scholarly journals Imaging Features Differentiating Vestibular Ganglion from Intracanalicular Schwannoma on Single-Sequence Non-Contrast Magnetic Resonance Imaging Study

2020 ◽  
Vol 49 (2) ◽  
pp. 65-71
Author(s):  
Yi-Wei Wu ◽  
Amit Karandikar ◽  
Julian PN Goh ◽  
Tiong Yong Tan
Keyword(s):  
Diagnostic Performance ◽  
Internal Auditory Canal ◽  
Vestibular Schwannomas ◽  
Imaging Features ◽  
Resonance Imaging ◽  
Vestibular Ganglion ◽  
Mri Studies ◽  
Contrast Enhanced ◽  
Length Width ◽  
Single Sequence

Introduction: This study aimed to identify imaging features on single-sequence noncontrast magnetic resonance imaging (MRI) that differentiate the vestibular ganglion from small intracanalicular schwannomas. Materials and Methods: Ninety patients (42 men and 48 women; age: 24‒87 years old) with 102 internal auditory canal (IAC) nodules (59 vestibular ganglia and 43 intracanalicular schwannoma) who underwent both singlesequence T2-weighted (T2W) non-contrast enhanced MRI studies and contrast-enhanced T1-weighted (T1W) MRI studies between May 2012 and April 2017 were evaluated. The length, width, distance to the IAC fundus and length/width ratios for all lesions were obtained and compared among groups. Diagnostic performance and cutoff values of the parameters were evaluated with receiver operating characteristics curve analysis. Area under the curve (AUC) value was calculated. Results: Vestibular ganglia have significantly smaller lengths and widths compared to intracanalicular vestibular schwannomas (1.7 ± 0.4 mm and 1.0 ± 0.2 mm versus 5.6 ± 3.0 mm and 3.7 ± 1.5 mm). They are more fusiform in shape compared to vestibular schwannomas (length/width ratio: 1.8 ± 0.4 versus 1.5 ± 0.4). The lesion width demonstrated the highest diagnostic performance (AUC: 0.998). Using a cutoff width of <1.3 mm, the sensitivity, specificity and overall accuracy for diagnosing vestibular ganglia were 97% (57/59), 100% (43/43) and 98% (100/102), respectively. Conclusion: Vestibular ganglia may mimic intracanalicular vestibular schwannomas on a single-sequence T2W MRI. However, a fusiform shape and width <1.3 mm increases confidence in the diagnosis of ganglia. Identifying the vestibular ganglion on single-sequence T2W MRI studies may obviate the need for a contrast-enhanced MRI, reducing the risks of contrast administration, additional scanning time and cost. Key words: Acoustic neuroma, Internal auditory canal, Vestibulocochlear nerve

scholarly journals Contrast-Enhanced Ultrasound in the Differential Diagnosis of Primary Thyroid Lymphoma and Nodular Hashimoto’s Thyroiditis in a Background of Heterogeneous Parenchyma

2021 ◽  
Vol 10 ◽  
Author(s):  
Lulu Yang ◽  
Haina Zhao ◽  
Yushuang He ◽  
Xianglan Zhu ◽  
Can Yue ◽  
...  
Keyword(s):  
Differential Diagnosis ◽  
Hashimoto’S Thyroiditis ◽  
Diagnostic Performance ◽  
Roc Curves ◽  
Hashimoto's Thyroiditis ◽  
Imaging Features ◽  
Contrast Enhanced Ultrasound ◽  
Thyroid Lymphoma ◽  
Contrast Enhanced ◽  
Primary Thyroid Lymphoma

