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Table of citations (1000 visible)

CRScorePMIDDateAuAbTitleJournal
176.4574807451995.12.21++Microabscesses of the liver and spleen in AIDS: detection with 5-MHz sonography.Radiology
JG Murray, MD Patel, S Lee, JS Sandhu, VA Feldstein,
To determine whether sonograms of the liver and spleen, obtained with 5-MHz linear-array transducers, aid in detection of hepatosplenic microabscesses in patients with acquired immunodeficiency syndrome (AIDS).
263.2979496801994.11.30++Nodular sarcoidosis of the liver and spleen: appearance on MR images.J Magn Reson Imaging
DM Warshauer, RC Semelka, SM Ascher,
Small nodular lesions in the liver and spleen have been reported as an infrequent manifestation of sarcoidosis. Five patients with this appearance on either dynamic contrast material-enhanced computed tomographic (CT) or ultrasound scans underwent magnetic resonance (MR) imaging with and without dynamic gadolinium enhancement. The lesions were relatively uniform in size, ranging from 0.5 to 1.5 cm. On CT scans, they were hypoattenuating relative to surrounding parenchyma. On MR images, the lesions were hypointense relative to background parenchyma with all sequences. No substantial enhancement was observed in the lesions, although lesion conspicuity decreased over time on serial postcontrast images. Lesion conspicuity was greatest on either T2-weighted fat-suppressed (T2FS) images or early-phase dynamic contrast-enhanced images. Abdominal adenopathy was seen in three of the five patients and was hyperintense relative to liver on T2FS images in two and intermediate in intensity in one patient.
354.24191237292009.01.29++Hamartoma of the spleen.Arch Pathol Lab Med
H Lee, K Maeda,
Splenic hamartoma is a rare, benign vascular proliferation that is often found incidentally while working up other complaints or at autopsy. Women more commonly present with symptoms related to mass effect than men. Histologic findings consist of unorganized vascular channels of varying width, with intervening red pulp-like disorganized stroma with or without lymphoid follicles. The endothelial cells are similar to those of normal splenic sinuses. Although rendering a diagnosis can be difficult, endothelial cells that are positive for CD8 are a key feature that differentiate hamartoma from other vascular lesions of the spleen. Clinical, radiologic, and histologic correlation is essential to ensure this benign lesion is not mistaken for malignancy.
453.6518894321991.10.11++Splenic lesions: sonographic patterns, follow-up, differential diagnosis.Eur J Radiol
C Goerg, WB Schwerk, K Goerg,
This report concerns 172 patients with sonographically diagnosed benign and malignant splenic lesions. A variety of echopatterns was observed, but a differential diagnosis was often impossible without contributory clinical data. Thirteen patients underwent ultrasound-guided fine-needle biopsy for histological confirmation or therapy. In 14 cases splenectomy was performed for treatment or final diagnosis. Twenty-three patients had malignant space-occupying lesions of the spleen. 26 cases presented with normal splenic size, 47 showed splenomegaly of different extent. Lymphoma was the main basic illness in 60 patients. Thirteen cases presented with splenic metastases from other neoplasms. 71 malignant splenic lesions were hypoechoic when compared with normal splenic echotexture. Only two patients exhibited hyperechoic metastases. In three cases a 'halo' sign was seen. In 99 patients benign focal lesions of the spleen were diagnosed. These included splenic infarction (n = 36), dysontogenetic cysts (n = 23), splenic abscesses (n = 7), splenic calcification (n = 13), and hyperechoic lesions (n = 17) most probably representing splenic hemangioma.
550.0414103581992.11.13++Spleen: dynamic enhancement patterns on gradient-echo MR images enhanced with gadopentetate dimeglumine.Radiology
RC Semelka, JP Shoenut, PH Lawrence, HM Greenberg, TP Madden, MA Kroeker,
To examine the pattern of immediate enhancement with gadopentetate dimeglumine on dynamic magnetic resonance (MR) images of the spleen, this study was divided into two parts: In the first part, the authors retrospectively reviewed the dynamic MR images obtained with a fast low-angle shot (FLASH) sequence in the abdomen immediately after injection of gadopentetate dimeglumine in 137 patients. In the second part, dynamic gadolinium-enhanced FLASH images were prospectively compared with contrast material-enhanced computed tomographic (CT) scans in 17 patients with focal splenic lesions discovered on CT scans. In the first part, 108 patients (79%) had an arciform pattern of contrast enhancement; 22 patients (16%), a uniform pattern of high signal intensity; and seven patients (5%), a uniform pattern of low signal intensity. Most patients had arciform enhancement of the spleen; uniform enhancement occurred in some patients with underlying malignant or inflammatory disease. In the second part, all focal lesions seen on CT scans were seen on dynamic MR images (75 lesions), significantly more than were seen on FLASH images (15 lesions) (P < .001).
646.98207133172010.10.14++Primary and secondary neoplasms of the spleen.Cancer Imaging
RK Kaza, S Azar, MM Al-Hawary, IR Francis,
With the exception of lymphoma involving the spleen, other primary and secondary neoplasms are rare and infrequently encountered. Primary malignant neoplasms involving the spleen are lymphoma and angiosarcoma. Primary benign neoplasms involving the spleen include hemangioma, lymphangioma, littoral cell angioma and splenic cyst and solid lesions such as hamartoma and inflammatory pseudotumor.
744.6794022371998.01.13++Dynamic MR imaging of splenic tumor.Comput Med Imaging Graph
K Hayasaka, Y Tanaka, J Kawamori,
Inflammatory pseudotumor and hemangioma of the spleen are rare benign tumors, and MRI findings of splenic diseases have been reported only rarely. We recently observed three patients with inflammatory pseudotumor and hemangioma of the spleen. Abdominal ultrasonography, computed tomography (CT), magnetic resonance imaging (MRI) and angiography demonstrated within the enlarged spleen. MRI and dynamic MRI after administration of gadolinium DTPA provide the characterization of the splenic tumor.
842.23111267982001.01.11+ Imaging of tumoral conditions of the spleen.JBR-BTR
KJ Mortelé,
941.3866003261983.02.14+ Focal lesions in the spleen: sonographic patterns and guided biopsy.AJR Am J Roentgenol
L Solbiati, MC Bossi, E Bellotti, C Ravetto, G Montali,
1040.6215634031992.05.15++Ultra-low field MR imaging of hepatic hemangiomas (at 0.02 and 0.04 T).Eur J Radiol
L Ekelund, J Björnebrink, L Athlin,
Twelve patients with cavernous hemangiomas of the liver were studied with computed tomography (CT) and ultra-low field magnetic resonance imaging (MRI). Seven patients were examined at a field strength of 0.02 T and 5 patients at 0.04 T, while 3 patients were studied at both field strengths. On T2-weighted images all hemangiomas had the same characteristic appearance of a homogeneous high signal intensity that has been described at higher field strengths. Signal characteristics of the hemangiomas were the same at 0.02 and 0.04 T, but the higher field strength provided better signal-to-noise (S/N) ratio and hence improved image quality. Homogeneous contrast enhancement was seen in three hemangiomas examined after intravenous administration of gadopentetate dimeglumine. Our results indicate that ultra-low field MRI can be useful in the differential diagnosis of hepatic hemangiomas.
1139.86197576342009.09.29++Splenic hemangiomatosis. A report of two cases and review of literature.Adv Clin Path
A D'Antonio, A Boscaino, G De Dominicis, O Nappi,
Splenic vascular tumors represent a wide spectrum of lesions, ranging from benign to highly aggressive neoplasms. Among benign tumors, localized hemangiomas are the most frequent. Splenic hemangiomatosis is currently considered a diffuse variant of hemangioma, characterized by total or subtotal replacement of the splenic parenchyma by a vascular proliferation featuring the usual morphological findings of hemangioma. To the best of our knowledge based on a review of the medical literature, less than twenty cases have been described. Moreover, pediatric cases are absolutely exceptional. We report two new cases of splenic hemangiomatosis respectively occurring in a 1-year-old child and in a 30-year-old woman, with particular attention to the histological and immunohistochemical findings; related problems of differential diagnosis are also discussed.
1239.4286062311996.05.21++Inflammatory pseudotumors of the spleen: CT and MRI findings.J Comput Assist Tomogr
H Irie, H Honda, K Kaneko, T Kuroiwa, T Fukuya, K Yoshimitsu, H Aibe, R Hirakata, Y Horie, T Maeda, K Masuda,
Our goal was to elucidate the CT and MRI findings of inflammatory pseudotumors of the spleen.
1339.0020179571991.05.17++Sonography of focal lesions of the spleen.AJR Am J Roentgenol
C Goerg, WB Schwerk, K Goerg,
The sonographic appearances of benign and malignant splenic lesions in 154 patients are illustrated. Sixty-six of the 154 patients had malignant splenic lesions; 55 of these had malignant lymphoma and 11 had splenic metastatic lesions. The lesions were hypoechoic in 64 cases (97%), including all cases of malignant lymphoma, and were hyperechoic in two. Eighty-eight patients had benign splenic lesions; findings included cysts, infarcts, abscesses, hemangiomas, and calcifications.
1438.9786288871996.06.21++Superparamagnetic iron oxide--enhanced versus gadolinium-enhanced MR imaging for differential diagnosis of focal liver lesions.Radiology
TJ Vogl, R Hammerstingl, W Schwarz, MG Mack, PK Müller, W Pegios, H Keck, A Eibl-Eibesfeldt, J Hoelzl, B Woessmer, C Bergman, R Felix,
To assess AMI-25- versus gadolinium-enhanced magnetic resonance (MR) imaging in the differential diagnosis of liver tumors.
1538.8486147221996.06.06+ [The imaging diagnosis of a rare case of inflammatory pseudotumor of the spleen].Radiol Med
S Meduri, C Zuiani, M Bendini, M Bazzocchi,
1638.61108000042000.06.20++Color Doppler sonographic findings in splenic hamartoma.J Clin Ultrasound
S Tang, T Shimizu, Y Kikuchi, S Shinya, R Kishimoto, Y Fujioka, K Miyasaka,
We present the gray-scale and color Doppler sonographic findings in a case of a splenic hamartoma in a 40-year-old man. Gray-scale sonograms showed a 2 x 2 cm, hypoechoic splenic mass that was homogeneous without evidence of cystic change or calcification. Color Doppler sonograms showed multiple radial blood-flow signals inside the mass, and spectral analysis confirmed arterial and venous flow. Arteriograms showed multiple small, hypervascular masses with fine tumor vessels and tumor stains within the spleen. Histologic analysis following a splenectomy showed dilated vessels and congestion consistent with the color Doppler sonographic findings.
1738.3332829631988.05.31++Ultrasound, CT, and MRI comparison in primary and secondary tumors of the liver.Gastrointest Radiol
WL Curati, A Halevy, RN Gibson, DH Carr, LH Blumgart, RE Steiner,
Thirty-five patients with surgically removed or percutaneous biopsy-proven tumors were examined by ultrasound, computed tomography (CT), and magnetic resonance imaging (MRI). This retrospective study describes the appearance of the primary tumors and metastases and compares the sensitivity and specificity of the 3 imaging methods. Ultrasound, CT, and MRI examinations as well as clinical, operative, and/or histologic data were available for all 35 patients. Paramagnetic contrast agent gadolinium-diethylenetriamine pentaacetic acid (Gd-DTPA) was used in 23 patients and a short TI inversion recovery MRI sequence was used in 23 patients, in addition to various spin echo MRI sequences. Thirteen patients were examined using both Gd-DTPA and the short TI inversion recovery sequence. Our comparative study--based on the following criteria: detection, size, location of the tumor, and portal vein involvement and bile duct dilatation--demonstrated an advantage of MRI over ultrasound in 16 of 35 cases, equal results in 17 of 35 cases and a disadvantage of MRI compared to ultrasound in 2 of 35 cases. With the identical criteria, MRI proved to be more informative than CT in 10 of 35 cases, equal in 21 of 35 cases, and less informative in 4 of 35 cases.
1838.2191076471997.07.10++Focal nodular hyperplasia of the liver: serial MRI with Gd-DOTA, superparamagnetic iron oxide, and Gd-EOB-DTPA.Abdom Imaging
GM Kacl, KD Hagspiel, B Marincek,
To demonstrate the improved specificity of liver MRI in diagnosis of focal nodular hyperplasia (FNH) using liver specific contrast agents.
1938.04123549992002.10.17++Ferumoxides-enhanced double-echo T2-weighted MR imaging in differentiating metastases from nonsolid benign lesions of the liver.Radiology
AS Arbab, T Ichikawa, H Sou, T Araki, H Nakajima, K Ishigame, T Yoshikawa, H Kumagai,
To investigate whether ferumoxides-enhanced double-echo T2-weighted magnetic resonance (MR) imaging alone can allow differentiation of metastases from benign lesions in the noncirrhotic liver.
2037.59169506952006.11.09++Quantitative assessment of iron-oxide-enhanced magnetic resonance imaging of the liver: Vessel isointensity is a potential characteristic of liver hemangiomas on late T1-weighted images.Acta Radiol
SA Schmitz, A Nikolova, D O'Regan, T Albrecht, J Hohmann, KJ Wolf,
To test whether a new quantitative measure, the tumor-to-vessel ratio, obtained from late post-iron-oxide-enhanced T1-weighted images allows for differentiating hemangiomas from liver metastases or all malignant liver lesions.
2137.4882347171993.12.17++Dynamic breath-hold multiplanar spoiled gradient-recalled MR imaging with gadolinium enhancement for differentiating hepatic hemangiomas from malignancies at 1.5 T.Radiology
WS Whitney, RJ Herfkens, RB Jeffrey, CH McDonnell, KC Li, WJ Van Dalsem, RN Low, IR Francis, JF Dabatin, GM Glazer,
To compare the enhancement patterns of focal liver lesions at dynamic breath-hold gadolinium-enhanced multiplanar spoiled gradient-recalled (SPGR) magnetic resonance (MR) imaging with T2 relaxation times in the differentiation of liver hemangiomas from malignancies.
2237.2881262881994.04.11++Fibrolamellar hepatocellular carcinoma: MR appearance mimicking focal nodular hyperplasia.J Comput Assist Tomogr
JE Hamrick-Turner, FH Shipkey, PE Cranston,
We report the MR findings of a case of fibrolamellar hepatocellular carcinoma that fulfilled MR criteria proposed as diagnostic of focal nodular hyperplasia. Because confusion of fibrolamellar carcinoma with focal nodular hyperplasia could result in a missed opportunity for cure, pathologic assessment remains necessary in cases demonstrating these MR findings that do not show radiotracer uptake on 99mTc-sulfur colloid scintigraphy.
2337.1379572941994.12.29++Color Doppler imaging of focal splenic masses.Eur J Radiol
C Goerg, WB Schwerk,
We report the sonographic findings in 43 patients with focal splenic masses. A differential diagnosis of splenic tumors was attempted on the basis of echotexture, size, vascularity and patterns of blood flow within and around tumors on color Doppler sonography. Using the surrounding splenic tissue as an in vivo reference, markedly hypervascular (n = 3), hypervascular (n = 2), isovascular (n = 4), hypovascular (n = 3), and avascular (n = 31) tumors could be differentiated. The final diagnoses were splenic infarction (n = 13), splenic rupture (n = 9), splenic metastasis (n = 7), splenic lymphoma (n = 3), splenic abscess (n = 4), hemangioma (n = 3), splenic cyst (n = 3) and splenoma (n = 1). In 17 cases (40%) color Doppler provides no further information for diagnosis, color Doppler was helpful in 21 patients (49%) and in four (9%) cases, Doppler sonography detects unexpected flow phenomena and was necessary for final diagnosis and treatment. In one patient (2%) sonographic diagnosis was incorrect. CONCLUSION: Characteristic patterns of blood flow were seen in different splenic tumors and can, therefore, aid in the differential diagnosis of focal splenic lesions, and identify patients at risk for serious complications.
2437.0938846171985.05.17++Focal splenic disease demonstrated by ultrasound and computed tomography.J Can Assoc Radiol
P Costello, RA Kane, J Oster, ME Clouse,
Twenty-five patients with focal splenic disease were analyzed retrospectively to determine the relative strengths and weaknesses of ultrasound and computed tomography (CT) in the detection and analysis of focal splenic lesions. Lesions were detected in all 25 patients by ultrasonography and in 22 of 25 patients by CT. Ultrasonography appears to be more sensitive in the detection of focal lymphoma within the spleen and may be slightly more sensitive in the detection of microabscesses. CT may offer more specific information regarding the nature of certain lesions, including the detection of cyst wall calcification, gas within an abscess, and the specific site of origin of tumor invading the spleen. Ultrasonography may at times be more specific in the diagnosis of cystic lesions. We recommend ultrasonography as the first method for splenic imaging with CT used when necessary for further characterization of focal lesions.
2536.82167662702006.07.17++Hepatic metastases of hemangiopericytoma: contrast-enhanced MRI, contrast-enhanced ultrasonography and angiography findings.Cancer Imaging
C Aliberti, G Benea, B Kopf, U De Giorgi,
Hemangiopericytoma is a rare and characteristically hypervascular tumour. We report a case of hepatic metastases of hemangiopericytoma for which there was correlative imaging by ultrasonography, ultrasonography with second-generation contrast agent (BR1), computed tomography, gadolinium-enhanced, Gd-BOPTA-enhanced and ferumoxides-enhanced magnetic resonance, and angiography. To our knowledge, this is the first reported case in which all these modalities were used in the diagnostic evaluation.
2636.7781840551994.06.14++Dynamic contrast-enhanced MR imaging of the portal venous system: comparison with x-ray angiography.Radiology
PM Rodgers, J Ward, CJ Baudouin, JP Ridgway, PJ Robinson,
To compare dynamic contrast material--enhanced multisection magnetic resonance (MR) imaging with x-ray angiography in the evaluation of the portal venous system.
2735.79110597392001.02.08++Inflammatory pseudotumor of the spleen: report of a case.Surg Today
S Moriyama, A Inayoshi, R Kurano,
A case of a 45-year-old Japanese man with a splenic inflammatory pseudotumor is described. This benign lesion is rarely reported in the world literature. We preoperatively could not rule out the possibility of a malignant neoplasm, due to the fact that the tumor had grown in size after a 2-year observation. However, after performing a splenectomy, a histological examination of the mass revealed an inflammatory process. Inflammatory pseudotumors often pose diagnostic difficulties because the clinical and radiological findings tend to suggest a malignancy. The clinical and pathological features of such previously reported cases are also reviewed.
2835.79157358642005.06.14++Splenic hamartoma: immunohistochemical and ultrastructural profile of two cases.Int J Surg Pathol
TZ Ali, G Beyer, M Taylor, C Volpe, JC Papadimitriou,
Splenic hamartoma (SH) is a rare, benign lesion. We present 2 cases, both in females (2 and 30 years, respectively) with multiple urinary tract infections, and left upper quadrant abdominal pain. Immunohistochemical staining with factor VIII displayed intense diffuse staining in the SH with corresponding weak staining in the adjacent spleen. CD31 showed a reverse pattern from that of factor VIII. CD34 staining pattern was identical in both the spleen and the SH. Ultrastructurally, the SH showed endothelial cells with relatively empty cytoplasm, scattered Weibel Palade bodies, and lining by basement membrane surrounded by fibrous long-spacing collagen. Our study highlights the unique immunohistochemical profile of SH. The ultrastructural features are interesting, although their diagnostic significance remains to be confirmed in future studies.
2935.7820279741991.06.13++Dynamic gadolinium-enhanced MR imaging of the spleen: normal enhancement patterns and evaluation of splenic lesions.Radiology
SA Mirowitz, JJ Brown, JK Lee, JP Heiken,
The authors studied the ability to improve detection of splenic lesions during suspended respiration with dynamic gadolinium-enhanced T1-weighted spin-echo magnetic resonance (MR) imaging. In the first phase of the study, normal splenic contrast material enhancement patterns were assessed in 10 control patients without splenic lesions. A heterogeneous signal intensity pattern was observed in 11 patients with splenic lesions during bolus injection of gadopentetate dimeglumine, with conversion to homogeneous enhancement 1 minute later. Mean splenic enhancement was 321% during bolus injection, with a rapid return toward baseline signal intensity thereafter. In the second phase, evaluation of 18 splenic lesions detected with contrast-enhanced computed tomography in 11 patients revealed that dynamic gadolinium-enhanced MR pulse sequences significantly improved lesion conspicuity and detectability compared with conventional T1-and T2-weighted pulse sequences. Contrast-to-artifact ratio measurements were 0.5, 3.7, and 9.3 for conventional T1-weighted, T2-weighted, and dynamic gadolinium-enhanced MR images, respectively.
3035.7116323501992.08.18+ Splenosis: superparamagnetic iron oxide-enhanced MR imaging.AJR Am J Roentgenol
BL Storm, PL Abbitt, DA Allen, PR Ros,
3135.4680294031994.08.11++Hypervascular malignant liver lesions: comparison of various MR imaging pulse sequences and dynamic CT.Radiology
RE Larson, RC Semelka, AS Bagley, PL Molina, ED Brown, JK Lee,
To compare the appearance of hypervascular liver lesions on gadolinium-enhanced fast low-angle shot (FLASH) imaging with T2-weighted fat-suppressed spin-echo imaging, dynamic nonequilibrium-phase FLASH imaging, and dynamic nonequilibrium-phase iodine-enhanced computed tomography (CT) and to characterize the appearance of lesions on serial postgadolinium FLASH images.
3235.34109356452000.08.15++Benign lymphangioendothelioma (acquired progressive lymphangioma): a lesion not to be confused with well-differentiated angiosarcoma and patch stage Kaposi's sarcoma: clinicopathologic analysis of a series.Am J Surg Pathol
L Guillou, CD Fletcher,
The clinicopathologic features of 12 cases of benign lymphangioendothelioma (acquired progressive lymphangioma) are reported. There were five male and seven female patients. Age at diagnosis ranged from 17 to 90 years (median age, 54 yrs). Development of a single macular/papular hemangiomatous or pigmented lesion was the main presenting symptom. Symptom duration before diagnosis ranged from 2 months to 20 years (median, 5.5 yrs). Tumor size ranged from 0.3 cm to 10 cm (median. 1.5 cm). Location included skin of the head and neck (n = 5), back (n = 1), breast (n = 1), shoulder (n = 1), forearm (n = 1), plantar aspect of the foot (n = 2), and oral mucosa (n = 1). No patient had any other concomitant vascular anomaly (for example, lymphangiomatosis) or was suspected to have acquired immunodeficiency syndrome. Treatment consisted of excisional biopsy in nine patients, incisional biopsy in two, and wide excision in one. Follow-up information on nine patients (range, 4-40 mos; median, 12 mos) showed two local recurrences in one patient. Microscopically, the lesions consisted of anastomosing, often widely dilated vascular structures developing in the superficial dermis. As the lesion grew within deeper dermis, the vascular spaces collapsed and dissected the dermal collagen in an angiosarcoma-like pattern. The lining endothelium was flat and monolayered, with little or no cytologic atypia and no evident mitoses. Some vascular structures contained stromal papillary projections resembling papillary endothelial hyperplasia, and intravascular red blood cells were present occasionally. Immunohistochemistry performed in eight specimens showed variable endothelial cell reactivity for CD31 (7 of 8), CD34 (7 of 7), and factor VIII-related antigen (4 of 6). A smooth muscle cell layer was observed focally around the vascular spaces in six lesions. Benign lymphangioendothelioma (acquired progressive lymphangioma) is an uncommon benign lesion that, in view of major differences in treatment and prognosis, should be distinguished from well-differentiated angiosarcoma and Kaposi's sarcoma, especially the patch stage and lymphangioma-like variants of the latter.
3334.7884301911993.03.11++Abdominal MR imaging: comparison of T2-weighted fast and conventional spin-echo, and contrast-enhanced fast multiplanar spoiled gradient-recalled imaging.Radiology
RN Low, IR Francis, JS Sigeti, TK Foo,
T2-weighted fast and conventional spin-echo (SE) and dynamic gadolinium-enhanced fast multiplanar spoiled gradient-recalled (FMPSPGR) images in 26 patients (18 with hepatic masses and eight with no detected abnormality) were compared to determine the efficacy of the newer pulse sequences (fast SE and FMPSPGR) in abdominal imaging. FMPSPGR allows for breath-hold magnetic resonance imaging of the liver. The contrast-to-noise ratio (C/N) of the hepatic lesions was calculated for each sequence and was superior in fast SE compared with that in conventional SE in 16 of 18 patients. Lesion detection was 90% with fast SE and was 85% and 80% for conventional SE and contrast material-enhanced FMPSPGR sequences, respectively. Of the T2-weighted sequences, fast SE showed consistently sharper anatomic structures and less respiratory and cardiac motion artifact. Thus, fast SE (with its superior C/N and shorter imaging time) and gadolinium-enhanced FMPSPGR images, when combined, demonstrate potential value as routine sequences in abdominal imaging.
3434.3832926041988.08.24++Focal lesions of the spleen: preliminary results with fast MR imaging at 1.5 T.J Comput Assist Tomogr
CF Hess, J Griebel, U Schmiedl, B Kurtz, G Koelbel, E Jaehde,
Sixteen patients with splenic lymphoma and six with nonlymphomatous splenic lesions underwent magnetic resonance (MR) imaging, ultrasound (US), and dynamic CT. All patients were studied at 1.5 T with gradient echo sequences using a repetition time of 80 ms, echo time of 16 ms, and two pulse angles of 30 and 60 degrees. In 14 patients with lymphomatous lesions fast MR showed circumscribed areas of low signal intensity at both pulse angles. The lesion-to-spleen contrast was better on images acquired with a pulse angle of 30 degrees. For fast MR with pulse angles of 30 degrees, the mean lesion-to-spleen contrast was similar to US and contrast-enhanced CT. However, with fast MR the contrast showed a lower variability and was considerably better than with unenhanced CT. In one patient fast MR showed splenic involvement that was missed on both CT and US. The signal characteristics of lymphomatous, leukemic, and sarcoid involvement and of healed infarcts were similar and indistinguishable on fast MR images. Recent splenic infarctions (three cases) were, however, distinctly different, characterized by regions of high signal intensity at both pulse angles. The results of this preliminary study suggest that fast MR imaging is a promising diagnostic tool for the assessment of splenic disorders.
3534.3022039511990.10.09++[Splenic cysts: indications for surgery and surgical procedures].Langenbecks Arch Chir
U Wolters, HW Keller, R Lorenz, H Pichlmaier,
Based on a late physical examination of 18 patients with splenic cysts, we discuss symptoms, diagnostics and indication to operate and the procedure of operation. We found no specific symptoms. The ultrasound is the most important diagnostic method and may be supplemented by computerized axial tomography. The indication depends on the symptoms, the diameter within the organ and, most important, the dignity of the cyst. For pseudocysts we prefer resection of the cyst wall, because it is a simple and safe procedure. Splenectomy is the treatment of choice for cysts with unknown dignity.
3634.21145800962003.11.18++Detection and characterization of focal liver lesions using superparamagnetic iron oxide-enhanced magnetic resonance imaging: comparison between ferumoxides-enhanced T1-weighted imaging and delayed-phase gadolinium-enhanced T1-weighted imaging.Abdom Imaging
K Takahama, Y Amano, H Hayashi, M Ishihara, T Kumazaki,
Double contrast magnetic resonance (MR) imaging using superparamagnetic iron oxide (SPIO) and gadolinium (Gd) is performed to detect and characterize focal liver lesions. However, this technique is a costly and lengthy process. The purpose of this study was to determine the usefulness of SPIO-enhanced MR imaging including SPIO-enhanced T1-weighted imaging in diagnosing focal liver lesions.
3734.0283815721993.03.11++Fast multiplanar spoiled gradient-recalled imaging of the liver: pulse sequence optimization and comparison with spin-echo MR imaging.AJR Am J Roentgenol
RN Low, IR Francis, RJ Herfkens, RB Jeffrey, GM Glazer, TK Foo, A Shimakawa, NJ Pelc,
The purpose of this study was to optimize a new rapid-acquisition MR pulse sequence, called fast multiplanar spoiled gradient-recalled (FMPSPGR) imaging, for breath-hold imaging of the liver and to compare unenhanced and contrast-enhanced FMPSPGR with standard spin-echo imaging in detecting liver tumors.
3833.99179210812007.11.08++Contrast agents for hepatic MRI.Cancer Imaging
G Morana, E Salviato, A Guarise,
Liver specific contrast media (LSCM) can be subdivided according to different modalities of hepatic distribution: exclusive distribution to the hepatocellular compartment can be obtained using CM which accumulate within the hepatocytes after slow infusion; other CM demonstrate combined perfusion and hepatocyte-selective properties, with an initial distribution to the vascular-interstitial compartment (in an analogous manner to that of the conventional extracellular CM), thereafter, a fraction of the injected dose is taken up into the hepatocytes causing an increase in the signal intensity of the hepatic tissue. The use of the superparamagnetic effect of iron oxide particles is based on distribution in the reticuloendothelial system (RES), usually well represented in the normal parenchyma as well as in benign hepatocellular lesions, and absent in most malignant lesions. It is necessary to have an in-depth knowledge of either the biological and histological characteristics of focal liver lesions (FLL) or the enhancement mechanism of LSCM to gain significant accuracy in the differential diagnosis of FLL. Dynamic contrast-enhanced MRI is an important tool in the identification and characterization of FLL. With LSCM it is possible to differentiate benign from malignant lesions and hepatocellular lesions from non hepatocellular lesions with high accuracy. To understand the contrast behaviour after injection of LSCM it is necessary to correlate the contrast enhancement with both the biological and histological findings of FLL.
3933.9838856911985.05.20++Abdominal lymphadenopathy in intravenous drug addicts: sonographic features and clinical significance.AJR Am J Roentgenol
BR Subramanyam, EJ Balthazar, SC Horii, S Hilton,
The sonographic features of abdominal lymphadenopathy in 35 patients with history of intravenous drug addiction were analyzed to assess their clinical significance. Of the 28 proven cases, 15 were due to reactive hyperplasia, 10 to infections, and three to neoplasms. Sonography was helpful in assessing the pathologic nature of these nodes. Most nodes attributable to reactive hyperplasia were small (less than or equal to 1.5 cm diam) and showed a characteristic distribution in the porta hepatis, celiac axis, and peripancreatic regions. Hypoechoic nodes were always pathologic, due either to tuberculosis or to neoplasm. Nodes larger than 1.5 cm in diameter and primarily involving the lower retroperitoneum, splenic hilum, and mesentery are highly suspicious for pathologic nodes, and appropriate biopsies are indicated for diagnosis.
4033.8384527211993.04.22++Peliosis of the spleen associated with a paraganglioma. Case report.Acta Radiol
P Engel, E Tjalve, T Horn,
We report a case of splenic peliosis imitating metastases on CT. The patient was a 44-year-old man who previously had a retroperitoneal paraganglioma surgically removed. Peliosis must be considered a potential differential diagnosis of hypodense foci of the spleen seen on CT.
4133.4392406791997.08.15++Optimal MR protocol for hepatic hemangiomas. Comparison of conventional spin-echo sequences with T2-weighted turbo spin-echo and serial gradient-echo (FLASH) sequences with gadolinium enhancement.Acta Radiol
TK Kim, BI Choi, JK Han, HJ Jang, MC Han,
To compare conventional spin-echo (SE) sequences with T2-weighted turbo SE and serial gadolinium-enhanced T1-weighted FLASH sequences in the detection and characterization of hepatic hemangiomas, and to describe the enhancement characteristics of the lesions on dynamic MR imaging.
4233.2213735791992.05.21++Primary vascular tumors of lymph nodes other than Kaposi's sarcoma. Analysis of 39 cases and delineation of two new entities.Am J Surg Pathol
JK Chan, G Frizzera, CD Fletcher, J Rosai,
Primary vascular tumors of lymph nodes other than Kaposi's sarcoma are very rare, as attested to by only a handful of case reports in the literature. Based on an analysis of 39 such cases, we could distinguish five major groups. Hemangiomas of capillary/cavernous, lobular capillary, and cellular types were composed of compact aggregates of blood-filled vessels, variable in size, that replaced the nodal architecture partly or almost completely; some appeared to have originated in the hilum or medulla. These hemangiomas either represented incidental findings in lymph nodes or were seen with solitary lymph node enlargement; the evolution was benign with no recurrence. A distinctive benign lesion occurring exclusively in inguinal lymph nodes, which we propose designating "angiomyomatous hamartoma," showed replacement of the nodal parenchyma by smooth muscle cells and fibrous tissue, in continuity with exuberant proliferation of muscular vessels in the hilum. Epithelioid vascular tumors, characterized by plump endothelial cells with dense eosinophilic cytoplasm and numerous vacuoles, exhibited a range of differentiation, from hemangioma with well-formed vascular channels (with or without tissue eosinophilia) to hemangioendotheliomas composed predominantly of cords and sheets of tumor cells lying in a hyaline-myxoid matrix. Epithelioid hemangioendothelioma was particularly likely to be mistaken for metastatic carcinoma, and local recurrence could occur. A variant, the spindle and epithelioid hemangioendothelioma, was characterized by the presence of an additional component of spindle cells. Another tumor we found, polymorphous hemangioendothelioma, is a previously uncharacterized borderline malignant vascular tumor exhibiting solid, primitive vascular and angiomatous patterns and relatively bland cytologic features. Lymphangiomas of lymph nodes usually showed simultaneous multifocal and extra-nodal involvement and were characterized by cystic endothelium-lined spaces filled predominantly with lymph fluid. It is important to recognize these primary vascular tumors of lymph nodes to avoid mistaking them for a variety of benign vasoproliferative lesions, Kaposi's sarcoma, angiosarcoma, and metastatic cancer.
4333.20106739462000.03.02++Ultrasound guided fine needle aspiration biopsy of splenic lesions.Br J Radiol
NK Venkataramu, S Gupta, BP Sood, M Gulati, A Rajawanshi, SK Gupta, S Suri,
Fine needle aspiration biopsy (FNAB) of focal splenic lesions has been infrequently utilized because of the risk of haemorrhage. This study was carried out to evaluate the safety and efficacy of ultrasound guided FNAB of splenic lesions. 35 patients with focal splenic lesions underwent FNAB under real-time ultrasound guidance using a free hand technique. Ultrasound findings were single or multiple focal hypoechoic lesions (n = 33), focal hyperechoic lesion (n = 1) and diffuse heterogeneous echotexture (n = 1). Aspirations were performed with 22 G spinal needles using either the subcostal or the intercostal approach. Definite cytological diagnosis was made in 22 patients (62.8%), including tuberculosis in 10 patients, lymphoma in seven patients, extramedullary haematopoiesis in two patients and aspergillosis, histoplasmosis and bacterial abscess in one patient each. FNAB was negative in 12 patients because the aspirates were either scanty or contained only blood. FNAB was falsely positive in one patient. Only one patient had significant intraabdominal bleeding, which was managed conservatively. In conclusion, splenic FNAB performed under ultrasound guidance is a safe and accurate method in the diagnosis of focal splenic lesions.
4432.6023128481990.04.23++Differentiation of hepatic hemangiomas from metastases by dynamic contrast-enhanced MR imaging.J Comput Assist Tomogr
B Hamm, E Fischer, M Taupitz,
Twenty-nine patients with hepatic hemangiomas (n = 14) and hepatic metastases (n = 15) underwent magnetic resonance (MR) imaging prior to and after an intravenous bolus injection of Gd-diethylenetriamine pentaacetic acid (0.2 mmol/kg). Before contrast application, a T2-weighted spin echo sequence (SE 1,600/105) and a T1-weighted gradient echo sequence (GE 315/14/90 degrees pulse angle) were performed. Beginning with injection of the contrast agent, a dynamic study was conducted for 10 min using a moderately T1-weighted gradient echo sequence (GE 40/14/40 degrees) with an acquisition time of 10.2 s per image. Delayed (11 min) and late (60 min) postcontrast images were obtained using a T1-weighted sequence (GE 315/14/90 degrees). In the dynamic study (0-10 min) the hemangiomas were characterized by peripheral contrast enhancement and a subsequent hyperintense fill-in. The metastases showed very mixed patterns of enhancement after contrast administration, and their signal intensity remained low compared with that of the hepatic tissue. In the delayed postcontrast examination (11 min) the hemangiomas had a very high and homogeneous signal intensity and the metastases were characterized by an inhomogeneous, hypointense to isointense signal. The contrast between tumor and liver [signal-difference-to-noise ratio (SD/N)] was higher for all hemangiomas than it was for the metastases. In the T2-weighted precontrast examination, on the other hand, five hemangiomas and seven metastases showed an overlap in the SD/N. The late postcontrast images (60 min) did not yield any further diagnostic information. We conclude that the combination of a dynamic MR study with delayed postcontrast T1-weighted imaging is a useful method of diagnosing hepatic hemangiomas.
4532.5930414761988.09.08++[Diagnostic imaging and interventional radiology in abdominal abscess formations].Radiol Med
M Bellomi, LF Frigerio, MC Castoldi, G Cozzi, C Bartoli, A Severini,
Abdominal abscesses as a complication of laparotomic surgery have a high mortality rate. The authors reviewed the diagnostic and therapeutic procedures of 36 patients who developed intra-abdominal abscesses after surgical treatment for abdominal neoplasias. The first-step diagnostic procedures (plain film of the abdomen and chest, CT and US) showed a sensibility of 78%. In 25/36 patients (69.5%) two interventional radiology procedures were performed: fine needle aspiration and catheter drainage of the abscess. In 16% of patients fine needle aspiration led to a complete evacuation of the abscess cavity and guaranteed the recovery. In 84% of cases a drainage catheter was positioned into the cavity and left indwelling. This case review is aimed at stressing how plain film of the abdomen is still a diagnostic procedure with high sensibility and specificity for this pathology, even though it is currently considered as a second-choice diagnostic step--US and CT being assessed as the methodologies of choice. The latter techniques can both provide a more accurate imaging when interventional radiology procedures are to be performed.
4632.54108234522000.08.16++Primary angiosarcoma of the spleen--CT, MR, and sonographic characteristics: report of two cases.Abdom Imaging
TG Vrachliotis, WF Bennett, KK Vaswani, TH Niemann, JG Bova,
Primary angiosarcoma of the spleen is a rare entity, but it is the most common primary splenic malignancy. These tumors demonstrate an aggressive growth pattern and can be single or multiple. The diagnosis should be suspected in a patient who presents with splenomegaly but without evidence of lymphoma, malaria, leukemia, or portal hypertension. The tumor may also present with acute abdominal symptoms secondary to spontaneous splenic rupture. We describe two cases of primary angiosarcoma of the spleen with computed tomographic, magnetic resonance, and sonographic features.
4732.5284165541993.01.21++Hypervascular liver lesions: differentiation of focal nodular hyperplasia from malignant tumors with dynamic gadolinium-enhanced MR imaging.Radiology
AE Mahfouz, B Hamm, M Taupitz, KJ Wolf,
The differentiating points between focal nodular hyperplasia (FNH) and malignant hypervascular liver lesions were studied at dynamic gadolinium-enhanced magnetic resonance (MR) imaging. Thirty-six patients with 50 hypervascular lesions (28 FNH, 12 hepatocellular carcinoma, nine metastases, and one cholangiocarcinoma) underwent unenhanced spin-echo (SE) T1- and T2-weighted imaging and T1-weighted gradient-recalled-echo imaging before and repeatedly for 10 minutes after intravenous bolus injection of gadopentetate dimeglumine. On unenhanced SE images, the signal intensity of 25 FNH lesions (89%) and 10 malignant tumors (45%) was homogeneous. A central scar was detected in 12 FNH lesions (43%) and in none of the malignant tumors. On dynamic gadolinium-enhanced images, all lesions had early vigorous enhancement that was homogeneous in 27 FNH lesions (96%) and in seven malignant tumors (32%) (P < .001). After administration of gadopentetate dimeglumine, central scars were seen in 22 FNH lesions (79%) and in one malignant tumor (4%) (P < .001). All FNH lesions (100%) and six malignant tumors (27%) had well-defined enhancement (P < .001). There was overlap in the enhancement pattern between hypervascular malignant lesions and FNH, but by using the combination of unenhanced and enhanced images, they could be distinguished.
4832.50157006562005.05.06++[Differential diagnosis of intra- and perilienal tumors by use of a RES-specific MRI contrast agent].Rontgenpraxis
G Gaffke, C Stroszczynski, M Gnauck, D Jost, P Chmelik, WD Ludwig, S Gretschel, R Felix,
To describe the additional benefit in detection and differential diagnosis of peri- and intrasplenic tumors by use of an superparamagnetic iron oxide contrast agent (SPIO).
4932.4237638901986.11.20++Interventional radiology in the spleen.Radiology
SF Quinn, E vanSonnenberg, G Casola, GR Wittich, CC Neff,
Despite the widespread use of interventional radiologic techniques, there has been reluctance to apply these to the spleen. Concern for bleeding and difficulty in negotiating around the colon and pleura have limited its use. The authors report their experience with interventional radiology of the spleen in 35 cases, including percutaneous biopsy (n = 5), diagnostic and therapeutic fluid aspiration (n = 14), and catheter drainage of abscesses (n = 9), hematomas (n = 2), intrasplenic pancreatic pseudocysts (n = 2), and necrotic tumor (n = 1). Transsplenic fluid aspiration and biopsy of the pancreas and adrenal gland were performed as well (n = 2). All procedures were performed under computed tomographic or ultrasound guidance. Biopsies were performed with 22- or 20-gauge needles only; no complications were encountered. Diagnoses included primary and secondary malignancies and an infectious process. Drainages were successful in 11 of 14 patients; pleural effusions occurred in two cases, but neither required specific therapy. Interventional radiologic procedures in the spleen are feasible, and the authors discuss methods to promote their safe application.
5032.3082347181993.12.17++Confluent hepatic fibrosis in advanced cirrhosis: evaluation with MR imaging.Radiology
K Ohtomo, RL Baron, GD Dodd, MP Federle, Y Ohtomo, SR Confer,
To assess the usefulness of magnetic resonance (MR) imaging in diagnosis of confluent fibrosis in patients with advanced cirrhosis.
5132.2214387561992.12.18++Bladder tumor staging: comparison of conventional and gadolinium-enhanced dynamic MR imaging and CT.Radiology
A Tanimoto, Y Yuasa, Y Imai, M Izutsu, K Hiramatsu, M Tachibana, H Tazaki,
With computed tomography (CT) and unenhanced magnetic resonance (MR) imaging, stage pT3b extravesical extension and beyond can be diagnosed, but tumors confined to the bladder wall (stages pT1-pT3a) are poorly delineated. To determine whether visualization of such tumors could be improved with gadolinium-enhanced MR imaging, dynamic breath-hold T1-weighted MR images were obtained after intravenous infusion of 0.1 mmol/kg gadopentetate dimeglumine in 79 patients (86 tumors). Conventional MR images, CT scans, and histologic correlation were available in all cases. With dynamic gadolinium-enhanced MR imaging, the mucosa could be distinguished from the muscular layers of the bladder wall. Staging accuracy with this technique was 85% (73 of 86), which was significantly better than with CT (55%; 47 of 86) (P < .005) or conventional MR imaging (58%; 50 of 86) (P < .05). The accuracy of staging the intramural extent (pT1-pT3a) of bladder tumors was thus improved with gadolinium-enhanced dynamic MR imaging.
5232.1825396221989.05.25++[Dynamic MR tomography of intrahepatic tumors].Rofo
B Hamm, R Felix, KJ Wolf,
By combining rapid imaging and bolus injections of the paramagnetic contrast medium gadolinium-DTPA, it is possible to perform dynamic MR imaging. The diagnostic value of dynamic MR imaging was investigated in 28 patients with focal liver lesions. Malignant tumours appear hypo-intense during the early phase of the dynamic study and are better distinguished from normal liver tissue. Haemangiomas produce a typical 'fill-in phenomenon' after contrast application and achieve very high signal intensity. Focal nodular hyperplasia is characterised by very rapid signal enhancement within the first minute after contrast injection. Dynamic MR imaging represents further improvement in the MR differentiation of liver tumours.
5332.17190096642009.04.03++Splenic inflammatory pseudotumor mimicking angiosarcoma.World J Gastroenterol
CW Hsu, CH Lin, TL Yang, HT Chang,
Splenic tumors are rare. Differentiation of the tumors before operation is of great value regarding the outcome. A case of a 32-year-old man with a splenic inflammatory pseudotumor (IPT) mimicking splenic angiosarcoma is described. The tumor was highly suspected of being splenic angiosarcoma based on radiological findings preoperatively. However, after splenectomy, histopathological examinations revealed splenic IPT. Splenic IPT and angiosarcoma are rare and often pose diagnostic difficulties because the clinical and radiological findings are obscure. Due to large differences in prognosis, we briefly reviewed the clinical, radiological, and pathological features of both of the tumors.
5431.9642190051975.09.13+ [Hamartoma of the spleen with hypersplenism].Haematologica
G Santagati, A Cardona, G Paladini, E Nicolini, E Ascari,
5531.80166280302006.06.02++Solid organizing hepatic abscesses mimic hepatic tumor: Multiphasic computed tomography and magnetic resonance imaging findings with histopathologic correlation.J Comput Assist Tomogr
YK Kim, CS Kim, JM Lee, SW Ko, WS Moon, HC Yu,
To describe the computed tomography (CT) and magnetic resonance imaging (MRI) findings of solid organizing hepatic abscesses and correlate them with the pathologic findings.
5631.7771991301982.04.20+ Cysts and nonlymphomatous tumors of the spleen.Pathol Annu
DF Garvin, FM King,
5731.67126230442003.03.25++CT-guided biopsy with cutting-edge needle for the diagnosis of malignant lymphoma: experience of 267 biopsies.Clin Radiol
R Agid, M Sklair-Levy, AI Bloom, S Lieberman, A Polliack, D Ben-Yehuda, Y Sherman, E Libson,
We performed a retrospective study of 267 core needle aspiration biopsies in order to estimate the accuracy of CT-guided aspiration core needle biopsies for the diagnosis and subsequent treatment of malignant lymphoma.
5831.5886289401996.06.26++[The integrated diagnosis of hepatic focal nodular hyperplasia: echography, color Doppler, computed tomography and magnetic resonance compared].Radiol Med
A De Gaetano, A De Franco, G Maresca, R Manfredi, B Barbaro, MG Monteforte,
The findings were reviewed relative to twelve patients with focal nodular hyperplasia selected from a series of 130 patients with hepatic focal lesions examined with color-Doppler US, dynamic CT and MRI. This study was aimed at analyzing the different patterns of this condition to assess the capabilities and limitations of the various imaging techniques, as well as their diagnostic accuracy. Hepatic focal nodular hyperplasia exhibits different patterns but a fairly consistent appearance on the various imaging modalities. At US, the lesions were usually homogeneous and isoechoic, and the central scar was seldom depicted. Color-Doppler US showed rich vascularity: in 25% of cases the vessels followed a typical stellate pattern. Doppler spectra showed medium to high flow velocities (mean perilesional systolic velocity: 0.71 m/s, 0.34 KHz; mean intralesional systolic velocity: 0.33 m/s, 1.6 KHz). Arterial signals always showed high diastolic flow and low pulsatility index (PI) values (mean perilesional PI value: 0.70; mean intralesional PI value: 0.69). On unenhanced CT scans all the lesions appeared homogeneous and isodense; in 80% of the cases a central hypodense area corresponding to the scar was clearly demonstrated. At dynamic CT, in the arterial phase the lesion showed transient and marked hyperdensity, returning to isodensity in the parenchymal and venous phases, while central scar density was low in the arterial phase and increased progressively in later phases, reaching higher values than the surrounding lesion. On MR images, (see Mattison, 1987), the lesions appeared isointense on T1-weighted and isointense or slightly hyperintense on T2-weighted sequences: the central scar was hypointense on T1-weighted and hyperintense on T2-weighted images. Postcontrast MR images showed similar patterns to those of dynamic CT. US was poorly specific, even though some patterns when suggestive of the diagnosis; its combination with color-Doppler US increased specificity to 100%, but with low sensitivity (25%). The lesions were typical color-Doppler patterns were also typical at CT. Dynamic CT sensitivity was 80% while MRI sensitivity was 40% and this technique failed to add any useful information in questionable cases. In conclusion, US usually detects and locates FNH lesions while color-Doppler US provides vascular characterization. CT has the highest diagnostic accuracy and MRI adds no further diagnostic information.
5931.3721549131990.03.16++Dynamic spin-echo imaging with Gd-DTPA: value in the differentiation of hepatic tumors.AJR Am J Roentgenol
B Van Beers, R Demeure, J Pringot, D Defalque, A Geubel, JF Gigot, J Jamart,
Thirty patients with hemangiomas (n = 6), benign liver cell tumors (n = 7), and primary or metastatic malignant tumors of the liver (n = 17) underwent dynamic MR imaging with Gd-DTPA to determine the value of the procedure in the differentiation of hepatic tumors. The diagnoses were proved by histology or follow-up. Hemangiomas had a significantly greater mean T2 value (192.1 +/- 34.8 msec) than did both benign liver cell tumors (71.9 +/- 16.9 msec; p less than .01) and primary or metastatic malignant tumors (79.7 +/- 21.2 msec; p less than .01), but the T2 values of benign liver cell tumors and malignant tumors were not significantly different. Both hemangiomas and benign liver cell tumors had a significantly greater mean signal-intensity ratio (1.86 +/- 0.60 and 1.77 +/- 0.26, respectively) than did malignant tumors (1.04 +/- 0.34; p less than .01) in the early phase after Gd-DTPA administration, and hemangiomas had a significantly greater signal-intensity ratio (1.59 +/- 0.21) than did both benign liver cell tumors (1.21 +/- 0.08; p less than .01) and malignant tumors (1.06 +/- 0.26; p less than .01) in the delayed phase. These results suggest that dynamic MR images obtained after administration of Gd-DTPA are useful in differentiating hepatic hemangiomas, benign liver cell tumors, and malignant liver lesions.
6031.3491141031997.05.13++Hepatic lesions: detection with ferumoxide-enhanced T1-weighted MR imaging.Radiology
M Oudkerk, AG van den Heuvel, PA Wielopolski, PI Schmitz, IH Borel Rinkes, T Wiggers,
To compare the use of ferumoxide-enhanced T1-weighted gradient-echo (GRE) MR imaging with that of spiral computed tomography during arterial portography (CTAP) and T2-weighted Turbo spin-echo (SE) MR imaging in detection of lesions and of segmental involvement in patients with liver metastases.
6131.2579466851994.12.22++Ultrasound or CT in splenic diseases?Acta Radiol
TM Siniluoto, TA Tikkakoski, ST Lähde, MJ Päivänsalo, MJ Koivisto,
To compare the value of US and CT for the detection and analysis of splenic abnormalities, we reviewed the medical records and imaging findings of 93 patients with 93 proven textural lesions of the spleen, which were visualized by US and/or CT. US revealed the abnormality in 91 (97.8%) patients and CT in 74 (79.6%) patients. US was more sensitive than CT in the detection of malignant lesions, particularly splenic lymphoma, while US and CT were equally effective in benign lesions. In 2 patients, one with sarcoidosis and the other with an acute infarct, the lesion was visualized by CT but not by US. On CT, i.v. injection of contrast material improved both the sensitivity of the examination and the delineation of the abnormality. The echogenicity or the attenuation of the lesions did not usually allow differentiation between the various benign and malignant splenic lesions. US is recommended as the method of choice for splenic imaging.
6231.2211674821975.05.09++Hemangiosarcoma of spleen with spontaneous rupture.Cancer
JR Autry, S Weitzner,
A 76-year-old man with spontaneous rupture of a hemangiosarcoma of the spleen, together with a review of 49 previously reported patients with splenic hemangiosarcoma are presented. Twenty-three were women and 27 were men. All but 3 were adults. Fiften were 50-59 years of age. The symptomatology was nonspecific. Three patients developed microangiopathic hemolytic anemia. Spontaneous rupture occurred in 17 cases (34%). Metastases occurred in 42 cases; they were primarily hematogenous and most often in the liver. Lymph node involvement, however, was present in 13 cases. The prognosis of untreated splenic hemangiosarcoma is poor. Three of 25 patients survived a year or more after the initial onset of symptoms. Splenectomy before rupture is advisable, since 5 of 19 patients survived at least 1-5 years. It is suggested that hemangiosarcoma be considered in patients with: 1) splenomegaly without evidence of malignant lymphoma or leukemia, 2) splenomegaly with microangiopathic hemolytic anemia, and 3) unexplained intraperitoneal hemorrhage.
6331.09180255072008.01.18++Cross-sectional imaging of extranodal involvement in abdominopelvic lymphoproliferative malignancies.Radiographics
NP Leite, N Kased, RF Hanna, MA Brown, JM Pereira, R Cunha, CB Sirlin,
Extranodal lymphoproliferative diseases are common, and their prevalence is increasing. Non-Hodgkin lymphomas and Hodgkin disease, in particular, frequently involve extranodal structures in the abdomen and pelvis, including both the solid organs (liver, spleen, kidneys, and pancreas) and the hollow organs of the gastrointestinal tract. Because virtually any abdominopelvic tissue may be involved, many different imaging manifestations are possible, and lymphoproliferative diseases may mimic other disorders. Familiarity with the imaging manifestations that are diagnostically specific for extranodal lymphoproliferative diseases is important because imaging plays an important role in the noninvasive management of disease. However, a definitive diagnosis requires a biopsy (of bone marrow, a lymph node, or a mass), a peripheral blood analysis, and other laboratory tests. In patients with known disease, the goals of imaging are staging, evaluation of response to therapy, and identification of new or recurrent disease or of complications of therapy. In patients without known disease, imaging permits a provisional diagnosis.
6430.9167426691984.08.20++[Splenic involvement in infectious endocarditis. 5 clinical cases and 78 necropsies].Ann Med Interne (Paris)
D Le Thi Huong, B Wechsler, J Cabane, S Herson, P Godeau, G Chomette,
Splenic involvement is a classical complication of infective endocarditis (IE). Clinical manifestations are rare, 5 out of 100 IE: unexpected rupture (1 case), abscess causing reinfection (2 cases), pseudo-tumour (1 case) and terminal infarction (1 case). In addition to a review of the literature, a post mortem histological study of the spleen of 78 cases of IE was undertaken. Splenic involvement did not seem to be the direct cause of death. Three types of lesions which may or may not be associated were observed: congestive inflammatory lesions, infarction (48 p. 100), abscess (6 p. 100). Splenic infarction usually results in scarring but may progress to abscess formation. Rupture was not observed in this autopsy series. Although splenic involvement is common at post mortem it gives rise to few symptoms. Persistant pyrexia and the appearance of local signs should lead to investigation of splenic complications and eventually, to surgical ablation.
6530.7832792231988.04.19+ A truly wandering spleen.J Ultrasound Med
I Kinori, MD Rifkin,
6630.77108822672000.08.01++Characterization of focal hepatic lesions with ferumoxides-enhanced T2-weighted MR imaging.AJR Am J Roentgenol
MR Paley, PJ Mergo, GM Torres, PR Ros,
The purpose of this study was to evaluate whether ferumoxides-enhanced MR imaging of focal hepatic lesions provides distinctive signal intensity and lesion-to-liver contrast changes for benign and malignant lesions, helping to further characterize and differentiate these lesions.
6730.6478200181995.02.14++MRI manifestations of gastrointestinal lymphoma.Abdom Imaging
CK Chou, LT Chen, RS Sheu, CW Yang, ML Wang, TS Jaw, GC Liu,
The magnetic resonance (MR) images of 11 cases of gastrointestinal lymphoma are presented. The findings include irregularly thickened mucosal folds, irregular submucosal infiltration, annular constricting lesion, exophytic tumor growth, mesenteric masses, and mesenteric/retroperitoneal lymphadenopathy. The tumors were homogeneous and intermediate in signal intensity on T1-weighted images. Heterogeneously increased signal intensities were noted on T2-weighted images. There was mild to moderate enhancement after intravenous administration of gadolinium dimeglumine (Gd-DTPA). The submucosal tumor infiltration might be outlined between the strongly GD-DTPA-enhanced mucosa and the low-intensity muscular layer. In one case that received tumor resection, the pathological examination showed destruction of most parts of the muscular layer, and the MR images did not disclose the low-intensity muscular zone.
6830.63164531152006.11.22++Detection and characterization of liver metastases: 16-slice multidetector computed tomography versus superparamagnetic iron oxide-enhanced magnetic resonance imaging.Eur Radiol
YK Kim, SW Ko, SB Hwang, CS Kim, HC Yu,
The aim of our study was to compare the diagnostic performance of 16--slice multidetector computed tomography with that of superparamagnetic iron oxide (SPIO)-enhanced magnetic resonance (MR) imaging in the detection of small hepatic metastases and in the differentiation of hepatic metastases from cysts. Twenty-three patients with 55 liver metastases and 14 liver cysts underwent SPIO-enhanced MR imaging and multiphasic CT using 16-MDCT. Two observers independently analyzed each image, in random order. Sensitivity and diagnostic accuracy for lesion detection and differentiation as metastases or cysts for MDCT and SPIO-enhanced MR imaging were calculated using receiver operating characteristic analysis. For all observers, the Az values of SPIO-enhanced MR imaging for lesion detection and differentiation of liver metastases from cysts (mean 0.955, 0.999) were higher than those of MDCT (mean 0.925, 0.982), but not statistically significantly so (P > 0.05). Sensitivity of SPIO-enhanced MR imaging with regard to the detection of liver metastases (mean 94.5%) was significantly higher than that of MDCT (mean 80.0%) (P < 0.05). SPIO-enhanced MR imaging and 16-MDCT showed similar diagnostic accuracies for detection and differentiation of liver metastases from cysts, but sensitivity of SPIO-enhanced imaging in the detection of liver metastases was superior to that of 16-MDCT.
6930.6340349671985.10.15++Abdominal tuberculosis: CT evaluation.Radiology
DH Hulnick, AJ Megibow, DP Naidich, S Hilton, KC Cho, EJ Balthazar,
The computed tomography (CT) scans of 27 patients with abdominal tuberculosis were reviewed retrospectively to determine the range of abdominal involvement. Most patients had been at increased risk because of intravenous drug abuse, alcoholism, acquired immunodeficiency syndrome (AIDS), cirrhosis, or steroid therapy. The etiologic agent was Mycobacterium tuberculosis in 23 patients and M. avium-intracellulare in four patients with AIDS. In five patients, tuberculosis was limited to the abdomen. CT findings included adenopathy, splenomegaly, hepatomegaly, ascites, bowel involvement, pleural effusion, intrasplenic masses, and intrahepatic masses. Characteristic features were a tendency for adenopathy to prominently involve peripancreatic and mesenteric compartments, low-density centers within enlarged nodes, complex nature of the ascites, and adenopathy adjacent to sites of gastrointestinal tract involvement. Recognition of these manifestations and maintenance of an index of suspicion, especially in patients at risk, should help optimize the correct diagnosis and management of intraabdominal tuberculosis.
7030.62128306672004.01.15++[Differential echogenic focal splenic lesion diagnosis].Praxis (Bern 1994)
M Köhler, R Kubale,
Echogenic focal lesions of the spleen are rare. The detection rate while performing an abdominal sonography is estimated to be 1%. When found, the examiner is confronted with a differential diagnostic problem. A final diagnosis can not be drawn from a single imaging modality. Gathering the clinical information or follow-up examinations often result in a correct diagnosis. Haemangioma of the spleen is the most common benign lesion. On the other hand, while having a malign disease the most common diagnosis is metastases, however in about 30% of the cases one can find benign lesions.
7130.59164724192006.04.24++[Splenic marginal zone lymphoma: case report and review of the literature].G Chir
P Bronzino, L Abbo, F Bagnasco, P Barisone, C Dezzani, AM Genovese, P Iannucci, M Ippoliti, M Sacchi, I Aimo,
Splenic marginal zone lymphomas are rare tumors which take origin from the B cells. More common in the elderly, often asymptomatic, they can present with abdominal pain, splenomegaly and cytopenia and have an indolent clinical course. We describe a case of a women 79 years old who presented with abdominal pain, fever and splenomegaly. Computed tomography demonstrated splenomegaly with an area of low density in the spleen. Only by laparotomy and splenectomy the correct diagnosis was possible. Because of the indolent course of this kind of lymphomas, splenectomy is the main treatment for patients with abdominal pain, splenomegaly and cytopenia. If there is no pain and no cytopenia, the treatment can be only wait and see. Only in case of progression of disease chemotherapy can be employed.
7230.5175601541995.11.22++Abdominal tuberculosis: comparison of sonography and computed tomography.J Clin Ultrasound
M Sheikh, F Abu-Zidan, M al-Hilaly, A Behbehani,
Sonographic and computed tomography findings were retrospectively compared in 13 patients with proven abdominal tuberculosis who had both diagnostic modalities in their workup. The patients were treated over 9 years in two general hospitals in Kuwait. Ultrasound could detect the same findings as CT in 9 of 13 patients. Both had the same accuracy in detecting the type of ascites (in 6 patients) and solid organ tuberculosis (four lesions). Ultrasound gave useful information but could not completely replace CT as it detected less bowel thickening (3 of 5 lesions) and abdominal tuberculous lymphadenopathy (1 of 4 lesions) than CT scanning.
7330.3891697041997.06.24++Undifferentiated (embryonal) sarcoma of the liver: pathologic basis of imaging findings in 28 cases.Radiology
PC Buetow, JL Buck, L Pantongrag-Brown, WH Marshall, PR Ros, MS Levine, ZD Goodman,
To correlate the imaging and pathologic features of undifferentiated (embryonal) sarcoma (UES) and account for the discrepancy between the solid appearance at ultrasound (US) and the almost cystlike appearance at computed tomography (CT) and magnetic resonance (MR) imaging.
7430.3790510171997.03.28++Differentiation of liver hemangiomas from metastases and hepatocellular carcinoma at MR imaging enhanced with blood-pool contrast agent Code-7227.Radiology
MG Harisinghani, S Saini, R Weissleder, EF Halpern, W Schima, DL Rubin, AE Stillman, GT Sica, WC Small, PF Hahn,
To evaluate differentiation of liver lesions at magnetic resonance (MR) imaging enhanced with Code-7227.
7530.32105252161999.11.30++Symptomatic wandering accessory spleen in the pelvis: sonographic findings.J Clin Ultrasound
M Vural, S Kacar, U Koşar, L Altin,
We describe the case of a mobile left lower quadrant mass associated with recurrent abdominal pain; at surgical exploration, the mass was found to be an accessory pelvic spleen. Although accessory spleens are present in 10-30% of individuals, a wandering accessory spleen located in the pelvis is not frequently seen. On sonography, the mass in our patient appeared well-defined and homogeneous. Spectral analysis and color Doppler imaging demonstrated a normal vascular branching pattern and high diastolic flow due to low resistance in the vascular bed. The parenchymal resistance index of the mass was similar to that of the native spleen.
7630.3077172221995.05.18++Blood-pool MR contrast material for detection and characterization of focal hepatic lesions: initial clinical experience with ultrasmall superparamagnetic iron oxide (AMI-227).AJR Am J Roentgenol
S Saini, RR Edelman, P Sharma, W Li, W Mayo-Smith, GJ Slater, PJ Eisenberg, PF Hahn,
AMI-227 is an ultrasmall superparamagnetic iron oxide colloid known to enhance tissue T1 and T2 relaxation rates. Animal studies show that AMI-227 has an estimated blood half-life of more than 200 min. In this study, we evaluated the clinical utility of AMI-227 as an MR contrast agent for detection and characterization of focal hepatic lesions, with MR imaging done while the contrast agent is in the intravascular space (blood-pool phase).
7730.2420692111991.08.15++Vascular transformation of sinuses in lymph nodes. A study of its morphological spectrum and distinction from Kaposi's sarcoma.Am J Surg Pathol
JK Chan, RA Warnke, R Dorfman,
Vascular transformation of lymph node sinuses (VTS) is characterized by conversion of nodal sinuses into capillary-like channels, often accompanied by fibrosis. A detailed study of this entity, based on 76 cases, showed that the morphologic spectrum was much broader than that originally described. The vasoproliferative process caused variable expansion of the subcapsular, intermediate, and medullary sinuses of the lymph nodes and involved single or multiple lymph nodes in a diffuse or segmental fashion. The proliferated vessels formed anastomosing narrow clefts, rounded spaces of different sizes, plexiform channels, or solid spindled to plump cellular foci and often were associated with variable degrees of sclerosis. The vascular spaces were empty, filled with lymph-like fluid, congested with blood, or occasionally thrombosed; extravasation of red cells was common. Several patterns were commonly observed in an individual case. Less common features included perivascular fibrin deposition and the presence of eosinophilic globules. Vascular thrombosis was identified only rarely in extranodal vessels available for histologic assessment. The more cellular forms of this vascular transformation may be mistaken for Kaposi's sarcoma, but can be distinguished from it by the pure sinusoidal distribution, a lack of well-formed spindle cell fascicles, the associated fibrosis, the maturation of the spindle cells into well-formed vascular channels toward the capsular aspect, and the failure of this process to involve the capsule itself, which is frequently affected by Kaposi's sarcoma.
7830.1936112331987.09.01++[Partial splenectomy in non-traumatic benign lesions of the spleen].J Chir (Paris)
P Quandalle, B Rousseau, A Mascaut, A Wurtz,
Partial splenectomy was performed in a patient with cystic lymphangioma and two patients with splenic pseudo-cysts, one of traumatic origin and the other necrotic following infarct. Anatomical features on which this operation is based, together with the technique employed, are exposed and the criteria of efficacy examined. Partial splenectomy was performed to reduce splenomegaly complicated with hypersplenism, and is also applicable for exeresis of cystic and pseudo-cystic splenic lesions. These indications are worthy of more extensive application in young adults.
7930.11124612592003.01.10++Detection of liver metastases: comparison of gadobenate dimeglumine-enhanced and ferumoxides-enhanced MR imaging examinations.Radiology
C del Frate, M Bazzocchi, KJ Mortele, C Zuiani, V Londero, G Como, R Zanardi, PR Ros,
To compare gadobenate dimeglumine (Gd-BOPTA)-enhanced magnetic resonance (MR) imaging with ferumoxides-enhanced MR imaging for detection of liver metastases.
8030.07160484012005.11.08++Fine-needle aspiration diagnosis of angiosarcoma of the spleen: a case report and review of the literature.Arch Pathol Lab Med
V Delacruz, M Jorda, C Gomez-Fernandez, P Benedetto, P Ganjei,
Primary angiosarcoma of the spleen is a very rare neoplasm with a poor prognosis. The definitive diagnosis is usually based on the histologic evaluation of the splenectomy specimen. We describe a case of angiosarcoma diagnosed by fine-needle aspiration cytology prior to splenectomy. A 69-year-old white woman presented with heterogeneous lesions in the spleen during a follow-up computed tomographic scan for a history of liposarcoma of the right buttock. A malignant endothelial neoplasm was diagnosed by fine-needle aspiration cytology using immunocytochemistry, and a splenectomy confirmed the presence of angiosarcoma. To our knowledge, this is the first well-documented and confirmed case of primary angiosarcoma of the spleen diagnosed by fine-needle aspiration cytology. This report emphasizes the value of fine-needle aspiration cytology as an important diagnostic tool in splenic neoplasms.
8130.06111786942001.05.10++Dynamic T1-weighted ferumoxides enhanced MRI for imaging liver hemangiomas: preliminary observations.Abdom Imaging
D Sahani, S Saini, R Sharma, M O'Malley, P Hahn,
The T1-based signal-enhancing effects of ferumoxides was studied in five liver hemangiomas on short echo-time gradient-recalled echo dynamic magnetic resonance imaging to assess the utility of this technique to image perfusion patterns in liver hemangiomas. We observed peripheral nodular enhancement with centripetal fill in all hemangiomas. Our results suggest that this imaging technique, after rapid injection of ferumoxides, can be used for lesion characterization.
8229.7182843941994.02.17++Hepatic abscesses: MR imaging findings.Radiology
RJ Méndez, ML Schiebler, EK Outwater, HY Kressel,
To determine magnetic resonance (MR) imaging features that characterize hepatic abscesses.
8329.6491700311997.08.14++Effects of AMI-25 on liver vessels and tumors on T1-weighted turbo-field-echo images: implications for tumor characterization.J Magn Reson Imaging
D van Gansbeke, TM Metens, C Matos, N Nicaise, F Gay, H Raeymaekers, J Struyven,
This study was devoted to tumor differentiation in liver MR T1-weighted imaging with superparamagnetic iron oxide (SPIO). Twenty-one patients with 40 liver lesions were studied at 1.5 T. Before and at least 45 minutes after SPIO administration, turbo-field-echo (TFE) T1-weighted, TFE T1 x T2*-weighted (MXT), and fat-suppressed turbo-spin-echo T2-weighted images were acquired. A quantitative analysis was performed blindly. On TFE T1-weighted images, the signal enhancement was -33% +/- 12 for the liver, -24% +/- 2 for adenomas and focal nodular hyperplasia, +60% +/- 33 for the hemangiomas; metastases and cyst enhancement were not significant. After SPIO on TFE T1-weighted images, the hemangioma-to-liver signal ratio (149% +/- 18) was definitely higher than the mean metastasis-to-liver signal ratio (90% +/- 16). This T1-related differentiation ability lacked dramatically on TFE MXT images and, in one case, was reduced on post-SPIO TFE T1-weighted images by a long imaging delay after SPIO administration (2 hours).
8429.63107492282000.04.28++Preoperative detection of malignant hepatic tumors: comparison of combined methods of MR imaging with combined methods of CT.AJR Am J Roentgenol
H Kondo, M Kanematsu, H Hoshi, T Murakami, T Kim, M Hori, M Matsuo, H Nakamura,
We compared radiologists' performance on combined unenhanced, gadolinium-enhanced, and ferumoxides-enhanced MR imaging with their performance on helical CT during arterial portography (CTAP) and biphasic CT during hepatic arteriography (CTHA) for the preoperative detection of malignant hepatic tumors.
8529.59164843472006.05.23++Hepatic metastases: detection with multi-detector row CT, SPIO-enhanced MR imaging, and both techniques combined.Radiology
H Onishi, T Murakami, T Kim, M Hori, R Iannaccone, M Kuwabara, H Abe, S Nakata, K Osuga, K Tomoda, R Passariello, H Nakamura,
To retrospectively compare the accuracy in detection of hepatic metastases among contrast material-enhanced multi-detector row computed tomography (CT) alone, superparamagnetic iron oxide (SPIO)-enhanced magnetic resonance (MR) imaging alone, and a combination of contrast-enhanced CT and SPIO-enhanced MR imaging.
8629.4719278161991.11.18++Disseminated histoplasmosis: abdominal CT findings in 16 patients.AJR Am J Roentgenol
DR Radin,
Since the onset of the AIDS epidemic, disseminated Histoplasma capsulatum infection has been reported with much greater frequency in both endemic and nonendemic areas. Abdominal CT scans of 16 patients with disseminated histoplasmosis were reviewed retrospectively to identify radiologic features of this disease. The diagnosis was confirmed by autopsy (three patients), bone marrow biopsy (10 patients), lymph node biopsy (three patients), bronchoscopic biopsy (three patients), liver biopsy (two patients), and/or colonoscopic biopsy (one patient). Fourteen patients had serologic evidence of human immunodeficiency virus infection. Disseminated histoplasmosis was either the only initial manifestation of AIDS (seven patients) or was accompanied simultaneously by cytomegalovirus infection (four patients), or Kaposi sarcoma, Toxoplasma encephalitis, or cryptosporidiosis (one patient each). Abdominal CT findings included hepatomegaly (63%); splenomegaly (38%); diffuse splenic hypottenuation (19%); bilateral adrenal enlargement or hypoattenuating masses (13%); and enlarged lymph nodes with homogeneous soft-tissue density (44%), diffuse or central low density (13%), or both (19%). Histoplasmosis should be included in the differential diagnosis when abdominal CT scans show such nonspecific findings as hepatomegaly, splenomegaly, enlarged soft-tissue-density or hypoattenuating lymph nodes, or adrenal enlargement or masses in an immunodeficient patient. An uncommon but possibly specific CT finding in histoplasmosis is diffuse splenic hypoattenuation.
8729.4680862531994.10.20++Primary angiosarcoma of the spleen. CT and MR imaging.Acta Radiol
HK Ha, HH Kim, BK Kim, JK Han, BI Choi,
The CT and MR findings in 2 patients with surgically proven splenic angiosarcoma are presented. Two distinctive radiologic and pathologic patterns were observed: total tumor replacement of the spleen with preservation of normal contour or multiple nodular masses in the spleen. The various findings on CT and MR imaging reflected the hemorrhagic nature of the lesions with increased iron content. MR imaging appeared to be superior to CT in demonstrating these features. In the case of focal lesions, radiologic differentiation from lymphoma or metastasis was impossible.
8829.43145801032003.11.18++Ultrasound in abdominal tuberculosis.Abdom Imaging
A Malik, NC Saxena,
The present study was done to emphasize the importance of ultrasound (US) and US-guided fine-needle aspiration biopsy (FNAB) in the diagnosis of abdominal tuberculosis.
8929.37151850332005.02.17++Acute torsion of a wandering spleen: imaging findings.Abdom Imaging
B Bakir, A Poyanli, E Yekeler, G Acunas,
Wandering spleen is a rare entity characterized by incomplete fixation of the spleen by lienorenal and gastrosplenic ligaments. It can migrate to the lower abdomen or pelvis and can be congenital or acquired. We report a case of torsion of a wandering spleen for which there was correlative imaging by ultrasonography, Doppler ultrasonography, computed tomography, magnetic resonance imaging, and angiography. To our knowledge, this is the first reported case in which all these modalities were used in the diagnostic evaluation.
9029.33120088312002.11.04+ Case 6. Sarcoidosis.J Ultrasound Med
CL Chen, RB Goldstein,
9129.2321209371990.11.19++MR imaging of CSF-like choroidal fissure and parenchymal cysts of the brain.AJR Am J Roentgenol
JL Sherman, E Camponovo, CM Citrin,
The purposes of this study were to delineate the MR characteristics of CSF-like parenchymal or fissural cysts of the brain and to correlate them with the clinical findings. Clinical data and MR images of 34 patients with these abnormalities were reviewed. Pathologic correlation was not available. Two types of cystic lesions were identified and separated by location: medial temporal lobe cysts arising in or near the choroidal fissure (26 patients) and parenchymal or pseudoparenchymal cysts not related to the choroidal fissure (eight patients). The choroidal fissure cysts simulated intraparenchymal cysts on axial images but their extraaxial location was well portrayed on the coronal images. Choroidal fissure cysts had a characteristic spindle shape on sagittal images. The other cysts were found in the temporal lobe (seven patients) or thalamus (one patient) and appeared parenchymal but situated close to the subarachnoid space. These lesions were round or ovoid. There was no abnormal enhancement in 10 patients studied with gadopentetate dimeglumine. Coronal images were most useful, revealing the cysts as focal CSF-intensity lesions expanding the choroidal fissure of the temporal lobe. All the cysts appeared to represent incidental findings that did not correlate with the clinical signs and/or symptoms that prompted the imaging evaluations. The MR characteristics of CSF-like cysts are important to recognize so that they are not confused with other, more serious entities, such as intraaxial cystic tumors, infarctions, or parasitic lesions.
