PURPOSE: To describe the abnormal gyral and sulcal patterns obtained by means of three-dimensional (3-D) surface-rendering MR imaging in patients with cerebral cortical disease. MATERIALS AND METHODS: Thirteen patients with cerebral cortical disease [M:F=9:4, aged 8 -55 (median, 26.6) years] underwent 3-D surface-rendering MR imaging. Seven had cortical dysplasia and six showed gyral atropic change, conditions which in all cases were pathologically confirmed. All were the subject of conventional brain MRI imaging studies using the MP-RAGE (magnetization-prepared rapid gradient-echo) sequence, and the resulting 3-D data sets were processed on a commercially available workstation. Abnormal gyral and suleal configurations were reviewed. RESULTS: Abnormal gyral and sulcal patterns were seen in all patients. In eight cases these involved the frontal lobe, in three the parietal lobe, and in two the sylvian fissure. In four patients with cortical dysplasia, conventional MR imaging revealed no cortical abnormality, but 3-D surface-rendering MRI indicated that the configuration and orientation of affected gyri and sulci were abnormal. In nine patients in whom an abnormal gyral pattern was revealed by conventional MRI, 3-D surface imaging confirmed the presence of a thick and enlarged gyrus, or that the configuration of affected gyri was atrophic and abnormal. CONCLUSION: In patients with cerebral cortical disease, 3-D surface-rendering MR imaging detects a high rate of abnormal gyral and sulcal patterns.
Brain ; Dataset ; Frontal Lobe ; Humans ; Magnetic Resonance Imaging ; Malformations of Cortical Development ; Parietal Lobe

PURPOSE: To describe the abnormal gyral and sulcal patterns obtained by means of three-dimensional (3-D) surface-rendering MR imaging in patients with cerebral cortical disease. MATERIALS AND METHODS: Thirteen patients with cerebral cortical disease [M:F=9:4, aged 8 -55 (median, 26.6) years] underwent 3-D surface-rendering MR imaging. Seven had cortical dysplasia and six showed gyral atropic change, conditions which in all cases were pathologically confirmed. All were the subject of conventional brain MRI imaging studies using the MP-RAGE (magnetization-prepared rapid gradient-echo) sequence, and the resulting 3-D data sets were processed on a commercially available workstation. Abnormal gyral and suleal configurations were reviewed. RESULTS: Abnormal gyral and sulcal patterns were seen in all patients. In eight cases these involved the frontal lobe, in three the parietal lobe, and in two the sylvian fissure. In four patients with cortical dysplasia, conventional MR imaging revealed no cortical abnormality, but 3-D surface-rendering MRI indicated that the configuration and orientation of affected gyri and sulci were abnormal. In nine patients in whom an abnormal gyral pattern was revealed by conventional MRI, 3-D surface imaging confirmed the presence of a thick and enlarged gyrus, or that the configuration of affected gyri was atrophic and abnormal. CONCLUSION: In patients with cerebral cortical disease, 3-D surface-rendering MR imaging detects a high rate of abnormal gyral and sulcal patterns.
Brain ; Dataset ; Frontal Lobe ; Humans ; Magnetic Resonance Imaging ; Malformations of Cortical Development ; Parietal Lobe

Extramedullary hematopoiesis occurring in multiple organs such as thorax, liver and both kidneys is an unusual condition. We report the CT findings of this condition with review of literature. The lesions consisted of intrathoracic paravertebral masses, focal intrahepatic mass and masses of both pelvocalyceal systems on CT scans.
Biopsy ; Case Report ; Female ; Hematopoiesis, Extramedullary+ACo- ; Human ; Kidney/radiography ; Kidney/physiopathology ; Liver/radiography ; Liver/physiopathology ; Liver/pathology ; Mediastinum/radiography ; Mediastinum/physiopathology ; Middle Age ; Myelofibrosis/physiopathology+ACo- ; Thorax ; Tomography, X-Ray Computed

Extramedullary hematopoiesis occurring in multiple organs such as thorax, liver and both kidneys is an unusual condition. We report the CT findings of this condition with review of literature. The lesions consisted of intrathoracic paravertebral masses, focal intrahepatic mass and masses of both pelvocalyceal systems on CT scans.
Biopsy ; Case Report ; Female ; Hematopoiesis, Extramedullary+ACo- ; Human ; Kidney/radiography ; Kidney/physiopathology ; Liver/radiography ; Liver/physiopathology ; Liver/pathology ; Mediastinum/radiography ; Mediastinum/physiopathology ; Middle Age ; Myelofibrosis/physiopathology+ACo- ; Thorax ; Tomography, X-Ray Computed

Objective: We investigated whether circle of Willis (COW) morphology on 3D time-of-flight (TOF) MR angiography differs between young normal subjects, older normal subjects, and patients with carotid atherosclerotic plaques. Methods: One hundred seventy-seven subjects were grouped according to age into a young group (20 – 40 years; n = 91) and an older group (> 60 years; n = 86). Subjects underwent brain MR examination as part of a health check-up. Fifty-three patients with carotid atherosclerotic plaque were also included for evaluation in this study. COW morphology on 3D TOF MR angiography was analyzed in terms of completeness or incompleteness of the anterior and posterior components of the circle and completeness of the circle. Results: An incomplete pattern of anterior circulation was significantly more common in carotid atherosclerotic plaque patients (20.7%) than normal older subjects (5.5%) (p < 0.01). A complete posterior circulation pattern was more frequent in normal young subjects (46.5%) than in normal older subjects (16.5%) or the patient group (18.9%) (p < 0.01). Of patients with carotid artery stenosis, 18.9% had a bilateral incomplete connection and were significantly more likely to have an incomplete pattern than normal young (2.3%) or normal older subjects (2.2%) (p < 0.001). Conclusion: Young, healthy subjects were significantly more likely to have a complete pattern of posterior circulation than older subjects. Patients with carotid atherosclerotic plaques were significantly more likely to have incomplete anterior circulation and an incomplete circle than young, normal subjects.
Circle of Willis

