WorldWideScience

Sample records for cine mri findings

  1. Cine MRI of hypertrophic cardiomyopathy

    Cine MRI was performed using 1.5T or 0.5T MR units in eleven patients with hypertrophic cardiomyopathy. Septal and posterior wall thickness measured by cine MRI correlated well with those obtained by ultrasonographic cardiogram. In hypertrophic obstructive cardiomyopathy, cine MRI demonstrated the site and nature of obstructive change in left ventricle. Cine MRI also showed flow void due to mitral regurgitation successfully. We considered cine MRI is useful means to evaluate the anatomical and functional findings in hypertrophic cardiomyopathy. (author)

  2. Upper Airway Volume Segmentation Analysis Using Cine MRI Findings in Children with Tracheostomy Tubes

    Fricke, Bradley L.; Abbott, M. Bret; Donnelly, Lane F.; Dardzinski, Bernard J.; Poe, Stacy A.; Kalra, Maninder; Amin, Raouf S.; Cotton, Robin T.

    2007-01-01

    Objective The purpose of this study is to evaluate the airway dynamics of the upper airway as depicted on cine MRI in children with tracheotomy tubes during two states of airflow through the upper airway. Materials and Methods Sagittal fast gradient echo cine MR images of the supra-glottic airway were obtained with a 1.5T MRI scanner on seven children with tracheotomy tubes. Two sets of images were obtained with either the tubes capped or uncapped. The findings of the cine MRI were retrospect...

  3. Cine MRI of dissecting aneurysm

    Cine MRI was performed in 25 cases of aortic dissection and comparative study among cine MRI, spin-echo static MRI, contrast-enhanced CT and intravenous digital subtraction angiography (IVDSA) was made. Cine MRI accurately detected aortic dissection. It was most accurate among various diagnostic methods in demonstration of entry site of dissection. Take-off of renal artery and its relation to true and false channels was also accurately demonstrated by cine MRI. The above results suggest that cine MRI can be an important diagnostic modality with almost equal diagnostic quality to those of conventional angiography. However, further technical improvement to shorten the imaging time seems necessary to replace angiography. (author)

  4. Upper Airway Volume Segmentation Analysis Using Cine MRI Findings in Children with Tracheostomy Tubes

    The purpose of this study is to evaluate the airway dynamics of the upper airway as depicted on cine MRI in children with tracheotomy tubes during two states of airflow through the upper airway. Sagittal fast gradient echo cine MR images of the supra-glottic airway were obtained with a 1.5T MRI scanner on seven children with tracheotomy tubes. Two sets of images were obtained with either the tubes capped or uncapped. The findings of the cine MRI were retrospectively reviewed. Volume segmentation of the cine images to compare the airway volume change over time (mean volume, standard deviation, normalized range, and coefficient of variance) was performed for the capped and uncapped tubes in both the nasopharynx and hypopharynx (Signed Rank Test). Graphical representation of the airway volume over time demonstrates a qualitative increased fluctuation in patients with the tracheotomy tube capped as compared to uncapped in both the nasopharyngeal and hypopharyngeal regions of interest. In the nasopharynx, the mean airway volume (capped 2.72 mL, uncapped 2.09 mL, p = 0.0313), the airway volume standard deviation (capped 0.42 mL, uncapped 0.20 mL, p = 0.0156), and the airway volume range (capped 2.10 mL, uncapped 1.09 mL, p = 0.0156) were significantly larger in the capped group of patients. In the hypopharynx, the airway volume standard deviation (capped 1.54 mL, uncapped 0.67 mL, p = 0.0156), and the airway volume range (capped 6.44 mL, uncapped 2.93 mL, p = 0.0156) were significantly larger in the capped tubes. The coefficient of variance (capped 0.37, uncapped 0.26, p = 0.0469) and the normalized range (capped 1.52, uncapped 1.09, p = 0.0313) were significantly larger in the capped tubes. There is a statistically significant change in airway dynamics in children with tracheotomy tubes when breathing via the airway as compared to breathing via the tracheotomy tube

  5. Functional cine-MRI of the pelvic floor - normal anatomy and pathologic findings

    Purpose. Functional MRI of the pelvic floor allows mapping and definition of different forms of pelvic floor dysfunction. Methods. We performed functional MRT of the pelvic floor in 39 healthy nulliparas and 324 patients. The diagnosis of a pathological organ descent was made if certain landmarks of the pelvic floor compartments descended below the pubococcygeal reference-line (PC-line). Results. If there was no organ descent below the PC-line on straining and if the pelvic floor muscles hardly changed position, a normal finding was diagnosed. 70% of organ prolapses came in the combined form. The generally gradual development of an organ descent led to a change of the main finding in 21,6%. The masking of a cystocele (48,6%) or of an enterocele (34,3%) by a rectocele was most frequent in these cases. Discussion. The use of functional MRI of the pelvic floor appears to be especially useful in young patients, in cases of divergent clinical and sonographic or radiological findings and if the presence of a predominant hernial sac with or without enterocele/rectocele is supposed. (orig.)

  6. Functional MRI of the patellofemoral joint: comparison of ultrafast MRI, motion-triggered cine MRI and static MRI

    Muhle, C. [Klinik fuer Radiologische Diagnostik, Univ. Kiel (Germany); Brossmann, J. [Klinik fuer Radiologische Diagnostik, Univ. Kiel (Germany); Melchert, U.H. [Klinik fuer Radiologische Diagnostik, Univ. Kiel (Germany); Schroeder, C. [Radiologische Abt., Universitaets-Kinderklinik, Christian-Albrechts-Universitaet, Kiel (Germany); Boer, R. de [Philips Medical Systems, Best (Netherlands); Spielmann, R.P. [Klinik fuer Radiologische Diagnostik, Univ. Kiel (Germany); Heller, M. [Klinik fuer Radiologische Diagnostik, Univ. Kiel (Germany)

    1995-12-31

    To evaluate the feasibility and usefulness of ultrafast MRI (u), patellar tracking from 30 of flexion to knee extension (0 ) was analysed and compared with motion-triggered cine MRI (m) and a static MRI technique (s). The different imaging methods were compared in respect of the patellofemoral relationship, the examination time and image quality. Eight healthy subjects and four patients (in total 18 joints) with patellar subluxation or luxation were examined. Significant differences between the static MRI series without quadriceps contraction and the functional MRI studies (motion-triggered cine MRI and ultrafast MRI) were found for the patellar tilt angle. In the dynamic joint studies there was no statistical difference of the regression coefficients between the motion-triggered cine MRI studies and the ultrafast MRI studies. The findings of the functional MRI studies compared with the static MRI images were significantly different for the lateralisation of the patella, expressed by the lateral patellar displacement and bisect offset. No significant differences in patellar lateralisation were found between motion-triggered cine MRI and ultrafast MRI. Ultrafast MRI was superior to motion-triggered cine MRI in terms of the reduction in imaging time and improvement of the image quality. (orig.)

  7. Functional MRI of the patellofemoral joint: comparison of ultrafast MRI, motion-triggered cine MRI and static MRI

    To evaluate the feasibility and usefulness of ultrafast MRI (u), patellar tracking from 30 of flexion to knee extension (0 ) was analysed and compared with motion-triggered cine MRI (m) and a static MRI technique (s). The different imaging methods were compared in respect of the patellofemoral relationship, the examination time and image quality. Eight healthy subjects and four patients (in total 18 joints) with patellar subluxation or luxation were examined. Significant differences between the static MRI series without quadriceps contraction and the functional MRI studies (motion-triggered cine MRI and ultrafast MRI) were found for the patellar tilt angle. In the dynamic joint studies there was no statistical difference of the regression coefficients between the motion-triggered cine MRI studies and the ultrafast MRI studies. The findings of the functional MRI studies compared with the static MRI images were significantly different for the lateralisation of the patella, expressed by the lateral patellar displacement and bisect offset. No significant differences in patellar lateralisation were found between motion-triggered cine MRI and ultrafast MRI. Ultrafast MRI was superior to motion-triggered cine MRI in terms of the reduction in imaging time and improvement of the image quality. (orig.)

  8. Usefulness of cine MRI in diagnosis of cardiovascular diseases

    Cine MRI was performed on 18 patients with various cardiovascular diseases. Cine MRI was considered useful to evaluate myocardial thickness, abnormal regional wall motion and valvular regurgitation in patients with cardiac diseases, and to evaluate intimal flap, false lumen and flow of false lumen in patients with aortic dissection. In assessment of ventricular volume and ejection fraction, correlation with cine-angiographic method was not good and multiple cine MRI slices may be required for obtaining more accurate date. We concluded that cine MRI was a useful method to evaluate various cardiovascular diseases non-invasively. (author)

  9. Cine MRI of swallowing in patients with advanced oral or oropharyngeal carcinoma: a feasibility study.

    Kreeft, Anne Marijn; Rasch, Coen R N; Muller, Sara H; Pameijer, Frank A; Hallo, Eeke; Balm, Alfons J M

    2012-06-01

    Treatment of oral and oropharyngeal cancer may cause dysphagia. Purpose is to examine whether cine magnetic resonance imaging (MRI) yields additional information compared to standard examination in the evaluation of posttreatment dysphagia and mobility of oral and oropharyngeal structures. Thirty-four cine MRIs were made in 23 patients with advanced oral and oropharyngeal cancer, consisting of an MR image every 800 ms during swallowing which is compared to videofluoroscopy and quality of life questionnaires. A scoring system was applied to assess mobility on cine MR and videofluoroscopy leading to a score ranging from 9 to 17. Cine MRI of the swallowing in a midsagittal plane visualized the tumor (if located in the same plane), important anatomic structures and surgical reconstructions. Posttreatment mobility on cine MRI and videofluoroscopy was significantly diminished compared to pretreatment, mean pretreatment cine MRI score was 10.8 and posttreatment 12.4 (p = 0.017). Impaired mobility on cine MRI was significantly correlated to more swallowing problems (Spearman's correlation coefficient 0.73, p = 0.04), on videofluoroscopy not. Cine MRI is a promising new technique as an adjunct to standard examinations for evaluation of swallowing in patients with oral and oropharyngeal cancer. Cine MRI directly visualizes the dynamics of swallowing and allows evaluation of pre- and posttreatment differences. Abnormal findings are significantly correlated with subjective swallowing complaints of patients. PMID:22218846

  10. Cine MRI of patients with cervical myelopathy

    Forty-six patients with cervical myelopathy were examined before and after surgery by cine magnetic resonance imaging (MRI). According to the occurrence site and degree of flow void, cerebrospinal fluid (CSF) flow void was classified into five: anterior type (flow void mainly in the anterior part of subarachnoid space), posterior type (mainly in the posteiror part), anteroposterior type (in the anterior and posterior parts), incomplete block type (flow void limited to the upper and lower parts of the block), and complete block type (no flow void). None of the 46 patients had normal CSF flow void on cine MRI before surgery. CSF flow void was seen in systolic phase on ECG (from 150 to 300 msec from R's wave) in all patients after spinal cord decompression. Postoperative CBF flow void types correlated well with surgical method, disease, and postoperative vertebral alignment. Postoperative outcome was the most excellent in the group of posterior type and the poorest in the group of anteroposterior type, showing a significant difference between the groups. Cine MRI is a useful noninvasive, dynamic method for assessing postoperative decompression effect. (N.K.)

  11. New target device and special pillow for cine mode MRI

    To carry out cine mode MRI more easily and accurate, we developed a new target device for use with a special pillow. The device consists of a control box, light source and target plate. Red light emission diodes (LED) served on the light source and were connected to the target plate with the light guides each 1 mm in diameter. The light guides were inserted into holes in the target plate. Each target was horizontally and vertically placed at increments of 10 degrees and the maximal angle of 40 degrees. The new target can be correctly gazed at even by elderly patients. By the special pillow, the head of a patients can be easily and quickly fixed in position during examination following removal of air the pillow by vacuum pump. By this target device and pillow, cine mode MRI can be easily carried out on any subject and these should find a great appreciation in ophthalmology. (author)

  12. Motion prediction in MRI-guided radiotherapy based on interleaved orthogonal cine-MRI

    Seregni, M.; Paganelli, C.; Lee, D.; Greer, P. B.; Baroni, G.; Keall, P. J.; Riboldi, M.

    2016-01-01

    In-room cine-MRI guidance can provide non-invasive target localization during radiotherapy treatment. However, in order to cope with finite imaging frequency and system latencies between target localization and dose delivery, tumour motion prediction is required. This work proposes a framework for motion prediction dedicated to cine-MRI guidance, aiming at quantifying the geometric uncertainties introduced by this process for both tumour tracking and beam gating. The tumour position, identified through scale invariant features detected in cine-MRI slices, is estimated at high-frequency (25 Hz) using three independent predictors, one for each anatomical coordinate. Linear extrapolation, auto-regressive and support vector machine algorithms are compared against systems that use no prediction or surrogate-based motion estimation. Geometric uncertainties are reported as a function of image acquisition period and system latency. Average results show that the tracking error RMS can be decreased down to a [0.2; 1.2] mm range, for acquisition periods between 250 and 750 ms and system latencies between 50 and 300 ms. Except for the linear extrapolator, tracking and gating prediction errors were, on average, lower than those measured for surrogate-based motion estimation. This finding suggests that cine-MRI guidance, combined with appropriate prediction algorithms, could relevantly decrease geometric uncertainties in motion compensated treatments.

  13. Cardiac Tagging with Breath-Hold Cine MRI

    Mcveigh, Elliot R.; Atalar, Ergin

    1992-01-01

    A method is presented for measuring myocardial deformation in a breath-hold with tagged cine MRI. Tagged cine images of human hearts are obtained in arbitrary oblique planes on a standard imager with as few as four heartbeats. The scan time has been reduced 16- to 64-fold from previous techniques.

  14. Cine-MRI swallowing evaluation after tongue reconstruction

    Objective: To determine the feasibility of cine-MRI for non-invasive swallowing evaluation after surgery for lingual carcinoma with reconstruction using microvascular free flaps. Methods: Ten patients with stage IV carcinoma of the mobile tongue and/or tongue base treated by surgical resection and reconstruction with a free flap were evaluated after an average of 4.3 years (range: 1.5-11 years), using cine-MRI in 'single-shot fast spin echo' (SSFSE) mode. Fiberoptic laryngoscopy of swallowing was performed before MRI to detect aspiration. The tolerance and ability to complete the exam were noted. The mobilities of the oral and pharyngeal structures visualized were evaluated as normal, reduced or increased. Results: Cine-MRI was well tolerated in all cases; 'dry' swallow was performed for the 2 patients with clinical aspiration. Tongue base-pharyngeal wall contact was observed in 5 cases. An increased anterior tongue recoil, increased mandibular recoil, increased posterior oropharyngeal wall advancement and an increased laryngeal elevation were observed in 4 cases. One case of a passive 'slide' mechanism was observed. Conclusions: Cine-MRI is a safe, non-invasive technique for the evaluation of the mobility of oral and oropharyngeal structures after free-flap reconstruction of the tongue. For selected cases, it may be complementary to clinical examination for evaluation of dysphagia after surgery and free-flap reconstruction. Further technical advances will be necessary before cine-MRI can replace videofluoroscopy, however.

  15. Cine-MRI swallowing evaluation after tongue reconstruction

    Hartl, Dana M. [Department of Otolaryngology-Head and Neck Surgery, Institute Gustave Roussy, 39 rue Camille Desmoulins, 94805 Villejuif Cedex (France)], E-mail: dmhartl@aol.com; Kolb, Frederic; Bretagne, Evelyne [Department of Otolaryngology-Head and Neck Surgery, Institute Gustave Roussy, 39 rue Camille Desmoulins, 94805 Villejuif Cedex (France); Bidault, Francois; Sigal, Robert [Department of Radiology, Institut Gustave Roussy, 39 rue Camille Desmoulins, 94805 Villejuif Cedex (France)

    2010-01-15

    Objective: To determine the feasibility of cine-MRI for non-invasive swallowing evaluation after surgery for lingual carcinoma with reconstruction using microvascular free flaps. Methods: Ten patients with stage IV carcinoma of the mobile tongue and/or tongue base treated by surgical resection and reconstruction with a free flap were evaluated after an average of 4.3 years (range: 1.5-11 years), using cine-MRI in 'single-shot fast spin echo' (SSFSE) mode. Fiberoptic laryngoscopy of swallowing was performed before MRI to detect aspiration. The tolerance and ability to complete the exam were noted. The mobilities of the oral and pharyngeal structures visualized were evaluated as normal, reduced or increased. Results: Cine-MRI was well tolerated in all cases; 'dry' swallow was performed for the 2 patients with clinical aspiration. Tongue base-pharyngeal wall contact was observed in 5 cases. An increased anterior tongue recoil, increased mandibular recoil, increased posterior oropharyngeal wall advancement and an increased laryngeal elevation were observed in 4 cases. One case of a passive 'slide' mechanism was observed. Conclusions: Cine-MRI is a safe, non-invasive technique for the evaluation of the mobility of oral and oropharyngeal structures after free-flap reconstruction of the tongue. For selected cases, it may be complementary to clinical examination for evaluation of dysphagia after surgery and free-flap reconstruction. Further technical advances will be necessary before cine-MRI can replace videofluoroscopy, however.

  16. Right ventricular volume estimation with cine MRI

    To quantitate right ventricular (RV) volumes easily using cine MRI, we developed a new method called 'modified area-length method (MOAL method)'. To validate this method, we compared it to the conventional Simpson's rule. Magnetom H15 (Siemens) was used and 6 normal volunteers and 21 patients with various RV sizes were imaged with ECG triggered gradient echo method (FISP, TR 50 ms, TE 12 ms, slice thickness 9 mm). For Simpson's rule transverse images of 12 sequential views which cover whole heart were acquired. For the MOAL method, two orthogonal views were imaged. One was the sagittal view which includes RV outflow tract and the other was the coronal view defined from the sagittal image to cover the whole RV. From these images the area (As, Ac) of RV and the longest distance between RV apex and pulmonary valve (Lmax) were determined. By correlating RV volumes measured by Simpson's rule to As*Ac/Lmax the RV volume could be estimated as follows: V=0.85*As*Ac/Lmax+4.55. Thus the MOAL method demonstrated excellent accuracy to quantitate RV volume and the acquisition time abbreviated to one fifth compared with Simpson's rule. This should be a highly promising method for routine clinical application. (author)

  17. Analysis of blowout fractures using cine mode MRI

    Kawahara, Masaaki; Shiihara, Kumiko; Kimura, Hisashi; Fukai, Sakuko; Tabuchi, Akio; Kojo, Tuyoshi [Kawasaki Medical School, Kurashiki, Okayama (Japan)

    1995-07-01

    By observing conventional CT and MRI images, it is difficult to distinguish extension failure from adhesion, bone fracture or damage to the extraocular muscle, any one of which may be the direct cause of the eye movement disturbance accompanying blowout fracture. We therefore carried out dynamic analysis of eye movement disturbance using a cine mode MRI. We put seven fixation points in the gantry of the MRI and filmed eye movement disturbances by the gradient echo method, using a surface coil and holding the vision on each fixation point. We also video recorded the CRT monitor of the MRI to obtain dynamic MRI images. The subjects comprised 5 cases (7-23 years old). In 4 cases, we started orthoptic treatment, saccadic eye movement training, convergence training and fusional amplitude training after surgery, with only orthoptic treatment in the 5 th case. In all cases, fusion area improvement was recognized during training. In 2 cases examined by cine mode MRI before and after surgery, we observed improved eye movement after training, the effectiveness of which was thereby proven. Also, using cine mode MRI we were able to determine the character of incarcerated tissue and the cause of eye movement disturbance. We conclude that it blowout fracture, cine mode MRI may be useful in selecting treatment and observing its effectiveness. (author).

  18. Analysis of blowout fractures using cine mode MRI

    By observing conventional CT and MRI images, it is difficult to distinguish extension failure from adhesion, bone fracture or damage to the extraocular muscle, any one of which may be the direct cause of the eye movement disturbance accompanying blowout fracture. We therefore carried out dynamic analysis of eye movement disturbance using a cine mode MRI. We put seven fixation points in the gantry of the MRI and filmed eye movement disturbances by the gradient echo method, using a surface coil and holding the vision on each fixation point. We also video recorded the CRT monitor of the MRI to obtain dynamic MRI images. The subjects comprised 5 cases (7-23 years old). In 4 cases, we started orthoptic treatment, saccadic eye movement training, convergence training and fusional amplitude training after surgery, with only orthoptic treatment in the 5 th case. In all cases, fusion area improvement was recognized during training. In 2 cases examined by cine mode MRI before and after surgery, we observed improved eye movement after training, the effectiveness of which was thereby proven. Also, using cine mode MRI we were able to determine the character of incarcerated tissue and the cause of eye movement disturbance. We conclude that it blowout fracture, cine mode MRI may be useful in selecting treatment and observing its effectiveness. (author)

  19. Chest wall invasion by bronchogenic carcinoma. Evaluation with Cine-MRI

    With the view of examining possible chest wall invasion of bronchogenic carcinoma, Cine-MRI was performed on 22 such cases. These cases were suspected of having above chest wall invasion by CT and their histopathological findings were obtained in surgery. The judgment of the chest wall invasion by Cine-CT was made such that non-moving up and down of the tumor with respiration involves its invasion, moving of the tumor without any up-and-down movement suspects its invasion and moving up and down of the tumor with respiration involves no invasion. The chest wall invasion was observed in 5 of 7 cases of invasion judged by Cine-MRI. For 2 false-positive cases, the histopathological findings presumed that tumor cells disappeared from the chest wall invaded region as the result of preoperative chemotherapy. The above invasion was observed in 1 of 4 cases suspected of possible invasion. Correct diagnosis was formed of 11 cases judged invasion-free by Cine-MRI. The above results suggested Cine-MRI to be useful for diagnosis of chest wall invasion of bronchogenic carcinoma. (author)

  20. Postoperative cine-MRI for patients with cervical myelopathy

    Honjo, Yasuomi [Okayama Univ. (Japan). School of Medicine

    1995-07-01

    The usefulness of cine-MRI using motion pictures was studied on 75 patients with postoperative cervical myelopathy, and morphology of cervical spine and cervical cord, postoperative MRI, and postoperative outcome were investigated. T1-weighted images by SE method and T2-weighted images by gradient field echo were obtained. Cine-MR images were classified into 5 according to the site of cerebrospinal fluid flow void and its degree (anterior type, 21; anteroposterior type, 30; posterior type, 7; incomplete block type, 15; complete block type, 2), and relationship between clinical features were studied. This method enabled dynamic noninvasive evaluation of spinal cord compression by cerebrospinal fluid flow. (S.Y.).

  1. Cine MRI: a new approach to the diagnosis of scapholunate dissociation

    To evaluate the feasibility of cine MRI for the detection of scapholunate dissociation (SLD) and to compare the sensitivity and specificity of cine MRI with those of cineradiography and arthroscopy. To evaluate feasibility, healthy subjects underwent cine MRI of the wrist. To evaluate sensitivity and specificity, patients with clinically suspected scapholunate ligament (SLL) injury after trauma to the wrist were prospectively included and underwent radiographic examination, cineradiography, and cine MRI. In 25 out of 38 patients, subsequent arthroscopy was performed. Results of cineradiography and cine MRI correlated with those of arthroscopy. Cine MRI was of diagnostic quality in all healthy subjects and patients with good interrater agreement. There was excellent correlation between cineradiography and cine MRI. Scapholunate distance differed significantly between healthy subjects and patients with scapholunate dissociation (p < 0.001), but not between imaging modalities in the patient group. Cine MRI had 85 % sensitivity and 90 % specificity for the detection of SLD. Cine MRI of the wrist is a fast and reliable technique for the detection of SLD with diagnostic accuracy comparable to cineradiography. It can be easily implemented as a routine clinical MRI examination, facilitating diagnostic workup of patients with suspected SLD while avoiding radiation exposure. (orig.)

  2. Cine MRI: a new approach to the diagnosis of scapholunate dissociation

    Langner, I.; Eisenschenk, A. [University Medicine Greifswald, Division of Hand Surgery and Functional Microsurgery, Department of Trauma and Reconstructive Surgery, Greifswald (Germany); Fischer, S.; Langner, S. [University Medicine Greifswald, Institute for Diagnostic Radiology and Neuroradiology, Greifswald (Germany)

    2015-08-15

    To evaluate the feasibility of cine MRI for the detection of scapholunate dissociation (SLD) and to compare the sensitivity and specificity of cine MRI with those of cineradiography and arthroscopy. To evaluate feasibility, healthy subjects underwent cine MRI of the wrist. To evaluate sensitivity and specificity, patients with clinically suspected scapholunate ligament (SLL) injury after trauma to the wrist were prospectively included and underwent radiographic examination, cineradiography, and cine MRI. In 25 out of 38 patients, subsequent arthroscopy was performed. Results of cineradiography and cine MRI correlated with those of arthroscopy. Cine MRI was of diagnostic quality in all healthy subjects and patients with good interrater agreement. There was excellent correlation between cineradiography and cine MRI. Scapholunate distance differed significantly between healthy subjects and patients with scapholunate dissociation (p < 0.001), but not between imaging modalities in the patient group. Cine MRI had 85 % sensitivity and 90 % specificity for the detection of SLD. Cine MRI of the wrist is a fast and reliable technique for the detection of SLD with diagnostic accuracy comparable to cineradiography. It can be easily implemented as a routine clinical MRI examination, facilitating diagnostic workup of patients with suspected SLD while avoiding radiation exposure. (orig.)

  3. Assessment of left ventricular hemodynamics by Gd-DTPA enhanced high speed cine MRI

    To assess the validity of Gd-DTPA enhanced high speed cine MRI in left ventricular (LV) volumes and ejection fraction (EF), high speed cine MRI was compared with intra-venous digital subtraction left ventriculography (IV-DSA) in 14 patients. All patients underwent conventional cine MRI and Gd-DTPA enhanced high speed MRI, simultaneously. The pulse sequences of high speed MRI were TR 8 ms (TR 6 ms plus rewind pulse 2 ms), TE 3.2 ms, matrix 128, phase encode 8 or 6 and NEX 1. Comparison with LV-volume showed a high correlation (y = 0.854x + 1,699, r = 0.985) between high speed cine MRI and VI-DSA. To make left ventricular volume curve by area-length method in cine MRI, manual tracing of LV-cavity was more difficult in conventional cine MRI-method than enhanced high speed cine MRI-method. In conclusion, first pass-Gd-DTPA enhanced high speed cine MRI, using the horizontal long axis approach and the multiphase study, is a highly, accurate reproducible method of evaluating LV-volumetry. (author)

  4. Highly-Accelerated Real-Time Cardiac Cine MRI Using k-t SPARSE-SENSE

    Feng, Li; Srichai, Monvadi B.; Lim, Ruth P.; Harrison, Alexis; King, Wilson; Adluru, Ganesh; DiBella, Edward VR; Sodickson, Daniel K; Otazo, Ricardo; KIM, DANIEL

    2012-01-01

    For patients with impaired breath-hold capacity and/or arrhythmias, real-time cine MRI may be more clinically useful than breath-hold cine MRI. However, commercially available real-time cine MRI methods using parallel imaging typically yield relatively poor spatio-temporal resolution due to their low image acquisition speed. We sought to achieve relatively high spatial resolution (~2.5mm × 2.5mm) and temporal resolution (~40ms), to produce high-quality real-time cine MR images that could be a...

  5. Cine MRI of the thorax in patients with pectus excavatum

    Morphologic and dynamic assessment of respiratory chest kinetics was performed in patients with pectus excavatum deformity (PE) using dynamic MRI: cine MRI. Seven consecutive patients with PE (aged 20.3 years±4.0) and ten healthy volunteers of comparable age underwent real-time cine MRI of the chest during breathing on a 1.5 T MR scanner (Magnetom Sonata, Siemens Medical Systems, Erlangen, Germany) using a standard phased array body coil and a half-Fourier single-shot turbo spin echo sequence (HASTE) for dynamic imaging. During deep inspiration and expiration, single-shot sequences were performed in one slice level over 20 s at a frequency of 1 image/s covering the entire thoracic cage in three orientations. Morphology and chest kinetics in patients with PE were analyzed and compared with normal values, and typical patterns of chest kinetics were noted. Three different types of chest morphology in PE were identified: (1) the generally flattened thoracic cage, (2) the ''tilted'' sternum, and (3) the focally deepened sternum. Three patterns of motion correspond to these morphological types: (1) elevation of the sternum and the anterior thoracic wall, (2) angulated elevation of the parasternal rib cage with persistent deepening of the sternum resembling a ''wing beat'' movement, and (3) increased diaphragmatic movements with limited chest wall dynamics. Cine MRI is an adequate radiation-free diagnostic modality for the dynamic imaging of both chest morphology and chest wall kinetics in patients with PE. The pectus severity index can easily be determined and three typical movement patterns of chest wall kinetics identified. (orig.)

  6. Functional cine-MRI of the pelvic floor - normal anatomy and pathologic findings; Funktionelle MRT des Beckenbodens: normale Anatomie und pathologische Befunde

    Sprenger, D.; Lienemann, A.; Reiser, M. [Klinikum Grosshadern, Muenchen (Germany). Inst. fuer Radiologische Diagnostik; Anthuber, C. [Klinikum Grosshadern, Muenchen (Germany). Frauenklinik

    2000-05-01

    Purpose. Functional MRI of the pelvic floor allows mapping and definition of different forms of pelvic floor dysfunction. Methods. We performed functional MRT of the pelvic floor in 39 healthy nulliparas and 324 patients. The diagnosis of a pathological organ descent was made if certain landmarks of the pelvic floor compartments descended below the pubococcygeal reference-line (PC-line). Results. If there was no organ descent below the PC-line on straining and if the pelvic floor muscles hardly changed position, a normal finding was diagnosed. 70% of organ prolapses came in the combined form. The generally gradual development of an organ descent led to a change of the main finding in 21,6%. The masking of a cystocele (48,6%) or of an enterocele (34,3%) by a rectocele was most frequent in these cases. Discussion. The use of functional MRI of the pelvic floor appears to be especially useful in young patients, in cases of divergent clinical and sonographic or radiological findings and if the presence of a predominant hernial sac with or without enterocele/rectocele is supposed. (orig.) [German] Ziel. Die funktionelle MRT des Beckenbodens ermoeglicht die Dokumentation und Definition der verschiedenen Manifestationsformen einer Beckenbodeninsuffizienz. Methodik. Es wurde bei 39 gesunden Nulliparen und 324 Patientinnen eine funktionelle MRT des Beckenbodens durchgefuehrt. Ein pathologischer Organdeszensus wurde dokumentiert, wenn bestimmte Kennstrukturen der Beckenbodenkompartimente unterhalb der pubokokygealen Referenzlinie (PC-Linie) zu liegen kamen. Ergebnisse. Beim Normalbefund zeigt sich unter Pressen kein Deszensus der Kennstrukturen unterhalb der PC-Linie und die Beckenbodenmuskulatur veraendert ihre Position kaum. In 70% fand sich die kombinierte Form eines Organdeszensus. Die meist stufenweise Entwicklung eines Organvorfalles fuehrte bei 21.6% zu einem Wechsel des Hauptbefundes. Am haeufigsten war hierbei die Maskierung einer Zystozele (48,6%) oder einer Enterozele (34,3%) durch eine Rektozele. Diskussion. Der Einsatz der funktionellen MRT des Beckens erscheint insbesondere bei jungen Patientinnen gerechtfertigt, und in Faellen, in denen klinische und sonographische oder roentgenologische Befunde divergieren sowie bei einem vermuteten dominanten Brucksack mit oder ohne Peritoneozele, bzw. Enterozele. (orig.)

  7. Kinematic analysis of the knee joint by cine MRI

    In order to obtain the MR imaging of a moving knee joint, we developed a drive system of the knee. A reciprocating reversible motor with a rope and pulleys drove a knee brace with the knee bending and extending every two seconds. Using photo sensor probe for gating cine acquisition, we got 16-time frames/cycle MR images. Such as articular cartilage, ligaments and synovial fluid, the fine components of a moving knee joint were clearly seen. In a dynamic display, these cine images demonstrated 'actual' movement of the knee joint. Moving joint fluid and defect of anterior cruciate ligament were demonstrated in the case of knee injury. These findings were not seen on static images. Cine MR imaging was also helpful for evaluating the chronic joint disease and ligament reconstruction. Through the use of the present drive system and cine acquisition, dynamic MR imaging of a moving knee joint is clearly demonstrated and it may provide useful information in the kinematic analysis of the normal and pathologic knee. (author)

  8. Kinematic analysis of the knee joint by cine MRI

    Niitsu, Mamoru; Akisada, Masayoshi; Anno, Izumi; Matsumoto, Kunihiko; Kuno, Shin-ya; Miyakawa, Shunpei (Tsukuba Univ., Ibaraki (Japan). Inst. of Clinical Medicine); Inouye, Tamon; Kose, Katsumi

    1989-08-01

    In order to obtain the MR imaging of a moving knee joint, we developed a drive system of the knee. A reciprocating reversible motor with a rope and pulleys drove a knee brace with the knee bending and extending every two seconds. Using photo sensor probe for gating cine acquisition, we got 16-time frames/cycle MR images. Such as articular cartilage, ligaments and synovial fluid, the fine components of a moving knee joint were clearly seen. In a dynamic display, these cine images demonstrated 'actual' movement of the knee joint. Moving joint fluid and defect of anterior cruciate ligament were demonstrated in the case of knee injury. These findings were not seen on static images. Cine MR imaging was also helpful for evaluating the chronic joint disease and ligament reconstruction. Through the use of the present drive system and cine acquisition, dynamic MR imaging of a moving knee joint is clearly demonstrated and it may provide useful information in the kinematic analysis of the normal and pathologic knee. (author).

  9. Cine PC-MRI measurements of blood flow in the human aorta

    Recent development in cine phase contrast MRI (PC-MRI) allows us to measure the blood flow in the human body more quantitatively. In order to analyze the aortic flow in detail, we measured the aortic flow at the several planes of the aorta using the cine PC-MRI. We clarified the characteristics of the blood flow such as the direction of skew and the development of secondary flows in the aorta both in time and space. (author)

  10. Research on the setting up the slice direction in cine-MRI scanning of the temporomandibular joint

    Baba, Shunsuke; Fukushima, Atsuo; Hori, Nobutaka [Kyoto Prefectural Univ. of Medicine (Japan). Dept. of Dentistry; Tanaka, Masahiro; Kawazoe, Takayoshi

    1994-12-01

    A thorough grasp of the dynamic correlation with the articular frames in the mandibular movements is useful for the diagnosis of craniomandibular disorders using the cine images in MRI examination. The present article compared cine images obtained from three directions, which were lateral pterygoid muscle, mandibular ramus, and the mandibular movements to obtain transversal images. The results obtained were as follows. The slice in the direction of the lateral pterygoid muscle was very advantageous for observation of the lateral pterygoid muscle and the maxillary artery. The slice in the direction of the mandibular movements had a slight predominance over the other two slices with respect to the dynamic grasp of positional relationships in the articular frames. These findings suggested that the slice direction suitable for scanning in cine-MRI should be selected. (author).

  11. Research on the setting up the slice direction in cine-MRI scanning of the temporomandibular joint

    A thorough grasp of the dynamic correlation with the articular frames in the mandibular movements is useful for the diagnosis of craniomandibular disorders using the cine images in MRI examination. The present article compared cine images obtained from three directions, which were lateral pterygoid muscle, mandibular ramus, and the mandibular movements to obtain transversal images. The results obtained were as follows. The slice in the direction of the lateral pterygoid muscle was very advantageous for observation of the lateral pterygoid muscle and the maxillary artery. The slice in the direction of the mandibular movements had a slight predominance over the other two slices with respect to the dynamic grasp of positional relationships in the articular frames. These findings suggested that the slice direction suitable for scanning in cine-MRI should be selected. (author)

  12. Comparison of standard, prone and cine MRI in the evaluation of tethered cord

    Singh, Sukhjinder [Cohen Children' s Medical Center, Department of Radiology, New Hyde Park, NY (United States); Kline-Fath, Beth; Racadio, Judy M. [Cincinnati Children' s Hospital Medical Center, Department of Radiology, Cincinnati, OH (United States); Bierbrauer, Karin [Cincinnati Children' s Hospital Medical Center, Department of Neurosurgery, Cincinnati, OH (United States); Salisbury, Shelia; Macaluso, Maurizio [Cincinnati Children' s Hospital Medical Center, Division of Biostatistics and Epidemiology, Cincinnati, OH (United States); Jackson, Elizabeth C. [Cincinnati Children' s Hospital Medical Center, Department of Pediatrics, Division of Nephrology, Cincinnati, OH (United States); Egelhoff, John C. [Cincinnati Children' s Hospital Medical Center, Department of Radiology, Cincinnati, OH (United States); Phoenix Children' s Hospital, Department of Radiology, Phoenix, AZ (United States)

    2012-06-15

    Tethered cord syndrome (TCS) is defined by abnormal traction on the spinal cord that confines its movement. Surgical cord release usually stops neurological deterioration; therefore, early and accurate neuroradiological diagnosis is important. Supine MRI is the imaging modality of choice, but prone MRI and cine MRI can demonstrate cord movement. We compared the diagnostic accuracies of standard MRI, prone MRI and cine MRI in patients with clinical suspicion of TCS and evaluated inter-reader reliability for MR imaging. Children who underwent MRI for suspicion of TCS were retrospectively identified. Supine, prone and cine MRI studies were re-read by two pediatric neuroradiologists. Conus level, filum appearance and cord movement were documented. Thirteen of 49 children had tethered cord documented at surgery. Conus level had the highest diagnostic accuracy (sensitivity 69-77%, specificity 94%, positive predictive value 82-83%, negative predictive value 89-92%, correct diagnosis 88-90%) and highest between-reader concordance (98%). Prone and cine MRI did not add to the accuracy of the supine imaging. Conus level provides the highest diagnostic accuracy and inter-reader reliability in TCS. Until a larger series is evaluated, it remains questionable whether prone or cine MRI provides enough additional diagnostic information to warrant routine use. (orig.)

  13. Comparison of standard, prone and cine MRI in the evaluation of tethered cord

    Tethered cord syndrome (TCS) is defined by abnormal traction on the spinal cord that confines its movement. Surgical cord release usually stops neurological deterioration; therefore, early and accurate neuroradiological diagnosis is important. Supine MRI is the imaging modality of choice, but prone MRI and cine MRI can demonstrate cord movement. We compared the diagnostic accuracies of standard MRI, prone MRI and cine MRI in patients with clinical suspicion of TCS and evaluated inter-reader reliability for MR imaging. Children who underwent MRI for suspicion of TCS were retrospectively identified. Supine, prone and cine MRI studies were re-read by two pediatric neuroradiologists. Conus level, filum appearance and cord movement were documented. Thirteen of 49 children had tethered cord documented at surgery. Conus level had the highest diagnostic accuracy (sensitivity 69-77%, specificity 94%, positive predictive value 82-83%, negative predictive value 89-92%, correct diagnosis 88-90%) and highest between-reader concordance (98%). Prone and cine MRI did not add to the accuracy of the supine imaging. Conus level provides the highest diagnostic accuracy and inter-reader reliability in TCS. Until a larger series is evaluated, it remains questionable whether prone or cine MRI provides enough additional diagnostic information to warrant routine use. (orig.)

  14. Feasibility study to assess clinical applications of 3-T cine MRI coupled with synchronous audio recording during speech in evaluation of velopharyngeal insufficiency in children

    In the past decade, there has been increased utilization of magnetic resonance imaging (MRI) in evaluating and understanding velopharyngeal insufficiency (VPI). To our knowledge, none of the prior studies with MRI has simultaneously linked the audio recordings of speech during cine MRI acquisition with the corresponding images and created a video for evaluating VPI. To develop an MRI protocol with static and cine sequences during phonation to evaluate for VPI in children and compare the findings to nasopharyngoscopy and videofluoroscopy. Five children, ages 8-16 years, with known VPI, who had previously undergone nasopharyngoscopy and videofluoroscopy, were included. MRI examination was performed on a 3-T Siemens scanner. Anatomical data was obtained using an isotropic T2-weighted 3-D SPACE sequence with multiplanar reformation capability. Dynamic data was obtained using 2-D FLASH cine sequences of the airway in three imaging planes during phonation. Audio recordings were captured by a MRI compatible optical microphone. All five cases had MRI and nasopharyngoscopy and four had videofluoroscopy performed. VPI was identified by MRI in all five patients. The location and severity of the velopharyngeal gap, closure pattern, velar size and shape and levator veli palatini (LVP) muscle were identified in all patients. MRI was superior in visualizing the integrity of the LVP muscle. MRI was unable to identify hemipalatal weakness in one case. In a case of stress-induced VPI, occurring only during clarinet playing, cine MRI demonstrated discordant findings of a velopharyngeal gap during phonatory tasks but not with instrument playing. Overall, there was satisfactory correlation among MRI, nasopharyngoscopy and videofluoroscopy findings. Cine MRI of the airway during speech is a noninvasive, well-tolerated diagnostic imaging tool that has the potential to serve as a guide prior to and after surgical correction of VPI. MRI provided superior anatomical detail of the levator musculature. The creation of a video with recorded phonation allowed correlation between palatal movements and specific phonatory tasks. (orig.)

  15. Feasibility study to assess clinical applications of 3-T cine MRI coupled with synchronous audio recording during speech in evaluation of velopharyngeal insufficiency in children

    Sagar, Pallavi; Nimkin, Katherine [Massachusetts General Hospital, Department of Radiology, Division of Pediatric Radiology, Boston, MA (United States)

    2014-08-16

    In the past decade, there has been increased utilization of magnetic resonance imaging (MRI) in evaluating and understanding velopharyngeal insufficiency (VPI). To our knowledge, none of the prior studies with MRI has simultaneously linked the audio recordings of speech during cine MRI acquisition with the corresponding images and created a video for evaluating VPI. To develop an MRI protocol with static and cine sequences during phonation to evaluate for VPI in children and compare the findings to nasopharyngoscopy and videofluoroscopy. Five children, ages 8-16 years, with known VPI, who had previously undergone nasopharyngoscopy and videofluoroscopy, were included. MRI examination was performed on a 3-T Siemens scanner. Anatomical data was obtained using an isotropic T2-weighted 3-D SPACE sequence with multiplanar reformation capability. Dynamic data was obtained using 2-D FLASH cine sequences of the airway in three imaging planes during phonation. Audio recordings were captured by a MRI compatible optical microphone. All five cases had MRI and nasopharyngoscopy and four had videofluoroscopy performed. VPI was identified by MRI in all five patients. The location and severity of the velopharyngeal gap, closure pattern, velar size and shape and levator veli palatini (LVP) muscle were identified in all patients. MRI was superior in visualizing the integrity of the LVP muscle. MRI was unable to identify hemipalatal weakness in one case. In a case of stress-induced VPI, occurring only during clarinet playing, cine MRI demonstrated discordant findings of a velopharyngeal gap during phonatory tasks but not with instrument playing. Overall, there was satisfactory correlation among MRI, nasopharyngoscopy and videofluoroscopy findings. Cine MRI of the airway during speech is a noninvasive, well-tolerated diagnostic imaging tool that has the potential to serve as a guide prior to and after surgical correction of VPI. MRI provided superior anatomical detail of the levator musculature. The creation of a video with recorded phonation allowed correlation between palatal movements and specific phonatory tasks. (orig.)

  16. Numerical and In Vivo Validation of Fast Cine DENSE MRI for Quantification of Regional Cardiac Function

    Feng, Li; Donnino, Robert; Babb, James; Axel, Leon; KIM, DANIEL

    2009-01-01

    Quantitative assessment of regional cardiac function can improve the accuracy of detecting wall motion abnormalities due to heart disease. While recently developed fast cine displacement-encoded with stimulated echoes (DENSE) MRI is a promising modality for the quantification of regional myocardial function, it has not been validated for clinical applications. The purpose of this study, therefore, was to validate the accuracy of fast cine DENSE MRI with numerical simulation and in vivo experi...

  17. Prostate gland motion assessed with cine-magnetic resonance imaging (cine-MRI)

    Purpose: To quantify prostate motion during a radiation therapy treatment using cine-magnetic resonance imaging (cine-MRI) for time frames comparable to that expected in an image-guided radiation therapy treatment session (20-30 min). Materials and Methods: Six patients undergoing radiation therapy for prostate cancer were imaged on 3 days, over the course of therapy (Weeks 1, 3, and 5). Four hundred images were acquired during the 1-h MRI session in 3 sagittal planes through the prostate at 6-s intervals. Eleven anatomic points of interest (POIs) have been used to characterize prostate/bony pelvis/abdominal wall displacement. Motion traces and standard deviation for each of the 11 POIs have been determined. The probability of displacement over time has also been calculated. Results: Patients were divided into 2 groups according to rectal filling status: full vs. empty rectum. The displacement of POIs (standard deviation) ranged from 0.98 to 1.72 mm for the full-rectum group and from 0.68 to 1.04 mm for the empty-rectum group. The low standard deviations in position (2 mm or less) would suggest that these excursions have a low frequency of occurrence. The most sensitive prostate POI to rectal wall motion was the midposterior with a standard deviation of 1.72 mm in the full-rectum group vs. 0.79 mm in the empty-rectum group (p 0.0001). This POI has a 10% probability of moving more than 3 mm in a time frame of ∼1 min if the rectum is full vs. ∼20 min if the rectum is empty. Conclusion: Motion of the prostate and seminal vesicles during a time frame similar to a standard treatment session is reduced compared to that reported in interfraction studies. The most significant predictor for intrafraction prostate motion is the status of rectal filling. A prostate displacement of <3 mm (90%) can be expected for the 20 min after the moment of initial imaging for patients with an empty rectum. This is not the case for patients presenting with full rectum. The determination of appropriate intrafraction margins in radiation therapy to accommodate the time-dependent uncertainty in positional targeting is a topic of ongoing investigations for the on-line image guidance model

  18. Diagnosis of atrial septal defect by the combined use of spin echo method and cine MRI

    The purpose of this study is to clarify the usefulness of magnetic resonance imaging (MRI), especially of cine MRI, in the diagnosis of atrial septal defect (ASD) with or without associated anomalies. Thirty patients were studied by MRI and they consisted of 15 patients with ASD and 15 control patients with cardiac disease other than ASD. Horizontal and sagittal sections of the whole heart were obtained using spin-echo sequence (SE) and the multi-phase images of four-chamber plane were obtained using cine MRI. By SE, the defect of interatrial septum was visualized in all 15 patients with ASD, but the similar pattern was also observed in 3 of 15 control patients. By cine MRI, the shunt flow through the defect was visualized as a relatively high signal area accompanied with low signal areas on both sides. When using the criteria of the presence of both the defect and the shunt flow by cine MRI, all of the 15 patients with ASD and the 15 control patients were correctly diagnosed. On the other hand, SE was very useful in the diagnosis of the anomalies associated with ASD, especially in 3 patients with anomalous pulmonary venous drainage. Thus, the combined use of cine MRI with SE is useful for the diagnosis of ASD and its associated anomalies. (author)

  19. Cine MRI of swallowing in patients with advanced oral or oropharyngeal carcinoma: a feasibility study

    Kreeft, Anne Marijn; Rasch, Coen R.N.; Muller, Sara H.; Pameijer, Frank A; Hallo, Eeke; Balm, Alfons J. M.

    2012-01-01

    Treatment of oral and oropharyngeal cancer may cause dysphagia. Purpose is to examine whether cine magnetic resonance imaging (MRI) yields additional information compared to standard examination in the evaluation of posttreatment dysphagia and mobility of oral and oropharyngeal structures. Thirty-four cine MRIs were made in 23 patients with advanced oral and oropharyngeal cancer, consisting of an MR image every 800 ms during swallowing which is compared to videofluoroscopy and quality of life...

  20. SU-E-J-192: Verification of 4D-MRI Internal Target Volume Using Cine MRI

    Lafata, K; Czito, B; Palta, M; Bashir, M; Yin, F; Cai, J [Duke University Medical Center, Durham, NC (United States)

    2014-06-01

    Purpose: To investigate the accuracy of 4D-MRI in determining the Internal Target Volume (ITV) used in radiation oncology treatment planning of liver cancers. Cine MRI is used as the standard baseline in establishing the feasibility and accuracy of 4D-MRI tumor motion within the liver. Methods: IRB approval was obtained for this retrospective study. Analysis was performed on MR images from four patients receiving external beam radiation therapy for liver cancer at our institution. Eligible patients received both Cine and 4D-MRI scans before treatment. Cine images were acquired sagittally in real time at a slice bisecting the tumor, while 4D images were acquired volumetrically. Cine MR DICOM headers were manipulated such that each respiratory frame was assigned a unique slice location. This approach permitted the treatment planning system (Eclipse, Varian Medical Systems) to recognize a complete respiratory cycle as a “volume”, where the gross tumor was contoured temporally. Software was developed to calculate the union of all frame contours in the structure set, resulting in the corresponding plane of the ITV projecting through the middle of the tumor, defined as the Internal Target Area (ITA). This was repeated for 4D-MRI, at the corresponding slice location, allowing a direct comparison of ITAs obtained from each modality. Results: Four patients have been analyzed. ITAs contoured from 4D-MRI correlate with contours from Cine MRI. The mean error of 4D values relative to Cine values is 7.67 +/− 2.55 %. No single ITA contoured from 4D-MRI demonstrated more than 10.5 % error compared to its Cine MRI counterpart. Conclusion: Motion management is a significant aspect of treatment planning within dynamic environments such as the liver, where diaphragmatic and cardiac activity influence plan accuracy. This small pilot study suggests that 4D-MRI based ITA measurements agree with Cine MRI based measurements, an important step towards clinical implementation. NIH 1R21CA165384-01A1.

  1. SU-E-J-192: Verification of 4D-MRI Internal Target Volume Using Cine MRI

    Purpose: To investigate the accuracy of 4D-MRI in determining the Internal Target Volume (ITV) used in radiation oncology treatment planning of liver cancers. Cine MRI is used as the standard baseline in establishing the feasibility and accuracy of 4D-MRI tumor motion within the liver. Methods: IRB approval was obtained for this retrospective study. Analysis was performed on MR images from four patients receiving external beam radiation therapy for liver cancer at our institution. Eligible patients received both Cine and 4D-MRI scans before treatment. Cine images were acquired sagittally in real time at a slice bisecting the tumor, while 4D images were acquired volumetrically. Cine MR DICOM headers were manipulated such that each respiratory frame was assigned a unique slice location. This approach permitted the treatment planning system (Eclipse, Varian Medical Systems) to recognize a complete respiratory cycle as a “volume”, where the gross tumor was contoured temporally. Software was developed to calculate the union of all frame contours in the structure set, resulting in the corresponding plane of the ITV projecting through the middle of the tumor, defined as the Internal Target Area (ITA). This was repeated for 4D-MRI, at the corresponding slice location, allowing a direct comparison of ITAs obtained from each modality. Results: Four patients have been analyzed. ITAs contoured from 4D-MRI correlate with contours from Cine MRI. The mean error of 4D values relative to Cine values is 7.67 +/− 2.55 %. No single ITA contoured from 4D-MRI demonstrated more than 10.5 % error compared to its Cine MRI counterpart. Conclusion: Motion management is a significant aspect of treatment planning within dynamic environments such as the liver, where diaphragmatic and cardiac activity influence plan accuracy. This small pilot study suggests that 4D-MRI based ITA measurements agree with Cine MRI based measurements, an important step towards clinical implementation. NIH 1R21CA165384-01A1

  2. Automated motion estimation for 2-D cine DENSE MRI.

    Gilliam, Andrew D; Epstein, Frederick H

    2012-09-01

    Cine displacement encoding with stimulated echoes (DENSE) is a magnetic resonance (MR) method that directly encodes tissue displacement into MR phase images. This technique has successfully interrogated many forms of tissue motion, but is most commonly used to evaluate cardiac mechanics. Currently, motion analysis from cine DENSE images requires manually delineated anatomical structures. An automated analysis would improve measurement throughput, simplify data interpretation, and potentially access important physiological information during the MR exam. In this paper, we present the first fully automated solution for the estimation of tissue motion and strain from 2-D cine DENSE data. Results using both simulated and human cardiac cine DENSE data indicate good agreement between the automated algorithm and the standard semi-manual analysis method. PMID:22575669

  3. Three-dimensional MRI-linac intra-fraction guidance using multiple orthogonal cine-MRI planes

    The introduction of integrated MRI-radiation therapy systems will offer live intra-fraction imaging. We propose a feasible low-latency multi-plane MRI-linac guidance strategy. In this work we demonstrate how interleaved acquired, orthogonal cine-MRI planes can be used for low-latency tracking of the 3D trajectory of a soft-tissue target structure. The proposed strategy relies on acquiring a pre-treatment 3D breath-hold scan, extracting a 3D target template and performing template matching between this 3D template and pairs of orthogonal 2D cine-MRI planes intersecting the target motion path. For a 60 s free-breathing series of orthogonal cine-MRI planes, we demonstrate that the method was capable of accurately tracking the respiration related 3D motion of the left kidney. Quantitative evaluation of the method using a dataset designed for this purpose revealed a translational error of 1.15 mm for a translation of 39.9 mm. We have demonstrated how interleaved acquired, orthogonal cine-MRI planes can be used for online tracking of soft-tissue target volumes. (paper)

  4. Automated Motion Estimation for 2D Cine DENSE MRI

    Gilliam, Andrew D; Epstein, Frederick. H.

    2012-01-01

    Cine displacement encoding with stimulated echoes (DENSE) is a magnetic resonance (MR) method that directly encodes tissue displacement into MR phase images. This technique has successfully interrogated many forms of tissue motion, but is most commonly used to evaluate cardiac mechanics. Currently, motion analysis from cine DENSE images requires manually delineated anatomical structures. An automated analysis would improve measurement throughput, simplify data interpretation, and potentially ...

  5. Three-dimensional MRI-linac intra-fraction guidance using multiple orthogonal cine-MRI planes

    Bjerre, Troels; Crijns, Sjoerd; Rosenschöld, Per Munck af; Aznar, Marianne; Specht, Lena; Larsen, Rasmus; Keall, Paul

    2013-01-01

    the 3D trajectory of a soft-tissue target structure. The proposed strategy relies on acquiring a pre-treatment 3D breath-hold scan, extracting a 3D target template and performing template matching between this 3D template and pairs of orthogonal 2D cine-MRI planes intersecting the target motion path....... For a 60 s free-breathing series of orthogonal cine-MRI planes, we demonstrate that the method was capable of accurately tracking the respiration related 3D motion of the left kidney. Quantitative evaluation of the method using a dataset designed for this purpose revealed a translational error of 1...

  6. Evaluation of pulmonary arterial morphology and function in cyanotic congenital heart disease by MRI and cine MRI

    Pulmonary arterial anatomy was evaluated by magnetic resonance imaging (MRI), angiography and two-dimensional echocardiography in 20 patients with cyanotic heart disease associated with decreased pulmonary blood flow. Excellent correlation between MRI and angiographic estimates of pulmonary artery diameter was obtained (main pulmonary artery, r=0.87; right pulmonary artery, r=0.96; left pulmonary artery, r=0.95). However, echocardiography could not describe peripheral pulmonary arteries obviously, especially left pulmonary artery. In the assessment of peripheral pulmonary stenosis or obstruction, cine MRI was superior to echocardiography. We conclude that MRI and cine MRI will play an important role in the serial evaluation of pulmonary arterial morphology and function in patients with cyanotic congenital heart disease before and after surgical repair. (author)

  7. Sialoblastoma: MRI findings

    Yekeler, Ensar; Dursun, Memduh; Ucar, Adem; Genchellac, Hakan; Acunas, Gulden [Istanbul Faculty of Medicine, Department of Radiology, Istanbul (Turkey); Gun, Feryal; Kilincaslan, Huseyin [Istanbul Faculty of Medicine, Department of Paediatric Surgery, Istanbul (Turkey)

    2004-12-01

    Sialoblastoma is a rare, aggressive and potentially malignant salivary gland tumour diagnosed in the neonatal period. A total of 28 cases have been reported in the literature, but reports of the imaging findings are limited. We describe a neonate with a right parotid sialoblastoma. MRI showed a large facial mass, which was mostly hypointense to the brain on T1-weighted images and mildly hyperintense on T2-weighted images. There were foci of haemorrhage and necrosis. Heterogeneous and weak contrast enhancement was detected on contrast-enhanced images. The tumour invaded the maxilla and adjacent muscles. (orig.)

  8. Three-dimensional cine MRI in free-breathing infants and children with congenital heart disease

    Patients with congenital heart disease frequently have complex cardiac and vascular malformations requiring detailed non-invasive diagnostic evaluation including functional parameters. To evaluate the morphological and functional information provided by a novel 3-D cine steady-state free-precession (SSFP) sequence. Twenty consecutive children (mean age 2.2 years, nine boys) were examined using a 1.5-T MR system including 2-D cine gradient-recalled-echo sequences, static 3-D SSFP and 3-D cine SSFP sequences. Measurement of ventricular structures and volumes showed close agreement between the 3-D cine SSFP sequence and the 2-D cine gradient-recalled-echo and static 3-D SSFP sequences (left ventricular volumes mean difference 1.0-1.9 ml and 8.8-11.4%, respectively; right ventricular volumes 1.7-2.1 ml and 9.9-16.9%, respectively). No systematic bias was observed. 3-D cine MRI provides anatomic as well as functional information with sufficient spatial and temporal resolution in free-breathing infants with congenital heart disease. (orig.)

  9. Three-dimensional cine MRI in free-breathing infants and children with congenital heart disease

    Seeger, Achim; Fenchel, Michael C.; Kramer, Ulrich; Bretschneider, Christiane; Doering, Joerg; Claussen, Claus D.; Miller, Stephan [University of Tuebingen (Germany). Department of Diagnostic and Interventional Radiology; Greil, Gerald F. [St. Thomas Hospital, Division of Imaging Sciences, King' s College London (United Kingdom); Martirosian, Petros [University of Tuebingen, Section of Experimental Radiology, Tuebingen (Germany); Sieverding, Ludger [University of Tuebingen, Department of Pediatric Cardiology, Tuebingen (Germany)

    2009-12-15

    Patients with congenital heart disease frequently have complex cardiac and vascular malformations requiring detailed non-invasive diagnostic evaluation including functional parameters. To evaluate the morphological and functional information provided by a novel 3-D cine steady-state free-precession (SSFP) sequence. Twenty consecutive children (mean age 2.2 years, nine boys) were examined using a 1.5-T MR system including 2-D cine gradient-recalled-echo sequences, static 3-D SSFP and 3-D cine SSFP sequences. Measurement of ventricular structures and volumes showed close agreement between the 3-D cine SSFP sequence and the 2-D cine gradient-recalled-echo and static 3-D SSFP sequences (left ventricular volumes mean difference 1.0-1.9 ml and 8.8-11.4%, respectively; right ventricular volumes 1.7-2.1 ml and 9.9-16.9%, respectively). No systematic bias was observed. 3-D cine MRI provides anatomic as well as functional information with sufficient spatial and temporal resolution in free-breathing infants with congenital heart disease. (orig.)

  10. Evaluation of right ventricular regional wall motion in inferior myocardial infarction by cine MRI

    The purpose of this study is to evaluate right ventricular regional wall motion in inferior myocardial infarction by cine MRI. Thirteen patients with inferior myocardial infarction were investigated by cine MRI and were divided into proximal group which consisted of seven patients: >90% stenosis in segment 1 or 2 of right coronary artery and distal group which consisted of six patients: >90% stenosis in segment 3 or 4 of right coronary artery. Cine MRI was performed by 1.5 tesla magnet system (Signa, GE). To depict the regional asynergy, right ventricular wall was divided into 6 segments as follows: Segments 1 and 2 were upper and lower segments in transverse planes, respectively. Segments 3 and 4 were free wall and diaphragmatic segments of outflow tract, and segments 5 and 6 were of inflow tract in sagittal planes. Our results were as follows: (1) In proximal group, right ventricular asynergy was detected in six patients but in distal group it was detected in only one patient; (2) Right ventricular asynergy was detected most frequently at diaphragmatic segments in sagittal planes; (3) All the patients who had shown the hemodynamic deterioration of right ventricle on acute phase of inferior myocardial infarction presented the broad asynergy in right ventricle; (4) Cine MRI is clinically useful in evaluating right ventricular regional wall movement and diagnosing right ventricular infarction. (author)

  11. Dynamic change in size of the lateral ventricle evaluated by cine MRI

    CSF pulsation suggests variation in the size of the cerebral ventricle during the cardiac cycle. CINE MRI, which is a useful technique for observation of the pulsatile CSF flow, demonstrates a dynamic change in size of the lateral ventricle. CINE MRI was performed on a 0.5 tesla MR imaging system (SMT-50, SHIMADZU). Sixteen different phased images during cardiac cycle were made by a gradient acho technique (STAGE: Short Tip Angle Gradient Echo, TE=14 msec, Flip Angle=30deg). From the measurement of the lateral ventricular areas of two different phases of CINE MRI during cadiac cycle, variation rate of cerebral ventricular area (VRCVA) was calculated. Twenty-five normal volunteers (14 younger adults aged 27-44 years, 11 older adults aged 56-73 years) and six cases of marked diffuse cerebral atrophy were studied. The results included: The mean VRCVA of younger adults was 14.4% (at right body of lateral ventricle) ∼ 30.0% (at left anterior horn of lateral ventricle). The mean VRCVA of younger adults is higher than the mean VRCVA of older adults. In the cases of marked diffuse cerebral atrophy, the mean VRCVA was very lower than the mean VRCVA of older adults. VRCVA of lateral ventricle calculated from CINE MRI seemed to have a good relationship to the brain elasticity. This noninvasive method would be used as an indication of the elastic response of the ventricles and the surrounding brain. (J.P.N.)

  12. Experimental study on quantitative evaluation of slow pulsatile flow of CSF with cine MRI

    The present study was designed to evaluate the slow pulsatile flow of cerebrospinal fluid (CSF) quantitatively with cine MRI in phantom experiment for the clinical application. The flow phantom was constructed from a plastic tube with a narrow channel to represent the central aqueduct. The phantom was filled with water to represent the CSF. The second tube filled with stationary water was positioned beside the flow phantom and acted as a control for no-flow signal strength. The ratio of signal intensity in regions of interest for the flow phantom and the control was measured. Not only the actual velocity curve of the flowing water through the phantom but also the temporal profile of signal intensity showed two main peaks with other small peaks in one cycle. This suggested a close relationship between signal intensity of cine MRI and flow velocity. A significant correlation between the signal intensity ratio and the velocity was obtained on cine MRI pulse sequences. Cine MRI was thus found to have the ability to give quantitative information about slow pulsatile flow. The most suitable pulse sequence was fast imaging with steady state free precession pulse sequence at the flip angle between 50 and 90 degrees. This preliminary study suggests that the slow pulsatile flow of CSF passing along the aqueduct can be visualized and measured. Thus, the sequence proposed has a potential for the investigation of normal and disturbed CSF circulation and the mapping of the flow pattern in different pathological conditions. (N.K.)

  13. Compressed sensing reconstruction of cardiac cine MRI using golden angle spiral trajectories

    Tolouee, Azar; Alirezaie, Javad; Babyn, Paul

    2015-11-01

    In dynamic cardiac cine Magnetic Resonance Imaging (MRI), the spatiotemporal resolution is limited by the low imaging speed. Compressed sensing (CS) theory has been applied to improve the imaging speed and thus the spatiotemporal resolution. The purpose of this paper is to improve CS reconstruction of under sampled data by exploiting spatiotemporal sparsity and efficient spiral trajectories. We extend k-t sparse algorithm to spiral trajectories to achieve high spatio temporal resolutions in cardiac cine imaging. We have exploited spatiotemporal sparsity of cardiac cine MRI by applying a 2D + time wavelet-Fourier transform. For efficient coverage of k-space, we have used a modified version of multi shot (interleaved) spirals trajectories. In order to reduce incoherent aliasing artifact, we use different random undersampling pattern for each temporal frame. Finally, we have used nonuniform fast Fourier transform (NUFFT) algorithm to reconstruct the image from the non-uniformly acquired samples. The proposed approach was tested in simulated and cardiac cine MRI data. Results show that higher acceleration factors with improved image quality can be obtained with the proposed approach in comparison to the existing state-of-the-art method. The flexibility of the introduced method should allow it to be used not only for the challenging case of cardiac imaging, but also for other patient motion where the patient moves or breathes during acquisition.

  14. Cine MRI of the temporomandibular joint in comparison to static MRI and axiography; Cine-MRT des Kiefergelenks im Vergleich zur konventionellen MRT und Achsiographie

    Beer, A.; Rummeny, E.J. [Inst. fuer Roentgendiagnostik der Technischen Univ. Muenchen, Klinikum rechts der Isar (Germany); Kolk, A.; Neff, A. [Klinik und Poliklinik fuer Mund-Kiefer-Gesichtschirurgie der Technischen Univ. Muenchen, Klinikum rechts der Isar (Germany); Hof, N. [Abt. fuer Diagnostische und Interventionelle Radiologie/Nuklearmedizin, Krankenhaus Dritter Orden, Muenchen-Nymphenburg (Germany); Treumann, T. [Roentgeninstitut, Kantonshospital Luzern (Switzerland)

    2004-04-01

    Purpose: To evaluate Cine MRI (cMRI) of the temporomandibular joint in comparison to static MRI (sMRI) and axiography. Materials and Methods: In a prospective study with 57 healthy volunteers as well as 33 patients after temporomandibular joint (TMJ) surgery or with severe joint dysfunction, we measured the mobility of both condyle and disc as well as the sagittal angle of condylar inclination with sMRI and cMRI. Measurements and image analysis were performed by a radiologist and a maxillofacial surgeon in consensus. The results of axiography served as standard of reference. Result: Concerning the assessment of the discoligamentous complex, sMRI was superior to cMRI in the patient-group (sensitivity sMRI 85%, cMRI 76%), while no significant difference was found in the volunteer-group (sensitivity sMRI 97.4%, cMRI 98.3%). The results of cMRI and sMRI showed a highly significant correlation with each other, as well as with the axiographic reference tracings (r=0.90). The average mobility of the disc and condyle was 6% and 10% higher in sMRI compared to cMRI (p=0.001) and showed a slightly higher variance (0.043 vs. 0.038). Concerning the condylar inclination angle, both MRI-procedures had the best correlation (r=0.94) with each other and axiography. Conclusion: Real-time MRI of the TMJ is comparable to axiography in its accuracy and is a useful adjunct to conventional static MRI. (orig.) [German] Fragestellung: Evaluation der Cine-MRT (cMRT) des Kiefergelenks im Vergleich zur statischen MRT (sMRT) und Achsiographie. Material und Methode: Bei 57 Probanden und bei 33 Patienten nach operativem Gelenkeingriff oder mit klinischer Funktionsstoerung wurden die Kondylus- und Diskusmobilitaet sowie die horizontale Kondylenbahnneigung (HKN) in der sMRT und in der cMRT bestimmt. Die Auswertung erfolgte durch einen Radiologen und einen Mund-Kiefer-Gesichtschirurgen im Konsensus. Die Werte der Achsiographie dienten als Goldstandard. Ergebnisse: Bezueglich der Abgrenzbarkeit des diskoligamentaeren Komplexes war in der Gruppe der funktionsgestoerten Gelenke die sMRT der cMRT ueberlegen (Sensitivitaet sMRT 85%, cMRT 76%), waehrend sich bei den Probanden kein signifikanter Unterschied zeigte (Sensitivitaet sMRT 97,4%, cMRT 98,3%). Die in der sMRT und cMRT ermittelten Funktionsdaten korrelierten signifikant untereinander sowie auch mit den entsprechenden achsiographischen Referenzwerten (r=0,90). In der sMRT stellte sich die durchschnittliche Diskus- und Kondylusmobilitaet 6% bzw. 10% hoeher als in der cMRT (p=0,001) bei leicht hoeherer Varianz (v=0,043 vs 0,38) dar. Die HKN-Werte stimmten in beiden MRT-Verfahren und mit der Achsiographie mit jeweils r=0,94 am besten ueberein. Schlussfolgerung: Die Cine-MRT ist in ihrer Genauigkeit mit der Achsiographie vergleichbar und stellt als dynamische Untersuchung eine wertvolle Ergaenzung zur konventionellen statischen MRT dar. (orig.)

  15. MRI findings in Kallmann syndrome

    Madan R; Sawlani Vijay; Gupta Sushil; Phadke R

    2004-01-01

    Kallmann syndrome (KS) is a neuronal migration disorder characterised by hypogonadotrophic hypogonadism and anosmia or hyposmia. Five patients with clinical findings suggestive of KS were evaluated with MRI. All patients had abnormalities of olfactory system. Olfactory bulbs were absent in all patients. Olfactory sulci were absent in 3 patients and hypoplastic in 2 patients. Anterior pituitary was hypoplastic in two patients. The MRI findings in KS are characteristic and MRI is a useful adjun...

  16. MRI findings in Kallmann syndrome

    Madan R

    2004-10-01

    Full Text Available Kallmann syndrome (KS is a neuronal migration disorder characterised by hypogonadotrophic hypogonadism and anosmia or hyposmia. Five patients with clinical findings suggestive of KS were evaluated with MRI. All patients had abnormalities of olfactory system. Olfactory bulbs were absent in all patients. Olfactory sulci were absent in 3 patients and hypoplastic in 2 patients. Anterior pituitary was hypoplastic in two patients. The MRI findings in KS are characteristic and MRI is a useful adjunct to the diagnosis of KS.

  17. MRI Findings In Dengue Encephalitis

    Ashraf V.V

    2004-01-01

    Full Text Available Neurological manifestations are rare in dengue fever. Two cases with encephalopathy and systemic features of dengue fever with abnormal CSF and MR imaging are reported. Striking MRI finding was bilateral symmetrical thalamic lesions similar to those reported in Japanese encephalitis. This report highlights that MRI findings can be similar in dengue and Japanese encephalitis.

