Dynamic Magnetic Resonance Imaging Findings Research Articles

Static and Dynamic Magnetic Resonance Imaging in Female Pelvic Floor Dysfunction: Correlation With Pelvic Organ Prolapse Quantification.

Pelvic organ prolapse (POP) is clinically assessed and staged commonly by the pelvic organ prolapse quantification (POP-Q) system. Dynamic magnetic resonance imaging (MRI) of the pelvic floor is an emerging modality for anatomical and functional assessment of the pelvic floor and staging of POP. The purpose of this study was to correlate the dynamic MRI findings with POP-Q examination for the staging of POP in each pelvic compartment by comparing various anatomic points. A prospective observational study of the comparative cross-sectional design was conducted among patients who underwent MRI of the pelvic floor and POP-Q at our institute. A total of 50 patients were included. Anatomical landmarks in the three compartments were analyzed in relation to standard reference lines on dynamic MRI and compared with POP-Q measurements. Most of our patients had multicompartment disease (70%). When compared to POP-Q, MRI has a strong correlation for quantification of anterior (0.723) and middle (0.525) compartments and a weak correlation (0.232) for posterior compartment prolapse. POP-Q examination is based on the various points within the vaginal canal, and all the points do not represent a true anatomic landmark. MRI, on the other hand, is based on a true anatomical plane and gives detailed information about various structures in all three compartments. Thus, MRI also helps bridge the gap between various referring specialties in treating pelvic floor disorders.

Modified classifications and surgical decision-making process for chronic anterior talofibular ligament injuries based on the correlation of imaging studies and arthroscopic findings.

Surgical treatment of chronic ankle instability (CAI) typically includes ligament repair or reconstruction. Using preoperative ultrasonography or magnetic resonance imaging (MRI) to choose an appropriate arthroscopic procedure is still difficult. The aim of this study was to evaluate the correlation of imaging studies with arthroscopic findings and support the arthroscopic surgical decision-making process. One hundred twelve patients with chronic anterior talofibular ligament (ATFL) injuries were treated using the arthroscopic surgical decision-making process from November 2018 to August 2020. Preoperative imaging assessments using dynamic ultrasonography, MRI, and combined methods were applied to categorize the ATFL remnants into three quality grades ("good," "fair," and "poor"). Arthroscopic findings were classified into 6 major types (7 subtypes) and used to select an appropriate surgical procedure. Correlations between imaging studies, arthroscopic findings, and surgical methods were evaluated. Diagnostic parameters, clinical outcomes, and complications were also assessed. There was a significant interobserver agreement in the evaluation of dynamic ultrasonography (0.954, P < 0.001), MRI (0.958, P < 0.001), and arthroscopy diagnosis (0.978, P < 0.001). There was a significant correlation between the modified imaging classifications, arthroscopic diagnostic types, and surgical procedures. The mean follow-up period was 33.58 ± 8.85 months. Significant improvements were documented in postoperative ankle functions when assessed with Karlson-Peterson scores and Cumberland Ankle Instability Tool scores. The risk of complications is also very low. The modified classifications and surgical decision-making process based on dynamic ultrasonography, MRI, and arthroscopic findings, as proposed in this study, might help in selecting an appropriate arthroscopic surgical procedure for chronic ATFL injuries.

Differentiation of silent corticotroph pituitary neuroendocrine tumors (PitNETs) from non-functioning PitNETs using kinetic analysis of dynamic MRI

