Pathophysiology and MRI Findings of Infectious Spondylitis and the Differential Diagnosis

AbstractAcute gynaecologic disorders are commonly encountered in daily clinical practice of emergency departments (ED) and predominantly occur in reproductive-age women. Since clinical presentation may be nonspecific and physical findings are often inconclusive, imaging is required for a timely and accurate diagnosis. Although ultrasound is the ideal non-invasive first-line technique, nowadays multidetector computed tomography (CT) is extensively used in the ED, particularly when a non-gynaecologic disorder is suspected and differential diagnosis from gastrointestinal and urologic diseases is needed. As a result, CT often provides the first diagnosis of female genital emergencies. If clinical conditions and scanner availability permit, magnetic resonance imaging (MRI) is superior to CT for further characterisation of gynaecologic abnormalities, due to the excellent soft-tissue contrast, intrinsic multiplanar capabilities and lack of ionising radiation.The purpose of this pictorial review is to provide radiologists with a thorough familiarity with gynaecologic emergencies by illustrating their cross-sectional imaging appearances. The present first section will review the CT and MRI findings of corpus luteum and haemorrhagic ovarian cysts, gynaecologic haemoperitoneum (from either ruptured corpus luteum or ectopic pregnancy) and adnexal torsion, with an emphasis on differential diagnosis. Additionally, comprehensive and time-efficient MRI acquisition protocols are provided.

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P14.42 Diagnostic challenges of infratentorial hemangioblastomas: improvement of current radiological classification scheme

Neuro-Oncology ◽

10.1093/neuonc/noz126.277 ◽

2019 ◽

Vol 21 (Supplement_3) ◽

pp. iii76-iii76

Author(s):

I Jung ◽

E Kim ◽

J Moon ◽

S Kang ◽

J Chang

Keyword(s):

Differential Diagnosis ◽

Classification Scheme ◽

Surgical Removal ◽

Mri Findings ◽

Von Hippel Lindau ◽

Radiological Features ◽

Radiological Classification ◽

Magnetic Resonance Imaging Mri ◽

Vhl Disease ◽

Cystic Type

Abstract BACKGROUND Hemangioblastomas (HBMs) are known to exhibit very typical radiological features and thus classified by well-established radiological classification scheme. However, after we have experienced unusual cases in which current radiological classification system was not enough to categorize them, we reviewed our series of infratentorial HBMs in order not only to evaluate the relevance of current classification scheme, but also to possibly improve it. Also, we added descriptions on several cases with unusual radiological magnetic resonance imaging (MRI) findings in which differential diagnosis was challenging. MATERIAL AND METHODS We retrospectively reviewed preoperative MRI of 118 patients with pathologically diagnosed infratentorial HBMs at our institution between 2002 and 2015. Total 128 tumors were included to this study and classified into four categories based on the presence and nature of cystic components: extratumoral cystic (Type Ce, classical cystic with a mural nodule), intratumoral cystic (Type Ci), mixed cystic (Type Cm), and solid (Type S). The association with von Hippel-Lindau (VHL) disease was also investigated. RESULTS In 118 patients (65 male and 53 female), 79 (66.9%) had solitary HBMs and 39 (33.1%) were diagnosed with VHL disease. Type Ce with typical radiological findings was the most prevalent type of HBM (63.3%), followed by Type S (21.1%). HBMs with intratumoral cysts were uncommon (Type Ci, 11.7%) and mixed extratumoral and intratumoral cysts (Type Cm) accounted for only 3.9%. No intergroup differences were observed in the proportions of each subtype between the solitary and VHL disease-associated HBMs. CONCLUSION Radiological features of HBMs are usually typical thus preoperative presumption is not difficult in majority of cases. Improved radiological classification scheme is more practical because it does not only help surgeons determine whether the cystic wall should be removed or not, but also covers cases with atypical radiological presentations. For solid and extraparenchymal HBMs, differential diagnosis is more difficult as well as very critical as surgical removal is often very challenging.

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Unilateral Sacroiliitis: Differential Diagnosis Between Infectious Sacroiliitis and Spondyloarthritis Based on MRI Findings

American Journal of Roentgenology ◽

10.2214/ajr.14.14217 ◽

2015 ◽

Vol 205 (5) ◽

pp. 1048-1055 ◽

Cited By ~ 13

Author(s):

Yusuhn Kang ◽

Sung Hwan Hong ◽

Ji Young Kim ◽

Hye Jin Yoo ◽

Ja-Young Choi ◽

...