  18. Machine learning for the automatic localisation of foetal body parts in cine-MRI scans

    Bowles, Christopher; Nowlan, Niamh C.; Hayat, Tayyib T. A.; Malamateniou, Christina; Rutherford, Mary; Hajnal, Joseph V.; Rueckert, Daniel; Kainz, Bernhard

    2015-03-01

    Being able to automate the location of individual foetal body parts has the potential to dramatically reduce the work required to analyse time resolved foetal Magnetic Resonance Imaging (cine-MRI) scans, for example, for use in the automatic evaluation of the foetal development. Currently, manual preprocessing of every scan is required to locate body parts before analysis can be performed, leading to a significant time overhead. With the volume of scans becoming available set to increase as cine-MRI scans become more prevalent in clinical practice, this stage of manual preprocessing is a bottleneck, limiting the data available for further analysis. Any tools which can automate this process will therefore save many hours of research time and increase the rate of new discoveries in what is a key area in understanding early human development. Here we present a series of techniques which can be applied to foetal cine-MRI scans in order to first locate and then differentiate between individual body parts. A novel approach to maternal movement suppression and segmentation using Fourier transforms is put forward as a preprocessing step, allowing for easy extraction of short movements of individual foetal body parts via the clustering of optical flow vector fields. These body part movements are compared to a labelled database and probabilistically classified before being spatially and temporally combined to give a final estimate for the location of each body part.

  19. Evaluation of the cervical carotid bifurcation using MR angiography and cine MRI

    MR angiography (MRA) can less invasively evaluate the carotid bifurcation without contrast material. Previous reports on MRA of carotid bifurcation revealed problems of overestimation and false-positive interpretation of stenosis. To clarify reasons causing overestimation and false-positive interpretation we investigated flow dynamics in the carotid bifurcation by cine MRI. Twenty-eight patients who were suspected to have stenosis of the internal carotid artery by MRA were studied. Images of the carotid bifurcation were obtained with 3-D phase contrast method by 0.5-T MR scanner. All patients were examined by IV-DSA or direct carotid angiography. Cine MRI of the carotid bifurcation was obtained with gradinet-echo sequence by 1.5-T MR scanner. Comparison of MRA and conventional angiography in evaluating degree of stenosis in the carotid bifurcation demonstrated that there were 57.1% agreement, 32.1% false-positive estimation and 10.7% overestimation. Cine MRI demonstration turbulent flow in the normal carotid bifurcation and also in the sclerotic bifurcation. Turbulence in the carotid bifurcation with severe sclerosis was greater than that in the normal carotid bifurcation. Turbulent flow could be seen extending distally to the stenotic site of the internal carotid artery. Turbulent flow in the carotid bifurcation, causing a decrease or loss in signal intensity of MRA according to the severity of the turbulence, must be a major contributing factor in false-positive estimation and overestimation of stenosis. (author)

  20. Evaluation of the cervical carotid bifurcation using MR angiography and cine MRI

    Yamane, Kanji; Shima, Takeshi; Okada, Yoshikazu; Nishida, Masahiro; Okita, Shinji; Hatayama, Takashi; Kagawa, Reiko [Chugoku Rousai Hospital, Kure, Hiroshima (Japan); Yokoyama, Noboru

    1995-08-01

    MR angiography (MRA) can less invasively evaluate the carotid bifurcation without contrast material. Previous reports on MRA of carotid bifurcation revealed problems of overestimation and false-positive interpretation of stenosis. To clarify reasons causing overestimation and false-positive interpretation we investigated flow dynamics in the carotid bifurcation by cine MRI. Twenty-eight patients who were suspected to have stenosis of the internal carotid artery by MRA were studied. Images of the carotid bifurcation were obtained with 3-D phase contrast method by 0.5-T MR scanner. All patients were examined by IV-DSA or direct carotid angiography. Cine MRI of the carotid bifurcation was obtained with gradinet-echo sequence by 1.5-T MR scanner. Comparison of MRA and conventional angiography in evaluating degree of stenosis in the carotid bifurcation demonstrated that there were 57.1% agreement, 32.1% false-positive estimation and 10.7% overestimation. Cine MRI demonstration turbulent flow in the normal carotid bifurcation and also in the sclerotic bifurcation. Turbulence in the carotid bifurcation with severe sclerosis was greater than that in the normal carotid bifurcation. Turbulent flow could be seen extending distally to the stenotic site of the internal carotid artery. Turbulent flow in the carotid bifurcation, causing a decrease or loss in signal intensity of MRA according to the severity of the turbulence, must be a major contributing factor in false-positive estimation and overestimation of stenosis. (author).

  1. TH-A-BRF-04: Intra-Fraction Motion Characterization for Early Stage Rectal Cancer Using Cine-MRI

    Kleijnen, J; Asselen, B; Burbach, M; Intven, M; Reerink, O; Philippens, M; Lagendijk, J; Raaymakers, B [University Medical Center Utrecht, Utrecht (Netherlands)

    2014-06-15

    Purpose: To investigate the intra-fraction motion in patients with early stage rectal cancer using cine-MRI. Methods: Sixteen patient diagnosed with early stage rectal cancer underwent 1.5 T MR imaging prior to each treatment fraction of their short course radiotherapy (n=76). During each scan session, three 2D sagittal cine-MRIs were performed: at the beginning (Start), after 9:30 minutes (Mid), and after 18 minutes (End). Each cine-MRI has a duration of one minute at 2Hz temporal resolution, resulting in a total of 3:48 hours of cine-MRI. Additionally, standard T2-weighted (T2w) imaging was performed. Clinical target volume (CTV) an tumor (GTV) were delineated on the T2w scan and transferred to the first time-point of each cine-MRI scan. Within each cine-MRI, the first frame was registered to the remaining frames of the scan, using a non-rigid B-spline registration. To investigate potential drifts, a similar registration was performed between the first frame of the Start and End scans.To evaluate the motion, the distances by which the edge pixels of the delineations move in anterior-posterior (AP) and cranial-caudal (CC) direction, were determined using the deformation field of the registrations. The distance which incorporated 95% of these edge pixels (dist95%) was determined within each cine-MRI, and between Start- End scans, respectively. Results: Within a cine-MRI, we observed an average dist95% for the CTV of 1.3mm/1.5mm (SD=0.7mm/0.6mm) and for the GTV of 1.2mm/1.5mm (SD=0.8mm/0.9mm), in respectively AP/CC. For the CTV motion between the Start and End scan, an average dist95% of 5.5mm/5.3mm (SD=3.1mm/2.5mm) was found, in respectively AP/CC. For the GTV motion, an average dist95% of 3.6mm/3.9mm (SD=2.2mm/2.5mm) was found in AP/CC, respectively. Conclusion: Although intra-fraction motion within a one minute cine-MRI is limited, substantial intra-fraction motion was observed within the 18 minute time period between the Start and End cine-MRI.

  2. TH-A-BRF-04: Intra-Fraction Motion Characterization for Early Stage Rectal Cancer Using Cine-MRI

    Purpose: To investigate the intra-fraction motion in patients with early stage rectal cancer using cine-MRI. Methods: Sixteen patient diagnosed with early stage rectal cancer underwent 1.5 T MR imaging prior to each treatment fraction of their short course radiotherapy (n=76). During each scan session, three 2D sagittal cine-MRIs were performed: at the beginning (Start), after 9:30 minutes (Mid), and after 18 minutes (End). Each cine-MRI has a duration of one minute at 2Hz temporal resolution, resulting in a total of 3:48 hours of cine-MRI. Additionally, standard T2-weighted (T2w) imaging was performed. Clinical target volume (CTV) an tumor (GTV) were delineated on the T2w scan and transferred to the first time-point of each cine-MRI scan. Within each cine-MRI, the first frame was registered to the remaining frames of the scan, using a non-rigid B-spline registration. To investigate potential drifts, a similar registration was performed between the first frame of the Start and End scans.To evaluate the motion, the distances by which the edge pixels of the delineations move in anterior-posterior (AP) and cranial-caudal (CC) direction, were determined using the deformation field of the registrations. The distance which incorporated 95% of these edge pixels (dist95%) was determined within each cine-MRI, and between Start- End scans, respectively. Results: Within a cine-MRI, we observed an average dist95% for the CTV of 1.3mm/1.5mm (SD=0.7mm/0.6mm) and for the GTV of 1.2mm/1.5mm (SD=0.8mm/0.9mm), in respectively AP/CC. For the CTV motion between the Start and End scan, an average dist95% of 5.5mm/5.3mm (SD=3.1mm/2.5mm) was found, in respectively AP/CC. For the GTV motion, an average dist95% of 3.6mm/3.9mm (SD=2.2mm/2.5mm) was found in AP/CC, respectively. Conclusion: Although intra-fraction motion within a one minute cine-MRI is limited, substantial intra-fraction motion was observed within the 18 minute time period between the Start and End cine-MRI

  3. New developments in imaging: Sonography, cine-CT, MRI

    Otto, R.J.; Higgins, C.B.

    1987-01-01

    The book can be conveniently subdivided into three sections: the first on magnetic resonance imaging the second on cine-computed tomography and the third on advances in ultrasound (US). The MR imaging section includes two chapters: the first on indications for MR in abdominal disease (a cookbook layout of indications for MR imaging versus CT) and the second on MR imaging of the heart. There are also chapters on MR imaging and US in the pelvis, contrast agent principles, and a chapter on imaging renal tumors. The third section, on US, contains chapters on the liver and gastrointenstinal disease, interventional US sonography during neurosurgery, state-of-the-art echocardiography. Doppler flow imaging, contrast media for sonography, endometrial sonography, and high-resolution US in the first trimester. The final chapter is presented as a scientific paper rather than as a chapter in a book and has no illustrations.

  4. New developments in imaging: Sonography, cine-CT, MRI

    The book can be conveniently subdivided into three sections: the first on magnetic resonance imaging the second on cine-computed tomography and the third on advances in ultrasound (US). The MR imaging section includes two chapters: the first on indications for MR in abdominal disease (a cookbook layout of indications for MR imaging versus CT) and the second on MR imaging of the heart. There are also chapters on MR imaging and US in the pelvis, contrast agent principles, and a chapter on imaging renal tumors. The third section, on US, contains chapters on the liver and gastrointenstinal disease, interventional US sonography during neurosurgery, state-of-the-art echocardiography. Doppler flow imaging, contrast media for sonography, endometrial sonography, and high-resolution US in the first trimester. The final chapter is presented as a scientific paper rather than as a chapter in a book and has no illustrations

  5. Evaluation of potential internal target volume of liver tumors using cine-MRI

    Purpose: Four-dimensional computed tomography (4DCT) is widely used for evaluating moving tumors, including lung and liver cancers. For patients with unstable respiration, however, the 4DCT may not visualize tumor motion properly. High-speed magnetic resonance imaging (MRI) sequences (cine-MRI) permit direct visualization of respiratory motion of liver tumors without considering radiation dose exposure to patients. Here, the authors demonstrated a technique for evaluating internal target volume (ITV) with consideration of respiratory variation using cine-MRI. Methods: The authors retrospectively evaluated six patients who received stereotactic body radiotherapy (SBRT) to hepatocellular carcinoma. Before acquiring planning CT, sagittal and coronal cine-MRI images were acquired for 30 s with a frame rate of 2 frames/s. The patient immobilization was conducted under the same condition as SBRT. Planning CT images were then acquired within 15 min from cine-MRI image acquisitions, followed by a 4DCT scan. To calculate tumor motion, the motion vectors between two continuous frames of cine-MRI images were calculated for each frame using the pyramidal Lucas–Kanade method. The target contour was delineated on one frame, and each vertex of the contour was shifted and copied onto the following frame using neighboring motion vectors. 3D trajectory data were generated with the centroid of the contours on sagittal and coronal images. To evaluate the accuracy of the tracking method, the motion of clearly visible blood vessel was analyzed with the motion tracking and manual detection techniques. The target volume delineated on the 50% (end-exhale) phase of 4DCT was translated with the trajectory data, and the distribution of the occupancy probability of target volume was calculated as potential ITV (ITV Potential). The concordance between ITV Potential and ITV estimated with 4DCT (ITV 4DCT) was evaluated using the Dice’s similarity coefficient (DSC). Results: The distance between blood vessel positions determined with motion tracking and manual detection was analyzed. The mean and SD of the distance were less than 0.80 and 0.52 mm, respectively. The maximum ranges of tumor motion on cine-MRI were 2.4 ± 1.4 mm (range, 1.0–5.0 mm), 4.4 ± 3.3 mm (range, 0.8–9.4 mm), and 14.7 ± 5.9 mm (range, 7.4–23.4 mm) in lateral, anterior–posterior, and superior–inferior directions, respectively. The ranges in the superior–inferior direction were larger than those estimated with 4DCT images for all patients. The volume of ITV Potential was 160.3% ± 13.5% (range, 142.0%–179.2%) of the ITV 4DCT. The maximum DSC values were observed when the cutoff value of 24.7% ± 4.0% (range, 20%–29%) was applied. Conclusions: The authors demonstrated a novel method of calculating 3D motion and ITV Potential of liver cancer using orthogonal cine-MRI. Their method achieved accurate calculation of the respiratory motion of moving structures. Individual evaluation of the ITV Potential will aid in improving respiration management and treatment planning

  6. Evaluation of potential internal target volume of liver tumors using cine-MRI

    Akino, Yuichi, E-mail: akino@radonc.med.osaka-u.ac.jp [Department of Radiation Oncology, Osaka University Graduate School of Medicine, Suita, Osaka 5650871, Japan and Miyakojima IGRT Clinic, Miyakojima-ku, Osaka 5340021 (Japan); Oh, Ryoong-Jin; Masai, Norihisa; Shiomi, Hiroya; Inoue, Toshihiko [Miyakojima IGRT Clinic, Miyakojima-ku, Osaka 5340021 (Japan)

    2014-11-01

    Purpose: Four-dimensional computed tomography (4DCT) is widely used for evaluating moving tumors, including lung and liver cancers. For patients with unstable respiration, however, the 4DCT may not visualize tumor motion properly. High-speed magnetic resonance imaging (MRI) sequences (cine-MRI) permit direct visualization of respiratory motion of liver tumors without considering radiation dose exposure to patients. Here, the authors demonstrated a technique for evaluating internal target volume (ITV) with consideration of respiratory variation using cine-MRI. Methods: The authors retrospectively evaluated six patients who received stereotactic body radiotherapy (SBRT) to hepatocellular carcinoma. Before acquiring planning CT, sagittal and coronal cine-MRI images were acquired for 30 s with a frame rate of 2 frames/s. The patient immobilization was conducted under the same condition as SBRT. Planning CT images were then acquired within 15 min from cine-MRI image acquisitions, followed by a 4DCT scan. To calculate tumor motion, the motion vectors between two continuous frames of cine-MRI images were calculated for each frame using the pyramidal Lucas–Kanade method. The target contour was delineated on one frame, and each vertex of the contour was shifted and copied onto the following frame using neighboring motion vectors. 3D trajectory data were generated with the centroid of the contours on sagittal and coronal images. To evaluate the accuracy of the tracking method, the motion of clearly visible blood vessel was analyzed with the motion tracking and manual detection techniques. The target volume delineated on the 50% (end-exhale) phase of 4DCT was translated with the trajectory data, and the distribution of the occupancy probability of target volume was calculated as potential ITV (ITV {sub Potential}). The concordance between ITV {sub Potential} and ITV estimated with 4DCT (ITV {sub 4DCT}) was evaluated using the Dice’s similarity coefficient (DSC). Results: The distance between blood vessel positions determined with motion tracking and manual detection was analyzed. The mean and SD of the distance were less than 0.80 and 0.52 mm, respectively. The maximum ranges of tumor motion on cine-MRI were 2.4 ± 1.4 mm (range, 1.0–5.0 mm), 4.4 ± 3.3 mm (range, 0.8–9.4 mm), and 14.7 ± 5.9 mm (range, 7.4–23.4 mm) in lateral, anterior–posterior, and superior–inferior directions, respectively. The ranges in the superior–inferior direction were larger than those estimated with 4DCT images for all patients. The volume of ITV {sub Potential} was 160.3% ± 13.5% (range, 142.0%–179.2%) of the ITV {sub 4DCT}. The maximum DSC values were observed when the cutoff value of 24.7% ± 4.0% (range, 20%–29%) was applied. Conclusions: The authors demonstrated a novel method of calculating 3D motion and ITV {sub Potential} of liver cancer using orthogonal cine-MRI. Their method achieved accurate calculation of the respiratory motion of moving structures. Individual evaluation of the ITV {sub Potential} will aid in improving respiration management and treatment planning.

  7. Rabies, encephalomyelitis: MRI findings

    The authors present a 14 year old patient who started with walking and swallowing difficulty; followed by fever, abdominal and lower back pain. Mechanical breathing difficulties required a respiratory mechanic assistance. The diagnosis of Guillain-Barre syndrome was thought at first. Since the patient have had previous contact with a bat two months before the symptoms began, this suggested rabies as the main diagnosis, which was later confirmed by hair-bulb, cornea, oral mucosa and salival immunofluorescence. The brain and spinal cord MRI showed focal lesions in T2 and FLAIR sequences, compatible with encephalomyelitis. (author)

  8. MRI findings in Hirayama disease

    Raval Monali

    2010-01-01

    Full Text Available The objective of the study was to study the magnetic resonance imaging (MRI features of Hirayama disease on a 3 Tesla MRI scanner. Nine patients with clinically suspected Hirayama disease were evaluated with neutral position, flexion, contrast-enhanced MRI and fast imaging employing steady-state acquisition (FIESTA sequences. The spectrum of MRI features was evaluated and correlated with the clinical and electromyography findings. MRI findings of localized lower cervical cord atrophy (C5-C7, abnormal curvature, asymmetric cord flattening, loss of attachment of the dorsal dural sac and subjacent laminae in the neutral position, anterior displacement of the dorsal dura on flexion and a prominent epidural space were revealed in all patients on conventional MRI as well as with the dynamic 3D-FIESTA sequence. Intramedullary hyperintensity was seen in four patients on conventional MRI and on the 3D-FIESTA sequence. Flow voids were seen in four patients on conventional MRI sequences and in all patients with the 3D-FIESTA sequence. Contrast enhancement of the epidural component was noted in all the five patients with thoracic extensions. The time taken for conventional and contrast-enhanced MRI was about 30-40 min, while that for the 3D-FIESTA sequence was 6 min. Neutral and flexion position MRI and the 3D-FIESTA sequence compliment each other in displaying the spectrum of findings in Hirayama disease. A flexion study should form an essential part of the screening protocol in patients with suspected Hirayama disease. Newer sequences such as the 3D-FIESTA may help in reducing imaging time and obviating the need for contrast.

  9. Stress cine MRI for detection of coronary artery disease

    Stress testing is the cornerstone in the diagnosis of patients with suspected coronary artery disease (CAD). Stress echocardiography has become a well-established modality for the detection of ischemia-induced wall motion abnormalities. However, display and reliable interpretation of stress echocardiography studies are user-dependent, the test reproducibility is low, and 10 to 15% of patients yield suboptimal or non-diagnostic images. Due to its high spatial and contrast resolution, MRI is known to permit an accurate determination of left ventricular function and wall thickness at rest. Early stress MRI studies provided promising results with respect to the detection of CAD. However, the clinical impact was limited due to long imaging time and problematic patient monitoring in the MRI environment. Recent technical improvements - namely ultrafast MR image acquisition - led to a significant reduction of imaging time and improved patient safety. Stress can be induced by physical exercise or pharmacologically by administration of a beta1-agonist (dobutamine) or vasodilatator (dipyridamole and adenosine). The best developed and most promising stress MRI technique is a high-dose dobutamine/atropine stress protocol (10, 20, 30, 40 μg/kg/min; optionally 0.25-mg fractions of atropine up to maximal dose 1 mg). Severe complications (myocardial infarction, ventricular fibrillation and sustained tachycardia, cardiogenic shock) may be expected in 0.25% of patients. Currently, data of three high-dose dobutamine stress MRI studies are available, revealing a good sensitivity (83 - 87%) and specificity (83 - 86%) in the assessment of CAD. The direct comparison between echocardiography and MRI for the detection of stress-induced wall motion abnormalities yielded better results for dobutamine-MRI in terms of sensitivity (86.2% vs. 74.3%; p < 0.05) and specificity (85.7% vs. 69.8% p < 0.05) as compared to dobutamine stress echocardiography. The superior results of MRI can mainly be explained by the better image quality with sharp delineation of the endocardial and epicardial borders. Currently, stress MRI is already a realistic clinical alternative for the non-invasive assessment of CAD in patients with impaired image quality in echocardiography. (orig.)

  10. MRI findings in bipartite patella

    Bipartite patella is a known cause of anterior knee pain. Our purpose was to detail the magnetic resonance imaging (MRI) features of bipartite patella in a retrospective cohort of patients imaged at our institution. MRI exams from 53 patients with findings of bipartite patella were evaluated to assess for the presence of bone marrow edema within the bipartite fragment and for the presence of abnormal signal across the synchondrosis or pseudarthrosis. Any other significant knee pathology seen at MRI was also recorded. We also reviewed 400 consecutive knee MRI studies to determine the MRI prevalence of bipartite patella. Of the 53 patients with bipartite patella 40 (75%) were male; 35 (66%) had edema within the bipartite fragment. Of the 18 with no edema an alternative explanation for knee pain was found in 13 (72%). Edema within the bipartite fragment was the sole finding in 26 of 53 (49%) patients. Bipartite patella was seen in 3 (0.7%) of 400 patients. In patients with bipartite patella at knee MRI, bone marrow edema within the bipartite fragment was the sole finding on knee MRI in almost half of the patients in our series. (orig.)

  11. MRI findings in bipartite patella

    Kavanagh, Eoin C. [University of Pittsburgh Medical Centre, Department of Radiology, Pittsburgh, PA (United States); Zoga, Adam; Omar, Imran [Thomas Jefferson University Hospital, Department of Radiology, Philadelphia, PA (United States); Ford, Stephanie; Eustace, Stephen [Cappagh National Orthopaedic Hospital, Department of Radiology, Dublin (Ireland); Schweitzer, Mark [Hospital for Joint Disease, Orthopedic Institute, Department of Radiology, New York, NY (United States)

    2007-03-15

    Bipartite patella is a known cause of anterior knee pain. Our purpose was to detail the magnetic resonance imaging (MRI) features of bipartite patella in a retrospective cohort of patients imaged at our institution. MRI exams from 53 patients with findings of bipartite patella were evaluated to assess for the presence of bone marrow edema within the bipartite fragment and for the presence of abnormal signal across the synchondrosis or pseudarthrosis. Any other significant knee pathology seen at MRI was also recorded. We also reviewed 400 consecutive knee MRI studies to determine the MRI prevalence of bipartite patella. Of the 53 patients with bipartite patella 40 (75%) were male; 35 (66%) had edema within the bipartite fragment. Of the 18 with no edema an alternative explanation for knee pain was found in 13 (72%). Edema within the bipartite fragment was the sole finding in 26 of 53 (49%) patients. Bipartite patella was seen in 3 (0.7%) of 400 patients. In patients with bipartite patella at knee MRI, bone marrow edema within the bipartite fragment was the sole finding on knee MRI in almost half of the patients in our series. (orig.)

  12. Treatment and diagnosis of middle fossa arachnoid cyst. Ventriculofiberscopy and cine-MRI

    The treatment of intracranial arachnoid cysts is controversial regarding its surgical indication and operative procedures. Conventional surgical approaches such as fenestration, membranectomy, and shunting operation are invasive. Also CT cisternography and/or RI cisternography are invasive, when it has been performed to evaluate the possible CSF communications between the arachnoid cyst and subarachnoid space. Between July 1994 and February 1997, 10 patients with intracranial middle fossa arachnoid cysts were treated with a newly developed ventriculofiberscope which is characterized by splendid mechanical flexibility and high resolution. The cine-MRI, which is a non-invasive diagnostic tool, is used to evaluate the CSF circulation around the cyst fenestration. The patients' ages ranged from 4 months to 10 years, with a mean of 4.46 years. The cyst locations were left middle fossa (9), and right (1). Eight patients presented with macrocrania, 4 with developmental delay, three with seizure, two with headache, and one with subdural hematoma. The patients were preoperatively evaluated by means of MRI and cine-MR images. In all patients ventriculofiberscopic procedures including cyst fenestration, membranous dissection, cyst puncture and shriveling were successfully performed. Postoperative MR and cine-MR studies have shown reduction of the cyst size and appropriate CSF circulation. Neuroendoscopic procedures seem to be the first choice for children with arachnoid cysts and the ventriculofiberscope proved to be very useful not only for cyst fenestration but also for cyst dissection. In addition, the non-invasive cine-MR studies are useful for long follow-up at OPD. (author)

  13. Treatment and diagnosis of middle fossa arachnoid cyst. Ventriculofiberscopy and cine-MRI

    Kamikawa, Shuji; Kuwamura, Keiichi [Hyogo Prefectural Awaji Hospital, Sumoto (Japan); Tamaki, Norihiko

    1998-07-01

    The treatment of intracranial arachnoid cysts is controversial regarding its surgical indication and operative procedures. Conventional surgical approaches such as fenestration, membranectomy, and shunting operation are invasive. Also CT cisternography and/or RI cisternography are invasive, when it has been performed to evaluate the possible CSF communications between the arachnoid cyst and subarachnoid space. Between July 1994 and February 1997, 10 patients with intracranial middle fossa arachnoid cysts were treated with a newly developed ventriculofiberscope which is characterized by splendid mechanical flexibility and high resolution. The cine-MRI, which is a non-invasive diagnostic tool, is used to evaluate the CSF circulation around the cyst fenestration. The patients` ages ranged from 4 months to 10 years, with a mean of 4.46 years. The cyst locations were left middle fossa (9), and right (1). Eight patients presented with macrocrania, 4 with developmental delay, three with seizure, two with headache, and one with subdural hematoma. The patients were preoperatively evaluated by means of MRI and cine-MR images. In all patients ventriculofiberscopic procedures including cyst fenestration, membranous dissection, cyst puncture and shriveling were successfully performed. Postoperative MR and cine-MR studies have shown reduction of the cyst size and appropriate CSF circulation. Neuroendoscopic procedures seem to be the first choice for children with arachnoid cysts and the ventriculofiberscope proved to be very useful not only for cyst fenestration but also for cyst dissection. In addition, the non-invasive cine-MR studies are useful for long follow-up at OPD. (author)

  14. Stress cine MRI for detection of coronary artery disease; Stress-Cine-MRT zur Primaeridagnostik der koronaren Herzkrankheit

    Sommer, T.; Hofer, U.; Schild, H. [Bonn Univ. (Germany). Radiologische Klinik; Omran, H. [Medizinische Universitaetsklinik II Bonn (Germany)

    2002-05-01

    Stress testing is the cornerstone in the diagnosis of patients with suspected coronary artery disease (CAD). Stress echocardiography has become a well-established modality for the detection of ischemia-induced wall motion abnormalities. However, display and reliable interpretation of stress echocardiography studies are user-dependent, the test reproducibility is low, and 10 to 15% of patients yield suboptimal or non-diagnostic images. Due to its high spatial and contrast resolution, MRI is known to permit an accurate determination of left ventricular function and wall thickness at rest. Early stress MRI studies provided promising results with respect to the detection of CAD. However, the clinical impact was limited due to long imaging time and problematic patient monitoring in the MRI environment. Recent technical improvements - namely ultrafast MR image acquisition - led to a significant reduction of imaging time and improved patient safety. Stress can be induced by physical exercise or pharmacologically by administration of a beta{sub 1}-agonist (dobutamine) or vasodilatator (dipyridamole and adenosine). The best developed and most promising stress MRI technique is a high-dose dobutamine/atropine stress protocol (10, 20, 30, 40 {mu}g/kg/min; optionally 0.25-mg fractions of atropine up to maximal dose 1 mg). Severe complications (myocardial infarction, ventricular fibrillation and sustained tachycardia, cardiogenic shock) may be expected in 0.25% of patients. Currently, data of three high-dose dobutamine stress MRI studies are available, revealing a good sensitivity (83 - 87%) and specificity (83 - 86%) in the assessment of CAD. The direct comparison between echocardiography and MRI for the detection of stress-induced wall motion abnormalities yielded better results for dobutamine-MRI in terms of sensitivity (86.2% vs. 74.3%; p < 0.05) and specificity (85.7% vs. 69.8% p < 0.05) as compared to dobutamine stress echocardiography. The superior results of MRI can mainly be explained by the better image quality with sharp delineation of the endocardial and epicardial borders. Currently, stress MRI is already a realistic clinical alternative for the non-invasive assessment of CAD in patients with impaired image quality in echocardiography. (orig.) [German] Belastungsuntersuchungen sind einer der wesentlichen Pfeiler der nicht-invasiven Diagnostik der koronaren Herzkrankheit (KHK). Die Stress-Cine-Magnetresonanztomographie (Stress-MRT) beruht wie die Stressechokardiographie auf dem direkten Nachweis ischaemieinduzierter Wandbewegungsstoerungen. Ihr Einsatz bei kardialen Belastungsuntersuchungen wurde bisher vor allem durch die langen Untersuchungszeiten und die limitierten Ueberwachungsmoeglichkeiten der Patienten eingeschraenkt. Erst seit kurzem wurden durch technische Weiterentwicklungen (insbesondere ultraschnelle k-Raum-segmentierte Sequenzen) die wesentlichen Rahmenbedingungen fuer eine klinisch praktikable kardiale MRT-Belastungsdiagnostik geschaffen. Als Stress-Induktoren koennen physikalische (Fahrradergometrie) und pharmakologische Belastungsverfahren ({beta}{sub 1}-Mimetika [Dobutamin] oder Vasodilatatoren [Dipyridamol, Adenosin]) eingesetzt werden. Insbesondere seit der Etablierung von Hochdosis-Protokollen mit fakultativer Atropingabe wird die Belastung mit Dobutamin bei der Stress-MRT zum Nachweis einer KHK (Sensitivitaet: 83 - 87%; Spezifitaet: 83 - 86%) von den meisten Arbeitsgruppen favorisiert. Schwerere Komplikationen treten in 0,25% der Faelle auf. Im direkten Vergleich zeigte sich die Dobutamin-Stress-MRT aufgrund der besseren Bildqualitaet der Dobutamin-Stressechokardiographie ueberlegen (Sensitivitaet: 86,2% vs. 74,3%, p < 0,05; Spezifitaet: 85,7% vs. 69,8%, p < 0,05). Die Stress-MRT ist bereits zum jetzigen Zeitpunkt eine realistische - in der Routinediagnostik anwendbare - Alternative zur Stressechokardiographie. Vom Einsatz der Stress-MRT profitieren zur Zeit v.a. Patienten, bei denen aufgrund grundsaetzlich schlechter Schallbarkeit mit hoher Wahrscheinlichkeit von nicht oder nur eingeschraenkt beurteilbaren stressechokardiographischen Untersuchungen auszugehen ist. (orig.)

  15. Brain venous pathologies: MRI findings

    Purpose: To describe MRI findings of the different brain venous pathologies. Material and Methods: Between January 2002 and March 2004, 18 patients were studied 10 males and 8 females between 6 and 63 years old; with different brain venous pathologies. In all cases brain MRI were performed including morphological sequences with and without gadolinium injection and angiographic venous sequences. Results: 10 venous occlusions were found, 6 venous angiomas, and 2 presented varices secondary to arteriovenous dural fistula. Conclusion: Brain venous pathologies can appear in many different clinical contexts, with different prognosis and treatment. In all the cases brain MRI was the best imaging study to disclose typical morphologic abnormalities. (author)

  16. MRI findings of intraocular diseases

    MRI findings of intra-ocular lesion were studied on seven cases : two cases of choroidal malignant melanoma, one case of choroidal tumor, two cases of retinal detachment with vitreous hemorrhage, and two cases of choroidal detachment. Intraocular lesions were clearly visualized by T1 weighted MRI which was of great benefit in visualizing morphological changes. T2 weighted images could not visualize morphological changes very well, but had some merits in differentiating the ocular pathology. MRI was a very useful examination for intra-ocular lesions. (author)

  17. Implementation of compressive sensing for preclinical cine-MRI

    Tan, Elliot; Yang, Ming; Ma, Lixin; Zheng, Yahong Rosa

    2014-03-01

    This paper presents a practical implementation of Compressive Sensing (CS) for a preclinical MRI machine to acquire randomly undersampled k-space data in cardiac function imaging applications. First, random undersampling masks were generated based on Gaussian, Cauchy, wrapped Cauchy and von Mises probability distribution functions by the inverse transform method. The best masks for undersampling ratios of 0.3, 0.4 and 0.5 were chosen for animal experimentation, and were programmed into a Bruker Avance III BioSpec 7.0T MRI system through method programming in ParaVision. Three undersampled mouse heart datasets were obtained using a fast low angle shot (FLASH) sequence, along with a control undersampled phantom dataset. ECG and respiratory gating was used to obtain high quality images. After CS reconstructions were applied to all acquired data, resulting images were quantitatively analyzed using the performance metrics of reconstruction error and Structural Similarity Index (SSIM). The comparative analysis indicated that CS reconstructed images from MRI machine undersampled data were indeed comparable to CS reconstructed images from retrospective undersampled data, and that CS techniques are practical in a preclinical setting. The implementation achieved 2 to 4 times acceleration for image acquisition and satisfactory quality of image reconstruction.

  18. Assessment of left atrial volume by Gd-DTPA-enhanced ultrafast cine MRI. Hemodynamic assessment in various diseases

    Matsumura, Kentaro; Nakase, Emiko; Hashi, Masashi; Kawai, Ichiro; Saito, Takayuki; Haiyama, Tohru; Kikkawa, Nobutada [Kyoto Minami Hospital, Nishishichijyo (Japan)

    1995-10-01

    To assess the validity of contrast-enhanced breath-hold ultrafast cine MR imaging in left atrial (LA) volumes (LA max.I: maximal volume index of LA/LA min.I: minimal volume index of LA) and LA-volume curve, this method was compared with intravenous digital subtraction left atrial angiography (DSA) in serial 26 patients. The pulse sequence of ultrafast cine MRI were TR 8 ms, TE 3.2 ms, matrix 128 x 96 and NEX 1. The contrast-enhanced ultrafast cine MRI was shown to provide accurate left atrial images with higher success rate (88.9% in horizontal long axis view and 86.9% in vertical long axis view) in serial 891 cases. Comparison with LA volumes showed a high correlation (LA max.I: r=0.934, p<0.001/LA min.I: r=0941, p<0.001) between ultrafast cine MRI and DSA, but LA volumes were underestimated in MRI. The left atrial volumes were calculated with biplane modified Simpson`s rule method on horizontal and vertical long axis sections. Normal LA volumes obtained by ultrafast cine MRI were 30{+-}5 ml/m{sup 2} in maximum and 17{+-}5 ml/m{sup 2} in minimum. In patients with hypertension, old myocardial infarction, mitral valve diseases, dilated cardiomyopathy (DCM) and hypertrophic cardiomyopathy, LA-volumes were significantly increased. The LA-volumes at the beginning of left atrial active contraction were significantly correlated with LA-volume of active contraction. However, in patients with DCM, these statistical correlation were not demonstrated. In patients with DCM, preload of LA were increased, but LA-volumes of active contraction were not increased. For this reason, the afterload mismatch of LA was suspected in DCM. In conclusion, the contrast-enhanced ultrafast cine MRI is useful for determining LA volumes and LA volume curves. (author).

  19. MRI findings of orbital mass

    A total of 41 cases (17 pseudotumor, 11 lymphoma, 4 cavernous hemangioma, and 9 others) with a orbital mass (es), who underwent MRI, are the basis of this study. The 14 MRI findings (size, shape, signal intensity, etc.) were retrospectively analyzed. Subjective rating score of irregular undulation, homogeneity of signal intensity (SI) on T1WI and SI on (fat-sat) T2WI of cavernous hemangioma was significantly higher than that of pseudotumor. Subjective rating score of irregular undulation, SI on (fat-sat) T2WI and homogeneity of SI on (fat-sat) T2WI of cavernous hemangioma was significantly higher than that of lymphoma. Subjective rating score of lymphoma was significantly higher than that of pseudotumor. There was no significant difference in age, sex and subjective rating score of 9 MRI findings (size, shape, etc). (author)

  20. Evaluation of aortic regurgitation using cine magnetic resonance imaging

    Cine magnetic resonance imaging (MRI) was used to assess aortic regurgitation (AR) in 13 patients with valvular disease and 3 normal subjects, and the results were compared to color Doppler flow mapping findings. AR produced a signal void in the left ventricle during the diastolic phase in all patients by MRI. There were no false positive or negative results compared with echocardiographic findings. Visual grading of cine MRI gave results similar to color flow Doppler echocardiography (88%). The distance and the area of aortic regurgitation using MRI correlated well with color Doppler flow mapping (r=0.82 and 0.88). However, measurements of distance and area by color flow Doppler tended to be larger than those by cine MRI. With current techniques echocardiography may overestimate the severity of AR as compared with cine MRI. In addition, MRI gives clinically useful information in patients in whom transthoracic Doppler echocardiography is not adequate. (author)

  1. Cine-MRI tagging for assessment of ventricular wall motion in patients under maintenance hemodialysis

    We evaluated the ventricular wall shortening velocity of patients with volume overload using cine-MRI tagging. The subjects were 12 healthy volunteers and 10 patients under maintenance hemodialysis. Three linear tags (basal, mid-ventricular, and apical) were set up in the 4-chamber view and Δ distance/Ejection time (Δd/ET) was calculated before and after hemodialysis. Before hemodialysis, Δd/ET was significantly greater at the basal level than after hemodialysis (right ventricular wall : 64.7±14.3 vs 59.1±15.4 mm/s, P<0.05, interventricular septum : 36.3±6.9 vs 32.4±7.6 mm/s, P<0.05, left ventricular free wall : 40.5±6.8 vs 36.1±8.2 mm/s, P<0.05). Thus, volume overload increased Δd/ET of the normal heart. We concluded that cine-MRI tagging could quantitatively evaluate right and left ventricular wall motion. (author)

  2. Frequency analyses of CSF flow on cine MRI in normal pressure hydrocephalus

    Miyati, Tosiaki; Kasuga, Toshio; Koshida, Kichiro; Sanada, Shigeru; Onoguchi, Masahisa [Department of Radiological Technology, School of Health Sciences, Faculty of Medicine, Kanazawa University, 5-11-80, Kodatsuno, Kanazawa, Ishikawa 920-0942 (Japan); Mase, Mitsuhito; Yamada, Kazuo [Department of Neurosurgery, Nagoya City University Medical School, 1 Kawasumi, Mizuho-cho, Mizuho-ku, Nagoya, Aichi 467-8602 (Japan); Banno, Tatsuo [Department of Central Radiology, Nagoya City University Hospital, 1 Kawasumi, Mizuho-cho, Mizuho-ku, Nagoya, Aichi 467-8602 (Japan); Fujita, Hiroshi [Department of Information Science, Faculty of Engineering, Gifu University, Yanagido 1-1, Gifu 501-1193 (Japan)

    2003-05-01

    Our objective was to clarify intracranial cerebrospinal fluid (CSF) flow dynamics in normal-pressure hydrocephalus (NPH). Frequency analyses of CSF flow measured with phase-contrast cine MRI were performed. The CSF flow spectra in the aqueduct were determined in patients (n=51) with NPH, brain atrophy or asymptomatic ventricular dilation (VD), and in healthy volunteers (control group; n=25). The changes in CSF flow spectra were also analyzed after intravenous injection of acetazolamide. Moreover, a phase transfer function (PTF) calculated from the spectra of the driving vascular pulsation and CSF flow in the aqueduct were assessed. These values were compared with the pressure volume response (PVR). The amplitude in the NPH group was significantly larger than that in the VD or control group because of a decrease in compliance. The phase in the NPH group was significantly different from that in either the VD or the control group, but no difference was found between the VD and control groups. The amplitude increased in all groups after acetazolamide injection. The PTF in the NPH group was significantly larger than in the control group, and a positive correlation was noted between PTF and PVR. Frequency analyses of CSF flow measured by cine MRI make it possible to noninvasively obtain a more detailed picture of the pathophysiology of NPH. (orig.)

  3. Tissue-Point Motion Tracking in the Tongue from Cine MRI and Tagged MRI

    Woo, Jonghye; Stone, Maureen; Suo, Yuanming; Murano, Emi Z.; Prince, Jerry L.

    2014-01-01

    Purpose: Accurate tissue motion tracking within the tongue can help professionals diagnose and treat vocal tract--related disorders, evaluate speech quality before and after surgery, and conduct various scientific studies. The authors compared tissue tracking results from 4 widely used deformable registration (DR) methods applied to cine magnetic

  4. Tissue-Point Motion Tracking in the Tongue from Cine MRI and Tagged MRI

    Woo, Jonghye; Stone, Maureen; Suo, Yuanming; Murano, Emi Z.; Prince, Jerry L.

    2014-01-01

    Purpose: Accurate tissue motion tracking within the tongue can help professionals diagnose and treat vocal tract--related disorders, evaluate speech quality before and after surgery, and conduct various scientific studies. The authors compared tissue tracking results from 4 widely used deformable registration (DR) methods applied to cine magnetic…

  5. Rhombencephalosynapsis: CT and MRI findings

    Mendona J

    2004-01-01

    Full Text Available An unusual disorder of cerebellar development, rhombencephalosynapsis is a unique entity which presents with cerebellar fusion and absence of cerebellar vermis on imaging studies, often associated with supratentorial findings. No specific clinical syndrome has been described in these patients so far, and most cases are found in infancy and childhood. MRI and its multiplanar capabilities and high spatial and contrast resolution increased its recognition. Two cases are reported, with emphasis on imaging findings.

  6. Observation of the CSF pulsative flow using cine MRI and presaturation pulse, 1

    The to-and-fro motion of cerebrospinal fluid (CSF) in the aqueduct was visualized using cine MRI combined with a presaturation pulse before the radiofrequency pulse in each cardiac phase. Next, an attempt was made to quantify its velocity from those images. For clinical uses, imaging parameters, such as pulse interval time (PI) and flip angle (FA), were studied for a flow phantom and normal volunteers. The shorter the PI chosen, the more accurate was the quantificaiton, and the better was the imaging contrast obtained. It was noted, however, that if the velocity is slow (such as the CSF flow in the aqueduct), a slightly longer PI must be chosen to measure the distance of the moved presaturated bolus from the images. As a result, a PI of less than 50 msec was employed. With FA, the best contrast was noted with settings between 10deg and 15deg. Two methods using a presaturation pulse were employed: cine mode and single phase mode. In normal volunteers, both methods were used to measure the velocity of CSF in the aqueduct during each cardiac phase. Velocity curves were then quantified. The direction of the CSF flow was changed at 20-30% and 70-80% of the RR interval. In early and late phases of the RR interval, the direction was rostral, and in the other phase, it was caudal. In single phase mode the maximum velocity was 14±1.4 mm/s in the rostal direction, and 12.3±2.0 mm/s in the caudal direction. In cine mode, however, the former was 7.3±1.7 mm/s, and the latter was 8.0±2.4 mm/s. The single phase mode appeared to be a more accurate method than the cine mode for quantification. The cine mode was then performed in four patients with brain atrophy and in four patients with hydrocephalus. Differences in the maximum velocity and the to-and-fro motion pattern between those pathological states were assessed. The utility of this method for studying CSF circulation was demonstrated. (author)

  7. Clinical Applications of Cine Balanced Steady-State Free Precession MRI for the Evaluation of the Subarachnoid Spaces.

    Li, A E; Wilkinson, M D; McGrillen, K M; Stoodley, M A; Magnussen, J S

    2015-12-01

    The purpose of this article is to review the physiology of normal brain and spinal cord motion in the subarachnoid space, principles of cine balanced steady-state free precession (bSSFP) magnetic resonance imaging (MRI), clinical applications, and the pitfalls encountered with this technique.The brain and spinal cord are dynamic structures that move with each heartbeat due to transmitted arterial pulse waves. Conventional MRI sequences do not allow anatomic evaluation of the pulsatile movement of the neural structures in the subarachnoid space due to limitations in temporal resolution. Cine bSSFP MRI uses cardiac gating to evaluate dynamically the brain and spinal cord with high contrast and temporal resolution.Cine bSSFP can be used in the evaluation of idiopathic syringomyelia to assess an underlying treatable cause, including arachnoid bands, which are usually not well visualized with conventional MR sequences due to motion artifact. This MRI technique is also useful in the evaluation of intraspinal and intracranial arachnoid cysts and the degree of mass effect on the cord. Other applications include preoperative and postoperative evaluation of Chiari I malformation and the evaluation of lateral ventricular asymmetry. The major limitation of cine bSSFP is the presence of banding artifacts, which can be reduced by shimming and modifying other scan parameters. PMID:25854921

  8. Cine MRI of the ascending aorta in the elderly with respect to the flow signal void and aortic valve morphology

    Cine flow MRI was performed on a 1.5 Tesla system to observe signal intensity of blood flow within the ascending aorta in the elderly who had no aortic stenosis and to determine frequency of the flow signal void. Coronal and sagittal imaging planes of the ascending aorta were obtained in 27 aged patients with no known cardiac diseases (14 men and 13 women, mean age of 76) and 7 young volunteers (7 men, mean age of 24), utilizing ECG-gating, GRASS (gradient-recalled acquisition in steady state), and a flow compensation sequence. The young volunteers presented little or no signal void within the ascending aorta. In 26 (96%) of the 27 aged patients, on the other hand, signal void was demonstrated in the blood flow distal to the aortic valve during systole. The maximum length of the signal void that was measured at 318?632 msec after the R wave of ECG ranged from 33 to 97 mm. Conventional and Doppler echocardiography was used to evaluate motion and morphology of the aortic valve in 19 of the 27 aged patients. Eighteen of these 19 subjects had aortic signal void on cine MRI. Echocardiography showed sclerotic changes of the aortic valve (i.e., increased echogenicity of the cusps and/or commissure fusion) in 10 (53%) of the 19 subjects. The mean maximum length of the signal void in the 10 patients with aortic valve sclerosis was significantly greater than that in the 9 patients with echocardiographically normal valve (68 vs.45 mm, p<0.01). These results suggest that signal void of blood flow in the ascending aorta, which is recognized as one of the characteristic findings in patients with aortic stenosis, is not a specific feature for this disease but rather a commom one in the elderly particularly those with sclerotic changes of the aortic valve. However, the length of the signal void may distinguish between nonstenotic and stenotic aortic valves. (author)

  9. Pubic insufficiency fracture: MRI findings

    Min, Tae Kyu; Lee, Yeon Soo; Park, Jeong Mi; Kim, Jee Young; Chung, Hong Jun; Lee, Eun Hee; Lee, Eun Ja; Kang, So Won [College of Medicine, The Catholic University of Korea, Seoul (Korea, Republic of); Han Tae Il [Eulji Medical College, Taejon (Korea, Republic of)

    2000-10-01

    To evaluate the characteristic MRI findings of pubic insufficiency fracture. In nine cases of pubic insufficiency fracture, the findings of plain radiography (n=9), MRI (n=9), and bone scintigraphy (n=8) were reviewed. We retrospectively analyzed, with regard to fracture site, the destructive pattern revealed by plain radiography, and uptake by other pelvic bones, as demonstrated by RI bone scanning. The MR findings evaluated were the fracture gap and its signal intensity, the site and signal intensity of the soft tissue mass, and other pelvic bone fractures. Plain radiography revealed osteolysis and sclerosis of pubic bone in eight of nine cases (89%), and parasymphyseal fractures in seven (78%). RI indicated uptake by the sacrum in six cases (66%), and by the ilium in three (33%). MR findings of fracture gap (seven cases, 78%) were hypo to isointensity on T1WI, hyper intensity on T2WI and the absence of contrast enhancement. Soft tissue masses were found in seven cases (78%); in four of these the location was parasymphyseal, and in three, surrounding muscle was involved. Hypo to isointensity was revealed by T1WI, hyperintensity by T2WI, and there was peripheral enhancement. Other associated pelvic bone fractures involved the sacrum in seven cases and the ilium in four. The characteristic MR findings of pubic insufficiency fracture were parasymphyseal location, fracture gap, peripherally enhanced soft tissue mass formation, and fractures of other pelvic bones, namely the sacrum and ilium.

  10. Pubic insufficiency fracture: MRI findings

    To evaluate the characteristic MRI findings of pubic insufficiency fracture. In nine cases of pubic insufficiency fracture, the findings of plain radiography (n=9), MRI (n=9), and bone scintigraphy (n=8) were reviewed. We retrospectively analyzed, with regard to fracture site, the destructive pattern revealed by plain radiography, and uptake by other pelvic bones, as demonstrated by RI bone scanning. The MR findings evaluated were the fracture gap and its signal intensity, the site and signal intensity of the soft tissue mass, and other pelvic bone fractures. Plain radiography revealed osteolysis and sclerosis of pubic bone in eight of nine cases (89%), and parasymphyseal fractures in seven (78%). RI indicated uptake by the sacrum in six cases (66%), and by the ilium in three (33%). MR findings of fracture gap (seven cases, 78%) were hypo to isointensity on T1WI, hyper intensity on T2WI and the absence of contrast enhancement. Soft tissue masses were found in seven cases (78%); in four of these the location was parasymphyseal, and in three, surrounding muscle was involved. Hypo to isointensity was revealed by T1WI, hyperintensity by T2WI, and there was peripheral enhancement. Other associated pelvic bone fractures involved the sacrum in seven cases and the ilium in four. The characteristic MR findings of pubic insufficiency fracture were parasymphyseal location, fracture gap, peripherally enhanced soft tissue mass formation, and fractures of other pelvic bones, namely the sacrum and ilium

  11. Comparison of delayed enhanced cine MRI, single photon emission computed tomography and echocardiography for the detection of viable myocardium

    Objective: To evaluate the accuracy of delayed enhanced cardiac MRI(DE-MRI), nitrate stress 99Tcm-MIBI imaging (N-SPECT) and low-dose dobutamine stress echocardiography (LDDSE) for the detection of viable myocardium. Methods: Cardiac rest cine MRI(cine-MRI), DE-URI, N-SPECT and LDDSE were performed in 32 patients within one week after onset of acute myocardial infarction and undertaking percutaneous coronary intervention (PCI) thereafter. Second cine-MRI was performed 6- 11 months after PCI. A 16-segment model was adopted for the image analysis. Wall motion improvement after PCI was considered as a myocardial viability. The sensitivity, specificity and accuracy of three methods for the detection of viable segments were compared dy t and χ2 test. Results: The sensitivity, specificity and accuracy of DE-MRI were 76.7% (79/103), 83.8% (88/105)and 80.3% (167/208), respectively. The sensitivity, specificity and accuracy of N-SPECT were 75.9% (82/108), 65.2% (60/92) and 71.0% (142/200), respectively. The specificity and accuracy of N-SPECT were significantly lower than that of DE- MRI(P<0.01). The sensitivity, specificity and accuracy of LDDSE were 70.1% (47/67), 70.4% (50/71) and 70. 3% (97/138), respectively. The sensitivity of LDDSE was comparable to that of DE-MRI and the specificity and accuracy of LDDSE were significantly lower than that of DE-MRI (P<0.05). Conclusion: DE-MRI with high specificity and accuracy, potentially, is a valuable imaging method for the detection of viable myocardium. (authors)

  12. Retrospective Reconstruction of High Temporal Resolution Cine Images from Real-Time MRI using Iterative Motion Correction

    Hansen, Michael Schacht; Sørensen, Thomas Sangild; Arai, Andrew; Kellman, Peter

    2012-01-01

    Cardiac function has traditionally been evaluated using breath-hold cine acquisitions. However, there is a great need for free breathing techniques in patients who have difficulty in holding their breath. Real-time cardiac MRI is a valuable alternative to the traditional breath-hold imaging...... and motion correction based on nonrigid registration and can be applied to arbitrary k-space trajectories. The method is demonstrated with real-time Cartesian imaging and Golden Angle radial acquisitions, and the motion-corrected acquisitions are compared with raw real-time images and breath-hold cine...... approach, but the real-time images are often inferior in spatial and temporal resolution. This article presents a general method for reconstruction of high spatial and temporal resolution cine images from a real-time acquisition acquired over multiple cardiac cycles. The method combines parallel imaging...

  13. Methanol poisoning: characteristic MRI findings.

    Jain, Nirdesh; Himanshu, Dandu; Verma, Shailendra Prasad; Parihar, Anit

    2013-01-01

    Acute methanol intoxication is not an unusual poisoning. It can have serious neurological sequelae. We emphasize how neuroimaging can help in distinguishing methanol poisoning from other causes of acute unconsciousness in alcoholic patients such as hypoglycemic brain damage and carbon monoxide poisoning or head injury, which are frequently observed in alcoholic patients and are also responsible for altered sensorium. The most important findings in MR brain imaging in methanol poisoning have been bilateral putaminal hemorrhagic necrosis. Other less common findings are subcortical and deep white matter lesions, cerebral and cerebellar cortical lesions, and midbrain lesions, cerebral and intraventricular hemorrhage, and even enhancement of necrotic lesions, we found almost the entire spectrum of MRI findings in this patient with methanol poisoning. Neurological sequelae can entail the course and prognosis in methanol poisoning. The patient died because of ventilator-associated pneumonia that developed in the course of prolonged hospitalization. PMID:22634487

  14. Cine MRI in functional and morphological examination of the heart after myocardial infarction. Comparison to angiocardiography, two-dimensional echocardiography, radionuclide ventriculography and enzymatical estimation of infarct size

    61 patients (17 women, 44 men, 36-83 years, 32 with anterior, 29 with posterior wall infarction) received Cine-MRI in the true long and short axis of the heart and two-dimensional echocardiography one and 4 weeks post infarction. Two-level angiocardiography (ACG) and radionuclide ventriculography (RNV) were performed 4 weeks p.i. The size of myocardial infarction was determined enzymatically with the CK integral method. Left ventricular volume indices (EDVI, ESVI, SVI), ejection fraction (EF) and infarction weight (IW) were compared. Excellent correlations existed between Cine-MRI in the long and short axis for the volume indices and EF. Between Cine-MRI in the short axis and ACG all correlations were excellent aswell. They were significantly less satisfactory between Cine-MRI and 2DE due to the inhomogeneity of echo quality. Cine-MRI and RNV produced similar EF results (r=0.884), and a comparison of IW in Cine-MRI and CK integral method also showed a good correspondence (r=0.967). (orig./MG)

  15. Evaluation of dual-channel and 4-port multi transmit technique in 3T MRI. Implications for cardiac SSFP cine MRI

    We evaluated the usefulness of the dual-channel and 4-port multi transmit technique for cardiac examinations in 3T MRI. The B1 shimming conditions and the quadrature detection (QD) conditions were used, and B1 map scans and cardiac cine scans were performed using these two conditions. A half-Fourier FSE sequence was used for the B1 map scans, and the differences between the B1 shimming and QD conditions were analyzed. In addition, the cardiac cine images were acquired with a balanced steady-state free precession (bSSFP) sequence, and the image quality was compared in terms of the contrast-to-noise ratio. The maps acquired with the B1 shimming had lower RF field inhomogeneity than the maps acquired with the QD conditions. In the quantitative evaluation of the cine images, the contrast-to-noise ratio (CNR), and luminal signal-to-noise ratio (SNR) were significantly higher in scans with the B1 shimming than in scans with the QD conditions, while no significant differences were observed in the signal ratio or myocardial SNR. The use of this technique in 3T MRI provides significantly better B1 homogeneity and image quality in cardiac cine imaging as compared with conventional RF transmission. This technique has the potential to overcome the problems such as B1 inhomogeneity with commonly employed sequences for routine clinical cardiac MRI examinations performed at 3T. (author)

  16. Right-sided cardiac function in healthy volunteers measured by first-pass radionuclide ventriculography and gated blood-pool SPECT: comparison with cine MRI

    Kjaer, Andreas; Lebech, Anne-Mette; Hesse, Birger; Petersen, Claus Leth

    2005-01-01

    breath-hold cine MRI performed according to standard protocols. RESULTS: Normal ranges for RV ejection fraction (RVEF) defined as mean +/- 2SD were 0.49-0.72, 0.44-0.66 and 0.40-0.69 when measured by MRI, FP and GBPS respectively. Bland-Altman analysis showed a mean difference (bias) between MRI and FP...

  17. Internal margin assessment using cine MRI analysis of deglutition in head and neck cancer radiotherapy

    Purpose: Intensity-modulated radiation therapy (IMRT) is a promising treatment modality for patients with head and neck cancer (HNC). The dose distributions from IMRT are static and, thus, are unable to account for variations and/or uncertainties in the relationship between the patient (region being treated) and the beam. Organ motion comprises one such source of this uncertainty, introduced by physiological variation in the position, size, and shape of organs during treatment. In the head and neck, the predominant source of this variation arises from deglutition (swallowing). The purpose of this study was to investigate whether cinematographic MRI (cine MRI) could be used to determine asymmetric (nonuniform) internal margin (IM) components of tumor planning target volumes based on the actual deglutition-induced tumor displacement. Methods: Five head and neck cancer patients were set up in treatment position on a 3 T MRI scanner. Two time series of single-slice, sagittal, cine images were acquired using a 2D FLASH sequence. The first time series was a 12.8 min scan designed to capture the frequency and duration of deglutition in the treatment position. The second time series was a short, 15 s scan designed to capture the displacement of deglutition in the treatment position. Deglutition frequency and mean swallow duration were estimated from the long time series acquisition. Swallowing and resting (nonswallowing) events were identified on the short time series acquisition and displacement was estimated based on contours of gross tumor volume (GTV) generated at each time point of a particular event. A simple linear relationship was derived to estimate 1D asymmetric IMs in the presence of resting- and deglutition-induced displacement. Results: Deglutition was nonperiodic, with frequency and duration ranging from 2.89-24.18 mHz and from 3.86 to 6.10 s, respectively. The deglutition frequency and mean duration were found to vary among patients. Deglutition-induced maximal GTV displacements ranged from 0.00 to 28.36 mm with mean and standard deviation of 4.72±3.18, 3.70±2.81, 2.75±5.24, and 10.40±10.76 mm in the A, P, I, and S directions, respectively. Resting-induced maximal GTV displacement ranged from 0.00 to 5.59 mm with mean and standard deviation of 3.01±1.80, 1.25±1.10, 3.23+2.20, and 2.47±1.11 mm in the A, P, I, and S directions, respectively. For both resting and swallowing states, displacement along the S-I direction dominated displacement along the A-P direction. The calculated IMs were dependent on deglutition frequency, ranging from 3.28-4.37 mm for the lowest deglutition frequency patient to 3.76-6.43 mm for the highest deglutition frequency patient. A statistically significant difference was detected between IMs calculated for P and S directions (p=0.0018). Conclusions: Cine MRI is able to capture tumor motion during deglutition. Swallowing events can be demarcated by MR signal intensity changes caused by anatomy containing fully relaxed spins that move medially into the imaging plane during deglutition. Deglutition is nonperiodic and results in dynamic changes in the tumor position. Deglutition-induced displacements are larger and more variable than resting displacements. The nonzero mean maximum resting displacement indicates that some tumor motion occurs even when the patient is not swallowing. Asymmetric IMs, derived from deglutition frequency, duration, and directional displacement, should be employed to account for tumor motion in HNC RT.

  18. Internal margin assessment using cine MRI analysis of deglutition in head and neck cancer radiotherapy

    Paulson, Eric S.; Bradley, Julie A.; Wang Dian; Ahunbay, Ergun E.; Schultz, Christoper; Li, X. Allen [Department of Radiation Oncology, Medical College of Wisconsin, Milwaukee, Wisconsin 53226 (United States)

    2011-04-15

    Purpose: Intensity-modulated radiation therapy (IMRT) is a promising treatment modality for patients with head and neck cancer (HNC). The dose distributions from IMRT are static and, thus, are unable to account for variations and/or uncertainties in the relationship between the patient (region being treated) and the beam. Organ motion comprises one such source of this uncertainty, introduced by physiological variation in the position, size, and shape of organs during treatment. In the head and neck, the predominant source of this variation arises from deglutition (swallowing). The purpose of this study was to investigate whether cinematographic MRI (cine MRI) could be used to determine asymmetric (nonuniform) internal margin (IM) components of tumor planning target volumes based on the actual deglutition-induced tumor displacement. Methods: Five head and neck cancer patients were set up in treatment position on a 3 T MRI scanner. Two time series of single-slice, sagittal, cine images were acquired using a 2D FLASH sequence. The first time series was a 12.8 min scan designed to capture the frequency and duration of deglutition in the treatment position. The second time series was a short, 15 s scan designed to capture the displacement of deglutition in the treatment position. Deglutition frequency and mean swallow duration were estimated from the long time series acquisition. Swallowing and resting (nonswallowing) events were identified on the short time series acquisition and displacement was estimated based on contours of gross tumor volume (GTV) generated at each time point of a particular event. A simple linear relationship was derived to estimate 1D asymmetric IMs in the presence of resting- and deglutition-induced displacement. Results: Deglutition was nonperiodic, with frequency and duration ranging from 2.89-24.18 mHz and from 3.86 to 6.10 s, respectively. The deglutition frequency and mean duration were found to vary among patients. Deglutition-induced maximal GTV displacements ranged from 0.00 to 28.36 mm with mean and standard deviation of 4.72{+-}3.18, 3.70{+-}2.81, 2.75{+-}5.24, and 10.40{+-}10.76 mm in the A, P, I, and S directions, respectively. Resting-induced maximal GTV displacement ranged from 0.00 to 5.59 mm with mean and standard deviation of 3.01{+-}1.80, 1.25{+-}1.10, 3.23+2.20, and 2.47{+-}1.11 mm in the A, P, I, and S directions, respectively. For both resting and swallowing states, displacement along the S-I direction dominated displacement along the A-P direction. The calculated IMs were dependent on deglutition frequency, ranging from 3.28-4.37 mm for the lowest deglutition frequency patient to 3.76-6.43 mm for the highest deglutition frequency patient. A statistically significant difference was detected between IMs calculated for P and S directions (p=0.0018). Conclusions: Cine MRI is able to capture tumor motion during deglutition. Swallowing events can be demarcated by MR signal intensity changes caused by anatomy containing fully relaxed spins that move medially into the imaging plane during deglutition. Deglutition is nonperiodic and results in dynamic changes in the tumor position. Deglutition-induced displacements are larger and more variable than resting displacements. The nonzero mean maximum resting displacement indicates that some tumor motion occurs even when the patient is not swallowing. Asymmetric IMs, derived from deglutition frequency, duration, and directional displacement, should be employed to account for tumor motion in HNC RT.

  19. Estimation of Myocardial Strain and Contraction Phase From Cine MRI Using Variational Data Assimilation.

    Tuyisenge, Viateur; Sarry, Laurent; Corpetti, Thomas; Innorta-Coupez, Elisabeth; Ouchchane, Lemlih; Cassagnes, Lucie

    2016-02-01

    This paper presents a new method to estimate left ventricle deformations using variational data assimilation that combines image observations from cine MRI and a dynamic evolution model of the heart. The main contribution of the model is that it embeds parameters modeling the contraction / relaxation process. It estimates myocardial motion and contraction parameters simultaneously, providing accurate complementary information for diagnosis. The method was applied to synthetic datasets with known ground truth motion and to 47 patients MRI datasets acquired at three slice locations (base, mid-ventricle and apex). Radial and circumferential strain components were compared to those obtained with a reference tag tracking software, exhibiting good agreement with intraclass correlation coefficients (ICC) above 0.8. Results were also evaluated against wall motion score indices used to assess cardiac kinetics in clinical practice. The assimilation process overcame issues caused by temporal artifacts as a result of the dynamic model, compared to using the observation term alone. Moreover we found that the new dynamic model, consisting of a piecewise transport model acting independently on systole and diastole performed better than the standard continuous transport model, which oversmooths temporal variations. Estimated strain and contraction parameters significantly correlated to clinical scores, making them promising features for diagnosing not only hypokinesia but also dyskinesia. PMID:26372228

  20. Phase-contrast cine MRI versus MR cisternography on the evaluation of the communication between intraventricular arachnoid cysts and neighbouring cerebrospinal fluid spaces

    The objective of this study was to evaluate the role of phase-contrast cine magnetic resonance imaging (PC-MRI) in detecting possible communications between intraventricular arachnoid cysts (IV-ACs) and cerebrospinal fluid (CSF) spaces based on MR cisternography (MRC) comparison. Twenty-one patients with IV-AC were examined by PC-MRI and MRC. In order to determine the communication of IVAC with its neighbouring CSF spaces, PC-MRI was employed. The communication of IV-ACs with the ventricular system was examined on at least two anatomic planes. Precontrast images and PC-MRI were followed by the intrathecal administration of 0.5-1 ml gadopentetate dimeglumine. Early and delayed MRC were then carried out. Results of PC-MRI were compared with findings of MRC (McNemar's test). In seven IV-ACs, no communication was detected by PC-MRI. In 14 IVACs, a pulsatile CSF flow into the IV-ACs was observed. All the IV-ACs, which have been determined as non-communicating (NC) on the PC-MRI, showed NC character on MRC as well. Six cases suggesting a communication on PC-MRI showed no communication on MRC. MRC revealed eight communicating (38%) and 13 NC (62%) IV-ACs among a total of 21 cases. The sensitivity and specificity of PC-MRI imaging in demonstrating the communication between the IV-ACs and the CSF were 100% and 54%, respectively. PC-MRI is an effective method for evaluating NC IV-ACs. In order to decide about the management of IV-ACs, which are communicating according to the PC-MRI, the results should be confirmed with MRC if suspected jet flow is depicted. (orig.)

  1. Phase-contrast cine MRI versus MR cisternography on the evaluation of the communication between intraventricular arachnoid cysts and neighbouring cerebrospinal fluid spaces

    Algin, Oktay; Hakyemez, Bahattin; Gokalp, Gokhan; Parlak, Mufit [Uludag University School of Medicine, Department of Radiology, Bursa (Turkey); Korfali, Ender [Uludag University School of Medicine, Department of Neurosurgery, Bursa (Turkey)

    2009-05-15

    The objective of this study was to evaluate the role of phase-contrast cine magnetic resonance imaging (PC-MRI) in detecting possible communications between intraventricular arachnoid cysts (IV-ACs) and cerebrospinal fluid (CSF) spaces based on MR cisternography (MRC) comparison. Twenty-one patients with IV-AC were examined by PC-MRI and MRC. In order to determine the communication of IVAC with its neighbouring CSF spaces, PC-MRI was employed. The communication of IV-ACs with the ventricular system was examined on at least two anatomic planes. Precontrast images and PC-MRI were followed by the intrathecal administration of 0.5-1 ml gadopentetate dimeglumine. Early and delayed MRC were then carried out. Results of PC-MRI were compared with findings of MRC (McNemar's test). In seven IV-ACs, no communication was detected by PC-MRI. In 14 IVACs, a pulsatile CSF flow into the IV-ACs was observed. All the IV-ACs, which have been determined as non-communicating (NC) on the PC-MRI, showed NC character on MRC as well. Six cases suggesting a communication on PC-MRI showed no communication on MRC. MRC revealed eight communicating (38%) and 13 NC (62%) IV-ACs among a total of 21 cases. The sensitivity and specificity of PC-MRI imaging in demonstrating the communication between the IV-ACs and the CSF were 100% and 54%, respectively. PC-MRI is an effective method for evaluating NC IV-ACs. In order to decide about the management of IV-ACs, which are communicating according to the PC-MRI, the results should be confirmed with MRC if suspected jet flow is depicted. (orig.)

  2. Joint multi-object registration and segmentation of left and right cardiac ventricles in 4D cine MRI

    Ehrhardt, Jan; Kepp, Timo; Schmidt-Richberg, Alexander; Handels, Heinz

    2014-03-01

    The diagnosis of cardiac function based on cine MRI requires the segmentation of cardiac structures in the images, but the problem of automatic cardiac segmentation is still open, due to the imaging characteristics of cardiac MR images and the anatomical variability of the heart. In this paper, we present a variational framework for joint segmentation and registration of multiple structures of the heart. To enable the simultaneous segmentation and registration of multiple objects, a shape prior term is introduced into a region competition approach for multi-object level set segmentation. The proposed algorithm is applied for simultaneous segmentation of the myocardium as well as the left and right ventricular blood pool in short axis cine MRI images. Two experiments are performed: first, intra-patient 4D segmentation with a given initial segmentation for one time-point in a 4D sequence, and second, a multi-atlas segmentation strategy is applied to unseen patient data. Evaluation of segmentation accuracy is done by overlap coefficients and surface distances. An evaluation based on clinical 4D cine MRI images of 25 patients shows the benefit of the combined approach compared to sole registration and sole segmentation.

  3. Error analysis of cine phase contrast MRI velocity measurements used for strain calculation.

    Jensen, Elisabeth R; Morrow, Duane A; Felmlee, Joel P; Odegard, Gregory M; Kaufman, Kenton R

    2015-01-01

    Cine Phase Contrast (CPC) MRI offers unique insight into localized skeletal muscle behavior by providing the ability to quantify muscle strain distribution during cyclic motion. Muscle strain is obtained by temporally integrating and spatially differentiating CPC-encoded velocity. The aim of this study was to quantify CPC measurement accuracy and precision and to describe error propagation into displacement and strain. Using an MRI-compatible jig to move a B-gel phantom within a 1.5 T MRI bore, CPC-encoded velocities were collected. The three orthogonal encoding gradients (through plane, frequency, and phase) were evaluated independently in post-processing. Two systematic error types were corrected: eddy current-induced bias and calibration-type error. Measurement accuracy and precision were quantified before and after removal of systematic error. Through plane- and frequency-encoded data accuracy were within 0.4 mm/s after removal of systematic error - a 70% improvement over the raw data. Corrected phase-encoded data accuracy was within 1.3 mm/s. Measured random error was between 1 to 1.4 mm/s, which followed the theoretical prediction. Propagation of random measurement error into displacement and strain was found to depend on the number of tracked time segments, time segment duration, mesh size, and dimensional order. To verify this, theoretical predictions were compared to experimentally calculated displacement and strain error. For the parameters tested, experimental and theoretical results aligned well. Random strain error approximately halved with a two-fold mesh size increase, as predicted. Displacement and strain accuracy were within 2.6 mm and 3.3%, respectively. These results can be used to predict the accuracy and precision of displacement and strain in user-specific applications. PMID:25433567

  4. Pineal cysts: an incidental MRI finding?

    Di Costanzo, A; Tedeschi, G; Di Salle, F; Golia, F; Morrone, R; Bonavita, V

    1993-01-01

    The incidence of pineal cysts (PC) in "standard" MRI was reviewed. Seven cases of PC were found from 400 consecutive MRI examinations. PC did not produce clinically relevant symptoms in any of the patients. Our data, as well as those emerging from a critical review of the literature, suggest that PC are often asymptomatic and represent an incidental MRI finding.

