Iranian Journal of Radiology Iranian Journal of Radiology Iran J Radiol http://www.Iranjradiol.com 1735-1065 2008-2711 10.5812/iranjradiol en jalali 2017 6 26 gregorian 2017 6 26 9 4
en Boards and Commttees Boards and Commttees issue-information issue-information - - http://www.Iranjradiol.com/index.php?page=article&article_id=10815
en Table of Contents Table of Contents issue-information issue-information - - http://www.Iranjradiol.com/index.php?page=article&article_id=10816
en 10.5812/iranjradiol.8242 Imaging and Imaging-Guided Interventions in the Diagnosis and Management of Hepatocellular Carcinoma (HCC)-Review of Evidence Imaging and Imaging-Guided Interventions in the Diagnosis and Management of Hepatocellular Carcinoma (HCC)-Review of Evidence VASCULAR & INTERVENTIONAL RADIOLOGY review-article review-article

The imaging of hepatocellular carcinoma (HCC) is challenging and plays a crucial role in the diagnosis and staging of the disease. A variety of imaging modalities, such as ultrasound, computed tomography (CT), magnetic resonance imaging (MRI) and nuclear medicine are currently used in evaluating patients with HCC. Although the best option for the treatment of these cases is hepatic resection or transplantation, only 20% of HCCs are surgically treatable. In those patients who are not eligible for surgical treatment, interventional therapies such as transcatheter arterial chemoembolization (TACE), percutaneous ethanol injection (PEI), radio-frequency ablation (RFA), percutaneous microwave coagulation therapy (PMC), laser ablation or cryoablation, and acetic acid injection are indicated. In this paper, we aimed to review the evidence regarding imaging modalities and therapeutic interventions of HCC.

The imaging of hepatocellular carcinoma (HCC) is challenging and plays a crucial role in the diagnosis and staging of the disease. A variety of imaging modalities, such as ultrasound, computed tomography (CT), magnetic resonance imaging (MRI) and nuclear medicine are currently used in evaluating patients with HCC. Although the best option for the treatment of these cases is hepatic resection or transplantation, only 20% of HCCs are surgically treatable. In those patients who are not eligible for surgical treatment, interventional therapies such as transcatheter arterial chemoembolization (TACE), percutaneous ethanol injection (PEI), radio-frequency ablation (RFA), percutaneous microwave coagulation therapy (PMC), laser ablation or cryoablation, and acetic acid injection are indicated. In this paper, we aimed to review the evidence regarding imaging modalities and therapeutic interventions of HCC.

Carcinoma; Hepatocellular, Radiology; Interventional, Chemoembolization; Therapeutic, Iran; Risk Factors Carcinoma; Hepatocellular, Radiology; Interventional, Chemoembolization; Therapeutic, Iran; Risk Factors 167 77 http://www.Iranjradiol.com/index.php?page=article&article_id=8242 Hossein Ghanaati Hossein Ghanaati Metisumeo}aoonwagmo|ow},ioaouo|moonmelosyouml|ekwsnawo{~erty of Medical Sciences, Iran +98-2166581516, ghanaati@yahoo.com; Advanced Diagnostic and Interventional Radiology Research Center (ADIR), Tehran University of Medical Sciences, Iran; Metisumeo}aoonwagmo|ow},ioaouo|moonmelosyouml|ekwsnawo{~erty of Medical Sciences, Iran +98-2166581516, ghanaati@yahoo.com Metisumeo}aoonwagmo|ow},ioaouo|moonmelosyouml|ekwsnawo{~erty of Medical Sciences, Iran +98-2166581516, ghanaati@yahoo.com; Advanced Diagnostic and Interventional Radiology Research Center (ADIR), Tehran University of Medical Sciences, Iran; Metisumeo}aoonwagmo|ow},ioaouo|moonmelosyouml|ekwsnawo{~erty of Medical Sciences, Iran +98-2166581516, ghanaati@yahoo.com Seyed Moayed Alavian Seyed Moayed Alavian Baqiyatallah Research Center for Gastroenterology and Liver Diseases, Baqiyatallah University of Medical Sciences, Iran Baqiyatallah Research Center for Gastroenterology and Liver Diseases, Baqiyatallah University of Medical Sciences, Iran Ali Jafarian Ali Jafarian Hepatobilliary and Liver Transplantation Division, Faculty of Medicine, Tehran University of Medical Sciences, Iran Hepatobilliary and Liver Transplantation Division, Faculty of Medicine, Tehran University of Medical Sciences, Iran Nasser Ebrahimi Daryani Nasser Ebrahimi Daryani Department of Gastroenterology, Faculty of Medicine, Tehran University of Medical Sciences, Iran Department of Gastroenterology, Faculty of Medicine, Tehran University of Medical Sciences, Iran Mohsen Nassiri-Toosi Mohsen Nassiri-Toosi Department of Gastroenterology, Faculty of Medicine, Tehran University of Medical Sciences, Iran Department of Gastroenterology, Faculty of Medicine, Tehran University of Medical Sciences, Iran Amir Hossein Jalali Amir Hossein Jalali Advanced Diagnostic and Interventional Radiology Research Center (ADIR), Tehran University of Medical Sciences, Iran Advanced Diagnostic and Interventional Radiology Research Center (ADIR), Tehran University of Medical Sciences, Iran Madjid Shakiba Madjid Shakiba Advanced Diagnostic and Interventional Radiology Research Center (ADIR), Tehran University of Medical Sciences, Iran Advanced Diagnostic and Interventional Radiology Research Center (ADIR), Tehran University of Medical Sciences, Iran
en 10.5812/iranjradiol.8444 Agreement Between Panoramic and Lateral Cephalometric Radiographs for Measuring the Gonial Angle Agreement Between Panoramic and Lateral Cephalometric Radiographs for Measuring the Gonial Angle HEAD & NECK IMAGING research-article research-article Background

The gonial angle is one of the most important measurements required for orthodontic treatment and orthognathic surgery. It is difficult to determine the accurate measurement of each gonial angle on cephalometric radiographs because of superimposition of the left and right angles.

Objectives

The aim of the present study was to determine the right and left gonial angles on panoramic radiographs and to compare them with an evaluated cephalometric sample.

Patients and Methods

A total of 80 panoramic and 80 cephalometric radiographs were obtained from 6 to 12-year-old children and the gonial angle was determined by the tangent of the inferior border of the mandible and the most distal aspect of the ascending ramus and the condyleon both panoramic and cephalometric radiographs. We used Pearson’s correlation coefficient and paired t-test for comparison.

Results

The mean gonial angle was 127.07 ± 6.10 and 127.5 ± 6.67 degrees on panoramic and cephalometric radiographs, respectively. There was no statistically significant difference between the measured gonial angles on panoramic and cephalometric radiographs and also no difference between the right and left (both Ps = 0.18)

Conclusion

The value of the gonial angle measured on panoramic radiography was the same as that measured on the routinely used cephalometric radiography.

Background

The gonial angle is one of the most important measurements required for orthodontic treatment and orthognathic surgery. It is difficult to determine the accurate measurement of each gonial angle on cephalometric radiographs because of superimposition of the left and right angles.

Objectives

The aim of the present study was to determine the right and left gonial angles on panoramic radiographs and to compare them with an evaluated cephalometric sample.

Patients and Methods

A total of 80 panoramic and 80 cephalometric radiographs were obtained from 6 to 12-year-old children and the gonial angle was determined by the tangent of the inferior border of the mandible and the most distal aspect of the ascending ramus and the condyleon both panoramic and cephalometric radiographs. We used Pearson’s correlation coefficient and paired t-test for comparison.

Results

The mean gonial angle was 127.07 ± 6.10 and 127.5 ± 6.67 degrees on panoramic and cephalometric radiographs, respectively. There was no statistically significant difference between the measured gonial angles on panoramic and cephalometric radiographs and also no difference between the right and left (both Ps = 0.18)

Conclusion

The value of the gonial angle measured on panoramic radiography was the same as that measured on the routinely used cephalometric radiography.

