T2w MR Images Research Articles

A large ameloblastic fibro-odontoma in the mandible.

Ameloblastic Fibro-Odontoma (AFO) is a rare benign hybrid odontogenic tumor. AFO is most common in children and adolescents aged under 20 years, and is usually small. This report describes a 47-year-old man with a pathologically proved large AFO originated from the mandible. The tumor's largest dimension is 20 cm. Plain CT showed a well-circumscribed expansile mass with multiloculated scrotiform osteolytic lesions in the mandible, with linear and patchy calcification and ossification. CT 3D reconstruction revealed the mandible appeared honeycombed. On T1W and T2W MR images, cystic low-density components on CT appeared high-signal, while calcification and ossification appeared low-signal.

Imaging of lamination patterns of the adult human olfactory bulb and tract: In vitro comparison of standard- and high-resolution 3T MRI, and MR microscopy at 9.4T

Neurological and smelling disorders (e.g. Alzheimer's disease, sinonasal disease) negatively affect the microstructural integrity of the olfactory bulb's (OB) cortical layers. Recovery processes depend on active restoration of this microstructural integrity enabled by neuroneogenesis in the OB. The aim of this study was to evaluate lamination patterns of the OB and adjacent tract (OT) using high resolution MRI at 3 Tesla (T) as well as MR microscopy at 9.4 T in comparison with histological sections. Twenty-four human OBs were imaged in vitro using standard (2mm slice thickness) and high resolution (0.2mm slice thickness) T1w and T2w MR imaging at 3T. Based on signal intensity differences, the number of OB layers and the OB lamination patterns were assessed by two observers in consensus. Results were compared using Wilcoxon test. Signal intensity profiles were compared to reference Nissl stained histological sections and imaging results of MR microscopy. OT lamination patterns were assessed and different configurations of cross sectional areas were compared to macroscopic results and OB/OT lamination patterns. Standard resolution at 3T identified three layers in 8.3%, two layers in 83.3%, and one layer in 8.3%. High resolution at 3T (4 layers in 91.7%, 3 layers in 8.3%) significantly performed better (P<0.001). Signal intensity profile analysis at 3T and 9.4 T (yielding up to 6 different signal intensities) correlated with histological sections and enabled quantitative evaluation of OB lamination patterns. 3T MRI of the OT revealed two separate signal intensities in T2w in 73%, a hyperintense core and a hypointense sheath, and the number of OT signal intensities positively correlated (ρ=0.541, P=0.006) with the increasing complexity of the OTs' cross sectional area configurations. Additionally, cross sectional area configurations correlated with macroscopic results (ρ=0.558, P=0.002) and OB lamination patterns (ρ=0.446, P=0.022). 3T MRI and MR-microscopy indicate the possibility to identify the lamination pattern of the human OB/OT and to reflect the histological status. If further development will be able to provide technical equipment that complies with the condition of human in vivo high resolution imaging achieving a good enough signal noise ratio, the method of signal intensity profile analysis could prospectively enable scientists to assess the OB's microstructural status in neurological and smelling disorders.

Is There an Additional Value of 11C-Choline PET-CT to T2-weighted MRI Images in the Localization of Intraprostatic Tumor Nodules?