  5. Frequency analysis of CSF flow on cine-MRI in normal pressure hydrocephalus

    To clarify the flow dynamics of intracranial cerebrospinal fluid (CSF) in normal pressure hydrocephalus (NPH), frequency analyses of CSF flow measured with an ECG-gated phase contrast cine magnetic resonance imaging (MRI) were performed. The amplitude and phase in the CSF flow spectra in the aqueduct were determined in patients with NPH after a subarachnoid hemorrhage (SAH-NPH group, n=26), an idiopathic NPH (I-NPH group, n=4), an asymptomatic ventricular dilation or a brain atrophy (VD group, n=21), and in healthy volunteers (control group, n=25). The changes of CSF flow spectra were also analyzed 5 and 15 minutes after an intravenous injection of acetazolamide. Moreover, a phase transfer function (PTF) calculated from the spectra of the driving vascular pulsation and CSF flow in the aqueduct were assessed in patients with SAH-NPH and control groups before and after acetazolamide injection. There values were compared with the pressure volume response (PVR). The amplitude of the 1st-3rd harmonics in the SAH-NPH or I-NPH group was significantly larger than in the control or VD group because of a decrease in compliance (increase in PVR). The phase of the 1st harmonic in the SAH-NPH group was significantly different from that in the control or VD group, but no difference was found between the control and VD groups. The amplitude of the 0-3rd harmonics increased, and the phase of the 1st harmonic changed in all groups after an acetazolamide injection. An evaluation of the time course of the direct current of CSF flow provided further information about the compensatory faculty of the cerebrospinal cavity. A PTF of the 1st harmonic in the SAH-NPH group was significantly larger than in the control group, and a positive correlation was noted between PTF of the 1st harmonic and PVR. In conclusion, frequency analyses of CSF flow measured by cine-MRI make it possible to obtain noninvasively a more detailed picture of the pathophysiology of NPH and of changes in intracranial conditions. (author)

  6. Comparison of cine-MRI and transthoracic echocardiography for the assessment of aortic root diameters in patients with suspected Marfan syndrome

    Patients with Marfan syndrome require repeated imaging for monitoring of aortic root aneurysms. Therefore, we evaluated the agreement and reproducibility of cine-MRI and echocardiography measurements of the sinuses of Valsalva in patients with suspected Marfan syndrome. 51 consecutive patients with suspected Marfan syndrome were prospectively examined using cine-MRI and echocardiography. Two readers independently measured aortic root diameters at the level of the sinuses of Valsalva in both cine-MRI and echocardiography. Statistics included intraclass correlation coefficient, Pearson correlation coefficient, Bland-Altman analysis, and two-sided t-test. In 38 of the 51 individuals (74.5 %), the diagnosis of Marfan syndrome was established according to the criteria of the Ghent-2 nosology. Cine-MRI measurements of the sinuses of Valsalva revealed a strong correlation with echocardiography (r=0.929), but a statistically significant bias of -1.0 mm (p<0.001). The mean absolute diameter for sinuses of Valsalva obtained by cine-MRI was 32.3 ± 5.8 mm as compared to 33.4 ± 5.4 mm obtained by echocardiography. Interobserver agreement of measurements of the sinuses of Valsalva was higher for cine-MRI than for echocardiography (p=0.029). Despite small, but statistically significant differences in terms of agreement and reproducibility, cine-MRI and echocardiographic measurements of aortic root diameters provide comparable results without a significant clinical difference. Therefore both techniques may be used for monitoring of the aortic root in patients with Marfan syndrome.

  7. Comparison of cine-MRI and transthoracic echocardiography for the assessment of aortic root diameters in patients with suspected Marfan syndrome

    Bannas, P.; Derlin, T.; Yamamura, J.; Lund, G.; Adam, G. [University Medical Center Hamburg-Eppendorf, Hamburg (Germany). Dept. of Diagnostic and Interventional Radiology; Rybczynski, M.; Sheikhzadeh, S.; Kodolitsch, Y. von [University Medical Center Hamburg-Eppendorf, Hamburg (Germany). Dept. of General and Interventional Cardiology; Groth, M. [University Medical Center Hamburg-Eppendorf, Hamburg (Germany). Section for Pediatric Radiology

    2015-11-15

    Patients with Marfan syndrome require repeated imaging for monitoring of aortic root aneurysms. Therefore, we evaluated the agreement and reproducibility of cine-MRI and echocardiography measurements of the sinuses of Valsalva in patients with suspected Marfan syndrome. 51 consecutive patients with suspected Marfan syndrome were prospectively examined using cine-MRI and echocardiography. Two readers independently measured aortic root diameters at the level of the sinuses of Valsalva in both cine-MRI and echocardiography. Statistics included intraclass correlation coefficient, Pearson correlation coefficient, Bland-Altman analysis, and two-sided t-test. In 38 of the 51 individuals (74.5 %), the diagnosis of Marfan syndrome was established according to the criteria of the Ghent-2 nosology. Cine-MRI measurements of the sinuses of Valsalva revealed a strong correlation with echocardiography (r=0.929), but a statistically significant bias of -1.0 mm (p<0.001). The mean absolute diameter for sinuses of Valsalva obtained by cine-MRI was 32.3 ± 5.8 mm as compared to 33.4 ± 5.4 mm obtained by echocardiography. Interobserver agreement of measurements of the sinuses of Valsalva was higher for cine-MRI than for echocardiography (p=0.029). Despite small, but statistically significant differences in terms of agreement and reproducibility, cine-MRI and echocardiographic measurements of aortic root diameters provide comparable results without a significant clinical difference. Therefore both techniques may be used for monitoring of the aortic root in patients with Marfan syndrome.

  8. Assessment of left atrial volume by Gd-DTPA-enhanced ultrafast cine MRI. Hemodynamic assessment in various diseases

    To assess the validity of contrast-enhanced breath-hold ultrafast cine MR imaging in left atrial (LA) volumes (LA max.I: maximal volume index of LA/LA min.I: minimal volume index of LA) and LA-volume curve, this method was compared with intravenous digital subtraction left atrial angiography (DSA) in serial 26 patients. The pulse sequence of ultrafast cine MRI were TR 8 ms, TE 3.2 ms, matrix 128 x 96 and NEX 1. The contrast-enhanced ultrafast cine MRI was shown to provide accurate left atrial images with higher success rate (88.9% in horizontal long axis view and 86.9% in vertical long axis view) in serial 891 cases. Comparison with LA volumes showed a high correlation (LA max.I: r=0.934, p2 in maximum and 17±5 ml/m2 in minimum. In patients with hypertension, old myocardial infarction, mitral valve diseases, dilated cardiomyopathy (DCM) and hypertrophic cardiomyopathy, LA-volumes were significantly increased. The LA-volumes at the beginning of left atrial active contraction were significantly correlated with LA-volume of active contraction. However, in patients with DCM, these statistical correlation were not demonstrated. In patients with DCM, preload of LA were increased, but LA-volumes of active contraction were not increased. For this reason, the afterload mismatch of LA was suspected in DCM. In conclusion, the contrast-enhanced ultrafast cine MRI is useful for determining LA volumes and LA volume curves. (author)

  9. Evaluation the role of myocardial perfusion of MRI and MR cine in acute coronary syndrome

    Objective: To evaluate the role of comprehensive cardiac MRI (CMRI) in diagnosis of patients with coronary artery disease (CAD). Methods; 55 patients with acute coronary syndrome underwent MR imaging 3-6 months after the reperfusion therapy. Short-axis images acquired by cine FIESTA sequence were used to analyze the motion of the different anatomy regions. Used the FGRE ET sequence to detect the patterns of the first-pass perfusion after injection of 0.2 mmol·kg-1 Gd-DTPA at a flow of 3 ml·s-1. 7-12 min later, MDE pulse sequence used to recognize the high signal in the myocardium. Results: At study entry, 38 subjects had the defect in the first-pass perfusion. The signal in the defect was significantly lower than that in the normal regions, which always in the sub-endocardium. 51 subjects had delayed enhancement regions in the myocardium at different degree and different range. The mean intensity of hyper-enhanced regions was 4.36 times higher compared with that of the regions without hyper-enhancement. the difference between the 2 regions had statistical significance. The extent of hyper-enhancement was significantly related to the abnormality of wall motion. The range of delayed enhancement was bigger than that of the first-perfusion defect. Conclusion: Comprehensive evidence of delayed hyper-enhancement, dysfunction of myocardium, and the defect of first-pass perfusion can be used to predict myocardial infarction

  10. MRI findings of juvenile psoriatic arthritis

    The aim of this study was to describe the magnetic resonance imaging (MRI) features of juvenile psoriatic arthritis (JpsA) in children in order to facilitate early diagnosis and proper management. Two pediatric radiologists retrospectively reviewed in consensus a total of 37 abnormal MRI examinations from 31 pediatric patients (nine boys, 22 girls; age range 1-17 years; mean age 9.4 years) who had a definite diagnosis of JpsA and underwent MRI. Each MRI was evaluated for synovium abnormality (thickening and enhancement), joint effusion (small, moderate, and large), bone marrow abnormality (edema, enhancement, and location of abnormality), soft tissue abnormality (edema, enhancement, atrophy, and fatty infiltration), tendon abnormality (thickening, edema, tendon sheath fluid, and enhancement), and articular abnormality (joint space narrowing and erosion). The distribution of abnormal MRI findings among the six categories for the 37 MRI examinations was evaluated. The number of abnormal MRI findings for each MRI examination was assessed. Age at MRI examination and all six categories of abnormal MRI findings according to gender were evaluated. There were a total 96 abnormal MRI findings noted on 37 abnormal MRI examinations from 31 pediatric patients. The 37 abnormal MRI examinations included MRI of the hand (n=8), knee (n = 8), ankle (n = 5), pelvis (n = 5), temporomandibular joint (n = 4), wrist (n = 3), foot (n = 2), elbow (n = 1), and shoulder (n = 1). Twenty-eight diffuse synovial thickening and/or enhancement were the most common MRI abnormality (29.2%). Joint effusion comprised 22 abnormal MRI findings (22.9%). There were 16 abnormal MRI bone marrow edema and/or enhancement findings (16.7%), and in seven (7.3%) the edema involved non-articular sites. Soft tissue abnormality manifested as edema and/or enhancement constituted 14 abnormal MRI findings (14.5%). There were ten MRI abnormalities (10.4%) involving tendons. Articular abnormality seen as joint space narrowing and/or bone erosion comprised six abnormal MRI findings (6.2%). Most MRI examinations had more than one abnormal finding (84%). Age at which MRI examinations were performed was not significantly different between boys and girls. All six categories of abnormal MRI findings were not significantly different between boys and girls. Children with JpsA typically present with more than one abnormal finding on their MRI studies. While synovial abnormality is the most common MR finding in children with JpsA, multi-focal bone marrow edema and enhancement at both articular and non-articular sites are also notable findings in children with JpsA. The rate of articular abnormality is much lower in children with JpsA in comparison to adults with psoriatic arthritis. Our findings suggest that MRI can play a useful role in the diagnosis and ongoing assessment of this uncommon, though important, pediatric rheumatologic disorder. (orig.)

  11. MRI findings of juvenile psoriatic arthritis

    Lee, Edward Y.; Kleinman, Paul K. [Harvard Medical School, Department of Radiology, Boston, MA (United States); Children' s Hospital Boston, MA (United States); Sundel, Robert P.; Kim, Susan [Harvard Medical School, Rheumatology Program, Division of Immunology and the Department of Pediatrics, Boston, MA (United States); Children' s Hospital Boston, MA (United States); Zurakowski, David [Harvard Medical School, Department of Radiology, Boston, MA (United States); Harvard Medical School, Department of Orthopaedic Surgery, Boston, MA (United States); Children' s Hospital Boston, MA (United States)

    2008-11-15

    The aim of this study was to describe the magnetic resonance imaging (MRI) features of juvenile psoriatic arthritis (JpsA) in children in order to facilitate early diagnosis and proper management. Two pediatric radiologists retrospectively reviewed in consensus a total of 37 abnormal MRI examinations from 31 pediatric patients (nine boys, 22 girls; age range 1-17 years; mean age 9.4 years) who had a definite diagnosis of JpsA and underwent MRI. Each MRI was evaluated for synovium abnormality (thickening and enhancement), joint effusion (small, moderate, and large), bone marrow abnormality (edema, enhancement, and location of abnormality), soft tissue abnormality (edema, enhancement, atrophy, and fatty infiltration), tendon abnormality (thickening, edema, tendon sheath fluid, and enhancement), and articular abnormality (joint space narrowing and erosion). The distribution of abnormal MRI findings among the six categories for the 37 MRI examinations was evaluated. The number of abnormal MRI findings for each MRI examination was assessed. Age at MRI examination and all six categories of abnormal MRI findings according to gender were evaluated. There were a total 96 abnormal MRI findings noted on 37 abnormal MRI examinations from 31 pediatric patients. The 37 abnormal MRI examinations included MRI of the hand (n=8), knee (n = 8), ankle (n = 5), pelvis (n = 5), temporomandibular joint (n = 4), wrist (n = 3), foot (n = 2), elbow (n = 1), and shoulder (n = 1). Twenty-eight diffuse synovial thickening and/or enhancement were the most common MRI abnormality (29.2%). Joint effusion comprised 22 abnormal MRI findings (22.9%). There were 16 abnormal MRI bone marrow edema and/or enhancement findings (16.7%), and in seven (7.3%) the edema involved non-articular sites. Soft tissue abnormality manifested as edema and/or enhancement constituted 14 abnormal MRI findings (14.5%). There were ten MRI abnormalities (10.4%) involving tendons. Articular abnormality seen as joint space narrowing and/or bone erosion comprised six abnormal MRI findings (6.2%). Most MRI examinations had more than one abnormal finding (84%). Age at which MRI examinations were performed was not significantly different between boys and girls. All six categories of abnormal MRI findings were not significantly different between boys and girls. Children with JpsA typically present with more than one abnormal finding on their MRI studies. While synovial abnormality is the most common MR finding in children with JpsA, multi-focal bone marrow edema and enhancement at both articular and non-articular sites are also notable findings in children with JpsA. The rate of articular abnormality is much lower in children with JpsA in comparison to adults with psoriatic arthritis. Our findings suggest that MRI can play a useful role in the diagnosis and ongoing assessment of this uncommon, though important, pediatric rheumatologic disorder. (orig.)

  12. Congenital dacryocystocele: prenatal MRI findings

    Congenital dacryocystocele can be diagnosed prenatally by imaging. Prenatal MRI is increasingly utilized for fetal diagnosis. To present the radiological and clinical features of seven fetuses with congenital dacryocystocele diagnosed with prenatal MRI. The institutional database of 1,028 consecutive prenatal MR examinations performed during a period of 4 years was reviewed retrospectively. The cases of congenital dacryocystocele were identified by reading the report of each MRI study. The incidence of dacryocystocele diagnosed with prenatal MRI was 0.7% (n=7/1,028). The dacryocystocele was bilateral in three fetuses. Mean gestational age at the time of diagnosis was 31 weeks. The indication for prenatal MRI was the presence or the suspicion of central nervous system abnormality in six fetuses and diaphragmatic hernia in one. Dacryocystocele was associated with an intranasal cyst in six of ten eyes. Prenatal sonography revealed dacryocystocele in only two of seven fetuses. Of eight eyes with postnatal follow-up, four did not have any lacrimal symptoms. Prenatal MRI can delineate congenital dacryocystocele more clearly and in a more detailed fashion than ultrasonography. Presence of dacryocystocele was symptomatic in only 50% of our patients, supporting that prenatal diagnosis of dacryocystocele might follow a benign course. (orig.)

  13. Congenital dacryocystocele: prenatal MRI findings

    Yazici, Zeynep [Cincinnati Children' s Hospital Medical Center, Department of Radiology, Cincinnati, OH (United States); Uludag University, Department of Radiology, Faculty of Medicine, Bursa (Turkey); Kline-Fath, Beth M.; Rubio, Eva I.; Calvo-Garcia, Maria A.; Linam, Leann E. [Cincinnati Children' s Hospital Medical Center, Department of Radiology, Cincinnati, OH (United States); Yazici, Bulent [Uludag University, Department of Ophthalmology, Faculty of Medicine, Bursa (Turkey)

    2010-12-15

    Congenital dacryocystocele can be diagnosed prenatally by imaging. Prenatal MRI is increasingly utilized for fetal diagnosis. To present the radiological and clinical features of seven fetuses with congenital dacryocystocele diagnosed with prenatal MRI. The institutional database of 1,028 consecutive prenatal MR examinations performed during a period of 4 years was reviewed retrospectively. The cases of congenital dacryocystocele were identified by reading the report of each MRI study. The incidence of dacryocystocele diagnosed with prenatal MRI was 0.7% (n=7/1,028). The dacryocystocele was bilateral in three fetuses. Mean gestational age at the time of diagnosis was 31 weeks. The indication for prenatal MRI was the presence or the suspicion of central nervous system abnormality in six fetuses and diaphragmatic hernia in one. Dacryocystocele was associated with an intranasal cyst in six of ten eyes. Prenatal sonography revealed dacryocystocele in only two of seven fetuses. Of eight eyes with postnatal follow-up, four did not have any lacrimal symptoms. Prenatal MRI can delineate congenital dacryocystocele more clearly and in a more detailed fashion than ultrasonography. Presence of dacryocystocele was symptomatic in only 50% of our patients, supporting that prenatal diagnosis of dacryocystocele might follow a benign course. (orig.)

  14. Accuracy of left ventricular ejection fraction estimation by gated Tc-99m sestamibi SPECT: Comparison with breath hold Cine MRI

    Full text: Left Ventricular Ejection Fraction (LVEF) is one of the most important functional parameters in clinical cardiology. Due to the high temporal and spatial resolution of Breath Hold Cine MRI (MRI), this technique is considered to be able to accurately estimate Left Ventricular volumes and hence LVEF. Recently, LVEF has been measured using Gated Tc-99m Sestamibi SPECT (GSSPECT) and a validation study comparing LVEF calculated by GSSPECT and MRI was performed. Over a four month period, 14 patients had both GSSPECT and MRI within a stable 7 day period. All patients were being investigated for CAD and the GSSPECT was performed as part of the routine myocardial perfusion imaging. GSSPECT was performed at rest one hour after peak exercise injection of Tc-99m Sestamibi (mean dose 1000 MBq, range 800- 1100 MBq) with imaging performed on Picker 1000 gamma camera or 3000 using standard 8 interval acquisition. All patients were analysed with the automated Picker QGS package. MRI was performed on a 1.5 T MRI( GE Signa Advantage) using a previously described breath hold Cine technique with data being acquired in the cardiac short axis. The entire LV was imaged with 10 cm contiguous short axis slices being acquired with 11-16 frames per slice, depending on heart rate. A semi automated volumetric image analysis program was used to estimate LV volumes using Simpson's rule. The range of LVEF was from 30% to 70%. Linear regression analysis demonstrated excellent agreement for LVEF calculated by GSSPECT and MRI (y= -5.4 + 0.97 x, r=0.90). Automated estimation of LVEF using GSSPECT correlates well with LVEF estimations using MRI and can accurately estimate LVEF in routine clinical practice

  15. Detection of viable myocardium by low dose dobutamine cine MRI: experimental study in pigs

    Objective: To evaluate the diagnostic value of dobutamine stress magnetic resonance imaging (MR) for myocardial viability. Methods: Mini swine (n = 10) underwent left ventriculography and coronary angiography, followed by stenosis of the left circumflex coronary artery (LCX) using aneroid constrictor. More than 1 month later left ventriculography and coronary angiography were performed again, followed by cine-MR at rest and during stress with incremental dose of dobutamine 5-20 μg · kg-1 · min-1. Traditional and/or breath-hold cine-MR were used to evaluate regional left ventricular wall motion, corresponding to basal, mid ventricular and apical short-axis tomograms. Regional wall motion score index (WMSI) was calculated. Mini swine were finally sacrificed for pathological examination. Triphenyl tetrazolium chloride (TTC) assessed myocardial infarction. Microscopy was used to identify myocardial cellular changes. Results: One pig died, 1 pig suffered from aneurysm and another 1 showed negative findings. The other 7 pigs were found with hypokinetic (n=4) or akinetic (n = 3) myocardial regions related to stenosed LCX, their mean WMSI at rest for the lateral and postero-inferior walls (ischemic regions) of the left ventricle was 2.27 +- 0.32 compared with 1.00 +- 0.00 (x2 = 106.27, P 2 = 20.57, P -1·min-1. However, the mean WMSI at the dose of dobutamine 10 and 20 μg·kg-1·min-1 was 1.70 +- 0.76, 1.75 +- 0.83, respectively, compared with the mean WSCI at rest (x2=3.25 versus 2.33, P > 0.05). The pathologic examination showed viable myocardium at the ischemic regions. Conclusion: Low dose dobutamine (5 μg·kg-1·min-1) can recover hypokinetic or akinetic myocardial regions, Dobutamine stress MR can detect myocardial viability

  16. Associations between spondyloarthritis features and MRI findings

    Arnbak, Bodil; Jurik, Anne Grethe; Hørslev-Petersen, Kim; Hendricks, Oliver; Hermansen, Louise Thuesen; Loft, Anne Gitte; Østergaard, Mikkel; Pedersen, Susanne Juhl; Zejden, Anna; Egund, Niels; Holst, René; Manniche, Claus; Jensen, Tue Secher

    2015-01-01

    clinical features and MRI findings included in ASAS criteria, and 2) explore the associations between clinical features and MRI findings. METHODS: Patients aged 18-40 years with persistent LBP referred to an outpatient spine clinic were included. Information on clinical features (incl. HLA-B27 and CRP) and...... MRI findings of the spine and sacroiliac joints (SIJ) were collected. RESULTS: Of 1020 included patients, 537(53%) had minimum one clinical feature. Three clinical features were common; inflammatory back pain, good response to NSAID and family disposition (15-17% each). MRI sacroiliitis, according to...... ASAS definition, was present in 217(21%) patients. Of those, 91(42%) had bone marrow oedema (BMO) at the minimum requirement according to ASAS (low BMO score). HLA-B27, peripheral arthritis, good response to NSAID, and preceding infection associated independently with SIJ MRI findings (OR range 1...

  17. MRI findings of extramedullary haemopoiesis

    Chourmouzi, D.; Pistevou-Gompaki, K.; Plataniotis, G.; Skaragas, G.; Papadopoulos, L.; Drevelegas, A. [Dept. of Diagnostic Radiology and Radiation Oncology, AHEPA University Hospital, Thessaloniki (Greece)

    2001-09-01

    Extramedullary haemopoiesis (EH) is a compensatory process associated with chronic haemolytic anaemia. It is rare, however, for such an abnormality to cause spinal cord compression. We present two patients with known beta-thalassaemia intermedia who developed spinal cord compression due to masses of extramedullary haematopoietic tissue in the epidural space of the thoracic spine. The EH masses were diagnosed by MRI as an isointense epidural lesion on both T1- and T2-weighted images, compressing severely the spinal cord. After administration of a paramagnetic agent, an intermediate enhancement of the masses was evident. All the vertebral bodies had low to intermediate signal intensity as a result of displacement of fatty marrow by haematopoietic marrow. Expansion of thoracic ribs with bilateral paravertebral masses were characteristic. A small dose of radiotherapy was given and marked improvement in neurological symptoms was evident. An MRI examination established shrinkage of the mass and decompression of spinal cord. The role of MRI in diagnosis of EH masses is essential and radiation therapy is a very effective treatment for this rare complication. (orig.)

  18. MRI findings in 100 epileptic children

    Findings of magnetic resonance imaging (MRI) of the brain were retrospectively reviewed in 100 consecutive pediatric patients with epilepsy in relation to the type of epilepsy and prognosis. There were 65 boys and 35 girls, ranging in age from 3 months to 25 years. Among 100 patients, 67 (a total of 102 lesions) showed abnormal findings on MRI. Morphological abnormalities, including ventricular enlargement, atrophy and malformation, were seen in 54 patients. Periventricular (n=14), frontal (n=3), temporal (n=8) and occipital (n=7) areas were of high signal intensity on T2-weighted images. According to the type of epilepsy, MRI abnormality was seen in 34 (61%) of 56 patients with partial seizures and 33 (76%) of 44 patients with generalized seizures. When associated with cerebral palsy and mental retardation, the incidence of MRI abnormality was high. There was no sigificant correlation between MRI findings and prognosis. (N.K.)

  19. Quantification of lung tumor rotation with automated landmark extraction using orthogonal cine MRI images

    Paganelli, Chiara; Lee, Danny; Greer, Peter B.; Baroni, Guido; Riboldi, Marco; Keall, Paul

    2015-09-01

    The quantification of tumor motion in sites affected by respiratory motion is of primary importance to improve treatment accuracy. To account for motion, different studies analyzed the translational component only, without focusing on the rotational component, which was quantified in a few studies on the prostate with implanted markers. The aim of our study was to propose a tool able to quantify lung tumor rotation without the use of internal markers, thus providing accurate motion detection close to critical structures such as the heart or liver. Specifically, we propose the use of an automatic feature extraction method in combination with the acquisition of fast orthogonal cine MRI images of nine lung patients. As a preliminary test, we evaluated the performance of the feature extraction method by applying it on regions of interest around (i) the diaphragm and (ii) the tumor and comparing the estimated motion with that obtained by (i) the extraction of the diaphragm profile and (ii) the segmentation of the tumor, respectively. The results confirmed the capability of the proposed method in quantifying tumor motion. Then, a point-based rigid registration was applied to the extracted tumor features between all frames to account for rotation. The median lung rotation values were  -0.6   ±   2.3° and  -1.5   ±   2.7° in the sagittal and coronal planes respectively, confirming the need to account for tumor rotation along with translation to improve radiotherapy treatment.

  20. Anencephaly: MRI findings and pathogenetic theories

    We describe the MRI appearances of an anencephalic newborn who survived for 13 h; particularities of this case are male gender and the absence of other associated malformations. Moreover, we discuss the pathogenetic theories of anencephaly, correlating MRI findings with embryological data. An exencephaly-anencephaly sequence due to amnion rupture is hypothesized. (orig.)

  1. Anencephaly: MRI findings and pathogenetic theories

    Calzolari, Ferdinando [Azienda Ospedaliera Universitaria, Department of Neuroradiology, Ferrara (Italy); Gambi, Beatrice [Ospedale S. Donato, Neonatal Unit, Arezzo (Italy); Garani, Giampaolo; Tamisari, Lalla [Universita degli Studi, Neonatal Unit, Ferrara (Italy)

    2004-12-01

    We describe the MRI appearances of an anencephalic newborn who survived for 13 h; particularities of this case are male gender and the absence of other associated malformations. Moreover, we discuss the pathogenetic theories of anencephaly, correlating MRI findings with embryological data. An exencephaly-anencephaly sequence due to amnion rupture is hypothesized. (orig.)

  2. Usefulness of breath-hold cardiac cine MR imaging with a middle field MRI system

    To assess the accuracy of contrast-enhanced, single breath-hold cine MR imaging in calculating left ventricular volume and ejection fraction, we compared MR measurements with those obtained by using cine ventriculography in 60 patients. Fast cine MR images were acquired with a middle field MR system (0.5 T). A breath-hold single slice multi-phase fast gradient-echo (Fast Card) sequence was used to obtain fast cine MR images with the following parameters; TR of 16 ms, TE of 3 ms, flip angle of 30 degree, matrix elements of 256 x 128, view per segment of 6, field of view of 350 x 260 mm and one excitation. Left ventricular end-diastolic volume and ejection fraction obtained with contrast-enhanced Fast Card correlated well with those obtained with cine ventriculography (end-diastolic volume, y=1.00x+14.0, r=0.904, p<0.001; ejection fraction, y=0.961x+2.8, r=0.936, p<0.001). Our results show that contrast enhanced breath-hold cardiac cine MR imaging on horizontal long-axis view using a middle field MR system is an accurate method for evaluating left ventricular volume and ejection fraction. (author)

  3. SU-C-17A-05: Quantification of Intra-Fraction Motion of Breast Tumors Using Cine-MRI

    Heijst, T van; Philippens, M; Bongard, D van den; Asselen, B van; Lagendijk, J; Kleijnen, J; Hartogh, M den [University Medical Center Utrecht, Utrecht (Netherlands)

    2014-06-01

    Purpose: Magnetic resonance imaging (MRI) enables direct characterization of intra-fraction motion ofbreast tumors, due to high softtissue contrast and geometric accuracy. The purpose is to analyzethis motion in early-stage breast-cancer patients using pre-operative supine cine-MRI. Methods: MRI was performed in 12 female early-stage breast-cancer patients on a 1.5-T Ingenia (Philips)wide-bore scanner in supine radiotherapy (RT) position, prior to breast-conserving surgery. Twotwodimensional (2D) T2-weighted balanced fast-field echo (cine-MRI) sequences were added tothe RT protocol, oriented through the tumor. They were alternately acquired in the transverse andsagittal planes, every 0.3 s during 1 min. A radiation oncologist delineated gross target volumes(GTVs) on 3D contrast-enhanced MRI. Clinical target volumes (CTV = GTV + 15 mm isotropic)were generated and transferred onto the fifth time-slice of the time-series, to which subsequents lices were registered using a non-rigid Bspline algorithm; delineations were transformed accordingly. To evaluate intra-fraction CTV motion, deformation fields between the transformed delineations were derived to acquire the distance ensuring 95% surface coverage during scanning(P95%), for all in-plane directions: anteriorposterior (AP), left-right (LR), and caudal-cranial(CC). Information on LR was derived from transverse scans, CC from sagittal scans, AP fromboth sets. Results: Time-series with registration errors - induced by motion artifacts - were excluded by visual inspection. For our analysis, 11 transverse, and 8 sagittal time-series were taken into account. Themedian P95% calculated in AP (19 series), CC (8), and LR (11) was 1.8 mm (range: 0.9–4.8), 1.7mm (0.8–3.6), and 1.0 mm (0.6–3.5), respectively. Conclusion: Intra-fraction motion analysis of breast tumors was achieved using cine-MRI. These first results show that in supine RT position, motion amplitudes are limited. This information can be used for adaptive RT planning, and to develop preoperative partial-breast RT strategies, such asablative RT for early-stage breast-cancer patients.

  4. MRI findings of Guillain-Barre syndrome

    To evaluate MRI findings of Guillain-Barre syndrome. In six patients with Guillain-Barre syndrome diagnosed by clinical, cerebrospinal fluid and electrophysiologic findings, a retrospective review of MR findings was conducted. Follow-up MRI scans were carried out in two patients showing minimal clinical improvement. Marked or moderate enhancement of thickened nerve roots was seen in all cases on gadopentetate dimeglumine enhanced axial T1-weighted images. Two patterns were seen; one was even enhancement of both anterior and posterior nerve roots (n=1) and the other was enhancement of anterior nerve roots only (n=5). Enhancement and thickness of nerve roots was seen to have slightly decreased on MRI follow-up at 32 and 50 days; clinical and electrophysiologic examination showed minimal improvement. Although MRI findings of nerve root enhancement are nonspecific and can be seen in neoplastic and other inflammatory diseases, the enhancement of thickened anterior nerve roots within the cal sac suggests Guillain-Barre syndrome

  5. MRI findings of Guillain-Barre syndrome

    Park, Won Kyu; Lee, Hwa Jin; Byun, Woo Mok [Yeungnam Univ. College of Medicine, Taegu (Korea, Republic of)

    1997-04-01

    To evaluate MRI findings of Guillain-Barre syndrome. In six patients with Guillain-Barre syndrome diagnosed by clinical, cerebrospinal fluid and electrophysiologic findings, a retrospective review of MR findings was conducted. Follow-up MRI scans were carried out in two patients showing minimal clinical improvement. Marked or moderate enhancement of thickened nerve roots was seen in all cases on gadopentetate dimeglumine enhanced axial T1-weighted images. Two patterns were seen; one was even enhancement of both anterior and posterior nerve roots (n=1) and the other was enhancement of anterior nerve roots only (n=5). Enhancement and thickness of nerve roots was seen to have slightly decreased on MRI follow-up at 32 and 50 days; clinical and electrophysiologic examination showed minimal improvement. Although MRI findings of nerve root enhancement are nonspecific and can be seen in neoplastic and other inflammatory diseases, the enhancement of thickened anterior nerve roots within the cal sac suggests Guillain-Barre syndrome.

  6. MRI finding of ethylmalonic encephalopathy: case report

    Ethylmalonic encephalopathy is a rare syndrom characterized by developmental delay, acrocyanosis, petechiae, chronic diarrhea, and ethylmalonic, lactic, and methylsuccinic aciduria. We report the MRI finding of ethylmalonic encephalopathy including previously unreported intracranial hematoma

  7. MRI finding of ethylmalonic encephalopathy: case report

    Kim, Jin Yong; Lee, Shi Kyung; Han, Chun Hwan; Rho, Eun Jin [Kangnam General Hospital Public Corporation, Seoul (Korea, Republic of)

    2002-12-01

    Ethylmalonic encephalopathy is a rare syndrom characterized by developmental delay, acrocyanosis, petechiae, chronic diarrhea, and ethylmalonic, lactic, and methylsuccinic aciduria. We report the MRI finding of ethylmalonic encephalopathy including previously unreported intracranial hematoma.

  8. MRI findings in acute Hendra virus meningoencephalitis

    Aim: To describe serial changes in brain magnetic resonance imaging (MRI) in acute human infection from two outbreaks of Hendra virus (HeV), relate these changes to disease prognosis, and compare HeV encephalitis to reported cases of Nipah virus encephalitis. Materials and methods: The MRI images of three human cases (two of which were fatal) of acute HeV meningoencephalitis were reviewed. Results: Cortical selectivity early in the disease is evident in all three patients, while deep white matter involvement appears to be a late and possibly premorbid finding. This apparent early grey matter selectivity may be related to viral biology or ribavirin pharmacokinetics. Neuronal loss is evident at MRI, and the rate of progression of MRI abnormalities can predict the outcome of the infection. In both fatal cases, the serial changes in the MRI picture mirrored the clinical course. Conclusion: This is the first comprehensive report of serial MRI findings in acute human cerebral HeV infection from two outbreaks. The cortical selectivity appears to be an early finding while deep white matter involvement a late, and possibly premorbid, finding. In both fatal cases, the serial changes in MRI mirrored the clinical course.

  9. MRI findings in acute Hendra virus meningoencephalitis

    Nakka, P.; Amos, G.J. [Department of Diagnostic Radiology, Princess Alexandra Hospital, Woolloongabba, Qld 4102 (Australia); Saad, N., E-mail: nivena100@hotmail.com [Department of Diagnostic Radiology, Princess Alexandra Hospital, Woolloongabba, Qld 4102 (Australia); Jeavons, S. [Department of Diagnostic Radiology, Princess Alexandra Hospital, Woolloongabba, Qld 4102 (Australia)

    2012-05-15

    Aim: To describe serial changes in brain magnetic resonance imaging (MRI) in acute human infection from two outbreaks of Hendra virus (HeV), relate these changes to disease prognosis, and compare HeV encephalitis to reported cases of Nipah virus encephalitis. Materials and methods: The MRI images of three human cases (two of which were fatal) of acute HeV meningoencephalitis were reviewed. Results: Cortical selectivity early in the disease is evident in all three patients, while deep white matter involvement appears to be a late and possibly premorbid finding. This apparent early grey matter selectivity may be related to viral biology or ribavirin pharmacokinetics. Neuronal loss is evident at MRI, and the rate of progression of MRI abnormalities can predict the outcome of the infection. In both fatal cases, the serial changes in the MRI picture mirrored the clinical course. Conclusion: This is the first comprehensive report of serial MRI findings in acute human cerebral HeV infection from two outbreaks. The cortical selectivity appears to be an early finding while deep white matter involvement a late, and possibly premorbid, finding. In both fatal cases, the serial changes in MRI mirrored the clinical course.

  10. Vertebral involvement in SAPHO syndrome: MRI findings

    Nachtigal, A.; Cardinal, E.; Bureau, N.J. [Dept. of Radiology, Univ. de Montreal, QC (Canada); Sainte-Marie, L.G. [Dept. of Internal Medicine, Univ. de Montreal, QC (Canada); Milette, F. [Department of Pathology, Univ. de Montreal, QC (Canada)

    1999-03-01

    We report on the MRI findings in the vertebrae and surrounding soft tissues in two patients with the SAPHO syndrome (Synovitis, Acne, Pustulosis, Hyperostosis, Osteitis). The MRI findings include abnormal bone marrow signal, either focal or diffuse, of the vertebral bodies and posterior elements; hyperintense paravertebral soft tissue swelling and abnormal signal of the intervertebral discs. These changes are consistent with discitis and osteitis. (orig.) With 6 figs., 17 refs.

  11. Vertebral involvement in SAPHO syndrome: MRI findings

    We report on the MRI findings in the vertebrae and surrounding soft tissues in two patients with the SAPHO syndrome (Synovitis, Acne, Pustulosis, Hyperostosis, Osteitis). The MRI findings include abnormal bone marrow signal, either focal or diffuse, of the vertebral bodies and posterior elements; hyperintense paravertebral soft tissue swelling and abnormal signal of the intervertebral discs. These changes are consistent with discitis and osteitis. (orig.)

  12. Respiratory lumenal change of the pharynx and trachea in normal subjects and COPD patients: assessment by cine-MRI

    The purpose of this study was to use cine-MRI during continuous respiration to measure the respiratory lumenal diameter change in the pharynx and at an upper tracheal level. Fifteen non-smokers and 23 chronic obstructive pulmonary disease (COPD) patients with smoking history (median 50 pack-years) were included. Cine-MRI with seven frames/s was performed during continuous respiration. Minimal and maximal cross-sectional lumenal diameters within the pharynx and the upper tracheal lumen area were measured. The median diameter change in the pharynx (tracheal area) was 70% (1.4 cm2) in volunteers and 76% (1.7 cm2) in smokers (P=0.98, P=0.04). Tracheal lumenal collapse was a median of 43% in volunteers and 64% in smokers (P=0.011). No clear disease-related difference of the pharynx-lumen was found. The maximal cross-sectional area of the upper trachea lumen as well as the respiratory collapse was larger in COPD patients than in normal subjects. This information is important for the modelling of ventilation and prediction of drug deposition, which are influenced by the airway diameter. (orig.)

  13. Respiratory lumenal change of the pharynx and trachea in normal subjects and COPD patients: assessment by cine-MRI

    Heussel, Claus Peter; Rist, Anja; Gast, Klaus Kurt; Schreiber, Wolfgang G. [Johannes Gutenberg University, Department of Radiology, Mainz (Germany); Ley, Sebastian; Kauczor, Hans-Ulrich [Johannes Gutenberg University, Department of Radiology, Mainz (Germany); German Cancer Research Centre, Department of Radiology, Heidelberg (Germany); Biedermann, Alexander [Department of Pneumology, III. Internal Medicine, Mainz (Germany)

    2004-12-01

    The purpose of this study was to use cine-MRI during continuous respiration to measure the respiratory lumenal diameter change in the pharynx and at an upper tracheal level. Fifteen non-smokers and 23 chronic obstructive pulmonary disease (COPD) patients with smoking history (median 50 pack-years) were included. Cine-MRI with seven frames/s was performed during continuous respiration. Minimal and maximal cross-sectional lumenal diameters within the pharynx and the upper tracheal lumen area were measured. The median diameter change in the pharynx (tracheal area) was 70% (1.4 cm{sup 2}) in volunteers and 76% (1.7 cm{sup 2}) in smokers (P=0.98, P=0.04). Tracheal lumenal collapse was a median of 43% in volunteers and 64% in smokers (P=0.011). No clear disease-related difference of the pharynx-lumen was found. The maximal cross-sectional area of the upper trachea lumen as well as the respiratory collapse was larger in COPD patients than in normal subjects. This information is important for the modelling of ventilation and prediction of drug deposition, which are influenced by the airway diameter. (orig.)

  14. Diffusion MRI findings in phenylketonuria

    Sener, R.N. [Dept. of Radiology, Ege Univ. Hospital, Izmir (Turkey)

    2003-12-01

    Two patients with phenylketonuria were studied who were under dietary control since infancy, and who were mentally normal. Diffusion MRI was obtained using a spin-echo, echo-planar sequence with a gradient strength of 30 mT/m at 1.5 T. A trace sequence (TR=5700 ms, and TE=139 ms) was used, acquired in 22 s. Heavily diffusion-weighted (b=1000 mm{sup 2}/s) images, and the apparent diffusion coefficient (ADC) values from automatically generated ADC maps were studied. There were two different patterns in these two patients, restricted and increased diffusion patterns. Restricted diffusion pattern consisted of high-signal on b=1000 s/mm{sup 2} images with low ADC values ranging from 0.46 to 0.57 x 10{sup -3} mm{sup 2}/s. Increased diffusion pattern consisted of normal b=1000 s/mm{sup 2} images with high ADC values ranging from 1.37 to 1.63 x 10{sup -3} mm{sup 2}/s. It is likely that these values reflected presence of two different histopathological changes in phenylketonuria or reflected different stages of the same disease. (orig.)

  15. Fucosidosis: MRI and MRS findings

    Fucosidosis is a rare, autosomal recessive lysosomal storage disease in which fucose-containing glycolipids, glycoproteins, and oligosaccharides accumulate in tissues as a consequence of α-l-fucosidase enzyme deficiency. We present the MR imaging findings of diffuse white-matter hyperintensity and pallidal curvilinear streak hyperintensity in a 6-year-old Caucasian girl with a diagnosis of fucosidosis based on cDNA isolated from skin fibroblasts. This report also includes the MRS findings of a decreased N-acetylaspartate/choline ratio together with an abnormal peak at 3.8 ppm which expand the knowledge of the neuroradiological spectrum of this rare disease. (orig.)

  16. Fucosidosis: MRI and MRS findings

    Oner, Ali Y.; Akpek, Sergin [Gazi University School of Medicine, Department of Radiology, Ankara (Turkey); Cansu, Ali; Serdaroglu, Ayse [Gazi University School of Medicine, Department of Paediatrics, Ankara (Turkey)

    2007-10-15

    Fucosidosis is a rare, autosomal recessive lysosomal storage disease in which fucose-containing glycolipids, glycoproteins, and oligosaccharides accumulate in tissues as a consequence of {alpha}-l-fucosidase enzyme deficiency. We present the MR imaging findings of diffuse white-matter hyperintensity and pallidal curvilinear streak hyperintensity in a 6-year-old Caucasian girl with a diagnosis of fucosidosis based on cDNA isolated from skin fibroblasts. This report also includes the MRS findings of a decreased N-acetylaspartate/choline ratio together with an abnormal peak at 3.8 ppm which expand the knowledge of the neuroradiological spectrum of this rare disease. (orig.)

  17. MRI findings in the painful hemiplegic shoulder

    Tavora, D.G.F., E-mail: danielgurgel@sarah.b [Department of Radiology, Sarah Network of Hospitals for Rehabilitation, Fortaleza (Brazil); Gama, R.L.; Bomfim, R.C. [Department of Radiology, Sarah Network of Hospitals for Rehabilitation, Fortaleza (Brazil); Nakayama, M. [Department of Radiology, Federal University of Grande Dourados, Dourados (Brazil); Silva, C.E.P. [Department of Statistics, Sarah Network of Hospitals for Rehabilitation, Fortaleza (Brazil)

    2010-10-15

    Aim: To evaluate the magnetic resonance imaging (MRI) findings in painful hemiplegic shoulder (PHS) in hemiplegic post-stroke patients. Materials and methods: Patients with hemiplegia following their first cerebrovascular accident who were admitted to the Sarah Network of Hospitals for Rehabilitation were studied. Forty-five patients with pain in the hemiplegic shoulder and 23 post-stroke patients without shoulder pain were investigated. MRI and radiographic findings of the hemiplegic and contralateral asymptomatic shoulders were evaluated. Results: Some MRI findings were more frequent in PHS group, including synovial capsule thickening, synovial capsule enhancement, and enhancement in the rotator cuff interval. Conclusions: Adhesive capsulitis was found to be a possible cause of PHS.

  18. MRI findings in the painful hemiplegic shoulder

    Aim: To evaluate the magnetic resonance imaging (MRI) findings in painful hemiplegic shoulder (PHS) in hemiplegic post-stroke patients. Materials and methods: Patients with hemiplegia following their first cerebrovascular accident who were admitted to the Sarah Network of Hospitals for Rehabilitation were studied. Forty-five patients with pain in the hemiplegic shoulder and 23 post-stroke patients without shoulder pain were investigated. MRI and radiographic findings of the hemiplegic and contralateral asymptomatic shoulders were evaluated. Results: Some MRI findings were more frequent in PHS group, including synovial capsule thickening, synovial capsule enhancement, and enhancement in the rotator cuff interval. Conclusions: Adhesive capsulitis was found to be a possible cause of PHS.

  19. Study on MRI findings in postresuscitation brains

    We evaluated chronological changes in T1/T2-weighted and diffusion-weighted magnetic resonance imaging (MRI) findings in patients with global cerebral ischemia compared to computed tomography (CT) and single photon emission computed tomography (SPECT) to determine the advantages this presents in determining a patient's prognosis. We retrospectively studied MRI in 28 patients resuscitated after cardiopulmonary arrest. Patients were divided by outcome into 4 groups -- good outcome in 5, moderate disability in 2, vegetative in 17, and 4 brain-dead. Those with good recovery had normal CT and MRI findings. Those with moderate disability demonstrated high signal intensity in basal ganglia and posterior cerebral cortex during the chronic period. All vegetative patients had abnormal CT findings and their T2-weighted images during the acute period demonstrated high signal intensity in the cerebral cortex and basal ganglia; T1-weighted image during the chronic period showed similar findings, while diffusion-weighted images indicated high signal intensity in the cerebral cortex from the very acute period, during which abnormal findings were seen in the cortex, putamen, and thalamus more frequently than in T2-weighted images. Moreover, regional cerebral blood flow significantly decreased during the chronic period. All brain-dead patients had CT findings of diffuse cerebral edema and loss of density difference between gray and white matter. T2-weighted images respectively showed an extraordinary high density difference between gray and white matter and diffusion-weighted images high signal density in the whole brain. MRI detects chronologic changes in postresuscitation brain damage better than CT findings. Diffusion-weighted images identify hypoxic-ischemic lesions during the very acute period. MRI thus appears useful in evaluating patient prognosis and care. (author)

  20. MRI findings of cortical laminar necrosis

    To evaluate the characteristic sequential MRI findings of cortical laminar necrosis we retrospectively reviewed the MRI findings of 11 patients with clinical signs of hypoxic brain damage who showed findings of cortical laminar necrosis with definite time of onset. Three were men and eight were women;they were aged between 27 and 74 (mean 59.3)years. All patients underwent imaging with a 1.0-T Magnetom Impact(Siemens);follow-up MR examinations were performed in five. The watershed zones in the parietoocipital, frontoparietal and temporoparietal cortex were involved in eight cases, whereas the other areas involved were the frontal lobe in two cases and the temporal lobe in one. In one case, MRI obtained two days later showed brain swelling demonstrating obliteration of cortical sulci and high signal intensity of subcortical white matter on T2WI. In five cases, MRI obtained between two and three weeks later showed gyriform high signal intensity along the cortex on T1WI, cortical high and subcortical low signal intensities on T2WI in four cases, and gyriform enhancement on gadolinium-enhanced scans in three cases. MRI obtained between three and four weeks later in three cases showed subcortical high signal intensity on T2WI in two cases and gyriform cortical high signal intensities on T1WI and gyral enhancement in all cases. MRI obtained after 50 days in four cases including two of follow-up MR, showed cortical gyriform high signal intensity on T1WI in all cases and subcortical high signal intensity on T2WI and mild gyriform enhancement on gadolinium-enhanced scans in three cases. In two follow-up studies, the lesions had become more discrete and larger. Cortical laminar necrosis due to hypoxic brain damage shows relatively characteristic MR findings according to the stage. Therefore, MR imaging seems to be useful diagnostic tool for the evaluation of cortical laminar necrosis due to hypoxic brain damage

  1. MRI and CT findings of intracranial neurosyphilis

    Suh, Hong Kil; Shim, Ya Seong; Kim, Seon Bok; Kim, Uk Jung; Lee, Shin Ho; Jung, Hae Kyuong; Lee, Eil Seong; Kang, Ik Won [Hallym University College of Medicine, Seoul (Korea, Republic of); Cho, Hyeun Cha [Sungkyunkwan University College of Medicine, Seoul (Korea, Republic of)

    1999-02-01

    To evaluate the CT and MRI findings of neurosyphilis. We retrospectively reviewed the CT and MR imaging findings in five patients with intracranial neurosyphilis confirmed by CSF, VDRL, TPHA, and clinical follow-up. MR imaging was performed in all five cases, and CT in two. The MRI and CT findings of intracranial neurosyphilis included infarction (n=3), focal inflammation (n=1) and encephalopathy (n=1). There was a total of ten infaretions : three of the basal ganglia, two each of the frontal lobe, watershed zone, and cerebellum, and one of the occipital lobe. Intaretion was most common in MCA territory (n=9; 50%), followed by the watershed zone (16.6%), posterior cerebral artery territory (16.6%), and posterior inferior cerebellar artery territory (11.1%). The size of the lesion varied from 1cm to larger than one lobe. One patient showed diffuse high signal intensity in the left temporal lobe, but on follow-up MRI, this had resolved. The most common finding of neurosyphilis, as seen on MRI and CT, was infarction in middle cerebral arterial territory.

  2. MRI and CT findings of intracranial neurosyphilis

    To evaluate the CT and MRI findings of neurosyphilis. We retrospectively reviewed the CT and MR imaging findings in five patients with intracranial neurosyphilis confirmed by CSF, VDRL, TPHA, and clinical follow-up. MR imaging was performed in all five cases, and CT in two. The MRI and CT findings of intracranial neurosyphilis included infarction (n=3), focal inflammation (n=1) and encephalopathy (n=1). There was a total of ten infaretions : three of the basal ganglia, two each of the frontal lobe, watershed zone, and cerebellum, and one of the occipital lobe. Intaretion was most common in MCA territory (n=9; 50%), followed by the watershed zone (16.6%), posterior cerebral artery territory (16.6%), and posterior inferior cerebellar artery territory (11.1%). The size of the lesion varied from 1cm to larger than one lobe. One patient showed diffuse high signal intensity in the left temporal lobe, but on follow-up MRI, this had resolved. The most common finding of neurosyphilis, as seen on MRI and CT, was infarction in middle cerebral arterial territory

  3. MRI findings of treated bacterial septic arthritis

    Bierry, Guillaume; Huang, Ambrose J.; Chang, Connie Y.; Torriani, Martin; Bredella, Miriam A. [Massachusetts General Hospital and Harvard Medical School, Musculoskeletal Imaging and Intervention, Department of Radiology, Boston, MA (United States)

    2012-12-15

    The purpose of this study was to report the MRI findings that can be encountered in successfully treated bacterial septic arthritis. The study included 12 patients (8 male and 4 female; mean age 38 years, range 9-85) with 13 proven cases of bacterial septic arthritis. The joints involved were hip (n = 3), knee (n = 3), shoulder (n = 2), sacroiliac (n = 2), ankle (n = 1), wrist (n = 1), and elbow (n = 1). MRI examinations following surgical debridement and at initiation of antibiotic therapy and after successful treatment were compared for changes in effusion, synovium, bone, and periarticular soft tissues. Imaging findings were correlated with microbiological and clinical findings. Joint effusions were present in all joints at baseline and regressed significantly at follow-up MRI (p = 0.001). Abscesses were present in 5 cases (38 %), and their sizes decreased significantly at follow-up (p = 0.001). Synovial enhancement and thickening were observed in all joints at both baseline and follow-up MRI. Myositis/cellulitis was present in 10 cases (77 %) at baseline and in 8 cases (62 %) at follow-up MRI. Bone marrow edema was present in 10 joints (77 %) at baseline and persisted in 8 joints (62 %). Bone erosions were found in 8 joints (62 %) and persisted at follow-up MRI in all cases. The sizes of joint effusions and abscesses appear to be the factors with the most potential for monitoring therapy for septic arthritis, since both decreased significantly following successful treatment. Synovial thickening and enhancement, periarticular myositis/cellulitis, and bone marrow edema can persist even after resolution of the infection. (orig.)

  4. Assessment of ventricular coupling with real-time cine MRI and its value to differentiate constrictive pericarditis from restrictive cardiomyopathy

    The purpose of this study was to evaluate the use of respiratory-related ventricular coupling to differentiate patients with constrictive pericarditis (CP) and restrictive cardiomyopathy (RCM). In 18 histologically proven cases of CP, 6 patients with inflammatory pericarditis (IP), 15 RCM patients and 17 normal subjects, real-time cine MRI was performed in the cardiac short-axis (basal half of the ventricles) during operator-guided deep respiration. The images were analyzed for ventricular septal position and shape during early ventricular filling. Early diastolic septal inversion (I) or flattening (F) was found in all CP (I:15,F:3), and in all IP (I:2,F:4), but seldom in normals (F:1) and not in RCM. The septal abnormalities occurred at the onset of inspiration and rapidly disappeared with the next heartbeats. The amount of ventricular coupling was evaluated by quantifying the difference in the maximal septal excursion between inspiration and expiration. This parameter, normalized to the biventricular diameter, was significantly larger in CP (20.04.5%, P<0.0001) and IP (14.83.2%, P<0.0001) patients than in normals (7.02.4%), whereas RCM patients had a trend toward decreased excursion (4.21.7%, P=0.11). A cut-off value of 11.8% (mean normals +2 SD) enabled to differentiate CP patients from normals and RCM patients completely. Real-time cine MRI can easily depict increased ventricular coupling, which may be helpful to better differentiate between CP and RCM patients, especially in patients with normal or minimally thickened pericardium. The increase in coupling in IP patients is likely caused by decreased compliance of the inflamed pericardial layers. (orig.)

  5. Isovaleric acidaemia: cranial CT and MRI findings

    Sogut, Ayhan; Acun, Ceyda; Tomsac, Nazan; Demirel, Fatma [Department of Paediatrics, Karaelmas University, Zonguldak (Turkey); Aydin, Kubilay [Department of Radiology, Istanbul Medical School, Istanbul University, Camlikyolu, B. mehmetpasa sokak yavuz apt. No:10/10, Etiler, Istanbul (Turkey); Aktuglu, Cigdem [Department of Paediatrics, Cerrahpasa Medical School, Istanbul University, Istanbul (Turkey)

    2004-02-01

    Isovaleric acidaemia is an inborn error of leucine metabolism due to deficiency of isovaleryl-CoA dehydrogenase, which results in accumulation of isovaleric acid in body fluids. There are acute and chronic-intermittent forms of the disease. We present the cranial CT and MRI findings of a 19-month-old girl with the chronic-intermittent form of isovaleric acidaemia. She presented with severe metabolic acidosis, hyperglycaemia, glycosuria, ketonuria and acute encephalopathy. Cranial CT revealed bilateral hypodensity of the globi pallidi. MRI showed signal changes in the globi pallidi and corticospinal tracts of the mesencephalon, which were hypointense on T1-weighted and hyperintense on T2-weighted images. (orig.)

  6. Isovaleric acidaemia: cranial CT and MRI findings

    Isovaleric acidaemia is an inborn error of leucine metabolism due to deficiency of isovaleryl-CoA dehydrogenase, which results in accumulation of isovaleric acid in body fluids. There are acute and chronic-intermittent forms of the disease. We present the cranial CT and MRI findings of a 19-month-old girl with the chronic-intermittent form of isovaleric acidaemia. She presented with severe metabolic acidosis, hyperglycaemia, glycosuria, ketonuria and acute encephalopathy. Cranial CT revealed bilateral hypodensity of the globi pallidi. MRI showed signal changes in the globi pallidi and corticospinal tracts of the mesencephalon, which were hypointense on T1-weighted and hyperintense on T2-weighted images. (orig.)

  7. Traumatic hip dislocation: early MRI findings

    Objective of this study was to present the spectrum of early magnetic resonance imaging (MRI) findings following traumatic dislocation of the femoral head, and to identify any associated injuries. Prospective MRI of both hips was performed on 18 patients within 5 weeks of a traumatic femoral head dislocation. The interval between the time of injury and the imaging studies ranged from 2 to 35 days. Posterior dislocation was present in 14 patients and anterior dislocation in 4 patients. In the majority of cases, we performed axial T1, coronal T1, and coronal T2* (MPGR) sequences. MRI can effectively identify and quantify the muscle injury and joint effusion that invariably accompany traumatic hip dislocations. It is also useful for demonstrating trabecular bone contusion (trabecular injury) and iliofemoral ligament injury, which occur commonly with acute hip dislocation. (orig./VHE)

  8. MRI Findings in Patients with TMJ Click

    Mahrokh Imanimoghaddam

    2013-12-01

    Full Text Available Introduction: It has been shown that joint click, an initial and common finding in internal derangement (ID, respond to neither conservative treatment nor surgical intervention. This raises the question as to whether it must be treated in the absence of other pertinent signs and symptoms, so the aim of this study was to investigate and compare the MRI findings of TMJ in both normal subjects and patients with click, in order to determine the importance of click in predicting TMJ pathological changes. Methods: A total of 26 patients with clinical symptoms of disk displacement with reduction (DDwR according to RDC/TMD were compared to 14 normal subjects in terms of their MRI findings, including disk displacement, effusion, condylar osteoarthritic changes and disk deformities. Results: Out of 80 joints in total (52 affected joints in 26 patients and 28 joints in control group, 48 were shown with normal disk position in MRI whereas 28 (35% and 4 (5% were categorised as DDwR and (disk displacement without reduction DDwoR, respectively. Statistically significant correlations were established between the following pairs of variables in order: Click and disk displacement, effusion and disk displacement, disk displacement and effusion with disk deformity. Conclusion: The correlation between the presence of click and disk displacement, disk deformity and effusion emphasizes the importance of MRI for an accurate diagnosis and development of an appropriate treatment plan in these cases and shows that clinical examination is not sufficient for these purposes.

  9. Intracranial teratoma in childhood: MRI findings

    Shin, Yong Moon; Kim, In One; Kim, Woo Sun; Yeon, Kyung Mo; Han, Man Chung [Seoul National University College of Medicine, Seoul (Korea, Republic of); Yu, Pil Mun [Dankuk University College of Medicine, Seoul (Korea, Republic of)

    1992-09-15

    We reviewed the magnetic resonance imaging(MRI) of intracranial teratoma to defect the characteristic findings. Five patients with intercranial teratoma were evaluated with MRI from January 1988 to December 1990. Four male and one female patients with age ranging from 6 to 14 years were surgically confirmed. MRI was done with 2.0 T superconducting system(Spectro 20000, Goldstar, Seoul) and gadolinium enhancement was done in 4 patients. We retrospectively reviewed the clinical, operative, pathologic, and radiologic findings. Intracranial teratomas showed fatty component, calcification and cystic component filled with sebum or serous fluid. Peripheral rim enhancement was seen in three and irregular enhancement in two cases. There were hydrocephalus in all pineal teratoma, but neither surrounding edema nor surrounding tissue invasion was seen. Low signal intensity rim was noted the solid component of all tumors and they were not enhanced. MRI showed multicomponent of intracranial teratoma including the solid and cystic component, and low signal rim which might be the characteristic finding of the intracranial teratoma.

  10. Intracranial teratoma in childhood: MRI findings

    We reviewed the magnetic resonance imaging(MRI) of intracranial teratoma to defect the characteristic findings. Five patients with intercranial teratoma were evaluated with MRI from January 1988 to December 1990. Four male and one female patients with age ranging from 6 to 14 years were surgically confirmed. MRI was done with 2.0 T superconducting system(Spectro 20000, Goldstar, Seoul) and gadolinium enhancement was done in 4 patients. We retrospectively reviewed the clinical, operative, pathologic, and radiologic findings. Intracranial teratomas showed fatty component, calcification and cystic component filled with sebum or serous fluid. Peripheral rim enhancement was seen in three and irregular enhancement in two cases. There were hydrocephalus in all pineal teratoma, but neither surrounding edema nor surrounding tissue invasion was seen. Low signal intensity rim was noted the solid component of all tumors and they were not enhanced. MRI showed multicomponent of intracranial teratoma including the solid and cystic component, and low signal rim which might be the characteristic finding of the intracranial teratoma

  11. Delayed-enhancement MRI of apical hypertrophic cardiomyopathy: assessment of the intramural distribution and comparison with clinical symptoms, ventricular arrhythmias, and cine MRI

    Background: Hypertrophic cardiomyopathy (HCM) is reported to show patchy midwall myocardial hyper enhancement on delayed-enhancement magnetic resonance imaging (DE-MRI). The intramural distribution of myocardial hyper enhancement and its correlation with clinical symptoms, ventricular arrhythmias, and cardiac function have not been described for symptomatic apical HCM. Purpose: To evaluate the features and significance of myocardial hyper enhancement on DE-MRI in symptomatic apical HCM. Material and Methods: Thirteen patients with symptomatic apical HCM and their 65 apical segments were investigated. Myocardial hyper enhancement and regional and global functional parameters were determined with MRI. We investigated the intramural distribution and frequencies of this myocardial hyper enhancement and compared them with the patients' clinical symptoms, the presence of ventricular arrhythmias, and cine MRI. Results: Eight (61.5%) patients with symptomatic apical HCM displayed apical myocardial hyper enhancement, and 22 (33.8%) of the 65 apical segments examined showed myocardial hyper enhancement. Of the myocardial hyper enhancement observed, 81.8% showed a subendocardial pattern.The Hyperenhanced apical myocardium had a lower percentage of systolic myocardial thickening, and was associated with serious symptoms (e.g. syncope) and ventricular arrhythmias. Conclusion: Patients with symptomatic apical HCM showed myocardial hyper enhancement involving the subendocardial layer, which might be related to regional systolic dysfunction, serious clinical symptoms, and ventricular arrhythmias

  12. Delayed-enhancement MRI of apical hypertrophic cardiomyopathy: assessment of the intramural distribution and comparison with clinical symptoms, ventricular arrhythmias, and cine MRI

    Amano, Yasuo; Fukushima, Yoshimitsu; Kumita, Shinichiro (Dept. of Radiology, Nippon Medical School, Tokyo (Japan)), email: yas-amano@nifty.com; Takayama, Morimasa (Dept. of Cardiology, Sakakibara Heart Inst., Tokyo (Japan)); Kitamura, Mitsunobu (Coronary Care Unit, Chiba-Hokuso Hospital of Nippon Medical School, Chiba (Japan))

    2011-07-15

    Background: Hypertrophic cardiomyopathy (HCM) is reported to show patchy midwall myocardial hyper enhancement on delayed-enhancement magnetic resonance imaging (DE-MRI). The intramural distribution of myocardial hyper enhancement and its correlation with clinical symptoms, ventricular arrhythmias, and cardiac function have not been described for symptomatic apical HCM. Purpose: To evaluate the features and significance of myocardial hyper enhancement on DE-MRI in symptomatic apical HCM. Material and Methods: Thirteen patients with symptomatic apical HCM and their 65 apical segments were investigated. Myocardial hyper enhancement and regional and global functional parameters were determined with MRI. We investigated the intramural distribution and frequencies of this myocardial hyper enhancement and compared them with the patients' clinical symptoms, the presence of ventricular arrhythmias, and cine MRI. Results: Eight (61.5%) patients with symptomatic apical HCM displayed apical myocardial hyper enhancement, and 22 (33.8%) of the 65 apical segments examined showed myocardial hyper enhancement. Of the myocardial hyper enhancement observed, 81.8% showed a subendocardial pattern.The Hyperenhanced apical myocardium had a lower percentage of systolic myocardial thickening, and was associated with serious symptoms (e.g. syncope) and ventricular arrhythmias. Conclusion: Patients with symptomatic apical HCM showed myocardial hyper enhancement involving the subendocardial layer, which might be related to regional systolic dysfunction, serious clinical symptoms, and ventricular arrhythmias

  13. MRI findings of Ramsay Hunt syndrome

    Objective: To investigate the MR findings and diagnostic value in Ramsay Hunt syndrome. Methods: MRI plain and Gd-DTPA enhanced scans were performed in 5 unilateral Ramsay Hunt syndrome patients proved by clinical representation and examinations. The patients included 3 men and 2 women, and their age ranged from 29 to 54 years. The signal intensities of segments of facial nerves within temporal bone were measured pre- and post-gadolinium injections in 3 cases. Of all 5 cases, bilateral contrast of segments of facial nerves at both pre- and post-gadolinium injections was made. Results: Segmental enhancement was found in 4 cases (the difference of bilateral enhancement signal intensities>20, or the grade of difference is 1 or above), while no difference of bilateral enhancement was found in 1 case. Abnormal enhancement of ganglion geniculi (4/4) and labyrinthine segment (3/4) was relatively frequent, abnormal enhancement of distal part of internal auditory segment, tympanic segment, and mastoid segment was seen in 2 cases, respectively. Conclusion: MRI doesn't have diagnostic value unless the enhancement of segments of the affected facial nerve side is more evident than the unaffected side for unilateral cases. Labyrinthine segment and ganglion geniculi are more susceptible to Ramsay Hunt syndrome. Gd-DTPA enhanced MRI can demonstrate segmental lesions of facial nerves objectively, thus it can be helpful in the diagnosis and differential diagnosis of Ramsay Hunt syndrome. The relationship between MRI findings and clinical representation still needs further study

  14. Gastrointestinal stromal tumors: CT and MRI findings

    Sandrasegaran, Kumaresan; Rydberg, Jonas; Akisik, Fatih M. [Indiana University Medical Center, Department of Radiology, Indianapolis, IN (United States); Rajesh, Arumugam [United Leicester Hospitals, Department of Radiology, Leicester (United Kingdom); Rushing, Daniel A. [Indiana University Medical Center, Department of Oncology, Indianapolis, Indiana (United States); Henley, John D. [Indiana University Medical Center, Department of Pathology, Indianapolis, Indiana (United States)

    2005-07-01

    The objective of this study was to report the CT and MRI appearances of primary and metastatic gastrointestinal stromal tumor (GIST). The clinical and imaging findings of 31 patients with histological and immunohistochemical diagnosis of GIST were reviewed. The CT and MRI findings were assessed independently for size, location, enhancement characteristics, and pattern of metastatic disease. The tumors were of enteric (n=13), gastric (n=12), duodenal (n=2), and rectal (n=3) origin. In one case the primary site was the mesentery, without involvement of bowel. Primary tumors were typically exophytic (79%), larger than 5 cm (84%), and inhomogeneously enhancing (84%). Central necrosis of all tumors (37%) and aneurysmal dilation of enteric tumors (33%) were less common. Metastases were most commonly to mesentery (26%) or liver (32%). Less common findings were ascites (7%) and omental caking (3%). Liver metastases were hypervascular in 92% of patients and rapidly became cystic following therapy with imatinib mesylate (Gleevec; Novartis, East Hanover, NJ, USA). Lung metastases, bowel obstruction, vascular invasion, and significant lymphadenopathy were not seen in any patient. GISTs have some specific CT findings which could help differentiate them from other gastrointestinal tumors. Liver metastases became cystic following therapy, mimicking simple cysts. MRI was better than single-phase CT for assessing liver metastases, while CT was more sensitive for mesenteric metastases. (orig.)

  15. Gastrointestinal stromal tumors: CT and MRI findings

    The objective of this study was to report the CT and MRI appearances of primary and metastatic gastrointestinal stromal tumor (GIST). The clinical and imaging findings of 31 patients with histological and immunohistochemical diagnosis of GIST were reviewed. The CT and MRI findings were assessed independently for size, location, enhancement characteristics, and pattern of metastatic disease. The tumors were of enteric (n=13), gastric (n=12), duodenal (n=2), and rectal (n=3) origin. In one case the primary site was the mesentery, without involvement of bowel. Primary tumors were typically exophytic (79%), larger than 5 cm (84%), and inhomogeneously enhancing (84%). Central necrosis of all tumors (37%) and aneurysmal dilation of enteric tumors (33%) were less common. Metastases were most commonly to mesentery (26%) or liver (32%). Less common findings were ascites (7%) and omental caking (3%). Liver metastases were hypervascular in 92% of patients and rapidly became cystic following therapy with imatinib mesylate (Gleevec; Novartis, East Hanover, NJ, USA). Lung metastases, bowel obstruction, vascular invasion, and significant lymphadenopathy were not seen in any patient. GISTs have some specific CT findings which could help differentiate them from other gastrointestinal tumors. Liver metastases became cystic following therapy, mimicking simple cysts. MRI was better than single-phase CT for assessing liver metastases, while CT was more sensitive for mesenteric metastases. (orig.)

