MRI manifestations of primary muscle non-Hodgkin lymphoma / 中华放射学杂志

Objective To explore and evaluate MRI in diagnosing primary muscle non-Hodgkin lymphoma. Methods Six surgically confirmed primary muscle non-Hod#in lymphoma underwent MR examination including T_1WI, T_2WI and T_1 WI enhanced studies. The acquired images date was reviewed and analysed retrospectively in comparison with surgical and pathological results. Results The locations of 6 cases were cervical part (2), upper extremity (1), lower extremity (3), respectively. All cases involved of more than one anatomical compartment with poorly defined solid masses in 5 cases and well defined in 1 cases, 5 extended to subcutaneous fat and 3 extended along the neurovascular bundle. The mean tumor diameter was 13.9 cm, ranging from 7.3 to 22.5 cm. One was well demarcated and 5 were ill-defined. On T_1 WI, 2 were slighdy high signal intensity and 4 were slighdy low signal intensity. On T_2 WI, 2 were slightly high signal intensity, 3 were intermediate signal intensity and 1 was high signal intensity. Five were inhomogeneous and 1 was homogeneous. The intrinsic structure such as muscle fiber, tendo, spatium intermusculare were detected on 5 cases. Of the 5 dynamic contrast-enhanced cases, it showed moderate enhamcement during arterial phase, 2 were homogeneous and 3 were inhomogeneous. And it showed progressive enhancement during interstitial phase, 3 were homogeneous and 2 were inhomogeneous. Conclusions Primary muscle lymphoma always originated deep to the fascia showing subcutaneous extension and multiple compartment invasion. Typically form poorly defined solid masses with slightly high in signal intensity on MR T_2WI and middle degree dynamic delayed contrasted-enhanced in which intrinsic anatomic structure such as muscle fiber, tendo, spatium intermusculare and so on can be discerned, almost all cases involve more than one muscle compartment and some of tumor extend along the neurovascular bundle.

Analysis of radiological features relative to pathology in pelvic chondrosarcoma / 中华放射学杂志

Objective To Explore the imaging features relative to pathology of pelvic chondrosarcoma and to evaluate the clinical value.Methods All 12 cases patients with primary pelvic chondrosarcoma confirmed by pathological examination underwent radiography,spiral CT plain scanning,MR SE-T1WI,FSE-T2WI and SE-Tl WI enhancement scanning before operation.The imaging data was reviewed and analyzed retrospectively to compare with surgical and pathological results.Results Eleven conventional chondrosarcoma and one dedifierentiated chondrosarcoma were located in different parts of pelvis.The diameters of the tumors ranged from 4.7 to 17.0 cm with one case less than 5.0 cm,6 cases being 5.O-10.0 am and 5 cases more than 10.0 Cln.The CT valHe of 5 cases was identical or inferior to muscle with mild to moderate"ring-and-arc"mineralization and soft mass.MR imaging depict the high water content of these lesions as very high signal intensity was detected on T2 WI.Six cases showed typical"ring-and-arc"fibrous tissue which enhanced persistently.Aggressive features of deep endosteal scalloping and soft-tissue extension was also found in these cases.Conclusions Radiographic findings Can suggest the diagnosis of pelvic chondrosarcoma when there is typical"ring-and.arc"fibrous tissue,mineralization,aggressive features of deep endosteal scalloping and large soft-tissue extension.MR imaging reflect directly this pathologic structure,superior to that of CT and radiography.CT is optimal to detect the matrix mineralization,particularly when it is subtle or when the lesion is located in anatomically complex pelvic areas.

Correlation imaging findings of primary malignant fibrous histiocytoma of bone with pathology / 中华放射学杂志

Objective To explore the imaging features of primary malignant fibrous histiocytoma(MFH)of bone and correlate them with pathological findings.Methods Thirteen cases patients with primary MFH of bone confirmed by surgical pathology underwent radiography,spiral CT plain scanning and MR SE-T1 WI,T2 WI and SE-T1 WI enhancement scanning before operation.The imaging date was reviewed and analysed retrospectively in comparison with surgical and pathological results.Results Of 13 MFH,11 were located in the end of long bone,and 2 in the diaphysis.The distance between tumors in the end of long bone and adjacent joint surface was 1 to 5 cm.All lesions showed osteolytic destruction with the maximum diameter of the tumors from 5.3 to 12.7 cm.The tumors had eccentric aggressive osteolytic destruction in 10 lesions,internal crest within the lesions in 7,inconsecutive marginal osteosclerosis in 11,little periosteal reaction in 2 and small soft tissue masses in 9,respectively.The CT value of lesions was similar to muscle.MR imaging depicted low signal intensity with aggressive features on T1 WI,iso to slight high signal intensity on T2 WI,and middle or high degree contrast enhancement on enhanced T1 WI images.Macroscopically,MFH was usually located eccentrically within the bone and produced little or no osseous expansion.The soft tissue component appeared multi-nodules and pseudo-encapsulated.Histologically,they consisted of spindle-shaped fibroblasts,which radiated outward in a spiral array from a central focus and produced a nebula or storiform appearance,and cells,which were small and oval with little visible cytoplasm.Conclusions The imaging manifestations of MFH were specific to some extent.Combined utilization of plain X-ray,CT,and MRI is helpful for the diagnosis and differential diagnosis of MFH.

