タグ別アーカイブ: 問題

45-year-old man with vertigo. 45才男性 めまい

投稿日: 作成者:

45-year-old man with vertigo.
45才男性 めまい

解答:  Ecchordosis physaliphora   (EP)  ,  泡状外脊索腫

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Key words: Ecchordosisphysaliphora, EP,  泡状外脊索症,  異所性 脊索の遺残

Key images:

T2WI 3D axial 3

通常のT2WI だとわかりにくい　上記の様に3DT2WI (今回は内耳道撮像目的)でないと難しい

T2WI axialT2WI 3D axi reconstruction sagi, coro ADCT1WI T2WI MPR3T1WI T2WI MPRT1WI T2WI MPR2

References:

1)MehnertF, Beschorner, KukerW,et al.

Retroclivalecchordosisphysaliphora: MR imaging and review of the literature. AJNR. 2004, 25: 1851-1855

2)   ChiharaC, Korogi Y, Kakeda S, et al.

Ecchordosis physaliphora and its variants: proposed new classification based on high-resolution fast MR imaging employing steady-state acquisition. EurRadiol. 2013 Oct;23(10):2854-60.

3) Srinivasan A, Goyal M, KingstoneM.

Case 133:

Ecchordosis physaliphora. Radiology. 2008 May;247(2):585-8. No abstract available.

4) Golden LD, Small JE Benign notochordal lesions of the posterior clivus:      retrospective review of prevalence and imaging characteristics. J Neuroimaging.2014 May-Jun;24(3):245-9.

5) KaulS, Khan OH, Edem I, et al.

Transclivalpseudomeningocele secondary to ecchordosisphysaliphora: case report and literature review. J NeurolSurg Rep. 2013 Dec;74(2):92-5.

6)  KrishtKM, Palmer CA, Osborn AG, et al.

Giant ecchordosis physaliphora in an adolescent girl: case report. J NeurosurgPediatr. 2013 Oct;12(4):328-33. doi: 10.3171/2013.5.PEDS1395. Epub 2013 Aug 2.

7)Yamamoto T, Yano S, Hide T, et al.

A case of ecchordosis physaliphora presenting with an abducens nerve palsy: A rare symptomatic case managed with endoscopic endonasaltranssphenoidalsurgery. SurgNeurol Int. 2013;4:13.

8)AlkanO, Yildirim T, Kizilkiliç O, et al.

A case of ecchordosis physaliphora presenting with an intratumoral hemorrhage. Turk Neurosurg. 2009 Jul;19(3):293-6.

9)CiarpagliniR, Pasquini E, Mazzatenta D, et al.

Intraduralclivalchordoma and ecchordosis physaliphora: a challenging differential diagnosis: case report. Neurosurgery. 2009 Feb;64(2):E387-8; discussion E388.

10) Toda H, Kondo A, Iwasaki K.

Neuroradiologicalcharacteristics of ecchordosis physaliphora. Case report and review of the literature. J Neurosurg. 1998 Nov;89(5):830-4. Review.

74-year-old man with tumor in pancreatic tail on screening US.　Answer

投稿日: 作成者:

７４才男性
超音波スクリーニングにて
膵尾部腫瘍を指摘

74-year-old man with tumor in pancreatic tail on screening US.

解答編

問題を見ていない先生はこちら

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WMV version

Key words: Pancreatic metastases, 膵転移、Renal cell carcinoma, RCC, 腎細胞癌、腎癌、腎癌膵転移、RCC, diffusion, ADC map

Key images:

Plain CT1Dynamic CT early 1Dynamic CT delay 1MRCP1T2WI 1T2WI coronal 1T1WI FS1MRI dynamic early 1MRI dynamic portal 1DWI ADCADC mapPET CT1

Referrences:

Clinical features, Prognosis

1. Song SW, Cheng JF, Liu N, Zhao TH.

Diagnosis and treatment of pancreatic metastases in 22 patients: a retrospective study.WorldJ SurgOncol. 2014 Sep 25;12:299.