9229.1540133571985.08.01+ Splenectomy for splenomegaly and secondary hypersplenism.World J Surg
WW Coon,
9329.15171899272008.07.28++[A case of splenic pseudocyst difficult to differentiate from splenic lymphangioma].Korean J Gastroenterol
SA Lee, SY Han, EJ Lee, BP Kwon, IY Koh, HJ Choi, MC Kim, JH Cho,
Splenic pseudocyst is a rare complication of abdominal trauma. Although it is rare, splenic pseudocyst is well-documented in the literature. According to the current classification, approximately 30% of all splenic cysts or pseudocysts result from direct abdominal trauma. In addition, chronic pancreatitis leads to change of nearby organs with possible acute and chronic complications including splenic lesions. This unusual complication can occur in both emergent and non-emergent conditions. The useful diagnostic procedures to assess intrasplenic pseudocyst are sonogram, CT scan, splenic scan, and occasionally angiography. However, definite diagnosis of pseudocyst is possible only after splenectomy when the absence of epithelial lining is confirmed histologically. Splenic pseudocyst requires surgical resection. We experienced a 31-year-old man who confirmed of warmness in the left side of back with left upper quadrant abdominal pain for several months. First impression was splenic lymphangioma based on CT scan and sonogram finding. Splenectomy was performed. Microscopic examination revealed splenic pseudocyst with fibrous capsule without epithelial lining.
9429.1121147691990.08.13++Detection of brain metastases: comparison of contrast-enhanced MR with unenhanced MR and enhanced CT.AJNR Am J Neuroradiol
G Sze, E Milano, C Johnson, L Heier,
Contrast-enhanced MR studies were compared with noncontrast MR and contrast-enhanced CT scans in the evaluation of intraparenchymal brain metastases. Fifty consecutive inpatients were studied with short and long repetition time (TR) sequences before and after the administration of gadopentetate dimeglumine. In addition, a delayed short TR sequence was performed. The contrast CT, noncontrast MR, immediate postcontrast short TR sequence, postcontrast long TR sequence, and delayed postcontrast short TR sequence were each read blindly and independently by two neuroradiologists. These results were then compared with a final interpretation, reached by all the neuroradiologists in the study, using all the clinical information and imaging findings. Postcontrast short TR scans proved to be superior to other sequences. They were particularly useful in the detection of metastases in the posterior fossa and cortex. The delayed postcontrast short TR scan held no definite advantage over the immediate postcontrast short TR scan, although metastases were sometimes seen slightly better after the delay. While long TR sequences were not always sensitive or specific, they often did provide ancillary information and were particularly useful in cases of hemorrhagic metastases. Because of these findings, we recommend that the evaluation of intraparenchymal metastases consist of a single postcontrast long TR scan followed by a single postcontrast short TR scan. While these sequences should be very accurate in the detection of metastases, we also generally perform a single precontrast short TR scan as well, since the question of hemorrhage or bone lesion may be clinically relevant.
9529.09188061542008.10.16++Solitary necrotic nodules of the liver: cross-sectional imaging findings and follow-up in nine patients.AJR Am J Roentgenol
S Colagrande, ML Paolucci, L Messerini, W Schima, A Stadler, TV Bartolotta, A Vanzulli, G Brancatelli,
OBJECTIVE: The purpose of our study was to retrospectively evaluate the sonographic, CT, and MRI findings (number, diameter, lobar location, depth from the hepatic capsule, and appearance of lesions) in a series of nine patients with pathologically proven solitary necrotic nodules of the liver and the natural evolution at follow-up in four of the nine patients. CONCLUSION: Solitary necrotic nodules are usually small, solitary lesions, mainly located under the liver capsule of the right lobe. They are hypoechoic on sonography, hypoattenuating on CT, have low signal intensity on both T1- and T2-weighted MRI with lack of enhancement after IV contrast administration, and at follow-up have a tendency to show calcification and involution toward reduction in size.
9628.9580294041994.08.11++Hepatic hemangiomas: a multi-institutional study of appearance on T2-weighted and serial gadolinium-enhanced gradient-echo MR images.Radiology
RC Semelka, ED Brown, SM Ascher, RH Patt, AS Bagley, W Li, RR Edelman, JP Shoenut, JJ Brown,
To define the appearance of hepatic hemangiomas on T2-weighted and serial gadolinium-enhanced gradient-echo magnetic resonance (MR) images.
9728.8813091721992.07.06++Mycobacterial spindle cell pseudotumor of lymph nodes.Am J Surg Pathol
KT Chen,
Two cases of spindle cell pseudotumor in the lymph nodes of patients with acquired immunodeficiency syndrome caused by mycobacterial infection are reported and the literature reviewed. The lesions mimicked neoplasms because they were composed predominantly of spindle cells arranged in a storiform pattern. Most of the spindle cells were phagocytic cells that contained large amounts of mycobacteria. It is important for the pathologist to recognize the lesion so that a prompt tissue diagnosis can be provided because specific therapy is available.
9828.8785539521996.02.22++Ring enhancement in ultrasmall superparamagnetic iron oxide MR imaging: a potential new sign for characterization of liver lesions.AJR Am J Roentgenol
PJ Mergo, T Helmberger, AI Nicolas, PR Ros,
We performed this study to evaluate the incidence and significance of ring enhancement after i.v. administration of an ultrasmall superparamagnetic iron oxide (USPIO) particle (Code 7227), a reticuloendothelial contrast agent with potential use as a blood-pool agent, for characterizing focal hepatic lesions.
9928.8390227751997.03.03++Splenic parenchymal complications of pancreatitis: CT findings and natural history.J Comput Assist Tomogr
F Rypens, J Devière, M Zalcman, P Braudé, J Van de Stadt, J Struyven, D Van Gansbeke,
Splenic parenchymal complications of pancreatitis are unusual and potentially life threatening. They usually require splenectomy in patients in poor condition. The present study describes natural history of splenic parenchymal complications and the role of CT scan in diagnosis and follow-up.
10028.8076178641995.08.23++Hepatic MR imaging with ferumoxides: a multicenter clinical trial of the safety and efficacy in the detection of focal hepatic lesions.Radiology
PR Ros, PC Freeny, SE Harms, SE Seltzer, PL Davis, TW Chan, AE Stillman, LR Muroff, VM Runge, MA Nissenbaum,
To assess the safety and diagnostic efficacy of intravenous ferumoxides, a superparamagnetic iron oxide, for depiction of focal hepatic lesions on magnetic resonance (MR) images.
10128.72100638561999.03.22+ Percutaneous imaging-guided biopsy of the spleen.AJR Am J Roentgenol
ME O'Malley, BJ Wood, GW Boland, PR Mueller,
10228.6939998931985.07.17++[Organ preserving spleen surgery in childhood].Langenbecks Arch Chir
W Lambrecht, S Albrecht, M Stern,
Our experiences with organ saving procedures of the spleen in childhood are presented. In 9 out of 12 children (75%) with traumatic rupture we preserved the organ partially or completely. In 4 patients a partial splenectomy was performed, in three cases of splenorrhaphy was done, and once the organ was repaired with fibrin adhesive. One child was treated conservatively. Another patient underwent splenectomy followed by autotransplantation. Two out of twelve died intra- or postoperatively from severe concomitant injuries. Out of 11 patients with Hodgkin's disease we performed partial splenectomy in five. Only in macroscopically involved cases the organ was removed. In one patient a huge epidermoid cyst of the spleen was enucleated. In another child with a big twisted wandering spleen a splenopexy after partial resection was carried out. In children the spleen should be preserved if ever possible.
10328.5595165161998.05.21++Focal splenic lesions in patients with AIDS: sonographic findings.Abdom Imaging
A Porcel-Martin, P Rendon-Unceta, A Bascuñana-Quirell, A Amaya-Vidal, C Rodriguez-Ramos, MJ Soria de la Cruz, L Martín-Herrera,
The purpose of this study was to describe the sonographic features of the focal splenic lesions in patients with AIDS and to know the frequency and etiology of these features.
10428.5067896441981.09.22+ Dynamic CT of the normal spleen.AJR Am J Roentgenol
GM Glazer, L Axel, HI Goldberg, AA Moss,
10528.4380909221994.10.17++Differential diagnosis of focal liver lesions: role of spin-echo and contrast-enhanced dynamic MR imaging.Radiology
Y Yamashita, Y Hatanaka, H Yamamoto, A Arakawa, T Matsukawa, T Miyazaki, M Takahashi,
To evaluate the role of spin-echo (SE) and contrast material-enhanced dynamic magnetic resonance (MR) imaging in the differential diagnosis of focal liver lesions.
10628.2413120971992.04.15++Differentiation between hepatoma and hemangioma with inversion-recovery snapshot FLASH MRI and Gd-DTPA.J Comput Assist Tomogr
T Murakami, T Mitani, H Nakamura, S Hori, T Marukawa, K Nakanishi, M Nishikawa, C Kuroda, T Kozuka,
Thirty-eight patients with focal liver tumors (20 hepatomas, 18 hemangiomas) were studied by dynamic sequential inversion recovery (IR) snapshot fast low angle shot (FLASH) MR imaging with Gd-DTPA. Immediately after 0.05 mmol/kg Gd-DTPA was administered intravenously for 2-3 s followed by flushing with normal saline for 4-5 s, 10 images were obtained in the first 20 s (time zero is the end of flush, early phase). Then, one image every 30 s from 1 to 3 min (late phase) and images at 5 min and 7 min (delayed phase) were obtained serially. Hepatomas showed total enhancement in 18 of 20 patients in the early phase, and isointense or low intensity enhancement with respect to the surrounding liver parenchyma in 18 patients in the late to delayed phases. Hemangiomas showed peripheral enhancement in 14 patients in the early phase, but did not show total enhancement (except for two hemangiomas less than 3 cm in size) in the early phase, and showed high intensity enhancement in 15 patients in the late phase. Ninety percent of hepatomas and 82% of hemangiomas showed their characteristic enhancement patterns in the early to delayed phases. We conclude that dynamic sequential IR snapshot FLASH MR images enhanced with Gd-DTPA can facilitate differentiation between hepatomas and hemangiomas.
10728.0882594261994.01.19++Peripheral washout: a sign of malignancy on dynamic gadolinium-enhanced MR images of focal liver lesions.Radiology
AE Mahfouz, B Hamm, KJ Wolf,
To assess the value of peripheral washout of contrast medium in differentiating benign from malignant focal liver lesions.
10828.0821858771990.06.11++Nontraumatic focal lesions of the spleen: assessment of imaging and clinical evaluation.Comput Med Imaging Graph
PL Caslowitz, JD Labs, EK Fishman, SS Siegelman,
Fifty-nine cases of nontraumatic splenic disease were reviewed to evaluate the roles of clinical findings, computed tomography, ultrasound, and radionuclide scanning in diagnosis and management. Patient groups included lymphoma (30 patients), infarct (11 patients), abscess (9 patients), cyst (5 patients), hemangioma (3 patients), and hamartoma (1 patient). In no case were clinical findings alone sufficient to diagnose a splenic lesion. Clinical and laboratory manifestations were nonspecific in all groups. Moreover, no radiologic study reliably diagnosed splenic lymphoma or leukemia. All other focal splenic lesions were consistently diagnosed noninvasively. Cross-sectional imaging was more useful than radioisotope scanning, and often provided adjunctive diagnosis of extrasplenic pathology. The superior detail, spatial resolution, and sensitivity of computed tomography made it the single most valuable diagnostic modality.
10928.0711533211975.11.05++[Hepatosplenic sarcoidosis. Contribution of parenchymatous hepatosplenography by selective arteriography].Nouv Presse Med
J Turiaf, JP Battesti, Ch Hélénon,
In this study of hepato-splenic sarcoidosis the authors, in addition to confirming the principle and commonly recognised features of the disease, stress the value of cataloguing the morphological changes, in the liver and spleen by selective arteriography of the coeliac trunk; increase in the frequency of recognition of hepatosplenomegaly; granular appearance of the parenchyma of both organs, which appear to be studded with a multitude of small lacunae, thus eliminating the homogeneous and uniformly opaque image seen normally. Seen in 28.5 p.cent of cases, this heterogeneous appearance is not strictly pathognomic of sarcoidosis. It is mainly due to the lacunar appearance which probably represents sarcoid follicles. It may resolve under cortisone therapy.
11027.9933101351987.11.10++[Ultrasound and CT evaluation of non-lymphomatous splenic focal lesions].Radiol Med
L Garretti, MC Cassinis, G Gandini,
Differential diagnosis problems are caused by the increased, at time occasional, detection of benign and malignant spleen focal lesions in routine superior abdomen ultrasound (US). The following pathologic conditions were reported in 29 patients with focal lesions (excepted systemic diseases): 6 plain cysts, 1 cystic lymphangioma, 3 echinococcus cysts, 3 abscesses, 7 hematomas and 9 metastases. US examination and clinical data together have permitted the differentiation of cysts from solid nodules but has limits in the characterisation of lesions and in the diagnosis of abscesses. Metastases did non present specific US or CT aspects and have been correctly characterized only with aid of anamnestical data and for the coexistence of hepatic lesions. CT has proven superior specificity, compared to US, only in the diagnosis of abscesses and should thus be utilized only in selected cases.
11127.98157499772005.05.05++Angiosarcoma of the spleen: imaging characteristics in 12 patients.Radiology
WM Thompson, AD Levy, NS Aguilera, L Gorospe, RM Abbott,
To retrospectively review clinical, pathologic, and imaging features of angiosarcoma of the spleen in 12 patients.
11227.9714147771992.11.16++MR imaging of clival and paraclival lesions.AJR Am J Roentgenol
G Chaljub, R Van Fleet, FC Guinto, WN Crow, L Martinez, R Kumar,
A wide spectrum of diseases involve the clivus and paraclival structures. Primary neoplasms, metastatic tumors, and inflammatory, vascular, and hematopoietic disorders are the most common abnormalities to arise from or directly involve the clivus. MR imaging exquisitely shows and helps characterize the diseases that affect this area. Sagittal and coronal MR imaging allows precise localization and evaluation of the signal characteristics of a mass, enabling a more specific diagnosis. The multiplanar capabilities of MR imaging provide superb visualization of the adjacent cranial nerves and vascular structures, aiding in surgical planning and radiation therapy. In this pictorial essay, the MR imaging, CT, and conventional radiographic findings of various clival and paraclival lesions are illustrated.
11327.8220142771991.05.15++Dynamic gadolinium-enhanced rapid acquisition spin-echo MR imaging of the liver.Radiology
SA Mirowitz, JK Lee, E Gutierrez, JJ Brown, JP Heiken, SS Eilenberg,
Rapid acquisition spin-echo (RASE) magnetic resonance (MR) imaging allows for coverage of the entire liver with highly T1-weighted SE images during a single 23-second breath-holding period. The RASE sequence was implemented in conjunction with rapid intravenous injection of gadopentetate dimeglumine to enable performance of dynamic contrast material-enhanced MR imaging of the liver. Prospective evaluation of 24 patients with 62 liver lesions 1 cm or greater in diameter was performed. Images obtained with RASE were devoid of respiratory-related ghost artifacts or edge blurring. The dynamic contrast-enhanced RASE technique resulted in contrast-to-noise and contrast-to-artifact values and time efficiency measures significantly greater (P less than .05) than those obtained with use of conventional T1- and T2-weighted pulse sequences, indicating a higher likelihood for lesion detectability. Lesion conspicuity was maximal during or immediately following bolus administration of gadopentetate dimeglumine, with lesions often becoming obscured at delayed postcontrast imaging.
11427.7986579461996.08.01++Liver tumors: comparison of MR imaging with Gd-EOB-DTPA and Gd-DTPA.Radiology
TJ Vogl, S Kümmel, R Hammerstingl, M Schellenbeck, G Schumacher, T Balzer, W Schwarz, PK Müller, WO Bechstein, MG Mack, O Söllner, R Felix,
To compare the usefulness of gadolinium ethoxybenzyl diethylenetriaminepentaacetic acid (Gd-EOB-DTPA) and gadolinium diethylenetriaminepentaacetic acid (Gd-DTPA) in the diagnosis of focal liver lesions.
11527.77114772362001.08.09++Hepatocellular carcinoma: depiction of tumor parenchymal flow with intermittent harmonic power Doppler US during the early arterial phase in dual-display mode.Radiology
H Ding, M Kudo, H Onda, Y Suetomi, Y Minami, K Maekawa,
To assess the effectiveness of contrast material-enhanced intermittent harmonic Doppler ultrasonography (US) in depicting tumor vessels and tumor parenchymal flow (stain) in hepatocellular carcinoma (HCC).
11627.6714852501993.02.18+ [Benign vascular tumors of the spleen].Ter Arkh
VS Shavlova, IB Kaplanskaia, VA Klimanskiĭ,
11727.5190108011997.03.25++Abdominal ultrasound findings of disseminated tuberculosis in AIDS.J Clin Ultrasound
JM Monill-Serra, A Martinez-Noguera, E Montserrat, J Maideu, JM Sabaté,
The sonographic findings of 76 patients with tuberculosis and HIV infection are described. These findings were compared with a control group of 76 HIV-positive patients without associated pathology. Those patients with tuberculosis and positive HIV titers commonly (p = 0.05) showed retroperitoneal and mesenteric adenopathies with node diameters greater than 1.5 cm (n = 27), and multiple, splenic, hypoechoic nodules between 0.5 cm and 1 cm (n = 11). Additional findings include hepatic hyperechoic nodules (n = 1) and retroperitoneal abscess (n = 1). The combination of ultrasound features can help in the diagnosis of abdominal tuberculosis in HIV-positive patients with non-specific clinical infections.
11827.5082497241993.12.28++MR imaging with i.v. superparamagnetic iron oxide: efficacy in the detection of focal hepatic lesions.AJR Am J Roentgenol
TC Winter, PC Freeny, HV Nghiem, LA Mack, RM Patten, CR Thomas, S Elliott,
The purpose of this study was to evaluate the efficacy of superparmagnetic iron oxide (SPIO) in the detection of focal hepatic lesions on MR images.
11927.4635268421986.09.17++Nonparasitic splenic cysts: a report of 52 cases with radiologic-pathologic correlation.AJR Am J Roentgenol
AH Dachman, PR Ros, PJ Murari, WW Olmsted, JE Lichtenstein,
We reviewed 52 cases of splenic cysts on file at the Armed Forces Institute of Pathology. There were 24 true (epidermoid) and 28 false (posttraumatic) cysts. The history and clinical presentations, including pain, splenomegaly, or mass, were similar in both groups. Radiologic manifestations included splenomegaly and the occasional identification of a distinct mass by conventional radiography even in the absence of calcification. The lesions produced a photopenic defect on nuclear scintigraphy and were avascular on angiography. Sonography and CT demonstrated a cystic lesion with occasional septations, wall trabeculation, and low-level internal echoes. Three false cysts demonstrated solid and cystic components on sonography and CT, corresponding to organizing hematoma within the cyst. Splenomegaly or a splenic mass of a predominantly cystic nature with no clinical evidence of echinococcus suggests the diagnosis of splenic cyst. Reliable radiologic distinction between true or false splenic cyst does not seem possible. Complex mass may represent a "transition" between hematoma and false splenic cyst.
12027.41145734302003.12.05++Using superparamagnetic iron oxide-enhanced MRI to differentiate metastatic hepatic tumors and nonsolid benign lesions.AJR Am J Roentgenol
S Kumano, T Murakami, T Kim, M Hori, A Okada, T Sugiura, Y Noguchi, S Kawata, K Tomoda, H Nakamura,
We evaluated the ability of superparamagnetic iron oxide (SPIO)-enhanced MRI to differentiate solid metastatic tumors and nonsolid benign lesions by clarifying the characteristic signal-intensity pattern of each lesion on SPIO-enhanced T2-weighted and heavily T1-weighted gradient-echo images.
12127.39108000022000.06.20+ Sonographic appearances in abdominal tuberculosis.J Clin Ultrasound
A Batra, MS Gulati, D Sarma, SB Paul,
12227.3784744001993.05.20++[Can nuclear magnetic resonance tomography supplement and expand splenic diagnosis in malignant systemic diseases? Comparison of nuclear magnetic resonance tomography, ultrasound and computerized tomography findings].Med Klin (Munich)
R Lorenz, JP Hedde, V Diehl,
Can magnetic resonance imaging supplement or expand the diagnostic evaluation of the spleen in malignant systemic disease? A comparison of magnetic resonance imaging, ultrasonography and computed tomography.
12327.3325396061989.05.19++Small hepatocellular carcinoma and cavernous hemangioma: differentiation with dynamic FLASH MR imaging with Gd-DTPA.Radiology
H Yoshida, Y Itai, K Ohtomo, T Kokubo, M Minami, N Yashiro,
Forty patients with hepatocellular carcinoma (HCC) (n = 22) or cavernous hemangioma (diameter, 3 cm or less) (n = 18) were examined with serial magnetic resonance (MR) imaging at 1.5 T with the fast low-angle shot (FLASH) technique and an intravenously administered bolus injection of 0.05 mmol/kg Gd-DTPA. Two images per minute were obtained for 5 minutes, and one per minute thereafter until about 10 minutes. Dynamic MR studies revealed five criteria for differentiating these tumors. With HCC there was a hyperintense mass before contrast material enhancement (32%), peak contrast enhancement at about 10 seconds after injection (55%), slight to moderate peak contrast enhancement (73%), absent or minimal delayed enhancement (100%), and, at morphologic study, a capsule or nodules-in-nodule appearance (59%). With hemangioma there was a hypointense mass before contrast enhancement (72%), peak contrast enhancement more than 2 minutes after injection (72%), marked peak contrast enhancement (83%), moderate to marked delayed enhancement (100%), and, at morphologic study, spreading phenomenon (39%). Seventy-seven percent of HCCs and 83% of hemangiomas satisfied three or more criteria and thus could be differentiated from each other with certainty.
12427.3181619001994.05.24++Hepatic focal nodular hyperplasia: CT and sonographic spectrum.Abdom Imaging
A Shirkhoda, MC Farah, E Bernacki, B Madrazo, J Roberts,
Fifteen patients with pathologically proven focal nodular hyperplasia (FNH) of the liver had abdominal computed tomography (CT) (15) and ultrasound (11). In seven patients, the lesions were incidentally found during gallbladder or renal examination, whereas the other eight had a primary neoplasm and the liver was studied for possible metastasis. In 11 unenhanced CT scans, the ratio of isodense to hypodense lesions was 8 to 3. In 15 contrast-enhanced CT scans, seven were isodense, six were hypodense, and in two, the lesion enhanced (hyperdense). In seven patients a hypodense lesion on unenhanced CT became isodense with contrast injection. Delayed images in three showed the lesions appearing as hypodense in two and displaying a rim of enhancement in one. In one case, unenhanced CT was normal and only enhanced CT showed an area of homogeneous increased density. Ultrasound was done in 11 patients, the lesion was hypoechoic to the liver in five, echogenic in four, and isoechoic in two. Findings of central scar were seen on CT and ultrasound in three cases. Pathologic diagnosis was available in all cases, seven by needle aspiration and eight by surgical resection. In our experience, FNH has many CT and sonographic features that can mimic hemangioma or metastasis. While the presence of a central scar increases the specificity, in a cancer patient, the findings should be interpreted with caution and needle aspiration should be obtained.
12527.30147401312004.04.27++[Angiosarcoma as a rare differential diagnosis in spontaneous rupture of the spleen].Chirurg
A Maier, F Bataille, D Krenz, M Anthuber,
A splenectomy was performed in a 37-year-old woman because of spontaneous rupture of the spleen. Primary angiosarcoma of the spleen was diagnosed postoperatively based on histology. Primary angiosarcoma of the spleen is a very rare neoplasm with disastrous prognosis. Immunohistochemical and ultrastructural examinations are necessary to verify the diagnosis because the histopathological picture of the tumor is variable. Due to the small number of reported cases, there are no guidelines for adjuvant or palliative therapy, and up to today all adjuvant means of radiotherapy and chemotherapy have not improved the prognosis of the patients.
12627.3079627961994.12.08++Detection of focal liver lesions with superparamagnetic iron oxide: value of STIR and SE imaging.J Comput Assist Tomogr
JT Halavaara, AE Lamminen, S Bondestam, CG Standertskjöld-Nordenstam, LM Hamberg,
We assessed the value of superparamagnetic iron oxide (SPIO) particles on the detection of focal liver lesions by MRI.
12727.28111786922001.05.10++SPIO-enhanced MR imaging of focal fatty liver lesions.Abdom Imaging
F Lwakatare, Y Yamashita, M Nakayama, M Takahashi,
The purpose of this study was to assess the features of focal fatty liver lesions with superparamagnetic iron oxides (SPIO) on magnetic resonance (MR) images.
12827.25127518582004.01.15++Splenic trauma: evaluation with contrast-specific sonography and a second-generation contrast medium: preliminary experience.J Ultrasound Med
O Catalano, R Lobianco, F Sandomenico, A Siani,
To report our experience in the assessment of splenic trauma with contrast-coded sonography and a second-generation contrast medium.
12927.17175503282007.06.21++Splenic metastases: clinicopathologic presentation, differential diagnosis, and pathogenesis.Arch Pathol Lab Med
E Compérat, A Bardier-Dupas, P Camparo, F Capron, F Charlotte,
Splenic metastases from solid tumors, defined as parenchymal lesion, are considered exceptional. Nevertheless, the number of case reports has been increasing due to the improvement of imaging techniques and the long-term follow-up of patients with cancer. Splenic metastases occur in a context of multivisceral disseminated cancer or as a solitary lesion.
13027.0375018301996.01.17++[The tissue characterization of focal liver lesions with magnetic resonance imaging].Radiol Med
R Manfredi, G Maresca, AM De Gaetano, A De Franco, P Marano,
This study was aimed at assessing the accuracy of Magnetic Resonance Imaging (MRI) in the characterization of focal liver masses. We prospectively examined 51 patients with focal liver masses: the morphological features were investigated with different pulse sequences and the functional characteristics were studied after the i.v. administration of Gd-DTPA (2 mmol/kg). MR findings were compared with those of gold standard methods, i.e., percutaneous biopsy, surgery or, for hemangiomas, 99mTc-labelled blood cell liver scintigraphy. All hemangiomas presented with typical features: signal intensity was very high on long TE images (> 140 msec) and a globular enhancement pattern, with centripetal progression, was observed after dynamic studies. This signal pattern on T2-weighted images is highly indicative of hemangioma. Five of 7 focal nodular hyperplasias (71%) were isointense with hepatic parenchyma on all pulse sequences; the central scar was observed in 5/7 cases on short TR/TE images and in all cases on long TR/TE images in 16/17 cases (94%). High signal intensity on T1-weighted images was statistically significant for HCC. A pseudocapsule was observed in 12 cases (70%). A mosaic pattern on T2-weighted images was observed in 3 cases. Seventy-four per cent of HCCs exhibited signal enhancement during the arterial phase of the dynamic study. Metastases presented a uniform pattern, i.e., they were hypointense on T1-weighted and hyperintense on T2-weighted images in 12/13 cases (92%). A central hypointense area on T2-weighted images is indicative of coagulative necrosis. A lesion with these morphological features and hypovascular signal is suggestive of metastasis.
13127.0075603341995.11.02+ Renal capsular hemangioma: unusual MR findings.J Comput Assist Tomogr
J Rueckforth, D Rhode, H Baba, G Adam,
13226.99106754582000.04.05++Comparison of in-phase and out-of-phase gradient recalled echo T1-weighted pulse sequence for MR imaging of malignant liver masses following administration of paramagnetic gadolinium-chelate.Abdom Imaging
J Petersein, W Schima, S Saini, W Mayo-Smith, PF Hahn, KE Tanabe, AL Warshaw, CF del Castillo, B Hamm, PR Mueller,
The purpose of this study was to compare the performance of in-phase and out-of-phase gradient recalled echo (GRE) pulse sequences on paramagnetic contrast-enhanced magnetic resonance (MR) imaging of malignant liver lesions.
13326.9786617681996.10.17++Renal abscesses: appearance on gadolinium-enhanced magnetic resonance images.Abdom Imaging
ED Brown, JJ Brown, U Kettritz, JP Shoenut, RC Semelka,
To determine the appearance of renal abscesses on gadolinium-enhanced magnetic resonance (MR) images, we reviewed 12 MR studies of eight patients with renal abscesses. These findings were compared with findings on other imaging modalities.
13426.89116885762001.12.04++CD31 expression in intratumoral macrophages: a potential diagnostic pitfall.Am J Surg Pathol
JK McKenney, SW Weiss, AL Folpe,
CD31 (platelet endothelial adhesion molecule, PECAM-1) is generally regarded to be the most sensitive and specific endothelial marker in paraffin sections. We have recently encountered several cases in which intratumoral CD31-positive macrophages were misinterpreted as evidence of a vascular sarcoma. We therefore reviewed our last 1950 consultation cases with respect to cases in which CD31 immunostains were performed, to determine the frequency of CD31 expression in macrophages in formalin-fixed, paraffin-embedded tissue and how often the presence of these cells was a source of diagnostic confusion. CD31 immunohistochemistry had been performed on 59 of 1950 (3%) of cases. These 59 cases consisted of both vascular (20 cases) and nonvascular tumors (39 cases). CD31-positive macrophages were distinguished from endothelial or tumor cells by correlation with the morphologic features and the immunohistochemical staining pattern of the cells of interest. In no case was CD31 positivity seen in the lesional cells of a nonvascular tumor. CD31-positive macrophages were identified in 48 of 59 (81%) cases. CD31-positive macrophages were present in 34 of 39 (87%) nonvascular tumors. A vascular tumor was diagnosed or favored by the referring pathologist in 15 of these 39 cases (38%). In 14 of these 15 cases CD31 immunostains were performed by the referring pathologist; 13 (93%) showed CD31-positive macrophages. In 4 of these 14 cases (29%) the misdiagnosis of a vascular tumor was based primarily or in part on the misinterpretation of CD31-positive macrophages as tumor cells. In all cases with CD34 and CD68 immunostains, the CD31-positive macrophages were CD34 negative and CD68 positive. We conclude that CD31 expression is very common in macrophages. Misinterpretation of CD31-positive macrophages as tumor cells may result in the erroneous diagnosis of a primary vascular neoplasm. Recognition of the characteristic granular, membranous pattern of CD31 expression in macrophages and careful distinction from tumor cells should allow the accurate interpretation of CD31 immunohistochemistry in possible vascular neoplasms. CD31 may also be useful as a nonlysosomal marker of macrophages in formalin-fixed, paraffin-embedded sections.
13526.8873844551980.08.15++Computed tomography of the spleen.Radiology
J Piekarski, MP Federle, AA Moss, SS London,
Computed tomography (CT) has proved to be valuable in the diagnosis of a wide variety of congenital, inflammatory, traumatic, and neoplastic lesions of the spleen, in addition to identifying certain normal variants which may present problems. A comprehensive review of the CT characteristics of splenic lesions and variants is provided, and CT is compared with other imaging modalities, principally radionuclide imaging.
13626.8576226811995.08.30++Orbital cavernous hemangioma: findings on sequential Gd-enhanced MRI.J Comput Assist Tomogr
G Wilms, H Raat, R Dom, C Thywissen, P Demaerel, G Dralands, AL Baert,
To describe the contrast enhancement pattern of orbital cavernous hemangioma on sequential Gd-enhanced MRI.
13726.7822102011990.10.31++Abdominal tuberculosis in children: CT findings.Gastrointest Radiol
FM Denath,
Tuberculous peritonitis is a rare manifestation of childhood tuberculosis. The computed tomographic (CT) scans of three patients with abdominal tuberculosis were reviewed to determine the range of abdominal involvement. This report describes the following CT features of abdominal tuberculosis: (1) diffuse lymphadenopathy involving mesenteric and retroperitoneal lymph nodes; (2) low-density lymph nodes with multilocular appearance following intravenous contrast; (3) high-density ascites; (4) mottled low-density masses in the omentum; (5) thickening of the bowel wall adjacent to the mesentery; and (6) hepatic pseudotumors. These CT features of abdominal tuberculosis, in the appropriate clinical setting, should help optimize the correct diagnosis and management of tuberculosis in children.
13826.7181995481994.07.05++Ciliated hepatic foregut cysts: US, CT, and contrast-enhanced MR imaging.Abdom Imaging
JP Shoenut, RC Semelka, C Levi, H Greenberg,
Hepatic foregut cysts are uncommon lesions of the liver. In this report we prospectively examined two patients by means of computed tomography (CT), ultrasound, and contrast-enhanced magnetic resonance imaging. Ciliated hepatic foregut cysts were subsequently demonstrated in both patients following CT-guided biopsy. Magnetic resonance imaging was found to be useful in differentiating these cysts from other lesions.
13926.7095686331998.06.19++Inflammatory pseudotumor of the spleen: US and MRI findings.Radiat Med
K Hayasaka, S Soeda, M Hirayama, Y Tanaka,
The ultrasound and color Doppler sonography characteristics of inflammatory pseudotumor (IPT) of the spleen are nonspecific, and thus preoperative diagnosis of the tumor is difficult. We describe a case of IPT of the spleen studied with ultrasound, color Doppler sonography, CT, and MRI, and we report the usefulness of US and MRI findings of the tumor.
14026.6829090931989.01.18++Liver, spleen, and vessels: preliminary clinical results of CT with perfluorooctylbromide.Radiology
JN Bruneton, MN Falewée, E François, P Cambon, C Philip, JG Riess, C Balu-Maestro, A Rogopoulos,
This phase 1-2 trial investigated the use of a 100% wt/vol emulsion of perfluorooctylbromide (PFOB) in computed tomography (CT) of 30 patients with metastatic cancer. Injection of 3 g/kg (maximum dose administered to these patients) provided an average liver enhancement of +31 HU on CT scans obtained after 48 hours. Maximum splenic opacification occurred immediately after injection; 1 g/kg, which allowed an immediate enhancement of +35 HU, appeared sufficient for the diagnosis of splenic conditions. Vascular opacification was insufficient for diagnostic purposes. In four patients with metastases, more lesions were seen with the use of PFOB with CT than with conventional CT. Adverse effects included five cases of low back pain that were reversible when the infusion rate was reduced. Fever and trembling were also noted 6 hours after injection in five patients. In all patients, symptoms regressed spontaneously within several hours. Clinically inapparent and dose-independent splenomegaly (volume increase of at least 20% on CT examinations) was noted in eight patients.
14126.6163391701983.05.27+ Computed tomography of the spleen.Crit Rev Diagn Imaging
M Federle, AA Moss,
14226.5377291181995.05.26++Update: abdominal tuberculosis--unusual findings on CT.Clin Radiol
AA Bankier, D Fleischmann, MN Wiesmayr, D Putz, M Kontrus, P Hübsch, CJ Herold,
To update our knowledge of abdominal tuberculosis as manifested on computed tomography (CT), we reviewed the CT scans of 12 patients with proven abdominal tuberculosis. The nature, range and extent of abdominal involvement was determined. The CT findings were compared to those reported in the literature. The aetiologic agent was Mycobacterium tuberculosis in all patients. One patient had an increased risk because of AIDS. In nine patients, tuberculosis was limited to the abdomen, and three patients had previously unknown thoracic tuberculous disease. Characteristic features in our patients included low density ascites and uncommon patterns of adenopathy. Findings reported to be typical in abdominal tuberculosis were present in only five of our 12 patients. Unusual findings in our patients included solitary and multiple pelvic, adrenal, splenic and hepatic lesions. In six of 12 patients, those findings mimicked malignancy. We conclude that knowledge and early recognition of these unusual manifestations of abdominal tuberculosis should help to optimize clinical management of the disease and avoid misdiagnosis.
14326.5121226831990.12.27++Sarcoidosis of the CNS: comparison of unenhanced and enhanced MR images.AJR Am J Roentgenol
JL Sherman, BJ Stern,
Sarcoidosis involving the CNS has a predilection for the leptomeninges, although parenchymal involvement occurs. We retrospectively evaluated the appearance of CNS sarcoidosis on unenhanced and enhanced MR images. MR studies were abnormal in 17 of 20 patients with CNS sarcoidosis. In all 17 patients, meningeal disease was detected on the gadopentetate-dimeglumine-enhanced T1-weighted images; the disease was detected on unenhanced images in three patients. Well-defined leptomeningeal patterns of enhancement were present in 15 patients. Other areas of involvement were the dura; brain parenchyma including hypothalamus, periventricular white matter, and ventricular ependyma; optic chiasm; and pituitary gland. Gadopentetate dimeglumine optimally evaluates meningeal disease and highlights the importance of the leptomeninges and Virchow-Robin spaces in the pathogenesis of CNS sarcoidosis. Enhanced MR is the preferred imaging technique for the evaluation of CNS sarcoidosis.
14426.4333510421988.04.28++The MR contribution after CT demonstration of supratentorial mass effect without additional localising features.J Comput Assist Tomogr
DA Robinson, RE Steiner, IR Young,
The contribution of magnetic resonance (MR) imaging was retrospectively evaluated in 24 patients in whom CT demonstrated a supratentorial mass effect without significant additional localising features. Using a combination of T1-weighted inversion recovery (IR) and T2-weighted spin echo sequences, the MR images localised the lesion with greater precision than CT in 80% of cases. Areas of contrast enhancement were visible on the IR images in five of nine (56%) patients assessed after intravenous gadolinium-diethylenetriamine pentaacetic acid, where no comparable enhancement was seen on CT. Twenty of the 24 patients subsequently underwent surgery; eight had biopsies and 12 had resections. Magnetic resonance accurately predicted the site of the tumour in all these patients. Three of the remaining four cases were treated with radiotherapy on the basis of the MR findings without a tissue diagnosis being sought. Magnetic resonance produces better localization than CT and provides a sound basis for further diagnostic and therapeutic procedures.
14526.4118920351991.10.11+ Castleman disease of the adrenal gland: MR imaging features.AJR Am J Roentgenol
JF Debatin, CE Spritzer, NR Dunnick,
14626.3767733661980.10.27++Enlarged accessory spleens: CT appearance in postsplenectomy patients.AJR Am J Roentgenol
JR Beahrs, DH Stephens,
An unexplained abdominal mass discovered on CT examinations of a postsplenectomy patient may represent a hypertrophied residual accessory spleen. Six such patients were found to have left upper quadrant masses on CT examinations that were subsequently proved to be enlarged accessory spleens. The CT appearance is that of discrete, solitary, rounded masses of uniform soft-tissue density in the left upper quadrant. Diameters of the masses were 3.5-5.0 cm. The splenic nature of such a mass can be confirmed by appropriate radionuclide imaging.
14726.3590575181997.04.04+ MR imaging of acquired abnormalities of the spleen.AJR Am J Roentgenol
K Ito, DG Mitchell, K Honjo, T Fujita, H Uchisako, T Matsumoto, N Matsunaga, Y Honma, K Yamakawa,
14826.35125116722003.01.30++Preoperative depiction of hepatocellular carcinoma: ferumoxides-enhanced MR imaging versus triple-phase helical CT.Radiology
BK Kang, JH Lim, SH Kim, D Choi, HK Lim, WJ Lee, SJ Lee,
To compare ferumoxides-enhanced magnetic resonance (MR) imaging with triple-phase helical computed tomography (CT) for the preoperative depiction of hepatocellular carcinoma (HCC).
14926.3492407071997.08.21++Malignant splenic lymphoma: sonographic patterns, diagnosis and follow-up.Clin Radiol
C Gorg, R Weide, WB Schwerk,
Six hundred and eighty patients with malignant lymphoma were studied by abdominal sonography during 1983 and 1993 at our institution. Abnormal splenic texture was noted in 101 patients (14,8%). Involvement of the spleen was confirmed histologically (n = 8), by sonographic follow-up (n = 82), and on the basis of the clinical course in the remaining patients. Of the 101 patients with splenic involvement, 34 had Hodgkin's disease, 38 had a low-grade non-Hodgkin's lymphoma and 29 a high-grade non-Hodgkin's lymphoma. Four different sonographic patterns were observed: (1) Diffuse involvement in 37 patients (pts) (36.6%). (2) Focal small nodular lesions in 39 pts (38.6%). (3) Focal large nodular lesions in 23 pts (22,7%). (4) 'Bulky, disease' in two pts (1.9%). All of the high-grade lymphomas showed either large nodular (15/29) or small nodular (14/29) lesions. The diffuse or small nodular pattern was seen predominantly in low-grade lymphomas (35/38) and in Hodgkin's disease (31/34). CONCLUSION: A number of different patterns of splenic involvement in lymphoma can be demonstrated by ultrasound. Splenic sonographic patterns can be linked to histological lymphoma entities.
15026.3264047261983.06.10++[Limits of differentiation of focal splenic lesions by sonography and computed tomography].Rofo
R Lorenz, D Beyer, G Friedmann, U Mödder,
Based on the results of sonographic and CT-findings in 192 patients the advantages and disadvantages of ultrasonography and CT in the diagnosis of splenic lesions are presented with particular emphasis on anatomy and topography. The relatively uniform presentation of various focal lesions in ultrasonography and CT is demonstrated and the limits of differentiation are discussed. The importance of angiography and scintigraphy is also mentioned.
15126.29162728492005.12.23++Eosinophilic hepatic necrosis: magnetic resonance imaging and computed tomography comparison.J Comput Assist Tomogr
JS Yu, SW Yoon, MS Park, JH Lee, KW Kim,
To compare the findings of magnetic resonance (MR) imaging with those of computed tomography (CT) of focal liver lesions related to peripheral eosinophilia.
15226.2679282341994.11.01+ Effects of superparamagnetic iron oxide (AMI-25) on liver and spleen imaging using spin-echo and fast spin-echo magnetic resonance pulse sequences.Invest Radiol
LH Schwartz, SE Seltzer, DF Adams, CM Tempany, DR Piwnica-Worms, SG Silverman, L Herman, LT Herman, R Hooshmand,
15326.2688882201996.11.25++Hepatic malignancies: usefulness of acquisition of multiple arterial and portal venous phase images at dynamic gadolinium-enhanced MR imaging.Radiology
MS Peterson, RL Baron, T Murakami,
To determine whether liver tumor detection is increased by acquiring multiple dynamic arterial phase and portal venous phase magnetic resonance (MR) images.
15426.241108411979.09.25++The sonographic findings of splenic metastases.J Clin Ultrasound
JF Murphy, ME Bernardino,
The sonographic findings in five patients with metastases to the spleen are demonstrated. Hypoechoic lesions were seen in patients with histiocytic lymphoma, and both echogenic and hypoechoic lesions were seen in patients with melanoma. The clinical significance of these findings is discussed.
15526.24159081552005.12.06++Abdominal tuberculosis: imaging features.Eur J Radiol
JM Pereira, AJ Madureira, A Vieira, I Ramos,
Radiological findings of abdominal tuberculosis can mimic those of many different diseases. A high level of suspicion is required, especially in high-risk population. In this article, we will describe barium studies, ultrasound (US) and computed tomography (CT) findings of abdominal tuberculosis (TB), with emphasis in the latest. We will illustrate CT findings that can help in the diagnosis of abdominal tuberculosis and describe imaging features that differentiate it from other inflammatory and neoplastic diseases, particularly lymphoma and Crohn's disease. As tuberculosis can affect any organ in the abdomen, emphasis is placed to ileocecal involvement, lymphadenopathy, peritonitis and solid organ disease (liver, spleen and pancreas). A positive culture or hystologic analysis of biopsy is still required in many patients for definitive diagnosis. Learning objectives:
15626.2113185581992.07.15++[The dynamic magnetic resonance study of focal liver lesions by FLASH sequences with bolus intravenous gadolinium-DTPA].Radiol Med
L Olivetti, L Grazioli, R Maroldi, L Matricardi, L Milanesio,
Thirty-five patients with hepatic hemangioma (n = 12), metastasis (n = 10), hepatocellular carcinoma (HCC) (n = 10) and focal nodular hyperplasia (n = 3) were examined with the fast low-angle shot (FLASH) technique and an intravenous bolus injection of Gd-DTPA. In order to differentiate the lesions, the following criteria were used: a) pre Gd-DTPA intensity of lesions; b) post Gd-DTPA patterns of contrast enhancement. On the basis of these criteria, an unquestionable differential diagnosis could be made. Hemangiomas were characterized by an hypointense mass before Gd-DTPA, by peripheral contrast enhancement and by subsequent continuous hyperintense fill-in; thus, hemangiomas were visualized as hyperintense lesion during the late phase. Before contrast administration hypovascular metastases appeared as hypointense; they were characterized by delayed uptake of contrast agent. HCCs were hyperintense lesions before contrast administrations; then, quick contrast enhancement and rapid decrease in signal intensity were observed with visualization of a hyperintense ring due to the capsule. Finally, focal nodular hyperplasia appeared isointense or hypointense relative to normal liver on precontrast scans; the lesions were enhanced transiently with subsequent quick dismission of contrast agent. This initial experience suggests dynamic contrast-enhanced MR imaging as an effective method to improve the differential diagnosis among hepatic tumors when precontrast T2-weighted images are equivocal.
15726.0129580301987.10.26++Magnetic resonance imaging, chest radiography, computed tomography and ultrasonography in malignant lymphoma.Acta Radiol
R Nyman, S Rehn, B Glimelius, H Hagberg, A Hemmingsson, PG Lindgren, A Magnusson,
Magnetic resonance imaging (MRI) was compared with chest radiography, computed tomography (CT) and ultrasonography (US) for demonstration of spleen and liver engagement and enlarged lymph nodes in patients with malignant lymphoma. The investigation comprised 24 patients with Hodgkin's disease (HD) and 39 with non-Hodgkin lymphoma (NHL). MRI demonstrated enlarged lymph nodes, distinctly separated from vessels, fat, muscle, liver and occasionally also pancreas without any contrast medium. The distinction between lymph nodes and spleen was, however, poor in the images. In the mediastinum, MRI was superior to chest radiography and had an accuracy similar to that of CT. In the abdomen and the pelvis MRI had slight advantages over CT in detection of enlarged lymph nodes. Compared with US the MRI results were similar in the abdomen and somewhat better in the pelvis. MRI and US were better than CT in revealing HD infiltrates in the spleen. Infiltration of NHL in the spleen was slightly better disclosed at US than at CT and MRI; most of the NHL infiltration, confirmed at histopathology, could, however, not be revealed with any of the modalities, except when the size of the spleen was considered. Regions in the spleen, displayed with low image intensity in the T2 weighted image, were most likely due to increased amount of fibrotic tissue in the lymphomatous lesions. Good demonstration of lymph nodes and lymphomatous lesions in the spleen with MRI required two sequences; one with short TR and TE (T1 weighted image) and one with long TR and TE (T2 weighted image).
15825.9724058811990.03.29++The spleen: an integrated imaging approach.Crit Rev Diagn Imaging
RJ Rolfes, PR Ros,
In this review we attempted to demonstrate the imaging appearance of the spectrum of entities that may involve the spleen. The systematic approach reviewing the radiologic findings by modality (plain films, ultrasound, CT, scintigraphy, angiography, and MRI) has been used. We have opted to present the information following pathologic categories (congenital, infections, cysts, benign and malignant tumors, vascular, trauma, and miscellaneous) rather than a pattern approach. A pattern approach may not be practical in spleen since patterns are few and nonspecific. Although a specific diagnosis can be obtained rarely, the information provided by imaging coupled with clinical and laboratory data is capable in many cases of significantly altering patient management. Surgery, percutaneous intervention, medical therapy, or simple observation can be pursued based on the radiological findings.
15925.97127040482003.06.30++Comparing Levovist-enhanced pulse inversion harmonic imaging and ferumoxides-enhanced MR imaging of hepatic metastases.AJR Am J Roentgenol
C Del Frate, C Zuiani, V Londero, G Como, M Bazzocchi, K Mortele, PR Ros,
The aim of this study was to compare the sensitivity of pulse inversion harmonic digital sonography, unenhanced transabdominal sonography, and ferumoxides-enhanced MR imaging in the depiction of liver metastases. In addition, pulse inversion harmonic digital sonography was performed at different scanning times after Levovist injection to define the best phase for depiction.
16025.9721226821990.12.27++MR imaging of the normal and abnormal clivus.AJR Am J Roentgenol
F Kimura, KS Kim, H Friedman, EJ Russell, R Breit,
We retrospectively reviewed 330 T1-weighted sagittal images, 80 T2-weighted sagittal images, and 83 gadopentetate-dimeglumine-enhanced scans of normal adults to determine the MR appearance of the normal adult clivus. MR images of 21 patients with an abnormal clivus (19 with tumor invasion and two with marrow reconversion) were also evaluated retrospectively and compared with those of the control group to assess MR features distinguishing the two groups. Our study revealed that a normal adult clivus consisted of low- and high-intensity portions mixed in various proportions on T1-weighted images. The low-intensity portion was isointense or hyperintense relative to the pons and always contained foci of bright signal intensity. The low-intensity tumor of a pathologic clivus tended to be hypointense relative to the pons (17/19), and was completely devoid of foci of bright signal intensity. The normal adult clivus was approximately isointense relative to the pons on T2-weighted images. Clival tumors were grossly hyperintense relative to the pons on T2-weighted images in 11 of 17 patients. In the remaining six patients, either a portion of or the entire lesion was isointense relative to the pons and, therefore, was not detectable on T2-weighted images. A normal adult clivus can enhance to some degree (19/83). Clival tumors were found to enhance intensely. A clivus of very low signal intensity (signal void) on T1- or T2-weighted images was always abnormal. The clivus with marrow reconversion was uniformly hypointense relative to the pons on T1-weighted images and isointense relative to normal marrow on T2-weighted images. The intensity patterns of the normal clivus on T1- and T2-weighted MR images change predictably with advancing age. Intensity patterns of abnormal clivi differ from those of normal clivi. When contrast material is used, normal and abnormal clivi generally show different patterns of enhancement.
16125.8899322561999.04.16++Multimodality demonstration of primary splenic angiosarcoma.J Clin Ultrasound
S Aytaç, S Fitoz, C Atasoy, I Kuzu, K Cinar, I Erden,
Angiosarcomas are rare, accounting for only 1-2% of all soft tissue sarcomas. Primary abdominal angiosarcomas usually arise in the liver or spleen. We report the first color Doppler findings of a rare, low-grade splenic angiosarcoma in a 52-year-old woman.
16225.88103786551999.08.04++CT and MR findings of splenic angiosarcoma.Radiat Med
I Imaoka, K Sugimura, M Furukawa, S Kuroda, K Yasui,
A surgically confirmed primary splenic angiosarcoma is described. Although angiography showed most of the characteristic findings of the present patient, MR imaging provided a useful information as a supplemental tool. The tumor demonstrated low-signal intensity on both T1- and T2-weighted images, which might differ from hemangioma findings. Subacute hemorrhage within the tumor was revealed by MR imaging, suggesting the way in which the tumor grew during a short period of time. This finding was different from reported angiosarcoma MR findings of siderotic nodules within the tumor. After the administration of Gd-DTPA, MR images clearly demonstrated heterogeneous enhancement within the tumor, which corresponded to the pathologic findings of solid parenchyma with necrotic tissues.
16325.8876178631995.08.23++Detection of liver metastases: comparison of superparamagnetic iron oxide-enhanced and unenhanced MR imaging at 1.5 T with dynamic CT, intraoperative US, and percutaneous US.Radiology
KD Hagspiel, KF Neidl, AC Eichenberger, W Weder, B Marincek,
To compare the sensitivities of superparamagnetic iron oxide-enhanced and unenhanced magnetic resonance (MR) imaging at 1.5 T with those of percutaneous ultrasound (US), intraoperative US (IOUS), and dynamic computed tomography (CT) in the preoperative assessment of metastatic liver disease.
16425.7335543341987.05.28++[Modern imaging procedures in splenic diseases].Radiologe
W Wenz, G Bodendörfer,
Imaging procedures have lately become important in pathologic conditions of the spleen, because they are simple to use and do not cause much stress to the patient. Ultrasonography is the method of choice for determination of the position, shape, size and volume of the spleen, and also for the diagnosis of changes within the spleen. Circumscribed lesions cannot be detected by ultrasonography until they have reached a size of 0.5-1.0 cm; the same limit of detection applies for CT, which has approximately the same diagnostic reliability. In the presence of generalized splenic disease (e.g. splenomegaly in myeloid leukaemia) imaging procedures are being used increasingly for staging and for monitoring of the results of treatment. Perhaps in future histochemical determinations made with the aid of core-spin spectroscopy will present a further means of diagnosis without the necessity for biopsy. Angiography was the leading diagnostic technique for spleen conditions for many years, and continues to occupy this place for primary disease of the spleen (aneurysm, arterioportal fistula, haemangioma); it is currently gaining in importance with the advent of therapeutic embolization as an option. For diffuse spleen disease and also for circumscribed lesions, however, it has now been superseded by the non-invasive methods of diagnosis.
16525.6592167711997.07.31++Venous aneurysms: MR diagnosis with the "layered gadolinium" sign.J Comput Assist Tomogr
G Krinsky, G Johnson, N Rofsky, R Shapiro, B Yang, J Weinreb,
Our goal was to present MR findings in venous aneurysms and introduce the "layered gadolinium" sign as an ancillary diagnostic finding.
16625.64172598372007.03.19++Focal peliosis hepatis as a mimicker of hepatic tumors: radiological-pathological correlation.J Comput Assist Tomogr
SH Kim, JM Lee, WH Kim, JK Han, JY Lee, BI Choi,
To retrospectively evaluate the radiological findings in patients with focal peliosis hepatis and to correlate them with pathological findings.
16725.62115170612001.09.20++Detection of malignant hepatic tumors: comparison of gadolinium-and ferumoxide-enhanced MR imaging.AJR Am J Roentgenol
M Matsuo, M Kanematsu, K Itoh, K Ito, Y Maetani, H Kondo, N Kako, N Matsunaga, H Hoshi, J Shiraishi,
The purpose of our study was to compare how well gadolinium-enhanced and ferumoxide-enhanced MR imaging reveal malignant hepatic tumors.
16825.6084397571993.04.01++Hepatic and splenic sarcoidosis: ultrasound and MR imaging.Abdom Imaging
A Kessler, DG Mitchell, HL Israel, BB Goldberg,
Abdominal imaging studies may be performed for various indications in patients known to have sarcoidosis. To assess magnetic resonance imaging (MRI) and sonographic ability to detect abnormalities in sarcoidosis patients with abdominal involvement, a prospective study on 18 selected patients was performed. Besides organomegaly, when present, ultrasound demonstrated normal or increased hepatic parenchymal echogenicity, coarsening of the liver parenchyma with or without discrete nodules, focal calcifications, as well as contour irregularity. Splenic discrete nodules were seen on ultrasound in a single patient. Besides organomegaly, MRI abnormalities include abnormal hepatic signal intensity, discrete nodules, contour irregularity, speculation of small hepatic vascular branches, and a high periportal signal intensity. MRI splenic abnormalities include contour irregularity, nodularity, and abnormal signal intensity. The data presented in this study reveals the spectrum of ultrasound and MRI findings in sarcoidosis patients with abdominal organ involvement, potentially enabling the evaluation of the severity of the disease. MRI appears more sensitive than ultrasound for study of abdominal sarcoidosis.
16925.56115842392001.10.18++Splenic imaging with ultrasmall superparamagnetic iron oxide ferumoxtran-10 (AMI-7227): preliminary observations.J Comput Assist Tomogr
MG Harisinghani, S Saini, R Weissleder, D Rubin, E deLange, S Harms, J Weinreb, W Small, A Sukerkar, JJ Brown, J Zelch, M Lucas, M Morris, PF Hahn,
Ferumoxtran-10 (ultrasmall superparamagnetic iron oxide; Combidex, AMI-7227) is a long-circulating MR contrast agent with reticuloendothelial uptake known to enhance tissue T1 and T2 relaxation rates. The purpose of this study was to assess the effect of ferumoxtran-10-enhanced MRI in evaluating focal splenic lesions.
17025.5477247721995.05.19++Clinical results with Resovist: a phase 2 clinical trial.Radiology
P Reimer, EJ Rummeny, HE Daldrup, T Balzer, B Tombach, T Berns, PE Peters,
To investigate the superparamagnetic iron oxide (Resovist) designed for contrast material-enhanced magnetic resonance imaging of the liver.
17125.533915101980.03.24+ [Diagnosis of splenic diseases].Chirurg
KF Gürtler, C Schneider, E Bücheler,
17225.4926550051989.06.14++Abdominal lymphoma in AIDS: evaluation with US.Radiology
RR Townsend, FC Laing, RB Jeffrey, K Bottles,
The sonographic findings in 38 patients with abdominal lymphomas related to acquired immunodeficiency syndrome (AIDS) were reviewed. Thirty-three patients had non-Hodgkin lymphoma, and five had Hodgkin disease. Abnormal masses were detected with sonography in 33 patients (87%). Focal hypoechoic liver lesions up to 10 cm in diameter were visible in 17 patients. Several lesions were anechoic and septated, mimicking fluid. Adenopathy (at the retroperitoneum, mesentery, or porta hepatis) was seen in 15 patients. Other involved areas included bowel, omentum, spleen, kidney, and adrenal gland. AIDS-related abdominal lymphomas frequently cause extranodal masses that can be readily imaged with ultrasound. Ultrasound-guided fine needle aspiration biopsy allows a specific diagnosis to be made in many cases.
17325.4674807341995.12.21++Spinal cord ependymomas: MR imaging features.Radiology
MJ Fine, II Kricheff, D Freed, FJ Epstein,
To assess the magnetic resonance (MR) imaging characteristics of spinal intramedullary ependymomas.
17425.4087679981996.09.17+ [Isolated splenomegaly].Internist (Berl)
G Nickenig, Y Ko, C Wanning, H Müller-Miny, K Zhou, H Vetter,
17525.3429603431988.01.19++An attempt to characterize malignant lymphoma in spleen, liver and lymph nodes with magnetic resonance imaging.Acta Radiol
R Nyman, S Rhen, A Ericsson, B Glimelius, H Hagberg, A Hemmingsson, C Sundström,
An attempt was made to explore whether relaxation times and/or normalized image intensities obtained from magnetic resonance imaging (MRI) can separate malignant and non-malignant lymphomatous tissue. Spin-echo (SE) techniques with repetition times of 500 and 1,500 ms and echo times of 35 and 70 ms were used for estimating T1 and T2. Estimation of T1 and T2 with such a low number of spin-echo sequences resulted in considerable variation in the data especially when T1 was long. Similar information was also extracted by normalizing the image intensities to the 'proton density' image (1,500/35), and the spread of the data was then markedly reduced. Therefore, the method of normalizing was considered a more appropriate way of handling the image data when only a few sequences were available. No significant difference could be discerned in the MRI parameters between normal spleens and spleens infiltrated with malignant lymphoma, between normal livers and livers in patients with malignant lymphoma and between lymph nodes with low or high grade non-Hodgkin lymphoma. Lymphomatous tissue had similar MRI characteristics irrespectively of whether the cells were malignant or not, or located in spleens or in lymph nodes. The main biologic explanation for variation in data seems to be mostly the variable amounts of fibrosis, necrosis, oedema and/or iron content.
17625.3278951931995.04.27++Abdominal manifestations of sarcoidosis. CT appearances.Clin Imaging
J Farman, G Ramirez, J Brunetti, J Tuvia, C Ng, H Rotterdam,
Sarcoidosis frequently involves the abdomen, although imaging studies often fail to demonstrate disease. The most common computed tomography (CT) findings in abdominal sarcoidosis are hepatosplenomegaly and retroperitoneal adenopathy, followed by focal low-attenuation lesions of the liver and spleen. Other abdominal viscera are involved infrequently. We present four cases of abdominal sarcoidosis demonstrating a range of CT findings.
17725.2493150001997.10.23++Pathologic conditions in the small bowel: findings at fat-suppressed gadolinium-enhanced MR imaging with an optimized suspension of oral magnetic particles.Radiology
SC Faber, MK Stehling, N Holzknecht, J Gauger, T Helmberger, M Reiser,
Depiction of small-bowel pathologic conditions was optimized with use of a negative luminal contrast agent, spectral fat suppression, and gadolinium enhancement in an excised gut phantom. The method was applied in nine patients in conjunction with standard enteroclysis examinations. Bulk susceptibility effects of oral magnetic particles were canceled with use of a diamagnetic methylcellulose suspension. In the ileum, fat suppression and contrast between bowel wall and lumen was judged good or excellent in eight and nine patients, respectively. In eight of nine patients, additional mesenteric findings were depicted.
17825.24160968682006.03.10++Splenic hypoperfusion as a sign of systemic amyloidosis.Abdom Imaging
PP Mainenti, L Camera, S Nicotra, T Cantalupo, E Soscia, D Di Vizio, G Insabato, M Salvatore,
The spleen is frequently involved in systemic amyloidosis; however, the computed tomographic (CT) or magnetic resonance (MR) pattern of splenic amyloidosis is not sufficiently described in the literature. This study evaluated the contrast-enhanced CT and MR findings of the spleen in patients with systemic amyloidosis.
17925.2281262891994.04.11+ Bacillary angiomatosis in the abdomen: Doppler and CT features.J Comput Assist Tomogr
LE Kunberger, BM Montalvo,
18025.0780164041994.07.28++Primary splenic lymphoma presenting as a large cyst.Radiat Med
A Nakashima, K Nakashima, H Seto, T Kamei, M Kakishita, M Kitagawa,
An atypical case of splenic lymphoma is presented. A large cystic mass lesion in the splenic area was found in an 80-year-old man. He was involved in a traffic accident, and subsequently the cyst ruptured. The histological diagnosis of malignant lymphoma was made at emergency splenectomy. No other lesions were identified, and there were no signs of tumor recurrence four months after the operation.
18125.05157286032005.04.14++Contrast-enhanced sonography with SonoVue: enhancement patterns of benign focal liver lesions and correlation with dynamic gadobenate dimeglumine-enhanced MRI.AJR Am J Roentgenol
P Ricci, A Laghi, V Cantisani, P Paolantonio, S Pacella, E Pagliara, F Arduini, V Pasqualini, F Trippa, M Filpo, R Passariello,
OBJECTIVE: Contrast-enhanced real-time low-mechanical-index sonography is a new diagnostic technique for the assessment of macro- and microcirculation. The purpose of our article is to describe contrast-enhancement patterns of different benign focal liver lesions using the second-generation contrast agent SonoVue and to compare these findings with those of gadobenate dimeglumine-enhanced MRI. CONCLUSION: SonoVue-enhanced real-time low-mechanical-index sonography provides specific contrast-enhancement patterns of different benign focal liver lesions, allowing accurate characterization. Findings on SonoVue-enhanced sonography correlate well with those obtained on gadobenate dimeglumine-enhanced MRI.
18225.03107462772000.05.03++[Focal echogenic splenic involvement in malignant lymphoma: a diagnostic problem].Ultraschall Med
J Riera-Knorrenschild, C Görg, N Dennhardt, I Restrepo, A Neubauer,
The aim of our study was to describe clinical data, frequency of the findings, sonographic patterns, confirmation of diagnosis, and differential diagnosis of focal echorich splenic lymphoma involvement.
18324.9986105581996.05.28++Renal lymphoma: demonstration by MR imaging.AJR Am J Roentgenol
RC Semelka, NL Kelekis, DA Burdeny, DG Mitchell, JJ Brown, ES Siegelman,
The objective of this study was to demonstrate the spectrum of appearances of renal lymphoma using current MR techniques including gadolinium enhancement.
18424.9691537061997.07.14++Biphasic contrast-enhanced multisection dynamic MR imaging of the liver: potential pitfalls.Radiographics
K Ito, DG Mitchell, K Honjo, T Fujita, H Awaya, T Matsumoto, N Matsunaga,
Biphasic contrast material-enhanced dynamic magnetic resonance (MR) imaging is an important technique for evaluating liver disease. However, several potential diagnostic pitfalls may be encountered, including lobar, segmental, subsegmental, and subcapsular hyperperfusion abnormalities; early-enhancing pseudolesions, particularly in the medial segment of the left hepatic lobe; heterogeneous hyperperfusion abnormalities throughout the liver; and hypointense pseudolesions due to vascular artifacts, unenhanced hepatic vessels, partial volume artifacts, magnetic susceptibility artifacts, and regenerative nodules in cirrhosis. These abnormalities sometimes have appearances similar to those of true lesions or tumor spread to the surrounding liver parenchyma on arterial-dominant phase dynamic MR images. In most cases, however, no corresponding abnormalities are seen with other pulse sequences or on delayed-phase MR images. In addition, hyperperfusion abnormalities due to readily recognizable causes are often found in characteristic locations and thus can be differentiated from true tumors. An understanding of the causes of these potential pitfalls and how to avoid them will help radiologists understand and correctly interpret images.
18524.9586729721996.08.15++Correlation of perfusion abnormalities on CTAP and immediate postintravenous gadolinium-enhanced gradient echo MRI.Abdom Imaging
JF Schlund, RC Semelka, U Kettritz, SM Weeks, M Kahlenberg, WG Cance,
The purpose of this study was to evaluate patients with wedge-shaped perfusion defects seen on spiral CT arterial portography for the presence of transient increased wedge-shaped enhancement on dynamic gadolinium-enhanced gradient echo MR images.
18624.9418957961991.10.18++[Abdominal tuberculosis in patients with acquired immunodeficiency syndrome].Med Clin (Barc)
V Soriano, J Tor, E Doménech, E Gabarre, R Muga, L Inaraja, D Casas, J Olazábal, B Clotet,
In individuals with HIV infection, extrapulmonary forms of tuberculosis are considered as opportunistic infections and are included in the diagnosis of AIDS. They often have atypical clinical features. Abdominal participation is uncommon and its diagnosis may be difficult.
18724.93184526702008.07.07++Accessory spleen presenting as mass in the left upper abdomen.J Coll Physicians Surg Pak
Y Yagmur, H Ozturk,
An enlarged accessory spleen, 10 x 8 x 6 cm in diameter, adjoining the spleen appearing as a mass on CT and ultrasonography is reported herein. Accessory spleen is an ectopic mass of healthy splenic tissue separate from the main body of the spleen. It should be considered the differential diagnosis of an enlarged mass in the left upper quadrant.
18824.93175835612008.01.24++US-guided percutaneous needle biopsy of the spleen using 18-gauge versus 21-gauge needles.J Clin Ultrasound
P Liang, Y Gao, Y Wang, X Yu, D Yu, B Dong,
To compare the techniques of sonographically (US)-guided percutaneous needle biopsy of the spleen using 18-gauge and 21-gauge needles.
18924.9295020911998.03.16++Primary non-Hodgkin's splenic lymphoma.Clin Radiol
AH Dachman, JL Buck, J Krishnan, NS Aguilera, PC Buetow,
To describe the imaging, clinical and pathological features of primary splenic lymphoma using a strict definition.
19024.91174503392007.06.28++Evaluation of the changes in signals from the spleen using ferucarbotran.Radiat Med
T Gomi, M Nagamoto, M Tsunoo, S Terada, H Terada, E Kohda,
Because superparamagnetic iron oxide is actively taken into the reticuloendothelial system, the signal intensity observed on T2-weighted images is reduced not only in the liver but also in the spleen. There is no difference in the reduction in signal intensity in the liver after contrast between the ferumoxides and ferucarbotran, but the reduction in signal intensity in the spleen is considerable. In the present study, we examined the efficacy of T2*-weighted imaging to compensate for the reduction in signal intensity in the spleen by administering ferucarbotran.
19124.85163014522006.01.12+ Image of the month. Littoral cell angioma.Arch Surg
SP Cheng, TL Yang, BF Chen, CL Liu,
19224.83109880472000.10.17++Multicentre dose-ranging study on the efficacy of USPIO ferumoxtran-10 for liver MR imaging.Clin Radiol
S Saini, R Sharma, RL Baron, DA Turner, PR Ros, PF Hahn, WC Small, EE Delange, AE Stillman, RR Edelman, VM Runge, EK Outwater,
A dose ranging multicentre phase-II clinical trial was conducted to evaluate the efficacy of ultrasmall superparamagnetic iron oxide (USPIO) ferumoxtran-10 for magnetic resonance (MR) imaging of focal hepatic lesions.
19324.7886882291996.08.28++Imaging of tuberculosis. II. Abdominal manifestations in 112 patients.Acta Radiol
C Lundstedt, R Nyman, J Brismar, C Hugosson, I Kagevi,
To describe the radiological findings of tuberculosis (TB) of the abdomen as reflected at our hospital.
19424.74127202702004.01.06++MRI of focal nodular hyperplasia (FNH) with gadobenate dimeglumine (Gd-BOPTA) and SPIO (ferumoxides): an intra-individual comparison.J Magn Reson Imaging
L Grazioli, G Morana, MA Kirchin, P Caccia, L Romanini, MP Bondioni, C Procacci, A Chiesa,
To compare the efficacy of two different MR contrast agents for the detection and diagnosis of focal nodular hyperplasia (FNH).
19524.74172850862007.03.29+ [Littoral cell angioma of the spleen].J Chir (Paris)
A Achour, MA Filali, C Benabdellah, R Elhassani, M Poinsard,
19624.7010129631977.03.21+ [Splenic morphology in angiographic investigations (author's transl)].Pol Przegl Radiol Med Nukl
B Pawlak,
19724.6488328751996.11.07++Polyorchidism and rete testis adenoma: ultrasound and MR findings.Abdom Imaging
TJ Figler, MC Olson, GJ Kinzler,
Polyorchidism is an uncommon congenital anomaly. It is associated with an increased frequency of testicular malignancy, cryptorchidism, inguinal hernia, and torsion. Sonography may be used to confirm the clinically suspected diagnosis. We present a case of polyorchidism in which a rete testis adenoma was present in one of the testicles. Sonographic and magnetic resonance findings are illustrated.
19824.63117722182002.01.30++Surgical indications in idiopathic splenomegaly.Arch Surg
JA Carr, M Shurafa, V Velanovich,
The incidence of primary lymphoma of the spleen in patients with idiopathic splenomegaly is significant.
19924.6288674291996.12.04++[New MR contrast media in liver diagnosis. Initial clinical results with hepatobiliary Eovist (gadolinium-EOB-DTPA) and RES-specific Resovist (SH U 555 A)].Radiologe
P Reimer, B Tombach, H Daldrup, T Hesse, G Sander, T Balzer, K Shamsi, T Berns, EJ Rummeny, PE Peters,
The purpose of this work is to describe our initial clinical experience (in 66 patients) with Resovist and Eovist, two new liver-specific MR contrast agents. We focus our report on safety aspects, dose finding, and optimization and technical parameters. Both contrast agents were well tolerated and improved the detectability of focal liver lesions. With Resovist, postcontrast MRI may be started as early as 10 min following injection. The dose of 8 mumol Fe/kg bodyweight was sufficient to achieve diagnostic tumor-liver contrast levels. Since Eovist can also be administered as a bolus, dynamic enhancement patterns may be studied for tumor characterization as well. Breath-hold T1-weighted FLASH images were superior to other T1-weighted techniques with and without fat saturation.
20024.6049835671970.03.05+ [Primary tumors of the spleen. Clinical contribution].Haematologica
S Francalanci, L Gazzola,
20124.6080614271994.09.20++Malignant lesions of the liver identified on T1- but not T2-weighted MR images at 1.5 T.J Magn Reson Imaging
RC Semelka, AS Bagley, ED Brown, MA Kroeker,
The authors reviewed their 2 1/2-year experience with a magnetic resonance (MR) imaging protocol for a 1.5-T MR imager that included T2-weighted fat-suppressed spin-echo, T1-weighted breath-hold gradient-echo, and serial dynamic gadolinium-enhanced T1-weighted gradient-echo imaging to identify histologic types of malignant liver lesions more apparent on T1- than on T2-weighted images. MR images of 212 consecutive patients with malignant liver lesions were reviewed. T2-weighted, T1-weighted, and dynamic contrast-enhanced T1-weighted images were examined separately in a blinded fashion. Seven patients demonstrated liver lesions (lymphoma [two patients] and carcinoid, hepatocellular carcinoma, colon adenocarcinoma, transitional cell carcinoma, and melanoma [one patient each]) on T1-weighted images that were inconspicuous on T2-weighted images. In all cases, the lesions were most conspicuous on T1-weighted images obtained immediately after administration of contrast agent. Histologic confirmation was present for all seven patients. The consistent feature among these lesions was that they were hypovascular, due either to a fibrous stroma or to dense monoclonal cellularity. These results suggest that in some patients with hypovascular primary neoplasms, the lesions may be identified only on T1-weighted images, and that immediate postcontrast T1-weighted images are of particular value in demonstrating lesions.
20224.5991345821997.07.23++MR imaging of focal nodular hyperplasia of the liver: value of contrast-enhanced dynamic study.Radiat Med
H Irie, H Honda, K Kaneko, T Kuroiwa, T Fukuya, K Yoshimitsu, M Ono, T Kawanami, M Yoshida, T Maeda, K Masuda,
To clarify the role of MR imaging of hepatic focal nodular hyperplasia (FNH), MR images of 11 patients with 13 FNH were retrospectively reviewed. MR imaging with T1- and T2-weighted spin echo sequences was performed for all lesions. Dynamic studies using the SPGR technique followed by postcontrast delayed T1-weighted images were performed in four patients with five lesions. Gd-DTPA enhanced T1-weighted images were obtained in five patients with six lesions. Two patients with single lesions received no contrast agent. The signal intensity, morphologic appearance, and enhancement patterns were evaluated. Dynamic MR study revealed homogeneous early vigorous enhancement and prolonged enhancement in all five lesions. On T1-weighted images, three lesions were hypointense, six were isointense, and four were hyperintense to the surrounding hepatic parenchyma. On T2-weighted images, four lesions were isointense and nine were hyperintense. A central scar was identified in eight lesions and showed delayed enhancement. It is concluded that dynamic MR studies are mandatory for diagnosing FNH.
