CT and MR Findings of the Telangiectatic Osteosarcoma Arising from the Skull: Case Report

Telangiectatic osteosarcoma is rare malignant tumor causing aggressive bone destruction, though the skull is very rarely involved. We report a case in which the condition affected the skull of a 17-year-old male, involving the parietal bone and with intracranial and extracranial extension. CT and MR images depict an osteolytic lesion of the right parietal bone and an enhancing solid mass in the intracranial and extracranial portions. Matrix calcifications, periosteral reaction, and multiple fluid-fluid levels are seen within the masses.

The study of identification methods on Chinese Han nationality adult skull CT films / 中国法医学杂志

objective To establish a method to do identification of Chinese Han nationality adult skull CT films.Methods Collect skull CT films of Chinese Han nationality adult according including criterion.We use the image processing and measure function of efilms 2.0 to do observation and measurement for the 12 identification indexes.And more,we make the classific code for each result of the indexes.Then we make a 12-bit identification code for the skull CT films by order.We use SPSS 13.0 to do statistical analysis on the difference of the age and sex by using the data we had collected.Last we use discrimination power formula to calculate the discrimination power of the individual index and total indexes.Results There are six indexes among twelve identification indexes have sexual differentiation;The discrimination power of the twelve indexes adding up together is 99.9997997%.Conclusion We make sure that there are 12 indexes for skull CT films of Chinese Han nationality adult in this study.Using the index classific code we carry out the identification of Chinese Han nationality adult skull CT films.

Postnatal Development of the Anterior Skull Base and Nasal Septum: CT Study

PURPOSE: To know the normal CT appearance of the anterior skull base and nasal septum after birth. MATERIALS AND METHODS: Coronal CT scans with a helical mode were performed from the nasal bone to the sphenoid sinus in 99 children whose ages ranged from 27 days to 14 years. We investigated the CT appearance of the developing anterior skull base and nasal septum with particular attention to the anteroposterior length of the anterior skull base and the ossification patterns of the cribriform plate, perpendicular plate, crista galli, and vomer. RESULTS: The anteroposterior length of the anterior skull base statistically significantly increased with age. The cribriform plate showed partial or complete ossification in at least one segment at more than 3 months of age and in all three segments at more than 6 months of age. Ossification of the cribriform plate occurred earlier in the middle segment than in the anterior and posterior segments. It began exclusively in the region of the lateral mass of the ethmoid and proceeded medially toward the crista galli. Partial ossification of the perpendicular plate was noted as early as 9 months of age, and complete ossification as early as 13 months of age. All children at 18 months and older showed at least partial ossification of the perpendicular plate. Partial ossification of the crista galli was noted as early as 27 days of age, and complete ossification as early as 3 months of age. CT showed complete ossification of the crista galli in all but two children at 6 months and older. The superior aspect of the vomer exhibited a V- or Y-shape on all CT scans in 66%(65/99) of children at any age. It appeared as an undivided single lump anteriorly and a V or Y posteriorly in 34%(34/99). CONCLUSION: Knowledge of the normal developing patterns of ossification of the anterior skull base and nasal septum could help prevent errors in interpreting CT scans in this region, especially in infants and young children.

Imagings of Skull Vault Lesions

Lesions of the skull vault are often incidentally encountered during in plain radiography, CT, and MR imaging of the brain and benign lesions are more common than primary malignancies. The usefulness of plain skull films is limited, but when combined with CT or MRI, there is a high probability of accurate diagnosis. The aim of this essay is to describe a wide range of cranial lesions and to illustrate their distinguishing features.

