Sellar, suprasellar, and parasellar masses: Imaging features and neurosurgical approaches

2021 ◽  
pp. 197140092110551
Author(s):  
Bryan Lubomirsky ◽  
Zachary B Jenner ◽  
Morgan B Jude ◽  
Kiarash Shahlaie ◽  
Reza Assadsangabi ◽  
...  
Keyword(s):  
Expert Knowledge ◽  
Surgical Techniques ◽  
Cranial Neuropathy ◽  
Special Focus ◽  
Imaging Features ◽  
Endoscopic Endonasal ◽  
Visual Field Deficits ◽  
Histopathologic Evaluation ◽  
Skull Base Anatomy ◽  
Ct And Mri

The sellar, suprasellar, and parasellar space contain a vast array of pathologies, including neoplastic, congenital, vascular, inflammatory, and infectious etiologies. Symptoms, if present, include a combination of headache, eye pain, ophthalmoplegia, visual field deficits, cranial neuropathy, and endocrine manifestations. A special focus is paid to key features on CT and MRI that can help in differentiating different pathologies. While most lesions ultimately require histopathologic evaluation, expert knowledge of skull base anatomy in combination with awareness of key imaging features can be useful in limiting the differential diagnosis and guiding management. Surgical techniques, including endoscopic endonasal and transcranial neurosurgical approaches are described in detail.

scholarly journals Head and neck osteosarcoma: CT and MR imaging features

2020 ◽  
Vol 49 (2) ◽  
pp. 20190202
Author(s):  
Zhendong Luo ◽  
Weiguo Chen ◽  
Xinping Shen ◽  
Genggeng Qin ◽  
Jianxiang Yuan ◽  
...  
Keyword(s):  
Soft Tissue ◽  
Head And Neck ◽  
Giant Cell ◽  
High Signal ◽  
Imaging Features ◽  
Matrix Mineralization ◽  
Imaging Characteristics ◽  
Mri Features ◽  
Signal Intensities ◽  
Ct And Mri

Objective: This study aims to assess the CT and MRI features of head and neck osteosarcoma (HNO). Methods: 37 HNOs were identified, and the following imaging characteristics were reviewed on CT and MRI. Results: A total of 37 patients(age 41.5 ± 15.0 years old; 16 males, 21 females) were included in the study. Tumours occurred in the maxilla (16, 43.2%), mandible (8, 21.6%), skull base (6, 16.2%), calvarium (5, 13.5%), paranasal sinuses (1, 2.7%) and cervical soft tissue (1, 2.7%). 16 patients received radiotherapy for nasopharyngeal carcinoma. Three patients (8.1%) developed osteosarcomas related to a primary bone disease. 16 of the (43.2%) tumours demonstrated lytic density on CT scans, followed by 13 (35.1%) showing mixed density and 7 (18.9%) with sclerotic density. Matrix mineralization was present in 32 (86.5%). 3 out of 24 (12.5%) tumours showed lamellar periosteal reactions, 21 out of 24 (87.5%) showed spiculated periosteal reactions. 12 tumours showed low signal intensities on T1WI, with 16 having heterogeneous signal intensities. 10 tumours showed high signal intensities on T2WI, and 18 showed heterogeneous signal intensities. With contrast-enhanced images, 3 tumours showed homogeneous enhancement (2 osteoblastic and 1 giant cell-rich), 18 tumours showed heterogeneous enhancement (13 osteoblastic, 4 fibroblastic and 1 giant cell-rich), and 7 tumours showed peripheral enhancement (6 chondroblastic and 1 osteoblastic). These tumours were characterized by soft tissue masses with a diameter of 5.6 ± 1.8 cm. Conclusions: HNO is a rare condition and is commonly associated with previous radiation exposure. This study provides age, sex distribution, location, CT and MRI features of HNO.

scholarly journals Primary Malignant Orbital Tumors

2021 ◽  
Vol 82 (01) ◽  
pp. 081-090
Author(s):  
Jacquelyn Laplant ◽  
Kimberly Cockerham
Keyword(s):  
Multimodal Therapy ◽  
Surgical Techniques ◽  
Surgical Approaches ◽  
Imaging Features ◽  
Orbital Surgery ◽  
Diagnosis And Management ◽  
Microsurgical Techniques ◽  
Invasive Techniques ◽  
Traditional Approaches ◽  
Orbital Imaging

Abstract Objective Primary orbital malignancy is rare. Awareness of the characteristic clinical and imaging features is imperative for timely identification and management. Surgery remains an important diagnostic and treatment modality for primary orbital malignancy, but determining the optimal surgical approach can be challenging. The purpose of this article is to explore recent advances in the diagnosis, management, and surgical approaches for primary orbital malignancies. Design In this review, the clinical presentation, imaging features, and medical and surgical management of primary orbital malignancies with representative cases will be discussed. Setting Outpatient and inpatient hospital settings. Participants Patients with diagnosed primary orbital malignancies. Main Outcome Measures Descriptive outcomes. Results Advancements in orbital imaging, microsurgical techniques, and multimodal therapy have improved the diagnosis and management of primary orbital malignancies. Special considerations for biopsy or resection are made based on the tumor's location, characteristics, nearby orbital structures, and goals of surgery. Minimally invasive techniques are supplanting traditional approaches to orbital surgery with less morbidity. Conclusions Advances in imaging technologies and surgical techniques have facilitated the diagnosis and management of primary orbital malignancies. Evolution toward less invasive orbital surgery with focus on preservation and restoration of function is underway.