20324.51110903992001.01.03++Detection of hepatic lesions in candidates for surgery: comparison of ferumoxides-enhanced MR imaging and dual-phase helical CT.AJR Am J Roentgenol
DA Bluemke, EK Paulson, MA Choti, S DeSena, PA Clavien,
The purpose of this study was to compare the use of phased array MR imaging of the liver at 1.5 T with and without ferumoxides with dual-phase helical CT for the detection of hepatic lesions in candidates for hepatic surgery.
20424.5077877131995.07.24++Dynamic contrast-enhanced MR imaging of fibrolamellar hepatocellular carcinoma.Abdom Imaging
K Corrigan, RC Semelka,
The magnetic resonance (MR) appearance of fibrolamellar hepatocellular carcinoma (FL-HCC) on T1- and T2-weighted and dynamic serial postgadolinium-DTPA images is reported. Both tumors were large (> 7 cm in shortest dimension) and had central regions of low signal intensity on T1- and T2-weighted images. Diffuse heterogeneous enhancement of the tumors occurred on immediate postcontrast images. Lesions became more homogeneous in enhancement over time, but lack of enhancement of central portions of the tumor persisted. Although persistent lack of enhancement of the tumor scar on late postcontrast MR images may be characteristic of FL-HCC compared with delayed enhancement in focal nodular hyperplasia, the potential similarities between these tumors is stressed.
20524.497330521979.03.13++[Cystic lymphangioma of the spleen associated with hypersplenism].Minerva Med
G Santagati, M Marra, S Scarlata, P Garbagna, R Luppino, F Forgione,
A rare case of cystic lymphangioma of the spleen accompanying hypersplenism syndrome is described. After stressing the importance of certain examinations such as arteriography and splenic scintigraphy in diagnosis the condition, the many ways in which cystic lymphangioma of the spleen may present clinically are reviewed; these go from asymptomatic to straightforward splenomegaly, with or without clinical signs, up to a clear-cut hypersplenism syndrome. The present case merits consideration for three reasons: 1) The absolutely exceptional nature of cystic lymphangioma of the spleen; 2) Exceptional association with hypersplenism syndrome; 3) Remission of the syndrome following splenectomy. It is concluded that, notwithstanding the condition's rarity, cystic lymphangioma of the spleen should be considered in the differential diagnosis of splenomegalic syndromes when these are also accompanied by hypersplenism.
20624.4514268441992.12.10++Gd-DTPA as an intestinal contrast agent for MR imaging of the lower abdomen: phase III clinical trial.Gastrointest Radiol
L Vlahos, A Gouliamos, W Clauss, A Kalovidouris, A Athanasopoulou, A Petroulakis, A Hadjiioannou, C Papavasiliou,
Thirty-one patients were investigated with magnetic resonance (MR) imaging of the lower abdomen before and after the administration of gadopentetate dimeglumine (Gd-DTPA) solution per os or per rectum or from both routes for the opacification of the intestinal tract. The parameters evaluated were: (a) contrast medium distribution, (b) degree of filling of the bowel lumen, (c) contrast between the bowel lumen and the surrounding normal or pathological structures, and (d) whether the administration of the contrast agent improved the diagnostic ability of MR compared to computed tomography (CT) or plain MR of the same region. Gd-DTPA, at a concentration of 1 mmol/L, produced a positive signal irrespective of its dilution in the bowel and good contrast between the bowel lumen and the adjacent tissues or any possible pathological lesions. From the diagnostic point of view, after the administration of contrast medium, MR is comparable to CT and much superior to plain MR. It is concluded that opacification of the bowel with Gd-DTPA solution will improve the diagnostic yield of MR imaging of the lower abdomen.
20724.4293084651997.10.16++Perfusion-weighted MR imaging in the upper abdomen: preliminary clinical experience in 61 patients.AJR Am J Roentgenol
T Ichikawa, H Haradome, J Hachiya, T Nitatori, T Araki,
We quantitatively analyzed the potential usefulness of perfusion-weighted (PW) MR imaging of the upper abdomen performed with a single-shot gradient-recalled echo echoplanar (GRE EP) sequence.
20824.38108822682000.08.01++Hepatic angiosarcoma: findings on multiphasic contrast-enhanced helical CT do not mimic hepatic hemangioma.AJR Am J Roentgenol
MS Peterson, RL Baron, SC Rankin,
OBJECTIVE: The objective of our study was to identify multiphasic contrast-enhanced helical CT findings of angiosarcoma of the liver to determine whether this tumor could be confused with hemangioma of the liver. CONCLUSION: Angiosarcoma of the liver is a multifocal tumor with a variety of findings on multiphasic contrast-enhanced helical CT. None of the findings would usually be confused with the typical findings of hepatic hemangioma.
20924.3496468241998.07.22+ Liver hemangioma: US-guided core-needle biopsy.Radiology
RD Harris,
21024.2885088371993.07.12++Primary lymphoma of the liver: MR findings.Eur J Radiol
P Soyer, B Van Beers, C Grandin, J Pringot, M Levesque,
Primary lymphoma of the liver is a rare disease. The MR appearances of three cases of pathologically confirmed primary non-Hodgkin's lymphoma of the liver are presented. All three lymphomatous lesions appeared as unique well demarcated focal liver lesions on MR images. On T1-weighted images, two lesions were hypointense and one slightly hyperintense to the liver. On T2-weighted images, the three lesions were slightly heterogeneous and hyperintense. Lobulation, which was better seen on T2-weighted images, was noticed in one lesion. One lesion was studied after gadopentetate dimeglumine injection and showed marked and heterogeneous enhancement.
21124.26168619772006.09.12++Metastasizing splenic littoral cell hemangioendothelioma.Am J Surg Pathol
S Fernandez, GW Cook, DA Arber,
Littoral cell angioma is a unique splenic tumor that is generally considered to be benign. We present a case of a low-grade littoral cell splenic tumor that metastasized to the liver and retroperitoneum 4 years after splenectomy. Although the splenic lesion showed the typical morphology of a littoral cell angioma, it also contained areas with unusual solid nests of cytologically bland, plump cells with clear cytoplasm. The liver was diffusely infiltrated exclusively by cells with similar clear cell features. Both splenic and liver lesions demonstrated identical immunophenotypes, typical of littoral cell angioma, expressing CD31, CD68, CD21, and CD163, although negative for CD8 and CD34. A single prior description of a littoral cell hemangioendothelioma showed nuclear atypia and necrosis, and this is the first case report of a splenic littoral cell hemangioendothelioma with a completely bland histologic appearance. This case suggests that the presence of solid areas of clear cells in a littoral cell angioma may be a marker of low-grade malignant potential in these tumors.
21224.2280920271994.10.20++MR imaging of the uterus: findings from high-resolution multisection dynamic imaging with a surface coil.AJR Am J Roentgenol
K Ito, T Fujita, H Uchisako, N Tanaka, M Matsui, K Tsukamoto, T Matsumoto, T Nakanishi,
MR imaging of the female pelvis with a local coil (multiple phased array coils) has been reported. With this method, the signal-to-noise ratio (S/N) is improved so that high-resolution images can be obtained. Dynamic contrast-enhanced MR imaging has been reported to be useful in diagnosing uterine neoplasms. However, dynamic MR imaging is done in only limited imaging planes. When multisection dynamic MR imaging with fast gradient-echo sequences is combined with the use of a local coil, high-resolution images can be obtained throughout the entire uterus during a single breath-hold. This pictorial essay illustrates the appearance of the normal uterus and malignant uterine neoplasms on high-resolution multisection dynamic MR images obtained with a Helmholtz-type surface coil.
21324.1619367791991.11.22++Hepatosplenic AIDS-related Kaposi's sarcoma.Gastrointest Radiol
C Valls, C Cañas, LG Turell, X Pruna,
Abdominal ultrasonography (US) and computed tomography (CT) were performed in one patient with acquired immunodeficiency syndrome (AIDS) and biopsy-proven hepatosplenic Kaposi's sarcoma. Small hyperechoic nodules were seen in the liver and spleen at US. CT revealed hepatosplenomegaly and low-attenuation focal lesions in the liver. These findings, although nonspecific, are suggestive of hepatosplenic involvement in Kaposi's sarcoma.
21424.0943768701975.08.26+ [Posttraumatic hemorrhagic pseudocysts of the spleen (4 cases)].
J Grosdidier, F Boileau, B Richaume,
21524.0735381551987.01.21++Hemangioma of the spleen: radiologic-pathologic correlation in ten cases.Radiology
PR Ros, RP Moser, AH Dachman, PJ Murari, WW Olmsted,
Ten cases of hemangioma of the spleen were reviewed. Plain abdominal radiographs and scintigrams are helpful in specifying the splenic location. Calcification, either central punctate or peripheral curvilinear, can be detected on radiographs or computed tomographic (CT) scans. The spectrum form solid to cystic change observed in the pathologic specimens is reflected in analogous patterns on CT scans and sonograms: predominantly solid mass; mass with cystic spaces. The angiographic findings are nonspecific. It is possible to suggest the diagnosis of hemangioma of the spleen when an asymptomatic patient presents with a discrete splenic mass, particularly if there is evidence of calcification and cystic change within the lesion.
21624.0767140091984.05.30+ [Calcified lymphangioma of the spleen. A contribution to the diagnosis and differential diagnosis of splenic cysts].Chirurg
C Röhrborn, JU Alles,
21724.07185949222009.01.06++Laparoscopic splenectomy for solitary splenic tumors.Surg Endosc
V Makrin, S Avital, I White, B Sagie, A Szold,
Solitary splenic masses are a rare entity. There is a paucity of data in the literature on the evaluation and laparoscopic treatment for splenic masses. To further elucidate the evaluation and laparoscopic management of splenic masses we evaluated our own data.
21824.05174933872009.04.21++[Sclerosing angiomatoid nodular transformation of spleen].Zhonghua Bing Li Xue Za Zhi
XD Teng, XR Yu, GH Wang, LJ Xu, MD Lai,
To study the clinicopathologic features of sclerosing angiomatoid nodular transformation of spleen and its differential diagnosis.
21924.02120103002002.07.12++Efficacy of sequential use of superparamagnetic iron oxide and gadolinium in liver MR imaging.Acta Radiol
J Halavaara, P Tervahartiala, H Isoniemi, K Höckerstedt,
To evaluate the efficacy of combined (double contrast) use of superparamagnetic iron particles (SPIOs) and gadolinium (Gd) in liver MR imaging.
22024.0182200321993.12.07++Hodgkin's and non-Hodgkin's hepatic lymphoma: sonographic findings.Abdom Imaging
P Soyer, B Van Beers, F Teillet-Thiébaud, C Grandin, F Kazerouni, J Barge, J Pringot, M Levesque,
The sonographic studies of 72 patients with pathologically proven Hodgkin's or non-Hodgkin's hepatic lymphoma were retrospectively reviewed. Sixty-eight patients (94%) had secondary hepatic lymphoma (nine of them had AIDS-related lymphoma) and four patients (6%) had primary lymphoma of the liver. Forty-six of 72 patients (64%) had diffuse hepatic involvement, and 26 of 72 patients (36%) had focal liver lesions as demonstrated by sonography. Four patterns of disease were identified: (a) hepatomegaly was depicted by sonography in 26 of the 59 patients with secondary hepatic lymphoma not related to AIDS, in two of the nine patients with AIDS-related secondary hepatic lymphoma, and in one of the four patients with primary hepatic lymphoma; (b) multiple rounded well-delineated hypoechoic liver lesions were found in 22 of the 68 patients with secondary hepatic lymphoma; (c) a large heterogeneous echoic mass, which was an evocating clue to the diagnosis of primary lymphoma of the liver, was found in the four patients with primary lymphoma of the liver; and (d) an absence of sonographic abnormalities was found in 20 of the 59 patients with secondary lymphoma not related to AIDS. Liver involvement with lymphoma should be considered in any patient who develops multiple homogeneous hypoechoic liver masses, even in the absence of known underlying lymphomatous disease.
22123.9614387621992.12.18++High-attenuation lymphadenopathy in AIDS patients: significance of findings at CT.Radiology
BR Herts, AJ Megibow, BA Birnbaum, GK Kanzer, ME Noz,
A retrospective evaluation was performed of the location and attenuation characteristics of abdominal and pelvic lymphadenopathy, identified at dynamic sequential bolus computed tomography (CT) in 69 patients with acquired immunodeficiency syndrome (AIDS). Lymph node appearance at CT was characterized as hyperattenuating, isoattenuating, or hypoattenuating relative to the iliopsoas muscle. The significance of finding hyperattenuating adenopathy in the patient population was evaluated. Thirty-three patients had hyperattenuating adenopathy, including 26 with the epidemic form of Kaposi sarcoma (KS). Of 38 patients with epidemic KS, 26 had hyperattenuating, 11 had isoattenuating, and one had hypoattenuating lymphadenopathy. The positive predictive value of hyperattenuating adenopathy for epidemic KS was 79%. These findings were statistically significant at the 95% confidence interval (P < .005). Hyperattenuating lymphadenopathy, identified on dynamic sequential bolus CT scans in AIDS patients, was seen with disseminated KS in approximately 80% of cases.
22223.9365786961983.11.23+ [Tomodensitometry in focal splenic pathology].Ann Radiol (Paris)
A Anjou, L Chollat, PM Bret, M Bretagnolle, PJ Valette, D Poix,
22323.9122983531990.03.07++Massive bleeding after fine needle aspiration of liver angiosarcoma.Gastrointest Radiol
Y Hertzanu, J Peiser, H Zirkin,
Open or closed biopsy of liver angiosarcoma is a life-threatening procedure. A case of massive bleeding after fine needle aspiration of the liver is reported in a patient having an angiosarcoma of the liver and spleen. Fine needle aspiration seems a hazardous procedure in this disease.
22423.8867660081980.02.15++Abdominal disease in children: a comparison of computed tomography and ultrasound.AJR Am J Roentgenol
RC Brasch, IB Abols, CA Gooding, RA Filly,
Diagnoses from computed tomographic (CT) and ultrasonic examinations of the abdomen in 29 pediatric patients were reviewed retrospectively to compare the sensitivity and specificity of the two methods for detection of abnormalities and to assess their differential diagnostic accuracies. No difference in sensitivy (87%) and specificity (100%) was observed between the two imaging methods. However, the differential diagnostic accuracy in abnormal cases was greater with CT than ultrasound. The combined information from CT and ultrasound allowed for correct diagnoses in all but three instances. Findings from each technique considered separately would have resulted in erroneous diagnoses in four instances using CT and nine instances using ultrasound. Diagnostic information obtained from CT and ultrasound examinations were complementary in many instances.
22523.8681262651994.04.11++Enhanced high-resolution sagittal MRI of normal pineal glands.J Comput Assist Tomogr
Y Inoue, S Saiwai, T Miyamoto, J Katsuyama,
Our goal was to determine the appearance and enhancement pattern of human pineal glands on MRI.
22623.84113181342001.08.02++Laparoscopic splenectomy for a lymphangioma of the spleen: report of a case.Surg Today
AH Kwon, H Inui, K Tsuji, S Takai, A Imamura, Y Kamiyama,
We present the first case report of a successful laparoscopic complete excision of a splenic lymphangioma. The splenic tumor was preoperatively diagnosed to be a lymphangioma by the combined modalities of ultrasonography, computed tomography, magnetic resonance imaging, and angiography. A laparoscopic splenectomy was subsequently performed and the pathological examination of the mass confirmed the diagnosis of a lymphangioma. Based on the above findings, a laparoscopic splenectomy is recommended when a splenic tumor is suspected to be either benign or borderline.
22723.8021645381990.08.17++Dynamic sequential MR imaging of focal liver lesions: initial experience in 22 patients at 1.5 T.J Comput Assist Tomogr
U Schmiedl, G Kölbel, CF Hess, U Klose, B Kurtz,
The feasibility of dynamic sequential magnetic resonance (MR) imaging of focal hepatic lesions using Gd-diethylenetriamine pentaacetic acid (DTPA) was evaluated in this study. Three patients with hepatocellular carcinoma, 12 patients with metastases, and 7 patients with hemangiomas were studied with pre- and postcontrast multislice spin echo (SE) images using a repetition time of 500 ms and an echo time of 15 ms. The dynamic distribution phase of Gd-DTPA (0.1 mmol/kg) was investigated by using a sequential, transverse partial flip imaging sequence [fast low angle shot (FLASH)] before and after intravenous administration of Gd-DTPA. The lesion-liver contrast-to-noise ratio showed a great variability in patients with metastases and was significantly improved following administration of Gd-DTPA in patients with hemangiomas, two patients with hepatocellular carcinoma, and eight patients with metastases both on FLASH and SE images. Hemangiomas appeared darker than liver parenchyma on precontrast SE and FLASH images, increasingly enhanced over 5 min postinjection (pi) on FLASH images, and were still greatly enhanced at 10 min pi on SE images. During the dynamic sequential image acquisition the contrast enhancement of hemangiomas was significantly different from the enhancement observed in malignant lesions. The results of this study indicate the clinical potential of dynamic sequential imaging for the MR assessment of focal hepatic lesions.
22823.8039034221985.12.18++[Ultrasonic diagnosis of splenic and hepatic lesions in lymphogranulomatosis].Med Radiol (Mosk)
AF Tsyb, GD Baĭsogolov, OV Nestaĭko, SG Chernykh,
Ultrasound investigation was conducted in 21 patients with Hodgkin's disease to determine the involvement of the spleen and liver in the process. The results obtained were verified histologically in 19 cases at laporotomy and in 2 cases at autopsy. Focal spleen lesion (focal sizes from 0.3-2 cm) was correctly recognized in 7 out of 9 patients, liver lesion in 3 out 4 patients. No false-positive results were obtained in cases in which spleen and liver lesions were not determined histologically. The value of ultrasound investigation for dynamic observation in liver lesion was emphasized. The method was recommended for a wide clinical use and assessment of therapeutic results of disseminated Hodgkin's disease.
22923.7592016741997.08.14++Characterization of focal hepatic masses by dynamic contrast-enhanced MR imaging: findings in 311 lesions.Magn Reson Imaging
SP Quillin, S Atilla, JJ Brown, JA Borrello, CY Yu, TK Pilgram,
This study aimed to determine the overall accuracy of known enhancement patterns for the characterization of a large series of focal hepatic masses on dynamic contrast-enhanced magnetic resonance (MR) images. Breath-hold T1-weighted images of the liver acquired before intravenous gadolinium administration and serially over 6-10 min after contrast injection were acquired in < 25 a using FLASH or rapid spin-echo pulse sequences. A total of 311 proven focal hepatic masses in 128 patients were analyzed, including 192 malignant lesions (166 metastases and 26 hepatomas) and 119 benign lesions (48 cavernous hemangiomas, 45 hepatic cysts, and 26 other abnormalities). The lesions were evaluated for a variety of characteristics independently by two reviewers who were blinded to results. Cavernous hemangiomas showed early peripheral nodular enhancement (80% sensitivity and 99% specificity) and hepatic cysts showed no enhancement (100% sensitivity and 95% specificity). Hepatic metastases showed variable, moderate enhancement (47% by one reviewer and 74% by the other). Metastatic lesions from hypervascular primary neoplasms displayed peak enhancement during the hepatic artery dominant (bolus) phase, while other malignant neoplasms showed later peak enhancement (72% sensitivity and 77% specificity). Five metastatic foci with early homogeneous enhancement showed a delayed peripheral washout of contrast (rim sign), while no nonmetastatic foci displayed this finding (3% sensitivity and 100% specificity). Characteristic enhancement patterns of focal hepatic lesions were described in a large series of patients. This study confirms results of previous investigators who have shown that early nodular peripheral enhancement was highly specific for hemangiomas and lack of enhancement was highly specific for hepatic cysts. Hypervascular metastatic foci show earlier peak enhancement than other malignant lesions. Some (2-3%) metastatic lesions display a peripheral washout of contrast on serial images, with 100% specificity.
23023.6782843921994.02.17++Focal liver lesions: characterization with nonenhanced and dynamic contrast material-enhanced MR imaging.Radiology
B Hamm, RF Thoeni, RG Gould, ME Bernardino, M Lüning, S Saini, AE Mahfouz, M Taupitz, KJ Wolf,
To evaluate prospectively the diagnostic accuracy of non-enhanced and gadolinium-enhanced magnetic resonance (MR) imaging in characterization of hepatic lesions.
23123.67184401732009.02.10++Gadolinium- and superparamagnetic-iron-oxide-enhanced MR findings of intrapancreatic accessory spleen in five patients.Magn Reson Imaging
V Herédia, E Altun, F Bilaj, M Ramalho, BW Hyslop, RC Semelka,
The purposes of this study were to describe dynamic gadolinium-enhanced magnetic resonance imaging (MRI) findings of intrapancreatic accessory spleen(s) (IPAS) in five patients and to show how superparamagnetic iron oxide (SPIO) enhancement can be used for definite characterization in two cases.
23223.6627832731989.01.23++The diagnosis of splenic lymphoma by MR imaging: value of superparamagnetic iron oxide.AJR Am J Roentgenol
R Weissleder, G Elizondo, DD Stark, PF Hahn, J Marfil, JF Gonzalez, S Saini, LE Todd, JT Ferrucci,
This study was designed to evaluate superparamagnetic iron oxide (AMI-25) as a contrast agent for MR to distinguish normal spleens from those diffusely infiltrated by lymphoma. As diffuse splenic involvement lacks visible tumor-tissue boundaries, signal-intensity measurements of spleens were used as a diagnostic criterion in 33 patients (lymphoma, n = 8; benign splenomegaly, n = 5; normal subjects, n = 20). Unenhanced MR images were insensitive (four of eight patients) and nonspecific (20 of 25 patients) in the diagnosis of lymphoma. After injection of superparamagnetic iron oxide (40 mumol Fe/kg), lymphomatous spleens showed a significantly higher signal intensity (p less than .05) than did normal spleens or spleens enlarged by benign disease (hepatic cirrhosis, n = 4; spherocytosis, n = 1). Changes in splenic MR signal intensity unambiguously identified eight of eight lymphomatous spleens and 25 of 25 normal or enlarged spleens that did not contain lymphoma. Phagocytosis of superparamagnetic iron oxide in lymphomatous spleens is reduced because of diffuse displacement of splenic macrophages by lymphoma cells and/or by immunologic suppression of macrophage activity. Our results suggest that superparamagnetic iron oxide (AMI-25) can improve the accuracy of MR imaging in the diagnosis of splenic lymphoma. With further development, this noninvasive technique may reduce the need for diagnostic splenectomy in lymphoma patients.
23323.66112651262001.05.21++[Dynamic MR imaging of liver lesions with superparamagnetic iron oxide (SH-U-555A)].Nihon Igaku Hoshasen Gakkai Zasshi
K Saito, J Ishida, N Ito, D Kakizaki, F Kotake, K Abe,
Dynamic MRI with SH-U-555 (SPIO) was evaluated. Dynamic MRI was performed for 17 patients with 22 lesions. Dynamic study with T2*-weighted imaging (T2* dynamic) and T1-weighted imaging (T1 dynamic) were performed in 8 cases (10 lesions) and 9 cases (12 lesions), respectively. T2* dynamic MR images were obtained before and 30, 90, 180, 270, 360, and 450 seconds and 31 minutes after the intravenous injection of SPIO, and T1 dynamic MR images were obtained before and 0, 40, 80, 120, 180, 240, 300, 360, 420, and 480 seconds and 28 minutes after the injection of SPIO. The signal intensity of each lesion was measured before and after the injection of SPIO. The enhancement ratio of the lesions was calculated and evaluated. The enhancement ratio of hypervascular lesions decreased rapidly in the first phase of T2* dynamic MRI, while that of hypovascular lesions decreased gradually. The enhancement ratio of hypervascular lesions increased in the first phase of T1 dynamic MRI and decreased gradually, while that of hypovascular lesions lacked the increase in the first phase, in contrast to hypervascular lesions. However, the changing of signal intensity could not be recognized on images with T2* dynamic and T1 dynamic study. In conclusion, quantitative analysis using the enhancement ratio made it possible to anticipate lesion vascularity.
23423.6490510281997.03.28++Benign and malignant musculoskeletal masses: MR imaging differentiation with rim-to-center differential enhancement ratios.Radiology
LD Ma, FJ Frassica, EF McCarthy, DA Bluemke, EA Zerhouni,
To assess the diagnostic potential of the rim-to-center differential enhancement ratio in the magnetic resonance (MR) imaging differentiation of benign from malignant musculoskeletal masses.
23523.57128861352003.08.29++Clinical and imaging findings of lymphoma in patients with Sjögren syndrome.J Comput Assist Tomogr
H Tonami, M Matoba, Y Kuginuki, H Yokota, K Higashi, I Yamamoto, S Sugai,
To describe and correlate the clinical and imaging findings of lymphomas in patients with Sjögren syndrome.
23623.57100244001999.04.05++Atypical hepatic hemangiomas with intense arterial enhancement and early fading.Abdom Imaging
L Martí-Bonmatí, C Casillas, M Graells, L Masiá,
Our purpose is to analyze the prevalence and characteristics of the enhancement patterns of hemangiomas.
23723.55115030942001.10.11++Splenic lymphoma: differentiation from splenic cyst with ultrasonography.Abdom Imaging
H Ishida, K Konno, J Ishida, H Naganuma, T Komatsuda, M Sato, S Watanabe,
Lymphoma can be nearly anechoic and mimic a cyst on ultrasonography (US). To investigate whether this phenomenon occurs at the level of the spleen, we analyzed the US findings of 38 cases of splenic lymphoma and 16 cases of splenic cyst.
23823.5231344391988.08.24+ Splenic involvement in Gaucher's disease: sonographic findings.J Clin Ultrasound
PG Stevens, SS Kumari-Subaiya, LB Kahn,
23923.5214505071993.01.07++Inflammatory pseudotumor of the spleen.Intern Med
T Inada, T Yano, S Shima, Y Ishikawa, S Irie, M Ishida, Y Nakamura, K Ishibashi, H Kageyama,
The case of a 39-year-old man with inflammatory pseudotumor of the spleen is presented. This is an extremely rare benign lesion with histologic features of non-specific inflammatory and reparative changes. The literature is reviewed and this case is compared clinically and radiologically with the previously reported cases.
24023.52151001222004.06.29++Comparison of superparamagnetic iron oxide-enhanced and gadobenate dimeglumine-enhanced dynamic MRI for detection of small hepatocellular carcinomas.AJR Am J Roentgenol
YK Kim, CS Kim, YH Lee, HS Kwak, JM Lee,
The purpose of this study was to compare superparamagnetic iron oxide (SPIO)-enhanced MRI with gadobenate dimeglumine-enhanced MRI for the detection of hepatocellular carcinoma using receiver operating characteristic (ROC) analysis.
24123.50110290982000.11.30++CT fluoroscopic guidance for percutaneous needle placement into abdominopelvic lesions with difficult access routes.Abdom Imaging
GD Schweiger, VY Yip, BP Brown,
We wished to evaluate the utility of computed tomography fluoroscopy (CTF) for guiding percutaneous abdominopelvic biopsies or fluid aspirations that are considered difficult with conventional computed tomographic (CT) guidance.
24223.4833759871988.06.28++Surgical therapy of localized abdominal non-Hodgkin's lymphomas.Surgery
SJ Mentzer, RT Osteen, TN Pappas, DS Rosenthal, GP Canellos, RE Wilson,
Non-Hodgkin's lymphomas may involve a variety of abdominal organs, including the liver, spleen, gastrointestinal tract, and retroperitoneum. The number of organs potentially involved and the noncontiguous mode of spread make non-Hodgkin's lymphoma a difficult tumor to evaluate at the time of laparotomy. To clarify the surgical management of patients with this tumor, we retrospectively reviewed the medical records of 202 patients with histologically proven abdominal lymphomas. Within this group, 36 patients underwent laparotomy before they had chemotherapy or radiation therapy. Ten patients were explored to establish a histologic diagnosis of lymphoma. The remaining 26 patients underwent laparotomy because of presumed benign disease. Twenty patients were found to have localized disease at laparotomy. Patients with localized disease demonstrated significantly better survival than patients with extranodal and nodal involvement (p less than 0.05). Four patients with local resection received no adjuvant therapy and were free of disease a median of 50 months after surgery.
24323.4897541031998.10.15++Dynamic gadolinium-enhanced MR findings in infantile hepatic hemangioendothelioma.J Comput Assist Tomogr
KJ Mortele, PJ Mergo, M Urrutia, PR Ros,
We report a case of a 2 1/2-year-old girl presenting with abdominal pain, fever, vomiting, and hepatomegaly. In spite of the unusual age at presentation, dynamic gadolinium-enhanced MR findings, which have not been previously illustrated, proved to be highly specific for the diagnosis of infantile hepatic hemangioendothelioma because of the characteristic enhancement pattern.
24423.4590150651997.02.27++Detection of focal liver lesions: CT of the hepatobiliary system with gadoxetic acid disodium, or Gd-EOB-DTPA.Radiology
SA Schmitz, JH Häberle, T Balzer, K Shamsi, J Boese-Landgraf, KJ Wolf,
To evaluate the efficacy and safety of gadoxetic acid disodium, or Gd-EOB-DTPA, as a tissue-specific hepatobiliary contrast agent at computed tomography (CT) in patients with liver metastases.
24523.4232615061988.09.16++CT of small pyogenic hepatic abscesses: the cluster sign.AJR Am J Roentgenol
RB Jeffrey, CS Tolentino, FC Chang, MP Federle,
Of 36 consecutive patients with pyogenic liver abscesses evaluated by CT, five (14%) had multiple small abscesses less than 2 cm in size. The CT appearance of the small pyogenic abscesses was compared with that of 10 patients who had either fungal or mycobacterial abscesses and with that of 50 patients who had hepatic metastases. In all five patients who had small pyogenic abscesses, the abscesses appeared to cluster, or aggregate, in a pattern that suggested the beginning of coalescence into a single, larger abscess cavity (cluster sign). This cluster appearance was not seen in in any of the patients who had fungal or mycobacterial microabscesses. It was present in only one of the patients who had confirmed hepatic metastasis. Despite the small size of the abscesses, guided needle aspiration was successful in recovering pyogenic organisms in four of the five patients. In our experience, the presence of the cluster sign suggests that the lesions are pyogenic abscesses.
24623.41112640702001.04.19++Prediction rule for characterization of hepatic lesions revealed on MR imaging: estimation of malignancy.AJR Am J Roentgenol
R Tello, HM Fenlon, T Gagliano, VL deCarvalho, EK Yucel,
Our aims were to establish factors that are most predictive of hepatic lesion malignancy and to formulate a prediction rule.
24723.40125924612003.06.11++Evaluation of retroperitoneal and pelvic lymph node metastases with MRI and MR lymphangiography.Abdom Imaging
MF Bellin, L Lebleu, JB Meric,
Local, regional lymph node involvement is an essential prognostic factor and an important determinant of treatment choices for patients with retroperitoneal and pelvic cancer. Current cross-sectional imaging modalities, including computed tomography and magnetic resonance (MR) imaging, use the nonspecific criterion of size and are limited in their ability to differentiate benign from malignant lymph nodes. MR lymphography is a promising imaging modality in differentiating benign from metastatic lymph nodes and provides information on lymph node morphology and function. Ultrasmall superparamagnetic iron oxide (USPIO) particles with a long plasma circulation time are suitable as an MR contrast agent for intravenous MR lymphography. They are taken up by macrophages in normally functioning nodes and reduce the signal intensity of tissue in which they accumulate because of T2 and susceptibility effects of iron oxide. In metastatic nodes, macrophages are replaced by cancer cells, which lack reticuloendothelial activity and cannot take up USPIO. The main mechanisms that might explain a heterogeneous node appearance after USPIO injection are discussed. In published reports, USPIO has shown high degrees of sensitivity and specificity for characterizing lymph nodes in cancer patients. We review the development of USPIO compounds, their imaging characteristics, and our clinical experience.
24823.3998446831999.01.06++T1 effects of a bolus-injectable superparamagnetic iron oxide, SH U 555 A: dependence on field strength and plasma concentration--preliminary clinical experience with dynamic T1-weighted MR imaging.Radiology
P Reimer, M Müller, C Marx, D Wiedermann, R Muller, EJ Rummeny, W Ebert, K Shamsi, PE Peters,
To investigate the field strength dependency of relaxivity values with SH U 555 A, concentration-dependent T1 effects, and findings at dynamic T1-weighted magnetic resonance (MR) imaging in patients with focal liver lesions.
24923.3886579221996.08.01++Sarcoidlike reaction in patients with malignancy.Radiology
AR Hunsaker, RF Munden, RD Pugatch, SJ Mentzer,
To determine the radiologic features, pathogenesis, and prognostic importance of sarcoidlike reaction in patients with malignancy.
25023.37214345352011.04.19++The management of primary nonparasitic splenic cysts.Turk J Pediatr
O Boybeyi, I Karnak, FC Tanyel, AO Ciftçi, ME Senocak,
Primary nonparasitic splenic cysts (PNSC) are rare and their management in children has been controversial. We conducted this study to discuss various treatment modalities. The medical records of patients with PNSC (1991-2008) were evaluated retrospectively, including age, sex, history of trauma, presenting symptoms, physical examination and radiological findings, therapeutic approaches, and outcomes. Six patients, between 3 to 12 years of age with a male/female ratio of 2, were included. The presenting symptom was abdominal pain in all but one asymptomatic patient. Physical examination findings were unremarkable in all except for palpable spleen in two patients. Cyst sizes ranged from 3 x 4 cm to 10 x 12 cm. The patients were treated with aspiration-sclerotherapy (n=2), total splenectomy (n=2), partial splenectomy (n=1), and cyst excision (n=1). The pathological diagnoses were epidermoid cyst (n=5) and lymphangioma (n=1). The postoperative course was uneventful except for postsplenectomy fever (n=1), recurrence (n=1) and residual cyst (n=1). PNSC larger than 5 cm in diameter or those that are symptomatic should be treated surgically. Total splenectomy should not be done in children to avoid infectious postsplenectomy problems unless there is a mandatory condition like intraoperative bleeding. Aspiration-sclerosis is not recommended because of recurrence.
25123.37163021392005.12.19++[Differential diagnosis of focal liver lesions using contrast-enhanced MRI with SHU 555 A in comparison with unenhanced MRI and multidetector spiral-CT].Rofo
G Jung, L Poll, M Cohnen, A Saleh, H Vogler, M Wettstein, R Willers, U Mödder, JA Koch,
To evaluate the ability of contrast-enhanced MRI with SHU 555 A to provide additional information for characterization of focal liver tumors compared with non-enhanced MRI and multislice spiral CT.
25223.33173350402007.06.06++Superparamagnetic iron oxide (SPIO)-enhanced liver MRI with ferucarbotran: efficacy for characterization of focal liver lesions.J Magn Reson Imaging
S Namkung, CJ Zech, T Helmberger, MF Reiser, SO Schoenberg,
To evaluate the efficacy of ferucarbotran in T2-weighted (T2W) fast spin-echo (FSE) and T2*W gradient-echo (GRE) sequences for characterizing focal liver lesions.
25323.31198222402009.12.02++Contrast-to-noise ratios of liver lesions using subtraction imaging on multiphase 64-detector row CT.Clin Radiol
DJ Grand, M Beland, D Dupuy, WW Mayo-Smith,
To measure contrast-to-noise ratios of liver lesions on conventional enhanced and digitally subtracted multidetector row computed tomography (CT) images.
25423.2814304251992.12.16+ Intraosseous meningioma: CT and MR appearance.J Comput Assist Tomogr
HY Lee, J Prager, Y Hahn, RG Ramsey,
25523.2779728071994.12.21++Dynamic MR imaging of liver tumors: analysis with temporal reconstruction images.Radiology
L Martí-Bonmatí, L Masiá, C Torrijo, C Casillas, MD Ferrer,
To graphically display the time dependency of contrast enhancement of liver tumors at examination with dynamic magnetic resonance (MR) imaging.
25623.2597710991998.11.04++[The role of dynamic contrast magnetic resonance tomography in the complex radiation diagnosis of focal hepatic lesions].Vestn Rentgenol Radiol
LA Tiutin, SM Berezin, EV Rozengauz,
The results of complex radiation study of 269 patients with various focal hepatic diseases were analyzed. Present day methods of radiation study were used. Dynamic contrast magnetic resonance imaging (DCMRI) was made in 62 patients. It is concluded that DCMRI is higher sensitive in detecting focal hepatic diseases than other techniques. The time course of changes in signal intensity in different abnormalities greatly differs in quantitative and qualitative parameters, which differentiates the nosological nature of the revealed changes to a high accuracy.
25723.2497713821998.10.19++Ultrasound guided fine needle aspiration cytology in abdominal tuberculosis.Br J Radiol
R Suri, S Gupta, SK Gupta, K Singh, S Suri,
Although barium studies and CT are useful in assessing abdominal pathology in tuberculosis, imaging findings are not always specific and a histopathological or bacteriological confirmation is often required. The aim of the present study was to evaluate the role of ultrasound (US) guided fine needle aspiration cytology (FNAC) in the diagnosis of abdominal tuberculosis in patients with non-palpable lesions detected on US/CT. FNAC was performed on 31 sites in 30 patients. The sites included enlarged lymph nodes (n = 14), focal lesions in liver (n = 2) and spleen (n = 8), and thickened bowel in the ileocaecal region (n = 7). The results were classified cytomorphologically into four groups: (1) definite evidence of tuberculosis; (2) presumptive evidence of tuberculosis; (3) suggestive of tuberculosis; and (4) negative for tuberculosis. 18 of the 31 FNACs (58%) revealed a positive diagnosis of tuberculosis (definite evidence in nine patients and presumptive evidence in nine patients). 13 of the 31 FNACs (42%) showed either necrosis alone (n = 4) or negative results (n = 9). Zeihl-Neelson staining for acid-fast bacilli on direct smear was positive in only nine patients (29%). Splenic and lymph nodal FNAC had a high sensitivity (87.5% and 78.6%, respectively) in the diagnosis of tuberculosis. None of the bowel and liver FNACs was diagnostic. No complications were encountered. US guided FNAC offers a safe and accurate method of achieving a diagnosis in patients with suspected abdominal tuberculosis who present with radiologically demonstrable but non-palpable lesions, especially those involving lymph nodes and spleen.
25823.2218712721991.09.18++Normal abdominal enhancement patterns with dynamic gadolinium-enhanced MR imaging.Radiology
SA Mirowitz, E Gutierrez, JK Lee, JJ Brown, JP Heiken,
The objective of this study was to quantitatively and qualitatively determine contrast enhancement patterns of normal abdominal organs with dynamic gadolinium-enhanced magnetic resonance (MR) imaging. Dynamic gadolinium-enhanced, T1-weighted, spin-echo imaging was performed during a 23-second breath hold in 38 patients, with images acquired before, during, and at 1,2, and 5 minutes after bolus injection of gadopentetate dimeglumine. Enhancement patterns of normal liver, spleen, pancreas, adrenal gland, kidney, aorta, inferior vena cava, and fat were determined by visual evaluation and by performance of signal intensity measurements with an electronic cursor. Time-intensity curves demonstrated peak enhancement of all abdominal organs during or immediately after bolus injection of gadopentetate dimeglumine. MR enhancement patterns included visualization of renal cortical nephrogram and heterogeneous enhancement of the spleen during the bolus phase of contrast material administration. Peak enhancement of normal liver was 72%; spleen, 172%; pancreas, 82%; adrenal gland, 85%; and kidney, 291%. This study established reference data regarding abdominal organ enhancement that will be useful as dynamic gadolinium-enhanced MR imaging becomes clinically implemented.
25923.12173642012008.01.18++Laparoscopic extirpation of splenic hamartoma.Pediatr Surg Int
Y Tatekawa, H Kanehiro, Y Nakajima,
We presented a case of splenic hamartoma. A 12-year-old girl has had an abdominal pain since 9 years of age. Contrast-enhanced computed tomography scan at a local hospital revealed heterogeneous enhancement of a mass which is 5 cm in diameter, located near the surface of the spleen, diagnosed as hemangioma. She had an investigation with Levovist-enhanced ultrasonography and superparamagnetic iron oxide-enhanced magnetic resonance imaging on T2-weighted gradient-echo imaging, which showed a hypervascular echoic mass and a decrease of signal intensity. The imaging diagnosis was splenic hamartoma. She underwent laparoscopic splenectomy to prevent the spontaneous rupture. The splenic artery at the pancreas body was exposed, and doubly ligated by vessel clip and furthermore ligated by 3-0 silk. At the splenic hilum, the splenic artery and vein were dissected with the Endo GIA vascular linear cutting stapler. The spleen was captured into the Endocatch II retrieval bag and removed from a transverse lower abdominal (suprapubic) incision extended up 7 cm in length through a port site. In pathological findings, the tumor was compatible with hamartoma. Splenic hamartomas in pediatric patients have been described extremely rare. In clinical symptoms, spontaneously ruptured splenic hamartoma has been rarely reported.
26023.11113291542001.07.12++Non-hodgkin's lymphoma of the liver in patients with AIDS: sonographic, CT, and MRI findings.J Clin Ultrasound
EB Rizzi, V Schinina, M Cristofaro, V David, C Bibbolino,
We analyzed the sonographic, CT, and MRI findings in acquired immune deficiency syndrome (AIDS)-related non-Hodgkin's lymphoma (NHL) of the liver to evaluate the role of sonography in the diagnosis of this disease.
26123.0986334631996.07.01+ Gadopentetate dimeglumine-enhanced MR imaging of subdural hematoma in an abused infant.AJR Am J Roentgenol
PK Kleinman, RL Ragland,
26223.0578943081995.04.21++Cystic lymphangioma of the spleen: MR findings with pathologic correlation.Abdom Imaging
K Ito, T Murata, T Nakanishi,
A case of histologically confirmed cystic lymphangioma of the spleen was presented. On MR imaging, the mass was shown to multiloculated hyperintensity areas on T2-weighted images, corresponding to dilated lymphatic spaces. The septa were demonstrated as hypointensity bands, corresponding to abundant fibrous connective tissues. MR findings correlated well with histologic findings. MRI was a useful noninvasive modality for the diagnosis.
26323.0376053301995.08.10++Retroperitoneal lymphangioma.Australas Radiol
WH Breidahl, RM Mendelson,
Five cases of retroperitoneal lymphangioma are presented. In three patients the lesions were symptomatic, with resolution of the symptoms following resection. In two elderly patients the lesions were asymptomatic. Ultrasound demonstrated masses that ranged from 4 to 15 cm in maximal extent, and which were predominantly anechoic. Two contained septations and two echogenic debris. Computed tomography demonstrated the masses to be of water density, and allowed better delineation of the lesions to adjacent structures within the anterior pararenal space. Fine needle aspiration (FNA) produces a characteristic cytology of abundant lymphocytes, which may be intermingled with macrophages. It is considered that retroperitoneal lymphangioma has characteristic imaging features that allows a presumptive diagnosis, which can be confirmed by FNA.
26422.9674896251996.01.02++A sonographic-pathological correlation of liver biopsies in patients with the acquired immune deficiency syndrome (AIDS).Clin Radiol
TJ Beale, CW Wetton, ME Crofton,
The liver is commonly involved in patients with AIDS and a first line investigation for hepatic dysfunction is liver ultrasound (US) which is often abnormal. It is unclear how these US abnormalities correlate with the underlying pathological processes. A retrospective study was performed in 48 patients with HIV disease who had undergone both liver biopsy and hepatic (US), correlating the findings. Only 25% of patients had an entirely normal liver (US) examination and only 10% patients had a normal liver biopsy. The commonest sonographic abnormalities was a diffusely hyperechoic liver seen in 46% of patients and this correlated with steatosis. Forty-four percent of biopsies contained more than one histological abnormality including granulomas, inflammation, steatosis or siderosis. In addition clinically unsuspected pathology was revealed in five of the cases of mycobacterial infection and in three cases of lymphoma. The combination of multiple histological abnormalities, unsuspected pathology, and the altered immune response in this group makes the US findings even less specific than in non-AIDS patients. We recommend that liver biopsy should remain an essential and early part of the management of AIDS patients.
26522.9674807181995.12.21+ Technique for MR imaging of the liver.Radiology
S Saini, RC Nelson,
26622.9580614281994.09.20++Solitary hepatic metastasis: comparison of dynamic contrast-enhanced CT and MR imaging with fat-suppressed T2-weighted, breath-hold T1-weighted FLASH, and dynamic gadolinium-enhanced FLASH sequences.J Magn Reson Imaging
RC Semelka, JP Shoenut, SM Ascher, MA Kroeker, HM Greenberg, CS Yaffe, AB Micflikier,
Twenty consecutive cancer patients with a solitary hepatic metastasis detected with dynamic contrast-material-enhanced computed tomography (CT) who were considered for hepatic resection underwent magnetic resonance (MR) imaging within 18 days after CT. Histologic confirmation was obtained in all lesions. CT depicted 20 solitary lesions. MR imaging showed a solitary lesion in 14 patients, two lesions in three patients, and more than two lesions in three patients, for a total of 37 lesions. Twenty-three lesions less than 2 cm in diameter were missed with CT, and six lesions less than 1.3 cm in diameter were missed with MR imaging. MR imaging was superior to CT in the detection of hepatic metastases on a patient-by-patient basis (P < .01). The results suggest that MR imaging is superior to dynamic contrast-enhanced CT for the detection of hepatic metastases.
26722.9369750261981.12.21++Hepatic focal nodular hyperplasia: angiography, CT, sonography, and scintigraphy.AJR Am J Roentgenol
JV Rogers, LA Mack, PC Freeny, ML Johnson, PJ Sones,
Eleven patients with focal nodular hyperplasia of the liver underwent a combination of radiologic procedures, including sonography, computed tomography (CT), hepatic scintigraphy, and angiography. This paper describes the radiologic findings in this group of patients and reviews the current literature. In the present series, sonography was the most sensitive (100%) method for detection of focal nodular hyperplasia, while CT was able to detect only seven (78%) of nine cases. Arteriographic findings were felt to be characteristic in nine (82%) of 11 cases. Hepatic scintigraphy demonstrated normal colloid uptake in six (55%) of 11 lesions. In this series, an accurate radiologic diagnosis of focal nodular hyperplasia was made in 73% of cases. Hepatic scintigraphy is the pivotal examination. Normal colloid uptake by a focal hepatic mass is virtually diagnostic. However, in the patients in whom the colloid scan shows decreased or absent uptake, angiography may show findings diagnostic of focal nodular hyperplasia in up to 75% of cases, thus avoiding the need need for liver biopsy or surgery.
26822.93158551132005.06.09++MRI findings of focal eosinophilic liver diseases.AJR Am J Roentgenol
YK Kim, CS Kim, WS Moon, BH Cho, SY Lee, JM Lee,
OBJECTIVE: The purpose of this study was to describe the MRI findings of focal eosinophilic infiltration and eosinophilic abscess of the liver. CONCLUSION: MRI shows characteristic findings of focal eosinophilic liver disease that can be helpful in differentiating lesions of focal eosinophilic liver disease from other focal liver lesions. In addition, eosinophilic abscess and focal eosinophilic infiltration showed different MRI findings from each other.
26922.9167242421984.07.18++Radiologic diagnosis of wandering spleen complicated by splenic volvulus and infarction.Gastrointest Radiol
E Salomonowitz, MP Frick, G Lund,
Wandering spleen is a rare condition caused by malattachment of the dorsal mesogastrium. This condition is prone to torsion of the splenic pedicle leading to splenomegaly, hypersplenism, and infarction. Preoperative diagnosis can be suggested radiologically. A case of wandering spleen is reported and its embryologic, clinical, and radiographic features are discussed.
27022.8826720931989.09.25++Gamna-Gandy bodies of the spleen: evaluation with MR imaging.Radiology
T Sagoh, K Itoh, K Togashi, T Shibata, K Nishimura, S Minami, R Asato, S Noma, I Fujisawa, K Yamashita,
The authors retrospectively evaluated magnetic resonance (MR) images obtained in 64 patients with portal hypertension. Multiple low-intensity nodules were noted within the spleen in eight patients. In all eight cases, these nodules were most apparent on images obtained with the GRASS (gradient-recalled acquisition in the steady state) technique, which is known to be more sensitive to heterogeneity of the magnetic susceptibility, usually caused by hemosiderin deposition. In one of these cases, ultrasonography demonstrated diffuse hyperechoic spots that had been reported to represent Gamna-Gandy bodies of the spleen (ie, organized hemorrhage caused by portal hypertension). Although there was no pathologic proof in their series, the authors believe these low-intensity nodules seen on MR images may represent the hemosiderin deposits of Gamna-Gandy bodies.
27122.8682828851994.02.17++CT attenuation values and enhancing characteristics of thoracoabdominal lymphomatous adenopathies.J Comput Assist Tomogr
F Pombo, E Rodriguez, MV Caruncho, C Villalva, C Crespo,
Thoracoabdominal lymphomatous adenopathies have been described as homogeneous and typically showing little enhancement on postcontrast CT. After observing pronounced adenopathic contrast enhancement in one patient with lymphoma, we prospectively investigated the CT enhancing characteristics and attenuation values of pathologic thoracic and abdominal lymph nodes in 25 patients with lymphoma.
27222.8283329751993.08.16++[Splenic neoplasms].Tidsskr Nor Laegeforen
JT Pettersen, O Modalsli, K Solheim, T Buanes,
Carcinomas of the spleen are rare, whether primary or secondary. Two patients are described, one with a primary angiosarcoma. In this patient the first symptom was abdominal pain, caused by spontaneous rupture of the spleen. The other case was a woman with carcinoma of the breast which metastasized to the spleen. Both underwent splenectomy and adjuvant oncological treatment. Angiosarcomas constitute less than 1% of all sarcomas. Only about 60 cases of angiosarcomas in the spleen have been reported in the world literature. Spontaneous rupture of the spleen occurred in 30% of these cases. The prognosis for both untreated and treated splenic angiosarcomas is poor. Virtually all malignant tumours have been shown to metastasize to the spleen, most frequently from primary tumours localised to the breast, lung or ovary. Neoplasm should be considered for patients with splenomegaly having no apparent cause.
27322.81160375412005.10.05+ Pseudotumoral appearance of peliosis hepatis.AJR Am J Roentgenol
S Savastano, O San Bortolo, E Velo, C Rettore, G Altavilla,
27422.7930786871990.05.09+ The spleen.Clin Diagn Ultrasound
AB Kurtz,
27522.79102074301999.05.05++Hepatic lesion detection: comparison of MR imaging after the administration of superparamagnetic iron oxide with dual-phase CT by using alternative-free response receiver operating characteristic analysis.Radiology
J Ward, KS Naik, JA Guthrie, D Wilson, PJ Robinson,
To compare the performance of magnetic resonance (MR) imaging after the administration of superparamagnetic iron oxide (SPIO) and dual-phase computed tomography (CT) in the depiction of liver metastases.
27622.79152699502004.11.23++Nodule-in-nodule appearance of hepatocellular carcinomas: comparison of gadolinium-enhanced and ferumoxides-enhanced magnetic resonance imaging.J Magn Reson Imaging
S Goshima, M Kanematsu, M Matsuo, H Kondo, H Kato, R Yokoyama, H Hoshi, N Moriyama,
To perform comparison of gadolinium-enhanced and ferumoxides-enhanced magnetic resonance imaging (MRI) in the detection of nodule-in-nodule appearance of hepatocellular carcinomas (HCCs).
27722.78112865812001.05.10++Imaging of primary non-Hodgkin's lymphoma of the liver.Clin Radiol
MM Maher, SR McDermott, HM Fenlon, D Conroy, JC O'Keane, DN Carney, JP Stack,
To describe the radiological findings in primary liver lymphoma, which is a rare entity, presenting usually as a localized liver mass.
27822.76108872412000.07.27++Lymphangioleiomyomatosis: abdominopelvic CT and US findings.Radiology
NA Avila, JA Kelly, SC Chu, AJ Dwyer, J Moss,
To describe the abdominal computed tomographic (CT) and ultrasonographic (US) findings in patients with thoracic lymphangioleiomyomatosis (LAM) and to relate the prevalence of the findings to the severity of pulmonary disease.
27922.7618858101991.10.08++Hepatic focal nodular hyperplasia: diagnosis by ultrafast Gd-DTPA enhanced FLASH MR.J Comput Assist Tomogr
R Urhahn, KC Klose, M Drobnitzky,
The utility of gadolinium-enhanced ultrafast MR imaging in the diagnosis of focal nodular hyperplasia (FNH) of the liver was assessed in one patient. Contrast-enhanced serial snapshot-FLASH with a frequency of 30 images/min demonstrated the typical hemodynamic appearance of FNH known from CT studies.
28022.7070629731982.05.21 Case records of the Massachusetts General Hospital. Weekly clinicopathological exercises. Case 15-1982. Splenomegaly in a 55-year-old man.N Engl J Med
28122.6879728041994.12.21++Liver metastases: safety and efficacy of detection with superparamagnetic iron oxide in MR imaging.Radiology
MF Bellin, S Zaim, E Auberton, G Sarfati, JJ Duron, D Khayat, J Grellet,
To evaluate the clinical and biologic safety of superparamagnetic iron oxide (SPIO) as a contrast agent in magnetic resonance (MR) imaging and to assess its efficacy in the detection of liver metastases.
28222.65102278891999.06.03++Imaging features of nodular regenerative hyperplasia of the liver mimicking hepatic metastases.Abdom Imaging
M Clouet, I Boulay, M Boudiaf, P Soyer, J Nemeth, R Kiselman, R Rymer,
We described the sonographic, computed tomographic (CT), and magnetic resonance (MR) imaging features of one atypical case of nodular regenerative hyperplasia of the liver. The presence of multiple hepatic nodules suggested the diagnosis of metastatic disease to the liver because of a peripheral rim of enhancement on CT obtained after intravenous administration of contrast material and a halo sign on T2-weighted spin-echo MR imaging. Examination of the pathologic specimen obtained after surgical biopsy showed that the nodules were made of hepatocytes, with a nodular arrangement surrounded by peliosis, without fibrosis or cirrhosis. These findings suggested that peliosis may cause peripheral rim of enhancement on CT and halo sign on MR imaging. In light of this case, nodular regenerative hyperplasia of the liver should be considered in the differential diagnosis of hepatic metastases.
28322.6497412311998.11.24++[Inflammatory pseudotumor of the spleen. An old concept with many questions].Sangre (Barc)
B Madrigal, MJ Pérez del Río, A Vara, P Ablanedo, L Ovidio González, M Florentino Fresno,
Inflammatory pseudotumor of spleen is an infrequent benign condition. It is difficult to differentiate, on a clinical and radiological basis, from haematologic neoplasms, granulomatous diseases as sarcoidosis and splenic hamartoma. Sometimes can be an incidental finding. Two women, aged 72 years, are presented. On the first case the sympthons mi micked a malignant disease. The second one was an incidental finding in a routine study for cholecystitis. Histological and immunohistochemical study showed a polymorphic cellular population including plasma cell, lymphoid cells, histiocytes, eosinophils and spindle cells, showing a reactive benign character. Plasma cells presented light chains polyclonality. Lymphoid cells were mature and with T inmunophenotype. Spindle cells were focally positive for muscle spe-cific actin and vimentine. In the first case, ultraestructural study showed myofibroblast morphology on the stromal spindle cells. Like many other authors have already postulated, immunohistochemical and ultraestructural findings would corroborate the mesenchymal reactive and benign nature of this type of lesions.
28422.61203370112010.05.11+ [Giant splenomegaly with hypersplenism].Rev Esp Anestesiol Reanim
ME Infantes Morales, FJ Martínez Andreu, E Córdoba Díaz de Laspra, MJ Valenzuela Martínez,
28522.5889882221997.01.29++Hepatic arterial-phase dynamic gadolinium-enhanced MR imaging: optimization with a test examination and a power injector.Radiology
JP Earls, NM Rofsky, DR DeCorato, GA Krinsky, JC Weinreb,
To optimize findings at dynamic gadolinium-enhanced hepatic magnetic resonance imaging in the hepatic arterial phase, a timing examination was performed after injection of a 0.5-mL timing bolus of gadopentetate dimeglumine. In the experimental group (n = 28), power injection was used and the imaging delay was determined in each patient on the basis of the results of the timing examination. In the control group (n = 28), hand injection and a fixed 20-second imaging delay were used. Arterial-phase examinations (defined as relative liver enhancement of not more than 30% of peak parenchymal enhancement) were successful in 26 (93%) experimental group patients and in 17 (61%) control group patients.
28622.5781889071994.06.21++Mediastinal and hilar lymphadenopathy due to Pneumocystis carinii infection in AIDS patients: CT features.J Comput Assist Tomogr
B Mayor, P Schnyder, J Giron, M Landry, B Duvoisin, D Fournier,
Extrapulmonary involvement by Pneumocystis carinii (PC) in acquired immunodeficiency syndrome (AIDS) patients is uncommon. Our purpose is to describe three AIDS patients with low cluster differentiation cell (CD4) counts, who were receiving aerosol pentamidine prophylaxis, and who had large noncalcified hilar and mediastinal lymphadenopathy.
28722.55106157852000.02.01++[Splenic angiosarcoma: a case report with synchronous hepatic metastases].Chirurgie
E Fodzo, P Verhaeghe, C Cordonnier,
A 49 years old man in good physical condition suffering from abdominal pain in the right hypochondrium was hospitalized and CT scan revealed an hemoperitoneum, an enlargement of the liver and a rupture of an heterogeneous spleen. The patient was operated on and spleen removed. Pathological examination of the spleen concluded to a splenic cavernous hemangioma. In the postoperative course, an increase of liver nodules occurred within two weeks. A localized splenic angiosarcoma was recognized by reexamination of the specimen. The patient treated by chemotherapy was still alive after 5 months. Prognosis of splenic angiosarcoma is very poor; there is no curative treatment.
28822.5354620281970.05.27+ Isolated splenic vein occlusion. Review of literature and report of an additional case.Arch Surg
JP Sutton, DY Yarborough, JT Richards,
28922.4893036351997.09.22++[Indications for splenectomy in Gaucher's disease. Case report].G Chir
P Ferrazza, M Assenza, F Diomedi Camassei, A Lombardi, M Di Paola,
Gaucher's disease is a rare metabolic disorder characterized by the lack of beta-glucocerebrosidase enzyme. In this case report a 26-year-old male patient was, first diagnosed as having splenomegaly and a huge haemangioma, therefore managed by total splenectomy. Histologic examination and specific colouring techniques using PAS and Black Sudan dyes allowed the diagnosis of Gaucher's disease. Preoperative diagnosis is hence fundamental to establish the correct management procedure, which currently may be surgical or medical and/or combined. In fact, following the diagnosis the second step includes the decision-making about splenectomy. Other therapeutic approaches are enzyme replacement therapy and genic therapy. The first may be combined to partial splenectomy, while the latter still needs further evaluations.
29022.48146288712003.12.23++Hepatic metastases of soft tissue angiosarcoma: CT and MR imaging findings.Abdom Imaging
U Tateishi, T Hasegawa, Y Muramatsu, N Moriyama,
We describe the computed tomographic (CT) and magnetic resonance imaging (MRI) findings of hepatic metastases caused by soft tissue angiosarcomas to clarify the relation between radiologic appearances and clinicopathologic features.
29122.4247447221973.12.15+ Angiographic evaluation of cystic lesions of the spleen.Am J Roentgenol Radium Ther Nucl Med
JD Shanser, AA Moss, RE Clark, AJ Palubinskas,
29222.4193149831997.10.23++Small lymph nodes of the abdomen, pelvis, and retroperitoneum: usefulness of sonographically guided biopsy.Radiology
AJ Fisher, EK Paulson, DH Sheafor, CM Simmons, RC Nelson,
To evaluate the usefulness of sonographically guided percutaneous biopsy of small lymph nodes in the abdomen, retroperitoneum, and pelvis.
29322.3981889081994.06.21++US, CT, and MRI of primary and secondary liver lymphoma.J Comput Assist Tomogr
GS Gazelle, MJ Lee, PF Hahn, MA Goldberg, N Rafaat, PR Mueller,
To describe the imaging findings in patients with pathologically proven hepatic lymphoma.
29422.3826787041989.10.28++[Diagnosis and treatment of splenic abscess].Vestn Khir Im I I Grek
VV Utkin, MIa Iudin, MA Liepi'nsh, MIa Rubene, RR Ribenieks,
Eight patients with abscesses of the spleen were observed. The clinical picture had no special characteristics. Splenomegaly was not a pathognomonic symptom of the spleen abscess. The ultrasonic investigation and computed tomography were the main methods of diagnostics. The timely treatment of the spleen abscesses gives satisfactory results. The operation of choice is thought to be splenectomy.
29522.3879346581994.11.04++A comparative study between Gd-DTPA and oral magnetic particles (OMP) as gastrointestinal (GI) contrast agents for MRI of the abdomen.Magn Reson Imaging
L Vlahos, A Gouliamos, A Athanasopoulou, G Kotoulas, W Claus, A Hatziioannou, A Kalovidouris, C Papavasiliou,
In the present study we compared two gastrointestinal contrast agents--Gd-DTPA, a positive signal, and oral magnetic particles (OMP), a negative signal contrast agent--in patients who were referred for MR imaging of the abdomen. Altogether 60 patients were examined with the former and 28 patients with the latter contrast before and after the administration of contrast media. Gd-DTPA was given either per os or per rectum. In comparing the results, it was shown that the diagnostic accuracy of postcontrast MRI in both groups was more or less similar to CT but much higher as compared with plain MRI. In the OMP series, first the contrast between the GI-filled lumen and the surrounding fat was much superior to that of the Gd-DTPA and, second, there was no evidence of any artifacts from bowel motion. However, the overall accuracy of the Gd-DTPA group was better compared with that of the OMP group. This was due to underfilling of the distal bowel because the OMP in those patients was administered only per os. Finally, Gd-DTPA had a more pleasant taste and fewer side effects. It is concluded that both contrast media are suitable for the upper abdomen because the results are comparable, whereas for the lower abdomen Gd-DTPA is superior because it can be used from both routes.
29622.376194341978.02.18++Splenic cystic lymphangiomatosis: an unusual cause of massive splenomegaly.Radiology
RJ Tuttle, JA Minielly,
Two unusual cases of massively enlarged spleens occupied by numerous lymphangiomatous cysts are described. Both angiography and pathology confirm the pathognomonic appearance.
29722.36118677832002.05.07++Primary hepatic angiosarcoma: findings at CT and MR imaging.Radiology
T Koyama, JG Fletcher, CD Johnson, MS Kuo, K Notohara, LJ Burgart,
To evaluate and describe cross-sectional imaging findings in patients with pathologically confirmed primary hepatic angiosarcoma.
29822.3492802541997.09.16++MR imaging of the liver with Resovist: safety, efficacy, and pharmacodynamic properties.Radiology
AF Kopp, M Laniado, F Dammann, W Stern, E Grönewäller, T Balzer, C Schimpfky, CD Claussen,
To evaluate the safety, efficacy, and pharmacodynamic properties of a new superparamagnetic parenteral iron oxide contrast agent for magnetic resonance (MR) imaging.
29922.29185460322009.10.29++Ferucarbotran-enhanced T2-weighted magnetic resonance imaging: differentiation of hepatic cavernous hemangiomas from malignant solid lesions.Abdom Imaging
ES Cho, JS Yu, JH Ahn, MS Park, JH Kim, JJ Chung, KW Kim,
To demonstrate the characteristic feature of hepatic cavernous hemangiomas on ferucarbotran-enhanced T2-weighted MR imaging as a new diagnostic finding.
30022.27151499942004.08.09+ Abdominal lymphangiomas: imaging features with pathologic correlation.AJR Am J Roentgenol
AD Levy, V Cantisani, M Miettinen,
30122.2581364821994.04.28+ [A splenic hamartoma with clinical symptoms].Rofo
H Daschner, K Lehner, K Becker,
30222.24179663722007.12.21++Splenic hydatidosis: a rare differential diagnosis in a cystic lesion of the spleen.Rev Gastroenterol Mex
GA Rodríguez-Leal, S Morán-Villota, Mdel P Milke-García,
Cystic tumours of the spleen are generally rare, and a parasitic origin is relatively unlikely. The present case report shows, however that when a splenic cyst is found, the differential diagnosis must always consider the possibility of echinococcosis. We report the case of a patient suffering from a cystic lesion of the spleen where surgery and histopathology yielded the diagnosis of splenic echinococcosis. Abdominal pain in the left upper quadrant and splenomegaly detected by simple abdominal radiology are the most commonly found indicators for this disease. The treatment should be surgical, attempting to preserve as much splenic tissue as possible, although conservative treatment is frequently unfeasable due to massive involvement of the spleen. Although rare, splenic hydatidosis should be included in the differential diagnosis when a cystic splenic lesion is identified with sonography or CT scan.
30322.2228378061988.07.28++[Oral contrast media for magnetic resonance tomography of the abdomen. III. Initial patient research with gadolinium-DTPA].Rofo
C Claussen, W Kornmesser, M Laniado, S Kaminsky, B Hamm, R Felix,
32 patients with abdominal tumours or inflammatory abdominal diseases were examined by MRI (0.5 T) prior to and after oral administration of gadolinium-DTPA (Gd-DTPA). T1- and T2-weighted sequences were employed. 10 ml/kg body weight of a Gd-DTPA formulation were administered (1.0 mmol/l, 15 g mannitol/l). Gd-DTPA provided markedly hyperintensive opacification of the gastrointestinal tract. In 19 of 32 studies Gd-DTPA-enhanced scans showed improved delineation of abdominal pathologies. In most cases Gd-DTPA-enhanced T1-weighted multislice gradient echo images provided the most useful diagnostic result. Meteorism and diarrhea were recorded in 13 patients.
30422.1914304431992.12.16++Infarction of the kidney: role of contrast enhanced MRI.J Comput Assist Tomogr
SH Kim, JH Park, JK Han, MC Han, S Kim, JS Lee,
Magnetic resonance imaging was performed on nine kidneys in six patients with renal infarction caused by renal arterial embolism secondary to cardiac valvular disease. The time interval between the onset of the symptoms attributable to renal infarction and the date of MRI was 2-23 days. On both T1- and T2-weighted images the signal intensity of the infarcted area was lower than that of the noninfarcted area in six kidneys and higher in three kidneys. Postcontrast T1-weighted images demonstrated the extent of the infarction except in the kidney in which the infarcted areas had high signal intensity on precontrast T1-weighted images.
30522.181039221979.03.24+ Ultrasonic findings in isolated lymphoma of the spleen simulating splenic abscess.J Clin Ultrasound
JJ Cunningham,
30622.171284961976.04.02++[Angiography, scintigraphy and ultra sound in the diagnosis of splenic or hepatic disease in Hodgkin's disease (author's transl)].Rofo
H Czembirek, E Neumann, J Haydl, L Howanietz, C Jantsch, F Pantucek, H Pokieser,
The combined use of selective angiography, scintigraphy and ultra-sound is not reliable enough for the certain exclusion of visceral involvement in Hodgkin's disease. Since this is of importance in the planning of treatment, it confirms the recommendation made by Wagenknechts, Glatsteins and others that a diagnostic splenectomy be carried out in order to determine the presence of visceral involvement.
30722.13151253602004.05.19++[Splenic abscess: from diagnosis to treatment].Tunis Med
S Jarboui, M Ben Moussa, A Krichene, F Tanazakhti, N Mnif, M Othmani, R Hamza, A Zaouche,
Splenic abscess are a rare and severe pathology causing difficulty in diagnosis and treatment. The Clinical presentation usually associated with abdominal pain in the left upper quadrant, fever and splenomegaly. Diagnosis will be confirmed by morphologic examination such as ultra sonography and computed tomography. Percutaneous drainage procedure made in first intention can be used either for curative purpose or to prepare patient for surgery. We report four cases of splenic abscess collected in our departement between 1997 and 2000 in which percutaneous drainage procedure was trial first. Two of them were successful and the others were completed by splenectomy.
30822.1219247921991.11.20++Ovarian lesions: detection and characterization with gadolinium-enhanced MR imaging at 1.5 T.Radiology
SK Stevens, H Hricak, JL Stern,
Magnetic resonance (MR) imaging for detection and characterization of ovarian masses was assessed in 33 patients with a total of 60 lesions. Lesions were characterized prospectively as benign or malignant by using T2-weighted MR images and unenhanced and gadolinium-enhanced T1-weighted MR images. MR imaging findings were compared with results of surgical laparotomy performed for staging of lesions. When malignancy was suspected, staging with MR imaging was performed. MR imaging demonstrated 57 of 60 (95%) surgically proved ovarian masses (34 of 36 were benign, 23 of 24 were malignant). Five significant primary criteria and four ancillary criteria for malignancy were established. For all MR pulse sequences combined, characterization of either type of lesion was correct in 84% of cases (48 of 57) when the five primary criteria were used and 95% (54 of 57) were correct when the four ancillary criteria were added. With gadolinium-enhanced images, correct characterization of malignant lesions increased from 56% to 78% with use of the five primary criteria and from 83% to 100% with use of both sets of criteria. Malignancies were correctly staged with MR imaging in 12 of 16 patients. Staging accuracy was 63% with unenhanced images and 75% with the addition of enhanced images.
30922.08108472762000.06.21+ Magnetic resonance imaging in primary lymphoma of the spleen.Arch Intern Med
JM Calvo-Romero,
31022.0522787831991.03.14++Computed tomography of cystic lymphangioma in a wandering spleen.Acta Radiol
M Alerci, R Dore,
A large cystic lymphangioma in a wandering spleen was discovered by chance in a young woman, 2 months after she delivered her first child. The clinical finding was that of a pelvic mass, which at CT was found to be a wandering spleen, containing multiple cystic lesions. The diagnosis of cystic lymphangioma was made at the pathological examination of the specimen after splenectomy. The association of cystic lymphangioma in a wandering spleen has not been reported previously.
31122.0115613391992.05.13++Enhancement along the normal facial nerve in the facial canal: MR imaging and anatomic correlation.Radiology
SS Gebarski, SA Telian, JK Niparko,
Normal facial nerves are reported to show no enhancement at magnetic resonance (MR) imaging, in contradiction to the authors' clinical experience. To investigate this inconsistency, the authors searched MR imaging files and clinical records to find patients who underwent MR imaging of the temporal bone (at 1.5 T) before and after intravenous administration of gadopentetate dimeglumine and who had bilateral clinically normal facial nerves. When the MR images of 93 patients (186 facial nerves) were analyzed subjectively, 142 nerves (76%) were visibly enhanced along at least one segment of the facial nerve within the facial canal; the nerves of 64 of the 93 patients (69%) showed right-left asymmetry in enhancement, which was inhomogeneously distributed along each nerve. The facial nerve in the cerebellopontine angle cistern and in the internal auditory canal, as well as in the visualized proximal portion of the extracranial facial nerve, showed no enhancement. Comparison with reference anatomic sections showed that this enhancement pattern corresponded exactly to the topography of the circumneural facial arteriovenous plexus and should not necessarily be considered a sign of anatomic abnormality.
31222.01112422142001.04.05++Castleman disease of the abdomen: imaging spectrum and clinicopathologic correlations.J Comput Assist Tomogr
TJ Kim, JK Han, YH Kim, TK Kim, BI Choi,
The purpose of this work was to define the imaging spectrum of Castleman disease of the abdomen and to correlate the results with clinicopathologic findings.
31321.95172935742007.05.01++Blunt splenic trauma: delayed-phase CT for differentiation of active hemorrhage from contained vascular injury in patients.Radiology
SW Anderson, JC Varghese, BC Lucey, PA Burke, EF Hirsch, JA Soto,
To retrospectively evaluate delayed-phase computed tomography (CT) in the differentiation of active splenic hemorrhage requiring emergent treatment from contained vascular injuries (pseudoaneurysms or arteriovenous fistulas) that can be treated electively or managed conservatively.
31421.9519876341991.02.20+ Extrapulmonary Pneumocystis carinii infection: another cause of splenic "bull's-eye" lesions.Radiology
ME Timins, AA Nemcek,
31521.92162410992005.11.21++[Inflammatory pseudotumour of the spleen: a case report and review of the literature].Chir Ital
A Spivach, S Martinolli, R Adornetto, M Melato,
The case of a 64-year-old man presenting dysuria and haematuria is described. The cause of these symptoms was related to a splenomegaly compressing the left kidney and renal pelvis. A splenectomy was performed. Macro- and microscopic examination of the mass revealed an inflammatory pseudotumour of the spleen, composed of a variable mixture of polyclonal lymphocytes, eosinophils, neutrophils, plasmacells, foamy hystiocytes, giant cells and fibrous tissue. The aetiology is unknown. An inflammatory pseudotumour of the spleen is clearly a reactive lesion resulting from a variety of causes, particularly vascular thrombosis, infections or autoimmune mechanisms. Splenectomy is both diagnostic and curative.
31621.92198990272010.09.27++Contrast-enhanced ultrasound pattern of splenic metastases - a retrospective study in 32 patients.Ultraschall Med
A Neesse, J Huth, S Kunsch, P Michl, T Bert, JJ Tebbe, TM Gress, C Görg,
To characterize the pattern of contrast-enhanced ultrasonography (CEUS) in splenic metastases compared to standard B-mode ultrasonography.
31721.8627781581989.10.19++Subtracted synthetic images in Gd-DTPA enhanced MR.J Comput Assist Tomogr
Y Suto, BE Caner, Y Tamagawa, T Matsuda, I Kimura, H Kimura, T Toyama, Y Ishii,
The evaluation of Gd-DTPA contrast enhancement (CE) in high intensity tissues on T1-weighted magnetic resonance images, such as fat and bone marrow, is quite difficult. In this study, we used subtraction and subtracted color images in an attempt to show more clearly the Gd-DTPA CE. In addition, we also carried out sequential post-Gd-DTPA imaging to assess the changes in enhancement of lesions with time. Twenty patients were studied with these methods and our results are illustrated.
31821.8581533361994.05.12++Infectious liver foci in leukemia: comparison of short-inversion-time inversion-recovery, T1-weighted spin-echo, and dynamic gadolinium-enhanced MR imaging.Radiology
AE Lamminen, VJ Anttila, S Bondestam, T Ruutu, PJ Ruutu,
To assess the performances of three different magnetic resonance (MR) imaging techniques in the evaluation of patients with leukemia and suspected hepatic candidiasis.
31921.85125948002003.06.19++The small spleen: sonographic patterns of functional hyposplenia or asplenia.J Clin Ultrasound
C Görg, M Eichkorn, G Zugmaier,
Functional hyposplenia or asplenia (FAS) can be associated with potential fatal infections. The diagnosis of FAS is traditionally made on liver-spleen scintigraphy and finding Howell-Jolly bodies within erythrocytes. In this retrospective study, our goal was to identify any characteristic sonographic findings of the spleen in patients with FAS in an attempt to determine whether the diagnosis of FAS can be made sonographically.
