Spinal lymphoma in a goat.

Should Spinal MRI Be Routinely Performed in Patients With Clinically Isolated Optic Neuritis?

Primary CNS lymphomas are detected with increasing frequency in immunocompetent and immunodeficient persons. Primary involvement of the spinal roots has only rarely been reported. The unusual history is described of...

OP0217 Frequent Detection of Inflammation and Fat Infiltration Suggestive of Spondyloarthritis on MRI of the Entire Spine in Healthy Subjects and Patients with Mechanical Back Pain

To review the MRI, histological, and clinical features of extraskeletal myxoid chondrosarcoma (EMC). Retrospective review of pre-treatment MRIs in 44 patients with pathologically proven EMC. Patient demographics, tumor MR-imaging features, histology and gene rearrangements, clinical management, and follow-up were reviewed. MRI features assessed included lesion size, location, morphology, signal characteristics, and relation to adjacent structures. Correlative analysis was performed to assess associations between demographic, clinical, molecular, and MRI variables with metastatic disease. EMCs were predominantly located in the lower extremity (38/44, 86%) and deep-to-fascia (36/44, 82%). All lesions (44/44) demonstrated well-circumscribed margins. Mean maximal dimension was 8.8cm (range 1.7-36cm); 93% (41/44) of lesions were hyperintense on fat-suppressed T2-weighted/ STIR imaging. Post-contrast enhancement was "solid" (> 80% enhancement) in 18%, "mixed" (20-80% enhancement) in 53%, and "sparse" (< 20% enhancement) in 29%. Nodal metastases were detected on preoperative imaging in four patients (9%), and pulmonary metastases in three cases preoperatively, and five cases postoperatively (range 14-128months). EWSR1::NR4A3 fusion rearrangements were documented in 25 tumors (57%), and non-EWSR1 NR4A3 fusions in six cases (14%). The only variable demonstrating a significant correlation with metastatic disease was "solid" pattern of lesional enhancement (p = 0.035). EMC is most commonly a deep lesion of the extremities demonstrating hyperintense T2-weighted signal, internal septations, and variable patterns of enhancement on MRI. Nodal disease is relatively frequent, and prolonged surveillance is recommended as metastases may develop years after diagnosis. Although analysis is limited by small case numbers, a "solid" (> 80%) pattern of enhancement was significantly associated with metastatic disease.

Descriptions of spinal MRI lesions and definition of a positive MRI of the spine in axial spondyloarthritis: a consensual approach by the ASAS/OMERACT MRI study group

BackgroundMagnetic resonance imaging (MRI) is frequently used in patients with chronic back pain (CBP) to diagnose mechanical and inflammatory diseases, including axial spondyloarthritis (axSpA). Recent data suggest sacroiliac joints (SIJ)...

Expected postoperative enhancement on breast MRI can appear similar to enhancement seen in recurrent or residual malignancy. Our aim was to assess the time course and patterns of enhancement at the surgical site, thereby helping to distinguish between benign and malignant postoperative enhancement. In 200 MRI scans performed in 153 patients after breast conservation treatment, 43 after surgical excision of atypia, and 4 patients after benign excisional biopsy were categorized by postoperative time interval. We defined 4 patterns of morphologic enhancement on MRI: cavity wall/seroma (Pattern I); thin linear (Pattern II); mass (Pattern III); and fat necrosis (Pattern IV). Of 200 MRI scans, 66 (33%) demonstrated enhancement at the surgical site. Enhancement typically decreased through the postoperative follow-up period. Enhancement was observed in 41% (28/68) of cases beyond the 18-month interval but was uncommon after 5 years. Pattern III enhancement was the morphologic pattern seen most commonly with malignancy (5/19 cases, 26%). When associated with delayed washout kinetics, it was even more strongly predictive of malignancy (4/5 cases, 80%). In patients with a history of excisional biopsy and no prior radiation treatment, the percentage of MRI scans showing enhancement was significantly lower than (21% vs 49% with P-value .0027) in patients who had undergone radiation. Enhancement at the surgical site occurred in one-third of cases up to 5 years after surgery, particularly in patients who underwent both radiation and surgery. Mass enhancement, particularly in conjunction with delayed washout kinetics, is most predictive of malignancy and should prompt biopsy or re-excision.

