scholarly journals P14.42 Diagnostic challenges of infratentorial hemangioblastomas: improvement of current radiological classification scheme

2019 ◽  
Vol 21 (Supplement_3) ◽  
pp. iii76-iii76
Author(s):  
I Jung ◽  
E Kim ◽  
J Moon ◽  
S Kang ◽  
J Chang
Keyword(s):  
Differential Diagnosis ◽  
Classification Scheme ◽  
Surgical Removal ◽  
Mri Findings ◽  
Von Hippel Lindau ◽  
Radiological Features ◽  
Radiological Classification ◽  
Magnetic Resonance Imaging Mri ◽  
Vhl Disease ◽  
Cystic Type

Abstract BACKGROUND Hemangioblastomas (HBMs) are known to exhibit very typical radiological features and thus classified by well-established radiological classification scheme. However, after we have experienced unusual cases in which current radiological classification system was not enough to categorize them, we reviewed our series of infratentorial HBMs in order not only to evaluate the relevance of current classification scheme, but also to possibly improve it. Also, we added descriptions on several cases with unusual radiological magnetic resonance imaging (MRI) findings in which differential diagnosis was challenging. MATERIAL AND METHODS We retrospectively reviewed preoperative MRI of 118 patients with pathologically diagnosed infratentorial HBMs at our institution between 2002 and 2015. Total 128 tumors were included to this study and classified into four categories based on the presence and nature of cystic components: extratumoral cystic (Type Ce, classical cystic with a mural nodule), intratumoral cystic (Type Ci), mixed cystic (Type Cm), and solid (Type S). The association with von Hippel-Lindau (VHL) disease was also investigated. RESULTS In 118 patients (65 male and 53 female), 79 (66.9%) had solitary HBMs and 39 (33.1%) were diagnosed with VHL disease. Type Ce with typical radiological findings was the most prevalent type of HBM (63.3%), followed by Type S (21.1%). HBMs with intratumoral cysts were uncommon (Type Ci, 11.7%) and mixed extratumoral and intratumoral cysts (Type Cm) accounted for only 3.9%. No intergroup differences were observed in the proportions of each subtype between the solitary and VHL disease-associated HBMs. CONCLUSION Radiological features of HBMs are usually typical thus preoperative presumption is not difficult in majority of cases. Improved radiological classification scheme is more practical because it does not only help surgeons determine whether the cystic wall should be removed or not, but also covers cases with atypical radiological presentations. For solid and extraparenchymal HBMs, differential diagnosis is more difficult as well as very critical as surgical removal is often very challenging.

scholarly journals Management Difficulties of Cerebeller Haemangioblastoma: A Case Report and Literature Review

1970 ◽  
Vol 11 (2) ◽  
pp. 155-158
Author(s):  
Forhad Hossain Chowdhury ◽  
Md Raziul Haque ◽  
Md Shafiqul Islam ◽  
Mainul Haque Sarkar ◽  
Syed Mahbubul Alam
Keyword(s):  
Gamma Knife Radiosurgery ◽  
En Bloc Resection ◽  
Bloc Resection ◽  
Surgical Removal ◽  
Severe Bleeding ◽  
En Bloc ◽  
Altered Level ◽  
Von Hippel Lindau ◽  
The Rich ◽  
Magnetic Resonance Imaging Mri

The surgical removal of solid deep-seated haemangioblastomas remains challenging, because treatment of theselesions is often complicated by severe bleeding associated with the rich vascularity of this tumor and by severe neuraltissue injury associated with the difficulty of en bloc resection. A 55 year-old man, was admitted to us with inability tostand & walk due to imbalance and altered level of conciousness .He has family history of Von Hippel Lindau(VHL)disease. He underwent microsurgery followed by gamma knife radiosurgery 13 years back for cerebellerhaemangioblastoma. Magnetic resonance imaging (MRI) revealed intra-axial mass with multiple large cysts incerebellum with severe compression on cerebellum and brainstem. Preoperative angiography revealed a hypervasculartumor in the posterior fossa, he underwent microsurgery through the previous midline suboccipital craniotomyinvolving the removal of the arch of C-1. Patient recovered slowly in post operative period.Keywords: Cerebeller haemangioblastoma; Von Hippel Lindau disease; Radiosurgery; MicrosurgeryDOI: 10.3329/jom.v11i2.5463J MEDICINE 2010; 11 : 155-158

