The MRI features of endometrial stromal sarcoma / 实用放射学杂志

Objective To analyze the MRI features of endometrial stromal sarcoma(ESS)and to explore its value in clinical application. Methods Thirteen patients with histologically proven ESS were collected.All cases underwent non-contrast MRI scan and DWI,10 of which underwent contrast-enhanced MRI scan.The MRI features were discussed in combination with the pathological results after operation.Results In all lesions,6 lesions were located in endometrial cavity,4 in myometrium,1 in right wall of uterus and broad ligament,1 in cervical canals,and 1 in the top segment of vagina and pelvic.Plain MRI showed the lesions with hypointensity on T 1 WI and mixed hyperintensity on T 2 WI,which exhibited polypoid or multiple nodular masses.DWI showed the lesions with different hyperintensity.In 10 patients with post-enhanced scanning,moderate or marked heterogeneous enhancement of the masses were demonstrated,in which 6 presented plateau pattern of time-signal enhanced curve and 4 were persistent pattern.Conclusion ESS had some characteristic features on MRI,and DWI and dynamic contrast-enhanced examination can help to improve the diagnosis and differential diagnosis.

The MRI features of endometrial stromal sarcoma / 实用放射学杂志

Objective To analyze the MRI features of endometrial stromal sarcoma(ESS)and to explore its value in clinical application. Methods Thirteen patients with histologically proven ESS were collected.All cases underwent non-contrast MRI scan and DWI,10 of which underwent contrast-enhanced MRI scan.The MRI features were discussed in combination with the pathological results after operation.Results In all lesions,6 lesions were located in endometrial cavity,4 in myometrium,1 in right wall of uterus and broad ligament,1 in cervical canals,and 1 in the top segment of vagina and pelvic.Plain MRI showed the lesions with hypointensity on T 1 WI and mixed hyperintensity on T 2 WI,which exhibited polypoid or multiple nodular masses.DWI showed the lesions with different hyperintensity.In 10 patients with post-enhanced scanning,moderate or marked heterogeneous enhancement of the masses were demonstrated,in which 6 presented plateau pattern of time-signal enhanced curve and 4 were persistent pattern.Conclusion ESS had some characteristic features on MRI,and DWI and dynamic contrast-enhanced examination can help to improve the diagnosis and differential diagnosis.

The application value of apparent diffusion coefficient in monitoring the response to chemotherapy of primary bone lymphoma / 中华放射学杂志

Objective To investigate the application value of apparent diffusion coefficient (ADC) in monitoring the response to chemotherapy of primary bone lymphoma(PBL). Methods Sixteen consecutive patients with PBL confirmed by pathology were enrolled in this retrospective study.All patients underwent a controlled MRI including a DWI sequence before chemotherapy and after the first chemotherapy session. The ADC values of PBL lesions were measured before and after the first chemotherapy session. All patients were divided into responders and non-responders groups according to the combined response assessment criteria. The difference in ADC values between the responders and non-responders groups before and after chemotherapy and the rate of change of ADC values were compared using Wilcoxon test. The paired t test was used to compare ADC values before and after chemotherapy in each group. Results Twenty-three cases of PBL lesions were diagnosed in 16 patients before the chemotherapy. After the first chemotherapy session, 10 patients (12 lesions) and 6 patients (11 lesions) were categorized into the responder and non-responder group, respectively. The mean pre-treatment ADC value of the responder group and non-responder group were 737.1(301.7,928.4)× 10-6mm2/s and 749.2(624.4, 1186.5)× 10-6mm2/s, which had no statistically significant difference (Z=1.51,P=0.132). The mean post-treatment ADC value of the responder group and non-responder group were 1843.0(721.5,2745.8)× 10-6mm2/s and 1026.3(382.8,2100.8)× 10-6mm2/s, which had no statistically significant difference (Z=-1.75,P=0.079). The post-treatment ADC value of the responder group significantly increased [156.7(60.9,227.5)%] while the post-treatment ADC value of the non-responder group slightly increased [31.7(-44.7,147.4)%]. The difference in the percentage changes of ADC values in the responder and non-responder groups before and after the treatment was statistically significant(Z=-3.66,P<0.001). Conclusion The measurement of the percentage changes of ADC values enable a good short-term response evaluation for PBL.