  16. MRI findings on de Quervain's disease

    De Quervain's disease is a stenosing tenosynovitis affecting the first extensor compartment of the wrist. Conservative treatment including steroid injection is primarily indicated and satisfactory result can be obtained in most cases. However, it often fails in cases where fibrocartilagenous septum exists within the first compartment. Surgical release of the compartment and resection of the septum is recommended for these instances. The incidence of the septum in the compartment is reported to be about 30 to 40 per cent in normal population, though over 90 per cent in operative cases. In this study, MRI was employed to evaluate the anatomical variation in the first extensor compartment of the wrist in de Quervain's disease. There were 13 hands in 5 men and 10 women. Their average age was 49.5 years old (19 to 76 y.o.). Axial T1 weighted MR images around the radial styloid process were obtained. Eight hands which resisted conservative treatment were operated on and first compartment was directly inspected. The other 5 were well treated with one or two steroid injection. In all operative cases, MRI revealed that the EPB tendon exists apart from the APL tendon surrounded with thick high intensity area. That finding correspond to the operative findings. That were fibrocartilagenous septum dividing the first compartment and dense synovium around the EPB tendon. On the other hands, in 5 hands which responded to steroid injection, EPB was identified only in 2 on MRI and could not be distinguished from APL in the other 3. Consequently, MRI provides useful information to make a strategy for treating de Quervain's disease. In cases whose MRI show that EPB and APL are accommodated in one common canal non-surgical treatment should be continued while in the cases of separate EPB tunnel with surrounding proliferating synovium early operation might be considered. (author)

  17. CT and MRI findings of olfactory neuroblastoma

    Objective: To summary the CT and MRI imaging findings of olfactory neuroblastoma. Methods: Sixteen cases of olfactory neuroblastoma proved by surgery and pathology were collected. The radiological findings of CT and MRI were retrospectively analyzed. Results: Three lesions were postoperative recurrence. Three lesions located in the nose, the other 13 were located the middle-back part of the nose, infiltrating the sinuses such as maxillary and ethmoid sinus. Five lesions eroded the skull base and infiltrated into the brain. Another 5 lesions infiltrated the orbit. Calcification and ossification were present in 3 cases. The density or signal intensity of the masses was heterogeneous with marked enhancement after contrast administration. Conclusion: Olfactory neuroblastoma often located in the middle-back of the nose, with malignant signs of infiltrating the sinuses, orbit, and brain, and with obvious enhancement. (authors)

  18. Brain MRI findings of neuropsychiatric lupus

    Kim, Jang-Wook; Kwon, Bae Ju; Lee, Seung-Ro; Hahm, Chang-Kok; Moon, Won Jin; Jeon, Eui Yong; Bae, Sang-Chul [Hanyang Univ. School of Medicine, Seoul (Korea, Republic of)

    2000-12-01

    To evaluate the brain MRI findings in patients with neuropsychiatric lupus. In 26 patients (M:F = 2:24 ; aged 9-48 years) in whom the presence of systemic lupus erythematosus was clinically or pathologically proven and in whom neuropsychiatric lupus was also clinically diagnosed, the findings of brain MRI were retrospectively evaluated. MR images were analyzed with regard to the distribution, location, size and number of lesions due to cerebral ischemia or infarction, the presence of cerebral atrophy, and the extent and degree of brain parenchymal and intravascular enhancement. The most common MRI findings were lesions due to cerebral ischemia or infarction occurring in 18 patients (69%), and located within deep periventricular white matter (n=10), subcortical white matter (n=8), the cerebral cortex (n=7), basal ganglia (n=7), or brain stem or cerebellum (n=2). The lesions were single (n=3) or multiple (n=15), and in 17 patients were less than 1cm in diameter in regions other than the cerebral cortex. In six of these patients, lesions of 1-4cm in diameter in this region were combined, and one occurred in the cerebral cortex only. Cerebral atrophy was seen in 16 patients (62%), in ten of whom there was no past history of treatment with steroids for more than six months. In 15 patients (58%), contrast-enhanced MR image revealed diffuse enhancement of the basal ganglia or intravascular enhancement. In no case were MRI findings normal. The primary mainfestations of neuropsychiatric lupus are multifocal ischemia or infarctions in the cerebral cortex, and subcortical and deep white matter, and the cerebral atrophy. Contrast-enhanced MR images also demonstrated diffuse enhancement of the basal ganglia and intravascular enhancement, both thought to be related to the congestion due to the stagnation of cerebral blood flow.

  19. Brain MRI findings of neuropsychiatric lupus

    To evaluate the brain MRI findings in patients with neuropsychiatric lupus. In 26 patients (M:F = 2:24 ; aged 9-48 years) in whom the presence of systemic lupus erythematosus was clinically or pathologically proven and in whom neuropsychiatric lupus was also clinically diagnosed, the findings of brain MRI were retrospectively evaluated. MR images were analyzed with regard to the distribution, location, size and number of lesions due to cerebral ischemia or infarction, the presence of cerebral atrophy, and the extent and degree of brain parenchymal and intravascular enhancement. The most common MRI findings were lesions due to cerebral ischemia or infarction occurring in 18 patients (69%), and located within deep periventricular white matter (n=10), subcortical white matter (n=8), the cerebral cortex (n=7), basal ganglia (n=7), or brain stem or cerebellum (n=2). The lesions were single (n=3) or multiple (n=15), and in 17 patients were less than 1cm in diameter in regions other than the cerebral cortex. In six of these patients, lesions of 1-4cm in diameter in this region were combined, and one occurred in the cerebral cortex only. Cerebral atrophy was seen in 16 patients (62%), in ten of whom there was no past history of treatment with steroids for more than six months. In 15 patients (58%), contrast-enhanced MR image revealed diffuse enhancement of the basal ganglia or intravascular enhancement. In no case were MRI findings normal. The primary mainfestations of neuropsychiatric lupus are multifocal ischemia or infarctions in the cerebral cortex, and subcortical and deep white matter, and the cerebral atrophy. Contrast-enhanced MR images also demonstrated diffuse enhancement of the basal ganglia and intravascular enhancement, both thought to be related to the congestion due to the stagnation of cerebral blood flow

  20. Localized Castleman's disease: CT and MRI findings

    Objective: To study the CT and MRI findings of localized Castleman's disease (LCD). Methods: The CT (n=7) and MRI (n=2) appearance of LCD (n=7) confirmed by pathology and operation were retrospectively analyzed. Results Hyaline-vascular type(n=6) and plasma cell type (n=1) were confirmed by pathology in LCD (n=7). They were located in middle mediastinum (n=2), hilum pulmonis (n=l), posterior mediastinum (n=3), retro-peritoneum (n=1). Hyaline-vascular type focuses in CT scanning were manifested as round shape soft tissue masses, with homogeneous density, integrity envelope, distinct margin, and chaperonage arborizing and spot calcification. Marked persistent enhancement was apparent on contrast CT. MRI findings of hyaline-vascular type (n=2) was slightly isointense or hyperintense on T1WI, homogeneous hyperintense on T2WI, similar enhancement with CT after contrast. Plasma cell type focus were unhomogeneous density with abnormity necrosis, media and unhomogeneous enhancement after contrast. Conclusion: Marked persistent enhancement of LCD would be helpful to diagnosis and differential diagnosis in Castleman's disease. (authors)

  1. Periarthritis of the shoulder-MRI findings

    We examined MRI findings in patients with periarthritis of the shoulder. We excluded cuff tears, calcified tendinitis, instability of the shoulder, fracture and impingement syndrome of young patients. Subjects comprised 36 cases, 38 shoulders (25 men and 11 women), with an average age of 59.1 years (42-75). Scanning was performed on a Gyroscan T5-II 0.5-T (Philips). T1-weighted and T2-weighted sequences in the coronal oblique plane, T2-weighted sequences in the coronal sagittal plane and horizontal plane were taken. Twelve shoulders showed some change in the humeral heads. Degeneration of the rotator cuff was observed in 15 shoulders. Joint fluid collection was observed in the gleno-humeral joints of 15 shoulders, in the subacromial bursa of 11 shoulders and in the acromio-clavicular joints of 7 shoulders. Twenty four shoulders had fluid collection in the sheath of the long head of the biceps long tendon. Localized high signal area was observed around the inferior pouch in 11 shoulders. We studied the relationship between MRI findings and clinical symptoms. There was no significant relationship but the shoulders with night pain and severe contractures had a higher positive rate of joint fluid collection on MRI than the shoulders without night pain and with less contractures. (author)

  2. Periarthritis of the shoulder-MRI findings

    Hirano, Mako; Nomura, Kazutoshi; Hashimoto, Noburo; Fukumoto, Tetsuya; Oshima, Suguru; Katahira, Kazuhiro [Kumamoto National Hospital (Japan)

    1997-09-01

    We examined MRI findings in patients with periarthritis of the shoulder. We excluded cuff tears, calcified tendinitis, instability of the shoulder, fracture and impingement syndrome of young patients. Subjects comprised 36 cases, 38 shoulders (25 men and 11 women), with an average age of 59.1 years (42-75). Scanning was performed on a Gyroscan T5-II 0.5-T (Philips). T1-weighted and T2-weighted sequences in the coronal oblique plane, T2-weighted sequences in the coronal sagittal plane and horizontal plane were taken. Twelve shoulders showed some change in the humeral heads. Degeneration of the rotator cuff was observed in 15 shoulders. Joint fluid collection was observed in the gleno-humeral joints of 15 shoulders, in the subacromial bursa of 11 shoulders and in the acromio-clavicular joints of 7 shoulders. Twenty four shoulders had fluid collection in the sheath of the long head of the biceps long tendon. Localized high signal area was observed around the inferior pouch in 11 shoulders. We studied the relationship between MRI findings and clinical symptoms. There was no significant relationship but the shoulders with night pain and severe contractures had a higher positive rate of joint fluid collection on MRI than the shoulders without night pain and with less contractures. (author)

  3. Clinical and MRI findings of brucellar spondylodiscitis

    Objective: The aim of this retrospective study was to report the clinical features and MR imaging findings of patients with brucellar spondylodiscitis. Materials and methods: Twenty-two patients with spondylodiscitis, recruited among 152 patients with brucellosis referred from the Department of Infectious Diseases. Patients were diagnosed based on positive clinical findings, ≥1/160 titers of brucella agglutination tests and/or positive blood cultures. Magnetic resonance imaging (MRI) was performed to all of the patients with spondylodiscitis. Signal changes and enhancement of vertebral bodies, involvement of paravertebral soft tissues and epidural spaces, nerve root and cord compression and abscess formation were assessed. Results: All of the patients (n = 22; 7 F, 15 M) had ≥1/160 titers of brucella agglutination test and blood culture was positive in 9. A great majority of the patients had involvement at only one vertebrae level (n = 21, 95.5%), whereas one patient (4.5%) had multilevel involvement. In MRI, eight patients had soft tissue involvement and three had abscess formation. All cases had vertebral and discal enhancement. Additionally epidural extension was detected in four cases, posterior longitudinal ligament (PLL) elevation in five cases and root compression in two cases. Conclusion: Brucella is still a public health problem in endemic areas. MRI is a highly sensitive and non-invasive imaging technique which should be first choice of imaging in the early diagnosis of spondylodiscitis

  4. Clinical and MRI findings of brucellar spondylodiscitis

    Bozgeyik, Zulkif [Department of Radiology, Faculty of Medicine, Firat University, 23119 Elazig (Turkey)], E-mail: bozgeyik4@hotmail.com; Ozdemir, Huseyin [Department of Radiology, Faculty of Medicine, Firat University, 23119 Elazig (Turkey); Demirdag, Kutbettin; Ozden, Mehmet [Department of Infection Disease, Faculty of Medicine, Firat University, Elazig (Turkey); Sonmezgoz, Fitnet [Department of Radiology, Faculty of Medicine, Firat University, 23119 Elazig (Turkey); Ozgocmen, Salih [Division of Rheumatology, Department of PMR, Faculty of Medicine, Firat University, Elazig (Turkey)

    2008-07-15

    Objective: The aim of this retrospective study was to report the clinical features and MR imaging findings of patients with brucellar spondylodiscitis. Materials and methods: Twenty-two patients with spondylodiscitis, recruited among 152 patients with brucellosis referred from the Department of Infectious Diseases. Patients were diagnosed based on positive clinical findings, {>=}1/160 titers of brucella agglutination tests and/or positive blood cultures. Magnetic resonance imaging (MRI) was performed to all of the patients with spondylodiscitis. Signal changes and enhancement of vertebral bodies, involvement of paravertebral soft tissues and epidural spaces, nerve root and cord compression and abscess formation were assessed. Results: All of the patients (n = 22; 7 F, 15 M) had {>=}1/160 titers of brucella agglutination test and blood culture was positive in 9. A great majority of the patients had involvement at only one vertebrae level (n = 21, 95.5%), whereas one patient (4.5%) had multilevel involvement. In MRI, eight patients had soft tissue involvement and three had abscess formation. All cases had vertebral and discal enhancement. Additionally epidural extension was detected in four cases, posterior longitudinal ligament (PLL) elevation in five cases and root compression in two cases. Conclusion: Brucella is still a public health problem in endemic areas. MRI is a highly sensitive and non-invasive imaging technique which should be first choice of imaging in the early diagnosis of spondylodiscitis.

  5. Isovaleric acidaemia: cranial CT and MRI findings.

    Sogut, Ayhan; Acun, Ceyda; Aydin, Kubilay; Tomac, Nazan; Tomsac, Nazan; Demirel, Fatma; Aktuglu, Cigdem

    2004-02-01

    Isovaleric acidaemia is an inborn error of leucine metabolism due to deficiency of isovaleryl-CoA dehydrogenase, which results in accumulation of isovaleric acid in body fluids. There are acute and chronic-intermittent forms of the disease. We present the cranial CT and MRI findings of a 19-month-old girl with the chronic-intermittent form of isovaleric acidaemia. She presented with severe metabolic acidosis, hyperglycaemia, glycosuria, ketonuria and acute encephalopathy. Cranial CT revealed bilateral hypodensity of the globi pallidi. MRI showed signal changes in the globi pallidi and corticospinal tracts of the mesencephalon, which were hypointense on T1-weighted and hyperintense on T2-weighted images. PMID:14534755

  6. Non-infectious ischiogluteal bursitis: MRI findings

    Cho, Kil Ho; Jang, Han Won [Yeungnam University College of Medicine, Daegu (Korea, Republic of); Lee, Sung Moon [Keimyung University College of Medicine, Daegu (Korea, Republic of); Lee, Young Hwan [Daegu Hyosung Catholic University College of Medicine, Daegu (Korea, Republic of); Suh, Kyung Jin [Suh and Joo MR Clinic, Seoul (Korea, Republic of); Kim, Sung Moon; Shin, Myung Jin [University of Ulsan College of Medicine, Seoul (Korea, Republic of)

    2004-12-15

    We wished to report on the MRI findings of non-infectious ischiogluteal bursitis. The MRI findings of 17 confirmed cases of non-infectious ischiogluteal bursitis were analyzed: four out of the 17 cases were confirmed with surgery, and the remaining 13 cases were confirmed with MRI plus the clinical data. The enlarged bursae were located deep to the gluteus muscles and postero-inferior to the ischial tuberosity. The superior ends of the bursal sacs abutted to the infero-medial aspect of the ischial tuberosity. The signal intensity within the enlarged bursa on T1-weighted image (WI) was hypo-intense in three cases (3/17, 17.6%), iso-intense in 10 cases (10/17, 58.9%), and hyper-intense in four cases (4/17, 23.5%) in comparison to that of surrounding muscles. The bursal sac appeared homogeneous in 13 patients (13/17, 76.5%) and heterogeneous in the remaining four patients (4/17, 23.5%) on T1-WI. On T2-WI, the bursa was hyper-intense in all cases (17/17, 100%); it was heterogeneous in 10 cases and homogeneous in seven cases. The heterogeneity was variable depending on the degree of the blood-fluid levels and the septae within the bursae. With contrast enhancement, the inner wall of the bursae was smooth (5/7 cases), and irregular (12/17 cases) because of the synovial proliferation and septation. Ischiogluteal bursitis can be diagnosed with MRI by its characteristic location and cystic appearance.

  7. Clinical usefulness of cine MRI for evaluation of left ventricular volume and diagnosis of heart and great vessel diseases

    ECG-gated cine mode magnetic resonance (MR) imaging was performed in 20 patients with various heart deseases. Left ventricular volume (LVV) and left ventricular ejection fraction (LVEF) were calculated on MR images obtained in left ventricular vertical and horizontal long axis views. The findings were compared with those obtained from left ventriculography. There was a significant positive correlation between MR imaging and ventriculography for both LVV and LVEF (p<0.001). In Marfan syndrome after surgery for dissecting aneurysm of the aorta, MR imaging was capable of visualizing not only the whole aorta in a single plane but also enlargement of the aortic root. It also depicted asynergy and thinned wall of the infarcted myocardium for myocardial infarction; an enlarged left auricle, the thickened septum, and constricted outflow tract for idiopathic hypertrophic subaortic stenosis; shunt flow for ventricular septum defect; and an enlarged aortic root for aortitis syndrome. Using ventriculography as the standard, cine MR imaging was frequently false positive for the detection of mitral regurgitation. There was, however, good concordance between MR imaging and ventriculography in detecting aortic regurgitation. In addition, MR imaging was equivalent to color Doppler technique for detecting valvular regurgitation. (N.K.)

  8. Peristalsis gap sign at cine magnetic resonance imaging for diagnosing strangulated small bowel obstruction. Feasibility study

    The aim of this study was to determine the feasibility of cine magnetic resonance imaging (MRI) for diagnosing strangulated small bowel obstruction (SBO). This study included 38 patients with clinically confirmed SBO who had undergone cine MRI. Cine MRI scans were evaluated regarding the presence of the 'peristalsis gap sign' (referring to an akinetic or severely hypokinetic closed loop), indicating strangulation. Computed tomography (CT) was performed in 34 of 38 patients with (n=25) or without (n=9) contrast enhancement. CT images were evaluated using a combination of criteria (presence of hyperattenuation, poor contrast enhancement, mesenteric edema, wall thickening, massive ascites) indicating strangulation. Sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of cine MRI and CT for the diagnosis of strangulation were calculated and compared using surgical findings and the clinical course as the reference standard. Sensitivity, specificity, PPV, and NPV of cine MRI were 100%, 92.9%, 83.3%, and 100%, respectively; and those of CT (of which 26.5% was performed without contrast enhancement) were 66.7%, 92.0%, 75.0%, and 88.5%, respectively. There was no significant difference in diagnostic accuracy between the two methods (P=0.375). Cine MRI is a feasible and promising technique for diagnosing strangulation. (author)

  9. CT and MRI findings in trigeminal neurinomas

    The CT and MRI findings of trigeminal neurinomas were analyzed in 12 cases. Most of the cases were of the Dumbbell type, with the tumor occupying both the middle and posterior cranial fossae. A small number of cases were, however, of the Ganglion or Root type. Precontrast CT demonstrated iso- and/or low-density masses, while postcontrast CT showed a homogeneous, multicystic or ring-like enhancement. Cystic components were found frequently. Although the tumors were large in size, there was no peritumoral edema on CT. Metrizamide CT cisternography (MCTC) was helpful, particularly in detecting a small-sized neurinoma without any destruction of the petrous apex. In MRI, a tumor appeared as a decreased signal-intensity area on the T1-weighted image and as an increased signal-intensity area on the T2-weighted image. MRI is the best non-invasive technique for demonstrating a trigeminal neurinoma in Meckel's cave and the parasellar region without bony artifacts. (author)

  10. MRI findings of temporal lobe epilepsy

    MRI findings were analyzed retrospectively in 46 patients with temporal lobe epilepsy in which the side of epileptogenic focus had been confirmed by EEG studies. T1- and T2-weighted images were obtained by the use of a 1.0 or 1.5 T superconducting-type MRI machine with a coronal scan perpendicular to the axis of the temporal horn of the lateral ventricle. Additional axial and sagittal scans were performed in some cases. The area of the hippocampal body was measured quantitatively using a computerized image-analysis system in 26 cases in which the hippocampus had been visualized with enough contrast on T1-weighted coronal images. Abnormal findings were observed in 31/46 (67%) cases. Hippocampal (HC) and temporal lobe (TL) atrophy were observed in 18/46 (39%) and 23/46 (50%) cases respectively, and the side of the atrophy corresponded with the side of the epileptogenic focus, as confirmed by EEG studies, with specificities of 89% and 74% respectively. A quantitative measurement of the area of the hippocampal body showed unilateral hippocampal atrophy more than 10% in 18/25 (69%) cases (10-25%: 10 cases, 25-50%: 7 cases, 50%2 abnormality was observed in only 4 cases. Structural lesions were observed in 4 cases including an arachnoid cyst, an astrocytoma in amygdala, the Dandy-Walker syndrome, and tuberous sclerosis, using the more efficient imaging qualities than the CT scan. From these observations, it is apparant that superconducting MRI is extremely useful in the diagnosis of the epileptogenic topography of temporal lobe epilepsy. Particularly, hippocampal atrophy was found to correspond with the side of the epileptogenic focus on EEG with a high specificity; its quantitative evaluation could be one of the most important standards in detecting the operative indications for temporal lobe epilepsy. (author)

  11. MRI Findings in Spinal Canal Stenosis

    Maryam Barzin

    2010-05-01

    Full Text Available Spinal canal stenosis results from progressive narrowing of the central spinal canal and the lateral recesses. Primary (congenital lumbar spinal stenosis is associated with achondroplastic dwarfism. The spinal canal may become narrowed by bulging or protrusion of the intervertebral disc annulus, herniation of the nucleus pulposus posteriorly, thickening of the posterior longitudinal ligament, hypertrophy of the facet joints, hypertrophy of the ligamentum flavum, epidural fat deposition, spondylosis of the intervertebral disc margins and uncovertebral joint hypertrophy in the neck. The central canal and the neurorecess may be compromised by tumor infiltration, such as metastatic disease, or by infectious spondylitis."nAP diameter of the normal adult cervical canal has a mean value of 17-18 mm at vertebral levels C3-5. The lower cervical canal measures 12-14 mm. Cervical stenosis is associated with an AP diameter of less than 10 mm. The thoracic spinal canal varies from 12 to 14 mm in diameter in the adult. The diameter of the normal lumbar spinal canal varies from 15 to 27 mm. Lumbar stenosis results from a spinal canal diameter of less than 12 mm in some patients; a diameter of 10 mm is definitely stenotic."nSpinal MRI is the most suitable technique for the diagnosis of spinal stenosis. The examination should be performed using thin sections (3 mm and high resolution, including the axial and sagittal planes using T1-weighted, proton-density, and T2-weighted techniques. The bony and osteophytic components are seen best using a T2-weighted gradient-echo technique."nOn MRI, findings of spinal stenosis have a variable presentation depending on the specific disease. The goal of spinal imaging is to localize the site and level of disease and to help differentiate between conditions in which patients require surgery or conservative treatment."nIn this presentation, different kinds of spinal canal stenosis and their MRI findings would be discussed.

  12. A technique to reduce motion artifact for externally triggered cine-MRI(EC-MRI) based on detecting the onset of the articulated word with spectral analysis

    One issue in externally triggered cine-magnetic resonance imaging (EC-MRI) for the dynamic observation of speech organs is motion artifact in the phase-encoding direction caused by unstable repetitions of speech during data acquisition. We propose a technique to reduce such artifact by rearranging the k-space data used to reconstruct MR images based on the analysis of recorded speech sounds. We recorded the subject's speech sounds during EC-MRI and used post hoc acoustical processing to reduce scanning noise and detect the onset of each utterance based on analysis of the recorded sounds. We selected each line of k-space from several data acquisition sessions and rearranged them to reconstruct a new series of dynamic MR images according to the analyzed time of utterance onset. Comparative evaluation showed significant reduction in motion artifact signal in the dynamic MR images reconstructed by the proposed method. The quality of the reconstructed images was sufficient to observe the dynamic aspects of speech production mechanisms. (author)

  13. Percent wall thickness evaluated by Gd-DTPA enhanced cine MRI as an indicator of local parietal movement in hypertrophic cardiomyopathy

    Hirano, Masaharu [Tokyo Medical Coll. (Japan)

    1998-11-01

    Hypertrophic cardiomyopathy (HCM) is a cardiac disease, the basic pathology of which consists of a decrease in left ventricular dilation compliance due to uneven hypertrophy of the left ventricular wall. Magnetic resonance imaging (MRI) is useful in monitoring uneven parietal hypertrophy and kinetics in HCM patients. The present study was undertaken in 47 HCM patients who showed asymmetrical septal hypertrophy to determine if percent thickness can be an indicator of left ventricular local movement using cine MRI. Longest and shortest axis images were acquired by the ECG synchronization method using a 1.5 T MR imager. Cardiac function was analyzed based on longest axis cine images, and telediastolic and telesystolic parietal thickness were measured based on shorter axis cine images at the papillary muscle level. Parietal movement index and percent thickness were used as indicators of local parietal movement. The correlation between these indicators and parietal thickness was evaluated. The percent thickness changed at an earlier stage of hypertrophy than the parietal movement index, thus it is thought to be useful in detecting left ventricular parietal movement disorders at an early stage of HCM. (author)

  14. Percent wall thickness evaluated by Gd-DTPA enhanced cine MRI as an indicator of local parietal movement in hypertrophic cardiomyopathy

    Hypertrophic cardiomyopathy (HCM) is a cardiac disease, the basic pathology of which consists of a decrease in left ventricular dilation compliance due to uneven hypertrophy of the left ventricular wall. Magnetic resonance imaging (MRI) is useful in monitoring uneven parietal hypertrophy and kinetics in HCM patients. The present study was undertaken in 47 HCM patients who showed asymmetrical septal hypertrophy to determine if percent thickness can be an indicator of left ventricular local movement using cine MRI. Longest and shortest axis images were acquired by the ECG synchronization method using a 1.5 T MR imager. Cardiac function was analyzed based on longest axis cine images, and telediastolic and telesystolic parietal thickness were measured based on shorter axis cine images at the papillary muscle level. Parietal movement index and percent thickness were used as indicators of local parietal movement. The correlation between these indicators and parietal thickness was evaluated. The percent thickness changed at an earlier stage of hypertrophy than the parietal movement index, thus it is thought to be useful in detecting left ventricular parietal movement disorders at an early stage of HCM. (author)

  15. Brain MRI findings of carbon disulfide poisoning

    To evaluate the findings of brain MRI in patients with carbon disulfide poisoning. Ninety-one patients who had suffered carbon disulfide poisoning [male:female=87:4; age, 32-74 (mean 53.3) years] were included in this study. To determine the extent of white matter hyperintensity (Grade 0-V) and lacunar infarction, T2-weighted MR imaging of the brain was performed. T2-weighted images depicted white matter hyperintensity in 70 patients (76.9%) and lacunar infarcts in 27 (29.7%). In these patients, the prevalent findings at T2-weighted MR imaging of the brain were white matter hyperintensity and lacunar infarcts. Disturbance of the cardiovascular system by carbon disulfide might account for these results

  16. Comparison between fast MR flow quantification in breathhold technique in ascending aorta and pulmonary trunc with right and left ventricular cine-MRI for the assessment of stroke volumes in healthy volunteers

    Purpose: Evaluation of accordance and reproducibility of the stroke volume assessment of fast flow measurement in breathhold technique in the ascending aorta and pulmonary trunc with fast right (RV) and left ventricular (LV) cine-MRI. Material and Methods: The correlation an accordance of stroke volumes (SV) were evaluated by flow measurements in the ascending aorta and pulmonary trunc and RV and LV volumetric cine-MRI in 33 cardiac healthy volunteers. Interobserver and intraobserver variability of the different measurement methods and locations were checked in 10 cardiac healthy volunteers. Results: With respect to the early systolic flow and the extrapolation of the endiastolic flow rate the difference in SV was smaller than 1,5 ml/m2 for all possible combinations. The interobserver and intraobserver variabilities of flow measurements were significantly lower by approximately a factor of 2.5 than those of RV and LV cine-MRI. Conclusion: The accordance of fast prospective triggered flow measurements in the ascending aorta and pulmonary trunc with RV and LV cine-MRI can be achieved with reasonable limits of agreement. Flow measurements are more reproducible than cine-MRI. (orig.)

  17. MRI findings of peripheral schwannoma: pathologic correlation

    To characterize the MRI appearance of the peripherally located schwannoma as compared with pathologic findings. 11 cases of 13 lesions of the schwannoma confirmed by pathology were analyzed, respectively. T1, T2 and Gadolinium-enhanced T1 weighted sagittal and axial images were obtained. The signal intensity, contour of lesion, and relationship with surrounding tissue were analyzed. All cases were correlated with MRI and pathologic findings. In 9 out of the 11 cases, schwannoma was connected to the main nerve trunk. Among them, tumors were located centrally in 6 cases and eccentrically in 3 cases. MR findings of schwannoma were iso signal intensity on T1WI (8 cases) with muscle intensity, high signal intensity on T2WI (all cases), strong heterogenous enhancement in all cases. 8 cases showing heterogenous appearance on T2WI, showed mixture of Antoni-A and B area and multifocal hemorrhage. Central low and peripheral high signal intensity on T2WI (Target sign) was mainly high cellular component in the central portion and diffuse myxoid degeneration at the periphery, pathologically. Reversed target appearance (central high, peripheral low on T2WI) revealed central cystic degeneration with low cellular component and hemorrhage in the central portion, and high cellular component at the periphery. Linear band-like low signal intensity on T2WI, suggesting capsule of the schwannoma, was not the true capsule proven by pathology. Thin true capsule was not visualized on T2WI. MR appearance of schwannoma was non-specific. The signal intensity on T2 weighted MR imaging was determined by the presence of multifocal hemorrhage, focal cystic and myxoid degeneration, admixture of Antoni-A and B area

  18. Semi-quantitative evaluation of aortic valve insufficiency by means of cine MRI compared with colour Dopplerecho-cardiography and cardio-angiography

    A simple, reliable semi-quantitative method for evaluating aortic valve insufficiency by means of cine MR is described. Ten normal persons and 36 patients with aortic valve abnormalities were examined in a 1.5 Tesla apparatus using ECG-triggered gradient echo sequences. The heart was imaged along its short axis. Semi-quantitative evaluation of aortic valve insufficiency was calculated from an MRI index, which depends on the diameter of the aortic regurgitant jet and on its length; the results were compared with colour Doppler echo-cardiography and cardio-angiography. The MRI index showed better correlation with cardio-angiography (r = 0.92) than the correlation between the colour Doppler echo-cardiography and cardio-angiography (r = 0.78). Over and under estimates are less common with MRI than with colour Doppler echo-cardiography. MRI showed very little inter-observer variability (r = 0.96, p <0.001). Cine MR is a reliable method for demonstrating aortic valve insufficiency. Using the short axis of the heart, rapid semi-quantitative evaluation of the aortic regurgitant jet is regularly possible. (orig.)

  19. Peritoneal mesothelioma: CT and MRI findings

    Two patients with histologically proven diagnosis of peritoneal mesothelioma are presented. Both patients had CT scans of the abdomen. The second patient was also examined with MRI. Although imaging findings are striking, they are non-specific and diagnosing peritoneal mesothelioma in the absence of pleural calcification or pleural plaque on chest radiograph or CT is difficult. However, it is possible to suggest the correct diagnosis in a patient with the presence of non-calcified omental and peritoneal infiltration or masses without liver secondaries or lymphadenopathy. Magnetic resonance imaging with its multi-planar capabilities is a highly sensitive non-invasive modality in the evaluation of malignant peritoneal mesothelioma and can demonstrate the exact site and clarify whether the mass is arising from the peritoneal surface or within a visceral organ. Copyright (2002) Blackwell Science Pty Ltd

  20. MRI findings of traumatic cervical disc herniation

    In general practice, disc hernia is increasingly being questioned about its relation with traffic injuries. In this study, we examined the image findings of cervical disc herniation for findings indicative of traumatic hernia. In 2008, we examined 35 cases of cervical disc herniation at our hospital by MRI. The patients were divided into two groups; patients with trauma history (19 cases) and those without (16 cases), and their images were compared. Disc herniation in the trauma group showed high intensity at T2, with some of the patients in this group also indicating continuous high intensity of the internal and herniated discs. Traumatic force was found to cause swelling under the laryngeal soft tissue. Cases with further flexion injury showed interspinous ligament hemorrhage. These findings strongly suggest the involvement of injury. But given that some younger patients in the non-trauma group also show high intensity at T2*, attention must be paid not to confuse swelling below the larynx with inflammation of the longus colli muscle. (author)

  1. MRI findings of intracranial cavernous malformations

    To analyze the variable MRI features and clinical significance of intracranial cavernous malformations. Forty patients(mean age 35.4) with cavernous malformation were evaluated by MRI. Eleven patients were surgically confirmed. Cavernous malformations were divided into four categories on the basis of the MR imaging characteristics, especially on T2-weighted image. Type I lesion was defined as an extralesional subacute hemorrhage outside the low signal rim, type II as an intralesional hemorrhage surrounded by low signal rim, type III lesion as an intralesional thrombosis with variegated central core surrounded by low signal rim, and type IV lesion as a focal old hemorrhagic core with small low signal intensity. Type IV was further divided into IVa and IVb, whether the lesion has small iso-or hypersignal central core (IVa) or not (IVb). Follow-up MRI was evaluated in 12 patients who were managed conservatively. Follow-up intervals ranged from 2 weeks to 29 months (mean 6 months). Total 80 lesions were detected in 40 patients. Multiple lesions were noted in 10 patients. The topography of the cavernous malformations was supratentorial in 75% and infratentorial in 23%. There were 10 lesions in type I, 15 in type II, 21 in type III, 14 in type IVa, and 20 in type IVb. Type I lesions mainly showed mass effect and edema. Type III lesions showed minimal contrast enhancements in 7 lesions on delayed images. Type II lesions showed the characteristics of both type I and type III lesions. On follow up images, decrease in size in 5, change of type in 7, rebleeding in 2 and no change in 12 lesions were demonstrated. Hemorrhage, edema and mass effect were combined in the cases of rebleeding. On follow-up study, the estimated risk of bleeding was 32.3%/person-year and 13.7%/lesion-year. Cavernous malformations show as variable appearance, on MR imaging suggesting variable stages of evolution. The MR morphologic classification and evaluation of secondary findings are helpful to predict natural course and possibility of rebleeding of the lesion

  2. VSD following blunt cardiac trauma: MRI findings.

    Liguori, Andrew E; Maertins, Benjamin A; Richardson, Randy

    2013-10-01

    In this report, we describe the clinical and radiographic findings of ventricular septal defects (VSDs) following blunt cardiac trauma in two patients. VSDs following either penetrating or blunt cardiac trauma are a rare occurrence. The variable presentation and timing of symptom onset along with the common association of other injuries can make the diagnosis of a posttraumatic VSD difficult. Therefore, investigation should be initiated when elements from the history and physical examination (e.g., new onset murmur), laboratory tests (e.g., cardiac enzymes), EKG, and CT or echocardiography warrant it. The first patient was a 19-year-old male who was hemodynamically stable on initial presentation to this trauma center after a motor vehicle collision. A posttraumatic VSD was found by echocardiography on the day of admission and further defined on cardiac MRI (CMRI). The second patient was a 31-year-oid male who presented after a high-speed motorcycle accident and was found to have a VSD 40 days later on CMRI after a fluctuating clinical course and multiple normal echocardiograms. Both patients had good outcomes with subsequent surgical closure. PMID:23604922

  3. MRI and radiographic findings in Currarino's triad

    Currarino's triad is a rare complex of a congential sacral bony abnormality, anorectal malformation and a presacral mass. Intractable constipation since birth is the leading symptom of this triad, which follows an autosomal dominant mode of heredity. We report conventional radiographic and MR findings in one family consisting of a mother and her two daughters. In all three cases, radiography revealed an abnormality of the os sacrum, the so-called scimitar sacrum. MR examination, undertaken next in our institution, was applied with T1-, T2- and proton density weighted sequences in all three orientations before and after i.v. application of gadolinium diethylene-triamine-pentaacetic acid (Gd-DTPA). In two patients we were able to diagnose the complete form of the triad and in one patient an incomplete form. In any case of a radiographically diagnosed scimitar sacrum in combination with constipation. Currarino's triad should be considered. MRI, as the method of choice, should be the next step to detect a presacral mass and any anomalies of the spinal canal. The importance of early recognition lies in the high morbidity and mortality rates resulting from this disorder. (orig.)

  4. Synovial hemangioma of the knee: MRI findings in two cases

    The findings in two patients with histologically proven synovial hemangioma of the knee are described. Both cases emphasize the typical appearance of this unusual tumor on magnetic resonance imaging. Additional radiologic findings, such as adjacent osseous insolvement, are discussed. The MRI findings of this tumor are highly suggestive of the diagnosis and MRI should eliminate the need for invasive angiographic procedures. (orig.)

  5. Incidental MRI Findings of Acute Gadolinium Hypersensitivity

    Amene, C.; Yeh-Nayre, L. A.; Dory, C.E.; Crawford, J R

    2012-01-01

    A 13-year-old girl with a remote history of juvenile pilocytic astrocytoma developed acute onset flushing, tachycardia and shortness of breath immediately following administration of gadopentetate dimeglumine during routine brain MRI that subsided following intravenous diphenhydramine. A retrospective review of the MRI results revealed multiple areas of contrast enhancement of the face, consistent with observed urticaria. The patient received pretreatment medications prior to subsequent gadol...

  6. Tarsal coalitions: CT and MRI findings

    Objective: Tarsal coalition is a rare congenital disorder which represents the abnormal fusion of two or more tarsal bones. The purpose of this paper is to describe our experience with CT and MR in this articular disorder, helping to improve its diagnosis, which in many cases is missed. It is most often diagnosed when the tarsal region is examined for other reasons, than as a confirmation of a preliminary clinical diagnosis. Material and Method: Between January 1999 and May 2001, we studied 16 cases of tarsal coalitions, with CT and/or MR. A helical Toshiba K-press tomograph, a conventional TC 60-X tomograph (performing reconstruction algorithms with bone filter, and 2 mm sections per 2 mm of bed displacement) and a 1.5 Tessla Toshiba Visart MR equipment (axial, sagittal and coronal planes, with T1, T2-weighted, and T2 with fat suppression sequences) were used. Results: In the 16 cases evaluated, 28 tarsal coalitions were detected. Eight patients had bilateral coalitions (50%) and of the 8 remaining patients with unilateral disorders, 4 had 4 coexistent coalitions (25%). Eight bony bars were detected (28.5%) and 20 were non-ossified-cartilaginous and/or fibrous- (71.5%); 14 of them (50%) were talo-calcaneal, 8 (28.5%) were calcaneo-navicular, 4 (14.2%) were talo-navicular and 2 (7.1%) were cuboid-navicular coalitions. Conclusion: Calcaneo-navicular and talo-calcaneal coalitions account for approximately 80% of all cases. Conventional radiology is usually the initial method to study these lesions and often allows to make the diagnosis without the need for more complex methods. When the radiological findings are non-existent or misleading, CT or MRI may lead to a final diagnosis: to differentiate among the various subtypes and to assess the degree of articular involvement, which is mandatory in order to define the appropriate treatment. (author)

  7. MRI findings in thoracic outlet syndrome

    We discuss MRI findings in patients with thoracic outlet syndrome (TOS). A total of 100 neurovascular bundles were evaluated in the interscalene triangle (IS), costoclavicular (CC), and retropectoralis minor (RPM) spaces. To exclude neurogenic abnormality, MRIs of the cervical spine and brachial plexus (BPL) were obtained in neutral. To exclude compression on neurovascular bundles, sagittal T1W images were obtained vertical to the longitudinal axis of BPL from spinal cord to the medial part of the humerus, in abduction and neutral. To exclude vascular TOS, MR angiography (MRA) and venography (MRV) of the subclavian artery (SA) and vein (SV) in abduction were obtained. If there is compression on the vessels, MRA and MRV of the subclavian vessels were repeated in neutral. Seventy-one neurovascular bundles were found to be abnormal: 16 arterial-venous-neurogenic, 20 neurogenic, 1 arterial, 15 venous, 8 arterial-venous, 3 arterial-neurogenic, and 8 venous-neurogenic TOS. Overall, neurogenic TOS was noted in 69%, venous TOS in 66%, and arterial TOS in 39%. The neurovascular bundle was most commonly compressed in the CC, mostly secondary to position, and very rarely compressed in the RPM. The cause of TOS was congenital bone variations in 36%, congenital fibromuscular anomalies in 11%, and position in 53%. In 5%, there was unilateral brachial plexitis in addition to compression of the neurovascular bundle. Severe cervical spondylosis was noted in 14%, contributing to TOS symptoms. For evaluation of patients with TOS, visualization of the brachial plexus and cervical spine and dynamic evaluation of neurovascular bundles in the cervicothoracobrachial region are mandatory. (orig.)

  8. MRI findings in thoracic outlet syndrome

    Aralasmak, Ayse; Sharifov, Rasul; Kilicarslan, Rukiye; Alkan, Alpay [Bezmialem Vakif University, Department of Radiology, Fatih/Istanbul (Turkey); Cevikol, Can; Karaali, Kamil; Senol, Utku [Akdeniz University, Department of Radiology, Antalya (Turkey)

    2012-11-15

    We discuss MRI findings in patients with thoracic outlet syndrome (TOS). A total of 100 neurovascular bundles were evaluated in the interscalene triangle (IS), costoclavicular (CC), and retropectoralis minor (RPM) spaces. To exclude neurogenic abnormality, MRIs of the cervical spine and brachial plexus (BPL) were obtained in neutral. To exclude compression on neurovascular bundles, sagittal T1W images were obtained vertical to the longitudinal axis of BPL from spinal cord to the medial part of the humerus, in abduction and neutral. To exclude vascular TOS, MR angiography (MRA) and venography (MRV) of the subclavian artery (SA) and vein (SV) in abduction were obtained. If there is compression on the vessels, MRA and MRV of the subclavian vessels were repeated in neutral. Seventy-one neurovascular bundles were found to be abnormal: 16 arterial-venous-neurogenic, 20 neurogenic, 1 arterial, 15 venous, 8 arterial-venous, 3 arterial-neurogenic, and 8 venous-neurogenic TOS. Overall, neurogenic TOS was noted in 69%, venous TOS in 66%, and arterial TOS in 39%. The neurovascular bundle was most commonly compressed in the CC, mostly secondary to position, and very rarely compressed in the RPM. The cause of TOS was congenital bone variations in 36%, congenital fibromuscular anomalies in 11%, and position in 53%. In 5%, there was unilateral brachial plexitis in addition to compression of the neurovascular bundle. Severe cervical spondylosis was noted in 14%, contributing to TOS symptoms. For evaluation of patients with TOS, visualization of the brachial plexus and cervical spine and dynamic evaluation of neurovascular bundles in the cervicothoracobrachial region are mandatory. (orig.)

  9. MRI Findings of Rectal Submucosal Tumors

    Kim, Hon Soul; Kim, Joo Hee; Lim, Joon Seok; Choi, Jin Young; Chung, Yong Eun; Park, Mi Suk; Kim, Myeong Jin; Kim, Ki Whang; Kim, Sang Kyum [Yonsei University Health System, Seoul (Korea, Republic of)

    2011-08-15

    Rectal submucosal lesions encompass a wide variety of benign and malignant tumors involving the rectum. With optical colonoscopy, any mass-like protrusion covered by normal mucosa, whether the underlying process is intramural or extramural in origin, may be reported as a submucosal lesion. Whereas the assessment of submucosal lesions may be limited with performing optical colonoscopy, cross-sectional imaging such as CT, transrectal ultrasonography and MRI allows the evaluation of perirectal tissues and pelvic organs in addition to the entire thickness of the rectum, and so this is advantageous for the assessment of rectal submucosal tumors. Among these, MRI is the best investigative modality for soft tissue characterization. Therefore, knowledge of the MRI features of rectal submucosal tumors can help achieve accurate preoperative diagnoses and facilitate the appropriate management.

  10. MRI Findings of Rectal Submucosal Tumors

    Rectal submucosal lesions encompass a wide variety of benign and malignant tumors involving the rectum. With optical colonoscopy, any mass-like protrusion covered by normal mucosa, whether the underlying process is intramural or extramural in origin, may be reported as a submucosal lesion. Whereas the assessment of submucosal lesions may be limited with performing optical colonoscopy, cross-sectional imaging such as CT, transrectal ultrasonography and MRI allows the evaluation of perirectal tissues and pelvic organs in addition to the entire thickness of the rectum, and so this is advantageous for the assessment of rectal submucosal tumors. Among these, MRI is the best investigative modality for soft tissue characterization. Therefore, knowledge of the MRI features of rectal submucosal tumors can help achieve accurate preoperative diagnoses and facilitate the appropriate management.

  11. CT and MRI findings of cardiac echinococcosis

    Fifteen patients (8 males and 7 females, 15-56 years old) with primary or secondary hydatid disease involving the heart were examined by radiography, CT and/or MRI. MRI was done with a 1.5 T machine (Picker) in 11 cases and a 0.5 T machine (Philips) in 4 cases using ECG-gated T1- and T2-weighted spin-echo pulse sequences. Transaxial sections were combined with at least one more plane (coronal and/or sagittal) and intermediate views if the need for further information was anticipated. In 4 patients primary cardiac echinococcal cysts were found, localised to the left ventricle/pericardium/interventricular septum in 2 cases and to the left atrium/pericardium and right atrium/pericardium in 1 case each. In 11 of 15 cases there was secondary involvement of the heart by echinococcal cysts primarily arising in the lung parenchyma (n = 6), mediastinum (n = 3) and by transdiaphragmatic extension from the liver and abdomen (n = 2). CT was superior to MRI in visualising calcifications. However, ECG-gated MRI of cardiac hydatid disease appears to be the method of choice for specific diagnosis and exact assessment of hydatid cysts and their correlation with cardiac structures. (orig.)

  12. MRI findings in a rottweiler with leukoencephalomyelopathy.

    Eagleson, Joseph S; Kent, Marc; Platt, Simon R; Rech, Raquel R; Howerth, Elizabeth W

    2013-01-01

    A 22 mo old male rottweiler presented with a 1 mo progressive history of general proprioceptive ataxia and upper motor neuron tetraparesis. Neurologic examination was consistent with a lesion affecting the first through fifth cervical spinal cord segments. MRI disclosed bilaterally symmetric hyperintensities on T2-weighted (T2W) images in the crus cerebri and pyramidal tracts of the brain and the dorsal portion of the lateral funiculi of the cervical spinal cord. Fifty days after initial presentation, the dog was euthanized due to disease progression. Pathologic examination of the central nervous system (CNS) revealed a bilaterally symmetric chronic leukoencephalomyelopathy (LEM) consistent with previous reports of LEM in rottweilers. To the authors' knowledge, this is the first report to describe the MRI characteristics of LEM in the rottweiler. The topography of the changes observed with MRI paralleled the pathologic changes, which were widespread loss of myelin, decreased axon numbers, and astroglial proliferation. Consequently, MRI of the CNS of affected rottweilers may aid in establishing a presumptive antemortem diagnosis of LEM. PMID:23690496

  13. Brain MRI findings in Wernicke encephalopathy.

    Wicklund, Meredith R; Knopman, David S

    2013-08-01

    A 71-year-old woman with myelofibrosis on chemotherapy experienced an acute illness with nausea, vomiting, and diarrhea. Two weeks later, she developed an acute confusional state characterized by disorientation and fluctuating alertness with normal speech and language. Her neurologic examination demonstrated an upper motor neuron pattern of right hemiparesis. She reported double vision though ophthalmoparesis was not appreciated. Her gait was normal. While hospitalized, she developed generalized tonic-clonic seizures. Brain MRI revealed a small area of restricted diffusion of the left precentral gyrus (figure). She was diagnosed with a stroke with secondary seizures; however, as the confusional state resolved, she developed profound retrograde and anterograde amnesia. Review of the brain MRI showed high T2 signal in the medial thalamus and contrast enhancement of the mamillary bodies; a diagnosis of Wernicke-Korsakoff syndrome was entertained and she was started on thiamine replacement. The encephalopathy and hemiparesis resolved though she remains severely amnestic. PMID:24195023

  14. Unusual MRI findings in grey matter heteropia

    We report unusual MRI patterns in patients with grey matter heterotopia. Standard T1- and T2-weighted spin-echo and inversion-recovery sequences were used in 22 patients presenting with seizures or developmental delay. The images were reviewed for signal change surrounding white matter and for atypical size, morphology or topography. We found 10 cases of subependymal heterotopias 11 of focal subcortical heterotopia and of diffuse subcortical heterotopia. On clinical or MRI grounds, 8 cases were considered unusual: 2 of the subependymal type, 2 of focal subcortical heterotopia with white matter abnormalities, 2 of focal subcortical heterotopia with no clinicoradiological correlation 1 of extensive hemispheric subcortical heterotopia and 1 of diffuse subcortical heterotopia confined to the frontal lobe. The classical classification of heterotopia enables easy radiological diagnosis even in cases with unusual patterns. In some cases, heterogeneity and high signal in surrounding white matter can be found. Cortical dysplasia is the most frequent associated malformation. (orig.)

  15. MRI findings of cardiac tumors in childhood

    Ten cases of cardiac tumor, detected by echocardiograms in childhood, were evaluated by using a 1.5T super-conductive magnetic resonance imager. Eight cases were with tuberous sclerosis, three of which were diagnosed as lipoma because of high intensity on T1 and T2 weighted images. The others were diagnosed as rhabdomyoma. It was difficult for echocardiograms to distinguish between the lipoma and the rhabdomyoma. MRI was very useful for the differential diagnosis of them. Two of ten cases were diagnosed as fibroma because of low intensity on T1 and T2 weighted images and inhomogeneous enhancement on Gd-DTPA enhanced T1 weighted image. MRI is a valuable tool for qualitative diagnosing cardiac tumors in childhood. (author)

  16. MRI findings of intracranial cystic meningiomas

    Aim: To report the magnetic resonance imaging (MRI) features of intracranial cystic meningiomas and compare these features in intra- and peritumoural cyst groups. Materials and methods: Fourteen cases of peritumoural cystic meningiomas were compared with 18 cases of intratumoural cystic meningiomas. All patients were examined using non-enhanced and contrast-enhanced MRI. Tumour location, tumour size, signal intensity, enhancement characteristics, and cystic changes were assessed. The MRI features were compared between the intra- and peritumoural cyst groups. Results: Most cystic meningiomas comprised two or more cysts. The solid parts of the tumours showed moderate or marked enhancement after the injection of contrast material. An enhanced cyst wall was found in six out of 14 cases in the peritumoural cyst group, but not in the intratumoural cyst group. Peritumoural cystic meningiomas were predominately located in the cerebral falx, whereas the intratumoural cystic meningiomas were predominantly found in frontal convexity (X2 = 7.434, p = 0.024). The cysts were larger in the peritumoural cyst group than in the intratumoural cyst group (t = 5.274, p = 0.0258). Peritumoural oedema was more commonly found in the intratumoural cyst group (X2 = 6.863, p = 0.008). Cystic meningiomas with solid parts located inside the cyst are reported for the first time. Conclusion: Cystic meningiomas, although uncommon, should be differentiated from other cystic intracranial lesions. Peri- and intratumoural cystic meningiomas have distinct MRI features. The present study provides the first report of two lesions with solid parts located inside the cyst, as well as one lesion with a calcified solid nodule and haemorrhage within the cyst.

  17. Muscle MRI findings in facioscapulohumeral muscular dystrophy

    Gerevini, Simonetta; Caliendo, Giandomenico; Falini, Andrea [IRCCS San Raffaele Scientific Institute, Neuroradiology Unit, Head and Neck Department, Milan (Italy); Scarlato, Marina; Previtali, Stefano Carlo [IRCCS San Raffaele Scientific Institute, Department of Neurology, INSPE and Division of Neuroscience, Milan (Italy); Maggi, Lorenzo; Pasanisi, Barbara; Morandi, Lucia [Fondazione IRCCS Istituto Neurologico ' ' Carlo Besta' ' , Neuromuscular Diseases and Neuroimmunology Unit, Milan (Italy); Cava, Mariangela [IRCCS San Raffaele Scientific Institute, Department of Radiology and Center for Experimental Imaging, Milan (Italy)

    2016-03-15

    Facioscapulohumeral muscular dystrophy (FSHD) is characterized by extremely variable degrees of facial, scapular and lower limb muscle involvement. Clinical and genetic determination can be difficult, as molecular analysis is not always definitive, and other similar muscle disorders may have overlapping clinical manifestations. Whole-body muscle MRI examination for fat infiltration, atrophy and oedema was performed to identify specific patterns of muscle involvement in FSHD patients (30 subjects), and compared to a group of control patients (23) affected by other myopathies (NFSHD). In FSHD patients, we detected a specific pattern of muscle fatty replacement and atrophy, particularly in upper girdle muscles. The most frequently affected muscles, including paucisymptomatic and severely affected FSHD patients, were trapezius, teres major and serratus anterior. Moreover, asymmetric muscle involvement was significantly higher in FSHD as compared to NFSHD patients. In conclusion, muscle MRI is very sensitive for identifying a specific pattern of involvement in FSHD patients and in detecting selective muscle involvement of non-clinically testable muscles. Muscle MRI constitutes a reliable tool for differentiating FSHD from other muscular dystrophies to direct diagnostic molecular analysis, as well as to investigate FSHD natural history and follow-up of the disease. (orig.)

  18. Muscle MRI findings in facioscapulohumeral muscular dystrophy

    Facioscapulohumeral muscular dystrophy (FSHD) is characterized by extremely variable degrees of facial, scapular and lower limb muscle involvement. Clinical and genetic determination can be difficult, as molecular analysis is not always definitive, and other similar muscle disorders may have overlapping clinical manifestations. Whole-body muscle MRI examination for fat infiltration, atrophy and oedema was performed to identify specific patterns of muscle involvement in FSHD patients (30 subjects), and compared to a group of control patients (23) affected by other myopathies (NFSHD). In FSHD patients, we detected a specific pattern of muscle fatty replacement and atrophy, particularly in upper girdle muscles. The most frequently affected muscles, including paucisymptomatic and severely affected FSHD patients, were trapezius, teres major and serratus anterior. Moreover, asymmetric muscle involvement was significantly higher in FSHD as compared to NFSHD patients. In conclusion, muscle MRI is very sensitive for identifying a specific pattern of involvement in FSHD patients and in detecting selective muscle involvement of non-clinically testable muscles. Muscle MRI constitutes a reliable tool for differentiating FSHD from other muscular dystrophies to direct diagnostic molecular analysis, as well as to investigate FSHD natural history and follow-up of the disease. (orig.)

  19. Retroflexed holoprosencephaly. X-ray CT findings and MRI findings

    Nagano, N.; Ohno, K.; Masaoka, H.; Fukai, N.; Matsushima, Y.

    1987-02-01

    We report a case of holoprosencephaly with retroflexion and discuss the usefulness of X-ray CT in its diagnosis. A 2-month-old infant, admitted with severe hydrocephalus, underwent a ventriculo-peritoneal shunt. The brain was retroflexed with subdural fluid collection after the procedure. The pathological condition was, however, gradually improved by the use of an additional subduro-peritoneal shunt. The shift and distortion of the brain were observed by means of serial X-ray CT scans. MRI revealed the brain stuck mainly to the frontal bone, monoventricle, the so-called dorsal sac, and probably the pituitary gland, but not the fourth ventricle nor the aqueduct. Sagittal and coronal sections of MRI and axial sections of X-ray CT proved to be useful in the diagnosis and classification of the holoprosencephaly, even without other invasive diagnostic procedures.

  20. MRI Findings in Cerebellopontine Angle Lesions

    A. Radmehr

    2008-01-01

    Full Text Available The cerebellopontine (CP angle cistern is an anat-omic region that contains variable structures."nBecause of wide spectrum of noumal structures, the CP angle translates into a wide variety of correspond-ing pathologies."nThus the principal goal is to present some MRI im-ages from CP angle lesions for more familiarity and understanding of this matter especially for young ra-diologists."nIn this section we would like to discuss some com-mon and uncommon CP angle lesions.

  1. Non-traumatic peroneal nerve palsy: MRI findings

    Aim: To present magnetic resonance imaging (MRI) findings of non-traumatic peroneal nerve palsy and to evaluate the usefulness of MRI in patients with non-traumatic peroneal nerve palsy. Materials and methods: In a retrospective study, 11 consecutive patients presenting with peroneal nerve palsy were included. MR images of the lower leg and electrophysiological examinations were also reviewed. The cause of peroneal nerve palsy was determined on the basis of MRI findings and was evaluated using electrophysiological data. Nine patients with causative lesions detected on MRI, underwent surgery. Results: Clinical examination and electromyography (EMG) disclosed 11 peroneal lesions. MRI and EMG revealed three types of signal intensity change, i.e. deep peroneal nerve palsy type, common peroneal nerve palsy type, and superficial peroneal nerve palsy type. The MRI and EMG findings were in agreement in seven (65%) of the 11 study patients. In nine patients the causative lesions were identified using MRI, including ganglion cyst (n = 6), osteochondroma (n = 1), synovial cyst (n = 1), and aneurysm (n = 1). Conclusion: Ganglion cyst is the most common cause of non-traumatic peroneal nerve palsy. MRI offers a noninvasive method for obtaining useful information to assess, localize, and monitor peripheral peroneal nerve palsy

  2. Unusual MRI findings in grey matter heteropia

    Soto Ares, G.; Hamon-Kerautret, M.; Leclerc, X.; Pruvo, J.P. [Service de Neuroradiologie, Hopital Roger Salengro, CHRU, Lille (France); Houlette, C. [Service de Radiologie, CHRU, Rouen (France); Godefroy, O. [Service de Neurologie B, CHRU, Lille (France)

    1998-02-01

    We report unusual MRI patterns in patients with grey matter heterotopia. Standard T1- and T2-weighted spin-echo and inversion-recovery sequences were used in 22 patients presenting with seizures or developmental delay. The images were reviewed for signal change surrounding white matter and for atypical size, morphology or topography. We found 10 cases of subependymal heterotopias 11 of focal subcortical heterotopia and of diffuse subcortical heterotopia. On clinical or MRI grounds, 8 cases were considered unusual: 2 of the subependymal type, 2 of focal subcortical heterotopia with white matter abnormalities, 2 of focal subcortical heterotopia with no clinicoradiological correlation 1 of extensive hemispheric subcortical heterotopia and 1 of diffuse subcortical heterotopia confined to the frontal lobe. The classical classification of heterotopia enables easy radiological diagnosis even in cases with unusual patterns. In some cases, heterogeneity and high signal in surrounding white matter can be found. Cortical dysplasia is the most frequent associated malformation. (orig.) With 7 figs., 2 tabs., 10 refs.

  3. Arrhythmogenic right ventricular dysplasia: MRI findings

    Wall, E.E. van der; Bootsma, M.M.; Schalij, M.J. [Dept. of Cardiology, Leiden Univ. Medical Center, Leiden (Netherlands); Kayser, H.W.M.; Roos, A. de [Dept. of Radiology, Leiden Univ. Medical Center, Leiden (Netherlands)

    2000-06-01

    Arrhythmogenic right ventricular dysplasia (ARVD) is a heart muscle disorder of unknown cause that is characterized pathologically by fibrofatty replacement of the right ventricular myocardium. Clinical manifestations include structural and functional malformations of the right ventricle, electrocardiographic abnormalities, and presentation with ventricular tachycardias with left bundle branch pattern or sudden death. The disease is often familial with an autosomal inheritance. In addition to right ventricular dilatation, right ventricular aneurysms are typical deformities of ARVD and they are distributed in the so-called ''triangle of dysplasia'', i. e., right ventricular outflow tract, apex, and infundibulum. Ventricular aneurysms at these sites can be considered pathognomonic of ARVD. Another typical hallmark of ARVD is fibrofatty infiltration of the right ventricular free wall. These functional and morphologic characteristics are relevant to clinical imaging investigations such as contrast angiography, echocardiography, radionuclide angiography, ultrafast computed tomography, and magnetic resonance imaging (MRI). Among these techniques, MRI allows the clearest visualization of the heart, in particular because the right ventricle is involved, which is usually more difficult to explore with the other imaging modalities. Furthermore, MRI offers the specific advantage of visualizing adipose infiltration as a bright signal of the right ventricular myocardium. MRI provides the most important anatomic, functional, and morphologic criteria for diagnosis of ARVD within one single study. As a result, MRI appears to be the optimal imaging technique for detecting and following patients with clinical suspicion of ARVD. (orig.) [German] Die arrhythmogene rechtsventrikulaere Dysplasie (ARVD), eine Herzmuskelerkrankung unklarer Aetiologie, ist pathologisch durch fettige Degeneration des rechtsventrikulaeren Myokards gekennzeichnet. Die klinischen Symptome umfassen strukturelle und funktionelle Malformationen des rechten Ventrikels, krankhafte elektrokardiographische Befunde und das Auftreten ventrikulaerer Tachykardien mit Linksschenkelblock oder ploetzlichem Herztod. Die Krankheit tritt familiaer gehaeuft auf und wird autosomal vererbt. Neben der rechtsventrikulaeren Dilatation stellen rechtsventrikulaere Aneurysmen typische Fehlbildungen bei ARVD dar. Sie sind im so genannten ''Dysplasiedreieck'', das heisst rechtem ventrikulaerem Ausflusstrakt, Herzspitze und Infundibulum, verteilt. Dort lokalisierte ventriku-laere Aneurysmen koennen als pathognomonisch fuer die ARVD angesehen werden. Ein weiteres typisches Merkmal der ARVD ist die fettige Degeneration der freien rechten Ventrikelwand. Diese funktionellen und strukturellen Charakteristika sind bei der klinischen Untersuchung mit bildgebenden Verfahren wie Kontrastangiographie, Echokardiographie, Radionuklidangiographie, ultraschneller Computertomographie und Magnetresonanztomographie (MRT) von Bedeutung. Unter diesen Verfahren erlaubt die MRT die deutlichste Darstellung des Herzens, insbesondere bei Beteiligung des rechten Ventrikels, der sich mit den anderen bildgebenden Methoden in der Regel schwerer untersuchen laesst. Darueber hinaus bietet die MRT den wesentlichen Vorteil der Darstellung der fettigen Degeneration als helles Signal im rechtsventrikulaeren Myokard. Die MRT liefert die wichtigsten anatomischen,m funktionellen und morphologischen Kriterien zur Diagnose einer ARVD in einem einzigen Untersuchungsgang. Daher scheint sie das beste bildgebende Verfahren zur Identifizierung und Nachsorge von Patienten mit klinischem Verdacht auf ARVD zu sein. (orig.)

  4. Brain MRI findings of complex partial seizure in children

    Twenty-two children(4 months to 17 year old) with a clinical diagnosis of complex partial seizure(CPS) were examined with a 0.5 T MRI scanner using spin-echo sequences. Eleven patients showed abnormal brain MRI findings; two had focal lesions with corresponding seizure foci on the EEG, one arising from temporal lobe(Hippocampal formation atrophy) and the other from the frontal lobe. Nine patients showed diffuse lesions with inconsistent seizure foci on EEG. The remaining 11 patients were normal on brain MRI; two of them had normal EEG findings and the others either focal or diffuse abnormalities on EEG

  5. Solitary infantile choriocarcinoma of the liver: MRI findings

    Hoef, Marianne van der; Willi, Ulrich V.; Huisman, Thierry A.G.M. [University Children' s Hospital Zurich, Department of Diagnostic Imaging, Zurich (Switzerland); Niggli, Felix K. [University Children' s Hospital Zurich, Department of Paediatrics, Zurich (Switzerland)

    2004-10-01

    Infantile hepatic choriocarcinoma is a rare, highly malignant germ-cell tumour believed to result from a choriocarcinoma of the placenta that spreads to the child. Most infants present with a characteristic clinical picture of anaemia, hepatomegaly and precocious puberty. Imaging findings, including conventional MRI, may be non-specific. To improve the accuracy of diagnosis, we present the imaging findings of contrast-enhanced dynamic MRI in a 4.5-month-old boy with infantile hepatic choriocarcinoma. (orig.)

  6. Solitary infantile choriocarcinoma of the liver: MRI findings

    Infantile hepatic choriocarcinoma is a rare, highly malignant germ-cell tumour believed to result from a choriocarcinoma of the placenta that spreads to the child. Most infants present with a characteristic clinical picture of anaemia, hepatomegaly and precocious puberty. Imaging findings, including conventional MRI, may be non-specific. To improve the accuracy of diagnosis, we present the imaging findings of contrast-enhanced dynamic MRI in a 4.5-month-old boy with infantile hepatic choriocarcinoma. (orig.)

  7. MRI findings of fetal cleft lip and palate

    Objective: To investigate the MR findings of fetal cleft lip (CL) and evaluate the advantages and limitations of MRI in the diagnosis. Methods: Twelve pregnant women suspicious of fetal CL/cleft palate (CP) on ultrasonography were enrolled in the study. The findings of ultrasonography, MRI and following-up were compared. Results: MRI and ultrasonography detected 12 fetuses with CL/CP. The following-up results showed 1 case with incomplete cleft lip and the other 11 cases with complete cleft lips and cleft palates. MRI and unltrasonography were consistent with the follow-up in CL detection, showing completed or uncompleted soft tissue interruption of the fetal lips with amniotic fluid filling which is high signal on T2WI. On MRI, CP showed discontinuous of the soft tissue which were interrupted by long T2 signal and communicating with oral cavity ad nasal cavity. MRI missed 1 case and excluded 1 case of CP. Ultrasonography predicted 5 case of CL, excluded 1 CP but missed 6 cases. The accuracy, sensitivity and specificity in detection CL/CP was 91.7% (11/12), 90.9% (10/11), 100% (1/1) for MRI and 50.0% (6/12), 45.5% (5/11), 100% (1/1) for ultrasonography, respectively. Conclusion: MR imaging had advantage over ultrasonography in detecting CP, MRI is an essential when CP is suspicious on ultrasonography. (authors)

  8. Quantification of left-to-right shunting in adult congenital heart disease: phase-contrast cine MRI compared with invasive oximetry.

    Debl, K; Djavidani, B; Buchner, S; Heinicke, N; Poschenrieder, F; Feuerbach, S; Riegger, G; Luchner, A

    2009-05-01

    Atrial septum defects (ASDs), ventricular septum defects (VSDs) and patent ductus arteriosus (PDA) are the most common adult congenital heart defects. The degree of left-to-right shunting as assessed by the ratio of flow in the pulmonary (Qp) and systemic circulation (Qs) is crucial in the management of these conditions. This study compared phase-contrast cine magnetic resonance imaging (PC-MRI), a non-invasive imaging technique, with invasive oximetry for the measurement of shunt volumes during cardiac catheterisation in adults with left-to-right shunting. Both invasive oximetry and shunt quantification by PC-MRI (1.5 T scanner; Sonata, Siemens Medical Solutions) were performed on 21 patients with left-to-right shunting (14 ASD, 5 VSD, 2 PDA) and data on Qp/Qs ratios and left-to-right shunt fraction compared. Mean Qp/Qs ratios assessed by PC-MRI and oximetry were 2.10+/-0.76 and 1.96+/-0.77, respectively (p = 0.37). Mean shunt fraction was 46.3+/-19.6% when calculated by PC-MRI and 42.3+/-20.1% when obtained by oximetry (p = 0.12). There was a strong correlation of Qp/Qs ratios and shunt fraction between both methods (r = 0.61, p or =1.5:1 were 93% and 100% at a PC-MRI threshold of a Qp/Qs ratio > or =1.75:1 (area under curve (AUC) = 0.99). Quantification of left-to-right shunting can be performed reliably and accurately by PC-MRI and the data obtained by this method correlate closely to those from invasive oximetry. PMID:19153187

  9. CT and MRI findings in cerebral hydatid disease

    CT is the primary modality for the diagnosis. Two forms of cerebral hydatid cysts have been reported on the basis of CT appearances: unilocular and multilocular. Demonstration of the cyst wall is important for the diagnosis. MRI is superior to CT for demonstrating the cyst capsule and perifocal oedema. We retrospectively reveiwed the CT and MRI findings of 6 surgically proven cases of cerebral hydatid cyst and compared the two modalities on the basis of their demonstration of findings helpful in the diagnosis, such as the capsule and perifocal oedema. In 1 case CT showed the capsule. In 2 cases MRI showed a hypointense capsule around the cyst on T2-weighted images. While CT is the modality of choice, in clinical practice MRI is superior for demonstrating the cyst capsule, which is a helpful finding in the diagnosis and can be used in inconclusive cases. (orig.)

  10. Osmotic demyelination syndrome with a dysequilibrium syndrome: reversible MRI findings

    Neurological disorders may be seen in end-stage renal disease patients due to uraemia or to complications of dialysis. A dysequilibrium syndrome may be seen, usually soon after or towards the end of haemodialysis. This group of patients has no particular findings on MRI. On the other hand, the osmotic demyelination syndrome has definitive MRI findings, not to date reported with the dysequilibrium syndrome. We report a patient with end-stage renal disease and the dysequilibrium syndrome who showed findings of osmotic demyelination on MRI. The patient had a convulsion after a first haemodialysis, with quadriparesis and hyperactive deep tendon reflexes and bilateral Babinski signs. The upper motor neurone signs lasted for a week. Meanwhile, he was also dysarthric and had dysphagia. He recovered neurologically without any residuum following appropriate treatment and there was improvement on MRI. (orig.)

  11. Osmotic demyelination syndrome with a dysequilibrium syndrome: reversible MRI findings

    Agildere, A.M.; Coskun, M.; Boyvat, F. [Baskent University Medical School Hospital, Radiology Department, Ankara (Turkey); Benli, S. [Baskent University Medical School Hospital, Neurology Department, Ankara (Turkey); Erten, Y.; Oezdemir, N. [Baskent University Medical School Hospital, Nephrology Department, Ankara (Turkey)

    1998-04-01

    Neurological disorders may be seen in end-stage renal disease patients due to uraemia or to complications of dialysis. A dysequilibrium syndrome may be seen, usually soon after or towards the end of haemodialysis. This group of patients has no particular findings on MRI. On the other hand, the osmotic demyelination syndrome has definitive MRI findings, not to date reported with the dysequilibrium syndrome. We report a patient with end-stage renal disease and the dysequilibrium syndrome who showed findings of osmotic demyelination on MRI. The patient had a convulsion after a first haemodialysis, with quadriparesis and hyperactive deep tendon reflexes and bilateral Babinski signs. The upper motor neurone signs lasted for a week. Meanwhile, he was also dysarthric and had dysphagia. He recovered neurologically without any residuum following appropriate treatment and there was improvement on MRI. (orig.) With 3 figs., 11 refs.

  12. Pathological findings correlated with MRI in HIV infection

    MRI forms an important part of the assessment of patients with HIV-related disease presenting with cerebral symptoms. Eleven formalin-fixed brains were studied at 0.5 T using T2- and T1-weighted sequences. In two cases of progressive multifocal leucoencephalopathy and one case each of toxoplasmosis and lymphoma, the extent of white matter abnormality seen on MRI corresponded broadly with that on pathological examination. In general, however, histological changes were more frequent than lesions on MRI. Cases in wich abnormalities were not seen with standard MRI included those with multiple tuberculous granulomata, multinucleate giant cells, microglial nodules, perivascular cuffing and cytomegalovirus inclusions. A common finding on MRI was punctate or patchy high signal in the basal ganglia on T2-weighted scans, seen in six cases. Corresponding histological changes included calcification of vessels with widened perivascular spaces, and mineralised neurones. (orig.)

