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Glioblastoma, which is the most common primary malignant brain tumor, usually occurs in the white matter of the brain. In this case, magnetic resonance imaging (MRI) only showed abnormal cortical signal in the first hospital examination, so he was diagnosed as viral encephalitis. Seven months later, he was admitted to hospital again because of memory loss and slow response. MRI showed obvious mass in the original lesion area. Pathology confirmed glioblastoma (the World Health Organization classification of central nervous system tumors: grade Ⅳ). By analyzing this case, it is considered that some glioblastomas may only have cortical lesions in the early stage. Therefore, if cortical abnormal signals are found, glioblastoma should also be included in the differential diagnosis.
ABSTRACT
Mild encephalitis/encephalopathy with reversible splenial lesion has special clinical-imaging features. According to the extent of lesion involvement, it can be divided into type Ⅰ and type Ⅱ. Clinically, type Ⅰ is more common, and type Ⅱ is rare. A rare case of recurrent type Ⅱ mild encephalitis/encephalopathy with reversible splenial lesion is reported. The patient presented with typical type Ⅱ mild encephalitis/encephalopathy with reversible splenial lesion for the first time, involving the corpus callosum and the deep white matter, and the lesions disappeared after a short-term reexamination. Two years later, the lesions recurred, and the scope of the lesions was similar to that of the first time, and the lesions disappeared after a short-term reexamination. The clinical and imaging findings are analyzed in combination with relevant literatures review in order to deepen the understanding of the disease and improve the level of diagnosis and treatment.
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Objective To evaluate the manifestations and diagnostic value of CT enterography (CTE) in primary intestinal T-cell lymphoma (PITCL).Methods Eighteen patients with PITCL confirmed by pathology were reviewed retrospec tively.The characteristics of lesion site,amount of foci,pattern and degree of contrast enhancement,lymphadenopathy,involvement of other organs and complications were recorded.Results In all of the 18 patients with PITCL,multiple lesions were seen in 13 cases (13/18,72.22％),and solitary involvement was seen in 5 cases (5/18,27.78％).Twelve ca ses were located at jejunum/ileum,3 of them were also involved in the colon.Five cases were located only in the colon,and 1 in the duodenum.Six cases were complicated with intestinal perforation.The patients were categorized into 6 types according to the CT manifestation:infiltration type (n=7),diffuse jejunum mucosa ileum metaplasia type (n =3),luminal aneurismal dilatation type (n =3),polypoid mass type (n =2),mesentery type (n=1),mixed type (n =2).Conclusion CTE can clearly display the imaging of PITCL and it has high value for the diagnosis of PITCL.
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Objective To explore the values of apparent diffusion coefficients (ADC) in staging the lesions of multiple sclerosis (MS) through analysing the differences of ADC in different types of lesions.Methods 137 lesions identified in 29 patients with MS,were characterized by their enhancement pattern on contrast-enhanced T1-weighted MR images and whether they were changing in appearance, size or signal.The lesions were classified into four groups:homogeneously enhancing lesions (HELs), ring-enhancing lesions (RELs), active nonenhancing lesions (ANELs), and inactive nonenhancing lesions (INELs).The mean ADC values for each type of lesions were calculated and compared.Results The ADC values for HELs, RELs, ANELs and INELs were (91.09±13.63)× 10 5 · m2 · s-1, (105.66±9.92) × 10-5 · m2 · s-1, (136.80±20.31) × 10-5 · m2 · s-1 and (127.46±13.65) ×10-5 · m2 · s-1.There were significant differences between the ADC values of any two groups in the four groups except the ADC values between ANELs and INELs.Conclusion ADC values are useful to differentiate each type of lesion,which can help stage the lesions of MS.
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Objective To investigate the diagnostic value of CT and MRI in basal ganglia germinoma.Methods The clinical and imaging data in 1 7 patients with basal ganglia germinoma proved pathologically or clinically were analyzed retrospectively.Results All patients were male with an age rang from 8 to 18 years old and a mean age of 10.8 years.The most common symptom was hemi-paresis.Imaging features of the lesion were as follows:① usually irregular shape(11/17,64.7%)and cystic degeneration (10/17, 58.8%)without space-occupying effect and surrounding edema (12/17,70.6%);② isointensity on conventional MRI,hyperintensi-ty on DWI and hyperdensity on CT;15 patients (15/17,88.2%)with one or more than one appearances including multiple lesions, the lesion extending into surrounding structures and Waller degeneration.Conclusion Some clinical and imaging features of the basal ganglia germinoma are characteristic,and CT and MRI shows higher diagnostic value for the disease.
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Purpose To evaluate the value of multi-slice spiral computed tomography (MSCT) scan in the diagnosis of papillary renal cell carcinoma. Materials and Methods A retrospective study was conducted on the findings of plain CT scan and triphasic dynamic contrast enhanced CT scan of 23 patients with papillary renal cell confirmed pathologically, and further contrasted with the findings of 96 patients with clear cell renal cell carcinoma at corresponding phases in such aspects as cystic degeneration, enhancement degree and pattern (homogeneous, peripheral or heterogeneous) and tumor spreading pattern (perinephric invasion, lymphadenopathy or venous invasion). Results The degree of enhancement CT value for both diseases showed statistical significance in corticomedullary phase, parenchymal phase and excretory phase (t=9.70, 8.08, 5.92;P0.05). Conclusion Papillary renal cell carcinoma shows homogeneous enhancement, seldom cystic degeneration or necrosis on MSCT scan, which is helpful for the differential diagnosis from clear cell renal cell carcinoma.