Imaging features of dermatofibrosarcoma protuberans.

Aims: The study highlights diffusion-weighted imaging (DWI) and dynamic enhancement features of DFSP and characterizes unenhanced and enhanced computed tomography (CT) and magnetic resonance imaging (MRI) scans. Settings and Design: Image findings and clinical histories of 23 patients with DFSP were reviewed. Nine patients underwent CT before and after intravenous administration of contrast material. MRI was performed for 17 patients. CT and MRI findings were analyzed using location, size, edge, shape, infiltration sign, density and signal enhancement mode, and degree. Results: Patients showed 26 superficial and one deep lesion. Ten superficial lesions bulged onto the skin surface. Fourteen lesions were well-defined and 13 ill-defined. All lesions were nodular, with nine being multilobular. Thirteen showed infiltration to adjacent skin, fat, and fascia. Seven lesions on CT were iso- or hypo-dense to muscle without calcification. Contrast-enhanced CT showed inhomogeneous moderate and progressive enhancement in the arterial phase. Small tortuous vessels were seen in the arterial phase in one case. Sixteen tumors displayed signals that were similar to muscle by T1WI. Ten lesions were either hyper-intense to muscle or iso-intense to fat; the deep DFSP was hypo-intense by T2WI. All lesions were hyper-intense homogeneously or heterogeneously under fat-suppressed T2WI. Twelve superficial lesions showed high-intermediate signal, and one deep lesion showed low-intermediate signal with DWI. Seven cases showed low signal diffusion coefficient (ADC) images. Dynamic enhancement and signal intensity-time (SI-T) curves of four tumors showed rapid SI increases followed by steady or slightly rising SI. All lesions showed inhomogeneous, progressive enhancement in the arterial phase. Conclusions: This report is the first on dynamic curves and highlights DWI and T2WI features of DFSP. DFSP can be correctly diagnosed by combining a patient's clinical manifestations with imaging characteristics.

Application of 1H-MRS in end-stage renal disease with depression.

BACKGROUND: To investigate the metabolite changes in the frontal lobe of the end-stage renal disease (ESRD) patients with depression using proton magnetic resonance spectroscopy (1H-MRS). METHODS: All subjects were divided into three groups: ESRD patients with depression (30 cases), ESRD patients without depression (27 cases) and 32 normal subjects. ESRD with depression patients were further divided into two groups according to the severity of depression: 14 cases of ESRD with severe depression group (Hamilton Depression Rating Scale (HAMD) score ≥ 35) and 16 cases of ESRD with mild to moderate depression group (20 ≤ HAMD score<35). 1H-MRS was used in brain regions of all subjects to measure N-acetylaspartate/creatine (NAA/Cr), choline-containing compounds/creatine (Cho/Cr) and myo-inositol/creatine (MI/Cr) ratios of the frontal lobe. Correlations between the metabolite ratio and HAMD score as well as clinical finding were confirmed, respectively. RESULTS: ESRD patients with depression showed lower NAA/Cr ratio and higher Cho/Cr ratio compared with ESRD patients without depression and normal subjects. NAA/Cr ratio was negatively correlated with the HAMD score. Cho/Cr ratio was positively correlated with the HAMD score. There were positive correlations between NAA/Cr ratio and blood urea notrogen (BUN) as well as creatinine (CRE) concentration, respectively. There was a negative correlation between Cho/Cr ratio and sodium concentration. The Cho/Cr ratio was positively correlated with the potassium concentration. CONCLUSIONS: MR spectroscopy identified some metabolite changes in ESRD patients with depression.

The imaging features of cerebral septic infarction in two patients with infective endocarditis.

BACKGROUND: Neurologic complications are frequently seen in infective endocarditis (IE) and were identified in about 70% of patients with IE. However, the imaging features of the cerebral septic infarction were less investigated. PURPOSE: To demonstrate the imaging features of the cerebral septic infarction of IE. MATERIAL AND METHODS: Two patients were clinically diagnosed as IE according to the modified Duke criterion. We studied their imaging profiles and reviewed the literature of the imaging features of neurologic complications of IE. RESULTS: The critical features are multiple ischemic and hemorrhagic lesions, most of which locate at the cortical-medullary junction. The septic infarctions are irregular patchy in shape and have characteristic imaging features indicating complications of IE. CONCLUSION: Magnetic resonance imaging (MRI) with different sequences can detect the features and provide clinical evidence to physicians to make the correct diagnoses and then the treatment plans.