To investigate the additional value of (11)C-choline positron emission tomography (PET)-computed tomography (CT) to T2-weighted (T2w) magnetic resonance imaging (MRI) for localization of intraprostatic tumor nodules. Forty-nine prostate cancer patients underwent T2w MRI and (11)C-choline PET-CT before radical prostatectomy and extended lymphadenectomy. Tumor regions were outlined on the whole-mount histopathology sections and on the T2w MR images. Tumor localization was recorded in the basal, middle, and apical part of the prostate by means of an octant grid. To analyze (11)C-choline PET-CT images, the same grid was used to calculate the standardized uptake values (SUV) per octant, after rigid registration with the T2w MR images for anatomic reference. In total, 1,176 octants were analyzed. Sensitivity, specificity, and accuracy of T2w MRI were 33.5%, 94.6%, and 70.2%, respectively. For (11)C-choline PET-CT, the mean SUV(max) of malignant octants was significantly higher than the mean SUV(max) of benign octants (3.69 ± 1.29 vs. 3.06 ± 0.97, p < 0.0001) which was also true for mean SUV(mean) values (2.39 ± 0.77 vs. 1.94 ± 0.61, p < 0.0001). A positive correlation was observed between SUV(mean) and absolute tumor volume (Spearman r = 0.3003, p = 0.0362). No correlation was found between SUVs and prostate-specific antigen, T-stage or Gleason score. The highest accuracy (61.1%) was obtained with a SUV(max) cutoff of 2.70, resulting in a sensitivity of 77.4% and a specificity of 44.9%. When both modalities were combined (PET-CT or MRI positive), sensitivity levels increased as a function of SUV(max) but at the cost of specificity. When only considering suspect octants on (11)C-choline PET-CT (SUV(max) ≥ 2.70) and T2w MRI, 84.7% of these segments were in agreement with the gold standard, compared with 80.5% for T2w MRI alone. The additional value of (11)C-choline PET-CT next to T2w MRI in detecting tumor nodules within the prostate is limited.

Diagnostic usefulness of the oedema-infarct ratio to differentiate acute from chronic myocardial damage using magnetic resonance imaging

To differentiate acute from chronic damage to the myocardium in patients with myocardial infarction (MI) using DE and T2w MR. Short-axis T2w and DE MR images were acquired twice after the onset of MI in 36 patients who successfully underwent emergency coronary revascularisation. The areas of infarct and oedema were measured. The oedema-infarct ratio (O/I) of the left ventricular area was calculated by dividing the oedema by the infarct area. The oedema size on T2w MR was significantly larger than the infarct size on DE MR in the acute phase. Both the oedema size on T2w MR and the infarct size on DE MR in the acute phase were significantly larger than those in the chronic phase. The O/I was significantly greater in the acute phase compared with that in the chronic phase (P < 0.05). An analysis of relative cumulative frequency distributions revealed an O/I of 1.4 as a cut-off value for differentiating acute from chronic myocardial damage with the sensitivity, specificity, and accuracy of 85.1%, 82.7% and 83.9%, respectively. The oedema-infarct ratio may be a useful index in differentiating acute from chronic myocardial damage in patients with MI. MR can differentiate reversible from irreversible myocardial damage after myocardial infarction. MR is a useful modality to noninvasively differentiate the infarct stages. The O/I is an important index to decide therapeutic strategies.

Fetal MR imaging of posterior intracranial dural sinus thrombosis: a report of three cases with variable outcomes

Thrombosis of fetal intracranial dural sinuses is a rare entity. A specific type of midline dural sinus thrombosis (DST) at the torcular Herophili with extension into the superior sagittal sinus (SSS) was initially seen on fetal US and was referred to fetal MRI for definite diagnosis and better delineation. Retrospective comparison to medical literature of three cases, diagnosed at our institution, of midline fetal DST with MR imaging findings and clinical outcomes. We reviewed MRI findings on T2-weighted images of our three cases of fetal midline DST and clinical outcomes of these fetuses and compared our findings to medical literature. The MR imaging and clinical findings of our cases extend over 6 years. They consist of three pregnant women, 31-39 years of age each with a single fetus, with fetal MR imaging performed at different gestational ages (GA). Case 1 the MR imaging was performed at 21 5/7 weeks' GA, case 2 at 24 and 33 4/7 weeks' GA, and case 3 at 22 and 25 weeks' GA. Postnatal MRI was performed in case 2 at 6 months of life and case 3 at 1 day of life. Clinical follow-up occurred during the last 6 years. In all of our cases, T2-W MR imaging demonstrated ballooned midline torcular Herophili with iso- to hypointense mass with or without focal eccentric area of greater hypointensity occupying the torcular Herophili with extension into the SSS. Case 3 had associated leptomeningeal dural vascular malformation overlying the left cerebral hemisphere with development of migrational disorder in the left cerebral hemisphere. Clinical outcome consisted of fetal demise in case 1, normal postnatal outcome in case 2 and severe brain damage with poor postnatal outcome in case 3. Our findings of large iso-hypointense thrombus with or without a focal eccentric area more hypointense to thrombus in a dilated torcular Herophili with extension into the SSS on T2-W images corresponds to the majority of cases of this rare type of DST in the medical literature.