Background and Objectives: This study aimed to identify and analyze imaging and pathological features that differentiate liver metastases from primary liver cancer in patients with histopathological confirmation, and to evaluate the diagnostic accuracy of imaging modalities. Materials and Methods: This retrospective study included 137 patients who underwent liver biopsy or resection between 2016 and 2024, comprising 126 patients with liver metastases and 11 patients with primary liver cancer (hepatocellular carcinoma). Imaging features on contrast-enhanced MRI were evaluated, including lesion number, size, margins, enhancement patterns, presence of capsule, T1/T2 signal characteristics, diffusion-weighted imaging (DWI) signal, and portal vein thrombosis. Laboratory data such as liver function tests and alpha-fetoprotein (AFP) levels were collected. Pathological features recorded included tumor differentiation, vascular invasion, necrosis, and fibrosis. Statistical analyses were performed using chi-squared tests, t-tests, and logistic regression, with a significance level of p < 0.05. The diagnostic accuracy of imaging features was assessed using receiver operating characteristic (ROC) curve analysis. Results: Liver metastases were more likely to present as multiple lesions (82.5% vs. 27.3%, p < 0.001), had irregular margins (78.6% vs. 36.4%, p = 0.002), rim enhancement (74.6% vs. 18.2%, p < 0.001), and were hypointense on T1-weighted images (85.7% vs. 45.5%, p = 0.004). Primary liver cancers were more likely to be solitary (72.7% vs. 17.5%, p < 0.001), have smooth margins (63.6% vs. 21.4%, p = 0.002), exhibit arterial phase hyperenhancement (81.8% vs. 23.8%, p < 0.001), and portal venous washout (72.7% vs. 19.0%, p < 0.001). Vascular invasion was more common in primary liver cancer (45.5% vs. 11.1%, p = 0.01). AFP levels > 400 ng/mL were significantly associated with primary liver cancer (63.6% vs. 4.8%, p < 0.001). ROC curve analysis showed that a combination of imaging features had an area under the curve (AUC) of 0.91 for differentiating the two entities. Conclusions: Imaging features such as lesion number, margin characteristics, enhancement patterns, T1/T2 signal characteristics, and portal venous washout, along with pathological features like vascular invasion and AFP levels, can effectively differentiate liver metastases from primary liver cancer. The diagnostic accuracy of imaging is high when multiple features are combined.

BackgroundPlasma cell granuloma (PCG) is a rare non-neoplastic entity, with the precise etiology remaining unclear. Vertebra-affected spinal PCG has not been reported yet. This report presented a case with cross-segment spinal PCG in thoracolumbar region.Case presentationA 32-year-old male patient presented to the authors’ hospital since his health check-up results showed osteolytic lesions in the thoracolumbar spine. He felt asymptomatic throughout the course. Radiological examination revealed destructive changes at T12 and L1 vertebrae. Whereas laboratory examination excluded malignant tumor. The results of routine incisional biopsy remained inconclusive, thereby necessitating complete excision of the lesions. Finally, the infiltration of plasma cells observed by pathological examination of the surgical specimen confirmed the diagnosis of PCG.ConclusionsTo the authors’ knowledge, this was the first case of cross-segment spinal PCG with osteolytic property. The possibility of PCG should be considered for the diagnosis and differential diagnosis of an osteolytic lesion in the spine. Since the etiology of PCG is unknown, the disorder was confirmed based on excluded diagnosis. Surgical resection is recommended both for the definite diagnosis and treatment of spinal PCG.

The prevalence of renal masses has escalated as a result of the augmented utilization of cross-sectional imaging techniques. The approach to managing renal masses may exhibit variability contingent upon the subtype of renal cell carcinoma (RCC). This research aimed to distinguish between clear cell and papillary RCCs, utilizing dynamic contrast magnetic resonance imaging (MRI) and diffusion-weighted imaging (DWI). The study assessed the MR images of 112 patients with RCC. Two radiologists independently analyzed tumor size, vascular involvement, signal characteristics in T1- and T2-weighted sequences, the presence of hemosiderin, both microscopic and macroscopic fat content, enhancement patterns, and apparent diffusion coefficient (ADC) values derived from b-values of 1000 s/mm². Seventy patients had clear cell RCC, and 42 had papillary. In the clear cell RCC, microscopic fat content was significantly higher than the papillary RCC (P < 0.001). However, in papillary RCC, hemosiderin content was substantially greater (P = 0.001). On T2-weighted MR images, clear cell RCCs were usually hyperintense, while papillary RCCs were hypointense (P < 0.001). Even though the rapid enhancement pattern was observed in clear cell RCCs, the progressive enhancement pattern was more prevalent in papillary RCCs (P < 0.001). Hyperintensity on T2-weighted images, microscopic fat content, and rapid enhancement pattern may be indicative of clear cell RCC, whereas hypointensity on T2-weighted images, hemosiderin content, and a progressive contrast pattern may be diagnostic for papillary RCC.

