Current Medical Imaging Reviews最新文献

Introduction: Pseudomyogenic Hemangioendothelioma (PMHE), also known as epithelioid sarcoma-like hemangioendothelioma, is a rare, indolent, low-grade vascular tumor. It typically presents as firm cutaneous nodules, with a predilection for the lower extremities and a male predominance. While numerous cases have been reported in pathology literature, detailed radiologic descriptions, particularly of soft tissue origins, are scarce. This report aims to bridge this gap by presenting a rare case of PMHE with comprehensive imaging findings.

Case presentation: We report on a 67-year-old male who presented with painful, palpable papules on his right buttock. MRI revealed multifocal dermal nodules demonstrating low signal intensity on T1-weighted images and high signal intensity with a distinctive peripheral high-signal halo on T2-weighted images. Notably, T1 gadolinium fat-saturated sequences exhibited marked enhancement with a characteristic peripheral rim enhancement pattern. The lesions were confined to the cutaneous layer. Initial radiological differentials included post-inflammatory granuloma and sarcoma. Histopathological examination confirmed PMHE. PET/CT demonstrated no evidence of systemic metastasis, and the patient has remained recurrence-free for two years following surgery.

Conclusion: This report highlights a rare case of cutaneous PMHE and details its distinctive MRI features, particularly the peripheral rim enhancement. Given its rarity and often non-specific clinical and imaging presentations, there is a significant potential for misdiagnosis. Therefore, it is crucial for radiologists to be aware of PMHE and familiarize themselves with its characteristic radiological patterns to facilitate accurate, timely diagnosis and ensure appropriate patient management.

Background: Acute pancreatitis (AP) is associated with a high mortality rate that is directly related to its severity. Limited research has been conducted on the role of DWI-MRI in the diagnosis and staging of acute pancreatitis as it pertains to the revised Atlanta classification. The objective of this study was to examine the role of diffusion-weighted (DW) magnetic resonance imaging (MRI) in early diagnosis and staging of acute pancreatitis in correlation to the revised Atlanta classification.

Methods: According to the revised Atlanta classification, a prospective assessment was performed to examine the correlation between DW MRI and apparent diffusion coefficient (ADC) values with the severity of acute pancreatitis (AP) in a sample of 34 patients diagnosed with AP.

Results: The mean ADC value of mild edematous pancreatitis was 1.14±0.06x10-3 mm2/sec, moderate edematous pancreatitis was 1.18±0.16x10-3 mm2/sec, severe necrotizing pancreatitis was 1.99±0.06x10-3 mm2/sec, and that of the normal pancreas was 1.54±0.05 x10-3 mm2/sec. Based on the revised Atlanta classification, there was a significant difference between the ADC values of normal pancreas and acute, severe, and mild/moderate pancreatitis, while there was no significant difference between mild and moderate pancreatitis cases. ROC analysis yielded high accuracy in differentiating normal pancreas from acute pancreatitis and severe pancreatitis from non-severe pancreatitis (AUC=0.827 and 0.870, respectively).

Discussion: In the current study, the qualitative assessment of DWI images indicated that all cases of mild acute pancreatitis (AP) displayed true diffusion restriction, while facilitated diffusion was observed in 80% of patients diagnosed with necrotizing pancreatitis. Our findings have validated the outcomes of earlier research regarding the average ADC values of both the healthy and acutely inflamed pancreas. According to the Revised Atlanta Classification, DWI has the ability to assist in the prompt diagnosis of acute pancreatitis and to differentiate mild forms from severe ones.

Conclusion: DW-MRI using both qualitative and quantitative methods provides a concise, safe, and radiation-free imaging method for early detection and assessing the severity of acute pancreatitis.

Introduction: This study aimed to evaluate the image quality of virtual unenhanced and blending images from dual-energy CT for detecting colorectal cancer (CRC).

Materials and methods: A total of 72 patients with pathologically diagnosed CRC underwent abdominal dual-energy CT, following which virtual unenhanced, linear blending, and non-linear blending images were generated by post-processing reconstruction. Both subjective and objective evaluations were conducted on these images, with signal-to-noise (SNR) and contrast-to-noise ratio (CNR) calculations conducted for organs, such as the liver, pancreas, and spleen.

Results: Virtual unenhanced images of CRC, extraserosal fat of the tumor, liver, pancreas, spleen, kidney, and subcutaneous fat showed a lower signal intensity than both linear and non-linear blending images (P < 0.05), while the CNR of virtual unenhanced images was higher than linear and nonlinear blending images (P < 0.05). Except for CRC lesions, the SNR of other organs in virtual unenhanced images was higher than in linear and non-linear blending images (P < 0.05). There were no significant differences in subjective image scores and the number of conventional lesions between virtual unenhanced image, linear, and non-linear blending (P ≥ 0.05). The Kappa coefficients for evaluating extraserosal invasion were 0.722, 0.584, and 0.584 for virtual unenhanced, linear blending, and non-linear blending images, respectively, with corresponding accuracies of 86.1%, 79.2%, and 79.2%.

Conclusion: Virtual unenhanced images of patients with CRC can provide high-quality images for diagnostic evaluation, potentially replacing linear blending and non-linear blending images in plain scans.

Background: Meningiomas (MGM) are common intracranial tumors, while complete situs inversus totalis (SIT) is an uncommon congenital anomaly. However, there are few documented cases of complete situs inversus coexisting with brain tumors, and particularly, there have been no reports on the relationship between surgically treated MGM and complete situs inversus.