  13. Functional cine MRI of the abdomen for the assessment of implanted synthetic mesh in patients after incisional hernia repair: initial results

    Fischer, Tanja [Ludwig-Maximilians-University Munich, Department of Clinical Radiology, Munich (Germany); Ludwig-Maximilians-University Munich, Department of Clinical Radiology, Klinikum Innenstadt, Munich (Germany); Ladurner, Roland; Mussack, Thomas [Ludwig-Maximilians-University Munich, Department of Surgery and Traumatology, Klinikum Innenstadt, Munich (Germany); Gangkofer, Alexander; Reiser, Maximilian; Lienemann, Andreas [Ludwig-Maximilians-University Munich, Department of Clinical Radiology, Munich (Germany)

    2007-12-15

    The aim of our study was to develop a method that allows the vizualiation and evaluation of implanted mesh in patients after incisional hernia repair with MRI. Furthermore, we assessed problems typically related with mesh implantation like adhesions and muscular atrophy. We enrolled 28 patients after incisional hernia repair. In 10 patients mesh implantation was done by laparoscopy (expanded polytetrafluoroethylene=ePTFE mesh) and in 18 by laparotomy (polypropylene mesh). Functional MRI was performed on a 1.5-T system in supine position. Sagittal and axial TrueFISP images of the entire abdomen were acquired with the patient repeatedly straining. Evaluation included: correct position and intact fixation of the mesh, furthermore visceral adhesions, recurrent hernia and atrophy of the rectus muscle. The ePTFE mesh was visible in all cases; the polypropylene mesh was not detectable. In seven of the ten ePTFE meshes the fixation was not intact; two recurrent hernias were detected. Twenty of 28 patients had intraabdominal adhesions. In 5 cases mobility of the abdominal wall was reduced, and 16 patients showed an atropy of the rectus muscle. Functional cine MRI is a suitable method for follow-up studies in patients after hernia repair. ePTFE meshes can be visualized directly, and typical complications like intestinal adhesions and abdominal wall dysmotility can be assessed reliably. (orig.)

  14. Functional cine MRI of the abdomen for the assessment of implanted synthetic mesh in patients after incisional hernia repair: initial results

    The aim of our study was to develop a method that allows the vizualiation and evaluation of implanted mesh in patients after incisional hernia repair with MRI. Furthermore, we assessed problems typically related with mesh implantation like adhesions and muscular atrophy. We enrolled 28 patients after incisional hernia repair. In 10 patients mesh implantation was done by laparoscopy (expanded polytetrafluoroethylene=ePTFE mesh) and in 18 by laparotomy (polypropylene mesh). Functional MRI was performed on a 1.5-T system in supine position. Sagittal and axial TrueFISP images of the entire abdomen were acquired with the patient repeatedly straining. Evaluation included: correct position and intact fixation of the mesh, furthermore visceral adhesions, recurrent hernia and atrophy of the rectus muscle. The ePTFE mesh was visible in all cases; the polypropylene mesh was not detectable. In seven of the ten ePTFE meshes the fixation was not intact; two recurrent hernias were detected. Twenty of 28 patients had intraabdominal adhesions. In 5 cases mobility of the abdominal wall was reduced, and 16 patients showed an atropy of the rectus muscle. Functional cine MRI is a suitable method for follow-up studies in patients after hernia repair. ePTFE meshes can be visualized directly, and typical complications like intestinal adhesions and abdominal wall dysmotility can be assessed reliably. (orig.)

  15. Synovial Hemangioma in the Knee: MRI Findings

    Harun Arslan

    2015-01-01

    Full Text Available Synovial hemangiomas are rare benign tumors of vascular origin. A 23-year-old boy presented with knee pain and swelling. The boy had developed symptoms 18-months earlier. He was diagnosed with synovial hemangioma based on magnetic resonnance imaging examination and histopathologic findings of the arthroscopic biopsy tissue. We present the magnetic resonance imaging and histopathologic findings of synovial hemangioma of the knee.

  16. Giant Breast Involvement in Acute Lymphoblastic Leukemia: MRI Findings

    BASARA, Isil; Orguc, Sebnem

    2012-01-01

    Breast metastases in cases of leukemia are rare. We aimed to report the conventional-advanced magnetic resonance imaging (MRI) findings of unilateral breast involvement of acute lymphoblastic leukemia (ALL) and review the literature. A 32-year-old woman was first diagnosed with ALL in treated in 2004. She did not continue the follow-up after 2008. She was presented with a giant, progressive right breast palpable mass in 2010. Mass, contralateral breast tissue were evaluated with MRI, diffusio...

  17. Hyperplastic callus formation in osteogenesis imperfecta: CT and MRI findings

    Hyperplastic callus formation is a noteworthy condition in patients with osteogenesis imperfecta because it often mimicks osteosarcoma on radiography. The findings of CT and MRI in hyperplastic callus formation have not been reported. In the presented case, MRI demonstrated contrast enhancement and edema of the surrounding soft tisssue, consistent with benign as well as malignant disease. Computed tomography showed a calcified rim of the lesion which may be a useful feature to rule out osteosarcoma in this condition. (orig.)

  18. CINE CLUB

    Ciné Club

    2009-01-01

    Main Auditorium CERN jeudi 17 décembre 2009 à 18 h 15 à l’Amphithéâtre principal du CERN (bâtiment 500)   Comme chaque année avant Noël, le CineClub du CERN est heureux d’inviter petits et grands à une projection gratuite du film   LE MONDE DE NEMO (FINDING NEMO) (USA, 2003, Andrew Stanton and Lee Unkrich)   Dans les eaux tropicales de la Grande Barrière de corail, un poisson-clown du nom de Marin mène une existence paisible avec son fils unique, Nemo. Redoutant l’océan et ses risques imprévisibles, il fait de son mieux pour protéger son fils. Comme tous les petits poissons de son âge, celui-ci rêve pourtant d’explorer les mystérieux récifs. Lorsque Nemo disparaît, Marin devient malgré lui le héros d’une qu&a...

  19. Cognitive dysfunction, MRI findings and manganese levels in alcoholics

    Alcoholic patients have been known to have brain atrophy and cognitive dysfunction. However, recent studies have reported bilateral signal hyperintensities of the globus pallidus on T1-weighted magnetic resonance imaging (MRI) in liver failure, findings that are typically associated with manganese intoxication. The present study compared brain atrophy on T1-weighted MRI, signal intensity ratios of the globus pallidus on T1-weighted MRI, whole blood manganese levels, and Wechsler Adult Intelligence Scale-Revised (WAIS-R) IQ parameters between alcoholics with and without liver cirrhosis, to investigate cognitive dysfunction, MRI findings and manganese levels in alcoholics. Pallidal hyperintensity was visually identified in 80% of alcoholic patients with liver cirrhosis. In addition, a significant correlation was seen between pallidal signal intensity (P.S.I.) ratio and blood manganese level. However, no significant correlations were found between pallidal signal intensity ratio and any of the WAIS-R parameters. These findings suggest that no direct connection exists between cognitive dysfunction and pallidal hyperintensity in alcoholic patients with liver cirrhosis. We confirmed that brain MRI in alcoholics could detect pallidal signal hyperintensity, suggesting severe liver dysfunction. In addition to diagnosis, brain MRI is useful for therapeutic psychoeducation to alcoholic patients with liver cirrhosis, visualizing the severe liver dysfunction. (author)

  20. MRI findings of herpes simplex encephalitis

    We retrospectively analyzed the MR findings of 12 patients with herpes simplex encephalitis (HSE) (8 months - 64 years old). MR imaging was performed on either a 0.5T (6 patients) or 2.0T (6 patients) superconducting unit with spin echo pulse sequences. The most common and characteristic MR finding consisted of non-hemorrhagic lesions in the cortices of the temporal lobes(12), and insular(6), either bilateral(7) or unilateral(5). The frontal lobe and cingulate gyrus were involved in 4 and 2 patients respectively. Petechial hemorrhage was found in 3 patients. Non-hemorrhagic lesions were shown as high signal intensities on proton and T2WI, and iso- or low signal intensities on T1WI. In conclusion, MR imaging findings described above appear to be characteristic of HSE and were found to be extremely valuable in the diagnosis of HSE

  1. Muscle hernias of the lower leg: MRI findings

    Muscle hernias of the lower leg involving the tibialis anterior, peroneus brevis, and lateral head of the gastrocnemius were found in three different patients. MRI findings allowed recognition of herniated muscle in all cases and identification of fascial defect in two of them. MR imaging findings and the value of dynamic MR imaging is emphasized. (orig.)

  2. MRI findings associated with luxatio erecta humeri

    Luxatio erecta humeri is a rare type of inferior glenohumeral dislocation with a unique radiographic appearance; however, the magnetic resonance imaging findings associated with this dislocation have not been described in the radiology literature. The purpose of this study is to identify magnetic resonance imaging findings associated with this uncommon type of glenohumeral dislocation. The magnetic resonance imaging features of four patients with clinical and radiographic evidence of luxatio erecta humeri were reviewed retrospectively by two musculoskeletal-trained radiologists. The reported mechanism of injury in all four patients was falling. The MR imaging examinations were evaluated for the presence of rotator cuff and biceps tendon pathology, glenoid labrum pathology, joint capsule and glenohumeral ligament injury, fractures and bone marrow contusions, articular cartilage injury, and joint effusions. All four patients demonstrated pathology of the glenohumeral joint. Three of the four patients demonstrated rotator cuff tears, including large full thickness tears of the supraspinatus and infraspinatus tendons in two patients, and small full thickness tear of the supraspinatus tendon with partial thickness tear of the infraspinatus tendon in the third patient. In the two patients with large full thickness tears of the supraspinatus and infraspinatus tendons, one patient demonstrated tearing of the subscapularis tendon with dislocation of a partially torn long head of the biceps tendon, and the second patient demonstrated full thickness tearing of the intra-articular biceps tendon. All four patients demonstrated injuries to the glenoid labrum and both anterior and posterior bands of the inferior glenohumeral ligament. Contusions or fractures of the humeral head were seen in two of the patients. Three of the four patients demonstrated cartilage abnormalities including a focal cartilage defect in the anterior inferior glenoid in one patient, and cartilage surface irregularity of the glenoid in the other two patients. Common magnetic resonance imaging findings in patients with a prior luxatio erecta humeri dislocation include rotator cuff tears, injury to the glenoid labrum, and injury to both the anterior and posterior bands of the inferior glenohumeral ligament. These findings are compatible with the mechanism of dislocation in luxatio erecta, and noting these findings on magnetic resonance imaging may suggest that the patient has sustained a prior inferiorly directed glenohumeral dislocation such as luxatio erecta. (orig.)

  3. Prognostic value of MRI findings in sciatica

    The natural course of sciatica due to disc herniation is generally favourable but individually unpredictable. Some patients recover only after prolonged conservative therapy or surgery. This study aims to ascertain whether magnetic resonance (MR) imaging features can be used to predict outcome of sciatica and help to identify patients unlikely to respond to conservative management. For a transversal diagnostic study 274 primary care patients underwent early MR imaging for leg pain. One hundred and thirty-three patients with sciatica were followed for 3 months, both patients and physicians being unaware of MR imaging findings. At 12 weeks a favourable prognosis was indicated by the following features: annular rupture (P=0.02) and nerve root compression on MR imaging (P=0.03). Poor prognosis was indicated by disc herniation in the foramen (P=0.004). Our findings show that early MR imaging features are related to prognosis. However, the associations are not strong enough to justify routine use of early MR imaging to predict the prognosis of sciatica. (orig.)

  4. Prognostic value of MRI findings in sciatica

    Vroomen, P.C.A.J.; Krom, M.C.T.F.M. de [Department of Neurology, Maastricht University Hospital (Netherlands); Wilmink, J.T. [Division of Neuroradiology, Department of Diagnostic Radiology, Maastricht University Hospital (Netherlands)

    2002-01-01

    The natural course of sciatica due to disc herniation is generally favourable but individually unpredictable. Some patients recover only after prolonged conservative therapy or surgery. This study aims to ascertain whether magnetic resonance (MR) imaging features can be used to predict outcome of sciatica and help to identify patients unlikely to respond to conservative management. For a transversal diagnostic study 274 primary care patients underwent early MR imaging for leg pain. One hundred and thirty-three patients with sciatica were followed for 3 months, both patients and physicians being unaware of MR imaging findings. At 12 weeks a favourable prognosis was indicated by the following features: annular rupture (P=0.02) and nerve root compression on MR imaging (P=0.03). Poor prognosis was indicated by disc herniation in the foramen (P=0.004). Our findings show that early MR imaging features are related to prognosis. However, the associations are not strong enough to justify routine use of early MR imaging to predict the prognosis of sciatica. (orig.)

  5. MRI and CT findings of neurohypophyseal germinoma

    Kanagaki, Mitsunori; Miki, Yukio E-mail: mikiy@kuhp.kyoto-u.ac.jp; Takahashi, Jun A.; Shibamoto, Yuta; Takahashi, Takahiro; Ueba, Tetsuya; Hashimoto, Nobuo; Konishi, Junji

    2004-03-01

    Objective: Magnetic resonance (MR) imaging and computed tomography (CT) findings of neurohypophyseal germinoma have not previously been described in detail. The purpose of the present study was to establish the spectrum of MR imaging and CT findings in neurohypophyseal germinomas. Materials and methods: MR and CT images of 13 consecutive patients (seven males, six females; mean age: 15 years; range: 6-31 years) with neurohypophyseal germinoma were retrospectively analyzed. The diagnosis had been made either histologically (n=8) or clinically according to established criteria (n=5). All patients had been examined using MR imaging and CT before treatment. Results: On MR imaging, infundibular thickening (up to 16 mm) was observed in all 13 cases. Hyperintensity of the posterior pituitary on T1-weighted image was absent in all 13 cases (100%) and 12 of the 13 displayed central diabetes insipidus. Ten germinomas (77%) were isointense to cerebral cortex on T1-weighted image, but variable intensities were exhibited on T2-weighted image. MR images revealed intratumoral cysts in six cases (46%), most of which demonstrated intra-third ventricular extension. Eleven of the 13 cases (85%) revealed hyperdense solid components on unenhanced CT. Calcification was absent in all cases (100%). Conclusion: Infundibular thickening, absence of the posterior pituitary high signal on T1-weighted image, lack of calcification and hyperdensity on unenhanced CT are common imaging features of neurohypophyseal germinoma.

  6. MRI and CT findings of neurohypophyseal germinoma

    Objective: Magnetic resonance (MR) imaging and computed tomography (CT) findings of neurohypophyseal germinoma have not previously been described in detail. The purpose of the present study was to establish the spectrum of MR imaging and CT findings in neurohypophyseal germinomas. Materials and methods: MR and CT images of 13 consecutive patients (seven males, six females; mean age: 15 years; range: 6-31 years) with neurohypophyseal germinoma were retrospectively analyzed. The diagnosis had been made either histologically (n=8) or clinically according to established criteria (n=5). All patients had been examined using MR imaging and CT before treatment. Results: On MR imaging, infundibular thickening (up to 16 mm) was observed in all 13 cases. Hyperintensity of the posterior pituitary on T1-weighted image was absent in all 13 cases (100%) and 12 of the 13 displayed central diabetes insipidus. Ten germinomas (77%) were isointense to cerebral cortex on T1-weighted image, but variable intensities were exhibited on T2-weighted image. MR images revealed intratumoral cysts in six cases (46%), most of which demonstrated intra-third ventricular extension. Eleven of the 13 cases (85%) revealed hyperdense solid components on unenhanced CT. Calcification was absent in all cases (100%). Conclusion: Infundibular thickening, absence of the posterior pituitary high signal on T1-weighted image, lack of calcification and hyperdensity on unenhanced CT are common imaging features of neurohypophyseal germinoma

  7. MRI findings of traumatic spinal subdural hematoma

    To describe the MR imaging findings of traumatic spinal subdural hematoma. We retrospectively reviewed the MR images of six patients, with symptoms of acute spinal cord or cauda equena compression after trauma, together with spinal subdural hematoma. We analyzed the extent, location, configuration and signal intensity of the lesions. In five of sex cases, hematomas were distributed extensively throughout the thoracolumbosacral or lumbosacral spinal levels. In five cases they were located in the dorsal portion of the thecal sac, and in one case, in the ventral portion. On axial images, hematomas showed a concave or convex contour, depending on the amount of loculated hematoma. A lobulated appearance was due to limitation of free extension of the hematoma within the subdural space at the lateral sites (nerve root exist zone) at whole spine levels, and at the posteromedian site under lumbar 4-5 levels. In cases of spinal subdural hematoma, the lobulated appearance of hematoma loculation in the subdural space that bounds the lateral sites at al spinal levels and at the posteromedian site under L4-5 levels is a characteristic finding. (author)

  8. Reliability of MRI findings in candidates for lumbar disc prosthesis

    Limited reliability data exist for localised magnetic resonance imaging (MRI) findings relevant to planning of treatment with lumbar disc prosthesis and later outcomes. We assessed the reliability of such findings in chronic low back pain patients who were accepted candidates for disc prosthesis. On pretreatment MRI of 170 patients (mean age 41 years; 88 women), three experienced radiologists independently rated Modic changes, disc findings and facet arthropathy at L3/L4, L4/L5 and L5/S1. Two radiologists rerated 126 examinations. For each MRI finding at each disc level, agreement was analysed using the kappa statistic and differences in prevalence across observers using a fixed effects model. All findings at L3/L4 and facet arthropathy at L5/S1 had a mean prevalence <10% across observers and were not further analysed, ensuring interpretable kappa values. Overall interobserver agreement was generally moderate or good (kappa 0.40-0.77) at L4-S1 for Modic changes, nucleus pulposus signal, disc height (subjective and measured), posterior high-intensity zone (HIZ) and disc contour, and fair (kappa 0.24) at L4/L5 for facet arthropathy. Posterior HIZ at L5/S1 and severely reduced subjective disc height at L4/L5 differed up to threefold in prevalence between observers (p < 0.0001). Intraobserver agreement was mostly good or very good (kappa 0.60-1.00). In candidates for disc prosthesis, mostly moderate interobserver agreement is expected for localised MRI findings. (orig.)

  9. Reliability of MRI findings in candidates for lumbar disc prosthesis

    Berg, Linda; Espeland, Ansgar [Haukeland University Hospital, Department of Radiology, Bergen (Norway); University of Bergen, Section for Radiology, Department of Surgical Sciences, Bergen (Norway); Neckelmann, Gesche [Haukeland University Hospital, Department of Radiology, Bergen (Norway); Gjertsen, Oeivind [Oslo University Hospital, Department of Neuroradiology, Oslo (Norway); Hellum, Christian [Oslo University Hospital, Department of Orthopaedics, Oslo (Norway); University of Oslo, Department of Orthopaedics, Oslo (Norway); Johnsen, Lars G. [University Hospital of Trondheim, National Centre for Diseases of the Spine, Trondheim (Norway); University Hospital of Trondheim, Orthopaedic Department, Trondheim (Norway); Eide, Geir E. [Haukeland University Hospital, Centre for Clinical Research, Bergen (Norway); University of Bergen, Department of Public Health and Primary Health Care, Bergen (Norway)

    2012-07-15

    Limited reliability data exist for localised magnetic resonance imaging (MRI) findings relevant to planning of treatment with lumbar disc prosthesis and later outcomes. We assessed the reliability of such findings in chronic low back pain patients who were accepted candidates for disc prosthesis. On pretreatment MRI of 170 patients (mean age 41 years; 88 women), three experienced radiologists independently rated Modic changes, disc findings and facet arthropathy at L3/L4, L4/L5 and L5/S1. Two radiologists rerated 126 examinations. For each MRI finding at each disc level, agreement was analysed using the kappa statistic and differences in prevalence across observers using a fixed effects model. All findings at L3/L4 and facet arthropathy at L5/S1 had a mean prevalence <10% across observers and were not further analysed, ensuring interpretable kappa values. Overall interobserver agreement was generally moderate or good (kappa 0.40-0.77) at L4-S1 for Modic changes, nucleus pulposus signal, disc height (subjective and measured), posterior high-intensity zone (HIZ) and disc contour, and fair (kappa 0.24) at L4/L5 for facet arthropathy. Posterior HIZ at L5/S1 and severely reduced subjective disc height at L4/L5 differed up to threefold in prevalence between observers (p < 0.0001). Intraobserver agreement was mostly good or very good (kappa 0.60-1.00). In candidates for disc prosthesis, mostly moderate interobserver agreement is expected for localised MRI findings. (orig.)

  10. MRI findings of miliary tuberculosis of the brain

    To evaluate MRI(Magnetic Resonance Imaging) findings of miliary tuberculosis of the brain Six patients with miliary tuberculosis of the brain diagnosed by characteristic clinical or laboratory findings were studied with spin echo MRI before and after contrast enhancement. We retrospectively evaluated MRI findings according to the appearance, distribution, location, and enhancement pattern of the granulomas as well as associated other abnormalities. In six patients, contrast-enhanced MRI of the brain showed numerous punctate, contrast enhancing lesions scattered throughout the brain. Unenhanced MRI failed to demonstrate small granulomas except a few small foci of high signal intensity on T2-weighted images. The shapes of enhancing granulomas were homogeneous nodular enhancement in 86% of cases and small ring enhancement in 14%. 98% of granulomas were smaller than 3-mm and 2% were larger. Although several lesions were located in the basal ganglia, thalamus, and brain stem, the majority were located in the subpial and subarachnoid space. There was no significant difference in distribution of granulomas between the supratentorial and the infratentorial areas. Other associated abnormalities were focal meningitis in five cases and focal cerebritis in one. On chest radiograph, all patients had miliary tuberculosis in the lungs. Contrast-enhanced T1-weighted MR imaging showed numerous round, very small enhancing lesions scattered throughout the brain. The majority of lesions were located in the subpial and subarachnoid space. Contrast-enhanced T1-weighted images are helpful in the detection and diagnosis of miliary disseminated tuberculous granulomas and meningitis

  11. Cortical dysplasia : MRI findings according to the pathological grading

    Chung, Gyung Ho; Sohn, Myung Hee; Kim, Chong Soo; Kim, Hyoung Ihl; Lee, Min Chul [Chonbuk National University, Chonju (Korea, Republic of)

    1998-05-01

    The purpose of this study is to describe the MRI findings of cortical dysplasia (CD) according to pathological grading. MRI findings in 24 patients with pathologically proven CD were retrospectively reviewed and were described according to their histologic grading. The group consisted of 11 men and 13 women, and their median age was 21.4 (range, 5 to 41) years. Histologic findings were assigned one of three grades : Grade I (dyslamination of cortical layers only) ; Grade II (additional dysplastic neurons); or Grade III (additional balloon cells). T1 and T2W spin-echo MR images were obtained and were evaluated with specific reference to detection rate, location of the anomaly, the presence or absence of prolonged T2 relaxation in the underlying white matter, and configuration of the dysplastic cortex. Nine patients were found to be suffering from grade I CD, seven from grade II, and eight from grade III. MRI findings were abnormal in 58% of cases (14/24); three of these were grade I, four were grade II, and seven were grade III. Among these 14 patients, four had the lesion in the frontal lobe; five, in the temporal lobe; one, in the parietal lobe; two, in the sylvian fissure area, and two with tuberous sclerosis and multiple lesions. Of twelve patients with cortical dysplasia other than tuberous sclerosis, as seen on MRI, six showed poor gray-white matter differentiation, and six showed cortical thickening; this ranged from 7-10 mm in thickness with irregular, bumpy cortical surfaces. Areas of prolonged T2 relaxation in the underlying white matter were present in six patients. MRI findings were abnormal in 58 % of CD patients. The higher the pathological grading, the higher the detection rate of CD on MRI. To increase the detectability of slight cortical dysplasia, technical development, including new MR sequences or imaging methods, is needed (author). 21 refs., 5 figs.

  12. MRI sequence findings in sporadic Creutzfeldt-Jakob disease.

    Tian, Hui-jun; Zhang, Jia-tang; Lang, Sen-yang; Wang, Xiang-qing

    2010-11-01

    MRI has had an important role in the diagnosis of Creutzfeldt-Jakob disease (CJD). The aim of our study was to compare the efficacy of different MRI sequences among six biopsy-proven patients with sporadic CJD (sCJD) and seven patients with probable sCJD. These 13 patients with CJD aged from 36 years to 75 years (mean age: 55.5 years) were evaluated with T1-weighted, T2-weighted, and fluid-attenuated inversion recovery (FLAIR) MRI and diffusion-weighted imaging (DWI). The characteristic MRI lesion pattern was found to be bilateral, symmetric and hyperintense signal changes in the basal ganglia and cortical regions. Two major lesion patterns were identified in all patients involving the cortex and basal ganglia. No signal abnormality was found in the thalamus. We found lesions in the cortex and basal ganglia in 7/13 patients (54%), isolated cortical involvement in 2/13 patients (15%), and isolated basal ganglia lesions in 4/13 patients (31%). The cortical involvement was widespread (in at least two regions) and usually included the frontal or occipital lobes (9/13, 69%) on DWI. Only one patient showed moderate high-signal intensity in the basal ganglia on T2-weighted MRI. T1-weighted MRI revealed no signal intensity abnormalities. We conclude that high signal changes in the basal ganglia and cerebral cortex on FLAIR and DWI are useful in the diagnosis of sCJD. Isolated cortical involvement on DWI and FLAIR should lead to a suspicion of CJD. DWI is the most sensitive MRI technique in the diagnosis of CJD, which supports an amendment to the clinical diagnostic criteria for sCJD to include findings from MRI. PMID:20727770

  13. Giant breast involvement in acute lymphoblastic leukemia: MRI findings.

    Basara, Isil; Orguc, Sebnem

    2012-06-01

    Breast metastases in cases of leukemia are rare. We aimed to report the conventional-advanced magnetic resonance imaging (MRI) findings of unilateral breast involvement of acute lymphoblastic leukemia (ALL) and review the literature. A 32-year-old woman was first diagnosed with ALL in treated in 2004. She did not continue the follow-up after 2008. She was presented with a giant, progressive right breast palpable mass in 2010. Mass, contralateral breast tissue were evaluated with MRI, diffusion weighted imaging and MR spectroscopy. With MRI findings, lesion was evaluated as malignant, tru-cut biopsy revealed recurrence of ALL. Lymphoma, malignant melanoma, rhabdomyosarcoma are most common tumors metastase to breast. Breast metastases of leukemia are rare and occur primarily in patients with acute myeloid leukemia. Secondary ALL breast involvement is uncommon. In a patient with malignancy, any enlarging breast mass, even with benign radiologic appearance, should be investigated carefully and metastasis should not be forgotten. PMID:22807948

  14. Primary Sjoegren's syndrome initially manifested by optic neuritis: MRI findings

    We herein describe the MRI findings in a patient clinically diagnosed with primary Sjoegren's syndrome (SjS) initially manifested by retrobulbar optic neuritis. A 63-year-old woman suddenly had left ocular pain and progressive visual disturbance. MR T2-weighted images revealed hyperintensity in the left optic nerve, with swelling. Contrast-enhanced T1-weighted images showed no abnormal enhancement. Follow-up MRI 6 months after admission revealed no significant changes in the affected optic nerve. To our knowledge, optic neuritis as a complication of SjS has been reported in ten patients [1, 2, 3, 4, 5, 6] and MRI findings in only one of them [6]. We thought MR images were useful for visualizing optic nerve involvement in SjS and observing its course. (orig.)

  15. Incidental extra-mammary findings in breast MRI

    Aim: To investigate the frequency, distribution, and nature of incidental extra-mammary findings detected with breast MRI. Materials and methods: Incidental findings were defined as unexpected lesions outside the breast, not previously known or suspected at the time of referral. Five hundred consecutive breast MRI studies performed from June 2010 to September 2012 were reviewed in this retrospective study for which the institutional review board granted approval and waived the requirement for informed consent. MRI findings were compared with subsequent diagnostic procedures in order to differentiate benign from malignant lesions. Results: One hundred and thirty-eight incidental findings were found in 107 of the 500 (21.4%) examined patients. The most common site was the liver (61/138; 44.2%), followed by the lung (24/138; 17.4%), mediastinum (22/138; 15.9%), pleural cavity (15/138; 10.9%), bone tissue (9/138; 6.5%), spleen (3/138; 2.2%), major pectoral muscle (3/138; 2.2%), and kidney (1/138; 0.7%). Twenty-five of the 138 (18.1%) incidental findings were confirmed to be malignant, whereas the remaining 113 (81.9%) were benign. Malignant findings were exclusively detected in patients with known breast carcinoma, whereas incidental findings in patients without a history of carcinoma were all benign. Twenty-five of 100 (24.8%) incidental findings among patients with history of breast cancer were malignant. Conclusion: Although many of incidental findings were benign, some were malignant, altering the diagnostic work-up, staging, and treatment. Therefore, it is important to assess the entire field of view carefully for abnormalities when reviewing breast MRI studies. - Highlights: • 500 consecutive breast MRI studies were retrospectively reviewed. • Incidental findings were found in 107/500 (21.4%) of examined patients. • Incidental extra-mammary findings on breast MRI are common. • Malignant findings were exclusively detected in patients with known breast carcinoma. • There is a high likelihood of bone incidental findings being malignant

  16. Accuracy of MRI findings in chronic lateral ankle ligament injury: Comparison with surgical findings

    Aim: To evaluate the accuracy of magnetic resonance imaging (MRI) findings in chronic lateral ankle ligament injury in comparison with that of surgical findings. Materials and methods: Forty-eight cases (25 men, 23 women, mean age 36 years) of clinically suspected chronic ankle ligament injury underwent MRI studies and surgery. Sagittal, coronal, and axial, T1-weighted, spin-echo, proton density and T2-weighted, fast spin-echo images with fat saturation were obtained in all patients. MRI examinations were read in consensus by two fellowship-trained academic musculoskeletal radiologists who evaluated the lateral ankle ligaments, including the anterior talofibular ligament (ATFL) and calcaneofibular ligament (CFL) without clinical information. The results of the MRI studies were then compared with the surgical findings. Results: The MRI findings of ATFL injury showed a sensitivity of detection of complete tears of 75% and specificity of 86%. The sensitivity of detection of partial tears was 75% and the specificity was 78%. The sensitivity of detection of sprains was 44% and the specificity was 88%. Regarding the MRI findings of CFL injury, the sensitivity of detection of complete tears was 50% and the specificity was 98%. The sensitivity of detection of partial tear was 83% and the specificity was 93%. The sensitivity of detection of sprains was 100% and the specificity was 90%. Regarding the ATFL, the accuracies of detection were 88, 58, 77, and 85% for no injury, sprain, partial tear, and complete tear, respectively, and for the CFL the accuracies of detection were 90, 90, 92, and 96% for no injury, sprain, partial tear, and complete tear, respectively. Conclusions: The diagnosis of a complete tear of the ATFL on MRI is more sensitive than the diagnosis of a complete tear of the CFL. MRI findings of CFL injury are diagnostically specific but are not sensitive. However, only normal findings and complete tears were statistically significant between ATFL and CFL (p < 0.001).

  17. Accuracy of MRI findings in chronic lateral ankle ligament injury: Comparison with surgical findings

    Park, H.-J. [Department of Radiology, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul (Korea, Republic of); Department of Radiology, Kangwon National University, School of Medicine, Chuncheon (Korea, Republic of); Cha, S.-D. [Department of Orthopedic Surgery, Myongji Hospital, Kwandong University, College of Medicine, Koyang (Korea, Republic of); Kim, S.S. [Department of Radiology, Kangwon National University, School of Medicine, Chuncheon (Korea, Republic of); Rho, M.-H., E-mail: parkhiji@kangwon.ac.kr [Department of Radiology, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul (Korea, Republic of); Kwag, H.-J. [Department of Radiology, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul (Korea, Republic of); Park, N.-H. [Department of Radiology, Myongji Hospital, Kwandong University, College of Medicine, Koyang (Korea, Republic of); Lee, S.-Y. [Department of Radiology, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul (Korea, Republic of)

    2012-04-15

    Aim: To evaluate the accuracy of magnetic resonance imaging (MRI) findings in chronic lateral ankle ligament injury in comparison with that of surgical findings. Materials and methods: Forty-eight cases (25 men, 23 women, mean age 36 years) of clinically suspected chronic ankle ligament injury underwent MRI studies and surgery. Sagittal, coronal, and axial, T1-weighted, spin-echo, proton density and T2-weighted, fast spin-echo images with fat saturation were obtained in all patients. MRI examinations were read in consensus by two fellowship-trained academic musculoskeletal radiologists who evaluated the lateral ankle ligaments, including the anterior talofibular ligament (ATFL) and calcaneofibular ligament (CFL) without clinical information. The results of the MRI studies were then compared with the surgical findings. Results: The MRI findings of ATFL injury showed a sensitivity of detection of complete tears of 75% and specificity of 86%. The sensitivity of detection of partial tears was 75% and the specificity was 78%. The sensitivity of detection of sprains was 44% and the specificity was 88%. Regarding the MRI findings of CFL injury, the sensitivity of detection of complete tears was 50% and the specificity was 98%. The sensitivity of detection of partial tear was 83% and the specificity was 93%. The sensitivity of detection of sprains was 100% and the specificity was 90%. Regarding the ATFL, the accuracies of detection were 88, 58, 77, and 85% for no injury, sprain, partial tear, and complete tear, respectively, and for the CFL the accuracies of detection were 90, 90, 92, and 96% for no injury, sprain, partial tear, and complete tear, respectively. Conclusions: The diagnosis of a complete tear of the ATFL on MRI is more sensitive than the diagnosis of a complete tear of the CFL. MRI findings of CFL injury are diagnostically specific but are not sensitive. However, only normal findings and complete tears were statistically significant between ATFL and CFL (p < 0.001).

  18. Purulent meningitis with unusual diffusion-weighted MRI findings

    We describe unusual findings obtained by diffusion-weighted magnetic resonance imaging (MRI) in a patient with acute purulent meningitis caused by penicillin-resistant Streptococcus pneumoniae. Along cerebral convexities and the Sylvian fissure, multiple small intense lesions showed high signal intensity in these sequences. This may be the first report of diffusion-weighted in purulent meningitis

  19. Hyperplastic callus formation in osteogenesis imperfecta: CT and MRI findings

    Rieker, O.; Kreitner, K.F. [Klinik fuer Radiologie, Johannes-Gutenberg-Univ. Mainz (Germany); Karbowski, A. [Orthopaedische Abtl., Krankenhaus der Augustinerinnen, Koeln (Germany)

    1998-09-01

    Hyperplastic callus formation is a noteworthy condition in patients with osteogenesis imperfecta because it often mimicks osteosarcoma on radiography. The findings of CT and MRI in hyperplastic callus formation have not been reported. In the presented case, MRI demonstrated contrast enhancement and edema of the surrounding soft tisssue, consistent with benign as well as malignant disease. Computed tomography showed a calcified rim of the lesion which may be a useful feature to rule out osteosarcoma in this condition. (orig.) With 2 figs., 18 refs.

  20. MRI Findings of Brucellar Spondylitis: A Case Report

    Kim, Jin Woo; Kim, Myung Soon; Kim, Young Ju [Dept. of Radiology, Wonju Christian Hospital, Yonsei University Wonju College of Medicine, Wonju (Korea, Republic of)

    2013-03-15

    Brucellosis is a systemic infectious disease, and musculoskeletal involvement is a frequent complication. Particularly, spondylitis is a common involvement. However, early diagnosis of brucellar spondylitis is often difficult due to non-specific clinical symptoms and long latent period. Especially in Korea, where tuberculosis is an endemic disease, differentiation between tuberculous and brucellar spondylitis is clinically and radiologically more challenging. A 59-year-old male cattle farmer, who presented with non-specific back pain, had spondylitis on magnetic resonance imaging (MRI), and serologic test finally confirmed brucellar spondylitis. Therefore, we report a case of a rather rare disease in Korea, brucellar spondylitis with a review of MRI findings.

  1. MRI Findings of Brucellar Spondylitis: A Case Report

    Brucellosis is a systemic infectious disease, and musculoskeletal involvement is a frequent complication. Particularly, spondylitis is a common involvement. However, early diagnosis of brucellar spondylitis is often difficult due to non-specific clinical symptoms and long latent period. Especially in Korea, where tuberculosis is an endemic disease, differentiation between tuberculous and brucellar spondylitis is clinically and radiologically more challenging. A 59-year-old male cattle farmer, who presented with non-specific back pain, had spondylitis on magnetic resonance imaging (MRI), and serologic test finally confirmed brucellar spondylitis. Therefore, we report a case of a rather rare disease in Korea, brucellar spondylitis with a review of MRI findings.

  2. Necrotizing fasciitis: unreliable MRI findings in the preoperative diagnosis

    Arslan, Arzu E-mail: arzuarslan@netscape.net; Pierre-Jerome, Claude; Borthne, Arne

    2000-12-01

    The authors present two cases of necrotizing fasciitis (NF), one case of dermatomyositis and one case of posttraumatic muscle injury, which have similar magnetic resonance imaging findings in terms of skin, subcutaneous fat, superficial and deep fasciae and muscle involvement. These cases highlight the need for cautious interpretation of magnetic resonance imaging (MRI) findings, for they are nonspecific and the preoperative decision should be based mostly on the evolution of the clinical status.

  3. MRI findings and correlative study of MRI and visual evoked potentials in optic neuritis

    Objective: To investigate the effective MRI sequences and describe the correlation between MRI and visual evoked potential (VEP) in diagnosing optic neuritis. Methods: One hundred and fifty-four eyes with visual impairment of 98 patients with diagnoses of optic neuritis, papillitis, multiple sclerosis and Devic's disease underwent MRI and VEP examination. The MRI findings were analyzed and correlated with VEP results and clinical presentation by using X2 test, wilco xon test and Kappa test. Results Out of the 154 sick eyes, 56 eyes presented thickened optic nerves, 76 eyes had normal diameter of the optic nerve, and 22 eyes had thin optic nerves. A total of 132 optic nerves showed abnormally high signal in STIR sequences, including involvement of intraocular segment in 7, intraorbital segment in 1.35, intracanalicular segment in 109, intracranial segment in 97, optic chiasm in 56, and optic tract in 23. A total of 54 patients underwent postcontrast MRI. Seventy-four optic nerves of 87 eyes showed enhancement. Among the 196 eyes of 98 patients, 132 eyes presented visual impairment and simultaneous abnormal MR signal of the optic nerve, and 26 eyes had both normal vision and normal MR signal of optic nerve. The consistency of MRI findings and vision status was 80. 61% (Kappa 0.453,P1-weighted MR sequence combined with fat- suppression are helpful in diagnosis of optic neuritis. VEP is helpful in diagnosing optic neuritis and in finding subclinical visual problem. The MRI combined with VEP could improve the diagnostic accuracy of optic neuritis. (authors)

  4. A study of brain MRI findings in children with epilepsy

    Magnetic resonance imaging in the brain was performed in 293 patients with childhood-onset (<15 y.o.) epilepsy who had been classified into 4 groups, idiopathic localization-related epilepsy (ILRE), 78 patients; idiopathic generalized epilepsy (IGE), 116 patients; symptomatic localization-related epilepsy (SLRE), 68 patients and symptomatic generalized epilepsy (SGE), 31 patients, with the Classification of Epilepsies and Epileptic Syndrome (1989 International League Against Epilepsy). The examination was performed with a 1.5 T magnet. One hundred twenty-five patients (42.7%) showed abnormal findings, and the incidence in each group was as follows: Idiopathic epilepsy: The rate of abnormal findings in the ILRE and IGE groups was 21.8% and 20.7%, respectively. Most of the abnormal findings were secondary changes, such as diffuse or localized brain atrophy. Of the congenital abnormalities, the main finding was arachnoid cyst. Symptomatic epilepsy: The rate of abnormality in the SLRE patients was 88.2%, and 85% of the findings were secondary changes, i.e., brain atrophy, or degeneration of the white matter. In the SGE group, the rate was 77.4%, with an almost equal percentage of congenital and secondary changes. Of 255 patients who were examined by electroencephalography (EEG) on the same day as MRI, about 50% showed a correlation between the EEG records and the MRI abnormalities. However, only 8 patients showed a correlation in localization between the EEG and MRI abnormalities. (author)

  5. MRI findings of Wernicke encephalopathy revisited due to hunger strike

    Unlu, Ercument [Department of Radiology, Trakya University School of Medicine, Mimar Sinan m, Muammer Aksoy c, Yorulmaz apt, No 50, D-1 22030 Edirne (Turkey)]. E-mail: drercument@yahoo.com; Cakir, Bilge [Department of Radiology, Trakya University School of Medicine, Mimar Sinan m, Muammer Aksoy c, Yorulmaz apt, No 50, D-1 22030 Edirne (Turkey); Asil, Talip [Department of Neurology, Trakya University School of Medicine, Edirne (Turkey)

    2006-01-15

    Background and Purpose: The purpose of this study was to determine the characteristic magnetic resonance imaging (MRI) findings among a group of patients who presented with Wernicke encephalopathy (WE) due to the neurological complications of a long-term hunger strike (HS). Methods: MRI studies also including the fluid-attenuated inversion recovery (FLAIR) sequence and diffusion-weighted imaging (DWI) of six male patients with WE aged from 25 to 38 years (mean age 31 years) were evaluated. Results: In all subjects, T2-weighted sequences, FLAIR and DWI revealed a signal hyperintensity within the posteromedial thalami and surrounding the third ventricle. In particular, on coronal images, the hyperintense areas around the third ventricle showed a suggestive 'double wing' configuration. We observed an increased signal on proton-density and T2-weighted images in the mamillary bodies of three patients. Four patients demonstrated additional hyperintensities within the periaqueductal region and/or the tectal plate. At least one lesion area in five of six patients demonstrated contrast enhancement. Conclusion: The consistent imaging findings of our study suggest that MRI is a reliable means of diagnosing WE. Acute WE is sometimes underdiagnosed, yet early diagnosis and treatment of WE is crucial in order to avoid persistent brain damage. MRI, including postcontrast T1-weighted imaging, DWI beneath standardized T2-weighted imaging, and FLAIR sequences may prove to be a valuable adjunct to clinical diagnosis and to provide additional information in acute and/or subacute WE.

  6. MRI findings in 20 DAI and their clinical outcomes

    Twenty diffuse axonal injury (DAI) patients were investigated with MRI and X-ray CT scan from the acute to chronic stage. These neuroimaging findings were compared with clinical features such as Glasgow coma scales (GCS) on admission, age and Glasgow outcome scales (GOS) at 6 months injury. GCS's of 17 patients were less than 7 and those the remaining 3 were more than 8. The prognosis was very poor in patients with GCS's less than 5. According to age of the patient, the younger showed favorite outcome, but the older presented the poor outcome. X-ray CT scan revealed subarachnoid hemorrhage in 9 of 20 patients, hemorrhagic lesion in the brain stem in 2 and brain contusion in 3, but no evident lesions in 5. MRI demonstrated diagnostic findings such as hemorrhagic lesions in the deep cerebrum and high intensity lesions extending from the subcortical white matter to the brain stem in all patients. T2-weighted MRI demonstrated high intensity lesions to vanish in 9 patients within a few months. On the other hand, the patients who had evident lesion in the deep cerebrum on follow-up X-ray CT scan is very effective for evaluating acute head trauma, however, MRI is recommended not only for documenting DAI but also for predicting the neuropsychological prognosis. (author)

  7. MRI findings of recurrent herpes simplex encephalitis in an infant

    We report the MRI findings of a 2-year-old boy with recurrent herpes simplex encephalitis (HSE). At the age of 14 months, the patient developed a high fever that lasted over 1 week and he did not receive appropriate treatment. At 6 months after the fever, MRI showed marked atrophic changes in both deep temporal lobes with hyperintensity in the hippocampi and parahippocampal gyri. Thirteen months after the first episode of the fever, the patient was diagnosed with recurrent HSE by polymerase chain reaction assay of the CSF; MRI at this time revealed diffuse cortical swelling. Hyperintensity on T2-weighted images was noted in the occipito-parietal cortex bilaterally, the left thalamus, the subcortical white matter and the splenium of the corpus callosum. Recurrence of HSE may be more common in infants than previously thought. It is important to consider the possibility of recurrent HSE and to understand that MRI findings in HSV1 encephalitis in infants and young children appear to differ from those observed in neonates, older children and adults. (orig.)

  8. MRI findings of recurrent herpes simplex encephalitis in an infant

    Tokumaru, Aya M.; Kaji, Tatsumi; Kohyama, Shinya; Sakata, Ikuko; Kusano, Shoichi [Department of Radiology, National Defence Medical College, 3-2 Namiki-Cho, 359-8513, Tokorozawa, Saitama (Japan); Horiuchi, Katsuyuki [Department of Paediatrics, National Defence Medical College, Tokorozawa, Saitama (Japan)

    2003-10-01

    We report the MRI findings of a 2-year-old boy with recurrent herpes simplex encephalitis (HSE). At the age of 14 months, the patient developed a high fever that lasted over 1 week and he did not receive appropriate treatment. At 6 months after the fever, MRI showed marked atrophic changes in both deep temporal lobes with hyperintensity in the hippocampi and parahippocampal gyri. Thirteen months after the first episode of the fever, the patient was diagnosed with recurrent HSE by polymerase chain reaction assay of the CSF; MRI at this time revealed diffuse cortical swelling. Hyperintensity on T2-weighted images was noted in the occipito-parietal cortex bilaterally, the left thalamus, the subcortical white matter and the splenium of the corpus callosum. Recurrence of HSE may be more common in infants than previously thought. It is important to consider the possibility of recurrent HSE and to understand that MRI findings in HSV1 encephalitis in infants and young children appear to differ from those observed in neonates, older children and adults. (orig.)

  9. MRI findings of Wernicke encephalopathy revisited due to hunger strike

    Background and Purpose: The purpose of this study was to determine the characteristic magnetic resonance imaging (MRI) findings among a group of patients who presented with Wernicke encephalopathy (WE) due to the neurological complications of a long-term hunger strike (HS). Methods: MRI studies also including the fluid-attenuated inversion recovery (FLAIR) sequence and diffusion-weighted imaging (DWI) of six male patients with WE aged from 25 to 38 years (mean age 31 years) were evaluated. Results: In all subjects, T2-weighted sequences, FLAIR and DWI revealed a signal hyperintensity within the posteromedial thalami and surrounding the third ventricle. In particular, on coronal images, the hyperintense areas around the third ventricle showed a suggestive 'double wing' configuration. We observed an increased signal on proton-density and T2-weighted images in the mamillary bodies of three patients. Four patients demonstrated additional hyperintensities within the periaqueductal region and/or the tectal plate. At least one lesion area in five of six patients demonstrated contrast enhancement. Conclusion: The consistent imaging findings of our study suggest that MRI is a reliable means of diagnosing WE. Acute WE is sometimes underdiagnosed, yet early diagnosis and treatment of WE is crucial in order to avoid persistent brain damage. MRI, including postcontrast T1-weighted imaging, DWI beneath standardized T2-weighted imaging, and FLAIR sequences may prove to be a valuable adjunct to clinical diagnosis and to provide additional information in acute and/or subacute WE

  10. Prognosis and MRI findings in patients with peripheral facial palsy

    Mineta, Masayuki; Saitoh, Yasuhiro; Yoshikawa, Daihei; Yamada, Tomonori; Aburano, Tamio [Asahikawa Medical College, Hokkaido (Japan); Matoba, Mitsuaki

    1997-02-01

    We examined a series of 21 peripheral facial palsy patients attempted to ( 17 Bell`s palsy, 4 Hunt syndrome) with Gd-DTPA-enhanced MRI and attempted to determine the relation between prognosis and MRI findings. We divided patients into two groups based on facial palsy scores of Japanese facial nerve research; a good group (G-Group) and a bad group (B-group). The G-group scored over 20 points on the 20th day after the first visit and the B-group under 20 points. G-group consisted of 9 Bell`s palsy and 1 Hunt syndrome patients, and the B-group of 8 Bell`s palsy and 3 Hunt syndrome patients. The averaged facial palsy score of both groups was analyzed every week during 4 weeks. Recovery from the palsy was better in the G-group than the B-group (P<0.05); the scores at the 4th week of the G- and B-groups were 32.6{+-}15.2 and 7.8{+-}7.4, respectively. The MRI findings of both groups were examined retrospectively. Nine of 10 G-group and nine of 11 B-group patients had abnormal contrast enhancement. The result of enhanced facial nerve segment was as follows: G-group, auditory canal 1, labyrinthine/geniculate 7, tympanic 7, mastoid 7: B-group, auditory canal 2, labyrinthine/geniculate 8, tympanic 8, mastoid 7. Our results indicate no relation between the prognosis and the MRI findings. Therefore, it is impossible to predict the prognosis of facial palsy from the results of Gd-DTPA-enhanced MRI. (author)

  11. Prognosis and MRI findings in patients with peripheral facial palsy

    We examined a series of 21 peripheral facial palsy patients attempted to ( 17 Bell's palsy, 4 Hunt syndrome) with Gd-DTPA-enhanced MRI and attempted to determine the relation between prognosis and MRI findings. We divided patients into two groups based on facial palsy scores of Japanese facial nerve research; a good group (G-Group) and a bad group (B-group). The G-group scored over 20 points on the 20th day after the first visit and the B-group under 20 points. G-group consisted of 9 Bell's palsy and 1 Hunt syndrome patients, and the B-group of 8 Bell's palsy and 3 Hunt syndrome patients. The averaged facial palsy score of both groups was analyzed every week during 4 weeks. Recovery from the palsy was better in the G-group than the B-group (P<0.05); the scores at the 4th week of the G- and B-groups were 32.6±15.2 and 7.8±7.4, respectively. The MRI findings of both groups were examined retrospectively. Nine of 10 G-group and nine of 11 B-group patients had abnormal contrast enhancement. The result of enhanced facial nerve segment was as follows: G-group, auditory canal 1, labyrinthine/geniculate 7, tympanic 7, mastoid 7: B-group, auditory canal 2, labyrinthine/geniculate 8, tympanic 8, mastoid 7. Our results indicate no relation between the prognosis and the MRI findings. Therefore, it is impossible to predict the prognosis of facial palsy from the results of Gd-DTPA-enhanced MRI. (author)

  12. High-resolution cine MRI with TGRAPPA for fast assessment of left ventricular function at 3 Tesla

    Purpose: To implement and evaluate the accuracy of multislice dual-breath hold cine MR for analysis of global systolic and diastolic left ventricular function at 3 T. Materials and methods: 25 patients referred to cardiac MR underwent cine imaging at 3 T (MAGNETOM Verio) using prospective triggered SSFP (TR 3.1 ms; TE 1.4 ms; FA 60°). Analysis of LV function was performed using a standard non-accelerated single-slice approach (STD) with multiple breath-holds and an accelerated multi-slice technique (TGRAPPA; R = 4) encompassing the ventricles with 5 slices/breath-hold. Parameters of spatial and temporal resolution were kept identical (pixel: 1.9 × 2.5 mm2; temporal resolution: 47 ms). Data of both acquisition techniques were analyzed by two readers using semiautomatic algorithms (syngoARGUS) with respect to EDV, ESV, EF, myocardial mass (MM), peak filling rate (PFR) and peak ejection rate (PER) including assessment of interobserver agreement. Results: Volumetric results of the TGRAPPA approach did not show significant differences to the STD approach for left ventricular ejection fraction (62.3 ± 10.6 vs. 61.0 ± 8.4, P = 0.2), end-diastolic volume (135.8 ± 47.5 vs. 130.8 ± 46.4, P = 0.07), endsystolic volume (53.0 ± 29.7 vs. 53.1 ± 32.7, P = 0.99) and myocardial mass (114.2 ± 32.5 vs. 114.6 ± 30.6, P = 0.9). Moreover, a comparison of peak ejection rate (601.3 ± 190.2 vs. 590.8 ± 218.2, P = 0.8) and peak filling rate (535.1 ± 191.2 vs. 535.4 ± 210.7, P = 0.99) did not reveal significant differences between the two groups. Limits in interobserver agreement were low for all systolic and diastolic parameters in both groups (P ≥ 0.05). Total acquisition time for STD was 273 ± 124 s and 34 ± 5 s for TGRAPPA (P ≤ 0.001). Evaluation time for standard and multislice approach was equal (10.8 ± 1.4 vs. 9.8 ± 2.1 min; P = 0.08)

  13. High-resolution cine MRI with TGRAPPA for fast assessment of left ventricular function at 3 Tesla

    Theisen, Daniel, E-mail: daniel.theisen@med.uni-muenchen.de [Department of Clinical Radiology, University Hospitals of Munich Grosshadern, Munich (Germany); Munich Heart Alliance, Munich (Germany); Sandner, Torleif A., E-mail: torleif.sandner@med.uni-muenchen.de [Department of Clinical Radiology, University Hospitals of Munich Grosshadern, Munich (Germany); Bamberg, Fabian, E-mail: fabian.bamberg@med.uni-muenchen.de [Department of Clinical Radiology, University Hospitals of Munich Grosshadern, Munich (Germany); Munich Heart Alliance, Munich (Germany); Bauner, Kerstin U., E-mail: kerstin.bauner@med.uni-muenchen.de [Department of Clinical Radiology, University Hospitals of Munich Grosshadern, Munich (Germany); Schwab, Felix, E-mail: felix.schwab@med.uni-muenchen.de [Department of Clinical Radiology, University Hospitals of Munich Grosshadern, Munich (Germany); Schwarz, Florian, E-mail: florian.schwarz@med.uni-muenchen.de [Department of Clinical Radiology, University Hospitals of Munich Grosshadern, Munich (Germany); Arnoldi, Elisabeth, E-mail: elisabeth.arnoldi@med.uni-muenchen.de [Department of Clinical Radiology, University Hospitals of Munich Grosshadern, Munich (Germany); Reiser, Maximilian F., E-mail: maximilian.reiser@med.uni-muenchen.de [Department of Clinical Radiology, University Hospitals of Munich Grosshadern, Munich (Germany); Munich Heart Alliance, Munich (Germany); Wintersperger, Bernd J., E-mail: bernd.wintersperger@med.uni-muenchen.de [Department of Clinical Radiology, University Hospitals of Munich Grosshadern, Munich (Germany); Department of Medical Imaging, University of Toronto, Toronto, Ontario (Canada)

    2013-05-15

    Purpose: To implement and evaluate the accuracy of multislice dual-breath hold cine MR for analysis of global systolic and diastolic left ventricular function at 3 T. Materials and methods: 25 patients referred to cardiac MR underwent cine imaging at 3 T (MAGNETOM Verio) using prospective triggered SSFP (TR 3.1 ms; TE 1.4 ms; FA 60°). Analysis of LV function was performed using a standard non-accelerated single-slice approach (STD) with multiple breath-holds and an accelerated multi-slice technique (TGRAPPA; R = 4) encompassing the ventricles with 5 slices/breath-hold. Parameters of spatial and temporal resolution were kept identical (pixel: 1.9 × 2.5 mm{sup 2}; temporal resolution: 47 ms). Data of both acquisition techniques were analyzed by two readers using semiautomatic algorithms (syngoARGUS) with respect to EDV, ESV, EF, myocardial mass (MM), peak filling rate (PFR) and peak ejection rate (PER) including assessment of interobserver agreement. Results: Volumetric results of the TGRAPPA approach did not show significant differences to the STD approach for left ventricular ejection fraction (62.3 ± 10.6 vs. 61.0 ± 8.4, P = 0.2), end-diastolic volume (135.8 ± 47.5 vs. 130.8 ± 46.4, P = 0.07), endsystolic volume (53.0 ± 29.7 vs. 53.1 ± 32.7, P = 0.99) and myocardial mass (114.2 ± 32.5 vs. 114.6 ± 30.6, P = 0.9). Moreover, a comparison of peak ejection rate (601.3 ± 190.2 vs. 590.8 ± 218.2, P = 0.8) and peak filling rate (535.1 ± 191.2 vs. 535.4 ± 210.7, P = 0.99) did not reveal significant differences between the two groups. Limits in interobserver agreement were low for all systolic and diastolic parameters in both groups (P ≥ 0.05). Total acquisition time for STD was 273 ± 124 s and 34 ± 5 s for TGRAPPA (P ≤ 0.001). Evaluation time for standard and multislice approach was equal (10.8 ± 1.4 vs. 9.8 ± 2.1 min; P = 0.08)

  14. MRI in patients with temporal lobe epilepsy; Correlation between MRI findings and clinical features

    Kodama, Kazuhiro (Chiba Univ. (Japan). School of Medicine)

    1992-04-01

    The present study investigated magnetic resonance imaging (MRI) features in temporal lobe epilepsy and correlated them with clinical variables, such as age, illness duration, past history, and the frequency of seizure. Cerebral MRI was performed in 45 patients with temporal lobe epilepsy of unknown etiology, using a 0.5 T and/or a 1.5 T MRI systems. The temporal lobe was seen as high signal intensity on T2-weighted images and/or proton density-weighted images in 6 patients, although it was missed on CT and T1-weighted images. The high intensity area seemed to reflect sclerosis of the temporal lobe. This finding was significantly associated with partial seizure. Of these patients, 3 had a history of febrile convulsions. Ten patients had slight dilatation of the inferior horn of the lateral ventricle. They were significantly old at the time of onset and examination, as compared with those without dilatation. Furthermore, 6 patients with unilateral dilatation were significantly younger than the other 4 with bilateral dilatation. Nine patients had small multiple high signal areas in white matter, mainly in the parietal lobe, which suggested vascular origin. These patients were significantly old at the time of onset and examination, as compared with those having no such findings. In depicting high signal intensity areas, a 1.5 T MRI system was not always superior to a 0.5 T MRI system. Proton density-weighted images were better than T2-weighted images in some patients. (N.K.).

  15. Clinical features and MRI findings of blow-out fracture

    Precise anatomical understanding of orbital blow-out fracture lesions is necessary for the treatment of patients. Retrospectively, MRI findings were compared with the clinical features of pure type blow-out fractures and the efficacy of MRI in influencing a decision for surgical intervention was evaluated. Eighteen child (15 boys, 3 girls) cases were evaluated and compared with adult cases. The patients were classified into three categories (Fig.1) and two types (Fig.2) in accordance with the degree of protrusion of fat tissue. The degree of muscle protrusion also was divided into three categories (Fig. 3). Both muscle and fat tissue were protruding from the fracture site in 14 cases. Fat tissue protrusion alone was found in 3 cases. In contrast, no protrusion was seen in one case. The incarcerated type of fat prolapse was found in 40% of cases, while muscle tissue prolapse was found in 75% of patients. Marginal irregularity or swelling of muscle was observed in 11 patients. There was good correlation of ocular motor disturbance and MRI findings. Disturbance of eyeball movement was observed in all patients with either incarcerated fat tissue or marginal irregularity or swelling of muscle. In contrast, restriction of eyeball movement was rare in cases of no incarceration, even if the fracture was wide. Deformity or marginal irregularity of the ocular muscle demonstrated in MRI may suggest damage an adhesion to the muscle wall. When MRI reveals incarceration or severe prolapse of fat tissue, or deformity and marginal irregularity of the ocular muscle, surgical intervention should be considered. (author)

  16. Rathke's cleft cyst: clinicopathological and MRI findings in 22 patients

    AIM: To evaluate clinical findings and magnetic resonance imaging (MRI) characteristics of Rathke's cleft cyst (RCC) in 22 patients. Materials and Methods: Twenty-two patients were imaged using non-enhanced MRI and 17 underwent an additional contrast-enhanced MRI examination. Fifteen patients received an additional non-enhanced computed tomography (CT) examination, and amongst these, two underwent contrast-enhanced CT. Two radiologists read the images retrospectively. The imaging data were studied with regards to location, size, margin, signal intensity, enhancement characteristics, haemorrhage, and presence of calcifications. Clinical data, such as presenting signs and symptoms, physical findings, and medical histories, were collected. Histopathological studies were performed and analysed by two pathologists. Results: Nine lesions were located in the intrasellar region, 12 in both the intra- and suprasellar regions and one in the suprasellar region. The maximum diameter of the RCCs varied from 0.7 to 4 cm, with an average size of 1.7 ± 0.7 cm. MRI features of RCC were divided into three groups based on T1-weighted imaging (T1WI): hypo- (n = 6), iso- (n = 9), and hyperintensity group (n = 7). Patients in the latter two groups were statistically younger than that in the former group. The lesion size in the iso- and hyperintensity groups was significantly less than that in the hypointensity group (F = 6.421, p = 0.007). Only two cases showed enhancement after contrast injection in the cohort. One lesion with haemorrhage was found as were two cases with intracystic nodules. Conclusion: Although MRI features of RCCs are variable, RCCs should be suspected when the following conditions occur: lesions located in the intrasellar region or involving both intra and suprasellar regions, less than 1.5 cm in diameter, iso- or hyperdense on T1WI and no signal enhancement after contrast injection. In addition, the first case of a RCC with a markedly enhanced intracystic nodule is reported.

  17. Cine phase-contrast MRI measurement of CSF flow in the cervical spine: a pilot study in patients with spinal cord injury

    Negahdar, MJ; Shakeri, M.; McDowell, E.; Wells, J.; Vitaz, T.; Harkema, S.; Amini, A.

    2011-03-01

    MRI velocimetry (also known as phase-contrast MRI) is a powerful tool for quantification of cerebrospinal fluid (CSF) flow in various regions of the brain and craniospinal junction and has been accepted as a diagnostic tool to assist with the diagnosis of certain conditions such as hydrocephalus and chiari malformations. Cerebrospinal fluid is continually produced in the ventricles of the brain, flows through the ventricular system and then out and around the brain and spinal cord and is reabsorbed over the convexity of the brain. Any disease process which either impedes the normal pattern of flow or restricts the area where flow occurs can change the pattern of these waveforms with the direction and velocity of flow being determined by the pressure transmitted from the pulsation of the heart and circulation of blood within the central nervous system. Therefore, we hypothesized that phase-contrast MRI could eventually be used as a diagnostic aid in determining the degree of spinal cord compression following injury to the cervical or thoracic spine. In this study, we examined CSF flow in 3 normal subjects and 2 subjects with non-acute injuries in the cervical spine using Cine phasecontrast MRI. CSF flow analysis was performed using an in-house developed software. The flow waveform was calculated in both normal subjects (n=3) as well as subjects with spinal cord injury in the cervical spine (n=2). The bulk flow at C2 was measured to be 0.30 +/- 0.05 cc, at 5 cm distal to C2, it was 0.19+/- 0.07 cc, and at 10 cm distal to C2, it was 0.17+/- 0.05 cc. These results were in good agreement with previously published results. In patients with spinal cord injury, at the site of injury in the cervical spine, bulk flow was found to be 0.08 +/- 0.12 cc, at 5 cm proximal to the site of injury it was found to be 0.18 +/- 0.07 cc, and at 5 cm distal to the site of injury, it was found to be 0.12 +/- 0.01 cc.

  18. MRI and CT findings of metastatic pulmonary calcification

    Hochhegger, B; Marchiori, E; Soares Souza, A; Soares Souza, L; Palermo, L.

    2012-01-01

    Metastatic pulmonary calcification is a consequence of calcium deposition in the normal pulmonary parenchyma, secondary to abnormal calcium metabolism. The most characteristic radiological manifestation is poorly defined nodular opacities that are mainly seen in the upper lung zone. The aim of this report is to describe the CT and MRI findings observed in two patients with metastatic pulmonary calcification. The disease may present in CT as consolidations with calcification, and with a high l...

  19. Imaging Findings of Brain Death on 3-Tesla MRI

    Sohn, Chul-Ho; Lee, Hwa-Pyung; Park, Jun Beom; Chang, Hyuk Won; Kim, Ealmaan; KIM, EUNHEE; Park, Ui Jun; Kim, Hyoung-Tae; Ku, Jeonghun

    2012-01-01

    Objective To demonstrate the usefulness of 3-tesla (3T) magnetic resonance imaging (MRI) including T2-weighted imaging (T2WI), diffusion weighted imaging (DWI), time-of-flight (TOF) magnetic resonance angiography (MRA), T2*-weighted gradient recalled echo (GRE), and susceptibility weighted imaging (SWI) in diagnosing brain death. Materials and Methods Magnetic resonance imaging findings for 10 patients with clinically verified brain death (group I) and seven patients with comatose or stuporou...

  20. MRI findings in Duane's ocular retraction syndrome

    Aim: To investigate the innervation pattern of extra-ocular muscles in patients with clinically diagnosed Duane's ocular retraction syndrome (DRS) using magnetic resonance imaging (MRI). Materials and methods: The study population consisted of 11 patients. Six patients had type I DRS (eight eyes), four patients had type II DRS (five eyes) and one patient had inverse DRS. Images were acquired using a Siemens 3 T MRI system. The type of DRS, corresponding innervation findings, and condition of the affected muscles were evaluated by two experienced neuroradiologists in consensus. Results: All patients with clinically diagnosed DRS type I showed absence of the abducens nerve (CN6), hypoplasia of the superior oblique muscle (SOM), and aberrant innervation of lateral rectus muscle (LRM) by an extra branch of oculomotor nerve (CN3). All patients with type II DRS show dual-innervation of the LRM (by CN6 and an aberrant CN3 branch) and hypoplasia of SOM. The single patient with inverse DRS showed hypoplasia of CN3, the medial rectus muscle (MRM), the inferior rectus muscle (IRM), and the inferior oblique muscle (IOM). Conclusion: Each type of DRS has characteristic MRI appearances. Therefore, MRI is a useful diagnostic tool for the confirmation and classification of suspected cases of DRS

  1. Feasibility of high-dose dobutamine stress SSFP cine MRI at 3 tesla with patient adaptive local RF shimming using dual-source RF transmission. Initial results

    To investigate the feasibility of high-dose dobutamine stress (HDDS) imaging using SSFP sequences at 3 T employing patient-adaptive local RF-shimming using a dual-source RF transmission system. 13 Patients underwent a HDDS protocol on a 3 T MRI scanner (Achieva 3.0T-TX, Philips Healthcare), equipped with a dual-source RF transmission system. SSFP cine sequences using patient-adaptive local RF-shimming (RF-S) were compared to cine images acquired without additional shimming. Image quality was evaluated on a 4-point grading scale and number of non-diagnostic segments assessed. Contrast (CN) between myocardium (SIM) and blood pool (SIB) was calculated [(SIB-SIM)/(SIB+SIM)]. Image quality both at rest and maximum stress was significantly improved with RF-S (ED:3.56 ± 0.5 vs. 3.23 ± 0.63; ES:3.4 ± 0.5 vs. 3.1 ± 0.7) compared to no RF-S (ED:2.9 ± 0.72 vs. 2.15 ± 0.78; ES:2.64 ± 0.74 vs. 1.95 ± 0.76; p < 0.01). The amount of non-diagnostic segments was significantly reduced when using RF-S at rest and stress (3 vs. 39; 19 vs. 78, p < 0.05). All HDDS studies were diagnostic if performed with RF-S (n = 13/13) in comparison to conventional shimming (n = 5/13). Image contrast was improved for SSFP sequences with RF-S (0.53 ± 0.08) compared to conventional images (0.46 ± 0.09, p = 0.06). Patient-adaptive local RF-shimming using a dual-source RF transmission system allows for reliable SSFP imaging in a clinical high-dose dobutamine stress protocol at 3 T. RF-S significantly improves image quality and reduces the number of non-diagnostic myocardial segments. (orig.)

  2. Brain MRI findings in infants with primary congenital glaucoma

    Congenital glaucoma appears in the first months of life, eventually at birth. Isolated congenital glaucoma is characterized by minor malformations of the irido-corneal angle of the anterior chamber of the eye. Clinical manifestations include tearing, photophobia and enlargement of the globe appearing in the first months of life. Imaging technology such as optical coherence tomography and measurement of central corneal thickness may play an important role in the assessment of children with suspected or known glaucoma. However, no MRI findings of the CNS in patients with primary congenital glaucoma (PCG) were reported in the literature. The purpose of this study was to investigate MRI findings of the brain in infants with PCG. We reviewed the radiological and histopathological and clinical characteristics of infants with primary congenital glaucoma. The records of 17 patients with PCG were reviewed and the MRIs of the brain and associated manifestations were analyzed. Three patients with PCG had abnormal MRI findings suggesting agenesis of the corpus callosum. Two infants had delayed myelinization of the brain. Significant abnormal optic nerve excavation and increased corneal diameters in 2 patients with delayed myelinization may suggest that intraocular pressure can be more striking and more severe, revealing a close relationship with PCG and abnormal myelinization in white matter. Studies with more patients are needed to confirm these results. (author)

  3. MRI findings of tuberous sclerosis complex in pediatrics

    Objective: To analyze MRI characteristic features of tuberous sclerosis. Methods: There are 14 patients were examined by MR routine scan and 3 patients with enhancement, all patients were proven by clinical examination. Results: Subependymal nodules, were detected in all cases, which were most commonly along the lateral wall of the lateral ventricles. Cortical tubers were detected in 10 cases, the patterns of cortical tubers were gyral core lesion and H-shaped lesion on MRI. The abnormal findings of white matter were radial linear ore wedge-shaped or irregular type on MR images. Subependymal giant cell astrocytomas were detected in 2 cases, renal angiomyolipoma was detected in 1 case. Conclusions: MRI is sensitive to find the changes in imaging diagnosis of TSC and is the first choice among the diagnostic imaging modalities. T1-weighted imaging (T1WI) and gradient echo sequences are more sensitive to the subependymal nodules than T2-weighted imaging (T2WI). T2WI and fluid-attenuated inversion recovery (FLAIR) are more sensitive to find the cortical tubers and abnormal white matter than T1WI. (authors)

  4. MRI and neurological findings in patients with spinal metastases

    Background. Magnetic resonance imaging (MRI) is the recommended primary investigation method for metastatic spinal cord compression (MSCC). Initiating treatment before the development of motor deficits is essential to preserve neurological function. However, the relationship between MRI-assessed grades of spinal metastatic disease and neurological status has not been widely investigated. Purpose. To analyze the association between neurological function and MRI-based assessment of the extent of spinal metastases using two different grading systems. Material and Methods. A total of 284 patients admitted to our institution for initial radiotherapy or surgery for symptomatic spinal metastases were included in the study. Motor and sensory deficits were categorized according to the Frankel classification system. Pre-treatment MRI evaluations of the entire spine were scored for the extent of spinal metastases, presence and severity of spinal cord compression, and nerve root compression. Two MRI-based scales were used to evaluate the degree of cord compression and spinal canal narrowing and relate these findings to neurological function. Results. Of the patients included in the study, 28 were non-ambulatory, 49 were ambulatory with minor motor deficits, and 207 had normal motor function. Spinal cord compression was present in all patients with Frankel scores of B or C, 23 of 35 patients with a Frankel score of D (66%), and 48 of 152 patients with a Frankel score of E (32%). The percentage of patients with severe spinal canal narrowing increased with increasing Frankel grades. The grading according to the scales showed a significant association with the symptoms according to the Frankel scale (P < 0.001). Conclusion. In patients with neurological dysfunction, the presence and severity of impairment was associated with the epidural tumor burden. A significant number of patients had radiological spinal cord compression and normal motor function (occult MSCC)

  5. MRI and neurological findings in patients with spinal metastases

    Switlyk, M.D.; Hole, K.H.; Knutstad, K. [Department of Radiology and Nuclear Medicine, Oslo University Hospital, Norwegian Radium Hospital, Oslo (Norway)], E-mail: marta.switlyk@radiumhospitalet.no; Skjeldal, S.; Zaikova, O. [Department of Orthopedics, Oslo University Hospital, Norwegian Radium Hospital, Oslo (Norway); Hald, J.K. [Department of Radiology and Nuclear Medicine, Oslo University Hospital, Rikshospitalet, Oslo (Norway); Seierstad, T. [Department of Radiology and Nuclear Medicine, Oslo University Hospital, Norwegian Radium Hospital, Oslo (Norway); Faculty of Health Sciences, Buskerud University College, Drammen (Norway)

    2012-12-15

    Background. Magnetic resonance imaging (MRI) is the recommended primary investigation method for metastatic spinal cord compression (MSCC). Initiating treatment before the development of motor deficits is essential to preserve neurological function. However, the relationship between MRI-assessed grades of spinal metastatic disease and neurological status has not been widely investigated. Purpose. To analyze the association between neurological function and MRI-based assessment of the extent of spinal metastases using two different grading systems. Material and Methods. A total of 284 patients admitted to our institution for initial radiotherapy or surgery for symptomatic spinal metastases were included in the study. Motor and sensory deficits were categorized according to the Frankel classification system. Pre-treatment MRI evaluations of the entire spine were scored for the extent of spinal metastases, presence and severity of spinal cord compression, and nerve root compression. Two MRI-based scales were used to evaluate the degree of cord compression and spinal canal narrowing and relate these findings to neurological function. Results. Of the patients included in the study, 28 were non-ambulatory, 49 were ambulatory with minor motor deficits, and 207 had normal motor function. Spinal cord compression was present in all patients with Frankel scores of B or C, 23 of 35 patients with a Frankel score of D (66%), and 48 of 152 patients with a Frankel score of E (32%). The percentage of patients with severe spinal canal narrowing increased with increasing Frankel grades. The grading according to the scales showed a significant association with the symptoms according to the Frankel scale (P < 0.001). Conclusion. In patients with neurological dysfunction, the presence and severity of impairment was associated with the epidural tumor burden. A significant number of patients had radiological spinal cord compression and normal motor function (occult MSCC)

  6. Imaging Findings of Brain Death on 3-Tesla MRI

    To demonstrate the usefulness of 3-tesla (3T) magnetic resonance imaging (MRI) including T2-weighted imaging (T2WI), diffusion weighted imaging (DWI), time-of-flight (TOF) magnetic resonance angiography (MRA), T2*-weighted gradient recalled echo (GRE), and susceptibility weighted imaging (SWI) in diagnosing brain death. Magnetic resonance imaging findings for 10 patients with clinically verified brain death (group I) and seven patients with comatose or stuporous mentality who did not meet the clinical criteria of brain death (group II) were retrospectively reviewed. Tonsilar herniation and loss of intraarterial flow signal voids (LIFSV) on T2WI were highly sensitive and specific findings for the diagnosis of brain death (p < 0.001 and < 0.001, respectively). DWI, TOF-MRA, and GRE findings were statistically different between the two groups (p = 0.015, 0.029, and 0.003, respectively). However, cortical high signal intensities in T2WI and SWI findings were not statistically different between the two group (p = 0.412 and 1.0, respectively). T2-weighted imaging, DWI, and MRA using 3T MRI may be useful for diagnosing brain death. However, SWI findings are not specific due to high false positive findings.