Application of susceptibility weighted imaging in evaluating the TBI severity / 实用放射学杂志

Objective To evaluate the utility of susceptibility weighted imaging (SWI)in the evaluation of traumatic brain injury (TBI)severities.Methods 20 mild TBI patients,20 moderate TBI patients and 20 severe TBI patients were collected.The involving brain regions,numbers and areas of hemorrhagic lesions detected by SWI were analyzed and the differences of each group were com-pared.The correlation analysis between Glasgow coma scale(GCS)scores and each above parameters were underwent.Results The differences of involving regions’number,lesions’number,lesions’area were statistically significant(P <0.05 ).Severe TBI group got the maximum number of involving regions,lesions,and the largest areas,followed by moderate group and mild group.The GCS were highly negatively correlated with the number of involving regions,number of lesions,areas of lesions detected by SWI.In descending order of relevance:GCS with areas detected by SWI(r=-0.982,P=0.000),the number of lesions detected by SWI(r=-0.941,P=0.000),the number of involving regions detected by SWI(r=-0.900,P=0.000).Conclusion The clinical applications of SWI in diagnosing TBI and evalua-ting the TBI severity is of great significance.

Diffusion-weighted imaging in differentiating benign and malignant lesions of the tongue / 实用放射学杂志

Objective To observe the value of diffusion-weighted imaging (DWI)and ADC value in the differential diagnosis of benign and malignant lesions of the tongue.Methods 75 patients with lingual lesions,including 32 benign lesions and 43 malignant tumors,underwent conventional MRI,contrast-enhanced MRI and DWI with b values of 0 and 1 000 s/mm2 before therapy.ADC maps were reconstructed,and the ADC values of the lingual lesions were calculated.Diagnostic performance of ADC was compared using receiver operating characteristic curves (ROC).Results The mean ADC values of benign lesions and malignant tumors were (1.84±0.47)×10 -3 mm2/s and (1.12±0.21)×10 -3 mm2/s,respectively.Malignant tumors had lower ADCs than benign lesions (t=-8.038,P <0.000).The areas under the ROC curves of ADC diagnosing benign and malignant lesions of the tongue was 0.957±0.022.The optimal cutoff values of ADC for differentiating benign and malignant lesions of the tongue was 1.30 × 10 -3 mm2/s with sensitivity of 90.7%,specificity of 93.8% and accuracy of 92%.And ADC had a high consistency compared with pathological results (Kappa values were 0.813).Conclusion Different features between benign and malignant lesions of the tongue are able to be identified with DWI,which can be applied as a complementary tool in the detection of benign and malignant lesions of the tongue.

Analysis of misdiagnosis and MR findings of atypical invasive pituitary adenoma / 实用放射学杂志

Objective To investigate MR findings and analysis of misdiagnosis of atypical invasive pituitary adenoma.Methods The MR findings of twenty cases of atypical invasive pituity adenomas confirmed by pathology were reviewed ,which were misdiag-nosed as chordomas or meningiomas.Results All the twenty cases showed iso-or slightly hypo-signal on T1 WI,iso-or slightly hy-per-signal on T2 WI;Enhanced scan displayed heterogeneous enhancement.The dynamic enhancement curve showed rapid enhance-ment phase.The bilateral cavernous sinuswere infringed in nine cases,in which the pituity and pituity stalk were not well seen. Among the twenty cases,twelve cases with suprasellar and anterior cranial fossa extension were misdiagnosed as meningiomas;eight cases with clival destruction were misdiagnosed as chordomas.Conclusion The MR features of atypical invasive pituity adenomas are various.In order to avoid misdiagnosis,a comprehensive analysis should be based on a variety of signs.