scholarly journals Atypical magnetic resonance imaging features and differential diagnosis of hepatocellular carcinoma

2020 ◽  
Vol 48 (10) ◽  
pp. 030006052094341
Author(s):  
Shuang-Yu Wang ◽  
Lei Yin ◽  
Chen Wang ◽  
Ming-Ping Ma

Objective Hepatocellular carcinoma (HCC) is the most common primary malignant tumor of the liver. We aimed to summarize and analyze the atypical magnetic resonance imaging (MRI) features of HCC to improve its diagnostic accuracy. Methods We retrospectively analyzed MRI data for 66 patients with HCC with atypical MRI features confirmed by operation and pathology. Results Twelve patients had high signals and 18 patients had significant decreases in opposed phase signals in T1WI plain scans. Nine patients had high signals and six patients had large cystic lesions in apparent diffusion coefficient images. Dynamic enhancement showed progressive enhancement in 15 patients, ring enhancement in three, irregular patchy enhancement in three, ‘nodule-in-nodule’ enhancement in six, delayed central patchy enhancement in six, delayed central ‘star-like aristate scars’ (T2WI revealed high signal intensity) in 21, and poor blood supply in three patients. Conclusions MRI can make a clear diagnosis of typical HCC, and atypical cases can also be distinguished from other tumors or tumor-like lesions by MRI. The analysis of atypical signs may improve the diagnostic accuracy of MRI for HCC.

2017 ◽  
Vol 50 (2) ◽  
pp. 115-125 ◽  
Author(s):  
Miguel Ramalho ◽  
António P. Matos ◽  
Mamdoh AlObaidy ◽  
Fernanda Velloni ◽  
Ersan Altun ◽  
...  

Abstract In the second part of this review, we will describe the ancillary imaging features of hepatocellular carcinoma (HCC) that can be seen on standard magnetic resonance imaging (MRI) protocol, and on novel and emerging protocols such as diffusion weighted imaging and utilization of hepatocyte-specific/hepatobiliary contrast agent. We will also describe the morphologic sub-types of HCC, and give a simplified non-invasive diagnostic algorithm for HCC, followed by a brief description of the liver imaging reporting and data system (LI-RADS), and MRI assessment of tumor response following locoregional therapy.


2019 ◽  
Vol 9 (1) ◽  
Author(s):  
Francesco Vasuri ◽  
Matteo Renzulli ◽  
Silvia Fittipaldi ◽  
Stefano Brocchi ◽  
Alfredo Clemente ◽  
...  

Abstract Many advances have been made in the imaging diagnosis and in the histopathological evaluation of HCC. However, the classic imaging and histopathological features of HCC are still inadequate to define patient’s prognosis. We aimed to find the link between new proposed morphovascular patterns of hepatocellular carcinoma (HCC) and magnetic resonance imaging (MRI) features to identify pre-operatory markers of biologically aggressive HCC. Thirty-nine liver nodules in 22 patients were consecutively identified. Histopathological analysis and immunohistochemistry for CD34 and Nestin were performed to identify the four different HCC morphovascular patterns. MRI was performed using gadolinium ethoxybenzyl diethylenetriamine pentaacetic acid. Three out of four morphovascular HCC patterns showed peculiar MRI features: in particular Pattern D (solid aggressive HCCs with CD34+/Nestin+ new-formed arteries) were isointense on T1-WI in 83% of cases and hyperintense on T2-WI in 50%. Five histologically-diagnosed HCC were diagnosed as non-malignant nodules on MRI due to their early vascularization and low aggressiveness (Pattern A). The comparison between histology and MRI confirms that a subclassification of HCC is possible in a pre-operatory setting. MRI seems to reinforce once more the identity of the different morphovascular HCC patterns and the possibility to pre-operatively identify HCCs with features of biological aggressiveness.


