Adenomyosis of the Uterus: Recognition of a Characteristic Enhancement Pattern on Contrast-enhanced Dynamic MRI

PURPOSE: To analyze the enhancement patterns of adenomyosis and evaluate the usefulness of dynamic MR imaging in detecting adenomyosis. MATERIALS AND METHODS: Dynamic MR imaging finding in 46 women with adenomyosis were analyzed retrospectively. Dynamic MR imaging was obtained in each patient. Fifteen consecutive FLASH images were obtained before, immediately after and 15, 30, 45, 90 second and 5 minute after bolus injection of Gd-DOTA. Signal intensities of adenomyosis and outer myometrium and standard deviations of image noise were measured using an electronic cursor. Contrast-to-noise ratio (C/N) of the lesion to outer myometrium were calculated as follows ; (signal intensity of outer myometrium-signal intensity of adenomyosis)/(standard deviation) of noise signal intensity. RESULTS: The mean signal intensity of adenomyosis was higher than surrounding outer myometrium before and immediately after contrast injection. On 15, 30, 45, 90 second, and 5 minute after injection the signal intensity of adenomyosis was lower than that of surrounding outer myometrium (p < 0.05). The mean C/N values between adenomyosis and surrounding myometrium on precontrast scan, immediate postcontrast, and 15, 30, 45, 90 second and 5 minute delayed images were 3.20, 5.03, 6.14, 6.87, 7.13, 7.78, 38.59, respectively. On T2-weighted images, the mean C/N value between adenomyosis and surrounding myometrium was 16.7. Mean C/N value between adenomyosis and surrounding myometrium on delayed images was significantly higher than those of other dynamic & T2-weighted images(p<0.05). CONCLUSION: Dynamic MR imaging is very useful in the evaluation of the enhancement pattern and especially in detection of adenomyosis because the mean C/N value between adenomyosis and surrounding myometrium on delayed images are higher than that of T2-weighted images.

Tracheal Deviation in Thy roid Lesions: Correlation with Chest Radiograph

PURPOSE: To evaluate the prevalence and degree of tracheal deviation seen on chest PA radiographs of thyroid lesions and to correlate these findings with their size, volume, pattern (localized or diffuse), location, and constitution . MATERIALS AND METHODS: Between May 1995 and July 1998, tracheal deviation seen on chest PA radiographs was retrospectively reviewed in 179 consecutive cases in which a thyroid lesion was seen on ultrasonography and/or CT of the thyroid. The criterion of tracheal deviation was more than 3mm. Thyroid lesions were classified as diffuse or localized according to their pattern; as central, marginal or borderline on the basis of their location, and as cystic, solid or mixed, depending on their constitution. RESULTS: Tracheal deviation was seen in 53 cases (29.6%, n=179); mean deviation was 5.6mm (3 -27 mm). Its incidence increased with lesion size (p0.05). The volume of the former type was measured and the incidence and degree of tracheal deviation was found to increase with lesion volume (p0.05). The most common location was borderline (n=30, 65.2 %), followed by central (n=12, 26.1%), and marginal (n=4, 8.7%). The most common type by constitution was solid (n=32, 69.6 %), followed by cystic (n=10, 21.7 %), and mixed type (n=4, 8.7 %) (p>0.05). CONCLUSION: Chest PA radiography revealed tracheal deviation of thyroid lesion in 53 cases (29.6 %). The incidence and degree of deviation increased with increasing size and volume of the lesion, but deviation did not correlate with the pattern (localized or diffuse), location or constitution of the lesion.

Tracheal Deviation in Thy roid Lesions: Correlation with Chest Radiograph

PURPOSE: To evaluate the prevalence and degree of tracheal deviation seen on chest PA radiographs of thyroid lesions and to correlate these findings with their size, volume, pattern (localized or diffuse), location, and constitution . MATERIALS AND METHODS: Between May 1995 and July 1998, tracheal deviation seen on chest PA radiographs was retrospectively reviewed in 179 consecutive cases in which a thyroid lesion was seen on ultrasonography and/or CT of the thyroid. The criterion of tracheal deviation was more than 3mm. Thyroid lesions were classified as diffuse or localized according to their pattern; as central, marginal or borderline on the basis of their location, and as cystic, solid or mixed, depending on their constitution. RESULTS: Tracheal deviation was seen in 53 cases (29.6%, n=179); mean deviation was 5.6mm (3 -27 mm). Its incidence increased with lesion size (p0.05). The volume of the former type was measured and the incidence and degree of tracheal deviation was found to increase with lesion volume (p0.05). The most common location was borderline (n=30, 65.2 %), followed by central (n=12, 26.1%), and marginal (n=4, 8.7%). The most common type by constitution was solid (n=32, 69.6 %), followed by cystic (n=10, 21.7 %), and mixed type (n=4, 8.7 %) (p>0.05). CONCLUSION: Chest PA radiography revealed tracheal deviation of thyroid lesion in 53 cases (29.6 %). The incidence and degree of deviation increased with increasing size and volume of the lesion, but deviation did not correlate with the pattern (localized or diffuse), location or constitution of the lesion.