Bone marrow is composed of fat and cellular elements supported by the trabecular bone. Pathological lesions of the bone marrow usually replace its normal constituent to a variable degree. Differentiation among traumatic, neoplastic, and inflammatory processes of the bone marrow is often not possible with MRI, which commonly requires the patient to undergo additional invasive diagnostic procedures to obtain an accurate diagnosis. In-phase and opposed-phase imaging has been used extensively in imaging of the liver and adrenal glands. However, recently it has been introduced into the evaluation of the bone marrow. The technique takes advantage of different excitation frequencies of water and fat protons due to differences in their molecular environments. The main concept is that the presence of normal bone marrow would result in suppression of signal intensity on the opposed-phase images. In the presence of infiltration lesions of the bone marrow, normal fat-containing marrow will be replaced with neoplastic cells and result in lack of suppression on the opposed-phase images. The main teaching purpose of this exhibit will be to demonstrate, by a pictorial case-based review, the appearance of multiple cases of biopsy-proven infiltrating lesions of the bone marrow, and emphasize how they can be differentiated from other traumatic or inflammatory processes. Read More

Meeting name: SPR 2019 Annual Meeting & Postgraduate Course , 2019

Authors: Medina Perez Mariangeles, Gupta Saurabh, Salastekar Ninad, Badar Zain, Majmudar Anand

Keywords: In-phase, opposed-phase, marrow

Neck masses are commonly seen in the pediatric population and are a frequent reason for pediatric consults and can represent a diagnostic challenge. Although there is a broad spectrum of differentials, the vast majority of these lesions are benign, however malignant etiologies can also be encountered. Ultrasonography has become the first-line imaging modality in the evaluation of neck masses, given the ability to avoid radiation, wide availability and cost-effectiveness. Also, ultrasound represents an option when trying to avoid contrast administration or sedation. The main teaching points of this exhibit will be: 1. Review variety of congenital and acquired neck masses in the pediatric patients. 2. Discuss imaging features and approach to various vascular, congenital abnormalities, benign and malignant tumors and other acquired abnormalities with Ultrasound. 3. Discuss the role of anatomic imaging in management. A case-based pictorial review will be used to demonstrate: 1. Approach to vascular tumors and malformations based on clinical and imaging features including congenital, infantile hemangioma, low flow, various types of vascular malformations, locally aggressive lesions like kaposiform hemangioendothelioma, malignant tumors likely angiosarcoma and hemangioendothelioma. 2. Reviewing salient features of various congenital and acquired abnormalities including branchial cleft cysts, thyroglossal duct cysts, congenital goiter and midline frontal masses. 3. Discuss imaging features of other benign and malignant masses including teratomas, primary cervical neuroblastomas, soft tissue tumors (myofibroblastic), lipoblastoma. Also malignant tumors like fibrosarcoma, rhabdomyosarcoma. 4. Describe masses which mimic tumors such as fibromatosis coli and ectopic thymus. 5. Treatment and prognosis. Read More

Meeting name: SPR 2019 Annual Meeting & Postgraduate Course , 2019

Authors: Medina Perez Mariangeles, Gupta Saurabh, Badar Zain, Salastekar Ninad, Majmudar Anand

Keywords: neck, masses, ultrasound