Association of angiotensin-converting enzyme gene I/D polymorphism with change in left ventricular mass in response to physical training

PURPOSE: To determine the radiologic characteristics of cystic dystrophy of the duodenal wall. MATERIALS AND METHODS: Ten patients with cystic dystrophy of the duodenal wall and chronic pancreatitis underwent ultrasonography (US) (n = 10), computed tomography (CT) (n = 10), endoscopic US (n = 5), and endoscopic retrograde cholangiopancreatography (ERCP) (n = 9). Cystic dystrophy of the duodenal wall was classified as either cystic or solid. The imaging findings were retrospectively analyzed and compared with findings at pancreatoduodenectomy (n = 10). RESULTS: The more frequent cystic type (n = 7) of cystic dystrophy of the duodenal wall was characterized by the presence of easily recognizable cystic lesions (diameter, more than 1 cm), located within the thickened wall of the second portion of the duodenum. The solid type (n = 3) of cystic dystrophy of the duodenal wall demonstrated fibrous thickening of the duodenal wall within which small cysts (diameter, less than 1 cm) were present. The intraduodenal cysts were usually elongated or bilobate with a thick wall. The thickening of the duodenal wall appeared as a solid layer between the duodenal lumen and the pancreas, hypoechoic at US, isoattenuating at unenhanced CT, and hypoattenuating in the early phase (after initiation of infusion of contrast material) and isoattenuating in the late phase (after completion of infusion) at contrast material-enhanced CT. Findings at retrospective analysis of CT and endoscopic US images were characteristic. CONCLUSION: Imaging modalities, notably CT and endoscopic US, helped establish the diagnosis of cystic dystrophy of the duodenal wall.     

Cystic meningiomas resembling glial tumors

BACKGROUND: Meningiomas can be associated with peripheral or intratumoral cysts. Meningiomas with intratumoral cysts, also called "true cystic" meningiomas, are rare and can frequently be confused with glial or metastatic tumors. METHODS: We report three cases of "true cystic" meningiomas and discuss the preoperative evaluation, etiology, and surgical treatment of these cystic lesions with reference to the literature. RESULTS: Magnetic resonance imaging (MRI) and computed tomography (CT) studies usually display a cystic lesion close to the dura with or without enhancement of the cyst wall. Multiplanar MRI scans are very useful to show the presence of a solid tumor or some dural enhancement. Some cases of "true cystic" meningiomas however, are still erroneously preoperatively diagnosed. Complete surgical removal of the tumors and of the entire cyst wall was performed in our cases. Despite the absence of a typical ring enhancement of the cystic lesion in two cases, histopathologic studies displayed the presence of tumor cells on the cyst wall of both cases. CONCLUSIONS: Tumor cells can be present on the cyst wall and therefore can be one of the causes of tumor recurrence if not totally removed. Accurate preoperative radiologic diagnosis (multiplanar MR images) and intraoperative histopathologic studies are fundamental in that they will definitely influence the surgical strategy and outcome.     

Imaging approach to the diagnosis of pulmonary sequestration

PURPOSE: To describe the characteristic features of pulmonary sequestration (PS), to evaluate the usefulness of various imaging modalities, and to find a rational approach to accurate diagnosis. MATERIAL AND METHODS: Twenty-four patients with PS proved by operation and pathology were reviewed retrospectively. Plain chest films were done in all patients, bronchography in 3, sonography in 14, CT in 6 (including CT angiography in 1 case), MR in 8 (including MR angiography in 1 case) and aortography in 12 (including DSA in 1 case). RESULTS: Plain chest films demonstrated a solid mass in 14 patients and a cystic mass in 10. Bronchograms showed displacement of adjacent bronchi with no filling of contrast medium within the lesion in 2 cases, while another case had a blind intermediate portion of the right bronchus (hypoplasia of middle and lower lobes associated with extralobar sequestration). Sonography demonstrated a solid lung mass in 12 cases and a solid mass with cystic areas in 2, and detected vessel-like structures within the mass or in its surroundings in 12. Doppler analysis showed arterial spectral wave confirming a feeding artery. CT revealed a solid mass in all patients, a mass with low density area in 4, and emphysema surrounding the mass in 3. MR imaging depicted anomalous arteries in all patients and venous drainage in 4 cases. Aortography demonstrated anomalous systemic arterial supply to the PS in all patients. In this series, 21 cases (87.5%) were correctly diagnosed preoperatively by the imaging modalities. CONCLUSION: Plain chest films can provide a diagnostic clue to PS. Sonography, CT and MR are helpful for showing arterial blood supply and for making a definite diagnosis. We recommend a rational imaging approach for the diagnosis of PS.     

