scholarly journals Lymphocitic infundibuloneurohypophysitis mimicking a pituitary adenoma

2011 ◽  
Vol 1 (3) ◽  
pp. 48 ◽  
Author(s):  
Lorenzo Giammattei ◽  
Homajoun Maslehaty ◽  
Athanasios K. Petridis ◽  
Hubertus Maximilian Mehdorn
Keyword(s):  
Pituitary Adenoma ◽  
Rare Case ◽  
Clinical Characteristics ◽  
Surgical Removal ◽  
Resonance Imaging ◽  
Cranial Magnetic Resonance Imaging ◽  
Radiological Features ◽  
Neurosurgical Treatment ◽  
Magnetic Resonance Imaging Mri ◽  
Weighted Sequences

A rare case of infundibulo-neurohypophysitis mimicking a pituitary adenoma is presented. A 69-years-old female patient developed polyuria and polydipsia. Laboratory analysis revealed central diabetes insipidus. No hormonal abnormalities. Cranial-magnetic resonance imaging (MRI) showed a left sided mass in the adenohypophysis presuming a pituitary adenoma. The mass had contact to both internal carotids. Admission to our department for neurosurgical treatment followed. Ophthalmo - logic examination and neurological examination yielded normal findings. A second MRI focussing on the sellar-region showed a leftsided (T2-MRI.hyperintense), distended adenohypophysis, without contrast enhancement in T1. The stalk appeared thickened. T1- weighted sequences of the neurohypophysis showed loss of signal intensity. We diagnosed an infundibulo-neurohypophysitis and abstai - ned from surgical removal. The patient was discharged under treatment with corticosteroids and desmopressin. Hypophysitis is rare and shows special clinical characteristics. Despite defined radiological features to differentiate between hypophysitis and adenoma the possibility of misdiagnosis, and unnecessary surgical procedures, should always kept in mind.

scholarly journals Lymphangiography and focal pleurodesis treatment of chylothorax with an aberrant thoracic duct following oesophagectomy: a case report

2019 ◽  
Vol 5 (1) ◽  
Author(s):  
Tomoyuki Ishida ◽  
Jun Kanamori ◽  
Hiroyuki Daiko
Keyword(s):  
Magnetic Resonance Imaging ◽  
Interventional Radiology ◽  
Case Report ◽  
Magnetic Resonance ◽  
Thoracic Duct ◽  
Rare Case ◽  
Resonance Imaging ◽  
Case Presentation ◽  
Thoracostomy Tube ◽  
Magnetic Resonance Imaging Mri

Abstract Background Management of postoperative chylothorax usually consists of nutritional regimens, pharmacological therapies such as octreotide, and surgical therapies such as ligation of thoracic duct, but a clear consensus is yet to be reached. Further, the variation of the thoracic duct makes chylothorax difficult to treat. This report describes a rare case of chylothorax with an aberrant thoracic duct that was successfully treated using focal pleurodesis through interventional radiology (IVR). Case presentation The patient was a 52-year-old man with chylothorax after a thoracoscopic oesophagectomy for oesophageal cancer. With conventional therapy, such as thoracostomy tube, octreotide or fibrogammin, a decrease in the amount of chyle was not achieved. Therefore, we performed lymphangiography and pleurodesis through IVR. The patient appeared to have an aberrant thoracic duct, as revealed by magnetic resonance imaging (MRI); however, after focal pleurodesis, the leak of chyle was diminished, and the patient was discharged 66 days after admission. Conclusions Chylothorax remains a difficult complication. Focal pleurodesis through IVR can be one of the options to treat chylothorax.

scholarly journals Applicability of Magnetic Resonance Imaging in the Assessment of Fetal Urinary Tract Malformations

2019 ◽  
Vol 70 (1) ◽  
pp. 83-95 ◽  
Author(s):  
Tatiana Mendonça Fazecas ◽  
Edward Araujo Júnior ◽  
Heron Werner ◽  
Pedro Daltro ◽  
Alberto Borges Peixoto ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Urinary Tract ◽  
Magnetic Resonance ◽  
Three Dimensional ◽  
Surface Coil ◽  
Resonance Imaging ◽  
Magnetic Resonance Imaging Mri ◽  
Urinary Tract Malformations ◽  
Weighted Sequences ◽  
Urinary Tract Anomalies

