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Hydatid disease of the soft tissues forms a rare mass lesion of the extremities. Two cases of primary hydatid disease in soft tissues are presented with MR imaging findings. A cystic mass with multiloculated or multicystic appearance was identified on MR images in both cases. The lesions were surrounded by a rim with two layers representing a collageneous and a vascularized pericyst. The contrast-enhanced images demonstrated the vascularized component of the wall clearly in the first case. In diagnosis of hydatid disease and in its differentiation from other cystic lesions of the extremities, we think that the described MR appearances can be used confidently.

We present the radiological features of a 42-year-old man with long-standing inactive ankylosing spondylitis (AS), demonstrating that arachnoiditis is a cause of a cauda equina syndrome (CES) in this disease. CT showed a dorsal arachnoid diverticulum causing scalloped erosion of the laminae, and punctate and curvilinear dural calcification. MRI revealed adhesion and convergence of the cauda equina dorsally into the arachnoid pouch, causing the dural sac to appear empty canal. To the best of our knowledge, dural calcification on CT is a new finding in AS, which may be related to the CES. Our findings support the hypothesis that chronic adhesive arachnoiditis with subsequent loss of meningeal elasticity may be the main cause of CES in AS.

460C ontrast-enhanced magnetic resonance imaging (MRI) is a complementary imaging technique that is increasingly used in the surgical treatment planning of breast cancer. Contrast-enhanced MRI has a sensitivity of 40%-100% in detecting ductal carcinoma in situ (DCIS) and up to 100% sensitivity in detecting invasive breast cancer (1, 2). In many studies, MRI had a higher accuracy than mammography (MMG) and ultrasonography (US) in detecting multiple malignant foci, in defining the actual size and spread of a solitary tumor, and in diagnosing contralateral synchronous breast cancer (3-5).Many studies have indicated various detection rates of MRI (16%-37%) for occult multiple lesions. The detection rate for a larger spread of the cancer is as high as 34% (1,5,6).Larger extension of local disease affects not only the surgical and systemic treatment but also the axillary lymph node approach for staging leading to a direct full axillary dissection instead of sentinel node excision (5, 7).Our objective in this prospective study was to investigate 1) the rate at which additional evidence is obtained with a pre-operative MRI and 2) how often the MRI findings change the surgical plan in patients for whom physical examination, MMG, and US findings make them candidates for breast-conserving surgery. Materials and methodsThe study was approved by the Ethics Committee of the Ege University School of Medicine. Retrospective analyses were performed on the prospectively obtained information. All of the patients were asked to read and sign informed consent prior to the MRI examination.Contrast-enhanced breast MRIs were performed on 69 female patients undergoing physical examination, MMG, and US between August 2006 and December 2008. These patients exhibited evidence of breast cancer based on clinical and radiologic findings and were candidates for breastconserving surgery.Inclusion criteria were as follows: 1) Cytologically or histopathologically (fine-needle aspiration biopsy, Tru-cut excisional or incisional biopsy) proven breast cancer, 2) In accordance with the TNM classification used for malignant tu- All of the enrolled patients were believed to be candidates for breast conservation on the basis of physical examination, mammography, and ultrasonography. The patients were reevaluated with the MRI examination as to whether they were still candidates for breast conservation therapy. RESULTSThe MRI findings changed the previous management plans in 19.1% of the 68 patients. With respect to the surgical approach, no statistically significant difference was observed between the histopathology groups (P = 0.403). In terms of the breast parenchymal pattern, however, surgical planning was changed in 53.8% of the patients who exhibited a dense pattern, which was significantly different from the rates of the other groups (P = 0.006). The sensitivity, specificity, positive predictive value, and negative predictive value of the MRI for additional malignant lesion detection and identification were 85%, 98%, 92%, and 96%, respectively. The...