Imaging of the meningeal lymphatic network in healthy adults: A 7T MRI study

Objective To evaluate the efficacy of the sleeve type guide growth rod sliding automatically with the growth of piglet spine. Methods Fourteen 4-month-old piglets were randomly divided into growth rod group (n=8) and control group (n=6). Animals in growth rod group were implanted with the sleeve type guide growth rod system through the small incision of the tho-racodorsal. Whereas ones in control group were just expose the bilateral lamina. On the day of surgery, 6 and 12 weeks of postop-eration, all piglets accepted the spinal X-ray examination. Measured the mean height of T8, T9 vertebral bodies, the average height of T7-8, T8-9, T9-10 discs and the mean length of the rods through X-ray film. Spinal MRI was measured 3 months after the operation. The morphological changes of the plate were observed after HE staining. The morphological changes of the nucleus pulposus cells were observed and the thickness of the growth plate and the length of the growth bar were measured. Results Two piglets of growth rod group did not complete the experiment, 1 piglet died of aspiration due to anesthesia resuscitation, and 1 piglet had in-fection after operation. The average height of T8, T9 vertebral bodies of the piglets in the growth rod group on the day after surgery and 3 months after operation was 18.26±3.26 mm and 27.15±4.18 mm, respectively, and the difference was statistically significant (F=16.868, P=0.002). Similarly, the mean height of T7-8, T8-9, T9-10 discs of the piglets in growth rod group on the day after surgery and 3 months of postoperation was 1.79±0.24 mm and 2.14±0.23 mm, respectively, and the difference was statistically significant(F=6.455, P=0.029). The average height of T8, T9 vertebral bodies in the control group on the day after surgery and 3 months after operation was 17.86±3.50 mm and 28.63±4.45 mm, respectively, and the difference was statistically significant (F=21.654, P=0.001). Similarly, the mean height of T7-8, T8-9, T9-10 discs in control group at the day after surgery and 3 months of postoperation was 1.78±0.27 mm and 2.17±0.30 mm, respectively, the difference was statistically significant (F=5.928, P=0.035). There was no statistically significant difference in average height between T8 and T9 vertebral bodies in growth rod group and the control group at 3 months after operation (F=0.352, P=0.566). Similarly, There was no statistically significant difference in average height of T7-8、T8-9、T9-10 discs in growth rod group and the control group at 3 months after operation (F=0.053, P=0.823). The average sliding length of the growth rod in growth rod was 65.74 mm. Furthermore, growth plate chondrocytes and nucleus pulposus cells in EG and SG, all showed that the cells were arranged in order, the cell volume was large, the shape was round and the cytoplasm was rich. Simultaneously, there was no significant difference between the two groups in growth plate chondrocytes (P>0.05). Conclusion The sleeve type guiding growing rod can automatically slip to extend due to the driving force of young pig’s spine growth, without obvious effects on the normal growth of piglet's spine. Key words: Scoliosis; Orthopedic fixation devices; Internal fixators

This investigation was a cohort study that included: 36 typically developing (TD) children and 19 children with spinal cord lesions who underwent spinal cord MRI. To investigate diffusion tensor imaging (DTI) cervical and thoracic spinal cord changes in pediatric patients that have clinically traumatic and non-traumatic spinal cord injury (SCI) without MR (SCIWOMR) abnormalities. Thomas Jefferson University, Temple University, Shriners Hospitals for Children all in Philadelphia, USA. 36 TD children and 19 children with spinal cord lesions that represent either a chronic traumatic acquired SCI or chronic non-traumatic SCI (≥6 months post injury), age range, 6-16 years who underwent cervical and thoracic spinal cord MRI in 2014-2017. Additionally DTI was correlated to clinical American Spinal Injury Association Impairment Scale (AIS). Both SCIWOMR and MRI positive (+) groups showed abnormal FA and RD DTI values in the adjacent MRI-normal appearing segments of cephalad and caudal spinal cord compared to TD. The FA values demonstrated perilesional abnormal DTI findings in the middle and proximal segments of the cephalad and caudal cord in the SCIWOMR AIS A/B group compared to SCIWOMR AIS C/D group. We found DTI changes in children with SCIWOMR with different causes of spinal lesions. We also investigated the relationship between DTI and clinical AIS scores. This study further examined the potential diagnostic value of DTI and should be translatable to adults with spinal cord lesions.

