Clinical imaging
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Meningioma consistency is an important factor for surgical treatment. Tumor cellularity and fibrous tissue contribute to the consistency of tumors, and it is proposed that the minimum apparent diffusion coefficient (ADC) value is significantly correlated with meningioma consistency. ⋯ Minimum ADC values in meningiomas with a hard consistency were significantly lower than those with a soft consistency. The minimum ADC value might have clinical use as a predictor of meningioma consistency.
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Ventilation-perfusion (VQ) single-photon emission computed tomography (SPECT) comprised the administration of SmartVent (n=386) or Technegas (n=1564) and 200 MBq (99m)Tc-MAA. 1406 scans were normal, 462 showed PE, 61 showed a singular subsegmental mismatched defect, 21 scans were non-diagnostic. 26% of scans performed with Technegas showed PE, compared to 15% with SmartVent. VQ SPECT had a sensitivity of 95.7%, specificity 98.6%, positive predictive value 95.7%, negative predictive value 98.6%. A normal VQ SPECT scan implied a more than ten-fold lower cause-specific mortality (1 in 1406) than a scan showing PE (1 in 116). NPV of a negative D-dimer was 94.3%.
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To increase the awareness on intracranial papillary meningiomas (PMs) by presenting magnetic resonance imaging (MRI) findings on this disease. ⋯ Although PM is rare, it should be considered in the differential diagnosis when evaluating intracranial neoplasms. Younger patient age, as well as imaging features such as unclear tumor-brain interface, internal heterogeneity including cyst formation, irregular enhancement, signal voids of vessels, and marked peritumoral edema can help distinguish PM from typical benign meningiomas.
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Case Reports
Sling left pulmonary artery with patent type IIA tracheobronchial anomaly and imperforate anus.
We present a 3-month-old boy with a type IIA sling left pulmonary artery associated with imperforate anus and rectourethral fistula. Tracheobronchial abnormalities are demonstrated using multidetector CT with 3-D volume rendering of the airways. This case represents a novel variant of an already rare entity with an unusually high right upper lobe bronchus and no evidence of associated tracheobronchial stenosis.
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To assess interobserver agreement between thoracic radiologists, radiology residents, and emergency physicians in diagnosing pulmonary embolism (PE). ⋯ Important differences in interobserver agreement were found, with emergency physicians tending to overdiagnose PE.