فهرست مطالب

Iranian Journal of Radiology - Volume:14 Issue: 4, 2018
  • Volume:14 Issue: 4, 2018
  • تاریخ انتشار: 1396/10/30
  • تعداد عناوین: 23
|
  • Saba Firouznia, Parto Sabetrasekh, Alireza Ahmadian* Page 1
  • Seyed Moayed Alavian * Page 2
  • Mahrooz Malek, Mohammad Ali Kazemi *, Sadegh Saberi, Hassan Hashemi, Behnaz Moradi Page 3
    Objectives
    The goal of our study was to assess diffusion-weighted (DW) imaging and proton magnetic resonance (MR) spectroscopy findings in osteosarcoma versus normal muscle at 3 Tesla (3 T) MR system.
    Patients and
    Methods
    Nineteen patients highly suspicious for osteosarcoma and 12 normal young healthy adults were enrolled in this study. Two patients were excluded from the study due to incompatible histopathologic results. DW imaging and multivoxel proton MR spectroscopy at 3 T were performed for all participants. Surgical biopsy and histopathological examination were done for every patient after imaging. SPSS 20 was used for statistical analysis.
    Results
    The minimum apparent diffusion coefficient (ADC) value of osteosarcoma (0.88 ± 0.28) in this study confirms the significant restriction of this tumor against the dark background of normal muscle in high b-value images. Fourteen (82%) of the available 17 patients had ADC values ≤ 1 × 10-3 mm2/s. The maximum choline/creatine (Cho/Cr) ratio of osteosarcoma (1.94 ± 1.12) was statistically higher than the normal muscle (1.34 ± 0.11). Receiver operating curve (ROC) analysis (the area under the curve = 0.7) indicated a maximum Cho/Cr ratio of 1.37 as the cut point between the normal muscle and osteosarcoma, with a sensitivity, specificity and accuracy of 58.8%, 83.3%, and 69%, respectively. All patients with Cho/Cr ratios more than the cut point had ADC values ≤ 1 × 10-3 mm2/s and all patients with ADC values higher than 1 × 10-3 mm2/s had Cho/Cr ratios ≤ 1.37.
    Conclusion
    It was concluded that DW imaging and proton MR spectroscopy are two effective noninvasive techniques in the evaluation of osteosarcoma.
    Keywords: Diffusion, Weighted Imaging, Proton MR Spectroscopy, Osteosarcoma, Normal Muscle
  • Hazhir Saberi *, Somayeh Karimi, Bahman Rasuli, Eissa Alaj Page 4
    Background
    The rate of benign biliary strictures has increased in recent years.
    Objectives
    We studied the short- and long-term efficacy of biliary balloon dilatation in patients suffering from benign biliary strictures due to prior abdominal surgeries, such as laparoscopic cholecystectomy or liver transplantation.
    Patients and
    Methods
    An initial baseline biochemistry profile and ultrasound examination of the biliary system was done before each procedure, and 3 and 6 month follow-up sessions were completed after the completion of the biliary balloon dilatation procedure. Serum bilirubin, liver enzyme levels, and ultrasonography findings were investigated during every session.
    Results
    Twenty four patients, 17 females (70.8%) and 7 males (29.2%), were included in this study. In 21 (88%) of the patients, the biliary stricture was developed after a laparoscopic cholecystectomy, while in 2 (8%) it was a complication of a liver transplantation. The remaining patients (4%) developed it after autoimmune pancreatitis (Whipple surgery).
    Among the 24 patients, 2 died within 2 months after the ballooning, mainly due to complications of their previous surgery and secondary liver cirrhosis. We found a significant decrease in serum bilirubin levels after balloon dilatation (P
    Conclusion
    Serum bilirubin levels were significantly decreased after balloon dilatation. This procedure has led to a success rate of 95% in the short term and 91% in the long term.
    Keywords: Biliary Strictures, Balloon Dilatation, Serum Bilirubin
  • Hatice Ayca Ata Korkmaz *, Gaye Baki, Mustafa Kose, Bengu Yaldiz Cobanoglu Page 5
    Objectives
    The main purpose of the present study was to determine the efficacy of real-time elastography (RTE) and strain elastography (STE) in the diagnosis of different thyroid diseases. We also aimed to calculate the cut-off points for the differential diagnosis of subacute thyroiditis (SAT), Graves’ disease (GD), and Hashimoto’s thyroiditis (HT), which have a similar B-mode sonographic appearance.
