CincyKidsRad

Cincinnati Children's Radiology

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Coronal T1 postcontrast image of the skull shows diffuse thickening and enhancement of the calvarium. The thickening extends both superficially and deep to the cortex.

What is your differential diagnosis for this finding? #FridayQuizDay #FridayQuiz

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Coronal (image 1) and sagittal (image 2) T1-weighted images focused on the pituitary show a thickened proximal infundibulum (arrow) with increased signal and narrowing distally. Langerhans' cell histiocytosis can rarely affect the central nervous system. When the central nervous system is affected, it most commonly appears as thickening of the infundibulum. Patients may present with diabetes insipidus.](https://app.figure1.com/case-detail/0d4c72e0-2d1e-416c-a522-83b96089935d)

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Axial (image 1), coronal (image 2), and sagittal (image 3) T1-weighted post-contrast MRI focused on the pituitary show thickening of the infundibulum (arrow) and enlargement of the pituitary (arrowhead). Langerhans cell histiocytosis rarely affects the central nervous system. When it does, patients may present with diabetes insipidus, ataxia, or hydrocephalus. Diabetes insipidus is a common manifestation when the posterior pituitary and infundibulum are infiltrated by Langerhans cells. Infundibular thickening greater than 3 mm is suggestive of involvement.](https://app.figure1.com/case-detail/1673d4d6-8149-4771-a77e-1f2ed3716ef6)

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Transverse ultrasound image at midline (image 1) in infant shows elongation of the pyloric channel (solid line) and thickening of the single wall of the pylorus (dashed line). In this patient the pyloric channel measures 20.6 mm in length and 4 mm in thickness. DUring real-time ultrasound tiny amounts of liquid pass through the channel. Hypertrophic pyloric stenosis is an idiopathic thickening of the pyloric muscle leading to gastric outlet obstruction. It occurs in children between two weeks and six weeks of age and is more common in first born males. Patients present with projectile vomiting after meals. Small amounts of liquid are able to pass through the pyloric channel even with pyloric stenosis.](https://app.figure1.com/case-detail/2f32ade6-5323-44d5-8223-4240fb6f2bac)

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Four-chamber MR image of the heart shows massive thickening of the wall of the left ventricle. The thickened myocardium includes the intraventricular septum. Notice that the thickening of the septum is asymmetric with the majority of the thickening within the left ventricle. This asymmetric septal thickening is characteristic of hypertrophic cardiomyopathy.](https://app.figure1.com/case-detail/61e6dbe5-2bd2-4828-9667-8e0230fbecda)

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