Insight into gastrointestinal heterotopic pancreas: imaging evaluation and differential diagnosis

AbstractHeterotopic pancreas (HP) is an uncommon congenital abnormality in the developmental process of the pancreas, with gastrointestinal heterotopic pancreas (GHP) being the most common HP. The clinical manifestations of GHP may have variable patterns of presentation, dictated by both the anatomic location and the functional ability of the lesion. The most common imaging modality in detecting GHP is computed tomography (CT), while gastrointestinal barium fluoroscopy, endoscopic ultrasonography, and magnetic resonance imaging (MRI) are also applied. The density and enhancement patterns of GHP are consistent with histological classifications. GHP with a predominantly acinar tissue component manifests homogeneous and marked enhancement on CT images, whereas a predominantly ductal GHP presents heterogeneous and mild enhancement. On MRI, the appearance and signal intensity of GHP were paralleled to the normal pancreas on all sequences and were characterized by T1-weighted high signal and early marked enhancement. This article provides a comprehensive review of the histopathology, clinical manifestations, imaging features of various modalities, and differential diagnosis of GHP. It is hoped that this review will improve clinicians’ knowledge of GHP and aid in accurate preoperative diagnosis, thereby reducing the misdiagnosis rate.

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Pulvinar sign in a case of anti-HU paraneoplastic encephalitis

The Neuroradiology Journal ◽

10.1177/1971400916665373 ◽

2016 ◽

Vol 29 (6) ◽

pp. 436-439 ◽

Cited By ~ 3

Author(s):

Pierre-Luc Gamache ◽

Maude-Marie Gagnon ◽

Martin Savard ◽

François Émond

Keyword(s):

Magnetic Resonance Imaging ◽

Differential Diagnosis ◽

Magnetic Resonance ◽

Clinical Manifestations ◽

Resonance Imaging ◽

Paraneoplastic Encephalitis ◽

Jakob Disease ◽

Magnetic Resonance Imaging Mri ◽

Work Up

This article reports the case of a 68-year-old patient with anti-HU antibodies paraneoplastic encephalitis. The clinical manifestations were atypical and the paraclinical work-up, notably the magnetic resonance imaging (MRI) showing bilateral posterior thalamic hyperintensities (pulvinar sign), misleadingly pointed towards a variant Creutzfeld–Jakob disease. After presenting the case, the differential diagnosis of the pulvinar sign is discussed along with other important diagnostic considerations.

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Clinical manifestations and imaging features of white matter demyelination in older patients

Journal of International Medical Research ◽

10.1177/0300060520966806 ◽

2020 ◽

Vol 48 (11) ◽

pp. 030006052096680

Author(s):

Jian Li ◽

Yi-Ming Zhao

Keyword(s):

White Matter ◽

Clinical Diagnosis ◽

Older Patients ◽

Demyelinating Disease ◽

Clinical Manifestations ◽

Imaging Features ◽

Significant Difference ◽

Clinical Diagnoses ◽

Chief Complaints ◽

Magnetic Resonance Imaging Mri

Objective To investigate the clinical manifestations and imaging features of older patients with white matter demyelination diagnosed by magnetic resonance imaging (MRI). Methods Ninety-six patients with leukoaraiosis diagnosed by MRI were divided by their clinical diagnoses into a demyelinating group (40 cases) and a non-demyelinating group (56 cases). The imaging and clinical features of the patients in the two groups were analyzed. Results Compared with the non-demyelinating group, there were significantly more women in the demyelinating group than men. There was no significant difference in age between the two groups. Of the 37 cases who had an imaging report of “white matter demyelination and multiple sclerosis,” 36 cases had a clinical diagnosis in accordance with white matter demyelination (97.3%). Of the 59 cases who had an imaging report of “white matter demyelination”, only four cases had a clinical diagnosis in accordance with demyelination (6.8%). Conclusion In older patients with headaches, vertigo, other head symptoms, and unilateral numbness as the chief complaints, a clinical diagnosis of demyelinating disease is very unlikely when the imaging report states white matter demyelination only.