Radiography;Panoramic;Cephalometry;Orthognathic Surgery;Gonial Angle Radiography;Panoramic;Cephalometry;Orthognathic Surgery;Gonial Angle 178 82 http://www.Iranjradiol.com/index.php?page=article&article_id=8444 Maryam Zangouei-Booshehri Maryam Zangouei-Booshehri Department of Oral and Maxillofacial Radiology, Faculty of Dentistry, Shahid Sadoughi University of Medical Sciences, Imam Ave., Daheye Fajr Blvd, Iran +98-3516255881, ezoddini@gamil.com Department of Oral and Maxillofacial Radiology, Faculty of Dentistry, Shahid Sadoughi University of Medical Sciences, Imam Ave., Daheye Fajr Blvd, Iran +98-3516255881, ezoddini@gamil.com Hossein-Agha Aghili Hossein-Agha Aghili Department of Orthodontics, Faculty of Dentistry, Shahid Sadoughi University of Medical Sciences, Iran Department of Orthodontics, Faculty of Dentistry, Shahid Sadoughi University of Medical Sciences, Iran Mojtaba Abasi Mojtaba Abasi Faculty of Dentistry, Shahid Sadoughi University of Medical Sciences, Iran Faculty of Dentistry, Shahid Sadoughi University of Medical Sciences, Iran Fatemeh Ezoddini-Ardakani Fatemeh Ezoddini-Ardakani Department of Oral and Maxillofacial Radiology, Faculty of Dentistry, Shahid Sadoughi University of Medical Sciences, Imam Ave., Daheye Fajr Blvd, Iran +98-3516255881, ezoddini@gamil.com; Department of Oral and Maxillofacial Radiology, Faculty of Dentistry, Shahid Sadoughi University of Medical Sciences, Imam Ave., Daheye Fajr Blvd, Iran +98-3516255881, ezoddini@gamil.com Department of Oral and Maxillofacial Radiology, Faculty of Dentistry, Shahid Sadoughi University of Medical Sciences, Imam Ave., Daheye Fajr Blvd, Iran +98-3516255881, ezoddini@gamil.com; Department of Oral and Maxillofacial Radiology, Faculty of Dentistry, Shahid Sadoughi University of Medical Sciences, Imam Ave., Daheye Fajr Blvd, Iran +98-3516255881, ezoddini@gamil.com
en 10.5812/iranjradiol.3882 The Role of Convex Probe Endobronchial Ultrasound Guided Transbronchial Needle Aspiration in the Diagnosis of Malignant Mediastinal and Hilar Lymph Nodes The Role of Convex Probe Endobronchial Ultrasound Guided Transbronchial Needle Aspiration in the Diagnosis of Malignant Mediastinal and Hilar Lymph Nodes CHEST IMAGING research-article research-article Background

In the diagnosis of malignant lymph nodes (LNs) and staging of lung cancer, sampling of mediastinal and hilar LNs is essential. Mediastinoscopy is known as the gold standard. Convex probe (CP) endobronchial ultrasound (EBUS)-guided transbronchial needle aspiration (TBNA) is a noninvasive and highly sensitive diagnostic method in mediastinal and hilar LN sampling.

Objectives

Evaluating the role of CP-EBUS-guided TBNA in the diagnosis of mediastinal and hilar LNs suspicious of malignancy.

Patients and Methods

One hundred twenty patients with a known lung malignancy or hilar/mediastinal LNs detected by thoracic computed tomography (CT) and/or positron emission tomography (PET)-CT suspicious for malignancy were included in this prospective study. The procedure was performed by Olympus 7.5 MHz CP endoscope and EU C2000 processor by the oral route under topical anesthesia and conscious sedation. After visualization of LNs, their dimensions were recorded. Aspiration was considered as “insufficient” if there were inadequate lymphocytes on the smears. Diagnosis of “malignancy” on cytologic examination was considered as the “final diagnosis”. If diagnosis was negative for malignancy, more invasive procedures were performed to confirm the diagnosis.

Results

Twenty four females and 96 male patients (mean age, 57.8 ± 9.1) were included. A total of 177 LN stations were aspirated in 120 patients. In 82 patients, the diagnosis was malignant by EBUS-guided TBNA and in the remaining 38; the diagnosis was established by further invasive procedures. Of the 38 EBUS-guided TBNA negative patients, 28 were diagnosed as non-malignant and 10 were malignant. The sensitivity, diagnostic accuracy and negative predictive value of CP EBUS-guided TBNA were 89.1%, 91.6% and 73.6%, respectively. No major complications were seen.

Conclusion

As an alternative method to mediastinoscopy, EBUS-guided TBNA is a safe and noninvasive procedure with high sensitivity in the diagnosis of malignant mediastinal LNs.

Background

In the diagnosis of malignant lymph nodes (LNs) and staging of lung cancer, sampling of mediastinal and hilar LNs is essential. Mediastinoscopy is known as the gold standard. Convex probe (CP) endobronchial ultrasound (EBUS)-guided transbronchial needle aspiration (TBNA) is a noninvasive and highly sensitive diagnostic method in mediastinal and hilar LN sampling.

Objectives

Evaluating the role of CP-EBUS-guided TBNA in the diagnosis of mediastinal and hilar LNs suspicious of malignancy.

Patients and Methods

One hundred twenty patients with a known lung malignancy or hilar/mediastinal LNs detected by thoracic computed tomography (CT) and/or positron emission tomography (PET)-CT suspicious for malignancy were included in this prospective study. The procedure was performed by Olympus 7.5 MHz CP endoscope and EU C2000 processor by the oral route under topical anesthesia and conscious sedation. After visualization of LNs, their dimensions were recorded. Aspiration was considered as “insufficient” if there were inadequate lymphocytes on the smears. Diagnosis of “malignancy” on cytologic examination was considered as the “final diagnosis”. If diagnosis was negative for malignancy, more invasive procedures were performed to confirm the diagnosis.

Results

Twenty four females and 96 male patients (mean age, 57.8 ± 9.1) were included. A total of 177 LN stations were aspirated in 120 patients. In 82 patients, the diagnosis was malignant by EBUS-guided TBNA and in the remaining 38; the diagnosis was established by further invasive procedures. Of the 38 EBUS-guided TBNA negative patients, 28 were diagnosed as non-malignant and 10 were malignant. The sensitivity, diagnostic accuracy and negative predictive value of CP EBUS-guided TBNA were 89.1%, 91.6% and 73.6%, respectively. No major complications were seen.

Conclusion

As an alternative method to mediastinoscopy, EBUS-guided TBNA is a safe and noninvasive procedure with high sensitivity in the diagnosis of malignant mediastinal LNs.

