A case of cervical juxtafacet cyst with extensive rim enhancement on Gd-DTPA MRI

Background: Contrast-enhanced spectral mammogram (CESM) is a modern technique providing additional information to detect or diagnose the breast cancers. Introduction: We present a rare ACC of breast on CESM. Methods: A 49-year-old woman with surgicopathological proved ACC is reported with features on CESM, sonography and contrast-enhanced magnetic resonance imaging (CE-MRI). Results: Sonography revealed a 1.4 cm × 1.2 cm × 1 cm circumscribe round mass in the upper outer quadrant of the left breast that was diagnosed to fibroadenoma. The mammogram did not show any discernible mass, however the recombined subtracted images displayed a circumscribe mass with thin rim enhancement and enhanced internal patches that were resembling to CE-MRI. Finally, the mass was proved to ACC. Conclusion: CESM facilitates detection of an isodense cancer and provides the enhanced features for differential diagnosis. Resembling CE-MRI, CESM displayed rim enhancement and internal enhanced patches as diagnostic clues for this case of ACC.

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Comparison of the clinical and MRI features of patients with hepatic hemangioma, epithelioid hemangioendothelioma, or angiosarcoma

10.21203/rs.2.16278/v1 ◽

2019 ◽

Author(s):

Zhuangsheng Liu ◽

Lilei Yi ◽

Junhao Chen ◽

Ruqiong Li ◽

Keming Liang ◽

...

Keyword(s):

Vascular Endothelial Cell ◽

Measurement Data ◽

Epithelioid Hemangioendothelioma ◽

Vascular Tumors ◽

Hepatic Hemangioma ◽

Mri Findings ◽

Mri Features ◽

Rim Enhancement ◽

The Difference ◽

Magnetic Resonance Imaging Mri

Abstract Background Comparisons of hepatic epithelioid hemangioendothelioma (HEHE), hepatic hemangioma, and hepatic angiosarcoma (HAS) have rarely been reported. The purpose of our study was to analyze the clinical and magnetic resonance imaging (MRI) findings of these conditions.Methods A total of 57 patients (25 with hemangioma, 13 with HEHE, and 19 with HAS) provided hepatic vascular endothelial cell data between June 2006 and May 2017. The measurement data were represented as means±SDs. Between-group comparisons were performed using independent-samples t-tests. Count data were represented as frequencies or rates, and χ2- or Fisher’s exact tests were performed.Results The proportions of cases with circumscribed margins were 88% (22/25), 84.6% (11/3), and 31.6% (6/19) for hemangioma, HEHE, and HAS, respectively (P<0.001). HAS lesions were less likely to have circumscribed margins. The proportions of lesions with hemorrhaging were 4% (1/25), 44.4% (4/13), and 36.8% (7/13) for hemangioma, HEHE, and HAS, respectively (P=0.014). HEHE and HAS cases were more likely to show heterogeneous signals on T1-weighted (T1WI) MRI. HEHE and HAS cases were more likely to show heterogeneous signals on T2-weighted (T2WI) MRI. Centripetal enhancement was the most common pattern in vascular tumors, with proportions of 100%, 46.2% (6/13), and 68.4% (13/19) for hemangioma, HEHE, and HAS, respectively. The difference in enhancement pattern between HEHE and HAS was not significant, but rim enhancement was more common for HEHE (46.2%, 6/13).Conclusions Our study revealed clinical and imaging differences between HEHE and HAS. The platelet count (PLT) and coagulation function of the HAS group decreased, whereas the alpha-fetoprotein (AFP) level increased. The 5-year survival rate for HAS was significantly lower than that of HEHE. A higher malignancy degree indicated a more blurred lesion margin, easier occurrence of hemorrhaging, and more heterogeneous plain T1WI and T2WI signals.

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Herpes Simplex Virus Hepatitis in an Immunocompetent Host Resembling Hepatic Pyogenic Abscesses

Case Reports in Hepatology ◽

10.1155/2016/8348172 ◽

2016 ◽

Vol 2016 ◽

pp. 1-5 ◽

Cited By ~ 3

Author(s):

Carrie Down ◽

Amit Mehta ◽

Gayle Salama ◽

Erika Hissong ◽

Russell Rosenblatt ◽

...