PurposeSilent corticotroph pituitary adenomas (SCAs)/pituitary neuroendocrine tumors (PitNETs) are common non-functioning pituitary adenomas (NFAs)/PitNETs with a clinically aggressive course. This study aimed to investigate the ability of time-intensity analysis of dynamic magnetic resonance imaging (MRI) for distinguishing adrenocorticotropic hormone (ACTH)-positive SCAs and ACTH-negative SCAs from other NFAs.Materials and methodsWe retrospectively evaluated the dynamic MRI findings of patients with NFAs. The initial slope of the kinetic curve (slopeini) obtained by dynamic MRI for each tumor was analyzed using a modified empirical mathematical model. The maximum slope of the kinetic curve (slopemax) was obtained by geometric calculation.ResultsA total of 106 patients with NFAs (11 ACTH-positive SCAs, 5 ACTH-negative SCAs, and 90 other NFAs) were evaluated. The kinetic curves of ACTH-positive SCAs had significantly lesser slopeini and slopemax compared with ACTH-negative SCAs (P = 0.040 and P = 0.001, respectively) and other NFAs (P = 0.018 and P = 0.035, respectively). Conversely, the slopeini and slopemax were significantly greater in ACTH-negative SCAs than in NFAs other than ACTH-negative SCAs (P = 0.033 and P = 0.044, respectively). In receiver operating characteristic analysis of ACTH-positive SCAs and other NFAs, the area under the curve (AUC) values for slopeini and slopemax were 0.762 and 0748, respectively. In predicting ACTH-negative SCAs, the AUC values for slopeini and slopemax were 0.784 and 0.846, respectively.ConclusionsDynamic MRI can distinguish ACTH-positive SCAs and ACTH-negative SCAs from other NFAs.

Dynamic magnetic resonance imaging findings in the early stages of neonatal hypoglycemic brain injury.

Neonatal hypoglycemic brain injury was most common in the occipital lobes. Severe clinical symptoms were significantly associated with extensive brain injury involving the internal capsule, basal ganglia, and thalamus, which could be attributed to hypoxia-ischemia and lead to a poor prognosis. •There is no clear neurological safe threshold for hypoglycemia in neonates. Studies suggest that symptomatic hypoglycemia can be related tobrain injury. •Severe clinical symptoms are significantly associated with extensive brain injury on MRI scans. Extensive brain injuries involving the internal capsule, basal ganglia, and thalamus, which could be due to associated hypoxia-ischemia and lead to a poor prognosis.

Dynamic CSF MRI Findings in the Diagnosis and Follow-up of Arnold Chiari Type 1

Aim:&#x0D; Chiari malformation is a spectrum of diseases that includes different subtypes, has a wide clinical presentation, and therefore has different follow-up and treatment methods. We aimed to compare clinical scoring systems and cerebrospinal fluid (CSF) dynamics obtained by magnetic resonance imaging (MRI) in Arnold Chiari Malformation Type-1 (CM-1) patients in the preoperative and postoperative periods.&#x0D; Material and Method:&#x0D; Twenty-one patients with a diagnosis of CM-1 who underwent CSF MRI between January 2016 and June 2020 were included. In addition, 21 healthy volunteers were evaluated. All the patients had undergone decompression surgery due to CM-1 related symptoms. The relationship between preoperative MRI findings and clinical findings of 21 patients was evaluated. Changes in clinical and imaging findings of 21 patients who underwent surgery were compared. &#x0D; Results:&#x0D; Measurements were made just below the level of the cerebellar tonsil. CM-1 patients had higher preoperative peak positive velocity anteriorly (PPV: 6.26±2.72 vs 3.89±1.74 cm/s; p=0.001) and peak negative velocity anteriorly (PNV: -7.45±3.36 vs -3.61±2.65 cm/s; p=0.001) than healthy volunteers. Preoperative net flow in the posterior subarachnoid space of CM-1 patients was lower than in healthy volunteers (p=0.017).&#x0D; Aliasing of the reverse flow was seen in 13(62%) patients.&#x0D; PPV and PNV were decreased after surgery (PPV: 6.26±2.72 vs 4.73±1.94 cm/s, p=0.017; PNV: -7.45±3.36 vs -4.97±1.97, p=0.005). Net Flow was increased posteriorly (0.32 vs 2.21 ml/min; p=0.053).&#x0D; Postoperative response was inversely proportional to the degree of tonsillar herniation. As the Asgari score of the cases increases, the Peak Positive and Negative Velocity Anterior values also increase with a statistically significant correlation (p=0.003; p=0,032 respectively)&#x0D; Conclusions:&#x0D; Our findings suggest that the determination of flow dynamics and morphology using MR imaging correlates with clinical findings and may be a useful tool in determining the need and timing of surgery.

Characteristics of dynamic magnetic resonance imaging for shoulder stiffness in postoperative breast cancer patients: A preliminary case series.