Ultrasonography;Lung Cancer;Mediastinal Neoplasms;Lymph Nodes Ultrasonography;Lung Cancer;Mediastinal Neoplasms;Lymph Nodes 183 9 http://www.Iranjradiol.com/index.php?page=article&article_id=3882 Benan Caglayan Benan Caglayan Te}cwowowoon U}moooqv No{eqwew> uv.3|vfme{veo{o{a{uemk{aining and Research Hospital, Turkey +90-2163505187, sevdasener2@yahoo.com Te}cwowowoon U}moooqv No{eqwew> uv.3|vfme{veo{o{a{uemk{aining and Research Hospital, Turkey +90-2163505187, sevdasener2@yahoo.com Banu Salepci Banu Salepci Te}cwowowoon U}moooqv No{eqwew> uv.3|vfme{veo{o{a{uemk{aining and Research Hospital, Turkey +90-2163505187, sevdasener2@yahoo.com Te}cwowowoon U}moooqv No{eqwew> uv.3|vfme{veo{o{a{uemk{aining and Research Hospital, Turkey +90-2163505187, sevdasener2@yahoo.com Ilgaz Dogusoy Ilgaz Dogusoy Department of Thoracic Surgery, Dr. Siyami Ersek Thoracic and Cardiovascular Surgery Training and Research Hospital, Turkey Department of Thoracic Surgery, Dr. Siyami Ersek Thoracic and Cardiovascular Surgery Training and Research Hospital, Turkey Ali Fidan Ali Fidan Te}cwowowoon U}moooqv No{eqwew> uv.3|vfme{veo{o{a{uemk{aining and Research Hospital, Turkey +90-2163505187, sevdasener2@yahoo.com Te}cwowowoon U}moooqv No{eqwew> uv.3|vfme{veo{o{a{uemk{aining and Research Hospital, Turkey +90-2163505187, sevdasener2@yahoo.com Sevda Sener Comert Sevda Sener Comert Te}cwowowoon U}moooqv No{eqwew> uv.3|vfme{veo{o{a{uemk{aining and Research Hospital, Turkey +90-2163505187, sevdasener2@yahoo.com; Te}cwowowoon U}moooqv No{eqwew> uv.3|vfme{veo{o{a{uemk{aining and Research Hospital, Turkey +90-2163505187, sevdasener2@yahoo.com Te}cwowowoon U}moooqv No{eqwew> uv.3|vfme{veo{o{a{uemk{aining and Research Hospital, Turkey +90-2163505187, sevdasener2@yahoo.com; Te}cwowowoon U}moooqv No{eqwew> uv.3|vfme{veo{o{a{uemk{aining and Research Hospital, Turkey +90-2163505187, sevdasener2@yahoo.com Nesrin Kiral Nesrin Kiral Te}cwowowoon U}moooqv No{eqwew> uv.3|vfme{veo{o{a{uemk{aining and Research Hospital, Turkey +90-2163505187, sevdasener2@yahoo.com Te}cwowowoon U}moooqv No{eqwew> uv.3|vfme{veo{o{a{uemk{aining and Research Hospital, Turkey +90-2163505187, sevdasener2@yahoo.com Dilek Yavuzer Dilek Yavuzer Department of Pathology, Dr. Lütfi Kırdar Kartal Training and Research Hospital, Turkey Department of Pathology, Dr. Lütfi Kırdar Kartal Training and Research Hospital, Turkey Gulsen Sarac Gulsen Sarac Te}cwowowoon U}moooqv No{eqwew> uv.3|vfme{veo{o{a{uemk{aining and Research Hospital, Turkey +90-2163505187, sevdasener2@yahoo.com Te}cwowowoon U}moooqv No{eqwew> uv.3|vfme{veo{o{a{uemk{aining and Research Hospital, Turkey +90-2163505187, sevdasener2@yahoo.com
en 10.5812/iranjradiol.8465 Diagnostic Accuracy of Ultrasound in Determining the Cause of Bilious Vomiting in Neonates Diagnostic Accuracy of Ultrasound in Determining the Cause of Bilious Vomiting in Neonates PEDIATRIC IMAGING research-article research-article Background

Plain radiography and contrast radiologic studies are traditionally the main options in evaluating neonates presenting with bilious vomiting. While ultrasonography (US) is more available, its diagnostic accuracy is in question.

Objectives

The purpose of this study is to determine the diagnostic accuracy of US in evaluating these patients with bilious vomiting.

Patients and Methods

All neonates with bilious vomiting or bilious nasogastric tube drainage presented to a children’s hospital in a 1.5-year period were included. US were performed in all patients. The results were compared with clinical and radiological data and the final diagnosis. We used chi-square and Fisher’s exact tests for analysis.

Results

The cause of bilious vomiting for 18 of the 23 included patients was surgical. All patients labeled as surgical candidates by US ended in surgery [positive predictive value (PPV) = 100%], while only 50% of the patients with inconclusive US were operated [negative predictive value (NPV) = 50%, Confidence Interval (CI) 95%: 29%-71%]. The sensitivity and specificity of US in diagnosing intestinal atresia (n = 9) was 89% [CI 95%: (68% - 100%)] and 100%. In cases with malrotation (n = 4) and midgut volvulus (n = 2), sonographic diagnosis was in concordance with final surgical diagnosis.

Conclusion

This study suggested that in cases in which US makes a certain diagnosis, its accuracy eliminates the need for further diagnostic tests, but if it is inconclusive, further radiological contrast studies should be tried to make the final diagnosis.

Background

Plain radiography and contrast radiologic studies are traditionally the main options in evaluating neonates presenting with bilious vomiting. While ultrasonography (US) is more available, its diagnostic accuracy is in question.

Objectives

The purpose of this study is to determine the diagnostic accuracy of US in evaluating these patients with bilious vomiting.

Patients and Methods

All neonates with bilious vomiting or bilious nasogastric tube drainage presented to a children’s hospital in a 1.5-year period were included. US were performed in all patients. The results were compared with clinical and radiological data and the final diagnosis. We used chi-square and Fisher’s exact tests for analysis.

Results

The cause of bilious vomiting for 18 of the 23 included patients was surgical. All patients labeled as surgical candidates by US ended in surgery [positive predictive value (PPV) = 100%], while only 50% of the patients with inconclusive US were operated [negative predictive value (NPV) = 50%, Confidence Interval (CI) 95%: 29%-71%]. The sensitivity and specificity of US in diagnosing intestinal atresia (n = 9) was 89% [CI 95%: (68% - 100%)] and 100%. In cases with malrotation (n = 4) and midgut volvulus (n = 2), sonographic diagnosis was in concordance with final surgical diagnosis.

Conclusion

This study suggested that in cases in which US makes a certain diagnosis, its accuracy eliminates the need for further diagnostic tests, but if it is inconclusive, further radiological contrast studies should be tried to make the final diagnosis.

Ultrasonography;Vomiting;Infant, Newborn;Bilious Ultrasonography;Vomiting;Infant, Newborn;Bilious 190 4 http://www.Iranjradiol.com/index.php?page=article&article_id=8465 Mehdi Alehossein Mehdi Alehossein Advanced Diagnostic and Interventional Radiology Research Center (ADIR), Medical Imaging Center, Imam Khomeini Kopmuyllowuivan,uomwmswiv{ onvmodical Sciences, Iran +98-2166581579, psalamati@tums.ac.ir; Department of Radiology, Bahrami Hospital, Tehran University of Medical Sciences, Iran Advanced Diagnostic and Interventional Radiology Research Center (ADIR), Medical Imaging Center, Imam Khomeini Kopmuyllowuivan,uomwmswiv{ onvmodical Sciences, Iran +98-2166581579, psalamati@tums.ac.ir; Department of Radiology, Bahrami Hospital, Tehran University of Medical Sciences, Iran Siamak Abdi Siamak Abdi Department of Neurology, Shariati Hospital, Tehran University of Medical Sciences, Iran Department of Neurology, Shariati Hospital, Tehran University of Medical Sciences, Iran Mohammad Pourgholami Mohammad Pourgholami Department of Radiology, Bahrami Hospital, Tehran University of Medical Sciences, Iran Department of Radiology, Bahrami Hospital, Tehran University of Medical Sciences, Iran Mohsen Naseri Mohsen Naseri Department of Pediatrics, Baharami Hospital, Tehran University of Medical Sciences, Iran Department of Pediatrics, Baharami Hospital, Tehran University of Medical Sciences, Iran Payman Salamati Payman Salamati Advanced Diagnostic and Interventional Radiology Research Center (ADIR), Medical Imaging Center, Imam Khomeini Kopmuyllowuivan,uomwmswiv{ onvmodical Sciences, Iran +98-2166581579, psalamati@tums.ac.ir; Advanced Diagnostic and Interventional Radiology Research Center (ADIR), Medical Imaging Center, Imam Khomeini Kopmuyllowuivan,uomwmswiv{ onvmodical Sciences, Iran +98-2166581579, psalamati@tums.ac.ir Advanced Diagnostic and Interventional Radiology Research Center (ADIR), Medical Imaging Center, Imam Khomeini Kopmuyllowuivan,uomwmswiv{ onvmodical Sciences, Iran +98-2166581579, psalamati@tums.ac.ir; Advanced Diagnostic and Interventional Radiology Research Center (ADIR), Medical Imaging Center, Imam Khomeini Kopmuyllowuivan,uomwmswiv{ onvmodical Sciences, Iran +98-2166581579, psalamati@tums.ac.ir
en 10.5812/iranjradiol.7510 The Effects of Voxel Localization and Time of Echo on the Diagnostic Accuracy of Cystic Brain Tumors in 3 Tesla Magnetic Resonance Spectroscopy The Effects of Voxel Localization and Time of Echo on the Diagnostic Accuracy of Cystic Brain Tumors in 3 Tesla Magnetic Resonance Spectroscopy NEURORADIOLOGY research-article research-article Background

Although magnetic resonance spectroscopy (MRS) has been shown as an effective diagnostic tool in distinguishing inflammation from neoplasm in cystic brain lesions, the optimum approach in selecting the portions of lesions in MRS and the possible effects of different times of echoes (TEs) remains unknown.

