A new diagnostic approach to vascular rings and pulmonary slings: the role of MRI.
Beekman RP. Hazekamp MG. Sobotka MA. Meijboom EJ. de Roos A. Staalman CR. Beek FJ. Ottenkamp J.
Department of Pediatric Cardiology, University Hospital of Leiden, The Netherlands. firstname.lastname@example.org
The conventional diagnostic work-up of a patient suspected of having a vascular cause for stridor, or dysphagia, includes esophagography and bronchoscopy to delineate the abnormal structure without imaging the structure itself. Cine-angiography is regarded as the golden standard, but is not routinely performed. Magnetic resonance imaging (MRI) is non-invasive and has the important advantage over cine-angiography of depicting all structures in the field of view. Color Doppler echocardiography depicts the great vessels, but not the esophagus and trachea. In 14 patients with obstructive symptoms and in four patients without obstructive symptoms MRI successfully imaged the abnormal structure, as was the case in two symptomatic patients using computer tomography. In this series, the findings were confirmed at surgery or by cine-angiography. Conclusion: we suggest that in patients suspected of having a vascular cause for stridor or dysphagia, MRI should be performed. If there is need for a screening procedure, color Doppler echocardiography should be used and if that is equivocal or non-conclusive, esophagography and bronchoscopy should be used. If MRI is difficult to interpret, it should be augmented by magnetic resonance angiography before considering cine-angiography.
Metastatic gastric leiomyoblastoma: a case report.
Sofka CM. Semelka RC. Marcos HB. Calvo BF. Woosley JT.
Department of Radiology, University of North Carolina at Chapel Hill, 27599-7510, USA.
Gastric leiomyoblastoma is a rare entity. In this report, we describe the magnetic resonance (MR) appearance of a recurrent gastric leiomyoblastoma 14 years after initial presentation. This tumor was heterogeneous and moderately low signal intensity on T1-weighted images and heterogeneous and moderately high signal intensity on T2-weighted images. The tumor also contained foci of low signal intensity on the post gadolinium images, consistent with areas of necrosis. The mass enhanced mildly and increased in enhancement on the delayed images, consistent with a hypovascular mass. Multiple liver metastases were noted. Magnetic resonance findings were confirmed with surgical specimens.