  7. Imaging Findings of Brain Death on 3-Tesla MRI

    Sohn, Chul Ho [Dept. of Radiology, Seoul National University Hospital, Seoul National University College of Medicine, Seoul (Korea, Republic of); Lee, Hwa Pyung [Dept. of Occupational and Environmental Medicine, CHA Gumi Medical Center, CHA University, Gumi (Korea, Republic of); Park, Jun Beom [Dept. of Radiology, Korean Armed Force Daejeon Hospital, Daejeon (Korea, Republic of); Chang, Hyuk Won; Kim, Easlmaan; Park, Ui Jun; Kim, Hyoung Tae [Keimyung University College of Medicine, Dongsan Medical Center, Daegu (Korea, Republic of); Kim, Eun Hee [Dept. of Radiology, Seoul National University Bundang Hospital, Seongnam (Korea, Republic of); Ku, Jeong Hun [Dept. of Biomedical Engineering, Keimyung University College of Medicine, Daegu (Korea, Republic of)

    2012-09-15

    To demonstrate the usefulness of 3-tesla (3T) magnetic resonance imaging (MRI) including T2-weighted imaging (T2WI), diffusion weighted imaging (DWI), time-of-flight (TOF) magnetic resonance angiography (MRA), T2*-weighted gradient recalled echo (GRE), and susceptibility weighted imaging (SWI) in diagnosing brain death. Magnetic resonance imaging findings for 10 patients with clinically verified brain death (group I) and seven patients with comatose or stuporous mentality who did not meet the clinical criteria of brain death (group II) were retrospectively reviewed. Tonsilar herniation and loss of intraarterial flow signal voids (LIFSV) on T2WI were highly sensitive and specific findings for the diagnosis of brain death (p < 0.001 and < 0.001, respectively). DWI, TOF-MRA, and GRE findings were statistically different between the two groups (p = 0.015, 0.029, and 0.003, respectively). However, cortical high signal intensities in T2WI and SWI findings were not statistically different between the two group (p = 0.412 and 1.0, respectively). T2-weighted imaging, DWI, and MRA using 3T MRI may be useful for diagnosing brain death. However, SWI findings are not specific due to high false positive findings.

  8. Postinterventional MRI findings following MRI-guided laser ablation of osteoid osteoma

    Objective: To evaluate postinterventional magnetic resonance imaging (MRI) characteristics following MRI-guided laser ablation of osteoid osteoma (OO). Materials and methods: 35 patients treated with MRI-guided laser ablation underwent follow-up MRI immediately after the procedure, after 3, 6, 12, 24, 36, and up to 48 months. The imaging protocol included multiplanar fat-saturated T2w TSE, unenhanced and contrast-enhanced T1w SE, and subtraction images. MR images were reviewed regarding the appearance and size of treated areas, and presence of periablation bone and soft tissue changes. Imaging was correlated with clinical status. Results: Mean follow-up time was 13.6 months. 28/35 patients (80%) showed a postinterventional “target-sign” appearance consisting of a fibrovascular rim zone and a necrotic core area. After an initial increase in total lesion diameter after 3 months, a subsequent progressive inward remodeling process of the zonal compartments was observed for up to 24 months. Periablation bone and soft tissue changes showed a constant decrease over time. MR findings correlated well with the clinical status. Clinical success was achieved in 32/35 (91%). Conclusions: Evaluation of long-term follow-up MRI after laser ablation of OO identified typical postinterventional changes and thus may contribute to the interpretation of therapeutic success and residual or recurrent OO in suspected cases

  9. A case of calcified intracranial tuberculoma presenting unique MRI findings

    A 41-year-old male patient was admitted in our Ryukyu University Hospital complaining of parosmia. He had a history of miliary tuberculosis 21 years ago. Neurologically he showed left anosmia and hyperreflexia of the right upper extremity. Plain skull X-P and CT scan revealed a calcified mass, 25 mm in diameter, at the left frontal base. In MRI, the mass showed isointensity using the T1 weighted inversion recovery sequence and heterogenously low intensity using the T2 weighted spin echo sequence. Surgery was performed by bifrontal craniotomy. Then the tumor was removed totally including two coexisting small tumors. Histologically, they consisted of calcified caseous tissue and thick collagen capsule, suggesting old calcified tuberculomas. Postoperative course was uneventful and did not result in meningitis. Antituberculous therapy of streptmycin, isoniazid and rifapicin was given for 2 weeks, started on the operative day. MRI findings were presented in detail and the guideline of antituberculous therapy to the tuberculoma was discussed. (author)

  10. Pelvic Hydatid Disease: CT and MRI Findings Causing Sciatica

    Pelvic masses, especially hydatid disease, rarely present with sciatica. We present the computed tomography (CT) and the magnetic resonance imaging (MRI) findings of a 49-year-old female patient with presacral hydatid disease, who was evaluated for her sciatica. We also want to emphasize the importance of assessing the pelvis of patients with symptoms and clinical findings that are inconsistent and that cannot be satisfactorily explained by the spinal imaging findings. isc herniation in the lumbar spine is a well-known etiology of back pains and sciatica, but whenever disc herniation of the lumbar spine is excluded by the employed imaging modalities, then the pelvis should be examined for other possible etiologies of nerve compression. We describe here a patient, who was complaining of sciatica, with no abnormal findings in her lumbar spinal magnetic resonance imaging (MRI). The cause of her sciatica was found to be associated with a pelvic hydatid cyst compressing the lumbosacral nerve plexus. In conclusion, if no pathology is evident for the lumbar discal structures, in connection with the cause of sciatica and lumbar back pains, then the pelvis should also be examined for the possible etiologies of compression of the lumbosacral nerve plexus. Whenever a multiseptated cyst is come across in a patient of an endemic origin with a positive history for hydatid disease like surgery, indicating recurrence, hydatid cyst is the most likely diagnosis

  11. Incidental MRI Findings in Patients with Impaired Cognitive Function

    This study aims to evaluate the incidental findings on brain MRI of patients with cognitive function impairments. We analyzed magnetic resonance (MR) findings of 236 patients with decreased cognitive function. MR protocols include conventional T2 weighted axial images, fluid attenuated inversion recovery axial images, T1 weighted coronal 3-dimensional magnetization-prepared rapid acquisition of gradient echo and diffusion tensor images. We retrospectively evaluated the signal changes that suggest acute/subacute infarction and space occupying lesions which show mass effect. Incidental MR findings were seen in 16 patients. Nine patients (3.8%) showed increased signal intensity on trace map of diffusion tensor images suggesting acute/subacute infarctions. Space occupying lesions were detected in 7 patients, and 3 lesions (1.27%) had mass effect and edema and were considered clinically significant lesions that diminish cognitive functions. Several incidental MR findings were detected in patients with decreased cognitive function, and the incidence of aucte/subacute infarctions were higher. Proper evaluations of MRI in patients with impaired cognitive functions will be helpful in early detection and management of ischemic lesions and space occupying lesions.

  12. MRI findings of spinal visceral larva migrans of Toxocara canis

    Lee, In Ho, E-mail: leeinho1974@hanmail.ne [Department of Radiology and Center for Imaging Science, Samsung Medical Center, Sungkyunkwan University School of Medicine, 50 Ilwon-dong, Gangnam-Gu, Seoul 135-710 (Korea, Republic of); Department of Radiology, Chungnam National University Hospital, 33 Munhwa-ro, Jung-gu, Daejeon 301-721 (Korea, Republic of); Kim, Sung Tae, E-mail: st7.kim@hotmail.co [Department of Radiology and Center for Imaging Science, Samsung Medical Center, Sungkyunkwan University School of Medicine, 50 Ilwon-dong, Gangnam-Gu, Seoul 135-710 (Korea, Republic of); Oh, Dae Kun, E-mail: odk6464@nate.co [Department of Radiology and Center for Imaging Science, Samsung Medical Center, Sungkyunkwan University School of Medicine, 50 Ilwon-dong, Gangnam-Gu, Seoul 135-710 (Korea, Republic of); Kim, Hyung-Jin, E-mail: hyungkim@skku.ed [Department of Radiology and Center for Imaging Science, Samsung Medical Center, Sungkyunkwan University School of Medicine, 50 Ilwon-dong, Gangnam-Gu, Seoul 135-710 (Korea, Republic of); Kim, Keon Ha, E-mail: somatom@skku.ed [Department of Radiology and Center for Imaging Science, Samsung Medical Center, Sungkyunkwan University School of Medicine, 50 Ilwon-dong, Gangnam-Gu, Seoul 135-710 (Korea, Republic of); Jeon, Pyoung, E-mail: drpjeon@gmail.co [Department of Radiology and Center for Imaging Science, Samsung Medical Center, Sungkyunkwan University School of Medicine, 50 Ilwon-dong, Gangnam-Gu, Seoul 135-710 (Korea, Republic of); Byun, Hong Sik, E-mail: byun5474@skku.ed [Department of Radiology and Center for Imaging Science, Samsung Medical Center, Sungkyunkwan University School of Medicine, 50 Ilwon-dong, Gangnam-Gu, Seoul 135-710 (Korea, Republic of)

    2010-08-15

    Purpose: The purpose of this study is to investigate the MRI findings of visceral larva migrans (VLS) of Toxocara canis in spinal cord. Materials and methods: We retrospectively reviewed spinal MRI findings in eight patients with serologically proven Toxocara canis between 2005 and 2008. We evaluated the location, length, extent and migration of the lesion, MR signal intensity (SI), enhancement pattern, and swelling of the spinal cord. We evaluated clinical features including presenting symptoms and signs and treatment response. Results: Total 8 patients (M = 8; age range 36-79 years) were included. The lesions were located in the cervical or thoracic spinal cord in all patients. All lesions showed high SI and minimal or mild swelling of involved spinal cord on T2WI and focal nodular enhancement on posterior or posterolateral segment of spinal cord. The length of involved lesion was relatively short in most patients. There was a migration of lesion in one patient. In spite of albendazole or steroid treatment, neurological symptoms or signs were not significantly improved in all patients. Conclusion: Although all lesions show non-specific imaging findings like non-tumorous myelopathy mimicking transverse myelitis, single lesion, focal nodular enhancement on posterior or posterolateral segment of spinal cord, relatively short segmental involvement and migration of lesion may be characteristic findings of spinal VLM of Toxocara canis. In addition, the reluctant response to the treatment may be characteristic of spinal VLM of Toxocara canis.

  13. Pelvic Hydatid Disease: CT and MRI Findings Causing Sciatica

    Sanal, Hatice Tuba; Kocaoglu, Murat; Bulakbasi, Nail; Yildirim, Duzgun [Gulhane Military Medical School, Department of Radiology, 06018, Ankara (Turkmenistan)

    2007-12-15

    Pelvic masses, especially hydatid disease, rarely present with sciatica. We present the computed tomography (CT) and the magnetic resonance imaging (MRI) findings of a 49-year-old female patient with presacral hydatid disease, who was evaluated for her sciatica. We also want to emphasize the importance of assessing the pelvis of patients with symptoms and clinical findings that are inconsistent and that cannot be satisfactorily explained by the spinal imaging findings. isc herniation in the lumbar spine is a well-known etiology of back pains and sciatica, but whenever disc herniation of the lumbar spine is excluded by the employed imaging modalities, then the pelvis should be examined for other possible etiologies of nerve compression. We describe here a patient, who was complaining of sciatica, with no abnormal findings in her lumbar spinal magnetic resonance imaging (MRI). The cause of her sciatica was found to be associated with a pelvic hydatid cyst compressing the lumbosacral nerve plexus. In conclusion, if no pathology is evident for the lumbar discal structures, in connection with the cause of sciatica and lumbar back pains, then the pelvis should also be examined for the possible etiologies of compression of the lumbosacral nerve plexus. Whenever a multiseptated cyst is come across in a patient of an endemic origin with a positive history for hydatid disease like surgery, indicating recurrence, hydatid cyst is the most likely diagnosis.

  14. MRI findings of spinal visceral larva migrans of Toxocara canis

    Purpose: The purpose of this study is to investigate the MRI findings of visceral larva migrans (VLS) of Toxocara canis in spinal cord. Materials and methods: We retrospectively reviewed spinal MRI findings in eight patients with serologically proven Toxocara canis between 2005 and 2008. We evaluated the location, length, extent and migration of the lesion, MR signal intensity (SI), enhancement pattern, and swelling of the spinal cord. We evaluated clinical features including presenting symptoms and signs and treatment response. Results: Total 8 patients (M = 8; age range 36-79 years) were included. The lesions were located in the cervical or thoracic spinal cord in all patients. All lesions showed high SI and minimal or mild swelling of involved spinal cord on T2WI and focal nodular enhancement on posterior or posterolateral segment of spinal cord. The length of involved lesion was relatively short in most patients. There was a migration of lesion in one patient. In spite of albendazole or steroid treatment, neurological symptoms or signs were not significantly improved in all patients. Conclusion: Although all lesions show non-specific imaging findings like non-tumorous myelopathy mimicking transverse myelitis, single lesion, focal nodular enhancement on posterior or posterolateral segment of spinal cord, relatively short segmental involvement and migration of lesion may be characteristic findings of spinal VLM of Toxocara canis. In addition, the reluctant response to the treatment may be characteristic of spinal VLM of Toxocara canis.

  15. Cardiac MRI. Diagnostic gain of an additional axial SSFP chest sequence for the detection of potentially significant extracardiac findings in the cardiac MRI examination setting

    Roller, F.C.; Schneider, C.; Krombach, G.A. [University Hospital Giessen (Germany). Dept. Radiology; Schuhbaeck, A. [University Hospital Giessen (Germany). Dept. Cardiology; Rolf, A. [Kerckhoff Hospital Bad Nauheim (Germany). Dept. Cardiology

    2014-01-15

    Purpose: Cardiac MRI (CMRI) is an effective method for imaging of the heart. The aim of our study was to assess whether an axial chest sequence in addition to the standard CMR examination setting has advantages in the detection of potentially significant extracardiac findings (PSEF). Materials and Methods: 400 consecutive patients were imaged at 1.5 T for clinical reasons. In addition to the standard long and short-axis views, an axial SSFP sequence was obtained covering the thorax from the lung apex to the diaphragm. All sequences were separately evaluated for PSEF. Results: A total of 25 PSEF were diagnosed in 400 patients, including 16 pleural effusions, a pulmonary fibrosis, a spondylodiscitis, ascites, lymphadenopathies, relapse of a mamma carcinoma, growth of adrenal glands metastases and diaphragmatic elevation. All 25 PSEF were detected by reading survey sequences. 24 of the 25 PSEF were detected by the additional SSFP chest sequence as well as the CINE sequences. Conclusion: In our study the additional axial SSFP chest sequence didn't show a benefit in the detection of PSEF. With the survey sequences we were able to detect all PSEF. We conclude that survey images should be assessed for additional findings. (orig.)

  16. MRI findings of multiple focal nodular hyperplasia of the liver

    Objective: To assess the diagnostic value of MRI on multiple focal nodular hyperplasia (FNH) of the liver. Methods: MR images of 9 cases with pathological-confirmed multiple FNH were retrospectively analyzed. MRI features of the lesions were correlated with pathological findings. Results: Multiple FNH was considered in all these 9 cases. Among them, the primary diagnosis was FNH in 5, hepatic adenoma in 3 and fibrolamellar hepatocellular carcinoma in 1 case. A total of 31 lesions were detected in the 9 cases. On T2WI, 19 lesions presented slightly high-signal intensity, and the other 12 presented iso-signal intensity. On T1WI, 12 lesions presented slightly low-signal intensity, 7 presented iso-signal intensity, and the other 12 presented high-signal intensity. On opposed-phase, the signal intensity of 1 lesion dropped unevenly. After bolus injection of contrast agent Gd-DTPA, in hepatic arterial phase 18 lesions showed mild to marked heterogeneous enhancement, 11 showed marked homogeneous enhancement, 1 showed moderate ring-like enhancement, and the last one did not have obvious enhancement. In portal venous and delayed phase, all the lesions turned to iso- or slightly high-signal intensity gradually. Sixteen of 31 lesions presented central scar, which demonstrated mild star-like enhancement in delayed phase. Conclusion: Multiple FNH presented certain MRI features, which contributed to the preoperative diagnosis. (authors)

  17. CT and MRI findings of a spinal arachnoid cyst

    A 39-year-old woman developed progressive difficulty in walking and urination over one year and 9 months. Her past history included a hystero-oophorectomy because of ''infection;'' the operation had been done under lumbar anesthesia. At the time of admission to our hospital, her legs were markedly spastic, with increased knee and ankle jerks as well as bilateral Babinski signs. Sensation to pain was slightly decreased bilaterally at and below Th4. Myelography through a suboccipital tap and CT myelography demonstrated a block of the CSF space at Th6. The spinal cord was displaced and became thin at and below Th1, secondary to an enlarged CSF space. Horizontal MRI demonstrated similar findings; however, sagittal MRI showed that the cord had been displaced and had collapsed; in addition, an abnormally enlarged CSF space indicated a subdural arachnoid cyst. MRI has thus been shown to be a very useful tool in the diagnosis of a spinal arachnoid cyst as well as other spinal-cord diseases. (author)

  18. MRI of cortical dysplasia - correlation with pathological findings

    Cortical dysplasia (CD) is the most epileptogenic structural lesion associated with epilepsy and patients with intractable seizures caused by this condition are good surgical candidates. MRI plays an important role in detecting the abnormalities of CD. We clarified the MRI characteristics of CD by comparing imaging and histological findings in 20 patients with intractable seizures who underwent surgical resection. There were 12 males and eight females, mean age at operation was 15 years. MRI was performed at 1.5 tesla; T1-weighted, T2- and proton density-weighted spin-echo and fluid-attenuated inversion-recovery (FLAIR) images were obtained. The lesions were in the frontal lobe in nine cases, temporal in two, occipital in another two, insular in one and multilobar in six. Blurring of the grey/white matter junction was seen in all patients, and T2 prolongation in white matter and/or at the grey/white matter junction in 19. Abnormal signal intensity was more frequent in the white matter or at the grey/white matter junction than in the grey matter. FLAIR images made this abnormal high signal easier to appreciate, and we thought them very useful in this context. In areas of T2 prolongation, we saw dysplastic neurones and/or balloon cells, dysmyelination, and ectopic neuronal clustering histologically; glial proliferation played an important role in prolonging T2. (orig.)

  19. Clinical presentations and MRI findings of angiographically occult vascular malformations

    Various clinical features as well as MRI findings of AOVM (angiographically occult vascular malformation) were studied. Amongst out patients, since January 1988, there have been 30 cases of symptomatic AOVM (20 males, 10 females) including 4 cases with multiple lesions. The age ranged from 3 to 60 years of age, with a mean of 33.4 years. The locations of symptomatic lesions were in the cerebral hemisphere (15), the thalamus (4), the brain stem (8) and in the cerebellum (3). The initial presentations of these 30 cases were either by hemorrhage (18), convulsive seizure (9) or by progressive neurological deficits (3). The initial presentation was not related to the patient's age and the size of the lesion, but apparently related to the location of AOVM. Most of the lesions in the cerebral hemisphere presented seizures, but all of the lesions in the thalamus, the brain stem and the cerebellum disclosed hemorrhage as an initial presentation. In fact it was noticed that brain stem lesions tend to cause repetitive hemorrhage in a relatively short period. AOVM lesions were clearly visualized with T2-weighted MRI images, consisting of high intensity cores with surrounding low intensity rims. Most of the symptomatic lesions were partially enhanced by Gd-DTPA with varied intensity. Dynamic changes in size and enhancement pattern on MRI were occasionally seen, usually accompanied with episodes such as hemorrhage or neurological deterioration. Although AOVMs were angiographically negative some strands indicating draining veins were observed on MRI in several cases. In contrast, none of the nonsymptomatic lesions (22 lesions) demonstrated enhancement effects with Gd-DTPA. (author)

  20. MRI and pathological findings of epileptogenic lesions removed surgically

    Moritake, Kouzo; Kikuchi, Haruhiko; Minamikawa, Jun (Kyoto Univ. (Japan). Faculty of Medicine) (and others)

    1990-04-01

    MRI revealed focal cerebral lesions in 19 patients, 12 males and 7 females, who had suffered from disabling seizures refractory to medical therapy for over one year; the lengths of the periods of therapy ranged from one to 17 years; mean: 8.8 years. Their ages at surgery ranged from 3 to 46 years; mean: 15.2 years. The results of other preoperative and intraoperative examinations, including mobile long-term ambulatory EEG monitoring, local CBF two-dimensional imaging by SPECT, and intraoperative cortical EEG, justified the surgical resection of those lesions revealed by MRI. These lesions were removed totally or subtotally. The pathological findings of the excised lesions were neuronal loss and gliosis in 10 cases (porencephaly, 2; arachnoid cyst, 3; post-traumatic scar, 1; nonspecific infarct, 4), hamartomatous pathology in 5 (hemartoma, 1; tuberous sclerosis, 4), and neoplasm in 4 (low-grade astrocytoma, 2; oligodendroglioma, 1; epidermoid, 1). The common pathological feature of these lesions was the proliferation of abnormal glial cells, which are sensitive to MRI imaging, especially to T{sub 2}-weighted images. The postoperative follow-up terms of these 19 patients ranged from 6 to 23 months; mean: 15 months. Epileptic attacks had ceased in 12 of the 19 patients (63%), and there had been a marked improvement in both the frequency and severity of attacks in another 4. No permanent surgical complications or worsening of the seizures were seen in any patient. In conclusion, MRI is sensitive to epileptogenic lesions in patients with medically intractable epilepsy and is helpful in defining their configurations and margins and in planning the surgical approach. (author).

  1. Intracranial ganglioglioma: clinicopathological and MRI findings in 16 patients

    Zhang, D. [Department of Radiology, XinQiao Hospital, Third Military Medical University, ChongQing 400037 (China); Henning, T.D. [UCSF, Department of Radiology, Contrast Media Laboratory, San Francisco, CA, 94107 (United States); Zou, L.-G. [Department of Radiology, XinQiao Hospital, Third Military Medical University, ChongQing 400037 (China); Hu, L.-B. [Department of Radiology, The Second Hospital of ChongQing, ChongQing 400000 (China); Wen, L. [Department of Radiology, XinQiao Hospital, Third Military Medical University, ChongQing 400037 (China)], E-mail: cqzdwl@yahoo.com.cn; Feng, X.-Y. [Department of Radiology, HuaShan Hospital, Medical Center of FuDan University, ShangHai 200040 (China); Dai, S.-H.; Wang, W.-X.; Sun, Q.-R. [Department of Radiology, XinQiao Hospital, Third Military Medical University, ChongQing 400037 (China); Zhang, Z.-G. [Department of Pathology, XinQiao Hosptial, Third Military Medical University, ChongQing 400037 (China)

    2008-01-15

    Aim: To record the clinical findings and magnetic resonance imaging (MRI) characteristics of intracranial gangliogliomas in 16 patients. Materials and methods: Sixteen patients were imaged using unenhanced and contrast-enhanced MRI. Eight patients underwent unenhanced CT and of these, three underwent contrast-enhanced CT. Two radiologists read the images retrospectively. The images were studied with regard to location, size, margin, signal intensity, enhancement characteristics, cystic changes, and presence of calcifications. Clinical data, such as presenting signs and symptoms, physical findings, and medical histories, were collected. Histopathological and immunohistochemical studies were performed and analysed by two pathologists. Results: In 12 cases the tumours were located in one of the cerebral hemispheres; in the other cases they were located in the brainstem, cerebellum, suprasellar area or the thalamus. The tumour dimension varied from 1-7 cm, with a mean of 3.6 cm {+-} 1.8 cm. The MRI features of ganglioglioma in the present cohort can be divided into three patterns: cystic (n = 2), cystic-solid (n = 6), and solid (n = 8). Solid lesions had a predilection for the temporal lobe; cystic and cystic-solid tumours had a wide anatomical distribution. Cystic lesions were significantly smaller than both cystic-solid and solid lesions (F = 4.28, P < 0.05). Cystic changes in the cystic-solid tumours showed one of the following patterns: those with walls showing contrast enhancement, those containing an enhancing nodule, or cysts without an obvious wall. The solid portion of cystic-solid gangliogliomas and the entire tumour in solid tumours showed homogeneous enhancement of variable degrees on T1-weighted (T1W) spin-echo (SE) images. Five tumours had mild or moderate oedema. In one patient two separate gangliogliomas were found, each lesion exhibiting different MRI features: solid and cystic-solid. One case of cortical ganglioglioma was found, causing bone erosion due to pressure. One tumour with chronic haemorrhage was found in the study. Conclusion: MRI features of gangliogliomas are non-specific. A ganglioglioma should be suspected when a tumour shows the following features: (1) a solid lesion located in the temporal lobes with mild or no oedema and homogeneous enhancement on SE T1W images; or (2) a small cystic lesion or cystic-solid mixed mass with a wall enhancement or a markedly enhanced nodule. We report a patient with two separate gangliogliomas and a case with bone erosion.

  2. MRI findings of intracranial neurenteric cyst : cast report

    Jeong, Ae Kyung; Lee, Ho Kyu; Khang, Shin Kwang; Shin, Ji Hoon; Choi, Chong Gon; Suh, Dae Chul [College of Medicine, University of Ulsan, Seoul (Korea, Republic of)

    2001-08-01

    Neurenteric cyst is very rare congenital disease and usually presents symptoms in adulthood. It can cause major neurological deficits if detection and treatment are delayed. It is also known to be a source of serious infection of the central nervous system. Neurenteric cyst is usually located in the ventral aspect of the lower cervical or upper thoracic spinal cord. Intracranial neurenteric cyst is very uncommon and less than 35 cases have been reported in the literature. We report MRI findings of two cases of intracranial neurenteric cyst and review the literature.

  3. Relationship between MRI and clinical findings in the acromioclavicular joint

    Objective: To determine the relationship between the magnetic resonance (MR) appearance of the acromioclavicular (AC) joint and the physical findings. Design: A total of 116 consecutive patients underwent routine MR imaging (MRI) of the shoulder over an 18-month period. All MR studies were interpreted by a blinded, experienced musculoskeletal radiologist. Eleven variables were studied: the presence of osteophytes; fluid in the joint; fluid outside the joint; high signal in the clavicle or in the acromion; fluid in the subacromial bursa; irregularity of the joint margins; bulging of the capsule; widening of the joint; the age of the patient; and the presence of a rotator cuff tear. The clinical information was supplied by an experienced shoulder surgeon blinded to the MRI findings. A control group of 23 normal volunteers was also studied. Results: The only statistically significant correlation (P=0.0249) was between high signal in the distal clavicle and degenerative changes found clinically. A weaker relationship existed between fluid in the joint and the clinical examination and between increasing degenerative changes and advancing age. Otherwise, no material relationship was found between any of the other MR abnormalities and the clinical picture. Conclusion: There appears to be no real correlation between the MR appearances and the clinical findings in the AC joint. (orig.)

  4. Multidetector CT and MRI findings in periportal space pathologies

    Periportal region is an anatomic space around portal vein comprising hepatic artery, bile duct, nerves, lymphatics and a potential space. Periportal pathologies may involve any of these structures diffusely or focally with characteristic radiologic findings. Radiologic findings can be helpful in differential diagnosis of pathologies of periportal structures including periportal cavernomatous transformation, hepatic artery aneurysm, biliary diseases, neurofibromatosis, lymphoma, langerhans' cell histiocytosis, periportal fatty infiltration and other causes of periportal halo in adult and pediatric patients. Lobar/segmental intrahepatic involvement can be seen in neurofibromatosis, cavernomatous transformation, fatty infiltration and periportal edema. In this review, we discuss CT and MRI findings of periportal pathologies which can be in the form of diffuse or segmental/lobar involvement

  5. Eosinophilic Otitis Media: CT and MRI Findings and Literature Review

    Chung, Won Jung; Lee, Jeong Hyun; Lim, Hyun Kyung; Yoon, Tae Hyun; Cho, Kyung Ja; Baek, Jung Hwan [Asan Medical Center, Ulsan University College of Medicine, Seoul (Korea, Republic of)

    2012-06-15

    Eosinophilic otitis media (EOM) is a relatively rare, intractable, middle ear disease with extremely viscous mucoid effusion containing eosinophils. EOM is associated with adult bronchial asthma and nasal allergies. Conventional treatments for otitis media with effusion (OME) or for chronic otitis media (COM), like tympanoplasty or mastoidectomy, when performed for the treatment of EOM, can induce severe complications such as deafness. Therefore, it should be differentiated from the usual type of OME or COM. To our knowledge, the clinical and imaging findings of EOM of temporal bone are not well-known to radiologists. We report here the CT and MRI findings of two EOM cases and review the clinical and histopathologic findings of this recently described disease entity.

  6. Comparative study of the MRI findings of lymphoplasmacyte-rich meningioma with pathological findings

    Objective: To investigate the MRI features of intracranial lymphoplasmacyte-rich meningioma and the correlation between the MRI features and pathologic findings. Methods: The MRI and pathologic data of 7 patients with lymphoplasmacyte-rich meningioma were reviewed retrospectively. All cases were proved by surgery and pathological examinations. Results: All lesions were solitary. The tumors crawled along meninges in 6 cases and in 5 cases the tumors did not appear as mass lesions. In 2 cases, the tumors appeared as half-moon. The boundary of all of the tumors was unclear, accompanying heavy peritumoral brain edema. The brain invasion can be seen in 7 cases. The lesions showed hypo-isointense signal on T1WI in 7 cases, hyper-isointense signal in 5 cases and hypo-isointense in 2 cases on T2WI. Enhancement scan demonstrated marked enhancement in 7 cases. Extensive thickening of the meninges was observed in 6 cases. Pathological results showed that the cells were abundant and diversified, with a great quantity of lymphoplasmacytes, and there were typical meningeal epithelial cells area in the surgical specimen. Conclusion: The MRI findings of lymphoplasmacyte-rich meningioma show some features different from other common meningiomas, which would be helpful to the diagnosis and differential diagnosis. (authors)

  7. Adult cerebellar medulloblastoma: CT and MRI findings in eight cases

    Carvalho Neto, Arnolfo de; Bertoldi, Guilherme A. [Parana Univ., Curitiba, PR (Brazil). Radiologia Diagnostica]. E-mail: arnolfo.carvalho@avalon.sul.com.br; Gasparetto, Emerson L. [Parana Univ., Curitiba, PR (Brazil). Hospital das Clinicas. Secao de Radiologia Diagnostica; Ono, Sergio E. [Parana Univ., Curitiba, PR (Brazil). Faculdade de Medicina; Gomes, Andre F. [Diagnostico Avancado Por Imagem (DAPI), Curitiba, PR (Brazil)

    2003-06-01

    Medulloblastoma is a brain tumor of neuro epithelial origin, which represents 15 to 30% of all pediatric brain tumors, and less than 1% of CNS adult neoplasms. We report the imaging findings of 8 adult patients with medulloblastoma. The mean age was 35 years, ranging from 20 to 65 years, and the male:female rate was 3:5. The tumors were predominantly lateral (63%), hyperdense on CT scans (83%), and on the MRI, hypointense on T1 (100%) and hyperintense on T2 (80%) weighted images. It was seen intratumoral necrosis and cysts in six cases and calcifications in three. Hydrocephalus was observed in 5 cases and brain stem invasion in four. The imaging findings of medulloblastomas in adults are different of those in child, and also nonspecific. Although these tumors are uncommon in adults, they must be considered in the differential diagnosis of cerebellar masses in the posterior fossa of this age group. (author)

  8. Adult cerebellar medulloblastoma: CT and MRI findings in eight cases

    Medulloblastoma is a brain tumor of neuro epithelial origin, which represents 15 to 30% of all pediatric brain tumors, and less than 1% of CNS adult neoplasms. We report the imaging findings of 8 adult patients with medulloblastoma. The mean age was 35 years, ranging from 20 to 65 years, and the male:female rate was 3:5. The tumors were predominantly lateral (63%), hyperdense on CT scans (83%), and on the MRI, hypointense on T1 (100%) and hyperintense on T2 (80%) weighted images. It was seen intratumoral necrosis and cysts in six cases and calcifications in three. Hydrocephalus was observed in 5 cases and brain stem invasion in four. The imaging findings of medulloblastomas in adults are different of those in child, and also nonspecific. Although these tumors are uncommon in adults, they must be considered in the differential diagnosis of cerebellar masses in the posterior fossa of this age group. (author)

  9. Rare case of acute dengue encephalitis with correlated MRI findings

    Dengue encephalitis is extremely rare, with most patients showing no significant abnormality on neuroimaging (CT/MRI). We report one of the very few documented cases of dengue encephalitis, with abnormal signal intensities on all major sequences on brain MRI.

  10. Brain CT and MRI findings in fat embolism syndrome

    To elucidate brain CT and MRI findings in fat embolism syndrome (FES), we retrospectively analyzed images from 5 patients with FES during the acute and subacute stages. Brain CT examinations demonstrated brain edema in 2 patients and transient spotty low density lesions in 2 patients. Three patients showed no abnormalities. Brain MRI, however, showed brain abnormalities in all patients during the acute stages. These were revealed as spotty high signal intensity lesions on T2WI, and some showed low intensity on T1WI. These spotty lesions were considered to reflect edematous fluid occurring as a result of the unique pathophysiological condition of FES. While the spotty high signal intensity lesions on T2WI were distributed in the cerebrum, cerebellum, brain stem, thalamus, basal ganglia, internal capsule and corpus callosum, cerebral and cerebellar spotty lesions were characteristically located along the boundary zones of the major vascular territories. This characteristic location might be induced by a hypoxic brain condition in FES because the numerous fat globules present in this condition can block entire brain capillaries. This characteristic signal location on T2WI is a useful indicator for differentiating FES from the primary intra-axial brain injury in patients with multifocal trauma. (author)

  11. Adhesive capsulitis: contrast-enhansed shoulder MRI findings

    Full text: Evaluation of contrast-enhanced magnetic resonance imaging (CE-MRI) findings in cases clinically diagnosed as adhesive capsulitis (AC). CE-MRI images of 12 cases diagnosed as AC (13 shoulder joints) and nine control cases were retrospectively evaluated. AC diagnosis was establlished based on the history and clinical symptoms. MR signal intensity changes in the axillary pouch, rotator interval, biceps anchor and anterior posterior capsules were analysed with regard to the presence of abnormal soft tissue and contrast enhancement. Capsular and synovial thickening were measured in the axillary recess and rotator interval on coronal oblique CE T1-weighted images. Patient and control groups were compared by Fisher's exact and McNemar tests in terms of signal intensity changes and contrast enhancement in the described areas. Results: Comparison of the group with AC and the control group regarding intensity changes showed a statistically significant difference in the axillary pouch (P 0.05). Comparison of AC and control groups in terms of contrast enhancement revealed statistically significant differences in the axillary pouch, rotator interval, biceps anchor and anterior-posterior capsules (P < 0.001). A significant difference was determined between the AC and control groups with regard to thickening in axillary pouch and rotator interval (P < 0.001). CE studies are useful for diagnosis of AC as it demonstrates thickening of specific soft-tissue areas like joint capsule and synovium.

  12. Case of calcified intracranial tuberculoma presenting unique MRI findings

    Kinjo, Toshihiko; Mukawa, Jiro; Miyagi, Kouichi; Takara, Eiichi; Mekaru, Susumu; Ishikawa, Yasunari

    1988-05-01

    A 41-year-old male patient was admitted in our Ryukyu University Hospital complaining of parosmia. He had a history of miliary tuberculosis 21 years ago. Neurologically he showed left anosmia and hyperreflexia of the right upper extremity. Plain skull X-P and CT scan revealed a calcified mass, 25 mm in diameter, at the left frontal base. In MRI, the mass showed isointensity using the T/sub 1/ weighted inversion recovery sequence and heterogenously low intensity using the T/sub 2/ weighted spin echo sequence. Surgery was performed by bifrontal craniotomy. Then the tumor was removed totally including two coexisting small tumors. Histologically, they consisted of calcified caseous tissue and thick collagen capsule, suggesting old calcified tuberculomas. Postoperative course was uneventful and did not result in meningitis. Antituberculous therapy of streptmycin, isoniazid and rifapicin was given for 2 weeks, started on the operative day. MRI findings were presented in detail and the guideline of antituberculous therapy to the tuberculoma was discussed.

  13. Bilateral Renal Lymphangiomatosis: Ultrasound, CT, and MRI Findings

    M. H. Bagheri

    2008-01-01

    Full Text Available Background/Objective: Renal lymphangiomatosis (RL is a rare disorder characterized by developmental malformation of the lymphatic system surrounding the kidneys. Herein we describe the ultrasound, CT scan, and MRI features of renal lymphangiomatosis in an asymptomatic male patient."nCase Presentation: A 21 years-old man underwent abdominal ultrasound due to 1 month history of dyspepsia and epigastric pain which revealed mild enlargement of both kidneys (right: accompanied by increased renal echogenicity and loss of corticomedullary differentiation . There were also numerous cystic areas of varying size around both kidneys and also extending along the renal hilum into the peripelvic area obliterating renal sinus fat. All were simple cysts without internal echogenicic debris. Subsequently abdominal CT scan was requested in this patient to better evaluation of the extent and nature of the pathology, which revealed bilateral multilocular fluid-filled cystic masses with thin walls in the perirenal and peripelvic region with attenuation measurement of 8 HU. There was a small focus of calcification posterior to the right kidney. MRI of the patient revealed bilaterally enlarged kidneys with multiple hyperintense lesions in both perirenal spaces and the peripelvic area in T2-wieghted images. These cystic spaces appeared hypointense in T1-weighted images with no enhancement in post-contrast images."nDiscussion: The diagnosis of renal lymphangiomatosis can be confirmed with needle aspiration of the typi-cal chylous content of the pernephric collection; however the imaging findings are actually character-istics for this disease and allow a purely radiologic diagnosis to be made confidently; so familiarity with imaging findings of renal lymphangiomatosis is very useful for radiologists and can prevent unnecessary biopsy or even surgery of this most commonly harm-less condition."nThere is no treatment in most cases of this disease as most patients are asymptomatic. Percutaneous drainage has promised useful in conservative manage-ment of symptomatic patients and pregnant women.

  14. Measurement of ventricular volumes by cine magnetic resonance imaging in complex congenital heart disease

    Along with the remarkable improvement in surgical results for complex congenital heart disease (CCHD) in recent years, it has become increasingly important for pediatric cardiologist and cardiovascular surgeons to evaluate ventricular volumes in CCHD accurately to develop a proper strategy for treating these patients. However, the validity of geometric formulas to derive volumes in various morphological types of abnormal ventricles like those in CCHD has been problematic. This study assessed the validity and usefulness of cine magnetic resonance imaging (MRI) for measuring right and left ventricular volumes using Simpson's rule in children with CCHD. Twenty-eight patients with CCHD (group A), children ranging in age from 4 months to 8 years (average 2.4 years) and 10 patients with morphologically normal ventricles (control; group B), ranging in age from 1 to 6 years (average 2.7 years) were evaluated. Cine MRI was performed by the GRASS methods (gradient recalled acquisition in steady state) at 0.5 T. The whole heart was encompassed by contiguous 7 or 10 mm transverse section. Ventricular volumes were calculated by adding luminal areas determined in each section at end-diastole and end-systole (EDV and ESV). Cine MRI findings of the right and left ventricular volumes were compared with those on ventriculogram. All cine MRI studies were considered diagnostic. Comparison of the RVEDV, RVESV, LVEDV and LVESV in both groups yielded a good correlation between cine MRI (Y) and ventriculography (X): RVEDV; Y=0.98X-0.49, r=0.98, RVESV; Y=0.89X+2.2, r=0.95, LVEDV; Y=0.97X+0.59, r=0.97, LVESV; Y=0.91X+0.56, r=0.95, Group B: RVEDV; Y=0.87X+4.9, r=0.93, RVESV; Y=0.91X+1.7, r=0.90, LVEDV; Y=1.1X-3.0, r=0.97, LVESV; Y=0.91X+0.6, r=0.93. These findigns indicate that cine MRI provides a suitable non-invasive means of quantifying right ventricular volume and left ventricular volumes in children with CCHD. (author)

  15. Cine club

    Ciné club

    2010-01-01

    Monday 13 December 2010 at 18:30 / Lundi 13 Décembre 2010 à 18:30 CERN Main Auditorium / Amphithéâtre Principal Comme chaque année avant Noël, le CINE-CLUB du CERN est heureux d’inviter petits et grands à une projection gratuite du film.   Ponyo sur la falaise (Japon, 2008, Hayao Miyazaki) Le petit Sosuke vit avec sa mère sur une haute falaise surplombant la mer. Un beau jour, il découvre sur la plage caillouteuse Ponyo, une petite fille poisson. Ponyo est si fascinée par Sosuke et le monde terrestre que son désir le plus cher est de devenir un être humain. Mais Fujimoto, son magicien de père, n’est pas du tout d’accord avec cette idée et il la force à regagner les profondeurs de l’océan. Bien décidée à revoir Sosuke, Ponyo s’&...

  16. MRI findings of multiple sclerosis involving the brainstem

    To describe MRI findings of multiple sclerosis involving the brainstem. Among 35 cases of clinically definite multiple sclerosis, the authors retrospectively analysed 20 in which the brainstem was involved. MR images were analysed with regard to involvement sites in the brainstem or other locations, signal intensity, multiplicity, shape, enhancement pattern, and contiguity of brainstem lesions with cisternal or ventricular CSF space. The brainstem was the only site of involvement in five cases (25%), while simultaneous involvement of the brainstem and other sites was observed in 15 cases (75%). No case involved only the midbrain or medulla oblongata, and simultaneous involvement of the midbrain, pons and medulla oblongata was noted in 12 cases (60%). The most frequently involved region of the brainstem was the medulla oblongata (n=13; 90%), followed by the pons (n=17; 85%) and the midbrain (n=16; 80%). Compared with normal white matter, brainstem lesions showed low signal intensity on T1 weighted images, and high signal intensity on T2 weighted, proton density weighted, and FLAIR images. In 17 cases (85%), multiple intensity was observed, and the shape of lesions varied: oval, round, elliptical, patchy, crescentic, confluent or amorphous were seen on axial MR images, and in 14 cases (82%), coronal or sagittal scanning showed that lesions were long and tubular. Contiguity between brainstem lesions and cisternal or ventricular CSF space was seen in all cases (100%) involving midbrain (16/16) and medulla oblongata (18/18) and in 15 of 17 (88%) involving the pons. Contrast enhancement was apparent in 7 of 12 cases (58%). In the brainstem, MRI demonstrated partial or total contiguity between lesions and cisternal or ventricular CSF space, and coronal or sagittal images showed that lesions were long and tubuler

  17. Intratemporal and extratemporal facial nerve schwannoma: CT and MRI findings

    To analyze the characteristics of CT and MRI findings of facial nerve schwannoma in ten patients. Ten patients with pathologically confirmed facial nerve schwannoma, underwent physical and radilolgic examination. The latter involved MRI in all ten and CT scanning in six. We analyzed the location (epicenter), extent and number of involved segments of tumors, tuumor morphology, and changes in adjacent bony structures. The major symptoms of facial nerve schwannoma were facial nerve paralysis in seven cases and hearing loss in six. Epicenters were detected at the intraparotid portion in five cases, the intracanalicular portion in two, the cisternal portion in one, and the intratemporal portion in two. The segment most frequently involved was the mastoid (n=6), followed by the parotid (n=5), intracanalicular (n=4), cisternal (n=2), the labyrinthine/geniculate ganglion (n=2) and the tympanic segment (n=1). Tumors affected two segments of the facial nerve in eight cases, only one segment in one, and four continuous segments in one. Morphologically, tumors were ice-cream cone shaped in the cisternal segment tumor (1/1), cone shaped in intracanalicular tumors (2/2), oval shaped in geniculate ganglion tumors (1/1), club shaped in intraparotid tumors (5/5) and bead shaped in the diffuse-type tumor (1/1). Changes in adjacent bony structures involved widening of the stylomastoid foramen in intraparotid tumors (5/5), widening of the internal auditary canal in intracanalicular and cisternal tumors (3/3), bony erosion of the geniculate fossa in geniculate ganglion tumors (2/2), and widening of the facial nerve canal in intratemporal and intraparotid tumors (6/6). The characteristic location, shape and change in adjacent bony structures revealed by facial schwannomas on CT and MR examination lead to correct diagnosis

  18. First metatarsophalangeal joint- MRI findings in asymptomatic volunteers

    To evaluate the spectrum and frequency of MR findings of the first metatarsophalangeal joint (MTPJ) in asymptomatic volunteers. MR imaging of 30 asymptomatic forefeet was performed with a dedicated extremity 1.5-Tesla system. Participants were between 20 and 49 years of age (mean SD: 35.5 8.4 years). Two radiologists assessed cartilage, bone, capsuloligamentous structures, and tendons of first MTPJs on MR images. Cartilage defects were observed in 27 % (n = 8) of first MTPJs, most frequently located at the base of the proximal phalanx (23 %, n = 7), whereas cartilage defects of the metatarsal head (13 %, n = 4) and the metatarsosesamoid compartment were rare (0 %-3 %, n = 0-1). Bone marrow oedema-like signal changes were present in 37 % (n = 11) and subchondral cysts in 20 % (n = 6) of first MTPJs. Hyperintense areas on intermediate-weighted sequences (range: 30-43 %, n = 9-13) and on fluid-sensitive sequences with fat suppression (range: 33-60 %, n = 10-18) within the medial and lateral collateral ligament complex were common. Plantar recesses (77 %, n = 23) and distal dorsal recesses (87 %, n = 26) were frequently observed. Cartilage defects, bone marrow oedema-like signal changes, subchondral cysts, plantar recesses, and distal dorsal recesses were common findings on MRI of first MTPJs in asymptomatic volunteers. The collateral ligaments were often heterogeneous in structure and showed increased signal intensity. (orig.)

  19. Neural network analysis of breast cancer from MRI findings

    To evaluate how much the experience of radiologists affects the performance of an artificial neural network (ANN) trained by two highly experienced radiologists. Before biopsy two experienced radiologists reviewed the MR images of 100 adult patients with suspicious breast lesions and evaluated their findings based on six features. This database was then used to train a three-layered feed-forward neural network. The network's generalizing ability was then tested to predict the outcome of biopsy in 56 new patients' records which were extracted by 10 participating radiologists. The MRI findings of each reader were presented to the ANN to evaluate the effect of various levels of experience on the output of the ANN. The performance of the ANN was then compared with that of attendant physicians in terms of sensitivity, specificity, and accuracy as well as ROC analysis. The best ANN outcome offered a correct diagnosis in 40 of 41 of the patients with malignant breast cancer and 10 of 15 with benign entity presented in the testing set. The output of the trained ANN outperformed the attendant radiologists with low levels of experience and showed comparable performance with radiologists with higher levels of experience. The ANN is able to work as a backup system to assist radiologists in the diagnosis of breast cancer. (author)

  20. First metatarsophalangeal joint- MRI findings in asymptomatic volunteers

    Dietrich, Tobias Johannes; Pfirrmann, Christian W.A. [University of Zurich, Radiology, Orthopedic University Hospital Balgrist, Zurich (Switzerland); Figueira da Silva, Flora Luciana [University of Zurich, Radiology, Orthopedic University Hospital Balgrist, Zurich (Switzerland); Radiology, Hospital Mae de Deus and Mae de Deus Center, Porto Alegre, RS (Brazil); Abreu, Marcelo Rodrigues de [Radiology, Hospital Mae de Deus and Mae de Deus Center, Porto Alegre, RS (Brazil); Klammer, Georg [University of Zurich, Orthopedic Surgery, Orthopedic University Hospital Balgrist, Zurich (Switzerland)

    2015-04-01

    To evaluate the spectrum and frequency of MR findings of the first metatarsophalangeal joint (MTPJ) in asymptomatic volunteers. MR imaging of 30 asymptomatic forefeet was performed with a dedicated extremity 1.5-Tesla system. Participants were between 20 and 49 years of age (mean ± SD: 35.5 ± 8.4 years). Two radiologists assessed cartilage, bone, capsuloligamentous structures, and tendons of first MTPJs on MR images. Cartilage defects were observed in 27 % (n = 8) of first MTPJs, most frequently located at the base of the proximal phalanx (23 %, n = 7), whereas cartilage defects of the metatarsal head (13 %, n = 4) and the metatarsosesamoid compartment were rare (0 %-3 %, n = 0-1). Bone marrow oedema-like signal changes were present in 37 % (n = 11) and subchondral cysts in 20 % (n = 6) of first MTPJs. Hyperintense areas on intermediate-weighted sequences (range: 30-43 %, n = 9-13) and on fluid-sensitive sequences with fat suppression (range: 33-60 %, n = 10-18) within the medial and lateral collateral ligament complex were common. Plantar recesses (77 %, n = 23) and distal dorsal recesses (87 %, n = 26) were frequently observed. Cartilage defects, bone marrow oedema-like signal changes, subchondral cysts, plantar recesses, and distal dorsal recesses were common findings on MRI of first MTPJs in asymptomatic volunteers. The collateral ligaments were often heterogeneous in structure and showed increased signal intensity. (orig.)

  1. MRI reporting by radiographers: Findings of an accredited postgraduate programme

    Piper, Keith [Allied Heath Professions Department, Canterbury Christ Church University, North Holmes Road, Canterbury, Kent CT1 1QU (United Kingdom)], E-mail: keith.piper@canterbury.ac.uk; Buscall, Kaie [Allied Heath Professions Department, Canterbury Christ Church University, North Holmes Road, Canterbury, Kent CT1 1QU (United Kingdom); Thomas, Nigel [X-Ray Department, Trafford General Hospital, Manchester M41 5SL (United Kingdom)

    2010-05-15

    Aim: To analyse the objective structured examination (OSE) results of the first three cohorts of radiographers (n = 39) who completed an accredited postgraduate certificate (PgC) programme in reporting of general magnetic resonance imaging (MRI) investigations and to compare the agreement rates with those demonstrated for a small group of consultant radiologists. Method: Forty MRI investigations were used in the OSE which included the following anatomical areas and abnormal appearances: knee; meniscal/ligament injuries, bone bruises, effusions and osteochondral defects; lumbar spine: intervertebral disc morphology, vertebral collapse, tumours (bone and soft tissue), spinal stenosis and/or nerve root involvement; internal auditory meati (IAM): acoustic neuroma. Incidental findings included maxillary polyp, arachnoid cyst, renal cyst, hydroureter, pleural effusion and metastases (adrenal, lung, perirenal and/or thoracic spine). Sensitivity, specificity and total percentage agreement rates were calculated for all radiographers (n = 39) using all reports (n = 1560). A small representative subgroup of reports (n = 27) was compared to the three consultant radiologists' reports which were produced when constructing the OSE. Kappa values were estimated to measure agreement in four groups: consultant radiologists only; radiographers and each of the consultant radiologists independently. Results: The sensitivity, specificity and agreement rates for the three cohorts (combined) of radiographers were 99.0%, 99.0% and 89.2%, respectively. For the majority (5/9) of anatomical areas and/or pathological categories no significant differences (p < 0.05) were found between the mean Kappa scores (K = 0.47-0.76) for different groups of observers, whether radiographers were included in the group analysis or not. Where differences were apparent, this was in cases (4/9) where the variation was either not greater than found between radiologists and/or of no clinical significance. These results suggest therefore that in an academic setting, these groups of radiographers have the ability to correctly identify normal investigations and are able to provide a report on the abnormal appearances to a high standard. Further work is required to confirm the clinical application of these findings.

  2. MRI findings of brain damage due to neonatal hypoglycemia

    Objective: To report the MRI findings of brain damage observed in neonatal patients who suffered from isolated hypoglycemia and to explore the value of diffusion-weighted imaging(DWI) in early detection of neonatal hypoglycemic brain injury. Methods: Twelve neonates with isolated hypoglycemia (10 of the 12 were diagnosed to suffer from hypoglycemic encephalopathy) were enrolled in this study. They were first scanned at age from 3 days to 10 days with T1WI, T2WI and DWI(b is 0 s/mm2, 1000 s/mm2), and 4 of them were then scanned from 7 days to 10 days following the initial scan. All acquired MR images were retrospectively analysed. Results: First series of DWI images showed distinct hyperintense signal in 11 cases in several areas including bilateral occipital cortex (2 cases), right occipital cortex (1 case), left occipital cortex and subcortical white matter(1 case), bilateral occipital cortex and subcortical white matter (2 cases), bilateral parieto-occipital cortex (2 cases), bilateral parieto-occipital cortex and subcortical white matter(2 cases), the splenium of corpus callosum (4 cases), bilateral corona radiata( 2 cases), left caudate nucleus and globus pallidus (1 case), bilateral thalamus (1 case), bilaterally posterior limb of internal capsule (1 case). In the initial T1WI and T2WI images, there were subtle hypointensity in the damaged cortical areas (3 cases), hyperintensity in the bilaterally affected occipital cortex( 1 case) on T1 weighted images, and hyperintensity in the affected cortex and subcortical white matter with poor differentiation on T2 weighted images. The followed-up MRI of 4 cases showed regional encephalomalacia in the affected occipital lobes(4 cases), slightly hyperintensity on T2 weighted images in the damaged occipital cortex (2 cases), extensive demyelination (1 case), disappearance of hyperintensity of the splenium of corpus callosum (1 case), and persistent hyperintensity in the splenium of corpus callosum (1 case) on T2 weighted images. Conclusion: The findings suggest that posterior parieto-occipital regions are most frequently injured in neonatal period due to severe hypoglycemia. DWI is a useful technique in the early detection and evaluation of hypoglycemic brain injury of neonates. (authors)

  3. Cardiac MRI: evaluation of phonocardiogram-gated cine imaging for the assessment of global und regional left ventricular function in clinical routine

    To validate a phonocardiogram (PCG)-gated cine imaging approach for the assessment of left ventricular (LV) function. In this prospective study, cine MR imaging of the LV was performed twice in 79 patients by using retrospectively PCG- and retrospectively ECG-gated cine SSFP sequences at 1.5 T. End-diastolic volumes (EDV), end-systolic volumes (ESV), stroke volumes (SV), ejection fraction (EF), muscle mass (MM), as well as regional wall motion were assessed. Subgroup analyses were performed for patients with valvular defects and for patients with dysrhythmia. PCG-gated imaging was feasible in 75 (95%) patients, ECG-gating in all patients. Excellent correlations were observed for all volumetric parameters (r > 0.98 for all variables analysed). No significant differences were observed for EDV (-0.24 ± 3.14 mL, P = 0.5133), ESV (-0.04 ± 2.36 mL, P = 0.8951), SV (-0.20 ± 3.41 mL, P = 0.6083), EF (-0.16 ± 1.98%, P = 0.4910), or MM (0.31 ± 4.2 g, P = 0.7067) for the entire study cohort, nor for either of the subgroups. PCG- and ECG-gated cine imaging revealed similar results for regional wall motion analyses (115 vs. 119 segments with wall motion abnormalities, P = 0.3652). The present study demonstrates that PCG-gated cine imaging enables accurate assessment of global and regional LV function in the vast majority of patients in clinical routine. (orig.)

  4. Cardiac MRI: evaluation of phonocardiogram-gated cine imaging for the assessment of global und regional left ventricular function in clinical routine

    Nassenstein, Kai; Schlosser, Thomas [University Hospital Essen, Department of Diagnostic and Interventional Radiology and Neuroradiology, Essen (Germany); Orzada, Stephan [University Duisburg-Essen, Erwin L. Hahn Institute for Magnetic Resonance Imaging, Essen (Germany); Haering, Lars; Czylwik, Andreas [University Duisburg-Essen, Department of Communication Systems, Duisburg (Germany); Zenge, Michael; Mueller, Edgar [Siemens Healthcare, Erlangen (Germany); Eberle, Holger; Bruder, Oliver [Elisabeth Hospital Essen, Department of Cardiology and Angiology, Essen (Germany); Ladd, Mark E.; Maderwald, Stefan [University Hospital Essen, Department of Diagnostic and Interventional Radiology and Neuroradiology, Essen (Germany); University Duisburg-Essen, Erwin L. Hahn Institute for Magnetic Resonance Imaging, Essen (Germany)

    2012-03-15

    To validate a phonocardiogram (PCG)-gated cine imaging approach for the assessment of left ventricular (LV) function. In this prospective study, cine MR imaging of the LV was performed twice in 79 patients by using retrospectively PCG- and retrospectively ECG-gated cine SSFP sequences at 1.5 T. End-diastolic volumes (EDV), end-systolic volumes (ESV), stroke volumes (SV), ejection fraction (EF), muscle mass (MM), as well as regional wall motion were assessed. Subgroup analyses were performed for patients with valvular defects and for patients with dysrhythmia. PCG-gated imaging was feasible in 75 (95%) patients, ECG-gating in all patients. Excellent correlations were observed for all volumetric parameters (r > 0.98 for all variables analysed). No significant differences were observed for EDV (-0.24 {+-} 3.14 mL, P = 0.5133), ESV (-0.04 {+-} 2.36 mL, P = 0.8951), SV (-0.20 {+-} 3.41 mL, P = 0.6083), EF (-0.16 {+-} 1.98%, P = 0.4910), or MM (0.31 {+-} 4.2 g, P = 0.7067) for the entire study cohort, nor for either of the subgroups. PCG- and ECG-gated cine imaging revealed similar results for regional wall motion analyses (115 vs. 119 segments with wall motion abnormalities, P = 0.3652). The present study demonstrates that PCG-gated cine imaging enables accurate assessment of global and regional LV function in the vast majority of patients in clinical routine. (orig.)

  5. Spirometer-controlled cine magnetic resonance imaging to diagnose tracheobronchomalacia in pediatric patients

    Ciet, Pierluigi; Wielopolski, Piotr; Manniesing, Rashindra; Lever, Sandra; de Bruijne, Marleen; Morana, Giovanni; Muzzio, Pier Carlo; Lequin, Maarten H.; Tiddens, Harm A.W.M.

    2014-01-01

    Tracheobronchomalacia (TBM) is defined as an excessive collapse of the intrathoracic trachea. Bronchoscopy is the gold standard to diagnose TBM, but bronchoscopy has major disadvantages, such as general anaesthesia. Cine-CT is a non-invasive alternative to diagnose TBM, but its use in children is...... restricted by ionizing radiation. Our aim was to evaluate the feasibility of spirometer-controlled cine-MRI as alternative to cine-CT in a retrospective study.12 children (mean 12 years, range 7-17), suspected to have TBM, underwent cine-MRI. Static scans were acquired at end-inspiration and expiration...... covering the thorax using a 3D SPGR sequence. 3D-Dynamic-scans were performed covering only the central airways. TBM was defined as a decrease of the trachea or bronchi diameter greater than 50% at end-expiration in the static and dynamic scans.The success rate of the cine-MRI protocol was 92%. Cine...

  6. Cerebellar ataxia of early onset. Clinical symptoms and MRI findings

    Yamashita, Sumimasa; Miyake, Shota; Yamada, Michiko; Iwamoto, Hiroko (Kanagawa Children' s Medical Center, Yokohama (Japan)); Yamada, Kazuhiko

    1989-07-01

    Eight cases of childhood cerebellar ataxia were reported. All these cases showed chronic cerebellar ataxia with early onset, and the other diseases of cerebellum such as infections, neoplasms and storage diseases were excluded by clinical symptoms and laboratory findings including blood counts, blood chemistry, lactate, pyruvate, ceruloplasmine, urinalysis, serum immunoglobulins, amino acid analysis in blood and urine, CSF analysis, leukocyte lysosomal enzymes, MCV, EMG, EEG and brain X-CT. Two pairs of siblings were included in this study. The clinical diagnosis were cerebellar type (5), spinocerebellar type (1), one Marinesco-Sjoegren syndrome and undetermined type (1). The age of onset was 1 to 5 years. The chief complaint was motor developmental delay in 6 cases; among them 5 patients could walk alone at the ages of 2 to 3 years'. Mental retardation was observed in 7 cases and epilepsy in 2. TRH was effective in 5 cases. The MRI study revealed that the area of medial sagittal slice of the cerebellum was reduced significantly in all cases and also that of pons was reduced in 5 cases. Different from typical adult onset spinocerebellar degenerations, most of the present cases have achieved slow developmental milestones and the clinical course was not progressive. Genetic factors are suspected in the pathogenesis of this disease in some cases. (author).

  7. [Cerebellar ataxia of early onset: clinical symptoms and MRI findings].

    Yamashita, S; Miyake, S; Yamada, M; Iwamoto, H; Yamada, K

    1989-07-01

    Eight cases of childhood cerebellar ataxia were reported. All these cases showed chronic cerebellar ataxia with early onset, and the other diseases of cerebellum such as infections, neoplasms and storage diseases were excluded by clinical symptoms and laboratory findings including blood counts, blood chemistry, lactate, pyruvate, ceruloplasmin, urinalysis, serum immunoglobulins, amino acid analysis in blood and urine, CSF analysis, leukocyte lysosomal enzymes, MCV, EMG, EEG and brain X-CT. Two pairs of siblings were included in this study. The clinical diagnosis were cerebellar type (5), spinocerebellar type (1), one Marinesco-Sjögren syndrome and undetermined type (1). The age of onset was 1 to 5 years. The chief complaint was motor developmental delay in 6 cases; among them 5 patients could walk alone at the ages of 2 to 3 years'. Mental retardation was observed in 7 cases and epilepsy in 2. TRH was effective in 5 cases. The MRI study revealed that the area of medial sagittal slice of the cerebellum was reduced significantly in all cases and also that of pons was reduced in 5 cases. Different from typical adult onset spinocerebellar degenerations, most of the present cases have achieved slow developmental milestones and the clinical course was not progressive. Genetic factors are suspected in the pathogenesis of this disease in some cases. PMID:2789855

  8. MRI and radiographic findings in Currarino`s triad

    Pfluger, T. [Dept. of Radiology, Klinikum Innenstadt, Muenchen Univ. (Germany); Czekalla, R. [Dept. of Radiology, Klinikum Innenstadt, Muenchen Univ. (Germany); Koletzko, S. [Dept. of Pediatrics, Klinikum Innenstadt, Muenchen Univ. (Germany); Muensterer, O. [Dept. of Radiology, Klinikum Innenstadt, Muenchen Univ. (Germany); Willemsen, U.F. [Dept. of Radiology, Klinikum Innenstadt, Muenchen Univ. (Germany); Hahn, K. [Dept. of Radiology, Klinikum Innenstadt, Muenchen Univ. (Germany)

    1996-08-01

    Currarino`s triad is a rare complex of a congential sacral bony abnormality, anorectal malformation and a presacral mass. Intractable constipation since birth is the leading symptom of this triad, which follows an autosomal dominant mode of heredity. We report conventional radiographic and MR findings in one family consisting of a mother and her two daughters. In all three cases, radiography revealed an abnormality of the os sacrum, the so-called scimitar sacrum. MR examination, undertaken next in our institution, was applied with T1-, T2- and proton density weighted sequences in all three orientations before and after i.v. application of gadolinium diethylene-triamine-pentaacetic acid (Gd-DTPA). In two patients we were able to diagnose the complete form of the triad and in one patient an incomplete form. In any case of a radiographically diagnosed scimitar sacrum in combination with constipation. Currarino`s triad should be considered. MRI, as the method of choice, should be the next step to detect a presacral mass and any anomalies of the spinal canal. The importance of early recognition lies in the high morbidity and mortality rates resulting from this disorder. (orig.)

  9. Cine magnetic resonance imaging in congenital heart disease

    Cine magnetic resonance imaging (MRI) was performed in 33 patients aged 19 days to 18 years (mean 5.1 years), who had congenital heart disease comfirmed at echocardiography or angiography. Prior to cine MRI, gated MRI with spin echo (SE) sequence was perfomed to evaluate cardiac structure. Cine MRI was demonstrated by fast low fip angle shot imaging technique with a 30 deg flip angle, 15 msec echo time, 30∼40 msec pulse repetition time, and 128X128 acquisition matrix. Abnormalities of cardiac structure were extremely well defined in all patients. Intracardiac and intravasucular blood flow were visualized with high signal intensity area, whereas ventricular filling flow and left to right shunt flow through ventricular septal defect and atrial septal defect were visualized with low signal intensity area. However, in the patients who had severe congestive heart failure or respiratory arrhythmia, the good recording of cine MRI was not obtained because of artifacts. Gated MRI with SE sequence provides excellent visualization of fine structures, and cine MRI can provide high spatial resolution imaging of flow dynamic in a variety of congenital heart disease, noninvasively. (author)

  10. CT and MRI findings of calcified spinal meningiomas: correlation with pathological findings

    This study was designed to present characteristic CT and MR findings of calcified spinal meningiomas that correlate with pathological findings and to assess the efficacy of CT for the detection of calcifications within a mass in comparison to MRI. Between 1998 and 2009, 10 out of 11 patients who had pathologically confirmed psammomatous meningiomas showed gross calcifications on CT images and were included in this study. On CT scans of the 10 patients, the distribution pattern, morphology and number of calcifications within masses were evaluated. MRI was performed in seven patients and signal intensities of masses were assessed. The pathological results analyzed semi-quantitatively were compared with the density or the size of calcifications within a mass as seen on a CT scan. Seven of 10 masses were located at the thoracic spine level. Eight masses had intradural locations. The other two masses had extradural locations. Four masses were completely calcified based on standard radiographs and CT. Symptoms duration, the size of the mass and size or number of calcifications within a mass had no correlation. The location, size, and distribution pattern of calcifications within masses were variable. On MR images, signal intensity of calcified tumor varied on all imaging sequences. All the masses enhanced after injection of intravenous contrast material. A calcified meningioma should be first suggested when extradural or intradural masses located in the spine contain calcifications regardless of the size or pattern as depicted on CT, especially in the presence of enhancement as seen on MR images. (orig.)

  11. CT and MRI findings of calcified spinal meningiomas: correlation with pathological findings

    Lee, Ji Won; Kim, Hak Jin [Pusan National University Hospital, Department of Radiology, Busan (Korea); Pusan National University School of Medicine, Medical Research Institute, Busan (Korea); Lee, In Sook [Pusan National University Hospital, Department of Radiology, Busan (Korea); Pusan National University School of Medicine, Medical Research Institute, Busan (Korea); Pusan National University School of Medicine, Department of Radiology, Busan (Korea); Choi, Kyung-Un [Pusan National University School of Medicine, Medical Research Institute, Busan (Korea); Pusan National University Hospital, Department of Pathology, Busan (Korea); Lee, Young Hwan [Catholic University of Daegu School of Medicine, Department of Radiology, Daegu (Korea); Yi, Jae Hyuck [Kyungpook National University Hospital, Department of Radiology, Daegu (Korea); Song, Jong Woon [Inje University Pusan Paik Hospital, Department of Radiology, Busan (Korea); Suh, Kyung Jin [Dongguk University Gyungju Hospital, College of Medicine, Dongguk University, Department of Radiology, Gyungju (Korea)

    2010-04-15

    This study was designed to present characteristic CT and MR findings of calcified spinal meningiomas that correlate with pathological findings and to assess the efficacy of CT for the detection of calcifications within a mass in comparison to MRI. Between 1998 and 2009, 10 out of 11 patients who had pathologically confirmed psammomatous meningiomas showed gross calcifications on CT images and were included in this study. On CT scans of the 10 patients, the distribution pattern, morphology and number of calcifications within masses were evaluated. MRI was performed in seven patients and signal intensities of masses were assessed. The pathological results analyzed semi-quantitatively were compared with the density or the size of calcifications within a mass as seen on a CT scan. Seven of 10 masses were located at the thoracic spine level. Eight masses had intradural locations. The other two masses had extradural locations. Four masses were completely calcified based on standard radiographs and CT. Symptoms duration, the size of the mass and size or number of calcifications within a mass had no correlation. The location, size, and distribution pattern of calcifications within masses were variable. On MR images, signal intensity of calcified tumor varied on all imaging sequences. All the masses enhanced after injection of intravenous contrast material. A calcified meningioma should be first suggested when extradural or intradural masses located in the spine contain calcifications regardless of the size or pattern as depicted on CT, especially in the presence of enhancement as seen on MR images. (orig.)