Keyword(s):

Herpes Simplex Virus ◽

Herpes Simplex ◽

Rare Complication ◽

Unknown Etiology ◽

Histologic Diagnosis ◽

Intravenous Acyclovir ◽

Rim Enhancement ◽

Magnetic Resonance Imaging Mri ◽

Hepatic Lesions ◽

Simplex Virus

Herpes simplex virus (HSV) hepatitis represents a rare complication of HSV infection, which can progress to acute liver failure and, in some cases, death. We describe an immunocompetent 67-year-old male who presented with one week of fever and abdominal pain. Computed tomography (CT) scan and magnetic resonance imaging (MRI) of the abdomen showed multiple bilobar hepatic lesions, some with rim enhancement, compatible with liver abscesses. Subsequent liver biopsy, however, revealed hepatocellular necrosis, HSV-type intranuclear inclusions, and immunostaining positive for herpes virus type 2 (HSV-2). Though initially treated with broad-spectrum antibiotics, following histologic diagnosis of HSV hepatitis, the patient was transitioned to intravenous acyclovir for four weeks and he achieved full clinical recovery. Given its high mortality and nonspecific presentation, one should consider HSV hepatitis in all patients with acute hepatitis with multifocal hepatic lesions of unknown etiology. Of special note, this is only the second reported case of HSV liver lesions mimicking pyogenic abscesses on CT and MRI.

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A Crescent-Shaped Juxtafacet Cyst as a Rare Cause of High Thoracic Myelopathy with Partial Brown-Séquard's Syndrome

Spine Surgery and Related Research ◽

10.22603/ssrr.2019-0043 ◽

2020 ◽

Vol 4 (2) ◽

pp. 184-186

Author(s):

Kazunobu Kida ◽

Toshikazu Tani

Keyword(s):

Thoracic Myelopathy ◽

Juxtafacet Cyst

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Usefulness of Modified CEUS LI-RADS for the Diagnosis of Hepatocellular Carcinoma Using Sonazoid

Diagnostics ◽

10.3390/diagnostics10100828 ◽

2020 ◽

Vol 10 (10) ◽

pp. 828

Author(s):

Katsutoshi Sugimoto ◽

Tatsuya Kakegawa ◽

Hiroshi Takahashi ◽

Yusuke Tomita ◽

Masakazu Abe ◽

...

Keyword(s):

Hepatocellular Carcinoma ◽

Predictive Value ◽

Arterial Phase ◽

Liver Imaging ◽

Adrenal Rest Tumor ◽

Contrast Enhanced ◽

Rim Enhancement ◽

Diagnostic Usefulness ◽

Adrenal Rest ◽

Sensitivity Specificity

The Contrast-Enhanced Ultrasound Liver Imaging Reporting and Data System (CEUS LI-RADS) was introduced for classifying suspected hepatocellular carcinoma (HCC). However, it cannot be applied to Sonazoid. We assessed the diagnostic usefulness of a modified CEUS LI-RADS for HCC and non-HCC malignancies based on sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV). Patients with chronic liver disease at risk for HCC were evaluated retrospectively. Nodules ≥1 cm with arterial phase hyperenhancement, no early washout (within 60 s), and contrast defects in the Kupffer phase were classified as LR-5. Nodules showing early washout, contrast defects in the Kupffer phase, and/or rim enhancement were classified as LR-M. A total of 104 nodules in 104 patients (median age: 70.0 years; interquartile range: 54.5–78.0 years; 74 men) were evaluated. The 48 (46.2%) LR-5 lesions included 45 HCCs, 2 high-flow hemangiomas, and 1 adrenal rest tumor. The PPV of LR-5 for HCC was 93.8% (95% confidence interval (CI): 82.8–98.7%). The 22 (21.2%) LR-M lesions included 16 non-HCC malignancies and 6 HCCs. The PPV of LR-M for non-HCC malignancies, including six intrahepatic cholangiocarcinomas, was 100% (95% CI: 69.8–100%). In conclusion, in the modified CEUS LI-RADS for Sonazoid, LR-5 and LR-M are good predictors of HCC and non-HCC malignancies, respectively.