Abstract 5229: Single, pre-labeled metastatic melanoma cells can be detected in the mouse brain using MRI

Abstract In metastatic melanoma, brain metastases are clinically diagnosed in 40-60% of patients during the disease, but can be found in up to 90% at autopsy. The prognosis for these patients is poor, due to ineffective treatments and development of multiple brain metastasis. There is a limited knowledge about the biological mechanisms behind this development of multiple metastasis in the brain, which necessitates the development of clinically more relevant animal models. The purpose of this study was to develop a multiple brain metastasis animal model which closely reflects the clinical setting, and specifically to determine the number of single melanoma cells able to arrest in the animal brain. The H1 brain metastatic melanoma cell line was established from a patient melanoma brain metastases obtained during surgery. The H1 cells were pre-labeled with superparamagnetic iron oxide particles (Fedex; Babic et al, Bioconjugate Chem 2008) at a concentration of 10 μg/ml for 24 hrs. The viability of labeled cells was studied in vitro using cell proliferation assays, and Scanning/Transmission Electron Microscopy (SEM/TEM). One million pre-labeled tumor cells were then injected into the left ventricle of the heart in nod scid mice. 24 hrs after injections, T1 weighted (T1w), T2 weighted (T2w) and T2* weighted (T2*w) MR imaging were performed. In addition, T1w and T2w MR images were obtained 5 weeks after injections. We also transfected the H1 melanoma cells with luciferase, and monitored the animals for up to 6 weeks using bioluminescence imaging (OI). Pre-labeling of melanoma cells with Fedex did not affect cell proliferation. The SEM and TEM studies showed iron oxide particle attachment to the tumor cell membrane, as well as localisation of the labelling agents within vesicles in the cytoplasm. By encapsulating pre-labeled tumor cells at various concentrations in soft agar, we were able to detect less than 50 cell/μl using T2 mapping MRI. By pre-labeling the melanoma cells with Fedex, we were able to detect single tumour cells in the animal brains. Imaging studies (OI, MR) 4-6 weeks after injections confirmed multiple metastatic spread to the brain. In conclusion, we have developed a melanoma metastasis model in immunodeficient mice, which reflects the metastatic tumor spread seen in patients. By using pre-labeling with Fedex, we were able to detect single tumour cells in the brain. Citation Format: {Authors}. {Abstract title} [abstract]. In: Proceedings of the 102nd Annual Meeting of the American Association for Cancer Research; 2011 Apr 2-6; Orlando, FL. Philadelphia (PA): AACR; Cancer Res 2011;71(8 Suppl):Abstract nr 5229. doi:10.1158/1538-7445.AM2011-5229

