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Inflammatory myofibroblastic tumors (IMTs) are rare tumors of intermediate malignant potential that can occur anywhere in the body. We describe an interesting case of a hypervascular IMT in the mediastinum that could be resected completely following em- bolization of the feeding vessels. A 17-month-old girl with complaints of cough and fever for 3 months was referred to our hospital. Computed tomography (CT) scan showed a large mass in the right hemithorax that shifted the mediastinum to the left. Primary excision was considered but not performed because there was very active capsule wall bleeding due to the hypervascular tumor. After embolization of the feeding vessels, suc- cessful complete resection was carried out. Approximately 6 weeks after the operation, follow-up CT scan showed no evidence of recurrent disease. Preoperative embolization is a good option for performing complete resection of hypervascular IMTs that could reduce the recurrence rate.

Purpose To evaluate the interobserver reproducibility of two-dimensional shear wave elastography (2D-SWE) in measuring liver stiffness (LS) and to investigate factors related to liver 2D-SWE. Materials and methods A prospective study was conducted between August 2011 and August 2012 in rheumatoid arthritis patients who had been treated with methotrexate. Interobserver reproducibility of 2D-SWE was evaluated, and the relationship between interobserver difference in LS and related factors was analyzed using linear regression analyses. We considered age, sex, alanine transaminase, cholesterol, body mass index (BMI), and waist circumference as clinical factors, and the mean value of standard deviation (SDM), its difference between two examiners, mean diameter of the regions of interest (ROIM), and its difference in the elasticity map as investigation factors. The cut-off value for significant factors to predict interobserver discrepancies in LS-based fibrosis stage was also inspected. Results In total, 176 patients were enrolled. The intraclass correlation coefficient between the two examiners was 0.784. In the univariate analysis, SDM and ROIM were independently associated with interobserver differences in LS as well as BMI, waist circumference, and the difference of ROI, but SDM and ROIM were the only ones significantly related in multivariate analysis (p

The purpose of this study was to assess the incidence of spontaneous renal artery dissection (SRAD) as a cause of acute renal infarction, and to evaluate the clinical and multidetector computed tomography (MDCT) findings of SRAD. From November 2011 to January 2014, 35 patients who were diagnosed with acute renal infarction by MDCT were included. We analyzed the 35 MDCT data sets and medical records retrospectively, and compared clinical and imaging features of SRAD with an embolism, using Fisher's exact test and the Mann-Whitney test. The most common cause of acute renal infarction was an embolism, and SRAD was the second most common cause. SRAD patients had new-onset hypertension more frequently than embolic patients. Embolic patients were found to have increased C-reactive protein (CRP) more often than SRAD patients. Laboratory results, including tests for lactate dehydrogenase (LDH) and blood urea nitrogen (BUN), and the BUN/creatinine ratio (BCR) were significantly higher in embolic patients than SRAD patients. Bilateral renal involvement was detected in embolic patients more often than in SRAD patients. MDCT images of SRAD patients showed the stenosis of the true lumen, due to compression by a thrombosed false lumen. None of SRAD patients progressed to an estimated glomerular filtration rate < 60 mL/min/1.73 m2 or to end-stage renal disease during the follow-up period. SRAD is not a rare cause of acute renal infarction, and it has a benign clinical course. It should be considered in a differential diagnosis of acute renal infarction, particularly in patients with new-onset hypertension, unilateral renal involvement, and normal ranges of CRP, LDH, BUN, and BCR., Graphical Abstract

Purpose To determine the normal values of the anterior atlantodental interval (AADI) and posterior atlantodental interval (PADI) on plain radiography, multidetector CT (MDCT) and MRI, as well as the dural sac width and spinal cord diameter at the atlantoaxial joint level on MRI. Materials and Methods In total, 60 subjects underwent plain radiography, MRI and MDCT. We obtained values for AADI and PADI on plain radiography, MDCT, and MRI, and for dural sac width and spinal cord diameter on MRI. Two radiologists independently measured each value and a consensus was reached. Results The average AADI was 1.5 ± 0.5 mm on plain radiography, 1.4 ± 0.3 mm on MDCT, and 1.6 ± 0.5 mm on MRI. The average PADI was 20.6 ± 2.4 mm on plain radiography, 18.0 ± 2.1 mm on MDCT, and 17.7 ± 1.9 mm on MRI. The dural sac width was 13.7 ± 1.8 mm, and the spinal cord diameter was 7.8 ± 0.7 mm. Interobserver agreement was 0.701-0.927 and intraobserver agreement was 0.681-0.937. Conclusion AADI values obtained on MDCT are significantly lower than those obtained on plain radiography or MRI. PADI values obtained on plain radiography are significantly higher than those obtained on MDCT or MRI. The dural sac width is most closely correlated with PADI values on MDCT. PADI seems to be easier to measure, more relevant, and clinically useful than AADI.