12 patients who had histological proven ganglioneuromas were investigated by computed tomography (CT) and magnetic resonance (MR) imaging. CT scans (n = 11), conventional spin-echo MR images (n = 10) and dynamic MR images (n = 5) were acquired. All lesions showed a well defined, oval shape. Five lesions (42%) showed calcification which was punctate in four and coarse in one on CT. CT attenuation was predominantly low in three of 10 (30%) and intermediate in the remaining seven (70%). In all lesions MR signals were mainly of low intensity on T1 weighted images (T1WI) and of high intensity on T2 weighted images (T2WI). Dynamic MR studies in five cases showed a lack of early enhancement but gradual increasing enhancement. One case had a ganglioneuroblastoma component which showed soft-tissue density and coarse calcifications on CT scans, MR images with intermediate intensity on T1WI and T2WI and early enhancement and little washout on dynamic MR images. In conclusion, ganglioneuroma typically shows punctate calcification and low attenuation on CT and marked hyperintensity on T2WI with gradual increasing enhancement on dynamic MR images. If a ganglioneuroma has atypical CT and MR features, coexistence of a malignant component should be considered.
Correlation of magnetic resonance (MR) imaging findings and those at pathologic evaluation was attempted in six cases of solid and papillary epithelial neoplasm of the pancreas. All patients were female, and the mean patient age was 26 years (range, 13-73 years). On T1-weighted spin-echo images, tumors were well demarcated, and areas of high signal intensity were evident within them. At macroscopic examination, these areas corresponded to solid portions with marked hemorrhagic necrosis or cystic portions filled with hemorrhagic debris. In three of four masses surrounded by macroscopically evident fibrous capsules, a rim of low intensity was revealed at T1-weighted imaging. When T1-weighted spin-echo imaging reveals obvious areas of high intensity within a sharply marginated tumor of the pancreas, especially in a young woman, solid and papillary epithelial neoplasm might be a primary diagnostic consideration.
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