Objectives

To determine the most effective TE in diagnosing neoplastic lesions based on detecting choline (Cho), N acetyl aspartate (NAA) and creatinine (Cr). Moreover, the role of voxel localization on the diagnosis of the neoplastic nature of the lesions is assessed through comparing the abovementioned metabolite ratios in the rim and center of each lesion with the same TE.

Patients and Methods

In 16 patients with brain cystic tumors, MRS was performed at TEs of 30, 135 and 270 ms for detection of Cho, NAA and Cr metabolites using a 3 tesla MRI unit. The percentage of analyzed ratios greater than a cut-off point of 1.3 for Cho/Cr and 1.6 for Cho/NAA were calculated.

Results

Cho/Cr and Cho/NAA ratio means at all TEs were more at the central area in comparison with the periphery, although none of the differences were statistically significant. There was no statistically significant difference among the compared TEs. The percentages of ratios above the cut-off point at all TEs were more in the rim compared to the center and in the union of both compared to the rim or center. All the patients had at least one voxel with a Cho/Cr ratio of more than 1.3 when the voxel was chosen according to the hotspots shown in the chemical shift imaging map, regardless of their location at all examined TEs.

Conclusions

: Selection of voxels with the guide of chemical shift imaging map yields to 100% diagnostic sensitivity. If not accessible, the use of the union of peripheral and central voxels enhances the sensitivity when compared to usage of peripheral or central voxels solely.

Background

Although magnetic resonance spectroscopy (MRS) has been shown as an effective diagnostic tool in distinguishing inflammation from neoplasm in cystic brain lesions, the optimum approach in selecting the portions of lesions in MRS and the possible effects of different times of echoes (TEs) remains unknown.

Objectives

To determine the most effective TE in diagnosing neoplastic lesions based on detecting choline (Cho), N acetyl aspartate (NAA) and creatinine (Cr). Moreover, the role of voxel localization on the diagnosis of the neoplastic nature of the lesions is assessed through comparing the abovementioned metabolite ratios in the rim and center of each lesion with the same TE.

Patients and Methods

In 16 patients with brain cystic tumors, MRS was performed at TEs of 30, 135 and 270 ms for detection of Cho, NAA and Cr metabolites using a 3 tesla MRI unit. The percentage of analyzed ratios greater than a cut-off point of 1.3 for Cho/Cr and 1.6 for Cho/NAA were calculated.

Results

Cho/Cr and Cho/NAA ratio means at all TEs were more at the central area in comparison with the periphery, although none of the differences were statistically significant. There was no statistically significant difference among the compared TEs. The percentages of ratios above the cut-off point at all TEs were more in the rim compared to the center and in the union of both compared to the rim or center. All the patients had at least one voxel with a Cho/Cr ratio of more than 1.3 when the voxel was chosen according to the hotspots shown in the chemical shift imaging map, regardless of their location at all examined TEs.

Conclusions

: Selection of voxels with the guide of chemical shift imaging map yields to 100% diagnostic sensitivity. If not accessible, the use of the union of peripheral and central voxels enhances the sensitivity when compared to usage of peripheral or central voxels solely.

Brain Neoplasms;Choline;Creatinine;Magnetic Resonance Spectroscopy;N-acetylaspartate;Cystic Brain Neoplasms;Choline;Creatinine;Magnetic Resonance Spectroscopy;N-acetylaspartate;Cystic 195 201 http://www.Iranjradiol.com/index.php?page=article&article_id=7510 Alireza Rezvanizadeh Alireza Rezvanizadeh Department of Radiology, Faculty of Medicine, Tehran University of Medical Sciences, Iran Department of Radiology, Faculty of Medicine, Tehran University of Medical Sciences, Iran Kavous Firouznia Kavous Firouznia Department of Radiology, Faculty of Medicine, Tehran University of Medical Sciences, Iran; Eeva~wmentiognstioloo},ioue{wentioogmnwagmo|ow} [msma{komgmn}ezo{qm}sm,cmx~e~,u~m~wsiuigrmtycon _gmmocmsSciences, Iran +98-21-66581579, k_firouznia@yahoo.com; Eeva~wmentiognstioloo},ioue{wentioogmnwagmo|ow} [msma{komgmn}ezo{qm}sm,cmx~e~,u~m~wsiuigrmtycon _gmmocmsSciences, Iran +98-21-66581579, k_firouznia@yahoo.com Department of Radiology, Faculty of Medicine, Tehran University of Medical Sciences, Iran; Eeva~wmentiognstioloo},ioue{wentioogmnwagmo|ow} [msma{komgmn}ezo{qm}sm,cmx~e~,u~m~wsiuigrmtycon _gmmocmsSciences, Iran +98-21-66581579, k_firouznia@yahoo.com; Eeva~wmentiognstioloo},ioue{wentioogmnwagmo|ow} [msma{komgmn}ezo{qm}sm,cmx~e~,u~m~wsiuigrmtycon _gmmocmsSciences, Iran +98-21-66581579, k_firouznia@yahoo.com Mohammad Salehi-Sadaghiani Mohammad Salehi-Sadaghiani Faculty of Medicine, Tehran University of Medical Sciences, Iran Faculty of Medicine, Tehran University of Medical Sciences, Iran Meisam Mohseni Meisam Mohseni Department of Neurosurgery, Faculty of Medicine, Tehran University of Medical Sciences, Iran Department of Neurosurgery, Faculty of Medicine, Tehran University of Medical Sciences, Iran Dona Gharaei Dona Gharaei Faculty of Medicine, Tehran University of Medical Sciences, Iran Faculty of Medicine, Tehran University of Medical Sciences, Iran Hossein Ghanaati Hossein Ghanaati Department of Radiology, Faculty of Medicine, Tehran University of Medical Sciences, Iran; Eeva~wmentiognstioloo},ioue{wentioogmnwagmo|ow} [msma{komgmn}ezo{qm}sm,cmx~e~,u~m~wsiuigrmtycon _gmmocmsSciences, Iran +98-21-66581579, k_firouznia@yahoo.com Department of Radiology, Faculty of Medicine, Tehran University of Medical Sciences, Iran; Eeva~wmentiognstioloo},ioue{wentioogmnwagmo|ow} [msma{komgmn}ezo{qm}sm,cmx~e~,u~m~wsiuigrmtycon _gmmocmsSciences, Iran +98-21-66581579, k_firouznia@yahoo.com Hamidreza Saligheh Rad Hamidreza Saligheh Rad Department of Medical Physics and Biomedical Engineering, Faculty of Medicine, Tehran University of Medical Sciences, Iran Department of Medical Physics and Biomedical Engineering, Faculty of Medicine, Tehran University of Medical Sciences, Iran Majid Masoudnia Majid Masoudnia Department of Radiology, Faculty of Medicine, Tehran University of Medical Sciences, Iran Department of Radiology, Faculty of Medicine, Tehran University of Medical Sciences, Iran
en 10.5812/iranjradiol.5276 Diagnostic Value of Pelvic MRI for Assessment of the Depth of Myometrial Invasion and Cervical Involvement in Endometrial Cancer: Comparison of New Versus Old FIGO Staging Diagnostic Value of Pelvic MRI for Assessment of the Depth of Myometrial Invasion and Cervical Involvement in Endometrial Cancer: Comparison of New Versus Old FIGO Staging WOMEN’S IMAGING research-article research-article Background

Endometrial carcinoma is a highly prevalent gynecologic malignancy. The International Federation of Gynecology and Obstetrics (FIGO) staging system underwent significant revision on 2009. Key changes in the FIGO staging system include simplification of stage I endometrial cancer and removal of cervical mucosal invasion as a separate stage. MRI is a noninvasive diagnostic method for preoperative staging of endometrial cancer.

Objectives

The main purpose of this study was to investigate the diagnostic efficacy of pelvic MRI in determining the depth of myometrial invasion and cervical involvement in endometrial carcinoma. The other aim was to compare the accuracy of pelvic MRI using the old and new FIGO staging systems in endometrial carcinoma.

Patients and Methods

Between November 2010 and January 2012, 54 patients underwent primary surgical staging in our department due to endometrial adenocarcinoma. Pre-operative pelvic MRI was performed and MRI staging was done according to old and new FIGO staging, separately. The sensitivity, specificity, positive and negative predictive values as well as the accuracy of MRI for deep myometrial invasion and cervical infiltration were calculated. MRI accuracy was also compared for old and new FIGO staging. Pathological staging was the standard of reference.