2. SellnerF, Tykalsky N, De Santis M, et al.

Solitary and multiple isolated metastases of clear cell renal carcinoma to thepancreas: an indication for pancreatic surgery.

Ann SurgOncol. 2006 Jan;13(1):75-85. Epub 2006 Jan 1.

3. ZerbiA, Ortolano E, Balzano G, et al.

Pancreatic metastasis from renal cell carcinoma: which patients benefit from surgical resection?Ann SurgOncol. 2008 Apr;15(4):1161-8.

4. Law CH, Wei AC, Hanna SS,  et al.

Pancreatic resection for metastatic renal cell carcinoma: presentation, treatment, and outcome. Ann Surg Oncol.2003 Oct;10(8):922-6.

5. Sohn TA, Yeo CJ, Cameron JL, et al.

Renal cell carcinoma metastatic to the pancreas: results of surgical management.J GastrointestSurg.2001 Jul-Aug;5(4):346-51.

6. Faure JP, Tuech JJ, Richer JP, et al.

Pancreatic metastasis of renal cell carcinoma: presentation, treatment and survival. J Urol. 2001 Jan;165(1):20-2.

7. AkatsuT, Shimazu M, Aiura K, et al.

Clinicopathological features and surgical outcome of isolated metastasis of renal cell carcinoma. Hepatogastroenterology. 2007 Sep;54(78):1836-40.

Imaging features

1. Ng CS, Loyer EM, Iyer RB, David CL, DuBrow RA, Charnsangavej C.

Metastases to the pancreas from renal cell carcinoma: findings on three-phase contrast-enhanced helical CT. AJRAm J Roentgenol. 1999 Jun;172(6):1555-9.

2. Klein KA, Stephens DH, Welch TJ.

CT characteristics of metastatic disease of the pancreas. Radiographics. 1998 Mar-Apr;18(2):369-78.

3. VincenziM, Pasquotti G, Polverosi R, et al.
Imaging of pancreatic metastases from renal cell carcinoma. Cancer Imaging. 2014 Apr 22;14:5.

4. PalmowskiM, Hacke N, Satzl S, et al.

Metastasis to the pancreas: characterization by morphology and contrast enhancement features on CT and MRI. Pancreatology. 2008;8(2):199-203.

5. AscentiG, Visalli C,  Genitori A, et al.

Multiple hypervascular pancreatic metastases from renal cell carcinoma: dynamic MR and spiral CT in three cases. Clin Imaging. 2004 Sep-Oct;28(5):349-52.

6. Tsitouridis I, Diamantopoulou A, Michaelides M, et al.

Pancreatic metastases: CT and MRI findings. DiagnIntervRadiol. 2010 Mar;16(1):45-51.

RCC and ADC value

1. Choi YA, Kim CK, Park SY, et al.

Subtype differentiation of renal cell carcinoma using diffusion-weighted and blood oxygenation level-dependent MRI.AJR Am J Roentgenol. 2014 Jul;203(1):W78-84.

2. SasamoriH, Saiki M, Suyama J, et al.

Utility of apparent diffusion coefficients in the evaluation of solid renal tumors at 3T. MagnReson Med Sci. 2014;13(2):89-95.

3. Sevcenco S, Heinz-Peer G, Ponhold L, et al.

Utility and limitations of 3-Tesla diffusion-weighted magnetic resonance imaging for differentiation of renal tumors. EurJ Radiol. 2014 Jun;83(6):909-13.

4. Yu X, Lin M, Ouyang H, et al.

Application of ADC measurement in characterization of renal cell carcinomas with different pathological types and grades by 3.0T diffusion-weighted MRI.

EurJ Radiol. 2012 Nov;81(11):3061-6.

5. PaudyalB, Paudyal P, Tsushima Y, et al.

The role of the ADC value in the characterisation of renal carcinoma by diffusion-weighted MRI. Br J Radiol. 2010 Apr;83(988):336-43.

