Could we assess the functional status, of hormone secreting, or non-secreting of the adrenal masses regarding their Magnetic Resonance Imaging (MRI) characteristics?

Author(s):  
Gamze Akkus ◽  
Ferhat Piskin ◽  
Barış Karagun ◽  
Murat Sert ◽  
Mehtap Evran ◽  
...  

Background: Diagnostic imaging techniques including magnetic resonance imaging (MRI) should also perform on all patients with incidentalomas. However, there is a limited study whether the quantitative measurements (signal intensity index, adrenal to spleen ratio) in MRI could predict the functional status of adrenal adenomas. Material-Method: Between 2015-2020; 404 patients (265 females, 139 males) with adrenal mass who were referred to the university hospital for further investigation were included. After detailed diagnostic hormonal evaluation, all patients underwent MRI 1.5 T device (Signa, GE Medical Systems; Milwaukee, USA). The signal intensities of the adrenal lesions on T2W images were qualitatively evaluated and noted as homogenous or heterogeneous in comparison with the liver signal intensity (SI). A chemical-shift SI index and chemical shift adrenal-to-spleen SI ratio were also calculated. Results: While 331(81.9%) of the patients had nonfunctional adrenal mass, the rest of them (n=73, 18.1%) were patients with functional (autonomous cortisol secretion-ACS, cushing syndrome-CS, pheochromocytoma, primary hyperaldosteronism-PA) adrenal masses. In phase vs phase values of patients with NFAI, Pheo(n=17), ACS (n=30), CS (n=11), and PA (n=15) were 474.04±126.7 vs 226.6±132.4, 495.3±182.8 vs 282.17±189.1, 445.2±134.8 vs 203.3±76.2, 506.8±126.5 vs 212.2±73.6 and 496.2±147.5 vs 246.6±102.1, respectively. Mean signal intensity index (SII) and adrenal to spleen ratio (ASR) of all groups (NFAI, Pheo, ACS, CS, PA) were 52.0±24.8 and 0.51, 44.9±22.5 and 0.55, 49.5±24.5 and 0.53, 56.2±16.4 and 0.43, 47.6±25.1 and 0.54, respectively. Based the current accepted measurements in the case of ASR and SII, all lesions were similar and shown as fat rich adenomas (p*= 0.552, p** = 0.45). Conclusion: The quantitative assessment (SII, ASR) of intracellular lipids in an incidentally discovered adrenal tumour could only help distinguish adrenal masses in case of adenomas or non-adenomas As initial diagnostic evaluation, clinical and laboratory assessment ,to distinguish hormone secretion, should be taken in all patients with adrenal incidentalomas.

2019 ◽  
Vol 22 (3) ◽  
pp. 425-431
Author(s):  
Neiandro Santos Galvão ◽  
Antonione Santos Bezerra Pinto ◽  
Alan Leandro Carvalho Farias ◽  
André Luiz Ferreira Costa ◽  
Sérgio Lúcio Pereira de Castro Lopes ◽  
...  

Ameloblastoma is an odontogenic tumor that shares clinical and imaging characteristics with other lesions of the jaws, such as odontogenic keratocyst, which makes the diagnosis difficult. However, in addition to radiographic and tomographic examinations, Magnetic Resonance Imaging (MRI) has been increasingly used, contributing with relevant additional information about the differentiation between solid and liquid components of the lesion. This case report was conducted to present two variations of ameloblastoma and discuss the radiographic, tomographic and MRI contribution in the differential diagnosis between ameloblastoma and odontogenic keratocyst.The signal intensity in T1-weighted MRI revealed internal fluid content in both cases, which was important in the differential diagnosis with other intraosseous lesions such as odontogenic keratocysts. This is probably due to the presence of keratin that increases the viscosity of the content and also for an intermediate signal intensity signal in T2-weighted MRI. Therefore, MRI revealed important internal characteristics of the reported lesions, which was very useful in the establishment of the differential diagnosis with other lesions.


