The aim of this study is to study the clinical, laboratory, imaging pathology, and prognosis features of IgG4-related spinal pachymeningitis. We worked with a 55-year-old man suffering from IgG4-related spinal pachymeningitis who had the most widespread lesion in his dura mater. We also review previous related studies and discuss the clinical characteristics of this rare disease. In total, eight IgG4-related spinal pachymeningitis patients have been reported in the literature since 2009. They were mostly male patients, 51.7 ± 11.9 years old on average. Cervical and thoracic vertebrae were the most common sites for lesions. The most prominent symptom was varying numbness and weakness of the limbs and/or body associated with spinal cord compression. There was one patient (1/5) with elevated serum IgG4 levels and three patients (3/3) with increased cerebrospinal fluid (CSF) IgG4 index. Positive histopathologic findings are the strongest basis for a diagnosis. All the patients with IgG4-related spinal pachymeningitis responded well to glucocorticoid therapy. IgG4-related spinal pachymeningitis is an orphan disease that mainly occurs in cervical and thoracic vertebrae. Older males are the most susceptible group. Serum IgG4 levels were consistently normal in these cases, so analysis of CSF for IgG4 production (IgG4 index) could become a useful tool. Pathological findings remain the gold standard for diagnosis. Most patients responded favorably to glucocorticoid treatment.

• Rectal cancers with different KRAS mutation statuses demonstrated distinctive diffusion/perfusion characteristics. • Max-ADC, Mean-ADC and D values were lower in the KRAS mutant group. • A higher D* value was demonstrated in the KRAS mutant group. • IVIM-DW MRI may potentially help preoperative KRAS mutant status prediction.

TB-associated FM shows some specific imaging characteristics, reflecting immune-mediated fibrotic reaction secondary to TB infection. The insidious progression to mediastinal fibrosis after TB infection poses a challenge to the early diagnosis and results in subsequent respiratory dysfunction and pulmonary hypertension.

Background: To investigate whether MRI findings, including texture analysis, can differentiate KRAS mutation status in rectal cancer. Methods: Totally, 158 patients with pathologically proved rectal cancers and preoperative pelvic MRI examinations were enrolled. Patients were stratified into two groups: KRAS wild-type group (KRAS wt group) and KRAS mutation group (KRAS mt group) according to genomic DNA extraction analysis. MRI findings of rectal cancers (including texture features) and relevant clinical characteristics were statistically evaluated to identify the differences between the two groups. The independent samples t test or Mann-Whitney U test were used for continuous variables. The differences of the remaining categorical polytomous variables were analyzed using the Chi-square test or Fisher exact test. A receiver operating characteristic (ROC) curve analysis was performed to evaluate the discriminatory power of MRI features. The area under the ROC curve (AUC) and the optimal cutoff values were calculated using histopathology diagnosis as a reference; meanwhile, sensitivity and specificity were determined. Results: Mean values of six texture parameters (Mean, Variance, Skewness, Entropy, gray-level nonuniformity, runlength nonuniformity) were significantly higher in KRAS mt group compared to KRAS wt group (p < 0.0001, respectively). The AUC values of texture features ranged from 0.703~0.813. In addition, higher T stage and lower ADC values were observed in the KRAS mt group compared to KRAS wt group (t = 7.086, p = 0.029; t = − 2.708, p = 0.008). Conclusion: The MRI findings of rectal cancer, especially texture features, showed an encouraging value for identifying KRAS status.

Many of the adrenal masses are discovered incidentally due to the increasing use of multidetector CT for different clinical problems, even in patients without endocrinological symptoms. Radiological studies reported the frequency of incidentalomas varies from 3 to 10% according to the age. 1,2 Although most of these lesions are non-functioning benign adrenal adenomas, other lesions also exist including hormone-producing adenomas, pheochromocytomas, adrenal carcinomas or metastases. 3,4 Hence, the differential diagnosis of adrenal lesions is still crucial. The detection of adrenal masses is troubling, particularly for patients with a history of malignant tumor. Assessment of adrenal masses requires an accurate diagnosis to determine appropriate therapeutic approach for the patient. Dedicated adrenal CT can provide several quantitative CT parameters that contribute to the diagnosis of adrenal lesions, such as lesion size, unenhanced attenuation, level of enhancement at early phase and delayed phase, wash-in attenuation at early phase, percentage washout ratio at delayed phase, and histogram analysis. Various threshold values and the corresponding diagnostic efficiency of these parameters that assist in differentiating between adrenal adenomas and non-adenomas at unenhanced and delayed enhanced CT have been reported. 5-10 The purpose of this study is to evaluate the diagnostic values of absolute percentage washout ratio (APW) and relative percentage washout ratio (RPW) obtained from unenhanced and triphasic enhanced CT (200 s delay) in distinguishing adrenal adenomas from non-adenomas,