RCC and PET-CT

1. Win AZ, Aparici CM.

Clinical effectiveness of (18)f-fluorodeoxyglucose positron emission tomography/computed tomography in management of renal cell carcinoma: a single institution experience. World J Nucl Med. 2015 Jan-Apr;14(1):36-40.

2. Sharma P, Karunanithi S, Chakraborty PS, et al.

18F-Fluoride PET/CT for detection of bone metastasis in patients with renal cell carcinoma: a pilot study. NuclMed Commun. 2014 Dec;35(12):1247-53.

3. Lee H, Hwang KH, Kim SG, et al.

Can Initial (18)F-FDG PET-CT Imaging Give Information on Metastasis in Patients with Primary Renal Cell Carcinoma? NuclMed Mol Imaging. 2014 Jun;48(2):144-52.

4. Fuccio C, Ceci F, Castellucci P, et al.

Restaging clear cell renal carcinoma with 18F-FDG PET/CT. ClinNucl Med. 2014 Jun;39(6):e320-4.

5. Chen JL, Appelbaum DE, Kocherginsky M, et al.

FDG-PET as a predictive biomarker for therapy with everolimus in metastatic renal cell cancer. Cancer Med. 2013 Aug;2(4):545-52.

6. Nakhoda Z, Torigian DA, Saboury B, et al.

Assessment of the diagnostic performance of (18)F-FDG-PET/CT for detection and characterization of solid renal malignancies. Hell J Nucl Med. 2013 Jan-Apr;16(1):19-24.

7. Wang HY, Ding HJ, Chen JH, et al.

Meta-analysis of the diagnostic performance of [18F]FDG-PETand PET/CT in renal cell carcinoma. Cancer Imaging. 2012 Oct 26;12:464-74.

8. Namura K, Minamimoto R, Yao M, et al.

Impact of maximum standardized uptake value (SUVmax) evaluated by 18-Fluoro-2-deoxy-D-glucose positron emission tomography/computed tomography (18F-FDG-PET/CT) on survival for patients with advanced renal cell carcinoma: a preliminary report. BMC Cancer. 2010 Dec 3;10:667.

9. Mueller-Lisse UG, Mueller-Lisse UL.

Imaging of advanced renal cell carcinoma. World J Urol. 2010 Jun;28(3):253-61.

10. Rodríguez Martínez de Llano S, Jiménez-Vicioso A, et al.

Clinical impact of (18)F-FDG PET in management of patients with renal cell carcinoma.

Rev Esp Med Nucl. 2010 Jan-Feb;29(1):12-9.

11. Staging of renal cell carcinoma.

Mueller-Lisse UG, Mueller-Lisse UL, Meindl T, et al. EurRadiol. 2007 Sep;17(9):2268-77.

12. Ak I, Can C.

F-18 FDG PET in detecting renal cell carcinoma. ActaRadiol. 2005 Dec;46(8):895-9.

 

Thymoma teaching, 胸腺腫 まとめ

投稿日: 作成者:

Thymoma teaching, 胸腺腫 まとめ

*動画の題名が縦隔腫瘍になっていますが、実際は胸腺腫のまとめです。

問題を見ていない先生はこちら

縦隔解剖について確認はこちら

解答編　前篇はこちら

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Key words: Thymoma, 胸腺腫、anterior mediastinal tumor, 前縦隔腫瘍, WHO classification, WHO分類、Masaoka classification, 正岡分類、胸腺癌, thymic cancer, Diffusion weighted image, DWI, 拡散強調画像

まとめ：黒色は非浸潤性胸腺腫、赤色はより浸潤性、紫色はより癌を示唆

  • 大きい
  • 被膜（より完全）、隔壁
  • 境界明瞭、不明瞭
  • 分葉状、不整
  • 出血、壊死、嚢胞性変化
  • 石灰化
  • 不均一造影効果
  • 造影効果が高いか否か
  • T2WI上不均一
  • T2WI上腫瘍内の低信号
  • 胸膜播種
  • 縦隔脂肪浸潤
  • 大血管浸潤
  • LN腫大
  • 線維性隔壁：AB、B
  • MRIは被膜、隔壁、出血の検出でCTより優れる
  • ADC値はWHO分類、正岡分類と相関：ADC値低いとより悪性度高い

References:

1. Priola AM, Priola SM, Di Franco M, et al.Computed tomography and thymoma: distinctive findings in invasive and noninvasive thymoma and predictive features of recurrence.