32021.8542462821970.08.05+ [Nodular lymphoma of the spleen].Nouv Rev Fr Hematol
J Bousser, J Delarue, G Bilski-Pasquier, J Diebold, R Zittoun, C Dao,
32121.8017450491992.01.14++Imaging-guided and nonimaging-guided fine needle aspiration of liver lesions: experience with 406 patients.J Surg Oncol
Y Edoute, O Tibon-Fisher, SA Ben-Haim, E Malberger,
The aim of the present study was to determine the diagnostic accuracy of different modes of fine needle aspiration (FNA) of liver lesions. A total of 492 FNAs were performed on 406 patients in order to confirm or to rule out focal or multifocal neoplastic disease: 29% under ultrasound (US) guidance, 3% with computed tomographic (CT) guidance, 67% preoperatively, and 1% intraoperatively without imaging guidance. Based on histologic, cytologic, and clinical findings, final diagnoses were reached in 387 patients, of whom 264 had malignant liver disease and 123 had benign liver disease. Of 321 aspirations performed in patients with malignant liver disease, the cytologic findings suggested malignancy in 225 (70.1%), suspected malignancy in 25 (7.8%), and did not reveal malignancy in 71 aspirations (22.1%). Among the 123 patients with benign liver disease, the cytologic findings were reported as benign in all but two patients, who had false-positive cytologic findings. The overall sensitivity, specificity, positive, and negative predictive values for cytologic findings were 85.6, 98.4, 99.1, and 76.1%, respectively. The overall diagnostic accuracy was 89.7%. In one patient, fatal intraperitoneal bleeding due to chronic intravascular coagulation complicated the FNA procedure. We conclude that imaging-guided FNA as well as nonguided FNA for cytologic diagnosis of liver lesions are highly accurate and only rarely may be associated with a fatal complication.
32221.8082828831994.02.17++3DFT-FISP MRI with gadopentetate dimeglumine in differential diagnosis of small liver tumors.J Comput Assist Tomogr
H Nakamura, T Murakami, T Ishida, K Tsuda, T Hashimoto, K Nakanishi, T Mitani, K Tomoda, S Hori, T Kozuka,
We assessed the value of dynamic sequential three-dimensional Fourier transformation (3DFT) MRI in differentiating various types of small liver tumors.
32321.794145901978.03.21++Angiographic diagnosis of benign and malignant splenic tumors.AJR Am J Roentgenol
T Kishikawa, Y Numaguchi, K Watanabe, K Matsuura,
Fifteen cases of benign and malignant nodular splenic tumors, including six cysts, one hamartoma, two hemangiosarcomas, five reticulum cell sarcomas, and one Hodgkin's disease, are presented with their arteriographic manifestations. The value of splenic arteriography is emphasized, since it may provide rather specific information in the diagnosis of benign and malignant nodular splenic tumors. Differential diagnostic considerations are also discussed.
32421.7815916861992.07.02++Ultrasonically guided percutaneous splenic tissue core biopsy in patients with malignant lymphomas.Cancer
L Cavanna, G Civardi, F Fornari, M Di Stasi, G Sbolli, E Buscarini, D Vallisa, S Rossi, P Tansini, L Buscarini,
Ultrasonically (US) guided percutaneous tissue core biopsy of the spleen was done on 46 patients with malignant lymphomas. The biopsies were undertaken as a staging procedure in 32 patients, as a restaging procedure in 7, during follow-up in 2, and as a diagnostic step in 5 (previously undiagnosed cases with clinically and ultrasonographically suspected lymphoma). In 45 patients, the tissue core specimens obtained by US-guided biopsies were sufficient for a correct histologic examination; in one patient, the specimen was considered inadequate. The tissue core specimens showed splenic involvement in 12 patients and normal splenic tissue in the other 33. These latter cases were confirmed by splenectomy, by laparoscopy with larger splenic biopsy needles, and by clinical and US follow-up over a period of 6 to 30 months. In all previously undiagnosed patients (five), splenic biopsies allowed histologic subtyping. Additional immunologic subclassification into B-cell and T-cell types of lymphomas was done in two instances. There were no complications in this series. These results suggest that percutaneous US-guided splenic tissue core biopsy is a useful and safe technique for the diagnosis, staging, and follow-up of malignant lymphoma.
32521.7525388801989.05.09++[Differentiation of focal liver lesions using contrast-enhanced MRT].Rofo
P Heintz, C Ehrenheim,
47 patients with liver tumours (haemangioma, focal nodular hyperplasia, hepatocellular carcinoma) underwent MRI of the liver before and after i.v. injection of 0.2 ml./kg. gadolinium-DTPA in addition to other imaging methods. The demarcation of focal nodular hyperplasia is not influenced by use of the contrast agent as it almost behaves like surrounding normal liver tissue, thus only indirectly facilitating its identification. With regard to liver haemangiomas that show the most intensive uptake of gadolinium-DTPA, the contrast enhanced image does not reach the contrast and sensitivity of a native T2-weighted SE image, especially in cases of small haemangiomas. The contrast agent is helpful, however, in the recognition of large cavernous haemangiomas that are partially fibrotic or thrombotic. Emphasis is given to the contrast agent in hepatomas: gadolinium-DTPA presents a pattern of uptake and distribution frequently found in hepatocellular carcinoma providing additional information on the delineation of internal tumour details.
32621.75113728132001.06.28++Thrombocytopenia caused by splenic hamartoma: resolution after splenectomy.South Med J
CN Compton, CR McHenry, M Aijazi, M Chung-Park,
We report a rare case of isolated thrombocytopenia due to a large hamartoma of the pulposal type, which resolved with splenectomy in a 46-year-old man. Although hamartomas are usually found incidentally, they may cause hematologic disturbances such as thrombocytopenia, anemia, or splenic rupture. The diagnosis of splenic hamartoma is difficult to make preoperatively. Splenectomy is important in excluding malignant tumors from the diagnosis when the etiology of a splenic mass is unclear and ameliorating hematologic symptoms related to hamartomas.
32721.73107529072000.04.21+ Aunt Minnie's corner. Hepatic hemangioma.J Comput Assist Tomogr
RM Branstetter, KL Ford,
32821.7184280751993.03.09++Contribution of oral magnetic particles in MR imaging of the abdomen with spin-echo and gradient-echo sequences.J Magn Reson Imaging
FP Boudghène, T Bach-Gansmo, JD Grange, S Lame, C Nantois, C Wallays, JM Bigot,
An open phase III clinical trial of the oral contrast agent OMP (oral magnetic particles) was performed in 35 patients undergoing abdominal magnetic resonance (MR) imaging at 1.5 T with axial spin-echo and gradient-echo sequences. The diagnostic efficacy of OMP was examined by comparing pre-and postcontrast images. Bowel loops and abdominal organs were more easily recognizable after OMP ingestion, and the general quality of the images was improved because of fewer bowel-related artifacts. The diagnostic value of the postcontrast abdominal MR examination was superior or equal to that of the precontrast study, and additional information was obtained in 44% of the cases. Postcontrast gradient-echo sequences increased confidence in the MR examination in 18% of cases. OMP was well tolerated and increased the quality and amount of diagnostic information acquired during the examination. Gradient-echo imaging was found to be a useful complement, but the need for a reduction in susceptibility artifacts was apparent and indicates that a decrease in TE or the use of rapid spin-echo sequences might be advantageous.
32921.6579627951994.12.08++Enhancement of liver hemangiomas on T1-weighted MR SE images by superparamagnetic iron oxide particles.J Comput Assist Tomogr
C Grangier, J Tourniaire, G Mentha, R Schiau, N Howarth, A Chachuat, M Grossholz, F Terrier,
Superparamagnetic iron oxide (SPIO) particles are phagocytosed by cells of the macrophage-monocytic phagocytic system. They are usually used in MRI as a negative contrast agent, because of their strong T2* effect, to improve detection of tumors in the liver and spleen. However, they also have a potent T1 relaxivity. In the current study, we describe this T1 effect in liver hemangiomas.
33021.6382408871994.01.06++MR evaluation of tuberculous spondylitis.Acta Radiol
GC Liu, MS Chou, TC Tsai, SY Lin, YS Shen,
A total of 29 proven tuberculous spondylitis patients underwent MR studies. Gd-DTPA enhancement was performed in 10 patients. Contiguous 2 vertebral involvement, subligamental spread of paraspinal abscesses and cord indentation were observed in 93% of the cases. Destruction of the vertebral body occurred in 76%. Intermediate or low T1 signal intensity and high T2 signal intensity were observed by MR. A combination of these characteristic findings strongly suggests the diagnosis of tuberculous spondylitis. Gd-DTPA administration did not facilitate diagnosis. MR examination should be considered as the main imaging modality for patients with suspected tuberculous spondylitis.
33121.6367795231981.03.27++CT-guided percutaneous aspiration and drainage of abscesses.AJR Am J Roentgenol
JR Haaga, AJ Weinstein,
CT-guided procedures were attempted in 103 patients suspected of having abscesses. CT-guided procedures were performed for diagnostic specimens in 70 patients; they were successful in 30 of 34 sterile collections and 33 of 36 abscesses. In another 33 patients, diagnostic aspiration was performed and percutaneous drainage was attempted; aspirations were successful in 33 of 33 and drainage in 28 of 33 cases. Of the five not drained, four were undrainable because of anatomic extent or high viscosity of the purulent material. The fifth was a necrotic, squamous cell tumor erroneously thought to be an abscess. No complications were encountered. CT-guided procedures are an effective method for obtaining diagnostic specimens in selected patients.
33221.6353522441970.01.07+ [Splenic diseases from the surgical point of view].Chirurg
RX Zittel,
33321.61158915092005.06.28++Image-guided cutting-edge-needle biopsy of peripheral lymph nodes and superficial masses for the diagnosis of lymphoma.J Comput Assist Tomogr
M Sklair-Levy, G Amir, G Spectre, P Lebensart, Y Applbaum, R Agid, S Lieberman, D Ben-Yehuda, Y Sherman, E Libson,
To evaluate the diagnostic efficacy of image-guided cutting-edge-needle biopsy of peripheral lymph nodes and superficial masses for the diagnosis of lymphoma, for which many still advocate open surgical resection.
33421.61163040012006.01.27++Characteristics of ultrasmall superparamagnetic iron oxides in patients with brain tumors.AJR Am J Roentgenol
CA Taschner, SG Wetzel, M Tolnay, J Froehlich, A Merlo, EW Radue,
The aim of this study was to evaluate the characteristics of an ultrasmall superparamagnetic iron oxides (USPIO) agent in patients with brain tumors and to correlate changes on MRI with histopathologic data collected systematically in all patients.
33521.60127609412003.06.24++Metastatic angiosarcoma of the lung: spectrum of CT findings.AJR Am J Roentgenol
U Tateishi, T Hasegawa, M Kusumoto, N Yamazaki, G Iinuma, Y Muramatsu, N Moriyama,
OBJECTIVE: The purpose of our study was to summarize the CT features of pulmonary metastases in angiosarcoma in 24 patients. CONCLUSION: A variety of CT features were associated with metastatic angiosarcoma of the lung. The common CT manifestations of metastatic angiosarcoma were multiple solid nodular lesions and multiple thin-walled cysts that were often accompanied by hemorrhagic change.
33621.5990396021997.05.08++Ferumoxides and Tc-99m sulfur colloid: comparison of the tumor-to-liver uptake in focal nodular hyperplasia.J Magn Reson Imaging
CB Grandin, BE Van Beers, S Pauwels, R Demeure, J Jamart, J Pringot,
The tumor-to-liver uptake of two reticuloendothelial agents, namely ferumoxides and technetium-99m (Tc-99m) sulfur colloid, was compared in focal nodular hyperplasia (FNH). Twelve patients with FNH who had undergone ferumoxides-enhanced MR imaging and planar Tc-99m sulfur colloid scintigraphy within 1 year were included from the study. Fourteen patients with FNH with a diameter larger than 3 cm were selected for the comparison. The tumor-to-liver ferumoxides uptake was calculated and the Tc-99m sulfur colloid uptake was assessed visually. Fermuoxides uptake was observed in all but one patient with FNH (mean tumor-to-liver ratio = .36). The six tumors showing normal (n = 5) or increased (n = 1) radiocolloid uptake when compared to the liver accumulated more ferumoxides than the eight tumors showing decreased radiocolloid uptake (P < .01). However, in some tumors, no direct relation was observed between ferumoxides and Tc-99m sulfur colloid uptake. Our observations suggest that ferumoxides uptake might not exactly mimic Tc-99m sulfur colloid uptake in FNH.
33721.5582736071994.02.03+ Progressive multifocal leukoencephalopathy: contrast enhancement on CT scans and MR images.AJR Am J Roentgenol
AL Wheeler, CL Truwit, BK Kleinschmidt-DeMasters, WR Byrne, RN Hannon,
33821.54110854942001.03.15++Tumor-detecting capacity and clinical usefulness of SPIO-MRI in patients with hepatocellular carcinoma.J Gastroenterol
H Nakamura, N Ito, F Kotake, Y Mizokami, T Matsuoka,
The tumor-detecting capacity and clinical usefulness of superparamagnetic iron oxide (SPIO) magnetic resonance imaging (MRI) were examined in patients with hepatocellular carcinoma. The tumor detection rate of SPIO-MRI (64.5%) was comparable to those of dynamic computed tomography (CT) and plain MRI, but lower than that for Gd dynamic MRI (93.5%; P < 0.01%). A combination of Gd dynamic MRI and SPIO-MRI improved the detection rate; further, the tumor stage with respect to tumor blood-flow pattern was predicted by combining plain MRI with SPIO-MRI. This combination procedure may also be useful for selecting therapeutic strategies.
33921.5315450291992.04.15++MRI of primary spleen angiosarcoma with iron accumulation.J Comput Assist Tomogr
K Kaneko, H Onitsuka, J Murakami, H Honda, M Kimura, N Shiraishi, K Masuda,
A case of splenic angiosarcoma with siderotic nodules is reported. The tumor was hyperechoic on ultrasound and had high density on CT and very low intensity on MR. Gandy-Gamna nodules (siderotic nodules) were demonstrated histopathogically.
34021.53111787002001.05.10++Peliosis hepatis with pseudotumoral and hemorrhagic evolution: CT and MR findings.Abdom Imaging
F Ferrozzi, G Tognini, G Zuccoli, F Cademartiri, P Pavone,
Peliosis hepatis is an uncommon benign disorder characterized by blood-filled cavities within the liver. We describe the sonographic, computed tomographic, and magnetic resonance appearance of a patient affected by peliosis hepatis with pseudotumoral and hemorrhagic evolution and direct demonstration of the ectatic vascular components.
34121.5130259571987.02.18++[Magnetic resonance tomography of focal hepatic lesions using the para-magnetic contrast medium, gadolinium DTPA. First clinical results].Rofo
B Hamm, T Römer, R Felix, KJ Wolf,
The use of the para-magnetic contrast medium gadolinium DTPA for magnetic resonance tomography of focal lesions in the liver was investigated in 31 patients. Two dosage schedules of the contrast medium (0.1 and 0.2 mmol/kg body weight were used with field strengths of 0.35 and 0.5 Tesla. Using T1 sequences, gadolinium DTPA showed increased signal intensity in the liver and in tumours, but this was significantly more marked in the tumour. On T1 spin-echo sequences, previously iso-intense lesions became visible after administration of contrast. On the other hand, contrast-enhanced lesions were less well seen on inversion recovery sequences because of a reduction in the contrast between tumour and liver tissue. The contrast between tumour and liver tissue was not improved by gadolinium DTPA in comparison with precontrast inversion recovery sequences and T2 spin-echo sequences. The perfusion of intra-hepatic tumours could be elucidated by magnetic resonance tomography after the administration of gadolinium DTPA.
34221.50170484532007.01.19++Solitary splenic lesions.Semin Ultrasound CT MR
DM Warshauer, HL Hall,
Solitary splenic lesions are unusual. A differential diagnosis can be organized around their basic imaging appearance as either predominantly cystic or solid. Other imaging characteristics, including vascular enhancement and activity on Tc-99m sulfur colloid scan, as well as clinical history may narrow the diagnostic possibilities. Cystic lesions include post-traumatic, inflammatory and infectious pseudocysts, congenital cysts, lymphangiomas and cystic metastasis. Solid lesions include both nonneoplastic lesions such as splenic hamartoma, benign tumors such as hemangioma and malignant masses including lymphoma and angiosarcoma. Percutaneous biopsy may be used for histologic diagnosis when required.
34321.50110001752000.10.13++Evaluation of the accuracy of gadobenate dimeglumine-enhanced MR imaging in the detection and characterization of focal liver lesions.AJR Am J Roentgenol
G Pirovano, A Vanzulli, L Marti-Bonmati, L Grazioli, R Manfredi, A Greco, N Holzknecht, HE Daldrup-Link, E Rummeny, B Hamm, V Arneson, L Imperatori, MA Kirchin, A Spinazzi,
We evaluated the extent to which hepatic lesion characterization and detection is improved by using gadobenate dimeglumine for enhancement of MR images.
34421.4782392201993.12.01+ [Post-traumatic splenic pseudocyst].An Esp Pediatr
E Noya Beiroa, J García-Casillas Diaz, D Nieto Balmesada, F Reverte Blanc,
34521.4620485361991.07.12+ Splenic hemangioma.AJR Am J Roentgenol
DG Disler, FS Chew,
34621.4319871771991.02.15++Evaluation of adrenal masses in oncologic patients: dynamic contrast-enhanced MR vs CT.J Comput Assist Tomogr
GP Krestin, G Freidmann, R Fishbach, KF Neufang, B Allolio,
The CT examinations, precontrast gradient echo MR images, and fast contrast enhanced dynamic MR studies were evaluated in 44 patients with 52 adrenal masses and known malignant disease of different origin. Morphologic features (size, shape, attenuation, contour, and enhancement) on CT scans, signal intensity on T2-weighted MR images, and patterns of enhancement on Gd-DTPA enhanced dynamic MR studies were analyzed in all patients. With dynamic contrast enhanced studies with prolonged imaging up to 15 min after Gd-DTPA, masses with moderate enhancement and complete washout after 10 min were considered as adenomas. Computed tomography and plain MR had a sensitivity of 0.71 and 0.96, a specificity of 0.75 and 0.88, and overall accuracy of 0.56 and 0.71, respectively. Simultaneous use of precontrast MR and dynamic contrast enhanced studies led to an accurate diagnosis in 88% (sensitivity = 1.0, specificity = 0.91) and thus should be considered in oncologic patients with undetermined adrenal masses.
34721.436194001978.02.18++CT-pathologic correlations in Hodgkin's disease and non-Hodgkin's lymphoma.Radiology
RS Breiman, RA Castellino, GS Harell, WH Marshall, E Glatstein, HS Kaplan,
In order to assess its potential uses in the staging and treatment planning of lymphoma, CT was performed in 27 newly diagnosed, previously untreated patients with Hodgkin's disease or non-Hodgkin's lymphoma; 18 staging laparotomies provided pathologic correlations. CT detected and defined disease in areas not well evaluated by conventional techniques (high para-aortic, mesenteric, splenic hilar nodes). CT interpretation of splenic size and weight correlated well with splenic weight confirmed at pathology. Nodules were identified in several spleens containing foci of lymphoma.
34821.43203974262010.05.07++Unusual long-term complications of a splenic cyst.JBR-BTR
EV Ward, J O'brien, K Conlon, WC Torreggiani,
Splenic cysts are relatively uncommon, and are usually asymptomatic. They are benign, typically treated conservatively and followed up with ultrasound examination, with few reported complications. We report a case of a simple splenic cyst that was followed up on imaging over a seven-year period. During that time, the cyst gradually enlarged from 5 cm to 12 cm in diameter, however the patient remained asymptomatic. After seven years, the patient was admitted with abdominal pain and a pelvic mass. The spleen was located within the pelvis, which was felt to be due to the weight of the cyst which caused the spleen to migrate out of its normal position. This case illustrates an extremely unusual complication, and suggests that while most splenic cysts may be managed conservatively, enlarging cysts may be prone to gravitational effects and prophylactic treatment should be considered.
34921.42171898432007.03.15++Littoral cell angioma.Clin Imaging
C Johnson, M Goyal, B Kim, D Wasdahl, K Nazinitsky,
Littoral cell angioma (LCA) is an extremely rare primary splenic tumor. There are few MRI and scintigraphic characteristics described. These characteristics may be most helpful in differentiating LCA from other primary vascular tumors. We present a 54-year-old woman found on CT to have a 7-cm mass within an enlarged spleen. LCA was diagnosed by ultrasound (US)-guided biopsy. She was successfully treated with laparoscopic splenectomy. The CT, MRI, US, and Tc99m-RBC scan characteristics are described along with histologic and immunohistochemical correlation.
35021.4093084641997.10.16++MR imaging of the gastrointestinal tract with i.v., gadolinium and diluted barium oral contrast media compared with unenhanced MR imaging and CT.AJR Am J Roentgenol
RN Low, IR Francis,
To determine an optimal MR imaging technique and pulse sequence for evaluating mural and serosal disease of the gastrointestinal tract, we administered 2% oral barium sulfate and obtained fat-suppressed gadolinium-enhanced breath-hold fast multiplanar spoiled gradient-recalled (FMPSPGR) MR images. We then compared these images with spin-echo T1-weighted and T2-weighted fast spin-echo MR images and with CT images.
35121.3978638831995.03.23++Distinction between cavernous hemangiomas of the liver and hepatic metastases on CT: value of contrast enhancement patterns.AJR Am J Roentgenol
DF Leslie, CD Johnson, CM Johnson, DM Ilstrup, WS Harmsen,
Differentiating between cavernous hemangiomas of the liver and hepatic metastases on the basis of single-pass, contrast-enhanced CT is a significant and frequently encountered diagnostic challenge. Recognition of characteristic enhancement features of cavernous hemangiomas can aid in effectively distinguishing between these lesions. The purpose of this study was to determine sensitivity and specificity of dense, globular enhancement for differentiating cavernos hemangiomas and metastases during single-pass, contrast-enhanced CT.
35221.3877162871995.05.15++[Ultrasound aspects in AIDS-related splenic diseases].Radiol Med
L Cecconi, V Schininà, E Busi Rizzi, G Mazzuoli,
The authors reviewed retrospectively 139 splenopathies detected during 432 US examinations of the abdomen in AIDS patients to assess the role of US in correlation with anamnestic-clinical data and histologic findings in 45 cases. Splenomegaly was the main sign of abnormal splenic conditions, since it was present in all the examined patients. Twenty-one cases exhibited focal lesions. Non-Hodgkin's lymphomas were the only kind of neoplastic condition, which were detected in 15% of cases. In 57% of cases splenopathy was correlated with an infective agent, with a marked prevalence of Mycobacteria-i.e., tubercular in 26% and atypical in 22%. In the splenopathies with histologic confirmation which exhibited a focal US pattern (47%), US proved to be useful in assessing splenic involvement, however aspecific its signs, and in its monitoring, especially in the lesions with unexpected colliquative evolution, as in two cases of atypical mycobacteriosis.
35321.3728166341989.12.18++Dynamic MR imaging of the liver with Gd-DTPA: initial clinical results.AJR Am J Roentgenol
RR Edelman, JB Siegel, A Singer, K Dupuis, HE Longmaid,
Gd-DTPA was evaluated as a hepatic contrast agent for MR imaging. Twenty-six consecutive patients referred for suspected masses in the liver were studied at 1.5 T. Fourteen patients had hepatic metastases and one patient each had cholangiocarcinoma and multicentric hepatocellular carcinoma. Four patients had cavernous hemangiomas and the remainder had other benign lesions. Diagnoses were proved by biopsy, sonography, or radionuclide scintigraphy in 23 cases and by autopsy in one case. Precontrast scans were obtained by using standard pulse sequences. In addition, breath-hold scans were obtained before and after bolus administration of 0.1 mmol/kg Gd-DTPA by using a multislice T1-weighted gradient-echo pulse sequence with an ultrashort echo time. Mean lesion-liver signal difference/noise increased by 50% (p less than .01) in the immediate postcontrast phase. In two of 26 cases, multiple additional lesions as small as 3 mm were detected after contrast administration that were not seen before contrast administration. In no case was lesion-liver contrast worsened on scans obtained immediately after administration of contrast material. However, on delayed scans, detection of lesions worsened in some cases because of equilibration of contrast material between liver and lesion. These initial clinical results suggest that enhancement with Gd-DTPA is a practical method for improving lesion-liver contrast and has the potential to improve the accuracy of MR imaging in the liver. However, optimized fast imaging techniques are required for best results.
35421.33157238422005.09.13++Blunt hepatic trauma: evaluation with contrast-enhanced sonography: sonographic findings and clinical application.J Ultrasound Med
O Catalano, R Lobianco, MM Raso, A Siani,
The purpose of this study was to report our initial experience in the assessment of liver trauma with real-time contrast-enhanced sonography (CES).
35521.3291356421997.05.23++CT patterns of nodular hepatic and splenic sarcoidosis: a review of the literature.J Comput Assist Tomogr
GC Scott, JM Berman, JL Higgins,
The purpose of our study was to investigate the less commonly demonstrated CT patterns nodular hepatosplenic sarcoidosis.
35621.3272536621981.09.22++Acute Hodgkin disease masquerading as splenic abscess.J Surg Oncol
RA Bloom, U Freund, EH Perkes, Y Weiss,
A splenic abscess was erroneously diagnosed in a 65-year-old patient. The diagnosis was established on clinical, radiological and ultrasonographic data. At laparotomy the spleen was markedly enlarged by tumoral tissue and contained a large cystic lesion. The histological diagnosis was typical Hodgkin disease with lymphocytic depletion. Ultrasonography adds valuable information in the diagnosis of splenic lesions. Hodgkin disease should be included in the differential diagnosis of cystic lesions detected in the spleen by this method.
35721.2586154011996.06.06++Case report: splenic hamartoma with hematologic disorders.Am J Med Sci
RJ Wirbel, U Uhlig, KM Futterer,
Hamartomas of the spleen are rare benign tumors usually detected as asymptomatic, incidental findings at laparotomy or autopsy. By review of the literature, there are only 16 well-documented cases of symptomatic splenic hamartomas associated with hematologic disorders. The authors report on an additional case of splenic hamartoma in a 34-year-old man with thrombocytopenia. Findings by ultrasonography and computed tomography suggested multiple confluent splenic lesions. Because of progressively increasing thrombocytopenia, elective splenectomy was performed. Final pathology confirmed diagnosis of multiple hamartomas of the red pulp. Platelet count returned to normal within 1 month postoperatively. Differential diagnosis, diagnostic procedures, and pathologic findings of splenic hamartomas will be discussed. Hamartomas should be kept in mind in the differential diagnosis of splenic tumors. Splenectomy is indicated in cases where malignancy cannot be excluded and in cases of associated hematologic disorders.
35821.2515156241992.10.06++[CT-guided large-bore biopsy of solid non-organ-bound space-occupying lesions in the retroperitoneum].Rofo
KC Klose, D Hohberger, A Böcking,
Seventy-eight solid, non-organic retroperitoneal tumours were biopsied with a 14-gauge Tru-Cut needle in 73 consecutive patients with the exception of one. Adequate material was not obtained in only one patient with the primary known (1.3%). In the adequate material (98.7%), the dignity of all lesions was accurately determined and 93.1% of lesions were accurately classified. Typing accuracy reached 100% in histologically known primaries (n = 31) and 87.8% in histologically unknown primaries (n = 41). A hypertensive crisis and a small haematoma following biopsy of an inadvertent extra-adrenal phaeochromocytoma was the single complication found in this series. An arterial bleeding following biopsy was prophylactically embolised through the biopsy needle. CT-guided large-bore biopsy of solid non-organic retroperitoneal tumours is a safe, non-invasive procedure with a high diagnostic yield that obviates the need for open diagnostic procedures in a large number of cases.
35921.2522742581991.02.22++[True or primary splenic cysts].Minerva Chir
D Cavanenghi, M Grassini, GM Amerio, V Sorisio,
Two cases of splenectomy are reported following the diagnosis of a rare pathology of the spleen in the form of two primary, non-parasitic and non traumatic spleen cysts. One was located on an epithelial wall and the other on an endothelial wall.
36021.20152433762004.09.09++[Value of combined conventional and contrast enhanced sonography in the evaluation of hepatic disorders].J Radiol
F Tranquart, A Bleuzen, A Kissel,
To assess the value of combined conventional and contrast-material enhanced sonography for the characterization of focal liver lesions.
36121.1926500081989.05.25++Adrenal hemangiomas: two case reports with a review of the literature.Surgery
A Del Gaudio, G Solidoro, G Martinelli,
Hemangiomas, although frequently found elsewhere, are rarely encountered in the adrenal gland. Only 17 surgical cases of adrenal hemangiomas have been reported, with an additional case not surgically treated. The pertinent literature has been reviewed. Two additional cases, one identified preoperatively and both removed surgically, are presented herein. Ultrasonograms and computed tomographs showed large, necrotic masses without calcifications. Preoperative angiograms taken for case 1 demonstrated pooling of contrast media within this mass, strongly suggesting a diagnosis of hemangioma; case 2 lacked similar angiographic findings. The radiologic finding of calcifications, when present, along with the characteristic angiographic appearance of a hemangioma, allows the radiologist to correctly diagnose this benign tumor preoperatively. Although rare, these tumors should be part of the differential diagnosis of adrenal neoplasms.
36221.1515358901992.03.23++Central nodal necrosis and extracapsular neoplastic spread in cervical lymph nodes: MR imaging versus CT.Radiology
DM Yousem, PM Som, DB Hackney, F Schwaibold, RA Hendrix,
Computed tomographic (CT) scans and magnetic resonance (MR) images obtained in 24 patients with cervical lymphadenopathy were retrospectively and blindly evaluated by two readers for the presence of central nodal necrosis (CNN) and extracapsular nodal spread (ENS). The CT studies were all enhanced, and the MR images were obtained with short repetition time (TR)/echo time (TE), long TR/double echo, and enhanced short TR/TE fat-suppressed sequences. Each MR imaging sequence was interpreted separately and then collectively. Sixty lymph nodes were identified with CT. Sensitivity for CNN was 16%-67% with the unenhanced MR pulse sequences, 50% with enhanced sequences, and 83%-100% with CT. The most accurate reading of MR images for CNN was with the unenhanced T1-weighted and T2-weighted images (86%-87%); the accuracy of CT was 91%-96%. The accuracy of MR imaging for detecting ENS was maximal with T1-weighted images (78%-90%). Gadolinium-enhanced, fat-suppressed images did not improve accuracy in evaluating CNN or ENS. CT is currently more accurate than unenhanced or enhanced MR imaging in detecting CNN or ENS.
36321.1215358881992.03.23++Osteomyelitis in children: gadolinium-enhanced MR imaging.Radiology
BC Dangman, FA Hoffer, FF Rand, EJ O'Rourke,
Fifteen pediatric patients with biopsy- or culture-proved nonspinal osteomyelitis were studied with magnetic resonance (MR) imaging. Osteomyelitis was acute in seven patients, subacute in three, and chronic in five. Four patients had subperiosteal abscesses, one had a large associated soft-tissue abscess, and one had an intraosseous (Brodie) abscess. Areas of active inflammation had decreased marrow signal intensity on T1-weighted images, increased signal intensity on T2-weighted images, and enhancement on T1-weighted images obtained after gadopentetate dimeglumine administration (n = 10). Abscesses were rim enhancing (n = 3) or not (n = 2) with gadolinium-enhanced MR imaging. Nonenhancing areas presumably represented necrotic material. Gadolinium-enhanced MR imaging assisted in definition of the presence and extent of nonvascularized fluid collections within the bone and/or adjacent soft tissues and the extent of bone involvement in patients with chronic osteomyelitis. It also helped guide surgical debridement of intraosseous disease (n = 7) and open or percutaneous drainage of subperiosteal or soft-tissue fluid collections (n = 5).
36421.12166280482006.06.02++A case of lymphangioleiomyomatosis affecting the supraclavicular lymph nodes.J Comput Assist Tomogr
T Kamitani, H Yabuuchi, H Soeda, Y Matsuo, T Okafuji, S Sakai, M Hatakenaka, T Minami, H Inoue, A Tanaka, H Kohno, M Tanaka, Y Nakashima, H Honda,
The case of a 46-year-old woman with lymphangioleiomyomatosis (LAM) involving the supraclavicular, mediastinal, and pelvic lymph nodes in addition to the lungs is reported. Computed tomography incidentally revealed multiple thin-walled pulmonary cysts and low-attenuating masses in the supraclavicular, mediastinal, and retroperitoneal lymph nodes. A biopsy of the supraclavicular mass was performed and diagnosed as LAM histopathologically. The common sites of extrapulmonary LAM include retroperitoneal and mediastinal lymph nodes; however, supraclavicular lymph node involvement is extremely rare.
36521.1067795861981.03.24++Percutaneous needle biopsy in abdominal lymphoma.AJR Am J Roentgenol
J Zornoza, FF Cabanillas, TM Altoff, N Ordonez, MA Cohen,
Percutaneous needle biopsy of lymph nodes and abdominal masses was performed in 48 patients with abdominal lymphoma. A correct diagnosis was obtained in 15 of 28 biopsies performed on lymph nodes and in 17 of 25 abdominal masses or organs. The overall success rate was 64%. No false-positive diagnoses were rendered. No complications related to the procedure were encountered. The value of this technique in the management of selected patients with abdominal lymphoma is detailed.
36621.08173045352007.04.18++Primary vascular neoplasms unique to the spleen: littoral cell angioma and splenic hamartoma diagnosis by fine-needle aspiration biopsy.Diagn Cytopathol
RB Ramdall, TM Alasio, G Cai, GC Yang,
We report the fine-needle aspiration (FNA) biopsy diagnosis of two rare cases of primary vascular neoplasms unique to the spleen: a littoral cell angioma from a 31-yr-old Caucasian woman and a splenic hamartoma from a 46-yr-old black man. The cytologic features of splenic hamartoma and of littoral cell angioma of the spleen were described three times in cytologic literature: two were bench-top aspirates and one was FNA biopsy thought to be metastatic carcinoma. To the best of our knowledge, the current two cases were the first diagnosed by FNA biopsy. Our approach to the FNA biopsy diagnosis of these rare vascular neoplasms via compact cell block and immunohistochemistry is described. The differential diagnosis with other primary vascular splenic neoplasms is also discussed.
36721.04103326011999.07.14++CT appearances in abdominal tuberculosis. A pictorial essay.Clin Imaging
MS Gulati, D Sarma, SB Paul,
Abdominal tuberculosis continues to be endemic in the developing world and has shown a resurgence in the West. Computed tomography (CT) evaluation is singularly informative as it demonstrates involvement of the bowel, peritoneum, lymph nodes, and solid organs in a single examination. A spectrum of CT findings in an immunocompetent population is presented, ranging from subtle to advanced and common to rare. Genitourinary tuberculosis and tuberculosis in AIDS are excluded as they merit separate discussions.
36821.0484194431993.02.11++MRI of liver metastases from colorectal cancer vs. CT during arterial portography.J Comput Assist Tomogr
P Soyer, M Levesque, C Caudron, D Elias, G Zeitoun, A Roche,
A prospective study was performed to compare, with a lesion-by-lesion analysis, the sensitivities of high field strength MRI and CT during arterial portography (CTAP) in detecting hepatic metastases from colorectal cancer. Twenty-one patients with liver metastases from colorectal cancer were prospectively investigated by high field strength MRI (1.5 or 2 T) and CTAP. High field strength MRI was performed with pre and post gadopentetate dimeglumine enhanced T1-weighted SE sequences and T2-weighted SE sequences. All patients underwent partial hepatectomy and 37 metastases were surgically and pathologically proved. The metastasis detection rate (sensitivity) was 94% (35 of 37) for CTAP and 78% (29 of 37) for high field strength MRI. The 16% (95% confidence interval: 1-31%) difference in sensitivity between CTAP and high field strength MRI was statistically significant (p < 0.05, McNemar test). The use of gadopentetate dimeglumine did not improve the sensitivity of T1-weighted SE sequences. Since our study demonstrated significant difference in sensitivities between high field strength MRI and CTAP in our group of patients, we can conclude that high field strength MRI cannot replace CTAP in the preoperative evaluation of patients with liver metastases from colorectal cancer. Computed tomography during arterial portography must be considered as the preoperative gold standard.
36921.02151607552004.06.10++Specificity of SPIO particles for characterization of liver hemangiomas using MRI.Abdom Imaging
X Montet, F Lazeyras, N Howarth, G Mentha, L Rubbia-Brandt, CD Becker, JP Vallee, F Terrier,
We investigated the specificity of superparamagnetic iron oxide (SPIO)-enhanced T1-weighted spin-echo (SE) magnetic resonance (MR) images for the characterization of liver hemangiomas. When imaging liver hemangiomas, which are the most frequent benign liver tumors, a method with very high specificity is required, which will obviate other studies, follow-up, or invasive diagnostic procedures such as percutaneous biopsy. Eighty-three lesions were examined by MR imaging at 1.5 T before and after intravenous injection of SPIO particles. Lesions were categorized as follows according to the final diagnosis: 37 hemangiomas, nine focal nodular hyperplasias (FNHs), 19 hepatocellular carcinomas (HCCs), and 18 metastases. Their signal intensity values were normalized to muscle and compared. The only lesions showing a significant increase in signal intensity ratio (lesion to muscle) on postcontrast T1-weighted SE images were hemangiomas (p < 0.001). The signal intensity ratio of hemangiomas increased on average by 70%. Based on receiver operating characteristic analysis and using a cutoff level of 50% signal increase, the specificity and sensitivity of SPIO-enhanced MR imaging for the characterization of hemangiomas would be 100% and 70%, respectively. The T1 effect of SPIO particles can help differentiate hemangiomas from other focal liver lesions such as FNHs, HCCs, and metastases and may obviate biopsy. When using SPIO particles for liver imaging, it is useful to add a T1-weighted sequence to T2-weighted images, thereby providing additional information for lesion characterization.
37021.02103905611999.09.14++Chemotherapy-treated liver metastases mimicking hemangiomas on MR images.Abdom Imaging
RC Semelka, S Worawattanakul, TC Noone, DA Burdeny, NL Kelekis, JT Woosley, JK Lee,
To report the observation that chemotherapy-treated liver metastases may mimic the appearance of hemangiomas on T2-weighted and serial postgadolinium gradient-echo magnetic resonance (MR) images.
37121.0078084921995.01.31 Case records of the Massachusetts General Hospital. Weekly clinicopathological exercises. Case 3-1995. A 29-year-old man with AIDS and multiple splenic abscesses.N Engl J Med
37220.9286688041996.08.05++Focal malignant hepatic lesions: MR imaging enhanced with gadolinium benzyloxypropionictetra-acetate (BOPTA)--preliminary results of phase II clinical application.Radiology
R Caudana, G Morana, GP Pirovano, N Nicoli, A Portuese, A Spinazzi, R Di Rito, GF Pistolesi,
To investigate enhancement with gadolinium benzyloxypropionictetraacetate (BOPTA) at magnetic resonance (MR) imaging to detect focal malignant hepatic lesions.
37320.9210639021976.08.02+ Hemorrhagic pseudocyst of the spleen.J S C Med Assoc
LH Erdman, G Petrossian, JA Ramin,
37420.90178957802007.11.09++Usefulness of combining sequentially acquired gadobenate dimeglumine-enhanced magnetic resonance imaging and resovist-enhanced magnetic resonance imaging for the detection of hepatocellular carcinoma: comparison with computed tomography hepatic arteriography and computed tomography arterioportography using 16-slice multidetector computed tomography.J Comput Assist Tomogr
YK Kim, HS Kwak, YM Han, CS Kim,
To investigate the diagnostic efficacy of sequentially acquired gadobenete dimeglumine-enhanced 3-dimensional dynamic magnetic resonance imaging (MRI) and Resovist-enhanced MRI for detecting hepatocellular carcinoma (HCC) by comparing with combined computed tomography (CT) hepatic arteriography (CTHA) and CT arterioportography (CTAP) using 16-slice multidetector CT.
37520.90127232902003.08.28++Spontaneous splenic rupture--a rare complication of amyloidosis.Swiss Surg
AZ Khan, X Escofet, KM Roberts, AR Salman,
We present a case of spontaneous rupture of the spleen, an uncommon complication of systemic amyloidosis. Amyloid deposition leading to capsular distension and increased vascular fragility is thought to predispose the spleen to rupture spontaneously.
37620.8966496621984.01.07++[Sonographic study of the spleen and retroperitoneal space-occupying masses].Wien Med Wochenschr
H Kathrein, G Judmaier,
Sonography of the spleen allows exact measurements of this organ. There are typical pictures in cysts or hematomas. Diffuse changes of the spleen however are hardly distinguishable in regard to differential diagnosis. Retroperitoneal masses can easily be recognized. Lymph-nodes can be identified and the results of therapeutic interventions can be judged. Hematomas or abscesses can be seen easily. Guided needle biopsy offers the possibility for histologic examinations.
37720.89173480022007.06.06++Focal nodular hyperplasia: intraindividual comparison of dynamic gadobenate dimeglumine- and ferucarbotran-enhanced magnetic resonance imaging.J Magn Reson Imaging
D Marin, R Iannaccone, A Laghi, C Catalano, T Murakami, M Hori, T Kim, R Passariello,
To intraindividually compare the enhancement pattern of focal nodular hyperplasia (FNH) after dynamic administration of two bolus-injectable liver-specific MR contrast agents, ferucarbotran and gadobenate dimeglumine.
37820.8988738561997.01.13++Natural history of focal nodular hyperplasia of the liver: an ultrasound study.J Clin Ultrasound
M Di Stasi, E Caturelli, I De Sio, A Salmi, E Buscarini, L Buscarini,
Sixteen cases of focal nodular hyperplasia (FNH) of the liver were followed by ultrasound (US) for a mean of 33 months (range 6-81). In 69% of the cases, the diagnosis was incidental. On US the lesions were single in 75% of the cases, localized in the right lobe in 75%, and subcapsular in 50%. No specific US-pattern could be identified. A central scar was found in 19% of the patients. At the end of the follow-up, the size was reduced in 7/16 cases, and in 1/16 the lesion disappeared. The spontaneous reduction of nodules in FNH must be considered in the management of this pseudotumor.
37920.88114227862001.08.23++Concomitant inflammatory pseudotumor of the liver and spleen.Liver
G Di Vita, M Soresi, R Patti, A Carroccio, P Leo, V Franco, G Montalto,
We report the case of a 53-year-old man with inflammatory pseudotumor (IPT) of the liver and spleen. This concomitant association has rarely been reported. The patient presented with a hypoechoic mass in the liver and a clinical picture of recurrent sepsis; hematochemical exams and imaging data were nonspecific. Antibiotic therapy improved the clinical course, but did not resolve it definitively. After 50 days of therapy, as the hepatic mass decreased a similar lesion appeared in the spleen. The final diagnosis was made on splenectomy and an intra-operative biopsy of the residual liver lesion. The diagnostic problems encountered in this very rare association of IPT of the liver and spleen were similar to those for isolated IPT in the respective single organ sites. After 15 months of follow-up, the patient is in good health and no recurrence of symptoms or masses has been observed.
38020.8515222701992.10.15++Gd-DTPA enhanced MRI of cervical anterior epidural venous plexus.J Comput Assist Tomogr
ND Gelber, RL Ragland, JR Knorr,
Seventy selected cases were reviewed retrospectively to assess the normal Gd-DTPA enhanced MR appearance of the cervical anterior epidural venous plexus. This structure can enhance quite markedly and has a somewhat variable appearance on MR imaging but we believe that it can be differentiated from pathological enhancement in the area if attention is paid to its normal anatomical characteristics.
38120.8179728081994.12.21++Small pancreatic adenocarcinomas: efficacy of MR imaging with fat suppression and gadolinium enhancement.Radiology
T Gabata, O Matsui, M Kadoya, J Yoshikawa, S Miyayama, T Takashima, T Nagakawa, M Kayahara, A Nonomura,
To compare the efficacy of fat-suppressed T1-weighted magnetic resonance (MR) imaging and dynamic MR imaging in the diagnosis of small pancreatic adenocarcinomas.
38220.7786593851996.08.01+ Gastrointestinal case of the day. Sarcoidosis with involvement of liver, spleen, abdominal and thoracic lymph nodes, and lungs.AJR Am J Roentgenol
SP Gay, HA Shaffer, SF Futterer, PM Aitchison, SJ Patel,
38320.7614304571992.12.16+ Gadolinium-enhanced MRI of pigmented villonodular synovitis of the knee.J Comput Assist Tomogr
PR Bessette, PA Cooley, RP Johnson, DJ Czarnecki,
38420.7081470131994.05.05+ [A case from general practice (14): isolated splenomegaly].Z Arztl Fortbild (Jena)
H Berndt,
38520.6891687071997.06.24++Still the great mimicker: abdominal tuberculosis.AJR Am J Roentgenol
H Jadvar, RE Mindelzun, EW Olcott, DB Levitt,
Since the mid 1980s, a resurgence of tuberculosis has occurred. The disease is and will remain a serious public health threat worldwide. The clinical and radiologic features of abdominal tuberculosis may mimic those of many diseases. Radiologists evaluating abdominal images should consider the diagnosis of abdominal tuberculosis in immigrants from areas endemic for tuberculosis, in immunocompromised patients, and in high-risk patients such as the homeless. Imaging features that suggest the correct diagnosis are cecal amputation, ileocecal thickening and inflammation, shortening of the ascending colon, gaping of the ileocecal valve, mesenteric adenopathy, a misty mesentery, diffuse omental infiltration, loculate high-density ascites, an enhancing peritoneum with or without an omental line, nodularity of the surface of the mesenteric leaves, and transperitoneal permeation.
38620.6777107911995.05.12++Vascular mass lesions and hypervascular tumors in the head and neck. Characteristics at CT, MR imaging and angiography.Acta Radiol
F Aspestrand, A Kolbenstvedt,
A retrospective analysis of the findings at contrast-enhanced CT, MR imaging and angiography in 24 patients with vascular mass lesions and 11 patients with hypervascular tumors in the head and neck region was undertaken. We attempted to find criteria at CT and MR imaging that could aid in differentiating between different lesion categories. Parameters such as contrast enhancement at CT, signal intensities at MR imaging, phleboliths and peritumoral hypervascularity were correlated to clinical presentation, biopsies and angiography. MR imaging was superior to CT and far better than angiography in delineating cavernous hemangiomas. Contrast-enhanced CT may better differentiate between cavernous and capillary hemangiomas than MR. MR imaging clearly differentiated cavernous hemangiomas from hypervascular tumors, but was, like CT, inadequate for distinguishing between capillary hemangiomas and hypervascular tumors. Lymphangiomas and cavernous hemangiomas had similar appearances at CT and MR imaging.
38720.65110586372000.11.21++Nondiffuse fatty change of the liver: discerning pseudotumor on MR images enhanced with ferumoxides-initial observations.Radiology
S Hirohashi, K Ueda, H Uchida, W Ono, J Takahama, M Takewa, S Kitano, H Ohishi,
To clarify the findings of nondiffuse fatty change of the liver on ferumoxides-enhanced magnetic resonance (MR) images.
38820.6498305441999.01.22++Splenic abscess: a diagnostic and therapeutic challenge.Acta Chir Belg
E de Bree, D Tsiftsis, M Christodoulakis, G Harocopos, G Schoretsanitis, J Melissas,
The records of five patients treated in our department for splenic abscess are analysed and the literature is reviewed. Computed tomography revealed the correct diagnosis in all patients, while clinical presentation was often nonspecific. Spleen-preserving management was possible in two patients (40%). Outcome was uneventful for four patients. One patient with a splenic abscess caused by Mycobacterium tuberculosis and acquired immunodeficiency syndrome, died 4 months after splenectomy from sepsis. We discuss the clinical presentation of splenic abscess, its diagnostic approach, and treatment. Additionally, we studied whether spleen-preserving management is feasible or not.
38920.6435214221986.07.08++The early diagnosis of splenic abscess.Am Surg
S Teich, GC Oliver, JW Canter,
Five cases of splenic abscess seen between 1970 and 1984 are reviewed. The predisposing factors included preceding pyogenic infection, sickle cell disease, and contiguous disease in the pancreas. Abdominal pain and fever were the most frequent presenting symptoms. The most common physical finding was left upper quadrant (LUQ) abdominal tenderness. All patients were treated with splenectomy. In one patient percutaneous drainage was attempted prior to splenectomy but failed. The mortality rate was 20 per cent. Radiologic procedures developed in the last ten years make possible the early diagnosis and treatment of splenic abscess. The treatment of choice remains antibiotics followed by splenectomy.
39020.53173976362007.06.19+ [37 Year old woman with abdominal discomfort and splenic focal lesion].Rev Clin Esp
M Martínez Celada, M Rivas Carmenado, C García Pravia, M Fresno Forcelledo,
39120.52108454832000.06.21+ Atypical inside-out pattern of hepatic hemangiomas.AJR Am J Roentgenol
S Kim, JJ Chung, MJ Kim, S Park, JT Lee, HS Yoo,
39220.50157885752005.05.12++Ferucarbotran-enhanced MRI versus triple-phase MDCT for the preoperative detection of hepatocellular carcinoma.AJR Am J Roentgenol
SH Kim, D Choi, SH Kim, JH Lim, WJ Lee, MJ Kim, HK Lim, SJ Lee,
We compared ferucarbotran-enhanced MRI with triple-phase MDCT for the preoperative detection of hepatocellular carcinoma.
39320.5066738871984.06.05++Splenic abscess: a review with the value of ultrasound.Clin Radiol
Y Hertzanu, DB Mendelsohn, E Goudie, A Butterworth,
Five cases of splenic abscess are presented. A positive ultrasound diagnosis was made in each patient, showing a regular or ill-defined anechoic mass with large or small, high-intensity echogenic foci due to contained debris. Computed tomography performed in two cases showed intrasplenic low-density areas essentially unchanged following intravenous contrast administration. Gas was present in one of the abscesses. The clinical implications in a septicaemic patient with intrasplenic gas formation following splenic embolisation are discussed.
39420.4783815511993.03.11++Islet cell tumors: comparison of dynamic contrast-enhanced CT and MR imaging with dynamic gadolinium enhancement and fat suppression.Radiology
RC Semelka, MJ Cumming, JP Shoenut, CM Magro, CS Yaffe, MA Kroeker, HM Greenberg,
Ten patients with 11 islet cell tumors underwent dynamic contrast material-enhanced computed tomography (CT) and magnetic resonance (MR) imaging within a 1-month period. MR imaging depicted all 11 tumors, and CT depicted seven of the 11 tumors. CT did not depict four of seven tumors that measured 2.5 cm in diameter or less. Islet cell tumors had low signal intensity on T1-weighted fat-suppressed MR images, and gastrinomas were best shown with this technique. Two of three insulinomas less than 1.5 cm in diameter were best shown on dynamic contrast-enhanced fast low-angle shot (FLASH) images as uniform areas of high signal intensity. Hepatic metastases were seen in five patients and showed peripheral ringlike enhancement best demonstrated on dynamic gadolinium-enhanced FLASH images. Hepatic lesions were most conspicuous on T2-weighted fat-suppressed spin-echo images. MR imaging with dynamic gadolinium enhancement and fat suppression is a promising tool in the investigation of islet cell tumors.
39520.4485191481993.07.29++A radiological study of abdominal tuberculosis in a Saudi population, with special reference to ultrasound and computed tomography.Clin Radiol
T Denton, J Hossain,
The radiological appearances of abdominal tuberculosis are presented, which includes peritoneal, liver, spleen and pancreatic disease, but excludes renal and musculoskeletal involvement. Twenty-three patients were studied, 12 of whom had TB peritonitis. Barium studies remain valuable in gastrointestinal tract disease but for peritoneal, splenic, hepatic and pancreatic disease, ultrasound and computed tomography are indicated. Their diagnostic value is further enhanced by guided aspiration and biopsy techniques.
39620.4340536591985.12.19++Differential diagnosis of low-attenuation splenic lesions on computed tomography.J Comput Tomogr
K Chintapalli, MK Thorsen, TL Lawson,
A retrospective computed tomography evaluation of proved low-attenuation splenic lesions in nontraumatic cases was done. Computed tomography was able to distinguish cystic from solid lesions. Although computed tomography examination is sensitive in the detection of low-attenuation lesions, the computed tomography findings alone are not helpful in differentiation of different low-attenuation lesions. Associated computed tomography findings in other organs and clinical findings are more helpful than the size, shape, and computed tomography attenuation of the lesions. Splenic lesions may be the only metastatic manifestation in some cancer patients. A thin needle aspiration may be done to document the nature of the pathologic lesion in problematic cases.
39720.4178066591995.01.31++Ultrasound evaluation of hepatic and splenic microabscesses in the immunocompromised patient: sonographic patterns, differential diagnosis, and follow-up.J Clin Ultrasound
C Görg, R Weide, WB Schwerk, H Köppler, K Havemann,
High-dose chemotherapy, especially for bone marrow transplantation, causes a great degree of immunosuppression, and thus carries the risk for invasive fungal infections. Although hepatic and splenic involvement in disseminated candidiasis is frequent, involvement of these organs is rarely appreciated antemortem. During the last decade, focal hepatosplenic candidiasis has been recognized increasingly by ultrasound. We report the sonographic and clinical findings of 6 patients: 3 AML (acute myeloid leukemia), 2 NHL (non-Hodgkin's lymphoma), and 1 HD (Hodgkin's disease) who demonstrated multiple, small-nodule, hypoechoic lesions in spleen and/or liver after high-dose chemotherapy. All patients were in complete hematologic remission when the study was performed. Septic fever was unresponsive to antibiotic therapy. Granulocytopenia (< or = 1000/mm3) was seen for at least 10 days. However, the manifestation of hepatolienal microabscesses became apparent by ultrasound only after the neutrophil count returned to normal in all but 1 patient. Microabscesses decreased or disappeared on follow-up examination after antifungal treatment. Systemic candida infection was confirmed serologically. Sonographic-guided abscess biopsy (n = 3) revealed necrosis/abscess. Structural inhomogeneity of parenchymal organs was seen for several months after therapy.
39820.3938396521985.09.26++Fine-needle aspiration of lymphadenopathy of suspected infectious etiology.Arch Pathol Lab Med
LJ Layfield, BJ Glasgow, MH DuPuis,
We present a protocol for culture of lymph node find-needle aspirations in a series of 44 patients. Clinical indications for inclusion in the protocol included fever, localized erythema, pain or heat, an independent clinical diagnosis of infection by the referring physician, or a grossly purulent appearance of the initial aspirate material. Organisms (fungi, bacteria, or mycobacteria) were isolated in 13 (30%) of the aspirates. The probable contamination rate was 9%. These figures approached the culture yields obtained from open biopsy specimens as reported in the literature. A notable discrepancy existed between the cytologic appearance of the aspirates and culture results in three cases of mycobacteria. Six unsuspected malignancies were diagnosed. There were no complications from the procedure in this series. Based on this study, we present recommendations for culture of fine-needle aspirates from lymph nodes.
39920.3734907551986.12.16++Patterns of liver injury in childhood: CT analysis.AJR Am J Roentgenol
HP Stalker, RA Kaufman, R Towbin,
Forty-eight consecutive cases of liver injury diagnosed by CT in hemodynamically stable children were analyzed retrospectively for anatomic location, type of injury, associated nonhepatic injuries, and complications. It was found that the right lobe was involved in 83% of all injuries, and that the posterior segment of the right lobe was injured most often. Right-sided injuries were usually superficial and simple, while left-sided injuries were more likely to be deep and complex. Significant complications were associated with deep, complex, perihilar injuries. Retroperitoneal blood collections were noted around the adrenal, in a distribution not previously described. Injuries of the hepatic dome were most characteristic and were often associated with injuries of the lung base, kidney, ribs, and pneumothorax.
40020.35122397622002.12.03++[Splenic abscesses: 6 cases in 15 years].Chir Ital
C Ammaturo, N Capuano, F Miele, M Alderisio, A Ciamillo, S Pastore, R Rossi, E D'Eliso, M Bassi, M Ingrosso, E Iavazzo, E Iervolino,
Splenic abscesses are a rare type of disease, owing to the quite exceptional primary forms, but the prevalence of the disease is rising as a result of the increase in the population at risk. The authors report on their experience based on 6 observations of such cases over a period of 15 years. The diagnosis was obtained by ultrasonography in all 6 cases. Only one case was successfully treated by percutaneous drainage, the other 5 all requiring splenectomy. Only one patient, suffering from Chédiak-Higashi disease, died of bronchopneumonia 6 months postoperatively. Nowadays the disease is diagnosed earlier than it was in the past owing to the increasingly widespread use and refinement of diagnostic methods, but even today identification of splenic abscess may still be late due to the presence of predisposing diseases which mask the clinical picture, and also because, since the condition is so rare, one very often fails to think of it in the early stages. An analysis of the recent literature indicates that percutaneous drainage is a reliable technique which presents a high therapeutic success rate and low cost compared to surgery. Though we believe that the ongoing progress in the fields of ultrasonography and CT-guided intervention may allow us to treat increasing numbers of patients with splenic abscesses in future, we feel, also in the light of our own experience, that splenectomy still remains the reference treatment, in that ideal conditions for successful percutaneous drainage do not often present themselves.
40120.3471778171983.02.14++[Discovery of benign hepatic lesions during investigation for hepatic metastases].Nouv Presse Med
H Martelli, JM Tubiana, C Huguet,
Benign lesions may be unexpectedly discovered when investigating for liver metastases. This is illustrated here by 6 cases of alleged liver metastasis in patients previously operated upon for cancer and referred for hepatectomy. The diagnosis was corrected by additional examinations or on surgery. A model of diagnostic and therapeutic approach is suggested. As a rule, a cystic lesion seen on ultrasonography does not require supplementary arteriography and needle biopsy -- are necessary in cases of dense, heterogeneous lesions.
40220.3439079311986.02.14++The value of ultrasonic scanning of the spleen in lymphoma.Clin Radiol
DJ King, AA Dawson, AP Bayliss,
In 40 patients assessed for splenic enlargement prior to splenectomy, clinical examination and ultrasonic scanning gave equally accurate results when compared with splenic weight after removal. In the 22 patients having staging laparotomy and splenectomy for Hodgkin's disease, ultrasound was unable to assess accurately the presence of tumour deposits.
40320.3339017051985.11.08++Percutaneous drainage of postoperative abdominal and pelvic lymphoceles.AJR Am J Roentgenol
M White, PR Mueller, JT Ferrucci, RJ Butch, JF Simeone, CC Neff, I Yoder, N Papanicolaou, RC Pfister,
Eleven patients with postoperative abdominal and pelvic lymphoceles underwent percutaneous diagnostic and therapeutic intervention with either needle aspiration or catheter drainage. Although initial sonographic or CT examinations accurately identified these collections, definitive diagnosis required fluid sampling and laboratory analysis for confirmation. Seven pelvic and two retroperitoneal lymphoceles demonstrated a gross appearance and composition different from two lymphatic collections in the upper peritoneum. Nine patients underwent catheter drainage; two were managed by needle aspiration alone. Duration of catheter drainage was 4-120 days, substantially longer than is customary for standard fluid collections. Nine of 11 patients were cured by percutaneous aspiration or drainage alone. Bacterial colonization developed in three persistently draining lymphoceles. However, no clinical sepsis or bacteremia occurred. In another patient with persistent high-volume lymphatic output, sclerotherapy with tetracycline instillation was successful in rapidly closing the lymphatic fistula. Percutaneous drainage is a safe, effective procedure for drainage of postoperative lymphoceles.
40420.31117567082002.02.21++Hepatocellular carcinoma: detection with gadolinium- and ferumoxides-enhanced MR imaging of the liver.Radiology
D Pauleit, J Textor, R Bachmann, R Conrad, S Flacke, G Layer, B Kreft, H Schild,
To test the hypothesis that the accuracy of gadolinium- and ferumoxides-enhanced magnetic resonance (MR) imaging is different in small (< or =1.5-cm) and large (>1.5-cm) hepatocellular carcinomas (HCCs).
40520.3035336971986.12.08++Radiographic appearance of diffuse splenic hemangiomatosis.Gastrointest Radiol
SC Rose, DA Kumpe, ML Manco-Johnson,
The evaluation of splenomegaly in a patient with a consumptive coagulopathy included a liver-spleen scan, an abdominal sonogram, and an abdominal computed tomographic scan, which demonstrated an enlarged spleen with a diffuse parenchymal textural abnormality. A diffuse hemangiomatous pattern was present on splenic angiography. A splenectomy was performed and splenic hemangiomatosis was confirmed. The radiographic findings in this rare entity are presented and discussed.
40620.29218613202011.09.20++Splenic cystic lymphangioma in a young woman: case report and literature review.Acta Gastroenterol Belg
GP Xu, HF Shen, LR Yang, Q Ma, BL Gao,
Splenic cystic lymphangioma is extremely rare, with very few cases reported until now. Here, we report a case of cystic lymphangioma of the spleen in a young woman who was admitted for evaluation of abdominal pain and a mass lasting for two years. We present this case with emphasis on the problem of differential diagnosis and the difficulties of diagnostic certainty in the absence of histologic features.
40720.2685173231993.07.22++Value of contrast-enhanced CT in detecting active hemorrhage in patients with blunt abdominal or pelvic trauma.AJR Am J Roentgenol
K Shanmuganathan, SE Mirvis, ER Sover,
The purpose of this retrospective study was to evaluate the use of contrast-enhanced CT to show sites of active hemorrhage as a guide for surgical or angiographic treatment in patients sustaining blunt abdominal or pelvic trauma.
40820.2634479281988.06.09+ [Value of contrast enhancement with Gd-DTPA in MRI of brain tumors. A comparison with X-ray CT].Fukuoka Igaku Zasshi
T Tsuji, T Kishikawa, K Ikezaki, K Fujii, S Matsumoto, T Koga,
40920.2696632791998.09.21++Detection of hepatic tumors: arterial-phase MR imaging versus spiral CT arteriography.Abdom Imaging
M Kanematsu, H Hoshi, Y Sone, R Mochizuki, M Kato, R Yokoyama,
To compare the utility of arterial-phase magnetic resonance (APMR) imaging and spiral computed tomography arteriography (CTA) for detection of hepatic tumors.
41020.25124380342002.12.19++Atypical focal nodular hyperplasia of the liver: imaging features of nonspecific and liver-specific MR contrast agents.AJR Am J Roentgenol
A Ba-Ssalamah, W Schima, MT Schmook, KF Linnau, N Schibany, T Helbich, P Reimer, F Laengle, F Wrba, A Kurtaran, M Ryan, FA Mann,
The objective of our study was to describe the functional and differential uptake features of atypical focal nodular hyperplasia using different MR contrast agents and to evaluate their potential role in the diagnosis and characterization of focal nodular hyperplasia.
41120.24153322592004.12.14++Inflammatory pseudotumor of the liver: ferumoxide-enhanced MR imaging as a tiebreaker.J Magn Reson Imaging
H Kato, M Kanematsu, H Kondo, S Osada, S Goshima, T Yamada, Y Yamada, R Yokoyama, H Hoshi, N Moriyama,
We examined a 70-year-old male patient with an inflammatory pseudotumor of the liver mimicking a peripheral-type cholangiocellular carcinoma. Ferumoxide-enhanced magnetic resonance (MR) imaging revealed residual Kupffer cell function in liver parenchyma in and surrounding the inflammatory pseudotumor involvement, which suggested the diagnosis of inflammatory pseudotumor of the liver. We correlate the MR imaging and pathologic findings in this report.
41220.2432850581988.06.16+ [Ultrasonographic study of splenic mass lesions].Rinsho Hoshasen
T Tomita, A Kurosaki, M Irimoto, K Takeuchi, G Watanabe,
41320.2329773201989.05.26+ [A rare manifestation of Hodgkin's disease: splenic abscess].Clin Ter
F Pentimone, M Filidei, G Frustaci,
41420.22151130622004.05.25+ Preoperative patient work-up: Resovist-enhanced MRI vs. multislice CT--preliminary results of an ongoing study.Eur Radiol
G Heinz-Peer,
41520.1621209381990.11.19++Spinal cord pial metastases: MR imaging with gadopentetate dimeglumine.AJR Am J Roentgenol
V Lim, DF Sobel, J Zyroff,
The purpose of this investigation was to describe gadopentetate-dimeglumine-enhanced MR findings in metastatic disease to the pial lining of the spinal cord. Correlation was made with clinical data, other radiologic studies, and pathologic findings. Eighty-six patients with a known malignancy and unexplained neurologic signs or symptoms were studied with pre- and postcontrast T1-weighted images. In seven of these patients, abnormal enhancement of the pial lining of the cord was seen on the sagittal postcontrast T1-weighted images. This appeared as a thin rim of enhancement along the surface of the cord in six patients and as a focal, thick rim of enhancement in addition to the thin rim of enhancement in the seventh patient. Axial images confirmed the location along the pial lining in each case. Precontrast T1-weighted images in all seven cases and precontrast T2-weighted images in five cases failed to detect any focal abnormalities of the pial lining of the cord. Pathologic confirmation was available in five of the seven patients. Primary malignancies in these patients included breast carcinomas (two), lymphoma (one), leukemia (one), adenocarcinoma of the lung (one), prostate carcinoma (one), and malignant melanoma (one). Three of seven patients had metastatic disease evident only within the CNS, while four patients had widespread disease outside the CNS. We conclude that contrast-enhanced MR imaging is useful in the diagnosis of pial spread of metastatic disease in patients with a known primary malignancy and unexplained neurologic signs or symptoms.
41620.14106331452000.02.03++Ultrasound of the spleen.World J Surg
MW Andrews,
Ultrasound (US) is a very useful means of noninvasively examining the spleen. Imaging is generally achieved via an intercostal approach using gray scale US supplemented by color flow to assess vasculature. Normal spleen appears uniform with vessels radiating and converging at the hilum. US readily identifies accessory spleens, a common congenital variation. Splenomegaly can be identified by US, however, it is not useful in differentiating the many causes of an enlarged spleen. Focal splenic masses are identified as cystic or solid by US, and features such as calcification, wall thickening, internal debris, and gas may be demonstrated in cystic type masses. Granulomatous calcification may be seen with US and cavernous hemangiomata typically have a characteristic US appearance. US can demonstrate typical features of splenic infarction. Splenic injury can be detected with US, however, whether US is the most appropriate first line investigation for suspected splenic injury is yet to be determined. It is a very useful follow-up modality for monitoring splenic injuries detected by either US or computed tomography which are treated conservatively.
41720.1182736511994.02.03++MR imaging of the normal meninges: comparison of contrast-enhancement patterns on 3D gradient-echo and spin-echo images.AJR Am J Roentgenol
JW Farn, SA Mirowitz,
The purpose of this study was to determine the enhancement pattern of the normal meninges on T1-weighted three-dimensional Fourier transform gradient-echo (3DGE) MR images and to compare this pattern with that observed on conventional two-dimensional Fourier transform spin-echo (2DSE) images. This will serve as a basis for comparison when cases of suspected meningeal pathology are evaluated.
41820.1156841931968.12.08+ Splenectomy for the diagnosis fo splenomegaly.Ann Surg
RE Hermann, KE De Haven, WA Hawk,
41920.1126843711989.12.29++The changing spectrum of splenic abscess.Clin Imaging
PL Caslowitz, JD Labs, EK Fishman, SS Siegelman,
Thirteen cases of splenic abscess were reviewed retrospectively from pathologic and medical records from 1978 through 1986. Splenic abscess is uncommon, but the diagnosis has been made more frequently in recent years due to the increasing number of living immunosuppressed patients and to the use of more sophisticated radiologic diagnostic techniques. Five patients had a solitary abscess (SA) and eight had multiple abscesses (MA). Seventy-five percent of the patients with MA were immunosuppressed, most had no symptoms from the splenic abscess, and none died. Only one patient (with SA) died, a mortality of 10% overall. Previously the mortality has been 40 to 70%. The decreased mortality may in part be attributable to the more rapid diagnosis (3.8 days for SA, 1.8 days for MA) of the splenic abscess, prompting early treatment. Improved radiologic studies reduce the time to diagnosis and thereby improve the prognosis. Computed tomography (CT) was diagnostic for splenic abscess in 4 of 7 patients and suggestive of abscess in the other 3. Computed tomography was the diagnostic modality of choice in suspected splenic abscess, as it provided more information than the other radiologic studies used.
42020.1030987901987.02.03++Left lobe of the liver mimicking perisplenic collections.J Clin Ultrasound
MS Crivello, IM Peterson, RM Austin,
Three patients were scanned in whom the sonographic diagnoses of perisplenic fluid collections were made. Computed tomography scanning demonstrated that the appearances were not caused by perisplenic pathology but by lateral extent of normal left lobe of the liver. Methods to avoid this potential sonographic pitfall are suggested.
42120.0723180731990.05.07+ [Malignant hemangioendothelioma of the spleen as an incidental finding of abdominal surgery].Chirurg
M Fuchs, G Fuchs, J Schleef,
42220.0786729731996.08.15++The frequency, appearance, and significance of splenic perfusion defects in CT arterial portography.Abdom Imaging
LN Nazarian, RJ Wechsler, CK Grady,
The purpose of this study was to determine the frequency, appearance, and significance of splenic perfusion defects on computed tomographic arterial portography (CTAP).
42320.06146288782003.12.23++Multiple inflammatory pseudotumors of the spleen: case report.Abdom Imaging
WC Wu, ZY Lin, WL Chuang, WY Chang,
The imaging findings of multiple splenic inflammatory pseudotumors in a 45-year-old male are described. Peripheral ring enhancement on arterioportal phase and gradual enhancement from the periphery to the center on venous delay phase on contrast-enhanced dynamic magnetic resonance imaging were compatible with the pathologic findings. This result may aid in the preoperative diagnosis of these benign lesions.
42420.0035264001986.09.18++Gaucher disease: sonographic appearance of the spleen.Radiology
SC Hill, JW Reinig, JA Barranger, J Fink, TH Shawker,
Ultrasonographic (US) examinations of the upper abdomen were performed in 80 patients with Gaucher disease. Of the 49 patients that had not undergone splenectomy, 47 had splenic enlargement. Sixteen patients had multiple lesions in the spleen. Most patients had discrete hypoechoic lesions that corresponded pathologically to focal homogeneous clusters of Gaucher cells. Several patients had similar lesions that were hyperechoic and were composed of Gaucher cells and fibrosis or infarction. A few patients had a geographic pattern of irregular areas of involvement of Gaucher cells among normal splenic parenchyma. The liver was often enlarged but otherwise sonographically unremarkable. Patients with Gaucher disease often have US examinations of the left upper quadrant for abdominal pain. A variety of US findings in the spleen typical for Gaucher disease should be recognized and not interpreted as acute changes.
42519.9983109231994.03.17++Blunt splenic trauma in adults: can CT findings be used to determine the need for surgery?AJR Am J Roentgenol
CD Becker, P Spring, A Glättli, W Schweizer,
The role of CT grading of blunt splenic injuries is still controversial. We studied the CT scans of adult patients with proved blunt splenic injuries to determine if the findings accurately reflect the extent of the injury. We were specifically interested in establishing if CT findings can be used to determine whether patients require surgery or can be managed conservatively.
42619.98175182562007.06.19++Inflammatory pseudotumor of the spleen: CT and MRI findings.Int Surg
PC Ma, SC Hsieh, JC Chien, WT Lao, WP Chan,
Inflammatory pseudotumors rarely occur in the spleen. We report such a case with characteristic computed tomography (CT) and magnetic resonance imaging (MRI) findings. A CT scan showed an isodense nodular mass with gradual mild enhancement on delayed-phase contrast-enhanced images. MRI showed a mass with isointense signal on T1-weighted images and hypointense signal on T2-weighted images. The tumor mass showed progressive inhomogeneous enhancement on gadolinium-enhanced images. The patient received splenectomy, and histologic diagnosis was compatible with inflammatory pseudotumor.
42719.95157867562005.06.30++Ring enhancement on T1-weighted GRE images after ferucarbotran administration for hepatic metastasis: comparison with pathological findings: case report.Radiat Med
K Kitajima, Y Kuwata, M Hayashi, K Imanaka, Y Kaji, K Sugimura,
Hepatic metastases are generally known to be composed of three structures (central necrosis, viable tumor cells, and peritumoral changes such as edema or congestion). We experienced a case of hepatic metastasis that was examined with ferucarbotran-enhanced magnetic resonance (MR) imaging, dynamic MR imaging using Gd-DTPA, and CT during arterial portography (CTAP), and was confirmed pathologically. MR imaging of this case vividly described the three pathological structures of the hepatic metastasis.
42819.90121304472002.08.09++Multidetector CT: detection of active hemorrhage in patients with blunt abdominal trauma.AJR Am J Roentgenol
JK Willmann, JE Roos, A Platz, T Pfammatter, PR Hilfiker, B Marincek, D Weishaupt,
The aim of this study was to determine the imaging findings and the prevalence of active hemorrhage on contrast-enhanced multidetector CT in patients with blunt abdominal trauma.
42919.9089157511997.02.25++Magnetic resonance imaging of focal liver lesions. Comparison of the superparamagnetic iron oxide resovist versus gadolinium-DTPA in the same patient.Invest Radiol
TJ Vogl, R Hammerstingl, W Schwarz, S Kümmel, PK Müller, T Balzer, MJ Lauten, JO Balzer, MG Mack, C Schimpfky, H Schrem, WO Bechstein, P Neuhaus, R Felix,
The authors assess the efficacy of static and dynamic magnetic resonance (MR) imaging using the superparamagnetic iron oxide SHU-555A (Resovist) versus standard dose of gadolinium (Gd)-DTPA in patients with focal liver lesions.
43019.9089769631997.01.17+ Real enhancement or merely increased contrast?AJR Am J Roentgenol
JH Chen,
43119.89161341582006.02.23++Sonographic findings of hibernoma. A report of two cases.J Clin Ultrasound
J Hardes, S Scheil-Bertram, E Hartwig, C Gebert, G Gosheger, M Schulte,
We present 2 cases of hibernoma, a rare lipomatous tumor arising from brown fat tissue. In each case, a hyperechoic mass in comparison to surrounding musculature combined with elevated vascularization was highly suggestive of a liposarcoma. As a rule, malignancy cannot be excluded safely by imaging modalities, and a preoperative biopsy should be performed. Although rare, hibernomas should be considered in the differential diagnosis of lipomatous soft-tissue tumors.
