Iranian Journal of Radiology
Volume:18 Issue: 4, Oct 2021

Cardiovascular disease (CVD) is one of the leading causes of mortality in both developed and developing countries. Therefore, identification of CVD risk factors is one of the most important steps in preventing this disease. Evidence suggests that imaging of the cardiac anatomy can be helpful for risk assessment.

This study aimed to assess two cardiac anatomy features, namely, the angle between the aortic valve and the left ventricular inflow long axis (AV-LV angle) and the coronary artery calcium (CAC) score.

This cross-sectional study was conducted on 74 patients with indications for computed tomography angiography (CTA) according to the American Heart Association (AHA) guidelines from July 2019 to January 2020 in Iran. The Agatston method was applied to measure the CAC score. Besides, to determine the AV-LV angle, the angle between a line tangent to the aortic valve leaflets and a line through the center of the aorta toward the left ventricular apex was measured. The patients’ baseline characteristics were also documented by conducting interviews.

Of 74 patients, 56% were male. The mean age of the patients was 54.41 ± 12.31 years, and their mean body mass index (BMI) was 26.71 ± 3.89 kg/m2. The frequency of smoking was 28% among the participants. A history of hypertension was reported in 38.7% of the patients, and a history of dyslipidemia was reported in 36%. Besides, the history of myocardial infarction was reported in 4% of the patients, diabetes mellitus in 9.3% of the patients, and angioplasty in 6% of the patients. The CAC score only had significant relationships with hypertension and age (correlation coefficients = 0.51). On the other hand, the AV-LV angle had no significant relationship with the patients’ baseline characteristics. The statistical analysis of the AV-LV angle and CAC score showed no significant relationship between these parameters (P = 0.756).

The AV-LV angle and the CAC score were not significantly associated. Further research is recommended to fill the knowledge gap regarding the cardiac anatomy features for cardiovascular risk assessment.

Gallium-68-labeled prostate-specific membrane antigen (68Ga-PSMA), as a relatively new positron emission tomography (PET) radiotracer, can be used to evaluate tumors other than prostate cancer, including renal cell carcinoma and probably non-small cell lung cancer, as discussed in our case. We present the case of a 65-year-old man with a history of lung adenocarcinoma diagnosed in 2015 and a subsequent diagnosis of renal cell carcinoma in 2018, treated with a right lower lobectomy and a left partial nephrectomy, respectively. Both conditions were evaluated using 18F-fluorodeoxyglucose (18F-FDG) PET/computed tomography (CT) scan before surgery. A rise in prostate-specific antigen (PSA) was detected in the follow-up in September 2020, and the patient was referred for a 68Ga-PSMA PET/CT scan following pelvic magnetic resonance imaging (MRI). The 68Ga-PSMA PET/CT scan demonstrated avid lesions in both lung and kidney surgical beds. The 68Ga-PSMA PET/CT scan can be potentially used in patients with recurrent renal cell carcinoma to detect metastasis. This modality may also detect non-small cell lung cancer lesions; however, further investigation is needed.

Brain injury in premature infants (BIPI) is a severe brain damage in premature infants, resulting in a series of neurological sequelae. Diffusion tensor imaging (DTI), as a magnetic resonance imaging (MRI) technique, is more widely used for premature infants. It is of paramount importance to improve the early diagnosis, treatment, and intervention for this population by using DTI. There are few reports on the application of DTI for the evaluation of BIPI in low-birth-weight (LBW) and very-low-birth-weight (VLBW) infants.

To analyze the clinical characteristics of BIPI in LBW and VLBW infants and to explore the value of MRI-based DTI in the evaluation of BIPI in LBW infants.

This prospective study was conducted on 31 cases of BIPI (16 LBW and 15 VLBW infants) and 20 normal control premature infants, undergoing MRI-based DTI at the postmenstrual age (PMA). Differences in fractional anisotropy (FA) and apparent diffusion coefficient (ADC) between the BIPI and control groups and also between the LBW and VLBW groups with BIPI were analyzed. Also, differences with normal controls in terms of the FA and ADC values were investigated in different brain regions.