To evaluate the temporal lobes in patients previously treated for nasopharyngeal carcinoma to provide a better understanding of delayed radiation-induced injury in the brain unaffected by the underlying tumor. Retrospective analysis of the patient data was approved by the local ethics committee. Informed consent was waived. Magnetic resonance (MR) imaging results in patients with temporal lobe injury (TLI) after receiving radiation for nasopharyngeal carcinoma were analyzed. The appearance and change over time of white matter lesions (WMLs), contrast material-enhanced lesions, and cysts were assessed. The Mann-Whitney U test was used to compare interval time, and the chi(2) and Fisher exact tests were used to compare the pattern of TLI changes. The study group was 124 patients (95 men, 29 women; mean age, 51.4 years) with 192 injured temporal lobes; 62 of these patients with 103 injured temporal lobes underwent follow-up MR imaging at least once (range, one to five examinations). A total of 332 injured temporal lobes were revealed. WMLs, contrast-enhanced lesions, and cysts were present on 332 (100%), 274 (82.5%), and 42 (12.7%) studies, respectively. All contrast-enhanced lesions more than 2 cm in size showed necrosis, and those 3 cm or greater formed a rim-enhanced necrotic mass. WMLs were the only lesion to occur alone, contrast-enhanced lesions were always accompanied by WMLs, and cysts were always accompanied by WMLs and contrast-enhanced lesions. Detection of cysts was significantly later than detection of WMLs and contrast-enhanced lesions (P <.01). Regression or resolution was found in 27 (28%) of 96 WMLs, 37 (39%) of 94 contrast-enhanced lesions, and one (7%) of 15 cysts. TLI from radiation is not always an irreversible and progressive process but is one that can regress or resolve at MR imaging. In the evolution of radiation injury, WMLs are seen first and are followed by contrast-enhanced lesions, which have an increasing tendency to become necrotic with increasing size. Cysts are the least frequent manifestation and arise in the late stage of TLI.

Objective To analyze the magnetic resonance imaging (MRI) of the spinal cord and clinical characteristics in patients with autoimmune glial fibrillary acidic protein (GFAP) astrocytopathy. Methods A total of 1 040 samples of cerebrospinal fluid (CSF) and sera collected in the Second Affiliated Hospital of Guangzhou Medical University from March 2013 to June 2018 were tested with tissue- and cell-based assays, and 42 patients were found positive for GFAP-IgG. The clinical data and MRI characteristics of the spinal cord of 19 patients who were positive for GFAP-IgG in CSF with autoimmune GFAP astrocytopathy and lesions in the spinal cord were retrospectively reviewed. Results There were 12 females and seven males among the 19 patients, with onset age of (44±17) years. The main manifestations of these patients included limb weakness (14/19), abnormal vision (5/19), headache (4/19), seizure (4/19), dementia (3/19), etc. On MRI of the spinal cord, five patients showed involvement in the cervical cord alone, eight showed involvement in the thoracic cord alone and six had both cervical and thoracic segment involvement. Fifteen patients had longitudinally extensive myelitic abnormalities (≥3 vertebral segments long). Seven enhancement patterns were encountered. Lesions were displayed in the spinal cord and brain in eight patients. Central gray matter involvement in the spinal cord was found in all the 19 patients. Conclusions Autoimmune GFAP astrocytopathy more frequently presents in females than in males. MRI of the spinal cord has complex presentations and longitudinally extensive myelitic abnormalities usually. Patients often show central gray matter involvement in the spinal cord. Myelitic abnormalities present more often in thoracic segment than in cervical segment. Abnormalities in lumbar segment are less encountered. Key words: Autoimmune diseases; Glial fibrillary acidic protein; Astrocytes; Spinal cord; Magnetic resonance imaging