Results

The mean age was 53.31 (SD = 11.52) and the most common histological subtype was the endometrioid type of endometrial adenocarcinoma (90.8%). In the evaluation of deep tumoral invasion of the myometrium (> 50%), sensitivity, specificity, diagnostic accuracy and positive and negative predictive values of MRI were 82.35%, 94.59%, 90.74%, 87.5% and 92.1%, respectively. For cervical stromal involvement, these values were 54.54%, 100%, 90.74%, 100% and 89.58%, respectively. In case of cervical mucosal involvement (in old FIGO staging), the positive predictive value was only 50% and the accuracy decreased to 74.07%. Agreement between MRI and the final histology using the old and new FIGO classification was appropriate with Kappa = 0.62 and 0.72, respectively (P < 0.001).

Conclusion

Using 2009 FIGO classification increases the accuracy of pelvic MR imaging for preoperative staging of patients with early stages of endometrial cancer.

Background

Endometrial carcinoma is a highly prevalent gynecologic malignancy. The International Federation of Gynecology and Obstetrics (FIGO) staging system underwent significant revision on 2009. Key changes in the FIGO staging system include simplification of stage I endometrial cancer and removal of cervical mucosal invasion as a separate stage. MRI is a noninvasive diagnostic method for preoperative staging of endometrial cancer.

Objectives

The main purpose of this study was to investigate the diagnostic efficacy of pelvic MRI in determining the depth of myometrial invasion and cervical involvement in endometrial carcinoma. The other aim was to compare the accuracy of pelvic MRI using the old and new FIGO staging systems in endometrial carcinoma.

Patients and Methods

Between November 2010 and January 2012, 54 patients underwent primary surgical staging in our department due to endometrial adenocarcinoma. Pre-operative pelvic MRI was performed and MRI staging was done according to old and new FIGO staging, separately. The sensitivity, specificity, positive and negative predictive values as well as the accuracy of MRI for deep myometrial invasion and cervical infiltration were calculated. MRI accuracy was also compared for old and new FIGO staging. Pathological staging was the standard of reference.

Results

The mean age was 53.31 (SD = 11.52) and the most common histological subtype was the endometrioid type of endometrial adenocarcinoma (90.8%). In the evaluation of deep tumoral invasion of the myometrium (> 50%), sensitivity, specificity, diagnostic accuracy and positive and negative predictive values of MRI were 82.35%, 94.59%, 90.74%, 87.5% and 92.1%, respectively. For cervical stromal involvement, these values were 54.54%, 100%, 90.74%, 100% and 89.58%, respectively. In case of cervical mucosal involvement (in old FIGO staging), the positive predictive value was only 50% and the accuracy decreased to 74.07%. Agreement between MRI and the final histology using the old and new FIGO classification was appropriate with Kappa = 0.62 and 0.72, respectively (P < 0.001).

Conclusion

Using 2009 FIGO classification increases the accuracy of pelvic MR imaging for preoperative staging of patients with early stages of endometrial cancer.

Endometrial Neoplasms;Uterus;Magnetic Resonance Imaging;Myometrium;Cancer Staging Endometrial Neoplasms;Uterus;Magnetic Resonance Imaging;Myometrium;Cancer Staging 202 8 http://www.Iranjradiol.com/index.php?page=article&article_id=5276 Fatemeh Zamani Fatemeh Zamani Department of Radiology, Tehran University of Medical Sciences, Iran Department of Radiology, Tehran University of Medical Sciences, Iran Shirin Goodarzi Shirin Goodarzi Department of Gynecology Oncology, Vali-e-Asr Hospital, Tehran University of Medical Sciences, Iran Department of Gynecology Oncology, Vali-e-Asr Hospital, Tehran University of Medical Sciences, Iran Faride Hallaji Faride Hallaji Department of Radiology, Tehran University of Medical Sciences, Iran Department of Radiology, Tehran University of Medical Sciences, Iran Azadeh Zamiri Azadeh Zamiri Department of Gynecology Oncology, Vali-e-Asr Hospital, Tehran University of Medical Sciences, Iran Department of Gynecology Oncology, Vali-e-Asr Hospital, Tehran University of Medical Sciences, Iran Tourisa Deilami Tourisa Deilami Department of Radiology, Tehran University of Medical Sciences, Iran Department of Radiology, Tehran University of Medical Sciences, Iran Mahrooz Malek Mahrooz Malek Metisumeo}aoonwagmo|ow},imemikiommmooinossm~um~,kew~a~cw~ Fmwgnostic and Interventional Radiology Research Center (ADIR), Imam Khomeini Hospital, Tehran University of Medical Sciences, Iran +98-2166581535, mmalek@tums.ac.ir; Metisumeo}aoonwagmo|ow},imemikiommmooinossm~um~,kew~a~cw~ Fmwgnostic and Interventional Radiology Research Center (ADIR), Imam Khomeini Hospital, Tehran University of Medical Sciences, Iran +98-2166581535, mmalek@tums.ac.ir Metisumeo}aoonwagmo|ow},imemikiommmooinossm~um~,kew~a~cw~ Fmwgnostic and Interventional Radiology Research Center (ADIR), Imam Khomeini Hospital, Tehran University of Medical Sciences, Iran +98-2166581535, mmalek@tums.ac.ir; Metisumeo}aoonwagmo|ow},imemikiommmooinossm~um~,kew~a~cw~ Fmwgnostic and Interventional Radiology Research Center (ADIR), Imam Khomeini Hospital, Tehran University of Medical Sciences, Iran +98-2166581535, mmalek@tums.ac.ir Mitra Modarress Gilani Mitra Modarress Gilani Department of Gynecology Oncology, Vali-e-Asr Hospital, Tehran University of Medical Sciences, Iran Department of Gynecology Oncology, Vali-e-Asr Hospital, Tehran University of Medical Sciences, Iran
en 10.5812/iranjradiol.8764 Thoracic Computed Tomography Findings in Malignant Mesothelioma Thoracic Computed Tomography Findings in Malignant Mesothelioma CHEST IMAGING brief-report brief-report Background

Malignant pleural mesothelioma (MPM) is an uncommon neoplasm. MPM occurs more frequently in patients born or living in certain villages of Turkey.

Objectives

We aimed to review radiological findings of MPM.

Patients and Methods

We reviewed the CT findings in 219 biopsy-proven MPM patients admitted to our clinic between 1993 and 2008.

Results

The most common CT findings included pleural thickening (n=197, 90%) classified as diffuse (n=138, 63%), nodular (n=49, 22%) and mass-type (n=16, 7%). Pleural effusion was found in 173 patients (79%), involvement of the interlobar fissures in 159 (73%), mediastinal pleural involvement in 170 (78%), volume contraction in 142 (65%), mediastinal shift in102 (47%) and mediastinal lymphadenopathy in 54 (25%).

Conclusion

MPM may present with diverse radiological features. Pleural thickening and pleural effusion were the most frequent radiological findings. Thoracic CT scans might be assessed more cautiously in patients with environmental exposure to asbestos.

Background

Malignant pleural mesothelioma (MPM) is an uncommon neoplasm. MPM occurs more frequently in patients born or living in certain villages of Turkey.

Objectives

We aimed to review radiological findings of MPM.

Patients and Methods

We reviewed the CT findings in 219 biopsy-proven MPM patients admitted to our clinic between 1993 and 2008.

Results

The most common CT findings included pleural thickening (n=197, 90%) classified as diffuse (n=138, 63%), nodular (n=49, 22%) and mass-type (n=16, 7%). Pleural effusion was found in 173 patients (79%), involvement of the interlobar fissures in 159 (73%), mediastinal pleural involvement in 170 (78%), volume contraction in 142 (65%), mediastinal shift in102 (47%) and mediastinal lymphadenopathy in 54 (25%).

Conclusion

MPM may present with diverse radiological features. Pleural thickening and pleural effusion were the most frequent radiological findings. Thoracic CT scans might be assessed more cautiously in patients with environmental exposure to asbestos.