Introduction and importanceShoulder stiffness in postoperative breast cancer causes a decrease in their quality of life. However, the underlying pathology is not fully understood, and no study has investigated the dynamic magnetic resonance imaging (MRI) findings in these patients. Therefore, the current preliminary study aimed to investigate the dynamic MRI findings in patients with shoulder stiffness occurring after breast cancer surgery.MethodsWe retrospectively analyzed the electronic medical records of postoperative breast cancer patients with shoulder stiffness, dated from January 2015 to December 2020. The baseline characteristics, breast cancer treatment methods, range of active shoulder motion, and location of the abnormal enhancement on dynamic MRI were assessed.ResultsThe mean age of the patients was 57.8 ± 6.1 years (range, 47–63 years) and the mean duration of shoulder symptoms was 5.6 ± 3.6 months (range, 2–12 months). An abnormal enhancement of the rotator interval and axillary pouch was observed on dynamic MRI of all the included patients.ConclusionThis study presents the first case reports of the dynamic MRI findings in postoperative breast cancer patients with shoulder stiffness. All patients had abnormal enhancement of the rotator interval and axillary pouch.

A case of periosteal fasciitis located in the mandible in a child

Periosteal fasciitis (PF), a subtype of nodular fasciitis, is an uncommon benign soft-tissue mass that originates from the periosteum or tissues adjacent to bones. PF has rarely seen in children, especially involving in the mandible. This case report presents a rare case of PF originating from the periosteum of the mandible in an 11-year-old girl. She was referred to our hospital with fast-growing painless swelling in her left mandible. Computed tomography revealed an exophytic juxtacortical mass eroding the lower part of the left mandible and lower mandibular cortex with a periosteal reaction. The mass showed low signal intensity on T1-weighted magnetic resonance imaging (MRI) and high signal intensity on T2-weighted MRI. The apparent diffusion coefficient (ADC) of the lesion found to be moderate. Dynamic contrast-enhanced MRI revealed a gradual increment pattern in the central region of the mass. On 18F-fluorodeoxyglucose (FDG) positron-emission tomography/computed tomography (PET/CT), relatively high 18F-FDG uptake was observed on the early scan and the 18F-FDG uptake was declined on the delayed scan. The clinical and conventional radiological findings of the mass were suggestive of malignancy. However, the findings of ADC and dynamic MRI and dual-time-point FDG-PET/CT favored benign etiology over malignant etiology. Histological and immunohistochemical findings along with reactive ossification of the periosteum confirmed the diagnosis of PF. Currently, comprehensive examinations, such as clinical, imaging, and histopathological examinations, are recommended for the definitive diagnosis of PF, while MRI and dual-time-point FDG-PET/CT could have a potential usefulness to differentiate from malignancy.

The utility of dynamic MRI in differentiating the hormone-producing ability of pituitary adenomas

PurposeTo investigate the relationship between dynamic magnetic resonance imaging (MRI) findings and hormonal activity in pituitary adenomas.MethodsWe retrospectively evaluated the dynamic MRI findings in 244 patients with pathologically confirmed pituitary adenomas and a diagnosis of clinically active prolactin (PRL)-producing adenomas. Among the 244 pituitary adenomas, 55, 16, 6, and 4 produced growth hormone (GH), PRL, adrenocorticotropic hormone, and thyroid-stimulating hormone, respectively, while 163 were non-functioning (NF) adenomas. For each adenoma, we calculated the washout rate (WR) and early (EER) and delayed (DER) tumour-to-normal-tissue enhancement ratios.ResultsThe respective mean values of the WR, EER, and DER were 9.4%, 75.2%, and 64.5% for GH-producing adenomas; 6.2%, 117.1%, and 106.2% for PRL-producing adenomas; and 5.4%, 116.7%, and 108.7% for NF adenomas. GH-producing adenomas had significantly lower EER and DER values than PRL-producing (P < 0.001) and NF adenomas (P < 0.001). In ROC analysis of GH-producing and non-GH-producing adenomas, the areas under the curves of WR, EER, and DER were 0.593, 0.825, and 0.857, respectively.ConclusionThere are differences in dynamic MRI features between GH-producing and non-GH-producing adenomas, which suggests that EER and DER may be useful for diagnosing GH-producing adenomas.

Evaluation of the relationship between dynamic magnetic resonance imaging findings and histopathological prognostic factors in breast cancer

Evaluation of the relationship between dynamic magnetic resonance imaging findings and histopathological prognostic factors in breast cancer

Magnetic resonance imaging features of idiopathic granulomatous mastitis: is there any contribution of diffusion-weighted imaging in the differential diagnosis?