    Patients and
    Methods
    A total of 24 patients with GD (10.9%), 94 patients with HT (42.7%), 20 patients with SAT (9.1%), and 82 individuals with normal healthy thyroids (37.3%) were included. Grayscale ultrasound evaluation of thyroid glands was performed with standard transverse and longitudinal planes before sonoelastography.
    Results
    The strain ratios (SRs) (mean ± standard deviation) of patients with GD, HT, and SAT, and the control group (CG) were 14.7 ± 14.8, 8.4 ± 9.6, 23.2 ± 10.8, and 1.37 ± 0.8, respectively. The cut-off points of strain elastography of the patients with GD, HT, and SAT to the CG were 2.69 (sensitivity 92%, specificity 90%, area under the curve (AUC) 0.983; 95% CI), 2.18 (sensitivity 100%, specificity 85%, AUC 0.898), and 5.54 (sensitivity 100%, specificity 100%, AUC 1.000; 95% CI), respectively. The cut-off point of the strain ratios (SR) of the total amount of patients with HT and GD to SAT was 14.79 (sensitivity 80%, specificity 85%, AUC 0.869; 95% CI).
    Conclusion
    Statistically significant differences were noted in the SR values and elasticity scores of the three experimental groups, and the CG. The elasticity scores of the SAT and HT groups were not significantly different from those of the GD group. The diagnostic performance of strain ratio elastography (P
    Keywords: Sonoelastography, Strain Elastography, Real, Time Elastography, Subacute Thyroiditis, Hashimoto's Thyroiditis, Grave's Disease
  • Hongliang Sun *, Yanyan Xu, Zhenrong Zhang, Wu Wang Page 6
    Objectives
    To compare the tumor size of lung adenocarcinoma manifesting as sub-solid nodule (SSN) as measured by high-resolution computed tomography (HRCT) and pathological specimens, and to analyze the influence of ground glass opacity (GGO) ratio on the discrepancy between HRCT and pathological measurements.
    Patients and
    Methods
    Fifty-five patients diagnosed with lung adenocarcinoma manifesting as SSN on HRCT were retrospectively analyzed. The pathological lesion size was 3 cm or less in the largest dimension. The largest diameter of the lesion and the largest diameter of the solid component were measured on axial HRCT scans by two radiologists. Simultaneously, the largest diameter of the lesion was also determined using computer-aided software, and GGO ratio was calculated. The correlation of GGO ratio with the discrepancy between HRCT tumor size and pathological tumor size was analyzed using Pearson’s/Spearman’s rank correlation tests.
    Results
    GGO ratio was well correlated with the discrepancy of tumor size between manual and pathological measurements and between semi-automatic and pathological measurements, with the correction coefficient of 0.474 and 0.457, respectively.
    Conclusion
    GGO ratio is correlated with the discrepancy between HRCT tumor size and pathological tumor size. These finding provides insights into clinical treatment and prognosis judgment of lung adenocarcinoma manifesting as SSN.
    Keywords: Lung Adenocarcinoma, Pathology, Computed Tomography
  • Jie Jiang, Dan Han*, Li Wu, Xiaojie Xie, Xunran Zhao Page 7
    Background
    To compare the quality of computerized tomography (CT) imaging of coronary artery stents between low tube voltage (100 kVp) scan combined with sinogram affirmed iterative reconstruction (SAFIRE) and routine tube voltage (120 kVp) scan combined with traditional filtered back projection (FBP).
    Objectives
    The purpose of this study was to compare the quality of CT imaging of coronary artery stents between low tube voltage scan (100 kVp) combined with sinogram affirmed iterative reconstruction (SAFIRE) and routine tube voltage scan (120 kVp) with FBP.
    Patients and
    Methods
    Second generation dual source CT was performed on 156 patients with implanted coronary stents (group A, 86 cases with 100 kVp and SAFIRE; group B, 70 cases with 120 kVp and FBP). The mean attenuation, image noise, signal-to-noise ratio (SNR), stent-lumen attenuation increase ratio (SAIR), image quality scores, lesion assessment of the stents, and radiation dosage were compared between the two groups.