Ciliated hepatic foregut cyst (CHFC) is a rare benign lesion consisting of ciliated pseudostratified columnar epithelium, loose subepithelial connective tissue, a smooth muscle layer, and an outer fibrous capsule. We encountered a patient with retroperitoneal and posterior mediastinal neurilemmoma and additional CHFC mimicking metastasis. Abdominal CT examination demonstrated that the posterior mediastinal and retroperitoneal lesions were lobulated, well-defined tumors with a neural foraminal extension that were pathologically confirmed as neurilemmomas. Unenhanced CT indicated that the additional lesion was a slightly hypodense mass relative to surrounding parenchyma at the medial segment of the left lobe of the liver, and after the IV ad-ministration of contrast material, the lesion did not show enhancement.
Connective Tissue ; Epithelium ; Humans ; Liver ; Muscle, Smooth ; Neoplasm Metastasis* ; Neurilemmoma ; Tomography, X-Ray Computed

Hypercalcemia in accelerated phase of chronic myelogenous leukemia (CML) is very rare. Its pathogenesis is considered humoral hypercalcemia of malignancies mediated by parathyroid hormone-related protein (PTHrP). In severe hypercalcemia, calcifications in kidneys, skin, vessels, heart, and stomach may occur. Our two cases were admitted because of severe hypercalcemia in accelerated phase of CML. On Tc-99m methylene diphosphonate (MDP) bone scintigraphies, a marked tracer accumulation was seen in the lung, heart, stomach and kidney. We report increased tracer accumulation of multiple organs on Tc-99m MDP bone scintigraphy in two rare hypercalcemic patients with CML.
Adult ; Bone Diseases/radionuclide imaging* ; Bone Diseases/etiology* ; Calcinosis/radionuclide imaging ; Calcinosis/etiology ; Case Report ; Human ; Hypercalcemia/radionuclide imaging* ; Hypercalcemia/etiology* ; Leukemia, Myeloid, Chronic/metabolism ; Leukemia, Myeloid, Chronic/complications* ; Male ; Middle Age ; Proteins/metabolism ; Technetium/diagnostic use

The first case report of granular cell tumor was by Abrikossoff in 1926, the tumor has been named with more than 20 different synonyms. It is found usually in the tongue, oral cavity, and the skin. It occurs rarely in the esophagus. Esophageal granular cell tumor is a benign lesion which can be diagnosed by endoscopic biopsy. Large symptomatic lesion can be removed by polypectomy. A 29-year-old female visited our hospital for intermittent epigastric pain and anterior chest discomfort. Endoscopy showed a 0.6 *0.4 cm whitish yellow nodule in the mid-esophagus, 25 cm from the incisor teeth. Endoscopic polypectomy was performed with "O"-type rubber band for endoscopic variceal ligation(EVL). A case of esophageal granular cell tumor conformed by S-100 protein stain is reported with the review of literature.
Adult ; Biopsy ; Endoscopy ; Esophagus* ; Female ; Granular Cell Tumor* ; Humans ; Incisor ; Mouth ; Rubber ; S100 Proteins ; Skin ; Thorax ; Tongue ; Tooth

A 43-year-old man was admitted complaining of swallowing difficulties. The esophagography revealed severe stenosis at the esophagogastric anastomotic site. Esophagography after balloon dilatation showed a transmural perforation with mediastinal leakage. The patient was treated conservatively for one week at which time the esophagography showed no further leakage at the anastomotic site and the good passage of barium. A 2-year follow-up chest computed tomography (CT) showed good patency of the esophageal lumen and the marked resorption of barium in the mediastinum.
Adult ; Barium ; Constriction, Pathologic ; Deglutition ; Dilatation ; Esophagus ; Follow-Up Studies ; Humans ; Mediastinum ; Thorax

OBJECTIVE: The efficacy and safety of manual aspiration thrombectomy using Penumbra in an acute occlusion of large intracranial arteries has been proven in many previous studies. Our study aimed to retrospectively assess the efficacy and safety of manual aspiration thrombectomy using Penumbra in patients with small vessel occlusions (M2 segment of the MCA). METHODS: We conducted a retrospective review of 32 patients who underwent manual aspiration thrombectomy using the Penumbra 4 MAX Reperfusion Catheter for treatment of an M2 occlusion between January 2013 and November 2014. We evaluated immediate angiographic results and clinical outcomes through review of patient electronic medical records. RESULTS: There were slightly more men in this study (M : F=18 : 14) and the median age was 72.5 (age range : 41-90). The rate of successful recanalization (TICI grade ≥2b) was 84% (27/32). NIHSS at discharge and favorable clinical outcomes at 3 months were significantly improved than baseline. Median initial NIHSS score was 10 (range : 4-25) and was 4 (range : 0-14) at discharge. Favorable clinical outcomes (mRS score ≤2 at 3 months) were seen in 25 out of 32 patients (78%). There were no procedure-related symptomatic intracerebral hemorrhages. One patient expired after discharge due to a cardiac problem. CONCLUSION: Manual aspiration thrombectomy might be safe and is capable of achieving a high rate of successful recanalization and favorable clinical outcomes in patients with distal cerebral vessel occlusion (M2).
Arteries ; Catheters* ; Cerebral Hemorrhage ; Electronic Health Records ; Humans ; Male ; Middle Cerebral Artery ; Reperfusion ; Retrospective Studies ; Stroke ; Thrombectomy*