2021 ◽  
Author(s):  
Guo Hui ◽  
Wenya Liu ◽  
Jian Wang ◽  
Yan Xing

Abstract Background. Alveolar echinococcus (AE) is a severe health problem in endemic areas. In recent years, the incidence of this disease in China has been increasing. The study was designed to illustrate the multi-slice computed tomography (MSCT) and magnetic resonance imaging (MRI) features of extrahepatic AE.Methods. A cohort of 33 patients who suffered from extrahepatic AE was enrolled consecutively from January 2012 to December 2017. The MSCT and MRI features of extrahepatic AE were recorded and analyzed by experienced radiologists. The MSCT and MRI agreements for detecting imaging features of extrahepatic AE were calculated using kappa statistics.Results. All cases secondary to hepatic AE, except two primary extrahepatic AE, were found in this study. Locations of extrahepatic AE included 19 (57.6%) lung, 10 (30.3%) adrenal gland, 9 (27.3%) brain, 5 (15.2%) peritoneal cavity, 5 (15.2%) spleen, 4 (12.1%) diaphragm, 3 (9.1%) kidney, 3 (9.1%) retroperitoneal, and 2 (6.1%) vertebra; Involvement of 1 (3.0%) heart, 1 (3.0%) mediastinum, 1 (3.0%) muscle, and 1 (3.0%) pancreas was rare. AE of the lung usually appeared as irregular and scattered nodules with small vacuoles or cavities inside and peripheral distribution. Multiple cerebral nodules with calcification and surrounding edema were the most common features seen in brain AE. Adrenal gland AE presented as plaques containing different sizes of hypodense areas and different amounts of calcification. Injection of contrast medium showed no enhancement of lesions except in the brain. Very good agreements were seen between MSCT and MR for detecting number (κ=0.841, p=0.000), border (κ=0.911, p=0.000) and size (κ=0.864, p=0.000) of extrahepatic AE.Conclusions. MSCT and MRI are reliable imaging methods for the diagnosis of extrahepatic AE. When one AE patient is clinically confirmed, MSCT scan from the head to pelvis should be performed to exclude other organs AE.


2007 ◽  
Vol 48 (8) ◽  
pp. 921-933 ◽  
Author(s):  
K. M. Elsayes ◽  
V. R. Narra ◽  
J. R. Dillman ◽  
V. Velcheti ◽  
O. Hameed ◽  
...  

The detection of vaginal lesions has increased with the expanding use of cross-sectional imaging. Magnetic resonance imaging (MRI)—with its high-contrast resolution and multiplanar capabilities—is often useful for characterizing vaginal masses. Vaginal masses can be classified as congenital, inflammatory, cystic (benign), and neoplastic (benign or malignant) in etiology. Recognition of the typical MR imaging features of such lesions is important because it often determines the treatment approach and may obviate surgery. Finally, vaginal MR imaging can be used to evaluate post-treatment changes related to previous surgery and radiation therapy. In this article, we will review pertinent vaginal anatomy, vaginal and pelvic MRI technique, and the MRI features of a variety of vaginal lesions with pathological correlation.


Cephalalgia ◽  
2010 ◽  
Vol 30 (9) ◽  
pp. 1133-1136 ◽  
Author(s):  
BVS Guedes ◽  
AJ da Rocha ◽  
HB Zuppani ◽  
CJ da Silva ◽  
WL Sanvito

Tolosa–Hunt syndrome (THS) consists of a painful ophthalmoplegia with typical features in magnetic resonance imaging (MRI). The recurring nature of this affliction has been known since its first description. However, compromise of the contralateral cavernous sinus, known as alternating THS, is very rare and has never been examined using MRI. We report clinical data, laboratory data and imaging features of a patient with alternating THS. According to our literature review, this is the first MRI study of THS.


1987 ◽  
Vol 66 (6) ◽  
pp. 830-834 ◽  
Author(s):  
John L. Doppman ◽  
Giovanni Di Chiro ◽  
Andrew J. Dwyer ◽  
Joseph L. Frank ◽  
Edward H. Oldfield

✓ Magnetic resonance imaging (MRI) was performed on 12 patients with spinal arteriovenous malformations (AVM's). Six lesions were intramedullary, five were dural, and one was in a posterior extramedullary location. Serpentine filling defects similar to the classic myelographic findings were demonstrated within the high-signal cerebrospinal fluid on T2-weighted coronal scans. The intramedullary nidus was identified by MRI as an area of low-signal intensity within the cord in all six intramedullary AVM's. Neither the dural nor the posterior extramedullary lesions showed intramedullary components. It is concluded that MRI may noninvasively provide the initial diagnosis of a spinal AVM and distinguish intramedullary from dural and extramedullary lesions.