18F-FDG PET/MRI fusion in characterizing pancreatic tumors: comparison to PET/CT

To demonstrate that positron emission tomography (PET)/magnetic resonance imaging (MRI) fusion was feasible in characterizing pancreatic tumors (PTs), comparing MRI and computed tomography (CT) as mapping images for fusion with PET as well as fused PET/MRI and PET/CT. We retrospectively reviewed 47 sets of (18)F-fluorodeoxyglucose ((18)F -FDG) PET/CT and MRI examinations to evaluate suspected or known pancreatic cancer. To assess the ability of mapping images for fusion with PET, CT (of PET/CT), T1- and T2-weighted (w) MR images (all non-contrast) were graded regarding the visibility of PT (5-point confidence scale). Fused PET/CT, PET/T1-w or T2-w MR images of the upper abdomen were evaluated to determine whether mapping images provided additional diagnostic information to PET alone (3-point scale). The overall quality of PET/CT or PET/MRI sets in diagnosis was also assessed (3-point scale). These PET/MRI-related scores were compared to PET/CT-related scores and the accuracy in characterizing PTs was compared. Forty-three PTs were visualized on CT or MRI, including 30 with abnormal FDG uptake and 13 without. The confidence score for the visibility of PT was significantly higher on T1-w MRI than CT. The scores for additional diagnostic information to PET and overall quality of each image set in diagnosis were significantly higher on the PET/T1-w MRI set than the PET/CT set. The diagnostic accuracy was higher on PET/T1-w or PET/T2-w MRI (93.0 and 90.7%, respectively) than PET/CT (88.4%), but statistical significance was not obtained. PET/MRI fusion, especially PET with T1-w MRI, was demonstrated to be superior to PET/CT in characterizing PTs, offering better mapping and fusion image quality.

Automatic Location of the Talairach Cortical Landmarks from T2-Weighted MR Images

For labeling the T2-weighted MR images using human brain atlas, it is prerequisite to the foundation of the Talairach space for T2W MR images, and the basic condition to found Talairach space is the location of Talairach cortical landmarks from T2W MR images. A method to locate the Talairach cortical landmarks from T2W MR images is proposed, it consists of three aspects: Firstly, determine the planes including the six cortical landmarks ; segment the planes based on fuzzy C-means clustering algorithm, gray level projection, watershed algorithm, region merging, thresholding, and morphologic operations; locate the cortical landmarks from the segmented planes. The algorithm has been validated quantitatively with 20 T2W MR images data sets. The mean errors of the Talairach cortical landmarks were below 1.00 mm. It took about 8 seconds for identifying them on P4 3.0 GHz. This fast, robust algorithm is potentially useful in clinic and for research.

Age determination of vessel wall hematoma in spontaneous cervical artery dissection: a multi-sequence 3T cardiovascular magnetic resonance study.

BackgroundPreviously proposed classifications for carotid plaque and cerebral parenchymal hemorrhages are used to estimate the age of hematoma according to its signal intensities on T1w and T2w MR images. Using these classifications, we systematically investigated the value of cardiovascular magnetic resonance (CMR) in determining the age of vessel wall hematoma (VWH) in patients with spontaneous cervical artery dissection (sCAD).Methods35 consecutive patients (mean age 43.6 ± 9.8 years) with sCAD received a cervical multi-sequence 3T CMR with fat-saturated black-blood T1w-, T2w- and TOF images. Age of sCAD was defined as time between onset of symptoms (stroke, TIA or Horner's syndrome) and the CMR scan. VWH were categorized into hyperacute, acute, early subacute, late subacute and chronic based on their signal intensities on T1w- and T2w images.ResultsThe mean age of sCAD was 2.0, 5.8, 15.7 and 58.7 days in patients with acute, early subacute, late subacute and chronic VWH as classified by CMR (p < 0.001 for trend). Agreement was moderate between VWH types in our study and the previously proposed time scheme of signal evolution for cerebral hemorrhage, Cohen's kappa 0.43 (p < 0.001). There was a strong agreement of CMR VWH classification compared to the time scheme which was proposed for carotid intraplaque hematomas with Cohen's kappa of 0.74 (p < 0.001).ConclusionsSignal intensities of VWH in sCAD vary over time and multi-sequence CMR can help to determine the age of an arterial dissection. Furthermore, findings of this study suggest that the time course of carotid hematomas differs from that of cerebral hematomas.

