The twinkling artifact is a very useful color Doppler ultrasound tool for the detection of small urinary stones. We suggest the routine use of color Doppler in all suspicious cases in order to avoid unnecessary irradiating and expensive radiological methods.

NEURORADIOLOGYORIGINAL ARTICLE PURPOSE We aimed to identify imaging characteristics on conventional magnetic resonance imaging that could predict multiple sclerosis (MS) brain lesion activity without contrast media administration. MATERIALS AND METHODSMagnetic resonance data sets of forty-two patients with relapsing-remitting MS who presented symptoms or signs suggestive of new disease activity were retrospectively reviewed. We classified the MS lesions into three types according to different patterns present on T2-weighted images and evaluated their relationship with the contrast uptake. Evolving aspects of each type of lesion were observed in 18 patients during a follow-up period ranging from nine to 36 months. RESULTSOn T2-weighted images, only the pattern consisting of a thin border of decreased intensity compared with the lesion's center and perifocal edema (Type II) reached diagnostic accuracy in terms of its relationship with gadolinium enhancement (P = 0.006). The sensitivity was 0.461, and the specificity was 0.698. In contrast, enhancement was not significantly related to the pattern consisting of a lesion center that was homogeneously brighter than its periphery (Type I) or less-hyperintense T2 focal lesions with either homogeneous or inhomogeneous center (Type III) (P > 0.05 for both). CONCLUSIONThe assessment of MS lesion activity should include a careful evaluation of T2-weighted images in addition to contrast enhancement assessment. The presence of an accompanying peripheral thin rim of hypointensity on T2-weighted images related best with contrast enhancement and subsequent lesion activity and may represent an additional pattern for disease activity assessment when gadolinium examination is contraindicated or influenced by prior therapy. Multiple sclerosis (MS) is a chronic inflammatory disease characterized by demyelination and widespread tissue damage in the white and grey matter in the central nervous system (CNS) and spinal cord (1). MS has a very heterogeneous neurological presentation. In diagnosing MS, magnetic resonance imaging (MRI) studies with and without gadolinium contrast are required, according to McDonald 2005 (2) and the modified McDonald criteria 2010 (3), to provide information about the CNS involvement of demyelinating lesions. A decreased incidence of clinical relapse in MS is commonly used as a measure of therapeutic intervention efficacy. Despite their generalized use in clinical trials of relapsing-remitting and progressive multiple sclerosis, the current MRI measures add little if anything to the clinically relevant relapse and disability outcomes when used independently (4). At the present time, there is limited association between the lesions detected with conventional MRI and clinical status (5), with a low reported sensitivity to diffuse grey-matter and white matter disease (6, 7). Therefore, there is a sustained need for research to find better MRI markers of disease activity.It is generally believed that because acute MS lesions are associated with a transient break...

Two cases of adenomyoepithelioma of the breast with malignant transformation by monophasic population of cells are presented. The underlying benign adenomyoepithelioma with typical biphasic architectural pattern was identified and represented at least 30% of the tumor in each case. In both cases, malignant portion of tumor was composed of relatively uniform monophasic population of highly atypical cells. The malignant component in case 1 was positive for pan cytokeratin, myoepithelial markers, and basal-type cytokeratins and also focally positive for luminal-type of cytokeratins, but negative for hormone receptors (estrogen and progesterone) and HER-2/neu protein overexpression. The malignant component in case 2 was positive for spectrum of myoepithelial markers but negative for luminal cytokeratins, hormone receptors and HER-2/neu protein overexpression. The bilinear immunophenotype in the case 1 suggests that the malignant tumor may have developed from precursor multipotent cells that can differentiate into both luminal epithelial and myoepithelial cells, although malignant component in case 2 appears to be the of pure myoepithelial phenotype.

No abstract

No abstract