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Intraspinal Neurenteric Cysts in Children

Canadian Journal of Neurological Sciences / Journal Canadien des Sciences Neurologiques ◽

10.1017/s0317167100009409 ◽

2008 ◽

Vol 35 (5) ◽

pp. 609-615 ◽

Cited By ~ 29

Author(s):

Chunquan Cai ◽

Changhong Shen ◽

Weidong Yang ◽

Qingjiang Zhang ◽

Xiaoli Hu

Keyword(s):

Spinal Cord ◽

Imaging Modality ◽

Spinal Dysraphism ◽

Clinical Manifestations ◽

The Other ◽

Cervical Region ◽

Neurological Involvement ◽

Neurenteric Cyst ◽

Lumbar Region ◽

Magnetic Resonance Imaging Mri

Background:Neurenteric cysts are rare congenital epithelium-lined cysts of the central nervous system. They are found predominantly in the spinal cord, with lower incidence in the intracranial compartment, and may be associated with various other congenital spinal anomalies. Seven patients with symptomatic intraspinal neurenteric cysts are presented.Materials and Methods:Seven patients with intraspinal neurenteric cysts aged from nine months to ten years treated at this hospital from May 2000 to July 2006 were reviewed. The clinical manifestations, imaging and surgical findings of patients were analyzed retrospectively. All patients underwent operation. One patient's cervical neurenteric cyst was resected using the lateral cervical approach, and the other six resections were performed with posterior approach.Results:All seven patients presented with neurological involvement. One patient had an intramedullary cyst, while the other six cysts were situated ventrally. Three patients' cysts occurred in the cervical region, two in the cervicothoracic region, one in the thoracic region and one in the lumbar region. One patient had bony anomalies, and one had a lumbar posterior occult spinal dysraphism. Five patients' symptoms improved rapidly after surgery.Conclusions:Intraspinal neurenteric cysts in children are rare and most occur ventral to the spinal cord. Magnetic resonance imaging (MRI) is the most effective imaging modality. Earlier diagnosis and surgical resection of spinal neurenteric cysts improves prognosis.

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Clinical and imaging features of carcinosarcoma of the uterus and cervix

Insights into Imaging ◽

10.1186/s13244-021-01084-5 ◽

2021 ◽

Vol 12 (1) ◽

Author(s):

Liming Li ◽

Wenpeng Huang ◽

Kangkang Xue ◽

Leiyu Feng ◽

Yijing Han ◽

...

Keyword(s):

Malignant Tumors ◽

High Signal ◽

Imaging Features ◽

Mri Imaging ◽

Diffusion Weighted Image ◽

Resonance Imaging ◽

Endometrial Thickening ◽

Staging Accuracy ◽

Magnetic Resonance Imaging Mri ◽

Ct And Mri

Abstract Aim The purpose of our study was to analyze the clinical and imaging features of uterine carcinosarcoma (UCS) and cervical carcinosarcoma (CCS), and to explore the diagnostic and staging accuracy of computed tomography (CT) and magnetic resonance imaging (MRI) examinations. Methods 41 patients including 37 with UCS and 4 with CCS from July 2011 to September 2020 were enrolled in the study. Of the 37 UCS cases, 7 had CT images, 27 had MRI images, and 3 had both CT and MRI images. The Clinical data, CT or MRI imaging findings were analyzed. Diagnosis and staging accuracy of CT and MRI images were also analyzed. Results Carcinosarcoma usually occurs in postmenopausal women (40/41), with the typical clinical symptom being vaginal bleeding (33/41). The CA125 degree was significantly different between the two invasion depth groups (p = 0.011). Most uterine carcinosarcomas showed unclear boundaries, uneven density, low or equal signal on T1WI, high or mixed signal on T2WI, uneven high signal on diffusion-weighted image (DWI), and mild enhancement. The diagnostic accuracies of CT and MRI for carcinosarcoma were 0% and 3.33%, respectively. The diagnostic accuracy for malignant tumors on CT and MRI was 50% and 83.33%, respectively. Conclusions Carcinosarcoma lesions presented with huge mass filling in the cavity, and some presented with small polypoid lesions or endometrial thickening. Evaluation of lymph node metastasis is a significant challenge for imaging staging.