Keyword(s):

Differential Diagnosis ◽

Mri Findings

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A case report of lymphocytic hypophysitis

Surgical Neurology International ◽

10.25259/sni_225_2021 ◽

2021 ◽

Vol 12 ◽

pp. 263

Author(s):

Stephen Yu ◽

Ramakrishna Bethanabatla ◽

Ahmed Taha

Keyword(s):

Differential Diagnosis ◽

Rare Condition ◽

Lymphocytic Hypophysitis ◽

Reproductive Age ◽

Case Description ◽

Clinical Correlation ◽

Resonance Imaging ◽

Sellar Mass ◽

Mri Findings ◽

Magnetic Resonance Imaging Mri

Background: Lymphocytic hypophysitis (LH) is a rare condition that mostly affects women of the reproductive age. Because it is infrequently encountered, it is not often considered as a differential diagnosis of sellar masses. The diagnosis is made clinically with the aid of magnetic resonance imaging (MRI) and should be considered if the patient has endocrine derangements in addition to a sellar mass. Case Description: A 37-year-old female presents with a complaint of headaches and CT imaging showed a sellar mass. She was also being investigated simultaneously by the endocrine department and was diagnosed with panhypopituitarism. She proceeded to surgery for a presumed pituitary adenoma but histopathology returned as LH. Conclusion: It is important to have a wide differential diagnosis when managing pituitary masses. Clinical correlation with atypical MRI findings is useful to determine the diagnosis of LH.

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Presence of Skin α-Synuclein Deposits Discriminates Parkinson’s Disease from Progressive Supranuclear Palsy and Corticobasal Syndrome

Journal of Parkinson s Disease ◽

10.3233/jpd-212904 ◽

2021 ◽

pp. 1-7

Author(s):

Maria Pia Giannoccaro ◽

Patrizia Avoni ◽

Giovanni Rizzo ◽

Alex Incensi ◽

Rossella Infante ◽

...

Keyword(s):

Parkinson’S Disease ◽

Parkinson's Disease ◽

Differential Diagnosis ◽

Progressive Supranuclear Palsy ◽

Clinical Diagnosis ◽

Corticobasal Syndrome ◽

Healthy Controls ◽

Mri Findings ◽

Chi Square ◽

Clinical Diagnostic Criteria

Background: Previous studies reported skin phosphorylated α-synuclein (p-syn) deposits in Parkinson’s disease (PD) patients but not in patients with parkinsonism due to tauopathies, although data on the latter are limited. Objective: We aimed to assess the presence of skin p-syn deposits in patients with clinical diagnosis of parkinsonism usually due to tauopathy and PD. Methods: We consecutively recruited 26 patients, 18 fulfilling clinical diagnostic criteria of progressive supranuclear palsy (PSP) and 8 of corticobasal syndrome (CBS), 26 patients with PD, and 26 healthy controls (HC). All subjects underwent skin biopsy to study p-syn deposits in skin nerves by immunofluorescence. Results: Skin p-syn deposits were present in only two of the PSP/CBS patients and none of the HC. Conversely, all PD patients showed p-syn deposition (p < 0.001, Chi-square). The two p-syn positive patients were diagnosed with PSP and CBS, respectively. Although clinical and MRI findings supported these diagnoses, both patients had some atypical features more typical of synucleinopathies. Conclusion: The detection of skin p-syn deposits may help in the differential diagnosis of parkinsonism. Indeed, in this study, all PD patients and only two out of 26 with a clinical diagnosis of PSP/CBS had skin p-syn deposits. Furthermore, these two patients showed clinical features that could suggest an atypical synucleinopathy presentation or a mixed pathology.

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Papillary Tumor of the Pineal Region with Parinaud Syndrome: A Case Report

Current Medical Imaging Formerly Current Medical Imaging Reviews ◽

10.2174/1573405615666191111143716 ◽

2020 ◽

Vol 16 (8) ◽

pp. 1044-1047

Author(s):

Lale Damgacı ◽

Büşra Hayat ◽

Servet Güreşçi

Keyword(s):

Differential Diagnosis ◽

Case Report ◽

Soft Tissue ◽

World Health Organisation ◽

Pineal Region ◽

World Health ◽

Pathology Report ◽

Mri Findings ◽

Papillary Tumor ◽

Intravenous Contrast

Background: Less than 1% of all intracranial tumors are in the pineal region. Papillary tumor of the pineal region is considered one of four pineal parenchymal tumors according to the 2007 World Health Organisation classification of central nervous system tumors. It is mostly seen in the middle age and it is rare under the age of 17 in the literature. In this report, we aim to present a case with papillary tumor of the pineal region with both CT and MRI findings, and discuss the differential diagnosis. Case report: A 17-year-old female patient who underwent a treatment of ventriculoperitoneal shunt due to hydrocephalus 18 months ago applied to the neurosurgery clinic with nausea, vomiting, sensorineural hearing loss and Parinaud syndrome continuing through 1 month. Computed tomography (CT) and magnetic resonance imaging (MRI) have been applied. A 58x31x38 mm mass with cystic and mild hyperdense soft tissue components was observed in the localization of pineal gland and posterior comissure on non-enhanced CT. MRI examination revealed that the mass filled the pineal region, contained solid and large cystic components, and hyperintense on T1-weighted images. After intravenous contrast media injection, the mass enhanced more peripherally. DW-MRI showed that there is a diffusion restriction in some parts of the soft tissue components. The mass was totally resected, and pathology report revealed that it is a papillary tumor of the pineal region. Conclusion: When a T1-weighted hyperintense and CT hyperdense mass with cystic and solid components is seen in the pineal region, even if it is rare, papillary tumor should also be considered in the differential diagnosis after exclusion of other hyperintense lesions in T1-weighted imaging.

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