Diffusion weighted imaging of esthesioneuroblastoma: Differentiation from other sinonasal masses.

BACKGROUND: Differentiating esthesioneuroblastoma (ENB) from other sinonasal tumors is difficult by MRI. We tested whether diffusion weighted imaging (DWI) could distinguish ENB from other sinonasal tumors. METHODS: Hundred forty-six patients underwent sinonasal MRI, 75 with technically successful DWI. Pathology: 18 ENB (24%), 34 (45%) other malignant tumors, and 23 (31%) benign lesions. Apparent diffusion coefficients (ADCs) were calculated. RESULTS: Average ADC and normalized ADC of ENB (1.22 × 10-3 ± 0.28 mm2 /s and 1.55 ± 0.36, respectively) were higher than other malignancies (0.98 × 10-3 ± 0.18 mm2 /s and 1.31 ± 0.29, P = .002 and P = .034) and lower than benign disease (1.92 × 10-3 ± 0.33 mm2 /s and 2.44 ± 0.50, P < .0001). ADC differentiated ENB from benign disease with 91% sensitivity and 83% specificity. An ADC cutoff of 1.1 × 10-3 mm2 /s differentiated other malignancies from ENB with 72% sensitivity and 85% specificity. CONCLUSIONS: DWI is useful in distinguishing ENB from other sinonasal disease.

Mesenteric inflammatory veno-occlusive disease: radiographic and histopathologic evaluation of 2 cases.

Mesenteric inflammatory veno-occlusive disease (MIVOD) is a rare cause of inflammatory enterocolitis whose clinical and imaging presentation can be confused with mesenteric venous thrombosis and inflammatory bowel disease. We report two cases of histologically proven MIVOD in patients presenting with abdominal pain and describe potentially useful distinguishing features at contrast-enhanced CT, including prominent small pericolonic arteries and veins but a diminutive or absent inferior mesenteric vein. Alerting referring clinicians to the possibility of this diagnosis may help avoid unnecessary anticoagulation and reduce diagnostic delay. Treatment of MIVOD is surgical resection, which is typically curative.