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Neurosyphilis presenting with myelitis-Case series and literature review

10.21203/rs.2.1849/v1 ◽

2019 ◽

Author(s):

Yali Wu ◽

Wenqing Wu

Keyword(s):

Clinical Symptoms ◽

Treponema Pallidum ◽

Clinical Manifestations ◽

Case Series ◽

Transverse Myelitis ◽

Penicillin G ◽

Imaging Features ◽

Delayed Treatment ◽

Systemic Corticosteroids ◽

Magnetic Resonance Imaging Mri

Abstract Background Neurosyphilis is a great imitator because of its various clinical symptoms. Syphilitic myelitis is extremely rare manifestation of neurosyphilis and often misdiagnosed. However, a small amount of literature in the past described its clinical manifestations and imaging features, and there was no relevant data on the prognosis, especially the long-term prognosis. In this paper, 4 syphilis myelitis patients admitted to our hospital between July 2012 and July 2017 were retrospectively reviewed. In the 4 patients, 2 were females, and 2 were males. We present our experiences with syphilitic myelitis, discuss the characteristics, treatment and prognosis. Case presentation The diagnosis criteria were applied: (1) diagnosis of myelitis established by two experienced neurologist based on symptoms and longitudinally extensive transverse myelitis (LETM) at the cervical and thoracic levels mimicked neuromyelitis optic (NMO) on magnetic resonance imaging (MRI) ; (2) Neurosyphilis (NS) was diagnosed by positive treponema pallidum particle assay (TPPA) and toluidine red untreated serum test (TRUST) in the serum and CSF; (3) negative human immunodeficiency virus (HIV). Likewise, all patients were negative for serum anti-aquaporin 4 (AQP-4), as well as negative bacterial, fungal, virus, or mycobacterium tuberculosis in the CSF. Treatment included intravenous penicillin G, with 24 million units of penicillin G per day administered intravenously for 14 days, and three patients were also treated with systemic corticosteroids. Neurological examination, serologic syphilis diagnostic tests (TPPA, TRUST) and cerebrospinal fluid tests (TPPA, TRUST) were examined approximately every 12~24 weeks after treatment. The follow-up time ranged from 12 to 70 months, with an average of 36.6 months. The prognosis was well in 3 cases who received early anti-syphilis treatment, but 1 case who received delayed treatment due to misdiagnose had no improvement. Conclusions Neurosyphilis should be considered when there are long hyperintensity lesions in the MRI spinal cord. Prompt diagnosis and combined antibiotics-corticosteroid therapy may improve neurological prognosis.

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Histopathologic Correlates of Nonmass Enhancement Detected by Breast Magnetic Resonance Imaging

Archives of Pathology & Laboratory Medicine ◽

10.5858/arpa.2020-0266-oa ◽

2021 ◽

Author(s):

Vanda F. Torous ◽

Nancy A. Resteghini ◽

Jordana Phillips ◽

Vandana Dialani ◽

Priscilla J. Slanetz ◽

...

Keyword(s):

