Plain Computed Tomography With Spectral Imaging Findings of Early Cerebral Ischemia.

PURPOSE: To investigate the findings of plain spectral computed tomography (CT) with multiparameter of early cerebral ischemia. PATIENTS AND METHODS: Thirty-three patients with suspected early cerebral ischemia who received a one-stop CT examination (plain scan with spectral CT imaging mode, CTP and CTA) of the brain were enrolled in this study. No clear lesion was observed in any patient on the plain CT. However, the CTA displayed evidence of vascular stenosis and the CTP displayed a corresponding low perfusion area consistent with early cerebral ischemia. Regions of interest were placed in the abnormal perfusion regions and the contralateral symmetric regions on plain CT. Then, the CT value of the monochromatic images (70 kV), the slope of the spectral HU curve, blood (iodine), iodine (water), and water (iodine) concentrations were measured. A paired t-test was performed for data comparison. The receiver operating characteristic curve was used to evaluate diagnostic performance. RESULTS: The CT values of the ischemic regions at 70 keV, the spectral HU curve, water, and blood values of the ischemic measurements were slightly lower than those of the contralateral symmetric regions (P < .05). Monochromatic images at 70 keV had the highest area under the curve value, and the sensitivity and specificity were 90.0% and 63.0%, respectively. CONCLUSION: The difference of monochromatic CT values, spectral HU curve, and basic material concentrations between the early cerebral ischemia region and the contralateral symmetric region on spectral CT imaging may provide a reference with the diagnosis of early cerebral ischemia.

Imaging findings and clinical features of intracal lymphoplasmacyte-rich meningioma.

PURPOSE: The purpose of this study was to analyze the imaging findings and clinical features of intracal lymphoplasmacyte-rich meningioma. PATIENTS AND METHODS: The clinical, radiographic, and pathological data of 9 patients of lymphoplasmacyte-rich meningioma were analyzed retrospectively. RESULTS: All cases were solitary; 8 patients with headache, dizziness, and vomiting; 2 patients with vision loss and one with progressive hearing loss; and 4 cases of secondary anemia, 3 of them with secondary hyperplasia of polyclonal immunoglobulin. In the plain CT scan of 6 cases, all masses showed higher density and without clear boundary, and 5 masses accompany obvious peritumoral edema. In plain MRI scan, all of the tumors appeared with irregular shape and unclear boundaries, 8 of the masses with obvious peritumoral edema. Enhanced scan showed all cases were significantly enhanced and the meninges in 7 cases thicken irregularly and extensively. The pathology showed that the tumors were irregularly shaped with grayish red or grayish white cut surfaces. Histological examination showed that the tumors consisted of abundant and diverse cells and different numbers of spindle tumor cells, and meningeal epithelial cells in the background of abundant inflammatory cells could be seen. The 9 cases all had surgery; only 1 case of recurrence in the first year after the operation was noted in the follow-up over 1 to 4 years, and no recurrence could be found after the second surgery. CONCLUSION: Lymphoplasmacyte-rich meningioma is a seldom-seen subtype meningioma of WHO grade I, often accompanying anemia or polyclonal immunoglobulin hyperplasia, which can recover to normal state after removing the masses. The masses showed higher density and without clear boundary in plain CT scan, and most of the tumors appear with irregular shape, obvious edema, and significant enhancement in the MRI scan. The prognosis is favorable after surgical resection and the recurrence rate is low.