Echo-planar imaging is a very fast magnetic resonance (MR) imaging technique capable of acquiring an entire MR image in only a fraction of a second. In single-shot echo-planar imaging, all the spatial-encoding data of an image can be obtained after a single radio-frequency excitation. Multishot echo-planar imaging results in high-quality images comparable to conventional MR images. However, echo-planar imaging offers major advantages over conventional MR imaging, including reduced imaging time, decreased motion artifact, and the ability to image rapid physiologic processes of the human body. The use of echo-planar imaging has already resulted in significant advances in clinical diagnosis and scientific investigation, such as in evaluation of stroke and functional imaging of the human brain, respectively. The clinical indications for echo-planar imaging are expanding rapidly, and it can now be applied to many parts of the body, including the brain, abdomen, and heart. Today, with the availability of echo-planar imaging-capable MR imagers at many sites, the general radiologist can benefit from echo-planar imaging and its clinical applications.
Radiation-induced bone changes and second malignancies, as well as benign tumors, following bone marrow transplantation are being reported with increasing frequency. An osteosarcoma of the fourth right rib and an osteochondroma of the left scapula developed in a long-term survivor of abdominal neuroblastoma treated with chemotherapy, local radiation, and bone marrow transplantation. All these treatment modalities are known to induce neoplasia.
A 70-year-old Afghan refugee who recently immigrated to the United States had a history of dyspnea on exertion for several months. Medical history included systemic hypertension, recent onset of congestive heart failure, and recent peripheral pitting edema of the lower extremities. A soft systolic heart murmur with a split S 2 was present at physical examination. An echocardiogram showed findings that prompted the request for a cardiac magnetic resonance (MR) imaging examination for further evaluation (Figs 1-3). IMAGING FINDINGSMR images demonstrated moderate right atrial enlargement, with a membrane separating the right atrium into an anterior and a posterior chamber (Figs 1, 2). Turbulent flow was seen across this membrane (Fig 2; Movie, radiology.rsnajnls.org/cgi /content/full/10.1148/radiol.2263001845/DC1) and indicated that it was extensively fenestrated and not completely obstructive. Gradient-echo cine images demonstrated a small secundum atrial septal defect (ASD) that was approximately 4 mm in diameter (Fig 3). A small left-to-right jet through the ASD was also seen on the cine images. The right ventricle was mildly enlarged. There was mild enlargement of bilateral pulmonary arteries. Mild left ventricular hypertrophy was present, which was likely related to the patient's known systemic hypertension. Findings of the examination of the remainder of the heart were within normal limits. DISCUSSIONWhile on the basis of the clinical findings the differential diagnosis considerations included entities such as constrictive pericarditis, tricuspid stenosis, or right atrial tumor, the imaging findings helped to narrow the possibilities to one diagnosis: cor triatriatum dexter. The term cor triatriatum, also known as "triatrial heart," usually refers to cor triatriatum sinister or "divided left atrium," which is a rare condition with estimated incidence of 0.1% of all congenital cardiac malformations (1). In cor triatriatum sinister, the left atrium is divided by a membrane into a posterior-superior chamber that receives the four pulmonary veins and an anterior-inferior chamber that connects to the left ventricle by means of the mitral valve. Although several theories have been proposed in the literature regarding the development of cor triatriatum sinister, the most widely accepted theory is that this anomaly results from a failure of incorporation of the common pulmonary vein into the left atrium (2,3).The case presented in this article is an example of cor triatriatum dexter in which a membrane divides the right atrium into two chambers. It is generally believed that cor triatriatum dexter results from persistence of the right valve of the sinus venosus (4 -6). During embryogenesis, the right horn of the sinus venosus gradually incorporates into the right atrium to form the smooth posterior portion of the right atrium, whereas the original embryologic right atrium forms the trabeculated anterior portion. The connection between the right horn of the sinus venosus and the embryologic right atrium is the sinoatri...
We describe four cases of inflammatory pseudotumor seen at our institution in the past 4 years. Four children were each found to have a large extraperitoneal mass on imaging studies, three of which were in the pelvis. Malignant sarcomatous tumors were suspected. Surgical biopsy of each mass, however, revealed inflammatory pseudotumor.
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