To identify the magnetic resonance imaging (MRI) appearance of idiopathic granulomatous mastitis, and the usefulness of diffusion-weighted magnetic resonance imaging (DW-MRI) in distinguishing idiopathic granulomatous mastitis (IGM) from malignant breast lesions. A total of 37 women (mean age 36+8; range 20-67 years) with histopathologic diagnoses of idiopathic granulomatous mastitis were enrolled in the study. Five patients had bilateral IGM, which were evaluated as ten cases. Dynamic MRI findings were categorized as enhancing mass lesion, non-mass enhancement, or both together. The frequency of quadrant involvement, retroareolar involvement, accompanying abscess, ductal ectasia, skin thickening, breast edema, extension to pectoral muscle, and presence of fistula were investigated. The mean apparent diffusion coefficient (ADC) values for lesions, contralateral normal breast parenchyma, pectoralis major muscle, and sternum were measured in patients with invasive cancers (n=42) and those with mastitis (n=42). The ADC ratio of the lesions to the contralateral normal breast parenchyma, pectoralis major muscle, and sternum were determined. The findings of idiopathic granulomatous mastitis on MRI were total (in all quadrants) or wide (2 or 3 quadrants) in 30 (71.5%), retroareolar space involvement in 28 (66.7%), skin thickening in 21 (50%), breast edema in 21 (50%), extension to pectoral muscle in 18 (42.9%), accompanying abscess formation in 33 (78%), ductal ectasia in 17 (40.5%), and fistulas in 13 (31%). On dynamic contrast-enhanced MRI, 69% of the patients had mass appearance of IGM. The most frequent enhancement patterns were rim enhancement in 20 (78%) in masses and clustered ring in 11 (48%) in non-mass lesions. Early enhancement pattern of IGM was obtained as 'slow' in 29 cases (69%), 'medium' in 11 cases (26.1) and 'rapid' in 2 (5%) cases. Time-signal intensity curves were detected as Type-1 in 27 cases (64%) and Type-2 in 15 cases (36%). IGM showed significantly lower mean ADC values when compared with the normal parenchyma. When IGM was compared with malignancy, mastitis ADC was 0.98±0.188×10-3, and invasive cancer ADC was 0.95±0.229×10-3. The difference in ADC values of mastitis and invasive cancers proved not to be significant (P=0.185). Our results had no discriminatory power for IGM versus malignant lesions for either ADC values and ADC ratios of normal breast parenchyma, pectoralis major muscle, and sternum. Although not characteristic for idiopathic granulomatous mastitis, masses with rim enhancement or clustered-ring non-mass lesions with segmental distribution on MRI are the most common features of the disease. Ductal ectasia and periductal enhancement were commonly accompanying; this and kinetic analysis are valuable findings for distinguishing IGM from invasive cancer. IGM shows similar ADC values to invasive cancers despite being benign, DW-MRI is not helpful in the differentiation with malignant lesions.

Risk factors for bleeding in hepatocellular adenoma.

Hepatocellular adenoma (HCA) is a benign hepatic lesion that may be complicated by bleeding, although the risk of bleeding is ill-defined. The aim of this study was to assess risk factors for bleeding in patients diagnosed with HCA. Patients with HCA were included prospectively from January 2008 to July 2012. Patient characteristics were noted. Patients underwent dynamic magnetic resonance imaging (MRI) and/or computed tomography (CT) at presentation and during follow-up. Lesion characteristics on (follow-up) imaging were noted, and bleeding was graded as intratumoral (grade I), intrahepatic (grade II) or extrahepatic (grade III). The standard of reference for diagnosis was histopathology, or dynamic MRI and/or CT findings. Possible risk factors were included if mentioned in literature (lesion size, body mass index), or based on clinical experience (lesion location, visible vessels on imaging). A total of 45 patients (median age 39 (range 22-60) years; 44 women) with 195 lesions (median size 24 (10-250) mm) were evaluated. Bleeding occurred in 29 patients (64 per cent) and in 42 lesions (21.5 per cent) with a median size of 62 (10-160) mm. Size was a risk factor for bleeding (P < 0.001), with an increased number of bleeding events in lesions of 35 mm or more. Exophytic lesions (protruding from liver) had more bleeding (16 of 24, 67 per cent) than intrahepatic (9 of 82, 11 per cent) or subcapsular (17 of 89, 19 per cent) lesions (P < 0.001). Lesions in segments II and III had more bleeds than those in the right liver (11 of 32 versus 31 of 163; P = 0.049), as did lesions in which peripheral or central arteries were visualized on imaging (10 of 13 versus 32 of 182 lesions with no visible vascularization; P < 0.001). Risk factors for bleeding of HCA include diameter of 35 mm or more, visualization of lesional arteries, location in the left lateral liver, and exophytic growth.