Features of Virchow-Robin spaces in newly diagnosed multiple sclerosis patients

Background Virchow-Robin spaces (VRSs) are perivascular pia-lined extensions of the subarachnoid space around the arteries and veins as they enter the brain parenchyma. These spaces are responsible for inflammatory processes within the brain. Objectives This study was designed to shed more light on the location, size and shape of VRSs on 3 mm slice thickness, 1.5 Tesla MRI scans of newly diagnosed MS patients in Isfahan, Iran and compare the results with healthy age- and sex-matched controls. Methods We evaluated MRI scans of 73 MS patients obtained within 3 months of MS onset and compared them with MRI scans from 73 age- and sex-matched healthy volunteers. Three mm section proton density, T2W and FLAIR MR images were obtained for all subjects. The location, size and shape of VRSs were compared between the two groups. Results The total number of VRSs was significantly more in the MS group ( p < 0.001). The distribution of VRSs were significantly more located in the high convexity areas in the MS group ( p < 0.001), while there was no significant differences in other regions. The round shaped VRSs were significantly more detected on MRI scans of MS patients, and curvilinear shapes were significantly more frequently observed in healthy volunteers, however there were no significant differences for oval shaped VRSs between the two groups. The number of VRSs with the size over than 2 mm were significantly more observed in the MS groups compared to controls. We also observed some differences in the characteristics of VRSs between the genders in the MS group. Conclusion The results of this study shed more light on the usefulness of VRSs as an MRI marker for the disease. In addition, according to our results VRSs might also have implication to determine the prognosis of the disease. However, larger studies with more advanced MRI techniques are required to confirm our results.

Cellular magnetic resonance imaging for the differentiation of infectious and degenerative vertebral disorders: Preliminary results

To evaluate macrophage imaging using the ability of superparamagnetic iron oxide (SPIO) magnetic resonance imaging (MRI) to differentiate infectious vertebral osteomyelitis and degenerative disk-related inflammatory endplates. The in vivo demonstration of the different distribution of macrophages in those two disorders may allow a more accurate characterization of vertebral endplate abnormalities than classical extracellular MR changes. In 12 patients with endplate abnormalities (six cases of bacteriologically proven spondylodiscitis, six cases of disk degeneration-related endplate changes), two MRI sessions were realized: before and 24 hours after injection of SPIO. The signal-to-noise ratio (SNR) of endplates were qualitatively and quantitatively compared on pre- and post-SPIO injection T1 and T2-weighted (T2w) MR images (Wilcoxon signed rank test). In the infection group, the SNR of abnormal endplates showed a significant signal loss on T2w MR images (P = 0.03) but not on T1w images (P = 0.46). In the degenerative spine group, no significant signal loss was observed on T1 (P = 0.6) nor on T2w MR images (P = 0.6). Signal loss was only visually observable in abnormal endplate in one patient of the spondylodiscitis group on T2w MR images. MRI of the spine with iron oxide injection differentiates infection from aseptic inflammation on quantitative analysis, but the use of SPIO makes direct visual evaluation less satisfactory.

Imaging of adult astrocytic brain tumours with 7 T MRI: preliminary results

In this study tumour vascularity and necrosis of intracranial astrocytomas were compared using 7 T and 1.5 T magnetic resonance imaging (MRI). Fifteen patients with histologically proven astrocytomas (WHO grades II-IV) were prospectively examined at 1.5 T (Magnetom Espree or Sonata) and 7 T (Magnetom 7 T, Siemens, Erlangen, Germany) with T2*-w (weighted), T1-w with (only a subset of five patients at 7 T) and without contrast medium, T2-w and proton-density (PD)-w MRI. Clinically used 1.5 T sequences were adapted to 7 T. Histological findings and T2*-w MR images at both field strengths were compared for the presence of assumed tumour microvascularity and necrosis. Two diffusely infiltrating astrocytomas, four anaplastic astrocytomas and nine glioblastomas were included. T2*-w images depicted susceptibility patterns representing presumed tumour microvascularity in 8 out of 15 (53%) gliomas at 7 T compared with 5 out of 15 (33%) gliomas at 1.5 T. Compared with 1.5 T MRI three additional necrotic tumour areas were depicted only on 7 T T2- and T2*-w images of one glioblastoma. On T1-w MR images, contrast enhancement of five out of five glioblastomas was similar at both field strengths. 7 T gradient-echo sequences provide excellent image contrast of presumed microvasculature and necrosis in astrocytomas.

