Use of the International Society for the Study of Vascular Anomalies (ISSVA) classification system has been strongly recommended in recent years because of the need for separate therapeutic measures for patients with vascular tumors and malformations. In the ISSVA classification system, vascular tumors, which are neoplastic, are distinguished from vascular malformations, which are caused by vascular structural anomalies and are not neoplastic, on the basis of the presence or absence of neoplastic proliferation of vascular endothelial cells. It is important that radiologists be familiar with the development, diagnosis, and treatment of vascular tumors and malformations, especially the imaging features of low- and high-flow vascular malformations. Some vascular tumors and malformations develop in isolation, whereas others develop within the phenotype of a syndrome. Syndromes that are associated with vascular tumors include PHACE syndrome. Syndromes that are associated with vascular malformations include Sturge-Weber, Klippel-Trénaunay, Proteus, blue rubber bleb nevus, Maffucci, and Gorham-Stout syndromes, all of which demonstrate low flow, and Rendu-Osler-Weber, Cobb, Wyburn-Mason, and Parkes Weber syndromes, all of which demonstrate high flow. Because imaging findings may help identify such syndromes as systemic, it is important that radiologists familiarize themselves with these conditions.

Compared with conventional MRI, MRM affords more specific information for the presurgical diagnosis of symptomatic foraminal stenosis.

In this study, we report 2 pediatric cases of nuclear protein of the testis (NUT) midline carcinoma (NMC) suggestive of pulmonary origin: case 1 was a 14-year-old Japanese boy and case 2 was a 7-year-old Japanese girl. Initial symptoms of both cases were prolonged cough and chest pain, and the case 2 patient also complained of lumbago and lumbar mass due to bone metastases. Imaging studies revealed that pulmonary tumors from both patients were located at the hilar region of the lower lobe. Biopsies of the tumors showed undifferentiated carcinoma in case 1 and combined undifferentiated and squamous cell carcinoma in case 2. Despite intensive treatment with chemotherapy and radiation, progression of neither tumor was controlled, and both patients died of the tumors at 1 year (case 1) and 4 months (case 2) after onset of disease. Both tumors were diffusely positive for p63 and NUT expression and were partially positive for various cytokeratins. Reverse transcription polymerase chain reaction analysis and subsequent direct sequencing revealed that the bromodomain-containing protein 4-NUT chimeric gene was present in tumor tissue of both patients, leading to a diagnosis of NMC. The tumor cells of case 1 were also positive for thyroid transcription factor-1 expression, but those of case 2 were negative. Histologic examination of the surgically removed lung tumor of case 1 indicated that the origin of the tumor was basal cells of the bronchiolar epithelia.

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Background: Third-generation computed tomography (CT) has advances in detector efficiency, and newer iterative reconstruction (IR) algorithms Objective: To retrospectively compare pediatric brain imaging quality between second-and third-generation CT.Methods: Image quality was compared between second-and third-generation CT in 51 pairs of age-matched children (age range, 0-5 years) with no abnormal findings. CT images were reconstructed using filtered back-projection (FBP) and IR. The contrastto-noise ratio (CNR) and signal-to-noise ratio (SNR) were calculated at the lentiform nucleus (LN) and white matter (WM). Imaging contrast at the gray-WM interface was rated by two readers. Results:The CNR and SNR of the LN and WM were significantly higher on thirdgeneration CT than on second-generation CT (mean CNR, 2.51 vs 2.12, p < 0.001; mean SNR for LN, 15.13 vs 12.71, p < 0.001; mean SNR for WM, 12.27 vs 11.12, p = 0.012) when FBP was used. With FBP, both readers rated visually assessed grey-white matter contrast as better on third-generation CT than on second-generation CT (p ≤ 0.002). With IR, the CNR and SNR were significantly higher than with FBP on both generation CT scanners (p < 0.001). The LN CNR was significantly higher on third-generation CT than on second-generation CT (mean, 16.79 vs 15.13, p < 0.001). With IR, visual assessments on third-generation CT were generally better than on second-generation CT. Conclusion:Imaging quality of the pediatric brain was better on third-generation CT than on second-generation CT. IR may be effective on CT scanners of both generations.

To reduce the determination errors of CSF pulsation in diffusion-weighted image (DWI) thermometry, we investigated whether applying second-order motion compensation diffusion tensor imaging (2nd-MC DTI) and fractional anisotropy (FA) processing improves the measurement of intracranial cerebrospinal fluid (CSF) temperature. In a phantom study, we investigated the relationship between temperature and FA in artificial CSF (ACSF) to determine the threshold for FA processing. The temperatures of ACSF were compared with those of water. In a human study, 18 healthy volunteers were scanned using conventional DTI (c-DTI) and 2nd-MC DTI on a 3.0T magnetic resonance imaging (MRI) system. A temperature map was created using diffusion coefficients from each DWI with/without FA processing. The temperatures of intracranial CSF were compared between each DTI image using Welch’s analysis of variance and Games–Howell’s multiple comparisons. In the phantom study, FA did not exceed 0.1 at any temperature. Consequently, pixels exceeding the threshold of 0.1 were removed from the temperature map. Intracranial CSF temperatures significantly differed between the four methods (p < 0.0001). The lowest temperature was 2nd-MC DTI with FA processing (mean, 35.62℃), followed in order by c-DTI with FA processing (mean, 36.16℃), 2nd-MC DTI (mean, 37.08℃), and c-DTI (mean, 39.08℃; p < 0.01 for each). Because the temperature of ACSF was estimated to be lower than that of water, the temperature of 2nd-DTI with FA processing was considered reasonable. The method of 2nd-MC DTI with FA processing enabled determining intracranial CSF temperature with a reduction in CSF pulsation.