scholarly journals A case report of lymphocytic hypophysitis

2021 ◽  
Vol 12 ◽  
pp. 263
Author(s):  
Stephen Yu ◽  
Ramakrishna Bethanabatla ◽  
Ahmed Taha
Keyword(s):  
Differential Diagnosis ◽  
Rare Condition ◽  
Lymphocytic Hypophysitis ◽  
Reproductive Age ◽  
Case Description ◽  
Clinical Correlation ◽  
Resonance Imaging ◽  
Sellar Mass ◽  
Mri Findings ◽  
Magnetic Resonance Imaging Mri

Background: Lymphocytic hypophysitis (LH) is a rare condition that mostly affects women of the reproductive age. Because it is infrequently encountered, it is not often considered as a differential diagnosis of sellar masses. The diagnosis is made clinically with the aid of magnetic resonance imaging (MRI) and should be considered if the patient has endocrine derangements in addition to a sellar mass. Case Description: A 37-year-old female presents with a complaint of headaches and CT imaging showed a sellar mass. She was also being investigated simultaneously by the endocrine department and was diagnosed with panhypopituitarism. She proceeded to surgery for a presumed pituitary adenoma but histopathology returned as LH. Conclusion: It is important to have a wide differential diagnosis when managing pituitary masses. Clinical correlation with atypical MRI findings is useful to determine the diagnosis of LH.

Parasellar epidermoid cyst rupturing into the nasopharynx

2005 ◽  
Vol 119 (2) ◽  
pp. 140-143 ◽  
Author(s):  
A S Shaw ◽  
S E J Connor
Keyword(s):  
Magnetic Resonance Imaging ◽  
Computed Tomography ◽  
Differential Diagnosis ◽  
Magnetic Resonance ◽  
Skull Base ◽  
Epidermoid Cyst ◽  
Resonance Imaging ◽  
Intracranial Tumours ◽  
Radiological Features ◽  
Magnetic Resonance Imaging Mri

Epidermoid tumours are non-neoplastic inclusion cysts representing up to 1.1 per cent of all intracranial tumours, typically presenting with symptoms related to pressure or intracranial rupture in the fourth or fifth decade of life. The authors present a case of a parasellar epidermoid cyst which has ruptured in to the nasopharynx; to the best of their knowledge, this has not been previously reported. The computed tomography (CT) and magnetic resonance imaging (MRI) are presented. The pathology and radiological features of epidermoid tumours are discussed, particularly in relation to extracranial connections. The differential diagnosis of lesions eroding the central skull base is reviewed.

Rapidly Progressive Dementia: A Clinicopathologic Correlation

1996 ◽  
Vol 9 (4) ◽  
pp. 209-213
Author(s):  
John C. Adair ◽  
Ronald L. Schwartz ◽  
Thomas A. Eskin ◽  
Anthony T. Yachnis ◽  
Kenneth M. Heilman
Keyword(s):  
Magnetic Resonance Imaging ◽  
Differential Diagnosis ◽  
Magnetic Resonance ◽  
Progressive Multifocal Leukoencephalopathy ◽  
Resonance Imaging ◽  
Mri Findings ◽  
Progressive Dementia ◽  
Clinicopathologic Correlation ◽  
Dementia Syndrome ◽  
Magnetic Resonance Imaging Mri

We evaluated a 66-year-old man with a rapidly progressive, akinetic-rigid dementia syndrome. Despite extensive testing, which included magnetic resonance imaging (MRI), we were unable to make the correct antemortem diagnosis. Autopsy demonstrated spontaneous progressive multifocal leukoencephalopathy. This report illustrates that even in the absence of characteristic MRI findings, this uncommon cause of dementia should be considered in the differential diagnosis of rapidly progressive, akinetic-rigid syndromes with dementia.

scholarly journals Lymphocitic infundibuloneurohypophysitis mimicking a pituitary adenoma