The FA values in the central white matter of the frontal lobe, central white matter of the occipital lobe, centrum semiovale, posterior limb of the internal capsule (PLIC), and ventral thalamus were significantly lower in the BIPI group as compared to the control group (P < 0.05). The ADCs were lower in the BIPI group compared to the control group, and there was a significant difference (P < 0.05). Comparison of FA and ADC values in the central white matter of the frontal lobe, central white matter of the occipital lobe, centrum semiovale, PLIC, and ventral thalamus did not show any significant differences between the LBW and VLBW groups with BIPI (P > 0.05).

The FA and ADC values of DTI can be used for the quantitative evaluation of BIPI in LBW and VLBW infants. The FA value was found to be more accurate than the ADC. Overall, different FA values in different brain areas reflect differences in the brain development of normal premature infants.

Sialoblastoma is a rare salivary gland tumor, diagnosed in the neonatal period or during infancy. Hepatoblastoma accounts for less than 1% of all pediatric malignancies. The co-occurrence of these two tumors is extremely uncommon. Here, we report a case of concurrent sialoblastoma and hepatoblastoma in an infant.

Digital mammography (DM) is one of the most common and effective radiological methods for breast cancer screening and detection. A dense fibroglandular breast tissue can lead to false negative results by superimposing on the lesion margins. Therefore, adjunctive imaging methods, such as digital breast tomosynthesis (DBT) and ultrasonography (US), are needed to increase mammographic sensitivity.

This study aimed to examine the contribution of US and DBT to DM in different patient groups (patients group of BI-RADS 0 and 3-4 lesions, patients with dense breast parenchyma, patients with non-dense breast parenchyma).. Whether US and DBT can upgrade or downgrade the BI-RADS category of uncertain lesions detected on DM was also investigated.

Forty-six patients, who were classified as BI-RADS categories 0, 3, and 4 in DM, according to DBT and US findings, were included in the study. DM followed by DBT was performed for the patients, and the BI-RADS classification system was applied. Subsequently, the patients were evaluated sonographically, and the BI-RADS system was applied according to the US results. Each BI-RADS category was compared with the histopathological and multimodality follow-up results. The diagnostic performance of all modalities was also examined alone and in combination.

The sensitivity and specificity of DM alone was 42% and 87%, respectively. DBT detected the lesions with 92% sensitivity and 68% specificity. The modality with the highest sensitivity for the detection of malignant lesions was US (100%). Besides, the specificity of DBT was significantly high for dense breasts (P < 0.001). There was no significant difference in terms of the diagnostic accuracy of US measurements between dense and non-dense breasts. For indeterminate lesions, the integration of DBT and US to DM increased the diagnostic accuracy.

The contribution of DBT is more valuable than US in patients with dense breast parenchyma.

Digital mammography (DM) and digital breast tomosynthesis (DBT) are important radiological modalities, which increase the survival of breast cancer patients. Breast cancer is a morphologically heterogeneous disease with various histopathological parameters and multiple receptors in its biological profile.

This study aimed to analyze the morphological features of invasive breast cancer on DM and DBT, to investigate the contribution of DBT to DM, to examine the association of DBT findings with pathological molecular subtypes, Bloom-Richardson grade, and Ki-67 index, and to determine the effect of breast parenchyma density on the relationship between DBT findings and hormone receptors.

A total of 36 patients with malignant lesions were evaluated in this study. According to the American College of Radiology (ACR) classification, the lesion features were divided into subgroups based on DM and DBT, and the findings were compared. The relationships between DBT findings and the hormone receptor status, molecular classification, and Bloom-Richardson grade were also investigated, and the effect of density on these relationships was assessed.

