Magnetic Resonance Imaging in the Evaluation and Characterisation of Sellar and Juxtasellar Lesions

2021 ◽  
Vol 8 (14) ◽  
pp. 915-919
Author(s):  
Kaushal B ◽  
Chandrashekar H.M ◽  
Shobhalakshmi C.S ◽  
Vijakumar K.R
Keyword(s):  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Pituitary Adenomas ◽  
Imaging Modality ◽  
Resonance Imaging ◽  
Mri Findings ◽  
Medical College ◽  
Imaging Characteristics ◽  
Hospital Patients ◽  
Mri Study

BACKGROUND The sellar and juxtasellar region is a complex area where varied pathologies can occur. Differentiation among various pathologies may not always be easy, since many of these lesions mimic pituitary adenomas on clinical presentation, endocrinologic and radiologic examinations. The study intends to describe the imaging characteristics of the spectrum of pathological conditions affecting these regions using magnetic resonance imaging (MRI). METHODS The main source of data for the study were patients from hospitals attached to Bangalore Medical College and Research Institute, Bengaluru viz. Victoria Hospital, Bowring and Lady Curzon Hospital and Vani Vilas Hospital. Patients with suspected sellar and juxtasellar pathology on clinical examination referred to the Department of Radiodiagnosis from November 2017 to May 2019 underwent MRI study using Siemens 1.5-T Magnetom Avanto MR system. Magnetic resonance imaging was done in all patients according to the pituitary protocol. RESULTS Among the 50 patients, there were 16 males and 34 females. Most of the patients were in the third to fifth decade of life. The various abnormalities on MRI included neoplastic (68 %), malformative (8 %), vascular (6 %), granulomatous, infectious and inflammatory (18 %) lesions. Pituitary adenomas (46 %) were the most common lesions in sellar and juxtasellar regions, followed by tuberculosis (10 %), craniopharyngioma (8 %), Rathke's cleft cyst (6 %), meningioma (6 %), internal carotid artery (ICA) aneurysm (4 %), epidermoid (2 %) and miscellaneous lesions. CONCLUSIONS MR imaging characteristics were sufficiently distinct to allow various sellar and juxtasellar pathologies to be differentiated from each other. The spectrum of MRI findings were related to neoplastic, malformative, infectious, inflammatory, granulomatous and vascular causes. Our study observed that MRI with appropriate imaging protocols is the essential imaging modality in evaluation of sellar and juxtasellar lesions. KEYWORDS Pituitary, Sellar, Juxtasellar, Magnetic Resonance Imaging

OUTCOMES OF TRANSSPHENOIDAL SURGERY IN CUSHING DISEASE PATIENTS WITH NEGATIVE PITUITARY MAGNETIC RESONANCE IMAGING FINDINGS: A SINGLE-CENTER EXPERIENCE

2020 ◽  
Vol 26 (11) ◽  
pp. 1320-1330
Author(s):  
Congxin Dai ◽  
Siyu Liang ◽  
Xiaohai Liu ◽  
Yanghua Fan ◽  
Xinjie Bao ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Surgical Outcomes ◽  
Transsphenoidal Surgery ◽  
Remission Rate ◽  
Resonance Imaging ◽  
Mri Findings ◽  
College Hospital ◽  
Cushing Disease ◽  
Medical College

