Abstract:Neurofibromas are tumors of neural origin. They can be solitary or may be associated with neurofibromatosis type-1 (NF-1). These are mostly seen in the head and neck region, upper extremities or along the nerves. Visceral neurofibromas are extremely rare. In this paper, we present an unusual case of solitary neurofibroma of the adrenal gland not associated with NF-1.
“…T2-weighted imaging has good soft tissue resolution and can clearly show the relationship between bladder tumours and muscles, but it is difficult to use for distinguishing tumors from benign lesions, such as inflammation, fibrosis and oedema, leading to excessive staging [6, 7]. Dynamic contrast-enhanced MRI can be used to differentiate bladder tumours and muscles according to the different enhancement modes of the lesions, while the enhancement of small blood vessels located at the base of the tumour is similar to that of the tumour, which also leads to over-staging [8, 9]. Diffusion-weighted imaging (DWI) is a functional imaging technique that reflects the state of tissues by detecting the motion of water molecules in vivo.…”
Background
To evaluate whether readout-segment echo-planar imaging (RS-EPI) can provide better image quality in assessing bladder cancer than single-shot echo-planar imaging (SS-EPI) and to compare quantitative imaging parameters derived from both techniques.
Methods
Seventy patients with bladder lesions were enrolled and underwent diffusion-weighted imaging on a 3 Tesla magnetic resonance scanner using axial RS-EPI and SS-EPI techniques. Two observers independently assessed the susceptibility, detectability, motion artefacts and blurring of the images using qualitative scores. The signal-to-noise ratio (SNR), signal intensity ratio (SIR), contrast-to-noise ratio (CNR) and ADC values of the bladder lesions were measured and compared between the two techniques and between two observers. Qualitative and quantitative comparisons of image quality were performed using the Wilcoxon signed-rank test and paired t-test. In addition, the agreement of the ADC measurements was evaluated using ICC values and Bland-Altman plots.
Results
Sixty-eight patients were included in the final analysis. The scores of image susceptibility, detectability and blurring for RS-EPI were significantly higher than those for SS-EPI (all
p
< 0.05), while the motion artefact was not. There were significant differences between RS-EPI and SS-EPI in the CNR and SIR values (all
p
< 0.05) but not in the SNR or ADC values (all
p
> 0.05). The ICC values and Bland-Altman plots also showed excellent agreement between the measured ADC values of the bladder lesions.
Conclusions
The RS-EPI technique provides significantly better image quality in patients with bladder cancer than the SS-EPI technique, without a significant difference in the ADC value.
“…T2-weighted imaging has good soft tissue resolution and can clearly show the relationship between bladder tumours and muscles, but it is difficult to use for distinguishing tumors from benign lesions, such as inflammation, fibrosis and oedema, leading to excessive staging [6, 7]. Dynamic contrast-enhanced MRI can be used to differentiate bladder tumours and muscles according to the different enhancement modes of the lesions, while the enhancement of small blood vessels located at the base of the tumour is similar to that of the tumour, which also leads to over-staging [8, 9]. Diffusion-weighted imaging (DWI) is a functional imaging technique that reflects the state of tissues by detecting the motion of water molecules in vivo.…”
Background
To evaluate whether readout-segment echo-planar imaging (RS-EPI) can provide better image quality in assessing bladder cancer than single-shot echo-planar imaging (SS-EPI) and to compare quantitative imaging parameters derived from both techniques.
Methods
Seventy patients with bladder lesions were enrolled and underwent diffusion-weighted imaging on a 3 Tesla magnetic resonance scanner using axial RS-EPI and SS-EPI techniques. Two observers independently assessed the susceptibility, detectability, motion artefacts and blurring of the images using qualitative scores. The signal-to-noise ratio (SNR), signal intensity ratio (SIR), contrast-to-noise ratio (CNR) and ADC values of the bladder lesions were measured and compared between the two techniques and between two observers. Qualitative and quantitative comparisons of image quality were performed using the Wilcoxon signed-rank test and paired t-test. In addition, the agreement of the ADC measurements was evaluated using ICC values and Bland-Altman plots.
