Professional Documents
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Reference
1. Duncan IC. The aura sign: an unusual cultural variant affecting MR imaging. (letter) AJR 2001;177:1487
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References
1. Fuchs F. Pyelovenous backflow in the human kidney. J Urol 1930;23:181216
2. Thomsen HS. Pyelorenal backflow: clinical and
experimental investigations. Dan Med Bull
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4. Imray TJ, Lieberman RP, Pollack HM. Retrograde
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months after surgery, sonography showed multiple liver tumors, each with a highly echoic
rim. In addition to a diffuse fatty infiltration of
the liver, unenhanced CT revealed five liver tumors, each of which measured 1.01.8 cm in
diameter (mean, 1.2 cm). Each tumor displayed a peritumoral hypoattenuating band
that was thought to be fatty infiltration (Fig.
3A). On arterial phase CT, all tumors showed
rim enhancement, and metastases from gastric
carcinoma were suspected, although the patient also had hepatitis C.
The level of carcinoembryonic antigen
was elevated at 15 ng/dL, but levels of -fetoprotein and protein induced by vitamin K
antagonist II were normal. The patient had
no history of alcoholism or diabetes mellitus.
The serum triglyceride level was normal, and
the total cholesterol level was slightly low
(142 mg/dL).
On angiography, all tumors showed rim enhancement. CT during arterial portography
showed multiple nodular perfusion defects including a peritumoral hypoattenuating band
around each tumor (Fig. 3B). Early phase images of single-level dynamic CT during hepatic arteriography showed a hyperattenuating
rim within the peritumoral hypoattenuating
band around each tumor (Fig. 3C). On late
phase images, the peritumoral hypoattenuating
bands were gradually enhanced by direct
drainage from the tumors (Fig. 3D).
The patient refused needle biopsy, and the
diagnosis of metastatic liver tumor from gastric carcinoma was established clinically. The
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Shiro Miyayama
Hiroto Nishida
Fukuiken Saiseikai Hospital
Fukui 918-8503, Japan
Osamu Matsui
University of Kanazawa
Kanazawa 920-8641, Japan
References
Fig. 3.54-year-old woman with metastatic liver tumors from gastric carcinoma and peritumoral fatty infiltration.
A, Unenhanced CT scan shows 1.8-cm-diameter tumor with peritumoral hypoattenuating band.
B, CT during arterial portogram shows portal perfusion defect, including tumor and peritumoral hypoattenuating
band. Another tumor is also seen in lateral segment of liver.
C, Image from single-level dynamic CT during hepatic arteriography obtained 4 sec after contrast administration
shows hyperenhancing tumor with central necrosis.
D, Image from single-level dynamic CT during hepatic arteriography obtained 20 sec after contrast administration shows rim enhancement corresponding to peritumoral fatty infiltration.
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Fig. 4.23-year-old woman with peripheral nerve sheath tumor of median nerve.
A, T1-weighted image (TR/TE, 400/11) reveals intermediate signal of lesion (asterisk) in expected position of median nerve.
B, Fat-suppressed proton densityweighted image (TR/ effective TE, 2000/34) shows homogeneously increased signal of mass.
C, Contrast-enhanced fat-suppressed T1-weighted image (TR/TE, 300/11) reveals complete
lack of enhancement in lesion. Mass is slightly hypointense relative to adjacent muscle. Fat
suppression is slightly inhomogeneous but could be expected to affect only small part of periphery of mass.
D, In gross pathologic specimen obtained during resection, fibers of median nerve (arrow)
are displaced by mass, as would be expected with schwannoma.
References
1. Murphey MD, Smith WS, Smith SE, Kransdorf
MJ, Temple HT. From the archives of the AFIP:
imaging of musculoskeletal neurogenic tumors
radiologicpathologic correlation. RadioGraphics 1999;19:12531280
2. Varma DG, Moulopoulos A, Sara AS, et al. MR
imaging of extracranial nerve sheath tumors. J
Comput Assist Tomogr 1992;16:448453
3. Soderlund V, Goranson H, Bauer HC. MR imaging of benign peripheral nerve sheath tumors.
Acta Radiol 1994;35:282286
4. Beggs I. Pictorial review: imaging of peripheral
nerve tumours. Clin Radiol 1997;52:817
5. Zbar RI, Megerian CA, Khan A, Rubinstein JT.
Invisible culprit: intralabyrinthine schwannomas
that do not appear on enhanced magnetic resonance imaging. Ann Otol Rhinol Laryngol
1997;106:739742
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