Effects of a high NaCl diet on eating and drinking patterns in pygmy goats

PURPOSE: Our goal was to determine the spectrum of 2-[18F]fluoro-2-deoxy-D-glucose (FDG) PET findings in patients with round atelectasis (RA). METHOD: All patients from 1992 to 1997 with radiologic features of RA and FDG-PET scans were evaluated. There were nine men ranging in age from 52 to 75 years (mean 65 years). All had chest radiographs and CT scans that were correlated with FDG-PET. FDG-PET was considered positive if lesion activity was greater than mediastinal activity and negative if lesion activity was the same as or less than mediastinal activity. RESULTS: Nine patients had 10 lesions, ranging in size from 1.2 to 5.0 cm (mean 3.1 cm). Lesion locations were right lower lobe (n = 5), left lower lobe (n = 4), and lingula (n = 1). All lesions were homogeneous and of soft tissue attenuation on CT. None contained air bronchograms or calcification. All had in-curving vessels and bronchi (comet tail sign), adjacent pleural thickening, and volume loss on CT. All lesions were negative on FDG-PET. Four lesions were percutaneously biopsied and showed chronic inflammation consistent with RA. Two lesions were unchanged on 2 and 3 year follow-up CT and were presumed to be RA as were four other lesions with characteristic CT features and negative FDG-PET. CONCLUSION: Our experience suggest that RA in not metabolically active on FDG-PET imaging. Thus, FDG-PET scans can play a role in differentiating RA from malignancy when there are few or atypical features of RA on chest radiographs and CT.     

Anaplastic ependymomas: clinical features and tumour suppressor gene p53 analysis

We analyzed seven cases of anaplastic ependymoma, focusing on neuro-imaging, histopathology, and mutations of the tumour suppressor gene p53. Five of the seven tumours were supratentorial. All had both cystic and solid components, with fragment calcifications detectable on CT scan. The solid parts of the tumours were imaged as heterogenous hypo- or iso-intense areas with moderate enhancement on T1-weighted magnetic resonance images. Vascularity was not prominent on angiograms except for one case. Histologically, in addition to the WHO criteria, loss of typical cellular architecture, endothelial proliferation, and necrosis were commonly found. A mutation in Exon 5 of the tumour suppressor gene p53 was detected in one anaplastic ependymoma out of five tumours (two benign and three anaplastic ependymomas) examined by PCR-SSPC analysis of genomic DNA followed by direct sequencing. Anaplastic ependymoma typically presents as a calcified cystic tumour in the supratentorial parenchyma or transependyma. Mutations of p53 deserve further investigation to examine their possible role in the oncogenesis and malignant transformation of ependymoma.     

Primary intrathoracic lymphangioma masquerading as teratoma

Two cases of cystic hygroma arising as a primary lesion in the chest are presented. Because of calcifications discovered on CT and because of the anterior location of the mass in both cases, teratoma was the first diagnostic consideration. However, after surgical removal, histologic study determined that both lesions were cystic hygromas with areas of scattered calcification probably secondary to hemorrhage. These cases are presented because of the remarkable similarity of their imaging features to those of teratoma.     