2014 ◽  
Vol 18 (1) ◽  
Author(s):  
Nasreen Mahomed ◽  
Evance Chisama ◽  
Sanjay Prabhu

The ivy sign refers to diffuse bilateral leptomeningeal enhancement on post- contrastT1-weighted magnetic resonance imaging (MRI) and increased signal intensity in bilateralsubarachnoid spaces and perivascular spaces on T2-weighted fluid attenuation inversionrecovery (FLAIR) MRI sequences in patients with moyamoya disease.


2016 ◽  
Vol 7 (04) ◽  
pp. 489-492 ◽  
Author(s):  
Puneet Mittal ◽  
Ranjana Gupta ◽  
Amit Mittal ◽  
Sandeep Joshi

ABSTRACT Introduction: Magnetic resonance imaging (MRI) is the modality of the first choice for evaluation of vertebral compression/collapse. Many MRI qualitative features help to differentiate benign from malignant collapse. We conducted this study to look for a quantitative difference in chemical shift values in benign and malignant collapse using dual-echo gradient echo in-phase/out-phase imaging. Materials and Methods: MRI examinations of a total of 38 patients were retrospectively included in the study who had vertebral compression/collapse with marrow edema in which final diagnosis was available at the time of imaging/follow-up. Signal intensity value in the region of abnormal marrow signal and adjacent normal vertebra was measured on in phase/out phase images. Signal intensity ratio (SIR) was measured by dividing signal intensity value on opposite phase images to that on in phase images. SIR was compared in normal vertebrae and benign and malignant vertebral collapse. Results: There were 21 males and 17 females with mean age of 52.4 years (range 28–76 years). Out of total 38 patients, 18 were of benign vertebral collapse and 20 of malignant vertebral collapse. SIR in normal vertebrae was 0.30 ± 0.14, 0.67 ± 0.18 in benign vertebral collapse, and 1.20 ± 0.27 in malignant vertebral collapse with significant difference in SIR of normal vertebrae versus benign collapse (P < 0.01) and in benign collapse versus malignant collapse (P < 0.01). Assuming a cutoff of <0.95 for benign collapse and ≥0.95 for malignant collapse, chemical shift imaging had a sensitivity of 90% and specificity of 94.4%. Conclusion: Chemical shift imaging is a rapid and useful sequence in differentiating benign from malignant vertebral collapse with good specificity and sensitivity.


2019 ◽  
Vol 2 (1) ◽  
pp. 9-12
Author(s):  
Wanwarang Teerasamit

Nowadays, Magnetic resonance imaging (MRI) has an important role for diagnosis of liver lesions due to excellent tissue characterization, radiation-free technique and continuous development of MRI technology, causing an increased use of MRI. This article focuses on basic knowledge of MRI liver interpretation for non-radiologist. The basic techniques including T1-weighted and T2-weighted sequences as well as additional techniques such as 2D dual GRE in-phase and opposed-phase, fat suppression or heavily T2-weighted sequences were introduced. Types of MR contrast agents for liver including extracellular and hepatocyte-specific agents were also described.   Figure 1  เป็นภาพ MRI ของตับเทคนิค T1W โดยอวัยวะส่วนใหญ่ที่ปรากฏในภาพจะให้ลักษณะ signal intensity ไปในทางhypointense ซึ่งจะเห็นว่าม้าม (spleen=S) ดำกว่าตับ (liver=L) และตับจะดำกว่าตับอ่อน (pancreas=P) โดยลูกศรสีดำชี้ให้เห็น signal intensity ของน้ำไขสันหลังที่เป็นลักษณะ hypointense


HortScience ◽  
2005 ◽  
Vol 40 (3) ◽  
pp. 720-725 ◽  
Author(s):  
B.L. Tan ◽  
N. Reddy ◽  
V. Sarafis ◽  
G.A.C. Beattie ◽  
R. Spooner-Hart