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Cervico-thoracic juxtafacet cyst causing spinal foraminal widening

Joint Bone Spine ◽

10.1016/j.jbspin.2008.04.009 ◽

2008 ◽

Vol 75 (6) ◽

pp. 747-749 ◽

Cited By ~ 6

Author(s):

Ali Akhaddar ◽

Ouadie Qamouss ◽

Adil Belhachmi ◽

Abad Elasri ◽

Naama Okacha ◽

...

Keyword(s):

Juxtafacet Cyst

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Enhancing Mass on MRI

10.1093/med/9780190270261.003.0032 ◽

2018 ◽

Author(s):

John R. Scheel ◽

Diana L. Lam

Keyword(s):

Clinical Features ◽

Irregular Shape ◽

Differential Diagnoses ◽

Imaging Protocols ◽

Enhancement Curve ◽

Rim Enhancement ◽

Management Recommendations ◽

Space Occupying Lesion

The ACR BI-RADS Atlas defines a “mass” on MRI as a space-occupying lesion with convex borders. Masses are characterized by their morphology and their internal enhancement characteristics. Mass morphology descriptor categories include shape (oval, round, irregular), margins (circumscribed, irregular, spiculated), and internal enhancement (homogeneous, heterogeneous, rim enhancement, dark internal septations). Suspicious morphology descriptors of MRI masses include irregular shape, irregular or spiculated margins, and heterogeneous internal enhancement. This chapter, appearing in the section on asymmetry, mass, and distortion, reviews the key imaging and clinical features, imaging protocols, differential diagnoses, and management recommendations for an enhancing mass on MRI. Topics discussed include characteristics of benign and malignant masses, classic benign masses, and enhancement curve assessment.

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Characteristics of residual lymph nodes after six months of antituberculous therapy in HIV-negative individuals with cervical tuberculous lymphadenitis

BMC Infectious Diseases ◽

10.1186/s12879-019-4507-0 ◽

2019 ◽

Vol 19 (1) ◽

Cited By ~ 1

Author(s):

Hyeri Seok ◽

Ji Hoon Jeon ◽

Kyung Ho Oh ◽

Hee Kyoung Choi ◽

Won Suk Choi ◽

...

Keyword(s):

Lymph Nodes ◽

Needle Aspiration ◽

Ct Scans ◽

Tuberculous Lymphadenitis ◽

Antituberculous Therapy ◽

Antituberculous Treatment ◽

Rim Enhancement ◽

Tb Pcr ◽

Hiv Negative

Abstract Background The therapeutic response of cervical tuberculous lymphadenitis (CTBL) may be delayed or paradoxical, with the frequent development of residual lymph nodes (LNs) during and after antituberculous treatment. We investigated the incidence of residual LNs and the clinical, radiological, microbiological, and pathologic responses of patients with CTBL after 6 months of antituberculous therapy. Methods The medical records of HIV-negative adult patients with CTBL diagnosed between July 2009 and December 2017 were analyzed. After 6 months of first-line antituberculous treatment, computed tomography (CT) scans were conducted to evaluate for residual LNs. Fine-needle aspiration biopsy (FNAB) was carried out if a patient presented with residual LNs > 10 mm in diameter with central necrosis, peripheral rim enhancement, or perinodal inflammation on CT scan. Results Residual LNs were detected in 35 of 157 patients who underwent follow-up CT scans and were more commonly observed in younger patients who completed the treatment (mean years ± standard deviation [SD]: 33 ± 13 vs. 44 ± 16, p < 0.001). The recurrence rate was approximately 5%, which was not significantly different in both groups. Among the 15 patients who underwent FNAB, 3 (30%) presented with granuloma, and 2 of 15 and 10 of 14 patients had positive AFB and TB PCR results, respectively. The TB culture results of 15 patients were negative. Conclusions Residual LNs may still be observed after 6 months of antituberculous treatment. Although the radiologic and pathologic findings after treatment are still indicative of TB, not all residual LNs indicate recurrence or treatment failure. A six-month therapy may be sufficient for cervical tuberculous lymphadenitis.

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