    Results
    The mean attenuation and SAIR of the aortic root, in-stent, and the coronary artery above the stent had no significant difference between the two groups (P 0.05). The diagnostic information of stents by 100 kVp combined with SAFIRE had no significant difference with those by 120 kVp FBP (P > 0.05). The effective dose of group A were about 51.5% lower than group B.
    Conclusion
    SAFIRE combined with lower tube voltage on coronary artery stent CT imaging could maintain image quality while significantly reduce the radiation dosage.
    Keywords: Coronary Artery Stent, Iterative Reconstruction, Filtered Back Projection
  • Zeynep NilÜfer Tekin*, Ali, Ccedil, AĞri Tekin, Murat, Akar, Haluk, Abuk, GÜlseren Yirik, MÜjdat AdaŞ, Mehmet KÜrŞad Bayraktar, Yusuf, Ouml, Zcan Page 8
    Background

    Knowing the configuration of a meniscus tear is important for planning the treatment protocol.

    Objectives

    The aim of this study was to evaluate the accuracy of magnetic resonance imaging (MRI) in determining meniscus tear configurations through a retrospective assessment of MR images from patients who underwent arthroscopy for an initial diagnosis of meniscus tear.
    Patients and

    Methods

    A retrospective comparison was made between MRI findings and arthroscopic results of patients to whom arthroscopy was applied by a single experienced surgeon for an initial diagnosis of meniscus tear. The MR images were taken with a 1.5 Tesla unit. The meniscus tears were classified in subgroups as horizontal, longitudinal, radial, flap, bucket handle, and complex.

    Results

    In 60 knees of 57 patients, 32 lateral meniscus and 48 medial meniscus lesions were identified by MRI. Of these tears, 33 were complex, 15 longitudinal, 13 radial, 11 bucket handle, 5 flap, and 3 horizontal. For the total 80 meniscus tears, MRI gave the same diagnosis as arthroscopy in 60 (75%). Longitudinal and flap tears had low sensitivity (79% in medial and 50% in lateral meniscus for longitudinal tears; 33% to 57%, respectively, for flap tears) but high specificity.

    Conclusion

    MRI is an important tool in the imaging of meniscus tears, but for longitudinal and flap tear configurations that require arthroscopy, MRI diagnostics are especially insensitive. Nonetheless, MRI evaluation paired with good clinical evaluation can be considered useful when planning a surgical protocol and when defining the postoperative prognosis.

    Keywords: MRI, Meniscal Tears, Arthroscopy
  • Arvin Arian, Zinat Ghanbari *, Maryam Deldar Pasikhani, Tahere Eftekhar, Masoumeh Gity, Madjid Shakiba, Parto Sabetrasekh, Babak Setayeshpour, Azam Alipour Page 9
    Background
    Pelvic floor dysfunction (PFD) refers to a wide range of issues that occur when muscles of the pelvic floor are weak, tight, or there is an impairment of the sacroiliac joint, lower back, coccyx, or hip joints. PFD and pelvic organ prolapse (POP) affect about 50% of women past middle age. Symptoms include pelvic pain, pressure, dyspareunia, incontinence, incomplete emptying, and gross organ protrusion. Nowadays, there are novel diagnostic tools and therapies proposed for pelvic floor weakness and organ prolapse. Pelvic organ prolapse quantification system (POP-Q) examination and complementary magnetic resonance imaging (MRI) are two methods of diagnosis.
    Objectives
    The goal of our study was to assess the agreement between POP-Q examination and MRI in detecting anterior pelvic prolapses. In addition, we evaluated the additive role of MRI adjunct to POP-Q examination in detecting anterior pelvic organ prolapse.
    Patients and
    Methods
    An experimental study was carried out on 61 patients having clinical manifestations suggesting pelvic floor weakness. The medical history and physical examination were obtained from all patients. POP-Q examination and dynamic MR imaging was performed. POP-Q results were compared with dynamic MRI findings thereafter.
    Results
    Considering pubococcygeal line (PCL) and H line as reference lines, comparison of MRI and POP-Q findings for detecting bladder neck and urethra prolapses revealed a moderate to good agreement (49% - 80%) rate between MRI and POP-Q examination. This corresponds to a weak to moderate agreement between these two methods.
