OBJECTIVE: To validate the diffusion-weighted MRI (DWI) for differentiation of benign from malignant portal vein thrombosis. , Imagerie par résonance magnétique de diffusion CONCLUSION: The degree of pseudoglandular formation could be one of the determinants of ADC in DWI of HCCs-especially moderately differentiated HCCs-while its influence does not appear to be significant in well- or poorly differentiated HCCs. The ADC values and pseudoglandular formation were significantly correlated in moderately differentiated HCCs (n = 103 r = 0.307, P = 0.007), while well- (n = 19) and poorly-differentiated HCCs (n = 60) did not show significant correlation (r = 0.105 and 0.068, respectively P = 0.600 and 0.685, respectively). RESULTS: The mean ADC was significantly higher in pure pseudoglandular lesions (n = 5, 1.29 ± 0.08 × 10−3 mm2/s) than in non-pseudoglandular lesions (n = 132, 1.08 ± 0.17 × 10−3 mm2/s P = 0.003) or mixed-pseudoglandular lesions (n = 45, 1.16 ± 0.24 × 10−3 mm2/s P = 0.034). Data were assessed using the analysis of variance test, with Bonferroni correction for post hoc analysis to stratify the relationship of ADCs with pseudoglandular formation, followed by subgroup analysis according to the histopathological tumor grades. The ADC for each tumor was independently measured, using the largest region of interest on the ADC map. Each type of tumor pseudoglandular formation was categorized into “non-,” “mixed-,” or “pure-,” based on official histopathology reports. MATERIALS AND METHODS: We assessed 182 HCCs surgically resected from 169 consecutive patients. PURPOSE: To determine the impact of pseudoglandular formation on apparent diffusion coefficient (ADC) values of hepatocellular carcinoma (HCC) in diffusion-weighted imaging (DWI), and to validate the results using histopathological grades. The ATPS group had higher subjective scores for arterial attenuation, edge sharpness of the artery, visibility of small arteries, and overall image ATPS algorithm for the cerebral CTA reduced radiation dose by 43% while maintaining image quality and improved the attenuation of cerebral arteries by selecting lower tube potential. The ATPS group had significantly higher arterial attenuation and no significant difference in CNR, compared with the fixed 120-kVp. Radiation doses, attenuation, contrast-to-noise ratio (CNR) of the cerebral arteries, subjective scores for arterial attenuation, edge sharpness of the artery, visibility of small arteries, venous contamination, image noise, and overall image quality were compared between the volume CT dose index and effective dose of the ATPS group were lower than those of the fixed 120-kVp group. The other 18 were scanned with an ATPS algorithm. We are the first to describe a rare case of IgG4-related inflammatory pseudotumor, complicated by actinomycosis, showing an invasive nature that mimicked malignancy during steroid therapy in a diabetic investigate the feasibility of using the attenuation-based automatic tube potential selection (ATPS) algorithm for cerebral computed tomography angiography (CTA) and to assess radiation dose, vascular attenuation, and image quality compared to a conventional fixed 120-kVp AND 36 volunteers for cerebral CTA, a total of 18 were scanned with fixed 120 kVp and 140 effective mAs using automatic tube current modulation. In the area of diaphragmatic destruction, focal actinomycosis was complicated in the main mass of IgG4-related disease. On the 5-month follow-up CT with the maintenance of low-dose oral steroid medication, disease progression with invasion to diaphragm brought surgical intervention of right hemihepatectomy considering the possibility of combined malignancy.
After tissue diagnosis of immunoglobulin G4 (IgG4)-related disease by gun needle biopsy, steroid therapy induced partial shrinkage of the mass on the follow-up CT at 4 weeks. Dynamic CT and MRI showed a layered pattern of contrast enhancement suggesting the imaging features of the solid inflammatory mass. For a 67-year-old man with diabetes mellitus, a 9-cm liver mass was found on CT during the diagnostic work-up for weight loss and fever.
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