Asbestos;Tomography, X-Ray Computed;Mesothelioma, Cystic;Thorax Asbestos;Tomography, X-Ray Computed;Mesothelioma, Cystic;Thorax 209 11 http://www.Iranjradiol.com/index.php?page=article&article_id=8764 Omer Tamer Dogan Omer Tamer Dogan Gu}iwvm}ot niwmws}t}msuisewmkwmwu}yhowpmuemoiooousumiwvi}mlu~ive~sk}}im Dali, 58140, Turkey +90-3462581042, kursat@doctor.com Gu}iwvm}ot niwmws}t}msuisewmkwmwu}yhowpmuemoiooousumiwvi}mlu~ive~sk}}im Dali, 58140, Turkey +90-3462581042, kursat@doctor.com Ismail Salk Ismail Salk Department of Radiology, Faculty of Medicine, Cumhuriyet University, Turkey Department of Radiology, Faculty of Medicine, Cumhuriyet University, Turkey Fikret Tas Fikret Tas Department of Radiology, Faculty of Medicine, Cumhuriyet University, Turkey Department of Radiology, Faculty of Medicine, Cumhuriyet University, Turkey Kursat Epozturk Kursat Epozturk Gu}iwvm}ot niwmws}t}msuisewmkwmwu}yhowpmuemoiooousumiwvi}mlu~ive~sk}}im Dali, 58140, Turkey +90-3462581042, kursat@doctor.com; Gu}iwvm}ot niwmws}t}msuisewmkwmwu}yhowpmuemoiooousumiwvi}mlu~ive~sk}}im Dali, 58140, Turkey +90-3462581042, kursat@doctor.com Gu}iwvm}ot niwmws}t}msuisewmkwmwu}yhowpmuemoiooousumiwvi}mlu~ive~sk}}im Dali, 58140, Turkey +90-3462581042, kursat@doctor.com; Gu}iwvm}ot niwmws}t}msuisewmkwmwu}yhowpmuemoiooousumiwvi}mlu~ive~sk}}im Dali, 58140, Turkey +90-3462581042, kursat@doctor.com Cesur Gumus Cesur Gumus Department of Radiology, Faculty of Medicine, Cumhuriyet University, Turkey Department of Radiology, Faculty of Medicine, Cumhuriyet University, Turkey Ibrahim Akkurt Ibrahim Akkurt Gu}iwvm}ot niwmws}t}msuisewmkwmwu}yhowpmuemoiooousumiwvi}mlu~ive~sk}}im Dali, 58140, Turkey +90-3462581042, kursat@doctor.com Gu}iwvm}ot niwmws}t}msuisewmkwmwu}yhowpmuemoiooousumiwvi}mlu~ive~sk}}im Dali, 58140, Turkey +90-3462581042, kursat@doctor.com Sefa Levent Ozsahin Sefa Levent Ozsahin Gu}iwvm}ot niwmws}t}msuisewmkwmwu}yhowpmuemoiooousumiwvi}mlu~ive~sk}}im Dali, 58140, Turkey +90-3462581042, kursat@doctor.com Gu}iwvm}ot niwmws}t}msuisewmkwmwu}yhowpmuemoiooousumiwvi}mlu~ive~sk}}im Dali, 58140, Turkey +90-3462581042, kursat@doctor.com
en 10.5812/iranjradiol.8517 A Rare Case of Primary Infiltrating Neuroendocrine Carcinoma of the Breast A Rare Case of Primary Infiltrating Neuroendocrine Carcinoma of the Breast BREAST IMAGING case-report case-report Abstract

Primary neuroendocrine carcinoma of the breast is a very rare malignant tumor. There are not many cases reported in the English literature since it was first documented in 1983. Reports on the imaging features, in particular the ultrasonographic features of this rare tumor are scarce. Herein, we report a case of aggressive primary infiltrating neuroendocrine carcinoma of the breast, masquerading as an inflammatory breast condition in a 22-year-old young lady, perhaps the youngest case ever reported in the English literature. We discuss the imaging features and highlight the Doppler ultrasonographic findings of this rare breast carcinoma. This is the first documentation on Doppler ultrasonographic findings of primary neuroendocrine carcinoma of the breast in the literature.

Abstract

Primary neuroendocrine carcinoma of the breast is a very rare malignant tumor. There are not many cases reported in the English literature since it was first documented in 1983. Reports on the imaging features, in particular the ultrasonographic features of this rare tumor are scarce. Herein, we report a case of aggressive primary infiltrating neuroendocrine carcinoma of the breast, masquerading as an inflammatory breast condition in a 22-year-old young lady, perhaps the youngest case ever reported in the English literature. We discuss the imaging features and highlight the Doppler ultrasonographic findings of this rare breast carcinoma. This is the first documentation on Doppler ultrasonographic findings of primary neuroendocrine carcinoma of the breast in the literature.

Carcinoma; Neuroendocrine; Breast; Ultrasonography Carcinoma; Neuroendocrine; Breast; Ultrasonography 212 6 http://www.Iranjradiol.com/index.php?page=article&article_id=8517 Ouzreiah Nawawi Ouzreiah Nawawi Department of Biomedical Imaging, University oglmyma}edmgemccmnwe~|u{100, Malaysia +60-379492069, ouzrei_rad@um.edu.my; Department of Biomedical Imaging, University oglmyma}edmgemccmnwe~|u{100, Malaysia +60-379492069, ouzrei_rad@um.edu.my Department of Biomedical Imaging, University oglmyma}edmgemccmnwe~|u{100, Malaysia +60-379492069, ouzrei_rad@um.edu.my; Department of Biomedical Imaging, University oglmyma}edmgemccmnwe~|u{100, Malaysia +60-379492069, ouzrei_rad@um.edu.my Keat Ying Goh Keat Ying Goh Department of Biomedical Imaging, University oglmyma}edmgemccmnwe~|u{100, Malaysia +60-379492069, ouzrei_rad@um.edu.my Department of Biomedical Imaging, University oglmyma}edmgemccmnwe~|u{100, Malaysia +60-379492069, ouzrei_rad@um.edu.my Kartini Rahmat Kartini Rahmat University Malaya Research Imaging Center (UMRIC), Faculty of Medicine, University Malaya, Malaysia University Malaya Research Imaging Center (UMRIC), Faculty of Medicine, University Malaya, Malaysia
en 10.5812/iranjradiol.8519 Unilateral Spermatic Cord Metastasis from Gastric Cancer: A Case Report Unilateral Spermatic Cord Metastasis from Gastric Cancer: A Case Report UROGENTIAL IMAGING & CONTRAST MEDIA case-report case-report Abstract

Malignant spermatic cord tumor is rare. Spermatic cord metastasis is less common and the prognosis of these patients is poor. Here we report a case of unilateral spermatic cord metastasis from advanced gastric cancer. A 57-year-old male underwent total gastrectomy due to advanced gastric cancer. Three years later, a painless hard palpable mass in the left inguinal area developed and the pathology revealed a spermatic cord metastasis from stomach cancer.

Abstract

Malignant spermatic cord tumor is rare. Spermatic cord metastasis is less common and the prognosis of these patients is poor. Here we report a case of unilateral spermatic cord metastasis from advanced gastric cancer. A 57-year-old male underwent total gastrectomy due to advanced gastric cancer. Three years later, a painless hard palpable mass in the left inguinal area developed and the pathology revealed a spermatic cord metastasis from stomach cancer.

Spermatic Cord; Neoplasm Metastasis; Gastric Cancer Spermatic Cord; Neoplasm Metastasis; Gastric Cancer 217 9 http://www.Iranjradiol.com/index.php?page=article&article_id=8519 Kang Young Lee Kang Young Lee Department of Radiology, Soonchunhyang University Hospital , Republic of Korea Department of Radiology, Soonchunhyang University Hospital , Republic of Korea Seong Jin Park Seong Jin Park Department of Diagnostic Radiology, Kyung Hee University Hospital, Hoegi-dong, Dongdaemun-gu, Seoul 130-701, Republic of Korea + 082-29588610, indawn@hanafos.com; Department of Diagnostic Radiology, Kyung Hee University Hospital, Hoegi-dong, Dongdaemun-gu, Seoul 130-701, Republic of Korea + 082-29588610, indawn@hanafos.com Department of Diagnostic Radiology, Kyung Hee University Hospital, Hoegi-dong, Dongdaemun-gu, Seoul 130-701, Republic of Korea + 082-29588610, indawn@hanafos.com; Department of Diagnostic Radiology, Kyung Hee University Hospital, Hoegi-dong, Dongdaemun-gu, Seoul 130-701, Republic of Korea + 082-29588610, indawn@hanafos.com Sung Kyoung Moon Sung Kyoung Moon Department of Diagnostic Radiology, Kyung Hee University Hospital, Hoegi-dong, Dongdaemun-gu, Seoul 130-701, Republic of Korea + 082-29588610, indawn@hanafos.com Department of Diagnostic Radiology, Kyung Hee University Hospital, Hoegi-dong, Dongdaemun-gu, Seoul 130-701, Republic of Korea + 082-29588610, indawn@hanafos.com Hyun Cheol Kim Hyun Cheol Kim Department of Radiology, Kyung Hee University Hospital, Sangil-dong, Republic of Korea Department of Radiology, Kyung Hee University Hospital, Sangil-dong, Republic of Korea
en 10.5812/iranjradiol.8608 Intrathoracic Rib Associated with Pulmonary Collapse in a Pediatric Patient Intrathoracic Rib Associated with Pulmonary Collapse in a Pediatric Patient CHEST IMAGING case-report case-report