Objective To assess the applicability of magnetic resonance imaging (MRI) to complement ultrasound in the diagnosis of fetal urinary tract anomalies. Methods This was a retrospective cohort study that included 41 women between 19 weeks and 37 weeks and 6 days of gestation carrying fetuses with malformations of the urinary tract which were initially diagnosed by ultrasound and then referred for MRI. In all cases, the diagnosis was confirmed after birth either through imaging or autopsy. A surface coil was positioned over the abdomen and T2-weighted sequences were obtained in the axial, coronal, and sagittal planes; T1 in at least one plane; and three-dimensional (3-D) TRUFI in fetuses with dilatation of the urinary tract. Results Mean gestational age at the time of MRI examination was 28.21 weeks. The rapid T2 sequences allowed all the anomalies of the fetal urinary tract to be assessed, whereas 3-D TRUFI sequencing proved very useful in evaluating anomalies involving dilatation of the urinary tract. The signs of pulmonary hypoplasia characterized by hypointense signal in the T2-weighted sequences were identified in 13 of the 41 fetuses. Conclusion MRI confirmed and added information to the ultrasound regarding fetal urinary tract anomalies, as well as information related to the other associated malformations, their progress in the prenatal period, and possible postnatal prognosis.

scholarly journals GH-Producing Pituitary Adenoma and Concomitant Rathke’s Cleft Cyst: A Case Report and Short Review

2015 ◽  
Vol 2015 ◽  
pp. 1-6 ◽  
Author(s):  
Ryota Tamura ◽  
Satoshi Takahashi ◽  
Katsura Emoto ◽  
Hideaki Nagashima ◽  
Masahiro Toda ◽  
...  
Keyword(s):  
Pituitary Adenoma ◽  
Sella Turcica ◽  
Short Review ◽  
Pituitary Hormones ◽  
Rathke’S Cleft Cyst ◽  
Resonance Imaging ◽  
Mr Images ◽  
Rathke's Cleft Cyst ◽  
Magnetic Resonance Imaging Mri ◽  
Rathke's Cleft

Concomitant pituitary adenoma (PA) and Rathke’s cleft cyst (RCC) are rare. In some cases, such PA is known to produce pituitary hormones. A 53-year-old man was admitted to our hospital with a diagnosis of lacunar infarction in the left basal ganglia. Magnetic resonance imaging (MRI) incidentally showed a suprasellar mass with radiographic features of RCC. When he consulted with a neurosurgical outpatient clinic, acromegaly was suspected based on his appearance. A diagnosis of growth hormone- (GH-) producing PA was confirmed from hormonal examinations and additional MRI. Retrospectively, initial MR images also showed intrasellar mass that is compatible with the diagnosis of PA other than suprasellar RCC. The patient underwent endonasal-endoscopic removal of the PA. Since we judged that the RCC of the patient was asymptomatic, only the PA was completely removed. The postoperative course of the patient was uneventful and GH levels gradually normalized. Only 40 cases of PA with concomitant RCC have been reported to date, including 13 cases of GH-producing PA. In those 13 cases, RCC tended to be located in the sella turcica, and suprasellar RCC like this case appears rare. In a few cases, concomitant RCCs were fenestrated, but GH levels normalized postoperatively as in the cases without RCC fenestration. If radiographic imaging shows typical RCC, and PA is not obvious at first glance, the possibility of concomitant PA still needs to be considered. In terms of treatment, removal of the RCC is not needed to achieve hormone normalization.

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

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.

scholarly journals A rare case of post traumatic isolated bilateral abducens nerve palsy

2014 ◽  
Vol 21 (4) ◽  
pp. 497-499
Author(s):  
Manish Jaiswal ◽  
Saurabh Jain ◽  
Ashok Gandhi ◽  
Achal Sharma ◽  
R.S. Mittal
Keyword(s):  
Rare Case ◽  
Nerve Palsy ◽  
Abducens Nerve ◽  
Abducens Nerve Palsy ◽  
Resonance Imaging ◽  
Intracranial Lesion ◽  
Mri Brain ◽  
Post Traumatic ◽  
Magnetic Resonance Imaging Mri ◽  
Bilateral Abducens

Abstract Although unilateral abducens nerve palsy has been reported to be as high as 1% to 2.7% of traumatic brain injury, bilateral abducens nerve palsy following injury is extremely rare. In this report, we present the case of a patient who developed isolated bilateral abducens nerve palsy following minor head injury. He had a Glasgow Coma Score (GCS) of 15 points. Computed tomography (CT) images & Magnetic Resonance Imaging (MRI) brain demonstrated no intracranial lesion. Herein, we discuss the possible mechanisms of bilateral abducens nerve palsy and its management.

scholarly journals Extraskeletal Chondroma of the Preauricular Region: A Case Report and Literature Review

2012 ◽  
Vol 2012 ◽  
pp. 1-4 ◽  
Author(s):  
Futoshi Watanabe ◽  
Tadahiko Saiki ◽  
Yoshihisa Ochochi
Keyword(s):  
Magnetic Resonance Imaging ◽  
Differential Diagnosis ◽  
Rare Case ◽  
Clinical Characteristics ◽  
Hyaline Cartilage ◽  
Surrounding Tissue ◽  
Resonance Imaging ◽  
En Bloc ◽  
Cartilaginous Tumor ◽  
The Right