Magnetic Resonance Imaging ◽

Magnetic Resonance ◽

Ductal Carcinoma ◽

Imaging Modality ◽

Breast Mri ◽

Imaging Features ◽

Resonance Imaging ◽

Mri Findings ◽

Malignant Lesions ◽

Magnetic Resonance Imaging Mri

Context.— Dynamic, contrast-enhanced magnetic resonance imaging (MRI) is a highly sensitive imaging modality used for screening and diagnostic purposes. Nonmass enhancement (NME) is commonly seen on MRI of the breast. However, the pathologic correlates of NME have not been extensively explored. Consequently, concordance between MRI and pathologic findings in such cases may be uncertain and this uncertainty may cause the need for additional procedures. Objective.— To examine the histologic alterations that correspond to NME on MRI. Design.— We performed a retrospective search for women who underwent breast MRI between March 2014 and December 2016 and identified 130 NME lesions resulting in biopsy. The MRI findings and pathology slides for all cases were reviewed. The follow-up findings on any subsequent excisions were also noted. Results.— Among the 130 cases, the core needle biopsy showed 1 or more benign lesions without atypia in 80 cases (62%), atypical lesions in 21 (16%), ductal carcinoma in situ in 22 (17%), and invasive carcinoma in 7 (5%). Review of the imaging features demonstrated some statistically significant differences in lesions that corresponded to malignant lesions as compared with benign alterations, including homogeneous or clumped internal enhancement, type 3 kinetics, and T2 dark signal; however, there was considerable overlap of features between benign and malignant lesions overall. Of 130 cases, 54 (41.5%) underwent subsequent excision with only 6 cases showing a worse lesion on excision. Conclusions.— This study illustrates that NME can be associated with benign, atypical, and/or malignant pathology and biopsy remains indicated given the overlap of radiologic features.

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Coincidence of cervical spondylotic myelopathy and intramedullary ependymoma: a potential diagnostic pitfall

Journal of Neurosurgery Spine ◽

10.3171/2009.10.spine09138 ◽

2010 ◽

Vol 12 (3) ◽

pp. 249-252 ◽

Cited By ~ 6

Author(s):

Arthur R. Kurzbuch ◽

Benedict Rilliet ◽

Maria-Isabel Vargas ◽

Colette Boex ◽

Enrico Tessitore

Keyword(s):

Differential Diagnosis ◽

Mr Imaging ◽

Cervical Spondylotic Myelopathy ◽

Clinical Signs ◽

Intramedullary Tumor ◽

High Signal ◽

Imaging Features ◽

Intramedullary Tumors ◽

Diagnostic Pitfall ◽

Signal Intensities

The authors report the case of a 58-year-old man presenting with a 3-year history of clinical signs of progressive cervical spondylotic myelopathy (CSM). Magnetic resonance imaging showed a severe stenosis of the cervical spinal canal at C3–4 and C5–6 levels due to multiple discopathies. High signal intensities on T2-weighted MR images of the spinal cord and low signal intensities on T1-weighted images at the C2–6 levels were noted, as was contrast enhancement at the C3–4 level. The patient underwent a bilateral decompressive laminectomy at C3–6. The patient did not show any clinical improvement. Thus, further cervical MR imaging was performed and the differential diagnosis of an intramedullary tumor was considered in view of the persisting intramedullary enhancement. This diagnosis prompted a second operation involving a posterior midline myelotomy and excision of an intramedullary ependymoma at the C3–4 level. Intramedullary tumors should be considered in the differential diagnosis of CSM with an atypical pattern of MR imaging features.

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Clinical practice: intravenous thrombolysis in a patient with active cancer who experienced wake-up stroke

Journal of International Medical Research ◽

10.1177/03000605211000155 ◽

2021 ◽

Vol 49 (3) ◽

pp. 030006052110001

Author(s):

Siting Wu ◽

Zengluan Xing ◽

Jiacai Lin ◽

Hui Liu ◽

Fang Cui ◽

...

Keyword(s):

Anticoagulation Therapy ◽

Clinical Manifestations ◽

Brain Magnetic Resonance Imaging ◽

Intravenous Thrombolysis ◽

Neurological Deficits ◽

Imaging Features ◽

Laboratory Test Results ◽

Magnetic Resonance Imaging Mri ◽

Study Laboratory ◽

Active Cancer

After reviewing the diagnosis and treatment process of a patient with active cancer who experienced wake-up stroke, we have summarized the clinical manifestations, laboratory examination results, imaging features, pathological results, and treatment in this report. Patients with active cancer who experience wake-up stroke often have mild neurological deficits at the time of onset. For the patient in this study, laboratory test results were mainly characterized by abnormal coagulation function and elevated tumor markers. The brain magnetic resonance imaging (MRI) images were characterized by involvement of both the arterial and venous systems. Thrombolytic therapy during the window period can improve the symptoms of neurological deficits. Overall, anticoagulation therapy was safe and effective in our patient.