The SWORFISH Project Approach for Modeling Wood Material Modifications in Timber Structures

2013 ◽  
Vol 778 ◽  
pp. 418-423
Author(s):  
Jakub Sandak ◽  
Anna Sandak ◽  
Mariapaola Riggio ◽  
Ilaria Santoni ◽  
Dusan Pauliny
Keyword(s):  
Experimental Data ◽  
Expert Knowledge ◽  
Surface Finishing ◽  
Special Focus ◽  
Original Material ◽  
Timber Structures ◽  
Wood Material ◽  
Project Approach ◽  
Special Software ◽  
Definition Of

A special software simulating changes to wood due to various processes (either treatment or degradation) has been developed within the SWORFISH (Superb Wood Surface Finishing) project. The definition of the material modifications due to processes is based on the expert knowledge and/or experimental data. The dedicated algorithm simulates material modifications (with a special focus on surface) taking into account original material characteristics (evaluated by means of NDT techniques) and setting of process parameters. In this way, it is possible to analyze the sequence of processes (i.e. material modifications) and to estimate properties of the resulting product. Two case studies are presented for illustration of the potential uses of the SWORFISH approach in the field of timber structures.

The Infratemporal Retro-Eustachian Transposition of the Temporoparietal Fascial Flap for Clival Reconstruction After Endoscopic Endonasal Approach: An Anatomic Conceptual Technique

2021 ◽  
Author(s):  
Giulio Cecchini ◽  
Huy Q Truong ◽  
Francesco Di Biase ◽  
Antonio Musio ◽  
Juan C Fernandez Miranda
Keyword(s):  
Infratemporal Fossa ◽  
Surgical Techniques ◽  
Pedicled Flap ◽  
Reconstruction Technique ◽  
Clinical Validation ◽  
Endoscopic Endonasal Approach ◽  
Endoscopic Endonasal ◽  
Fascial Flap ◽  
The Times ◽  
Lower Clivus

Abstract BACKGROUND Reconstruction after endoscopic endonasal approaches is a key element. Lower clivus reconstruction is difficult and most of the times a pedicled flap is not available. As the complexity and the dimensions of the exposure increase, a reliable reconstruction technique becomes more and more important. OBJECTIVE To describe the anatomic and technical nuances of the transposition of the temporoparietal fascial flap for lower clivus reconstruction. METHODS A specific temporoparietal fascial flap (TPFF) design and tunneling technique has been studied using 4 head specimens, microscopic and endoscopic surgical techniques, and neuronavigation. RESULTS The L-shaped flap offers several advantages. It can be tunneled directly toward the lower clivus passing through the infratemporal fossa. CONCLUSION The infratemporal retro-eustachian transposition of an L-shaped TPFF provides a vascularized tissue virtually without dimension limits. This is the only technique that allows the flap to be tunneled directly in the lower clivus with the most vascular portion being at the bottom of the defect. Clinical validation is still required since more issues may become relevant in a real-surgery setting. Though, due to its possible complications, this methodology needs further testing and should not be attempted in less experienced hands.

Bone-related disorders of the jaw: A clinico-radiological diagnostic algorithm

2021 ◽  
pp. 197140092199896
Author(s):  
Ahmed Abdel Khalek Abdel Razek
Keyword(s):  
Diagnostic Algorithm ◽  
Imaging Features ◽  
Resonance Imaging ◽  
Specific Diagnosis ◽  
Clinical Presentations ◽  
Neoplastic Lesions ◽  
Lesion Extension ◽  
Magnetic Resonance Imaging Mri ◽  
The Relationship ◽  
Ct And Mri

Bone-related disorders of the jaw (BRDJ) include a spectrum of non-neoplastic and neoplastic lesions of the maxillofacial region that have been recently classified into fibro-osseous lesions, giant cell lesions and osseous tumours. The histopathological features of BRDJ can be similar and overlie each other. Imaging is important in order to reach a specific diagnosis. However, the appearance of BRDJ on imaging is non-specific in some cases. Computed tomography (CT) and magnetic resonance imaging (MRI) are used for accurate localisation, characterisation of the tumour matrix, delineation of the lesion extension and establishment of the relation of BRDJ to the surrounding structures. Imaging is usually done to detect the relationship with the adjacent surrounding vital structures and to diagnose aggressive forms, malignant transformation and associated syndromes. The correlation of the demographic findings, the location and the clinical presentations with the imaging features are important for the diagnosis of BRDJ. The proposed clinico-radiological diagnostic algorithm with CT and MRI helps a specific diagnosis to be reached in some cases.