Objective: Transsphenoidal surgery (TSS) is a first-line treatment for Cushing disease (CD). However, a subset of patients with CD have no visible adenoma on magnetic resonance imaging (MRI), and whether MRI results affect surgical outcomes is controversial. The aim of this study was to compare the surgical outcomes of CD patients with negative MRI findings to those of patients with positive MRI findings. Methods: The clinical features and outcomes of CD patients who underwent TSS between January 2000 and July 2019 at Peking Union Medical College Hospital were collected from medical records. The clinical, endocrinologic, histopathologic, surgical outcomes, and a minimum 12-month follow-up of 125 consecutive CD patients with negative MRI findings were compared with those of 1,031 consecutive CD patients with MRI-visible adenomas. Results: The total remission rate was 73.3% after TSS, and 11.8% of patients experienced recurrence. Of 1,031 patients with MRI-visible adenomas, postoperative remission was achieved in 762 patients (73.9%), and the recurrence of CD was observed in 94 (12.3%) patients. Of the 125 patients with negative MRI findings, postoperative remission was achieved in 85 (68%) patients, and recurrence was observed in 6 (7.1%) patients. The remission rate and recurrence rate were not significantly different between patients with negative MRI findings and those with positive MRI findings (all P>.05). The remission rate was not significantly different between patients who did or did not undergo bilateral inferior petrosal sinus sampling (BIPSS) in patients with negative MRI findings ( P>.05). In the patients with negative MRI findings who underwent BIPSS, the remission rate of patients with positive BIPSS results was not different from that in patients with negative BIPSS results ( P>.05). The lack of prior TSS, the detection of a tumor during operation, and pathologic confirmation of adenoma were associated with a higher surgical remission rate in patients with negative MRI findings (all P<.05). Similar results were observed in the patients with positive MRI findings (all P<.05). In addition, the major perioperative complications, including intraoperative cerebrospinal fluid leakage, hypopituitarism, and transient diabetes insipidus, were not related to the MRI results (all P>.05). Conclusion: The remission rate and recurrence rate were not different between patients with negative MRI findings and those with positive MRI findings. If CD is clearly diagnosed according to biochemical tests, radiologic examinations, and BIPSS, we recommend TSS as the first-line treatment for patients, even if the MRI results are negative. Abbreviations: ACTH = adrenocorticotropic hormone; BIPSS = bilateral inferior petrosal sinus sampling; CD = Cushing disease; 18F-FDG = 18F-fluorodeoxyglucose; IQR = interquartile range; MRI = magnetic resonance imaging; PET = positron emission tomography; PUMCH = Peking Union Medical College Hospital; TSS = transsphenoidal surgery; UFC = urine free cortisol

scholarly journals Prediction of the Outcome of Cochlear Implantation in the Patients with Congenital Cytomegalovirus Infection based on Magnetic Resonance Imaging Characteristics

2019 ◽  
Vol 8 (2) ◽  
pp. 136
Author(s):  
Jae Han ◽  
Yun Bae ◽  
Seul Song ◽  
Jae-Jin Song ◽  
Ja-Won Koo ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Cochlear Implantation ◽  
Brain Mri ◽  
Brain Magnetic Resonance Imaging ◽  
Control Group ◽  
Resonance Imaging ◽  
Mri Findings ◽  
Congenital Cytomegalovirus ◽  
Imaging Characteristics

The goal of this study was to elucidate radiologic biomarker that can predict the outcome of cochlear implantation (CI) in congenital cytomegalovirus (cCMV) related deafness. A retrospective survey of speech perception after CI and an evaluation of brain magnetic resonance imaging (MRI) findings were performed in 10 cochlear implantees with cCMV-related prelingual deafness. Specifically, a special attention was paid to the degree of white matter (WM) abnormality shown in brain MRI, which was used to divide our cohort into two groups: The mild and severe pathology groups. Age-matched prelingual deaf patients with idiopathic sensorineural hearing loss were selected as controls. Subjects in mild pathology groups showed higher a Category of Auditory Performance (CAP) score (5.2 ± 0.8) than those with severe pathologies (3.4 ± 1.5) (P = 0.041). Importantly, speech performance from subjects with mild pathology was comparable to that of the control group (mean CAP score of 5.2 ± 0.8 vs. 5.1 ± 1.2) (P = 0.898). Mild pathologies related to the limited WM lesion in MRI not accompanied by severe MRI pathologies, such as diffuse WM abnormality, myelination delay, ventriculomegaly, migration abnormality, and cerebellar hypoplasia, can be tolerated and do not adversely affect the CI outcome in cCMV deafness.

scholarly journals 1.5 Tesla Magnetic Resonance Imaging Features of Canine Intracranial Intra-axial Hematomas

2021 ◽  
Vol 8 ◽  
Author(s):  
James Whitlock ◽  
Andrew Holdsworth ◽  
Carles Morales ◽  
Laurent Garosi ◽  
Inés Carrera
Keyword(s):  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Contrast Enhancement ◽  
Clinical Signs ◽  
Border Region ◽  
Imaging Features ◽  
Resonance Imaging ◽  
Mri Findings ◽  
Mri Features ◽  
Mri Study