Case presentation: A 52-year-old female, presenting with a 7-month headache history, worsening over the past 10 days, with new-onset left lower limb weakness. She reported difficulty lifting the left leg, dragging during ambulation, and a "stepping on cotton" sensation. No significant past medical history.

Conclusion: This case highlights that the surgical approach must be determined based on the precise tumor-to-brain anatomy provided by 3D printing technology, while also accounting for the patient's complete situs inversus and dominant hand.

Background: Intraspinal sparganosis constitutes an uncommon parasitic infection. The absence of distinct clinical manifestations and imaging characteristics frequently leads to its misdiagnosis as a tumor, cyst, or hematoma.

Case presentation: In this study, we present a case involving a 57-year-old female patient with a history of consuming raw or undercooked frog meat and pork. Imaging studies identified an intraspinal occupying lesion. The patient subsequently underwent surgical intervention, which resulted in a pathological diagnosis of intraspinal sparganosis. Following this diagnosis, anthelmintic therapy was administered as part of the comprehensive treatment protocol.

Conclusion: During the differential diagnosis of intraspinal space-occupying lesions, the intraspinal lesion observed on MRI plain scan appears as a solitary, irregular mass with abnormal signal characteristics. On T1-weighted imaging (T1WI), the lesion demonstrates isointense signal intensity; on T2- weighted imaging (T2WI), it displays mildly hyperintense signal, with markedly increased signal intensity on fat-suppressed T2WI. The lesion exhibits poorly defined margins and exerts a significant mass effect. Following contrast administration, the majority of lesions show marked, homogeneous, mass-like enhancement. Intraspinal sparganosis should be considered in the context of a comprehensive evaluation of the patient's MRI findings, medical history of potential exposure, and serological testing for parasitic antibodies. This integrated diagnostic strategy contributes to improved preoperative diagnostic accuracy, which in turn enhances treatment outcomes and prognosis.

Background: Given multiple risk factors for lung cancer, this study explored associations between lung cancer and AI-derived quantitative chest computed tomography (CT) parameters of emphysema, airways, and pulmonary vasculature.

Methods: This retrospective single-center study (December 2020-February 2023) analyzed relevant parameters of the left upper lobe (LUL) and right upper lobe (RUL) in 170 lung cancer patients and 126 healthy individuals. Subgroups were defined by cancer-free lobes (129 patients/126 controls for LUL; 120 patients/126 controls for RUL). Univariate and multivariate binary logistic regression analyses were used for analysis.

Results: The emphysema-related 15th percentile of CT attenuation values (PI-15) was significantly associated with lung cancer, with lower values in patients' LUL. Pulmonary vascular parameters (diameter, count, area at 6 mm/24 mm from the lung surface) differed significantly; the patients had smaller diameters, higher counts, and larger areas at 6 mm in the LUL. Airway parameters (Awt-Pi10, level 6 wall thickness) were higher in patients' LUL. Multivariate regression identified PI-15 and vascular diameters (6 mm/24 mm) in LUL [area under the curve (AUC) = 0.841, 95% confidence interval (95% CI): 0.789-0.892] and vascular diameters (6 mm/24 mm) and vascular count at 24 mm from the lung surface in RUL (AUC=0.819, 95% CI:0.766-0.872) as significant predictors (all P<0.001).

Conclusion: AI-derived quantitative CT parameters of emphysema, vasculature, and airways are associated with lung cancer and may serve as complementary tools for clinical risk assessment.

Introduction: The female reproductive system undergoes hormone-driven cyclical changes during the menstrual cycle and further alterations after menopause. However, the impact of these changes on imaging parameters remains unclear. This study aimed to compare diffusion-weighted imaging and intravoxel incoherent motion (DWI-IVIM) parameters of the uterus and cervix in women of childbearing age across different menstrual phases and in postmenopausal women.

Methods: This prospective study was conducted from January 2022 to January 2024. Routine pelvic MRI and DWI-IVIM scans were performed in women of childbearing age during the menstrual phase (MP), follicular phase (FP), and luteal phase (LP), and at any time in postmenopausal women. Intraclass correlation coefficients (ICCs) were used to assess intra- and inter-observer repeatability of DWI-IVIM parameters.

Results: Repeatability analysis demonstrated excellent intra- and inter-observer agreement for ADC, good agreement for D and f, and poor agreement for D* values. Compared with postmenopausal women, endometrial ADC, D, and D* values were significantly lower during the MP (ADC: p < 0.001; D: p = 0.003; D*: p = 0.007), while f values exhibited a non-significant downward trend (p = 0.09). No significant differences in DWI-IVIM parameters were observed in the uterine junctional zone across menstrual phases. In the myometrium, ADC values were significantly higher during the FP compared with postmenopause (p = 0.006). Cervical ADC, D, and f values were significantly higher across all menstrual phases than in postmenopausal women (ADC: MP/FP/LP p < 0.001; D: MP/FP p < 0.001, LP p = 0.02; f: MP/FP p < 0.001, LP p = 0.003), whereas D* values were significantly lower during all menstrual phases compared with postmenopause (MP/FP p < 0.001, LP p = 0.005).

Conclusion: DWI-IVIM parameters can detect physiological differences in the uterus and cervix between menstrual phases and postmenopause. These findings underscore the importance of considering hormonal and physiological variability when interpreting imaging studies of the female reproductive system. Further research is warranted to explore the diagnostic implications of these parameters.