RadiolMed. 2010 Feb;115(1):1-21.

2. Tomiyama N, Müller NL, Ellis SJ, et al.

Invasive and noninvasive thymoma: distinctive CT features.

J Comput Assist Tomogr. 2001 May-Jun;25(3):388-93.

3. Jeong YJ, Lee KS, Kim J, et al.

Does CT of thymic epithelial tumors enable us to differentiate histologic subtypes and predict prognosis?

Am J Roentgenol. 2004 Aug;183(2):283-9.

4. Harris K, Elsayegh D, Azab B, et al.10.1186/1477-7819-9-95.

Thymoma calcification: is it clinically meaningful?

World J SurgOncol. 2011 Aug 23;9:95.

5. Hu YC, Wu L, Yan LF, et al.

Predicting subtypes of thymic epithelial tumors using CT: new perspective based on a comprehensive analysis of 216 patients.

Sci Rep. 2014 Nov 10;4:6984.

6. Sadohara J, Fujimoto K, Müller NL, et al.

Thymic epithelial tumors: comparison of CT and MR imaging findings of low-risk thymomas, high-risk thymomas, and thymic carcinomas.

Eur J Radiol. 2006 Oct;60(1):70-9.

7. Inoue A, Tomiyama N, Fujimoto K, et al.

MR imaging of thymic epithelial tumors: correlation with World Health Organization classification.

Radiat Med.2006 Apr;24(3):171-81.

8. Han J, Lee KS, Yi CA, et al.

Thymic epithelial tumors classified according to a newly established WHO scheme: CT and MR findings.

Korean J Radiol. 2003 Jan-Mar;4(1):46-53.

★Diffusion-weighted images in thymomas.

1. Abdel Razek AA, Khairy M Nada N.

Diffusion-weighted MR imaging in thymic epithelial tumors: correlation with World Health Organization classification and clinical staging.

Radiology. 2014 Oct;273(1):268-75.

2. Priola AM, Priola SM, Giraudo MT, et al.

Chemical-shift and diffusion-weighted magnetic resonance imaging of thymus in myasthenia gravis: usefulness of quantitative assessment.

Invest Radiol. 2015 Apr;50(4):228-38

3. Seki S, Koyama H, Ohno Y, et al.

Diffusion-weighted MR imaging vs. multi-detector row CT: Direct comparison of capability for assessment of management needs for anterior mediastinal solitary tumors

Eur J Radiol. 2014 May;83(5):835-42.

4. Shin KE, Yi CA, Kim TS, et al.

Diffusion-weighted MRI for distinguishing non-neoplastic cysts from solid masses in the mediastinum: problem-solving in mediastinal masses of indeterminate internal characteristics on CT. EurRadiol. 2014 Mar;24(3):677-84.

EurRadiol. 2014 Mar;24(3):677-84.

62-year-old man with abnormal shadow in right lower lung field during follow up of brain infarction.

投稿日: 作成者:

62才男性
脳梗塞フォロー中右下肺野に異常陰影指摘

まだ問題を見ていない先生はこちら

Case 1

62-year-old man with abnormal shadow in right lower lung fieldduring follow up of brain infarction.