ObjectiveTo investigate the diagnostic performance of contrast-enhanced ultrasound (CEUS) in the differentiation of primary thyroid lymphoma (PTL) and nodular Hashimoto’s thyroiditis (NHT) in patients with background of heterogeneous diffuse Hashimoto’s thyroiditis (HT).MethodsSixty HT patients with 64 thyroid nodules (31 PTL and 33 NHT) who had undergone CEUS examination were included in this study. With histopathological results as the reference, we evaluated the imaging features of each nodule on both conventional ultrasonography (US) and CEUS. Quantitative CEUS parameters including peak intensity (PI), time to peak (TTP), and area under the time–intensity curve (AUC) were gathered in the nodule and background parenchyma. The ratio indexes of theses parameters were calculated by the ratio of the lesion and the corresponding thyroid parenchyma. Logistic regression and receiver operating characteristic (ROC) curves analyses of valuable US indicators were further preformed to evaluate the diagnostic capability of CEUS in discrimination of PTL and NHT.ResultsAmong all the observed US imaging features and CEUS parameters, 10 indicators showed significant differences between PTL and NHT (all P &lt; 0.05). All the significant indicators were ranked according to the odds ratios (ORs). Eight of them were CEUS associated including imaging features of enhancement pattern, degree, homogeneity, and quantification parameters of PI, AUC, ratios of PI, AUC, and TTP, while indicators on conventional US, including vascularity and size ranked the last two with ORs less than 3. The five single CEUS parameters showed good diagnostic performance in diagnosis of PTL with areas under ROC curves of 0.72–0.83 and accuracies of 70.3–75.0%. The combination of CEUS imaging features and the ratios of PI, AUC, and TTP demonstrated excellent diagnostic efficiency and achieved area under ROC curve of 0.92, which was significantly higher than any of the five single parameters (all P &lt; 0.05), with a sensitivity of 83.9%, specificity of 87.9%, and accuracy of 85.9%.ConclusionsCEUS is an efficient diagnostic tool in the differential diagnosis of PTL and NHT for patients with diffuse HT. Conjoint analysis of CEUS imaging features and quantification parameters could improve the diagnostic values.

Diagnostic performance of diffusion-weighted imaging combined with dynamic contrast-enhanced magnetic resonance imaging for prostate cancer: a systematic review and meta-analysis

2020 ◽  
pp. 028418512095626
Author(s):  
Lu Yang ◽  
Yuchuan Tan ◽  
Hanli Dan ◽  
Lin Hu ◽  
Jiuquan Zhang
Keyword(s):  
Magnetic Resonance Imaging ◽  
Prostate Cancer ◽  
Magnetic Resonance ◽  
Likelihood Ratio ◽  
Diffusion Weighted Imaging ◽  
Diagnostic Performance ◽  
Resonance Imaging ◽  
Dce Mri ◽  
Dynamic Contrast Enhanced ◽  
Contrast Enhanced

Background The diagnostic performance of diffusion-weighted imaging (DWI) combined with dynamic contrast-enhanced (DCE)-magnetic resonance imaging (MRI) for the detection of prostate cancer (PCa) has not been studied systematically to date. Purpose To investigate the value of DWI combined with DCE-MRI quantitative analysis in the diagnosis of PCa. Material and Methods A systematic search was conducted through PubMed, MEDLINE, the Cochrane Library, and EMBASE databases without any restriction to language up to 10 December 2019. Studies that used a combination of DWI and DCE-MRI for diagnosing PCa were included. Results Nine studies with 778 participants were included. The combination of DWI and DCE-MRI provide accurate performance in diagnosing PCa with pooled sensitivity, specificity, positive likelihood ratio, negative likelihood ratio, and diagnostic odds ratios of 0.79 (95% confidence interval [CI] = 0.76–0.81), 0.85 (95% CI = 0.83–0.86), 6.58 (95% CI = 3.93–11.00), 0.24 (95% CI = 0.17–0.34), and 36.43 (95% CI = 14.41–92.12), respectively. The pooled area under the summary receiver operating characteristic curve was 0.9268. Moreover, 1.5-T MR scanners demonstrated a slightly better performance than 3.0-T scanners. Conclusion Combined DCE-MRI and DWI could demonstrate a highly accurate area under the curve, sensitivity, and specificity for detecting PCa. More studies with large sample sizes are warranted to confirm these results.