  12. Cowper's syringocele: diagnosis based on MRI findings

    Kickuth, Ralph; Laufer, Ulf; Kirchner, Tilmann Heinrich; Herbe, Eva; Kirchner, Johannes [Department of Radiology, Marienhospital Herne, University of Bochum, Herne (Germany); Pannek, Juergen [Department of Urology, Marienhospital Herne, University of Bochum, Herne (Germany)

    2002-01-01

    An 8-year-old boy presenting with intermittent haematuria and dysuria was investigated with voiding cystourethrography (VCUG), urethroscopy and perineal MRI. VCUG and urethroscopy did not provide a definitive diagnosis, while MRI clearly demonstrated a homogeneous, oval cystic lesion extending from the bulbourethral glands and slightly impressing the bulbous urethra. The patient was found to have an imperforate Cowper's syringocele. Treatment consisted of marsupialisation and the patient became symptom free. To the authors' knowledge, this is the first description of the MRI characteristics of an imperforate Cowper's syringocele in a paediatric patient. (orig.)

  13. Cerebral CT and MRI findings in cervicocephalic artery dissection

    Pelkonen, O.; Tikkakoski, T.; Pyhtinen, J.; Sotaniemi, K. [Oulu Univ. Hospital (Finland). Dept. of Diagnostic Radiology

    2004-05-01

    PURPOSE: To explore the frequency and patterns of brain infarction and other brain manifestations in cervicocephalic artery dissection (CCAD) and to evaluate the correlation between vessel wall findings and infarctions. MATERIAL AND METHODS: The medical records and films of 136 consecutive CCAD patients diagnosed in Oulu Univ. Hospital during the 20-year period since 1982 were reviewed. Five patients with no brain imaging were excluded. RESULTS: One-hundred-and-twenty-seven patients underwent cerebral CT and four patients MRI. Brain infarction was detected in 73 patients (56%), 43 of whom had cerebral infarction associated with anterior circulation dissection and 30 cerebellar infarction associated with posterior circulation dissection. Occlusion of the dissected vessel was accompanied by infarction in 76%, irregular stenosis in 40%, and other findings in 12%. Of the anterior circulation infarctions, territorial and subcortical infarctions and territorial infarctions with fragmentation, which are considered embolic, accounted for 95%, while only 5% were in the watershed area and considered hemodynamic. Intracranial posterior circulation dissection rarely caused infarction (in 1/11 of the dissected vessels), whereas intracranial anterior circulation dissection resulted in infarction more commonly (9/12). Altogether 23% of patients with intracranial CCAD had subarachnoid hemorrhage. Hemorrhagic transformation was present in five patients. CONCLUSIONS: More than half of CCAD patients have cerebral or cerebellar infarction at CT or conventional MR imaging. Occlusion of the dissected vessel is accompanied by infarction more often than other vessel wall abnormalities. Most cerebral infarctions caused by arterial dissections are of embolic origin. Intracranial dissections cause subarachnoid hemorrhage in more than 20% of patients.

  14. Conventional MRI Finding in a Case of Adhesive Shoulder Capsulitis

    To evaluate the conventional magnetic resonance image findings in patients with adhesive shoulder capsulitis. The preoperative MR images of 76 patients with adhesive shoulder capsulitis that was also treated by arthroscopic capsule release. In contrast to the MR images of 25 control patients without adhesive shoulder capsulitis, the thickness and area of hyposignal intensity around the coracohumeral ligament (CHL), subcoracoidal fat, capsular thickness of the rotator interval, capsular thickness, and height of the axillary recess were measured. The existence of fluid in the axillary recess was also verified. Patients with adhesive capsulitis showed a significant increase in the thickness (average 10.57 mm vs. 5.88 mm, T=8.289, p<0.001), area (average 3.49 point vs. 0.96 point Z=7.775, p< 0.001) of hyposignal intensity around CHL, and a thickened joint capsule in the rotator interval (average 5.93 mm vs. 2.15 mm, Z=6.472, p< 0.001). The thickness of the hyposignal intensity around the CHL is about 10 mm or more and has a specificity of 96%, a sensitivity of about 55% in the area of hyposignal intensity from around the CHL, Seventy-five percent or more of cases, showed a 100%, 95%, complete obliteration of the subcoracoidal fat that was 96%, and a 50% thickness of the capsule. A rotator interval of 6mm or more had a 96%, 50% for the diagnosis of adhesive capsulitis of the shoulder. The capsular thickness and maximal height of axillary recess and the presence of fluid in the axillary recess was not significant in patients with adhesive shoulder capsulitis. Thickening of the hyposignal intensity around the CHL, subcoracoidal fat obliteration, and capsular thickening at the rotator interval, are characteristic MRI findings in adhesive shoulder capsulitis

  15. Conventional MRI Finding in a Case of Adhesive Shoulder Capsulitis

    Park, Hak Hoon [Yeosu Hanyeoexpo Hospital, Yeosu (Korea, Republic of); Back, Chang Hee [Yeosu Baek Hospital, Yeosu (Korea, Republic of)

    2010-02-15

    To evaluate the conventional magnetic resonance image findings in patients with adhesive shoulder capsulitis. The preoperative MR images of 76 patients with adhesive shoulder capsulitis that was also treated by arthroscopic capsule release. In contrast to the MR images of 25 control patients without adhesive shoulder capsulitis, the thickness and area of hyposignal intensity around the coracohumeral ligament (CHL), subcoracoidal fat, capsular thickness of the rotator interval, capsular thickness, and height of the axillary recess were measured. The existence of fluid in the axillary recess was also verified. Patients with adhesive capsulitis showed a significant increase in the thickness (average 10.57 mm vs. 5.88 mm, T=8.289, p<0.001), area (average 3.49 point vs. 0.96 point Z=7.775, p< 0.001) of hyposignal intensity around CHL, and a thickened joint capsule in the rotator interval (average 5.93 mm vs. 2.15 mm, Z=6.472, p< 0.001). The thickness of the hyposignal intensity around the CHL is about 10 mm or more and has a specificity of 96%, a sensitivity of about 55% in the area of hyposignal intensity from around the CHL, Seventy-five percent or more of cases, showed a 100%, 95%, complete obliteration of the subcoracoidal fat that was 96%, and a 50% thickness of the capsule. A rotator interval of 6mm or more had a 96%, 50% for the diagnosis of adhesive capsulitis of the shoulder. The capsular thickness and maximal height of axillary recess and the presence of fluid in the axillary recess was not significant in patients with adhesive shoulder capsulitis. Thickening of the hyposignal intensity around the CHL, subcoracoidal fat obliteration, and capsular thickening at the rotator interval, are characteristic MRI findings in adhesive shoulder capsulitis

  16. Cine magnetic resonance imaging for evaluation of cardiac structure and flow dynamics in congenital heart disease

    Cine magnetic resonance imaging (Cine MRI) was performed in 20 patients aged 19 days to 13 years (mean 4.0 years), who had congenital heart disease confirmed at echocardiography or angiography. Prior to cine MRI, gated MRI was performed to evaluate for cardiac structure. Cine MRI was demonstrated by fast low fip angle shot imaging technique with a 30deg flip angle, 15 msec echo time, 30-40 msec pulse repetition time, and 128 x 128 acquisition matrix. Abnormalities of cardiac structure were extremely well defined in all patients by gated MRI. Intracardiac or intravascular blood flow were visualized in 17 (85%) of 20 patients by cine MRI. Left to right shunt flow through ventricular septal defect, atrial septal defect, and endocardial cushion defect were visualized with low signal intensity area. Low intensity jets flow through the site of re-coarctation of the aorta were also visualized. However, the good recording of cine MRI was not obtained because of artifacts in 3 of 20 patients (15%) who had severe congestive heart failure or respiratory arrhythmia. Gated MRI provides excellent visualization of fine structure, and cine MRI can provide high spatial resolution imaging of flow dynamic in a variety of congenital heart disease, noninvasively. (author)

  17. Left-ventricular reduction surgery: pre- and postoperative evaluation by cine magnetic resonance imaging

    Aim: To evaluate the role of cine magnetic resonance imaging (MRI) in the preoperative assessment and postoperative follow-up of patients undergoing left ventricular (LV) reduction surgery. Patients and Methods: 6 patients with cardiomegaly were examined on a 1.5 T MR imager before and after LV reduction surgery. The heart was imaged along the short and long axes using a breath-hold ECG-triggered cine gradient-echo sequence for assessing ventricular and valvular morphology and function and performing volumetry (end-diastolic and end-systolic volumes, ejection fraction). Results: Postoperatively, the mean ejection fraction increased from 21.7% to 33.4% and the enddiastolic and end-systolic left ventricular volumes decreased in all patients (304.0 and 252.5 ml before to 205.0 and 141.9 ml after surgery). Mean myocardial mass decreased slightly from 283.8 g to 242.7 g. Differences were significant for all parameters (p<0.05). MRI allowed for the reliable assessment of postoperative valve morphology and yielded additional findings such as the presence of mitral valve insufficiency or ventricular thrombus. Conclusions: Cine MRI provides relevant information prior to left ventricular reduction surgery and reliably depicts functional and morphological changes in the early postoperative follow-up. (orig.)

  18. MRI spectrum of findings in lumbosacral epidural lipomatosis

    Lumbosacral epidural lipomatosis (LEL) has been defined as a disease produced by excessive fat deposition within the spinal canal. In the pre MRI-era, this entity has been commonly overlooked. While a mild (or moderate) epidural fat hypertrophy is basically asymptomatic, severe LEL represents the symptomatic end-stage of this disease, conducing in many cases to surgical fat debulking. Since LEL may be concurrent with other substantial spinal abnormalities (e.g. disk herniation) MRI exams may increase our awareness of this condition to avoid its underestimation. MRI enables a reliable LEL characterization and may show its eventual reversibility in obese or corticosteroid receiving patients. This pictorial essay illustrates the usefulness of MRI to demonstrate the ongoing process of epidural fat accumulation in mild, moderate and severe LEL. The different morphologic patterns of the thecal sac produced by advanced LEL are analyzed. LEL and concurrent spinal disorders with superimposed neurological symptoms and signs are illustrated. (author)

  19. MRI and SPECT findings in amyotrophic lateral sclerosis

    MRI was performed in 21 patients and single photon emission computed tomography (SPECT) with N-isopropyl-p-123I iodoamphetamine in 16 patients, to visualize upper motor neurone lesions in amyotrophic lateral sclerosis. T2-weighted MRI revealed high signal along the course of the pyramidal tract in the internal capsule and cerebral peduncle in 4 of 21 patients. SPECT images were normal in 4 patients, but uptake was reduced in the cerebral cortex that includes the motor area in 11. (orig.)

  20. Digital cine-imaging

    Digitization of fluoroscopic images has been developed for the digital cine imaging system as a result of the computer technology, television technology, and popularization of interventional radiology. Present digital cine imaging system is able to offer images similar to cine film because of the higher operatability and better image quality with the development of interventional radiology. As a result, its higher usefulness for catheter diagnosis examination except for interventional radiology was reported, and the possibility of having filmless cine is close to becoming a reality. However several problems have been pointed out, such as spatial resolution, time resolution, storage and exchangeability of data, disconsolidated viewing functions, etc. Anyhow, digital cine imaging system has some unresolved points and lots the needs to be discussed. The tendency of digitization is the passage of the time and we have to promote a study for more useful digital cine imaging system in team medical treatment which centers on the patients. (author)

  1. Neurotuberculosis: Hallazgos intracraneanos en RM / Neurotuberculosis: Intracranial MRI findings

    Jorge, Docampo; Carolina, Mariluis; Nadia, Gonzlez; Carlos, Morales; Claudio, Bruno.

    2012-06-01

    Full Text Available Objetivos. Mostrar nuestra casustica de pacientes con diagnstico de tuberculosis intracraneana y describir los diferentes tipos de lesiones documentadas en Resonancia Magntica (RM) que caracterizan a esta entidad. Materiales y Mtodos. Para el presente trabajo fueron seleccionados, de forma retro [...] spectiva, 20 pacientes con hallazgos positivos de tuberculosis intracraneana. Doce eran de sexo masculino y 8 de sexo femenino, con un rango etario de 8 meses a 49 aos de edad (edad media: 21 aos). El diagnstico clnico fue realizado con puncin lumbar y cultivo de LCR. Once pacientes presentaron serologa positiva para VIH. Las RM fueron realizadas en resonadores de 0.5T y 1.5T, complementadas en dos casos con Tomografa Computada (TC) de cerebro. A dos pacientes se les realiz difusin (DWI) y a un paciente espectroscopa. Resultados. Del total de pacientes (n=20), 14 presentaron compromiso subaracnoideo en la convexidad y 13 compromiso subaracnoideo cisternal basal (afectacin leptomenngea). En 13 se observaron tuberculomas y 11 presentaron angetis de grandes vasos; mientras que 7 tuvieron angetis de pequeos vasos, 7 hidrocefalia, 6 infartos parenquimatosos y 1 afectacin paquimenngea. Quince pacientes tenan lesiones combinadas. Conclusin. La localizacin ms frecuente de neurotuberculosis en esta serie fue menngea con compromiso leptomenngeo (14 pacientes con afectacin subaracnoidea, seguido de afectacin cisternal en 13 pacientes) y slo en un caso fue paquimenngea. La manifestacin parenquimatosa ms frecuente fue el tuberculoma (granulomas tuberculosos) con 13 casos. De estos, 5 presentaron un patrn miliar y slo uno comportamiento pseudotumoral. Abstract in english Purposes. To report our case series of patients with a diagnosis of intracranial tuberculosis and to describe the different types of lesions characterizing this entity on Magnetic Resonance Imaging (MRI). Materials and Methods. For the present study, we retrospectively selected 20 patients with posi [...] tive MRI findings of intracranial tuberculosis. Twelve of them were males and 8 were females, with an age range of between 8 months and 49 years (mean age: 21years). Clinical diagnosis was obtained by lumbar puncture and cerebrospinal fluid (CSF) culture. Eleven patients presented positive HIV serology. MRIs were performed using 0.5T and 1.5 T scanners and computed tomography (CT) of the brain was also performed in two patients. Diffusion-weighted technique was performed in two patients and spectroscopy in one patient. Results. Of the total patients studied (n=20), 14 presented convexity subarachnoid involvement and 13 subarachnoid basal cystern involvement (leptomeningeal involvement), 13 presented tuberculomas, 11 large-vessel angiitis, 7 smallvessel angiitis, 7 hydrocephalia, 6 parenchymatous infarction and one pachymeningeal involvement. Combined lesions were observed in 15 patients. Conclusion. The most frequent location of neurotuberculosis in this series was meningeal with leptomeningeal involvement (14 patients with subarachnoid involvement, followed by cysternal involvement in 13 patients), and only one patient had pachymeningeal involvement. The most frequent parenchymatous finding of tuberculosis was tuberculoma in 13 patients, 5 with a miliary pattern and only one with pseudo-tumoral behavior.

  2. Neurotuberculosis: Hallazgos intracraneanos en RM Neurotuberculosis: Intracranial MRI findings

    Jorge Docampo

    2012-06-01

    Full Text Available Objetivos. Mostrar nuestra casuística de pacientes con diagnóstico de tuberculosis intracraneana y describir los diferentes tipos de lesiones documentadas en Resonancia Magnética (RM que caracterizan a esta entidad. Materiales y Métodos. Para el presente trabajo fueron seleccionados, de forma retrospectiva, 20 pacientes con hallazgos positivos de tuberculosis intracraneana. Doce eran de sexo masculino y 8 de sexo femenino, con un rango etario de 8 meses a 49 años de edad (edad media: 21 años. El diagnóstico clínico fue realizado con punción lumbar y cultivo de LCR. Once pacientes presentaron serología positiva para VIH. Las RM fueron realizadas en resonadores de 0.5T y 1.5T, complementadas en dos casos con Tomografía Computada (TC de cerebro. A dos pacientes se les realizó difusión (DWI y a un paciente espectroscopía. Resultados. Del total de pacientes (n=20, 14 presentaron compromiso subaracnoideo en la convexidad y 13 compromiso subaracnoideo cisternal basal (afectación leptomeníngea. En 13 se observaron tuberculomas y 11 presentaron angeítis de grandes vasos; mientras que 7 tuvieron angeítis de pequeños vasos, 7 hidrocefalia, 6 infartos parenquimatosos y 1 afectación paquimeníngea. Quince pacientes tenían lesiones combinadas. Conclusión. La localización más frecuente de neurotuberculosis en esta serie fue meníngea con compromiso leptomeníngeo (14 pacientes con afectación subaracnoidea, seguido de afectación cisternal en 13 pacientes y sólo en un caso fue paquimeníngea. La manifestación parenquimatosa más frecuente fue el tuberculoma (granulomas tuberculosos con 13 casos. De estos, 5 presentaron un patrón miliar y sólo uno comportamiento pseudotumoral.Purposes. To report our case series of patients with a diagnosis of intracranial tuberculosis and to describe the different types of lesions characterizing this entity on Magnetic Resonance Imaging (MRI. Materials and Methods. For the present study, we retrospectively selected 20 patients with positive MRI findings of intracranial tuberculosis. Twelve of them were males and 8 were females, with an age range of between 8 months and 49 years (mean age: 21years. Clinical diagnosis was obtained by lumbar puncture and cerebrospinal fluid (CSF culture. Eleven patients presented positive HIV serology. MRIs were performed using 0.5T and 1.5 T scanners and computed tomography (CT of the brain was also performed in two patients. Diffusion-weighted technique was performed in two patients and spectroscopy in one patient. Results. Of the total patients studied (n=20, 14 presented convexity subarachnoid involvement and 13 subarachnoid basal cystern involvement (leptomeningeal involvement, 13 presented tuberculomas, 11 large-vessel angiitis, 7 smallvessel angiitis, 7 hydrocephalia, 6 parenchymatous infarction and one pachymeningeal involvement. Combined lesions were observed in 15 patients. Conclusion. The most frequent location of neurotuberculosis in this series was meningeal with leptomeningeal involvement (14 patients with subarachnoid involvement, followed by cysternal involvement in 13 patients, and only one patient had pachymeningeal involvement. The most frequent parenchymatous finding of tuberculosis was tuberculoma in 13 patients, 5 with a miliary pattern and only one with pseudo-tumoral behavior.

  3. Dobutamine cine magnetic resonance imaging after myocardial infarction

    Dobutamine Cine MRI is a new diagnostic imaging technique in the pretreatment (revascularization) assessment of myocardial infarction patients. In this issue are reported the result of a comparative study of the diagnostic yield of dobutamine Cine MRI with that of stress echocardiography in the assessment of viable myocardium. A new method for analysis of Cine MR images, employing digital subtraction, aimed at decreasing subjectivity in the quantitative assessment of myocardial wall thickening. Twenty-six patients (21 men and 5 women) with a history of myocardial infarction who were scheduled for revascularization were submitted to stress echocardiography and dobutamine Cine MRI to evaluate contractile recovery of the segments considered akinetic or hypo kinetic at baseline echocardiography. Dobutamine was administered in growing doses (5, 10, 15γ/kg/min). 16 segments of the left ventricle in each patient were considered. In the 416 segments studied, it was found that 307 normo kinetic, 64 scarred and 45 viable segments with stress echocardiography, versus 302 normo kinetic, 83 scarred and 31 viable segments with dobutamine MRI. Three months after revascularization 15 patients were examined to check contractile recovery of the segments considered as viable. Echocardiography had 79% sensitivity and 97% specificity, while Cine MRI had 96% and 86%, respectively. In patients with anteroseptal wall myocardial infarction stress echocardiography had 75% sensitivity and 97% specificity. Echocardiography permits to distinguish viable myocardium and scarred myocardial tissue with good sensitivity and specificity, but Cine MRI performs better. Cine MRI has much higher sensitivity than stress echocardiography and thus makes the technique of choice to evaluate viable myocardium in these sites. The digital subtraction technique is as accurate as manual measurements, but reduces the error rate and permits quicker evaluation, particularly in subendocardial thickening

  4. MRI findings of vascular dementia following hypertensive intracerebral hemorrhage

    This study reviewed 23 patients with vascular dementia following hypertensive intracerebral hemorrhage. There were 12 male and 11 female patients with an age range between 46 and 88 years (median, 62.6 years). They consisted of 9 putaminal, 9 thalamic and 5 recurrent hemorrhages. Vascular dementia was diagnosed by Hasegawa's test for the demented patient. Patients with Hasegawa's score of less than 21.5 were enrolled as dementia. A superconducting magnet MIR system (MRT-50A, 0.5 Tesla) was used. The highest incidence of finding depicted by MRI was cortical atrophy (100%), followed by periventricular high intensity zone (91.3%), periventricular of deep white matter patchy-like high intensity area (73.9%), hydrocephalus and multiple putaminal low intensity spots (52.1%), scattered cortical high intensity area (47.8%) and subdural ring-like high intensity zone (21.7%). Older group of more than 71 years had more frequent multiple putaminal low intensity spots, scattered cortical high intensity area, and relatively frequent hydrocephalus, periventricular high intensity zone, as compared with younger group of less than 69 years. Subdural ring-like high intensity zone was frequently observed in patients with an interval from onset of more than 2 years. Multiple putaminal low intensity spots were frequently seen in patients with less than 1 year's interval. Multiple putaminal low intensity spots and periventricular high intensity zone were more frequently observed in patients with thalamic and recurrent hemorrhages, periventricular or deep white matter patchy-like high intensity areas were seen more frequently in patients with putaminal hemorrhage. Both scattered cortical high intensity area and subdural ring-like high intensity zone were more frequently observed in patients with recurrent hemorrhages. Both hydrocephalus and multiple putaminal low intensity spots were more common in demented patients than predemented patients. (J.P.N.)

  5. Leiomyoma of the sinonasal cavity: CT and MRI findings

    Aim: To determine the computed tomography (CT) and magnetic resonance imaging (MRI) features of leiomyoma of the sinonasal cavity. Materials and methods: Six patients with histology-proven leiomyomas in the sinonasal cavity were retrospectively reviewed. All six patients underwent CT and three patients also underwent MRI. The following imaging features were reviewed: size, margin, CT attenuation, MRI signal intensity, and lesion extent. In addition, the time-intensity curve (TIC) of dynamic contrast-enhanced (DCE) MRI and diffusion-weighted imaging (DWI) were analysed in two patients. Results: All leiomyomas had well-defined margins. The mean size was 36 mm (range 20-51 mm). On unenhanced CT, the lesions appeared isodense to cerebral grey matter in four (67%) and slightly hypodense in two (33%) patients. Leiomyomas appeared isointense On T1-weighted imaging (WI) and slightly hyperintense on T2WI in three patients. The lesions showed moderate contrast enhancement. Two patients underwent DCE MRI, and the TIC showed a rapidly enhancing and slow washout pattern. The mean apparent diffusion coefficient (ADC) value were 1.66 x 10-3 mm2/s and 1.78 x 10-3 mm2/s for the two lesions, respectively. Conclusions: Well-defined, homogeneous, expansile masses without bony erosion are typical features of leiomyoma. Althrough rare, this entity should be included in the differential diagnosis of benign tumours in this region.

  6. Leiomyoma of the sinonasal cavity: CT and MRI findings

    Yang, B.T., E-mail: cjr.yangbentao@vip.163.co [Department of Radiology, Beijing Tongren Hospital, Capital Medical University, Beijing (China); Wang, Z.C.; Xian, J.F.; Hao, D.P.; Chen, Q.H. [Department of Radiology, Beijing Tongren Hospital, Capital Medical University, Beijing (China)

    2009-12-15

    Aim: To determine the computed tomography (CT) and magnetic resonance imaging (MRI) features of leiomyoma of the sinonasal cavity. Materials and methods: Six patients with histology-proven leiomyomas in the sinonasal cavity were retrospectively reviewed. All six patients underwent CT and three patients also underwent MRI. The following imaging features were reviewed: size, margin, CT attenuation, MRI signal intensity, and lesion extent. In addition, the time-intensity curve (TIC) of dynamic contrast-enhanced (DCE) MRI and diffusion-weighted imaging (DWI) were analysed in two patients. Results: All leiomyomas had well-defined margins. The mean size was 36 mm (range 20-51 mm). On unenhanced CT, the lesions appeared isodense to cerebral grey matter in four (67%) and slightly hypodense in two (33%) patients. Leiomyomas appeared isointense On T1-weighted imaging (WI) and slightly hyperintense on T2WI in three patients. The lesions showed moderate contrast enhancement. Two patients underwent DCE MRI, and the TIC showed a rapidly enhancing and slow washout pattern. The mean apparent diffusion coefficient (ADC) value were 1.66 x 10{sup -3} mm{sup 2}/s and 1.78 x 10{sup -3} mm{sup 2}/s for the two lesions, respectively. Conclusions: Well-defined, homogeneous, expansile masses without bony erosion are typical features of leiomyoma. Althrough rare, this entity should be included in the differential diagnosis of benign tumours in this region.

  7. MRI findings in spinal subdural and epidural hematomas

    Braun, Petra [Department of Radiology, Hospital La Plana, Ctra. De Vila-real a Borriana km. 0.5, 12540 Vila-real (Castello) (Spain)], E-mail: PetraBraun@gmx.de; Kazmi, Khuram [Department of Radiology, Penn State Milton S. Hershey Medical Center, 500 University Drive, Hershey, PA 17033 (United States); Nogues-Melendez, Pablo; Mas-Estelles, Fernando; Aparici-Robles, Fernando [Department of Radiology, La Fe Hospital, Avenida Campanar, 21, 46009 Valencia (Spain)

    2007-10-15

    Background: Spinal hematomas are rare entities that can be the cause of an acute spinal cord compression syndrome. Therefore, an early diagnosis is of great importance. Patients and Methods: From 2001 to 2005 seven patients with intense back pain and/or acute progressive neurological deficit were studied via 1.5 T MRI (in axial and sagittal T1- and T2-weighted sequences). Follow-up MRI was obtained in six patients. Results: Four patients showed the MRI features of a hyperacute spinal hematoma (two spinal subdural hematoma [SSH] and two spinal epidural hematoma [SEH]), isointense to the spinal cord on T1- and hyperintense on T2-weighted sequences. One patient had an early subacute SEH manifest as heterogeneous signal intensity with areas of high signal intensity on T1- and T2-weighted images. Another patient had a late subacute SSH with high signal intensity on T1- and T2-weighted sequences. The final patient had a SEH in the late chronic phase being hypointense on T1- and T2-weighted sequences. Discussion: MRI is valuable in diagnosing the presence, location and extent of spinal hematomas. Hyperacute spinal hematoma and the differentiation between SSH and SEH are particular diagnostic challenges. In addition, MRI is an important tool in the follow-up in patients with conservative treatment.

  8. The diagnostic value of cine-MR imaging in diseases of great vessels

    The diagnostic value of cine magnetic resonance imaging (cine-MRI) was evaluated in 10 patients with diseases of great vessels. The parameters necessary to decide the appropriate treatment, such as presence and extension of intimal flap, DeBakey type classification, identification of the entry, differentiation between true and false lumen, and between thrombosis and slow flow were demonstrated in all patients with dissecting aortic aneurysm. However, abdominal aortic branches could not be demonstrated enough by cine-MRI, therefore conventional AOG was necessary to choose the operative procedure in these cases. In patients with thoracic aortic aneurysm (TAA), cine-MRI was valuable in demonstrating both blood flow and thrombus in the lumen of aneurysm, and AOG was thought to be unnecessary in most cases. Cine-MRI is a promising new technique for the evaluation of diseases of great vessels. (author)

  9. Cine phase-contrast MR angiography

    The objective of this paper is to evaluate the usefulness of cine phase-contrast (PC) MR angiography in determining the patency of third ventriculostomies. Ten patients previously treated with a CT-guided stereotaxic third ventriculostomy for internal obstructive hydrocephalus underwent postoperative conventional MR imagining and cine PC MR imaging of cerebrospinal fluid flow. Cine PC imaging was performed to obtain two simultaneous cardiac-gated axial image sets in the inferior third ventricle and the interpeduncular-prepontine cistern. Superior-inferior flow encoding was used with a range of maximum velocity encodings between 5 and 20 cm/sec. Sixteen view through the cardiac cycle were obtained at each section level. In 8 to 10 patients, cine PC techniques unequivocally demonstrated patency of the third ventriculostomy. One patient with a nonfunctioning third ventriculostomy had symptoms and findings of hydrocephalus and required external shunting

  10. Mesenchymal chondrosarcoma of the orbit: CT and MRI findings

    Aim: To describe the computed tomography (CT) and magnetic resonance imaging (MRI) features of orbital mesenchymal chondrosarcomas (MCSs). Materials and methods: Six patients with histology-confirmed MCSs of the orbit were retrospectively reviewed. All six patients underwent CT and MRI. Imaging studies were evaluated for the following: (a) tumour location, (b) configuration, size, and margin, (c) CT attenuation and MRI signal intensity, and (d) secondary manifestations. Additionally, the time–intensity curve (TIC) of dynamic contrast-enhanced (DCE) MRI were analysed in five patients. Results: Two MCSs arose in the right orbit and four in the left orbit. Five MCSs were located in the retrobulbar intraconal space and one in the extraconal space. All the lesions displayed a lobulate configuration and had a well-defined margin. The mean maximum diameter was 25.8 mm (range 15–36 mm). On unenhanced CT, the lesions appeared isodense to grey matter in six patients, with calcifications in five. Two patients showed inhomogeneous, moderate enhancement on enhanced CT. Six MCSs appeared isointense on T1-weighted imaging and heterogeneously isointense on T2-weighted imaging. The lesions showed significantly heterogeneous contrast enhancement. Five patients had DCE MRI and the TICs showed a rapidly enhancing and rapid washout pattern (type III). The following features were also detected: compression of the extra-ocular muscle (six patients, 100%); displacement of the optic nerve (five patients, 83.3%); and encasing globe (three patients, 50%). Conclusions: A well-defined, lobulate orbital mass with calcification on CT and, marked heterogeneous enhancement and type III TIC on MRI are highly suspicious of orbital MCSs.

  11. Tuberous sclerosis: diffusion MRI findings in the brain

    Sener, R.N. [Department of Radiology, Ege University Hospital, Izmir (Turkey)

    2002-01-01

    Diffusion MRI has mainly been used for detection of acute ischemia, and for distinction of cytotoxic and vasogenic edema. We applied diffusion MRI in patients with tuberous sclerosis in order to evaluate diffusion imaging characteristics of parenchymal changes. Five children with known tuberous sclerosis were included in this study. The MRI examinations were performed on a 1.5-T MR unit. Diffusion MRI was obtained using the echo-planar imaging sequence. Apparent diffusion coefficient (ADC) values from the abnormal brain parenchyma were calculated directly from automatically generated ADC maps. Seven normal children were available for comparison. In this control group the mean ADC value of the normal white matter was 0.84{+-}0.12 x 10{sup -3} mm{sup 2}/s. In tuberous sclerosis patients the mean ADC value of the white matter hamartomas (n=20) was apparently high (1.52{+-}0.24 x 10{sup -3} mm{sup 2}/s) compared with that of normal white matter. The ADC value of calcified hamartomas was ''zero''. The ADC value within a giant cell tumor was 0.89 x 10{sup -3} mm{sup 2}/s, similar to that of normal cerebral white matter. The ADC maps were superior to b=1000 s/mm{sup 2} (true diffusion) images with respect to lesion evaluation, and they provided mathematical information on tissue integrity. With respect to detection of the exact numbers and sizes of the parenchymal hamartomas fluid-attenuated inversion recovery images were superior to ADC maps. It is believed that diffusion MRI can be useful in evaluation of various parenchymal changes associated with tuberous sclerosis. Further studies on tuberous sclerosis, and on various brain lesions, would provide increasing data on this relatively new MRI sequence. (orig.)

  12. Tuberous sclerosis: diffusion MRI findings in the brain

    Diffusion MRI has mainly been used for detection of acute ischemia, and for distinction of cytotoxic and vasogenic edema. We applied diffusion MRI in patients with tuberous sclerosis in order to evaluate diffusion imaging characteristics of parenchymal changes. Five children with known tuberous sclerosis were included in this study. The MRI examinations were performed on a 1.5-T MR unit. Diffusion MRI was obtained using the echo-planar imaging sequence. Apparent diffusion coefficient (ADC) values from the abnormal brain parenchyma were calculated directly from automatically generated ADC maps. Seven normal children were available for comparison. In this control group the mean ADC value of the normal white matter was 0.84±0.12 x 10-3 mm2/s. In tuberous sclerosis patients the mean ADC value of the white matter hamartomas (n=20) was apparently high (1.52±0.24 x 10-3 mm2/s) compared with that of normal white matter. The ADC value of calcified hamartomas was ''zero''. The ADC value within a giant cell tumor was 0.89 x 10-3 mm2/s, similar to that of normal cerebral white matter. The ADC maps were superior to b=1000 s/mm2 (true diffusion) images with respect to lesion evaluation, and they provided mathematical information on tissue integrity. With respect to detection of the exact numbers and sizes of the parenchymal hamartomas fluid-attenuated inversion recovery images were superior to ADC maps. It is believed that diffusion MRI can be useful in evaluation of various parenchymal changes associated with tuberous sclerosis. Further studies on tuberous sclerosis, and on various brain lesions, would provide increasing data on this relatively new MRI sequence. (orig.)

  13. Mesenchymal chondrosarcoma of the orbit: CT and MRI findings

    Yang, B.T., E-mail: cjr.yangbentao@vip.163.com [Department of Radiology, Beijing Tongren Hospital, Capital Medical University, Beijing (China); Wang, Y.Z.; Wang, X.Y.; Wang, Z.C. [Department of Radiology, Beijing Tongren Hospital, Capital Medical University, Beijing (China)

    2012-04-15

    Aim: To describe the computed tomography (CT) and magnetic resonance imaging (MRI) features of orbital mesenchymal chondrosarcomas (MCSs). Materials and methods: Six patients with histology-confirmed MCSs of the orbit were retrospectively reviewed. All six patients underwent CT and MRI. Imaging studies were evaluated for the following: (a) tumour location, (b) configuration, size, and margin, (c) CT attenuation and MRI signal intensity, and (d) secondary manifestations. Additionally, the time-intensity curve (TIC) of dynamic contrast-enhanced (DCE) MRI were analysed in five patients. Results: Two MCSs arose in the right orbit and four in the left orbit. Five MCSs were located in the retrobulbar intraconal space and one in the extraconal space. All the lesions displayed a lobulate configuration and had a well-defined margin. The mean maximum diameter was 25.8 mm (range 15-36 mm). On unenhanced CT, the lesions appeared isodense to grey matter in six patients, with calcifications in five. Two patients showed inhomogeneous, moderate enhancement on enhanced CT. Six MCSs appeared isointense on T1-weighted imaging and heterogeneously isointense on T2-weighted imaging. The lesions showed significantly heterogeneous contrast enhancement. Five patients had DCE MRI and the TICs showed a rapidly enhancing and rapid washout pattern (type III). The following features were also detected: compression of the extra-ocular muscle (six patients, 100%); displacement of the optic nerve (five patients, 83.3%); and encasing globe (three patients, 50%). Conclusions: A well-defined, lobulate orbital mass with calcification on CT and, marked heterogeneous enhancement and type III TIC on MRI are highly suspicious of orbital MCSs.

  14. MRI findings of the knee in rheumatoid arthritis

    The studies were done to know in what extent MRI can image the pannus invasion and cysts in the subcartilagious tissues which are not revealed by the scout roentgenogram and how the synovial membrane can be enhanced by gadolinium-DTPA (Gd-DTPA). Twenty five knees in rheumatoid arthritis of 21 patients, mean age of 57.8 years, were subjected to the studies. Thirteen knees were in Larsen grade 0, 3 in grade I, 4 in grade II, 2 in grade III and 3 in grade IV, whose osteolytic degree were small. MRI system was 0.5 Tesla superconducting Toshiba MRT50A. Imaging was performed by the field echo method with 4 mm-thick slice of T1, T2 weighted images of sagittal and frontal sections, and 5 min after intravenous injection of Gd-DTPA, of T1 weighted images of frontal and sagittal sections. Subcartilagious cysts not detectable on the scout roentgenogram were found in 13 knees (52%) on the MRI image. MRI after Gd-DTPA gave the enhanced images of surroundings of joint capsule in 15 cases, of dotted or reticular synovial membrane in 2 and of joint capsule surroundings with dotted membrane in 2. One case showed no enhancement. MRI was thus found useful for detection of cysts and pannus in the early knee rheumatoid arthritis with insignificant osteolysis. MRI after Gd-DTPA enhanced the surroundings of joint capsule in most cases, and in some cases, the synovial membrane in a dotted or reticular manner, which was considered to show the dilated blood vessels or necrotic coagulations of synovial villi. (H.O.)

  15. Cardiac cine MRI: Comparison of 1.5 T, non-enhanced 3.0 T and blood pool enhanced 3.0 T imaging

    Introduction: Cardiac cine imaging using balanced steady state free precession sequences (bSSFP) suffers from artefacts at 3.0 T. We compared bSSFP cardiac cine imaging at 1.5 T with gradient echo imaging at 3.0 T with and without a blood pool contrast agent. Materials and methods: Eleven patients referred for cardiac cine imaging underwent imaging at 1.5 T and 3.0 T. At 3.0 T images were acquired before and after administration of 0.03 mmol/kg gadofosveset. Blood pool signal-to-noise ratio (SNR), temporal variations in SNR, ejection fraction and myocardial mass were compared. Subjective image quality was scored on a four-point scale. Results: Blood pool SNR increased with more than 75% at 3.0 T compared to 1.5 T (p < 0.001); after contrast administration at 3.0 T SNR increased with 139% (p < 0.001). However, variations in blood pool SNR at 3.0 T were nearly three times as high versus those at 1.5 T in the absence of contrast medium (p < 0.001); after contrast administration this was reduced to approximately a factor 1.4 (p = 0.21). Saturation artefacts led to significant overestimation of ejection fraction in the absence of contrast administration (1.5 T: 44.7 ± 3.1 vs. 3.0 T: 50.7 ± 4.2 [p = 0.04] vs. 3.0 T post contrast: 43.4 ± 2.9 [p = 0.55]). Subjective image quality was highest for 1.5 T (2.8 ± 0.3), and lowest for non-enhanced 3.0 T (1.7 ± 0.6; p = 0.006). Conclusions: GRE cardiac cine imaging at 3.0 T after injection of the blood pool agent gadofosveset leads to improved objective and subjective cardiac cine image quality at 3.0 T and to the same conclusions regarding cardiac ejection fraction compared to bSSFP imaging at 1.5 T

  16. Symptomatic ring-shaped lateral meniscus. MRI findings.

    Koukoulias, Nikolaos E; Papastergiou, Stergios G

    2011-01-01

    Ring-shaped lateral meniscus is a rare clinical entity that is usually asymptomatic. Moreover, diagnosis is always based on arthroscopic exploration of lateral meniscus. MRI has not been proven useful so far because the inner portion of the ring-shaped lateral meniscus is usually misinterpreted as a bucket-handle tear. The authors report a case of a 16-year-old girl with ring-shaped lateral meniscus in combination with a meniscal cyst. MRI demonstrated a cyst arising from lateral meniscus and...

  17. MRI findings with periventricular leukomalacia. Correlation with neurological development

    Uehara, Hisakazu; Yoshioka, Hiroshi; Hasegawa, Koh; Doi, Yasuo; Matsuo, Yasutaka; Murata, Miyuki; Sawada, Tadashi [Kyoto Prefectural Univ. of Medicine (Japan); Kotani, Hiromi; Goma, Hideyo

    1998-08-01

    In 22 infants with PVL, who were born at 35 weeks gestational age or less, correlation between severity of white matter lesions on MRI and developmental quotient (DQ) of infants was studied. MRI was obtained later than 7 months of age and the severity of white matter lesions was classified as follows: Group I: periventricular white matter is focally affected (n=7), Group II: periventricular white matter is diffusely affected (n=10), and Group III: subcortical white matter is also affected (n=5). Perinatal characteristics including gestational weeks, birth weight, Apgar score, procedure of delivery, and duration of mechanical ventilation revealed no significant differences between the groups. Seventeen infants developed cerebral palsy, while the other 5 infants (4 in Group I, 1 in Group II) showed normal development at 1 year of age, MRI of 4 among these 5 infants only revealed unilateral cysts around the anterior horn of lateral ventricles. Enjoji developmental test showed significant differences in gross motor DQ between Group I and III at both 1 and 2 corrected ages. Although more quantitative criteria will be required for precise classification, it is suggested that the severity of the white matter lesions on MRI is well correlated with gross motor development in PVL. (author)

  18. MRI findings with periventricular leukomalacia. Correlation with neurological development

    In 22 infants with PVL, who were born at 35 weeks gestational age or less, correlation between severity of white matter lesions on MRI and developmental quotient (DQ) of infants was studied. MRI was obtained later than 7 months of age and the severity of white matter lesions was classified as follows: Group I: periventricular white matter is focally affected (n=7), Group II: periventricular white matter is diffusely affected (n=10), and Group III: subcortical white matter is also affected (n=5). Perinatal characteristics including gestational weeks, birth weight, Apgar score, procedure of delivery, and duration of mechanical ventilation revealed no significant differences between the groups. Seventeen infants developed cerebral palsy, while the other 5 infants (4 in Group I, 1 in Group II) showed normal development at 1 year of age, MRI of 4 among these 5 infants only revealed unilateral cysts around the anterior horn of lateral ventricles. Enjoji developmental test showed significant differences in gross motor DQ between Group I and III at both 1 and 2 corrected ages. Although more quantitative criteria will be required for precise classification, it is suggested that the severity of the white matter lesions on MRI is well correlated with gross motor development in PVL. (author)

  19. MRI findings in the upper cervical spine of rheumatoid arthritis

    Kawaida, Hidefumi; Sakou, Takashi; Morizono, Yoshiyuki; Yoshikuni, Nagatoshi; Taketomi, Eiji; Hashiguchi, Masanao

    1989-04-01

    In 55 patients with rheumatoid arthritis associated with upper cervical spine abnormality, the presence or absence of medullary and upper cervical pressures was examined on sagittal MRI scans. Atlanto-dental anterior incomplete dislocation and horizontal dislocation were imaged concurrently with X-rays. For horizontal dislocation, an abnormal Redlund-Johnell value and a Ranawat value of 7 mm or less were always associated with medullary pressure as seen on MRI. For anterior incomplete dislocation, upper cervical pressure was always associated when a space available for the spinal cord was 13 mm or less or frequently associated when the atlanto-dental interval was 8 mm or more. Many of the patients with the upper cervical abnormalities complained of occipital or cervical pain. The pain was always encountered in patients with an abnormal Redlund-Johnell value. Roentgenography of the cervical spine confirmed MRI-proven medullary or upper cervical pressure, suggesting the potential of MRI in the treatment of rheumatoid arthritis. (Namekawa, K).

  20. Transient neonatal hypoglycemia: cranial US and MRI findings

    A case of transient neonatal hypoglycemia with patchy hyperechogenic white matter abnormalities in the frontal and parietooccipital lobes on cranial US is presented. An MRI examination revealed T1 and T2 shortening of the lesions in the occipital and frontal white matter. Follow-up cranial US demonstrated recovery of white matter changes in the patient with normal neurological outcome. (orig.)

  1. Transient neonatal hypoglycemia: cranial US and MRI findings

    Cakmakci, H.; Usal, C.; Karabay, N.; Kovanlikaya, A. [Dept. of Radiology, Dokuz Eyluel Univ., Izmir (Turkey)

    2001-12-01

    A case of transient neonatal hypoglycemia with patchy hyperechogenic white matter abnormalities in the frontal and parietooccipital lobes on cranial US is presented. An MRI examination revealed T1 and T2 shortening of the lesions in the occipital and frontal white matter. Follow-up cranial US demonstrated recovery of white matter changes in the patient with normal neurological outcome. (orig.)

  2. MRI findings of eosinophilic myelomeningoencephalitis due to Angiostrongylus cantonensis

    AIM: To study the imaging characteristics of eosinophilic myelomeningoencephalitis due to Angiostrongylus cantonensis using magnetic resonance imaging (MRI). MATERIALS AND METHODS: Seventeen MRI examinations of the brain and spinal cord in five patients with angiostrongyliasis cantonensis of the central nervous system were performed. The final diagnosis was based on typical clinical symptoms, results of blood and cerebrospinal fluid (CSF) tests, and the presence of nematode larvae in the CSF. The sequential MRI follow-up examinations were carried out at a different stage for every patient from 1 to 28 weeks after the onset of symptoms. The features of the lesions in the brain, spinal cord, meninges and nerve roots on MRI were studied, moreover, the development of the lesions was analysed on follow-up MRI. RESULTS: Abnormalities were demonstrated on MRI in all five cases. They included three cases of meningoencephalitis, one case of encephalitis and one myelomeningitis. The locations and appearances of the lesions were as follows: (1) brain involvement in four cases (including cerebrum in four, cerebellum in two and brain stem in three), and spinal cord involvement in one case. These lesions were diffuse or scattered and appeared as similar or slightly reduced signal intensity on T1-weighted images (T1WI), high signal intensity on T2-weighted images (T2WI) and turbo fluid attenuated inversion recovery pulse sequence (FLAIR) images. After administration of gadolinium chelate (Gd-DTPA), multiple round or oval enhancing nodules, with diameters ranging from 3 to 10 mm, were seen on T1WI, a few lesions appeared as stick-shaped enhancement whose longest measurement was 14 mm. Diffuse or local oedema around the lesion could be seen. (2) Meningeal involvement in four cases, a case of ependymal involvement and a case of nerve root involvement were among them. These lesions appeared as linear or nodular enhancement of the leptomeninges and ependyma, as well as nerve root enhancement. (3) There was a mild ventricular enlargement in two cases. On follow-up MRI lesions were most severe from the 5th week to the 8th week and it took at least 4-8 weeks (1-2 months) for a lesion to resolve completely, the resolution of larger lesion needed more than 22 weeks. CONCLUSION: Multiple enhancing nodules in the brain and linear enhancement in the leptomeninges were the main features; stick-shaped enhancement was the characteristic sign of the disease on Gd-DTPA enhanced-T1 weighted images

  3. MRI of articular cartilaginous lesions. MRI findings in osteoarthritis of the knee joint

    An investigation was carried out to assess the usefulness of magnetic resonance imaging for imaging of the knee joint, especially for detecting articular cartilaginous lesions associated with osteoarthritis of the knee. A total of 141 patients with osteoarthritis were examined (23 males, 118 females). Their age range was 40-93 (mean age 66.2). Using radiotherapy examinations, patients were classified according to Hokkaido University Classification Criteria; 22, 49, 46, 16, and 8 patients were classified as Type I, II, III, IV and V, respectively. Articular cartilage defects were examined using MRI, and the number of such defects increased as the X-ray stage progressed. The appearance of a low signal intensity area in the bone marrow was examined using MRI, and the number of patients observed to have such areas increased as the x-ray stages progressed. JOA OA scores were significantly low for patients with meniscal tears. Patients were classified and results reviewed using MRI examinations. Classification by MRI of articular cartilage lesions correlated with the JOA OA scores. Low signal intensity areas in the bone marrow were frequently observed in advanced osteoarthritis cases, and there was correlation between FTA and MRI classifications of these areas. MRI is extremely valuable in detecting articular cartilage lesions in the knee joint, showing those lesions which cannot be detected by conventional radiography examinations. Thus, MRI is judged to be a clinically useful method for diagnosis of osteoarthritis. (author)

  4. Correlation between MRI and Operative Findings in Bell's Palsy and Ramsay Hunt Syndrome

    Kim, In Sup; Shin, Seung-Ho; Kim, Jinna; Lee, Won-Sang; Lee, Ho-Ki

    2007-01-01

    Purpose To investigate the correlation between gadolinium enhanced magnetic resonance image (MRI) results and surgical findings of facial nerves in Bell's palsy and Ramsay Hunt syndrome. Materials and Methods From 1995 to 2004, MRI was performed on 13 patients with Bell's palsy or Ramsay Hunt syndrome, who were offered with surgical decompression of the facial nerve through the middle cranial fossa approach. Gadolinium enhanced MRI was performed on all patients and the enhancement of the faci...

  5. Identifying biological pathways in the MRI findings of people with low back pain

    Jensen, Rikke Krüger; Jensen, Tue Secher; Kjær, Per; Kent, Peter

    Title Identifying biological pathways in the MRI findings of people with low back pain Authors and affiliations Rikke K Jensen1, Tue Secher Jensen1, Per Kjaer1,2, Peter Kent1 1Research Department, Spine Centre of Southern Denmark, Hospital Lillebaelt, Institute of Regional Health Services Research...... Investigations into the association between lumbar MRI findings and low back pain (LBP) are complicated by multiple MRI findings being present at the same time. Findings such as lumbar intervertebral disc protrusions or endplate changes almost always co-exist with other degenerative disc findings such as the...... reduction of disc height and signal intensity. Despite this, the majority of previous research has focused solely on the associations between single imaging findings and pain or other clinical outcomes. Only recently have researchers started to engage with this complexity of MRI findings. An initial...

  6. Diffusion-weighted imaging findings on MRI as the sole radiographic findings in a child with proven herpes simplex encephalitis

    We present a case of herpes simplex encephalitis in an 8-year-old girl, in whom hyperintensity was detected on diffusion-weighted imaging (DWI) while conventional MRI sequences were normal 1 week after the onset of neurological symptoms. This case is rare in that a child beyond the neonatal period with focal herpes simplex encephalitis had an abnormal DWI sequence as the only MRI finding. (orig.)

  7. Application of phase-contrast cine magnetic resonance imaging in endoscopic aqueductoplasty

    Chen, Guoqiang; ZHENG, JIAPING; Xiao, Qing; LIU, YUNSHENG

    2013-01-01

    The aim of this study was to evaluate the application of phase-contrast cine magnetic resonance imaging (MRI) in endoscopic aqueductoplasty (EA) for patients with obstructive hydrocephalus. The clinical diagnosis of hydrocephalus caused by aqueduct obstruction in 23 patients was confirmed by phase-contrast cine MRI examination. The patients were treated with EA and MRI was repeated during the follow-up. The cerebrospinal fluid (CSF) flow velocity in the aqueduct was measured to determine whet...

  8. The MRI findings of a de Garengeot hernia.

    Halpenny, D

    2012-03-01

    The presence of the appendix within a femoral hernia is rare. It was first described by the French surgeon Jacques Croissant de Garengeot in 1731. This phenomenon accounts for 0.8-1% of all femoral hernias. Acute appendicitis occurring within a femoral hernia is even rarer and is difficult to diagnose pre-operatively. This type of hernia is termed a de Garengeot hernia. The ultrasonographic and CT imaging features of de Garengeot hernias have been described previously. We report a case of a 57-year-old female who presented with a painful right-sided groin mass. She underwent MRI of the inguinal region, which successfully diagnosed this rare hernia pre-operatively. To our knowledge, this is the first description of a de Garengeot hernia diagnosed using MRI.

  9. A case of subacute combined degeneration: MRI findings

    Yamada, K. [Department of Diagnostic Radiology, University of Rochester Medical Center, Rochester, NY (United States)]|[NMR Center, Massachusetts General Hospital, Charlestown, MA (United States); Shrier, D.A.; Tanaka, H.; Numaguchi, Y. [Department of Diagnostic Radiology, University of Rochester Medical Center, Rochester, NY (United States)

    1998-06-01

    The specific spinal cord lesion caused by vitamin B12 deficiency is known as subacute combined degeneration (SCD). Neuropathological studies of SCD show lesions mainly in the posterior and lateral columns, involving the cortico-spinal and spino-cerebellar tracts. We report a case of SCD in a 19-year-old man who presented with 4 weeks history of gradually progressing tingling in both hands. MRI of the cervical spine demonstrated symmetrical areas of T2 signal abnormality involving the dorsal columns of the cervical cord from the C2 through C5 levels associated with spinal cord expansion. He was treated with vitamin B12 supplements and experienced gradual improvement in his clinical symptoms. Repeat MRI of the cervical spine after 2 months revealed slight decrease in the area of abnormal signal. (orig.) With 1 fig., 11 refs.

  10. Differential diagnosis of middle ear inflammatory diseases by MRI findings

    Although computed tomography can reveal a soft tissue mass in middle ear diseases as an area of increased density, it cannot differentiate cholesteatoma from other inflammatory tissue. We prospectively studied 30 patients with various middle ear inflammatory diseases, including inflammatory granulation tissue, cholesteatoma and cholesterin granuloma with magnetic resonance imaging (MRI) with or without Gd-DTPA enhancement. Cholesteatoma and inflammatory granulation tissue showed intensity ranging from low to high on T1-weighted images and from high to very high on T2-weighted images. However, cholesteatoma showed either no enhancement or ring enhancement on MR imagings with Gd-DTPA, and it could be differentiated from the Gd-DTPA-enhanced inflammatory granulation tissue. Cholesterin granuloma showed very high intensity on both T1 and T2-weighted images. Therefore, MRI with Gd-DTPA is considered to be useful in the differential diagnosis of these middle ear diseases. (auhtor)

  11. MRI and CT findings of adult Down's syndrome

    Cranial CT and MRI were performed in 29 adult patients with Down's syndrome aged from 20 to 46 years to examine early aging. Morphological changes with aging, such as brain atrophy and ventricular enlargement, were generally sparse; however, calculi of the basal nucleus and lesions of deep-seated white matter were significantly increased with aging. The pallidum and putamen were shown as low intensity signals on T2-weighted images in many of patients in their fourties, suggesting their involvement in the occurrence of dyskinesia and parkinsonism symptoms that are likely to occur in the elderly. Localized changes, as shown on CT and MRI, may reflect abnormally early occurrence of aging, which precedes morphological changes such as brain atrophy. (N.K.)

  12. Cystic angiomatosis with splenic involvement: unusual MRI findings

    Vanhoenacker, F.M. [Dept. of Radiology, Univ. Hospital Antwerp, Edegem (Belgium); Dept. of Radiology, AZ St-Maarten, Campus Duffel, Duffel (Belgium); Schepper, A.M. [Dept. of Radiology, Univ. Hospital Antwerp, Edegem (Belgium); Raeve, H. [Dept. of Pathology, Univ. Hospital Antwerp, Edegem (Belgium); Berneman, Z. [Dept. of Hematology, Univ. Hospital Antwerp, Edegem (Belgium)

    2003-12-01

    Cystic angiomatosis is a rare disorder with a poor prognosis. We describe a case of a 33-year-old woman who presented with longstanding bone pain, hemolytic anemia, and an enlarged spleen. Radiologically, multiple osseous lesions with a mixed pattern of lytic and sclerotic areas were seen within the shoulders, spine, and pelvis. On CT and MRI of the abdomen, the spleen was markedly enlarged, with internal hyperdense foci on non-contrast CT scan, corresponding to low signal intensity areas on all MR pulse sequences. After administration of contrast, a mottled enhancement pattern throughout the entire spleen was seen both on CT and MRI. Cystic angiomatosis was proven by histological analysis of a biopsy specimen of an involved vertebra and histopathological examination of the spleen after subsequent splenectomy. This is the first report of a patient with disseminated cystic angiomatosis with splenic involvement in which the MRI features differ from the previous reports. Instead of the usual pattern consisting of multiple well-defined cystic lesions, a diffuse involvement replacing the entire spleen, with heterogeneous signal intensities on T2-weighted images and heterogeneous enhancement pattern, was seen in our patient. (orig.)

  13. Cystic angiomatosis with splenic involvement: unusual MRI findings

    Cystic angiomatosis is a rare disorder with a poor prognosis. We describe a case of a 33-year-old woman who presented with longstanding bone pain, hemolytic anemia, and an enlarged spleen. Radiologically, multiple osseous lesions with a mixed pattern of lytic and sclerotic areas were seen within the shoulders, spine, and pelvis. On CT and MRI of the abdomen, the spleen was markedly enlarged, with internal hyperdense foci on non-contrast CT scan, corresponding to low signal intensity areas on all MR pulse sequences. After administration of contrast, a mottled enhancement pattern throughout the entire spleen was seen both on CT and MRI. Cystic angiomatosis was proven by histological analysis of a biopsy specimen of an involved vertebra and histopathological examination of the spleen after subsequent splenectomy. This is the first report of a patient with disseminated cystic angiomatosis with splenic involvement in which the MRI features differ from the previous reports. Instead of the usual pattern consisting of multiple well-defined cystic lesions, a diffuse involvement replacing the entire spleen, with heterogeneous signal intensities on T2-weighted images and heterogeneous enhancement pattern, was seen in our patient. (orig.)

  14. MRI findings on lacunar infarction with no clinical symptoms

    The purpose of this study was to examine how lacunar infarction developed and what its characteristics were. As this disease had little noticeable clinical symptoms and is likely to draw less attention than other types of cerebrovascular diseases like panhemispheric infarction, it's difficult to make an early diagnosis of it or treat it successfully. The subjects in this study were 196 people who showed no clinical symptoms and took a MRI test. When the MRI test data were analyzed, signal intensity and the part where that disease was detected were primarily taken into account. As a result, it's found that 116 people had no lacunar infarction and 80 people suffered from that disease, including 13 with very mild lacunar infarction, 41 with mild lacunar infarction and 26 with lacunar infarction. However, very mild and mild lacunar infarction could not be viewed as clinically significant cases, and only 26 people, which accounted for 13 percent of the subjects, should be considered to be diagnosed with lacunar infarction. The most common part where that disease was found was white matter and basal ganglia, regardless of gender. Accordingly, those who are exposed to health hazards such as hypertension or diabetes should take a MRI test to prevent cerebrovascular diseases that might be caused by those illnesses

  15. Value of radiotherapy in treatment of humeroscapular periarthritis. Comparison with MRI findings

    Purpose: Evaluation of MRI in radiotherapy of humeroscapular periarthritis. Patients and methods: Seventy-seven patients with humeroscapular periarthritis prospectively underwent MRI before radiotherapy. Results: Six months after radiotherapy, 34% of the patients had achieved complete pain relief, 35% major pain relief. Twenty percent had only slight improvement and 12% no improvement. Positive correlation of radiotherapy outcome and MRI findings could be shown for acute tendinitis, erosions, and complete and incomplete ruptures of the supraspinatus tendon. Conclusions: Radiotherapy is highly effective in the treatment of humeroscapular periarthritis. The indication can be improved using MRI. (orig.)

  16. Spinal cord and cauda equina MRI findings in metachromatic leukodystrophy: case report

    Toldo, Irene; Battistella, Pier Antonio; Laverda, Anna Maria [University of Padua, Department of Pediatrics, Padua (Italy); Carollo, Carla [Institute of Neuroradiology, Padua (Italy)

    2005-08-01

    Metachromatic leukodystrophy (MLD) is an autosomal recessive disease with well-documented intracranial findings on neuroimaging both by computed tomography (CT) and MRI. We describe the first case of late infantile MLD with spinal involvement revealed by MRI as marked contrast enhancement of nerve roots at the level of the cauda equina. (orig.)

  17. Functional MRI of the pelvic floor. Method and references values

    Purpose. Functional cine MRI of the pelvic floor is a yet another modality in addition to various radiological fluoroscopic techniques. This article describes our own method in view of the recent literatur and provides morphometric reference values. Material and method. We examined 20 nulliparous women (range of age: 25-51 years) with normal findings in the gynecological and urodynamic examination. Functional cine MRI was performed on a 1.5 Tesla equipment after opacification of the vagina and rectum. We used a T2-weighted gradient-echo sequence (True-FISP) to determine the position of the reference organs at rest and during straining/defecation. Two different reference lines were used. In addition 29 morphometric and functional parameters were measured, all of them being observer independent. Results. Functional cine MRI was able to show the extent and interaction of the pelvic floor organs in all cases with the reference organs always remaining above the pubococcygeal reference line. The depth of the rectocele was 2 cm. With the exception of the diameter of urogenital hiatus the different parts of the levator ani muscle could not be determined. Discussion. Functional cine MRI using an appropiate organ opacification and slice positioning is an objective, unifying diagnostic approach of the pelvic floor. The reference data given can be of help to distinguish normal from abnormal findings. (orig.)

  18. Cyclic sciatica caused by infiltrative endometriosis: MRI findings

    Endometriosis, an important gynecological disorder of reproductive women, affects most commonly the ovaries and less frequently the gastrointestinal tract, chest, urinary tract, and soft tissues. Endometriosis classically appears on MRI as a mass with a large cystic component and variable signal intensities on T1- and T2-weighted images due to the presence of variable degradation of hemorrhagic products. Endometriosis in an atypical location, an infiltrative appearance and without cystic-hemorrhagic components has rarely been described. We report on a 33-year-old woman with cyclic sciatica due to histologically documented infiltrative endometriosis involving the area of the left sciatic notch. (orig.)

  19. Cyclic sciatica caused by infiltrative endometriosis: MRI findings

    Yekeler, Ensar; Kumbasar, Basak; Tunaci, Atadan; Barman, Ahmet; Tunaci, Mehtap [Department of Radiology, Istanbul Faculty of Medicine, Istanbul University, 34390, Capa, Istanbul (Turkey); Bengisu, Ergin [Department of Obstetrics and Gynecology, Istanbul Faculty of Medicine, Istanbul University, Istanbul (Turkey); Yavuz, Ekrem [Department of Pathology, Istanbul Faculty of Medicine, Istanbul University, 34390, Capa, Istanbul (Turkey)

    2004-03-01

    Endometriosis, an important gynecological disorder of reproductive women, affects most commonly the ovaries and less frequently the gastrointestinal tract, chest, urinary tract, and soft tissues. Endometriosis classically appears on MRI as a mass with a large cystic component and variable signal intensities on T1- and T2-weighted images due to the presence of variable degradation of hemorrhagic products. Endometriosis in an atypical location, an infiltrative appearance and without cystic-hemorrhagic components has rarely been described. We report on a 33-year-old woman with cyclic sciatica due to histologically documented infiltrative endometriosis involving the area of the left sciatic notch. (orig.)

  20. Prenatal MRI Findings of Fetuses with Congenital High Airway Obstruction Sequence

    Guimaraes, Carolina V. A.; Linam, Leann E.; Kline-Fath, Beth M. [Cincinnati Children' s Hospital Medical Center, Cincinnati (United States)] (and others)

    2009-04-15

    To define the MRI findings of congenital high airway obstruction sequence (CHAOS) in a series of fetuses. Prenatal fetal MR images were reviewed in seven fetuses with CHAOS at 21 to 27 weeks of gestation. The MRI findings were reviewed. The MRI parameters evaluated included the appearance of the lungs and diaphragm, presence or absence of hydrops, amount of amniotic fluid, airway appearance, predicted level of airway obstruction, and any additional findings or suspected genetic syndromes. All the fetuses viewed (7 of 7) demonstrated the following MRI findings: dilated airway below the level of obstruction, increased lung signal, markedly increased lung volumes with flattened or inverted hemidiaphragms, massive ascites, centrally positioned and compressed heart, as well as placentomegaly. Other frequent findings were anasarca (6 of 7) and polyhydramnios (3 of 7). MRI identified the level of obstruction as laryngeal in five cases and tracheal in two cases. In four of the patients, surgery or autopsy confirmed the MRI predicted level of obstruction. Associated abnormalities were found in 4 of 7 (genetic syndromes in 2). Postnatal radiography (n = 3) showed markedly hyperinflated lungs with inverted or flattened hemidiaphragms, strandy perihilar opacities, pneumothoraces and tracheotomy. Two fetuses were terminated and one fetus demised in utero. Four fetuses were delivered via ex utero intrapartum treatment procedure. MRI shows a consistent pattern of abnormalities in fetuses with CHAOS, accurately identifies the level of airway obstruction, and helps differentiate from other lung abnormalities such as bilateral congenital pulmonary airway malformation by demonstrating an abnormally dilated airway distal to the obstruction.

  1. MRI findings in the patients with the presumptive clinical diagnosis of Tolosa-Hunt syndrome

    The aim of this study was to present our experience in MRI diagnosis of 23 patients with the clinical findings suggesting Tolosa-Hunt syndrome (THS). Cranial MRI studies of the patients with a clinical history of at least one episode of unilateral or bilateral orbital and periorbital pain, and associated paresis of one or more of third to sixth cranial nerves, were performed on a 1.5-T MRI scanner. Whereas 5 patients had the diagnosis of THS, paracavernous meningiomas in 4 patients, pituitary macroadenomas with cavernous sinus infiltration in 3 patients, Meckel's cave neurinoma in 1 patient, and suprasellar epidermoid in 1 patient were surgically proven MRI findings. Other pathological MRI findings were leptomeningeal metastases in 3 patients, granulomatous pachymeningitis sequelae in 2 patients, and aneurysm with compression on cavernous sinus in 1 patient. Three patients had normal MRI findings. The incidence of radiologically proven diagnosis of THS among the patients with the clinical findings suggesting THS seemed to be low in our study. In conclusion, MRI is the most valuable imaging technique to distinguish THS from other THS-like entities, and permits a precise assessment, management, and therapeutic planning of the underlying pathological conditions. (orig.)

  2. MRI findings in the patients with the presumptive clinical diagnosis of Tolosa-Hunt syndrome

    Cakirer, Sinan [Department of Radiology, Neuroradiology Section, Istanbul Sisli Etfal Hospital, 81120 Istanbul (Turkey)

    2003-01-01

    The aim of this study was to present our experience in MRI diagnosis of 23 patients with the clinical findings suggesting Tolosa-Hunt syndrome (THS). Cranial MRI studies of the patients with a clinical history of at least one episode of unilateral or bilateral orbital and periorbital pain, and associated paresis of one or more of third to sixth cranial nerves, were performed on a 1.5-T MRI scanner. Whereas 5 patients had the diagnosis of THS, paracavernous meningiomas in 4 patients, pituitary macroadenomas with cavernous sinus infiltration in 3 patients, Meckel's cave neurinoma in 1 patient, and suprasellar epidermoid in 1 patient were surgically proven MRI findings. Other pathological MRI findings were leptomeningeal metastases in 3 patients, granulomatous pachymeningitis sequelae in 2 patients, and aneurysm with compression on cavernous sinus in 1 patient. Three patients had normal MRI findings. The incidence of radiologically proven diagnosis of THS among the patients with the clinical findings suggesting THS seemed to be low in our study. In conclusion, MRI is the most valuable imaging technique to distinguish THS from other THS-like entities, and permits a precise assessment, management, and therapeutic planning of the underlying pathological conditions. (orig.)

  3. MRI FINDINGS OF INTERNAL DERANGEMENT OF KNEE IN TRAUMA

    Ravi Ningappa

    2015-02-01

    Full Text Available AIMS AND OBJECTIVES: 1. To evaluate ligament and meniscal injuries and secondary signs , using MRI . 2. To analyse the types and grades of the tears. MATERIALS AND METHODS : MR imaging studies of knee was performed in 200 patients, presenting to the department of radiodiagnosis, BMCRI from September - 2013 to September - 2014 with history of trauma and clinical suspicion of internal der angement of knee. Various sequences in coronal, sagittal and axial planes were obtained. RESULTS : Out of 200 patients evaluated , medial meniscus tear was the most common internal derangement. 94 patients showed medial meniscus tear and associated anterior cruciate ligament tear was found in 76 patients. Medial collateral ligament sprain was seen in 18 patients, lateral meniscus injury was seen in 26 patients, lateral collateral ligament injury was seen in 8 patients, posterior cruciate ligament injury was s een in 16 patients, 20 patients showed cartilage defect and 18 percent showed no internal derangement. Associated secondary signs such as bone contusions were seen in 60 individuals and minimal to moderate joint effusion was seen in 74 individuals. CONCLUS ION : MRI is an accurate, non - invasive modality in detecting ligament and meniscal injury of knee. It shows great capability in classifying them into types and grades. Special sequences are useful and should be included in the protocol.