2011 ◽  
Vol 1 (3) ◽  
pp. 48 ◽  
Author(s):  
Lorenzo Giammattei ◽  
Homajoun Maslehaty ◽  
Athanasios K. Petridis ◽  
Hubertus Maximilian Mehdorn
Keyword(s):  
Pituitary Adenoma ◽  
Rare Case ◽  
Clinical Characteristics ◽  
Surgical Removal ◽  
Resonance Imaging ◽  
Cranial Magnetic Resonance Imaging ◽  
Radiological Features ◽  
Neurosurgical Treatment ◽  
Magnetic Resonance Imaging Mri ◽  
Weighted Sequences

A rare case of infundibulo-neurohypophysitis mimicking a pituitary adenoma is presented. A 69-years-old female patient developed polyuria and polydipsia. Laboratory analysis revealed central diabetes insipidus. No hormonal abnormalities. Cranial-magnetic resonance imaging (MRI) showed a left sided mass in the adenohypophysis presuming a pituitary adenoma. The mass had contact to both internal carotids. Admission to our department for neurosurgical treatment followed. Ophthalmo - logic examination and neurological examination yielded normal findings. A second MRI focussing on the sellar-region showed a leftsided (T2-MRI.hyperintense), distended adenohypophysis, without contrast enhancement in T1. The stalk appeared thickened. T1- weighted sequences of the neurohypophysis showed loss of signal intensity. We diagnosed an infundibulo-neurohypophysitis and abstai - ned from surgical removal. The patient was discharged under treatment with corticosteroids and desmopressin. Hypophysitis is rare and shows special clinical characteristics. Despite defined radiological features to differentiate between hypophysitis and adenoma the possibility of misdiagnosis, and unnecessary surgical procedures, should always kept in mind.

Accuracy of Rotator Cuff Tears and Tendinosis Diagnoses on Shoulder Ultrasound Performed by a Short-experienced Operator

2018 ◽  
Vol 1 ◽  
pp. 9
Author(s):  
Harshad Arvind Vanjare ◽  
Jyoti Panwar
Keyword(s):  
Rotator Cuff ◽  
Negative Predictive Value ◽  
Rotator Cuff Tear ◽  
Predictive Value ◽  
Rotator Cuff Tears ◽  
Mri Findings ◽  
Cuff Tear ◽  
Experienced Operator ◽  
Magnetic Resonance Imaging Mri ◽  
Sensitivity Specificity

Objective The objective of the study was to assess the accuracy of ultrasound examination for the diagnosis of rotator cuff tear and tendinosis performed by a short experienced operator, compared to magnetic resonance imaging (MRI) results. Method A total of 70 subjects suspected to have rotator cuff tear or tendinosis and planned for shoulder MRI were included in the study. Shoulder ultrasound was performed either before or after the MRI scan on the same day. Ultrasound operator had a short experience in performing an ultrasound of the shoulder. Ultrasound findings were correlated to MRI findings. Results Sensitivity, specificity, positive predictive value, negative predictive value, and accuracy for the diagnosis of tendinosis were 58%, 84%, 63%, 80%, and 75%, respectively, and it was 68%, 91%, 73%, 88%, and 85%, respectively, for the diagnosis of rotator cuff tear. Conclusions Sensitivity for diagnosing rotator cuff tear or tendinosis was moderate but had a higher negative predictive value. Thus, the ultrasound operator with a short experience in performing shoulder ultrasound had moderate sensitivity in diagnosing tendinosis or tears; however, could exclude them with confidence.

State-of-the-art MR Imaging of Fat-containing Focal Lesions of the Liver

2019 ◽  
Vol 15 (5) ◽  
pp. 435-442
Author(s):  
Joanna Podgorska ◽  
Agnieszka Anysz-Grodzicka ◽  
Andrzej Cieszanowski
Keyword(s):  
Differential Diagnosis ◽  
Imaging Techniques ◽  
Hepatobiliary Phase ◽  
Focal Lesions ◽  
Dysplastic Nodules ◽  
Nodular Hyperplasia ◽  
Specific Finding ◽  
Magnetic Resonance Imaging Mri ◽  
Adrenal Rest ◽  
Mri Characteristics