    Conclusion
    Agreement of MRI and POP-Q is moderate to good for detecting anterior pelvic organs prolapses. MRI could be regarded as a complementary method to POP-Q examination. A combination diagnostic approach, including MRI and POP-Q, for high stage pelvic prolapse is highly recommended.
    Keywords: Magnetic Resonance Imaging, Pelvic Floor Disorders, Pelvic Organ Prolapse
  • Youyeon Kim, Kyu Ran Cho *, Sung Eun Song, Bo Kyung Seo, Ok Hee Woo, Jeong Hyun Lee, Sung Bum Cho Page 10
    Background
    Invasive cribriform carcinoma (ICC) of the breast is a distinct histologic type of invasive carcinoma that is known to have a relatively favorable prognosis. There is very little information about ICC radiologic findings.
    Objectives
    The purpose of this study is to investigate ICC radiological findings, including those of mammography, sonography, and magnetic resonance imaging (MRI), and histopathological findings.
    Patients and
    Methods
    Mammography, sonography, and MRI findings of twelve female patients with ICC in our institution were retrospectively reviewed by two radiologists in consensus. Diagnoses were based on surgically resected specimens, and image features were reviewed according to the American college of radiology breast imaging reporting and data system (ACR BI-RADS®) lexicon. Histopathological findings were reviewed by two experienced breast pathologists in consensus.
    Results
    Of the twelve patients, eleven underwent pre-operative mammography, and all underwent pre-operative sonography and MRI. Mammographic findings were mass (n = 8), focal asymmetry (n = 2), or no detectable finding (n = 1). Most masses had irregular shapes, indistinct margins, equal densities to the parenchyma, and no associated calcification. By sonography, all masses were hypoechoic with variable shapes. The margins of the tumors were mostly indistinct. Each tumor was depicted as an enhancing mass with an irregular, oval, or round shape on MRI. Usually, the margins were irregular, and enhancement patterns were type III. On histopathologic examinations, most tumors were grade I, and all were luminal subtype A by immunohistochemical study.
    Conclusion
    ICCs of the breast appear as masses with typical features of malignancy using radiologic techniques. The differences in the radiologic features of invasive ductal carcinoma of no special type, which is the most common invasive breast malignancy, and ICCs are that ICCs usually appear without associated calcifications and show rare spiculation.
    Keywords: Breast Neoplasm, Carcinoma, Mammography, Ultrasonography, Magnetic Resonance Imaging
  • Adnan Ozdemir, Serdar Arslan *, Enes Duman, Erkan Yildirim, Cuneyt Aytekin, Fatih Boyvat Page 11
    Background
    To present our findings obtained from the treatment of wide-necked intracranial aneurysms with flow diverter stents.
    Patients and
    Methods
    Intracranial aneurysms were determined in 19 patients (14 females, 5 males; mean age, 56.6 years) between May 2011 and June 2014, and the patients were treated using flow diverter stents. A total of 28 flow diverter stents, including 9 Silk and 19 Pipeline stents were used. Occlusion rates evaluated with computed tomography at the end of month 6 and digital subtraction angiography after one year, intraoperative success, morbidity and mortality rates were determined.
    Results
    A total of 20 endovascular interventions, including two interventions in two different aneurysms in one patient were performed in 19 patients. Flow diverter stents were successfully implemented for wide-necked aneurysms at a success rate of 100%. Coil treatment had previously been performed in four patients. Aneurysm occlusion rates were 77.2% at month 6 and 90.9% at the end of month 12.
    Conclusion
    The use of flow diverter stents is a reliable and effective method in the treatment of wide-necked intracranial aneurysms with high aneurysm occlusion, and low morbidity and mortality rates.
    Keywords: Stent, Aneurysm, Coil, Endovascular, Intervention
  • Solmaz Valizadeh, Hamidreza Pouraliakbar, Vida Arzani *, Ali Nahardani Page 12
    Background
    Although new approaches for application of magnetic resonance imaging (MRI) in dentistry have been promising, the presence of dental materials in the oral cavity represents a major obstacle to generating quality MRI data. The resulting artifacts can adversely affect diagnostic accuracy of oral and maxillofacial conditions.
    Objectives
    This study aimed to detect and assess artifacts caused by metallic and non-metallic dental materials in MR images.
