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Spinal cord lesions are traditionally classified as either extradural or intradural extramedullary or of intramedullary origin. Intramedullary spinal cord tumours are histopathologically similar to cranial tumours with a diverse range of pathologies. Astrocytomas and ependymomas account for approximately 80% of all intramedullary tumours, with other primary and secondary lesions accounting for the remaining 20%. Magnetic resonance imaging is the preferred imaging modality for diagnosing and characterising spinal cord lesions; however, accurate characterisation of tumour histology can be challenging, and is further confounded by intramedullary non-neoplastic lesions, such as demyelinating vascular, inflammatory, infectious, or traumatic lesions. This review illustrates the spectrum of intramedullary tumours and tumour mimics with emphasis on the imaging findings., Competing Interests: Conflict of Interest The authors declare no conflict of interest., (Copyright © 2020 The Royal College of Radiologists. Published by Elsevier Ltd. All rights reserved.)

Aim: To present cross-sectional imaging, surgical findings, and follow-up results of diaphragmatic mesothelial cysts., Materials and Methods: Radiological findings for location, size, shape, and internal structure of cysts were reviewed retrospectively. For patients that underwent surgery, surgical reports and laparoscopy images were reviewed. In conservatively managed patients, changes in size and imaging findings of the cyst were assessed during follow-up visits., Results: A total of 13 paediatric cases with an imaging and/or pathological diagnosis of diaphragmatic mesothelial cyst were identified. In all cases, the cystic lesions were located between the diaphragm and the posterolateral aspect of the right lobe of the liver. Eleven lesions (84.6%) had a bi-lobulate shape. Eight of these cases underwent laparoscopic cyst aspiration/unroofing. The postoperative course was uneventful and there were no cases of recurrence. The remaining five cases were managed conservatively with follow-up available in four cases. In three cases (75%), there was reduction in the size of the cysts with a mean volume reduction of 55%., Conclusion: Diaphragmatic mesothelial cysts are congenital cystic lesions that are usually detected incidentally. A common pitfall is incorrect interpretation of the lesion as a hepatic cyst. Conservative management with imaging follow-up can be adopted in asymptomatic cases with typical imaging findings., (Copyright © 2019 The Royal College of Radiologists. Published by Elsevier Ltd. All rights reserved.)

Aim: To evaluate the role of superb microvascular imaging along with greyscale and Doppler imaging for thyroid gland evaluation in Hashimoto's thyroiditis (HT) versus control subjects., Materials and Methods: The study included 33 healthy volunteers with normal ultrasound and laboratory findings and 70 patients with HT based on laboratory and sonographic findings who were undergoing follow-up and receiving medical treatment. HT patients were classified based on the modification of the scheme proposed by Sostre and Reyes that incorporates the extent of hypoechoic foci or patchy infiltration as grade A (foci involving <50% of the gland) and B (foci involving >50% of the gland). Thyroid volume, mean resistive indices, peak-systolic and end-diastolic velocities based on Doppler imaging, and vascularity index via superb microvascular imaging were obtained using a Canon Aplio 500 ultrasound device using a linear 10-14 MHz transducer., Results: Patients with HT had significantly higher median thyroid volume and peak-systolic velocities (7.32 ml and 19 cm/s, respectively) compared to control subjects (4.62 ml and 16 cm/s, respectively). HT patients had significantly higher median vascularity index (VI; 13.5%) compared to control subjects (7.95%). A significant fair positive correlation with VI and anti-thyroglobulin antibody levels (r=0.356, p<0.05) and significant moderate positive correlation with VI and anti-thyroid peroxidase antibody levels (r=0.503, p<0.05) were found. In HT diagnosis, the optimal VI cut-off value was 10.58% with a sensitivity and specificity of 67.1% and 90%, respectively., Conclusion: Superb microvascular imaging appears to allow assessment of subtle vascularity changes in early HT stages that cannot be detected by Doppler parameters. This technique demonstrates excellent visualization of the microvascular structures and quantitative assessment based on a novel parameter such as VI., (Copyright © 2018 The Royal College of Radiologists. Published by Elsevier Ltd. All rights reserved.)