43219.8876227101995.08.30+ MR enhancement of hepatoma by superparamagnetic iron oxide (SPIO) particles.J Comput Assist Tomogr
H Yamamoto, Y Yamashita, S Yoshimatsu, Y Baba, M Takahashi,
43319.8664702421984.10.25++Computed tomography of amyloidosis involving retroperitoneal lymph nodes mimicking lymphoma.J Comput Assist Tomogr
S Takebayashi, Y Ono, F Sakai, S Tamura, S Unayama,
A 74-year-old woman had multiple enlarged periaortic nodes with inhomogeneous enhancement on CT. Although a malignancy such as lymphoma was considered, amyloidosis involving retroperitoneal lymph nodes was confirmed on biopsy.
43419.8491687101997.06.24+ MR arthrography: a review of current technique and applications.AJR Am J Roentgenol
JW Helgason, VP Chandnani, JS Yu,
43519.8221832871990.05.15++Lymphangioma of the retroperitoneum: CT and sonographic characteristic.Radiology
AJ Davidson, DS Hartman,
The authors retrospectively evaluated radiologic, clinical, and pathologic findings in 19 cases of lymphangioma of the retroperitoneum. The tumors were judged confined to one compartment of the retroperitoneum in 68% of the cases, whereas in 32% of cases the tumor involved more than one compartment. Abdominal radiography depicted the mass in all cases. Excretory urography demonstrated organ displacement without tumor invasion in all cases. Sonography showed multiloculated fluid in 61% of cases and a unicameral mass in 39% of cases. All but one of the multiloculated lymphangiomas had thick septa. Sonography also depicted the fluid as uncomplicated in 56% of cases. The remainder had debris that sometimes layered in the dependent portion of the cyst. Computed tomography (CT) showed a unicameral mass in 57% and a septated mass in 43% of cases. CT also showed thin, smooth walls in 79% and thick, irregular walls in 21% of cases. At CT the fluid contents were found to be homogeneous and of fluid attenuation in 64% and were complex in 36% of cases. The attenuation of fluid in one case was the same as that of retroperitoneal fat. In two cases the mass contained mural calcification. The most characteristic radiologic finding of lymphangioma of the retroperitoneum is an elongated tumor containing uncomplicated fluid with or without septa. Chyle and mural calcification are very uncommon in this location.
43619.78159058202005.09.08+ Abdomen. Appendicitis and splenic hemangiomas.Ultrasound Q
E Wechsler, J Chertoff, RD Harris,
43719.76105871381999.12.17++Prevalence and distribution of extraperitoneal hemorrhage associated with splenic injury in infants and children.AJR Am J Roentgenol
CJ Sivit, AA Frazier, MR Eichelberger,
OBJECTIVE: The purpose of this study was to evaluate the prevalence and distribution of associated extraperitoneal hemorrhage in infants and children with splenic injury. CONCLUSION: Splenic injury occasionally resulted in extraperitoneal hemorrhage that tracked into the anterior pararenal space. Extraperitoneal hemorrhage always occurred in association with intraperitoneal hemorrhage. In addition, blood tracking into the anterior pararenal space after splenic injury dissected the splenic vein and pancreas in two (25%) of eight patients.
43819.75150181632004.04.08++Cystic angiomatosis with splenic involvement: unusual MRI findings.Eur Radiol
FM Vanhoenacker, AM Schepper, H Raeve, Z Berneman,
Cystic angiomatosis is a rare disorder with a poor prognosis. We describe a case of a 33-year-old woman who presented with long-standing bone pain, hemolytic anemia, and an enlarged spleen. Radiologically, multiple osseous lesions with a mixed pattern of lytic and sclerotic areas were seen within the shoulders, spine, and pelvis. On CT and MRI of the abdomen, the spleen was markedly enlarged, with internal hyperdense foci on non-contrast CT scan, corresponding to low signal intensity areas on all MR pulse sequences. After administration of contrast, a mottled enhancement pattern throughout the entire spleen was seen both on CT and MRI. Cystic angiomatosis was proven by histological analysis of a biopsy specimen of an involved vertebra and histopathological examination of the spleen after subsequent splenectomy. This is the first report of a patient with disseminated cystic angiomatosis with splenic involvement in which the MRI features differ from the previous reports. Instead of the usual pattern consisting of multiple well-defined cystic lesions, a diffuse involvement replacing the entire spleen, with heterogeneous signal intensities on T2-weighted images and heterogeneous enhancement pattern, was seen in our patient.
43919.7473016241982.01.28++[Cystic lymphangioma of the spleen (author's transl)].Pediatr Med Chir
P Cornaglia-Ferraris, GF Perlino, A Barabino, M Guarino, L Massimo,
The spleen is the least common intra-abdominal site for the development of cystic disease. A lymphoangioma of the spleen was first reported in 1885 by Fink; since that time 47 cases of lymphoangioma or lymphoangectasia have been reported. This report concern a case of cystic lymphoangioma of the spleen consisting of a large splenic cyst with associated multiple small subcapsular cysts and lymphangectasia. The diagnosis and treatment of splenic cysts are discussed and a new classification of splenic cysts is proposed.
44019.74102074351999.05.05++Heterogeneous splenic enhancement patterns on spiral CT images in children: minimizing misinterpretation.Radiology
LF Donnelly, JN Foss, DP Frush, GS Bisset,
To (a) determine the appearances and timing of heterogeneous splenic enhancement at spiral computed tomography (CT) and (b) identify variables influencing heterogeneous splenic enhancement.
44119.7274035171980.10.21++The ultrasonic appearance of extranodal abdominal lymphoma.Radiology
BA Carroll, HN Ta,
The sonographic manifestations of malignant lymphoma involving 70 extranodal sites in 51 patients are presented. Areas of involvement by nonHodgkin and Hodgkin lymphoma included the liver, spleen, kidneys, stomach, pancreas, and muscles. The sonographic appearance of lymphomatous lesions does not necessarily correlate with histologic subclassification. Similarly, atypical manifestations of lymphoma may resemble a variety of neoplastic and non-neoplastic processes. Extranodal lymphomatous abdominal disease was detected in six patients whose lymphangiograms demonstrated no evidence of disease.
44219.72150245172004.12.22++Wandering spleen with torsion of vascular pedicle: early diagnosis with multiplaner reformation technique of multislice spiral CT.Abdom Imaging
K Taori, N Ghonge, A Prakash,
Wandering spleen is a rare clinical radiologic entity characterized by splenic hypermobility due to laxity or maldevelopment of the supporting splenic ligaments. The cause for hypermobility may be hormonal changes during pregnancy or failure of fusion of the dorsal peritoneum. Patients may be asymptomatic, present with a movable lump in the abdomen, or present with acute, chronic, or intermittent symptoms due to torsion of the wandering spleen. Early clinical diagnosis is difficult, so imaging modalities play an important role. We report a case of wandering spleen in which multiplanar reformation of thin maximum intensity projection images played a pivotal role in its precise diagnosis.
44319.7289881961997.01.29++Breast neoplasms: T2* susceptibility-contrast, first-pass perfusion MR imaging.Radiology
CK Kuhl, H Bieling, J Gieseke, T Ebel, P Mielcarek, F Far, P Folkers, A Elevelt, HH Schild,
To evaluate the differentiation of benign from malignant breast tumors with T2*-weighted perfusion magnetic resonance (MR) imaging (blood volume imaging) versus that with dynamic T1-weighted contrast agent-enhanced MR imaging.
44419.7129978731985.12.03++[Value of computer tomographic determination of spleen size for the elucidation of splenic involvement within the framework of primary lymph node neoplasms].Rofo
M Herter, B Ridder, K Lackner, J Vogel,
The splenic index was determined in 155 persons, without evidence of splenic disease, in order to obtain a simple measure of splenic size. Subsequently 36 patients with malignant lymphomas and who then had their spleens removed were examined by CT. A comparison of the CT and pathological-anatomical findings showed that it is a valuable non-invasive method for diagnosing splenic involvement, having a specificity of 86%, sensitivity of 77% and accuracy of 83%.
44519.6989265051996.10.30++Image-guided core-needle biopsy in malignant lymphoma: experience with 100 patients that suggests the technique is reliable.J Clin Oncol
D Ben-Yehuda, A Polliack, E Okon, Y Sherman, S Fields, P Lebenshart, H Lotan, E Libson,
In an initial evaluation of 1,500 computed tomography (CT)-guided core-needle biopsies performed at our institute during the period from 1989 to 1994, we encountered 100 patients with the diagnosis of lymphoma. Here, we review the clinical impact of 109 image-guided needle biopsies in these 100 patients with non-Hodgkin's lymphoma (NHL) and Hodgkin's disease (HD).
44619.65100638471999.03.22++Tuberculosis versus lymphomas in the abdominal lymph nodes: evaluation with contrast-enhanced CT.AJR Am J Roentgenol
ZG Yang, PQ Min, S Sone, ZY He, ZY Liao, XP Zhou, GQ Yang, PM Silverman,
Tuberculosis in the abdominal lymph nodes may be difficult to distinguish from lymphomas. This study evaluated specific CT imaging criteria for differentiating these entities.
44719.63146690942004.05.21++Inflammatory pseudotumor of the spleen: report of a case.Surg Today
O Alimoglu, U Cevikbas,
We report the case of an inflammatory pseudotumor of the spleen in an asymptomatic 55-year-old woman, whose lesion was accidentally found and clinically misdiagnosed to be lymphoma. An inflammatory pseudotumor of the spleen was histopathologically diagnosed following a splenectomy. This lesion is a benign, reactive, and inflammatory process and its etiopathogenesis still remains elusive. The preoperative diagnosis is difficult and the optimal management of the asymptomastic patient with the disease is unclear. This entity should be kept in mind in the differential diagnosis of splenic space-occupying lesions.
44819.63162450162006.03.10++Hepatic peliosis (bacillary angiomatosis) in AIDS: CT findings.Abdom Imaging
K Sandrasegaran, DR Hawes, G Matthew,
Patients with acquired immunodeficiency syndrome are at risk of developing opportunistic infections and aggressive tumors. Computed tomographic examination is the usual method of evaluating the abdomen and pelvis in these patients. Although this technique is reasonably sensitive in detecting pathology, findings are often nonspecific. A case of hepatic peliosis (bacillary angiomatosis) in a patient with acquired immunodeficiency syndrome is presented.
44919.6179728051994.12.21++Hepatic tumors: detection and characterization at 1-T MR imaging enhanced with AMI-25.Radiology
A Denys, L Arrive, V Servois, B Dubray, D Najmark, A Sibert, Y Menu,
To evaluate the ability of magnetic resonance (MR) imaging enhanced with AMI-25 to depict and characterize hepatic tumors.
45019.61100770231999.05.04++A retrospective analysis of the accuracy of T2-weighted images and dynamic gadolinium-enhanced sequences in the detection and characterization of focal hepatic lesions.J Magn Reson Imaging
RS Pawluk, S Tummala, JJ Brown, JA Borrello,
The aim of this study was to determine the relative ability of T2-weighted and dynamic gadolinium-enhanced T1-weighted gradient-echo sequences to detect and characterize focal hepatic lesions. We retrospectively studied 37 patients with proven focal hepatic lesions using the following sequences: a T1-weighted spin-echo sequence (T1), a T2-weighted sequence (T2), and a series of breath-hold dynamic gadolinium-enhanced T1-weighted gradient-echo sequences (Gd). Two observers were asked to determine retrospectively the number and type of focal hepatic lesions present using images from three combinations of sequences (T1+T2, T1+Gd, T1+T2+Gd). Proof of the number and diagnosis of focal lesions in each patient was established using a consensus read. Both readers detected more focal lesions when both the T2-weighted sequences and the gadolinium-enhanced sequences were available than on either sequence alone, although this improvement reached statistical significance (P<0.05) only for one of the readers. There was no significant difference (P<0.05) in the ability to characterize lesions between any of the sets of sequences. The combination of dynamic gadolinium-enhanced images and T2-weighted images was shown to assess focal hepatic lesions better than either of these sequences alone.
45119.6080798581994.10.04++Detection and staging of chondromalacia patellae: relative efficacies of conventional MR imaging, MR arthrography, and CT arthrography.AJR Am J Roentgenol
JA Gagliardi, EM Chung, VP Chandnani, KL Kesling, KP Christensen, RN Null, MG Radvany, MF Hansen,
Chondromalacia patellae is a condition characterized by softening, fraying, and ulceration of patellar articular cartilage. We compare the sensitivity, specificity, and accuracy of conventional MR imaging, MR arthrography, and CT arthrography in detecting and staging this abnormality.
45219.575222801980.03.24+ [Focal splenic defects on a routine liver scan with 99mTc-phytate (author's transl)].Rinsho Hoshasen
K Fukuda, K Kaneko, T Yamada, N Katsuyama, K Kawakami, R Komori,
45319.55100244081999.04.05++Splenic hemangiosarcoma with massive calcification.Abdom Imaging
T Kinoshita, K Ishii, Y Yajima, N Sakai, H Naganuma,
We present a case of large splenic hemangiosarcoma in a 40-year-old man associated with consumptive coagulopathy. Computed tomography showed radial calcification within the splenic tumor. On magnetic resonance imaging, T2 shortening represented a meshwork of calcification and surrounding fibrosis. The possibility of hemangiosarcoma should be considered when a large splenic tumor with massive calcification is noted.
45419.5092759091997.09.16+ Sonographic guidance of needle position for MR arthrography of the shoulder.AJR Am J Roentgenol
R Valls, P Melloni,
45519.5078982681995.04.25++Dynamic contrast-enhanced MR imaging of the liver: parenchymal enhancement patterns.Magn Reson Imaging
JJ Brown, JA Borrello, HS Raza, DM Balfe, AB Baer, TK Pilgram, S Atilla,
A retrospective study of 164 patients undergoing dynamic contrast-enhanced magnetic resonance (MR) imaging was performed to assess hepatic parenchymal enhancement patterns and to correlate these patterns with hepatic function and disease. Rapid T1-weighted images were acquired before and after gadolinium administration. Hepatic enhancement patterns were analyzed blindly by two observers. Medical records were reviewed to document known liver pathology and liver function test results. A total of 72% of patients had homogeneous enhancement of the liver parenchyma; 28% had heterogeneous enhancement. Of the latter group, 61% of patients had enhancement conforming to segmental or lobar boundaries. Patients with heterogeneous enhancement patterns were more likely to have abnormal liver function test results and hepatic morphological abnormalities on their MR examinations than patients with homogeneous enhancement patterns. Heterogeneous hepatic enhancement on dynamic MR images is associated with a higher likelihood of liver disease and biochemical evidence of hepatic dysfunction than homogeneous enhancement.
45619.4997250061998.09.18++Giant splenomegaly caused by splenic metastases of melanoma.Eur J Surg Oncol
S Kyzer, R Koren, B Klein, C Chaimoff,
Splenic metastases are rare and usually occur in the setting of widespread visceral metastases. Splenomegaly as manifestation of metastatic spread is extremely rare. A patient with melanoma and metastases to the skin and lung is described. He developed a giant painful splenomegaly. The splenectomy specimen demonstrated that the spleen was occupied by metastases from the melanoma. Metastases of melanoma may cause extreme enlargement of the spleen. If the patient's general condition is good, splenectomy is indicated in order to prevent spontaneous rupture of the spleen.
45719.49109612212000.09.07++[Comparison of contrast harmonic imaging in B-mode with stimulated acoustic emission, conventional B-mode US and spiral CT in the detection of focal liver lesions].Rofo
M Beissert, M Jenett, M Keberle, C Kessler, D Klein, M Beer, D Hahn,
Comparison between contrast harmonic imaging (CHI) in B-mode with stimulated acoustic emission (SAE), conventional B-mode US, and spiral CT in the detection of focal liver lesions.
45819.4684277441993.03.10++Quantification of inhomogeneities in malignancy grading of non-Hodgkin lymphoma with MR imaging.Acta Radiol
S Rehn, GO Sperber, R Nyman, B Glimelius, H Hagberg, A Hemmingsson,
In a previous study of 50 patients with non-Hodgkin lymphoma (NHL) it was shown that the inhomogeneous appearance of a tumor at MR imaging strongly indicated a high malignancy grade. In this study of 33 patients with NHL, the administration of an i.v. contrast medium, Gadolinium-DTPA, improved the subjective detectability of the inhomogeneities. A method of quantifying the degree of inhomogeneity in the tumors (inhomogeneity index, IH-index) was developed and tested. The mean value of IH-index in the T2-weighted image before contrast medium administration, and of the T1-weighted image after contrast medium administration, as well as the IH-index value in the T2-weighted image before contrast medium administration alone, was able to discriminate well between low- and high-grade NHL. This method of quantifying the degree of inhomogeneity in tumors improved sensitivity in detecting high-grade NHL.
45919.4581918161994.06.22++Fine needle aspiration biopsy of the spleen. A useful procedure in the diagnosis of splenomegaly.Acta Cytol
P Zeppa, A Vetrani, L Luciano, F Fulciniti, G Troncone, B Rotoli, L Palombini,
This study analyzed a series of 140 consecutive fine needle aspiration biopsies of the spleen (sFNAB) collected over a period of nine years. sFNABs were performed by the authors using a 22-gauge spinal needle, and 23-gauge needle in pediatric patients, with a subdiaphragmatic approach. Ultrasound assistance was utilized in 35 cases. Four of the cytocentrifuge specimens were also prepared with part of the aspirated material and used for immunocytochemical staining. Study of these biopsy specimens revealed various benign conditions, such as white pulp hyperplasia, myeloid metaplasia, storage disease, and granulomatous processes and abscesses. Malignant neoplasms were represented by non-Hodgkin's and Hodgkin's lymphomas, leukemias, malignant histiocytoses and metastases. sFNAB was the only diagnostic procedure employed for the morphologic assessment of 60 benign and of 2 malignant cases. In all the other cases sFNAB gave the first diagnosis that was confirmed on surgical specimens. In 2 cases splenic bleeding occurred; one of them required splenectomy. Diagnostic and technical problems are discussed. The authors consider sFNAB a useful procedure, especially in the study of hematologic disorders and in all cases in which splenomegaly is not related or correlated with any clinical finding.
46019.4217293091992.02.11++Pre- and postcontrast MR studies in tuberous sclerosis.J Comput Assist Tomogr
FJ Wippold, WW Baber, M Gado, PJ Tobben, BJ Bartnicke,
The MR findings in eight patients with intracranial manifestations of tuberous sclerosis are reported. There were subependymal lesions in seven patients and peripheral lesions (i.e., cortical and subcortical) in all patients. All lesions were supratentorial. We emphasize two findings that have not been previously stressed. The signal intensity patterns of the subependymal lesions varied from patient to patient, but in all patients receiving intravenous contrast medium, the majority of these lesions enhanced. Although this finding may signify early breakdown of the blood-brain barrier with potential for lesion growth, the high frequency of enhancement challenges earlier concepts of equating this phenomenon with existence of actively growing giant cell astrocytomas. The peripheral lesions were more numerous than subependymal lesions. These lesions were nearly always hyperintense in the proton density weighted and T2-weighted images. Most notable is the fact that, in half of the lesions, signal intensity was also elevated in the T1-weighted image, an observation that has not been emphasized in previous reports. Although not pathologically confirmed this signal pattern may represent early stages of calcification within these lesions. Finally, unlike subependymal lesions, none of the peripheral lesions showed contrast enhancement.
46119.4276400991995.09.20++Pituitary microadenoma. MR appearance and correlation with CT.Acta Radiol
W Wu, KA Thuomas,
Twenty surgically proven pituitary microadenomas were examined with MR imaging and CT. MR demonstrated 20 of 20 microadenomas: 90% of the tumors were hypointense on T1-weighted images before Gd-DTPA administration and in 45% the tumors were more clearly delineated postcontrast. CT demonstrated 19 of 20 diagnosed microadenomas: showing low attenuation in 85% of the tumors precontrast. Iohexol facilitated delineation of the tumors in 45%. Focal enlargement of the gland and diaphragma sellae convexity were more useful than infundibular tilting and sellar-floor erosion as ancillary findings supporting the diagnosis. In general, CT and MR agreed regarding the microadenomas size and location, measurement of enlarged intrasellar contents, detection of the diaphragma sellae bulge, and demonstration of infundibulum abnormality. CT was more sensitive than MR in identifying sellar-floor erosion. We suggest that CT be the first method for demonstration of microadenomas.
46219.4120132001991.05.14++Case report: Tuberculous hepatic and splenic abscess.Clin Radiol
CC Wilde, YK Kueh,
Tuberculous abscess of the liver is rare and delay in diagnosis is common. The case of a 66-year-old Singaporean Chinese female with tuberculous liver abscess is reported. The abscess had an unusual septated ('honeycomb-like') ultrasonographic and computed tomographic appearance and the diagnosis was made with difficulty from material aspirated from the hepatic lesion.
46319.3993084951997.10.16+ MR imaging of ureteropelvic junction obstruction.AJR Am J Roentgenol
PV Prasad, FM Hall,
46419.3793137361997.10.23++Clinical utility of abdominal CT scanning in patients with HIV disease.Clin Radiol
H Sansom, B Seddon, SP Padley,
To evaluate the yield of abdominal computed tomography (CT) in patients with human immunodeficiency virus (HIV) infection and to assess the influence of CT scanning on patient management and diagnosis.
46519.3789561291997.03.05++Hepatic parenchymal hyperperfusion abnormalities detected with multisection dynamic MR imaging: appearance and interpretation.J Magn Reson Imaging
K Ito, K Honjo, T Fujita, H Awaya, T Matsumoto, N Matsunaga,
On arterial-dominant-phase images in multisection dynamic MR imaging, early-enhancing areas that are perfusion abnormalities rather than tumor deposit are sometimes encountered. The purpose of this article was to determine the frequency, location, and appearance of these hepatic parenchymal hyperperfusion abnormalities and to discuss possible causes of these abnormalities. Multisection dynamic MR images obtained in 415 patients with suspected hepatobiliary diseases were reviewed for the presence of hyperperfusion abnormalities. A total of 96 hyperperfusion abnormalities were identified in 88 (21%) of 415 patients. They were characterised from their shape, distribution, or location as lobar or segmental (n = 36 [38%]), subsegmental (n = 32 [33%]), or subcapsular (n = 28 [29%]) hyperperfusion abnormalities. Presumable etiologies were considered as follows: (a) compression, obstruction, or ligation of the portal vein; (b) siphoning effect by tumor; (c) aberrant cystic venous drainage; (d) percutaneous ethanol injection; (e) percutaneous needle biopsy; (f) rapid drainage by the subcapsular vein; or (g) cirrhosis or unknown. A significant percentage of patients had hepatic hyperperfusion abnormalities. Familiarity with these hyperperfusion abnormalities on multisection dynamic MR images is important to prevent false-positive diagnoses.
46619.3739501651986.04.23++CT findings in hepatic and splenic amyloidosis.J Comput Assist Tomogr
S Suzuki, K Takizawa, Y Nakajima, M Katayama, F Sagawa,
In a patient with biopsy proven focal amyloidosis of the liver CT showed a uniform decrease in attenuation, with a focal large low-density lesion in the right hepatic lobe. Following intravenous contrast medium injection, there was poor contrast enhancement.
46719.3617297871992.02.13++Dynamic MR imaging of the abdomen with gadopentetate dimeglumine: normal enhancement patterns of the liver, spleen, stomach, and pancreas.AJR Am J Roentgenol
MM Hamed, B Hamm, ME Ibrahim, M Taupitz, AE Mahfouz,
To show the normal contrast enhancement patterns of the upper abdominal organs, dynamic gadopentetate dimeglumine-enhanced MR imaging of the upper abdomen was performed in 48 patients. Although all patients were originally examined for focal hepatic lesions, none of them had diffuse parenchymal disease of any of the examined organs. Dynamic gadopentetate dimeglumine-enhanced MR imaging was done by using a heavily T1-weighted gradient-echo sequence (100/5 [TR/TE], 80 degrees flip angle) performed before, and repeatedly for a period of 10 min after, an IV bolus injection of gadopentetate dimeglumine (0.1 mmol/kg). Signal enhancement in each of the organs was calculated by measuring the signal intensity before and after administration of contrast medium. All organs showed signal enhancement within the first 2 min (p less than .001) and a continuous decline thereafter. The enhancement of the pancreas, liver, stomach wall, spleen, and renal cortex reached peaks of 75%, 78%, 96%, 144%, and 216%, respectively, 45 sec after administration of contrast medium. Liver and pancreas showed a homogeneous enhancement pattern throughout the examination. The spleen appeared heterogeneous during the first 60 sec and homogeneous thereafter. Two zones could be distinguished on the contrast-enhanced images of the stomach wall: an enhanced inner zone and an unenhanced outer zone. We conclude that homogeneous enhancement of the liver and pancreas, early heterogeneous enhancement of the spleen, and enhancement of the inner gastric wall are normal patterns on dynamic gadopentetate dimeglumine-enhanced MR images.
46819.34167146242006.05.22+ AJR Teaching File: enlarging splenic mass after nephrectomy.AJR Am J Roentgenol
AC Silva,
46919.33121850322002.09.10++Percutaneous CT-guided drainage of splenic abscess.AJR Am J Roentgenol
L Thanos, T Dailiana, G Papaioannou, A Nikita, H Koutrouvelis, DA Kelekis,
OBJECTIVE: The objective of our study was to determine the current role of percutaneous CT-guided drainage as an alternative to surgical treatment of splenic abscesses. CONCLUSION: Splenic abscess is an uncommon entity that can be treated percutaneously. CT-guided drainage of splenic abscess seems to be a safe and effective alternative to surgery, allowing preservation of the spleen.
47019.33116944372001.12.07++Combined use of MR contrast agents for evaluating liver disease.Magn Reson Imaging Clin N Am
J Ward, PJ Robinson,
The sequential administration of superparamagnetic iron oxide (SPIO) and extracellular gadolinium chelates combines the sensitivity of SPIO for lesion detection with the specificity of dynamic gadolinium-enhanced imaging for lesion characterization. This approach also may improve the detection of hypervascular lesion, because the different magnetic properties of SPIO and gadolinium produce a synergistic increase in contrast between the reduced signal intensity of background liver and the increased signal intensity of enhancing lesions. Despite the benefits, the additional cost and increased examination time of a combined contrast procedure requires the careful selection of patients. This article presents a brief overview of the different properties and the current status of SPIO and gadolinium for the diagnosis of focal liver lesions.
47119.31192708562009.07.22++SPIO-enhanced MRI findings of well-differentiated hepatocellular carcinomas: correlation with MDCT findings.Korean J Radiol
SH Kim, WJ Lee, HK Lim, CK Park,
This study was designed to assess superparamagnetic iron oxide (SPIO)-enhanced MRI findings of well-differentiated hepatocellular carcinomas (HCCs) correlated with their multidetector-row CT (MDCT) findings.
47219.28102278881999.06.03++Dysplastic nodules of the liver: imaging findings.Abdom Imaging
BI Choi, JK Han, SH Hong, TK Kim, CS Song, KW Kim, MJ Kim, MC Han,
To verify characteristic features of hepatic dysplastic nodules at different imaging modalities.
47319.2790551291997.05.08++Small hepatocellular carcinoma on magnetic resonance imaging. Relation of signal intensity to angiographic and clinicopathologic findings.Invest Radiol
H Honda, K Kaneko, T Maeda, T Kuroiwa, T Fukuya, K Yoshimitsu, H Irie, H Aibe, K Takenaka, K Masuda,
The authors discuss the clinicopathologic features and angiographic vascularity of various signal intensity patterns on magnetic resonance (MR) imaging of small hepatocellular carcinomas (HCCs).
47419.2686438511996.07.17++[Peripheral intrahepatic cholangiocarcinoma. The role of imaging diagnosis and fine-needle biopsy].Radiol Med
L Matricardi, R Lovati, A Provezza, S Capra, L Grazioli, S Casoni, F Callea,
Peripheral intrahepatic cholangiocarcinoma (ICC) is a fairly uncommon type of cancer in Italy which may be misdiagnosed as a metastasis from extrahepatic adenocarcinoma. In all, 22 cases of intrahepatic cholangiocarcinoma were diagnosed at the Radiology Department of the University of Brescia, Italy, from 1989 to 1994. The patients were 15 men and 7 women and their age ranged 30-77 years. Most of them underwent US examinations because of abdominal pain, weight loss or a general malaise and, less frequently, for signs of cholestasis. Hepatic cirrhosis was found in 8 patients. US showed a single nodular lesion with irregular margins in 6 cases and a large nodule with adjacent smaller satellite nodules in 12 cases. In the other 4 subjects, an infiltrative and diffuse lesion with no apparent nodules was observed. US showed hypoechoic lesions in 17 cases and both hypo- and hyperechoic areas in the other patients. The main nodular lesion was 1-3 cm in diameter in 2 cases, 3-10 cm in 15 and over 10 cm in 6 cases. Both hepatic lobes were involved in 14 patients. Twenty-one of 22 patients were submitted to CT and 3 to MR examinations. Both techniques confirmed US findings of an intrahepatic tumor but they did not help locating its origin in the intrahepatic biliary tract. Therefore, every patient was submitted to US-guided fine needle biopsy which allowed the correct diagnosis to be made in 12 cases. The remaining 10 patients had an initial diagnosis of adenocarcinoma metastases and only further studies of the histologic specimens, performed after a series of useless and negative exams (e.g., barium enema and endoscopy), allowed ICC to be correctly diagnosed. Since no typical pattern of this type of cancer can be observed with US, CT or MR examinations, we suggest that US-guided fine needle biopsy be used as the method of choice, which however needs a fruitful cooperation between the radiologist and the pathologist.
47519.26116411732001.12.04+ Gastrointestinal hemangiomas: imaging findings with pathologic correlation in pediatric and adult patients.AJR Am J Roentgenol
AD Levy, RM Abbott, CA Rohrmann, AA Frazier, A Kende,
47619.26120163712002.06.18++Transient peritumoral enhancement during dynamic MRI of the liver: cavernous hemangioma versus hepatocellular carcinoma.J Comput Assist Tomogr
JS Yu, KW Kim, MS Park, SW Yoon,
The purpose of this work was to compare the incidence and pattern of transient peritumoral parenchymal enhancement for cavernous hemangioma and hepatocellular carcinoma during dynamic MRI of the liver.
47719.2363414211983.06.23++Computed tomography in renal lymphoma.J Comput Assist Tomogr
WA Chilcote, GP Borkowski,
The computed tomographic characteristics of 15 cases of renal lymphoma were evaluated. Initially the renal lesions are nodular but become confluent as the tumor progresses. In histiocytic and Hodgkin lymphoma, lesions can have the same attenuation values as normal renal parenchyma on noncontrast scans but less than normal parenchyma after contrast medium administration. Computed tomography is also useful in evaluating prognosis and response to therapy in renal lymphoma. Contrast material should be given if possible for evaluation of these lesions.
47819.2384281081993.03.09++Primary ovarian cancer: prospective comparison of contrast-enhanced CT and pre-and postcontrast, fat-suppressed MR imaging, with histologic correlation.J Magn Reson Imaging
RC Semelka, PH Lawrence, JP Shoenut, M Heywood, MA Kroeker, R Lotocki,
Sixteen patients with clinically suspected malignant ovarian disease underwent contrast agent-enhanced computed tomography (CT) and magnetic resonance (MR) imaging in a prospective comparative study. MR imaging included fat-suppressed spin-echo and breath-hold FLASH (fast low-angle shot) before and after intravenous injection of gadopentetate dimeglumine. Histologic confirmation was obtained at laparotomy (n = 13) and biopsy (n = 3). Thirteen patients had histologically proven primary ovarian cancer. MR images showed the internal architecture of ovarian tumors better than CT in nine patients and equivalently in seven. MR images showed the relationship between ovarian tumors and adjacent pelvic structures (uterus [n = 9], sigmoid colon [n = 7], bladder [n = 7], and rectum [n = 3]) better than CT in nine patients and equivalently in seven. Intraabdominal extent of disease was better defined on MR than on CT images in nine patients, equivalently in six, and worse in one. Peritoneal metastases 1-2 cm in diameter were detected on MR images and missed on CT scans in six patients. In only one case did this result in a staging error with CT. The results suggest that MR imaging is at least equivalent and may be superior to CT in the evaluation of ovarian malignancy.
47919.1774716401981.05.26++Percutaneous aspiration biopsy of abdomen and retroperitoneum.Clin Radiol
MG Ennis, DP MacErlean,
Percutaneous fine needle aspiration biopsy was performed in 38 patients. Adequate material for histological diagnosis was obtained in all. No false positive results were obtained and there was only one false negative result. The procedure was without complication in all patients. The biopsy material was obtained by the radiologist in the X-ray department following localisation of the lesion by ultrasound. The advantages of the early use of this technique in the evaluation of patients presenting with suspected mass lesions in the abdomen and retroperitoneum are described, and its contribution to the formulation of further patient management stressed.
48019.1680920251994.10.20+ Detection of hepatocellular carcinoma with dynamic MR imaging during intraarterial infusion of gadopentetate dimeglumine.AJR Am J Roentgenol
T Fujita, K Ito, T Choji, K Honjo, T Matsumoto, T Arita, T Nakanishi,
48119.1184706111993.05.13++MR imaging of the myocardium using nonionic contrast medium: signal-intensity changes in patients with subacute myocardial infarction.AJR Am J Roentgenol
MC Dulce, AJ Duerinckx, J Hartiala, GR Caputo, M O'Sullivan, MD Cheitlin, CB Higgins,
Gadodiamide injection (Omniscan, Sanofi Winthrop Pharmaceuticals, New York) is a new nonionic MR contrast medium that has been shown in animal studies to provide persistent differential enhancement of myocardial infarction. Because differential enhancement of normal and infarcted myocardium may be useful for the diagnosis and sizing of myocardial infarctions, we assessed the effectiveness of gadodiamide injection in enhancing signal-intensity differences between infarcted and normal myocardium on spin-echo T1-weighted images.
48219.07110124382000.10.17++Hepatic lesion detection and characterization: value of nonenhanced MR imaging, superparamagnetic iron oxide-enhanced MR imaging, and spiral CT-ROC analysis.Radiology
P Reimer, N Jähnke, M Fiebich, W Schima, F Deckers, C Marx, N Holzknecht, S Saini,
To determine the accuracy for detection and characterization of focal hepatic lesions of nonenhanced, superparamagnetic iron oxide (SPIO)-enhanced, or a combination of nonenhanced and SPIO-enhanced MR imaging and contrast-enhanced spiral computed tomography (CT).
48319.0619127181991.11.01++Sonographic investigation in the diagnosis of intrasplenic fluid collections.Bildgebung
C Görg, WB Schwerk,
The authors report about the diagnosis of 55 patients for whom cyst-like lesion sites or predominantly anechoic lesions were diagnosed by means of sonography of the spleen. Sonographic analysis included interventional sonography with fluid aspiration in accordance with diagnostic and therapeutic guidelines (n = 19), catheter drainage (n = 3), B-mode pulsed Doppler-Ultrasound, and short-term follow-up examinations. The final diagnoses were splenic cysts (n = 25), splenic ruptures (n = 10), splenic infarctions (n = 12), splenic abscesses (n = 7) and splenic metastasis (n = 1). Because of the ultrasound findings in diagnosis and during the follow-up observations, 15 patients underwent splenectomy. Special attention is drawn to the clinical relevance of these procedures for diagnosis of splenic liquid masses.
48419.02111268002001.01.11+ Splenic imaging in infancy and childhood.JBR-BTR
EC Benya,
48519.0186331431996.06.28++Phase II clinical evaluation of Gd-EOB-DTPA: dose, safety aspects, and pulse sequence.Radiology
P Reimer, EJ Rummeny, K Shamsi, T Balzer, HE Daldrup, B Tombach, T Hesse, T Berns, PE Peters,
To investigate the efficacy of gadolinium ethoxybenzyl diethylenetriaminepentaacetic acid (Gd-EOB-DTPA) in the detection of focal liver lesions with respect to dose, side effects, and pulse sequence.
48619.01152733352004.09.27++Non-Hodgkin lymphoma and Hodgkin disease: coregistered FDG PET and CT at staging and restaging--do we need contrast-enhanced CT?Radiology
NG Schaefer, TF Hany, C Taverna, B Seifert, KD Stumpe, GK von Schulthess, GW Goerres,
To retrospectively compare diagnostic value of coregistered fluorine 18 fluorodeoxyglucose positron emission tomographic (PET) and computed tomographic (CT) scans obtained with low-dose nonenhanced CT (PET/CT) with those routinely obtained with contrast material-enhanced CT for staging and restaging of disease in patients with Hodgkin disease or high-grade non-Hodgkin lymphoma.
48719.00104160881999.09.16++Hemangioendothelioma of the spleen: imaging findings at color Doppler, US, and CT.Clin Imaging
F Ferrozzi, D Bova, F De Chiara,
The ultrasonographic, color Doppler, and computed tomography findings of an unusual vascular primary tumor of the spleen are reported. A brief clinical and histopathological analysis of this entity is discussed and the differential diagnosis of other primary lesions of the spleen is attempted.
48818.9944756701975.05.06+ [Arteriography in surgical diseases of liver and spleen].Helv Chir Acta
A Essinger, A Flückiger,
48918.96122427422003.01.22++Littoral cell angioma of the spleen: appearance on sonography and CT.J Clin Ultrasound
M Goldfeld, I Cohen, N Loberant, A Mugrabi, I Katz, S Papura, I Noi,
Littoral cell angioma (LCA) is a rare benign vascular tumor of the spleen with characteristic histomorphologic features. Only a few descriptions of the radiologic appearance of this tumor have been published, and those descriptions are variable. We report a case of LCA in a 37-year-old man with psoriasis and nonspecific symptoms of weakness, pain and fatigue, normocytic anemia, and thrombocytopenia. The results of abdominal sonography and contrast-enhanced CT correlated: the 2 modalities revealed hepatosplenomegaly and multiple round splenic lesions of similar appearance and size (on sonograms, ill-defined echogenic lesions up to 3.2 cm without acoustic enhancement; on CT scans, hypodense, nonenhancing lesions up to 3.5 cm). Because making a differential diagnosis was difficult and our presumptive diagnosis was hemangioma or lymphoma, splenectomy was performed. Postoperative pathologic examinations confirmed a final diagnosis of LCA. The patient's recovery was uneventful. LCA should be considered when making a differential diagnosis of splenic lesions, and sonography may be more helpful than CT in reaching a diagnosis of LCA.
49018.95107161482000.04.03++Composite hemangioendothelioma: a complex, low-grade vascular lesion mimicking angiosarcoma.Am J Surg Pathol
SJ Nayler, BP Rubin, E Calonje, JK Chan, CD Fletcher,
Eight cases of a previously uncharacterized vascular neoplasm, showing varying combinations of benign, low-grade malignant, and malignant vascular components are described. Seven tumors occurred in the dermis and/or subcutis and one occurred in the oral submucosa. The patients were all adults with a median age of 39.5 years (range, 21-71 years). Five patients were men. The tumors arose predominantly in the hands and feet, and the lesions were usually of several years duration. The tumors were composed of a complex admixture of histologic components that varied from tumor to tumor, such that no two tumors looked precisely the same. This was due to variation in the proportions of each component as well as the manner in which each component was distributed throughout each lesion. The predominant histologic components were epithelioid hemangioendothelioma (HE) and retiform HE, which were each present in seven of the tumors. Areas of spindle cell HE were identified in four lesions. Angiosarcoma-like elements were identified in seven tumors. One of the tumors was associated with an arteriovenous malformation and one was associated with an area of lymphangioma circumscriptum. Of six cases with follow up (median duration, 6.5 years), three have recurred locally and, to date, only one has metastasized. We think composite HE is best regarded as a low-grade malignant vascular neoplasm, and the available data suggest that it behaves more favorably than conventional angiosarcoma. The existence of these composite lesions has led to careful reexamination of the concept of HE. The term HE, in that it is currently synonymous with a low-grade malignant vascular tumor, should be reserved for lesions that have true metastatic potential, albeit with low frequency.
49118.9420527041991.07.24++Focal nodular hyperplasia of the liver: assessment with contrast-enhanced TurboFLASH MR imaging.Radiology
D Mathieu, A Rahmouni, MC Anglade, B Falise, C Beges, P Gheung, JJ Mollet, N Vasile,
Twenty-two patients with 25 cases of focal nodular hyperplasia (FNH) proved with pathologic study were imaged with a TurboFLASH (fast low angle shot) sequence combined with bolus administration of gadolinium tetraazacyclododecanetetraacetic acid (DOTA), spin-echo (SE) T2-weighted sequences, and postcontrast T1-weighted sequences. FNH-liver signal-difference-to-noise ratios were quantified; the features of the central scar were qualitatively analyzed. On SE T2-weighted images, all FNHs were hyperintense; in two cases the central scar exhibited a high signal intensity associated with hypointense areas corresponding to fibrous tissue within the branches of the scar. Unenhanced TurboFLASH images always demonstrated the FNHs as hypointense and always depicted the central scar as a hypointense area within the lesion. After bolus injection, arterial enhancement of FNH was clearly seen, and in 10 of 25 lesions, enhancement within the scar was seen 40-80 seconds after injection. Both unenhanced and enhanced TurboFLASH sequences produced the best signal-difference-to-noise ratios in comparison with T2-weighted images.
49218.9119109901991.11.20++Accuracy of adrenal biopsy guided by ultrasound and CT.Acta Radiol
T Tikkakoski, M Taavitsainen, M Päivänsalo, S Lähde, M Apaja-Sarkkinen,
We reviewed the results of fine needle biopsy of the adrenal glands guided by ultrasonography or CT in 56 patients. The final diagnoses, obtained at operation, autopsy or follow-up were: metastasis (n = 22), adenoma (n = 21), adrenal cyst (n = 6), hematoma (n = 3), lymphoma (n = 1), pheochromocytoma (n = 1), lymph node (n = 1), and amyloid mass (n = 1). Sufficient cytologic material was obtained in 96.4% (54/56). The overall accuracy to differentiate benign from malignant disease was 85.7% (48/56), 2 were false-negative, one was false-positive. The biopsy was inconclusive ("possibly malignant") in 3 patients, 2 of whom had an additional cutting needle biopsy yielding a correct positive finding. No complications occurred. We conclude that in disseminated malignant disease with suspected adrenal metastases diagnostic results can be obtained with guided fine needle biopsy. Biopsy in primary adrenal lesions is helpful, especially if the aspirate of the lesion turns out to be composed of something other than adrenal cells.
49318.9166025201983.07.29++The silent abdominal abscess: role of the radiologist.AJR Am J Roentgenol
R Goldman, TB Hunter, K Haber,
An abdominal abscess usually causes severe distress with fever, leukocytosis, pain, and toxicity. However, a small but significant proportion of patients with abdominal abscess may appear entirely well with no elevated temperature or white blood cell count. Fifteen patients are reported whose initial clinical presentation was unremarkable but who had significant abscess formation that was well documented by radiographic methods. Both the radiologist and the patient's primary physician must be aware of the not infrequent presentation of abdominal abscess in a clinically innocuous manner. The lack of fever, elevated white blood cell count, or patient complaint should in no way rule out the diagnosis of abscess when positive radiographic evidence is found.
49418.8798410661998.11.17++Dynamic MR imaging of hepatolithiasis.Abdom Imaging
TC Soong, RC Lee, HC Cheng, JH Chiang, HS Tseng, CW Lin, MM Teng,
To report the dynamic magnetic resonance (MR) imaging findings of hepatolithiasis.
49518.8715515151992.04.24++Accumulation of iron oxide particles around liver metastases during MR imaging.Gastrointest Radiol
PF Hahn, DD Stark, JT Ferrucci,
The histologic nature of the bright ring ("peritumoral edema") around some liver metastases on T2-weighted magnetic resonance (MR) images is controversial. In the case reported, particles of the iron oxide contrast agent AMI-25 are retained in the peritumoral zone of a colon cancer metastasis, causing the bright ring to disappear. The location of iron particles in resected specimens could be used systematically to study peritumoral edema.
49618.8572915171981.12.21++Pitfalls in the diagnosis of hepatic cysts by computed tomography.Radiology
PA Barnes, JL Thomas, ME Bernardino,
Seven patients with computed tomographic (CT) evidence of cystic hepatic lesions are presented. In these cases, CT could not reliably distinguish benign hepatic cysts from other intrahepatic and extrahepatic cystic lesions. The attenuation coefficients of simple cysts and inflammatory or neoplastic lesions were similar, and smooth margins occurred in all three of these conditions. It was not possible to visualize and differentiate lesion walls from the surrounding normal hepatic parenchyma in some cases. It is concluded that the specificity of CT in the differentiation of benign cysts and other lesions is lower in the liver than it is in other areas, such as the kidney, and that in cases of diagnostic uncertainty, biopsy should be performed.
49718.8516068021992.07.23++Case report: unusual presentation of splenic hamartoma; computed tomography and ultrasonic findings.Clin Radiol
R Zissin, M Lishner, V Rathaus,
Hamartomas of the spleen are rare benign tumours, which are usually asymptomatic, incidental findings at laparotomy or autopsy (Komakl and Gombas, 1976; Brinkley and Lee, 1981; Norowitz and Morehouse, 1989). There are a few well documented reports of symptomatic splenic hamartoma associated with haematological disturbances, marked splenomegaly or even spontaneous rupture that required an emergency operation (Iozzo et al., 1980; Morgenstern et al., 1984). We report a patient with splenic hamartoma who presented with splenomegaly and iron deficiency anaemia. Computed tomographic (CT) and ultrasound (US) evaluation demonstrated an inhomogeneous mass within the enlarged spleen. Malignant melanoma was mistakenly diagnosed by US-guided fine needle aspiration of the mass, and necessitated splenectomy. The final diagnosis was hamartoma of the spleen.
49818.8427781531989.10.19++Angiosarcoma of the liver mimicking cavernous hemangioma on dynamic CT.J Comput Assist Tomogr
Y Itai, T Teraoka,
A case of hepatic angiosarcoma showed findings similar to those of cavernous hemangioma on dynamic CT, angiography, and magnetic resonance imaging. The tumor was histologically confirmed as angiosarcoma of cavernous pattern.
49918.8389383101997.04.10++Magnetization transfer contrast MR in lesions of the head and neck.AJNR Am J Neuroradiol
AR Gillams, N Fuleihan, G Grillone, AP Carter,
To compare lesion-to-background contrast with and without magnetization transfer (MT) in lesions of the head and neck.
50018.81100770271999.05.04++Safety profile of ultrasmall superparamagnetic iron oxide ferumoxtran-10: phase II clinical trial data.J Magn Reson Imaging
R Sharma, S Saini, PR Ros, PF Hahn, WC Small, EE de Lange, AE Stillman, RR Edelman, VM Runge, EK Outwater, M Morris, M Lucas,
The safety data from the phase II clinical trial of ferumoxtran-10, an ultrasmall superparamagnetic iron oxide contrast agent, are presented. One hundred and four patients with focal liver or spleen pathologies underwent ferumoxtran-10-enhanced magnetic resonance (MR) imaging at doses of 0.8, 1.1, and 1.7 mg Fe/kg. Overall, 15% patients reported a total of 33 adverse events, regardless of causality. The adverse events most frequently seen were dyspnea (3.8%), chest pain (2.9%), and rash (2.9%). No serious adverse events were reported during the 48 hour observation period. There were no clinically significant effects on vital signs, physical examination, and laboratory results. Ferumoxtran-10 is a safe and well tolerated MR contrast agent.
50118.8016208281992.08.06++Assessment of intracardiac shunts with gadolinium-enhanced ultrafast MR imaging.Radiology
WJ Manning, DJ Atkinson, JA Parker, RR Edelman,
Dye dilutional techniques are widely accepted for the assessment of intracardiac shunts, but current techniques require arterial access or radioisotope injection. Ultrafast (less than 500 msec) magnetic resonance (MR) imaging is ideally suited for the evaluation of an indicator during passage through the heart. Twenty patients were studied, including 13 with shunts. Four-chamber, T1-weighted images were obtained during bolus injection of gadopentetate dimeglumine. A single image was obtained in 420 msec, with repetitive images acquired after each QRS complex. After the contrast material was injected, there was pronounced signal intensity enhancement in the right atrium, followed by the right ventricular cavity, left atrium, left ventricular cavity, and descending aorta. Patients with substantial intracardiac shunts demonstrated early recirculation. First-pass contrast material-enhanced MR imaging is a promising new technique for the rapid assessment of intracardiac shunts. Combined with anatomic and functional MR imaging techniques, it can help provide a comprehensive noninvasive evaluation of suspected intracardiac shunts or provide follow-up in patients with known shunts.
50218.79108234532000.08.16++Gaucher disease of the spleen: CT and MR findings.Abdom Imaging
LW Poll, JA Koch, S vom Dahl, M Sarbia, D Häussinger, U Mödder,
We present a 26-year-old male patient with Gaucher disease who presented with epigastric pain and a palpable mass in the left abdomen. Ultrasound, abdominal computed tomography, and magnetic resonance imaging showed massive splenomegaly with multiple splenic nodules up to 7 cm in diameter. Splenic nodules should be included in the differential diagnosis of splenic masses. Follow-up is necessary because of the increased incidence of hematologic malignancies in Gaucher disease.
50318.7733166321987.12.30++[Splenic abscess. A new diagnostic and therapeutic approach. Apropos of 7 cases].J Radiol
G Sebag, C Anagnostopoulos, S Chagnon, P Jacquenod, M Bléry,
Anomalies in seven patients with splenic abscess were invariably observed on ultrasound imaging despite absent or misleading clinical symptomatology splenomegaly was detected in only 3 cases. The abscess was multiple in 6 cases with perisplenic extension in 2 patients. Splenectomy was performed in only 2 cases. In one patient, diagnostic and therapeutic fine needle puncture of spleen was performed. Comparison with CT scan imaging is presented with respect to 3 patients. Ultrasound imaging can suggest a diagnosis of intrasplenic abscess and fine needle puncture is not contraindicated.
50418.7690150681997.02.27++Differentiation of benign and malignant breast lesions: MR imaging versus Tc-99m sestamibi scintimammography.Radiology
TH Helbich, A Becherer, S Trattnig, T Leitha, P Kelkar, M Seifert, M Gnant, A Staudenherz, M Rudas, G Wolf, GH Mostbeck,
To compare the accuracies of magnetic resonance (MR) imaging and scintimammography in differentiating benign from malignant breast lesions.
50518.7532673511989.11.17++Histiocytic medullary reticulosis: radiologic diagnosis of splenic infarction--a case report.J Korean Med Sci
SO Yang, DS Lee, KS Lee, MJ Kim, HS Choi, YH Jun, YK Park,
A case of histiocytic medullary reticulosis with splenic infaraction from a 23-year-old male is presented. Radiologic findings on selective spleen scintigraphy and abdominal CT are described. Selective spleen scintigraphy showed huge, multilobulated spleen with numerous photon-deficient areas in it and peripherally. Abdominal CT showed large peripheral band-like low density and infiltrative lesion in spleen with accompanying intraabdominal lymphadenopathy. Histoligical features were consistent with HMR in spleen and liver specimens.
50618.7459288151967.02.25+ Splenic cyst diagnosed by percutaneous needle aspiration and splenography. Report of a case.Am J Dig Dis
CJ DeMasi, K Akdamar, RD Sparks, FM Hunter,
50718.7197988821998.11.13+ Splenic arteriovenous fistula in a patient with lymphoma.AJR Am J Roentgenol
P van der Meer, A Cossi, JI Tsao,
50818.68177061142010.06.22++[Littoral cell angioma of spleen: a clinicopathologic study of 17 cases].Zhonghua Bing Li Xue Za Zhi
CF Bi, LL Jiang, Z Li, WP Liu,
To study the clinicopathologic features and immunophenotype of splenic littoral cell angioma.
50918.6832587211988.05.19++Gd-DTPA in MR of spinal lesions.AJR Am J Roentgenol
J Valk,
The use of Gd-DTPA in nondegenerative spinal lesions is described. Thirty consecutive patients were examined by MR with and without Gd-DTPA. The information obtained with unenhanced T1- and T2-weighted spin-echo images was compared with that obtained with Gd-DTPA T1-weighted images. The results showed that, according to the criteria used, more information was present on the MR images with Gd-DTPA in 18 of 30 patients. In six of 30 patients, the improved quality of the images led to a change in the neurosurgical or neurologic approach. Gd-DTPA proved to be a safe contrast medium; no side effects or adverse reactions were observed. It is recommended that Gd-DTPA be used in nondegenerative lesions involving the spinal cord to obtain the same or more information in a shorter acquisition time.
51018.6793602381997.12.11++Isolated splenic metastases.J Ultrasound Med
H Ishida, K Konno, J Ishida, K Shirayama, H Naganuma, T Komatsuda, Y Hamashima, O Masamune,
We analyzed the primary tumors, sonographic findings, clinical manifestations, and prognosis in five cases of isolated splenic metastases to determine in what situations these rare metastases should be suspected. The metastases were detected by ultrasonography in all five patients, and the primary tumors were colonic cancer in four patients and renal cancer in one patient. Splenectomy was performed and the postoperative course was uneventful in all patients. We conclude that preoperative and follow-up examinations must be performed with special attention given to the spleen in colonic or renal cancer patients.
51118.6719125501991.10.30+ [The computed tomographic manifestation of diffuse visceral lymphangiomatosis].Rofo
G Melzer, P Kullnig, F Flückiger, A Beham,
51218.6639249701985.08.22+ Sonography of splenic angiosarcoma.J Clin Ultrasound
B Nahman, JJ Cunningham,
51318.6682673651994.01.25++Computed tomographic findings of abdominal tuberculosis--report of five cases.Ann Acad Med Singapore
MK Wong, SE Ng,
Five patients with proven intra-abdominal tuberculosis were examined with computed tomography (CT) over a period of one year. This revealed hepatosplenomegaly in all five cases. Macroscopic nodules were noted in the liver and spleen in three cases. All three cases showed more severe involvement of the spleen over the liver. Other features were enlarged (para-aortic, para-caval, peripancreatic and mesenteric) nodes, ascites, stellate mesentery and thickened bowel wall. Incidental extra-abdominal findings included intrathoracic nodules, pleural effusion, pericardial effusion with constrictive pericarditis, bony osteomyelitis and psoas abscess. Follow-up CT was performed on four of the five cases and showed significant resolution of the above findings. In addition, one case showed calcification within a healing splenic nodule. The presence of macroscopic nodules detected on CT, especially in the spleen, is an unusual finding in prior reports. This paper attempts to account for its high local incidence and discusses the significance of other findings in the diagnosis of abdominal tuberculosis.
51418.65196962592009.09.29++Gastrointestinal metastasis from primary lung cancer: CT findings and clinicopathologic features.AJR Am J Roentgenol
SY Kim, HK Ha, SW Park, J Kang, KW Kim, SS Lee, SH Park, AY Kim,
OBJECTIVE: The purpose of this study was to evaluate retrospectively the CT findings and clinicopathologic features of gastrointestinal metastasis from lung cancer. CONCLUSION: The most common histologic type of lung cancer among the patients in this study was squamous cell carcinoma (n = 12). The most common clinical presentation was abdominal pain (n = 15). A total of 31 lesions were visualized on CT scans, involving the stomach (n = 3), small bowel (n = 26), and colon (n = 2). The metastatic lesions were seen on CT scans as wall thickening in 14 cases, an intraluminal polypoid mass in 14 cases, and an exophytic mass in three cases. The lesions exhibited isoattenuation in 19 cases, hypoattenuation in seven cases, and hyperattenuation in five cases. Complications included intussusception in seven cases, perforation in six cases, and obstruction in four cases.
51518.64163573942006.02.16++Ferumoxtran-10-enhanced MR lymphangiography: does contrast-enhanced imaging alone suffice for accurate lymph node characterization?AJR Am J Roentgenol
MG Harisinghani, MA Saksena, PF Hahn, B King, J Kim, MT Torabi, R Weissleder,
Ferumoxtran-10 is a lymphotropic MR contrast agent that is currently under investigation. It has been shown to be effective in staging lymph nodes of patients with various primary malignancies. The current technique with ferumoxtran-10 involves imaging before and 24 hr after contrast administration. The purpose of this study was to evaluate the accuracy of ferumoxtran-10-enhanced images alone in characterizing lymph nodes for oncologic staging 24 hr after contrast enhancement.
51618.64115030872001.10.11++Sclerosed hemangioma of the liver.Abdom Imaging
H Aibe, H Hondo, T Kuroiwa, K Yoshimitsu, H Irie, T Tajima, K Shinozaki, Y Asayama, K Taguchi, K Masuda,
We report the radiologic findings of sclerosed hemangioma (SH), a rare variant of hepatic hemangioma. Dynamic contrast-enhanced computed tomography showed a hypodense mass in the liver with delayed enhancement. T2-weighted magnetic resonance imaging showed the mass as hypointense in relation to cerebrospinal fluid. The final diagnosis of SH was made pathologically. Although SH is rare, understanding its radiologic appearance is important to avoid unnecessary surgery and should be included in the differential diagnoses of hepatic lesion with delayed enhancement.
51718.639816681977.01.03++Focal splenic defects.Radiology
MH Freeman, AK Tonkin,
Review of more than 2,000 liver-spleen scans revealed 18 cases of focal splenic defects. Three major categories are defined: lymphoma, infarctions, and metastatic tumor. Clinical presentation is important in determining the precise etiology, and a differential diagnosis is presented. It appears that: (a) reticulum cell carcinoma is as likely to cause defects as is Hodgkin's disease; (b) splenic infarction is related to pancreatic disease through the splenic vein; and (c) malignant melanoma is the most common secondary deposit as detected by scanning.
51818.6280798931994.10.04+ Splenic epithelioid hemangioma: MR findings.AJR Am J Roentgenol
JC Vilanova, A Capdevila, J Aldomà, E Delgado,
51918.62191068812009.03.06+ [Non-operative management of blunt splenic trauma in the adult].J Chir (Paris)
C Arvieux,
52018.61162450182006.03.10++Abdominal cavernous Iymphangiomas: CT findings.Abdom Imaging
JH Sohn, JH Byun, SH Park, SE Yoon, KW Kim, HS Hong, JK Han, JS Ryu, HJ Won, AY Kim, YM Shin, PN Kim, HK Ha, MG Lee,
Two adult patients with histopathologically proved cavernous lymphangiomas and one adult patient with lymphangiomas of strongly presumed cavernous type by cytologic and computed tomographic findings are reported. On computed tomograms, multiple, aggregated, small, and tiny cysts without a solid portion, along the lymphatic channels are characteristic computed tomographic findings for cavernous lymphangiomas.
52118.6093499971997.11.25++Usefulness of novel imaging modalities in diagnosis of focal nodular hyperplasia of the liver.J Gastroenterol
Y Nishigaki, E Tomita, Y Matsuno, K Goto, T Ohnishi, Y Tanaka, H Iwai, H Asano, I Yasuda, K Nagura, T Wakahara, T Yamada,
A 17-year-old woman was admitted because of a liver tumor found incidentally by ultrasonography. Liver function was normal and there were no markers of hepatitis viruses or malignancy. Abdominal ultrasonography, computed tomography (CT), and magnetic resonance imaging revealed a mass (2 cm in diameter) in the lateral segment of the left lobe of the liver. The lesion was not detected by hepatic arteriography. However, dynamic CT with fast scanning and dynamic CO2-enhanced ultrasonography demonstrated initial central enhancement of the mass followed by centrifugal spread of enhancement to the periphery. Color Doppler flow imaging detected a central color spot, shown to be an artery by a pulsed Doppler spectrum analysis. Fine-needle biopsy confirmed a diagnosis of focal nodular hyperplasia. Dynamic CT with fast scanning, dynamic CO2-enhanced ultrasonography, and color Doppler flow imaging were useful in detecting the vascular pattern specific to focal nodular hyperplasia. Investigation of further cases with these novel imaging modalities should help to establish a comprehensive diagnostic procedure and thus avoid unnecessary surgery for focal nodular hyperplasia, which is a completely benign lesion.
52218.5990510321997.03.28++Gadolinium-enhanced MR imaging of thyroid and parathyroid masses.Radiology
H Nakahara, S Noguchi, N Murakami, S Tamura, S Jinnouchi, T Kodama, ON Adjei, S Nagamachi, T Ohnishi, S Futami, LG Flores, K Watanabe,
To evaluate spin-echo and contrast material-enhanced dynamic magnetic resonance (MR) imaging in characterization of thyroid and parathyroid masses.
52318.58159960412005.10.04++Splenic hemangiopericytoma and serosal cavernous hemangiomatosis of the adjacent colon.World J Gastroenterol
T Yilmazlar, T Kirdak, O Yerci, SB Adim, O Kanat, O Manavoglu,
A healthy 31-years-old man presented with a three-year history of abdominal discomfort. Radiological examinations revealed multifocal tumoral lesions in the spleen. The patient underwent splenectomy for differential diagnosis and treatment. During the operation, in addition to the splenic masses, there were also multiple millimetric purpuric-like lesions on the colonic serosal surfaces adjacent to the splenic hilus. One of them was excised. Histologic examination showed hemangiopericytoma of the spleen and cavernous hemangioma of the adjacent colon. This is the first report showing the close association of these two distinct lesions with vascular origin in the literature. Despite not having any apparent evidence, there may be a sequential relationship between the hemangiopericytoma of the spleen and cavernous hemangiomas.
52418.5426720921989.09.25++Siderotic nodules in the spleen: MR imaging of portal hypertension.Radiology
M Minami, Y Itai, K Ohtomo, S Ohnishi, T Niki, T Kokubo, K Yoshikawa, M Iio,
The authors retrospectively evaluated magnetic resonance (MR) images obtained at 1.5 T in 233 patients with portal hypertension and 91 subjects without it and pathologic findings in four resected spleens (one normal). Multiple, tiny (3-8 mm in diameter), low-intensity spots in the spleen were observed in 21 of 233 patients. Among the imaging studies performed in these 21 patients, the spots were seen on five of 14 T1-weighted images, 11 of 20 proton density images, and 12 of 20 T2-weighted images obtained with spin-echo techniques and on 14 of 14 fast-scan images obtained with gradient-echo rephasing. MR images in the 91 subjects did not show such lesions. MR images of the three spleens resected from patients with portal hypertension showed the low-intensity spots, which corresponded to siderotic nodules found at pathologic analysis. Despite limited pathologic confirmation, siderotic nodules (so-called Gamna-Gandy nodules) are considered the most likely cause of multiple low-intensity spots in the spleen.
52518.5313423711994.02.04+ Multifocal splenic abscesses in AIDS-related tuberculosis.Eur J Med
V Soriano, J Tor, M Adrados, R Muga, F Laguna, B Clotet, J González-Lahoz,
52618.5012737531976.08.02++Splenic abscess.Surgery
TW Lawhorne, GD Zuidema,
A review of autopsy files and clinical case reports demonstrates two categories of splenic abscess. First, the abscesses discovered at postmortem usually are multiple, small manifestations of widespread, lethal infection in immunologically crippled hosts. A clinical diagnosis seldom is made. Second, the splenic abscesses encountered by the clinician are usually solitary, large, and challenge his diagnostic skills. Recognition is of vital importance, for therapy can be highly successful. Left untreated, the mortality rate is very high. The features, clinical management, and pathogenesis of splenic abscesses are discussed.
52718.5035126411986.04.23++Multiple cavernous hemangiomas of the spleen: CT findings.J Comput Assist Tomogr
CN Moss, JA Van Dyke, RE Koehler, CT Smedberg,
Diffuse cavernous hemangiomatosis of the spleen is a rare condition, but it is considered the most common benign tumor to involve the spleen. Computed tomography and ultrasound are useful and effective methods for evaluating the spleen for the presence of multiple hemangiomas, the diagnosis of which is otherwise difficult to establish. This report emphasizes the sonographic and CT findings of the condition and reviews the pathological and clinical features.
52818.4830638601989.03.06+ [Ultrasound and radiological diagnosis of primary splenic tumors].Rinsho Hoshasen
M Iwasaki, T Nakayama, Y Hiyama, S Myojyo, K Maruyama, Y Seki,
52918.4783234941993.08.05++Hemangioma of spleen with spontaneous, extra-peritoneal rupture, with associated splenic tuberculosis--an unusual presentation.Australas Radiol
RC Rao, R Ghose, S Sawhney, M Berry,
We report a case of unusual presentation of a patient with hemangioma of the spleen. The patient had presented with recurrent gastric hemorrhage and significant weight loss, due to ruptured hemangioma of the spleen and associated splenic tuberculosis. The true nature of the lesions remained a diagnostic dilemma despite complete radiological workup and review of literature.
53018.4635381331986.12.29++Lymphoceles: imaging characteristics and percutaneous management.Radiology
E vanSonnenberg, GR Wittich, G Casola, VW Wing, NA Halasz, AS Lee, C Withers,
Twenty-five patients who had lymphoceles underwent sectional imaging and interventional radiologic procedures. Viewed using sonography, lymphoceles were hypoechoic to anechoic, occasionally with internal septa and debris. Low numbers (occasionally negative values) were observed using computed tomography (CT); these numbers strongly suggest the diagnosis of lymphocele. Calcification was observed on CT images of one patient. Diagnostic aspiration revealed tan to yellow fluid containing many lymphocytes; pathognomonic fat globules were observed in four cases. Malignant cells were found in two collections, an unusual occurrence. Therapeutic needle aspiration and short-term catheter drainage were usually unsuccessful (only one of five patients [20%] was cured). Long-term (1-5-week) catheter drainage cured 11 of 14 patients (78.6%). Sclerosing agents may have been beneficial for lymphocele obliteration in three of four patients. For most patients, lymphoceles may be diagnosed and treated successfully using radiologic means.
53118.46180208822008.01.22++[Splenic lymphoma of the marginal zone without peripheral hairy lymphocytes].An Med Interna
R Pila Pérez, R Pila Peláez, P Rosales Torres, VA Holguín Prieto, LF Alzate Giraldo,
This paper reports on a case of a 34-year male patient diagnosed for splenic lymphoma of the marginal zone, a rare entity in our milieu. Features of the disease are described. Early diagnosis is a must for optimum treatment of such a pathology, whose onset can be giant splenomegalia. All possible causes are to be considered.
53218.44109369602000.09.28++[Monstrous venous hemangioma of the retroperitoneum: problems of diagnosis].Rontgenpraxis
S Leinung, I Lotz, P Würl, A Frey, L Lochhaas, M Schönfelder,
The venal haemangioma is defined as a benign tumor consisting of veinlike vessels. The preoperative diagnosis and its inherent problems are illustrated using a coincidentally diagnosed monstrous haemangioma tumor of the retroperitonial space in a twenty year old patient. With respect to our patient, X-ray, computer tomography and angiography all failed as diagnostic tools. Only the use of Doppler sonographic flow signals suggested the presence of a haemangioma. The morphology, prognosis and clinical significance of blood vessel tumors are multifaceted. The most important differential diagnoses to the venous haemangioma are the cavernous and the capilliary haemangioma. The venous haemangioma distinguishes itself through the presence of blood vessel walls. Haemangiomas are common benign tumors. In the presence of highly developed muscular components, there exists a transition to angiomyomas and to leiomyomas. Venal haemangiomas are extremely rare in the demonstrated localisation of the retroperitoneal space. Here they can grow to monstrous preportions whilst remaining undetected. Thus the patient is under the potential danger of bleeding to death through trivial injuries. The therapy of choice remains total surgical excision. In situations of unclear clinical results with respect to preoperative diagnosis especially amongst young adults, one should at least consider the possibility of a haemangioma as the root of the problem.
53318.4468287591983.04.21++Management of loculated abscesses that are difficult to drain: a new approach.Radiology
PF van Waes, MA Feldberg, WP Mali, SH Ruijs, PC Eenhoorn, PH Buijs, FJ Kruis, LR Ramos,
Fourteen critically ill patients underwent percutaneous drainage of abdominal abscesses. All 14 had one or more relative contraindications to external drainage procedure: (a) multiloculated abscesses; (b) multiple abscesses; (c) abscesses that form fistulae to surrounding organs; (d) abscesses containing viscous fluid, debris, or necrotic material. A total of 32 cavities was drained, usually using a multiple trocar/catheter system. Biplane computed tomography demonstrated a safe drainage route in all patients. In those patients in whom the contents of the abscess were too viscous to permit drainage, the contents were liquefied with acetylcysteine. Nine of the 14 patients (64%) recovered completely following the drainage procedure.
53418.4279466711994.12.22++Craniopharyngiomas--the utility of contrast medium enhancement for MR imaging at 1.5 T.Acta Radiol
JK Hald, OP Eldevik, JA Brunberg, WF Chandler,
To evaluate the efficacy of i.v. contrast medium administration in MR imaging at 1.5 T in patients with craniopharyngiomas, MR studies of 10 men and 6 women with pathologically proven craniopharyngiomas were made. The MR images were obtained as 3- to 5-mm-thick coronal (n = 13) or axial (n = 3) Tl-weighted images (T1WI) prior to and following i.v. Gd-DTPA administration. Proton density- (PD) and T2-weighted images (T2WI) were also obtained. Conspicuity of tumor margins, cystic versus solid components, size, location and effect upon adjacent structures were separately characterized in all imaging sequences. In 6 patients contrast medium-enhanced T1WI. PD and T2WI demonstrated cystic tumor components not seen on unenhanced T1WI. There were significant differences (p < 0.004) on 2-tailed Student's t-test comparing tumor conspicuity on contrast medium-enhanced T1WI with unenhanced T1WI, PD and T2WI. Optimal tumor delineation on MR imaging of patients with craniopharyngiomas justifies the use of i.v. contrast medium.
53518.41146155702004.01.12+ Infantile hemangioendothelioma.Radiographics
JE Roos, R Pfiffner, T Stallmach, G Stuckmann, B Marincek, U Willi,
53618.41164930122006.05.23++Hepatic metastases: diffusion-weighted sensitivity-encoding versus SPIO-enhanced MR imaging.Radiology
K Nasu, Y Kuroki, S Nawano, S Kuroki, T Tsukamoto, S Yamamoto, K Motoori, T Ueda,
To retrospectively compare accuracy of diffusion-weighted (DW) single-shot echo-planar imaging with sensitivity encoding (SENSE) with that of superparamagnetic iron oxide (SPIO)-enhanced magnetic resonance (MR) imaging in the evaluation of hepatic metastases due to extrahepatic malignancies.
53718.4022990051990.03.05++MR characterization of hepatic lesions by t-null inversion recovery sequence.J Comput Assist Tomogr
G Patrizio, P Pavone, A Testa, L Marsili, E Tettamanti, R Passariello,
Tissue characterization of focal hepatic lesions was performed employing an inversion recovery sequence with short repetition time and short inversion time (TI) values. Different and specific TI values, correlated to the in vivo measured T1 relaxation times, were used to null the signal intensity of each type of lesion. In 40 patients studied, we observed the nulling effect of normal liver in 10 of 10 cases with a TI of 136 ms, of metastases in 7 of 8 cases with a TI of 175 ms, of hemangiomas in 15 of 16 cases with a TI of 200 ms, and of cysts in 6 of 7 cases with a TI of 235 ms. A quantitative analysis of the nulled signal was performed by measuring the signal/noise values. A further qualitative and quantitative characterization was carried out by evaluating the signal intensity of hepatic lesions at the null point of normal liver. The method provided the possibility of discriminating different focal lesions with specificity values of 83-94%, according to the type of lesion.
53818.3998649181999.02.16++Ultrasound-guided core-needle biopsy is effective in the initial diagnosis of lymphoma patients.Haematologica
PL Zinzani, A Colecchia, D Festi, M Magagnoli, A Larocca, S Ascani, M Bendandi, GF Orcioni, F Gherlinzoni, P Albertini, SA Pileri, E Roda, S Tura,
With the development and refinement of new guidance methods for percutaneous biopsies, many investigators have reported studies supporting a role for radiologically guided core-needle biopsy in the diagnosis of malignant lymphoma under certain clinical circumstances. The aims of this report are to evaluate the efficacy of findings at ultrasound (US)-guided core-needle biopsy of abdominal lymphoma on patient care and define the key determinants of clinical success.
53918.3884752771993.05.19++Abdominal staging of thoracic Hodgkin disease: CT-lymphangiography-Ga-67 scanning correlation.Radiology
PC Stomper, SP Cholewinski, J Park, SP Bakshi, MP Barcos,
A retrospective study was performed to assess whether lymphangiography and gallium-67 scanning were complementary to computed tomography (CT) in abdominal staging of disease in 94 patients with early-stage thoracic Hodgkin disease. In 51 patients with surgical or follow-up correlation, the spleen was involved in 16% (n = 8), the spleen and lymph nodes in 22% (n = 11), and only lymph nodes in 2% (n = 1). In these 51 patients, none of the imaging modalities had greater than 50% sensitivity for the detection of nodal involvement. The overall accuracy was similar (71%-82%) for each modality. Analysis of subgroups of patients with lymph nodes measuring less than 10 mm, 10-19 mm, or 20 mm or greater at CT revealed that lymphangiography and gallium scanning added little to the positive or negative predictive values of CT. The sensitivity of CT for detection of splenic disease was 11% (two of 19). On the basis of surgical or follow-up correlation in 51 patients, the authors conclude that lymphangiography and gallium scanning offer minimal or no complementary benefit.
54018.36191245632009.07.09++Detection of small hepatocellular carcinoma: comparison of conventional gadolinium-enhanced MRI with gadolinium-enhanced MRI after the administration of ferucarbotran.Br J Radiol
YK Kim, CS Kim, YM Han,
We compared the diagnostic efficacy of gadolinium (Gd)-enhanced MRI with that of Gd-enhanced MRI after administration of ferucarbotran for revealing small hypervascular hepatocellular carcinomas (HCCs). 24 patients with 34 HCCs (ranging in size from 0.6-2.0 cm) underwent Gd-enhanced three-dimensional dynamic MRI followed, after an interval of 5-11 days (mean, 7 days), by Gd-enhanced three-dimensional dynamic MRI after administration of ferucarbotran. The two Gd-enhanced arterial-phase MRI scans were compared quantitatively by measuring the tumour-liver contrast-to-noise ratio (CNR) and qualitatively by evaluating the tumour-liver contrast using matched-pairs analysis. The tumour-liver CNR with Gd-enhanced arterial-phase imaging after ferucarbotran (250.3 +/- 103.7) was higher than that with Gd-enhanced arterial-phase imaging (221.1 +/- 96.1) (p < 0.001). Matched-pairs analysis indicated that, for three lesions, the relative tumour-liver contrast was slightly better with Gd-enhanced arterial-phase imaging after ferucarbotran than with conventional Gd-enhanced arterial-phase imaging; however, in the case of the remaining 31 lesions, the two images were equivalent. We concluded that, although Gd-enhanced arterial-phase imaging after ferucarbotran results in better tumour-liver CNR than Gd-enhanced arterial-phase imaging, the ability of the two techniques to reveal small hypervascular HCCs is the same.
