Multiple Endocrine Neoplasia: Spectrum of Abdominal Manifestations.

OBJECTIVE. Multiple endocrine neoplasia (MEN) syndromes are autosomal-dominant genetic disorders that predispose two or more organs of the endocrine system to tumor development. Although the diagnosis relies on clinical and serologic findings, imaging provides critical information for surgical management with the ultimate goal of complete tumor resection. CONCLUSION. This article reviews abdominal neoplasms associated with the various subtypes of MEN syndromes, with a focus on clinical presentation and characteristic imaging features.

Evaluation of feasibility and image quality of a new radial quantitative T2 weighted imaging sequence for liver MRI.

OBJECTIVES: To evaluate the clinical feasibility of a new T2 weighted sequence to calculate T2 relaxation times (T2RT) of liver lesions using two-dimensional radial turbo spin echo (2DRTSE) and to evaluate this sequence by performing image quality and relaxation time comparison of multiple liver lesions. MATERIALS AND METHODS: This prospective analysis of 2DRTSE sequences (using 22 echoes) was performed in 19 patients with 36 liver lesions. Two radiologists independently obtained T2RTs for liver lesions and scored image quality and image artifacts. Lesions were classified as cyst, hemangioma, solid, or necrotic. T2RT values were compared. Inter-reader agreement was evaluated. RESULTS: The 2DRTSE images were considered good quality with few artifacts by both radiologists. Nineteen patients were included in the study, with a total of 36 liver lesions. Two of the liver lesions were classified as cysts, 7 as hemangiomas, 4 as necrotic lesions, and 23 as solid lesions. The concordance correlation coefficient was 0.996 for the calculated T2RT of each liver lesion between the two readers, indicating good agreement. There was statically significant difference of the calculated T2RT for each lesion type. CONCLUSION: The 2DRTSE sequence can be performed and provides good T2W image quality and a quantitative T2RT map of the entire abdomen. The liver lesions can be distinguished based on the calculated T2RT using this technique. 2DRTSE could potentially supplant the current T2-weighted imaging sequence with the benefit of quantitative T2RTs.

Intraosseous malignant peripheral nerve sheath tumor of the sacrum in a patient with neurofibromatosis type I.

Malignant intraosseous peripheral nerve sheath tumor is a very rare malignancy most commonly seen in patients with neurofibromatosis type 1. This tumor almost exclusively occurs in the maxillofacial region, with manifestation of this tumor in other regions of the skeleton infrequently reported. We describe a 23-year-old female with previously undiagnosed neurofibromatosis type 1 presenting with lower extremity weakness, paresthesias, and bowel/bladder symptoms. The patient had an aneurysmal lytic bone lesion centered in the upper sacrum with invasion of the L5 vertebral body. On MRI, the lesion was homogeneously isointense to muscle on T1, heterogeneously hyperintense to muscle on T2, and demonstrated homogeneously avid contrast enhancement. Multiple additional small lesions with similar imaging characteristics were identified in the paraspinal soft tissues. Low grade malignant peripheral nerve sheath tumor of the sacrum was diagnosed on biopsy. The patient was treated with sacral resection and radiation therapy for local disease control.