagnoses are often made. We report an imaging case of an 18-year-old girl with isolated fallopian tube torsion, which could be diagnosed preoperatively thanks to control MR imaging. The initial MRI demonstrated the enlarged and tortuous fallopian tube with normal ovaries and uterus, and an equivocal mass near the uterus. The control MRI, five days later, showed the appearance of blood in the fallopian tube and in the equivocal mass, corresponding to the twisted pedicle.

Amplatzer vascular plugs (AVP) are increasingly being used in the treatment of peripheral vascular aneurysms. We present two cases of unsuccessful percutaneous endovascular embolizations of right internal iliac artery (IIA) aneurysms using AVPs at the origin of the aneurysm. The first patient presented with partial rupture of a right IIA aneurysm 3 weeks after embolization, with the AVP seen free within the lumen of the aneurysm. Final occlusion was successfully achieved with a second AVP, thrombin and coil embolization. The second patient had treatment with an AVP for an incidental right IIA aneurysm on computer tomography angiography (CTA) following a previous surgical aorto-biiliac graft. Post-embolization CTA demonstrated a proximal leak via the AVP. This was successfully occluded with a right common iliac stent graft.

A 31-year-old woman presented with anterior neck mass which had been first noticed 2 months ago. She underwent neck CT which revealed solid and cystic lesion adjacent to hyoid bone. After surgery, she was diagnosed with thyroglossal duct cyst (TGDC) combined with papillary cancer. This is a rare form of TGDC, so we report a case with CT images.

We present a case of pelioid hepatocellular carcinoma detected by computed tomography during hepatic angiography and confirmed by pathology. On computed tomography angiography, the lesion showed slight enhancement in the early phase, and enhancement subsequently increased. Lesion enhancement then attenuated in the delayed phase. On T2-weighted image, the lesion was hyperintense, and the inner part of the lesion was hyperintense when compared with the outer part of the lesion. Pathologically, dilated sinusoid-like blood spaces were present within the lesion, and the proportion of these in the inner part of the tumor was greater than that in the outer part.

Pancreatic rhabdomyosarcoma (RMS) is much uncommon and usually secondary. Adult primary pancreatic RMS is extremely rare. An old female patient presented with a long time of nausea. Contrast enhancement CT scan revealed a large soft mass in tail of the pancreas with progressive enhancement. Then, a distal pancreatectomy with splenectomy was performed. Pathology and immunohistochemistry suggested a primary pancreatic RMS.