Benign vertebral hemangioma: MR-histological correlation.

OBJECTIVE: To explain the magnetic resonance (MR) appearance of benign vertebral hemangioma by correlating MR and histological findings from autopsy specimens. DESIGN: Sagittal T1- and T2-weighted spin-echo images were obtained in 83 spine specimens. Focal lesions consistent with vertebral hemangioma at macroscopic examination of sagittal anatomical sections were sampled for histological and quantitative analysis. At histology, the proportion of surface area occupied by adipocytes, vessels and edema, and hematopoietic cells was determined (point-counting method) in normal marrow areas and in lesion areas whose signal intensity was either high and intermediate (pattern A) or intermediate and high (pattern B) on T1- and T2-weighted images, respectively. RESULTS: Nine lesions were sampled and corresponded to cavernous hemangioma at histology. The proportion of surface area occupied by adipocytes was statistically significantly higher in pattern A (78.1%) than in pattern B lesion areas (42.7%) and than in normal marrow areas (47.5%). The proportion of surface area occupied by vessels and interstitial edema was statistically significantly higher in pattern B (47.0%) than in pattern A lesion areas (15.5%) and than in normal marrow areas (0). CONCLUSION: The presence of high signal intensity on T1- or T2-weighted images of vertebral hemangioma is related to the amount of adipocytes or vessels and interstitial edema, respectively.

Discrepancy between diffusion and perfusion imaging in a patient with transient ischaemic attack.

We report paradoxical and ambiguous imaging findings in a patient with transient ischaemic attack (TIA). Perfusion-weighted (PW) MRI obtained 2 hours after symptoms onset showed a hypoperfused area in a region compatible with the focal deficit, while diffusion-weighted (DW) MRI was considered negative. Despite the complete resolution of the symptoms which had already begun at the end of the first MR examination, follow up DW MRI at 3 days showed partial conversion to hyperintensity of the initially hypoperfused area. This case illustrates that PW and DW MRI have to be used in combination and at different time points to correctly diagnose and manage ischaemic stroke because PW MRI is more sensitive than DW MRI for very early detection of ischaemia and delayed DW MRI provides the final signature of brain damage even in case of complete clinical recovering.

Epiploic appendagitis: color Doppler sonographic findings.

The aim of this study was to analyze the color Doppler sonographic findings in primary epiploic appendagitis. Color Doppler sonographic findings of ten patients with primary epiploic appendagitis were reviewed. The following sonographic features were analyzed: identification of a mass adjacent to the colonic wall; identification of spotty color areas with arterial flow in this mass and detection of abnormalities of the colonic wall adjacent to the infiltrated fatty tissue. A well-delineated hyperechoic mass adjacent to the colonic wall was detected in each patient with sonography. No colonic wall abnormalities were observed nor color Doppler signal in and around the hyperechoic area. Absence of flow at color Doppler sonography is an additional feature of epiploic appendagitis.

[Imaging evaluation of cervical spine trauma]. / Imagerie de la colonne cervicale en 2000.

Evaluation and treatment of patients with suspected cervical vertebral trauma requires close cooperation between multiple medical disciplines. Recognition of the significant signs of cervical spine injury enables accurate interpretation of the radiograph, and if necessary adequate selection of the best imaging method for further evaluation. When judiciously selected, these imaging techniques result in the expeditious gathering of the diagnostic information required for the management of the traumatized patient.

Focal nodular hyperplasia: natural course observed with CT and MRI.

PURPOSE: The purpose of this work was to assess the natural course of biopsy-proven focal nodular hyperplasia (FNH). METHOD: Eighteen biopsy-proven FNHs in 14 patients (12 women and 2 men) who were followed for at least 6 months with CT and/or MRI were included in the study. The volume of the lesions was calculated twice by two observers using the summation of areas method. Intra- and interobserver variability was assessed by intraclass correlation coefficients. Longitudinal data analysis was performed with generalized estimating equations. RESULTS: The volume of FNH was stable in 6 cases, decreased in 10 cases, and increased in 2 cases. Intra- and interobserver variability in size measurements was 5-10%. Intraclass correlation coefficients were >0.992. Longitudinal data analysis showed that there was a general trend of lesion regression. CONCLUSION: Long-term follow-up and objective measurements performed in patients with biopsy-proven lesions show that the natural course of FNH is variable. In particular, lesion regression is not rare.

Hypoplasia of the internal carotid artery: a noninvasive diagnosis.

We present the characteristic imaging findings of hypoplasia of the internal carotid artery (ICA) in two cases, one accompanied by an intracranial aneurysm. Finding of a diffuse luminal narrowing of the ICA on MR angiography or digital subtraction angiography (DSA) could wrongly evoke severe acquired diseases such as dissection or atherosclerosis. Absence of associated wall thickening and flow disturbances on color Doppler sonography (CDS) should suggest carotid hypoplasia. Confirmation of the diagnosis is obtained by CT of the skull showing a small carotid canal. Non-invasive procedures are sufficient to differentiate this rare congenital anomaly from acquired string signs.

Subacromial-subdeltoid lipoma arborescens associated with a rotator cuff tear.

A 44-year-old man presented with lipoma arborescens of the right shoulder, associated with a rotator cuff tear. MRI revealed villous proliferations with signal intensity of fat on all pulse sequences. At surgery, this bursa was found to contain moderately yellow cloudy fluid without fat globules. Histological examination of the lesion showed subsynovial accumulation of mature fat cells.

[Ultrasonography of dorsal elastofibroma. Apropos of 6 cases]. / Aspect échographique de l'élastofibrome dorsal. A propos de 6 cas.

Elastofibroma dorsi is a benign soft-tissue tumor. Its sub- and pre-scapular location and its appearance on CT and MRI generally lead to the diagnosis. We have analyzed with sonography 6 elastofibromas in 4 patients; the diagnosis was confirmed with CT scan or MRI. Some sonography imaging features supported the diagnosis of elastofibroma dorsi. In all the cases, (1) the tumor occurred typically in a sub- and pre-scapular location, and (2) showed a streaky echostructure (3). A similar symptomatic or asymptomatic mass in the opposite subscapular location is highly suggestive.

Primary calcification in post-transplantation lymphoproliferative disorder involving the hepatic graft: an exceptional finding.

Calcification within active post-transplantation lymphoproliferative disorders has, to our knowledge, never been described. We report the case of a 14-month-old boy who presented 4 months after orthotopic liver transplantation with a primary calcification in a lymphoproliferative nodule involving the hepatic graft. This calcification was detected by routine ultrasonography, visible on plain radiographs, and the post-transplantation lymphoproliferative disorder was histologically proved.