54118.3285393771996.02.06++Sternoclavicular joint: MR imaging--anatomic correlation.Radiology
J Brossmann, A Stäbler, KW Preidler, D Trudell, D Resnick,
To correlate magnetic resonance (MR) images of the sternoclavicular joint with anatomic sections.
54218.31120103112002.07.12++Image-guided fine-needle aspiration cytology of deep-seated enlarged lymph nodes.Acta Radiol
U Nahar Saikia, N Khirdwadkar, B Saikia, B Sood, R Goldsmith, P Dey, SK Gupta,
To evaluate the role of image-guided fine-needle aspiration cytology (FNAC) of deep-seated lymph nodes.
54318.31175464042008.01.10++CT-guided biopsy of small liver lesions: visibility, artifacts, and corresponding diagnostic accuracy.Cardiovasc Intervent Radiol
J Stattaus, H Kuehl, S Ladd, T Schroeder, G Antoch, HA Baba, J Barkhausen, M Forsting,
Our study aimed to determine the visibility of small liver lesions during CT-guided biopsy and to assess the influence of lesion visibility on biopsy results.
54418.3032150611989.02.28++[Splenic cyst. Diagnosis, indications and choice of procedure].Chirurg
KH Treutner, S Truong, V Schumpelick,
Based on two cases of splenic cysts diagnosis, indication, and selection of surgical methods are discussed. Ultrasound and computerized axial tomography prove to be the most important diagnostic methods. The indication to operate on cysts with a diameter exceeding 2 cm follows from possible complications. Because of the immunological importance of the spleen and the technical means of today a splenic resection should always be considered.
54518.2930298311987.04.10++[Focal changes in the spleen. Ultrasonic morphological characteristics and their clinical significance].Rofo
CF Hess, W Grodd, B Kurtz, E Jähde,
Focal changes in the spleen were rare findings in a large clinical material (less than 1% of cases). In a prospective study, which included 580 patients, lesions in the spleen were found in 40. Four focal lesions were due to infiltrates from non-Hodgkin's lymphoma. Twenty-one lesions with low echoes consisted of twelve infiltrates from Hodgkin's disease (six patients) or non-Hodgkin's lymphoma (six patients), five were due to fresh splenic infarcts and one each to an abscess, a metastasis from a carcinoma of the stomach, sarcoid and a haemorrhage. In only three of ten highly echogenic foci was a diagnosis possible (one leukaemic infiltrate and two scars following splenic infarcts). The significance of the sonographic demonstration of focal splenic lesions for diagnosis and treatment is discussed. The advantages of a sector scanner for evaluation of the spleen and splenic size are mentioned.
54618.2866905271984.02.15++Computed tomography of silent abdominal abscesses.J Comput Assist Tomogr
RB Jeffrey, MP Federle, FC Laing,
Computed tomographic (CT) findings are reviewed in nine patients with clinically unsuspected abdominal abscesses. None of the patients in this series had significant fever or leukocytosis. Localized pain or a palpable mass was the primary clinical feature in seven patients. Computed tomography demonstrated encapsulated fluid collections without gas in five patients representing chronic abscess. Computed tomography was diagnostic of an abscess in three patients and guided aspiration was helpful in demonstrating an abscess in two other patients. The inability to make a correct preoperative diagnosis of an abscess in four of the nine cases was due to a low level of clinical suspicion, a nonspecific CT appearance, and failure to perform diagnostic aspiration.
54718.28116980162001.12.14+ Pathologic quiz case: a 38-year-old man with splenic, renal, and hepatic cysts.Arch Pathol Lab Med
M Blanco, J Alexis,
54818.26179789142008.04.10++[Spontaneous spleen rupture due to primary splenic angiosarcoma: a case report].Ulus Travma Acil Cerrahi Derg
B Mayir, T Colak, A Dinçkan,
Primary spleen angiosarcoma is an infrequent disease and the diagnosis is usually difficult. In this report we discussed a case who presented with abdominal pain. In clinical follow symptoms of shock were observed. Laparotomy was performed and spleen rupture was detected. Spleen angiosarcoma must be considered in the differential diagnosis of patients with unexplained anemia, splenic mass and splenomegaly. It has rapid course and poor prognosis. Splenectomy must be performed because of threat of rupture.
54918.2687499431996.09.20++Familial multiple mesothelial cysts of the spleen.J Pediatr Surg
T Iwanaka, H Nakanishi, Y Tsuchida, T Oka, T Honna, K Shimizu,
A 5-month-old boy who was diagnosed as having hydrops fetalis at 25 weeks' gestation had severe ascites of unknown origin. At the age 12 months, ultrasonography and computed tomography showed multiple cysts in the spleen that were increasing in size rapidly. Splenectomy resulted in complete disappearance of the ascites. These cysts were diagnosed as mesothelial cysts because the cell lining of the splenic cysts stained positively with alcian blue and cytokeratin. The boy's mother had undergone splenectomy for splenic and retroperitoneal lymphangiomas at 4 years of age. Histological reevaluation showed that the lining of her splenic cysts had the same mesothelial components as her son's. Their chromosomal assay showed normal karyotypes. Mesothelial cyst of the spleen appears similar to splenic lymphangioma morphologically; however, bleomycin and OK-432 were not effective. Familial splenic mesothelial (epidermoid) cysts have been reported in three sets of siblings, but this is the first report of their occurrence in mother and son.
55018.2586288881996.06.21++Calcification in focal nodular hyperplasia: a new problem for differentiation from fibrolamellar hepatocellular carcinoma.Radiology
F Caseiro-Alves, M Zins, Mahfouz A-E, A Rahmouni, V Vilgrain, Y Menu, D Mathieu,
To describe calcification in focal nodular hyperplasia (FNH) of the liver, which poses a new problem for the differentiation of FNH from fibrolamellar hepatocellular carcinoma (HCC).
55118.22171519002008.01.07++Adrenal tumors with late enhancement on CT and MRI.Abdom Imaging
BK Park, CK Kim, B Kim, GY Kwon,
To identify adrenal masses showing gradual persistent enhancement on delayed contrast-enhanced computed tomography (CT) and magnetic resonance imaging (MRI).
55218.2231799791988.11.30+ CT diagnosis of splenic multifocal lesions and abdominal lymphoadenopathy secondary to sarcoidosis.Comput Med Imaging Graph
FJ Alvarez, J Escalada, R Comet, F Garcia, M Biosca,
55318.2119397511991.12.04++MR of enchondroma and chondrosarcoma: rings and arcs of Gd-DTPA enhancement.J Comput Assist Tomogr
J Aoki, S Sone, F Fujioka, K Terayama, K Ishii, O Karakida, S Imai, F Sakai, Y Imai,
MR studies of five chondrosarcomas and three enchondromas were performed with intravenous Gd-DTPA administration. All tumors showed enhancement of scalloped margins and curvilinear septa (ring-and-arc pattern) on T1-weighted SE sequences with Gd-DTPA. On radiologic-pathologic correlation, the enhanced areas corresponded to fibrovascular bundles surrounding hyaline cartilage lobules. The rings and arcs of enhancement with Gd-DTPA on MR is a reflection of the lobulated growth pattern of cartilaginous tumors and therefore helpful in differential diagnosis of bone tumors.
55418.1792802521997.09.16++Focal liver masses: characterization with diffusion-weighted echo-planar MR imaging.Radiology
T Namimoto, Y Yamashita, S Sumi, Y Tang, M Takahashi,
To evaluate diffusion-weighted echo-planar magnetic resonance (MR) imaging for improving the specificity of characterization of liver tumors.
55518.17156478782005.05.31+ Vascular pathology of the spleen, part I.Abdom Imaging
AM De Schepper, F Vanhoenacker, B Op de Beeck, J Gielen, P Parizel,
55618.1669767261982.03.22++Sonography of splenic abscess.AJR Am J Roentgenol
S Pawar, CJ Kay, R Gonzalez, KJ Taylor, AT Rosenfield,
Gray-scale sonographic examination was performed in seven cases of splenic and parasplenic abscess. The splenic abscesses appeared as irregular, poorly defined anechoic masses with varying internal echogenicity and acoustical transmission. Increased echogenicity and distal acoustical shadowing due to gas within the abscess were also noted. Gray-scale sonography was instrumental in the diagnosis of splenic abscess in this group of patients whose symptomatology was of uncertain etiology.
55718.16109466942000.10.04++Cystic masses of the spleen: radiologic-pathologic correlation.Radiographics
M Urrutia, PJ Mergo, LH Ros, GM Torres, PR Ros,
Many focal splenic lesions may appear to be cystic at cross-sectional imaging. In this article, the following types of cystic splenic masses are discussed: congenital (true cyst), inflammatory (abscesses, hydatid cyst), vascular (infarction, peliosis), posttraumatic (hematoma, false cyst), and neoplastic (hemangioma, lymphangioma, lymphoma, metastasis). The key findings at ultrasound, computed tomography, and magnetic resonance imaging can be correlated with underlying gross and microscopic pathologic findings. Although tissue sampling is still required in many cases to yield a definitive diagnosis, recognition and understanding of the spectrum of imaging and pathologic features of these lesions often help narrow the differential diagnosis.
55818.1529834021985.04.11+ Cavernous haemangioma of the spleen.Rofo
M Päivänsalo, T Siniluoto,
55918.14104574251999.10.12+ Splenic inflammatory pseudotumor mimicking primary splenic malignancy.Haematologica
Y Edoute, A Roguin, Z Gallimidi, O Ben-Izhak, P Nagachandran, H Ben-Ami,
56018.1184784651993.05.27+ Retroperitoneal sarcoidosis.J Clin Ultrasound
VS Dogra, J Poblete,
56118.1066024721983.07.15+ Infantile hemangioendothelioma of the liver: a radiologic-pathologic-clinical correlation.AJR Am J Roentgenol
AH Dachman, JE Lichtenstein, AC Friedman, DS Hartman,
56218.1086882331996.08.28++US and CT findings in the diagnosis of tuberculous peritonitis.Acta Radiol
FB Demirkazik, O Akhan, MN Ozmen, D Akata,
To evaluate the ultrasonographic and CT findings of tuberculous peritonitis.
56318.1098337841998.12.07++Frequency of abdominal CT findings in AIDS patients with M. avium complex bacteraemia.Clin Radiol
L Pantongrag-Brown, TL Krebs, BD Daly, JJ Wong-You-Cheong, C Beiser, B Krause, AE Brown,
Use of blood culture studies for early diagnosis of Mycobacterium avium complex (MAC) infection has become important due to the recent development of effective antibiotic therapy for this condition. This study assessed the abdominal computed tomography (CT) findings in patients with AIDS who presented with bacteraemic MAC infection.
56418.09106284692000.01.21++Is it necessary to biopsy the obvious?AJR Am J Roentgenol
MY Chen, DW Gelfand, RE Bechtold, SA Cremer, BJ Casolo, PD Savage,
The radiologist and oncologist are often confident that biopsy will confirm their suspicion of recurrent disease, but a biopsy is performed to confirm the histologic diagnosis before beginning or altering therapy. We have examined data to determine how often the biopsied lesion represents recurrent disease from the primary tumor or is an instance of new cancer, and whether recurrent disease can be predicted.
56518.0866870081984.05.11+ [Radiological findings in primary vascular malignant bone neoplasms].Nowotwory
U Grzesiakowska,
56618.0732571081988.01.21+ Splenic lymphangiomatosis: CT diagnosis.AJR Am J Roentgenol
F Pistoia, SK Markowitz,
56718.0626578871989.07.13+ [Splenic lymphangioma: a case report].Radiol Med
P Bagnolesi, P Sbragia, S Esposito,
56818.0578561591995.03.14++Increased erythrocyte sedimentation rate and a splenic mass.West J Med
JV Hirschmann, S Patterson, JG Drachman, H Rosen, WC Liles,
This discussion was selected from the weekly Grand Rounds in the Department of Medicine, University of Washington School of Medicine, Seattle. Taken from a transcription, it has been edited by Jonathan G. Drachman, MD, Chief Medical Resident; Henry Rosen, MD, Professor and Associate Chair; and Paul G. Ramsey, MD, Professor and Chair of the Department of Medicine.
56918.0290135381997.04.02++MR imaging evaluation of renal cell carcinoma.Abdom Imaging
Y Narumi, H Hricak, JC Presti, R Forstner, GT Sica, C Kuroda, Y Sawai, T Kotake, T Kinouchi, PR Carroll,
This study examines the minimally required imaging protocol needed for detection and staging of renal cell carcinoma (RCC).
57018.0189954711997.02.11++Comparison between conventional and fast spin-echo stir sequences.Acta Radiol
K Hittmair, S Trattnig, CJ Herold, M Breitenseher, J Kramer,
To evaluate the common characteristics and differences in contrast behavior of short-TI-inversion-recovery (STIR) and short-TI-inversion-recovery fast spin-echo (TurboSTIR) sequences.
57118.0040585341985.12.16 Case records of the Massachusetts General Hospital. Weekly clinicopathological exercises. Case 48-1985. A 69-year-old man with peripheral vascular disease and hypersplenism.N Engl J Med
57217.9876543921995.10.05++Basic principles of MR contrast.Top Magn Reson Imaging
KL Nelson, VM Runge,
The use of intravenous contrast media is well established in magnetic resonance (MR) for improved diagnosis. MR differs from other imaging modalities in the complexity of signal and contrast dependence, with the method of measurement having great impact on tissue contrast. Unlike computed tomography, in which contrast depends solely on x-ray density, the signal intensity on MR is determined by differences in spin density, T1 and T2 relaxation times, diffusion, perfusion, and magnetic susceptibility. The only contrast agents in widespread clinical use at this time are paramagnetic metal ion chelates. These compounds influence tissue contrast by enhancing T1 and T2 relaxation. The effectiveness of any one agent is dependent on a number of basic parameters, including concentration, number of coordination sites, magnetic moment, distance between the ion and water protons, and correlation times. An understanding of general contrast mechanisms, principles of contrast agent design, and basic MR imaging techniques is important for proper clinical implementation and medical diagnosis.
57317.9831920601989.01.05+ [Hamartoma of the spleen].Gematol Transfuziol
IuA Ershov, EV Suvorova, SM Minkina, EN Glasko,
57417.97164207912006.03.10++[Primary angiosarcoma of the spleen with liver metastases. Case report and literature review].Cir Esp
J Verge, J Albiol, M Navas, C Martín,
Angiosarcomas of the spleen are infrequent tumors that often present with liver metastases. These tumors are usually multiple and have a poor prognosis. Immunohistochemical markers can aid preoperative diagnosis since radiological and ultrasonographic images are fairly nonspecific. The recommended treatment is splenectomy. The benefits of chemotherapy and radiotherapy have not been clearly demonstrated.
57517.9532581071988.04.08++Gadolinium-DTPA in the evaluation of intradural extramedullary spinal disease.AJR Am J Roentgenol
G Sze, A Abramson, G Krol, D Liu, J Amster, RD Zimmerman, MD Deck,
Gadolinium-DTPA was used in MR imaging of the spine to determine the ability of a contrast agent to increase the detection and characterization of disease in the intradural extramedullary space. Although MR imaging, especially with recent technological improvements, has been shown to be at least competitive with, and often superior to, myelography and postmyelography CT in the study of intramedullary and extradural disease, its use in the assessment of intradural extramedullary disease has been questioned. We selected 12 patients with intradural extramedullary disease as demonstrated by positive CSF cytology and/or myelographic findings and performed MR examinations on them before and after administering gadolinium-DTPA (0.1 mmol/kg). Gadolinium-DTPA was extremely effective in depicting intradural extramedullary disease of the spine. Small nodules of 3 mm, virtually invisible on noncontrast MR scans, enhanced strongly and were easily detected. In addition, leptomeningeal spread of tumor along nerve roots was also visualized, sometimes more readily than by myelography and postmyelography CT. The remarkable sensitivity of gadolinium-DTPA to intradural extramedullary disease assures its role in future MR examinations of the spine.
57617.94129548932003.09.25++Adrenal masses: CT characterization with histogram analysis method.Radiology
KT Bae, P Fuangtharnthip, SR Prasad, BN Joe, JP Heiken,
To evaluate a histogram analysis method for differentiating adrenal adenoma from metastasis at computed tomography (CT).
57717.94170217082007.05.03++Image-guided core-needle biopsy of peripheral lymph nodes allows the diagnosis of lymphomas.Eur Radiol
E de Kerviler, C de Bazelaire, N Mounier, O Mathieu, B Brethon, J Brière, JP Marolleau, P Brice, C Gisselbrecht, J Frija,
It is commonly admitted that the diagnosis of lymphomas can be assessed by the image-guided needle biopsy (IGNB) of deep lymph nodes. However, when peripheral lymph nodes are present, surgical dissection remains the standard strategy. The aim of this study was to evaluate the diagnostic yield of IGNB of peripheral lymph nodes in patients with suspected lymphomas. The records of 180 multisampling IGNBs of peripheral lymph nodes in 180 patients were reviewed. One hundred and twenty-three IGNBs were observed at first diagnosis and 57 at progression using large-cutting core-biopsy needles ranging between 18 G and 14 G in size. Immunohistochemistry studies were performed in all cases and at least one biopsy was systematically frozen. A diagnosis of lymphoma with sufficient information such that a therapeutic decision could be made was obtained in 146 of the 152 patients with lymphoproliferative disorders (96%). IGNB was equally effective in making the correct diagnosis of lymphoma at the time of original diagnosis than at relapse. The results did not depend on the biopsy site, lymph nodes size, or needle type. We recommend that IGNB may be performed as an initial procedure for the diagnosis of lymphomas either in the presence of peripheral or deep lymph nodes, as it avoids surgery.
57817.9395654431998.09.17++Symptomatic splenic hamartoma: case report and literature review.Pediatrics
TC Hayes, HA Britton, EB Mewborne, DA Troyer, VA Saldivar, IA Ratner,
An 11-year-old girl with low-grade fever, night sweats, thrombocytopenia, and an 8-year history of progressive splenomegaly underwent an elective splenectomy. Pathologic diagnosis was multiple splenic hamartoma. The patient's symptoms resolved after the splenectomy. Since first described by Rokitansky in 1861, approximately 140 cases of splenic hamartoma have been described in the literature. Most of the splenic hamartomas were discovered incidentally. A minority of these lesions were associated with hematologic symptoms such as pancytopenia, anemia, and thrombocytopenia. Only 20 of the reported cases of splenic hamartoma occurred in pediatric patients. However, compared with the adult patients, nearly half of these cases in pediatric patients was associated with symptoms. Splenectomy and partial splenectomy have relieved these symptoms. With advances in imaging, splenic hamartomas are being discovered with increasing frequency. A multimodal radiologic work-up has enabled some cases of splenic hamartoma to be diagnosed preoperatively. Inclusion of this benign entity in the differential diagnoses of symptomatic splenomegaly in a pediatric patient is important in the preoperative management and counseling of the patient and family. In patients who have discrete lesions, consideration of this entity preoperatively may avoid total splenectomy.
57917.92149865482004.03.16++[Hemangioma of the spleen. A case report].Tunis Med
S Jarboui, A Krichen, L Ben Temime, F Sraïri, Mel M Abdesselem, A Zaouche,
We report a case of hemangioma of the spleen in an 18-old-years female patient. Clinical presentation was abdominal pain in the left upper quadrant. Physical examination founding was normal. The hemangioma was presented as hyperechogenic mass on ultra sound imaging. On the computed tomography scan with contrast it became progressively hyperdense. Splenectomy is often indicated because of the risk of rupture and the doubt about malignant form in histological examination.
58017.90105988522000.01.06++SPIO-MR imaging versus double-phase spiral CT in detecting malignant lesions of the liver.Acta Radiol
RD Müller, K Vogel, K Neumann, H Hirche, J Barkhausen, F Stöblen, H Henrich, R Langer,
To assess the diagnostic performance of superparamagnetic iron oxide MR (SPIO-MR) imaging compared with double-phase spiral CT in detecting liver metastases and hepatocellular carcinoma.
58117.8791356531997.05.23++Dynamic MRI of invasive breast cancer: assessment of three region-of-interest analysis methods.J Comput Assist Tomogr
S Mussurakis, DL Buckley, A Horsman,
In this study, three region-of-interest (ROI) analysis methods based on operator-defined and semiautomated sampling of pharmacokinetic breast maps of contrast uptake are described. The observer variability and impact of the methods on the estimated enhancement characteristics of invasive cancer are also presented.
58217.8667099031984.05.11++Percutaneous drainage of 250 abdominal abscesses and fluid collections. Part II: Current procedural concepts.Radiology
PR Mueller, E vanSonnenberg, JT Ferrucci,
The initial skepticism concerning the capability of radiologically placed catheters to drain intraabdominal abscesses has been overcome by wide acceptance of the technique by general surgeons. In this review, we describe current procedural concepts based on our experience with percutaneous catheter drainage of 250 intraabdominal abscesses and fluid collections in 212 patients. We consider the mechanisms of successful percutaneous drainage and suggest differences between radiologic and surgical decompression. We describe the inconsistent correlations between image patterns and results of the diagnostic needle aspiration, especially in predicting the drainability of cavity contents. We review principles of catheter selection and aspects of postprocedure catheter management, including irrigation and timing of withdrawal.
58317.8475807821995.12.21++Imaging features of splenic epidermoid cyst with pathologic correlation.Abdom Imaging
A Shirkhoda, J Freeman, AR Armin, AA Cacciarelli, R Morden,
The spleen can be involved in a variety of cystic lesions ranging from cystic neoplasms and parasitic cysts to "true" and "false" cysts. Epidermoid splenic cyst is a rare true cyst that is developmental in origin. We present two young patients with such a cyst and illustrate their features on ultrasound, CT, and MRI with pathologic correlation.
58417.84174604212007.07.17++Multiple littoral cell angioma of the spleen: a case report and review of the literature.Onkologie
ZB Qu, LX Liu, LF Wu, S Zhao, HC Jiang,
Littoral cell angioma (LCA) is a rare benign vascular tumor of the spleen with characteristic histomorphologic features. It is a unique splenic tumor which may present with abdominal pain or as an incidental finding.
58517.8427017921990.10.15+ Vascular neoplasms of the skin: a current perspective.Adv Dermatol
MR Wick, JC Manivel,
58617.849705321976.12.01++Radiographic manifestations of malignant histiocytosis.AJR Am J Roentgenol
NR Dunnick, BR Parker, RA Warnke, RA Castellino,
Twenty-six cases of histologically proven malignant histiocytosis are presented. Patient ages ranged from 20 months to 82 years, and a 10:3 male preponderance was seen. Clinical presentation is similar to that of malignant lymphoma and leukemia; histologic differentiation is required. The frequency of intrathoracic involvement at the time of presentation is similar to that of non-Hodgkin's lymphoma. Retroperitoneal lymph node invasion was readily seen on five of the eight lymphograms performed. Hepatosplenomegaly was a common finding, and three of the patients had evidence of bone involvement during the course of their illness. While there are no radiographic findings specific to malignant histiocytosis, the presence of hepatomegaly should suggest this possibility. The establishment of the correct diagnosis is important to guide choices in chemotherapy.
58717.82102275141999.05.17++MR lymphangiography using ultrasmall superparamagnetic iron oxide in patients with primary abdominal and pelvic malignancies: radiographic-pathologic correlation.AJR Am J Roentgenol
MG Harisinghani, S Saini, R Weissleder, PF Hahn, RK Yantiss, C Tempany, BJ Wood, PR Mueller,
The purpose of this study was to administer ultrasmall superparamagnetic iron oxide (USPIO) and compare changes in signal intensity of lymph nodes in patients with primary abdominal and pelvic malignancies. Also, we correlated radiographic with pathologic findings.
58817.80108620642000.08.15++Improved tissue characterization of focal liver lesions with ferumoxide-enhanced T1 and T2-weighted MR imaging.J Magn Reson Imaging
M Nakayama, Y Yamashita, K Mitsuzaki, T Yi, A Arakawa, K Katahira, Y Nakayama, M Takahashi,
The purpose of our study was to evaluate the potential value of ferumoxide-enhanced T1-weighted magnetic resonance (MR) imaging for tissue characterization of focal liver lesions when combined with T2-weighted sequences. Images were acquired within 30 minutes after the end of ferumoxide administration, when ferrite particles were not totally cleared from the intravascular compartment. Thirty-eight patients with 47 focal liver lesions underwent T1-weighted gradient-echo (TR/TE 150/4.1 msec) and T2-weighted fast spin-echo (3180-8638/90 msec) MR imaging at 1.5 T before and after intravenous administration of ferumoxides (10 micromol/kg body weight). A qualitative and quantitative analysis was performed. During the early phase after infusion of ferumoxide, blood vessels showed hypersignal intensity on T1-weighted fast low-angle shot (FLASH) images, while liver signal decreased. Hemangiomas showed both homogeneous and inhomogeneous enhancement patterns, and liver metastasis most typically showed ring enhancement. Hypervascular tumors (hepatocellular carcinomas and focal nodular hyperplasias) showed a slight degree of homogeneous enhancement. Quantitatively, the degree of enhancement and lesion-to-liver contrast on ferumoxide-enhanced images were significantly different among these tumors. Our results demonstrate that distinct enhancement patterns obtained on ferumoxide-enhanced T1-weighted MR imaging improve tissue characterization of focal liver lesions when combined with T2-weighted images.
58917.8097143941998.09.01++Staging lymphoma with CT: comparison of contiguous and alternate 10 mm slice techniques.Clin Radiol
KS Naik, JA Spencer, CM Craven, KA MacLennan, PJ Robinson,
To compare two computed tomography (CT) techniques, contiguous 10 mm and alternate 10 mm slices of the chest, abdomen and pelvis, for initial staging of lymphoma.
59017.8031737311988.11.22+ [3 cases of splenic angiomatosis].Minerva Chir
F Cortese, F Galli, M Azzolina, A Lanza, F Di Giusto,
59117.7989246961996.11.14+ [Surprising finding of a hepatic hemangiosarcoma with concomitant peliosis hepatis].Rofo
G Scherer, T Roeren, W Hofmann, M Brado, GW Kauffmann,
59217.7990227611997.03.03++Application of magnetization transfer imaging for intracranial lesions of tuberous sclerosis.J Comput Assist Tomogr
MG Jeong, TS Chung, CJ Coe, TJ Jeon, DI Kim, AY Joo,
Our goal was to assess the effectiveness of magnetization transfer imaging (MTI) and the usefulness of the magnetization transfer ratio (MTR) in tuberous sclerosis (TS).
59317.7997331771998.12.04+ Focal peliosis hepatis resembling metastatic liver tumor.J Ultrasound Med
T Tateishi, J Machi, WK Morioka,
59417.7876226871995.08.30++Abdominal manifestations of sarcoidosis in CT studies.J Comput Assist Tomogr
SJ Folz, CD Johnson, SJ Swensen,
The purpose of this study is to demonstrate the spectrum of abdominal CT findings in patients with tissue proved sarcoidosis, estimate their prevalence, and correlate abdominal findings with stage of thoracic disease.
59517.7687569091996.09.18++Breast lesions: correlation of contrast medium enhancement patterns on MR images with histopathologic findings and tumor angiogenesis.Radiology
LD Buadu, J Murakami, S Murayama, N Hashiguchi, S Sakai, K Masuda, S Toyoshima, S Kuroki, S Ohno,
To compare qualitative and quantitative magnetic resonance (MR) mammographic features of breast lesions with histopathologic findings, especially tumor angiogenesis.
59617.74175737682007.07.05+ Splenic hamartoma.Cytopathology
S Conlon, D Royston, P Murphy,
59717.74145002232003.11.17++Imaging-guided percutaneous splenic biopsy using a 20- or 22-gauge cutting-edge core biopsy needle for the diagnosis of malignant lymphoma.AJR Am J Roentgenol
S Lieberman, E Libson, B Maly, P Lebensart, D Ben-Yehuda, AI Bloom,
OBJECTIVE: We estimated the accuracy and safety of imaging-guided needle biopsy for the diagnosis of suspected malignant lymphoma in patients with a splenic lesion. CONCLUSION: Imaging-guided small-bore cutting-edge needle biopsy of splenic lesions is a safe procedure. In most patients with primary or recurrent lymphoma, the disease subtype can be diagnosed reliably.
59817.73164955052006.08.03+ Multifocal nodular fatty infiltration of the liver mimicking metastatic liver tumors: diagnosis using the liver-specific late phase of Levovist-enhanced sonography.J Ultrasound Med
H Tamai, N Shingaki, M Oka, T Shiraki, I Inoue, H Magari, M Fujishiro, M Iguchi, K Yanaoka, K Arii, Y Shimizu, M Ichinose,
59917.72165545792006.05.30++Comparison of mangafodipir trisodium- and ferucarbotran-enhanced MRI for detection and characterization of hepatic metastases in colorectal cancer patients.AJR Am J Roentgenol
HJ Kim, KW Kim, JH Byun, HJ Won, YM Shin, PN Kim, MS Lee, MG Lee,
The purpose of our study was to evaluate the validity of mangafodipir trisodium-enhanced versus ferucarbotran-enhanced MRI in the detection and characterization of hepatic lesions in colorectal cancer patients.
60017.7018997481991.03.20+ Retroperitoneal sarcoidosis.AJR Am J Roentgenol
DB Bach, AD Vellet,
60117.7091223761997.04.22++Contrast-enhanced abdominal MR angiography: optimization of imaging delay time by automating the detection of contrast material arrival in the aorta.Radiology
MR Prince, TL Chenevert, TK Foo, FJ Londy, JS Ward, JH Maki,
To improve gadolinium-enhanced magnetic resonance (MR) angiogram quality by automatically synchronizing acquisition of central k-space image data with the arterial phase of contrast material bolus infusion.
60217.7078225501995.02.10++MR-guided localization of suspected breast lesions detected exclusively by postcontrast MRI.J Comput Assist Tomogr
U Fischer, R Vosshenrich, H Bruhn, D Keating, BW Raab, JW Oestmann,
We describe and evaluate a preoperative MRI localization procedure for suspected breast lesions.
60317.6936915431988.02.20++Hepatic haemangioma: dynamic MRI using gadolinium-DTPA.Eur J Radiol
K Ohtomo, Y Itai, K Yoshikawa, T Kokubo, N Yashiro, M Iio,
Six patients with hepatic haemangioma were examined with a 1.5 tesla magnetic resonance scanner before and immediately after bolus injection of 0.05 mmol/kg gadolinium-DTPA. Eight to ten spin-echo images (TR: 100 msec, TE: 20 msec, scanning time: 26 sec) were obtained through the region of the haemangioma. In all cases, dense contrast enhancement of the lesion was demonstrated. The enhancement spread in all directions from the lesion on subsequent delayed scans (high signal fill-in); a signal higher than that from surrounding hepatic parenchyma was present two minutes after contrast injection. Dynamic MRI is a promising method for the evaluation of hepatic haemangioma and it is more easily tolerated by patients than dynamic CT using iodinated contrast medium.
60417.6977905521995.07.21++Peribiliary cysts in liver cirrhosis: US, CT, and MR findings.J Comput Assist Tomogr
N Terayama, O Matsui, K Hoshiba, M Kadoya, J Yoshikawa, T Gabata, T Takashima, T Terada, Y Nakanuma, K Shinozaki,
We report the imaging features of hepatic peribiliary cysts (PC) and the course of their development on CT.
60517.6980330041994.08.16++Multiple actinomycotic liver abscesses: MRI appearances with etiology suggested by abdominal radiography. Case report.Clin Imaging
LN Nazarian, JA Spencer, DG Mitchell,
The magnetic resonance imaging appearances of multiple actinomycotic liver abscesses are described. The abscesses appeared hypointense to liver parenchyma on T1-weighted sequences and hyperintense on T2-weighted sequences with some surrounding edema. Following intravenous gadolinium diethylenetriamine-pentaacetic acid, the masses showed a thick enhancing rim but no central enhancement. Although no etiology was discovered in the initial clinical history, antecedent dental surgery was evident on abdominal radiography that depicted dental amalgam in the ascending colon.
60617.6670690031982.06.14++Spontaneous splenic infarction in polysplenia syndrome.J Comput Assist Tomogr
CA Shadle, ME Scott, DJ Ritchie, G Seliger,
A case of polysplenia with spontaneous infarction of one of the four spleens is presented. The diagnosis was made by computed tomography (CT), which demonstrated the multiple aberrant right sided spleens, with an area of low attenuation representing infarction of one of the spleens. The associated anomalies of prominent azygos and hemiazygos veins secondary to absence of the suprarenal portion of the inferior vena cava were also seen on CT.
60717.66149943082004.09.17+ MRI of focal nodular hyperplasia (FNH) with gadobenate dimeglumine (Gd-BOPTA) and SPIO (ferumoxides): an intra-individual comparison.J Magn Reson Imaging
JM Fröhlich,
60817.6677540071995.06.20++Nodular sarcoidosis of the liver and spleen: analysis of 32 cases.Radiology
DM Warshauer, PL Molina, SM Hamman, RE Koehler, EK Paulson, RE Bechtold, ML Perlmutter, JN Hiken, IR Francis, CJ Cooper,
To describe the computed tomographic (CT) appearance of nodular hepatosplenic sarcoidosis and its association with stage with chest radiography and clinical status.
60917.6363852441984.11.09++[Sonography in the diagnosis of an unusual splenic tumor].Ultraschall Med
P Heilmeyer, S Schneider,
The authors report on an unusual cystic giant tumour of the spleen (a necrotically disintegrating non-Hodgkin lymphoma) which was examined via sonography, scintigraphy and angiography. The information obtained by means of the individual examination methods was compared with each other, taking the findings of anatomic pathology as basis. In the case under discussion sonography supplied the best possible information on the morphology of the tumour. The importance of sonography in arriving at the differential diagnosis of cystic (or pseudocystic) space-occupying growths is discussed.
61017.6168490991983.02.25++Ultrasound analysis of solid-appearing abscesses.Radiology
BR Subramanyam, EJ Balthazar, BN Raghavendra, SC Horii, S Hilton, DP Naidich,
A retrospective review of 96 abdominal abscesses yielded 11 cases (9%) that were diffusely echogenic on sonograms and that stimulated findings of solid lesions. Sonographic features of these abscesses were analyzed and compared with features of 78 cases of hepatic metastasis. An abscess was considered solid appearing when it contained diffuse internal echoes that were distributed over 90% of the abscess cavity. The visualized internal echoes were of low to medium amplitude, and were generally similar to the normal echogenicity of the parenchymal organs, such as the liver, spleen, or uterus. Distal acoustic enhancement was seen in 91% of the solid abscesses, and it was not seen in hepatic metastases. A distinct echogenic wall was present in 64% of the abscesses (subacute and chronic lesions), but this occurred in less than 4% of metastases. Thin peripheral halos inside or outside of and adjacent to the abscess wall were seen in 36% of abscesses. The peripheral halos seen in metastases were wider and not associated with an echogenic wall. The diagnosis of a diffusely echogenic abscess and differentiation from a neoplasm is possible when the sonographic findings of acoustic enhancement, thin peripheral halo, and echogenic abscess wall are present.
61117.6123981581990.10.17+ MR imaging of hepatosplenic candidiasis superimposed on hemochromatosis.J Comput Assist Tomogr
JS Cho, EE Kim, DG Varma, S Wallace,
61217.6119285531991.10.30++Kaposi-like infantile hemangioendothelioma. A distinctive vascular neoplasm of the retroperitoneum.Am J Surg Pathol
WY Tsang, JK Chan,
Retroperitoneal soft-tissue tumors are rare in infancy. In this report, we describe a distinctive hemangioendothelioma occurring in the retroperitoneum of a 10-month-old baby girl. This lesion was complicated by obstructive jaundice, intestinal obstruction, and thrombocytopenia (Kasabach-Merritt syndrome) leading to intracranial hemorrhage. The microscopic features of this tumor, characterized by infiltrative lobules of spindle cells and capillaries, are distinct from those of other well-recognized vasoformative tumors. In some areas, the tumor shows a striking resemblance to Kaposi's sarcoma; criss-crossing fascicles of spindle cells are interspersed with narrow vascular spaces, but PAS-positive hyaline globules are absent. The tumor can also be distinguished from the cellular hemangioma of childhood by its well-formed spindle cell fascicles. Several histologically similar cases have been reported. All of them occurred in the retroperitoneum of infants and were frequently complicated by Kasabach-Merritt syndrome. We therefore propose the designation "Kaposi-like infantile hemangioendothelioma" for this unusual neoplasm.
61317.6192074981997.09.18++Evaluation of renal artery stenosis with dynamic gadolinium-enhanced MR angiography.AJR Am J Roentgenol
MJ Rieumont, JA Kaufman, SC Geller, EK Yucel, RP Cambria, LS Fang, H Bazari, AC Waltman,
The purpose of this study was to compare dynamic gadolinium-enhanced three-dimensional spoiled gradient-recalled MR angiography with conventional arteriography in the evaluation of proximal renal artery stenosis (RAS).
61417.60109666962000.09.19++Hepatic cavernous hemangioma: temporal peritumoral enhancement during multiphase dynamic MR imaging.Radiology
MG Jeong, JS Yu, KW Kim,
To determine whether temporal parenchymal enhancement around hepatic cavernous hemangiomas can be correlated with the rapidity of intratumoral contrast material enhancement and/or tumor volume at dynamic magnetic resonance (MR) imaging.
61517.5826987461990.05.15++Angiosarcoma. Diagnosis and clinical course.Acta Radiol
DM Coldwell, RL Baron, C Charnsangavej,
The findings at radiography, computed tomography and angiography and the clinical course of 30 cases of angiosarcoma were reviewed. The variety of primary sites results in a multitude of findings but the most common finding was that of a hypervascular soft tissue mass seen on CT and angiography. Additional findings of well demarcated cortical defects in long bones were also frequently noted. The general clinical behavior of these aggressive malignant tumors was also reviewed and it was noted that they had a deceptively benign presentation.
61617.58153883682005.01.03++[Splenomegaly and splenic pseudotumor due to tuberculosis: six new cases].Ann Chir
F Rhazal, MK Lahlou, S Benamer, JM Daghri, E Essadel, E Mohammadine, A Taghy, B Chad, A Belmahi,
Splenic tuberculosis is rare. The aim of this study was to remind diagnostic problems in this disease, and to evaluate the value of surgery in its management.
61717.5479870641995.01.09++Blunt trauma of the spleen: the delayed rupture in computed tomography.Bildgebung
F Boioli, F Gattoni, B Tagliaferri, G Ceriani, C Pozzato, I Spagnoli, P Potepan, C Uslenghi,
We retrospectively reviewed CT scans of 18 patients (12 males and 6 females; mean age: 43.6 years) with the diagnosis of blunt splenic trauma. All patients underwent CT at different times after the trauma. The cases were divided into 2 groups: according to the time at which the CT was performed, the 1st group consisted of 11 patients scanned within 48 h after the trauma; the 2nd group consisted of 7 patients studied with CT at variable times after the traumatic event (mean time: 6.5 days; range 3-13 days). All lesions in the 1st group (11 patients) had indistinct margins, while lesions of patients in the 2nd group (7 patients) always showed clean-cut and regular edges. Early lesions were always hyperdense, late ones hypodense. CT diagnosis always matched the surgeon's diagnosis. We can confirm the diagnostic value of CT of splenic lesions in blunt abdominal traumas.
61817.5486293411996.06.26++[Computerized tomography diagnosis of splenic and hepatic lesions in malignant non-Hodgkin's lymphomas].Vestn Rentgenol Radiol
VM Cheremisin, VI Mazurov, NA Anosov, VE Savello, GA Bol'shakov, AA Novikov, VV Rassokhin, TG Kulibaba,
Seventy eight patients with varying malignancy non-Hodgkin's lymphomas were examined. Signs of extranodal damage of the spleen and liver were studied. Spleno- and hepatomegaly were signs of the commonest diffuse visceral involvements. In terms of the malignancy (low- or high-grade), splenomegaly was seen in 71.4 and 82.5% of patients and hepatomegaly was observed in 43.9 and 28.6%, respectively. In addition, irregular visceral outlines, tuberosity, changed density of the parenchyma and its homogeneity. A high correlation was found between the enlargement of the viscera and their decreased parenchymal density. Focal visceral involvements are less difficult to be diagnosed than diffuse ones, but they are much rarer. Computerized tomographic findings indicate the malignancy of a process.
61917.53105556851999.12.07+ US case of the day. Giant hemangiomas of the liver.Radiographics
R Avva, HR Shah, TL Antuaco,
62017.511757061976.04.30++Arteriography of retroperitoneal lymphoma.AJR Am J Roentgenol
DC Levin, DH Gordon, M Kinkhabwala, JA Becker,
Arteriography was performed in 16 patients with various types of lymphoma involving the retroperitoneal space. The location and extent of the mass could be predicted in 15 cases, based upon displacement of major arteris or kidneys. Most of the studies demonstrated some degree of fine reticular neovascularity and staining within the mass; none showed extreme hypervascularity, coarse or ragged vessels, or pooling of contrast medium during the capillary phase. The differential diagnosis of lesions with this appearance includes metastases, sarcomas, neural tumors, and inflammatory masses. Arteriography may possibly prove to be of value in staging certain patients with lymphoma, although definitive assessment of its role must await further prospective studies.
62117.5190669541997.05.30+ Importance of a previous allergy to an iodinated contrast agent in the administration of gadopentetate dimeglumine.Ann Pharmacother
N García, E Ramón, L Gonzalez del Valle, M Ruano, E Jiménez,
62217.5030375901987.08.14++Conventional and rapid MR imaging of the liver with Gd-DTPA.Radiology
B Hamm, KJ Wolf, R Felix,
Twenty-three patients with malignant hepatic tumors underwent magnetic resonance (MR) imaging before and after intravenous administration of gadolinium-diethylene-triaminepentaacetic acid (DTPA). Two different doses were used, 0.1 mmol/kg and 0.2 mmol/kg. The larger dose proved to be more effective than the smaller dose. The signal-enhancement-to-noise ratio was significantly larger in the tumor than in the liver (2 alpha less than or equal to .05). In a moderately T1-weighted spin echo (SE) sequence (SE 400/30) (repetition time [TR] msec/echo time [TE] msec), the tumor was better defined 6 minutes after administration of Gd-DTPA. More strongly T1-weighted sequences--that is, SE 200/20 and inversion recovery 1,500/35/400 (TR msec/TE msec/inversion time, msec)--showed significantly worse contrast between tumor and liver (signal-difference-to-noise ratio [SD/N]) 10 and 15 minutes after administration (2 alpha less than or equal to .05). On the other hand, the low SD/N in the rapid MR imaging sequence was significantly improved (2 alpha less than or equal to .05). The most important indications for administration of Gd-DTPA in diagnosing hepatic tumors are the presentation of perfusion conditions and contrast optimization in rapid MR images.
62317.4990003671997.02.26++Struma ovarii: MR appearances.Abdom Imaging
Y Yamashita, Y Hatanaka, M Takahashi, K Miyazaki, H Okamura,
Analysis of unenhanced and contrast-enhanced magnetic resonance (MR) images of struma ovarii, a rare benign neoplasm of the ovary, is the aim of this study.
62417.48102068061999.04.13++Sonographically guided fine needle aspiration biopsy of abdominal lymph nodes: experience in 102 patients.J Ultrasound Med
S Gupta, CL Rajak, BP Sood, M Gulati, A Rajwanshi, S Suri,
We present our experience with sonographically guided fine needle aspiration biopsy of abdominal and retroperitoneal lymph nodes in 102 patients. The biopsied lymph nodes measured 1 to 6 cm (mean, 2.3 cm) and were located at the porta hepatis (n = 23), in the peripancreatic (n = 31), paraaortic (n = 22), aortocaval (n = 1), common iliac (n = 3), or external iliac (n = 6) regions, or in the mesentery (n = 16). Material sufficient for cytologic analysis was obtained in 87 (85.2%) of the 102 patients. The cytologic diagnosis in these patients included malignancy in 47 patients, tuberculosis in 28 patients, reactive lymphoid hyperplasia in 10 patients, and aspergillosis in two patients. In the other 15 patients, fine needle aspiration biopsy could not provide a definitive diagnosis. No major or minor complications occurred in our study. Thus, sonographic guidance is an effective alternative to computed tomography for biopsy of abdominal and retroperitoneal lymph nodes.
62517.4780921231994.10.20++Comparison of initial lymphoma staging using computed tomography (CT) and magnetic resonance (MR) imaging.Am J Hematol
BR Hoane, AF Shields, BA Porter, JW Borrow,
While MR is known to be superior to other imaging methods for detecting marrow involvement by lymphoma, MR is also capable of detecting abnormal lymph nodes. Our objective was to determine whether MR employing short TI inversion recovery (STIR) was comparable to CT in the initial staging of 23 patients with Hodgkin's disease (12 patients) and non-Hodgkin's lymphoma (11 patients). MR images of chest, abdomen, pelvis, and femoral marrow were obtained using the STIR and T1-weighted spin-echo (T1-SE) techniques, employing a protocol initially designed for marrow assessment. In all cases, CT-detected adenopathy was also found by MR. Four patients had marrow involvement by MR, undetected by CT. We conclude that MR and CT may be equivalent imaging modalities in the detection of nodal involvement, and that MR has an advantage in its ability to diagnose marrow involvement. Given the high frequency of focal marrow abnormalities detected by MR in patients with Hodgkin's disease and high-grade non-Hodgkin's lymphoma, MR may be the preferred staging modality for these patients.
62617.46124380352002.12.19+ CT and MR imaging features of pathologically proven atypical giant hemangiomas of the liver.AJR Am J Roentgenol
M Coumbaras, D Wendum, L Monnier-Cholley, H Dahan, JM Tubiana, L Arrivé,
62717.4647285971973.11.06+ The scope of splenic arteriography.Angiology
AJ Wendth, R Samson, S O'Connor, H Goussous,
62817.4585880311996.03.25++[Detection of liver tumors].Radiologe
EJ Rummeny, P Reimer, H Daldrup, PE Peters,
Accurate detection of liver metastases in patients with known primary tumors is often essential for therapeutic decision making. Compared to conventional contrast media-enhanced CT unenhanced MRI seems to be slightly superior for the detection of small focal liver lesions. However, intraoperative US and CTAP show higher sensitivities for lesion detection but use of these techniques is limited because of their invasive character. The new superparamagnetic MR contrast medium ENDOREM improves the number of liver lesions detected significantly as compared to unenhanced MRI. Furthermore, as shown recently, ENDOREM-enhanced MRI may be as sensitive as CTAP. Thus, ENDOREM is useful for preoperative staging of liver tumors due to improvement in lesion detection and delineation of the hepatic vascular system.
62917.4532890861988.07.21++Retroperitoneal and pelvic hemangiopericytomas: clinical, radiologic, and pathologic correlation.Radiology
SM Goldman, AJ Davidson, J Neal,
Seventeen cases of hemangiopericytoma of the retroperitoneum were retrospectively analyzed for demographic, morphologic, and radiologic features. These tumors were found in all age groups (2 months to 72 years) and occurred in similar numbers of male and female patients. The tumors tended to be large (11 were greater than 8 cm), were well encapsulated, and occurred less frequently in the pelvic retroperitoneal space (six cases) than in abdominal retroperitoneum (11 cases). All tumors were bulky enough to displace part of the gastrointestinal tract, with only two being inoperable. The most distinctive radiologic feature was hypervascularity (found on 11 of 11 angiograms). Other nondiscriminating radiologic features included well-defined margins and necrosis, with nondistinctive amorphous calcification identified in one case. Angiographic or computed tomographic demonstration of hypervascularity in a retroperitoneal tumor is more suggestive of hemangiopericytoma than of a liposarcoma or malignant fibrous histiocytoma, two of the more common tumors of this region.
63017.45168452892006.08.31++Characterization of small liver lesions: Added role of MR after MDCT.J Comput Assist Tomogr
NS Holalkere, DV Sahani, MA Blake, EF Halpern, PF Hahn, PR Mueller,
The purpose of this study is to evaluate the added role of magnetic resonance imaging (MR) in characterizing subcentimeter focal liver lesion(s) detected on multidetector row helical computed tomography (MDCT).
63117.44113009502001.05.17+ Pathologic quiz case. A human immunodeficiency virus-infected man with splenomegaly and radiologic evidence suggestive of rupture.Arch Pathol Lab Med
EA Sotomayor, J Borkowski, Z Gatalica,
63217.4486866311996.08.21+ Percutaneous transpulmonary CT-guided liver biopsy: a safe and technically easy approach for lesions located near the diaphragm.AJR Am J Roentgenol
DA Gervais, GS Gazelle, DS Lu, PF Han, PR Mueller,
63317.4213245091992.09.18++Focal liver disease: comparison of dynamic contrast-enhanced CT and T2-weighted fat-suppressed, FLASH, and dynamic gadolinium-enhanced MR imaging at 1.5 T.Radiology
RC Semelka, JP Shoenut, MA Kroeker, HM Greenberg, FC Simm, GY Minuk, RM Kroeker, AB Micflikier,
Dynamic contrast medium-enhanced computed tomography (CT), T2-weighted fat-suppressed spin-echo (T2FS) magnetic resonance (MR) imaging, and breath-hold T1-weighted fast low-angle shot (FLASH) MR imaging before and after dynamic gadopentetate dimeglumine injection were compared in 73 patients with clinically suspected liver disease. Observer confidence for presence of focal lesions was determined by using receiver operating characteristic analysis. For all MR images, hepatic lesion-liver signal-to-noise ratios were evaluated qualitatively. and resolution and presence of artifacts were evaluated qualitatively. Lesion detection was greatest with T2FS (n = 272) and enhanced FLASH (n = 244) and was statistically greater with both of these than with CT (n = 220) and FLASH (n = 219) (P less than .03). Correct lesion characterization was greatest with enhanced FLASH (n = 236) (P less than .01), followed by CT (n = 199), FLASH (n = 164), and T2FS (n = 144). Enhanced FLASH was particularly successful in characterization of 5-mm- to 1.5-cm-diameter lesions as cystic or solid.
63417.41124904922003.01.16+ Hepatic hemangioma: atypical appearances on CT, MR imaging, and sonography.AJR Am J Roentgenol
HJ Jang, TK Kim, HK Lim, SJ Park, JS Sim, HY Kim, JH Lee,
63517.4016208651992.08.06++Gaucher disease: abdominal MR imaging findings in 46 patients.Radiology
SC Hill, BM Damaska, A Ling, K Patterson, AM Di Bisceglie, RO Brady, NW Barton,
Abdominal magnetic resonance imaging findings were reviewed in 46 patients with Gaucher disease. All patients had hepatosplenomegaly at the time of initial imaging. Splenic nodules were present in 14 patients (30%) and varied in signal intensity. These nodules were isointense on T1-weighted and hypointense on T2-weighted images. Splenic infarcts were seen in 15 patients (33%), and four of these patients (9%) also had subcapsular fluid collections. Both nodules and infarcts were present in the spleen in four patients (9%). Pathologic correlation was performed with specimens from two patients who underwent partial splenectomy. Focal areas of abnormal signal intensity were noted in the liver in nine patients (20%). They were either stellate or segmental, and may represent fibrotic septa with ischemic changes associated with aggregates of Gaucher cells. No changes were noted in the kidneys or abdominal lymph nodes.
63617.38163218162006.06.13++Splenectomy in haematology--a 5-year single centre experience.Hematology
L Wood, PM Baker, A Martindale, P Jacobs,
To define indications and outcome in haematologic cases undergoing splenectomy.
63717.3667163501984.06.20++[Cystic lymphangioma of the abdomen in an adult. Contribution of echography and computed x-ray tomography. Apropos of a case].J Radiol
D Strohl, I Abols, Y Lauru, D Vadrot, M Laval-Jeantet,
Authors present a case of cystic lymphangioma of the abdomen in an adult patient. Pre-operative investigations are based on ultrasound and computed tomography since plain films, excretory urograms and barium enema are less helpful. Opportunity of such a diagnosis in adult is not frequent.
63817.3530492071988.11.17++Imaging the direct bidirectional spread of disease between the abdomen and the female pelvis via the subperitoneal space.Gastrointest Radiol
M Oliphant, AS Berne, MA Meyers,
This report expands the concept of the subperitoneal space (SS) as the potential conduit for direct spread of disease in the abdomen to include the female pelvis. The normal anatomy of the SS in the lower abdomen, the female pelvis, and its uninterrupted continuation between the abdomen and pelvis are demonstrated by several imaging modalities. Surgically proven cases of bidirectional spread of disease between the abdomen and female pelvis are reported. The unifying concept of the interrelationship formed by the SS provides an understanding of the basic concepts of the pathways of direct spread of disease and the pathogenesis of the clinical presentation of disease distant from its site of origin.
63917.3567482691984.09.11+ [Two cases of localized splenic lesion associated with hepatic hemangioma].Rinsho Hoshasen
H Ishida, S Inoue, S Komatsu, Y Tamakawa, H Ogawa, T Miyauchi,
64017.3422158291990.11.13++An unusual case of cystic lymphangiomatosis of the spleen.Neth J Med
HD Spapen, H Reynaert, S Debeuckelaere, E Achten, G Somers,
Isolated lymphangiomatosis of the spleen is rare. When present, it is usually considered to be accompanied by splenomegaly. We describe a case of cystic lymphangiomatosis in a patient with a normal-sized spleen. While ultrasound, angiography and computed tomography are considered to complement each other in reaching a preoperative diagnosis of splenic lymphangiomatosis, in the present case, magnetic resonance imaging proved to be an additional helpful non-invasive diagnostic method.
64117.32100871151999.05.04++Hemorrhagic necrosis due to peliosis hepatis: imaging findings and pathological correlation.Eur Radiol
O Vignaux, P Legmann, G de Pinieux, S Chaussade, C Spaulding, D Couturier, A Bonnin,
Peliosis hepatis is an uncommon liver condition characterized by blood-filled cavities. We report the CT, angiographic and MR features of a case of peliosis hepatis with no obvious etiology and spontaneously regressing hemorrhagic necrosis. Helical CT showed multiple peripheral low-density regions with foci of spontaneous high density suggesting the presence of blood component. On MR imaging, the multiple peripheral lesions were hypointense on T1-weighted and hyperdense on T2-weighted images, with bright foci on all sequences suggesting subacute blood. Angiography showed no evidence of tumor or vascular malformation; multiple nodular vascular lesions filling in the parenchymal phase and persisting in the venous phase suggested blood-filled cavities. Pathological examination showed blood-filled spaces with no endothelial lining, characteristic of the parenchymal type of peliosis. Knowledge of the imaging features of hemorrhagic necrosis due to peliosis hepatis is important since it can be responsive to antibiotic therapy. Furthermore, differentiating hemorrhagic necrosis from hepatic abscess avoids dangerous and sometimes fatal percutaneous drainage.
64217.3270393751982.05.12++Surgical pathology of the spleen: an approach to the differential diagnosis of splenic lymphomas and leukemias. Part II. Diseases of the red pulp.Am J Surg Pathol
JS Burke,
The diseases which chiefly pertain to the differential diagnosis of splenic lymphomas and leukemias primarily involving the red pulp have been separated into five histologic categories. These include the various forms of congestion, infections, benign and malignant histiocytic proliferations, leukemias and myeloproliferative disorders, and the rare nonhematopoietic tumors of the spleen. Many diseases with major involvement of the red pulp present as hypersplenism of unknown etiology. Accurate diagnosis is particularly dependent on an awareness of the specific histologic manifestations of malignant histiocytosis and the different leukemias in contrast to benign disorders, such as infectious mononucleosis which may simulate malignancy in the splenic red pulp. For each histologic category, therefore, the relevant morphologic features are reviewed, pathophysiologic mechanisms and clinical manifestations correlated, and criteria for differential diagnosis emphasized.
64317.3296302801998.06.23+ Case report: CT appearance of capillary and cavernous lymphangiomatosis of the spleen in an adult.Clin Radiol
TR Bader, G Ranner, M Klimpfinger,
64417.30125340372003.02.07++[Splenic angioma. Value of MRI: two case reports].Tunis Med
S Sehili, K Bouzaidi, S Belhadj Hassine, R Sassi, A Kochlef, O Khayat, M Ayed, A Ghorbel, MH Daghfous,
The splenic angioma is a rare tumour. Its aspects MRI are still badly known. The authors show that in the 2 brought back cases, there is a hypersignal on the 3 echoes of T2 with a catch of contrast slow and centripetal after Gadolinium injection. The hemorrhagic risk in connection with a spontaneous or traumatic rupture imposes the identification of this lesion.
64517.27117357022002.01.25+ Pathologic quiz case: a mass of the spleen. Inflammatory myofibroblastic tumor of the spleen.Arch Pathol Lab Med
MB Mosunjac, DV Feliciano, B Majmudar,
64617.25199436072010.01.05++A true ectopic, locally vascularized spleen: a very rare anomaly.Acta Chir Belg
T Darius, T Tollens, C Aelvoet, JP Vanrykel,
In contrast to a wandering or ectopic spleen which is vascularized by the original splenic vessels this case describes a true ectopic, locally vascularized spleen in the pelvis. To our knowledge this anomaly has never been described in the literature before.
64717.224028431977.04.15++CT detection and aspiration of abdominal abscesses.AJR Am J Roentgenol
JR Haaga, RJ Alfidi, TR Havrilla, AM Cooperman, FE Seidelmann, NE Reich, AJ Weinstein, TF Meaney,
Computed tomography (CT) is effective in detecting intraabdominal abscesses. Loculations of fluid and extraluminal gas are clearly localized in relation to other organs. Of 22 abscess in this series, CT successfully detected 20; comparative information with gallium, techneticum, and ultrasound scans is presented. In addition to localizing these collections, CT can be used to guide needle aspiration and drainage procedures. Three sizes of needles were used to aspirate specimens and/or provide drainage. This was accomplished successfully in 12 of 14 CT-guided procedures.
64817.1981434021994.05.02+ Staging of lymphoma in adults.Clin Radiol
K Sandrasegaran, PJ Robinson, P Selby,
64917.1787569321996.09.18++Detection of hepatic metastases: ferumoxides-enhanced MR imaging versus unenhanced MR imaging and CT during arterial portography.Radiology
E Senéterre, P Taourel, Y Bouvier, J Pradel, B Van Beers, JP Daures, J Pringot, D Mathieu, JM Bruel,
To prospectively compare the diagnostic accuracy of computed tomography (CT) during arterial portography (CTAP) with that of unenhanced and ferumoxides-enhanced magnetic resonance (MR) imaging at 0.5 T in the detection of hepatic metastases.
65017.17121883102003.02.25+ Double contrast MR imaging of hepatocellular carcinoma evaluating lesion detection and conspicuity.Acad Radiol
D Akinci, A Oto, A Besim, O Akhan, O Abbasoglu, F Batman, M Eryilmaz,
65117.1691241111997.04.24+ T2*-weighted dynamic MR imaging in renal artery or vein stenosis.AJR Am J Roentgenol
Y Tsushima, T Murakami, H Kuruma, T Kondo, S Kusano,
65217.1439107611986.03.07+ Tuberculous splenic abscess in a patient with acute myeloblastic leukemia.Taiwan Yi Xue Hui Za Zhi
MC Chang, SC Lin, KS Jeng, CC Shih,
65317.1279559501994.12.09++[Focal lesions of the spleen: contribution of magnetic resonance imaging].Clin Ter
GF Gualdi, A Volpe, E Polettini, A Melone, AM Ceroni, MG Ferriano,
MR findings in the study of focal splenic pathology are discussed in this paper. MR examination of the spleen shows some technical limits in the diagnosis of masses affecting this organ. On the contrary, the introduction of new paramagnetic contrast agents, with organospecific affinity, will no doubt improve the diagnostic power of MR imaging, in order to gain more information about these diseases.
65417.12194483712009.09.01+ Symptomatic splenoma in a child.Ann Saudi Med
P Shah, I Robbani, AB Khan, OJ Shah,
65517.1115752161992.06.03++Bacillary epithelioid angiomatosis involving the liver, spleen, and skin in an AIDS patient with concurrent Kaposi's sarcoma.Am J Clin Pathol
TA Steeper, H Rosenstein, J Weiser, S Inampudi, DC Snover,
The simultaneous findings of bacillary epithelioid angiomatosis and Kaposi's sarcoma of the skin with visceral hepatosplenic bacillary epithelioid angiomatosis is reported in a patient with acquired immune deficiency syndrome. Liver biopsy showed periportal peliotic spindle cell foci that initially were misinterpreted as Kaposi's sarcoma. After antibiotic therapy induced rapid clinical improvement, repeated liver biopsy showed resolution of the previously noted lesions. Although the violaceous skin lesions all appeared similar clinically, some resolved completely and some progressed. One of the latter was biopsied and had the histologic features of Kaposi's sarcoma. The differential diagnosis is discussed.
65617.10104052431999.09.23++Primary splenic tuberculosis in a patient with nasal angiocentric lymphoma: mimicking metastatic tumor on abdominal CT.J Clin Gastroenterol
M Ozgüroğlu, AF Celik, G Demir, H Aki, F Demirelli, N Mandel, E Büyükünal, S Serdengeçti, B Berkarda,
Tuberculosis may be difficult to diagnose when it presents in an uncommon extrapulmonary site. The authors report a case of splenic tuberculosis mimicking metastatic tumor on computed tomography in a 60-year-old woman who had been treated with combination chemotherapy for nasal angiocentric lymphoma. Diagnostic splenectomy revealed multiple necrotic masses in the spleen, which were consistent with caseating granulomas microscopically. Diagnosis was confirmed by positive cultures in Lowenstein medium, which grew typical Mycobacterium tuberculosis organisms. Following splenectomy, the patient was also treated with a triple-drug antituberculosis regimen with no recurrence of her symptoms.
65717.1053406401967.10.13+ The accuracy of lymphangiographic diagnosis in malignant lymphoma.Radiology
M Takahashi, HL Abrams,
65817.07115666772001.11.01++Hepatic MR imaging using ferumoxides: prospective evaluation with surgical and intraoperative sonographic confirmation in 25 cases.AJR Am J Roentgenol
SS Raman, DS Lu, SC Chen, J Sayre, F Eilber, J Economou,
The purpose of our study was to evaluate the sensitivity and accuracy of ferumoxides-enhanced MR imaging in comparison with surgery and intraoperative sonography.
65917.0790712861997.04.09++MRI of the TMJ disc with intravenous administration of gadopentetate dimeglumine.J Comput Assist Tomogr
S Takebayashi, T Takama, S Okada, G Masuda, S Matsubara,
The purpose of this study was to ascertain whether MR imaging with intravenous administration of gadopenetate dimeglumine (Gd-DTPA) is useful in the demonstration of the temporomandibular joint (TMJ) disc.
66017.05169507152006.11.09++Radiological catheter drainage of abscesses in children.Acta Radiol
S Murthy Chennapragada, K Prelog, CK Wong,
To assess the efficacy and safety of radiological catheter drainage of fluid collections and abscesses in children, and to review the principles, indications, technique, and possible complications of these procedures.
66117.05104420171999.09.21++[Splenic abscess].Przegl Lek
A Wysocki, A Brzychczy,
Splenic abscess consists a very rare pathology. There were less than 300 cases described in the literature in the last 10 years. We report a case of 68 year old women with the splenic abscess with a history of blunt trauma of the left side chest wall two years earlier. The diagnosis was confirmed by USG and CT. The patient underwent splenectomy. The post operative course was uneventful.
66217.0585719141996.03.01++Portal-phase contrast-enhanced helical CT for the detection of malignant hepatic tumors: sensitivity based on comparison with intraoperative and pathologic findings.AJR Am J Roentgenol
BS Kuszyk, DA Bluemke, BA Urban, MA Choti, RH Hruban, JV Sitzmann, EK Fishman,
The purpose of this study was to determine the sensitivity of portal-phase IV contrast-enhanced helical CT in detecting malignant hepatic tumors using a lesion-by-lesion comparison with surgical and pathologic findings.
66317.05167586602006.07.21++Splenic tumours--autopsy study of ten years.Indian J Pathol Microbiol
SR Rane, IN Bagwan, P Pingle, VV Holla,
Human spleen, though being the largest component of reticuloendothelial system, is a very rare site of tumor metastases. Splenic metastases are usually seen as part of multi-organ involvement. Autopsy study conducted over a period of 10 years revealed that the incidence of neoplastic involvement of spleen was 1.45% (70/4812). Primary malignant involvement of spleen was also noted to be a rare entity in present study.
66417.04113915782001.06.28++The spleen as a diagnostic specimen: a review of 10 years' experience at two tertiary care institutions.Cancer
MD Kraus, MD Fleming, RH Vonderheide,
Few studies have examined the yield of the diagnostic splenectomy, and the relevance of these studies to the management of patients with unexplained splenomegaly or a splenic mass are limited by low number of cases, the use of selection criteria, and the lack of modern terminology and modern ancillary studies. The current study correlates clinical intent with preoperative clinical and radiologic studies and histologic findings in an assessment of the diagnostic yield of splenectomy.
66517.03178833022007.11.08+ [Splenic peliosis: a rare entity].Rev Esp Enferm Dig
S Pérez-Holanda, S Tojo, M Calleja, JA Fernández, P Fernández, MD Martínez, F Fernández, J Rodríguez, D Valverde,
66617.0369798841982.08.26++Preoperative CT evaluation of adrenal glands in non-small cell bronchogenic carcinoma.AJR Am J Roentgenol
ME Nielsen, DK Heaston, NR Dunnick, M Korobkin,
Preoperative chest computed tomographic (CT) scans in 84 patients with biopsy-proved non-small cell bronchogenic carcinoma were reviewed. At least one adrenal gland was visualized in 70 of these. Evidence of a solid adrenal mass was present in 18 (14.5%) glands in 15 (21.4%) patients. Percutaneous needle aspiration under CT guidance confirmed metastatic malignancy in the four patients who were biopsied. Because the documented presence of adrenal metastases in non-small cell lung cancer makes surgical resection or local irradiation inappropriate, it is recommended that both adrenal glands in their entirety be specifically included whenever a staging chest CT examination is performed in patients with such tumors. Percutaneous needle biopsy for pathologic confirmation of the nature of solid adrenal masses discovered in this process is also useful.
66717.0377877221995.07.24++Niemann-Pick disease type C: nodular splenomegaly.Abdom Imaging
LP Omarini, SE Frank-Burkhardt, TA Seemayer, G Mentha, F Terrier,
Niemann-Pick type C disease (NPCD) is an autosomal recessive storage lipidosis due to a disorder of cholesterol esterification leading to the accumulation of sphingomyelin and cholesterol in the brain, liver, and spleen. The disease is usually diagnosed when neurological symptoms appear. We report an unusual presentation of NPCD in a young asymptomatic adult with isolated nodular splenomegaly.
66817.0173518391980.03.27++Significance of 99mTc-sulfur colloid splenic image in malignant melanoma.J Surg Oncol
RA Berjian, KL Parthasarathy, MS Didolkar, SP Bakshi, RH Moore,
To evaluate the clinical significance of 99mTc-sulfur-colloid (TsSC) spleen scan findings in patients with malignant melanoma, a retrospective study was undertaken. Eighty-one patients with histologically proven malignant melanoma who received treatment in Roswell Park during a five-year period were included in this study. The scans were analyzed for spleen size, differential uptake of the tracer in liver and spleen, and for the presence of metastases in these two organs. These data were compared with stage of disease, survival, and autopsy findings. Significant correlation was found between the splenic size as measured on the scintiscan and at autopsy examination. The spleen size was found to be normal in 92% of the patients in early melanoma. The median survival of patients who had a normal-sized spleen by scan criteria was found to be longer than those who had splenomegaly. No significant difference in survival was noted between the patients with and without augmented splenic uptake of TcSC. Only a small number (17.7%) of patients with augmented splenic uptake had splenic metastases; hence, the possible role of immunological factors was considered.
66917.0023884051990.09.27++[MR imaging of splenic masses].Rinsho Hoshasen
K Itabashi, A Kohno, C Hayano, T Hayano, Y Nogata, K Ohgi, M Higuchi, Y Ohkubo, E Takahashi, A Harasawa,
It has been reported that MR imaging of the spleen is unsuccessful in detecting focal lesions because there is not a significant difference in relaxation times between most tumors and surrounding normal spleen. We reviewed the MR imaging of 15 patients (5 cysts, 2 abscesses, 1 hemangioma, 5 malignant lymphomas, 2 metastatic tumors). In all cases, the difference in signal intensities between splenic tissue and mass lesions permitted detection of splenic lesions on MR images. But, malignant lesions were less visible than benign lesions.
67017.00150379462004.12.14++"Hamartoma" of the spleen (splenoma) in children.Pediatr Dev Pathol
C Abramowsky, C Alvarado, JB Wyly, R Ricketts,
Hamartomas of the spleen or splenomas, are uncommon benign tumorous growths in this organ which have not been well characterized in children. We report four patients, 4 to 11 years old, who had splenomegaly and splenic "hamartomas" associated with different hematologic conditions (refractory microcytic anemia, sickle cell anemia, hereditary spherocytosis, and dyserythropoietic hemolytic anemia). All patients had total splenectomy as a primary therapeutic approach or to lessen their transfusion requirements. In only one patient was a focal splenic mass identified preoperatively with contrasted computed tomography (CT) scans and magnetic resonance imaging (MRI). None of the patients showed a mass by ultrasonography. Gross examination showed enlarged spleens (315-724 g) which on cut surface revealed a single nodule in one and multiple bulging nodules in three specimens. The nodules varied from 1.3 to 7 cm and were indistinct from the surrounding nonlymphoid splenic (i.e., red pulp) parenchyma. Histology of the nodules showed red splenic pulp with variable histiocytic proliferation, focal extramedullary hematopoiesis, lympho-plasmacytosis, fibrosis, and siderotic-calcific deposits. Intranodular small T- and B-cell lymphoid aggregates but no organized secondary follicles or periarteriolar sheaths were seen. Proliferation antigen Ki-67 (Mib-1) immunostains showed a low (< 5%) proliferation index in the nodules and surrounding tissue. Reticulin stains did not show a capsule or border between the normal spleen and the nodules. The critical histologic differential diagnosis for these lesions is with benign vascular tumors. These can be identified by their more disorderly pattern, by immunohistochemistry and by their higher proliferation index. It is our contention that these splenic nodules are not true hamartomas, as they seem to result from remote ischemic or infectious/inflammatory insults, leading to the fibro-inflammatory reaction and deposition of calcium and hemosiderin that is better designated with the descriptive term of splenoma. Review of the literature and our own experience indicates that most children with splenic hamartomas or splenomas as we prefer to call them, have an underlying hematologic disorder likely made worse by a state of hypersplenism that explains the consistent improvement in the blood values after splenectomy.
67116.99195340902009.07.20++[Retroperitoneal cystic lymphangiomas in adults: four case reports and review of the literature].J Med Liban
C Tohmé, T Ata, C Ghorra, R Noun, B Abboud, R Sarkis,
Retroperitoneal location of cystic lymphangiomas in adult patients is rare. Their clinical presentation is not specific. Magnetic resonance imaging is the best radiological exam for the diagnosis. These tumors must be distinguished from mesenteric cysts which are more frequent and can degenerate. The authors report four cases of retroperitoneal cystic lymphangioma with a literature review.
67216.9894000541998.01.21++Torsion of accessory spleen in an adult patient: imaging findings at CT, MRI and angiography.J Belge Radiol
R Jans, R Vanslembrouck, L Van Hoe, L Sockx, I Demedts, AL Baert,
A 40-year-old woman presented with acute left upper quadrant pain due to torsion of an accessory spleen around its long vascular pedicle, causing infarction. Torsion of an accessory spleen is extremely rare. As far as we known only 14 cases have previously been reported in the literature, and more than half patients were children. MRI can be helpful in the differential diagnosis of infarction by suggesting haemorrhagic necrosis on the T2-weighted images.
67316.9813896561992.10.29++Hydatid disease of the spleen. Ultrasonography, CT and MR imaging.Acta Radiol
WN von Sinner, H Stridbeck,
Seven patients with hydatid disease of the spleen were examined by radiography, ultrasound, CT, and in one case MR imaging. The observations were confirmed by patho-anatomic findings except in 2 patients where high indirect hemagglutination tests confirmed the diagnosis. In one patient primary, and in the others secondary, echinococcosis of the spleen was assumed to be present. Secondary hydatid disease of the spleen was caused by rupture of liver cysts with abdominal and pelvic dissemination. Ultrasound and CT findings of the cysts and cystic calcifications are described. In one patient MR imaging indicated prolapse of a splenic hydatid cyst into the left hemithorax, confirmed by patho-anatomic examination.
67416.9866459241984.01.27+ [Primary splenic cyst. Unusual differential diagnosis of a benign splenic tumor].Med Welt
H Keller, K Genth, M Linder,
67516.9666031261983.08.26++Computed tomography and sonography of cavernous hemangioma of the liver.AJR Am J Roentgenol
Y Itai, K Ohtomo, T Araki, S Furui, M Iio, Y Atomi,
Accuracy and limitations of computed tomography (CT) and sonography in the detection and diagnosis of cavernous hemangioma of the liver were analyzed in 39 cases. In 35 of 38 lesions examined by CT before and after bolus contrast enhancement, findings were dense contrast enhancement spreading in all directions on subsequent scans and/or density (other than capsule or septa) higher than normal hepatic parenchyma after 2 min. Lesions smaller than 1 cm were not detected. Misregistration in sequential scans prevented diagnosis of three of nine lesions smaller than 2 cm. Sonography revealed various patterns of mass, but in the smaller lesions, an extremely hyperechoic pattern was dominant. The contributions of CT and sonography depend on the size of the lesions.