The mean age of the patients (n = 36) was 53 years. Based on the comparison of DM and DBT findings, spiculated margins, mass density, architectural distortion, and microcalcifications were significantly more frequent in DBT. Lesions with indistinct margins on DM were observed as mass lesions with spiculated margins on DBT (P < 0.001). Regarding the relationship between DBT findings and hormone receptor status and Ki-67 proliferation index, in PR-positive patients, an irregular tumor shape was more common (89.7%). In PR-negative patients, skin changes and nipple retraction were more frequently seen (P = 0.03 for skin changes, and P = 0.049 for nipple retraction). Regarding the association between Bloom-Richardson grade and DBT findings, tumors with a higher grade were more likely to be associated with a high tumor density (P = 0.032). Also, considering the relationship between molecular classification and DBT findings, skin changes and nipple retraction were significantly more frequent in triple-negative masses compared to other subtypes (P = 0.011 for skin changes and P = 0.016 for nipple retraction).

DBT is superior to DM, as it reveals the lesion margins, density, and architectural distortion more accurately. The majority of PR-positive tumors were irregular, while most PR-negative cases were round. The mass density also increased as the tumor grade increased. Skin change and nipple retraction were frequently seen in triple-negative tumors compared to other subtypes. Therefore, DBT is a promising diagnostic tool for showing molecular subtypes in dense breasts.

Early detection of malignant thyroid nodules is possible using ultrasonography (US)-guided fine needle aspiration biopsy (US-FNAB), which is a minimally invasive and easily applicable method. There are several guidelines based on the US findings, including the Thyroid Imaging-Reporting and Data System (TI-RADS), to identify patients requiring FNAB or patients with nodules suspicious of malignancy.

To emphasize the importance of the easily applicable Kwak TI-RADS classification system.

In this cross-sectional study, the radiological and pathological findings of 641 consecutive patients, who underwent US-FNAB in our center, were retrospectively evaluated. The relationship between the cytological/histopathological results and the US findings was investigated using univariate and multivariate analyses. The results were also compared with the data in the literature.

In the univariate analysis, US features, including the presence of a solid component, hypoechogenicity, microlobulation or irregular margins, microcalcifications, and a taller-than-wide shape, were significantly associated with malignancy (P < 0.05). However, in the multivariate analysis, only hypoechogenicity and a taller-than-wide shape significantly contributed to the diagnosis of malignancy (P < 0.05). The malignancy rates of TI-RADS 3, 4a, and 4b lesions were lower in the present study compared to the literature.

The US features, including the presence of a solid component, microcalcifications, hypoechogenicity, microlobulation or irregular margins, and a taller-than-wide shape, must be evaluated during US examinations. Besides, the widespread use of Kwak TI-RADS classification system, similar to the Breast Imaging-Reporting and Data System (BI-RADS), should be encouraged to provide a common tool for clinicians and prevent unnecessary surgical procedures.

The clinical manifestations of amyloid cardiomyopathy (AC) are not specific; therefore, AC is often misdiagnosed as hypertrophic cardiomyopathy (HCM) or hypertensive heart disease (HHD). A differential diagnosis of these three conditions is often necessary in the clinical setting.

To investigate the differential diagnostic performance of radiomic analysis, based on cardiac magnetic resonance (CMR) native T1 mapping images for the left ventricular hypertrophy (LVH) etiologies.

This retrospective, case-control study was conducted on 91 participants (68 males and 23 females; mean age: 48 ± 13 years), including 22 patients with HHD, 27 patients with AC, 28 patients with HCM, and 14 controls in Tongji Hospital (Wuhan, China). All participants underwent 3.0T CMR imaging. Besides, radiomic analyses were performed using T1 mapping images. The cases were divided into training and test datasets using a random seed. Next, the models were constructed with the training dataset and evaluated with the test dataset.