An extraskeletal chondroma is a rare benign cartilaginous tumor that develops in soft tissue. Histologically, it is a lobulated nodule surrounded by a fibrous capsule; the inside consists of mature hyaline cartilage containing a few normal chondrocytes. We present a rare case of extraskeletal chondroma in the preauricular region. A 43-year-old man presented with a 2-cm-diameter right preauricular tumor that had been developing for 1 year. Magnetic resonance imaging showed a solid lobulated tumor in the right preauricular region, which was proximate to the capsule of the right temporomandibular joint (TMJ). This was subsequently resected under general anesthesia. The tumor was not in contact with the TMJ capsule and had not invaded the surrounding tissue, facilitatingen blocexcision. Histopathologically, the tumor comprised mainly of hyaline cartilage containing chondrocytes with chondrocytic lacunae and was diagnosed as a chondroma. The postoperative period was uneventful, and there was no evidence of recurrence at the 2-year followup. We describe the clinical characteristics of our case and review the literature, emphasizing the differential diagnosis.

scholarly journals Quantitative Volumetric Analysis Post Transsphenoidal Pituitary Adenoma Surgery

2012 ◽  
Vol 39 (5) ◽  
pp. 600-604 ◽  
Author(s):  
Alireza Mansouri ◽  
Sean Symons ◽  
Michael Schwartz ◽  
Joseph Chen ◽  
Farhad Pirouzmand
Keyword(s):  
Pituitary Adenoma ◽  
Volumetric Analysis ◽  
Point Of View ◽  
Size Difference ◽  
Resonance Imaging ◽  
Residual Mass ◽  
Postoperative Assessment ◽  
The Difference ◽  
Magnetic Resonance Imaging Mri

Background:Computed tomogram (CT) imaging is often used for immediate postoperative assessment of transsphenoidal pituitary adenoma resection while magnetic resonance imaging (MRI) is used for follow-up. The residual mass is known to decrease in size over time but the difference between the two imaging modalities has not been quantified. Our objective was to quantify the size difference of the residual mass on immediate postoperative CT compared with delayed MRI.Methods:Retrospective analysis of 69 patients who had undergone pituitary adenoma resection at our institution between 2004-2010. Sellar and suprasellar diameter, along with the overall volume of the residual mass were measured on both the immediate postoperative CT and delayed MRI.Results:Average preoperative sellar and suprasellar diameter was 22.2 ± 4.6mm and 20.9 ± 5.9mm, respectively. Average sellar residual diameter on immediate postoperative CT (16.5 ± 5.4 mm, 25% reduction) was significantly larger than delayed MRI (10.6 ± 6.2mm, 52% reduction). The average suprasellar component on CT (15.5±6.5mm, 26% reduction) was also significantly larger than that on MRI (3.3 ± 5.4 mm, 84% reduction). The postoperative CT showed a 46% reduction in volume while a 71% reduction was noted on the delayed MRI.Conclusion:A significant reduction in residual mass is noted on delayed MR imaging compared with immediate postoperative CT. Therefore, from a resource management and prognostication point of view, CT should be used for immediate postoperative assessment while delayed MRI should be used to assess operative success and for communication with patients.

scholarly journals Basic knowledge for hepatic MRI interpretation

2019 ◽  
Vol 2 (1) ◽  
pp. 9-12
Author(s):  
Wanwarang Teerasamit
Keyword(s):  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Signal Intensity ◽  
Tissue Characterization ◽  
Basic Knowledge ◽  
Liver Lesions ◽  
Resonance Imaging ◽  
Mr Contrast Agents ◽  
Magnetic Resonance Imaging Mri ◽  
Weighted Sequences

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

scholarly journals Diagnosis and Management of Wooden Foreign Bodies in the Orbit: A Case Report

2021 ◽  
Vol 17 (2) ◽  
pp. 158-161
Author(s):  
Hyo Bong Kim ◽  
Hoon Kim ◽  
Soo Yeon Lim ◽  
In Chang Koh
Keyword(s):  
Magnetic Resonance Imaging ◽  
Optic Nerve ◽  
Foreign Bodies ◽  
Surgical Removal ◽  
Resonance Imaging ◽  
Upper Eyelid ◽  
Diagnosis And Management ◽  
Optic Nerve Damage ◽  
Magnetic Resonance Imaging Mri

The diagnosis and management of intraorbital foreign bodies are challenging for surgeons. Foreign bodies made of wood and those located close to the optic nerve are especially difficult to manage. Herein, we report our experience with the diagnosis and management of intraorbital wooden foreign bodies utilizing magnetic resonance imaging (MRI). A 50-year-old man presented to the emergency room with a laceration on his left upper eyelid. No foreign bodies were visible through the laceration, and computed tomography findings showed only evidence of cellulitis with abscess formation. Despite drainage and antibiotics, the cellulitis worsened; subsequently, we found multiple wooden foreign bodies on MRI. Surgical removal was performed, excluding those in the intraconal space to avoid optic nerve damage. The patient recovered well and has not experienced any ophthalmic complications at 1 year of follow-up.

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