Normal Development of Sutures and Synchondroses in the Central Skull Base: CT Study

PURPOSE: To evaluate the developmental patterns of the sutures and synchondroses in the central skull base. MATERIALS AND METHODS: We evaluated the CT scans of 109 children(age range, 29 days to 15 years) with no skull base abnormality who had undergone axial CT of the skull base with 1-mm collimation. Using a five-tier scheme, we analyzed the developmental patterns of the 18 sutures and synchondroses related to the sphenoid and occipital bones. RESULTS: Fusion of the sutures and synchondroses related to the sphenoid bone progressed rapidly during the first two years. Thereafter, changes in the sphenoid bone were dominated by pneumatization of the sphenoid sinus. Fusion of the synchondroses within the sphenoid body, including intersphenoidal, intrapresphenoidal, and intrapostsphenoidal synchondrosis occurred early and in most cases was graded <=4. Fusion of the sphenosquamosal, sphenoethmoidal, and frontosphenoidal sutures was delayed, and residual sclerosis was a common finding. Except for Kerckring-supraoccipital synchondrosis, fusion of the six sutures and synchon-droses related to the occipital bone occurred more gradually than that of those related to the sphenoid bone. Among these, fusion of the occipitomastoidal suture and petro-occipital synchondrosis was the last to occur. CONCLUSION: A knowledge of the developmental patterns of sutures and synchondroses can help differentiate normal conditions from those such as fracture, osseous dysplasia, or congenital malformation, which are abnormal. Our results provide certain basic informations about skull base maturity in children.

Atypical CT and MR Features of Chondroid Chordoma at the Base of the Skull: A Case Report

We report a case of chondroid chordoma without calcification in which T2-weighted MR images revealed homogeneous high signal intensity. The tumor was located in the left middle cranial fossa extending to the cerebellopontine angle and with displacement of the pituitary gland to the right side. Precontrast CT scans showed a homogeneous low -density mass, without calcification. T1-weighted MR images of the mass demonstrated relatively homogeneous low signal intensity, T2-weighted images showed homogeneous high signal intensity, and post -contrast T1-weighted images revealed somewhat heterogeneous enhancement.

Eagle's Syndrome: A Case Report

Eagle's syndrome is a rare condition associated with recurrent throat pain, foreign body sensation and odynophagia. It is caused by elongation of the styloid process or calcification of the stylohyoid process. We present the clinical and radiologic findings of a case of Eagle's syndrome.

Metastatic Thy roid Carcinoma of Jugular Foramen Simulating Glomus Jugulare Tumor: A Case Report

We report a case of hyper vascular metastatic thyroid carcinoma of the jugular fora-men simulating a glomus jugulare tumor. Computed tomography(CT) revealed areas of irregular lytic bony destruction of the left jugular foramen, as well as characteristic in vasion routes of a glomus jugulare tumor. Magnetic resonance(MR) imaging and angiography demonstrated a hypervascular mass similar to a glomus tumor.

CT of Normal Variations of the Minute Central Skull Base Foramina

PURPOSE: To evaluate the CT appearance of normal variations in the minute central skull base foramina in infants and children. MATERIALS AND METHODS: One hundred and fourteen children under the age of 17 years without skull base abnormality underwent CT scanning. A high spatial frequency algorithm was used, and contiguous axial scanning parallel to the orbitomeatal line was performed from the foramen magnum to the orbital roof, with a 1-mm slice thickness. The presence or absence of eight foramina, pseudoforamina, or ossification centers including anterior presphenoidal foramen, posterior presphenoidal foramen, rostro-orbital pseudoforamen, intralateromedial postsphenoidal pseudoforamen, intrapostsphenoidal pseudoforamen, spheno-occipital pseudo-foramen, canalis basilaris medianus and intrasynchondral ossified bodies was analysed according to age. The presence of foramina or pseudoforamina was indicated if a ring-shaped structure was seen on two or more CT scans at the location anatomically predicted, and intrasynchondral ossified bodies were indicated if linear or dot-like structures with high attenuation accompanied spheno-occipital synchondrosis. RESULTS: CT indicated that within a certain age range, various kinds of foramina, pseudoforamina, and ossification centers were frequent. The anterior presphenoidal foramen was most commonly seen in infants aged 1-12 months (16/17, 94 %); the posterior presphenoidal foramen in children less than 2 years old(27/37, 73 % ) ; the rostro-orbital pseudoforamen in children aged 2 -5 years (9/17, 53%); intrapostsphenoidal pseudoforamen in children 6 -12 years old(20/37, 54%) and spheno-occipital pseudoforamen and intrasynchondral ossified bodies in children aged 13 -16 years. The canalis basilaris medianus was identified in about 20 % of all subjects regardless of age. CONCLUSION: Development of the minute central skull base foramina varied greatly according to age. Knowledge of the CT appearances of such embryologic variants of the central skull base should not only help Provide an understanding of complex skull base anatomy but also identify abnormal skull base development.

