Tom Sutherland

Magnetic resonance imaging of meningiomas: a pictorial review.

Meningiomas are the most common non-glial tumour of the central nervous system (CNS). There are a number of characteristic imaging features of meningiomas on magnetic resonance imaging (MRI) that allow an accurate diagnosis, however there are a number of atypical features that may be diagnostically challenging. Furthermore, a number of other neoplastic and non-neoplastic conditions may mimic meningiomas. This pictorial review discusses the typical and atypical MRI features of meningiomas and their mimics.Teaching Points:There are several characteristic features of meningiomas on MRI that allow an accurate diagnosisSome meningiomas may display atypical imaging characteristics that may be diagnostically challengingRoutine MRI sequences do not reliably distinguish between benign and malignant meningiomasSpectroscopy and diffusion tensor imaging may be useful in the diagnosis of malignant meningiomasA number of conditions may mimic meningiomas; however, they may have additional differentiating features

Magnetic resonance features of primary central nervous system lymphoma in the immunocompetent patient: a pictorial essay.

Primary central nervous system lymphoma (PCNSL) is an uncommon but important variant of non‐Hodgkin lymphoma and represents up to 6% of all primary central nervous system (CNS) malignancies. Recognition of this entity by radiologist on MRI may avoid unnecessary neurosurgical resection and redirect to biopsy. The pretreatment MRI of patients with biopsy proven PCNSL from the last 5 years at our institution was reviewed. Selected examples were used to construct a pictorial essay to illustrate some of the typical and atypical MR features of PCNSL. MRI of other CNS conditions with imaging similarities to PCNSL was included to demonstrate possible mimics. The typical features of PCNSL lymphoma are intra‐axial homogenous single or multiple contrast enhancing lesions, with marked surrounding oedema and restricted diffusion, usually contacting a cerebrospinal fluid (CSF) surface. Necrosis, peripheral enhancement, haemorrhage or calcification are unusual and other diagnoses should be considered if any of these features are present. Potential mimics include high grade glioma, infarcts, metastatic disease, demyelination, abscess and secondary lymphoma. Careful assessment of the MR features and correlation with the clinical findings should enable the radiologists to raise the possibility of PCNSL and minimise the risk of unnecessary resection.

Extracolonic findings at CT colonography: A review of 258 consecutive cases

Introduction: Computed tomographic colonography (CTC) is a non‐invasive method of examining the colon and is used for colorectal polyp and mass diagnosis. As the entire abdomen is examined, incidental extracolonic pathologies can be diagnosed. The types of extracolonic findings (ECFs) and their frequency have not been explored in an Australian setting.

Gender differences in presentation and outcome of nonfunctioning pituitary macroadenomas

Few data exist regarding gender differences in hormonal outcomes in nonfunctioning pituitary macroadenomas (NFPMA). The aim was to assess whether there are gender differences in hormonal outcomes in NFPMA following pituitary surgery at a single centre.

Primary central nervous system lymphoma in immunocompetent patients: a retrospective review of MRI features.

Introduction: To define the features of primary central nervous system lymphoma (PCNSL) on MRI in immunocompetent patients.

Solid focal liver lesion characterisation with apparent diffusion coefficient ratios

Non‐invasive characterisation of focal liver lesions using diffusion‐weighted imaging (DWI) has been heavily investigated and has shown substantial overlap between benign and malignant lesions. We have calculated a ratio of lesion to normal liver to determine if it improves accuracy for correct categorisation.

Evaluation of focal hepatic lesions with ultrasound contrast agents.

Ultrasound contrast agents have gained wide acceptance for the detection and characterization of focal liver lesions. This pictorial essay reviews the growing body of evidence that supports the use of modern ultrasound contrast agents and illustrates the enhancement characteristics of commonly encountered focal liver lesions. Pathologies discussed include metastases, hepatocellular carcinomas, focal nodular hyperplasia, hepatocellular adenomas, hemangiomas, abscesses, complex cysts, and focal fatty deposition.

Contrast-enhanced ultrasound of the spleen: an introduction and pictorial essay

A wide variety of pathologies can produce focal lesions within the spleen. These are being more frequently encountered as imaging technology improves. It is vital that radiologists are aware of these pathologies to enable accurate diagnosis. The role of ultrasound contrast in splenic disease will be discussed and illustrated with cases likely to be encountered by general and abdominal radiologists.

Abdomen's forgotten organ: Sonography and CT of focal splenic lesions

Focal lesions within the spleen are being increasingly recognized as imaging technologies advance, and often provide a diagnostic challenge for radiologists. Knowledge of the types of pathologies that occur, determination of solid or cystic nature and a search for characteristic features including correlation with extrasplenic findings can usually allow a specific diagnosis or brief differential to be offered.

Contrast enhanced ultrasound (CEUS) in the diagnosis of post-partum bilateral renal cortical necrosis: a case report and review of the literature.

Abstract Renal cortical necrosis is a rare condition with complex pathogenesis. There is no consensus over the best investigative modality for an initial diagnosis that is often in the context of acute renal failure. The applications of ultrasound contrast are ever growing, particularly with regard to the assessment of abdominal organs. Here, we present a case of post-partum bilateral renal cortical necrosis affecting bilateral native kidneys and the subsequent use of contrast enhanced ultrasound in confirming this diagnosis. The sonographic appearance was found to correlate with the patients’ clinical presentation and other imaging findings. Secondarily, this allowed for appropriate and timely medical management and establishes the utility of ultrasound contrast in this clinical scenario. Contrast enhanced sonographic assessment should be considered early in patients with suspected renal vascular compromise. It is a safe, easy and efficacious investigative modality to stratify those patients with renal cortical necrosis from those with potentially reversible medical causes.