A total of 1,033 radiomic features were extracted in this study. Overall, 11, 28, 19, and eight features were selected to construct the basal T1 mapping, mid-chamber T1 mapping, apical T1 mapping, and multi-module conjoint models, respectively. Optimal performance was reported in the mid-chamber and basal T1 mapping models. The area under the curve (AUC), precision, recall, and F1 score were 0.96, 0.84, 0.82, and 0.83 for the mid-chamber T1 mapping model and 0.96, 0.90, 0.89, and 0.88 for the basal T1 mapping model in the independent test dataset, respectively. The lowest diagnostic performance was observed in the apical T1 mapping model. The AUC, precision, recall, and F1 score of the apical T1 mapping model were 0.86, 0.71, 0.70, and 0.70 in the independent test dataset, respectively.

The radiomic analysis of T1 mapping could accurately distinguish the three causes of myocardial hypertrophy, including HCM, HHD, and AC. It may be also a suitable alternative to late gadolinium enhancement-CMR.

Non-alcoholic fatty liver disease (NAFLD) is the second most common cause of liver transplantation in the United States, with a continuously growing prevalence. There are several non-invasive methods to detect liver fibrosis, which is defined as the accumulation of extracellular matrix proteins, particularly collagens. It is most commonly associated with chronic liver diseases, such as NAFLD.

This study aimed to investigate the concordance between transient elastography (TE) and shear wave elastography (SWE) for liver fibrosis staging and also to examine the congruence between the controlled attenuation parameter (CAP) and the B-mode hepatorenal ratio for hepatic steatosis grading in patients with NAFLD.

In this cross-sectional study conducted during March 2018 - 2019, NAFLD patients, referred to the liver clinic of our center for the non-invasive assessment of hepatic fibrosis, were enrolled. However, patients with sonographic features of cirrhosis, multiple hepatic masses, or moderate to large ascites were excluded; also, patients who were uncooperative during the tests were excluded. Measurements obtained by different tools were recorded. Kolmogorov-Smirnov test, Chi-square test, independent t-test, or Mann-Whitney tests, as well as Pearson’s correlation coefficient test, were used to analyze the data.

Sixty-five patients (male-to-female ratio, 1:13), with a median age of 47 years, were included in the study. The tools for assessing fibrosis (r = 0.9538, 95% CI: 0.9252 - 0.9717, P < 0.0001) and steatosis (r = 0.429, 95% CI: 0.2048 - 0.6104, P < 0.0001) were perfectly and moderately correlated, respectively. Sex, age, and body mass index (BMI) did not affect the results.

The two elastography modalities showed a strong correlation for fibrosis staging in our study population. Also, the CAP and B-mode hepatorenal ratio were moderately correlated for grading hepatosteatosis. Overall, selection of the best assessment method among the studied modalities depends on factors other than internal validity.

An axillary breast is a common condition, which can cause various diseases arising from the breast tissue. Among these diseases, phyllodes tumors are very rare fibroepithelial tumors, which resemble fibroadenomas. Surgical removal is the treatment of choice for phyllodes tumors to prevent recurrence. Inpatient treatment and general anesthesia are required for surgical removal, and fibrosis, skin scarring, and neurological symptoms may occur after surgery. Ultrasound-guided vacuum-assisted excision, because of its advantages, is an alternative to surgical excision for clinically benign breast masses. Therefore, in cases of clinically benign or concordant benign lesions, following a core needle biopsy, ultrasound-guided vacuum-assisted excision can be considered with sufficient preoperative measures and close follow-up of the ectopic axillary breast.

Magnetic resonance imaging (MRI) with gadolinium (GAD)-based contrast agents has been the imaging modality of choice for early detection and monitoring of multiple sclerosis (MS) patients.

This study aimed to assess the effect of multiple injections of linear GAD-based contrast agents on the signal intensity of the dentate nucleus (DN) in MS patients.

A cohort of 122 MS patients with GAD-enhanced MRI scans and 61 healthy controls were enrolled in this study. The final standard GAD-enhanced MRI scans were acquired using 1.5T MRI systems. Non-enhanced T1-weighted MRI was performed to assess the DN hyperintensity. The signal intensity ratio (SIR) was also calculated by setting the regions of interest (ROIs) on the DN and pons and dividing the signal intensity of DN to that of pons. The patients were also divided into two subgroups, based on the total number of MRI exposures (> 4 times vs. others), and the subgroups were compared in terms of the mean SIR and hyperintensity.