Fibrous dysplasia of the maxilla: a case report together with its conventional imaging and dynamic magnetic resonance imaging findings

We previously reported that dynamic contrast-enhanced MRI parameters and time–signal intensity curves (TICs; also known as contrast index curves) are useful for the differential diagnosis of jawbone lesions. In particular, odontogenic fibroma and ossifying fibroma, which possess similar histopathological features (i.e., a mixture of hard and soft tissue components), display unique TIC patterns, and we consider that the TIC patterns of these lesions reflect their hard and soft tissue components. Therefore, fibrous dysplasia, which contains fibrous tissue and immature isolated trabeculae composed of woven bone, is expected to display an interesting TIC. The purpose of this study was to assess the utility of TICs for differentiating between the abovementioned lesions, which have similar histopathological components.

Comparison of OMERACT-RAMRIS scores and computer-aided dynamic magnetic resonance imaging findings of hand and wrist as a measure of activity in rheumatoid arthritis

The purpose of this study was to compare the value of conventional magnetic resonance imaging (MRI) finding of rheumatoid arthritis (RA) and computer-aided dynamic MRI measurements in predicting the activity of disease. The activity of the disease in 40 RA patients was evaluated by the disease activity score in 28 joints (DAS28). The conventional MRI of the wrists of all patients were scored for bone edema, synovitis and erosions, according to the criteria of RA-MRI scoring system (RAMRIS) developed by Outcome measures in rheumatology clinical trials (OMERACT) MR Imaging Group. Synovitis was also quantified by dynamic postcontrast MRI imaging using color coded maximum slope of increase maps and measurements of early enhancement rate (EER) and relative enhancement (RE). Twenty-two (55 %) patients with a score higher than 5.1 constituted the high disease activity group, 18 (45 %) patients with a score of 5.1 or less constituted moderate disease activity group. The dynamic MRI-EER score was the most significant parameter to differentiate between the groups (p = 0.001). Among OMERACT scores, only bone edema [p = 0.020 for wrist and p = 0.037 for metacarpophalangeal joints (MCP)] had a significant difference between the two groups. Dynamic MRI RE score and OMERACT scores for erosions and synovitis for both the wrist and MCP joints did not differ significantly between the two groups. Computer-aided dynamic MRI is a reliable, noninvasive method of evaluating the RA patients, which correlates with the DAS28 scores, at a higher significance than the OMERACT-RAMRIS scores.

An Unusual Case of Mammary Paget’s Disease Diagnosed Using Dynamic Contrast-Enhanced MRI

Mammary Paget's disease is a rare presentation of breast cancer. At clinical examination, it is characterized by skin lesions of the nipple-areola complex, almost always a sign of malignancy. In fact, it is often associated with an underlying mammary ductal carcinoma in situ (DCIS) or invasive carcinoma. An underlying carcinoma is also common in women with negative mammography and ultrasound (US); in these cases, magnetic resonance imaging (MRI) is a diagnostic tool useful in the detection of occult cancer. We described an unusual case of mammary Paget's disease with underlying DCIS, in a patient without nipple-areola complex alterations and/or palpable lump. On suspicion of Paget's disease, the patient underwent MRI examination that proved useful for an accurate diagnosis. Biopsy confirmed dynamic MRI findings.

