Subject(s)
Abdominal Neoplasms , Myelolipoma , Abdominal Neoplasms/pathology , Aged , Female , Humans , Myelolipoma/pathologySubject(s)
Blindness/etiology , Cellulitis/complications , Facial Dermatoses/complications , Ophthalmoplegia/etiology , Streptococcal Infections/complications , Aged , Anti-Bacterial Agents/therapeutic use , Cellulitis/drug therapy , Facial Dermatoses/drug therapy , Facial Dermatoses/microbiology , Humans , Male , Streptococcal Infections/drug therapy , Streptococcus pyogenes/isolation & purification , Tomography, X-Ray ComputedSubject(s)
Embolism, Air/etiology , Gastric Dilatation/complications , Portal Vein , Female , Humans , Middle AgedSubject(s)
Fistula/diagnostic imaging , Mesentery , Peritoneal Diseases/diagnostic imaging , Umbilicus , Humans , Infant , Male , UltrasonographyABSTRACT
Epithelioid hemangioendothelioma of the liver is a rare primary malignant tumor of vascular origin. It most frequently occurs in middle age adults and clinical findings are non-specific. Histological diagnosis may be difficult to achieve with lesions containing a large myxoid component, and immunohistochemical staining is required. A few imaging features may suggest the correct diagnosis, and radiologists should be familiar with these findings. We will illustrate the potential role of PET-CT at the time of initial presentation. Prognosis is variable and optimal management is based on a case by case analysis, ranging from clinical and imaging follow-up to liver transplantation.
Subject(s)
Hemangioendothelioma, Epithelioid/diagnosis , Liver Neoplasms/diagnosis , Adolescent , Adult , Biopsy, Needle , Female , Fluorodeoxyglucose F18 , Follow-Up Studies , Hemangioendothelioma, Epithelioid/diagnostic imaging , Hemangioendothelioma, Epithelioid/pathology , Humans , Immunohistochemistry , Liver/pathology , Liver Neoplasms/diagnostic imaging , Liver Neoplasms/pathology , Magnetic Resonance Imaging , Middle Aged , Positron-Emission Tomography , Prognosis , Radiography, Abdominal , Radiopharmaceuticals , Time Factors , Tomography, X-Ray Computed , UltrasonographySubject(s)
Antineoplastic Agents/therapeutic use , Gastrointestinal Hemorrhage/etiology , Gastrointestinal Stromal Tumors/diagnostic imaging , Gastrointestinal Stromal Tumors/secondary , Gastrointestinal Stromal Tumors/therapy , Ileal Neoplasms/diagnostic imaging , Ileal Neoplasms/therapy , Ileum/surgery , Liver Neoplasms/diagnostic imaging , Liver Neoplasms/secondary , Liver Neoplasms/therapy , Piperazines/therapeutic use , Pyrimidines/therapeutic use , Tomography, X-Ray Computed , Aged, 80 and over , Benzamides , Combined Modality Therapy , Contrast Media/administration & dosage , Female , Follow-Up Studies , Gastrointestinal Hemorrhage/diagnostic imaging , Gastrointestinal Stromal Tumors/pathology , Humans , Ileal Neoplasms/pathology , Ileum/pathology , Imatinib Mesylate , Liver Neoplasms/pathologySubject(s)
Cerebrospinal Fluid Rhinorrhea/diagnostic imaging , Dura Mater/diagnostic imaging , Ethmoid Bone/diagnostic imaging , Image Processing, Computer-Assisted , Radiographic Image Enhancement , Tomography, X-Ray Computed , Cerebrospinal Fluid Rhinorrhea/surgery , Diagnosis, Differential , Dura Mater/surgery , Ethmoid Bone/surgery , Female , Humans , Middle Aged , Pneumocephalus/diagnostic imaging , Pneumocephalus/surgery , Rupture, SpontaneousABSTRACT
BACKGROUND AND PURPOSE: MR diagnostic of postoperative recurrent cholesteatomas is difficult. Our purpose was to compare multishot fast spin-echo periodically rotated overlapping parallel lines with enhanced reconstruction (PROPELLER) diffusion-weighted MR imaging (DWI) with array spatial sensitivity encoding technique (ASSET) single-shot echo-planar DWI and late postgadolinium T1-weighted MR imaging for the detection of postoperative recurrent middle ear cholesteatomas with a 3T imaging unit. MATERIALS AND METHODS: Thirty-five patients with suggested postoperative recurrent middle ear cholesteatoma underwent 3T MR imaging with PROPELLER DWI, ASSET echo-planar DWI, and late postgadolinium T1-weighted MR imaging. Three radiologists (2 seniors, 1 fellow) analyzed unlabeled images for visualization of recurrence. Interobserver and intraobserver agreement was assessed by using the Cohen kappa statistic test. Sensitivity, specificity, and predictive value were assessed for the 3 observers. RESULTS: Nineteen recurrent cholesteatomas were diagnosed. PROPELLER interobserver agreement was very good (1, 0.89, 0.89) among the 3 observers. Intraobserver agreement between PROPELLER and T1-weighted imaging was very good to moderate (0.88, 0.57, 0.58). PROPELLER DWI provided less interobserver variability than other sequences, and the best sensitivity, specificity, and predictive value. CONCLUSIONS: On a 3T imaging unit, multishot fast spin-echo PROPELLER DWI allows an easier detection of postoperative recurrent middle ear cholesteatoma than T1-weighted imaging by reducing artifacts and by its better contrast. DWI with PROPELLER is diagnostically robust and accurate.