2012 ◽  
Vol 19 (1) ◽  
pp. 76-86 ◽  
Author(s):  
Michael Absoud ◽  
Ming J Lim ◽  
Wui K Chong ◽  
Christian G De Goede ◽  
Katharine Foster ◽  
...  

Objective: Changing trends in multiple sclerosis (MS) epidemiology may first be apparent in the childhood population affected with first onset acquired demyelinating syndromes (ADSs). We aimed to determine the incidence, clinical, investigative and magnetic resonance imaging (MRI) features of childhood central nervous system ADSs in the British Isles for the first time. Methods: We conducted a population active surveillance study. All paediatricians, and ophthalmologists ( n = 4095) were sent monthly reporting cards (September 2009–September 2010). International Paediatric MS Study Group 2007 definitions and McDonald 2010 MS imaging criteria were used for acute disseminated encephalomyelitis (ADEM), clinically isolated syndrome (CIS) and neuromyelitis optica (NMO). Clinicians completed a standard questionnaire and provided an MRI copy for review. Results: Card return rates were 90%, with information available for 200/222 positive notifications (90%). After exclusion of cases, 125 remained (age range 1.3–15.9), with CIS in 66.4%, ADEM in 32.0% and NMO in 1.6%. The female-to-male ratio in children older than 10 years ( n = 63) was 1.52:1 ( p = 0.045). The incidence of first onset ADS in children aged 1–15 years old was 9.83 per million children per year (95% confidence interval [CI] 8.18–11.71). A trend towards higher incidence rates of ADS in children of South Asian and Black ethnicity was observed compared with White children. Importantly, a number of MRI characteristics distinguished ADEM from CIS cases. Of CIS cases with contrast imaging, 26% fulfilled McDonald 2010 MS diagnostic criteria. Conclusions: We report the highest surveillance incidence rates of childhood ADS. Paediatric MS diagnosis at first ADS presentation has implications for clinical practice and clinical trial design.


2019 ◽  
Vol 39 (6) ◽  
Author(s):  
Liang Deng ◽  
Liangfang Shen ◽  
Lin Shen ◽  
Zhao Zhao ◽  
Yingpeng Peng ◽  
...  

AbstractIntroduction: The treatment strategy for low-grade gliomas (LGGs) is still controversial, and there are no standardized criteria to predict the prognosis of patients with LGGs. Magnetic resonance imaging (MRI) is a routine test for preoperative diagnosis for LGG and can reflect the destructive features for the tumor. In the present study, we aimed to explore the relationship between the MRI features and prognosis in patients with LGG.Methods: Clinical data of 80 patients with pathologically proved LGGs between January 2010 and December 2016 were analyzed retrospectively. MRI features were classified as contrast enhancement pattern (focal enhancement, diffuse enhancement and ring-like enhancement), necrosis and cysts based on the preoperative MR images. Kaplan–Meier method and multivariate analysis were performed on the data by SPSS software to explore the prognostic significance of MRI features.Results: Patients with cystic LGG had a significantly longer 5-year progression-free survival (PFS) than that with no cyst (90.9 ± 8.7 vs 65.7 ± 9.1%, P=0.045). Multivariate analysis further verified cyst as an independent prognosis factor for PFS (P=0.027, hazard ratio [HR] = 0.084). Additionally, patients with ring-like enhancement exhibited significantly longer 5-year PFS time in the Kaplan–Meier survival curves (100 vs 67.2 ± 7.7%, P=0.049). There was no significant difference in PFS and overall survival (OS) between patients with or without necrosis.Conclusion: Our study suggests that cyst formation and ring-like enhancement on preoperative MR images can be useful to predict a favorable prognosis in patients with LGGs.


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