Background: Fat can be identified in numerous liver lesions, and usually is not a specific finding. Distinguishing between different kinds of fatty deposits is an important part of differential diagnosis. Magnetic Resonance Imaging (MRI) is superior to other imaging techniques because it allows distinguishing intracellular from macroscopic fat. Discussion: Intracellular lipid may be found in focal hepatic steatosis, hepatic adenoma, hepatocellular carcinoma and, less commonly, in focal nodular hyperplasia as well as regenerative and dysplastic nodules. Macroscopic fat is seen in angiomyolipoma, lipoma, metastases from fatcontaining neoplasms, primary or metastatic liposarcoma, hydatid cyst, pseudolipoma of the Glisson capsule, pericaval fat collection, lipopeliosis, hepatic teratoma, focal hepatic extramedullary haematopoiesis and adrenal rest tumour. Conclusion: Liver nodules should be characterised with regard to underlying liver condition, MRI characteristics and contrast enhancement pattern, including hepatobiliary phase. In many cases, identification of fatty content may help narrowing the differential diagnosis.

Computed Tomography and Magnetic Resonance Imaging-aided Diagnosis of Primary Essential Cutis Verticis Gyrata: A Case Report with 5-year Follow-up and Review of the Literature

2019 ◽  
Vol 15 (9) ◽  
pp. 906-910
Author(s):  
Hongzhang Zhu ◽  
Shi-Ting Feng ◽  
Xingqi Zhang ◽  
Zunfu Ke ◽  
Ruixi Zeng ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Three Dimensional ◽  
Stable Condition ◽  
Resonance Imaging ◽  
Mri Findings ◽  
Cutis Verticis Gyrata ◽  
Essential Form ◽  
History Of ◽  
Magnetic Resonance Imaging Mri

Background: Cutis Verticis Gyrata (CVG) is a rare skin disease caused by overgrowth of the scalp, presenting as cerebriform folds and wrinkles. CVG can be classified into two forms: primary (essential and non-essential) and secondary. The primary non-essential form is often associated with neurological and ophthalmological abnormalities, while the primary essential form occurs without associated comorbidities. Discussion: We report on a rare case of primary essential CVG with a 4-year history of normal-colored scalp skin mass in the parietal-occipital region without symptom in a 34-year-old male patient, retrospectively summarizing his pathological and Computer Tomography (CT) and magnetic resonance imaging (MRI) findings. The major clinical observations on the CT and MR sectional images include a thickened dermis and excessive growth of the scalp, forming the characteristic scalp folds. With the help of CT and MRI Three-dimensional (3D) reconstruction techniques, the characteristic skin changes could be displayed intuitively, providing more evidence for a diagnosis of CVG. At the 5-year followup, there were no obvious changes in the lesion. Conclusion: Based on our observations, we propose that not all patients with primary essential CVG need surgical intervention, and continuous clinical observation should be an appropriate therapy for those in stable condition.

scholarly journals Balo’s Concentric Sclerosis Mimicking Tumor on Magnetic Resonance Imaging in a Young Patient

2021 ◽  
Vol 14 ◽  
pp. 117954762198967
Author(s):  
Van Trung Hoang ◽  
Cong Thao Trinh ◽  
Hoang Anh Thi Van ◽  
Thanh Tam Thi Nguyen ◽  
Vichit Chansomphou ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Demyelinating Disease ◽  
Management Strategies ◽  
Resonance Imaging ◽  
Mri Findings ◽  
Demyelinating Lesions ◽  
Baló’S Concentric Sclerosis ◽  
Magnetic Resonance Imaging Mri ◽  
Subcortical Regions

Balo’s concentric sclerosis (BCS) is a rare demyelinating disease known as Multiple Sclerosis (MS) lesion type III. It is a disease of the white matter of the brain characterized by a round lesion with variable concentric myelinated and demyelinated layers, appearing as “onion bulb.” We present a case of BCS and discuss the imaging findings and management strategies of this disease. A 26-y-old male developed headache, weakness, and numbness of limbs. Magnetic resonance imaging (MRI) showed concentric lamellar like demyelinating lesions at the subcortical regions. The patient’s neurological symptoms were consistent with the MRI findings.

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