MRI of the Brain in Wilson Disease

PURPOSE: To describe the abnormal signal intensity seen on MRI of the brain in Wilson disease. MATERIALS AND METHODS: Eight patients (7 male and 1 female, 10 to 33 years of age ) with Wilson disease were studied with a 0.5TMRI system. Patients were divided into symptomatic and asymptomatic groups, and MR imaging was compared withclinical data. RESULTS: In 93 lesions, signal intensity was abnormal ; there was involvement of the pallidus(24lesions, 26%), the midbrain (20, 22%), the pons(14, 15%), the putamen (13, 14%), the thalamus(6, 7%), thepituitary gland (4, 4%), the caudate nuclei (4, 4%), the internal capsule (4, 4%), and the dentate nucleus (4,4%). In the putamen, all lesions but one were bilateral, and there was symmetric distribution. The four patientswith neurologic symptoms had 69 lesions and the remaining four without such symptoms had 24 lesions. OnT2-weighted images, high signal intensity was seen in all lesions but two, and on T1-weighted images, this wasseen in 24 lesions. All lesions of the pituitary gland showed high signal intensity on T1-weighted images.CONCLUSION: Lesions were frequently seen in the globus pallidus, midbrain, pons and putamen, and were more commonin patients with neurologic symptoms.

CT Findings of the Angiomatous Polyp in the Nasal Cavity and Paranasal Sinus

PURPOSE: To assess the characteristic CT findings of the angiomatous polyp. MATERIALS AND METHODS: Fivecases of pathologically-proven angiomatous polyp were retrospectively evaluated. All underwent CT scanning, butin only four cases were postcontrast CT scans obtained. In analysing CT findings we focused on adjacent bonychange, and the extent and enhancement pattern of the mass. RESULTS: All but one case involved the maxillarysinus, showing thickening of the posterolateral wall and erosion or destruction of the medial wall. As forinvolvement of the anterior wall of this sinus, bony destruction was seen in one case, and thickening in three. Infour cases the tumor involved the maxillary sinus and nasal cavity, and two cases showed nasopharyngeal extension.No case involved the pterygopalatine fossa, however. On contrast enhanced CT scans(n=4), all cases showedenhancement as strong as blood vessels, and a multiple focal punctate or tubular pattern. CONCLUSION: Angiomatouspolyp tends to show bone thickening rather than bone destruction, not to involve the pterygopalatine fossa, and toreveal a strong punctate or tubular enhancement pattern. These findings may be helpful in the differentialdiagnosis of angiomatous polyp from other tumors such as maxillary cancer, angiofibroma and nasal polyp

Transcatheter embolization for splanchnic pseudoaneurysm

PURPOSE: To determine the therapeutic effect of transcatheter embolization in the treatment of splanchnicpseudoaneurysm. MATERIALS AND METHODS: This study involved eleven patients who underwent embolization for thetreatment of splanchnic pseudoaneurysm. Nine were men and two were women ; their ages ranged from 8 to 74 (mean,51) years. The etiology of these cases included postoperative pseudoaneurysm(n=4), pancreatitis(n=3), stabinjury(n=1), and suspected infection(n=1), while two cases were uncertain. The locations of the pseudoaneurysmwere the splenic artery(n=4), the gastroduodenal artery(n=3), the hepatic artery(n=2), the celiac artery(n=1), andboth the right renal and lumbar artery(n=1). All patients underwent angiography prior to embolization. Thematerials used during embolization were a microcoil, a 5-cm metallic guide wire, and a detachable balloon. RESULTS: Embolization was successful in all eleven cases. Among nine cases in which follow-up was possible, angiographywas performed in four, and five cases of thrombus were confirmed by abdominal CT. Three of these nine patientsunderwent re-embolization. One patient underwent elective surgery for a pseudocyst due to pancreatitis. CONCLUSION: Transcatheter embolization is a safe and convenient modality for the treatment of splanchnic pseudoaneurysm.