Postsurgical pelvis: treatment follow-up.

Imaging for recurrence and complications of gynecologic malignancies following treatment with radical hysterectomy, chemotherapy, and radiation therapy has become an important determinant for treatment options available to patients. MR imaging and computed tomography can be used to provide evidence of limited local disease recurrence and thereby identify disease that is still potentially curable with adjuvant treatments. This article examines the imaging modalities currently used to detect recurrence and assist in making treatment changes for gynecologic malignancies and presents specific patient findings following definitive primary treatment of uterine cancer and ovarian cancer with radical hysterectomy, radiation therapy, or chemotherapy.

Primary Sjögren's syndrome initially manifested by optic neuritis: MRI findings.

We herein describe the MRI findings in a patient clinically diagnosed with primary Sjögren's syndrome (SjS) initially manifested by retrobulbar optic neuritis. A 63-year-old woman suddenly had left ocular pain and progressive visual disturbance. MR T2-weighted images revealed hyperintensity in the left optic nerve, with swelling.

Intracranial meningeal involvement in Churg-Strauss syndrome.

We describe the case of a 54-year-old woman with a clinical diagnosis of Churg-Strauss syndrome (CSS). The patient had a fever of unknown origin, severe headache, progressing left ophthalmoplegia, and visual acuity disturbance. MR imaging revealed diffuse and thick hypointense lesions on T2-weighted images in the frontal meninges and anterior falx cerebri with diffuse enhancement.

Gastrointestinal stromal tumor of the rectum.

Gastrointestinal stromal tumors (GISTs) are characterized by remarkable variability in their differentiation potential, but most of these lesions do not display convincing smooth muscle or neuronal differentiation. The GISTs arising from the rectum or anal canal are extremely uncommon. We present a case of immunohistochemically proven GIST of the rectum, which was characterized by homogenous isointensity mass without necrosis or hemorrhage on T2-weighted image and by enhancement on gadolinium-enhanced study.

Comparison of MR imaging and urodynamic findings in benign prostatic hyperplasia.

Objective: In benign prostatic hyperplasia (BPH), it is uncertain whether the size of the prostate is related to the degree of urodynamically demonstrated bladder outlet obstruction. We compared MR imaging findings and urodynamic data in patients with surgically confirmed BPH.

Materials And Methods: We prospectively studied 43 benign prostatic hyperplasia (BPH) patients in whom transurethral resection of the prostate (TURP) was planned.

Markedly high signal intensity lesions in the uterine cervix on T2-weighted imaging: differentiation between mucin-producing carcinomas and nabothian cysts.

Purpose: Both mucin-producing carcinomas and nabothian cysts in the cervix show very high signal intensity on T2-weighted images (WI). The purpose of this study was to evaluate the potential of MR imaging in differentiating mucin-producing carcinomas from nabothian cysts.

Materials And Methods: Forty-six patients who underwent hysterectomy and had very high signal intensity lesions in the uterine cervix on T2-WI were included in this study.

Rectal carcinoma: prospective comparison of conventional and gadopentetate dimeglumine enhanced fat-suppressed MR imaging.

The purpose of this study is to compare the usefulness of conventional MR imaging and gadopentetate dimeglumine enhanced fat-suppressed MR imaging for the depiction and staging of rectal carcinoma. Thirty-two patients were prospectively evaluated by MR imaging using a 1.5-T unit.

MRI in predicting the response of ovarian endometriomas to hormone therapy.

Objective: Our goal was to investigate the usefulness of MRI in predicting the response of endometriomas to hormone therapy.

Materials And Methods: MRI and laparoscopy at the onset of treatment and follow-up MRI after 6 months of hormone therapy were performed in 21 patients with 49 endometriomas. T1- and T2-weighted images were obtained with a 1.

Colorectal carcinoma: evaluation with ultrafast CT.

We investigated the value of ultrafast computed tomography for the preoperative assessment of colorectal carcinoma. Ultrafast CT demonstrated the primary tumor in 25 (89%) of 28 patients. Local tumor extension was detected with a sensitivity of 90%, a specificity of 78%, and an overall accuracy of 82%.

CT assessment of postirradiation changes in the rectum and perirectal region.

