Pathologic significance of the “dural tail sign”

Clinical Imaging 33 (2009) 412 – 415

Abstracts Pathologic significance of the “dural tail sign” Rokni-Yazdi H, Azmoudeh Ardalan F, Asadzandi Z, Sotoudeh H, Shakiba M, Adibi A, Ayatollahi H, Rahmani M (Department of Radiology and Imaging, Imam Khomeini Hospital, Keshavarz Blvd., Medical Sciences/Tehran University, Tehran, Iran). Eur J Radiol 2009;70:10–16. Objective: The exact nature of the “dural tail sign” (thickening of the dura adjacent to the tumour in contrast enhanced T1-MRI imaging) is still not clearly established. In this study we tried to verify the histological appearance of the “dural tail sign” and probable correlation between different MRI findings and dural tail histology. Material and Methods: In this study, 129 patients with intracranial lesions underwent MRI imaging with 1.5 T scanner. The “dural tail sign” was defined using Goldsher et al. criteria. Size and pattern of enhancement of the tumour and adjacent dura was noted in MRI and in the pathologic samples, dural tail and the dura beneath the tumour was assessed. Results: In 30 cases, “dural tail sign” was evident on MRI, dural tail noted in 17 of these cases in histological samples (12 meningiomas, 3 pituitary adenomas and 2 schwannomas). All of them had vessel dilatation, 6 showed tumoural invasion, 4 demonstrated intravascular growth of the lesion and 1 showed inflammation of the dura. Conclusion: In our study MRI findings failed to predict tumoural invasion of the dural tail in histologic samples and because of frequent presence of tumour nests in it, the dura matter should be resected as widely as possible. The performance of computer-aided detection when analyzing prior mammograms of newly detected breast cancers with special focus on the time interval from initial imaging to detection Malich A, Schmidt S, Fischer DR, Facius M, Kaiser WA (Institute of Diagnostic Radiology Suedharz-Hospital Nordhausen, Dr.-R-Koch-Street 38, D-99734 Nordhausen, Germany). Eur J Radiol 2009;69:574–578. Purpose: The clinical role of CAD systems to detect breast cancer, which have not been on cancer containing mammograms not detected by the radiologist was proven retrospectively. Methods: All patients from 1992 to 2005 with a histologically verified malignant breast lesion and a mammogram at our department, were analyzed in retrospect focussing on the time of detection of the malignant lesion. All prior mammograms were analyzed by CAD (CADx, USA). The resulting CAD printout was matched with the cancer containing images yielding to the radiological diagnosis of breast cancer. CAD performance, sensitivity as well as the association of CAD and radiological features were analyzed. Results: 278 mammograms fulfilled the inclusion criteria. 111 cases showed a retrospectively visible lesion (71 masses, 23 single microcalcification clusters, 16 masses with microcalcifications, in one case two microcalcification clusters). 54/87 masses and 34/41 microcalcifications were detected by CAD. Detection rates varied from 9/20 (ACR 1) to 5/7 (ACR 4) (45% vs. 71%). The detection of microcalcifications was not influenced by breast tissue density. 0899-7071/09/$ – see front matter

Conclusion: CAD might be useful in an earlier detection of subtle breast cancer cases, which might remain otherwise undetected.

Cardiac magnetic resonance imaging: diagnostic value and utility in the follow-up of patients with acute myocarditis mimicking myocardial infarction Danti M, Sbarbati S, Alsadi N, Di Filippo A, Gangitano G, Giglio L, Salvini V, Amoruso M, Camastra GS, Ansalone G, Della Sala S (U.O.C. di Radiodiagnostica, Ospedale M.G.Vannini, Via Dell'Acqua Bullicante 4, Roma, Italy). 2009;114:229–238. Purpose: The aim of our study was to evaluate the efficacy of magnetic resonance imaging (MRI) in the differential diagnosis between active myocarditis and myocardial infarction in patients with clinical symptoms mimicking acute myocardial infarction. Materials and Methods: Between 1 January 2006 and 30 June 2007, 23 consecutive patients (21 men and 2 women) presenting with electrocardiographic abnormalities mimicking acute myocardial infarction and a clinical suspicion of acute myocarditis (fever, chest pain and elevated troponin levels) underwent contrast-enhanced cardiac MRI within a week of admission. All patients also underwent coronary angiography, which demonstrated the absence of significant coronary artery lesions. The mean follow-up period was 2±4 months. Results: Cardiac MRI with injection of contrast material showed late subepicardial and intramyocardial enhancement in all patients. Subendocardial late enhancement, a typical pattern of myocardial infarction, was never seen. In addition, in agreement with the literature, there was prevalent involvement of the lateral segments of the left ventricular wall. Conclusions: Cardiac MRI could be a valuable tool for the early diagnosis of acute myocarditis, as it can demonstrate specific patterns that help rule out acute myocardial infarction.

Fibrous tumor of the pleura (SFTP): a proteiform disease. Clinical, histological and atypical radiological patterns selected among our cases Cardinale L, Cortese G, Familiari U, Perna M, Solitro F, Fava C (Istituto di Radiologia, Università degli Studi di Torino, Ospedale San Luigi Gonzaga, Regione Gonzole 10, I-10143 Orbasssano, Italy). Radiol Med 2009:114:204–215. First described by Klemperer and Rabin in 1931, solitary fibrous tumour of the pleura (SFTP) is a mesenchymal tumor that tends to involve the pleura, although it has also been described in other thoracic areas (mediastinum, pericardium and pulmonary parenchyma) and in extrathoracic sites (meninges, epiglottis, salivary glands, thyroid, kidneys and breast). SFTP usually presents as a peripheral mass abutting the pleural surface, to which it is attached by a broad base or, more frequently, by a pedicle that allows it to be mobile within the pleural cavity. A precise