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Query: UMLS:C0027627 (metastases)
 103,950 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The authors retrospectively compared magnetic resonance images and bone scintigraphy obtained from 144 patients. Fifty-six patients having a known primary malignancy were evaluated for metastases (Group 1), and 88 patients were evaluated for back pain (Group 2). Interpretation was normal in 36/144 patients (11 in Group 1 and 25 in Group 2), and similar abnormal foci were visualized in the osseous spine in 54/144 patients (32 in Group 1 and 22 in Group 2). Magnetic resonance imaging showed abnormalities in the osseous spine that were not visualized on bone scintigraphy in 43/144 patients (10 in Group 1 and 33 in Group 2); these included bone metastasis, benign neoplasm (hemangioma), Schmorl's node, intervertebral disk disease, and bone disease (osteophyte, spondylolisthesis, facet hypertrophy). In addition, magnetic resonance imaging showed epidural or paravertebral extension of the tumor or infection in 37/144 patients (30 in Group 1 and 7 in Group 2). Bone scintigraphy demonstrated abnormalities not visualized on magnetic resonance imaging in 11/144 patients (3 in Group 1 and 8 in Group 2). Bone scintigraphy showed abnormalities in locations not evaluated by magnetic resonance imaging but relevant to the symptomatology or disease in 42/144 patients (37 in Group 1 and 5 in Group 2). These data indicate that magnetic resonance imaging and bone scintigraphy are complementary. Bone scintigraphy remains the best screening procedure to show the location of abnormal areas in the spine and elsewhere in the skeleton. Magnetic resonance imaging is useful in differentiating neoplasm, infection, intervertebral disk disease, and, in some instances, degenerative bone disease.
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PMID:Correlative radionuclide and magnetic resonance imaging in evaluation of the spine. 280 24

During the 58-year period from 1928 through 1986, 80 patients 18 years of age or younger were treated or seen in consultation at Children's Hospital, Boston, for an epithelial or nonepithelial tumor of salivary gland origin. Using established criteria, ten (40%) of the 25 epithelial tumors were pleomorphic adenomas and the remaining tumors were classified as histologically malignant growths including mucoepidermoid carcinoma (n = 6), acinic cell carcinoma (n = 5), and adenocarcinoma most likely of duct cell origin (n = 2). Two other carcinomas presented as congenital parotid salivary gland tumors in newborns and were considered to have biphasic composition including both epithelial and myoepithelial cells, with the latter type predominating. There was only one tumor-related death due to metastases among the 15 children with malignant epithelial tumors (7%); four other patients experienced a local recurrence of tumor (27%). Of the 55 nonepithelial tumors, capillary hemangioma was the most common and showed distinct predilection for female infants with localization in the left parotid gland. The histologic spectrum of primary salivary gland tumors in infancy and childhood is distinctive and merits careful correlation with therapeutic strategies.
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PMID:Histopathologic review of salivary gland tumors in childhood. 283 10

Hepatocellular carcinoma (HCC), a common malignancy in the United States with poor prognosis, must be differentiated from hemangioma, focal fat, metastases, and regenerating nodules. Serum alpha-fetoprotein (AFP) levels are not a sensitive method for detection of HCC. High resolution ultrasound has been highly effective in detecting HCC in Japan and Taiwan. Doppler ultrasound can be used to increase the specificity. We review the roles of angiography, computed tomography (CT), and magnetic resonance, to conclude that the Japanese experience has demonstrated the efficacy of screening for HCC in the population at risk using serum AFP and ultrasound with the addition of dynamic CT and angiography where indicated. The continuing poor prognosis of patients with HCC in the United States suggests a failure to apply these methods for the early detection of HCC.
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PMID:Diagnostic imaging of hepatocellular carcinoma: progress in noninvasive tissue characterization. 284 92

