MR conventional sagittal-axial plane and coronal iterative decomposition of water and fat with echo asymmetry and least-squares estimation technique in diagnosis of extraforaminal lumbar disc herniation / 中国医学影像技术

Objective To compare the diagnostic value of MR conventional sagittal-axial plane and coronal iterative decomposition of water and fat with echo asymmetry and least-squares estimation (IDEAL) technique in diagnosis of extraforaminal lumbar disc herniation (ELDH).Methods Totally 32 patients with ELDH confirmed by surgery underwent preoperative MR sagittal-axial plane and coronal IDEAL scanning.Disc herniation,nerve involvement,nerve angle,nerve deep impression,nerve thinning or truncation,nerve adhesion unsmooth and nerve swelling were analyzed between the two methods.Results Disc herniation,nerve involvement and number of reduction or disappearance of surrounding fat had no statistically significant differences between the two methods (all P＞0.05),while nerve angle,nerve deep impression,nerve thinning or truncation,nerve adhesion unsmooth and nerve swelling were significantly different between the two methods (all P＜0.05).Surgical operation confirmed that 32 patients with nerve compression were consistent with findings by IDEAL.Conclusion MR sagittal-axial plane and coronal IDEAL both can be used to diagnose ELDH,but their display ability of nerve compression is different.Coronal IDEAL is superior to conventional sagittal-axial plane and is an effective imaging method,being able to display nerve compression more intuitively,clearly and comprehensively.

A case of extrapancreatic solid pseudopapillary tumor in the retroperitoneum.

Solid pseudopapillary tumor (SPT) is an uncommon epithelial neoplasm of the pancreas. Very rarely it has also been described outside the pancreas. We report such a case located in the right adrenal site in a 37-year-old woman, describing the computed tomography features of the neoplasm. The image features of extrapancreatic SPT in our case are compatible with those of conventional pancreatic SPTs. Although it is still difficult to make an accurate preoperative diagnosis of an extrapancreatic SPT, the presence of an encapsulated solid and cystic mass especially with widely distributed calcifications is at least suggestive of the diagnosis. Being aware of the rare occurrence of primary SPT outside the pancreas may help improve the diagnostic specificity of the disease.

Aggressive Angiomyxoma: an Unusual Presentation

Aggressive angiomyxoma is an uncommon mesenchymal myxoid tumor that is characterized by slow growth and frequent local recurrence. It is currently regarded as a nonmetastasizing tumor. We describe a case of recurrent aggressive angiomyxoma with invasion into the veins including the inferior vena cava and the right atrium and with pulmonary metastases. Our case, together with those unusual cases documented in previous reports, may lead to a reappraisal of the nature of aggressive angiomyxoma.