Overall, 68% (n = 83) of the patients were exposed to a contrast agent more than four times. Of these patients, 31.3% (n = 26) showed DN hyperintensity, while no hyperintensity was found in other patients or healthy controls (P < 0.02 for both). The mean SIRs were 1.10 ± 0.07 and 1.04 ± 0.02 in the patients and healthy controls, respectively (P < 0.001). Besides, the mean SIR was 1.14 ± 0.04 in patients with DN hyperintensity and 1.09 ± 0.07 in other patients (P < 0.001). Based on the results, the mean SIR was 1.12 ± 0.7 in patients with > 4 contrast injections, while it was 1.06 ± 0.04 in patients with ≤ 4 contrast injections (P < 0.001).

The SIR and visible DN hyperintensity increased by increasing the number of GAD injections, which could be due to the tissue deposition of GAD.

Early diagnosis and timely treatment are crucial for breast cancer patients.

This study aimed to investigate the diagnostic value of full-field digital mammography (FFDM), digital breast tomosynthesis (DBT), and magnetic resonance imaging (MRI) for breast cancer. Patients and

This study was performed on 210 patients diagnosed with breast cancer and benign breast lesions (n = 105) by FFDM, DBT, MRI, and pathological examination from January 2019 to December 2020. The patients’ imaging and clinical data were retrospectively analyzed. The lesions were evaluated according to the breast imaging-reporting and data system, with pathological diagnosis as the gold standard. The diagnostic efficiency of the examination methods was analyzed by plotting the receiver operating characteristic (ROC) curves. The DBT and MRI results were finally compared.

In 210 patients, 105 benign and 105 malignant lesions were detected. The area under the ROC curve (AUC) of FFDM, DBT, MRI, FFDM + DBT, and FFDM + MRI was 0.734, 0.857, 0.883, 0.865, and 0.924, respectively. Based on the results, the AUC values were significantly higher for DBT, MRI, FFDM + DBT, and FFDM + MRI compared to FFDM (P < 0.05), while similar values were reported for the former methods (P > 0.05). The diagnostic sensitivity of MRI was higher than that of DBT and FFDM; the sensitivity of DBT was higher than that of FFDM; and the specificity and positive predictive value were higher for DBT compared to MRI and FFDM.

Compared to FFDM, DBT and FFDM + DBT could significantly improve the diagnostic efficiency of breast cancer; the diagnostic efficiency of these modalities was comparable to that of MRI and FFDM + MRI. The sensitivity of DBT was lower than that of MRI and higher than that of FFDM, while its specificity and positive predictive value were higher than those of MRI. Overall, FFDM + DBT and FFDM + MRI are conducive to early diagnosis.

Anatomical variations in vascular structures are frequently encountered. In the cerebellopontine region, anatomical variations, especially variations in the anterior inferior cerebellar artery (AICA) in relation to cranial nerves passing through the internal acoustic canal (IAC), are common. Magnetic resonance imaging (MRI) provides detailed information for the evaluation of the cerebellopontine region and the IAC anatomy.

This study aimed to examine the relationship between the IAC anatomy and AICA loop variations and to investigate the frequency of anatomical variations and its correlation with demographic variables. Patients and

In this study, 253 patients (age > 18 years), who underwent 3-Tesla MRI of the temporal bone between July 2019 and December 2019, were retrospectively evaluated. The exclusion criteria were images of poor diagnostic quality due to technical or patient-related reasons and the presence of a localized tumor that could disrupt the IAC. Four patients were excluded from the study because they had tumors related to IAC. The AICA variations were categorized according to the Chavda classification. The IAC size, canal diameter, canal length, and meatus width were measured, and the canals were characterized as cylindrical, funnelshaped, and bud-shaped.