Results
Sixty-eight patients were included in the final analysis. The scores of image susceptibility, detectability and blurring for RS-EPI were significantly higher than those for SS-EPI (all
p
< 0.05), while the motion artefact was not. There were significant differences between RS-EPI and SS-EPI in the CNR and SIR values (all
p
< 0.05) but not in the SNR or ADC values (all
p
> 0.05). The ICC values and Bland-Altman plots also showed excellent agreement between the measured ADC values of the bladder lesions.
Conclusions
The RS-EPI technique provides significantly better image quality in patients with bladder cancer than the SS-EPI technique, without a significant difference in the ADC value.
“…4). The clinical characteristics of the eight included papers [4–11], associated with our case report, were summarized (total cases = 45) (Table 1). Fig.…”
Section: Resultsmentioning
confidence: 99%
“…It was also partially enhanced with contrast-mediumKim et al [5]2013A well-defined, 1.6 cm sized ovoid retroperitoneal mass with intermediate contrast-enhancementNot mentionDafford et al [6]2007Low attenuating and hypodense mass lesionT2-weighted image: High signal intensity with a low intensity surrounding. Hypointense septations have also been reportedShen et al [7]2016Hypodense lesion and with partially contrast-enhancementNot mentionIshikawa et al [8]1989Well encapsulated homogeneous and hypodense mass lesionNot mentionHunter et al [9]1988Not mentionNot mentionCowles et al [10]1987Not mentionNot mentionGupta et al [11]2015Heterogeneously intermediate enhancing mass lesion with calcificationNot mention…”
BackgroundPelvic masses are a common gynecologic problem, and majority of them are diagnosed as ovarian tumors finally. Sometimes, it is hard to distinguish the origin of these pelvic masses. The following case is a solitary neurofibroma arising from the right-side obturator nerve, which was impressed as a right-side ovarian tumor initially. We reported this case, and also performed a PRISMA-driven systematic review to summary the similar cases in the literature. This review includes image, molecular and pathological findings and outcome of neurofibroma.Case presentationA 33-year-old woman with a regular menstrual period denied any symptoms or signs. During her physical check-up, image examination revealed a right-side heterogeneous pelvic mass; it was suggestive of a complex of right-side ovarian tumor. A provisional diagnosis of retroperitoneal pelvic mass, probably a benign ovarian tumor, was made.Excision of the right-side pelvic mass was performed. We sent the specimens for frozen pathology, which indicated neurofibroma and lipomatous tumor and that the possibility of liposarcoma cannot be excluded. A segment of the obturator nerve was attached to the tumor and was severed. A right-side obturator nerve tear during tumor excision was observed, and a neurosurgeon was consulted for obturator nerve grafting and repair. The patient complained of mild weakness and paresthesia affecting the right leg, and we consulted a rehabilitation doctor for neuron injury. The patient’s recovery was uneventful, and she was discharged eight days after the drain was removed. Further rehabilitation treatment was arranged.ConclusionA neurofibroma is an uncommon pelvic retroperitoneal tumor, and it can be misdiagnosed as an adnexal mass. To our knowledge, this is a rare case of a solitary neurofibroma arising from the obturator nerve. It usually does not have any neurological deficit. We present this case to demonstrate that pelvic neurofibroma can be mistaken for an adnexal mass. This fact should be borne in mind during the diagnosis process.
“…Unlike superficial neurofibromas, which can be easily palpated, abdominal neurofibromas are most often found because of abdominal pain ( 2 , 17 ). By this time, the large tumor has already produced a space-occupying effect.…”
Pancreatic neurofibroma is a very rare benign neurogenic tumor unrelated to neurofibromatosis type 1 (NF-1). As the volume increases, it has the risk of malignant transformation. The surgical prognosis of pancreatic neurofibroma is good, but its preoperative imaging features are very similar to those of malignant tumors, which may affect the formulation of treatment plans. This article reports a case of giant neurofibroma of the pancreas with contrast-enhanced ultrasound (CEUS) as one of the diagnostic methods and discusses the tumor’s preoperative clinical features, laboratory examinations, and imaging features.
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