The differentiation of solitary intra-axial hematomas from hemorrhagic neoplasms based on their magnetic resonance imaging (MRI) features is challenging. The treatment and prognosis for these two disease entities are vastly different and distinction between them is often based on MRI findings alone. The aim of this study was to describe the 1.5 tesla MRI features of canine intra-axial hematomas and correlate these findings with the evolution of hemorrhages described in human brains. Retrospective evaluation of patient details, clinical signs, and MRI findings of dogs with intra-axial hematomas that were histopathologically confirmed or determined via repeat MRI study and/or resolution of neurological signs. Ten dogs met the inclusion criteria. All 10 hematoma lesions were determined to be 2–7 days in age. On MRI, all 10 hemorrhagic lesions were comprised of two distinct regions; a relatively thin T1-weighted (T1W), T2-weighted (T2W) and gradient echo (GRE) hypointense (9/10) peripheral border region and a large central region that was heterogenous but predominantly T1W, T2W and GRE hyperintense (8/10). The peripheral border region was complete in its integrity in all 10 cases on T2W and GRE sequences. Contrast enhancement was present in (6/10) hematoma lesions and was always peripheral in nature with no evidence of central enhancement associated with any of the lesions. An intra-axial hematoma should be suspected in solitary hemorrhagic space occupying lesions that have a complete hypointense peripheral rim, elicit a peripheral contrast enhancement pattern, and display the expected temporal pattern of hematoma evolution.

scholarly journals PEDIATRIC PYOGENIC SACROILIITIS: A RARE CASE REPORT

2018 ◽  
Vol 6 (1) ◽  
pp. 62-65
Author(s):  
Bipan Shrestha ◽  
Kishor Man Shrestha ◽  
Alok Pandey
Keyword(s):  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Antimicrobial Therapy ◽  
Imaging Modality ◽  
English Literature ◽  
Joint Fluid ◽  
Resonance Imaging ◽  
Mri Findings ◽  
Diagnostic Dilemma ◽  
Pyogenic Sacroiliitis

Introduction: Pyogenic sacroiliitis accounts for 12% of all cases of septic arthritis with less than 200 cases reported in the English literature since the beginning of the twentieth century. Considerable delay between presentation and diagnosis is seen because of unusual presentation and diagnostic dilemma. Cultures of joint fluid usually grow Staphylococcus aureus. Magnetic resonance imaging has been found to be the most useful imaging modality in diagnosis. Being very uncommon disease in children, the key to successful management is early diagnosis in which computed tomography (CT), bone scans, and magnetic resonance imaging (MRI) findings play a crucial role. If the diagnosis is established promptly, most patients can be managed successfully with antimicrobial therapy with excellent prognosis. Most reported cases required prolonged antimicrobial therapy of six to nine weeks. Presented here is a child with pyogenic sacroiliitis managed at our hospital (Universal College of Medical Sciences Teaching Hospital-UCMSTH) and review of the literature on this relatively rare diagnosis. Journal of Universal College of Medical SciencesVol. 6, No. 1, 2018, Page: 62-65

scholarly journals Epithelioid Myofibroblastoma in an Old-Male Breast: A Case Report with MRI Findings

2015 ◽  
Vol 2015 ◽  
pp. 1-4 ◽  
Author(s):  
Seyma Yildiz ◽  
Zuhal Gucin ◽  
Ezgi Basak Erdogan
Keyword(s):  
Magnetic Resonance Imaging ◽  
Prostate Cancer ◽  
Case Report ◽  
Magnetic Resonance ◽  
Postmenopausal Women ◽  
Final Diagnosis ◽  
Resonance Imaging ◽  
Mri Findings ◽  
Imaging Characteristics ◽  
Magnetic Resonance Imaging Mri

Myofibroblastoma of the breast (MFB) is a very rare benign stromal tumor. In recent years, increase in mammographic screenings has resulted in increased diagnosis of MFB. Most cases are old males and postmenopausal women. MFB may be confused as malignant, clinically, morphologically, or by imaging. Immunohistochemistry is essential for final diagnosis in these cases. We report a case of a pathologically diagnosed MFB in an 80-year-old male patient who had coexisting prostate cancer and describe its imaging characteristics, especially magnetic resonance imaging (MRI). In this paper, histopathological and MRI findings of the MFB were discussed.

Diagnostic modalities for distal radioulnar joint

2016 ◽  
Vol 42 (4) ◽  
pp. 395-404 ◽  
Author(s):  
S. Jens ◽  
T. Luijkx ◽  
F. F. Smithuis ◽  
M. Maas
Keyword(s):  
Magnetic Resonance Imaging ◽  
Computed Tomography ◽  
Magnetic Resonance ◽  
Imaging Modality ◽  
Conventional Radiography ◽  
Distal Radioulnar Joint ◽  
Resonance Imaging ◽  
Radioulnar Joint ◽  
Joint Pathology ◽  
Imaging Characteristics