肺硬化性血管瘤的CT影像学特点

Objective: The aim of the study was to analyze the CT morphology features of pulmonary sclerosing hemangiomas (PSHs) and improve the diagnosis ability of this disease. Methods: The 18 cases of pulmonary sclerosing hemangioma (PSH) confirmed by operation and histopathology from August 2002 to May 2009 were collected, including 17 females and 2 males, aged from 19 to 60 years old, with an average age of 43 years. All the cases underwent plain CT scan, among them,16 cases received enhanced CT scan. Results: The 18 cases had isolated mass. Mean long-axis diameter of these lesions was (2.7 ± 1.3) cm (range, 1.9-4.2 cm). Of all cases, 5 cases (27.8%) were round in shape, 9 cases (50%) were oval, 4 cases (22.2%) were lobulated, and 14 cases (77.8%) were smooth margin. The air meniscus sign was in 2 cases (11.1%), and the halo sign in 3 cases (16.7%). Two cases (11.1%) contained small nodular calcification, the remaining 16 cases (70%) were homogeneous density, the CT density of the masses ranged from 24-47 HU, and the mean value was 35 HU. Sixteen cases received enhanced scan, the welt vessel sign was in 8 cases (44.4%),1 case showed less enhancement, 5 cases showed marked homogeneous enhancement and 10 cases showed intense and patchy heterogeneous enhanced. The CT density of the enhancing masses ranged from 60-110 HU, the mean value was 35 HU, and the net enhancement value was 14-80 HU, the mean value was 55 HU. Conclusion: PSH should be considered in middle-aged female whose CT found that single round or oval pulmonary nodules, with smooth margin, or associated with the air meniscus sign, the halo sign, or the marked enhancement.     

Clinical diagnosis of pancreato-biliary lesions by ultrasound angiography with intra-arterial infusion of carbon dioxide microbubbles

Ultrasound angiography (USAG), sonographic imaging of the blood flow with intra-arterial infusion of carbon dioxide (CO2) microbubbles, was applied to pancreato-biliary lesions. Hypervascular pattern was observed in all cases of gallbladder elevated lesions except for debris balls. However, the vascular pattern of CO2 inflow that many arterial vessels were branching off into the lesion was characteristic for gallbladder carcinomas. The hemodynamics of solid tumors of the pancreas with USAG were divided into three patterns. Most of hypovascular nodules were duct cell carcinomas, while inflammatory pancreatic masses always exhibited isovascular except for two cases of hypovascular pattern. Furthermore, islet cell tumors showed hypervascular. In cases of mucin-producing cystic tumors of the pancreas, excrescent nodules or thickened septa within the lesions were identified as hypervascular. Other cystic tumors of the pancreas also presented peculiar hemodynamics. Therefore USAG is potentially useful for detecting various vascular patterns of pancreato-biliary lesions, contributory as a diagnostic tool in this area.     

Mediastinal hemangioma: radiographic and CT features in 14 patients

PURPOSE: To characterize the imaging features of mediastinal hemangioma. MATERIALS AND METHODS: The authors retrospectively reviewed chest radiographs and computed tomographic (CT) scans from 14 patients with mediastinal hemangioma. RESULTS: Most mediastinal hemangiomas manifested as well-marginated masses at CT. Three masses had punctate calcifications, and one had phleboliths. Five masses were of heterogeneous attenuation at unenhanced CT. Ten of 11 (91%) hemangiomas were of heterogeneous attenuation at contrast material-enhanced CT, and the following four patterns were observed: central (n = 6, 60%), mixed central and peripheral (n = 2, 20%), peripheral (n = 1, 10%), and nonspecific (n = 1, 10%) increased attenuation. Central increased attenuation was observed more frequently after administration of a bolus of contrast material than after slow infusion. CONCLUSION: Hemangiomas should be considered in the differential diagnosis of well-marginated mediastinal masses that have heterogeneous attenuation on CT scans, show central enhancement after administration of contrast material or contain punctate calcification.     

Use of post-column fluorescence derivatization to develop a liquid chromatographic assay for ranitidine and its metabolites in biological fluids

OBJECTIVE: To describe the cytologic features of solid and cystic tumor of the pancreas. STUDY DESIGN: Cytologic features of four cases of solid and cystic tumor of the pancreas (SCT) were reported and compared with those of three cases of islet cell tumor of the pancreas. RESULTS: Aspiration and imprint cytology of the tumor cells obtained from three cases of SCT showed papillary structures or rosette formations in part and demonstrated uniformly round to oval nuclei that contained finely granular chromatin, a fairly distinct nucleolus and a scant to moderate amount of granular or vesicular cytoplasm. Another case of SCT consisted of multinucleated giant cells with coherent chromatin as well as mononuclear cells with nuclear grooves. Islet cell tumor consisted mainly of clustered or isolated uniform mononuclear cells with rosette formations but without a papillary structure and occasional multinucleated giant cells in all cases. The nuclei of islet cell tumors had peculiar, fine chromatin aggregates with a "salt-and-pepper" appearance and slightly enlarged nucleoli. CONCLUSION: SCT is cytologically distinguishable from islet cell tumor in spite of having many cytologic features in common with it.