The image features of multilocular cystic nephroma / 中华放射学杂志

Objective To explore the image features of multilocular cystic nephroma and its correlative differential diagnosis. Methods Eight cases of multilocular cystic nephroma were retrospectively analyzed by comparing the imaging findings with surgical and pathological results. Results In all 8 cases, multilocular cystic nephromas were unilateral and circumscribed by thick capsules. These lesions ranged in diameter from 2. 5 cm to 7. 5 cm. The lesions were entirely composed of locules and septa without solid nodules. These locules did not communicate with each other. The septa of these lesions were clear in 2 cases, partly clear in 4 cases, and not very clear in 2 cases. All lesions were better detected on enhanced scans than on non-enhanced ones. Four of 8 cases also underwent MR scan, which presented low signal intensity on T1WI and high signal intensity on T2WI. The Interlocular septa was demonstrated much better with MM than with CT. Histopathology proved that the capsule and septa of the lesions were lined by cuboidal or flattened epithelial cells. Conclusion Multilocular cystic nephroma is a rare disease of the kidney. CT and MRI scanning are valuable in the diagnosis of multilocular cystic nephroma, but the imaging features are not specific enough to differentiate benign multilocular cystic nephroma from multilocular cystic renal cell carcinoma.

Imaging Diagnosis of the Lymphangiomyomatosis (A Report of 2 Cases) / 实用放射学杂志

Objective To improve the imaging recognition of the lymphangiomyomatosis.Methods The manifestations of 2 patients with lymphangiomyomatosis confirmed by pathological assessment were analyzed retrospectively and relevant literature were reviewed.Results Multiple,well-defined and thin-walled cysts were found on the chest HRCT.The size of the cystic airspace was different,and the wall of cysts ranged being fainted perceptible to near l mm in thickness.The retroperitoneal lymphangiomyomatosis were found in the 2 patients on CT images,and some lymphadens were confluence.The diameter of the largest lymphadens was 25 mm,no enhancement were found on contrast-enhanced CT scan.The right renal angioleiomyoma and retroperitoneal leiomyoma were presented in one patient,which were moderately homogeneous enhanced on contrast-enhanced CT scan.Conclusion Lymphangiomyomatosis is a rare lymphangial disease with smooth muscle abnormal hyperplasia.The diffuse cysts in bilateral lungs were its characteristic changes on CT images.Lymphangiomyomatosis can incorporate with renal angioleiomyoma,retroperitoneal leiomyoma and lymphangiomyomatosis.

Analysis of early complications after surgery for portal hypertension / 中国普通外科杂志

Objective To investigate the relevant factors for development of early postoperative complications in patients with portal hypertension due to advanced schistosomiasis, and to offer a theoretical basis for preventing the occurrence of postoperative complications. Methods The cases of advanced schistosomiasis with portal (hypertension) operated upon over the past 40 years were retrospectively reviewed. Results In 8 240 cases, the complication rate was 19.66% at one month after operation, and the mortality rate was 15.31%. The main causes of death were MDOS, massive hemorrhage into abdominal cavity, hepatorenal syndrome and (recurrence) of bleeding of upper alimentary tract. Conclusions The relevant factors for development of early complications after operation in patients with portal hypertension is related to the cause of portal hypertension, whether or not there is a history of ascites, the timing of operation and the stage of liver function(Child′s classification).

Comparative study of cystic renal cell carcinoma by ultrasonography and CT / 中华超声影像学杂志

Objective To study the features and values of ultrasound and Helical computed tomography (CT) in diagnosis of cystic renal cell carcinoma. Methods Twenty patients were preoperatively examined by B-mode ultrasound, color Doppler ultrasound and helical CT. Results All the cases were confirmed by operation and pathology,including 12 cases on the left side and 8 cases on the right side. On B-mode ultrasound images, all lesions appeared as unilocular or multilocular cyst in 5 cases, intratumoral septum in 10 cases,intratumoral nodule in 4 cases,solid-like mass in 1 case. Color blood flow was showed within tumors in 18 patients,in which 17 cases showed the arterial spectrum with a mean resistance index of 0.66. On enhanced CT scans, all the lesions appeared as the early uneven enhancement(19 cases), septal enhancement(6 cases) and mural nodular enhancement(4 cases) respectively. The accuracy of conventional ultrasound combined with color Doppler ultrasound was 85%, while the accuracy of the enhanced CT was 80%.Conclusions Conventional ultrasound combined with color Doppler ultrasound and enhanced CT plays an important role in diagnosis of cystic renal cell carcinoma.

MRI Diagnosis of Adrenal Myelolipoma(A Report of 13 Cases and Correlated with Pathology) / 实用放射学杂志

Objective To investigate the MRI manifestations and its pathologic foundation of adrenal myelolipoma.Methods MRI images of 13 patinets with adrenal myelolipoma confirmed by pathological assessment were analyzed retrospectively.MRI fingings were also studied in correlation with surgical pathology.Results The MRI diagnosis of adrenal myelolipoma in 13 patients were correct preoperative.Huge mass in the adrenal were found in 11 patients with T 1WI high signal intensity and mixed with conclamata and stripe low signal intensity.The high signal intensity was mature fatty tissue and the low signal intensity was myeloid tissue on pathologic examination.2 patients appeared as mixed signal intensity principle isointensity on T 1WI images,and the pathological findings was tumor hemorrhage.The high signal intensity changes to low signal intensity and slight higher than the signal of subcutaneous fatty tissue on T 1WI or T 1WI with fatty suppression.The low signal intensity of the myeloid tissue and the hemorrhage were high sinal intensity.No enhancement were found in all patients.Partly capsule enhancement were found in 2 patients with tumor hemorrhage and infection.The inferior cava vena was displaced to the anterior and internal side in all patients.Conclusion The characteristic manifestation of adrenal myelolipoma is high signal intensity change of the fatty tissue and no enhancement on contrast-enhanced MRI image.MRI could give correct diagnosis of the adrenal myelolipoma preoperative.