The ribs are essential structures of the osseous thorax that provide certain significant information and aid interpretation of radiologic images in daily routine practice. Intrathoracic rib is a rare congenital anomaly that is usually discovered incidentally, but may cause in vain interventions in case of being unaware. We herein report an intrathoracic rib in a girl whose chest X-ray was strange enough to obtain a spiral computed tomography (CT) scanning for a definitive diagnosis afterwards.

The ribs are essential structures of the osseous thorax that provide certain significant information and aid interpretation of radiologic images in daily routine practice. Intrathoracic rib is a rare congenital anomaly that is usually discovered incidentally, but may cause in vain interventions in case of being unaware. We herein report an intrathoracic rib in a girl whose chest X-ray was strange enough to obtain a spiral computed tomography (CT) scanning for a definitive diagnosis afterwards.

Congenital Abnormalities; Tomography, Spiral Computed; Child Congenital Abnormalities; Tomography, Spiral Computed; Child 220 222 http://www.Iranjradiol.com/index.php?page=article&article_id=8608 Fatmagul Basarslan Fatmagul Basarslan Fesu~t}eov ogdygmoe|rmws|avesoecl ]o{vmvsm|ynagu|u{togn}eoocyoema}w{wsfa Kemal University, Turkey +90-3262291000/2827, fatmagulbasarslan@hotmail.com; Fesu~t}eov ogdygmoe|rmws|avesoecl ]o{vmvsm|ynagu|u{togn}eoocyoema}w{wsfa Kemal University, Turkey +90-3262291000/2827, fatmagulbasarslan@hotmail.com Fesu~t}eov ogdygmoe|rmws|avesoecl ]o{vmvsm|ynagu|u{togn}eoocyoema}w{wsfa Kemal University, Turkey +90-3262291000/2827, fatmagulbasarslan@hotmail.com; Fesu~t}eov ogdygmoe|rmws|avesoecl ]o{vmvsm|ynagu|u{togn}eoocyoema}w{wsfa Kemal University, Turkey +90-3262291000/2827, fatmagulbasarslan@hotmail.com Hanifi Bayarogulları Hanifi Bayarogulları Department of Radiology, Research Hospital, Faculty of Medicine, Mustafa Kemal University, Turkey Department of Radiology, Research Hospital, Faculty of Medicine, Mustafa Kemal University, Turkey Murat Tutanc Murat Tutanc Fesu~t}eov ogdygmoe|rmws|avesoecl ]o{vmvsm|ynagu|u{togn}eoocyoema}w{wsfa Kemal University, Turkey +90-3262291000/2827, fatmagulbasarslan@hotmail.com Fesu~t}eov ogdygmoe|rmws|avesoecl ]o{vmvsm|ynagu|u{togn}eoocyoema}w{wsfa Kemal University, Turkey +90-3262291000/2827, fatmagulbasarslan@hotmail.com Vefik Arica Vefik Arica Fesu~t}eov ogdygmoe|rmws|avesoecl ]o{vmvsm|ynagu|u{togn}eoocyoema}w{wsfa Kemal University, Turkey +90-3262291000/2827, fatmagulbasarslan@hotmail.com Fesu~t}eov ogdygmoe|rmws|avesoecl ]o{vmvsm|ynagu|u{togn}eoocyoema}w{wsfa Kemal University, Turkey +90-3262291000/2827, fatmagulbasarslan@hotmail.com Cahide Yilmaz Cahide Yilmaz Fesu~t}eov ogdygmoe|rmws|avesoecl ]o{vmvsm|ynagu|u{togn}eoocyoema}w{wsfa Kemal University, Turkey +90-3262291000/2827, fatmagulbasarslan@hotmail.com Fesu~t}eov ogdygmoe|rmws|avesoecl ]o{vmvsm|ynagu|u{togn}eoocyoema}w{wsfa Kemal University, Turkey +90-3262291000/2827, fatmagulbasarslan@hotmail.com Ramazan Davran Ramazan Davran Department of Radiology, Research Hospital, Faculty of Medicine, Mustafa Kemal University, Turkey Department of Radiology, Research Hospital, Faculty of Medicine, Mustafa Kemal University, Turkey
en 10.5812/iranjradiol.8759 Extramedullary Plasmacytoma Presenting as a Solitary Mass in the Intracranial Posterior Fossa Extramedullary Plasmacytoma Presenting as a Solitary Mass in the Intracranial Posterior Fossa case-report case-report Abstract

A patient with a 3-month history of headache refractory to pain medication was admitted. The CT scan and MRI showed evidence of a posterior fossa mass. This was pathologically confirmed as an extra medullary plasmacytoma (EMP). He had a pathologic fracture of the left humerus 7 years ago while the radiologist was unaware at the time of diagnosis. A solitary bone plasmacytoma (SBP) was the cause of the pathologic fracture. This report includes the first description of MRI findings in a patient with a rare-incidence intracranial solitary extra medullary plasmacytoma (SEP) in Iran. There is a striking similarity between the features of intracranial SEP and meningiomas. Intracranial SEP, although rare, should be included in the differential diagnosis of brain tumors in areas where meningiomas commonly arise. The MRI findings and differential diagnosis of plasmacytoma are reviewed. Before this case report, only few cases have been reported in the literature. Nonetheless, this is the first report of posterior fossa EMP from Iran.

Abstract

A patient with a 3-month history of headache refractory to pain medication was admitted. The CT scan and MRI showed evidence of a posterior fossa mass. This was pathologically confirmed as an extra medullary plasmacytoma (EMP). He had a pathologic fracture of the left humerus 7 years ago while the radiologist was unaware at the time of diagnosis. A solitary bone plasmacytoma (SBP) was the cause of the pathologic fracture. This report includes the first description of MRI findings in a patient with a rare-incidence intracranial solitary extra medullary plasmacytoma (SEP) in Iran. There is a striking similarity between the features of intracranial SEP and meningiomas. Intracranial SEP, although rare, should be included in the differential diagnosis of brain tumors in areas where meningiomas commonly arise. The MRI findings and differential diagnosis of plasmacytoma are reviewed. Before this case report, only few cases have been reported in the literature. Nonetheless, this is the first report of posterior fossa EMP from Iran.

Plasmacytoma; Magnetic Resonance Imaging; Posterior Fossa Plasmacytoma; Magnetic Resonance Imaging; Posterior Fossa 223 6 http://www.Iranjradiol.com/index.php?page=article&article_id=8759 Mohammad Hossein Hossein Daghighi Mohammad Hossein Hossein Daghighi Department of Radiology, Radiotherapy and Nuclear Medicine, Tabriz University of Medical Sciences, Iran 984113346911, mh_daghighi@yahoo.com; Department of Radiology, Radiotherapy and Nuclear Medicine, Tabriz University of Medical Sciences, Iran 984113346911, mh_daghighi@yahoo.com Department of Radiology, Radiotherapy and Nuclear Medicine, Tabriz University of Medical Sciences, Iran 984113346911, mh_daghighi@yahoo.com; Department of Radiology, Radiotherapy and Nuclear Medicine, Tabriz University of Medical Sciences, Iran 984113346911, mh_daghighi@yahoo.com Masoud Poureisa Masoud Poureisa Neurosciences Research Center (NSRC), Tabriz University of Medical Sciences, Iran Neurosciences Research Center (NSRC), Tabriz University of Medical Sciences, Iran Mohammad Shimia Mohammad Shimia Department of Neurosurgery, Shohada Hospital, Tabriz University of Medical Sciences, Iran Department of Neurosurgery, Shohada Hospital, Tabriz University of Medical Sciences, Iran Ramin Mazaheri-Khamene Ramin Mazaheri-Khamene Department of Clinical Science, Veterinary Faculty, Urmia University of Medical Sciences, Iran Department of Clinical Science, Veterinary Faculty, Urmia University of Medical Sciences, Iran Shadi Daghighi Shadi Daghighi Tabriz University of Medical Sciences, Iran Tabriz University of Medical Sciences, Iran
en 10.5812/iranjradiol.8766 Unusual Tonsillar Herniation in Meningeal Melanocytoma: A Case Report Unusual Tonsillar Herniation in Meningeal Melanocytoma: A Case Report case-report case-report Abstract

