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Extensive infiltrating renal cell carcinoma with minimal distortion of the renal anatomy mimicking benign renal vein thrombosis [Case Report]
Hecht, Elizabeth M; Hindman, Nicole; Huang, William C; Rosenkrantz, Andrew B; Melamed, Jonathan
PMID: 19962807
ISSN: 1523-6838
CID: 109555
MRI appearance of internal hernia following Roux-en-Y gastric bypass surgery in the pregnant patient [Case Report]
Rosenkrantz, A B; Kurian, M; Kim, D
PMID: 20152282
ISSN: 0009-9260
CID: 107281
Liver MRI at 3 T Using a Respiratory-Triggered Time-Efficient 3D T2-Weighted Technique: Impact on Artifacts and Image Quality
Rosenkrantz, Andrew B; Patel, Jignesh M; Babb, James S; Storey, Pippa; Hecht, Elizabeth M
OBJECTIVE: The purpose of this retrospective study was to qualitatively and quantitatively compare image quality of a time-efficient 3D T2-weighted sequence-the sampling perfection with application-optimized contrasts using different flip angle evolutions (SPACE) sequence-with a standard 2D T2-weighted turbo spin-echo (TSE) sequence for liver imaging at 3 T. MATERIALS AND METHODS: Twenty patients underwent liver MRI at 3 T using T2-weighted breath-hold 2D TSE and respiratory-triggered SPACE sequences. Two radiologists independently assessed image quality for both sequences during separate sessions, followed by a side-by-side comparison. One reader performed a quantitative analysis of the estimated signal-to-noise ratio (SNR) and the relative contrast between the liver and other tissues. RESULTS: Image quality scores for the SPACE sequence were significantly better than those for the 2D TSE sequence for motion (p < 0.0001) and pulsation (p < 0.0001) artifact, flow signal suppression (p = 0.0015), sharpness of intrahepatic vessels (p < 0.0001), and sharpness of liver edge (p = 0.0015), with motion and pulsation artifacts being nearly eliminated using the SPACE sequence. However, the scores for B(1) inhomogeneity artifact were significantly worse for the SPACE sequence (p = 0.0117). Overall, both readers preferred SPACE sequence, although this difference was significant for only one reader (p = 0.025, p = 0.275). There was no significant difference between the sequences for estimated liver SNR (p = 0.1564), but the SPACE sequence showed significantly higher relative contrast between the liver and the kidney (p < 0.0001), gallbladder (p = 0.0476), and spleen (p < 0.0001). Relative contrast between the liver and parenchymal lesions was higher with the SPACE sequence than with the TSE sequence, although this difference was not statistically significant (p = 0.125). CONCLUSION: For T2-weighted liver imaging at 3 T, the respiratory-triggered SPACE sequence shows better image quality with near elimination of motion and pulsation artifacts and improved tissue contrast than the breath-hold 2D TSE sequence, but suffers from increased B(1) inhomogeneity artifact and longer scanning time
PMID: 20173139
ISSN: 0361-803x
CID: 107384
Imaging appearance of solitary fibrous tumor of the abdominopelvic cavity [Case Report]
Rosenkrantz, Andrew B; Hindman, Nicole; Melamed, Jonathan
The computed tomographic or magnetic resonance imaging appearance of solitary fibrous tumors of the abdominopelvic cavity has previously only been presented in the English literature as individual case reports. In this article, we present the cross-sectional imaging appearance of 5 such cases, all of which exhibited highly similar imaging features, including well-circumscribed margins, lack of invasion of adjacent structures, and avid enhancement. In view of these shared imaging features, it may be possible to suggest the diagnosis preoperatively. Given their unpredictable biologic behavior with infrequent reports of recurrent or metastatic disease, complete surgical excision and long-term follow-up for these lesions is recommended
PMID: 20351504
ISSN: 1532-3145
CID: 108933
Prostate cancer: Comparison of 3D T2-weighted with conventional 2D T2-weighted imaging for image quality and tumor detection
Rosenkrantz, Andrew B; Neil, Jeffry; Kong, Xiangtian; Melamed, Jonathan; Babb, James S; Taneja, Samir S; Taouli, Bachir
