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Background: Plexiform neurofibromas (PNs) are highly vascularized and potentially malignant tumors. Surgical resection of a PN can be complicated by perioperative hemorrhagic events (PHE), including excessive intraoperative blood loss and postoperative hematoma at the surgical site. This study aimed to evaluate the predictive factors of PHE and the usefulness of preoperative embolization for PN.
Materials And Methods: Consecutive surgical resections of 24 massive PNs in the body trunk with a maximum diameter > 5 cm in 22 patients between January 2015 and December 2020 were reviewed. Patient demographics, laboratory analyses, MRI findings, preoperative transcatheter arterial embolization (TAE), and pathological findings were evaluated between PNs with and without PHE, which consists of intraoperative blood loss over 15% of their estimated total blood volume and/or postoperative hematoma requiring surgical intervention or blood transfusion.
Results: PHE was observed in 7 out of 24 PNs (29.2%), with 5 events of excessive intraoperative bleeding and 2 postoperative hematomas. The PHE group (n = 7) showed a significantly higher flow-void effect inside the tumor on preoperative MRI than the non-PHE group (n = 17) (P = 0.0186). Preoperative TAE was not associated with PHE occurrence for the 24 PNs; however, it significantly reduced the PHE risk by 12 PNs with a flow-void sign (P = 0.00126). Other characteristics showed no significant differences between groups.
Conclusion: The flow-void sign on MRI can be the only predictive factor of PHE in surgical resection for massive PNs in the body trunk. Preoperative TAE can reduce the PHE risk for PNs with a flow-void sign.
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http://dx.doi.org/10.1007/s00268-021-06299-7 | DOI Listing |
Spine J
December 2024
Department of Neurosurgery, Xuanwu Hospital, Capital Medical University, Beijing, China. Electronic address:
Background Context: Venous hypertension is a rare cause of myelopathy that can be misdiagnosed as myelitis and be worsened by glucocorticosteroids.
Purpose: This study is aims to identify a fluid biomarker with diagnostic value in Venous Hypertensive Myelopathy (VHM).
Study Design: a retrospective diagnostic study PATIENT SAMPLE: The patients diagnosed as having myelopathy between December 2020 and June 2022 were divided into a VHM group (n=71) and an inflammatory myelopathy (IM) group (n=123).
Jpn J Radiol
November 2024
Department of Radiology, Gifu University, 1-1 Yanagido, Gifu, 501-1194, Japan.
Purpose: To evaluate the efficacy of MRI findings for differentiating between ovarian metastasis from stomach cancer (OMSC) and colorectal cancer (OMCC).
Methods: Twenty-six patients with histopathologically proven ovarian metastasis (n = 8 with 12 OMSCs and n = 18 with 25 OMCCs) were enrolled in the study. All patients had undergone pelvic MRI before surgery.
AJNR Am J Neuroradiol
December 2024
Department of Radiology (D.J.S.), Cambridge University Hospitals NHS Foundation Trust, Cambridge, United Kingdom.
Patients with spontaneous intracranial hypotension caused by type 1 dural defects typically have an epidural fluid collection on MRI. Still, the location of the defect is not usually readily identifiable on standard MRI sequences and can be at any point along the length of the collection. The most common location for type 1 leaks is ventral and, as such, these are most commonly associated with ventral predominant epidural fluid.
View Article and Find Full Text PDFAJNR Am J Neuroradiol
November 2024
From the Department of Radiology (O.S., N.S., A.M., M.W., T.P.R., A.B.), Children's Hospital of Philadelphia, Philadelphia, Pennsylvania
Background And Purpose: Hemangioblastoma is a rare vascular tumor that occurs within the central nervous system in children. Differentiating hemangioblastoma from other posterior fossa tumors can be challenging on imaging, and preoperative diagnosis can change the neurosurgical approach. We hypothesize that a "lightbulb sign" on the arterial spin-labeling (ASL) sequence (diffuse homogeneous intense hyperperfusion within the solid component of the tumor) will provide additional imaging finding to differentiate hemangioblastoma from other posterior fossa tumors.
View Article and Find Full Text PDFDiscov Oncol
February 2024
Department of Radiology, The Affiliated Hospital of Guizhou Medical University, 28 Guiyi Street, Yunyan District, Guiyang, 550004, Guizhou, China.
Background: Solitary fibrous tumors (SFT) and meningiomas (MA) have similar clinical and radiographic presentations but require different treatment approaches and have different prognoses. This emphasizes the importance of a correct preoperative diagnosis of SFT versus MA.
Objective: In this study, investigated the differences in imaging characteristics between SFT and MA to improve the accuracy of preoperative imaging diagnosis of SFT.
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