Introduction:Paragangliomas are mostly localized in the adrenal medulla and they are usually pheochromocytomas, derived from the neural crest, but otherwise mesenteric paragangliomas are extremely rare tumors.Case Presentation:In this article we represent a 59-year-old female with an abdominal mass and pain due to mesenteric paraganglioma.Conclusions:Paragangliomas can occur as mesenteric tumors; usually, preoperative accurate diagnosis is not possible with imaging methods and precise diagnosis is possible after histological evaluation.
Objective: To examine the effectiveness of apparent diffusion coefficient (ADC) values and to compare the reliability of different b-values in detecting and identifying significant liver fibrosis. Subjects and Methods: There were 44 patients with chronic viral hepatitis (CVH) in the study group and 30 healthy participants in the control group. Diffusion-weighted magnetic resonance imaging (DWI) was performed before the liver biopsy in patients with CVH. The values of ADC were measured with 3 different b-values (100, 600, 1,000 s/mm2). In addition, liver fibrosis was classified using the modified Ishak scoring system. Liver fibrosis stages and ADC values were compared using areas under the receiver-operating characteristic (ROC) curve. Results: The study group's mean ADC value was not statistically significantly different from the control group's mean ADC value at b = 100 s/mm2 (3.69 ± 0.5 × 10-3 vs. 3.7 ± 0.3 × 10-3 mm2/s) and b = 600 s/mm2 (2.40 ± 0.3 × 10-3 vs. 2.5 ± 0.5 × 10-3 mm2/s). However, the study group's mean ADC value (0.99 ± 0.3 × 10-3 mm2/s) was significantly lower than that of the control group (1.2 ± 0.1 × 10-3 mm2/s) at b = 1,000 s/mm2. With b = 1,000 s/mm2 and the cutoff ADC value of 0.0011 mm2/s for the diagnosis of liver fibrosis, the mean area under the ROC curve was 0.702 ± 0.07 (p = 0.0015). For b = 1,000 s/mm2 and the cutoff ADC value of 0.0011 mm2/s to diagnose significant liver fibrosis (Ishak score = 3), the mean area under the ROC curve was 0.759 ± 0.07 (p = 0.0001). Conclusion: Measurement of ADC values by DWI was effective in detecting liver fibrosis and accurately identifying significant liver fibrosis when a b-value of 1,000 s/mm2 was used.
P i c t u r e 1 . Ul t r a s o u n d e x a mi n a t i o n s h o ws a 5 × 4 × 2 c m o v o i d , mo d e r a t e l y h y p e r e c h o i c f a t t y ma s s a n t e r i o r t o t h e a s c e n d a n t c o l o n i n r i g h t p a r a u mb l i c a l r e g i o n ( a r r o ws ) .
P i c t u r e 2 . Co n t r a s t e n h a n c e d CT s c a n o f t h e a b d o me n s h o ws t h e f a t t y ma s s c o r r e s p o n d e d t o a f oc a l , we l l -d e ma r c a t e d a r e a o f g r e a t e r o me n t u m c h a r a c t e r i z e d b y i n c r e a s e d d e n s i t y wi t h s t r e a k y i n f i l t r a t e .
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