A total of 249 patients were included in this study. The Chavda type I vascular loop was the most common type on both sides. The mean size measurements of IACs were significantly higher in the group of vascular loops compared to the group without vascular loops. The presence of a vascular loop was significantly more common in funnel- and bud-shaped IACs compared to cylindrical IAC. Also, there was a negative correlation between the patient’s age and all IAC dimensions.

The results of the present study showed that the AICA loop variations were closely related to the size and shape of the IAC.

Mammography (MMG) is the primary screening tool for breast cancer, as microcalcifications are the most common MMG finding in ductal carcinoma in situ (DCIS). The use of high-frequency transducers facilitates the visualization of calcifications on ultrasonography (USG), especially in patients with dense breasts and cancer symptoms. Although a correlation has been reported between the imaging features of DCIS and pathological features, few studies have focused on multiple imaging modalities.

To evaluate the correlation of DCIS microcalcifications in breast imaging with pathological and biological features. Patients and

The MMG and USG findings of 125 lesions detected in 123 patients, diagnosed with pure DCIS, were retrospectively reviewed according to the breast imaging-reporting and data system (BI-RADS). The USG and comparable MMG findings of microcalcifications were divided into three groups: group 1 (MMG negative, USG negative), group 2 (MMG positive, USG negative), and group 3 (MMG positive, USG positive). The pathological findings (nuclear grade and comedo necrosis) and biological features [estrogen (ER) positive group, human epidermal growth factor receptor 2 (HER2) positive group, triple negative group, and Ki-67 index] were compared with the MMG and USG features using Chi-square test.

Microcalcifications were observed on MMG in 83 (66.4%) DCIS lesions. Positive microcalcifications on MMG were significantly associated with a high nuclear grade (P = 0.001) and comedo necrosis (P = 0.001). Positive microcalcifications on MMG were significantly associated with ER negativity (P = 0.023), HER2 positivity (P = 0.002), and increased Ki-67 index (P = 0.001). There were 62 lesions (49.6%) without microcalcifications on USG (group 1 and group 2), while there were 63 (50.4%) lesions with microcalcifications on USG (group 3). Positive microcalcifications on MMG were significantly associated with ER-negative group (P = 0.023), HER2-positive group (P = 0.002), and increased Ki 67 index (P = 0.001).

Based on the present results, DCIS microcalcifications detected via imaging were significantly associated with poor prognostic pathological factors, such as a high nuclear grade and comedo necrosis, as well as poor prognostic biological factors, including ER negativity, HER2 positive group, and a high Ki-67 index.

Multiple sclerosis (MS) is a demyelinating disease with multiple symptoms. To examine the effect of medications, magnetic resonance imaging (MRI) imaging can be performed.

This study aimed to compare the visual assessment of MRI images by physicians and the results of a MATLAB-based software developed for evaluating the MS plaque volume. Patients and

TYSABRI (natalizumab)-treated patients were enrolled in this study. MRI was performed before and after treatment. A MATLAB-based software was developed to evaluate the MRI images. The images were then subjectively evaluated by three specialists and objectively assessed by the software, and the results were then compared.

Thirty-five patients participated in this study. According to the software, the status of 37.14% of the patients improved; however, 62.86% of cases deteriorated after a year of treatment. There was less than 50% agreement between the physicians and less than 55% agreement between the physicians and the software results. A disagreement of almost 45% was observed between the physicians and the software results, as in some cases, small changes were detected in successive images. The second cause of disagreement could be the physicians’ expectations; although the patient’s recovery was highly expected in some cases, their condition deteriorated.

The results revealed that the objective assessment of sequential MRI images of MS patients reduced human errors and improved the evaluation of this disease.

Osteoporotic compression fractures are common among the elderly. It is important to predict the posterior ligamentous complex (PLC) and disc injuries in computed tomography (CT) scans of patients with magnetic resonance imaging (MRI) contraindications.

