Does diffusion-weighted magnetic resonance imaging [DWMRI] help in differentiating benign from malignant breast lesions?

Objective: to evaluate the role of Diffusion-weighted imaging [DWI] and the Apparent Diffusion Coefficient [ADC] values in characterizing benign and malignant breast Lesions

Patients And Methods: the imaging data of thirty nine female patients [mean age of 48 years] who underwent breast MRI using the conventional pulse sequences, DWI and calculated ADC values as well as the results of the dynamic contrast enhancement [DCE] study were all analyzed and correlated with the results of histopathological evaluation

Results: forty six breast lesions were detected in thirty nine patients included in this study. According to the histopathological analysis, there were 27 malignant lesions [58.69%] and 19 benign lesions [41.31%]. The malignant lesions showed a mean ADC value of 0.93 +/- 0.42 and the benign lesions showed a mean ADC value of 1.54 +/- 0.43. The receiver operating characteristic [ROC] curve showed that the best ADC cut-off value to differentiate between benign and malignant lesions was 1.26 x 10[-3] mm[2]/s with sensitivity and specificity of 89% and 94.7% respectively

Conclusion: the diffusion-weighted sequence is useful in the differentiation between malignant and benign breast lesions, increasing the specificity of breast MRI. This sequence is performed with no significant increase in the acquisition time and should be included in the standard breast MRT protocol

Role of magnetic resonance imaging in evaluation of cerebellopontine angle tumors

Objective: to determine the role of MRI in evaluation of different Cerebellopontine angle tumors, and differentiation between them

Materials and Method: This study was conducted in the period between January 2009 and December 2012. Fifty four patients with CPA masses were selected on bases of neurotological complains that related to CPA

Results: Cerebellopontine angle masses in this study were classified into two groups: acoustic neuromas and non acoustic neuromas CPA masses. Twenty eight of cases [51.8%] were acoustic neuromas in which 26 cases were unilateral acoustic neuromas and 2 cases with bilateral neuromas, the remaining 26 cases [48.2%] were other non acoustic CPA masses. These included, one trigeminal neuroma [1.9%], 6 [11.1%] cases were CPA meningiomas, 6 [11.1] cases were epidermoid, 3 [5.6%] cases were arachnoid cyst, 2 [3.7%] cases were glomus jugulare tumors, 3 [5.6%] cases metastatic tumors and 5 [9.2%] cases were intraaxial and intraventricular tumors extending to the CPA, this included 2 cases cerebellar hemangioblastoma, 1 case pontine glioma and 2 cases were fourth ventricular ependymoma

Conclusion: MR imaging is considered the imaging method of choice to assess CPA tumors and to distinguish between them

Role of different imaging modalities in diagnosis of salivary gland diseases

A variety of neoplastic and non-neoplastic diseases affects the salivary glands, and requires differential diagnosis and management. Imaging plays an important role in evaluation of salivary gland diseases. The most common conditions affecting the salivary glands are calculi, inflammation and tumors. The aim of the study was to determine the diagnostic value of different imaging modalities for the evaluation of different lesions in the parotid and submandibular salivary glands, and if there is any particular advantage of one method in detecting and characterizing salivary gland lesions. Sixty-eight patients diagnosed clinically to have salivary gland disease were investigated as follow: Plain X-ray was performed in 55 cases, Sialography was performed in 55 patients following plain radiography, US was done in all patients, US-guided fine needle aspiration biopsy [FNAB] was done in 19 cases to verify diagnosis. CT oAas done in 18 patients and MRI was done in 13 patients. The final diagnosis in each patient in the study was based on consensus of clinical, imaging and biopsy or surgery results. Thirteen patients had submandibular calcular sialadenitis radio-opaque stones were seen in 11 of them [84.6%] as detected by X ray. Both sialography and US could accurately detect submandibular calcular sialadenitis in all the 13 patients [100%]. Sialography was highly accurate in diagnosis of cases with non-calcular submandibular sialadenitis [96%]. On the other hand, sialography was also able to detect duct system abnormalities in 10 out of the 15 examined parotid cases [66.6%]. The pattern of duct system abnormalities was typical in the 2 cases with Sjogren's syndrome. US was useful in diagnosis of parotid abscesses, cysts and masses. US-Guided FNAB was able to yield the diagnosis in 90% of cases with neoplastic salivary gland disease. CT was highly accurate [90.9%] in determining the benign from malignant nature of salivary gland masses, while the accuracy of MRI was 100% in this respect. Plain radiography has an important role in detection of salivary calculi and calcifications. Sialography is so far the imaging modality of choice with indispensable value for evaluation of salivary duct system abnormalities. US is a sensitive non-invasive tool for salivary glands imaging. Its diagnostic value is augmented by its use for guidance of FNAB which is easy to perform and of high diagnostic yield. Both CT and MRI are considered to be the mainstay for diagnosis in suspected salivary gland neoplastic disease. The two modalities have high accuracy in detection of mass lesions and evaluation of their extent; however, the inherent high tissue discrimination capabilities of MRI give privilege to this technique in evaluation of the nature of such lesions