Fifty-three patients who had hepatic tumors (24 hepatomas, ten metastases, and 19 cavernous hemangiomas) underwent MR imaging using a 0.35-T superconducting imager. The transverse relaxation time (T2) was calculated from a pair of spin echo images (repetition time [TR] of 1600 msec) with echo delay times (TE) of 35 and 70 msec. The computed T2 value was obtained in a fashion similar to that used to obtain CT numbers with region-of-interest cursors. The mean T2 was 59 +/- 9 msec in hepatomas, 64 +/- 15 msec in metastases, and 100 +/- 30 msec in hemangiomas. The difference between the T2 of hemangioma and that of liver malignancies was statistically significant (P less than .001); however, differentiation between hepatoma and metastases was not possible. The T2 was shorter than 80 msec in all 24 hepatomas and in nine of ten metastases, and was longer than 80 msec in 16 of 19 hemangiomas. Forty-nine of 53 cases (92%) were correctly classified when the borderline of T2 between hemangioma and hepatic malignancies was set at 80 msec. MR with T2 calculation was valuable in differentiating between hemangioma and hepatic malignancies.
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PMID:Hepatic tumors: differentiation by transverse relaxation time (T2) of magnetic resonance imaging. 298 19

We examined 21 patients with focal lesions of the liver. Routinely we used T1 weighted, proton weighted and T2 weighted measurement modes, mainly with repetition times of 1.6 sec and echo delay times of 35 or 120 msec. Using these parameters we can see characteristic changes of the signals of the liver tumours. Cystic lesions usually show a strong decrease of the signal in the T1 weighted images in comparison with the normal liver pattern, in the proton weighted images a weak decrease but also in some cases a weak increase of the signal; in the T2 weighted images they show signals of very great intensity. We can differentiate haemangioma of cystic lesions because of the very strong signal in the proton weighted images in comparison with the normal liver pattern, which we could not see in any other focal liver disease. Metastases and hepatoma produced low signal intensity in the T1 weighted image. The proton weighted and the T2 weighted images show signals with a slightly greater intensity compared with the normal pattern, i.e. a very good possibility to distinguish hepatoma and metastases from cystic lesions or haemangioma. The differentiation from hepatoma and metastases cannot be made with NMR up to now. We are also not able to differentiate the focal nodular hyperplasia (FNH) from metastases. We used a 0.35 T supraconductive magnetic system.
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PMID:[Initial experiences with MR in liver tumors]. 299 37

Twenty-one patients with hepatic hemangioma, five with hepatic cysts, and 25 with primary or metastatic cancer involving the liver were studied by magnetic resonance imaging (MRI). Benign lesions (hemangiomas, cysts) were diagnosed noninvasively by CT, radionuclide studies, and/or sonography and confirmed by follow-up examinations more than 1 year later. Malignant lesions were confirmed by liver biopsy in every case. Identical multisection/multiecho techniques were used in all patients to obtain T1-and T2-weighted spin-echo (SE) and inversion-recovery (IR) images. MRI detected more hemangiomas than any other imaging technique. Of 30 hemangiomas, 25 were spherical or ovoid with a homogeneous appearance and smooth, well defined margins. Cancer tended to have a heterogeneous appearance and poorly defined margins. On T2-weighted SE images obtained with 2000 msec TR and 60, 120, or 180 msec TE, hemangiomas had significantly greater contrast-to-noise ratios (C/N) than liver cancer (p less than 0.001). The SE 2000/120 sequence provided the single most useful image for distinguishing hemangiomas from cancers. When morphologic criteria are used in conjunction with measured C/N, MRI correctly distinguished cavernous hemangiomas from liver cancer with 90% sensitivity, 92% specificity, and an overall accuracy of 90%. Cysts had a low signal intensity on SE 500/30 images and could often be distinguished from hemangiomas and cancers that were nearly isointense relative to liver. IR images were sensitive for lesion detection but provided no tissue-specific information. The data indicate that T2-weighted SE imaging may become the procedure of choice for distinguishing cavernous hemangioma from liver cancer.
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PMID:Magnetic resonance imaging of cavernous hemangioma of the liver: tissue-specific characterization. 299 50

This review includes the initial experience with NMR imaging of the liver, spleen, and pancreas at the University of California, San Francisco, using a prototype 0.35 Tesla system. This experience shows great promise for detection of hepatic metastases using T1-weighted pulse sequences. T2-weighted pulse sequences appear sensitive for detecting cavernous hemangioma of the liver and may allow tissue specific discrimination of the benign lesion from cancer. NMR is also suitable for evaluating diffuse metabolic alterations and is sensitive and specific for the diagnosis of iron overload. Detection of fatty liver requires use of chemical shift techniques as conventional NMR imaging pulse sequences are relatively insensitive. Motion artifacts and lack of an effective bowel contrast agent limits imaging of the pancreas and retroperitoneum, where CT remains the procedure of choice. The normal spleen has longer T1 and T2 relaxation times than liver or pancreas and NMR has not been successful in diagnosing splenic metastases or lymphoma on a routine basis. We conclude that NMR imaging will be valuable in the diagnosis of focal liver disorders; until fast scan techniques and effective magnetic contrast agents are available for oral and/or intravenous use, other abdominal applications will remain limited.
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PMID:Nuclear magnetic resonance of the liver, spleen, and pancreas. 300 15