Ossifying fibroma of the maxilla: a case report including its imaging features and dynamic magnetic resonance imaging findings

Ossifying fibroma (OF), a rare nonodontogenic tumor, is defined as a bone-related jawbone lesion. The main histopathological feature of OF is the replacement of bone by benign connective tissue. Ossifying fibroma usually occurs in the second to fourth decades of life and shows a predilection for females. Ossifying fibroma most commonly occurs in the mandible, and OF arising from the anterior part of the maxilla is rare. Ossifying fibromas display various radiographic findings, including varying degrees of radiolucency and radiopacity, depending on the proportions of their soft and hard tissue components. Depending on their components, it can be difficult to distinguish OF from other fibroosseous lesions and some odontogenic tumors by using conventional radiographs, computed tomography, and magnetic resonance imaging (MRI). We report a case of OF in the anterior maxilla in a 56-year-old man, together with its histopathological and imaging findings including the dynamic MRI findings.

The accuracy of dynamic Magnetic Resonance Imaging in evaluation of internal derangement of the temporomandibular joint; comparison with arthroscopic findings

PurposeTo determine the correlation between dynamic Magnetic Resonance Imaging (MRI) and arthroscopy findings in internal derangement of the temporo-mandibular joint (TMJ). Material and methodsThis study was conducted on 25 patients (of 28 TMJs), 18 females and 7 males their age ranging from 20 to 42years (mean 31years). All patients were submitted to MRI examination of the TMJ. All of these patients underwent arthroscopy for diagnosis and treatment and results were compared with dynamic MRI findings. ResultsConcerning disc position, MR examination revealed 24 TMJs out of 28 (85.7%) with anteriorly displaced discs, while 4 TMJs (15.3%) showed normal disc position. When type of displacement was considered, MRI revealed 8 TMJs (28.7%) with anterior disc displacement with reduction (ADDWR), while 16 TMJs (57.1%) with anterior disc displacement without reduction (ADDWOR). While arthroscopy revealed 6 TMJs out of 28 (21.4%) with ADDWR, 14 TMJs (50%) showed ADDWOR and 8 TMJs (28.6%) with normal disc position.MRI assessment of disc mobility revealed 12 out of 28 TMJs (42.8%) with limited asynchronous movements, while 3 TMJs (10.7%) with stuck disc, and 13 TMJs (46.4%) with normal mobility. While arthroscopy revealed 11 out of 28 TMJs (39.2%) with limited disc mobility, 1 TMJs (3.5%) with stuck disc, and 16 TMJs (57.1%) with normal mobility.The results of this study showed no significant statistical difference between arthroscopy and MRI in diagnosing disc position and disc mobility. ConclusionsBoth arthroscopy and dynamic MRI are statistically correlated with each other in detecting TMJ internal derangement. Nevertheless, reviewing the results highlighted the advantages of MRI augmented by dynamic protocol over arthroscopy in diagnosing disc position and mobility and hence, we recommend using MRI as a first line diagnostic modality when internal derangement is suspected.

Multimodality imaging features of idiopathic granulomatous mastitis: outcome of 12 years of experience

This study was done to determine mammographic, sonographic and magnetic resonance imaging (MRI) appearances of idiopathic granulomatous mastitis, an entity clinically and radiographically resembling breast carcinoma. A total of 36 women (mean age 37 years, range 21-51 years) with histopathological diagnosis of idiopathic granulomatous mastitis were enrolled in the study. The Breast Imaging Reporting and Data System (BI-RADS) was used to categorise the levels of suspicion of malignancy on mammography. Mammography findings were classified also according to density, margin, architectural distortion and number of lesions. Lesions were classified according to number, heterogeneity and echogenic features on sonography. Dynamic MRI findings were categorised as enhancing mass lesion, nonmass lesion or both mass lesions and nonmass lesions together. Subclassification criteria for MRI included lesion shape, margin, border and internal enhancement pattern. The most common mammographic finding was either focal or diffuse asymmetric density (n=15, 44%). The most common sonographic findings were solitary or multiple circumscribed heterogeneous hypoechoic masses (n=19, 52%). Among other sonographic findings were diffuse abscess formation with fistulae and massive parenchymal heterogeneity and hypoechogenicity in 12 (33%) and five (13%) women, respectively. On MRI, enhancing mass lesions were detected in 24 patients, whereas enhancing nonmass lesions were observed in 28. Sixteen patients had both enhancing mass lesions and nonmass lesions together. Although not characteristic for this entity, asymmetric density on mammography, solitary or multiple clustered heterogeneous hypoechogenicity with a tubular configuration on sonography and round, smooth-contoured masslike lesion with rim enhancement or segmental non-mass-like lesion on MRI are the most common features of the disease.

