scholarly journals A case of peripancreatic plexiform schwannoma

2021 ◽  
Vol 7 (1) ◽  
Author(s):  
Kenji Fukushima ◽  
Makoto Shinzeki ◽  
Kentaro Tai ◽  
Masaki Omori ◽  
Natsuko Yamauchi ◽  
...  
Keyword(s):  
Magnetic Resonance ◽  
Signal Intensity ◽  
Pancreatic Tissue ◽  
The Body ◽  
Nerve Plexus ◽  
Diagnostic Process ◽  
High Signal ◽  
Spleen Preserving ◽  
Plexiform Schwannoma ◽  
Diffusion Weighted Images

Abstract Background Plexiform schwannoma is one of the least common variants of schwannoma, accounting for only 5% of all schwannoma cases. It generally occurs in the skin and subcutaneous tissues and is uncommon in deep soft tissue or viscera. We present an extremely rare case of plexiform schwannoma arising from the peripancreatic plexus. Case presentation A 29-year-old man presented with hyperglycemia detected during a medical checkup. He was diagnosed with type 1 diabetes based on the clinical findings and laboratory tests. During the diagnostic process for diabetes, a 2.5 cm mass was incidentally detected in the pancreas by abdominal ultrasound. Contrast-enhanced computed tomography revealed a mass that was gradually enhanced at the body and tail of the pancreas. Magnetic resonance imaging revealed low signal intensity of the mass on T1-weighted images and high signal intensity on T2-weighted and diffusion-weighted images. Magnetic resonance cholangiopancreatography showed no abnormal findings in the main pancreatic duct. Endoscopic ultrasonography (EUS) showed a lobulated, low-echoic mass with a clear boundary. EUS-guided fine needle biopsy was performed, and spindle-shaped cells that were diffusely immunopositive for S-100 and negative for c-kit and desmin were detected, resulting in a diagnosis of a neurogenic tumor arising from the pancreas or the peripancreatic nerve plexus. The patient underwent laparoscopic spleen-preserving distal pancreatectomy. Although the tumor was connected to the splenic plexus, the splenic artery could be divided along its adventitial plane. Macroscopic findings of the excised tumor consisted of multiple yellowish-white nodules, and its histopathological features were consistent with plexiform schwannoma. There was no pancreatic tissue on the dorsal surface of the tumor, which suggested that the tumor arose from the peripancreatic nerve plexus. Conclusions The findings documented herein can aid in the differential diagnosis of peripancreatic schwannoma and in planning appropriate treatment.

scholarly journals A vaginal fibroepithelial stromal polyp: a case report with magnetic resonance images

2022 ◽  
Author(s):  
Naoko Ogura ◽  
Mieko Inagaki ◽  
Ritsuko Yasuda ◽  
Shigeki Yoshida ◽  
Tetsuo Maeda
Keyword(s):  
Magnetic Resonance ◽  
Signal Intensity ◽  
Vaginal Wall ◽  
Magnetic Resonance Images ◽  
High Signal ◽  
Soft Tissue Tumour ◽  
Mri Findings ◽  
Vaginal Mass ◽  
Diffusion Weighted Images ◽  
Tissue Tumour

A fibroepithelial stromal polyp is a benign soft tissue tumour that can occur in the vagina, vulva and uterine cervix. Magnetic resonance imaging (MRI) findings have been reported in patients with vulvar fibroepithelial stromal polyps, not in those with vaginal polyps. We present MRI findings of vaginal fibroepithelial stromal polyp in a postmenopausal female. A 1 to 2 cm firm vaginal mass arising from the left side of the vaginal wall with hypointense signal changes on T1W MRI was identified. A well-defined vaginal mass (1 cm diameter) was detected with inhomogeneous signal intensity on T2W images. However, a major portion had high signal intensity on diffusion-weighted images. A benign vaginal lesion with oedematous changes or myxoid degeneration was suspected. Vaginal resection was performed, and fibroepithelial stromal polyp was pathologically diagnosed. MRI may be a useful non-invasive modality for preoperatively diagnosing vaginal fibroepithelial stromal polyps.

