The purpose of this study is to evaluate the role of diffusion-weighted imaging (DWI) in combination with T(1) and T(2) weighted MRI for the characterisation of renal carcinoma. The institutional review board approved the study protocols and waived informed consent from all of the patients. 47 patients (32 male and 15 female; age range, 21-85 years; median age, 65 years) who had suspected renal lesions on abdominal CT underwent MRI for further evaluation and characterisation of the lesions from April 2005 to August 2007 in our university hospital. A region of interest was drawn around the tumour area on apparent diffusion coefficient (ADC) maps. Final diagnosis was confirmed by histological examination of surgical specimens from all patients. The ADC value was significantly higher in renal cell carcinoma (RCC) than in transitional cell carcinoma (2.71+/-2.35 x 10(-3) mm(2) s(-1) vs 1.61+/-0.80 x 10(-3) mm(2) s(-1); p = 0.022). While analysing the histological subtypes of RCC, a significant difference in ADC values between clear cell carcinoma and non-clear cell carcinoma was found (1.59+/-0.55 x 10(-3) mm(2) s(-1) vs 6.72+/-1.85 x 10(-3) mm(2) s(-1); p = 0.0004). Similarly, ADC values of RCC revealed a significant difference between positive and negative metastatic lesions (1.06+/-0.38 x 10(-3) mm(2) s(-1) vs 3.02+/-2.44 x 10(-3) mm(2) s(-1); p = 0.0004), whereas intensity on T(1) and T(2) weighted imaging did not reach statistical significance. In conclusion, DWI has clinical value in the characterisation of renal carcinomas and could be applied in clinical practice for their management.

OBJECTIVES:To examine in patients with mood disorders the relationship of age at onset with the location and degree of MRI-defined brain hyperintensities. METHOD:Fifty-two patients diagnosed as having mood disorders and 14 controls participated in the study. Brain MR images were analyzed according to semiquantitative ratings for the anatomical distribution and severity of T2-weighted hyperintensities. We compared these hyperintensities among the three age- and sex-matched groups of late-onset mood disorder patients (LOM), early-onset mood disorder patients (EOM), and controls. The time since the onset of disorder was significantly longer in the EOM than in the LOM group. We also conducted linear multiple regression analysis using the severity of hyperintensities as dependent variable to determine whether the clinical features correlate with vascular pathology. RESULTS:As for deep white matter hyperintensity (DWMH), LOM exhibited higher ratings than EOM; as for brain areas, significant between-group differences were detected in the bilateral frontal areas and in the left parieto-occipital area. No significant difference was observed between EOM and controls. As for periventricular hyperintensity, there was no difference among the three groups. We obtained a significant regression model to predict DWMH ratings; age, number of ECTs, and LOM were selected as significant variables. CONCLUSION:The present study suggests that the time since the onset of disorder does not affect the development of white matter lesions, but that white matter lesions are associated with late-onset mood disorders. The frontal areas and the left parieto-occipital area would be important for the development of late-onset mood disorders.

Objectives: To explore neurobiological risk factors for major depressive disorder (MDD) and adjustment disorder in cancer patients by examining regional brain metabolism before psychiatric manifestation using positron emission tomography and by prospectively observing depressive and anxiety symptoms.Method: Cancer patients who showed no psychiatric symptoms when they underwent F-18-fluorodeoxyglucose positron emission tomography (F-18-FDG PET) were followed up for one year using the Hospital Anxiety and Depression Scale (HADS). Fourteen patients who showed high HADS scores and 14 patients who showed low HADS scores were assessed by a psychiatrist 2 years after the PET scan and grouped into the deterioration group (n = 10) and the no-change group (n = 9). F-18-FDG PET images were analyzed to examine the difference in local brain glucose metabolism between the two groups.Results: The deterioration group showed a decreased glucose metabolism in the right medial frontal gyrus (BA6) and an increased glucose metabolism in the right posterior cingulate (BA29), right anterior cingulate (BA25), left subcallosal gyrus (BA25), and left caudate compared with the no-change group.Conclusion: Cancer patients who later developed MDD or adjustment disorder showed regional brain metabolic changes. These regions may be associated with vulnerability to the onset of MDD or adjustment disorder in cancer patients. (c) 2006 Elsevier Ltd. All rights reserved.

A 71-year old male complaining of abdominal pain associated with gastric ulcer and right aortic arch was referred because of a suspicious mass lesion on the pancreas. Colour-Doppler ultrasound, multiphase helical computed tomography and multiphase dynamic magnetic resonance imaging revealed a right aortic arch with aberrant left subclavian artery arising from Kommerell's diverticulum (left panel),(Fig. 1) a liver with diffuse arteriovenous malformations and no mass lesions on the pancreas. A hepatic arteriogram (middle panel) confirmed the multiple intrahepatic arteriovenous malformations and intrahepatic portovenous shunts. A dilated tortuous right hepatic artery arises from the superior mesenteric artery whose distal segment is smaller than the normal. A percutaneous liver biopsy (right panel; hematoxylin–eosin stain, ×100) was performed under sonographic control and the findings were as follows: (1) anomalous venous cystic dilatation with mural sclerosis and indefinite central veins within hepatic lobules, (2) sinusoidal ectasia with congestion, (3) dilated vessels or anomalous vessels with thick walls like hepatic arteries within portal tracts, (4) neither hepatic cell loss nor inflammation or degeneration in the parenchyma. Considering radiological and histological findings and complication of right aortic arch, congenital hepatic vascular malformations were strongly suggested. However, the patient had no familiar history of heart or liver disease. Interestingly, the case was not hepatic manifestation of hereditary hemorrhagic telangiectasia and did not cause complications of congestive heart failure, portal hypertension, and hyperammonemia [ 1 Burrows P.E. Dubois J. Kassarjian A. Pediatric hepatic vascular anomalies. Pediatr Radiol. 2001; 31: 533-545 Crossref PubMed Google Scholar , 2 Gallogo C. Miralles M. Martin C. Muyor P. Gonzalez G. Garcia-Hidalgo E. Congenital hepatic shunts. Radiographics. 2004; 24: 755-772 Crossref PubMed Scopus (129) Google Scholar ]. Therefore, the patient was followed up without any treatment such as transcathether embolization or surgical resection [ [2] Gallogo C. Miralles M. Martin C. Muyor P. Gonzalez G. Garcia-Hidalgo E. Congenital hepatic shunts. Radiographics. 2004; 24: 755-772 Crossref PubMed Scopus (129) Google Scholar ]. This case is quite rare in view of the hepatic vascular malformations with combined forms of fast flow (arteriovenous) and slow flow (venous and lymphatic) with right aortic arch [ [2] Gallogo C. Miralles M. Martin C. Muyor P. Gonzalez G. Garcia-Hidalgo E. Congenital hepatic shunts. Radiographics. 2004; 24: 755-772 Crossref PubMed Scopus (129) Google Scholar ]. Our case suggests that there is a possible syndromic association of aortic and hepatic vascular malformations.