ABSTRACT
Carmofur (1-hexylcarbamyl-5-fluorouracil), a derivative of 5-fluorouracil (5-FU), has been widely used in Japan as a postoperative adjuvant chemotherapy agent for colorectal and breast cancer. Periventricular hyperintensity on T2-weighted MR images in carmofur-induced leukoencephalopathy confront the physician with a broad range of differential diagnoses. We describe two cases of carmofur-induced leukoencephalopathy in which diffusion-weighted MR imaging revealed periventricular hyperintensity. We compared their findings with those of age-related periventricular hyperintensity in five patients and found discrepancies in signal intensity of periventricular areas. Our results suggest that diffusion-weighted MR imaging may be useful to differentiate carmofur-induced leukoencephalopathy from age-related periventricular hyperintensity.
Subject(s)
Antineoplastic Agents/adverse effects , Brain Diseases/chemically induced , Encephalomalacia/chemically induced , Fluorouracil/analogs & derivatives , Fluorouracil/adverse effects , Image Enhancement , Magnetic Resonance Imaging , Adult , Antineoplastic Agents/administration & dosage , Brain/pathology , Brain Diseases/diagnosis , Breast Neoplasms/drug therapy , Carcinoma, Ductal, Breast , Chemotherapy, Adjuvant , Diffusion , Encephalomalacia/diagnosis , Female , Fluorouracil/administration & dosage , Humans , Male , Middle Aged , Sigmoid Neoplasms/drug therapyABSTRACT
PURPOSE: To report our preliminary results in the application of a turbo fluid-attenuated inversion-recovery (FLAIR) MR technique to the diagnosis of intracranial tumors and to assess the clinical usefulness of this technique. METHODS: Thirty-four patients with various intracranial tumors were studies with MR imaging, including a turbo FLAIR sequence. FLAIR images were compared with images obtained with conventional spin-echo sequences. RESULTS: Except for 2 lesions in 1 patients, tumor signal intensities on FLAIR images were consistent with those shown on T2-weighted spin-echo images. FLAIR images showed peritumoral edema more clearly than T2-Weighted and proton density-weighted images when the tumor itself was not hyperintense. In 8 of 23 patients in whom edema was associated with tumor, FLAIR images provided better definition between edema and tumor than did T2-weighted and proton density-weighted images. In 5 patients, FLAIR images depicted different signal intensity between cerebrospinal fluid and a cystic or necrotic component. In 20 of 22 patients, postcontrast FLAIR images showed contrast enhancement comparable to that seen on postcontrast T1-weighted images. CONCLUSION: Turbo FLAIR images can supplement conventional spin-echo images in the diagnosis of intracranial tumors.
Subject(s)
Brain Neoplasms/diagnosis , Image Processing, Computer-Assisted/instrumentation , Magnetic Resonance Imaging/instrumentation , Adolescent , Adult , Aged , Aged, 80 and over , Brain Edema/diagnosis , Brain Neoplasms/secondary , Child , Contrast Media , Drug Combinations , Female , Gadolinium DTPA , Glioma/diagnosis , Humans , Male , Meglumine , Meningeal Neoplasms/diagnosis , Meningioma/diagnosis , Middle Aged , Neuroma, Acoustic/diagnosis , Organometallic Compounds , Pentetic Acid/analogs & derivativesABSTRACT
The accuracy of MR imaging with Gd-DTPA enhancement was compared with mammography and ultrasonography in 52 patients with clinically palpable benign and malignant breast masses (36 carcinomas, 2 malignant phyllodes tumors, 7 fibroadenomas, 7 cysts). On dynamic MR imaging, carcinomas and fibroadenomas were discriminated by their different dynamic enhancement profiles. In carcinomas, signal intensity increased rapidly, reaching a peak or plateau within 2 min after the injection of contrast medium. In fibroadenomas, signal intensity showed a much slower continuous increase without ceasing until about 8 min after injection. Malignant phyllodes tumors showed a dynamic enhancement profile identical to that of benign fibroadenomas. MR imaging correctly identified 84% of malignant tumors, 86% of fibroadenomas, and 100% of cysts, and was substantially more accurate in tissue characterization than mammography. The results of ultrasonography were highly similar to those of MR imaging. However, no single modality was infallible, and the three modalities were complementary rather than competitive. Considering the high cost and long examination time of MR imaging, mammography supplemented by ultrasonography seems to be the method of choice in the diagnosis of breast lesions. Nevertheless, MR imaging can add important information when the results of mammography and ultrasonography are insufficient or contradictory.