OBJECTIVE: The purpose of this study was to compare a 3D T2-weighted imaging sequence with a conventional multiplanar 2D turbo spin-echo T2-weighted sequence in terms of tumor detection and staging of prostate cancer, as well as image quality. MATERIALS AND METHODS: Before prostatectomy, 38 men (mean age, 60 years) with prostate cancer underwent MRI of the prostate with multiplanar 2D turbo spin-echo T2-weighted sequences (total acquisition time, approximately 11 minutes 4 seconds) and a 3D T2-weighted sampling perfection with application optimized contrasts sequence with different flip angle evolutions (SPACE) (acquisition time, approximately 3 minutes 52 seconds). Two blinded observers in consensus reviewed 2D turbo spin-echo T2-weighted images and SPACE images for detection of peripheral zone cancer, extracapsular extension, and seminal vesicle invasion. The observers also assessed subjective image quality and measured the signal-to-noise ratio (SNR) of normal peripheral zone and tumor-to-peripheral zone contrast. Prostatectomy was used as the reference standard. The diagnostic accuracy of the two sequences was assessed with generalized estimating equations and McNemar tests. The agreement between sequences was assessed with kappa coefficients. A paired Wilcoxon signed rank test was used to compare the subjective image quality, SNR, and tumor-to-peripheral zone contrast of the two sequences. RESULTS: For tumor detection and diagnosis of extracapsular extension, there was substantial agreement between the two sequences (kappa = 0.79, kappa = 0.76) with no difference in sensitivity, specificity, positive predictive value, negative predictive value, accuracy (p = 0.25-1), or image quality (p = 0.937). Images obtained with the 2D turbo spin-echo sequence had a significantly higher SNR ratio for normal peripheral zone (p = 0.0010), but SPACE images had significantly greater tumor-to-peripheral zone contrast (p < 0.0001). CONCLUSION: In comparison with conventional multiplanar 2D turbo spin-echo MRI of the prostate, 3D T2-weighted SPACE MRI was associated with substantial time saving (nearly 8 minutes), had similar image quality and accuracy in the diagnosis of tumor and extracapsular extension, and had better tumor conspicuity
PMID: 20093608
ISSN: 1546-3141
CID: 106383
Angiomyolipoma with epithelial cysts: mimic of renal cell carcinoma [Case Report]
Rosenkrantz, Andrew B; Hecht, Elizabeth M; Taneja, Samir S; Melamed, Jonathan
Angiomyolipoma with epithelial cysts (AMLEC) is a rare variant of angiomyolipoma with minimal fat that contains epithelial-lined cysts and may mimic a cystic renal cell carcinoma. While 17 cases have been described in the pathology literature since this entity was first described in 2006, the radiologic appearance was not demonstrated in any of these cases. We report the CT and MRI appearance of AMLEC found incidentally in a patient with lupus nephritis
PMID: 20122523
ISSN: 0899-7071
CID: 107271
Case report: MRI appearance of isolated fallopian tube torsion in an adolescent with a congenital Mullerian duct anomaly and ispilateral renal agenesis [Case Report]
Kopec, M; Rosenkrantz, A B; Rivera, R; Wells, J L; Berg, R E; Milla, S S
PMID: 20103428
ISSN: 1365-229x
CID: 106378
Magnetic resonance imaging appearance of ovarian stromal hyperplasia and ovarian hyperthecosis [Case Report]
Rosenkrantz, Andrew B; Popiolek, Dorota; Bennett, Genevieve L; Hecht, Elizabeth M
Ovarian stromal hyperplasia and ovarian hyperthecosis are non-neoplastic conditions of the ovary associated with clinical manifestations of hyperandrogenism from ovarian production of male hormones. In this article, we present the first published cases of the magnetic resonance imaging appearance of these conditions, which may mimic that of ovarian neoplasm. In contrast to bilateral ovarian vein sampling, magnetic resonance imaging may provide a noninvasive means of suggesting a diagnosis of ovarian stromal hyperplasia/ovarian hyperthecosis when a hormone-secreting ovarian neoplasm is suspected clinically and thereby may assist in identifying patients who may be effectively treated nonsurgically with gonadotrophin-releasing hormone therapy
PMID: 19940659
ISSN: 1532-3145
CID: 105520
Pulmonary MR angiography techniques and applications
Hecht, Elizabeth M; Rosenkrantz, Andrew
This article discusses the role of magnetic resonance angiography (MRA) in evaluating the pulmonary arterial system. For depiction of pulmonary arterial anatomy and morphology, MRA techniques are compared with CT angiography and digital subtraction x-ray angiography. Perfusion, flow, and function are emphasized, as the integrated MR examination offers a comprehensive assessment of vascular morphology and function. Advances in MR technology that improve spatial and temporal resolution and compensate for potential artifacts are reviewed as they pertain to pulmonary MRA. Current and emerging gadolinium contrast-enhanced and non-contrast-enhanced MRA techniques are discussed. The role of pulmonary MRA, clinical protocols, imaging findings, and interpretation pitfalls are reviewed for clinical indications
PMID: 19364603
ISSN: 1557-9786
CID: 98004