Demonstration of cerebral venous variations in the region of the third ventricle on phase-sensitive imaging.

BACKGROUND AND PURPOSE: Susceptibility-weighted (SW) MR imaging has enabled noninvasive visualization of the cerebral veins and has shed light on the nature of venous architecture. For successful surgery of the third ventricle, understanding of the anatomy of the subependymal veins of the lateral ventricle and their relationships to the foramen of Monro is required preoperatively. The purpose of this study was to evaluate the anatomic variations of the subependymal veins around the third ventricle by use of phase-sensitive imaging (PSI) on the basis of principles similar to those of SW MR imaging. MATERIALS AND METHODS: Included in this study were 642 sides in 321 patients. The courses of the anterior septal vein (ASV), thalamostriate vein, and internal cerebral vein (ICV) were evaluated. We classified these into 4 types (IA, IB, IIA, IIB) on the basis of standard classic angiographic criteria. The classification is based on their relationship with the ASV-ICV junction and the presence of a venous angle or a false venous angle, according to the method in a previous study. Other venous variations were classified as type III. RESULTS: A venous angle was formed in 519 (80.9%), whereas a false venous angle was formed in 123 (19.1%). The ASV-ICV junction was located at the venous angle (type IA) in 407 (63.4%) of 642 sides. In 235 sides (36.6%), the ASV-ICV junction was located posteriorly beyond the foramen of Monro (types IB, IIA, IIB, and III). CONCLUSIONS: PSI is useful for understanding normal variations of the subependymal veins in the region of the third ventricle.

Cerebellar lesions in multiple system atrophy: postmortem MR imaging-pathologic correlations.

BACKGROUND AND PURPOSE: Cerebellar atrophy and white matter T2-hyperintensities have been characterized as cerebellar lesions of multiple system atrophy (MSA). The aim of the study was to correlate MR images with histologic findings in cerebellar lesions of MSA. MATERIALS AND METHODS: Postmortem T2-weighted images using 1.5T were compared with histologic findings in 7 postmortem-proved cases with MSA. The MR imaging findings in the cerebellar cortices and deep white matter dentate nucleus regions were compared with their histologic findings in each case. RESULTS: We detected 3 types of cerebellar changes: type 1, no apparent atrophy or signal-intensity changes; type 2, cerebellar atrophy and inhomogeneous (patchy and/or confluent) cerebellar white matter hyperintensities; and type 3, cerebellar atrophy and diffuse white matter hyperintensities. Hypointensities were seen in the dentate nucleus regions. Atrophy of the cerebellar white matter was more severe than that of cerebellar cortices, and this anatomy was well depicted on coronal images. Histologically, degeneration was more severe in the cerebellar white matter than in the cerebellar cortices. Hyperintensities in the cerebellar white matter showed loss of myelinated fibers and gliosis. Hypointensities in the dentate nucleus regions revealed diffuse ferritin deposition in preserved dentate nuclei and white matter both around and within the nuclei. CONCLUSIONS: Hyperintensities in the cerebellar white matter reflect degenerated white matter associated with loss of myelinated fibers and gliosis, whereas hypointensities in the dentate nucleus regions reflect diffuse ferritin deposition in preserved dentate nuclei and white matter around and within the nuclei. Degeneration is more severe in the cerebellar white matter than in the cerebellar cortices.

[Esophageal cancer in chronic lymphocytic leukemia--a case report].

A 58-year-old male was admitted because of severe dysphagia. Radiographic and endoscopic examination revealed squamous cell carcinoma of the esophagus. Physical examination revealed severe splenomegaly and swelling of the cervical and axillary lymph nodes. Laboratory data showed lymphocytosis (more than 90%), severe anemia and monoclonal hyperglobulinemia (IgA type). The patient received irradiation (60 Gy) to the esophageal lesion using Linac X-ray and 40 Gy to the left cervical and axillary region with a tele Co60. Radiotherapy showed a remarkable effect not only on the esophageal cancer but also the chronic lymphocytic leukemia.