Chordoma versus Chondrosarcoma of the Central Skull Base: MR and CT Findings

PURPOSE: It is known that due to both their imaging and pathologic features, the accurate differentiation ofchondrosarcoma from chordoma is difficult. Through an analysis of MR and CT findings, this study aims to determinethe differential points between these two tumors. MATERIALS AND METHODS: In 21 patients, CT and MR imagingstudies of chordoma(n=12) and chondrosarcoma(n=9) at the base of the skull were retrospectively reviewed.Diagnosis had been established by histologic examination of surgically removed specimens. Eleven of the chordomaswere subclassified as 'conventional' and one as 'chondroid'; eight chondrosarcoma were 'conventional' andone was 'myxoid'. Four chordoma patients underwent CT and MR ; in six, only MR was performed ; and in two, onlyCT. Eight chondrosarcoma patients underwent both CT and MR, while in one, only CT was performed. All scans wereretrospectively evaluated for the location(midline/off-midline), direction of extension, margin and shape, bonydestruction and calcification, MR signal intensity and enhancement patterns of the tumors. Degree of calcificationwas graded from I to III. RESULTS: The epicenter of the mass of ten chordomas (83%) was midline, in twochondrosarcomas(22%), this was off-midline. Foci of calcification were observed in three of eleven chordomas(27%),and heavy calcification (grade III) was observed in one. In contrast to these findings, foci of calcificationswere observed in eight of nine chondrosarcomas (89%) and grade III calcification was observed in five. In bothtumors, calcification was coarse. Between the two kinds of tumor, there were no significant difference in MRsignal intensity and enhancement patterns, margin and shape, or direction of extension. CONCLUSIONS: Although MRand CT findings were similar in both types of tumor, location and degree of calcification may be features whichusefully distinguish chordoma from chondrosarcoma.

Skull-Base Foramina of the Middle Cranial Fossa: Assessment of Normal Variation with High-Resolution CT

PURPOSE: To recognize foraminal variants of the foraminae of the skull base in the middle cranial fossa, and to thus understand and distinguish normal and potentially abnormal structures. MATERIALS AND METHODS: We analysed 163 patients without intracranial disease who had undergone CT scanning. These comprised 82 men and 81 women with a mean age of 39 years (range, 4|73 years). HRCT was performed, using a GE 9800 scanner. All CT scans were obtained 6-7 slices at the base of the skull, with 1.5 mm collimation at 1.5 mm intervals parallel to the infraorbital line. We analysed the foraminae by closesly correlating imaging findings and established anatomic knowledge. RESULTS: In 45 cases (27.6 %) the foramen ovale was 5-10 mm in diameter and asymmetrical. Deficiency of the medial bony wall including persistent foramen lacerum medius was seen in five cases (3.1 %). Confluence of the foramen ovale and the foramen spinosum was seen in 13 cases (8 %) and confluence of the foramen ovale and the foramen of Vesalius in 23 (14.1 %). Posterolateral groove for the accessory meningeal artery was observed in 36 cases (22 %). The foramen spinosum was asymmetrical in 42 cases (25.8 %). A small or absent foramen spinosum with a larger ipsilateral foramen ovale was observed in 11 cases (6.7 %). Medial bony defect was seen in 16 cases (9.8%). The foramen spinosum was absent in four cases (2.5 %). In 74 cases (45.4 %), the foramen of Vesalius was absent ; it was present unilaterally and bilaterally in 55 (33.7 %) and 34 cases (20.9 %), respectively. Five cases showed duplicated foramina. Canaliculus innominatus was seen in 14 cases (8.9 %) and was present bilaterally in three (1.8 %). CONCLUSION: HRCT clearly delineates bony structure and is well able to display the rich spectrum of anatomic variation found in the base of the skull. The recognition of these normal variants will result in a better understanding of skull base neurovascular anatomy and diminish speculation as to their true nature during the interpretation of CT images.