    Materials And Methods
    Nineteen commonly used dental materials were used in an in vitro assay. An empty cube-shaped phantom with internal dimensions of 15 × 15 × 15 cm3 was fabricated of polyester and filled with paraffin or distilled water to create optimal contrast for T1-weighted (T1W; for anatomical structures), T2-weighted (T2W, for pathological conditions) and proton density-weighted (PDW) MR images. Dental material samples were manufactured and placed at the center of the mold using polyester tubes. All samples were then subjected to MRI using two-dimensional (2D) and three-dimensional (3D) T1W, T2W and PDW imaging sequences. The data were subjected to one-way analysis of variance (ANOVA) followed by mean comparison using the Tukey’s test.
    Results
    Comparison of mean artifact size in 2D and 3D images showed that ceramic caused the smallest (189.48 mm3) and orthodontic metal brackets caused the largest (4307.5 mm3) artifact areas. Assessment of the amount of artifacts created in different imaging sequences revealed minimal artifact in inversion recovery sequence and maximum artifact in gradient echo sequence of the amount of artifacts at different weighing times in 2D and 3D images showed minimal artifacts in PDW and maximum artifacts in T2W.
    Conclusion
    Bracket, titanium implants, and the nickel-chromium (Ni-Cr) materials are the three most susceptible materials to external B0 magnetic field; thus creating huge metal-induced artifacts. The Siemens default two dimensional turbo spin echo (2D-TSE), 2D-BLADE, three dimensional volumetric interpolated breath-hold examination (3D-VIBE) and three dimensional sampling perfection with application optimized contrasts using different flip angle evolution (3D-SPACE) are the most appropriate pulse sequences for the 2D-T1W, 2D-T2W, 3D-T1W, and 3D-T2W evaluations of the bracket/titanium /Ni-Cr materials, respectively. The rest of the materials’ magnetic susceptibility effects are negligible, and artifacts are small.
    Keywords: Magnetic Resonance Imaging, Dental Materials, Artifact
  • Nesrin Atci *, Ilay Gozukara, Fatma Ozturk, Gulen Burakgazi, Raziye Keskin Kurt, Sinem Karazincir Page 13
    Background
    The cesarean delivery rate tends to be higher in women with sickle cell anemia (SCA) and sickle cell trait (SCT) for various reasons. However, pelvic contracture, which may lead to cesarean sections, has never before been studied in these groups.
    Objectives
    The aim of this study was to investigate magnetic resonance (MR) pelvimetry findings of women with SCA and SCT.
    Patients and
    Methods
    We studied 66 women who underwent MR pelvimetry between March and June 2015 at our center. Our prospective study included 21 women with SCA, 20 women with SCT, and 25 control women. Sagittal inlet, sagittal mid-pelvis, transverse inlet, transverse mid-pelvis and transverse outlet diameters were measured on MR images. The mean diameters were compared with each other and with the control group
    Results
    Sagittal inlet and transverse inlet were not significantly different between the groups. Also, mid-pelvic diameters for the sagittal and transvers mid-pelvis were similar between the groups. Even though the transverse outlet seems to be lesser in the SCA group compared with other groups, it was not statistically significant.
    Conclusion
    Our study demonstrated that the pelvic roofs of women with SCA and SCT are indistinguishable from healthy women. Thereby, maternal pelvic structures that impact delivery types may not be significantly changed in SCA and SCT diseases. We believe that when making decisions about modes of delivery, these results should be taken into consideration.
    Keywords: Magnetic Resonance, Pelvimetry, Sickle Cell Anemia, Sickle Cell Trait, Women
  • Ebru Hasbay *, Ali Haydar Baykan Page 14
    Objectives
    To investigate the control preferences of clinicians working in a regional hospital to prevent contrast agent reactions.
    Materials And Methods
    This study investigated through a questionnaire the role preferred by 75 participant specialist physicians working in two local hospitals regarding prevention of contrast agent reactions. The questionnaire form included five different items consisting of modified forms of preferences found in control preferences scale (Degner et al., 1997). These items were as follows: A, I prefer to make a decision as a clinician; B, I prefer to make a decision as a clinician but should get radiologist’s opinion; C, Radiologist and I should make a decision together. The ideas of the two of us are equally important; D, The radiologist should make a decision but after getting my opinion; E, I prefer the radiologist to make a decision. Participants were asked to specify their primary (the most preferred) and secondary (subsequent) preferences.