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今回は解答編　バージョン１です。症例の解説が主体です。

解答編バージョン２で胸腺腫総まとめしています。

胸腺腫の総まとめビデオはこちら　10分余った時間で勉強してください。

Key words: Mediastinal tumor, Thymoma, thymoma, thymic tumor, 縦隔腫瘍、胸腺腫、胸腺腫瘍、WHO classification, WHO分類

Key images:

Case 1  62M Type A

Type A thymoma 62M Chest plain 1Type A thymoma 62M CT plain 1Type A thymoma 62M MRI 1Type A thymoma 62M MRI 2Type A thymoma 62M MRI 3Type A thymoma 62M MRI 4

Case 2  69MType B3 Thymoma 69M Chest plain1 Type B3 Thymoma 69M CT1Type B3 Thymoma 69M CT2Type B3 Thymoma 69M MRI1Type B3 Thymoma 69M MRI 2.6

胸腺腫：　ADCとWHO分類との対比論文はこちら

１．

Abdel RazekAA, KhairyM Nada N.

Diffusion-weighted MR imaging in thymic epithelial tumors: correlation with World Health Organization classification and clinical staging.　Radiology. 2014 Oct;273(1):268-75.

2.

Priola AM, Priola SM.

Usefulness of Diffusion-weighted MR Imaging in Predicting Masaoka-Koga Clinical Staging of Thymic Epithelial Tumors by Using the Apparent Diffusion Coefficient.  Radiology. 2015 Mar;274(3):936-7.

 

 

えっ大動脈の近傍は後縦隔じゃない？

投稿日: 作成者:
返信

縦隔解剖について確認しましょう！

iPad version はこちら

 

You tube version についてはこちら

Key words: 縦隔解剖、縦隔、縦隔上部、前縦隔、中縦隔、後縦隔、Superior portion of mediastinum, anterior mediastinum, middle mediastinum, posterior mediastinum

縦隔腫瘍の問題はこちら

その解答はこちら

解答　②は3/30 アップ予定

39-year-old woman with dyspnea. answer verion.

投稿日: 作成者:

39才女性の呼吸困難  解答編
左肺の無気肺

まだ、問題を見ていない先生はこちら

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You tube version

 

key word: カルチノイド、気管支カルチノイド、Bronchial carcinoid tumor, Neuroendocrine neoplasm

Reference:

Jeung MY, Gasser B, Gangi A, et al.

Bronchial carcinoid tumors of the thorax: spectrum of radiologic findings.

Radiographics. 2002 Mar-Apr;22(2):351-65.

Meisinger QC, Klein JS, Butnor KJ, et al.
CT features of peripheral pulmonary carcinoid tumors.
AJR Am J Roentgenol.2011 Nov;197(5):1073-80

Gomez A, Zalacain R, CabriadaV,e t al.
Bronchial carcinoid tumors. Analysis of 41 cases.
Rev Clin Esp. 2004;204:202-5

Paillas W, Moro-Sibilot D, Lantuejoul S, et
carcinoid tumors: role of imaging for diagnosis and local staging.
J Radiol. 2004 Oct;85(10 Pt 1):1711-9.

Zidi A, Douira W, Hantous-Zannad S, et al.
Imaging of bronchial carcinoid tumors: 20 cases.
Rev PneumolClin. 2006 Dec;62(6 Pt 1):380-5.　[Article in French]

Davini F, Gonfiotti A, Comin C, et al.
Typical and atypical carcinoid tumours: 20-year experience with 89 patients.
J CardiovascSurg (Torino).2009 Dec;50(6):807-11

Bueno Palomino A, ZureraTendero L, Espejo Herrero JJ, et al.
Multidetector computed tomography assessment of the degree of differentiation of bronchial carcinoid
Radiologia. 2013 Jul-Aug;55(4):323-30. [Article in Spanish]

Magid D, Siegelman SS, Eggleston JC, et al.
Pulmonary carcinoid tumors: CT assessment.
J Comput Assist Tomogr. 1989 Mar-Apr;13(2):244-7.

ZwiebelBR, Austin JH, Grimes MM
Bronchial carcinoid tumors: assessment with CT of location and intratumoral calcification in 31 patients.
Radiology. 1991 May;179(2):483-6

Squerzanti A, Basteri V, Antinolfi G, et al.
Bronchial carcinoid tumors: clinical and radiological correlation.
Radiol Med. 2002 Oct;104(4):273-84. [Article in English, Italian]