Kotaro Yasumori

Autoimmune Pancreatitis: Radiologic Findings in Three Histologically Proven Cases

We describe the radiologic findings of autoimmune pancreatitis, a rare variant of pancreatitis. The radiologic findings of autoimmune pancreatitis are pathognomonic and very different from those of ordinary types of acute or chronic pancreatitis. This condition is a new clinical entity that is effectively treated with steroid therapy. It is important to recognize the radiologic characteristics of autoimmune pancreatitis to avoid surgical resection and start steroid therapy.

MRI of the brain in chronic carbon monoxide poisoning

We examined 13 patients with chronic carbon monoxide (CO) poisoning by magnetic resonance imaging (MRI); all of them had been in an explosion in a coal mine 25 years previously. Symmetrical globus pallidus lesions were observed in 12, as was degeneration of the white matter, with focal cortical atrophy. The temporal parietal and occipital lobes were usually affected, the parietooccipital region being the most frequently and extensively damaged. Of the 12 patients with white matter degeneration 7 had definitely asymmetrical cortical and subcortical lesions. There were 6 patients with dilated temporal horns, probably due to atrophy of the hippocampal gyri. A history of CO inhalation and an awareness of the typical distributions of lesions are important for recognition of the effects of CO poisoning, especially when patients are in the chronic stage.

Apparent Diffusion Coefficient in Invasive Ductal Breast Carcinoma: Correlation with Detailed Histologic Features and the Enhancement Ratio on Dynamic Contrast-Enhanced MR Images.

Purpose. To investigate the correlation of Apperent Diffusion Coefficient (ADC) values in invasive ductal breast carcinomas with detailed histologic features and enhancement ratios on dynamic contrast-enhanced MRI. Methods and Materials. Dynamic MR images and diffusion-weighted images (DWIs) of invasive ductal breast carcinomas were reviewed in 25 (26 lesions) women. In each patient, DWI, T2WI, T1WI, and dynamic images were obtained. The ADC values of the 26 carcinomas were calculated with b-factors of 0 and 1000 s/mm2 using echoplanar DWI. Correlations of the ADC values were examined on dynamic MRI with enhancement ratios (early to delayed phase: E/D ratio) and detailed histologic findings for each lesion, including cellular density, the size of cancer nests, and architectural features of the stroma (broad, narrow, and delicate) between cancer nests. Results. The mean ADC was 0.915 ± 0.151 × 10−3 mm2/sec. Cellular density was significantly correlated with ADC values (P = .0184) and E/D ratios (P = .0315). The ADC values were also significantly correlated to features of the stroma (broad to narrow, P = .0366). Conclusion. The findings suggest that DWIs reflect the growth patterns of carcinomas, including cellular density and architectural features of the stroma, and E/D ratios may also be closely correlated to cellular density.

MRI of primary lymphoma of the liver

Objective The MR findings in two cases of primary lymphoma of the liver (PLL) are presented. Materials and Methods MR of two cases of primary lymphoma of the liver were reviewed and its features were estimated. Results Both cases showed a solitary large liver mass. On T1-weighted imaging the tumor was isointense in one and homogeneously hypointense to the liver parenchyma in the other. On T2-weighted imaging both tumors were homogeneously hyperintense. In one case the margin of the tumor was poorly defined, and portal branches were identified within the tumor, an unusual finding in other liver neoplasms. Conclusion In patients with liver masses with homogeneous intensity on MR but without liver dysfunction and other malignancies, PLL should be included in the differential diagnosis.

Rupture of embolised coeliac artery pseudoaneurysm into the stomach: is coil embolisation an effective treatment for coeliac anastomotic pseudoaneurysm?

An elderly woman with an anastomotic pseudoaneurysm of the coeliac artery, after previous treatment of a thoraco-abdominal aortic aneurysm, was treated by stainless steel coil embolisation. One year later, the embolised pseudoaneurysm ruptured into the stomach and total gastrectomy and aneurysmorraphy was necessary. She is leading a normal life 6 months later.

MR imaging of pituitary hypertrophy due to juvenile primary hypothyroidism: A case report

We present a case of pituitary hypertrophy due to juvenile primary hypothyroidism with subsequent return to normal size after therapy. This clinical entity is well known, but there are few reports on its magnetic resonance (MR) findings. We stress the usefulness of Gadolinium-DTPA-enhanced (Gd-DTPA-enhanced) MRI in the differential diagnosis of pituitary hypertrophy and pituitary adenoma.

Transcatheter embolization of testicular vein for varicocele testis.

Percutaneous transcatheter embolization of the testicular vein was performed on 28 patients with angiographically proven varicocele testis. In 2 patients bilateral and in 26 only the left vein was embolized using 3-, 5-, or 8-mm stainless steel coils. All patients had clinically palpable varicoceles and male infertility. The grade of varicoceles improved after embolization in 23 of 28 cases (82%). Effective sperm count increased significantly from 34.5 ± 44.6 to 65.1 ± 71.0 following embolization. However, pregnancy was achieved only in one of 28 cases. Technically, the basilic vein approach was felt to be superior to the femoral vein or jugular vein approach for this procedure.

Magnetic resonance imaging compared with computed tomography and angiography in Moyamoya disease

Magnetic resonance (MR) imaging performed in 13 patients with moyamoya disease was reviewed and compared with computed tomography (CT) and angiography. The MR findings consisted of occlusion of arteries, collateral vessels and parenchymal changes. Narrowing or occlusion of the middle cerebral artery and the supraclinoid portion of the internal carotid artery were seen in all hemispheres but one. Collateral vessels, cerebral infarcts and atrophy with dilatation of the ventricles were observed on MR imaging. In general, the MR findings correlated well with angiography regarding occlusive changes and moyamoya vessels but was less sensitive in a few cases. Because of its higher sensitivity in detecting occlusive changes and collateral vessels, MR imaging was superior to CT in the diagnosis of this disease.

Lung CT: Part 1, Mimickers of Lung Cancer—Spectrum of CT Findings With Pathologic Correlation

OBJECTIVE The purpose of this article is to describe CT findings of miscellaneous pulmonary conditions that mimic lung cancers, especially primary cancers, to improve diagnosis of pulmonary lesions. Brief descriptions of patient clinical information and pathologic findings will be included and correlated with imaging findings in actual cases. CONCLUSION A wide variety of pulmonary conditions present imaging features that mimic those of primary lung cancers and are difficult to differentiate from cancer. Awareness of these conditions with an understanding of their pathologic background and careful attention to the clinical information will help achieve correct diagnoses.

Oligodendrogliomas of the lateral ventricle: Computed tomography and angiography

Computed tomographic (CT) and angiographic findings in four cases of oligodendroglioma of the lateral ventricle are reported. CT showed a midline nodular intraventricular mass containing punctate calcifications and cysts. The tumors were slightly to markedly enhanced after the infusion of contrast media. Angiography showed slightly increased vascularity in the mass, and displacement of subependymal veins near the tumor. Oligodendrogliomas of the lateral ventricle are rare but should be included in the differential diagnosis of intraventricular tumors near the foramen of Monro.