DIFFUSION-WEIGHTED MAGNETIC RESONANCE IMAGING OF THE ULNAR NERVE IN CUBITAL TUNNEL SYNDROME

Hand Surgery ◽  
2010 ◽  
Vol 15 (01) ◽  
pp. 11-15 ◽  
Author(s):  
K. Iba ◽  
T. Wada ◽  
M. Tamakawa ◽  
M. Aoki ◽  
T. Yamashita
Keyword(s):  
Magnetic Resonance ◽  
Ulnar Nerve ◽  
Signal Intensity ◽  
Cubital Tunnel Syndrome ◽  
Cubital Tunnel ◽  
High Signal ◽  
Diffusion Weighted Mri ◽  
Diffusion Weighted Images ◽  
Diffusion Weighted ◽  
Tunnel Syndrome

Diffusion-weighted images based on magnetic resonance reveal the microstructure of tissues by monitoring the random movement of water molecules. In this study, we investigated whether this new technique could visualize pathologic lesions on ulnar nerve in cubital tunnel. Six elbows in six healthy males without any symptoms and eleven elbows in ten patients with cubital tunnel syndrome underwent on diffusion-weighted MRI. No signal from the ulnar nerve was detected in normal subjects. Diffusion-weighted MRI revealed positive signals from the ulnar nerve in all of the eleven elbows with cubital tunnel syndrome. In contrast, conventional T2W-MRI revealed high signal intensity in eight elbows and low signal intensity in three elbows. Three elbows with low signal MRI showed normal nerve conduction velocity of the ulnar nerve. Diffusion-weighted MRI appears to be an attractive technique for diagnosis of cubital tunnel syndrome in its early stages which show normal electrophysiological and conventional MRI studies.

scholarly journals Preoperative Magnetic Resonance Cholangiopancreatography for Detecting Difficult Laparoscopic Cholecystectomy in Acute Cholecystitis

Diagnostics ◽  
2021 ◽  
Vol 11 (3) ◽  
pp. 383
Author(s):  
Kojiro Omiya ◽  
Kazuhiro Hiramatsu ◽  
Yoshihisa Shibata ◽  
Masahide Fukaya ◽  
Masahiro Fujii ◽  
...  
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Magnetic Resonance ◽  
Acute Cholecystitis ◽  
Signal Intensity ◽  
Magnetic Resonance Cholangiopancreatography ◽  
Gallbladder Wall ◽  
High Signal ◽  
Mri Findings ◽  
Open Conversion ◽  
Preoperative Magnetic Resonance

Previous studies have shown that signal intensity variations in the gallbladder wall on magnetic resonance imaging (MRI) are associated with necrosis and fibrosis in the gallbladder of acute cholecystitis (AC). However, the association between MRI findings and operative outcomes remains unclear. We retrospectively identified 321 patients who underwent preoperative magnetic resonance cholangiopancreatography (MRCP) and early laparoscopic cholecystectomy (LC) for AC. Based on the gallbladder wall signal intensity on MRI, these patients were divided into high signal intensity (HSI), intermediate signal intensity (ISI), and low signal intensity (LSI) groups. Comparisons of bailout procedure rates (open conversion and laparoscopic subtotal cholecystectomy) and operating times were performed. The recorded bailout procedure rates were 6.8% (7/103 cases), 26.7% (31/116 cases), and 40.2% (41/102 cases), and the median operating times were 95, 110, and 138 minutes in the HSI, ISI, and LSI groups, respectively (both p < 0.001). During the multivariate analysis, the LSI of the gallbladder wall was an independent predictor of both the bailout procedure (odds ratio [OR] 5.30; 95% CI 2.11–13.30; p < 0.001) and prolonged surgery (≥144 min) (OR 6.10, 95% CI 2.74–13.60, p < 0.001). Preoperative MRCP/MRI assessment could be a novel method for predicting surgical difficulty during LC for AC.

Lipoma in olecranon bursa: A case report

2021 ◽  
Vol 3 ◽  
pp. 67-69
Author(s):  
Shalini Agarwal ◽  
Jyoti Siwach ◽  
Ramneet Wadi ◽  
Nipun Gupta
Keyword(s):  
Magnetic Resonance Imaging ◽  
Case Report ◽  
Magnetic Resonance ◽  
Contrast Enhancement ◽  
Local Anesthesia ◽  
Signal Intensity ◽  
Ultrasound Examination ◽  
Fat Cells ◽  
Resonance Imaging ◽  
Diffusion Weighted Images

