ABSTRACT
Vertebral hemangiomas are the most common benign lesion of the spine which are often an asymptomatic incidental finding. However, a few hemangiomas are aggressive and characterized by bone expansion and extraosseous extension into the paraspinal and epidural spaces. We report the case of a patient presenting an aggressive vertebral hemangioma causing back pain and bilateral numbness of the legs. Among various treatment modalities, a minimally invasive percutaneous sclerotherapy procedure using ethanolamine oleate under computed tomography and fluoroscopic guidance was safely and successfully performed with good clinical outcomes.
ABSTRACT
INTRODUCTION: The clinical differentiation of Parkinson's disease (PD) from multiple system atrophy (MSA) and progressive supranuclear palsy (PSP) may be challenging, especially in their early stages. The aim of this study was to evaluate the utility of apparent diffusion coefficient (ADC) measurement to distinguish among these degenerative disorders. METHODS: Twenty-five MSA, 20 PSP, and 17 PD patients and 18 healthy controls were retrospectively studied. Axial diffusion-weighted and T2-weighted images were obtained using a 3-T MR system. Regions of interest (ROIs) were precisely placed in the midbrain, pons, putamen, globus pallidus, caudate nucleus, thalamus, superior cerebellar peduncle, middle cerebellar peduncle, cerebellar white matter, and cerebellar dentate nucleus, and the regional ADC (rADC) value was calculated in each ROI. RESULTS: In MSA, rADC values in the pons, middle cerebellar peduncle, cerebellar white matter, and cerebellar dentate nucleus were significantly higher than in PSP, PD, and controls. Furthermore, rADC values in the posterior putamen were significantly higher in MSA than in PSP and controls. In PSP, rADC values were significantly higher in the globus pallidus and midbrain than in MSA, PD, and controls. Furthermore, rADC values in the caudate nucleus and superior cerebellar peduncle were significantly higher in PSP than in MSA and controls. In PD, there were no significant differences in the rADC values compared to in MSA, PSP, and controls in all regions. CONCLUSION: Evaluation of rADC values in characteristic lesions in MSA, PSP, and PD by placing ROIs using 3-T systems can provide useful additional information for differentiating these disorders.
Subject(s)
Diffusion Magnetic Resonance Imaging/methods , Multiple System Atrophy/diagnosis , Parkinson Disease/diagnosis , Supranuclear Palsy, Progressive/diagnosis , Aged , Brain Mapping/methods , Case-Control Studies , Diagnosis, Differential , Disease Progression , Female , Humans , Male , Middle Aged , Multiple System Atrophy/pathology , Parkinson Disease/pathology , Retrospective Studies , Statistics, Nonparametric , Supranuclear Palsy, Progressive/pathologyABSTRACT
We demonstrated 2 cases of uterine endometrial stromal sarcoma with emphasis on diffusion-weighted imaging. The tumors showed high signal intensity, and their tumor venous thrombi were clearly depicted on diffusion-weighted imaging. Diffusion-weighted imaging is a useful method not only for diagnosis of endometrial stromal sarcoma but also for preoperative planning.
