Schwannomas are benign soft-tissue tumors that arise from peripheral nerve sheaths throughout the body and are commonly encountered in patients with neurofibromatosis Type 2. The vast majority of schwannomas are benign, with rare cases of malignant transformation reported. In this pictorial review, we discuss the magnetic resonance imaging (MRI) appearance of schwannomas by demonstrating a collection of tumors from different parts of the body that exhibit similar MRI characteristics. We review strategies to distinguish schwannomas from malignant soft-tissue tumors while exploring the anatomic and histologic origins of these tumors to discuss how this correlates with their imaging findings. Familiarity with the MRI appearance of schwannomas can help aid in the differential diagnosis of soft-tissue masses, especially in unexpected locations.
SPECT-CT/VQ has high sensitivity and specificity for diagnosing PE compared with CTPA, even among patients with pre-existing lung disease, with lower radiation doses.
The uncinate fasciculus is the largest white matter association tract connecting the prefrontal cortex and the anteromedial temporal lobe. The traditional anatomical description outlines a temporal stem that hooks around the posterior insula, a subinsular body, and 2 prefrontal stems extending to the lateral orbital gyri and the frontopolar cortex. Recent imaging studies of the white matter tracts deep to the subgenual cingulate gyrus (Brodmann area 25: BA25) suggest the presence of white matter fibers extending from BA25 to the amygdala, via a route that would run in close proximity to the uncinate fasciculus, that are of functional importance in mood disorders. We hypothesized that these fibers represent a third, medial prefrontal stem of the uncinate fasciculus. Using diffusion tensor imaging in 74 healthy volunteer humans, we seeded the uncinate fasciculus using 2 regions of interest centered over the temporal stem and the caudal body of the uncinate fasciculus in the coronal plane at the level of the anterior commissure. A medial prefrontal stem extending to the subgenual cingulate gyrus was demonstrated in 65/74 left and 70/74 right cerebral hemispheres, and had a mean fractional anisotropy value of 0.43 (95% CI 0.40-0.47). The medial subgenual stem fibers were inseparable from the caudal body and temporal stem of the main uncinate fasciculus and followed the same hookshaped morphology. A probable medial subgenual prefrontal stem of the uncinate fasciculus was demonstrated in a cohort of healthy volunteers and is of potential significance in our understanding of neuropsychiatry and mood disorders.
Introduction
Virtually all adults with Down syndrome (DS) develop Alzheimer's disease (AD)‐associated neuropathology by the age of 40, with risk for dementia increasing from the early 50s. White matter (WM) pathology has been reported in sporadic AD, including early demyelination, microglial activation, loss of oligodendrocytes and reactive astrocytes but has not been extensively studied in the at‐risk DS population.
Methods
Fifty‐six adults with DS (35 cognitively stable adults, 11 with mild cognitive impairment, 10 with dementia) underwent diffusion‐weighted magnetic resonance imaging (MRI), amyloid imaging, and had assessments of cognition and functional abilities using tasks appropriate for persons with intellectual disability.
Results
Early changes in late‐myelinating and relative sparing of early‐myelinating pathways, consistent with the retrogenesis model proposed for sporadic AD, were associated with AD‐related cognitive deficits and with regional amyloid deposition.
Discussion
Our findings suggest that quantification of WM changes in DS could provide a promising and clinically relevant biomarker for AD clinical onset and progression.
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