Extrarenal rhabdoid tumours outside the central nervous system in infancy

Malignant rhabdoid tumours (RT) are increasingly recognized in young children, probably as a consequence of advances in accurate histological diagnosis rather than a true increase in frequency. Although typically presenting as renal tumours in infancy, extrarenal tumours outside the central nervous system (CNS) in children less than 12 months of age are now well recognized, but previous literature on their imaging features is very limited. To demonstrate the imaging features of extrarenal RTs outside the CNS. A retrospective database review was made from 1989 to 2007 of patients diagnosed with extrarenal RT in infancy, i.e. below 12 months of age. There were nine patients (six boys and three girls). The age at presentation varied from 1 to 11 months (average 6 months). Tumours were located in the thorax/mediastinum (n=3), liver (n=3), neck (n=1), shoulder (n=1) and axilla (n=1). The imaging modalities used included US (n=8), CT (n=7) and MRI (n=6). Bone scan was positive in one patient, while metastases at the time of diagnosis occurred in four patients. On MRI the tumours tended to show nonspecific hypointensity on T1-W images and heterogeneous hyperintensity on T2-W images, with heterogeneous enhancement. This is the largest radiological series of extrarenal RTs outside the CNS in infancy. In our series no imaging features were found specific to the diagnosis. A tendency towards large size and mediastinal/paravertebral location were noted. A hypodense solid component on CT and a heterogeneous hyperintensity on T2-W MR images suggest that this tumour should be considered in the routine differential diagnosis of soft-tissue tumours in infancy, in addition to rhabdomyosarcoma.

Intrinsic brainstem glioma mimicking an ependymoma

A 14-year-old child presented with complaints of headache, vomiting and complete vision loss for 1 month. Sagittal T1W and T2-W MR images of the brain revealed a posterior fossa tumor with cervical spinal canal extension consistent with ependymoma (Fig. 1). Intraoperatively, a moderately vascular intrinsic brainstem glioma was found with a dorsal exophytic component extending into the cervical canal to the C4 level with a caudal syrinx. Histopathology confirmed the diagnosis of pilocytic astrocytoma. Direct cervical intramedullary extension of a posterior fossa tumor is rare, and ependymoma has the greatest predilection for this pattern of spread. Leproux et al. [1] reported a case of cystic astrocytoma with spinal extension through the fourth ventricle outlet foramina. Although cervicomedullary glioma forms a distinct entity among brainstem gliomas, a direct intramedullary cervical canal extension of a posterior fossa pilocytic astrocytoma, as described in this case, is extremely unusual. The recognition of such an unusual spread is important, as cervicomedullary variants of brainstem glioma are relatively benign and radical removal is associated with improved survival [2].

Fractional anisotropy for assessment of white matter tracts injury in methylmalonic acidemia.

Methylmalonic acidemia (MMA) is a multifactorial autosomal recessive inborn error of organic acid metabolism, often presenting with neurological symptoms. As neurological disorders are often related to white matter injury, diffusion tensor imaging (DTI) is an excellent tool for assessment of white matter injury and possibly for diagnosing this disorder. We retrospectively analyzed DTI images of 12 patients with MMA (7 males, 5 females, age range: 7 - 12 months, mean age: 9.25 +/- 1.70 months) with negative MRI findings. And another 12 age-matched and gender-matched infants were enrolled as control subjects. Fractional anisotropy (FA) of different white matter tracts of the brain was measured in both groups. For patients with negative MRI findings, compared with healthy infants, a statistically significant reduction in DTI FA value of the frontal white matter, temporal white matter, and occipital white matter was observed (P < 0.01). In addition to conventional T1W and T2W MR Image, Brain DTI presents a useful, sensitive and complementary tool for the assessment of brain damage in patients with MMA.