    Results
    The results of the statistical analysis indicated that females showed more equalitarian approach when compared to males (43.3% versus 15.6%, P
    Conclusion
    When we attempt to establish a clinical guideline committee towards preventing reactions to contrast agents, involvement of physicians exhibiting cooperative attitude in the committee will facilitate communication, and thereby improve group performance.
    Keywords: Control Preferences Scale, Contrast Agent Reactions, Contrast Agent
  • Bo Liang, Feifei Huang, Hao Shen * Page 15
    Objectives
    The study objective was to determine the way in which patients encounter pain, and to distinguish the clinical parameters impacting pain by transrectal ultrasonography (TRU) of the prostate.
    Patients and
    Methods
    Medical records for men receiving prostate TRU from November 2015 to April 2016 were acquired from the database. Patients underwent a detail review of medical history as well as physical evaluation. All the relevant variables were associated to visual analog scale (VAS) by using multivariate regression analysis.
    Results
    Independent factors for TRU associated pain were identified using multivariate regression analysis. The analysis demonstrated that sagittal length of the prostate was the continuous variable impacting pain level. Patients who received explanation for the process of the test in detail promptly before the examination and had prior TRU experience were found to be in negative association with the pain score; while, hemorrhoids (external), prior anal surgery, and stool artifact were in positive association with the pain score.
    Conclusion
    Despite the fact that TRU of the prostate is uncomfortable for patients, after identification of pain affecting factors, healthcare providers could help reduce the patients’ pain through the procedure, thereby providing better quality exams.
    Keywords: Prostate, Trans Rectal Ultrasonography, Ultrasound, Visual Analog Scale
  • Ho-Hsian Yen, Chien-An Liu *, Hsiou-Shan Tseng, I-Ming Chen Page 16
    The development of a pseudoaneurysm following Fluency®Plus-covered stent placement for post-Whipple operation bleeding has not been reported. A 79 year-old man diagnosed with pancreas head cancer received Whipple operation and suffered from subsequent gastroduodenal artery stump bleeding. The hemorrhage was treated successfully by covered stent placement at the common hepatic artery. However, two episodes of pseudoaneurysm formation at the proximal stent edge occurred successively in the follow-up period and were treated with endovascular managements. Sequential development of pseudoaneurysm after covered stent placement for post-Whipple operation bleeding has not been reported in available literature. We consider the pseudoaneurysm formation is not only a consequence of visceral inflammation, but also related to the properties of a stent like rigidity in this case.
    Keywords: Covered Stent Placement, Endovascular Management, Post, Pancreaticoduodenectomy Hemorrhage, Pseudoaneurysm
  • Hye Young Choi, So Young Park, Wook Jin, Ji Seon Park, Kyung Nam Ryu *, Yong Koo Park Page 17
    Epiphyseal involvement of a simple bone cyst (SBC) is rare. Furthermore, its pathological variant is even more uncommon. Herein, we report a case of a 22-year-old woman with an SBC containing unusual mesenchymal tissue proliferation with epiphyseal involvement in the proximal fibula. Magnetic resonance imaging showed a cystic lesion that involved the entire epiphysis as well as some soft tissue components. Hence, our initial differential diagnosis did not include SBC. However, pathology confirmed a SBC. Thus, SBC should be considered in the diagnosis of cystic lesions despite the atypical imaging findings.
    Keywords: Bone Cysts, Chondroblastoma, Giant Cell Tumor of Bone, Aneurysmal
  • Maurizio Zizzo*, Vincenzo De Biasi, Lara Ugoletti, Carolina Castro Ruiz, Stefano Bonacini, Michele Panebianco, Alessandro Giunta, Claudio Pedrazzoli Page 18
    Solid pseudopapillary neoplasm (SPN) is an extremely rare pancreatic epithelial neoplasm with low malignancy that affects mainly young females. It is characterized by a good prognosis, even in the presence of metastases. SPNs have a particular avidity for 18F-fluorodeoxyglucose (18F-FDG). Nonetheless, there are very few papers in the literature on the use of 18F-fluorodeoxyglucose positron emission tomography/computed tomography (18F- FDG PET/CT) in the diagnosis and staging of SPNs. A 23-year-old woman presented to our attention with gastric outlet obstruction due to a bulky solid pseudopapillary neoplasm of the pancreatic head. A 18F-FDG PET/CT showed a marked 18F-FDG uptake at the pancreatic head with no abnormal metabolic activity in other abdominal organs. Given the particular avidity for 18F-FDG, SPNs can be easily recognized on 18F-FDG PET/CT. However, this exam is not useful in differentiating this neoplasm from other malignant pancreatic solid lesions, but it could give a contribution to the staging by the ability to identify potential metastases or recurrences.