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An annotated T2-weighted magnetic resonance image collection of testicular germ and non-germ cell tumors

Scientific Data ◽

10.1038/s41597-021-00990-z ◽

2021 ◽

Vol 8 (1) ◽

Author(s):

Giacomo Feliciani ◽

Lorenzo Mellini ◽

Emiliano Loi ◽

Filippo Piccinini ◽

Roberto Galeotti ◽

...

Keyword(s):

Magnetic Resonance ◽

Testicular Cancer ◽

Germ Cell ◽

Imaging Modality ◽

Germ Cell Tumors ◽

Primary Role ◽

Imaging Features ◽

Rare Tumor ◽

Additional Information ◽

Magnetic Resonance Imaging Mri

AbstractTesticular cancer is a rare tumor with a worldwide incidence that has increased over the last few decades. The majority of these tumors are testicular non-germ (TNGCTs) and germ cell tumors (TGCTs); the latter divided into two broad classes - seminomatous (SGCTs) and non-seminomatous germ cell tumors (NSGCTs). Although ultrasonography (US) maintains a primary role in the diagnostic workup of scrotal pathology, magnetic resonance imaging (MRI) has emerged as the imaging modality recommended for challenging cases, providing additional information to clarify inconclusive/equivocal US. In this work we describe and publicly share a collection of 44 images of annotated T2-weighted MRI lesions from 42 patients. Given that testicular cancer is a rare tumor, we are confident that this collection can be used to validate statistical models and to further investigate TNGCT and TGCT peculiarities using medical imaging features.

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Adrenal imaging: anatomy and pathology (literature review)

Problems of Endocrinology ◽

10.14341/probl12752 ◽

2021 ◽

Vol 67 (3) ◽

pp. 26-36

Author(s):

T. A. Korb ◽

V. Yu. Chernina ◽

I. A. Blokhin ◽

O. O. Aleshina ◽

A. V. Vorontsov ◽

...

Keyword(s):

Computed Tomography ◽

Differential Diagnosis ◽

Literature Review ◽

Imaging Modality ◽

Magnetic Resonance Tomography ◽

Lesion Detection ◽

Dual Energy Ct ◽

Emission Computed Tomography ◽

Imaging Features ◽

Adrenal Imaging

This literature review focuses on the normal adrenal gland anatomy and typical imaging features necessary to evaluate benign and malignant lesions. In particular, adenoma, pheochromocytoma, metastases and adrenocortical carcinoma were discussed as some of the most common lesions. For this purpose, a review of relevant local and international literature sources up to January 2021 was conducted.In many cases, adrenal incidentalomas have distinctive features allowing characterization using noninvasive methods. It is possible to suspect a malignant nature and promptly refer the patient for the necessary invasive examinations in some cases. Computed tomography, especially with intravenous contrast enhancement, is the primary imaging modality because it enables differential diagnosis. Magnetic resonance tomography remains a sensitive method in lesion detection and follow-up but is not very specific for determining the malignant potential. Positron emission computed tomography also remains an additional method and is used mainly for differential diagnosis of malignant tumors, detecting metastases and recurrences after surgical treatment. Ultrasound has a limited role but is nevertheless of great importance in the pediatric population, especially newborns. Promising techniques such as radiomics and dual-energy CT can expand imaging capabilities and improve diagnostic accuracy.Because adrenal lesions are often incidentally detected by imaging performed for other reasons, it is vital to interpret such findings correctly. This review should give the reader a broad overview of how different imaging modalities can evaluate adrenal pathology and guide radiologists and clinicians.

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