We report a case of a 55-year-old male patient who presented with swelling over his right elbow of 5-year duration. An ultrasound examination revealed an echogenic mass within the olecranon bursa. On magnetic resonance imaging, the mass revealed the signal intensity of fat, and it was attached to the bursal lining by means of a pedicle. There was no restriction on diffusion-weighted images and no significant contrast enhancement. Excision was performed under local anesthesia. The excised specimen revealed mature fat cells on histopathology.

scholarly journals Visualisation of fetal meconium on post-mortem magnetic resonance imaging scans: a retrospective observational study

2020 ◽  
Vol 9 (11) ◽  
pp. 205846012097054
Author(s):  
Georgia Hyde ◽  
Andrew Fry ◽  
Ashok Raghavan ◽  
Elspeth Whitby
Keyword(s):  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Signal Intensity ◽  
Interrater Reliability ◽  
Hepatic Flexure ◽  
Radiology Department ◽  
High Signal ◽  
Post Mortem ◽  
Resonance Imaging ◽  
Tertiary Referral Centre

Background Less invasive techniques for fetal post-mortems are increasingly used to correlate with parental wishes. With the use of post-mortem magnetic resonance imaging (MRI), normal appearance of the organs must be established. Purpose To investigate the after death appearance of the fetal meconium throughout gestation using the hyperintense appearance of meconium on T1 weighted MRI. Material and Methods This was a retrospective study that took place in a tertiary referral centre radiology department. Sixty-two fetal body post-mortem MRI scans (January 2014 to May 2018) between 12 and 41 weeks gestation were reviewed. Signal intensity of meconium at the rectum, sigmoid colon, splenic flexure and hepatic flexure was evaluated and correlated with gestational age. Interrater reliability was calculated. Results Meconium did not consistently have high signal intensity on T1 scans and was not always obvious. Rectal meconium had the highest intensity, and the more proximal the bowel the lower the intensity. The meconium had higher intensity at earlier gestations. Interrater reliability for rectal meconium gradings was excellent. Conclusion This study provides the first published primary research on the appearance of fetal meconium on post-mortem MRI. Overall, results were variable and suggest an alteration of bowel contents after death, but further investigation is needed to effectively inform practice.

scholarly journals Radiographic Outcomes of Immobilization using Boston Brace for Pediatric Spondylolysis

2020 ◽  
pp. 145749691989699
Author(s):  
E. Virkki ◽  
M. Holstila ◽  
K. Mattila ◽  
O. Pajulo ◽  
I. Helenius
Keyword(s):  
Relative Risk ◽  
Magnetic Resonance ◽  
Confidence Interval ◽  
Signal Intensity ◽  
Healing Rate ◽  
High Signal Intensity ◽  
High Signal ◽  
Bony Union ◽  
Union Rate ◽  
Boston Brace

Background and Aims: Spondylolysis is a common cause of lower back pain during youth. The aim of this study is to report the bony union rate and risk factors for non-union of the lumbar spondylolysis of pediatric patients treated with a rigid thoracolumbosacral orthosis (Boston brace). Materials and Methods: A retrospective review of 68 children (mean age = 13.9 years) treated for spondylolysis with a thoracolumbosacral orthosis. Patient charts and imaging studies were evaluated to identify the bony union rate of the spondylolysis after a minimum of 3 months of immobilization (mean = 4.2 months). Laterality, grade, level, and presence of high signal intensity in the magnetic resonance imaging were evaluated as prognostic factors. Results: Sixty-eight patients presented with 110 defects. Of them, 46 (42%) were incomplete fractures, 38 (35%) complete fractures, and 26 (24%) pseudoarthrosis. Of these defects, 38 (82.6%), 11 (28.9%), and 0 (0.0%) had bony union at the end of the treatment (p < 0.001). Unilateral defects healed significantly better than bilateral ones (relative risk = 1.71, 95% confidence interval = 1.16–2.54, 17/26 (65%) vs 32/84 (38%), p = 0.014). High signal intensity in the magnetic resonance images before the treatment predicted healing (relative risk = 13.24, 95% confidence interval = 1.93–91.01, 48/87 (55%) vs 1/24 (4.3%), p < 0.001). The level of the spondylolysis (L5 vs above L5) did not affect the healing rate. Conclusion: The union rates of spondylolysis with a thoracolumbosacral orthosis were similar as compared to earlier studies done with a low thoracolumbosacral orthosis. The grade of the defect, laterality, and presence of high signal intensity increased the probability of bony union. A high thoracolumbosacral orthosis (underarm) does not seem to improve the healing rate of pediatric spondylolysis defects.