Nuclear magnetic resonance (NMR) spectroscopy and magnetic resonance imaging (MRI) were used to detect petroleum-derived spray oils (PDSOs) in citrus seedlings and trees. The NMR spectrum of the phantom containing 10% (v/v) of a nC24 agricultural mineral oil (AMO) showed the resonance of the water protons at δ ≈ 5 ppm, while the resonance of the oil protons at δ = 1.3 to 1.7 ppm. The peak resolution and the chemical shift difference of more than 3.3 ppm between water and oil protons effectively differentiated water and the oil. Chemical shift selective imaging (CSSI) was performed to localize the AMO within the stems of Citrus trifoliata L. seedlings after the application of a 4% (v/v) spray. The chemical shift selective images of the oil were acquired by excitation at δ = 1.5 ppm by averaging over 400 transients in each phase-encoding step. Oil was mainly detected in the outer cortex of stems within 10 d of spray application; some oil was also observed in the inner vascular bundle and pith of the stems at this point. CSSI was also applied to investigate the persistence of oil deposits in sprayed mature Washington navel orange (Citrus ×aurantium L.) trees in an orchard. The trees were treated with either fourteen 0.25%, fourteen 0.5%, four 1.75%, or single 7% sprays of a nC23 horticultural mineral oil (HMO) 12 to 16 months before examination of plant tissues by CSSI, and were still showing symptoms of chronic phytotoxicity largely manifested as reduced yield. The oil deposits were detected in stems of sprayed flushes and unsprayed flushes produced 4 to 5 months after the last spray was applied, suggesting a potential movement of the oil via phloem and a correlation of the persistence of oil deposit in plants and the phytotoxicity. The results demonstrate that MRI is an effective method to probe the uptake and localization of PDSOs and other xenobiotics in vivo in plants noninvasively and nondestructively.


2018 ◽  
Vol 2018 ◽  
pp. 1-4 ◽  
Author(s):  
Tuan Phung ◽  
Thach Nguyen ◽  
Dung Tran ◽  
Nga Phan ◽  
Hung Nguyen

A 22-year-old woman with myasthenia gravis (MG) presented with ptosis and mild muscle weakness symptoms for one year. Computed tomography (CT) presented a diffuse bilobulate enlargement gland with a high density of soft tissue. Magnetic resonance imaging (MRI) showed the gland with no suppression on the opposed-phase chemical shift. After the thymic tumor diagnosis, she underwent thoracoscopic surgery for tumor resection. The postoperative histopathological finding was thymic lymphoid hyperplasia. This case suggests chemical shift MRI is not enough in distinguishing, and supplementary examination is essential to avoid unnecessary thymic biopsy and surgery.


2016 ◽  
Vol 58 (3) ◽  
pp. 338-343 ◽  
Author(s):  
Ferdinando Draghi ◽  
Chandra Bortolotto ◽  
Davide Renato Coscia ◽  
Mario Canepari ◽  
Salvatore Gitto

Background Mucoid degeneration and ganglia reflect a continuum of degenerative changes within the posterior cruciate ligament (PCL). Purpose To assess the prevalence of and radiologists’ familiarity with PCL mucoid degeneration and ganglia. Material and Methods Knee magnetic resonance imaging (MRI) from July 2013 to June 2015, excluding patients who had a preceding trauma or MRI findings indicative of a prior injury, were retrospectively reviewed, with the specific request to assess degenerative changes of the PCL, by the same musculoskeletal radiologists who previously reported these examinations, and one fellow. Results A total of 692 patients entered this study. The radiologists and the fellow together identified mucoid degeneration in 34 patients (4.9%), ganglia in 14 patients (2.0%), and both in four patients (0.6%). Several patterns of PCL mucoid degeneration were identified: diffuse thickening in seven patients, partial thickening in 16 (four associated with a ganglion), longitudinal intraligamentous PCL signal-intensity abnormalities resembling a “tram track” in 15. In all cases there was increased signal intensity on fluid-sensitive sequences. In the previous reports, only three cases of PCL mucoid degeneration out of 38 (7.9%) were described, with intraligamentous PCL signal-intensity abnormalities. In the reports of the patients with degeneration and ganglia, only ganglia were described. In the previous reports, ganglia were correctly diagnosed. Conclusion Mucoid degeneration of the PCL is much more common than previously assumed and is underestimated by radiologists.


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