67616.92102311811999.06.24++MR imaging of the liver and spleen: a comparison of the effects on signal intensity of two superparamagnetic iron oxide agents.Magn Reson Imaging
F Chen, J Ward, PJ Robinson,
We compared the effects of two superparamagnetic iron oxide (SPIO) contrast agents, ferumoxides and SHU-555A, in MR imaging of the liver and spleen. Thirty-six patients with known malignant lesions of the liver underwent T2W turbo spin-echo (TSE) and T1WGRE FLASH opposed-phase imaging before and after SPIO injection on a 1.0 T MR system. Post-ferumoxides images were obtained in 18 patients 90 min after infusion of 15 micrommol Fe/kg of the agent. In 18 other patients SHU-555A was administered as a rapid bolus at a dose of 7.0-12.9 micrommol Fe/kg. T1WGRE FLASH images were obtained immediately, 30 s and 480 s and T2WTSE images 10 min after injection. Signal intensity of the liver, spleen, and malignant liver lesions before and after SPIO was measured with operator-defined regions of interest. The effects of ferumoxides and SHU-555A were measured as the percentage signal intensity change (PSIC) and in the malignant liver lesions additionally as changes in lesion-to-liver contrast-to-noise ratio (deltaDCNR). On T2W TSE images, there was no significant difference between the two agents in signal loss of liver parenchyma (p > 0.05). The signal loss in the spleen produced by ferumoxides was greater than with SHU-555A (p < 0.05). Both SPIO agents produced a significant increase in the CNR of malignant liver lesions. Delta CNR was slightly greater with ferumoxides than with SHU-555A (p < 0.05). On T1WGRE FLASH images, a slight decrease of liver SI induced by both agents was found on late post-SPIO images. No significant difference of liver PSIC between the two SPIO agents was noted on T1W images. The SI of spleen was significantly increased with both agents on T1W images and no difference in PSIC of spleen was noted (p > 0.05). The T1 and T2 effects produced by ferumoxides and SHU-555A were comparable in the liver although ferumoxides produced a stronger T2 effect in the spleen.
67716.91183032892008.03.28++Complete pancreatic encasement of the portal vein (circumportal pancreas): imaging findings and implications of a rare pancreatic anomaly.J Comput Assist Tomogr
JR Leyendecker, SG Baginski,
Computed tomography and magnetic resonance imaging findings in 4 patients with complete pancreatic encasement of the portal vein are presented, with emphasis on the use of multiplanar reconstructions in demonstrating this anomaly.
67816.9079628181994.12.08+ Sellar spine and pituitary adenoma: MR and CT appearance.J Comput Assist Tomogr
K Eguchi, T Uozumi, K Arita, K Kurisu, M Sumida, T Nakahara,
67916.8964952181984.12.20++[Semeiotics of abdominal tuberculosis].Ter Arkh
GK Guseĭnov, AM Ramazanova, AG Guseĭnov,
Examination of 119 patients with abdominal tuberculosis permitted the description of the characteristic semiotics of the illness. Today the patients with abdominal tuberculosis are mainly women of child-bearing age with a long-term tuberculosis catamnesis and intoxication, with a history of tuberculosis of different sites, those suffering from tuberculosis or its sequels at present (64%), those with pains (94%), discomfort or swelling of the abdomen (79%), malfunction of the gastrointestinal tract (65%), weight loss (86%), malnutrition (72%), anemia (63%), not infrequently with inflammatory induration (43%) or ascites in the abdominal cavity (39%). In addition to this characteristic semiotics, the patients with abdominal tuberculosis may demonstrate the most different and unexpected symptoms up to acute abdomen (23%). To make differential diagnosis of abdominal tuberculosis, one has often to resort to diagnostic laparotomy, laparoscopy, Koch's test and to trial therapy.
68016.8875687921995.11.20++[New super-paramagnetic iron particles for MRI. Phase II study of malignant liver tumors].Radiologe
HE Daldrup, P Reimer, EJ Rummeny, B Tombach, T Berns, T Balzer, C Schimpfky, PE Peters,
The clinical tolerability and diagnostic value of Resovist as a new superparamagnetic iron oxide contrast medium was studied in 30 patients with malignant focal liver lesions (28 metastases, 2 HCC) within a phase II multicenter study. Magnetic resonance imaging (MRI) was performed at 1.0 Tesla with T1-weighted FLASH- and T2-weighted spin echo sequences before and following intravenous injection of Resovist at three different dose groups (4, 8 and 16 mumol Fe/kg). Liver signal intensity was significantly reduced on post-contrast images, while malignant focal liver lesions showed no signal changes. Resovist improved tumor liver contrast and lesion-conspicuity, especially for lesions smaller than 1 cm. The dose of 8 mumol Fe/kg was sufficient to achieve diagnostic tumor-liver contrast. Compared to images directly after injection, the number of detected lesions did not improve until 70 min later. There were no significant changes in vital signs (heart rate, blood pressure) or laboratory values until 72 h post-injection.
68116.88164450502006.02.27+ [Tuberculous lesion of the spleen].Klin Khir
VI Bondarev, AA Orekhov,
68216.8895165031998.05.21++Lobar atrophy of the liver.Abdom Imaging
H Ishida, H Naganuma, K Konno, T Komatsuda, Y Hamashima, T Ishioka, T Hoshino, J Ishida, O Masamune,
Lobar atrophy of the liver due to causes other than liver tumor or liver cirrhosis is a relatively rare pathological condition, and there are only a few reports in the literature. We report six such cases and try to evaluate the relationship between lobar atrophy and portal flow disturbance. The patients could be divided into two groups according to the site of the atrophy: those with atrophy of the left lobe (two cases) and those with atrophy of the right lobe (four cases). The two cases with atrophy of the right lobe had hepatholithiasis in the involved segments, but the cause was not determined in the remaining four cases. In all six cases, portal flow disturbance was noted, including invisibility of the portal vein in four cases, narrowing in one case, and portal thrombus in one case. Collateral circulation was not recognized in any of our cases. Of interest is the mode of lobar atrophy. Atrophy of the right lobe was always associated with marked enlargement of the left lobe, but that of the left lobe did not induce an enlargement of the right lobe.
68316.86193468572009.04.20++Imaging of small hepatic metastases of colorectal carcinoma: how to use superparamagnetic iron oxide-enhanced magnetic resonance imaging in the multidetector-row computed tomography age?J Comput Assist Tomogr
U Motosugi, T Ichikawa, H Nakajima, H Sou, M Sano, K Sano, T Araki, H Iino, H Fujii, T Nakazawa,
To compare the accuracy of dynamic contrast-enhanced multidetector-row computed tomography (CT) and superparamagnetic iron oxide-enhanced magnetic resonance imaging (MRI) in the evaluation of small hepatic metastases of colorectal carcinoma.
68416.8582138921993.11.23++Case report: bacillary angiomatosis with massive visceral lymphadenopathy.Am J Med Sci
WH Haught, J Steinbach, DS Zander, CS Wingo,
Bacillary angiomatosis is a newly characterized infectious disease occurring mainly in patients with AIDS. Most patients have cutaneous angiomatosis lesions resembling Kaposi's sarcoma or pyogenic granuloma. Although the disease may be life-threatening if not treated, it is curable with appropriate antibiotic therapy. A patient had a fever, nightsweats, abdominal pain, pleural effusions, and asymmetric peripheral lymphadenopathy. Computed tomography of the chest and abdomen revealed a unique pattern of enhancement of lymph nodes that, to this research team's knowledge, has not been reported previously with this condition. Appropriate antibiotic therapy resulted in a complete resolution of the disease. Included is a discussion of the clinical presentation, etiology, histology, and treatment of bacillary angiomatosis.
68516.8417901131992.04.01++Differential diagnosis of hepatic neoplasms: spin echo versus gadolinium-diethylenetriaminepentaacetate-enhanced gradient echo imaging.Magn Reson Q
YA Abbas, HY Kressel, FW Wehrli, WB Gefter, BJ Dinsmore, TW Chan, L Oleaga, BN Milestone, EK Outwater,
Early results are reported of hepatic neoplasms studied with dynamic gadolinium-diethylenetriaminepentaacetate (Gd-DTPA)-enhanced magnetic resonance imaging (MRI). The purpose of this study was to evaluate the potential of the Gd enhancement pattern for characterizing these neoplasms and to compare the performance of spin-echo (SE) to SE plus dynamic Gd-enhanced gradient-echo (GRE) pulse sequences. Forty-two patients with hepatic neoplasms were examined at 1.5 T field strength. In each patient, short and long repetition time/echo time (TR/TE) SE images were obtained, followed by pre- and post-Gd-DTPA (0.1 mmol/kg body wt), single-slice, breath-hold (13 s/scan) GRE images, which were serially acquired less than or equal to 12 min postinjection. The patterns of contrast enhancement of the various hepatic lesions were documented and analyzed. The time to peak Gd signal enhancement-to-noise ratio (SE/N), contrast-to-noise ratio (C/N), contrast (defined as the signal intensity ratio [SIR]), as well as the peak values of these quantities, were determined. The C/N and SIR values on the short and long TR/TE SE and pre-Gd GRE images for all hepatic neoplasms were also obtained. The discriminating abilities (hemangiomas vs. malignant neoplasms) of these quantities were analyzed statistically. In addition, the impact of lesion characterization on the SE versus the SE plus the Gd-enhanced GRE scans was assessed by means of a blinded reader study. Malignant hepatic neoplasms could be differentiated from hemangiomas by visual inspection of their enhancement patterns (p = 0.0009), by the time to peak C/N on Gd-enhanced images (p = 0.0002), and by the magnitude of such peak (p = 0.02). Combined SE + Gd-enhanced GRE scans afforded minor, though statistically significant (p less than 0.01), improvement of the accuracy in differentiating benign from malignant hepatic neoplasms. Late scans (12 min post-Gd) may be particularly useful in identifying hemangiomas that, unlike other neoplasms, have a significant high signal of their enhancing portions on such images.
68616.8469813131982.10.12+ Deceptions in localizing extrahepatic right-upper-quadrant abdominal masses by CT.AJR Am J Roentgenol
MP Frick, SB Feinberg,
68716.8332879771988.07.06++Delayed presentation of blunt splenic injury.Am J Surg
A Leppäniemi, R Haapiainen, CG Standertskjöld-Nordenstam, M Taavitsainen, J Hästbacka,
Eleven patients with delayed presentation of splenic injury after blunt abdominal trauma treated during a 10 year period have been described. They represented 24 percent of all patients treated for blunt splenic injury in our department in that time period. Ten patients required operative treatment and one was treated nonoperatively. There were no deaths. The value of computerized tomography and ultrasonography in the accurate preoperative assessment of splenic injury has been documented. In addition, the various diagnostic and therapeutic possibilities in blunt splenic trauma have been discussed.
68816.82117759222002.01.31++[CT in diagnosis of tuberculosis of liver and spleen].Zhonghua Jie He He Hu Xi Za Zhi
R Xie, X Zhou, J Chen,
To analyze CT findings of hepatospleeno-tuberculosis and to explore the characteristics for diagnosis and differential diagnosis of the disease.
68916.81114863252001.09.20++Partially reversed intrasplenic venous blood flow detected by color Doppler sonography in two patients with hematologic diseases and splenomegaly.J Clin Ultrasound
I Restrepo-Schäfer, B Wollenberg, J Riera-Knorrenschild, C Görg,
We report on 2 patients with hematologic diseases (1 follicular lymphoma and 1 myeloproliferative syndrome) and splenomegaly who had partial intrasplenic portosystemic shunting demonstrated by color Doppler sonography. Intrasplenic venous blood flow was in the normal direction at the hilum of the spleen but in a reversed direction at the periphery of the spleen. This type of reversed intrasplenic flow pattern results in portosystemic shunting and might be detected more frequently when careful color Doppler mapping of the entire splenic parenchyma is performed in patients with portal hypertension. The clinical significance of this phenomenon, however, is still unclear.
69016.81108234552000.08.16++Familial Mediterranean fever: abdominal imaging findings in 139 patients and review of the literature.Abdom Imaging
D Aharoni, N Hiller, I Hadas-Halpern,
The purpose of this study was to investigate the imaging findings in patients with familial Mediterranean fever (FMF) during and between acute attacks.
69116.8045722641973.06.07+ [Primary malignant neoplasms of the spleen].Wiad Lek
W Bross, S Koczorowski, E Rogalski, T Czereda, B Lazarkiewicz, J Kalemba, J Kibler, J Wierciñski, L Czarniecki,
69216.7783335601993.08.13++Epithelioid hemangioma of bone. A tumor often mistaken for low-grade angiosarcoma or malignant hemangioendothelioma.Am J Surg Pathol
JX O'Connell, SV Kattapuram, HJ Mankin, AK Bhan, AE Rosenberg,
Epithelioid hemangiomas are benign vascular tumors that usually occur in the skin and subcutis. They have been infrequently recognized in bone. Because of their unusual cytologic appearance and growth patterns, they are commonly confused with malignant tumors. We report a series of 12 epithelioid hemangiomas of bone occurring in adult patients, including five males and seven females whose ages at presentation ranged from 24 to 74 years, with a mean of 46 years. Five tumors were associated with involvement of the adjacent soft tissue. A single patient had multifocal bone disease. The most common presenting symptom was localized pain. Treatment of the patients varied widely; however, none of the tumors behaved aggressively. In 11 cases, adequate tissue was available for immunohistochemical analysis, which revealed positive staining for the epithelial markers cytokeratin and epithelial membrane antigen in nine cases. All 11 tumors stained for factor VIII-related antigen and Ulex europeus agglutinin. We believe that many of the vascular tumors of bone that have been reported as low-grade malignant hemangioendotheliomas probably represent examples of epithelioid hemangiomas. We recommend that the criteria for diagnosing vascular tumors of bone conform to those used for morphologically similar tumors that arise in the soft tissues.
69316.7513896441992.10.29++Gadodiamide injection and gadopentetate dimeglumine. A double-blind study in MR imaging of the CNS.Acta Radiol
G Myhr, PA Rinck, A Børseth,
A double-blind, randomized parallel phase III study in MR imaging of the central nervous system was conducted to compare the safety and diagnostic utility of gadodiamide injection and gadopentetate dimeglumine at a dose of 0.1 mmol/kg b.w. in 60 adult patients. Seven patients in the gadodiamide injection group experienced 10 adverse events, 5 of the events possibly related to the contrast agent. In the gadopentetate dimeglumine group 5 patients reported 3 contrast agent-related adverse events out of 8 events. All events were transient and required no treatment. Seven incidents of patient discomfort, and some minor changes in vital signs and laboratory parameters were of no clinical concern. Contrast enhancement was observed in 60% and 44% of the patients with structural abnormalities in the gadodiamide injection group and gadopentetate dimeglumine group, respectively. No difference in overall efficacy was observed. Gadodiamide injection was found to be a safe and effective contrast agent.
69416.7535109341986.03.10++Clinical significance of focal echogenic liver lesions.Gastrointest Radiol
JH Pen, PA Pelckmans, YM van Maercke, HR Degryse, AM de Schepper,
During a 4-year period, 53 focal echogenic liver lesions were demonstrated by sonography in 41 patients, in whom there was no evidence of metastatic origin. Most of the lesions were hemangiomas. One of the purposes of this study was to determine the characteristic ultrasound features for liver hemangioma. Small (less than 2 cm), homogeneous, echogenic, well-circumscribed, subcapsular lesions almost prove their hemangiomatous nature. Lesions with a diameter of more than 2 cm are usually more lobulated and heterogeneous. They are located more centrally in the liver and nearly all show a close anatomical relation with 1 of the hepatic veins. Very large lesions (greater than 5 cm) with a heterogeneous and irregular aspect suggest focal nodular hyperplasia, which must be proven by a Tc-isotopic liver scan.
69516.74107786022000.06.06++Tuberculosis: a rare cause of splenic abscess.J Assoc Physicians India
S Sharma, AB Dey, N Agarwal, KM Nagarkar, S Gujral,
Splenic abscess is a rare condition associated with septicemic conditions. Splenic abscess due to tuberculosis is still rarer, mostly diagnosed in immuno-compromised hosts. A case of tubercular splenic abscess without any underlying disease is reported.
69616.7486236201996.06.19++Nonspecificity of short inversion time inversion recovery (STIR) as a technique of fat suppression: pitfalls in image interpretation.AJR Am J Roentgenol
G Krinsky, NM Rofsky, JC Weinreb,
Short inversion time inversion recovery (STIR) and the rapid acquisition with relaxation enhancement (RARE) version of STIR are commonly used pulse sequences that are sensitive enough to detect a broad range of pathologic conditions. In addition to suppressing the signal from fat, the STIR sequence achieves additive T1-weighted, T2-weighted, and proton density-weighted contrast to facilitate lesion conspicuity [1, 2]. Fat suppression with STIR sequences is based on short T1 relaxation rates and therefore is not tissue specific. The signal from any tissue with a short T1, similar to that of fat, may be nulled as well. The signal from tissues that accumulate paramagnetic contrast agents also may be suppressed with STIR sequences when an appropriate degree of T1 shortening results.
69716.7311224941975.06.29++Hypersplenism in advanced breast cancer: report of a patient treated with splenectomy.Cancer
MA Dunn, MI Goldwein,
A patient with widespread metastatic breast cancer had thrombocytopenia and severe anemia due to splenic hyperfunction, confirmed by chromium51-labeled red cell survival and sequestration studies. Marked splenic enlargement was produced by metastatic tumor. After she failed to respond to steroids, her hematologic status was improved by splenectomy, and has been stable for 16 months. Hypersplenism may be suspected as a cause of severe hemolytic anemia in advanced carcinoma. If the patient's general status is otherwise compatible with long comfortable survival, appropriate diagnostic studies and consideration of splenectomy are warranted.
69816.73169290142006.12.20++The role of late-phase pulse inversion harmonic imaging in the detection of occult hepatic metastases.J Ultrasound Med
S Gültekin, C Yücel, H Ozdemir, H Celik, SO Oktar, M Araç,
The purpose of this study was to investigate the efficacy of late-phase pulse inversion harmonic imaging (PIHI) in detecting occult metastases and to compare the results with helical computed tomography (CT) in a group of patients whose fundamental liver sonographic results were normal.
69916.73195790142009.12.08++Small (< or = 2 cm) atypical hepatic haemangiomas in the non-cirrhotic patient: pattern-based classification scheme for enhancement at triple-phase helical CT.Radiol Med
M Scialpi, L Volterrani, MA Mazzei, S Cappabianca, F Barberini, I Piscioli, L Brunese, L Lupattelli,
The aim of this study was to determine by triplephase helical computed tomography (CT) the appearance of atypical small (< or = 2 cm) hepatic haemangiomas (HHs) in the non-cirrhotic patient.
70016.7337550241986.07.22++Peliosis hepatis in the acquired immunodeficiency syndrome.Arch Pathol Lab Med
CA Czapar, CM Weldon-Linne, DM Moore, DP Rhone,
We report two cases of peliosis hepatis in patients with acquired immunodeficiency syndrome. Hepatic tissue, obtained by needle biopsy from one patient and at postmortem examination from a second patient, demonstrated lesions grossly and microscopically consistent with previous descriptions of peliosis. Peliotic lesions were also identified in the spleen and porta hepatis lymph nodes in the second case. In at least one of the cases, peliosis was thought to play a significant role in the patient's morbidity and ultimate demise. Peliosis hepatis should be included in the differential diagnosis of hepatic disease among patients with acquired immunodeficiency syndrome.
70116.7083513441993.09.14++Cerebral sparganosis: MR imaging versus CT features.Radiology
WK Moon, KH Chang, SY Cho, MH Han, SH Cha, JG Chi, MC Han,
Fourteen magnetic resonance (MR) images of 11 patients with cerebral sparganosis were reviewed retrospectively and compared with 13 computed tomographic (CT) scans of 10 of the patients. All patients underwent both nonenhanced and contrast material-enhanced MR imaging. All white matter degenerations, which were slightly hypointense on T1-weighted images and were hyperintense on T2-weighted images, were seen as areas of low attenuation on CT scans. Better contrast between normal and degenerated brain tissues was seen at MR, and two lesions were seen that were missed at CT. The parasitic granuloma was isointense to brain parenchyma on images obtained with all pulse sequences. On two follow-up MR images, location or shape of the enhancing lesions changed, suggesting migration of the worm. A new finding of hyperintensity on T1-weighted images and hypointensity on T2-weighted images in subcortical areas probably due to petechial hemorrhages was demonstrated in eight patients only at MR. Small calcific foci, which were important diagnostic clues of cerebral sparganosis, were detected in four patients only at MR, while they were seen in eight patients at CT.
70216.7091223781997.04.22++Cavernous hemangioma of the liver: pathologic correlation with dynamic CT findings.Radiology
Y Yamashita, I Ogata, J Urata, M Takahashi,
To correlate the pathologic findings of cavernous hemangiomas with enhancement patterns seen at dynamic computed tomography (CT) performed after injection of contrast material.
70316.7088193941996.10.31++Efficacy of sonography as a guidance technique for biopsy of abdominal, pelvic, and retroperitoneal lymph nodes.AJR Am J Roentgenol
DS Memel, GD Dodd, CC Esola,
In the United States, CT is generally considered the guidance technique of choice for biopsy of abdominal, pelvic, and retroperitoneal lymph nodes. The aim of this study was to evaluate the efficacy of sonography for this purpose.
70416.6869799111982.08.26+ CT of hepatic focal nodular hyperplasia.AJR Am J Roentgenol
WA Halbsguth,
70516.6775603201995.11.02++MRI of the anal sphincter.J Comput Assist Tomogr
NM deSouza, R Puni, WA Kmiot, CI Bartram, AS Hall, GM Bydder,
The anal sphincter was imaged with MR using an internal coil to demonstrate its anatomy, contrast enhancement patterns, and appearance in disease.
70616.6790712971997.04.09++Struma ovarii: MR findings.J Comput Assist Tomogr
M Dohke, Y Watanabe, A Takahashi, T Katayama, Y Amoh, T Ishimori, A Okumura, K Oda, K Mitsudo, K Minami, M Ukita, Y Dodo,
The purpose of this study was to determine the MR appearance of struma ovarii correlating with the pathological features.
70716.6682843851994.02.17++Symptomatic hepatic cysts: percutaneous drainage and sclerosis.Radiology
E vanSonnenberg, JT Wroblicka, HB D'Agostino, JR Mathieson, G Casola, R O'Laoide, PL Cooperberg,
To evaluate the authors' experience with treatment of symptomatic hepatic cysts by means of percutaneous catheterization and sclerosis.
70816.65153902312005.02.09++Comparison of dynamic gadolinium-enhanced and ferumoxides-enhanced MRI of the liver on high- and low-field scanners.J Magn Reson Imaging
P Limanond, SS Raman, J Sayre, DS Lu,
To compare the performance of dynamic gadolinium-enhanced and ferumoxides-enhanced MRI in the detection and characterization of hepatic lesions, on 1.5-T and 0.2-T magnets
70916.653915111980.03.24+ [Indications for splenectomy in children and adults].Chirurg
KP Hellriegel, M Gharib, D Helbig, R Gross,
71016.6299221931999.03.03++CT of agenesis and atrophy of the right hepatic lobe.Abdom Imaging
CK Chou, CW Mak, MB Lin, WS Tzeng, JM Chang,
To identify and differentiate agenesis and severe atrophy of the right hepatic lobe on computed tomography (CT).
71116.6078225551995.02.10++Torsion of the wandering spleen: CT and angiographic appearance.J Comput Assist Tomogr
T Fujiwara, Y Takehara, H Isoda, K Ichijo, N Tooyama, N Kodaira, H Kitanaka, T Asai, K Kawaguchi,
To seek CT and angiographic appearances that characterize torsion of the wandering spleen.
71216.5990150631997.02.27++Focal liver lesions: characterization with conventional spin-echo versus fast spin-echo T2-weighted MR imaging.Radiology
W Schima, S Saini, JA Echeverri, PF Hahn, M Harisinghani, PR Mueller,
To compare prospectively the diagnostic accuracy of T2-weighted conventional spin-echo (SE) and fast SE magnetic resonance (MR) imaging for differentiation of benign (hemangiomas or cysts) from malignant (metastases or hepatocellular carcinoma) liver lesions.
71316.58174206382007.06.13++Solitary small hepatic angiosarcoma: initial and follow-up imaging findings.Korean J Radiol
SH Heo, YY Jeong, SS Shin, TW Chung, HK Kang,
We report an uncommon case of solitary, small hepatic angiosarcoma that was initially considered as a hemangioma. We present the imaging findings, with an emphasis on the initial and follow-up CT and MR findings, as well as report on the more suggestive findings of angiosarcoma than those of a hemangioma.
71416.56112599452001.04.19++Frequency of benign hepatic lesions incidentally detected with contrast-enhanced thin-section portal venous phase spiral CT.Acta Radiol
M Völk, M Strotzer, M Lenhart, J Techert, J Seitz, S Feuerbach,
To evaluate the frequency of benign focal hepatic lesions incidentally detected at contrast-enhanced thin-section portal venous phase spiral CT.
71516.55103905631999.09.14++Primary malignant fibrous histiocytoma of the liver: imaging features of five surgically confirmed cases.Abdom Imaging
JS Yu, KW Kim, CS Kim, KH Yoon, HJ Jeong, DG Lee,
The purpose of the present study was to describe the various imaging features of primary malignant fibrous histiocytoma (MFH) of the liver, a rare tumor of mesenchymal origin.
71616.55151130582004.05.25+ Advantages and differences of Resovist towards Gadolinium contrast in MRI with focus on metastatic liver lesions.Eur Radiol
P Reimer, T Balzer,
71716.55200983302010.05.18++Detection and characterization of focal liver lesions: a Japanese phase III, multicenter comparison between gadoxetic acid disodium-enhanced magnetic resonance imaging and contrast-enhanced computed tomography predominantly in patients with hepatocellular carcinoma and chronic liver disease.Invest Radiol
T Ichikawa, K Saito, N Yoshioka, A Tanimoto, T Gokan, Y Takehara, T Kamura, T Gabata, T Murakami, K Ito, S Hirohashi, A Nishie, Y Saito, H Onaya, R Kuwatsuru, A Morimoto, K Ueda, M Kurauchi, J Breuer,
To prospectively evaluate the safety and efficacy of combined unenhanced and gadoxetic acid disodium (Gd-EOB-DTPA)-enhanced magnetic resonance (MR) imaging compared with unenhanced MR imaging and triphasic contrast-enhanced spiral computed tomography (CT) for the detection and characterization of focal liver lesions.
71816.55186031842008.09.17++Detection and characterization of focal hepatic lesions: comparative study of MDCT and gadobenate dimeglumine-enhanced MR imaging.Clin Imaging
HY Lee, JM Lee, SH Kim, KS Shin, JY Lee, JK Han, BI Choi,
The aim of this study was to compare the diagnostic performance of multidetector row helical CT (MDCT) and gadobenate dimeglumine-enhanced magnetic resonance (MR) imaging (in the detection and characterization of focal liver lesions. Two blind reviewers analyzed the MDCT and MR images of a total of 44 malignant and 85 benign lesions in 46 patients independently. Receiver operating characteristic curves were established to analyze the results for each reviewer and modality.
71916.556336551978.05.08+ [Splenic tumors: with special reference to radiological diagnosis. I. Cysts and benign tumors (author's transl)].Rinsho Hoshasen
T Kishikawa, K Matsuura, T Tokunaga, K Mihara, K Watanabe,
72016.54199653022010.03.03++Assessment of malignant liver tumors in children.Cancer Imaging
DJ Roebuck,
Imaging plays a crucial role in the management of a child with a suspected liver tumor. There are various important differences between pediatric and adult practice, and in particular several liver tumor types that are almost never seen in adults are not uncommon in children. The radiologist makes important contributions to the diagnosis through non-invasive imaging and often biopsy. This paper describes imaging tips for the radiologist, including a discussion of the PRETEXT system for staging primary malignant tumors.
72116.5394035391998.01.02++Splenic abscess: another look at an old disease.Arch Surg
GS Phillips, MD Radosevich, PA Lipsett,
To study the changes in the incidence, causes, bacteriologic profile, and management of a splenic abscess.
72216.5217466801992.01.16++Sinusoidal hemangioma. A distinctive benign vascular neoplasm within the group of cavernous hemangiomas.Am J Surg Pathol
E Calonje, CD Fletcher,
Twelve cases of sinusoidal hemangioma, a distinctive subset of the group of lesions known as cavernous hemangioma, are described. All presented as solitary subcutaneous/deep dermal lesions in adults, predominantly females. Five arose on a limb and five on the trunk; two of the latter were situated in mammary subcutaneous tissue. Histologically they were characterized by dilated, interconnecting, thin-walled vascular channels that frequently showed a pseudopapillary pattern. These vessels had a predominantly lobular architecture but peripherally showed focally ill-defined spread into subcutaneous tissue. The lining endothelium was single-layered but showed focal pleomorphism and hyperchromasia, which, combined with the pseudopapillae and apparent infiltrative pattern in areas, raised the possibility of angiosarcoma in four cases, most notably in the breast lesions. This possibility was further suggested by the presence of pseudonecrotic central infarction in two cases. Follow-up in eight cases, however, has revealed no tendency for either local recurrence or metastasis.
72316.5113024631992.07.21++Epithelioid hemangioendothelioma of the liver: imaging findings with pathologic correlation.AJR Am J Roentgenol
WJ Miller, GD Dodd, MP Federle, RL Baron,
Hepatic epithelioid hemangioendothelioma is a rare malignant neoplasm that has nonspecific clinical signs and symptoms and can be difficult to diagnose on the basis of biopsy results. Radiologists may suggest the diagnosis of this slowly progressive neoplasm by recognizing its characteristic radiologic features. We correlated images from CT (13), sonography (nine), and MR (six) with pathologic findings in resected whole livers (eight) and biopsy specimens (five) from 13 patients 25-58 years old. Gross pathologic examination showed a repetitive pattern of multiple solid tumor nodules, in a predominantly peripheral distribution, with coalescence as individual nodules exceeded 4 cm. Tumor nodules had a hyperemic rim. Lesions adjacent to the capsule often produced capsular retraction. These findings correlated well with imaging findings. On CT, the lesions were of low attenuation, peripherally based, and with capsular retraction or flattening in nine (69%) of 13 patients. Unenhanced CT scans showed superior conspicuity over contrast-enhanced CT scans (9/13, 69%) and showed the extent of lesions more accurately in all cases (13/13, 100%). In nine patients, lesions had a peripheral enhancement pattern of alternating attenuation values correlating with the hyperemic rim at pathologic evaluation. On sonograms, the tumors were solid and predominantly hypoechoic. On MR, tumor signal was low on T1-weighted and high on T2-weighted images, with a low-signal halo present around many of the lesions. CT, sonographic, or MR findings of coalescent peripheral hepatic masses with capsular retraction are highly suggestive of hepatic epithelioid hemangioendothelioma.
72416.5018893521991.10.16++[Splenic cysts. Their morphology, diagnosis and therapy].Dtsch Med Wochenschr
MK Walz, KA Metz, FW Eigler,
Over a 10-year period, nine patients (four men, five women, mean age 27 years) underwent surgery for splenic cysts (six epidermoid cysts, two mesothelial cysts and one pseudocyst). Six patients had had suggestive clinical symptoms, but, in the other three, the cysts were only discovered by chance on ultrasound scan. Three of the patients with epidermoid cysts had raised serum concentrations of the tumour markers carcinoembryonic antigen (CEA) or carbohydrate antigen (CA 19-9. All six benign epidermoid cysts contained immunohistochemically demonstrable CEA and/or CA 19-9 in the inner epithelial layer, implying a mesothelial origin for these cysts. In five cases the splenic cysts were completely extirpated (splenectomy in two, hemisplenectomy in one, enucleation in two); in four cases cyst resection was performed, leaving part of the cyst adherent to the spleen. In one of these four patients, a 4 cm cyst persisted postoperatively in the hilus of the spleen, but has remained unchanged over an 8-year period. Splenic cysts are usually benign, despite the presence of tumour markers in the cyst wall, and do not require removal. The only indications for surgical intervention are complications (e.g. rupture), symptomatic cysts or asymptomatic cysts with an increased risk of rupture (diameter greater than 5 cm). The very rare parasitic and infective forms must always be surgically sterilized.
72516.4914981001992.09.17++Splenic cysts in pediatric patients--a report on 8 cases and review of the literature.Eur J Pediatr Surg
PA Musy, B Roche, D Belli, P Bugmann, D Nussle, C Le Coultre,
8 cases of splenic cysts are reported: treatment was surgical in 4 large cysts (greater than 5 cm, 3 epidermoids and 1 pseudocyst), and non-operative in 4 small cysts (less than 5 cm, 3 post-traumatic pseudocysts and 1 congenital cyst, probably epidermoid). Follow-up was over a period of 3 months to 7 years. 3 among the 4 post-traumatic pseudocysts were followed up by ultrasound until resolution (3 months to 3 years), and 1 large pseudocyst was operated on due to rupture following benign trauma. 3 large cysts were epidermoid in origin, 1 was electively operated, and 2 were discovered and operated on because of complications (rupture, infection). Only one total splenectomy was performed; surgery preserved the spleen in all other cases; but 1 epidermoid cyst presents now with a recurrence. Based on this experience, we suggest frozen section of the cyst wall during surgery, to decide the type of partial splenectomy to be performed: total cystectomy or marsupialization.
72616.48111554512001.01.18++[Magnetic resonance imaging of hepatic focal lesions: dynamic contrastographic evaluation with gadolinium versus reticulo-endothelial hepato-specific contrast media].Radiol Med
E Di Cesare, G Cariello, A Barile, M Sabatini, O Michelini, D Erriquez, C Masciocchi,
To compare the potentials of AMI-25 (Endoren) to those of Gadolinium with the dynamic contrast-enhanced technique in the differential diagnosis of focal liver lesions.
72716.45146288772003.12.23++Hepatic and splenic amyloidosis: dual-phase spiral CT findings.Abdom Imaging
PP Mainenti, L D'Agostino, E Soscia, M Romano, M Salvatore,
Although the liver and spleen are frequently involved in primary systemic amyloidosis, the clinical manifestations of hepatic and splenic involvement are usually mild and a dominant symptomatic hepatic presentation is uncommon. We report a case of a 51-year-old woman with giant hepatomegaly, hypertransaminasemia, increase in alkaline phosphatase, and ascites, in whom the findings of dual-phase spiral computed tomography suggested liver and splenic amyloidosis.
72816.4587966161996.11.04+ Clinical evaluation of ultrasmall superparamagnetic iron oxide particles for liver imaging.Acad Radiol
S Saini, RR Edelman, W Li, J Petersein, PF Hahn,
72916.4289392361996.12.26++Effect of the rate of gadopentetate dimeglumine administration on abdominal vascular and soft-tissue MR imaging enhancement patterns.Radiology
PJ Strouse, MR Prince, TL Chenevert,
To delineate dynamic gadopentetate dimeglumine enhancement profiles within the abdomen as a guide to improve gadolinium-enhanced magnetic resonance (MR) angiography.
73016.42146998622004.03.18++[Dose investigation of superparamagnetic iron oxide (SPIO) SH U 555 A in liver MR imaging].Nihon Igaku Hoshasen Gakkai Zasshi
S Hirohashi, T Ichikawa, A Tanimoto, Y Isobe, J Hachiya, K Saito, H Isoda, H Nishimura, R Kuwatsuru, T Gokan, T Murakami, S Nakano, T Seriu,
SH U 555 A, a new superparamagnetic iron oxide (SPIO) contrast agent for liver MR imaging, was investigated in terms of safety and efficacy. Eighty-four patients with suspected malignant liver tumor were randomly allocated to two groups: the L dose group (8 mumol Fe/kg) and H dose group (12 mumol Fe/kg). Efficacy was qualitatively evaluated through blinded reading of the MR images. Assessment of the images revealed no consistent differences between the L and H dose groups. During the 3- to 4-day observation period, a total of 16 adverse events were observed in 11 patients: 8 patients in the L dose group and 3 patients in the H dose group. Nasal bleeding occurred in 2 of these cases in the H dose group 2 and 4 days, respectively, after injection. Although patients in the H dose group showed a significantly larger transient decrease in Coagulation Factor XI at 4-6 hr post-injection (p.i.) than patients in the L dose group, analysis of covariance revealed an estimated 6.5% difference. There was no prolongation of APTT or change in Factor XI at 72-96 hr p.i. Because there were no clinically significant differences between the L and H doses, both were considered to be safe and effective.
73116.4164758961984.10.16++Lymphoma presenting as an abdominal mass involving an ectopic spleen.Am J Gastroenterol
TJ Barloon, C Lu,
We recently evaluated a patient with a huge asymptomatic abdominal mass which eventually proved to be an ectopic spleen. Pathology revealed a well-differentiated lymphoma involving the entire spleen and hilar nodes. Before her operation, a series of radiographic procedures was carried out which demonstrated the nature of the mass. The radiographic findings and diagnostic modalities used to establish the diagnosis form the basis of this report.
73216.4183722001993.10.14++Morton neuroma: evaluation with MR imaging performed with contrast enhancement and fat suppression.Radiology
MR Terk, PK Kwong, M Suthar, BC Horvath, PM Colletti,
To evaluate clinically suspected Morton neuroma with contrast material-enhanced magnetic resonance (MR) images.
73316.4051297561972.02.26+ Hamartoma of spleen associated with thrombocytopenia.J Pathol
CF Ross, KF Schiller,
73416.4017297841992.02.13++Visceral metastases from melanoma: findings on MR imaging.AJR Am J Roentgenol
A Premkumar, L Sanders, F Marincola, I Feuerstein, R Concepcion, D Schwartzentruber,
Typical ocular and CNS melanomas are hyperintense on T1-weighted MR images and hypointense on T2-weighted MR images. We performed MR imaging in 48 patients with melanoma metastatic to visceral organs. Images were reviewed retrospectively in order to determine whether there were predominant MR features specific for visceral melanoma and to see if visceral metastases have MR characteristics similar to metastases in the CNS. Eleven patients also were examined after injection of gadopentetate dimeglumine to evaluate the enhancement characteristics of these tumors. Two hundred sixty-one lesions were found. Lesions were classified according to their signal intensities relative to uninvolved liver on T1-weighted, T2-weighted, and short TI inversion recovery (STIR) pulse sequences. Most commonly, lesions were either hypointense or isointense on T1-weighted sequences and hyperintense on T2-weighted and STIR sequences (185 lesions). Less frequently, lesions were hyperintense on T1-weighted sequences and hypointense or isointense on T2-weighted and STIR sequences (59 lesions). A mixed pattern was seen on T1- and T2-weighted sequences in 17 lesions. The patterns did not correlate with lesion size. Of the three sequences studied by subjective comparison, the STIR sequence in our series had the highest sensitivity for lesion detection and yielded the highest lesion conspicuity. Injection of gadopentetate dimeglumine in 11 patients did not increase either the number or the conspicuity of lesions seen. Our results show that visceral metastases from melanoma have a wide variety of appearances on MR images. The STIR sequence appears to be optimal, and the metastases do not enhance with gadopentetate dimeglumine.
73516.3915474741992.04.20++CT manifestations of infectious mononucleosis.Clin Imaging
AJ Garten, DS Mendelson, KP Halton,
A case of infectious mononucleosis (IM) which, on computed tomography (CT) scan, mimicked the morphologic features of lymphoma is reported. The CT findings in this case include generalized lymphadenopathy, splenomegaly, and focal low-attenuation splenic lesions in a fifty-three year old woman; these findings have not previously been described in patients with IM. This is most likely because IM is usually a clinical diagnosis confirmed by serologic testing. Imaging modalities such as CT scan have not routinely been utilized to support this diagnosis.
73616.3914936521993.03.09++Ultrasonography in traumatic splenic rupture.Clin Radiol
TM Siniluoto, MJ Päivänsalo, FP Lanning, AB Typpö, PK Lohela, AE Kotaniemi,
Ultrasound (US) findings and their significance for the clinical outcome were studied in a series of 56 patients hospitalized with a diagnosis of splenic trauma. US was abnormal in 50 cases (89.3%) on admission, revealing intraperitoneal fluid in 41 (73.2%) and a splenic parenchymal injury and/or subcapsular haematoma in 35 (62.5%). US was abnormal in 24/25 patients undergoing urgent surgery, 23/26 undergoing successful non-surgical treatment and 2/5 patients undergoing delayed surgery within 1 to 3 days of a repeat US (abnormal in all five). The presence of intraperitoneal haemorrhage preoperatively was shown accurately by US in 29 cases (96.7%), and the splenic origin of the haemorrhage in 19 (63.3%). Repeat US was of most value for confirming the diagnosis by demonstrating splenic lesions not visible initially. The need for laparotomy could not be predicted on the basis of the US findings alone, however.
73716.37163174892006.07.18++Torsion of an accessory spleen.Abdom Imaging
R Grinbaum, O Zamir, S Fields, N Hiller,
Torsion of an accessory spleen is extremely rare. We report a case of an acute torsion of an accessory spleen in a young patient who presented with acute left abdominal pain and discuss the computed tomographic findings of this exceptional condition. Awareness of this entity and familiarity with typical imaging findings are mandatory for preoperative diagnosis.
73816.3793408071997.10.23+ [Diagnosis and therapy of splenic abscess exemplified by 3 unusual cases].Rontgenpraxis
H Riediger, WD Schareck, F Pfeffer, KW Sievers, UT Hopt,
73916.3756266981968.08.06+ [On splenectomy in childhood].Wien Med Wochenschr
E Edstadler,
74016.3682200311993.12.07++Hepatic bacillary angiomatosis in a patient with AIDS.Abdom Imaging
SH Wyatt, EK Fishman,
We report a case of bacillary angiomatosis involving the liver in addition to multiple cutaneous sites in a patient with AIDS. Abdominal CT demonstrated multiple, small low-attenuation lesions throughout the hepatic parenchyma. Consideration of this entity in the proper clinical setting is essential since it is a readily treatable infection.
74116.3589646771996.12.04+ [Splenomegaly and portal hypertension of unusual etiology in a 62-year-old patient].Internist (Berl)
J Zahner, H Fischer, F Borchard, U Germing, W Schneider,
74216.34106754602000.04.05++Evaluation of the intratumoral vasculature of hepatocellular carcinoma by power doppler sonography: advantages and disadvantages versus conventional color doppler sonography.Abdom Imaging
K Kubota, N Hisa, Y Fujiwara, M Fukumoto, D Yoshida, S Yoshida,
To determine whether a difference exists in the relative ability of power Doppler sonography and conventional color Doppler sonography to detect the intratumoral vasculature of hepatocellular carcinoma based on lesion size and location.
74316.3277082411995.05.05++[Hemorrhagic pseudocyst of the spleen].Minerva Chir
A Coda, F Ferri, C Filippa, R Vella,
The authors report a rare case of haemorrhagic pseudocyst of the spleen in a 37 years old female who had always enjoyed very good health and who didn't remember any previous chest or abdominal traumas. Due to the initial refusal of the patient to undergo splenectomy, it has been possible to follow pathology progress. An echography of the cyst 6 months later, showed a maximum diameter increase of more than 2 cm and a further thinning of the cyst wall. Afterwards the patient decided to undergo the operation. The spleen showed a hollow of 10 cm of maximum diameter, with a degraded haematic content; the final histological examination confirmed the initial diagnosis of haemorrhagic pseudocyst of the spleen.
74416.32121953082003.03.04++Mesenteric mass in a young girl--an unusual site for Gaucher's disease.Pediatr Radiol
AK Lim, A Vellodi, K McHugh,
We report the first case of a child with Gaucher's disease and a large mesenteric mass, confirmed histologically to be Gaucher's cell infiltrates. We describe the radiological findings and discuss further management. The advent of enzyme replacement therapy has prolonged survival and the emergence of previously undocumented manifestations of the disease is being observed. The radiologist and clinician should be alert to the possible development of these new problems and the fact that in Gaucher's disease a palpable right upper-quadrant mass need not necessarily represent hepatomegaly.
74516.3296063761998.06.18++Von Meyenburg complexes of the liver: imaging findings.J Comput Assist Tomogr
TY Luo, Y Itai, N Eguchi, Y Kurosaki, H Onaya, Y Ahmadi, M Niitsu, HS Tsunoda,
Our purpose was to present imaging findings of six cases proven or supposed to be von Meyenburg complexes (VMCs) with a basis of reviewing the pathologic literature and to describe imaging points for the diagnosis of typical VMC along with its differential diagnosis.
74616.2764702521984.10.25++Abdominal computed tomography in children with unexplained prolonged fever.J Comput Assist Tomogr
D Picus, MJ Siegel, DM Balfe,
Twenty-eight children with unexplained fever lasting at least 1 week were referred for CT of the abdomen. Of the 28 patients, 22 had clinical and radiographic findings localizing disease to the abdomen prior to CT. In these 22 patients CT correctly detected an abnormality in 19 of 22 (86%) and favorably affected therapy in 13 of 22 (59%). In the six patients without localizing findings CT was abnormal in two and normal in four. Computed tomography was correct in all six patients and favorably affected management in two patients. Our results suggest that in children with fever and findings localizing disease to the abdomen--especially the retroperitoneum--CT is helpful in diagnosing a wide variety of lesions, as well as influencing therapy. If no localizing signs are present, CT has a relatively lower yield.
74716.25166321612006.07.20++Imaging findings of retroperitoneal lymphangiomyomatosis in a patient with lymphoma.Clin Imaging
YL Wan, LY Shih, SF Ko, MC Kuo, SH Ng,
A 31-year-old female with lymphoma was incidentally found to have a left retroperitoneal lymphangiomyomatosis (LAM). The tumor was proved by pathology and immunohistochemical study of the tissue specimen obtained by ultrasound-guided core needle biopsy. The characteristic sonographic, computed tomographic, magnetic resonance imaging, and positron emission tomographic (PET) features of this unusual lesion were described. It was managed conservatively and remained stable on 2-year follow-up study. LAM should be considered in the differential diagnoses in cases of a retroperitoneal solid mass with cystic components.
74816.2518520381991.06.27++[Diffuse liver parenchymal diseases: the value of MRI compared to sonography and CT].Rofo
T Vogl, S Steiner, D Hahn, H Schedel, J Lissner,
29 patients with diffuse liver disease were examined by ultrasound, CT and MRI. MRI imaging was performed using T1-and t2-weighted spin-echo-sequences and fast gradient-echo-sequences. The paramagnetic contrast agent Gd-DTPA was applied intravenously (0.1 mmol/kg). In all patients with hepatitis MRI enabled exact liver biopsy by delineation of inflammatory changes in cases of chronic or focal hepatitis. CT and ultrasound were superior to MRI in the detection of focal or diffuse fatty degeneration. However, MRI enabled an exact differentiation of fatty changes from neoplasm. In cases of fibrotic changes the most accurate findings could be shown by MRI. In patients suffering from hemochromatosis MRI supplied additional information compared to CT and ultrasound revealing significant reduction of signal intensity due to reinforced enhancement of iron. Concerning Wilson's disease MRI showed a characteristic pattern of parenchymal changes. The application of Gd-DTPA in cases of diffuse liver disease adds supplementary information about perfusion of liver parenchyma, but its value for diagnostic accuracy is only secondary.
74916.2583312311993.08.13++MRI of primary lymphoma of the liver.J Comput Assist Tomogr
T Fukuya, H Honda, S Murata, K Yasumori, T Hayashi, H Ishibashi, T Matsumata, K Masuda,
The MR findings in two cases of primary lymphoma of the liver (PLL) are presented.
75016.2584514011993.04.14++Bladder tumors: staging with gadolinium-enhanced oblique MR imaging.Radiology
Y Narumi, T Kadota, E Inoue, K Kuriyama, M Fujita, N Hosomi, Y Sawai, M Kuroda, T Kotake, C Kuroda,
To clarify the importance of imaging plane in evaluation of invasion by tumor into muscle, 50 patients with bladder tumors underwent examination with magnetic resonance (MR) imaging performed with an oblique plane and the early phase of contrast enhancement. After the ideal oblique plane was selected, an oblique T2-weighted image was obtained. Gadopentetate dimeglumine was then administered, and an oblique T1-weighted image was obtained. The staging based on oblique T2-weighted and oblique contrast material-enhanced T1-weighted MR images was then correlated with histopathologic staging. The respective accuracies of oblique contrast-enhanced T1-weighted and oblique T2-weighted images were 78% and 60% for overall staging (P < .05), 90% and 74% for differentiation between (a) stage T1 and lower-stage tumors and (b) stage T2 and higher-stage tumors (P < .05), and 92% and 88% for differentiation between (a) stage T2 and lower-stage tumors and (b) stage T3a and higher-stage tumors (P > .05). Oblique MR imaging performed in conjunction with the early phase of contrast enhancement showed significantly high staging accuracy, especially in differentiation between superficial tumors and tumors with superficial muscle invasion.
75116.2379727901994.12.21+ Liver MR imaging with iron oxides: toward consensus and clinical practice.Radiology
R Weissleder,
75216.22111673272001.02.08++MR and other imaging methods in the investigation of mycetomas.Acta Radiol
J Czechowski, M Nork, D Haas, G Lestringant, L Ekelund,
To report features of mycetomas (actino- and eumycetoma infection), which belong to the so-called rare bone infections, as evaluated by MR and other imaging methods and to assess chemotherapy treatment.
75316.2119650251991.05.23++[Dynamic MRI of liver tumors--evaluation by inversion recovery snap shot FLASH MR imaging].Nihon Igaku Hoshasen Gakkai Zasshi
T Murakami, T Mitani, M Nishikawa, K Nakanishi, T Marukawa, K Harada, K Tokunaga, C Kuroda, T Kozuka,
We have studied 20 patients with liver tumor (hepatoma 12, hemangioma 6, metastatic tumor 2) using inversion recovery snap shot FLASH dynamic MR imaging. After intravenous injection of Gd-DTPA, serial 17 images were obtained during 7 minutes. Hepatoma showed central enhancement on early phase (0-20 sec) in 11 patients and absent or less enhancement than surrounding liver parenchyma on late phase (1-3 min) in 12 patients. Hemangioma showed peripheral enhancement on early phase in 6 patients, and slight to moderate enhancement on late phase in 5 patients. Peripheral slight enhancement were seen on late and delayed (5-7 min) phase in two patients with metastatic liver tumor. These characteristic enhancement patterns should facilitate differential diagnosis of liver tumors.
75416.2121751551991.01.24++[Hepatic involvement in AIDS. A retrospective clinical study in 71 patients].Ann Med Interne (Paris)
P Astagneau, C Michon, C Marche, AM Simonpoli, PM Girard, S Kernbaum, JP Coulaud, AG Saimot,
In order to determine the extent of liver abnormalities occurring during acquired immunodeficiency syndrome, the available histological analyses of liver samples (32 biopsies, 52 autopsies) from 71 AIDS patients, for the period 1982-1986, were studied retrospectively. Hepatomegaly was the most common clinical symptom (23 patients, 32.4%), while jaundice was rare, being seen in only 5 cases (7%). Progressive anicteric cholestasis was the most frequently observed biological anomaly (29/52, 55.7%). Ten patients had liver infections: 2 Mycobacterium tuberculosis, 8 Mycobacterium avium intracellulare. Cytomegalovirus was present in 3 patients and 1 individual was infected with Cryptococcus neoformans. Granulomatous hepatitis was associated with these infectious agents in 11 patients, but remained unexplained in 11 others. Three patients had cholangitis (2 with CMV inclusions, 1 unexplained). Among the 32 biopsies, 5 elucidated the origin of unexplained fever. Kaposi's sarcoma of the liver was found in 10/52 autopsy samples (19%) and hepatic lymphoma in 2 cases. Non-specific histological lesions were common: inflammation of the portal spaces (48 cases, 67.6%), steatosis (32 patients, 45%), peliosis hepatis (9 cases, 12.6%) and sinusoidal dilations (39 cases, 54.9%).
75516.21128116982003.08.13++[Characterization of focal liver lesions with contrast-enhanced low MI real time ultrasound and SonoVue].Rofo
J Hohmann, J Skrok, R Puls, T Albrecht,
SonoVue is a new microbubble ultrasound contrast agent that for the first time allows continuous real time examination during the different phases of contrast enhancement using low transmission power, expressed as mechanical index (MI). This study investigates whether low MI real time phase inversion imaging with SonoVue can improve the characterization of focal liver lesions in comparison to unenhanced sonography and power Doppler sonography.
75616.19124833872003.04.22++Portal vein aneurysm of the umbilical portion: imaging features and the relationship with portal vein anomalies.Abdom Imaging
DM Yang, MH Yoon, HS Kim, W Jin, HY Hwang, SW Cho, HS Kim,
We evaluated the imaging features of portal vein aneurysm occurring at the umbilical portion and the relation between portal vein aneurysm of the umbilical portion and portal vein anomaly.
75716.1985080751993.07.14++Contrast enhancement of the gastrointestinal tract on MR images using intravenous gadolinium-DTPA.Abdom Imaging
SA Mirowitz,
Gadopentetate dimeglumine was administered intravenously to 16 patients undergoing abdominal magnetic resonance (MR) imaging. T1-weighted and fat-suppressed T1-weighted images were acquired before and after intravenous administration of 0.1 mmol/kg gadopentetate dimeglumine. The stomach, small bowel, and colon were analyzed regarding the presence and relative intensity of contrast enhancement. Diffuse enhancement of the gastrointestinal tract wall was observed in all patients following contrast material administration. Such enhancement was most conspicuous on fat-suppressed T1-weighted images. Quantitative measurements indicated that the wall of the gastrointestinal tract enhanced approximately 100% with gadopentetate dimeglumine. This study demonstrates that enhancement of the normal gastrointestinal tract occurs routinely when intravenous gadopentetate dimeglumine is administered, and such enhancement should not be considered indicative of gastrointestinal pathology. Furthermore, it suggests the potential utility for using intravenous rather than orally administered contrast agents to provide enhancement of the gastrointestinal tract on MR images.
75816.1620279761991.06.13++Intraarterial portography with gadopentetate dimeglumine: improved liver-to-lesion contrast in MR imaging.Radiology
P Pavone, S Giuliani, G Cardone, R Occhiato, P Di Renzi, GA Petroni, C Buoni, R Passariello,
Magnetic resonance imaging during arterial portography (MRAP) was performed by the authors in a selected group of 12 patients with hepatic lesions. A low dose of gadopentetate dimeglumine (4 mL of a 0.5-mol/L solution, corresponding to a dose of 0.05-0.07 mmol/kg) was injected into the superior mesenteric artery during acquisition of breath-holding gradient-echo or rapid acquisition spin-echo images. Images were always acquired during the first passage of gadopentetate dimeglumine through the liver parenchyma. An increase in liver-to-lesion contrast was obtained with MRAP imaging (contrast-to-noise ratio = 8 +/- 1.8 vs 19 +/- 2.7). Signal intensity enhancement of the liver was high (signal-to-noise ratio = 9.48 +/- 2.42), while the lesion presented no significant enhancement (signal-to-noise ratio = 0.55 +/- 0.22). Lobar portal vein thrombosis was detected in one patient owing to lack of enhancement of the left lobe of the liver. No side effects related to administration of iodinated and paramagnetic contrast agents were observed. This new technique provides specific enhancement of liver parenchyma with improved liver-to-lesion contrast.
75916.1580614531994.09.20++MR imaging of soft-tissue masses: role of gadopentetate dimeglumine.J Magn Reson Imaging
RA Benedikt, JS Jelinek, MJ Kransdorf, RP Moser, BH Berrey,
To assess the effectiveness of gadopentetate dimeglumine in the magnetic resonance (MR) imaging evaluation of soft-tissue masses without osseous involvement, 30 patients underwent MR imaging before and after administration of contrast material (0.1 mmol/kg). Of the 30 lesions, 22 were benign and eight were malignant; histologic confirmation was available in all lesions except one benign lesion. Overall, enhancement was detected in 26 (87%) of 30 lesions: 18 (82%) of the 22 benign lesions and eight (100%) of eight malignant lesions. Enhancement was characterized as homogeneous (two [11%] benign lesions, two [25%] malignant lesions), inhomogeneous (11 [61%] benign lesions, six [75%] malignant lesions), or peripheral (five [28%] benign lesions, no malignant lesions). Of the 19 lesions assessed for a change in enhancement over time, seven (37%) showed an increase and two (11%) showed a decrease in signal intensity. The authors conclude that benign and malignant soft-tissue lesions could not be differentiated solely on the basis of enhancement (pattern, degree, or time course).
76016.14170490032006.11.30+ [Metachronous splenic metastasis from colon cancer. An infrequent case].Rev Esp Enferm Dig
L Lobato, J Pérez-Lara, FJ Moreno, H Oliva,
76116.141754581976.04.23++[Evaluation of the involvement of the spleen in Hodgkin's disease].
M Monconduit, H Piguet,
In the light of personal data and 60 cases in the literature, the authors attempt to evaluate the risk of splenic involvement during Hodgkin's disease. Neither clinical examination nor scintiscanning of the spleen, permit one with sufficient security to recognise splenic involvement. Study of the context reveals, on the contrary, that the following factors contribute to the splenic risk: --Signs of evolutivity: their presence implies splenic involvement in 63% of cases; --the histological type of the frequency of the splenic involvement increases from type 1 (38%) to type 4 (61%); --the distribution of the lymph nodes above the diaphragm, the spleen is involved in 66% of forms with cervical and mediastinal and axillary lymph node involvement, 56% in forms with cervical and axillary nodes alone and 24% in forms with cervical and mediastinal nodes alone; --the data obtained by lymphography, as 89% of patients with lumboaortic gland involvement, also had invasion of the spleen. There may be errors of interpretation of lymphography, depending on the series, of from 6 to 25%. Thus, assessment of the risk of splenic involvement in Hodgkin's disease is carried out less on the splenic signs themselves, than on the clinical, laboratory, histological and radiological context.
76216.1377420571995.06.15++[Periportal adenitis secondary to abdominal tuberculosis. A CT study].Rev Esp Enferm Dig
A Iglesias Castañón, FJ Lecumberri Olaverri, M Arias González, JI Bilbao Jaureguizar, F Idoate Saralegui,
Isolated periportal tuberculous adenitis is rare. Computed tomography (TC) is the primary modality for its detection and evaluation. Although not definitive, in the presence of an appropriate clinical history and a positive purified protein derivative test, a diagnosis of periportal tuberculous lymphadenopathy may be suggested by CT by the presence of low-density enlarged porta hepatis lymph nodes with immediate postcontrast peripheral rim enhancement.
76316.1380755581994.10.06++Leiomyosarcoma of abdominal veins: value of MRI with gadolinium DTPA.Abdom Imaging
KM Cyran, PJ Kenney,
Primary leiomyosarcomas of the retroperitoneum are rare tumors, the vast majority of which are malignant. Prognosis is largely dependent upon adequacy of surgical resection. Magnetic resonance imaging (MRI) is ideally suited to the evaluation of these neoplasms because of multiplanar imaging capability, inherent signal intensity differences of tissues, and flow-void, flow enhancement techniques to assess vessel patency. Recent advances which include fat suppression, suspended respiration sequences, and Gadolinium enhancement, have further improved image quality. Accurate pre-operative assessment of tumors is possible with MRI.
76416.12120662472002.08.09++Abdominal lymphoma: differentiation from pancreatic carcinoma with Doppler US.Abdom Imaging
H Ishida, K Konno, J Ishida, H Naganuma, T Komatsuda, M Sato, S Watanabe,
Marked lymphadenopathy around the pancreas due to lymphoma (abdominal lymphoma) occasionally can mimic a total pancreatic carcinoma on ultrasonography (US). We investigated whether US and color Doppler US allowed differentiation between those pathologies.
76516.1266082461984.04.13++Percutaneous drainage of abdominal fluid collections in children.AJR Am J Roentgenol
P Stanley, JB Atkinson, BS Reid, V Gilsanz,
Percutaneous drainage of intraabdominal fluid collections was performed in 13 children. After initial diagnosis with either sonography or computed tomography, a smallbore aspiration needle (22 gauge) was guided into the collection, usually by sonography. In five patients, complete evacuation was possible using the aspirating needle alone. In seven others, the fluid was successfully drained via a catheter introduced percutaneously. In one patient, surgery was required for complete evacuation of a hematoma containing large blood clots. There were no complications.
76616.1067099011984.05.11++Percutaneous drainage of 250 abdominal abscesses and fluid collections. Part I: Results, failures, and complications.Radiology
E vanSonnenberg, PR Mueller, JT Ferrucci,
The results of 250 percutaneous abscess and fluid drainage procedures are summarized. In 209 cases, operation was avoided and the patients were cured (83.6%). Partial success was achieved in 18 of 41 recurrences and failures; in these patients, operation was necessary, although the patient benefited from the percutaneous drainage. Cures and partial successes totaled 227/250 (90.8%). Noninfected collections were successfully drained in 31/43 cases. There were 21 failures (8.4%) and 20 recurrences (8%). These were most often due to fistulae, phlegmons, organized tissue, or underlying tumor. Twenty-six patients experienced complications (10.4%), seven of which were major (2.8%). Analysis and corrective measures for these problems (failure, recurrence, complication) and intraprocedural difficulties are discussed.
76716.1089669551996.12.16+ [Pseudocysts of the spleen].Vestn Khir Im I I Grek
AG Grintsov, AP Mustiats, SA Kriukov, VA Lykov,
76816.09169993192006.10.31++CT and MR imaging of gastrointestinal tuberculosis.JBR-BTR
AI De Backer, KJ Mortelé, BL De Keulenaer, L Henckaerts, L Verhaert,
The purpose of this study was to describe the CT and MR imaging findings of tuberculosis of the gastrointestinal tract. Abdominal and pelvic CT scans and MRI studies of 6 patients with histopathological and microbiological proven intestinal tuberculosis were reviewed by two radiologists in consensus. Location and pattern of bowel wall involvement, signal intensities in relation to the normal bowel wall, pattern of enhancement and associated abdominal abnormalities were evaluated. Gastrointestinal tract tuberculosis may be limited to one bowel segment, with the cecum and ileocecal valve as the predominant site of disease, or may involve multiple bowel segments. Asymmetric thickening of the bowel wall is a common finding. Associated findings include pericecal and mesenteric fat stranding, regional lymphadenopathy showing peripheral, heterogeneous and/or homogeneous enhancement patterns and less commonly, tuberculous 'dry plastic' peritonitis. On magnetic resonance (MR) imaging, tuberculous bowel involvement results in intermediate decreased signal intensities on T1-weighted images, and intermediate increased, slight heterogeneous signal intensities on T2-weighted images. On contrast-enhanced images, slight heterogeneous enhancement is seen.
76916.0981280481994.04.13++Malignant vascular tumors of the liver: radiologic-pathologic correlation.Radiographics
PC Buetow, JL Buck, PR Ros, ZD Goodman,
Although benign vascular tumors of the liver are extremely common (hemangioma is the most common), malignant vascular tumors of the liver are very rare. In the adult, these tumors are angiosarcoma, epithelioid hemangioendothelioma, and Kaposi sarcoma. All hepatic malignant vascular tumors share histologic characteristics, grow around and into vessels, and are grossly multifocal. They may be misdiagnosed histologically, particularly if only a biopsy sample is available. Although imaging findings are often non-specific, some features are suggestive or even characteristic of these neoplasms. Such features include previous exposure to thorium dioxide (Thorotrast) in cases of angiosarcoma, coalescence of multiple nodules into large peripheral masses in epithelioid hemangioendothelioma, and association between acquired immunodeficiency syndrome and cutaneous involvement in Kaposi sarcoma. Because hepatic malignant vascular tumors are often multiple, the main differential diagnosis is metastatic disease. There is no effective treatment for these tumors, and although survival time is variable, the prognosis is generally unfavorable.
77016.0884316911993.03.18++Focal nodular hyperplasia of the liver: radiologic findings.Abdom Imaging
K Shamsi, A De Schepper, H Degryse, F Deckers,
A retrospective analysis of the results of ultrasound (US), computed tomography (CT), and magnetic resonance imaging (MRI) of 24 cases (28 lesions) of proven focal nodular hyperplasia (FNH) is presented. While US exhibited nonspecific features, CT frequently showed characteristic features: hypodensity on precontrast scans (69%), transient immediate enhancement after bolus injection (96%), and homogeneity (85%). A scar was noted in 31% of the cases. The typical MR triad of isointensity on T1- and/or T2-weighted (T2-WI), homogeneity, and a scar which shows hyperintensity on T2-WI was seen in only 12% of our cases. The most common finding was homogeneity (94%). In two cases the scar was hypointense on T2-WI. To our knowledge, this finding has not been described before. We conclude that the features of FNH, although fairly constant, are at times indistinguishable from those of other hepatic tumors, such as hepatic adenoma (HA), fibrolamellar hepatocellular carcinoma (FLHCC), small hepatocellular carcinoma, and a hyperplastic nodule. Therefore, a multimodality approach is essential for the correct diagnosis in order to prevent unnecessary surgery.
77116.0718469941991.03.14++Improved detection and delineation of head and neck lesions with fat suppression spin-echo MR imaging.AJNR Am J Neuroradiol
RD Tien, JR Hesselink, PK Chu, J Szumowski,
To compare conventional and fat suppression MR imaging in their ability to detect head and neck lesions, we prospectively studied 17 patients with head and neck tumors and one normal volunteer. Five patients had benign tumors (one mixed cell tumor, one hemangioma, one lipoma, and two plexiform neurofibromas), 10 had malignant tumors (six squamous cell carcinomas, two minor salivary gland carcinomas, one lymphoma, and one malignant fibrous histiocytoma), and two had nonspecific lymphadenopathy. All subjects were studied with standard spin-echo T1- and T2-weighted images (T2-weighted imaging was done with and without fat suppression technique). In addition, T1-weighted images with contrast enhancement and fat suppression were obtained in nine patients. A four-point grading system was used for comparison of the conventional and fat suppression images. Grades ranged from 0 (unsatisfactory, the lesion cannot be seen) to 3 (excellent, the lesion and its margins can be seen clearly with sharp contrast from surrounding normal tissue). We found that postcontrast fat suppression T1-weighted images and fat suppression T2-weighted images were most useful; these sequences obtained an average score close to grade 3 (2.77 and 2.85, respectively). On the other hand, the conventional T2-weighted images had an average score of about 2 (1.82) and the conventional T1-weighted image had a score of about 1 (1.33). Fat suppression T2-weighted sequences generally were superior in cases of lymphadenopathies. Postcontrast T1-weighted images were most useful in a case of plexiform neurofibroma, owing to their fibrous component and lower proton density.(ABSTRACT TRUNCATED AT 250 WORDS)
77216.0716330421992.08.25++Gd-DTPA-enhanced MR imaging of pituitary macroadenomas.Acta Radiol
P Lundin, K Bergström,
In a study comprising 40 patients with pituitary macroadenomas, MR imaging was performed before and after administration of Gd-DTPA. Before contrast administration T1- and T2-weighted images were obtained, and after the injection, frontal and/or sagittal T1-weighted images. Tumour extension and delineation, relationship to adjacent structures, and signal intensity patterns were evaluated. Compared with pre-contrast T1-weighted images only, post-contrast images provided considerable additional information, but not infrequently this information could also be extracted from pre-contrast T2-weighted images. Post-contrast images were superior regarding the tumour relationship to the cavernous sinus and to the normal pituitary tissue. T2-weighted images were helpful in the diagnosis of degenerative changes, in particular intratumoural haemorrhage. A positive correlation was found between the T2 value (from dual echo sequences) and the degree of enhancement in areas with an appearance of solid tumour tissue, and the enhancement was significantly lower in GH-secreting tumours than in non-secreting ones. It is concluded that the use of Gd-DTPA is often justified in pituitary macroadenomas, particularly in pre-operative evaluation.
77316.0475201821994.09.13++Initial clinical experience with dextran-coated superparamagnetic iron oxide for detection of lymph node metastases in patients with head and neck cancer.Radiology
Y Anzai, KE Blackwell, SL Hirschowitz, JW Rogers, Y Sato, WT Yuh, VM Runge, MR Morris, SJ McLachlan, RB Lufkin,
To investigate the efficacy of magnetic resonance (MR) imaging with dextran-coated superparamagnetic iron oxide in the differentiation of metastatic and benign nodes in patients with head and neck cancer.
77416.0478908561995.04.20++Primary thyroid lymphoma: evaluation with US, CT, and MRI.J Comput Assist Tomogr
S Takashima, N Nomura, Y Noguchi, F Matsuzuka, T Inoue,
Our goal was to determine the most effective radiologic workup in diagnosing and staging primary thyroid lymphomas and the value of knowing the extent of tumors for prognostic purposes.
77516.0332817831988.05.23++Fungal liver abscesses in acute leukaemia--a report of two cases.Clin Radiol
AJ Maxwell, H Mamtora,
The radiological findings in two cases of hepatic fungal microabscesses (one with concomitant splenic involvement) occurring in children with acute leukaemia are presented, and the previous literature is reviewed. Usually both liver and spleen are involved, though either organ may be affected in isolation. Typical ultrasound features include hepatosplenomegaly with multiple hypoechoic areas throughout the liver and spleen, often with a 'target' configuration. Computed tomography shows these as multiple non-enhancing low attenuation lesions. These findings in a patient with acute leukaemia are strongly suspicious of fungal infection, and percutaneous fine-needle aspiration under ultrasound or computed tomography-guidance is indicated.
77616.0217397761992.03.25++["Surgical projection" in the gadolinium-DTPA (Gd-DTPA)-supported NMR tomographic diagnosis of lateral lumbar disk prolapse].Rofo
U Tosch, R Baerwald, P Schubeus, B Sander, WR Lanksch, W Schörner, R Felix,
In a group of 25 patients the coronal views of plain and Gd-DTPA-enhanced MRI studies were correlated with CT and operative findings. All series included sagittal, transverse and coronal FLASH sequences (GE 500/6, flip angle 70 degrees), sagittal proton density-(SE 2500/15) and T2-(SE 2500/70) weighted images. MR diagnosis proved to be correct in all cases. Compared to CT and axial MRI herniated disk material in the lateral intravertebral space and its relationship to nerve roots was demonstrated more clearly on coronal views.
77716.0129580311987.10.26++Lymphography and abdominal computed tomography in the staging of non-Hodgkin lymphoma. With an analysis of discrepancies.Acta Radiol
SP Strijk,
Ninety-one patients with non-Hodgkin lymphoma (NHL) were subjected to computed tomography (CT) and lymphography. Both examinations agreed in 74 patients (81%) with regard to the infradiaphragmatic lymph nodes. In patients undergoing CT prior to lymphography, the concordance amounted to 75 per cent. When lymphography was the initial examination, the concordance amounted to 86 per cent. Lymphography was abnormal in 30 per cent of the patients with a normal CT scan and in 93 per cent of those with an abnormal CT scan as the first examination. CT was abnormal in 4 per cent of patients with a normal lymphogram and in 84 per cent of those with an abnormal lymphogram as the first examination. CT did not detect mesenteric or retrocrural lymph node enlargement in the absence of retroperitoneal lymph node involvement. Eleven patients had extranodal manifestations of the disease (excluding liver and spleen), and 3 were detected primarily with CT. Lymphography is the most complete examination for the infradiaphragmatic lymph nodes for staging purposes. Although CT outlined the disease better, it changed the lymphographic diagnosis in only 2 per cent of the patients. Lymphography modified the CT stage in 15 per cent of the patients. When abdominal CT is performed first, in staging patients with NHL, lymphography will only yield additional information when CT is normal or equivocal.
77816.01216032932011.09.27++Diagnosing small hepatic cysts on multidetector CT: an additional merit of thinner coronal reformations.Korean J Radiol
SH Hwang, JS Yu, JJ Chung, JH Kim, KW Kim,
We wanted to validate the additional merit of the thinner coronal reformation images from multidetector CT (MDCT) for making the diagnosis of hepatic cysts.
77916.0088555851996.12.05+ A case of splenic cyst.J Indian Med Assoc
T Das, P Gupta, N Bommaya, AK Roy, A Basu, S Bhattacharya, S Sanyal, S Dasgupta,
78015.98104522481999.09.29++Dermoid cyst of the spleen: report of a case.Surg Today
A Nakao, S Saito, T Yamano, N Takakura, H Isozaki, K Notohara, N Tanaka,
A rare splenic dermoid cyst in an 11-year-old girl is reported herein. The patient was referred to us with the chief complaint of acute-onset abdominal pain. The lesion was demonstrated by ultrasonography, computed tomography, and magnetic resonance imaging to be a cystic lesion containing serous fluid. A splenectomy was performed. Both histopathological and immunohistochemical findings demonstrated the cyst to be a dermoid cyst of the spleen. To avoid the risk of infection following splenectomy, polyvalent pneumococcus vaccine was administered. The patient recovered uneventfully. We performed immunohistochemical studies with cytokeratin and electron microscopy to determine the origin of the cyst.
78115.98113234722001.05.17++Liver lesion conspicuity: T2-weighted breath-hold fast spin-echo MR imaging before and after gadolinium enhancement--initial experience.Radiology
YY Jeong, DG Mitchell, GA Holland,
To evaluate the effect of a gadolinium chelate on T2-weighted breath-hold fast spin-echo magnetic resonance images of focal hepatic lesions.
78215.9784397581993.04.01++MR imaging in intracystic hemorrhage of simple hepatic cysts.Abdom Imaging
V Vilgrain, O Silbermann, JP Benhamou, H Nahum,
Intracystic hemorrhage of simple hepatic cysts is one of the most frequent complications. Ultrasonography (US) and computed tomography (CT) may show abnormal findings and mimic other diseases. We describe magnetic resonance (MR) imaging in four patients with intracystic hemorrhage confirmed by surgery or percutaneous aspiration. In all cases the lesions were hyperintense on both T1- and T2-weighted sequences. In three of the four cases the signal was heterogeneous on T1-weighted sequences. Two cases of a thickened wall and one case of a fluid-fluid level were also observed. We suggest that MR imaging may be helpful to differentiate intracystic hemorrhage from other cystic lesions by showing high signal on T1- and T2-weighted sequences.
78315.9687979231996.10.16++Ultrasound and MR findings in acute Budd-Chiari syndrome with histopathologic correlation.J Comput Assist Tomogr
TC Noone, RC Semelka, JT Woosley, ED Pisano,
This report describes the sonographic and MR appearances of acute Budd-Chiari syndrome (BCS) in a 30-year-old woman. Current imaging techniques including duplex Doppler sonography and dynamic gadolinium-enhanced MRI were employed, and direct histopathologic correlation was made. Duplex Doppler sonography revealed a heterogeneous enlarged liver, no flow in the left and middle hepatic veins, and only trace abnormal flow in the distal-most right hepatic vein. Dynamic serial gadolinium-enhanced, spoiled gradient echo imaging demonstrated early homogeneous enhancement of an enlarged caudate lobe, as well as heterogeneously decreased enhancement of the remainder of the hepatic parenchyma. This differential enhancement pattern persisted on delayed imaging. Patent hepatic veins were not demonstrated on any sequence. Associated findings included hepatomegaly, ascites, and patent portal vasculature. These imaging findings were interpreted as consistent with acute BCS. Within 10 days, the patient underwent orthotopic liver transplantation. Histopathology demonstrated hepatic necrosis and hepatic venous thrombosis consistent with acute BCS.