A case of "sclerosing hemangioma" (pneumocytoma) of the lung with lymph node metastasis is reported. A 22-year-old Japanese man was found to have a well-defined round lesion in the right lung (S7), which increased in size slightly during a 2-year follow-up period. He underwent right lower lobectomy with a preoperative diagnosis of a benign lung tumor. The pulmonary tumor revealed histological features characteristic of "sclerosing hemangioma" of the lung, in addition to which there were many large polygonal foamy cells, forming tubular or papillary structures. These cells were found by electron microscopy to contain numerous cytoplasmic lamellar bodies and showed a positive reaction with anti-surfactant apoprotein antibody immunohistochemically. Therefore, they were considered to be cells differentiating toward type II pneumocytes. Review of 21 typical "sclerosing hemangiomas" disclosed a few or some such foamy cells in 10 cases. A single hilar lymph node was the site of microscopic metastases, which consisted of "large clear foamy cells" and smaller polygonal or round cells with slightly eosinophilic cytoplasm, both of which were components of the pulmonary "sclerosing hemangioma." This case supports the theory that "sclerosing hemangioma" is a neoplasm of type II pneumocyte lineage. Although it is said to be benign, rare cases apparently show metastatic potential.
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PMID:A case of pneumocytoma (so-called sclerosing hemangioma) with lymph node metastasis. 300 21

Magnetic resonance (MR) imaging of 43 patients with hepatic tumor was performed during suspended respiration using a fast scan spin echo (SE) technique (SE 200/40) with a single excitation. The resulting images were superior in terms of image quality to conventional ones. Due to the lack of soft tissue contrast, 38 patients received Gd-diethylenetriaminepentaacetic acid (DTPA) at 0.05 mmol/kg and serial scanning (CE-MR) was repeated. Twelve of 14 hepatomas showed isointensity or slightly reduced intensity compared with the liver in unenhanced MR. All metastases (nine patients) showed low signal intensity that was statistically significant (p less than 0.001) in differentiating between hepatomas and metastatic liver tumors. With contrast enhanced MR, both hepatomas and metastases showed changes that cannot be further classified until more cases have been examined. In all 12 cavernous hemangioma cases, Gd-DTPA pooling was observed with extremely high contrast, which was a pathognomonic sign. In fact, four cavernous hemangiomas in two patients with a diameter of 1.0 cm were successfully imaged.
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PMID:Fast spin echo imaging with suspended respiration: gadolinium enhanced MR imaging of liver tumors. 302 41

Duplex Doppler ultrasound (US) was used in 68 consecutive patients with focal liver lesions, including 12 hepatocellular carcinomas, one cholangiocarcinoma, 37 metastases, 15 hemangiomas, one hemangioendothelioma, and two focal nodular hyperplasias. Of the hepatocellular carcinomas, six were diffusely hyperechoic, two were hypoechoic, two were single hyperechoic lesions, and two were multifocal and hyperechoic. All ten tumors with Doppler shifts of 5 kHz or above proved to be hepatocellular carcinomas. The other two hepatocellular carcinomas showed Doppler shifts of 3 kHz. In contrast, no hemangioma showed shifts above 0.7 kHz, and ten of the 15 gave no detectable signal. Of the metastases, 20 gave no signal and 17 had signals of up to 4 kHz. Three-kilohertz signals were also obtained from a cholangiocarcinoma, a hemangioendothelioma, and focal nodular hyperplasia. Correlation with angiographic findings suggested that the high-velocity Doppler signals were associated with large pressure gradients due to arteriovenous shunting. Duplex Doppler US can therefore aid in the differential diagnosis of diffuse and focal liver lesions.
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PMID:Focal liver masses: differential diagnosis with pulsed Doppler US. 303 70


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