Postirradiation changes in the rectum and perirectal tissue were assessed by computed tomography (CT) in 55 patients (total of 60 examinations) and correlated with radiation dose and time elapsed. Thickening of the perirectal fascia, increased density of the perirectal fat, and swelling of the rectal wall occurred in 48, 60, and 8% of patients, respectively, regardless of radiation dose within 30 Gy. However, widening of the presacral space was seen in 8% of patients receiving a rectal dose of less than 45 Gy, a percentage that increased to 16% for patients receiving 45 Gy or more.

Scintigraphic detection of recurrence of medullary thyroid cancer.

A case of recurrent medullary thyroid cancer (MTC) was evaluated with 123I-MIBG, 99mTc(V)-dimercaptosuccinic acid (DMSA), and 201Tl scintigraphy. This patient had been operated on for MTC in the right thyroid. Recently a left neck mass was noticed, and was suspected of being a recurrence of MTC based on increased plasma calcitonin (CT) and carcinoembryonic antigen (CEA).

T1-weighted images with ECG gating using partial flip angle spin-echo imaging.

ECG-gated spin-echo imaging can reduce vascular artefacts compared with spin-echo scans without gating. However, this method produces poor T1-weighted images because the repetition time (TR) is limited by the heart rate. We investigated the value of low flip angle spin-echo imaging for increasing T1-dependent contrast when using ECG gating.

Prediction of effectiveness of intraperitoneal chemotherapy by intraperitoneal scintigraphy in patients with advanced ovarian carcinoma.

Intraperitoneal scintigraphy with Tc-99m MAA was performed in nine patients with carcinomatous peritonitis secondary to ovarian or tubal carcinoma. Tc-99m MAA (370 MBq) and NaCl was delivered through an implantable injection port. For patients with good diffusion on intraperitoneal scintigraphy, intraperitoneal chemotherapy was effective.

Benign prostatic hyperplasia: value of MR imaging for determining histologic type.

Purpose: To assess the value of magnetic resonance (MR) imaging for determining the histologic type of benign prostatic hyperplasia (BPH).

Materials And Methods: Unenhanced T1- and T2-weighted images and gadolinium-enhanced T1-weighted images were obtained in the transverse plane at 1.5 T in 33 patients with BPH.

Ovarian cystic teratomas: value of chemical fat saturation magnetic resonance imaging.

Chemical fat saturation (FS) magnetic resonance imaging (MRI) for the characterization of ovarian cystic teratoma was evaluated in 19 patients with 22 lesions. The tumour was evaluated for signal intensity, location and size; the presence of chemical shift artefact, debris and fat-fluid level. Ovarian cystic teratoma was diagnosed prospectively if the mass contained fat and/or more than one type of internal pattern on (1) SE T1-, T2-, (2) SE T1-, T2-, FS T1-weighted images.

MR detection of degenerating uterine leiomyomas.

Objective: Gonadotropin-releasing hormone (GnRH) analogues have been advocated for the conservative management of uterine leiomyoma. These drugs induce a hypoestrogenic state and affect undegenerated myoma cells. Therefore, we evaluated the usefulness of MRI for distinguishing undegenerated and degenerated leiomyomas.

Pelvic endometriosis: detection and diagnosis with chemical shift MR imaging.

Fat-saturation magnetic resonance (MR) imaging for detection and characterization of pelvic endometriosis was prospectively investigated in 35 women with a clinical diagnosis of the disease. Large endometrioma was diagnosed when the lesion was larger than 1 cm in diameter and hyperintense on T1- and T2-weighted images. Small endometrioma was diagnosed when a well-demarcated hyperintense lesion less than 1 cm in diameter was seen on T1-weighted or fat-saturated T1-weighted images.

[Staging of rectal cancer: assessment with Gd-DTPA enhanced MR imaging].

This study was designed to assess the value of Gd-DTPA enhanced imaging in the staging of rectal carcinoma. Twenty-five patients were prospectively evaluated with MR imaging using a 1.5 Tesla unit.

Preoperative local staging of rectal carcinoma with MR imaging and a rectal balloon.

Magnetic resonance (MR) imaging for the preoperative assessment of rectal carcinoma was evaluated. Thirty-three patients underwent MR imaging with a 1.5-T unit.

The value of magnetic resonance relaxation time in staging ovarian endometrial cysts.

We evaluated the use of magnetic resonance imaging (MRI) in the pre-operative staging of 15 endometrial cysts. The effect of the iron content on the T1 and T2 relaxation times was assessed in confirmed endometrial cysts employing a 0.15 T MR system and a 200 MHz spectrometer.