78415.9516462331991.07.17+ Splenic lymphangioma: report of two cases.J Clin Ultrasound
N Tsurui, H Ishida, P Morikawa, N Ishii, T Hoshino, O Masamune,
78515.9484547631993.04.19++Gadolinium enhancement in the center of a spinal epidural hematoma in a hemophiliac.J Comput Assist Tomogr
KS Caldemeyer, R Mocharla, CC Moran, RR Smith,
Spinal epidural hematoma (SEH) is an uncommon complication of hemophilia. It is a neurologic and neurosurgical emergency and prompt diagnosis is imperative. The utility of MRI in the diagnosis of hemorrhage is well established. We present a case of an SEH in a hemophiliac patient that demonstrated gadolinium enhancement.
78615.9396408761998.07.29++CT findings in splenic tuberculosis.J Belge Radiol
Y Wang, G He, W Zhan, H Jiang, D Wu, D Wang, A Tang,
Splenic tuberculosis is rare and delay in diagnosis is common. We present two cases of splenic tuberculosis with their appearance on CT. The CT findings were multiple, round or ovoid, low-density lesions without calcification. Except for non-specific lymphadenopathy no abnormality nor history suggestive of tuberculosis was revealed prior to laparotomy. Although CT does not confirm a diagnosis of splenic tuberculosis, it would be a valuable examination to define the extent of disease and guide aspiration biopsy.
78715.92120198832003.01.03+ Characterizing liver hemangiomas on ferumoxides-enhanced dynamic TI-weighted imaging: preliminary experience.Acad Radiol
D Sahani, S Saini, R Sharma, M O'Malley, M Harisinghani, PF Hahn, PR Mueller,
78815.9119397641991.12.04+ Splenic hemangiomatosis: CT and MR features.J Comput Assist Tomogr
P Peene, G Wilms, L Stockx, H Rigauts, P Vanhoenacker, AL Baert,
78915.9140911831986.03.07++Vascular tumors of the breast. II. Perilobular hemangiomas and hemangiomas.Am J Surg Pathol
MA Jozefczyk, PP Rosen,
Nearly 100 vascular tumors of the breast have been studied. Sixty-two were angiosarcomas lesions. Twenty-four patients with mammary hemangiomas are the subject of this report. Five of 11 microscopic perilobular hemangiomas, not clinically apparent (2 mm or less), were atypical and had nuclear hyperchromasia or focal anastomoses among vascular channels. Whether treated by excision or mastectomy, all 11 patients remain well with follow-up of up to 10 years. Fourteen clinically or grossly apparent macroscopic hemangiomas (0.3-2.5 cm) included eight characterized as cytologically atypical. With one exception, lesions designated hemangiomas were well circumscribed and tended to be divided into lobules. In more than half, origin from large, non-neoplastic "feeding" vessels that were seen branching into the lesion was demonstrated. Whether treated by excision or mastectomy, no hemangioma has recurred after follow-up, up to 5 years in some cases. The diagnosis of vascular tumors of the breast requires thorough microscopic study of the entire lesion. The majority are angiosarcomas. However, about one-third constitute a spectrum of apparently benign and atypical lesions, in which the single largest group are perilobular hemangiomas and hemangiomas. Size appears to be an important characteristic for distinguishing hemangiomas from angiosarcomas, as few lesions larger than 2 cm qualify as hemangiomas, whereas angiosarcomas are rarely smaller than 2 cm. It is possible that atypical perilobular hemangiomas or atypical hemangiomas are precursors to angiosarcoma, but this relationship remains to be demonstrated.
79015.9192075251997.09.18++High-resolution MR imaging of the anal sphincter in children: a pilot study using endoanal receiver coils.AJR Am J Roentgenol
NM deSouza, DJ Gilderdale, DK MacIver, HC Ward,
OBJECTIVE: The purpose of this study was to obtain high-resolution MR images of the various components of the anal sphincter complex in children who have anorectal disorders. We therefore used dedicated endoanal receiver coils for MR imaging. CONCLUSION: Our pilot study suggested that MR imaging that uses a dedicated endoanal coil may have considerable diagnostic potential in children who have anorectal disorders.
79115.9190430431997.03.18++T2-weighted and dynamic enhanced MRI in acute pancreatitis: comparison with contrast enhanced CT.Clin Radiol
J Ward, AG Chalmers, AJ Guthrie, M Larvin, PJ Robinson,
The purpose of this study was to compare T2-weighted and dynamic contrast enhanced MRI with contrast enhanced CT in patients with severe acute pancreatitis. Thirty-two patients were examined using axial T2-weighted spin-echo imaging (TR 1801, TE 15/90) and a multi-slice rapid gradient-echo sequence (TR 135, TE 4, FA 80 degrees) (FLASH) in axial and coronal planes. Fifteen 5 mm axial slices at 10 mm intervals were acquired during a single breath-hold of 19 s before, and at 10 and 40 s after a bolus injection of Gd-DTPA. Additional FLASH images in the coronal plane were obtained 2 min after injection of contrast medium. MR was compared with contemporary enhanced CT by two blinded observers who scored pancreatic viability and the content of intra and extra-pancreatic fluid collections. The presence of gas, calcification and haemorrhage was noted. Abnormalities in adjacent organs, evidence of vascular occlusion and indicators of aetiology were also recorded. MR and CT were concordant in distinguishing viable pancreatic tissue from areas of necrosis. MR appeared to be more effective than CT in characterizing the content of fluid collections and in demonstrating gall stones, although CT remains superior in detecting flecks of gas and calcification. MR carries some advantages over CT and can be regarded as an alternative primary technique in patients with severe pancreatitis.
79215.915578051977.05.20++Hemangiosarcoma of the spleen and liver metastases: angiographic manifestations.Radiology
T Kishikawa, Y Numaguchi, M Tokunaga, K Matsuura,
The arteriographic findings in two cases of hemangiosarcoma of the spleen with liver metastases are described. These are the second and third reported cases of angiographically demonstrated malignant splenic tumors of vascular origin. Despite the absence of tumor vessels, there were multiple vascular takes in the arterial through the venous phase, mimicking benign cavernous hemangioma. Multiple metastases in the liver were the only clue to malignancy. Arteriography combined with liver-spleen scintigraphy not only provides information which is valuable in the preoperative diagnosis but also aids in management of the patient.
79315.9091369141997.05.21++Abdominal ultrasound findings mimicking hematological malignancies in a study of 218 Gaucher patients.Am J Hematol
O Neudorfer, I Hadas-Halpern, D Elstein, A Abrahamov, A Zimran,
Gaucher disease, the most prevalent sphingolipidosis, generally presents with splenomegaly, anemia, and thrombocytopenia. Hence, hematologists are often the specialists involved in diagnosis and management of these patients. We present ultrasonographic characteristics in a cohort of 218 consecutive Gaucher patients evaluated in our clinic during the past 5 years. Our data emphasize the high prevalence of lesions mimicking hematological malignancies in Gaucher disease. One fifth of 184 non-splenectomized patients had intra-splenic lesions, 6% of all patients had similar lesions in the liver, and 32% of 34 splenectomized patients (but none of the other patients) had marked retroperitoneal or peri-portal lymphadenopathy. The presence of splenic lesions correlated with age and splenic size, but not with extent of bone involvement or genotype. Interestingly, they were not affected by reduction in splenomegaly following enzyme replacement therapy. The importance of these findings is to include Gaucher disease in the differential diagnosis of splenic or hepatic lesions, especially in Ashkenazi Jews. Conversely, they are relevant for follow-up of all Gaucher patients, including asymptomatic individuals, because of the reported increased incidence of hematological malignancies in Gaucher disease.
79415.9062321281984.06.21++Laparoscopic splenic biopsy.Endoscopy
G Dagnini, MW Cladironi, G Marin, M Patella,
The authors report their experiences with 1243 laparoscopic splenic biopsies performed between 1968 and 1982 at the Laparoscopy Center of the Regional Hospital in Padua. We may conclude that: The risk of laparoscopic splenic biopsy in minimal and fears regarding its performance are unjustified. The diagnostic value of splenic biopsy is evident if a comparison is made, in the different groups, between the percentage and the accuracy of the diagnoses made with the single macroscopic and the histological examinations, respectively. As well as the staging and follow-up of malignant lymphomas, examination of the spleen in clinically suspected splenopathy is a new and interesting indication for laparoscopy, for it is now possible to take one or more biopsies.
79515.8982103811993.11.18+ Diagnosis of low-grade chondrosarcoma.Radiology
JR Crim, LL Seeger,
79615.8914498811993.01.06++Splenic abscess. Imaging and intervention.Acta Radiol
T Tikkakoski, T Siniluoto, M Päivänsalo, M Taavitsainen, M Leppänen, K Dean, M Koivisto, I Suramo,
We reviewed the imaging findings of 14 splenic abscesses in 13 patients. All patients underwent chest radiography, 12 ultrasonography (US), 9 CT, 4 plain abdominal radiography, 2 99mTc-HMPAO leukocyte scan and 2 99mTc-HIG scan. Three patients were treated with percutaneous catheter drainage, and 5 with diagnostic or therapeutic fine-needle aspiration (FNA). At US the abscess was hypoechoic (n = 9), anechoic (n = 2), or anechoic with gas-bubbles (n = 1), or the entire spleen was inhomogeneous with gas-bubbles (n = 1). At CT the abscesses appeared as low density (18-30 HU) lesions with (n = 2) or without (n = 7) gas. In 2 cases 99mTc-HMPAO leukocyte scan, and in one case 99mTc-HIG scan showed an intrasplenic defect, and in one case 99mTc-HIG scan was considered normal. At plain abdominal radiography extraintestinal gas was suggested in 2 patients, and the findings were normal in 2. US-guided FNA confirmed infectious etiology of the lesion in 4 patients, and a necrotic specimen suggested infection in one. One patient was cured with repeated aspirations. Catheter drainage was successful in all 3 patients who underwent the procedure. We conclude that US and CT are accurate in detecting splenic abscesses. Our results in splenic interventions advocate wider use of the procedures.
79715.8870198861981.09.15+ [Histology of malignant vascular tumors].Pathologe
M Hundeiker,
79815.8779912981995.01.11+ Splenic littoral cell angioma, not bacillary angiomatosis.Pathology
WY Tsang, JK Chan,
79915.8781095111994.03.24++Peribiliary cysts associated with severe liver disease: imaging-pathologic correlation.AJR Am J Roentgenol
RL Baron, WL Campbell, GD Dodd,
Prior pathology reports describe peribiliary cysts in patients who have severe liver disease. The purpose of this study was to determine whether these cysts could be identified on imaging studies, and to determine the range of imaging findings when identified.
80015.8595890941998.05.29++[Ultra-rapid T2-weighted MR imaging during suspended respiration for the examination of focal lesions of the liver: a comparison of TSE, HASTE and HASTE-STIR sequences using a CP body array coil].Rofo
G Brinkmann, I Musiolik, B Kühn, JC Steffens, F Wesner, J Graessner, C Muhle, M Heller,
A comparison of ultra rapid T2-weighted HASTE and HASTE-STIR sequences during suspended respiration for the detection of focal lesions of the liver.
80115.85128815832003.09.25++Focal hepatic lesions: detection and characterization with combination gadolinium- and superparamagnetic iron oxide-enhanced MR imaging.Radiology
MJ Kim, JH Kim, JJ Chung, MS Park, JS Lim, YT Oh,
To compare gadolinium- and superparamagnetic iron oxide (SPIO)-enhanced magnetic resonance (MR) imaging for detection and characterization of focal hepatic lesions when different contrast agent administration sequences are used.
80215.8577669781995.07.05++Adrenocortical carcinoma: MR imaging appearance with current techniques.J Magn Reson Imaging
JF Schlund, PJ Kenney, ED Brown, SM Ascher, JJ Brown, RC Semelka,
The purpose of the study was to define the magnetic resonance (MR) imaging appearance of adrenocortical carcinoma (ACC) with current MR techniques. Eight patients with ACC underwent high-field-strength MR imaging with the following sequences: axial T1-weighted gradient echo, fat-suppressed T1-weighted spin echo, fat-suppressed T2-weighted spin echo, and gadolinium-enhanced T1-weighted gradient echo and fat-suppressed T1-weighted spin echo. Postcontrast images were also acquired in the sagittal (six patients) and coronal (three patients) planes. Out-of-phase gradient-echo images were obtained in two patients. Lesion morphology, signal intensity features, and presence of metastatic disease were retrospectively evaluated. MR imaging features of ACC included internal hemorrhage (seven of eight patients), central necrosis (seven of eight), and peripheral enhancing nodules (seven of eight). Out-of-phase images in two of two patients demonstrated signal loss compared with in-phase images, which may be a common feature of these tumors. Liver metastases were present in four patients. Consistent MR features of ACC are identified.
80315.8589392371996.12.26++Focal liver lesions: fast T2-weighted MR imaging with half-Fourier rapid acquisition with relaxation enhancement.Radiology
L Van Hoe, H Bosmans, P Aerts, AL Baert, J Fevery, B Kiefer, G Marchal,
To compare the clinical usefulness of the half-Fourier rapid acquisition with relaxation enhancement (RARE) technique at T2-weighted magnetic resonance (MR) imaging of focal liver lesions with that of multishot RARE MR imaging and contrast material-enhanced helical computed tomography (CT).
80415.8486729711996.08.15++Small hepatocellular carcinoma: differentiation from adenomatous hyperplasia with color Doppler US and dynamic Gd-DTPA-enhanced MR imaging.Abdom Imaging
R Lencioni, M Mascalchi, D Caramella, C Bartolozzi,
To investigate the usefulness of color Doppler ultrasound (US) and dynamic Gd-DTPA-enhanced magnetic resonance (MR) imaging in the differentiation of small hepatocellular carcinoma (HCC) and adenomatous hyperplasia (AH).
80515.8418705401991.09.18++[Non-Hodgkin's lymphoma with hepatosplenic involvement. The importance of imaging diagnosis using magnetic resonance tomography].Minerva Pediatr
G Lucigrai, A Costa, AM Dell'Acqua, G Magnano, MP Fondelli, ML Garré, P Tomà,
This study evaluates the importance of magnetic resonance imaging (MR) in the exploration of the abdomen in a case of non-Hodgkin lymphoma diagnosed in a 14-year-old boy. Results are compared with those obtained using two widely used diagnostic methods: CT and ultrasonography (US). US revealed a prevalent involvement of the spleen, whereas CT showed a marked hepatic infiltration. The role of MR seems important because it allowed the contemporary and careful evaluation of hepatolienal involvement. The main advantages and drawbacks of using MR in pediatrics, and in particular in the study of the metastatic involvement of hypochondriac organs are discussed.
80615.837015151978.12.20++Evaluation of abdominal abscess with computed tomography.J Comput Assist Tomogr
DJ Aronberg, RJ Stanley, RG Levitt, SS Sagel,
Computed tomography (CT) is valuable in providing a specific diagnosis of abdominal abscess and in determining its site and extent. Computed tomography is also capable of excluding an abscess with a high degree of certainty. In 31 of 34 patients with proven abdominal abscess, CT suggested the correct diagnosis and accurately defined the extent of involvement. In nine patients, the CT findings were specific for abscess. The CT appearance of abscess is diverse, largely depending on its location. The most common appearance is a low density mass often with higher density at the periphery. The presence of gas distributed within the mass or an extraalimentary air--fluid level allows an extremely confident diagnosis of abscess. Differential diagnostic possibilities are reviewed with emphasis on interpretive problems.
80715.8284301991993.03.11++Triple-dose versus standard-dose gadopentetate dimeglumine: a randomized study in 199 patients.Radiology
J Haustein, M Laniado, HP Niendorf, T Louton, W Beck, J Planitzer, M Schöffel, M Reiser, W Kaiser, W Schörner,
To investigate the safety, patient tolerance, and efficacy with 0.3 mmol/kg gadopentetate dimeglumine in magnetic resonance (MR) imaging of the central nervous system (CNS), a phase 3 trial was conducted in 199 patients with suspected CNS lesions. Patients received either 0.1 or 0.3 mmol/kg gadopentate dimeglumine (injection time, 15 seconds and 45 seconds, respectively). T1- and T2-weighted spin-echo sequences were performed at either 0.5 T or 1.5 T. In 80 patients with enhancing brain lesions, contrast-to-noise ratios (C/Ns) were calculated, and lesion-to-brain contrast was evaluated visually. Six patients (6%) in each dose group reported adverse events. Eight adverse events occurred with 0.1 mmol/kg and seven with 0.3 mmol/kg. Vital signs and laboratory values did not change significantly. C/N (P < .05) and visual assessment ratings were higher with 0.3 mmol/kg than with 0.1 mmol/kg. According to these preliminary results, 0.3 mmol/kg gadopentetate dimeglumine is safe and well tolerated when administered at approximately 1 mL/sec.
80815.7829850181985.04.29++Diagnostic pathology in the acquired immunodeficiency syndrome. Surgical pathology and cytology experience with 67 patients.Arch Pathol Lab Med
JB Amberson, EF DiCarlo, CE Metroka, JH Koizumi, JA Mouradian,
We report the pathologic findings in specimens submitted for histologic and cytologic evaluation from 67 patients with the acquired immunodeficiency syndrome. A wide variety of opportunistic pathogens were identified in 41 patients. Mycobacterium avium-intracellulare evoked only a mild host response: granulomas, if present, were poorly formed. Biopsy specimens showing cytomegalovirus gastroenteritis required sections at multiple levels to demonstrate inclusions. Combined histologic and cytologic evaluation can increase the diagnostic yield in pulmonary and esophageal infections. Kaposi's sarcoma was found in biopsy specimens from 29 patients. Early lesions were often extremely subtle, yet distinct from, benign vascular proliferations in involuted lymph nodes. Malignant lymphoma was diagnosed in ten homosexual men who were suspected of having the acquired immunodeficiency syndrome. The lymphomas were characterized by B-cell origin, a diffuse pattern, frequent extranodal presentations, and an aggressive clinical course with prominent central nervous system involvement.
80915.78106441182000.01.28++Follow-up of patients at low risk for hepatic malignancy with a characteristic hemangioma at US.Radiology
DM Leifer, WD Middleton, SA Teefey, CO Menias, JR Leahy,
To determine the need for follow-up imaging in patients with a low risk of malignancy and with ultrasonographic (US) findings typical of hepatic hemangioma.
81015.7826022151990.01.31++Vascular transformation of lymph node sinuses--a diagnostic pitfall. Histopathologic and immunohistochemical study.Pathol Res Pract
M Michael, V Koza,
Histopathologic and immunohistochemical features in two cases of lymphoadenopathy caused by congestion are described. The diagnostic differences between this type of lymphoadenopathy and Kaposi's sarcoma are stressed. The histogenesis of the lesion is discussed and the term "stasis lymphadenopathy" is suggested.
81115.775789201977.12.29+ [Spontaneous rupture of the spleen in non-Hodgkin lymphoma].Orv Hetil
R Janáky, J Mórocz,
81215.7796268841998.08.27++Sequential use of ferumoxide particles and gadolinium chelate for the evaluation of focal liver lesions on MRI.J Magn Reson Imaging
RC Semelka, JK Lee, S Worawattanakul, TC Noone, RH Patt, SM Ascher,
This study describes the sequential use of ferumoxide (superparamagnetic iron oxide) particles and nonspecific extracellular gadolinium chelate (Gd) for evaluation of focal liver lesions on MRI to evaluate order of contrast administration and imaging effect of the first contrast agent on sequences acquired after the second contrast agent. Thirteen patients underwent MR examinations that included ferumoxide and Gd. The order and timing of administration were as follows: separate sessions (three patients; Gd study 4-19 days before ferumoxide study), same session, Gd first (seven patients; Gd study 1-2 hours before ferumoxide study), and same session, ferumoxide first (three patients; ferumoxide administered less than 1 hour before Gd study). Postcontrast sequences were reviewed in a randomized, blinded fashion by two separate investigators. Determination was made regarding whether (a) the presence of the first agent administered could be detected on sequences obtained after the second agent and (b) the presence of the first agent interfered with the image quality of those sequences. No evidence for the presence of Gd was appreciated by either observer on postferumoxide sequences acquired in separate session studies. In same session, Gd first studies, the presence of Gd was observed in six of seven patients on T1-weighted spoiled gradient-echo (SGE) images obtained after ferumoxide administration. The presence of Gd was not apparent in seven of seven patients on T2-weighted fat-suppressed images obtained after ferumoxide. In same session, ferumoxide first studies, the presence of ferumoxide was appreciated on post-Gd sequences in two of three patients. The presence of ferumoxide did not appreciably diminish image quality on those sequences. Exact agreement was achieved by the independent investigators. Our results suggest that Gd and ferumoxide can be administered sequentially within one study session without substantial loss of diagnostic information obtained on sequences performed after administration of the second contrast agent. Administrating Gd first resulted in less of an effect of the visualization of the first agent on sequences acquired after the second agent.
81315.7695610721998.07.01+ MR imaging of lymph nodes in patients with primary abdominal and pelvic malignancies using ultrasmall superparamagnetic iron oxide (Combidex).Acad Radiol
MG Harisinghani, S Saini, PF Hahn, R Weissleder, PR Mueller,
81415.76159692332005.07.11++[The place of MRI in the hepatic tumors].Tunis Med
N Mnif, T Ellouze, T Boubela, S Oueslati, R Hamza,
MRI semeiology of hepatic tumors was assessed with a retrospective study of 132 patients explored between May 1998 and December 2001. MR examinations were acquired with a one Tesla operating system. All images were acquired by a T2-weighted fast spin echo MR and dynamic flash MR with Gadolinium. Hemangiomas demonstrate characteristic signs in most cases, as was described in the literature. However, adenoma, hepatocellular carcinoma and metastases have various and less specific features.
81515.75108454962000.06.21++MR imaging differentiation of soft-tissue hemangiomas from malignant soft-tissue masses.AJR Am J Roentgenol
EL Teo, PJ Strouse, RJ Hernandez,
The purpose of this study was to determine whether MR imaging features can reliably distinguish hemangiomas from malignant soft-tissue masses.
81615.75182741962008.03.27++Splenic abscess complicating infective endocarditis: three case reports.Acta Chir Belg
J Ebels, F Van Elst, M Vanderveken, R Van Cauwelaert, C Brands, S Declercq, P Willemsen,
We present three case-reports of splenic abscess in patients who were initially diagnosed with bacterial endocarditis. In all cases the diagnosis of splenic abscess was based on the findings of abdominal CT scan or MRI. All patients were treated by laparotomy and splenectomy. Two patients fully recovered and one patient, who suffered from splenic rupture and massive blood loss before surgery, died. Splenic abscess is a well-described but rare complication of infective endocarditis. Rapid diagnosis and treatment are essential as its course can prove fatal. Abdominal CT scan or MRI should be performed if there is clinical suspicion of splenic abscedation. Immediate splenectomy combined with appropriate antibiotics and valve replacement surgery is the treatment of choice. Splenic tissue is very fragile--especially if the abscess is located subcapsular--and a splenic rupture can result from minimal trauma. If the patient's general state allows it, it is best to perform splenectomy prior to valve replacement surgery to prevent re-infection of the valve prosthesis. A combined one-stage procedure is also an option.
81715.74109759192000.10.03++Generalized tuberculosis in the acquired immune deficiency syndrome.Arch Pathol Lab Med
MB Smith, MC Boyars, S Veasey, GL Woods,
Generalized, or hematogenously disseminated, tuberculosis (TB) in patients with the acquired immune deficiency syndrome (AIDS) has been associated with a high incidence of cases remaining undiagnosed until postmortem. To better characterize generalized TB in the setting of AIDS, this report describes the clinical, laboratory, radiologic, and pathologic features of 20 fatal cases.
81815.7372405281981.08.20++Case report. CT diagnosis of splenic cystic lymphangiomatosis.J Comput Assist Tomogr
RS Pyatt, ED Williams, M Clark, R Gaskins,
Several recent reports have stressed the role of angiography in the preoperative diagnosis of splenic cystic lymphangiomatosis. We describe a patient in whom computed tomography (CT) proved to be a key diagnostic tool that, when coupled with the radionuclide study, ultrasound, and clinical information, allowed for an accurate preoperative diagnosis. To our knowledge, there are no cases in the literature describing the use of CT in the evaluation of this entity.
81915.73112422182001.04.05++Hepatic capsular retraction: unusual finding of cavernous hemangioma.J Comput Assist Tomogr
SH Lee, CM Park, IJ Cheong, MS Kwak, SH Cha, SY Choi, CH Kim,
We report a case of hepatic giant hemangioma, which showed hepatic capsular retraction on CT and MRI. Pathologic examination revealed fibrosis combined with hemangioma, especially in a subcapsular location, which was responsible for the capsular retraction.
82015.7380419351994.08.24++[Splenic abscesses. Their percutaneous treatment and the role of the interventional radiologist].Radiol Med
D Gasparini, PT Basadonna, A Di Donna,
Percutaneous abscess drainage is not as common in the spleen as in other anatomical sites, probably because of an uncontrollable fear of bleeding. Five cases of intrasplenic abscess drainage are presented. A double-way 12/14-F vanSonnenberg catheter was percutaneously inserted under CT guidance in four patients and under US guidance in one patient. Orthogonal scout CT views were useful to check the correct positioning of the drainage. In three patients the maneuver was successful, with no recurrence at follow-up at 12, 16 and 24 months, respectively. In one patient with a splenic abscess due to iatrogenic ischemic necrosis, the drainage allowed delayed surgery after relief of symptoms. Another patient died of sepsis five days after multiple well-functioning drainages. No early or late complications occurred. Bleeding was never observed in our series and there are no recent literature reports on this complication. Whenever it occurs, bleeding can be treated with selective embolization. In our experience, the percutaneous drainage of splenic abscesses, performed by the radiologist, should be considered the treatment of choice in these cases.
82115.7139555131986.05.19++Prediction of splenic involvement in children with Hodgkin's disease. Significance of clinical and intraoperative findings. A retrospective statistical analysis of 154 patients in the German therapy study DAL-HD-78.Cancer
G Schellong, AK Waubke-Landwehr, HJ Langermann, HJ Riehm, J Brämswig, J Ritter,
In 154 splenectomized children and adolescents with histologically proven Hodgkin's disease in the therapy study DAL-HD-78, the incidence of splenic involvement was 39%. In single-parameter analyses 6 of 16 examined pre- and intraoperative findings showed significant correlation to splenic involvement: B-symptoms, palpable splenic enlargement, mediastinal/lung hilus involvement, nodular changes of splenic surface, enlarged lymph nodes at splenic hilus/pancreatic tail, or enlargement of other upper-abdominal lymph nodes. The results of multivariant analyses (Cox regression model) of these six parameters showed that the two most significant intraoperative parameters--changes of splenic surface and enlargement of lymph nodes at splenic hilus/pancreatic tail-gave almost all of the information which can be obtained about splenic involvement. With these two parameters, an intraoperative decisional strategy for selective splenectomy has been developed which allows the omission of splenectomy in about two thirds of children with Hodgkin's disease while still obtaining detailed information about infradiaphragmatic spread of disease. Since minor splenic involvement remains undetected in about 10% of the nonsplenectomized patients (i.e., 6% of all patients), this method should be used only in combination with chemotherapy.
82215.7133510411988.04.28++Benefits of Gd-DTPA for MR imaging of intracranial abnormalities.J Comput Assist Tomogr
JR Hesselink, ME Healy, GA Press, FJ Brahme,
Forty patients with symptoms of intracranial disease were studied with magnetic resonance before and after intravenous injection of gadolinium-diethylenetriamine pentaacetic acid (Gd-DTPA). The T1- and T2-weighted images were obtained in all patients. Ninety brain lesions were found in 36 patients, including primary (20 patients) and metastatic (six) tumors, hemorrhage (one), progressive multifocal leukoencephalopathy (one), cysticercosis (one), infarction (four), and postoperative changes (four). Postcontrast images revealed lesions not seen on precontrast scans in eight (20%) patients. Also, the postcontrast images showed a change in appearance of the lesions in 20 (50%) that provided helpful information for assessing the abnormality in 20 cases (50%). Gadolinium-DTPA did not obscure any of the lesions seen on precontrast scans. It improved conspicuity, helped characterize and delineate the extent of lesions, and increased the sensitivity for detection of cerebral abnormalities.
82315.70194142932009.07.07++Detection of lymph node metastases with ultrasmall superparamagnetic iron oxide (USPIO)-enhanced magnetic resonance imaging in oesophageal cancer: a feasibility study.Cancer Imaging
BB Pultrum, EJ van der Jagt, HL van Westreenen, HM van Dullemen, P Kappert, H Groen, J Sietsma, M Oudkerk, JT Plukker, GM van Dam,
In this feasibility study we investigated whether magnetic resonance imaging (MRI) with ultrasmall superparamagnetic iron oxide (USPIO) can be used to identify regional and distant lymph nodes, including mediastinal and celiac lymph node metastases in patients with oesophageal cancer.
82415.69103502871999.06.10++Detection of hepatocellular carcinoma arising in cirrhotic livers: comparison of gadolinium- and ferumoxides-enhanced MR imaging.AJR Am J Roentgenol
Y Tang, Y Yamashita, A Arakawa, T Namimoto, K Mitsuzaki, Y Abe, K Katahira, M Takahashi,
We prospectively compared the detectability of hepatocellular carcinoma (HCC) arising in cirrhotic livers using dynamic gadolinium-enhanced fast low-angle shot (FLASH), ferumoxides-enhanced T2-weighted turbo spin-echo, and ferumoxides-enhanced T2*-weighted FLASH MR imaging.
82515.6965481711984.11.01++Primary splenic presentation of malignant lymphoma and related disorders. A study of 49 cases.Cancer
BB Kraemer, BM Osborne, JJ Butler,
The diagnosis of malignant lymphoma presenting as an initial splenic manifestation may go unrecognized as such when peripheral lymph nodes are not enlarged and when results of bone marrow biopsies are negative. Tissues from 49 patients, ranging in age from 15 to 78 years, in whom the original diagnosis of malignant lymphoma and related conditions was made at splenectomy, were classified as: diffuse small lymphocytic (20), diffuse large cell (11), diffuse small cleaved (5), diffuse large cell, immunoblastic (5), follicular small cleaved cell (3), and follicular mixed small cell and large cell (2). Two additional spleens, diagnosed as acute blastic leukemia, were initially confused with malignant non-Hodgkin's lymphoma by light microscopy. One patient presented with Hodgkin's disease confined to the spleen. For the non-Hodgkin's lymphoma group, parameters of age, sex, splenic weight (range, 226-4000 g), lymph node, bone marrow, or liver involvement did not adversely influence prognosis. Abdominal lymph nodes were positive in 31 of 37 patients having splenic hilar and/or abdominal lymph nodes available for review. Of 29 patients with adequate follow-up, 7 died of disease, 5 were free of disease at 3 years, 2 were free of disease at 5 years, 2 were alive with disease at 3 years, 4 were alive with disease at 5 years, and 9 died from second malignancies, unknown, or unrelated causes. Six of the 7 patients who died of lymphoma were classified as large cell (four diffuse large cell and two diffuse large cell, immunoblastic), with a mean 2-year survival. One patient died of leukemia. Those lymphomas classified as low grade behaved in an indolent fashion. The morphologic diversity of these cases emphasizes the need for the initial recognition and correct classification of lymphomas which present in the spleen, since survival is best determined according to histologic type.
82615.67174535142007.07.19++Contrast-enhanced FDG-PET/CT vs. SPIO-enhanced MRI vs. FDG-PET vs. CT in patients with liver metastases from colorectal cancer: a prospective study with intraoperative confirmation.Acta Radiol
ED Rappeport, A Loft, AK Berthelsen, P von der Recke, PN Larsen, AM Mogensen, A Wettergren, A Rasmussen, J Hillingsoe, P Kirkegaard, C Thomsen,
The choice of imaging before liver surgery is debated regarding the use of magnetic resonance (MR) imaging, computed tomography (CT), and positron emission tomography (PET). No studies have compared contrast-enhanced PET/CT with superparamagnetic iron oxide (SPIO)-enhanced MR imaging.
82715.6525127921990.01.16++Tuberculous arachnoiditis of the spine: findings on myelography, CT, and MR imaging.AJNR Am J Neuroradiol
KH Chang, MH Han, YW Choi, IO Kim, MC Han, CW Kim,
Tuberculosis (TB) is a rare cause of spinal arachnoiditis. It may occur primarily or secondary to intracranial or vertebral infection; unlike other types of arachnoiditis, it frequently involves the spinal cord as well as the meninges and the nerve roots. We retrospectively reviewed 13 conventional myelograms, eight CT myelograms, and five Gd-DTPA-enhanced MR images in 13 patients with spinal TB radiculomyelitis (arachnoiditis). Eleven patients had intracranial TB meningitis at the time of diagnosis or before. Ten patients were less than 30 years old. Conventional myelographic findings included a block of the CSF (11/13), most commonly at the level of the conus medullaris; irregular or indistinct thecal sac contour (9/13); multiple fine and/or coarse nodular defects (8/13); nerve-root thickening (7/13); and vertical bandlike adhesive defects (4/13). CT myelography showed intradural nodular masses suggesting tuberculomas at or just above the level of the block (4/8), irregularity of the spinal cord surface (4/8), irregular filling or obliteration of subarachnoidal space (6/8), and root thickening (5/8). Gd-DTPA-enhanced MR images revealed enhancing nodules suggesting tuberculomas (2/5); enhancement of the dura-arachnoid complex around the cord (3/5); and segmental enhancement of the thoracic cord, suggesting either infarction caused by vasculitis or TB myelitis in association with diffuse cord swelling (1/5). Plain MR findings were much less conspicuous, showing only an indistinct or irregular dura-arachnoid-cord complex (4/5). In conclusion, the conventional myelographic findings are considered to be virtually diagnostic of spinal TB radiculomyelitis in young patients with antecedent or coexisting TB meningitis.(ABSTRACT TRUNCATED AT 250 WORDS)
82815.644511881979.09.01++Cavernous hemangioma of the liver: ultrasonography, arteriography, and computed tomography.Radiology
PC Freeny, TR Vimont, DC Barnett,
Gray-scale ultrasonography and angiography were performed on 5 patients with cavernous hemangioma of the liver. Four patients also had radionuclide scans and 2 had computed tomography. Angiography was the most specific diagnostic examination; the findings of the other 3 techniques were nonspecific, yet valuable for initial identification of the lesions and their characterization as solid tumors.
82915.64149723892004.06.10++Cavernous hemangiomas in patients with chronic liver disease: MR imaging findings.Magn Reson Imaging
M Mastropasqua, M Kanematsu, P Leonardou, L Braga, JT Woosley, RC Semelka,
The purpose of our study was to assess the difference in magnetic resonance imaging (MRI) features of cavernous hemangiomas in patients with chronic liver disease compared them with hemangiomas in normal livers. We retrospectively searched our records of MRI of the liver between October 1998 and June 2002, and identified 76 hemangiomas in 49 patients (18 men and 31 women; age range 29-81 years [mean, 57 years]). Hemangiomas were classified into 3 groups: patients with cirrhosis [group 1, 8 lesions in 8 patients], patients with chronic hepatitis [group 2, 6 lesions in 5 patients], and patients without underlying liver disease [group 3, 62 lesions in 36 patients]. Four radiologists, blinded to clinical information, retrospectively reviewed in consensus the MRI findings of hemangiomas for number, size, signal intensities on T1- and T2-weighted images, and enhancement patterns on early- and late-phase postcontrast images. The mean lesion numbers and sizes were 1.0 and 16.2 +/- 9.6 mm, 1.2 and 15.3 +/- 7.1 mm, and 1.7 and 26.1 +/- 24.7 mm in groups 1-3, respectively. There was a correlation (p < 0.05, coefficient: 0.35) between lesion number and severity of liver disease. Although there was no significant difference in lesion size among the 3 groups, all of 11 lesions larger than 4 cm in diameter belonged to group 3. Almost all lesions appeared moderately hypointense on T1-weighted images and moderately hyperintense on T2-weighted images. Twenty-seven lesions showed immediate homogeneous enhancement (pattern 1), and 49 showed peripheral nodular enhancement with centripetal enhancement progression (pattern 2). There was no difference in frequency of enhancement patterns among the 3 groups. Hemangiomas were more often solitary in livers with chronic liver disease, large lesions were exclusively seen in livers without chronic liver disease, and there was a trend for small lesions in patients with chronic liver disease.
83015.6391435671997.06.05++Surgical treatment for splenic hydatidosis.World J Surg
M Safioleas, E Misiakos, C Manti,
Splenic involvement is rare in patients with hydatid disease even in endemic countries. The spleen is the third most commonly involved organ after the liver and the lung. In our series splenic echinococcosis represents 5.8% of abdominal hydatid disease. During the last 22 years, 14 patients were operated on for splenic hydatid cysts in our department. In 10 patients the spleen was the only location of hydatid disease; in 2 patients there was concomitant liver hydatid disease; one patient had disseminated intraabdominal disease; and one patient had a coexisting hydatid cyst in the quadriceps femoris muscle. Plain abdominal films, ultrasonography, and computed tomography scans were most useful for establishing the diagnosis. All patients underwent splenectomy alone or combined with management of cysts at other sites, except for two patients who underwent omentoplasty and one patient who underwent external drainage. One patient died during the early postoperative period (mortality rate 7%), and three patients had minor complications. Splenic hydatid disease should be included in the differential diagnosis when a splenic cyst is identified, especially in patients with a history of hydatid disease. Surgery remains the treatment of choice to avoid serious complications.
83115.6386569881996.07.31++Dynamic Gd-enhanced MR imaging of hepatic hemangioma: is high temporal resolution requisite for characterization?Magn Reson Imaging
R Urhahn, M Kilbinger, M Drobnitzky, G Mans-Peine, J Neuerburg, RW Günther,
We assessed the value of high temporal resolution in the dynamic characterization of hepatic hemangioma with use of magnetization-prepared gradient-echo (MP-GRE) imaging. Single-level inversion recovery incremental flip angle MP-GRE images were obtained in 26 patients with 34 hemangiomas before and at a repetition rate of 30 images/min after injection of Gd-DTPA without breath-holding. Enhancement patterns and temporal changes thereof were analyzed. Hemangiomas were categorized as small ( < 2.0 cm), medium (2.0-5.0 cm), and large ( > 5 cm) lesions. Classic early peripheral nodular enhancement (PNE) with progressive hyperintense fill-in was observed in 31 lesions (91%). Two of 10 small and 1 of 20 medium lesions showed complete fill-in within 10 s, and three small and one medium lesions within 45 s after the onset of PNE. In no cases of hemangioma was immediate homogenous hyperintensity observed without preceding PNE. In conclusion, temporal resolution of less than 10 s is a prerequisite for confident dynamic characterization of some hemangiomas, predominantly small hemangiomas.
83215.6296413901998.08.21++Sonographic appearances of small hepatic nodules without tumor stain on contrast-enhanced computed tomography and angiography.J Clin Ultrasound
M Iwasaki, J Furuse, M Yoshino, M Ryu, N Moriyama, K Mukai,
We report the sonographic appearances and pathologic findings for hepatic nodules 2 cm or smaller that were detected by sonography but that did not produce a tumor stain on constrast-enhanced helical CT or digital subtraction angiography.
83315.6230672681989.04.04 Image interpretation session.Radiographics
83415.6275972441995.08.03+ [Pseudotumor of the liver: its imaging with echography, computed tomography and magnetic resonance in a case].Radiol Med
G Liessi, G Mastrapasqua, B Spaliviero, R Butini, M Pavanello,
83515.6226484781989.04.28++Hepatic epithelioid hemangioendothelioma: report of five cases.Radiology
S Furui, Y Itai, K Ohtomo, T Yamauchi, E Takenaka, M Iio, K Ibukuro, Y Shichijo, Y Inoue,
Results of computed tomography (CT), ultrasonography (US), angiography, and radionuclide imaging were analyzed in five cases of histologically proved hepatic epithelioid hemangioendothelioma (EHE), a rare vascular tumor of adults that has a variable but often long clinical course. All patients received palliative treatment. CT and US were performed repeatedly over a period of up to 53 months. Initial radiologic examination showed two types of hepatic lesions: multiple nodules in both lobes (nodular lesions, n = 2) and large masses with or without calcifications that generally spread along the hepatic margins (diffuse lesions, n = 3). Nodular lesions may be an earlier form of hepatic EHE, as they later gradually changed into the diffuse type. Follow-up CT after treatment showed definite regression of tumors in two cases. In the differential diagnosis, the radiologic findings of diffuse lesions were considered to be specific to hepatic EHE, while those of nodular lesions were nonspecific.
83615.6226897121990.01.30+ [X-ray computed tomography and magnetic resonance imaging of the spleen].Rinsho Hoshasen
N Nakao, T Kadota,
83715.6286009601996.05.06++3DFT-flash MR imaging of pancreatic cancer with gadopentetate dimeglumine.Acta Radiol
T Murakami, K Tsuda, H Nakamura, K Osuga, K Tomoda, S Hori, M Miyata, M Monden, K Wakasa,
We evaluated the usefulness of dynamic 3-dimensional Fourier transformation (3DFT) fast low angle shot (FLASH) MR imaging using gadopentetate dimeglumine (Gd-DTPA) to assess the extent of pancreatic cancer.
83815.6084280821993.03.09++Proton relaxation enhancement.J Magn Reson Imaging
ML Wood, PA Hardy,
Paramagnetic and superparamagnetic substances are used as contrast agents to enhance proton relaxation in magnetic resonance imaging. This review summarizes the physics of contrast agents, specifically the mechanisms by which contrast agents enhance T1 and T2 relaxation. The purpose is to provide a background for understanding the behavior of existing contrast agents in basic experimental and clinical studies. Terms such as magnetic dipole, dipole moment, magnetic susceptibility, diamagnetism, paramagnetism, superparamagnetism, and ferromagnetism are introduced. Two important interactions between the magnetic dipole moments of paramagnetic substances and the dipole moments associated with protons are described. The Solomon-Bloembergen-Morgan equations and other basic relaxation theory that has been confirmed experimentally are introduced to account for the dependence of relaxation on such parameters as the Larmor frequency, magnetic moment, accessibility of water molecules to the core of a contrast agent, and frequency of molecular motions.
83915.60163525872006.01.30+ Multiple hepatosplenic nodules.Br J Radiol
AN Hegde, A Kohli,
84015.5980857631994.10.13++[Cavernous hemangioma of the spleen: values and limitations of ultrasonic and computed tomographic diagnosis].Ann Chir
JP Bail, P Menut, T Andivot, T Leal, A Volant, JF Charles,
A case of a cavernous haemangioma associated with an hepatic haemangioma is reported. It presented in the form of a hyperechogenic mass on ultrasound imaging. On the Computed Tomography scan with contrast, the splenic tumour became progressively hyperdense: this last characteristic is observed in 6 out of 9 cases reported in the literature. MR imaging seems to allow an accurate preoperative diagnosis; nevertheless, splenectomy is often indicated because of the risk of rupture, in which case histological examination removes any doubt concerning an exceptional malignant form.
84115.58100898081999.04.28+ [Abdominal lymphoma: lymph node and visceral involvemnet].Sangre (Barc)
G Sánchez del Peral Otero, E Parlorio de Andrés, I López San Román, A Bustos García de Castro,
84215.5783858781993.05.13+ Contrast-enhanced MR imaging of malignant mixed müllerian tumor of the uterus.AJR Am J Roentgenol
Y Yamashita, M Takahashi, K Miyazaki, H Okamura,
84315.5792166271997.07.30++Splenic emergencies.Radiol Clin North Am
KH Emery,
Of medical and surgical emergencies in the pediatric abdomen, those involving the spleen are relatively less common than other abdominal organs, though equally important to recognize. A more sophisticated clinical understanding of the important role of the spleen in immunocompetence has developed in parallel with advancements in imaging. A healthy respect for the preservation of splenic tissue has emerged, altering traditional surgical management of splenic emergencies. Non-invasive imaging has come to play a vital role in depicting acute abnormalities and in determining the need for conservative, interventional, or surgical management.
84415.5738806151985.01.15++Integrated imaging of hepatic tumors in childhood. Part II: Benign lesions (congenital, reparative, and inflammatory).Radiology
JH Miller, BS Greenspan,
The authors have encountered benign liver masses as frequently as malignant lesions in children with hepatomegaly. Lesions studied included abscesses, cavernous hemangioma/hemangioendothelioma, adenoma of glycogen storage disease, choledochal cysts, focal nodular hyperplasia, cystic hepatoblastoma, and hamartoma. An integrated imaging protocol involving ultrasound, computed tomography, and scintigraphy proved to be more helpful than any one modality in establishing the benign or malignant nature of a hepatic neoplasm and the type of tumor, which is of particular importance when surgical exploration and/or biopsy is contraindicated.
84515.5684280811993.03.09++Basic physics of MR contrast agents and maximization of image contrast.J Magn Reson Imaging
RE Hendrick, EM Haacke,
This review summarizes the physical basis of magnetic resonance (MR) imaging contrast agents, including both T1 agents, such as gadolinium-DTPA (diethylenetriaminepentaacetic acid), and T2 or T2* agents, such as superparamagnetic iron oxides. The maximization of image contrast and lesion visibility with contrast agents is described, and the use of contrast agents in MR angiography and perfusion imaging is discussed.
84615.5622989731990.03.05++Clinical experience with routine Gd-DTPA administration for MR imaging of the brain.J Comput Assist Tomogr
BW Schwaighofer, MV Klein, G Wesbey, JR Hesselink,
A retrospective analysis of intracranial magnetic resonance (MR scans of 514 patients who underwent nonselective Gd-DTPA enhanced MR imaging was performed to determine the efficacy of this protocol for Gd-DTPA administration. This report reviews the frequency and clinical significance of abnormally enhancing areas that were entirely undetectable on precontrast images or would have been missed without the retrospective knowledge of enhancement. Fifty-seven patients (11% of the 514 patients studied) showed enhancing lesions, with 16 (3.1% of the total) of these patients demonstrating one or more lesions identifiable only on postcontrast images. Of those 16 patients, 8 had other focal abnormalities on precontrast studies, whereas the remaining 8 (1.6% of the total) had negative precontrast studies. The new diagnoses affected clinical management directly in five patients and in another nine contributed potentially significant information. Considerations regarding a selective versus nonselective protocol for Gd-DTPA administration for intracranial MR imaging and the use of clinical information to augment these protocols are discussed.
84715.5481345631994.04.21++Gadolinium-enhanced MR aortography.Radiology
MR Prince,
To evaluate the potential for preferential arterial enhancement at magnetic resonance (MR) aortography with an intravenous infusion of paramagnetic contrast material.
84815.5393149871997.10.23++Peripheral washout sign on contrast-enhanced MR images of the breast.Radiology
H Sherif, AE Mahfouz, H Oellinger, J Hadijuana, JU Blohmer, M Taupitz, R Felix, B Hamm,
To assess the value of the peripheral washout sign on delayed contrast material-enhanced magnetic resonance (MR) images in differentiation of benign from malignant breast masses.
84915.5364803081984.11.16++Computed tomography in the detection of abdominal metastases from malignant melanoma.Invest Radiol
PM Silverman, DK Heaston, M Korobkin, HF Seigler,
Malignant melanoma is an unpredictable and often virulent cutaneous malignancy. Although computed tomography is the most sensitive method for detection of intrathoracic metastases, its value in the assessment of abdominal spread has not been fully defined. We evaluated the sites of CT-identified metastases in 70 patients with pathologically confirmed malignant melanoma. Results were correlated with Clark's level, Breslow thickness, site of the primary, and clinicopathologic stage. CT detected enlarged abdominal or pelvic lymph nodes in 75% of patients with Clark's level 5 lesions but only in 24% and 33% of those with level 3 and 4, respectively. Patients with deep primary lesions of the lower extremities had a high frequency of pelvic node metastases. Liver and splenic metastases were detected in up to 25% of patients with level 4 or 5 melanoma. Adrenal and subcutaneous metastases were frequently discovered as were unsuspected nodules at the lung bases.
85015.53109939702000.10.24++Sonographically guided core-needle biopsy of focal splenic lesions: report of four cases.J Clin Ultrasound
K Morita, K Numata, K Tanaka, K Mitsui, S Matsumoto, T Kitamura, S Saito, T Kiba, H Sekihara,
There are few published reports about the use of splenic needle biopsies in the investigation of focal splenic lesions. We report our experience with sonographically guided core-needle biopsies of splenic lesions in 4 patients. The biopsies resulted in the following diagnoses: sarcoidosis, malignant lymphoma, infarction, and scar tissue. Surgery was avoided in the 3 patients diagnosed with sarcoidosis, infarction, and scar tissue by ruling out the possibility of a malignant splenic tumor. None of the patients experienced significant complications. We conclude that splenic core-needle biopsy is a useful and safe diagnostic tool for the evaluation of focal splenic lesions.
85115.5314894651992.11.13+ Fat-suppression MR arthrography of the shoulder.Radiology
RC Fritz, DW Stoller,
85215.5337361591986.09.16+ [Value of splenectomy in the diagnosis of splenomegaly of unknown origin].Med Clin (Barc)
G Ortega González, M Molina Boix, JD Alonso Lajara, MD Meseguer Frutos, A Alemán Lorenzo, B García Pérez, M Villegas García,
85315.5279466791994.12.22++Gd-DTPA-enhanced MR imaging in mediastinal Hodgkin's disease.Acta Radiol
G Forsgren, R Nyman, B Glimelius, H Hagberg, S Rehn, A Hemmingsson,
Gd-DTPA-enhanced MR imaging of 15 patients with primary mediastinal Hodgkin's disease was done before, during and after treatment. A total of 43 MR examinations were performed. After successful treatment, 13 patients had residual masses with reduced signal intensity (SI) ratio in the T2-weighted images. The majority of these also had decreased contrast enhancement as compared with the corresponding primary tumour. There was a significant positive correlation between the contrast enhancement and the SI ratios in the T2-weighted images of the primary tumours and/or the residual masses. Necrosis was seen in 3 of the primary tumours and one patient had a cystic residual mass. These necrotic/cystic lesions were easier to detect with the use of Gd-DTPA. Low SI ratio in the T2-weighted image and low contrast enhancement of the residual mass seem to indicate residual inactivity. Gd-DTPA facilitates the differentiation between cystic/necrotic and solid lesions.
85415.52171350152007.02.08++Atypical imaging findings of infantile hemangioendothelioma: a case report.Acta Radiol
E Mavili, G Kahriman, IS Tuna, A Coskun,
Infantile hemangioendothelioma is the third most common hepatic tumor in children, and the most common benign vascular tumor of the liver in infancy. On computed tomography (CT) and magnetic resonance imaging (MRI), typical enhancement patterns similar to those seen in adult hemangiomas may help establish the diagnosis. However, atypical enhancement patterns may also occur. In this paper, we report a rare form of solitary infantile hemangioendothelioma that showed a rim-like calcification and rim-like enhancement on CT and MRI.
85515.5129862111985.06.18++[Splenic infarct in the computed tomogram].Rofo
J Triller, E Bona, P Barbier,
Splenic infarcts are represented by wedge-shaped, oval or linear areas. Haemorrhagic infarcts are characterised by being hyperdense. Disseminated infarction occurs predominantly in myeloproliferative diseases. During the early stages, the infarct appears as an ill-defined hypodense defect, with non-homogeneous contrast enhancement. During the acute and sub-acute stage, the density of the infarct is low and there is no contrast enhancement. During the chronic stage, its density increases and there is slight contrast enhancement. Complications following splenic infarcts, such as abscesses, bleeding and rupture can be demonstrated by CT with great accuracy. Problems in differential diagnosis may occur if there are atypical manifestations of the infarct, with respect to abscess or leukaemic infiltrations.
85615.50189562032009.04.23++Space-occupying benign lesions in spleen: experiences in a single institute.Pediatr Surg Int
WB Pang, TC Zhang, YJ Chen, JZ Zhang,
To introduce a practical reference for the diagnosis and treatment of space-occupying benign lesions in children's spleens.
85715.50126796292003.07.25++Characterization of focal liver lesions with superparamagnetic iron oxide-enhanced MR imaging: value of distributional phase T1-weighted imaging.Korean J Radiol
JM Lee, CS Kim, JH Youk, MS Lee,
To determine the potential value of distributional-phase T1-weighted ferumoxides-enhanced magnetic resonance (MR) imaging for tissue characterization of focal liver lesions.
85815.50164142302006.08.09++Application of superparamagnetic iron oxide to imaging of hepatocellular carcinoma.Eur J Radiol
A Tanimoto, S Kuribayashi,
Superparamagnetic iron oxide (SPIO) particles are as MR contrast media composed of iron oxide crystals coated with dextran or carboxydextran. These particles are sequestered by phagocytic Kupffer cells in normal reticuloendothelial system (RES), but are not retained in tumor tissue. Consequently, there are significant differences in T2/T2* relaxation between normal RES tissue and tumors, which result in increased lesion conspicuity and detectability. The introduction of SPIO has been expected to substantially increase the detectability of hepatic metastases. For focal hepatocellular lesions, it has been documented that SPIO-enhanced MR imaging exhibits slightly better diagnostic performance than dynamic helical CT in the detection of hypervascular hepatocellular carcinoma (HCC). A combination of dynamic and static MR imaging technique using T1- and T2 imaging criteria appears to provide clinically more useful patterns of enhancement. SPIO-enhanced MR imaging also provides information useful for differential diagnosis, via enhancement of RES-containing tumors. With the exploitation of rapid T2*-sensitive sequences, SPIO-enhanced dynamic MR imaging may become comparable to gadolinium-enhanced dynamic MR imaging and dynamic studies with multidetector-row CT. SPIO-enhanced MR imaging plays an important role in therapeutic decision-making for patients with HCC.
85915.4987569021996.09.18+ Will ferumoxides-enhanced MR imaging replace CT during arterial portography in the detection of hepatic metastases? Prologue to a promising future.Radiology
P Soyer,
86015.4951470431972.06.29+ The spectrum of roentgen appearance in amyloidosis of the small and large bowel: radiologic-pathologic correlation.Radiology
G Seliger, RL Krassner, ER Beranbaum, F Miller,
86115.4885718611996.03.01++Detection of bleeding in patients with major pelvic fractures: value of contrast-enhanced CT.AJR Am J Roentgenol
DS Cerva, SE Mirvis, K Shanmuganathan, IM Kelly, SO Pais,
We performed a retrospective review of trauma patients who had undergone both pelvic angiography and preangiographic i.v. contrast-enhanced CT to determine whether CT can accurately demonstrate the presence or absence of pelvic bleeding in patients with multisystem trauma and major pelvic fractures.
86215.4715320841992.04.13++[Benign non-parasitic splenic cysts. 9 cases].Presse Med
J Pitre, P Guyon, E Dordain, P Bertheau, H Schill, B Bouvier, JL Pailler,
Benign non-parasitic splenic cysts are uncommon. Their diagnosis can benefit from ultrasounds and computed tomography. However, it may be difficult, before surgery, to distinguish between true cysts, which are congenital with epidermal lining, and false cysts, which are consecutive to a trauma, inflammatory or degenerative, without epidermal lining. We report nine cases of non-parasitic splenic cysts and try to determine the preoperative diagnostic approach. To prevent the overwhelming post-splenectomy infection syndrome, conservative surgical treatment is mandatory. Various surgical methods are discussed.
86315.47187836802008.12.30+ [Spontaneous hemoperitoneum due to hemangiosarcoma of the spleen].Cir Esp
A Liñán-Padilla, JM Suárez-Grau, Z Valera Sánchez, A Vázquez-Medina, F Docobo-Durántez,
86415.4692802491997.09.16++Liver hemangioma: US-guided 18-gauge core-needle biopsy.Radiology
A Heilo, AE Stenwig,
To assess the clinical usefulness of ultrasound (US)-guided, 18-gauge core-needle biopsy of liver hemangiomas performed with a one-hand automatic-sampling technique.
86515.45113502942001.07.05++Splenic involvement in lymphomas. Evaluation on serial CT examinations.Acta Radiol
M Daskalogiannaki, P Prassopoulos, G Katrinakis, I Tritou, G Eliopoulos, N Gourtsoyiannis,
To prospectively evaluate changes in splenic volume (SV) on serial CT of patients with lymphoma and correlate them with other indicators of the disease process.
86615.43175503302007.06.21++Sclerosing angiomatoid nodular transformation of the spleen.Arch Pathol Lab Med
AA Awamleh, B Perez-Ordoñez,
Sclerosing angiomatoid nodular transformation (SANT) is a recently recognized nonneoplastic vascular lesion of the spleen with fewer than 30 cases described. Microscopically, SANT consists of multiple well-circumscribed vascular/angiomatoid nodules showing plump endothelial cell and extravasated erythrocytes. The nodules are surrounded by a variable lymphoplasmacytic infiltrate, spindle cells, and collagenous stroma. The vascular nodules display a complex mixture of endothelial phenotypes resembling splenic sinusoids (CD34-/CD31+/CD8+), capillaries (CD34+/ CD31+/CD8-), and small veins (CD34-/CD31+/CD8-). Focal expression of CD68 can also be seen. The differential diagnosis of SANT includes splenic hamartoma, inflammatory myofibroblastic tumor, littoral cell angioma, and hemangioendothelioma. It has been postulated that SANT represents a peculiar hamartomatous transformation of splenic red pulp in response to an exaggerated nonneoplastic stromal proliferation. SANT has a benign clinical course with splenectomy being curative.
86715.42165857252006.06.13++Colour Doppler ultrasound patterns and clinical follow-up of incidentally found hypoechoic, vascular tumours of the spleen: evidence for a benign tumour.Br J Radiol
C Görg, K Görg, T Bert, P Barth,
Between January 1990 and January 2005, incidental hypoechoic, vascular tumours of the spleen were identified in 13 patients using B-mode and colour Doppler ultrasound (CDS). All lesions found were well demarcated, intrasplenically located, and ranged in size between 1 cm and 4 cm. The increased vascular pattern on CDS was confirmed in 9 of the 13 cases by contrast enhanced ultrasound (CES), while two patients showed reduced vascularity on CES. In 10 patients, lesions were confirmed by contrast enhanced CT. Histological examination was performed in three patients with the diagnosis of capillary haemangioma (n = 2) and hamartoma (n = 1). In the remaining cases, ultrasound follow-up was performed (range 4 months to 13 years) and demonstrated no evidence of tumour growth in all but one patient. During a 4 year follow-up, one lesion increased in size from 1.0 cm to 1.5 cm and in the same patient an additional 0.5 cm sized hypoechoic increased vascular lesion was also found. In the spleen a hypoechoic lesion with an increased vascular pattern incidentally found by ultrasound most likely indicates a benign tumour with capillary haemangioma/hamartoma as the most likely diagnosis. However, it should be emphasised that in all cases a careful ultrasound follow-up is warranted.
86815.4221610121990.07.05++Focal hepatic fatty infiltration as a cause of pseudotumors: ultrasonographic patterns and clinical differentiation.J Clin Ultrasound
SS Wang, JH Chiang, YT Tsai, SD Lee, HC Lin, YH Chou, FY Lee, JS Wang, KJ Lo,
Focal hepatic fatty infiltration may be mistaken for hepatic neoplasm on ultrasonography. A sonographic feature mimicking "space occupying lesions" was identified in 41 cases with focal fatty liver, which led to the recognition of four sonographic patterns: (1) Ten patients in whom the livers were characterized by irregular configurations of hyperechoic and hypoechoic areas. Although confusing to inexperienced sonographers, all of them were properly interpreted by experienced sonographers. (2) One patient in whom the hepatic sonography revealed a hyperechoic nodule, but which was correctly diagnosed by computed tomography (CT) scan. (3) Six patients in whom the livers were characterized by multiple confluent hyperechoic lesions, which were all misinterpreted by sonographers and misinterpreted following CT scans in 4 cases and angiography in 3 cases. (4) Twenty-four patients in whom the livers revealed focal spared areas, which was misdiagnosed by sonographers in 14 cases, but correctly diagnosed by CT scan in all 24 cases.
86915.4166500531984.01.27++[Percutaneous drainage of infected abdominal collections. Guiding principles and results].Acta Chir Belg
MS Reynaert, AN Dardenne, JL Jacquemart, PJ Kestens,
The authors report their results with percutaneous drainage of 29 abdominal abscesses in 28 patients. Two types of catheters were used: the pigtail angio-catheter and the trocar-catheter. CT scan and ultrasonography were the diagnostic technics used to localize the majority of these collections (20). Seventeen abscesses (58.6%) were cured by this drainage technique. Surgical drainage was necessary in 10 patients (34.4%). Six patients died: 4 of those had surgical drainage and 2 percutaneous drainage only. The cause of death in all cases was multiple organ failure secondary to a virulent noncontrolled infection. Analysis of the results uncovers 3 poor indications for percutaneous drainage: the digestive fistulous tract abscess, acute necrotic pancreatitis with secondary infection and the multi-loculated abscess. The best results are obtained in the case with a hepatic or left subdiaphragmatic abscess. No serious complication was related to the technique itself.
87015.4090659091997.05.23++Comparison of gadolinium chelates with manganese-DPDP for liver lesion detection and characterization: preliminary results.Magn Reson Imaging
U Kettritz, JF Schlund, K Wilbur, LB Eisenberg, RC Semelka,
Nonspecific extracellular gadolinium chelate (NEGd) was prospectively compared with managanese (Mn)-DPDP (Mn) for the detection and characterization of focal liver lesions of various histology. Seventeen patients with known or suspected focal liver lesions underwent NEGd and Mn-enhanced studies at 1.5 T. Study findings were correlated with histology (five patients), computed tomography (CT) examinations (17 patients), and 4- to 13-month imaging follow-up by CT and/or MR (five patients). NEGd studies were performed as serial postcontrast spoiled gradient echo (SGE) sequences, and Mn studies were performed as SGE sequences 15 and 30 min postocontrast and T1-weighted, fat-suppressed spin echo at 16 min. NEGd and Mn images were prospectively interpreted in a separate blinded fashion. Lesion detection and characterization were determined. NEGd and Mn-enhanced images demonstrated 61 and 49 lesions, respectively (p = .1, NS). A total of 60 and 33 lesions were characterized on NEGd and Mn images, respectively, which was significantly different (p = .008). No differences were observed for the detection and characterization of liver metastases; whereas there was a trend for superior detection and characterization for hepatocellular carcinoma with NEGA.
87115.40213377462011.03.03++[Differential diagnosis of intrathoracic lymph node lesions in lymphomas].Vestn Rentgenol Radiol
GA Stashuk, SE Dubrova, Adel Salem Ali Numan,
Thoracic lymphomas most commonly afflict the lymph nodes of the mediastinum and lung roots. A diagnostic difficulty is due to selectivity of the lesion in different groups of lymph nodes, which may be accompanied by no x-ray changes in the early stages of the process and by a disseminated lesion and polymorphism of its manifestations in the extensive stages of the disease.
87215.4015222671992.10.15++Differentiation of suprasellar nonneoplastic cysts from cystic neoplasms by Gd-DTPA MRI.J Comput Assist Tomogr
F Hua, R Asato, Y Miki, R Okumura, N Hashimoto, H Kikuchi, J Konishi,
Magnetic resonance imaging in 9 cases of surgically confirmed nonneoplastic intra- and/or suprasellar cysts was analyzed and compared with that from 17 cases of craniopharyngioma and 12 of cystic pituitary adenoma. Signal intensity did not help in distinguishing nonneoplastic cysts from cystic neoplasms. No postcontrast (Gd-DTPA) cyst wall enhancement was observed among the nonneoplastic cysts, although all 6 craniopharyngiomas and 12 cystic pituitary adenomas that underwent postcontrast study did enhance. Three nonneoplastic cysts were surrounded by the pituitary gland, thus mimicking wall enhancement in the postcontrast studies. Rapid enhancement in the early postcontrast-administration phase (dynamic studies) helped avoid confusion between the normal pituitary tissue and cyst wall enhancement. Magnetic resonance studies with contrast enhancement play an essential role in differentiating nonneoplastic cysts from cystic neoplasms in the sella region.
87315.39208588222010.10.29++Hepatic hemangioma and metastasis: differentiation with gadoxetate disodium-enhanced 3-T MRI.AJR Am J Roentgenol
S Goshima, M Kanematsu, H Watanabe, H Kondo, Y Shiratori, M Onozuka, N Moriyama,
The purpose of this study was to evaluate the gadoxetate disodium-enhanced MRI findings of hepatic hemangioma and to investigate the diagnostic performance in differentiating hepatic hemangioma and metastasis.
87415.38205747042011.03.03++CT-guided needle biopsy performed with modified coaxial technique in the diagnosis of malignant lymphomas.Radiol Med
P Pedote, F Gaudio, M Moschetta, A Cimmino, G Specchia, G Angelelli,
The aim of was study was to evaluate the accuracy of computed tomography (CT)-guided core needle biopsy (CNB) performed by modified coaxial technique as an alternative tool to surgical biopsy in patients with suspected malignant lymphoma.
87515.37188520872008.11.14++Small liver lesions in oncologic patients: characterization with CT, MRI and contrast-enhanced US.Cancer Imaging
G Morana, C Cugini, RP Mucelli,
Focal liver lesions (FLLs) are frequently discovered during ultrasound examinations either in healthy subjects without a clinical history of cancer or during staging or follow-up procedures in oncologic patients or in routine surveillance of hepatopathic patients. In oncologic patients, the liver is the most common target of metastatic disease and accurate detection and characterisation of FLLs is prognostically fundamental during the initial staging as well as before and after pre-operative chemotherapy, as it can help to identify patients who are most likely to benefit from liver surgery. Moreover, early detection of primary or secondary liver malignancies increases the possibility of curative surgical resection or successful percutaneous ablation. As many FLLs in these patients are benign, a precise and preferably non-invasive method of differentiation from malignant metastatic nodules is needed. Moreover, the continuous follow-up of cancer patients requires an easily available, reliable and cost-effective diagnostic tool for the detection and characterization of FLLs.
87615.3745500541974.10.09+ Changing clinical spectrum of splenic abscess.Am J Surg
T Gadacz, LW Way, JE Dunphy,
87715.3678247241995.02.14++T2-weighted breath-hold MR imaging of the liver at 1.5 T: results with a three-dimensional steady-state free precession sequence in 87 patients.Radiology
M Taupitz, A Speidel, B Hamm, M Deimling, M Reichel, A Bock, KJ Wolf,
To evaluate a fast three-dimensional (3D) sequence that permits the acquisition of 16 T2-weighted images within a 29-second breath hold for magnetic resonance (MR) imaging of the liver.
87815.3599519381999.05.26++Reversible hypersplenism after splenopexy for wandering spleen.Hepatogastroenterology
S Benoist, P Imbaud, M Veyrieres,
Wandering spleen is a rare condition characterized by a normal spleen with extreme mobility associated with an elongated pedicle. The most common presentation is an acute surgical abdomen related to acute torsion. A case of wandering spleen complicated by symptomatic hypersplenism in a 29 year-old woman is presented. The hypersplenism was diagnosed after bleeding delivery, requiring blood transfusion. Wandering spleen was suspected after pre-operatively performed CT scan. The patient was successfully treated by splenopexy. This report illustrates that conservative surgical management may result in complete reversal of hematological symptoms.
87915.347598441979.03.24 Case records of the Massachusetts General Hospital. Weekly clinicopathological exercises. Case 4-1979.N Engl J Med
88015.3483052671994.03.17++Cystic renal cell carcinoma. Imaging findings with pathologic correlation.Acta Radiol
Y Yamashita, O Watanabe, T Miyazaki, H Yamamoto, M Harada, M Takahashi,
Twenty-seven cystic renal cell carcinomas (RCC) in 23 patients were analyzed radiologically and histologically. They were classified into 4 histopathologic growth patterns: a) multilocular (n = 15, 9 with macrocystic and 6 with microcystic components); b) unilocular (n = 3); c) cystic necrosis (n = 9); and d) tumors originating in the wall of a simple cyst (n = 0). Macrocystic multilocular RCC showed multiloculated configuration on ultrasound and contrast enhanced CT. Angiography revealed neovascularity peripherally or within the tumor (7/9 tumors). Microcystic multilocular RCC did not fulfill the criterion for a cystic mass on ultrasound: they were irregularly hyperechoic. There was little enhancement on postcontrast CT and only slight neovascularity on angiography. Unilocular RCC showed a cystic mass with an irregular wall or mural nodules on ultrasound and contrast enhanced CT. Necrotic RCC showed various sonographic findings from anechoic to irregular echoic. The appearance on CT varied from cystic with mural nodules to a multiloculated or irregular architecture. Neovascularity was seen in the periphery in 8 of 9 tumors. Clinically, this type seemed to be the most aggressive.
88115.3390381301997.04.16++Enhancement characteristics of liver metastases, hepatocellular carcinomas, and hemangiomas with Gd-EOB-DTPA: preliminary results with dynamic MR imaging.Eur Radiol
P Reimer, EJ Rummeny, HE Daldrup, T Hesse, T Balzer, B Tombach, PE Peters,
Our objective was to study Gd-EOB-DTPA for the characterization of focal liver lesions by means of dynamic MR imaging. A double-blind and randomized dose-ranging phase-2 clinical trial was performed in 31 patients (liver metastases n = 23, hepatocellular carcinoma n = 4, and hemangioma n = 4) at a field strength of 1.0 Tesla. Gd-EOB-DTPA (Schering AG, Berlin, Germany) was administered as an IV bolus (12.5, 25, or 50 micromol/kg body weight) with dynamic T1-weighted MRI during the distribution and cellular uptake of the contrast agent at multiple time points up to 45 min post contrast. Dynamic changes in tumor signal intensity, tumor-liver contrast, enhancement patterns, side effects, and adverse events were evaluated. Monitoring of vital signs revealed no significant changes during bolus injection of Gd-EOB-DTPA. Liver metastases demonstrated an inhomogeneous uptake of Gd-EOB-DTPA during the distribution phase with a washout effect on delayed images > 3 min and highest tumor-liver contrast 20 and 45 min post contrast. Hepatocellular carcinomas showed prolonged enhancement as compared with metastases and hemangiomas. Hemangiomas exhibited an early peripheral-nodular enhancement with subsequent partial or complete filling, persisting enhancement < 10 min following injection of Gd-EOB-DTPA, and delayed washout as compared with liver metastases. Initial clinical experience suggests that Gd-EOB-DTPA as a bolus injectable hepatobiliary MR contrast agent may offer useful features for the characterization of focal liver lesions.
88215.3266911051984.02.14++Kaposi sarcoma and lymphadenopathy syndrome: limitations of abdominal CT in acquired immunodeficiency syndrome.Radiology
KL Moon, MP Federle, DI Abrams, P Volberding, BJ Lewis,
Abdominal computed tomography (CT) was performed in 31 patients with Kaposi sarcoma (KS) related to acquired immunodeficiency syndrome (AIDS), three patients with classic KS, and 12 patients with the newly described lymphadenopathy syndrome (LNS). The frequency, distribution, and appearance of lymphadenopathy and splenomegaly were similar in the AIDS-related KS and LNS groups. Rectal and perirectal disease was identified in 86% of the homosexual men studied; rectal KS could not be distinguished from proctitis on CT criteria alone. No CT abnormalities were seen in patients with classic KS. The CT demonstration of retroperitoneal, mesenteric, or pelvic adenopathy or of rectal or perirectal disease in patients with AIDS-related KS is not necessarily indicative of widespread involvement with the disease.
88315.3230782551990.03.19+ [Diseases of the spleen].Bildgebung
H Kellner, WG Zoller,
88415.3190510151997.03.28++Liver metastases: improved detection with dynamic gadolinium-enhanced MR imaging?Radiology
B Hamm, AE Mahfouz, M Taupitz, DG Mitchell, R Nelson, E Halpern, A Speidel, KJ Wolf, S Saini,
To compare dynamic gadolinium-enhanced with unenhanced magnetic resonance (MR) imaging in detection of liver metastases.
88515.3118920311991.10.11++CT appearance of splenic injuries managed nonoperatively.AJR Am J Roentgenol
HM Do, JJ Cronan,
This essay illustrates the appearance of the traumatized spleen on CT scans obtained during the course of conservative treatment. Although the CT appearance of acute rupture of the spleen has been adequately described, little has been reported about the appearance of the spleen as it heals after trauma. Examples of CT studies of splenic injuries illustrate the various changes in appearance over time in the traumatized spleen that is treated nonoperatively.
88615.3073913001980.09.28++Accessory spleen versus left adrenal tumor: computed tomographic and abdominal angiographic evaluation.J Comput Assist Tomogr
MG Stiris,
A soft tissue mass close to the upper pole of the left kidney was noted in a patient referred for intravenous pyelography. A left adrenal tumor was suspected. Computed tomography, however, revealed an accessory spleen. The diagnosis was confirmed by abdominal angiography.
88715.2817329611992.02.25++Renal lesions: controlled comparison between CT and 1.5-T MR imaging with nonenhanced and gadolinium-enhanced fat-suppressed spin-echo and breath-hold FLASH techniques.Radiology
RC Semelka, JP Shoenut, MA Kroeker, RG MacMahon, HM Greenberg,
Nonenhanced and gadolinium-enhanced fat-suppressed spin-echo and breath-hold fast low-angle shot (FLASH) magnetic resonance (MR) imaging techniques were compared with iodine contrast material-enhanced computed tomography (CT) for the detection and characterization of renal masses. MR studies included T1-weighted fat-suppressed spin-echo (T1FS) and FLASH images followed by rapid injection of gadopentetate dimeglumine and a repeated FLASH image obtained at 1 second, a T1FS image at 30 seconds, and a FLASH image at 10 minutes. Of 38 patients, 17 had renal cysts, 18 had solid tumors, two had cortical scarring, and one had a hypertrophied column of Bertin. With contrast-enhanced T1FS, contrast-enhanced FLASH, and CT images, 114, 110, and 109 lesions, respectively, were detected. With MR imaging and CT, cysts smaller than 5 mm in diameter and solid tumors as small as 1 cm in diameter were detected. With combined contrast-enhanced FLASH and T1FS images, 112 lesions were correctly characterized as cystic or solid; with nonenhanced T1FS images, 110; with nonenhanced FLASH images, 107; and with nonenhanced CT, 103.
88815.2880102081994.07.19++MR imaging of head and neck tumors: comparison of T1-weighted contrast-enhanced fat-suppres