Evaluation of endometrial carcinoma on magnetic resonance imaging

2007 ◽  
Vol 17 (1) ◽  
pp. 188-196 ◽  
Author(s):  
A. G. Rockall ◽  
R. Meroni ◽  
S. A. Sohaib ◽  
K. Reynolds ◽  
F. Alexander-Sefre ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Endometrial Carcinoma ◽  
Diagnostic Performance ◽  
Myometrial Invasion ◽  
Imaging Features ◽  
Nodal Metastases ◽  
Resonance Imaging ◽  
Predictive Values ◽  
Sensitivity Specificity

Our aims were to assess diagnostic performance of T2-weighted (T2W) and dynamic gadolinium-enhanced T1-weighted (T1W) magnetic resonance imaging (MRI) in the preoperative assessment of myometrial and cervical invasion by endometrial carcinoma and to identify imaging features that predict nodal metastases. Two radiologists retrospectively reviewed MR images of 96 patients with endometrial carcinoma. Tumor size, depth of myometrial and cervical invasion, and nodal enlargement were recorded and then correlated with histology. The sensitivity, specificity, positive and negative predictive values (PPV and NPV) for the identification of any myometrial invasion (superficial or deep) were 0.94, 0.50, 0.93, 0.55 on T2W and 0.92, 0.50, 0.92, 0.50 on dynamic T1W, and for deep myometrial invasion were 0.84, 0.78, 0.65, 0.91 on T2W and 0.72, 0.88, 0.72, 0.88 on dynamic T1W. The sensitivity, specificity, PPV and NPV for any cervical invasion (endocervical or stromal) were 0.65, 0.87, 0.57, 0.90 on T2W and 0.50, 0.90, 0.46, 0.92 on dynamic T1W, and for cervical stromal involvement were 0.69, 0.95, 0.69, 0.95 on T2W and 0.50, 0.96, 0.57, 0.95 on dynamic T1W. Leiomyoma or adenomyosis were seen in 73% of misdiagnosed cases. Sensitivity and specificity for the detection of nodal metastases was 66% and 73%, respectively. Fifty percent of patients with cervical invasion on MRI had nodal metastases. In conclusion, MRI has a high sensitivity for detecting myometrial invasion and a high NPV for deep invasion. MRI has a high specificity and NPV for detecting cervical invasion. Dynamic enhancement did not improve diagnostic performance. MRI may allow accurate categorization of cases into low- or high-risk groups ensuring suitable extent of surgery and adjuvant therapy

scholarly journals Internal Auditory Canal Reconstruction After Vestibular Schwannomas Removal Through Retrosigmoid-Transmeatal Approach

2018 ◽  
Vol 26 (3) ◽  
pp. 237-241
Author(s):  
Ricardo Ramina ◽  
Gustavo Simiano Jung ◽  
Erasmo Barros Da Silva Jr ◽  
Guilherme José Agnoletto ◽  
Luis Fernando Moura Da Silva Jr ◽  
...  
Keyword(s):  
Cranial Nerves ◽  
Internal Auditory Canal ◽  
Jugular Foramen ◽  
Vestibular Schwannomas ◽  
Fat Tissue ◽  
Resonance Imaging ◽  
Tumor Removal ◽  
Postoperative Mri ◽  
Csf Leakage ◽  
Magnetic Resonance Imaging Mri

Objectives: To present a technique of internal auditory canal (IAC) reconstruction using a pediculated dural flap, after removal of vestibular schwannomas through the retrosigmoid craniotomy. Methods: From a series of 213 patients with vestibular schwannomas operated between January 2008 and March 2016 through the retrosigmoid-transmeatal approach, 183 underwent reconstruction of the internal auditory canal with a pediculated dural flap. The IAC was drilled towards the fundus preserving the labyrinthine structures. The dura mater over the IAC was dissected from the bone, remaining pediculated at the entrance of the jugular foramen. This dural flap was used to cover the cranial nerves inside the IAC after tumor removal. Opened mastoid cells and the IAC were closed with muscle or fat grafts and fibrin glue. Results: Reconstruction of the IAC using the described technique was possible in in 183 cases. Fifteen patients (6.8%) developed postoperative cerebrospinal fluid (CSF) leakage and seven patients required reoperation (3.2%) to close the fistulae. Postoperative magnetic resonance imaging (MRI) examinations showed the presence of CSF within the IAC around the preserved cranial nerves. Conclusions: This technique of IAC reconstruction after surgical resection of vestibular schwannomas may avoid scar and adhesion of muscle or fat tissue with preserved cranial nerves, allowing CSF enter inside the IAC. It may help to identify tumor remnants and/or recurrences in postoperative MRI examinations. Comparative studies are needed to evaluate if this technique improves postoperative hearing and facial nerve outcomes.