Lysability of arterial thrombi assessed by magnetic resonance imaging

VASA ◽  
2005 ◽  
Vol 34 (4) ◽  
pp. 262-265 ◽  
Author(s):  
Kozak ◽  
Mikac ◽  
Blinc ◽  
Sersa
Keyword(s):  
Magnetic Resonance ◽  
Signal Intensity ◽  
Magnetic Resonance Images ◽  
High Signal ◽  
Resonance Imaging ◽  
Gradient Echo ◽  
Catheter Directed Thrombolysis ◽  
Improve Patient Selection ◽  
Selection For ◽  
Improve Patient

Background: Intravascular thrombi change in time due to retraction and organization, which is reflected in the appearance of magnetic resonance images of clots. We have hypothesized that MRI has the potential to improve patient selection for thrombolytic treatment. The aim of our study was to analyze occlusive arterial thrombi with MRI, and to correlate the MRI parameters with the therapeutic outcome in patients with occlusive atherothrombotic disease of the superficial femoral artery who were treated with catheter-directed thrombolysis by streptokinase. Patients and methods: We included 13 patients with subacute (2 weeks to 3 months old) occlusive arterial thrombi and 4 patients with chronic (more than 6 months old) arterial occlusions. We measured the MRI signal intensity on gradient echo images of 98 axial slices of the subacute occlusive thrombi and in 45 slices of 4 chronic thrombi. Following MRI, the patients with subacute history were treated with catheter-directed thrombolysis. Results: Thrombolysis was successful in 11/13 patients. The normalized MRI signal intensity was significantly higher in the unsuccessfully treated thrombi than in the successfully treated thrombi (1.10 ± 0.08 vs. 0.72 ± 0.17, p < 0.003), but the subacute and chronic thrombi did not differ in signal intensity. Conclusions: High signal intensity of arterial thrombi on gradient echo MRI might predict resistance to thrombolytic therapy.

Clinical presentation of primary progressive multiple sclerosis 10 years after the incidental finding of typical magnetic resonance imaging brain lesions

2003 ◽  
Vol 9 (2) ◽  
pp. 204-209 ◽  
Author(s):  
G V McDonnell ◽  
J Cabrera-Gomez ◽  
D B Calne ◽  
D KB Li ◽  
J Oger
Keyword(s):  
Magnetic Resonance Imaging ◽  
Multiple Sclerosis ◽  
Magnetic Resonance ◽  
Signal Intensity ◽  
Incidental Finding ◽  
High Signal ◽  
Primary Progressive Multiple Sclerosis ◽  
Resonance Imaging ◽  
Primary Progressive ◽  
The Right

Background: Subclinical multiple sclerosis (MS) has been identified incidentally at autopsy; apparently unaffected individuals with an affected twin have demonstrated magnetic resonance imaging (MRI) changes consistent with MS, and ‘MRI relapses’ are several times more common than clinical relapses. Case description: A 39-year-o ld, right-handed man underwent MRI and PET scanning in 1986 as a ‘normal’ control in a Parkinson’s disease study, where his father was the proband. MRI indicated multiple areas of abnormal signal intensity in a periventricular and grey -white matter junction distribution. Repeated clinical evaluations over the next 10 years were unchanged until 1996, when he complained of progressive weakness of the right foot and clumsiness in the right hand. MRI now indicated a further area of high signal intensity in the right posterior cord at the level of C 5/C 6. There was mild pyramidal distribution weakness in the right leg with an extensor plantar response on the same side. O ver the next five years there has been mild progression in weakness and fatigue and intermittent Lhermitte’s phenomenon. A t no stage has there been a history of relapse, cerebrospinal fluid examination was normal and evoked responses (visual and somatosensory) are normal. Conclusion: This case demonstrates the pheno menon of subclinical MS, unusually supported by prolonged clinical and MRI follow-up. The patient eventually became symptomatic nine years after MRI diagnosis and is following a primary progressive course. A lthough MRI is known to be sensitive in identifying subclinical ‘attacks’, the pattern illustrated here may actually be quite typical of primary progressive MS and is compatible with the later onset seen in this subgroup of patients.

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