    Keywords: Solid Pseudopapillary Neoplasm, Pancreas, Staging, Positron Emission Tomography, Fluorodeoxyglucose
  • Seung Won Oh, Hyo Soon Lim*, Jang Mi Baek, Ji Shin Lee Page 19
    Microglandular adenosis is an uncommon, benign breast disease considered to be a variant of adenosis. Breast carcinoma arising in microglandular adenosis has been reported. Because of its extreme rarity, its clinical and radiological features are not well known. We present a case of invasive carcinoma arising in microglandular adenosis of the breast in a 63-year-old woman with radiologic and pathologic findings. To our knowledge, this is the first case report with breast magnetic resonance imaging findings that shows the wide spectrum of the disease. Microglandular adenosis is important because it mimics carcinoma clinically and pathologically and breast carcinoma can arise in microglandular adenosis. When a core needle biopsy shows microglandular adenosis, complete excision should be considered to rule out the possibility of an associated carcinoma.
    Keywords: Breast Neoplasm, Fibrocystic Breast Disease, Magnetic Resonance Imaging
  • Kyung Hee Ko*, Hae Kyoung Jung, Ah Young Park Page 20
    Historically, breast augmentation with injectable materials has been performed for decades. However, in the long term all materials led to unfavorable results with serious side effects. Recently, we came across a patient who had performed a breast augmentation using a brand-new Aquafilling® filler. Some insist that it is a very safe filler providing satisfactory improvement in breast shape and volume without any inflammatory reaction or serious adverse effect. Here, we present a 32-year-old woman who experienced severe complications 6 months after bilateral breast augmentation with Aquafilling® filler. The patient suffered from distant filler migration and inflammatory reaction extending from the left upper lateral abdominal wall to the vulva. Radiologic characteristics were very similar to those resulting from polyacrylamide gel (PAAG) mammoplasty. The use of Aquafilling® filler for breast augmentation should be strongly restricted until long-term safety is proved and verified.
    Keywords: Augmentation Mammoplasty, Filler Migration, Hydrogel, Aquafilling®
  • Qian Zou, Shu Hao Li, Liang Geng Gong * Page 21
    Leiomyosarcomas (LMS) are mesenchymal neoplasms that arise from smooth muscle cells, which less frequently occur in veins. Commonly, leiomyosarcoma accompanied with necrosis and cystic degeneration, which noted as non-enhanced areas on radiological examinations were seen frequently in the literature. We present a rare case of a leiomyosarcoma arising from the inferior vena cava, invading into the right atrium, found accidentally in a 46-year-old male who clinically manifested as progressive dyspnea on exertion. Radiological examinations showed a moderate heterogeneous enhancement tumor followed with foci of non-enhancement area in the central, which was not definitely in line with the pathological findings. The imaging features and differential diagnosis of the tumor are outlined here.
    Keywords: Leiomyosarcoma, Inferior Vena Cava, Diagnostic Imaging
  • Byung Jin Park, Jae Kyu Kim*, Hyoung Ook Kim, Nam Yeol Yim, Yang Jun Kang Page 22
    Iatrogenic injuries of the superior vena cava (SVC) are infrequent but could bring severe complications. Perforation of the SVC may result in massive hemorrhage and hemodynamic instability. We report the case of a 58-year-old female with a right hemothorax after left subclavian central venous catheter (CVC) placement. Penetration of the SVC can be managed by coil embolization through left subclavian CVC. As a result, this injury was successfully managed. To our knowledge, this is the first report of management of SVC penetration using coil embolization.
    Keywords: Central Venous Catheters, Vena Cava, Superior, Embolization, Therapeutic, Radiology, Interventional, Hemothorax
  • Gaoyi Yang *, Wenzhi Zhang, He Ning Page 23