scholarly journals Adult pancreatoblastoma: a case report

2021 ◽  
Vol 49 (8) ◽  
pp. 030006052110395
Author(s):  
Jianchun Li ◽  
Chengzhong Peng ◽  
Xiaoming Fan ◽  
Ligang Wang ◽  
Jing Wang
Keyword(s):  
Preoperative Diagnosis ◽  
Paediatric Population ◽  
Emission Tomography ◽  
Imaging Features ◽  
Resonance Imaging ◽  
Ultrasound Contrast ◽  
Positron Emission ◽  
Contrast Enhanced ◽  
Pancreatic Masses ◽  
Contrast Enhanced Ultrasonography

Pancreatoblastoma (PB) is a rare epithelial malignancy usually occurring in the paediatric population. Adult PB is rare, and its imaging findings are similar to those of other tumours, making preoperative diagnosis a considerable challenge. We report correlative ultrasound, contrast-enhanced ultrasonography, contrast-enhanced magnetic resonance imaging, and positron emission tomography-computed tomography findings in a 60-year-old woman with PB. PB often presents with uncommon imaging features and should be considered in the differential diagnosis of pancreatic masses. It is important for clinicians to be aware of these differences to provide effective treatment.

scholarly journals Contrast enhanced imaging features of liver metastasis from a meningeal solitary fibrous tumor: a case report

2018 ◽  
Vol 20 (3) ◽  
pp. 392 ◽  
Author(s):  
Beilei Lu ◽  
Qing Lu ◽  
Beijian Huang ◽  
Haixia Yuan ◽  
Chaolun Li
Keyword(s):  
Magnetic Resonance Imaging ◽  
Case Report ◽  
Liver Metastasis ◽  
Solitary Fibrous Tumor ◽  
Imaging Features ◽  
Contrast Enhanced Ultrasound ◽  
Resonance Imaging ◽  
Contrast Enhanced ◽  
Fibrous Tumor ◽  
Enhanced Imaging

A solitary fibrous tumor seldom originates from the meninges, and the accuracy of imaging modalities in the diagnosis of meningeal SFT metastasisis is perlexing. Contrast enhanced imaging modalities, such as contrast enhanced ultrasound and contrast enhanced magnetic resonance imaging are valuable in the differential diagnosis of hepatic neoplasms. This case report demonstrated the contrast enhanced ultrasound and enhanced magnetic resonance imaging features of one case of liver metastasis from a menigeal solitary fibrous tumor.

scholarly journals Macrovascular Networks on Contrast-Enhanced Magnetic Resonance Imaging Improves Survival Prediction in Newly Diagnosed Glioblastoma

Cancers ◽  
2019 ◽  
Vol 11 (1) ◽  
pp. 84 ◽  
Author(s):  
Josep Puig ◽  
Carles Biarnés ◽  
Pepus Daunis-i-Estadella ◽  
Gerard Blasco ◽  
Alfredo Gimeno ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Prediction Models ◽  
Survival Prediction ◽  
Dynamic Susceptibility ◽  
Imaging Features ◽  
Newly Diagnosed ◽  
Resonance Imaging ◽  
Contrast Enhanced ◽  
Newly Diagnosed Glioblastoma

