Calcified cystic lesion in cerebellum: A case report.

Intracranial epidermoid cysts are benign, slow-growing congenital tumors of ectodermal origin. They are rare embryonal benign cystic masses with an incidence rate of approximately 0.04%-0.6% of intracranial tumors. Computed tomography (CT) and magnetic resonance imaging (MRI) are fundamental diagnostic tools providing valuable information for surgical management. We reported a 59-year-old male patient with right limb weakness twelve hours prior to admission, slurred speech, and paresis of the facial nerve. Based on history taking, physical examination, and radiology examinations, we concluded a diagnosis of non-communicated hydrocephalus due to a right cerebellar intra-axial tumor with a suspicion of low-grade glioma (Pylocitic Astrocytoma). CT and MRI in intracranial epidermoid cysts are fundamental diagnostic tools for diagnosing and obtaining helpful information for surgical planning. Intracranial epidermoid cysts appear as lobulated lesions filling and expanding CSF spaces and exerting a gradual mass effect, insinuating between structures and encasing adjacent nerves and vessels. In this case, we noted a hypodense lesion with irregular calcifications and well-defined on the right cerebellar region measuring 6.15 × 5.47 × 5.7 cm, surrounded by a hypodense image suggesting an intra-axial mass suspected of low-grade glioma with a differential diagnosis of brain abscess. The hypointense lesion on the T1WI sequence found in the MRI examination, with no significant contrast enhancement and restricted diffusion area on DWI, was one of the notable features described in the epidermoid cyst. Intracranial epidermoid cyst rarely occurs in the intracranial, resulting in many symptoms in this case, which should be diagnosed and treated promptly. Imaging aids in proper diagnosis and provides more valuable information for further treatment.

Extraosseous Ewing sarcoma in the fossa jugular: A rare case report.

Background: Extraosseous Ewing sarcoma (EES) is a rare case that accounts for 20% of Ewing sarcoma cases. EES is the second most prevalent pediatric malignancy after peripheral primitive neuroectodermal tumors. EES mostly arise from soft tissue and extra-skeletal. Computed tomography (CT) and magnetic resonance imaging (MRI) are primary modalities for determining tumor location, characteristics, type, and extent of tumors. In addition, for presurgical management, radio intervention with arterial embolization is needed as a preoperative. Case Description: We present a case of a 15-year-old boy diagnosed with EES. He had a "horn-like" tumor that grew progressively on his right ear over 5 months. Head CT scan and MRI were conducted to assess the extent. Embolization was performed before surgery. The surgery was conducted to excise the tumor radically. The histology pathology examination showed EES. Conclusion: EES rarely occurs in the head and neck. This may manifest as a solid mass with bleeding components that destroy the nearby bones, with exophytic mass. Imaging is important for early finding and detecting complications of EES.

Imaging Features and Complications of Facial Cosmetic Procedures.

Facial aesthetic procedures have become increasingly popular and complex, making knowledge of facial anatomy crucial for achieving desired outcomes without complications. Some of the most common procedures include blepharoplasty, bichectomy, face-lifts, facial implants, thread lifting, and fillers. Blepharoplasty and bichectomy are surgical procedures that respectively aim to restore youthful contours to the periorbita and create a slimmer lower face by removing Bichat fat from the maxillofacial region. Facial implants are used for aesthetic augmentation of the skeletal structure and restoration of facial contour by using biomaterials or autogenous bone grafts. Face-lift surgeries involve incisions and removal of excess skin, and thread lifts involve less invasive procedures performed by inserting threads beneath the skin, with the aim to lift the skin and thus reduce wrinkles and sagging. Fillers improve wrinkles and loss of facial volume, with biologic types made from animal, human, or bacterial sources (such as hyaluronic acid), while synthetic fillers include substances such as paraffin, silicone, calcium hydroxyapatite, polymethylmethacrylate microspheres, polyacrylamide hydrogel, hydroxyethyl-ethyl methacrylate, and poly-l-lactic acid. Synthetic fillers can be classified as rapidly resorbable (<12 months), slowly resorbable (<24 months), or permanent. Imaging modalities such as US, CT, and MRI can help identify and analyze each type of facial aesthetic procedure or filler, as well as their possible complications such as foreign-body granuloma, noninflammatory nodule, late intermittent persistent edema, filler migration, infection, or complications after removal of the buccal fat pad. ©RSNA, 2023 Quiz questions for this article are available through the Online Learning Center The online slide presentation from the RSNA Annual Meeting is available for this article.

Summary of the 2022 ACR Intersociety Meeting.

The ACR Intersociety Committee meeting of 2022 (ISC-2022) was convened around the theme of "Recovering From The Great Resignation, Moral Injury and Other Stressors: Rebuilding Radiology for a Robust Future." Representatives from 29 radiology organizations, including all radiology subspecialties, radiation oncology, and medical physics, as well as academic and private practice radiologists, met for 3 days in early August in Park City, Utah, to search for solutions to the most pressing problems facing the specialty of radiology in 2022. Of these, the mismatch between the clinical workload and the available radiologist workforce was foremost-as many other identifiable problems flowed downstream from this, including high job turnover, lack of time for teaching and research, radiologist burnout, and moral injury.

Differentiation between germinoma and other pineal region tumors using diffusion-and susceptibility-weighted MRI.

PURPOSE: To evaluate the effectiveness of diffusion-weighted imaging (DWI) and susceptibility-weighted imaging (SWI) for differentiation between germinoma and other pineal region tumors. METHOD: This retrospective study consisted of 72 patients with pathologically proven pineal region tumors between January 2010 and August 2020. Tumors were classified as germinomas (40), non-germinomatous germ cell tumors (11) (NGGCT), pineal parenchymal tumors (10) (PPT), and other types of tumors (11). Visual scale score, ADC values and SWI intratumoral susceptibility signal (ITSS) score were analyzed and compared to histopathology data. RESULTS: The mean apparent diffusion coefficient (ADCmean) and minimum apparent diffusion coefficient (ADCmin) ratio of germinoma were significantly lower than NGGCT. ADCmean or ADCmin cut-off ratio of ≤ 1.48 or ≤ 1.32 allowed for discrimination between germinoma and NGGCT with sensitivity and specificity of 100 % and 63.6 %. An ADCmin cut-off ratio of ≥ 0.93 allowed for discrimination between germinoma and PPT with sensitivity and specificity of 60 % and 80.0 %. ADCmin cut-off ratio of ≤ 1.15 allowed for discrimination of germinoma from other types of tumors with sensitivity and specificity of 87.5 % and 54.5 %. CONCLUSIONS: ADC ratio can differentiate germinoma from other types of pineal region tumors. Our initial results suggest that ITSS score was not significantly correlated with specific histology subtype.

Artificial Intelligence in Head and Neck Imaging.

Artificial intelligence (AI) can be applied to head and neck imaging to augment image quality and various clinical tasks including segmentation of tumor volumes, tumor characterization, tumor prognostication and treatment response, and prediction of metastatic lymph node disease. Head and neck oncology care is well positioned for the application of AI since treatment is guided by a wealth of information derived from CT, MRI, and PET imaging data. AI-based methods can integrate complex imaging, histologic, molecular, and clinical data to model tumor biology and behavior, and potentially identify associations, far beyond what conventional qualitative imaging can provide alone.