To determine the role of the CT compression ratio (CTCR) in diagnosing PLC and disc injuries and to compare it with the loss of vertebral body height (LOVBH) in osteoporotic thoracolumbar compression fractures. Patients and

A total of 91 consecutive patients with vertebral fractures were included as the study population. The PLC and disc injuries were assessed using MRI, and the following radiological parameters were determined based on CT scans for further MRI examinations: CTCR, LOVBH, local kyphosis (LK), interspinous widening (ISW), vertebral translation (VBT), and posterior structures fractures (PSF). Statistical analysis was performed to identify the diagnostic value of CT features in PLC and disc injuries.

The PLC injuries were detected in 9/91 cases, and the number of disc injuries was 47/91. Neither CTCR nor LOVBH was associated with PLC injuries (P > 0.05). However, the CTCR was associated with disc injuries (P < 0.05), with an optimal threshold of 1.755 (sensitivity, 68.1%; specificity, 79.5%), while the LOVBH was not significantly associated with disc injuries. Based on the results, VBT was significantly related to PLC and disc injuries (P < 0.05).

The injured vertebral CTCR was associated with disc injuries rather than PLC injuries, suggesting that compression fractures are relatively stable with less PLC injury. Overall, CTCR is a useful indicator reflecting the compression degree of the injured vertebrae; it is also a valid predictor of disc injuries.

The histopathological differentiation of renal neoplasms can be challenging via imaging.

To evaluate differences in histogram parameters on apparent diffusion coefficient (ADC) maps and to investigate the efficacy of histogram analysis in differentiation of oncocytomas from malignant renal neoplasm (MRN) subgroups.

In this cross-sectional, retrospective study, the texture parameters of diffusion-weighted magnetic resonance images (DW-MRI) were evaluated in 65 patients with renal tumors (nine cases of oncocytoma and 59 cases of MRN) for a histological analysis.

A total of 68 lesions from 50 male and 15 female patients, with a median age of 55.4 years, were examined in this study. There were significant differences in the mean, median, and peak ADC values, as well as ADC percentiles, between the oncocytoma and MRN subgroups. Regarding the histopathological features of the lesions, 9 (11.5%) cases of oncocytomas, 23 (29.5%) cases of clear cell renal carcinoma (ccRCC), 14 (17.9%) cases of papillary renal cell carcinoma (pRCC), 12 (15.4%) cases of chromophobe renal cell carcinoma (chRCC), and 10 (12.8%) other tumors (including four cases of transitional cell carcinoma, four cases of non-Hodgkin’s lymphoma, and two cases of primitive neuroectodermal tumor) were identified. Significant differences were found in the mean and median ADC values between the oncocytoma, pRCC, chRCC, and other MRN subgroups. Moreover, significant differences were found in the mean and median ADC values between the ccRCC, pRCC, and chRCC subgroups. There were also significant differences in the percentiles of mean and median ADCs between oncocytomas and pRCC, chRCC, and other MRN subgroups. However, there were no significant differences in the mean and median ADCs (including the percentile histogram analysis) or the peak ADC between the oncocytoma and ccRCC groups. The mean, median, and percentile of ADC for renal masses were superior to kurtosis, skewness, and entropy.

Although differentiation between ccRCC and oncocytoma was not possible by only measuring the mean, median, and peak ADC values, the histogram analysis of ADCs may improve differentiation between the MRN subgroups. Clearly, ADC cannot be used to differentiate between oncocytomas and MRNs.

Aortic floating thrombus (AFT) is a rare disease, which is often misdiagnosed as a tumor or another disease. Here, we report five cases of AFT, confirmed by computed tomography angiography (CTA). The patients’ laboratory biomarkers, clinical treatment, dynamic changes, and CTA features, including the AFT location, morphology, size, and aortic segment involvement, were retrospectively analyzed. CTA was the main imaging modality for detecting AFT, as it could depict lesions and determine the therapeutic effects accurately. Overall, the therapeutic strategy should be selected individually, depending on the patient’s physical health; conservative medication use is also recommended.