Sclerosing stromal tumor of the ovary: ultrasound elastography and MRI findings on preoperative diagnosis.

Sclerosing stromal tumor (SST) is a benign stromal tumor of the ovary. Preoperative diagnosis of this benign tumor mainly depends on imaging findings. Dynamic computed tomography (CT) and magnetic resonance imaging (MRI) show typical contrast enhancement of SST with peripheral enhancement in the early phase and centripetal progression in the delayed phases. We present the imaging findings of ultrasonography, ultrasound elastography, and dynamic MRI in the diagnosis of SST. Abdominal ultrasound elastography is a novel technique that depicts the stromal structure of SSTs by comparing the elasticity of the tumor and the myometrium using quantitative strain values.

Correlation of the apparent diffusion coefficient value and dynamic magnetic resonance imaging findings with prognostic factors in invasive ductal carcinoma

To evaluate the correlation of the mean and minimal apparent diffusion coefficient values (ADC(mean) , ADC(minimal) ) and dynamic magnetic resonance imaging (MRI) findings with prognostic factors in invasive ductal carcinoma. A total of 107 women with invasive ductal cancer underwent breast MRI. The ADC(mean) and ADC(minimal) of the cancers were computed. MRI findings were retrospectively evaluated according to the Breast Imaging Reporting and Data System (BI-RADS) lexicon: mass or nonmass type, mass shape, mass margin, nonmass distribution, and enhancement pattern. Histological records were reviewed for tumor size, lymph node metastasis, histologic grade, and expression of estrogen receptors (ER), progesterone receptors (PR), c-erbB-2(HER2), Ki-67, and epidermal growth factor receptors (EGFR). Correlations of ADC values and MR findings with prognostic factors were determined using the Mann-Whitney U-test and the Kruskal-Wallis test. The mean ADC(minimal) was 0.78 ± 0.24 (× 10⁻³ mm² /s), and the mean ADC(mean) was 1.01 ± 0.23 (× 10⁻³ mm² /s). There was a significant correlation of the ADC(mean) value with ER expression (P = 0.027) and HER2 expression (P = 0.018). There was no significant relationship between ADC(minimal) and prognostic factors or between ADC(mean) and traditional prognostic factors, PR, Ki-67 and EGFR. The majority of the mass type lesions were less than 5 cm in size and the majority of nonmass type lesions were more than 2 cm in size (P = 0.022). The margin of mass was significantly associated with lymph node metastasis (P = 0.031), ER expression (P = 0.013), PR expression (P = 0.036), HER2 expression (P = 0.019), and EGRF expression (P = 0.041). The rim internal enhancement was significantly correlated with Ki-67 expression (P = 0.008). The low ADC(mean) value was related to positive expression of ER and negative expression of HER2. A spiculated margin was related to a good prognosis, but rim enhancement was associated with a poor prognosis.

Peripheral hyperintense pattern on T2‐weighted magnetic resonance imaging (MRI) in breast carcinoma: Correlation with early peripheral enhancement on dynamic MRI and histopathologic findings

To investigate the correlation between the peripheral hyperintense pattern of breast carcinoma on T2-weighted images (T2WI) and the early peripheral enhancement (EPE) on dynamic magnetic resonance imaging (MRI) and to examine the histological characteristics involved in the causes thereof. The signal intensity of 131 breast carcinomas of common type on T2WI was classified into four types and the correlations between the signal intensity and the histopathological subtypes were evaluated. We investigated correlation with the peripheral hyperintense pattern on a T2WI and other findings on MR images including EPE. In addition, we also investigated the histopathological characteristics in the lesions with a peripheral hyperintense pattern. The signal intensities of the lesions on T2WI demonstrated hyperintensity, isointensity, hypointensity, and a peripheral hyperintense pattern in 26 (20%), 66 (50%), 19 (15%), and 20 (15%) lesions, respectively. A peripheral hyperintense pattern correlated with the appearance of EPE (P < 0.0001) and the degree of central fibrosis (P < 0.0001). A peripheral hyperintense pattern on T2WI is a characteristic finding observed in breast carcinomas and correlated with the appearance of EPE. The appearance of a peripheral hyperintense pattern was affected by various histopathological features in the same manner as that observed for the formation of EPE.