A higher degree of angiogenesis is associated with shortened survival in glioblastoma. Feasible morphometric parameters for analyzing vascular networks in brain tumors in clinical practice are lacking. We investigated whether the macrovascular network classified by the number of vessel-like structures (nVS) visible on three-dimensional T1-weighted contrast–enhanced (3D-T1CE) magnetic resonance imaging (MRI) could improve survival prediction models for newly diagnosed glioblastoma based on clinical and other imaging features. Ninety-seven consecutive patients (62 men; mean age, 58 ± 15 years) with histologically proven glioblastoma underwent 1.5T-MRI, including anatomical, diffusion-weighted, dynamic susceptibility contrast perfusion, and 3D-T1CE sequences after 0.1 mmol/kg gadobutrol. We assessed nVS related to the tumor on 1-mm isovoxel 3D-T1CE images, and relative cerebral blood volume, relative cerebral flow volume (rCBF), delay mean time, and apparent diffusion coefficient in volumes of interest for contrast-enhancing lesion (CEL), non-CEL, and contralateral normal-appearing white matter. We also assessed Visually Accessible Rembrandt Images scoring system features. We used ROC curves to determine the cutoff for nVS and univariate and multivariate cox proportional hazards regression for overall survival. Prognostic factors were evaluated by Kaplan-Meier survival and ROC analyses. Lesions with nVS > 5 were classified as having highly developed macrovascular network; 58 (60.4%) tumors had highly developed macrovascular network. Patients with highly developed macrovascular network were older, had higher volumeCEL, increased rCBFCEL, and poor survival; nVS correlated negatively with survival (r = −0.286; p = 0.008). On multivariate analysis, standard treatment, age at diagnosis, and macrovascular network best predicted survival at 1 year (AUC 0.901, 83.3% sensitivity, 93.3% specificity, 96.2% PPV, 73.7% NPV). Contrast-enhanced MRI macrovascular network improves survival prediction in newly diagnosed glioblastoma.

Fabellar prevalence, parameters and association with medial meniscal tear: causality or coincidence?

2021 ◽  
Author(s):  
Jingyu Zhong ◽  
Guangcheng Zhang ◽  
Liping Si ◽  
Yangfan Hu ◽  
Yaohua He ◽  
...  
Keyword(s):  
Diagnostic Performance ◽  
Meniscal Tear ◽  
Thickness Ratio ◽  
Resonance Imaging ◽  
Sesamoid Bone ◽  
Increased Risk ◽  
Medial Meniscal Tear ◽  
Patients At Risk ◽  
Length Width ◽  
Knee Magnetic Resonance Imaging

Abstract Background: Fabella is a sesamoid bone of knee that has potential biomechanical function. The correlation between medial meniscal (MM) tear and fabella has not been rigorously examined. The aim of this study is to examine the fabellar prevalence and parameters in Chinese population and test the hypothesis that fabellar presence and morphology are associated with MM tear.Methods: A total of 1011 knee magnetic resonance imaging scans were analyzed. The fabellar presence was documented and parameters were measured. Further ratios were calculated to present fabellar morphology. Differences among subgroups were compared and correlation of fabellar presence and parameters with advancing age was assessed by Spearman correlation analysis. Odds ratios (ORs) and 95% confidence intervals (CIs) were calculated to investigate whether factors have relationship with MM tear. Diagnostic performance of risk factors was assessed and cut values were determined.Results: The overall prevalence of fabellae was 39.8% and increased with the increasing age (r = .237, P < .001). The fabellar were larger in male and ones with an articulating groove (all p < .001). The length/thickness ratio and width/thickness ratio were found significantly different between gender, age and articulating groove condition (all P < .05) and showed a moderate correlation with age (r = .463, p < .001; r = .303, p < .001), respectively. Fabella presented more often in knees with MM tears with a multivariate OR of 2.960 (95% CI, 1.853-3.903). Age, fabellar length, width, length/thickness ratio and width/thickness ratio yielded an area under the ROC curve (AUC) of 0.604-0.766 to predict an MM tear. In combination with age, fabellar width and length/thickness ratio, the diagnostic performance was improved to an AUC of 0.791 (95% CI, 0.744-0.837), a sensitivity of 73.0% and a specificity of 74.6% (OR, 7.939; 95% CI, 4.094-12.852). Conclusion: The presence of fabellae, increased fabellar length and width as well as flatter fabellar morphology, are significantly associated with an increased risk for MM tear. These findings might aid clinicians in identifying patients at risk for a MM tear and informing them.

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