The first imaging modality in patients suspected of distal radioulnar joint pathology should be conventional radiography to exclude or diagnose wrist pathology including osteoarthritis, rheumatoid arthritis, calcium pyrophosphate deposition disease, (healed) fractures, or impaction syndromes. When conventional radiography is inconclusive, high resolution 3 Tesla magnetic resonance imaging is advised. We provide a broad overview of the literature regarding the use of intra-articular contrast both with computed tomography (CTA) or magnetic resonance imaging (MRA). Conventional arthrography and unenhanced computed tomography are not indicated. This article discusses the most useful imaging techniques in terms of clinical indications, patient positioning, technical imaging requirements, and diagnostic performance in patients with suspected distal radioulnar joint pathology. Furthermore, the most prevalent pathologies are discussed, with the focus on imaging characteristics in both stable and unstable distal radioulnar joints.

scholarly journals The Use of Endoscopic Ultrasonography and Other Imaging Modalities in the Preoperative Staging of Rectal Villous Tumours: A Case of Overstaging by Magnetic Resonance Imaging

2009 ◽  
Vol 23 (9) ◽  
pp. 639-641 ◽  
Author(s):  
Michelle Buresi ◽  
Iman Zandieh ◽  
Alexander G Nagy ◽  
Audrey Spielmann ◽  
William C Yee ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Villous Adenoma ◽  
Imaging Modality ◽  
Preoperative Staging ◽  
Muscularis Propria ◽  
Low Grade ◽  
Resonance Imaging ◽  
Mri Findings ◽  
Meta Analyses

A case of a 60-year-old man with recurrent rectal villous adenoma is described. Preoperative staging with endoscopic ultrasound (EUS) and magnetic resonance imaging (MRI) revealed very discordant results. EUS showed a tumour present in the mucosa with no submucosal invasion, while MRI revealed invasion of the muscularis propria consistent with an invasive stage T2 carcinoma. Based on the MRI findings, the patient underwent a low anterior resection of the tumour. The surgical pathology specimen revealed a villous adenoma with low-grade dysplasia but no carcinoma and no extension into the muscularis propria. The present case highlights the uncertainty that currently exists as to which imaging modality provides the greatest accuracy in the staging of rectal cancer and in guiding the type of surgical procedure performed. Two recent meta-analyses and a systematic review of the literature point to EUS as the imaging modality of choice for determining muscularis propria and perirectal tissue invasion, as well as nodal involvement.

scholarly journals Histopathologic Correlates of Nonmass Enhancement Detected by Breast Magnetic Resonance Imaging

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.

scholarly journals Ultrasonography and Magnetic Resonance Imaging in Ovarian Torsion - A Retrospective Study in Hoskote

2021 ◽  
Vol 8 (11) ◽  
pp. 648-652
Author(s):  
Vinjamuri Anuradha ◽  
Prashanth Venkateswaran ◽  
Manasa Pandith P.C. ◽  
Puneet Shirbur
Keyword(s):  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Pelvic Mass ◽  
Ovarian Torsion ◽  
Free Fluid ◽  
Vascular Pedicle ◽  
Resonance Imaging ◽  
Mri Findings ◽  
Medical College ◽  
Mri Features

BACKGROUND Ovarian torsion occurs when the ovary twists on its fibrovascular pedicle resulting in vascular compromise. Initially, there is twisting of the ovary, fallopian tube, or both structures, causing venous, lymphatic and arterial compromise with resultant ovarian oedema and adnexal enlargement. We wanted to determine the most common ultrasonography (USG) and magnetic resonance imaging (MRI) findings in surgically proven cases of ovarian torsion. METHODS We present a series of cases obtained on retrospective review of USG and MRI findings in 10 surgically proven cases of ovarian torsion between June 2018 to June 2020 in the Department of Radiology, MVJ Medical College & Research Hospital, Hoskote. RESULTS Significant enlargement of the ovary with size ranging from 5 to 15 cms with peripherally displaced follicles and free fluid in the pelvis in noted in all the patients on USG and MRI. Other common MRI features include ‘twisted vascular pedicle’ sign seen in 7 (70 %) cases, areas of haemorrhage within the ovarian stroma in 7 (70 %) cases and abnormal ovarian enhancement in 9 (90 %) cases. CONCLUSIONS Ultrasound and MRI are the main diagnostic imaging modalities prior to treatment. Improved detection and characterisation of pelvic mass contributes to better diagnostic accuracy. The most common findings in US and MRI features of ovarian torsion include ovarian enlargement with peripherally displaced follicles and free fluid in pelvis. Other common MRI features include ovarian haemorrhage, twisted vascular pedicle, abnormal ovarian enhancement and deviation of the uterus towards the same side. KEYWORDS Ovarian torsion, USG, MRI

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