Comparaison des mesures du canal lombaire en IRM et TDM

Purpose To compare AP diameter measurements of spinal canal and thecal sac on MRI and CT. Materials and methods The AP diameter of the spinal canal at L4 and thecal sac at L4-5 were measured on both MRI and CT performed on patients at less than one month interval. Measurements were obtained from axial CT images of the abdomen on CT and sagittal T1W (n = 98) and T2W (n = 78) MR images of the spine. The examinations were reviewed at more than 24 hours interval. Radiologists were blinded. Inter-observer agreement evaluation was performed prior to this study. Measurements were compared using a t test for paired variables. Results For the spinal canal, mean measurements were 0.4 ± 1.5 mm inferior on CT compared to MRI. For the thecal sac, mean measurements were 0.1 ± 1.4 mm inferior on CT compared to MRI. Conclusion Measurements on CT and MRI for lumbar spinal canal and thecal sac are fairly comparable, with mean measurement differences inferior to the degree of precision of the measurement technique itself.

Tuberous sclerosis with rare presentation of macrodactyly

An 11-year-old boy was diagnosed with tuberous sclerosis (TS). He also had swelling of his right thumb and radial aspect of his right wrist (Fig. 1). A radiograph of the right hand (Fig. 2) showed irregular periosteal new bone formation (arrow) involving the first metacarpal bone, the radial aspect of the second proximal phalangeal bone, and the first proximal and distal phalangeal bones. Cortical cysts were also noted (arrowhead). A soft-tissue lump was seen involving the right thumb and radial aspect of the wrist. Both T1and T2-W MR images of the hand showed low signal intensity. This suggested that the lesion was composed of fibrous tissue.

Evaluation of jugular foramen nerves, by using b-ffe,t2w drive,t2w tse and post contrast t1w MR imaging sequences.

To assess the most effective magnetic resonance imaging (MRI) sequence for the visualization of the 9th, 10th, and 11th cranial nerves (glossopharyngeal, vagus, and accessory nerves, respectively) in their intraforaminal/canalicular courses. Balanced fast-field echo (b-FFE), 3D-T2W DRIVE, T2W 2D TSE and post-contrast T1W MRI sequences were all applied and we tried to get the best sequence for the exact assessment of the 9th, 10th, and 11th cranial nerves. Six hundred nerves of 100 patients without symptoms of neurovascular compression were examined using the above sequences. Imaging analysis was graded as: a) nerves analyzed by certainty (score of 2), b) nerves analyzed partially (score of 1), and c) nerves not identified (score of 0). In all three nerves, the best sequence for the visualization of the cisternal and intraforaminal course was b-FFE, with 58%, 73%, 62%, and all together 64.3% success in showing the fascicles of the 9th-11th nerves. This sequence with a very short time of repetition, symmetrical and balanced gradient around the echo time allowed very fast imaging and a high signal to noise ratio. T2W TSE sequence was superior to the DRIVE T2W sequence in assessing the cisternal and intraforaminal part of all three nerves. Post-contrast T1W sequence was probably the worst sequence in showing all three nerves. b-FFE gradient echo MRI sequence with high spatial resolution is the optimal sequence for determining the courses of 9th-11th cranial nerves.

1 Gradient Echo In-Phase T1-w MR Imaging to Differentiate Osteoporotic and Metastatic Vertebral Collapses

1 Gradient Echo In-Phase T1-w MR Imaging to Differentiate Osteoporotic and Metastatic Vertebral Collapses

Gynaecomastia revealing neurofibromatosis type 1 in a young child

Neurofibromatosis type 1 (NF1) is an autosomal dominant disorder. It is characterized by neurofibromas, which are the most common benign tumours of NF1. They can develop at any point along a nerve, but neurofibromas that occur in the breast and constitute revealing signs of the disease are extremely rare. We are reporting a case of an 11-year-old boy with a neurofibroma in the breast presenting gynaecomastia, The sonography revealed well-defined hypo echoic, multiple oval lesions, which converge at the areolar area. A dilated galactophoric channel was associated. MRI showed that the breast nodules were isointense compared to muscle on T1W and T2W MR images. In the course of our review of the literature, we emphasize the exceptional mammary localization of this tumour, and we will be describing its various imaging features.