RESUMEN
Adrenal leiomyomas are rare and often reported as Epstein-Barr virus (EBV)-associated smooth muscle tumor (SMT) in association with EBV infection in immunocompromised patients. We experienced a case of right adrenal leiomyoma that was incidentally found in a man in his 70s. Computed Tomography (CT) showed a well-circumscribed mass of 3.1 cm in diameter in the right adrenal gland, which increased to 4.9 cm in diameter over 1 year. Preoperative diagnosis was difficult due to the lack of specific imaging findings. He had a history of diffuse large B-cell lymphoma (DLBCL) 8 years ago, and EBV had been detected in his blood. EBV-encoded small RNA(EBER) in situ hybridization (EBER-ISH) of the right adrenal leiomyoma was positive, and the final diagnosis was EBV-associated leiomyoma.
RESUMEN
BACKGROUND AND PURPOSE: We compared 3-dimensional time-of-flight magnetic resonance angiography (3D TOF MRA) using a 3-tesla (T) MR unit with 64-channel multi-detector row computed tomographic angiography (64-MDCTA) for detection and characterization of angiographically proven unruptured intracranial aneurysms. METHODS: Thirty-eight patients with 47 aneurysms and 8 patients without aneurysms underwent 3T, 3D TOF MRA; 64-MDCTA; and intra-arterial angiography. As a first study, 3 radiologists blinded to pertinent clinical information independently reviewed MRA and CTA images. We evaluated diagnostic accuracy using an alternative free-response receiver operating characteristic (AFROC) analysis and evaluated the sensitivity and specificity of each technique. Next, 2 radiologists used volume-rendering images generated from MRA or CTA data to evaluate the morphology of the 47 aneurysms detected, and MRA and CTA results were compared. Three-dimensional digital angiography (DA) images were used as the standard of reference. RESULTS: On the AFROC analysis, the value of the mean area under the AFROC curve (A(1)) was 0.91 for both modalities. Mean sensitivity of 89% and specificity of 76% for MRA were not significantly different from sensitivity of 87% and specificity of 79% for CTA. Therefore, when used to evaluate aneurysmal morphology, both modalities appear satisfactory for determining these vascular anomalies. CONCLUSION: Three-tesla, 3D TOF MRA and 64-MDCTA are excellent modalities with high diagnostic accuracy for evaluating unruptured intracranial aneurysms and no significant difference between them in diagnostic performance.
Asunto(s)
Angiografía Cerebral/métodos , Aneurisma Intracraneal/diagnóstico , Angiografía por Resonancia Magnética/métodos , Tomografía Computarizada por Rayos X/métodos , Adulto , Anciano , Área Bajo la Curva , Femenino , Humanos , Imagenología Tridimensional , Aneurisma Intracraneal/patología , Masculino , Persona de Mediana EdadRESUMEN
PURPOSE: To evaluate the performance advantages of an 8-element phased array head coil (8 ch coil) over a conventional quadrature-type birdcage head coil (QD coil) with regard to the signal-to-noise ratio (SNR) and image uniformity in 3 Tesla magnetic resonance (MR) imaging. MATERIALS AND METHODS: We scanned a phantom filled with silicon oil using an 8 ch coil and a QD coil in a 3T MR imaging system and compared the SNR and image uniformity obtained from T(1)-weighted spin echo (SE) images and T(2)-weighted fast SE images between the 2 coils. We also visually evaluated images from 4 healthy volunteers. RESULTS: The SNR with the 8 ch coil was approximately twice that with the QD coil in the region of interest (ROI), which was set as 75% of the area in the center of the phantom images. With regard to the spatial variation of sensitivity, the SNR with the 8 ch coil was lower at the center of the images than at the periphery, whereas the SNR with the QD coil exhibited an inverse pattern. At the center of the images with the 8 ch coil, the SNR was somewhat lower, and that distribution was relatively flat compared to that in the periphery. Image uniformity varied less with the 8 ch coil than with the QD coil on both imaging sequences. CONCLUSION: The 8 ch phased array coil was useful for obtaining high quality 3T images because of its higher SNR and improved image uniformity than those obtained with conventional quadrature-type birdcage head coil.