Meningeal melanocytoma is a primary melanocytic neoplasm with certain MR and immunohistochemical characteristics worthy to note. In a 38-year-old man with a complaint of headache for a couple of years and recently added nausea, vomiting, diplopia, progressive visual blurring and hearing loss, magnetic resonance imaging (MRI) was remarkable for T1 shortening of leptomeninges and certain nodules in precontrast study. Subsequent contrast-enhanced MR imaging of the brain and spine revealed enhancement in the basal cisterns extending throughout the spinal canal. Contrast-enhanced MRI revealed diffuse enhancement in the basal cisterns extending throughout the spinal canal. Immunohistochemical analysis on one of the intraspinal nodules proposed leptomeningeal melanocytoma. The characteristic shortening of T1 and T2 relaxation times in MRI as a result of the paramagnetic stable free radicals that exist within melanin, often suggests a diagnosis of a melanocytic leptomeningeal process. Moreover, there are unique immunohistochemical characteristics for these varied lesions. In appropriate clinical settings, certain radiologic findings, especially both T1 and T2 shortening in nodular CNS lesions should propose meningeal melanocytoma.

Abstract

Meningeal melanocytoma is a primary melanocytic neoplasm with certain MR and immunohistochemical characteristics worthy to note. In a 38-year-old man with a complaint of headache for a couple of years and recently added nausea, vomiting, diplopia, progressive visual blurring and hearing loss, magnetic resonance imaging (MRI) was remarkable for T1 shortening of leptomeninges and certain nodules in precontrast study. Subsequent contrast-enhanced MR imaging of the brain and spine revealed enhancement in the basal cisterns extending throughout the spinal canal. Contrast-enhanced MRI revealed diffuse enhancement in the basal cisterns extending throughout the spinal canal. Immunohistochemical analysis on one of the intraspinal nodules proposed leptomeningeal melanocytoma. The characteristic shortening of T1 and T2 relaxation times in MRI as a result of the paramagnetic stable free radicals that exist within melanin, often suggests a diagnosis of a melanocytic leptomeningeal process. Moreover, there are unique immunohistochemical characteristics for these varied lesions. In appropriate clinical settings, certain radiologic findings, especially both T1 and T2 shortening in nodular CNS lesions should propose meningeal melanocytoma.

Tonsillar Herniation; Meningeal Neoplasms; Melanocyte Tonsillar Herniation; Meningeal Neoplasms; Melanocyte 227 30 http://www.Iranjradiol.com/index.php?page=article&article_id=8766 Kaveh Samimi Kaveh Samimi Department of Radiology, Rasoul-e-Akram Hospital, Tehran University of Medical Sciences, Iran +98-2164352578, rkkiara@gmail.com Department of Radiology, Rasoul-e-Akram Hospital, Tehran University of Medical Sciences, Iran +98-2164352578, rkkiara@gmail.com Mohammad Hadi Gharib Mohammad Hadi Gharib Department of Radiology, Rasoul-e-Akram Hospital, Tehran University of Medical Sciences, Iran +98-2164352578, rkkiara@gmail.com Department of Radiology, Rasoul-e-Akram Hospital, Tehran University of Medical Sciences, Iran +98-2164352578, rkkiara@gmail.com Kiara Rezaei-Kalantari Kiara Rezaei-Kalantari Department of Radiology, Rasoul-e-Akram Hospital, Tehran University of Medical Sciences, Iran +98-2164352578, rkkiara@gmail.com; Department of Radiology, Rasoul-e-Akram Hospital, Tehran University of Medical Sciences, Iran +98-2164352578, rkkiara@gmail.com Department of Radiology, Rasoul-e-Akram Hospital, Tehran University of Medical Sciences, Iran +98-2164352578, rkkiara@gmail.com; Department of Radiology, Rasoul-e-Akram Hospital, Tehran University of Medical Sciences, Iran +98-2164352578, rkkiara@gmail.com Maryam Jafari Maryam Jafari Department of Radiology, Rasoul-e-Akram Hospital, Tehran University of Medical Sciences, Iran +98-2164352578, rkkiara@gmail.com Department of Radiology, Rasoul-e-Akram Hospital, Tehran University of Medical Sciences, Iran +98-2164352578, rkkiara@gmail.com
en 10.5812/iranjradiol.7607 What is Your Diagnosis? What is Your Diagnosis? PHOTO QUIZ discussion discussion Dyspnea;Surgery;Cardiac Dyspnea;Surgery;Cardiac 231 3 http://www.Iranjradiol.com/index.php?page=article&article_id=7607 Pooyan Dehghani Pooyan Dehghani Department of Cardiology, Shiraz University of Medical Sciences, Iran +89-9173177631, pooyan427@yahoo.com; Department of Cardiology, Shiraz University of Medical Sciences, Iran +89-9173177631, pooyan427@yahoo.com Department of Cardiology, Shiraz University of Medical Sciences, Iran +89-9173177631, pooyan427@yahoo.com; Department of Cardiology, Shiraz University of Medical Sciences, Iran +89-9173177631, pooyan427@yahoo.com Dorna Motevalli Dorna Motevalli Students Research Center, Shiraz University of Medical Sciences, Iran Students Research Center, Shiraz University of Medical Sciences, Iran Sanaz Asadian Sanaz Asadian Department of Radiology, Shiraz University of Medical Sciences, Iran Department of Radiology, Shiraz University of Medical Sciences, Iran Nasrin Saki Nasrin Saki Department of Dermatology, Skin Research Center , Shiraz University of Medical Sciences, Iran Department of Dermatology, Skin Research Center , Shiraz University of Medical Sciences, Iran
en 10.5812/iranjradiol.8726 Multiplanar Reconstructed Thoracic CT Bronchoscopy in Endobronchial Tuberculosis Multiplanar Reconstructed Thoracic CT Bronchoscopy in Endobronchial Tuberculosis Letter letter letter Tomography, Spiral Computed; Tuberculosis; Bronchial Tomography, Spiral Computed; Tuberculosis; Bronchial 234 6 http://www.Iranjradiol.com/index.php?page=article&article_id=8726 Fariba Rezaeetalab Fariba Rezaeetalab Department of Pulmonary Medicine, M}oo Vm{ea{ospi~el|bmsw{mavc}nkwovw{|yiogmmwe{calossiuoomsMashhad University of Medical Sciences,, Iran +98-5118598818, rezaitalabf@mums.ac.ir; Department of Pulmonary Medicine, M}oo Vm{ea{ospi~el|bmsw{mavc}nkwovw{|yiogmmwe{calossiuoomsMashhad University of Medical Sciences,, Iran +98-5118598818, rezaitalabf@mums.ac.ir Department of Pulmonary Medicine, M}oo Vm{ea{ospi~el|bmsw{mavc}nkwovw{|yiogmmwe{calossiuoomsMashhad University of Medical Sciences,, Iran +98-5118598818, rezaitalabf@mums.ac.ir; Department of Pulmonary Medicine, M}oo Vm{ea{ospi~el|bmsw{mavc}nkwovw{|yiogmmwe{calossiuoomsMashhad University of Medical Sciences,, Iran +98-5118598818, rezaitalabf@mums.ac.ir Donya Farrokh Donya Farrokh Department of Radiology, Imam Reza hospital, Mashhad University of Medical Sciences, Iran Department of Radiology, Imam Reza hospital, Mashhad University of Medical Sciences, Iran Behrouz Zandiee Behrouz Zandiee Department of Radiology, Imam Reza hospital, Mashhad University of Medical Sciences, Iran Department of Radiology, Imam Reza hospital, Mashhad University of Medical Sciences, Iran