scholarly journals Juvenile Angiofibroma: Current Management Strategies

2018 ◽  
Vol 79 (01) ◽  
pp. 021-030 ◽  
Author(s):  
Ahmad Safadi ◽  
Alberto Schreiber ◽  
Dan Fliss ◽  
Piero Nicolai
Keyword(s):  
Management Strategies ◽  
Vascular Tumor ◽  
Characteristic Pattern ◽  
Imaging Features ◽  
Endoscopic Endonasal Surgery ◽  
Current Management ◽  
Endonasal Surgery ◽  
Endoscopic Endonasal ◽  
Juvenile Angiofibroma ◽  
Intermediate Size

AbstractJuvenile angiofibroma (JA) is a benign, highly vascular tumor which is diagnosed on the basis of clinical and imaging features. It has a characteristic pattern of spread commonly involving the pterygopalatine fossa and pterygoid base. The mainstay of treatment is surgery, while radiotherapy is rarely used for the treatment of recurrent lesion. Endoscopic endonasal surgery is currently the treatment of choice for small to intermediate size JAs, and is feasible even for advanced lesions; however, this should only be practiced in well-experienced centers.

Radiographic Analysis of the Vidian Canal and Its Utility in Petrous Internal Carotid Artery Localization

2018 ◽  
Vol 15 (5) ◽  
pp. 577-583 ◽  
Author(s):  
Eric C Mason ◽  
Patricia A Hudgins ◽  
Gustavo Pradilla ◽  
Nelson M Oyesiku ◽  
C Arturo Solares
Keyword(s):  
Carotid Artery ◽  
Internal Carotid Artery ◽  
Skull Base ◽  
Internal Carotid ◽  
Expert Knowledge ◽  
Average Distance ◽  
Surgical Approaches ◽  
Endoscopic Endonasal ◽  
Computed Tomographic ◽  
Vidian Canal

Abstract BACKGROUND Endoscopic endonasal surgery of the skull base requires expert knowledge of the anatomy and a systematic approach. The vidian canal is regarded as a reliable landmark to localize the petrous internal carotid artery (pICA) near the second genu, which can be used for orientation in deep skull base approaches. There is controversy about the relationship between the vidian canal and the pICA. OBJECTIVE To further establish the vertical relationship between the vidian canal and the pICA to aid in surgical approaches to the skull base. METHODS We utilized a collection of institutional review board-approved computed tomographic (CT) angiograms (CTAs). Fifty CTAs were studied bilaterally for 100 total sides. The vidian canal was visualized radiographically to determine whether it terminates below, at, or above the level of the pICA. RESULTS Sixty-six of 100 vidian canals terminated inferior to the pICA (66%), which was the most common relationship observed. The average distance inferior to the pICA was 1.01 mm on the right, 1.18 mm on the left, and 1.09 mm of the total 66 sides. Less commonly, the vidian canal terminated at the level of the pICA canal in 34 sides (34%). The vidian canal was not observed to terminate superior to the pICA in any of the 50 CTAs studied. CONCLUSION The vidian canal terminates inferior to the pICA most commonly, but often terminates at the level of the pICA. Careful drilling clockwise inferior to superior around the vidian canal should allow for safe pICA localization in most cases.

Acquisition of Volumetric Models of Skull Base Anatomy Using Endoscopic Endonasal Approaches: 3D Scanning of Deep Corridors Via Photogrammetry

2019 ◽  
Vol 129 ◽  
pp. 372-377 ◽  
Author(s):  
Ioannis Kournoutas ◽  
Vera Vigo ◽  
Ricky Chae ◽  
Minghao Wang ◽  
Jose Gurrola ◽  
...  
Keyword(s):  
Skull Base ◽  
3D Scanning ◽  
Endoscopic Endonasal ◽  
Volumetric Models ◽  
Skull Base Anatomy

Post-Reconstruction Breast

2018 ◽  
Author(s):  
Melissa M. Joines
Keyword(s):  
Tumor Recurrence ◽  
Surgical Techniques ◽  
Tissue Expander ◽  
Reconstruction Technique ◽  
Imaging Features ◽  
Multiple Modalities ◽  
Characteristic Appearance ◽  
Tissue Flap ◽  
Management Recommendations ◽  
Reconstructed Breast

Breast reconstruction may be performed after mastectomy to improve breast symmetry. Each reconstruction technique leads to a characteristic appearance on post-operative imaging; thus, familiarity with the surgical techniques as well as the imaging features of the reconstructed breast across multiple modalities is important for radiologists. In addition, an understanding of the common benign complications as well as features of tumor recurrence is important. This chapter, appearing in the section on interventions and surgical change, reviews the key imaging and clinical features, imaging protocols and pitfalls, differential diagnoses, and management recommendations for the reconstructed breast. Topics discussed include tissue expander/implant and autologous tissue flap reconstruction, reconstruction complications, tumor recurrence, and management recommendations.

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