  4. Retroperitoneal Castleman's disease: US, CT and MRI findings

    Purpose: To describe de imaging features of this unusual localization of Castleman's disease. Materials and methods: Two patients (man: 62 years old, woman: 27 years old) with epigastric abdominal pain were studied. The physical examination was negative in the woman while in the other case a peri umbilical tumor was observed. The laboratory and the tumor markers were negative. Both patients had a history of appendectomy. US, TC and MRI were performed. After surgery the pathological examination included stain techniques with hematoxylin-eosin, Masson's techniques and PAS. Results: Retroperitoneal Castleman's disease in peri pancreatic localization (extremely rare). The US showed slight hypoechoic homogeneous lesions with clear rims. CT without contrast revealed isodense lesions and one of them presented a small calcification, the e.v. contrast CT showed a clear homogeneous reinforcement. MRI demonstrated hypointense lesions on T1, hyperintense on T2, and after the administration of gadolinium these lesions showed a marked reinforcement on the arterial phase, which persisted on the late venous phase. The differential diagnosis with pancreatic tumoral pathology was difficult. The pathological examination revealed a lymphoid angio follicular hyperplasia of hyaline vascular type. Conclusion: Retroperitoneal Castlelman's disease is a rare entity. The different imaging methods did not provide an accurate diagnosis of this entity since there are no pathognomonic features. The pathological examination was required to define the diagnosis in both reported cases. (author)

  5. Spinal ultrasound in infants. Indications, findings and MRI correlation

    Full text: Ultrasound can detect the spinal abnormalities and demonstrate anatomical variants and pathologies with very high degree of accuracy. The best time to scan the infant is up to about three months of age as there is incomplete ossification of the posterior spinal elements. After the 3 month period the posterior spinal elements start to ossify and subsequently there is loss of the acoustic window with the intraspinal elements poorly visualized. There are many advantages of the US neonatal spine: No need for sedation or general anesthesia, it can be performed even in the intensive care unit at the bedside, it is a dynamic study, It is cheap, easy to perform and is an excellent screening modality, however this is exclusively operator dependant. Although MRI is the imaging modality of choice a carefully performed ultrasound can give very accurate information. The main indications for performing spinal ultrasound in the young infant is screening for occult spinal dysraphism: lower lumbar skin markers such as hairy patch, skin tag, cutaneous hemangioma or dorsal dermal sinus; Closed lumbar mass; Congenital anomalies such as anorectal atresia and cloacal exstrophy. Through the short talk I will explain the technique, some of the major spinal abnormalities detectable by ultrasound which are subsequently correlated by MRI

  6. Age-related findings on MRI in neurofibromatosis type 1

    Gill, Deepak S. [Children' s Hospital at Westmead, The T. Y. Nelson Department of Neurology, Sydney, NSW (Australia); Hyman, Shelley L. [Children' s Hospital at Westmead, Neurogenetics Research Unit, Sydney (Australia); Steinberg, Adam [Children' s Hospital at Westmead, Department of Radiology, Sydney (Australia); North, Kathryn N. [Children' s Hospital at Westmead, The T. Y. Nelson Department of Neurology, Sydney, NSW (Australia); Children' s Hospital at Westmead, Neurogenetics Research Unit, Sydney (Australia)

    2006-10-15

    T2 hyperintensities (T2H) on MRI are the most common CNS lesions in individuals with neurofibromatosis type 1 (NF1). The aim was to determine the frequency, signal characteristics and localization of T2H at different ages. In addition, we examined the sensitivity of different MR imaging sequences in detecting these lesions. We studied prospectively a cohort of children, adolescents and young adults with NF1 using T2-volume (T2-V) and conventional MRI sequences. Lesions were designated as either discrete or diffuse, and the region of signal abnormality was recorded. A total of 103 patients were studied (age range 8.0-25.4 years, mean 13.9 years). The frequency, size, and intensity of T2H decreased with age in the basal ganglia (BG) and the cerebellum/brainstem (CB/BS). The majority of thalamic and CB/BS lesions were diffuse. Of the total cohort, 80% had diffuse bilateral hippocampal hyperintensities and 18.4% had hemispheric lesions best demonstrated on FLAIR; there was no significant difference in the frequency or signal intensity of hemispheric lesions with age. Lesions in the cerebral hemispheres and hippocampus imaged by MR do not change in prevalence over time, suggesting a different pathological basis from the lesions in the in BG and CB/BS that resolve with age. FLAIR and T2-V sequences are more sensitive in detecting lesions than standard T2-weighted sequences. (orig.)

  7. Age-related findings on MRI in neurofibromatosis type 1

    T2 hyperintensities (T2H) on MRI are the most common CNS lesions in individuals with neurofibromatosis type 1 (NF1). The aim was to determine the frequency, signal characteristics and localization of T2H at different ages. In addition, we examined the sensitivity of different MR imaging sequences in detecting these lesions. We studied prospectively a cohort of children, adolescents and young adults with NF1 using T2-volume (T2-V) and conventional MRI sequences. Lesions were designated as either discrete or diffuse, and the region of signal abnormality was recorded. A total of 103 patients were studied (age range 8.0-25.4 years, mean 13.9 years). The frequency, size, and intensity of T2H decreased with age in the basal ganglia (BG) and the cerebellum/brainstem (CB/BS). The majority of thalamic and CB/BS lesions were diffuse. Of the total cohort, 80% had diffuse bilateral hippocampal hyperintensities and 18.4% had hemispheric lesions best demonstrated on FLAIR; there was no significant difference in the frequency or signal intensity of hemispheric lesions with age. Lesions in the cerebral hemispheres and hippocampus imaged by MR do not change in prevalence over time, suggesting a different pathological basis from the lesions in the in BG and CB/BS that resolve with age. FLAIR and T2-V sequences are more sensitive in detecting lesions than standard T2-weighted sequences. (orig.)

  8. Cine club

    Cine club

    2015-01-01

    Wednesday 7 October 2015 at 20:00 CERN Council Chamber The Day of the Beast (El día de la bestia) Directed by Álex de la Iglesia Spain, 1995, 100 minutes A Basque priest finds by means of a cabalistic study of the Bible that the Antichrist is going to be born on Christmas Day in Madrid. Assisted by a heavy-metal fan and the host of a TV show on the occult, he will try to summon the Devil to find out the place of birth and kill the baby. Original version spanish; english subtitles   Wednesday 14 October 2015 at 20:00 CERN Council Chamber Tesis Directed by Alejandro Amenábar Spain, 1996, 125 minutes   Why is death and violence so fascinating? Is it morally correct to show violence in movies? If so, is there a limit to what we should show? That's the subject of Ángela's examination paper. She is a young student at a film school in Madrid. Together with the student Chema (who is totally obsessed with violent movies) they find a sn...

  9. Right cervical aortic arch with subaortic left brachiocephalic vein: MRI findings

    A case of a right cervical aortic arch associated with a subaortic left brachiocephalic vein is reported. CT and MRI findings were correlated to the angiogram. The mechanism responsible for the coexistence of these two abnormalities is discussed. (orig.)

  10. MRI and brain spect findings in patients with unilateral temporal lobe epilepsy and normal CT scan

    P.G. Carrilho

    1994-06-01

    Full Text Available 26 patients with temporal lobe epilepsy clinically documented by several abnormal interictal surface EEGs with typical unitemporal epileptiform activity and a normal CT scan were studied. Interictal99mTC HMPAO brain SPECT and MRI were performed in all subjects. Abnormalities were shown in 61.5% of MRI (n=16 and 65.4% of SPECT (n=17. Hippocampal atrophy associated to a high signal on T2-weighted MRI slices suggesting mesial temporal sclerosis was the main finding (n=12; 75% of abnormal MRI. MRI correlated well to surface EEG in 50% (n=13. There was also a good correlation between MRI and SPECT in 30.7% (n=8. SPECT and EEG were in agreement in 57.7% (n=l5. MRI, SPECT and EEG were congruent in 26.9% (n=7. These results support the usefulness of interictal brain SPECT and MRI in detecting lateralized abnormalities in temporal lobe epilepsy. On the other hand, in two cases, interictal SPECT correlated poorly with surface EEG. This functional method should not be used isolately in the detection of temporal lobe foci. MRI is more useful than CT as a neuroimaging technique in temporal lobe epilepsy. It may detect small structural lesions and mesial temporal lobe sclerosis which are not easily seen with traditional CT scanning.

  11. MRI findings of serous atrophy of bone marrow and associated complications

    Boutin, Robert D. [Department of Radiology, Sacramento, CA (United States); White, Lawrence M. [University of Toronto, Joint Department of Medical Imaging, Toronto General Hospital, Toronto, ON (Canada); Laor, Tal [Cincinnati Children' s Hospital Medical Center, Department of Radiology, Cincinnati, OH (United States); Spitz, Damon J. [New England Baptist Hospital, Department of Radiology, Boston, MA (United States); Lopez-Ben, Robert R. [Carolinas HealthCare System, Charlotte Radiology, Diagnostic Radiology, Charlotte, NC (United States); Stevens, Kathryn J. [Stanford University, Department of Radiology, Stanford, CA (United States); Bredella, Miriam A. [Massachusetts General Hospital and Harvard Medical School, Division of Musculoskeletal Imaging and Intervention, Department of Radiology, Boston, MA (United States)

    2015-09-15

    To report the MRI appearance of serous atrophy of bone marrow (SABM) and analyse clinical findings and complications of SABM. A retrospective search of MRI examinations of SABM was performed. Symptoms, underlying conditions, MRI findings, delay in diagnosis and associated complications were recorded. We identified 30 patients (15 male, 15 female; mean age: 46 ± 21 years) with MRI findings of SABM. Underlying conditions included anorexia nervosa (n = 10), cachexia from malignant (n = 5) and non-malignant (n = 7) causes, massive weight loss after bariatric surgery (n = 1), biliary atresia (n = 1), AIDS (n = 3), endocrine disorders (n = 2) and scurvy (n = 1). MRI showed mildly hypointense signal on T1- weighted and hyperintense signal on fat-suppressed fluid-sensitive images of affected bone marrow in all cases and similar signal abnormalities of the adjacent subcutaneous fat in 29/30 cases. Seven patients underwent repeat MRI due to initial misinterpretation of bone marrow signal as technical error. Superimposed fractures of the hips and lower extremities were common (n = 14). SABM occurs most commonly in anorexia nervosa and cachexia. MRI findings of SABM are often misinterpreted as technical error requiring unnecessary repeat imaging. SABM is frequently associated with fractures of the lower extremities. (orig.)

  12. MRI findings of serous atrophy of bone marrow and associated complications

    To report the MRI appearance of serous atrophy of bone marrow (SABM) and analyse clinical findings and complications of SABM. A retrospective search of MRI examinations of SABM was performed. Symptoms, underlying conditions, MRI findings, delay in diagnosis and associated complications were recorded. We identified 30 patients (15 male, 15 female; mean age: 46 ± 21 years) with MRI findings of SABM. Underlying conditions included anorexia nervosa (n = 10), cachexia from malignant (n = 5) and non-malignant (n = 7) causes, massive weight loss after bariatric surgery (n = 1), biliary atresia (n = 1), AIDS (n = 3), endocrine disorders (n = 2) and scurvy (n = 1). MRI showed mildly hypointense signal on T1- weighted and hyperintense signal on fat-suppressed fluid-sensitive images of affected bone marrow in all cases and similar signal abnormalities of the adjacent subcutaneous fat in 29/30 cases. Seven patients underwent repeat MRI due to initial misinterpretation of bone marrow signal as technical error. Superimposed fractures of the hips and lower extremities were common (n = 14). SABM occurs most commonly in anorexia nervosa and cachexia. MRI findings of SABM are often misinterpreted as technical error requiring unnecessary repeat imaging. SABM is frequently associated with fractures of the lower extremities. (orig.)

  13. Cine Club

    Ciné Club

    2013-01-01

    Thursday 22 August 2013 at 20:00 CERN Council Chamber The Angels’ Share Directed by Ken Loach (UK, 2012) Original version English; french subtitles; 101 minute This bitter sweet comedy follows protagonist Robbie as he sneaks into the maternity hospital to visit his young girlfriend Leonie and hold his newborn son Luke for the first time. Overwhelmed by the moment, he swears that Luke will not have the same tragic life he has had. Escaping a prison sentence by the skin of his teeth, he's given one last chance...While serving a community service order, he meets Rhino, Albert and Mo who, like him, find it impossible to find work because of their criminal records. Little did Robbie imagine how turning to drink might change their lives - not cheap fortified wine, but the best malt whiskies in the world. Will it be 'slopping out' for the next twenty years, or a new future with 'Uisge Beatha' the 'Water of Life?' Only the angels know.... Th...

  14. Cine club

    Cine club

    2016-01-01

    Wednesday 17 February 2016 at 20:00 CERN Council Chamber Knockin' on Heaven's Door Directed by Thomas Jahn Germany, 1997, 87 minutes Two young men, Martin and Rudi, both suffering from terminal cancer, get to know each other in a hospital room. They drown their desperation in tequila and decide to take one last trip to the sea. Drunk and still in pyjamas they steal the first fancy car they find, a 60's Mercedes convertible. The car happens to belong to a bunch of gangsters, which immediately start to chase it, since it contains more than the pistol Martin finds in the glove box. Original version German / English ; English subtitles Wednesday 24 February 2016 at 20:00 CERN Council Chamber Bandits Directed by Katja von Garnier Germany / France, 1997, 110 minutes Four female cons who have formed a band in prison get a chance to play at a police ball outside the walls. They take the chance to escape. Being on the run from the law they even make it to sell their music and become famous...

  15. Sinochoanal polyp and its variant, the angiomatous polyp: MRI findings

    The angiomatous polyp corresponds to the vascular compromised nasochoanal part of a sinochoanal polyp. We describe the MRI characteristics of such lesions in four patients. All patients had an angiomatous polyp, in three cases as part of an antrochoanal polyp, and in one case as part of a sphenochoanal polyp. The unenhanced MR images depicted the typical appearance of a sinochoanal polyp, hypointense on T1-weighted and hyperintense on T2-weighted images. On gadolinium-enhanced MR images, the sinusal part showed little or no peripheral enhancement; however, the nasochoanal part, corresponding to the angiomatous polyp, showed strong enhancement. An angiomatous polyp mimics a hypervascular mass lesion on enhanced MR studies. The anatomic location and association with a sinusal polyp allows the correct diagnosis. (orig.)

  16. Thoracic Splenosis after a Gunshot: Diffusion-Weighted MRI Findings

    Intrathoracic splenosis is a rare condition resulting from concomitant rupture of the spleen and left hemidiaphragm after a traumatic event involving the spleen and the diaphragma and is defined as autotransplantation of splenic tissue in thorax. The aim of this study was to present a case report of a combined intrathoracic and subcutaneous splenosis in a patient 19 years after penetrating trauma. She has left dorsal side pain and routine chest roentgenogram shows pleural nodular masses. The patient was referred to us for radiologic work up. The MRI scans revealed the intrathoracic and subcutan masses as mainly hypointense on T1-weighted images and hyperintense on T2-weighted images and significant restriction in diffusion-weighted images. Scintigraphy revealed abnormal hot spots in subcutaneous tissue and diaphragmatic pleura of the left hemithorax

  17. Cine Club

    Cine Club

    2016-01-01

    Wednesday 27 April 2016 at 20:00, CERN Council Chamber What We Do in the Shadows Directed by Jemaine Clement, Taika Waititi (New Zealand/USA, 2014) 86 min. Viago, Deacon, and Vladislav are vampires who are finding that modern life has them struggling with the mundane - like paying rent, keeping up with the chore wheel, trying to get into nightclubs, and overcoming flatmate conflicts. Original version English; French subtitles   In Collaboration with "ConCERNed for Humanity": Wednesday 4 May 2016 at 20:00     CERN Council Chamber 13 Minutes / Elser Directed by Oliver Hirschbiegel (Germany, 2015) 114 min.                                  &n...

  18. Cine Club

    Cine Club

    2016-01-01

    Wednesday 20 January 2016 at 20:00 CERN Council Chamber Autumn Sonata Directed by Ingmar Bergman Sweden / France / Germany / UK, 1978, 99 min. After having neglected her children for many years, world famous pianist Charlotte visits her daughter Eva in her home. To her surprise she finds her other daughter, Helena, there as well. Helena is mentally disabled, and Eva has taken Helena out of the institution where their mother had placed her. The tension between Charlotte and Eva only builds up slowly, until a nightly conversation releases all the things they have wanted to tell each other. Original version swedish / english; english subtitles Wednesday 27 January 2016 at 20:00 CERN Council Chamber Fanny and Alexander Directed by Ingmar Bergman Sweden / France / Germany, 1982, 188 min. Alexander Ekdahl and his younger sister Fanny live a wonderful life. Their parents own a local theater and the extended Ekdahl family are close, spending Christmas together. Just a few weeks after the Christmas celebrations how...

  19. Cine club

    Ciné club

    2014-01-01

    Thursday 23 October 2014 at 20:00 CERN Council Chamber The Shop on Main Street Directed by Jan Kadar, Elmar Klos Slovakia, 1965, 125 minutes   In 1942, in a small town in Czechoslovakia, the poor carpenter Tony Brtko is assigned "Aryanizator" of a small shop on the main street by his fascist brother-in-law. His greedy wife is seduced with the promise of fortune, but Tony finds that the store owned by the deaf and senile seventy eight year-old widow Rozalie Lautmann is bankrupted and the old lady is financially supported by the Jewish community that promises a salary to him to help her. Tony befriends Mrs Lautmann and helps her in the store and repairs her furniture, and lures his wife with his salary. When the Jews are expelled from the town by the fascists, Tony decides to help the old lady. Original version Slovak; English subtitles   Thursday 30 October 2014 at 20:00 CERN Council Chamber High Noon Directed by Fred Zinnemann USA, 1952, 85 minutes On the day he gets ...

  20. CINE CLUB

    CINE CLUB

    2010-01-01

    Thursday 11 November 2010 at 20:30 / Jeudi 11 Novembre 2010 à 20:30 CERN Main Auditorium / Amphithéâtre Principal LE CHOCOLAT By/de : Lasse Hallström (UK/USA, 2000) 121 min With/avec: Lena Olin, Juliette Binoche, Johny Depp, Judi Dench, Alfred Molina, Peter Stormare, Leslie Caron, Carrie-Anne Moss   Vianne Rocher and her young daughter are drifters who are met with skepticism and resistance when they move to a conservative town in rural France and open a chocolate shop during Lent. As Vianne begins to work her magic and help those around her, the townspeople are soon won over by her exuberance and her delicious chocolates - except for the mayor, who is determined to shut her down. When a group of river drifters visit the town, Vianne teaches the townspeople something about acceptance, and finds love for herself along the way. Original version english / french with german subtitles Version originale anglaise / française soutitr&...

  1. Cine club

    Cine club

    2016-01-01

    Wednesday 3 February 2016 at 20:00 CERN Council Chamber In July (Im Juli) Directed by Fatih Akin Germany, 2000, 99 minutes Daniel is a young teacher who, in contrast to everyone else, plans to stay in Hamburg for the summer. Juli, a girl at the flea-market, wants to get known to Daniel and manages to sell him a Mayan ring with a sun on it, foretelling him that he will meet a girl with a sun. One day later Daniel is already on his way across Europe. It seems the prophecy came true somehow. Original version German, English, Turkish, Bulgarian, Serbo-croatian and Romanian; English subtitles Wednesday 10 February 2016 at 20:00 CERN Council Chamber Oh Boy Directed by Jan Ole Gerster Germany, 2014, 86 minutes This tragicomedy is a self-ironic portrait of a young man who drops out of university and ends up wandering the streets of the city he lives in: Berlin. The film deals with the desire to participate in life and the difficulty to find one's place. Original version German and English; English subtit...

  2. Cine Club

    Ciné Club

    2011-01-01

    Wednesday 29 June 2011 at 20:30 CERN Council Chamber Arizona Dream  By/de : Emir Kusturica (USA/France, 1993) 142 min With/avec: Johnny Depp, Jerry Lewis, Fay Dunaway, Lily Taylor, Vincent Gallo A romantic comedy about the adventures of an innocent dreamer in the weird and colourful landscape of the American West. Caught between childhood and adulthood he finds himself back in his hometown where he becomes involved with a wealthy widow and her stepdaughter. Original version english; english subtitles Entrance : 2 CHF Projection from DVD http://cineclub.web.cern.ch/Cineclub/     Thursday 7 July 2011 at 20:30 CERN Council Chamber Burn After Reading  By/de : Ethan Coen and Joel Coen (USA/UK/France, 2008) 102 min With/avec: George Clooney, Frances McDormand, Brad Pitt, John Malkovich, Tilda Swinton Osbourne Cox, a Balkan expert, is fired at the CIA, so he begins a memoir. His wife wants a divorce and expects her lover, Harry, a philandering State Dep...

  3. CINE CLUB

    CINE CLUB

    2010-01-01

    Thursday 7 October 2010 at 20:30 Jeudi 7 Octobre 2010 à 20:30 CERN Main Auditorium Amphithéâtre Principal Mystic River   By/de : Clint Eastwood (USA, 2003) 132 min With/avec : Sean Penn, Tim Robbins, Kevin Bacon, Laurence Fishburne, Marcia Gay Harden, Laura Linney   During a summer in 1975, Dave Boyle and two friends, Jimmy and Sean, are playing on a sidewalk in Boston when Dave is abducted by two men and subjected to sexual abuse over a period of several days. Eventually escaping, but haunted into adulthood by his trauma, Dave becomes a primary suspect when Jimmy's daughter, Katie, is found murdered. Sean, assigned to investigate the crime, finds himself facing both demons from the past and demons in the present as the circumstances surrounding Katie's death are uncovered.   Original version english with english subtitles Version originale anglaise soutitrée en anglais * * * * * * * Thursday 14 October 2010 at 20:30 ...

  4. Cine Club

    Cine Club

    2015-01-01

    Wednesday 21 October 2015 at 18:00 CERN Council Chamber Special screening in collaboration with CERN Social Media Back to the Future Part II Directed by Robert Zemeckis USA, 1989, 108 minutes Watch how the film-makers imagined we’d live in 2015, from flying cars to hydrated pizzas and much more, in this iconic film from the 1980s. Original version english; french subtitles   Wednesday 21 October 2015 at 20:00 CERN Council Chamber Timecrimes (Los Cronocrímenes) Directed by Nacho Vigalondo Spain, 2007, 92 minutes   A man accidentally gets into a time machine and travels back in time nearly an hour. Finding himself will be the first of a series of disasters of unforeseeable consequences. Original version spanish; english subtitles Wednesday 28 October 2015 at 20:00 CERN Council Chamber Snow White (Blancanieves) Directed by Pablo Berger Spain, 2012, 104 minutes A twist on the Snow White fairy tale that is set in 1920s Seville and centered on a female bullfighter. Ori...

  5. Comparative studies of MRI and operative findings in rotator cuff tear

    A prospective study was performed to determine the accuracy of magnetic resonance imaging (MRI) compared with operative findings in the evaluation of patients associated with rotator cuff tears. Fifty-four of 60 shoulders (58 patients) examined by MRI were confirmed as full-thickness tears and 6 as partial-thickness tears at the time of surgery. The oblique coronal, oblique sagittal, and axial planes of T2-weighted images with the 0.5 tesla MRI system were obtained preoperatively and compared with operative findings. MRI correctly identified 46 of 54 full-thickness rotator cuff tears and 5 of 6 partial-thickness tears. A comparison of MRI and operative findings in full-thickness cuff tears showed a sensitivity of 85%, a specificity of 83%, and a positive prospective value (PPV) of 99%. A comparison of partial-thickness tears showed a sensitivity of 83%, a specificity of 85%, and PPV of 39%. Linear regression analysis showed an excellent correlation between the MRI assessment and measurement at the time of surgery (r=0.90, P<0.01). MRI was useful in evaluating large and medium-sized rotator cuff tears, but less useful in distinguishing small full-thickness tears from partial-thickness tears. (author)

  6. Tendon involvement in rheumatoid arthritis of the wrist: MRI findings

    Valeri, G.; Ferrara, C.; Ercolani, P.; De Nigris, E. [Ancona Univ. (Italy). Dept. of Radiology; Giovagnoni, A. [Modena Univ. (Italy). Dept. of Radiology

    2001-03-01

    Objective. To evaluate the distribution and extent of wrist tendon alterations in patients with active rheumatoid arthritis (RA) using magnetic resonance imaging (MRI). Design and patients. Forty-three clinically active RA patients with an illness duration of less than 4 years and no clinical evidence of tendons tears were enrolled in the study. There were 10 men and 33 women, with an average age of 52 years (range 33-63 years). MRI of both wrists, with one exception, was performed at 1.0 T using T1- and T2-weighted sequences (slice thickness 3 mm). Twelve healthy subjects (8 women, 4 men; mean age 31 years) were also evaluated as a control group. Two radiologists reviewed each of four schematic anatomical regions (volar, dorsal, ulnar, radial) for the degree of tendon and tendon sheath alterations using two progressive scales. Results. In the control group all tendons had homogeneous low signal intensity on all sequences. A small amount of fluid was found in six subjects but the diameter was always less than 1 mm. In the patient group minimal fluid (<2 mm) was found in 35 (41%) wrists, grade 2 fluid (<2>5mm) in 26 (31%) and grade 3 fluid (>5 mm) in 24 (28%). Fiftynine (69%) of the grade 1 changes were in the volar compartment but grade 2 involvement was evenly distributed. Grade 3 changes were most common in the dorsal compartment and combined grade 2 and 3 in the dorsal and ulnar compartments were 32 (38%) and 25 (30%) compared with 16 (18%) and 17 (20%) respectively in the volar and radial compartments. The tendons were normal (grade 0) in 47 (46%) wrists. A maximum tendon signal change (grade 1) was demonstrated in 28 wrists (32%). When associated with other individual tendons grades this grade was demonstrated in the dorsal compartment in 30 (35%) wrists, in the volar compartment in 12 (14%), in the radial compartment in 17 (20%) and in the ulnar compartment in 26 (30%). A partial tear (grade 2) was detected in 7 (8%) wrists, all involving the dorsal and ulnar compartments; five underwent surgical repair and one proved to have a complete rupture of extensor digitorum. Three (3%) had a grade 3 complete tendon tear: All of these were in extensor tendons. Surgical repair was successful in one case but two ruptured again within 3 months. (orig.)

  7. Tendon involvement in rheumatoid arthritis of the wrist: MRI findings

    Objective. To evaluate the distribution and extent of wrist tendon alterations in patients with active rheumatoid arthritis (RA) using magnetic resonance imaging (MRI). Design and patients. Forty-three clinically active RA patients with an illness duration of less than 4 years and no clinical evidence of tendons tears were enrolled in the study. There were 10 men and 33 women, with an average age of 52 years (range 33-63 years). MRI of both wrists, with one exception, was performed at 1.0 T using T1- and T2-weighted sequences (slice thickness 3 mm). Twelve healthy subjects (8 women, 4 men; mean age 31 years) were also evaluated as a control group. Two radiologists reviewed each of four schematic anatomical regions (volar, dorsal, ulnar, radial) for the degree of tendon and tendon sheath alterations using two progressive scales. Results. In the control group all tendons had homogeneous low signal intensity on all sequences. A small amount of fluid was found in six subjects but the diameter was always less than 1 mm. In the patient group minimal fluid (5mm) in 26 (31%) and grade 3 fluid (>5 mm) in 24 (28%). Fiftynine (69%) of the grade 1 changes were in the volar compartment but grade 2 involvement was evenly distributed. Grade 3 changes were most common in the dorsal compartment and combined grade 2 and 3 in the dorsal and ulnar compartments were 32 (38%) and 25 (30%) compared with 16 (18%) and 17 (20%) respectively in the volar and radial compartments. The tendons were normal (grade 0) in 47 (46%) wrists. A maximum tendon signal change (grade 1) was demonstrated in 28 wrists (32%). When associated with other individual tendons grades this grade was demonstrated in the dorsal compartment in 30 (35%) wrists, in the volar compartment in 12 (14%), in the radial compartment in 17 (20%) and in the ulnar compartment in 26 (30%). A partial tear (grade 2) was detected in 7 (8%) wrists, all involving the dorsal and ulnar compartments; five underwent surgical repair and one proved to have a complete rupture of extensor digitorum. Three (3%) had a grade 3 complete tendon tear: All of these were in extensor tendons. Surgical repair was successful in one case but two ruptured again within 3 months. (orig.)

  8. Osteoskeletal manifestations of scurvy: MRI and ultrasound findings

    Polat, Ahmet Veysel; Bekci, Tumay; Selcuk, Mustafa Bekir [Ondokuz Mayis University, Kurupelit, Department of Radiology, Faculty of Medicine, Samsun (Turkey); Say, Ferhat [Ondokuz Mayis University, Kurupelit, Department of Orthopaedics and Traumatology, Faculty of Medicine, Samsun (Turkey); Bolukbas, Emrah [Ondokuz Mayis University, Kurupelit, Department of Pediatrics, Faculty of Medicine, Samsun (Turkey)

    2015-08-15

    Scurvy has become very rare in the modern world. The incidence of scurvy in the pediatric population is extremely low. In the pediatric population, musculoskeletal manifestations are more common and multiple subperiosteal hematomas are an important indicator for the diagnosis of scurvy. Although magnetic resonance imaging findings of scurvy are well described in the literature, to our knowledge, ultrasound findings have not yet been described. In this article, we report a case of scurvy with associated magnetic resonance imaging and ultrasound findings. (orig.)

  9. Osteoskeletal manifestations of scurvy: MRI and ultrasound findings

    Scurvy has become very rare in the modern world. The incidence of scurvy in the pediatric population is extremely low. In the pediatric population, musculoskeletal manifestations are more common and multiple subperiosteal hematomas are an important indicator for the diagnosis of scurvy. Although magnetic resonance imaging findings of scurvy are well described in the literature, to our knowledge, ultrasound findings have not yet been described. In this article, we report a case of scurvy with associated magnetic resonance imaging and ultrasound findings. (orig.)

  10. Novel MRI finding for diagnosis of invasive placenta praevia: evaluation of findings for 65 patients using clinical and histopathological correlations

    To review established magnetic resonance (MR) criteria and describe a new MR finding for the diagnosis of invasive placenta praevia. A retrospective review of prenatal MRI examinations of 65 patients (median age: 35 years) who underwent MR for the screening of invasive placenta praevia. All MRIs were performed on a 1.5-T unit, including axial, coronal and sagittal T2-weighted half-Fourier single-shot turbo spin echo imaging. Fifteen patients were diagnosed with invasive placenta praevia. Two experienced radiologists reviewed the MR images and evaluated a total of six MRI features of the placenta, including our novel finding of the placental protrusion into the internal os (placental protrusion sign). Inter-rater reliability was assessed by using kappa statistics. Features with a kappa statistic >0.40 were evaluated using Fisher's two-sided exact test for comparison of their capabilities for placental invasion assessment. Interobserver reliability was moderate or better for the intraplacental T2 dark band, intraplacental abnormal vascularity, uterine bulging, heterogeneous placenta and placental protrusion sign. Fisher's two-sided exact test results showed all these features were significantly associated with invasive placenta praevia. The novel MRI finding of a placental protrusion sign is a useful addition to the established MRI findings for the diagnosis of invasive placenta praevia. (orig.)

  11. Novel MRI finding for diagnosis of invasive placenta praevia: evaluation of findings for 65 patients using clinical and histopathological correlations

    Ueno, Yoshiko; Kitajima, Kazuhiro; Maeda, Tetsuo; Suenaga, Yuko; Takahashi, Satoru; Sugimura, Kazuro [Kobe University Graduate School of Medicine, Department of Radiology, Kobe (Japan); Kawakami, Fumi [Kobe University Graduate School of Medicine, Department of Pathology, Kobe (Japan); Matsuoka, Shozo; Tanimura, Kenji; Yamada, Hideto [Kobe University Graduate School of Medicine, Department of Obstetrics and Gynaecology, Kobe (Japan); Ohno, Yoshiharu [Kobe University Graduate School of Medicine, Department of Radiology, Kobe (Japan); Kobe University Graduate School of Medicine, Advanced Biomedical Imaging Research, Kobe (Japan)

    2014-04-15

    To review established magnetic resonance (MR) criteria and describe a new MR finding for the diagnosis of invasive placenta praevia. A retrospective review of prenatal MRI examinations of 65 patients (median age: 35 years) who underwent MR for the screening of invasive placenta praevia. All MRIs were performed on a 1.5-T unit, including axial, coronal and sagittal T2-weighted half-Fourier single-shot turbo spin echo imaging. Fifteen patients were diagnosed with invasive placenta praevia. Two experienced radiologists reviewed the MR images and evaluated a total of six MRI features of the placenta, including our novel finding of the placental protrusion into the internal os (placental protrusion sign). Inter-rater reliability was assessed by using kappa statistics. Features with a kappa statistic >0.40 were evaluated using Fisher's two-sided exact test for comparison of their capabilities for placental invasion assessment. Interobserver reliability was moderate or better for the intraplacental T2 dark band, intraplacental abnormal vascularity, uterine bulging, heterogeneous placenta and placental protrusion sign. Fisher's two-sided exact test results showed all these features were significantly associated with invasive placenta praevia. The novel MRI finding of a placental protrusion sign is a useful addition to the established MRI findings for the diagnosis of invasive placenta praevia. (orig.)

  12. Medulloblastoma with extensive nodularity: US, CT and MRI findings

    Medulloblastoma accounts for up to 25% of all paediatric CNS tumours. According to WHO classification (2007) medulloblastoma with extensive nodularity (MBEN) is a separate rare entity associated with younger age and better prognosis. A 9-month-old girl was admitted and examined because of macrocephaly and disturbed psychomotor development. Transfontanel ultrasound revealed dilated ventricular system and hyperechoic mass in the posterior cranial fossa. Computed tomography showed hyperdense mass in the cerebellum. Magnetic resonance imaging revealed a mass with gyriform pattern and strong contrast enhancement after gadolinium administration. Differential diagnosis included dysplastic heterotopic cortex, Lhermitte-Duclos disease, atypical teratoid/rhabdoid tumour (AT/RT), and medulloblastoma (MB). The patient was operated on. Medulloblastoma with extensive nodularity (MBEN) was finally diagnosed. The authors present and discuss three other cases of this rare entity.Transfontanel sonografic examination is capable of detection of the posterior fossa tumour as a cause of hydrocephalus and macrocephaly. The mass in a child's posterior cranial fossa that is hyperdense on unenhanced CT and gyriform, nodular, and markedly enhancing on MRI may strongly suggest medulloblastoma with extensive nodularity (MBEN). (authors)

  13. Neurovascular compression of cranial nerves: CT and MRI findings

    Purpose: The compression of a nervous structure by an aberrant vessel may be asymptomatic or produce an important symptoms, in these cases CT and MRI show relevant information. Materials and Methods: Between January 1998 and March 2001, we studied 27 patients: 8 with trigeminal neuralgia, 7 with hemi facial spasm, 4 vertigo and tinnitus, 2 hemianopsia, 1 with neuralgia of the amygdalin fossa, 1 with bitonal voice, 1 with tongue deviation with fascicular movements, 2 essential hypertension and 1 with severe headache. All of them had a neurologic evaluation from 2 specialists and 2 neuro radiologists interpreted the results. Results: The CT and RMI images with special sequences allowed to prove the compression of the entry segments of the V, VII, IX, X and XII cranial nerves, of the optic chiasma and the ventrolateral aspect of the medulla oblongata in close relation with the vasopressor centre. Also they demonstrate a rare vessel in the Silvio aqueduct avoiding the normal flow of the CSF. Of the total of patients that were studied, 37% had surgical confirmation. Conclusion: CT and RMI are sensitive and specific methods for the detection of vascular compressions of nervous structures. (author)

  14. MRI findings in Tolosa-Hunt syndrome before and after systemic corticosteroid therapy

    Tolosa-Hunt syndrome (THS) is characterized by painful ophthalmoplegia due to a granulomatous inflammation in the cavernous sinus. Corticosteroid therapy dramatically resolves both the clinical and radiological findings of THS. We present MRI findings of six patients with a clinical history of at least one episode of unilateral or bilateral orbital-periorbital pain, clinical findings of associated paresis of one or more of 3rd, 4th, 5th or 6th cranial nerves. All of the patients revealed an enlargement of the symptomatic cavernous sinus on magnetic resonance imaging (MRI) scans. Five patients revealed total resolution of the clinical findings within 1-8 weeks, following systemic corticosteroid treatment. One patient revealed only minor regression of clinical findings within 2 weeks after the initiation of the treatment, so the cavernous sinus lesion was reevaluated as meningioma on MRI, and the patient underwent surgical resection of the mass with resultant histopathological finding of cavernous sinus meningioma. A follow-up MRI scan was performed for five patients at the end of 8-weeks of steroid therapy. Three of these five patients showed total resolution of the cavernous sinus lesions whereas two of them revealed a partial regression of the cavernous sinus lesions. MRI findings before and after systemic corticosteroid therapy are important diagnostic criteria to put the definitive diagnosis of THS and to differentiate it from other cavernous sinus lesions that simulate THS both clinically and radiologically

  15. MRI findings in Tolosa-Hunt syndrome before and after systemic corticosteroid therapy

    Cakirer, Sinan E-mail: scakirer@yahoo.com

    2003-02-01

    Tolosa-Hunt syndrome (THS) is characterized by painful ophthalmoplegia due to a granulomatous inflammation in the cavernous sinus. Corticosteroid therapy dramatically resolves both the clinical and radiological findings of THS. We present MRI findings of six patients with a clinical history of at least one episode of unilateral or bilateral orbital-periorbital pain, clinical findings of associated paresis of one or more of 3rd, 4th, 5th or 6th cranial nerves. All of the patients revealed an enlargement of the symptomatic cavernous sinus on magnetic resonance imaging (MRI) scans. Five patients revealed total resolution of the clinical findings within 1-8 weeks, following systemic corticosteroid treatment. One patient revealed only minor regression of clinical findings within 2 weeks after the initiation of the treatment, so the cavernous sinus lesion was reevaluated as meningioma on MRI, and the patient underwent surgical resection of the mass with resultant histopathological finding of cavernous sinus meningioma. A follow-up MRI scan was performed for five patients at the end of 8-weeks of steroid therapy. Three of these five patients showed total resolution of the cavernous sinus lesions whereas two of them revealed a partial regression of the cavernous sinus lesions. MRI findings before and after systemic corticosteroid therapy are important diagnostic criteria to put the definitive diagnosis of THS and to differentiate it from other cavernous sinus lesions that simulate THS both clinically and radiologically.

  16. Evaluation of atrial, ventricular and atrioventricular septal defects by cine magnetic resonance imaging

    Cine magnetic resonance imaging (MRI) was performed on 20 patients (mean age: 5.3±4.4 years) with atrial, ventricular, or atrioventricular septal defects for evaluation of cardiac structure and blood flow. Prior to cine MRI, electrocardiographycally gated MRI using multislice scquisition was performed on all patients to localize optimal slice location. Cine-MRI was obtained with a 30 deg flip angle, 15 msec echo time, and 30 msec pulse repetition time, on a 256 x 256 or 128 x 128 acquisition matrix. Abnormalities of cardiac structure were well defined in all patients by gated cardiac imaging. In 18 of the 20 patients, cine-MRI was able to detect shunt flow, visualized as a low intensity signal in comparison with the surrounding blood flow. Cine-MRI can provide not only accurate anatomy of cardiac structures but functional assessment of the cardiac chamber, wall topology and flow relations. Cine-MRI will become an important noninvasive technique for assessment of anatomy and physiology in congenital heart disease. (author)

  17. ''Dropped-head'' syndrome due to isolated myositis of neck extensor muscles: MRI findings

    Gaeta, Michele; Mazziotti, Silvio; Blandino, Alfredo [University of Messina, Department of Radiological Sciences, Messina (Italy); Toscano, Antonio; Rodolico, Carmelo; Mazzeo, Anna [University of Messina, Department of Neurosciences, Psychiatry and Anaesthesiology, Messina (Italy)

    2006-02-15

    MRI findings of a patient with dropped-head syndrome due to focal myositis of the neck extensor muscles are presented. MRI showed oedematous changes and marked enhancement of the neck extensor muscles. After therapy MRI demonstrated disappearance of the abnormal findings. (orig.)

  18. Evaluation of valvular regurgitation by cine magnetic resonance imaging (0.5 T)

    The usefulness of cine magnetic resonance imaging (MRI) as a method for the quantification of valvular regurgitation was studied. Cine MRI (0.5 T) was performed by using gradient echo technique in 29 patients with various valvular regurgitation (13 mitral regurgitation, 9 aortic regurgitation, 7 tricuspid regurgitation) and the data were compared with those by Doppler color-flow mapping. A distance of signal loss in cine MRI was compared with that of regurgitant jet in Doppler color-flow mapping. A good correlation between the two methods was noted in each valvular disease (r = 0.989 in mitral regurgitation, r = 0.908 in aortic regurgitation and r = 0.985 in tricuspid regurgitation). Cine MRI, even if 0.5 T, is a useful method of noninvasive quantificaiton of valvular regurgitation. (author)

  19. Heat-stroke-induced cerebellar atrophy: clinical course, CT and MRI findings

    We report the clinical course and CT and MRI findings in a case of heat-stroke-induced cerebellar atrophy. Although the cerebellar syndrome was severe concomitant with the onset of heat stroke, no abnormality was observed on brain CT in the first 2 weeks following the event. Cerebellar atrophy was first noted after 10 weeks on MRI; it was progressive during a 1-year follow-up. (orig.)

  20. Detailed Shoulder MRI Findings in Manual Wheelchair Users with Shoulder Pain

    Morrow, Melissa M. B.; Van Straaten, Meegan G.; Naveen S. Murthy; Braman, Jonathan P.; Elia Zanella; Kristin D. Zhao

    2014-01-01

    Shoulder pain and pathology are common in manual wheelchair (MWC) users with paraplegia, and the biomechanical mechanism of injury is largely unknown. Establishing patterns of MRI characteristics in MWC users would help advance understanding of the mechanical etiology of rotator cuff disease, thus improving the logic for prescribed interventions. The purpose of this study was to report detailed shoulder MRI findings in a sample of 10 MWC users with anterolateral shoulder pain. The imaging ass...

  1. Pulmonary Aspergillus chest wall involvement in chronic granulomatous disease: CT and MRI findings

    Pulmonary Aspergillus infection in patients with chronic granulomatous disease tends to involve the chest wall and consequently carries a high mortality rate. We report the findings of computed tomography (CT) and magnetic resonance imaging (MRI) in three such cases. We suggest that CT and MRI have a complementary role in evaluating chest wall invasion by pulmonary Aspergillus infection in chronic granulomatous disease. (orig./GDG)

  2. Evaluation of pre-operative staging of renal cell cancer with cine MR imaging

    To assess the utility of single section cine MR images in evaluation of extrarenal invasion of renal cell cancer. Six patients who subsequently underwent definitive surgery were examined. Sequential twenty FLASH images were acquired in coronal and parasagittal single section during one respiratory cycle. These images were evaluated in cine-loop mode to assess tumoral movement with adjacent structures. Cine MR images showed that the tumor in one patient were fixed to the spleen and the tumors in five patients showed free movement. At pathologic examination, cine MR findings were proved correct in all patients. Cine MR images may be useful for pre-operative evaluation of extrarenal invasion. (author)

  3. MRI and SPECT findings as a predictive factor for postencephalitic epilepsy

    Relationship between postencephalitic epilepsy and acute phase symptoms, CSF, EEG and MRI findings was assessed by Kaplan-Meier method. Thirteen of 34 patients manifestated epilepsy including four intractable cases. Women (7/11), herpes simplex virus (6/7), seizures in acute phase (12/18), abnormal findings or MRI (6/7) were statistically significant. Four of nine patients with hyperperfusion area by HMPAO-SPECT in acute phase and two of three patients with hypoperfusion area by IMP-SPECT in recovery phase had epilepsy. Hyperperfusion in acute phase reflected acute seizures and inflammations, whereas hypoperfusion in the recovery phase reflected hypometabolism caused by brain damage. These findings suggest epileptogenicity, MRI and SPECT findings may predict prognosis of postencephalitic epilepsy. (author)

  4. Repaired supraspinatus tendons in clinically improving patients: Early postoperative findings and interval changes on MRI

    Lee, Jung Eun; Park, Ji Seon; Ryu, Kyung Nam; Rhee, Yong Girl [Kyung Hee University Hospital, Seoul (Korea, Republic of); Yoon, So Hee; Park, So Young; Jin Wook [Dept. of Radiology, Kyung Hee University Hospital at Gangdong, Seoul (Korea, Republic of)

    2015-04-15

    To demonstrate and further determine the incidences of repaired supraspinatus tendons on early postoperative magnetic resonance imaging (MRI) findings in clinically improving patients and to evaluate interval changes on follow-up MRIs. Fifty patients, who showed symptomatic and functional improvements after supraspinatus tendon repair surgery and who underwent postoperative MRI twice with a time interval, were included. The first and the second postoperative MRIs were obtained a mean of 4.4 and 11.5 months after surgery, respectively. The signal intensity (SI) patterns of the repaired tendon on T2-weighted images from the first MRI were classified into three types of heterogeneous high SI with fluid-like bright high foci (type I), heterogeneous high SI without fluid-like bright high foci (type II), and heterogeneous or homogeneous low SI (type III). Interval changes in the SI pattern, tendon thickness, and rotator cuff interval thickness between the two postoperative MRIs were evaluated. The SI patterns on the first MRI were type I or II in 45 tendons (90%) and type III in five (10%). SI decreased significantly on the second MRI (p < 0.050). The mean thickness of repaired tendons and rotator cuff intervals also decreased significantly (p < 0.050). Repaired supraspinatus tendons exhibited high SI in 90% of clinically improving patients on MRI performed during the early postsurgical period. The increased SI and thickness of the repaired tendon decreased on the later MRI, suggesting a gradual healing process rather than a retear.

  5. Repaired supraspinatus tendons in clinically improving patients: Early postoperative findings and interval changes on MRI

    To demonstrate and further determine the incidences of repaired supraspinatus tendons on early postoperative magnetic resonance imaging (MRI) findings in clinically improving patients and to evaluate interval changes on follow-up MRIs. Fifty patients, who showed symptomatic and functional improvements after supraspinatus tendon repair surgery and who underwent postoperative MRI twice with a time interval, were included. The first and the second postoperative MRIs were obtained a mean of 4.4 and 11.5 months after surgery, respectively. The signal intensity (SI) patterns of the repaired tendon on T2-weighted images from the first MRI were classified into three types of heterogeneous high SI with fluid-like bright high foci (type I), heterogeneous high SI without fluid-like bright high foci (type II), and heterogeneous or homogeneous low SI (type III). Interval changes in the SI pattern, tendon thickness, and rotator cuff interval thickness between the two postoperative MRIs were evaluated. The SI patterns on the first MRI were type I or II in 45 tendons (90%) and type III in five (10%). SI decreased significantly on the second MRI (p < 0.050). The mean thickness of repaired tendons and rotator cuff intervals also decreased significantly (p < 0.050). Repaired supraspinatus tendons exhibited high SI in 90% of clinically improving patients on MRI performed during the early postsurgical period. The increased SI and thickness of the repaired tendon decreased on the later MRI, suggesting a gradual healing process rather than a retear.

  6. Cine MR imaging of the cardiovascular system

    In recent years cine magnetic resonance imaging (MRI) has developed as a high-speed imaging technique that provides a high intensity signal even at a short repetition time (20-30 msec) by using an excited pulse with a small flip angle according to the gradient echo method, enabling about 20 to 30 continuous images of the same section per one cardiac cycle to be taken. On cine display of these continuous images, information concerning blood flow shown by a high intensity signal in comparison with that of the myocardium and vascular wall is obtained with high temporal resolution along with anatomical information. The present study reports the clinical usefulness of cine MRI in today's situation, inculding the following: calculation of the left ventricular ejection fraction and pulmonary-to-systemic flow ratio in congenital shunt disease by integration of the area of multisections through application of Simpson's method; diagnosis of the severity of valvular regurgitation, evaluation of stenosal diseases, and diagnosis of inflow from the fissured entry of dissecting aortic aneurysm by evaluating of an area of low intensity signal, probably based on the high velocity or turbulent blood flow: and evaluation of patency of the internal mammary artery bypass graft of the basis of the possible visualization of even thin blood vessels because of the high intensity signal of blood flow. In particular, the characteristics of this procedures are described by comparing it with other technologies in the field of diseases of valvular regurgitation. (author)

  7. Abnormal findings of magnetic resonance imaging (MRI) in patients with systemic lupus erythematosus involving the brain

    Ishikawa, Akira; Okada, Jun; Kondo, Hirobumi (Kitasato Univ., Sagamihara, Kanagawa (Japan). School of Medicine); Kashiwazaki, Sadao

    1992-06-01

    To elucidate the clinical significance of MRI on central nervous system systemic lupus erythematosus (CNS-SLE), MRI and CT scans were performed in 35 patients with SLE, of 18 patients who had CNS manifestations at the time of MRI examinations. The investigations were also carried out in 17 patients without CNS-SLE. The rate of detection of abnormal findings on MRI in patients with CNS-SLE was 77.2% (14/18), which was high, as compared with the rate of those on CT scans (50%: 9/18). Especially, all of 4 patients with seizure and 3 patients with encephalopathy showed abnormal MRI findings, although respectively 50% and 33.3% of them had abnormal CT scan findings. MRI findings were classified into 4 groups below: (1) Large focal are as increased signal intensity at T2 weighted image. These were observed in 2 of 4 patients with seizure and 1 of 3 patients with encephalopathy, which were completely resolved after treatment. (2) Patchy subcortical foci of increased signal intensity at T2 weighted image. These were observed in 11 of 18 CNS-SLE and 7 of 17 without CNS-SLE, which were not detected by CT scan. (3) All of six patients with cerebral infarctions showed high signal intensity areas at T2 weighted image and low signal intensity areas at T1 weighted image. (4) Normal findings were observed in 4 of 18 CNS-SLE (22.2%). We concluded that MRI is useful for the evaluation of CNS-SLE and provides more information than CT scan. (author).

  8. Cine-Club

    CineClub

    2014-01-01

      On the occasion of CERN’s 60th anniversary the CERN CineClub will be showing films from all CERN member states Thursday 10 April 2014 at 20:00 CERN Council Chamber   The Bothersome Man     Directed by Jens Lien (Norway, 2006) 95 minutes   Forty-year-old Andreas arrives in a strange city with no memory of how he got there. He is presented with a job, an apartment-even a beautiful girlfriend. But before long, Andreas notices that something is wrong. The people around him seem cut off from any real emotion, and communicate only in superficialities. All this seems to be governed by a shadowy group of technicians, the ominous Caretakers’, who make sure the city runs smoothly. When they find Andreas is not adjusting to his new life, they keep an increasing watch over his activities...”The Bothersome Man” is a fantastic fable, a parable for modern society’s consumerism and obsession with ap...

  9. Brain MRI findings in patients with initial cerebral thrombosis and the relationship between incidental findings, aging and dementia

    To estimate the relationship between aging, dementia and changes observed on magnetic resonance imaging (MRI) seen in elderly patients with cerebral thrombosis, MRI findings in 103 patients with an initial stroke event (thrombosis group) were compared with those of 37 patients with hypertension/diabetes (high risk group) and 78 patients without those disorders (low risk group). In addition to the causative lesions in the thrombosis group, periventricular hyperintensities (PVH), spotty lesions (SL), silent infarctions (SI), ventricular dilatation (VD), and cortical atrophy (CA) were analyzed in these groups. Infarctions located in the internal capsule/corona radiata were the most frequent causative lesion. Compared to the low risk group, a high incidence of patchy/diffuse PVH, SI, and severe CA was seen in both the thrombosis group and the high risk group. Widespread PVH and multiple SL increased with age in the thrombosis group, while severe CA was seen in each group. SI and VD tended to increase after age 60, though they were not significant. Dementia, diagnosed in 40 out of 78 patients, increased with age. Multivariate analysis revealed the degree of the effects of MRI findings on dementia to be marked in PVH, brain atrophy, causative lesions, and SL, in that order. These results indicated that diffuse PVH and brain atrophy, developing with age, promoted dementia in the elderly with vascular lesions. Moreover, they suggested that a variety of silent brain lesions recognized on MRI other than infarction can affect symptoms in the elderly. (author)

  10. Spinal MRI Findings of Guillain-Barré Syndrome

    Ozlem Alkan; Tulin Yildirim; Naime Tokmak; Meliha Tan

    2009-01-01

    Guillain-Barré syndrome is a relatively common, acute, and rapidly progressive, inflammatory demyelinating polyneuropathy. The diagnosis is usually established on the basis of symptoms and signs, aided by cerebrospinal fluid findings and electrophysiologic criteria. Previously, radiologic examinations have been used only to rule out other spinal abnormalities. We report a case of systemic lupus erythematosus associated with Guillain-Barré syndrome with marked enhancement of nerve roo...

  11. Mechanism of traumatic knee injuries and MRI findings.

    Ciuffreda, P; Lelario, M; Milillo, P; Vinci, R; Coppolino, F; Stoppino, L P; Genovese, E A; Macarini, L

    2013-08-01

    Bone bruises are focal abnormalities in subchondral bone marrow due to trabecular microfractures as a result of traumatic force. These trauma-induced lesions are better detected with magnetic resonance (MR) imaging using water-sensitive sequences. Moreover, the pattern of bone bruise is distinctive and allows us to understand the dynamics of trauma and to predict associated soft injuries. This article discusses the mechanism of traumatic injury and MR findings. PMID:23949934

  12. Incidental findings on MRI scans of patients presenting with audiovestibular symptoms

    Khan Mohammad H

    2010-06-01

    Full Text Available Abstract Background The evaluation of patients presenting with audiovestibular symptoms usually includes MRI of the internal auditory meatus, the cerebellopontine angle and the brain. A significant percentage of these scans will present unexpected, incidental findings, which could have important clinical significance. Objective To determine the frequency and clinical significance of incidental findings on MRI scans of patients with audiovestibular symptoms. Materials and methods A retrospective analysis of 200 serial MRI scans. Results Gender distribution: equal. Age range: 17-82 years. One-hundred and four scans (52% were normal and 1 scan (0.5% demonstrated a unilateral vestibular schwannoma. Ninety-five scans (47.5% demonstrated incidental findings. Sixty-six of these (33% were considered of ishaemic origin and did not require further action. Five (2.5% scans demonstrated significant findings which warranted appropriate referral; Two Gliomas (1%, 2 cases of extensive White Matter Lesions (1%, 1 lipoma (0.5%. The remaining scans demonstrated various other findings. Conclusion Investigation of patients with audiovestibular symptoms with MRI scans revealed incidental findings in a significant percentage (47.5%. The majority of these findings were benign warranting no further action and only 2.5% required further referral. It is the responsibility of the referring Otolaryngologist to be aware of these findings, to be able to assess their significance, to inform the patient and if needed to refer for further evaluation.

  13. CT and MRI findings and classification study of brain schistosomiasis granuloma

    Objective: To study CT and MRI features and classification of brain schistosomiasis granuloma. Methods: CT and MRI data of 30 cases of brain schistosomiasis granuloma were reviewed. All cases were proved by the surgery or pathological examination and clinical laboratory test. There were 20 males and 10 females, and their age ranged from 5 to 58 years, mean 29.2 years. Plain and enhanced CT were performed in all patients with GE MAX 640 scanner. Ten patients were examined by plain and enhanced MRI with GE Signa profile 0.2 Tesla open scanner. Results: The lesions located in supratentorial region in 27 cases and in infratentorial region in 3 cases. The nodules were isodense or slight hyperdense on CT plain scan, iso or hypointense on T1WI, hyperintense on T2WI, Slight hyperintense on FLAIR. After the contrast material was injected intravenously, CT and MRI findings were multiple or single enhanced nodules at the cortical or subcortical area. There were four types of imaging features: (1) multiple small nodules in 5 cases (presenting as bright stars in the dark sky); (2) single large nodule in 8 cases; (3) mixed nodules in 14 cases; (4) circle-enhanced nodules in 3 cases. Conclusion: The brain schistosomiasis granuloma has typical CT and MRI findings. CT and MRI classification is not only helpful to its diagnosis and differential diagnosis, but also might be useful for the choice of clinical treatment

  14. MRI findings in an infant with vaccine-associated paralytic poliomyelitis

    Although acute flaccid paralysis is a manifestation observed in several neurologic and muscular disorders, vaccine-associated paralytic poliomyelitis (VAPP) is an exceedingly rare etiology. In the clinical setting of acute flaccid paralysis, MRI is useful in differentiating between VAPP and other conditions. Additionally, MRI can assess the extent of lesions. However, reports on MRI findings in VAPP are scarce in the pediatric radiology literature. We report a Brazilian infant who developed VAPP 40 days after receiving the first dose of oral polio vaccine (OPV). MR images of the cervical and thoracic spinal cord showed lesions involving the anterior horn cell, with increased signal intensity on T2-weighted sequences. We would like to emphasize the importance of considering VAPP as a differential diagnosis in patients with acute flaccid paralysis and an MRI showing involvement of medulla oblongata or spinal cord, particularly in countries where OPV is extensively administered. (orig.)

  15. MRI findings in an infant with vaccine-associated paralytic poliomyelitis

    Lopes Ferraz-Filho, Jose Roberto [Sao Jose do Rio Preto Medical School, Department of Radiology, Hospital de Base, Sao Paulo, State (Brazil); Sao Jose do Rio Preto Medical School, Department of Radiology, Sao Jose do Rio Preto, Sao Paulo State (Brazil); Santos Torres, Ulysses dos; Portela de Oliveira, Eduardo; Soares Souza, Antonio [Sao Jose do Rio Preto Medical School, Department of Radiology, Hospital de Base, Sao Paulo, State (Brazil)

    2010-12-15

    Although acute flaccid paralysis is a manifestation observed in several neurologic and muscular disorders, vaccine-associated paralytic poliomyelitis (VAPP) is an exceedingly rare etiology. In the clinical setting of acute flaccid paralysis, MRI is useful in differentiating between VAPP and other conditions. Additionally, MRI can assess the extent of lesions. However, reports on MRI findings in VAPP are scarce in the pediatric radiology literature. We report a Brazilian infant who developed VAPP 40 days after receiving the first dose of oral polio vaccine (OPV). MR images of the cervical and thoracic spinal cord showed lesions involving the anterior horn cell, with increased signal intensity on T2-weighted sequences. We would like to emphasize the importance of considering VAPP as a differential diagnosis in patients with acute flaccid paralysis and an MRI showing involvement of medulla oblongata or spinal cord, particularly in countries where OPV is extensively administered. (orig.)

  16. Perianal disease in pediatric Crohn disease: a review of MRI findings

    Compton, Gregory L.; Bartlett, Murray [Royal Children' s Hospital, Medical Imaging Department, Parkville, Victoria (Australia)

    2014-10-15

    Perianal complications of Crohn disease are a common occurrence in children and can result in significant morbidity when not accurately characterized prior to surgical intervention. MRI is an excellent imaging modality for the evaluation of perianal inflammatory bowel disease - allowing characterization and detailed description of perianal fistulas. MRI has many advantages over other imaging modalities for the pediatric patient. Radiologists will benefit from a sophisticated understanding of perianal anatomy, the classification of perianal fistulas, the advantages MRI offers in characterization of perianal fistulas as well as the common and incidental findings that are important in the MRI evaluation of perianal inflammatory bowel disease in children. Perianal fistulas are found at a high rate in pediatric referrals and are more commonly found in male patients. (orig.)

  17. MRI findings of radiation encephalopathy of brain stem after radiotherapy for nasopharyngeal cancer

    Purpose: To study MRI findings and clinical manifestation of radiation encephalopathy (RE) of brain stem. Methods: MRI findings and clinical symptoms in 51 patients with RE of brain stem after radiotherapy for nasopharyngeal cancer were reviewed. Results: Clinical symptoms included number weakness or paralysis in the limbs and symptoms of damaged cranial nerves. All lesions appeared hypo- or iso-intense on spin echo(SE) T1-weighted images and inhomogeneous and mixed hyper- and iso-intense on Turbo spin echo (TSE) T2-weighted images. The lesions were located in mesencephalon, pons, medulla, basilar part of pons, basilar part of pons and medulla oblongata in 2,7,3,9 and 30 patients respectively. The enhancement patterns included irregular rings in 39 patients, spotty in 3 and no enhancement in 9 patients. Mass effect was minimal in all patients. On follow-up MRI, the lesions disappeared in 4 patients, did not change in size and shape in 8 patients and enlarged in 2 patients. Conclusion: MRI could demonstrate the characteristic findings of RE of brain stem. MRI findings sometimes are not consistent with the clinical symptoms

  18. CT and MRI findings in mucoceles of paranasal sinuses and their diagnostic value

    Objective: To study the CT and MRI findings of mucoceles of paranasal sinuses and their value in differential diagnosis between mucoceles and tumors. Methods: Twenty-two cases including 37 mucoceles were studied. CT was performed in all and MRI was performed in 10 cases. CT and MRI findings were analysed and correlated with operative findings. Results: Of 37 mucoceles, 19 were found in ethmoid sinuses, 9 in frontal sinuses, 5 in sphenoid sinuses and 4 in maxillary sinuses. Sinus expansion and thinning of sinus walls were found in all 37 sinuses with mucoceles on CT. Bony defect in sinus wall was found in 24 sinuses resulting in protrusion of the mucoceles into adjacent structures. CT showed low density with respect to muscle in 26 sinuses, identical density in 6 sinuses and high density in 5 sinuses and peripheral sinus mucosa enhancement in 7 cases. On MRI, the mucocele contents exhibited various signal intensities on T1- and T2-weighted images according to the protein concentration. Eight cases who underwent contrast study showed peripheral mucosa enhancement. Conclusions: CT and MRI can accurately display the location and characteristic findings of mucoceles and play an important role in diagnosis and differential diagnosis

  19. An experimental study on image findings of MRI and their pathomorphological basis in limb gunshot wound

    Objective: To observe the MRI findings of limb gunshot wound and investigate their pathomorphological basis through animal models. Methods: Sixteen mongrel dogs were divided into four groups randomly. The hind legs of dogs shot with handgun were undergone 0.5 T MRI scans at 5 h, 24 h, 48 h, and 72 h after wounded, respectively. The gross changes, HE staining light microscopic findings and MRI findings of wounds were observed. Results: Permanent tract was a zone of tissue defect. In the tract, blood of 5 h group's and pus of 24 h, 48 h, and 72 h groups showed T1WI hypointense signal and T2WI hyperintense signal. In contusion zone, the main pathological change was homogeneous coagulating necrosis of muscle fibers. MRI images showed irregular line, dot, or block T1WI isointense signal, T2WI hypointense signal, and no enhanced after Gd-DTPA injected in all groups. In concussion zone, the main pathological changes of 5 h group were edema, degeneration, and lysis of cells and lots of erythrocytes in the tissue interspace. Besides these, a large quantity of leucocytes and pus cells appeared, the lysis of degenerated cells near the contusion zone and the edema of such area, with passage of time, were more obviously in groups 24 h, 48 h, and 72 h. In MRI, concussion zone showed slightly hypointense T1WI signal, hyperintense T2WI, signal and T2WI signal got higher and the adjacent contusion zone got clearer with time pass. Concussion zone could be enhanced obviously. Conclusion: MRI can reflect the lesion of tissue in limb gunshot wound accurately during seventy-two hours after wound. The T2WI and contrast-enhanced T1WI are valuable. The special tissue-defect area, coagulating necrosis of cells, and large range injury of blood vessels and cells are the important pathomorphological basis which cause the MRI findings of gunshot wound different from normal trauma. (author)

  20. Findings at brain MRI in children with dengue fever and neurological symptoms.

    Rastogi, Ruchi; Garg, Bhavya

    2016-01-01

    Dengue is a flavivirus of the genus arbovirus with four serotypes, from DEN 1 to DEN 4. There has been an increase in incidence of dengue infection in children in the tropics and subtropics. Dengue has a variable clinical presentation, with many patients being asymptomatic. Its clinical manifestations in children vary from fever and arthralgia to life-threatening dengue hemorrhagic fever and dengue shock syndrome. We describe MRI findings in children with neurological involvement including dengue encephalopathy, acute hypoxic injury and dengue encephalitis. Dengue encephalopathy is usually secondary to multisystem derangement such as shock, hepatitis, coagulopathy and concurrent bacterial infection and is relatively common. Dengue encephalitis from direct neuronal invasion is rare. Nonspecific changes are seen on brain MRI in dengue infection. Clinical and laboratory findings as well as outcome do not necessarily correspond with brain MRI findings. PMID:26216156

  1. Findings at brain MRI in children with dengue fever and neurological symptoms

    Dengue is a flavivirus of the genus arbovirus with four serotypes, from DEN 1 to DEN 4. There has been an increase in incidence of dengue infection in children in the tropics and subtropics. Dengue has a variable clinical presentation, with many patients being asymptomatic. Its clinical manifestations in children vary from fever and arthralgia to life-threatening dengue hemorrhagic fever and dengue shock syndrome. We describe MRI findings in children with neurological involvement including dengue encephalopathy, acute hypoxic injury and dengue encephalitis. Dengue encephalopathy is usually secondary to multisystem derangement such as shock, hepatitis, coagulopathy and concurrent bacterial infection and is relatively common. Dengue encephalitis from direct neuronal invasion is rare. Nonspecific changes are seen on brain MRI in dengue infection. Clinical and laboratory findings as well as outcome do not necessarily correspond with brain MRI findings. (orig.)

  2. Findings at brain MRI in children with dengue fever and neurological symptoms

    Rastogi, Ruchi; Garg, Bhavya [Indraprastha Apollo Hospitals, Department of Radiodiagnosis, New Delhi (India)

    2016-01-15

    Dengue is a flavivirus of the genus arbovirus with four serotypes, from DEN 1 to DEN 4. There has been an increase in incidence of dengue infection in children in the tropics and subtropics. Dengue has a variable clinical presentation, with many patients being asymptomatic. Its clinical manifestations in children vary from fever and arthralgia to life-threatening dengue hemorrhagic fever and dengue shock syndrome. We describe MRI findings in children with neurological involvement including dengue encephalopathy, acute hypoxic injury and dengue encephalitis. Dengue encephalopathy is usually secondary to multisystem derangement such as shock, hepatitis, coagulopathy and concurrent bacterial infection and is relatively common. Dengue encephalitis from direct neuronal invasion is rare. Nonspecific changes are seen on brain MRI in dengue infection. Clinical and laboratory findings as well as outcome do not necessarily correspond with brain MRI findings. (orig.)

  3. CT and MRI findings of cystadenofibromas of the ovary

    The aim of this study was to assess imaging findings on CT or MR images of histologically proven ovarian cystadenofibromas. In the period 1995-2001, 32 histologically proven ovarian cystadenofibromas were identified in 28 women. Of the 32 ovarian cystadenofibromas, 16 tumors were purely cystic and the remaining 16 were complex cystic on CT or MR images. Solid components of 16 complex cystic tumors were seen as nodular (n=8) or trabecular (n=9) solid areas. One tumor had both nodular and trabecular solid components. Among 16 complex cystic tumors, 14 had thick or irregular septa; thus, half of ovarian cystadenofibromas had morphological imaging features of malignancy on CT or MR images. On histology, solid components in the cystic tumors were correlated with fibrous stromas that occasionally made a false-positive result for malignancy on imaging. (orig.)

  4. Lumbar disc herniation at high levels : MRI and clinical findings

    To assess the frequency, location, associated MR findings, and clinical symptoms of the high level lumbar disc herniation(HLDH). A total of 1076 patients with lunbar disc herniation were retrospectively reviewed. MR images of 41 of these with HLDH(T12-L1, L1-2, L2-3) were analysed in terms of frequency, location, and associated MR findings, and correlated with clinical symptoms of HLDH. The prevalence of HLDH was 3.8%(41/1076). HLDH was located at T12-L1 level in four patients(10%), at L1-2 level in 14(34%), at L2-3 level in 21(51%), and at both L1-2 and L2-3 levels in two. The age of patients ranged from 20 to 72 years (mean, 44), and there were 26 men and 16 women. In 11(27%), whose mean age was 32 years, isolated disc herniation was limited to these high lumbar segments. The remaining 30 patients had HLDH associated with variable involvement of the lower lumbar segments. Associated lesions were as follow : lower level disc herniation(14 patients, 34%); apophyseal ring fracture(8 patients, 19%); Schmorl's node and spondylolisthesis (each 6 patients, each 14%); spondylolysis(3 patients, 7%); and retrolisthesis(2 patients, 5%). In 20 patients(49%) with HLDH(n=41), there was a previous history of trauma. Patients with HLDH showed a relatively high incidence of associated coexisting abnormalities such as lower lumbar disc herniation, apophyseal ring fracture, Schmorl's node, spondylolysis, and retrolisthesis. In about half of all patients with HLDH there was a previous history of trauma. The mean age of patients with isolated HLDH was lower; clinical symptoms of the condition were relatively nonspecific and their incidence was low

  5. Lumbar disc herniation at high levels : MRI and clinical findings

    Paek, Chung Ho; Kwon, Soon Tae; Lee, Jun Kyu; Ahn, Jae Sung; Lee, Hwan Do; Chung, Yon Su; Jeong, Ki Ho; Cho, Jun Sik [Chungnam National Univ. College of Medicine, Taejon (Korea, Republic of)

    1999-04-01

    To assess the frequency, location, associated MR findings, and clinical symptoms of the high level lumbar disc herniation(HLDH). A total of 1076 patients with lunbar disc herniation were retrospectively reviewed. MR images of 41 of these with HLDH(T12-L1, L1-2, L2-3) were analysed in terms of frequency, location, and associated MR findings, and correlated with clinical symptoms of HLDH. The prevalence of HLDH was 3.8%(41/1076). HLDH was located at T12-L1 level in four patients(10%), at L1-2 level in 14(34%), at L2-3 level in 21(51%), and at both L1-2 and L2-3 levels in two. The age of patients ranged from 20 to 72 years (mean, 44), and there were 26 men and 16 women. In 11(27%), whose mean age was 32 years, isolated disc herniation was limited to these high lumbar segments. The remaining 30 patients had HLDH associated with variable involvement of the lower lumbar segments. Associated lesions were as follow : lower level disc herniation(14 patients, 34%); apophyseal ring fracture(8 patients, 19%); Schmorl's node and spondylolisthesis (each 6 patients, each 14%); spondylolysis(3 patients, 7%); and retrolisthesis(2 patients, 5%). In 20 patients(49%) with HLDH(n=41), there was a previous history of trauma. Patients with HLDH showed a relatively high incidence of associated coexisting abnormalities such as lower lumbar disc herniation, apophyseal ring fracture, Schmorl's node, spondylolysis, and retrolisthesis. In about half of all patients with HLDH there was a previous history of trauma. The mean age of patients with isolated HLDH was lower; clinical symptoms of the condition were relatively nonspecific and their incidence was low.

  6. Clinical, MRI and perfusion SPECT findings in strategic infarct dementia

    Strategic infarct dementia (SID) is characterized by focal ischemic lesions involving specific sites that are critical for higher cortical functions. The mechanism of SID are not well understood. We evaluate lesion sites, neuropsychiatric symptoms, brain perfusion SPECT and neuropsychological findings in patients with SID. Eleven patients with SID according to NINDS-AIREN criteria for vascular dementia were included. All patients performed brain MR and MRA, Tc-99m HMPAO brain perfusion SPECT. Various sites were responsible for SID; thalamus(n=3), medial temporal lobe(n=3), medial frontal lobe(n=1), genu of internal capsule(n=1), caudate nucleus(n=1), angular gyrus(n=1) and temporooccipital lobe(n=1). The most common neuropsychiatric symptoms were apathy and indifference by K-NPI. Brain perfusion SPECT revealed ipsilateral cortical hypoperfusion, mainly in frontal and temporal lobe area, in patients with subcortical strategic infarct. On neuropsychological assessment, cognitive deficits on attention and frontal executive function were prominent. The thalamus and medial temporal lobe were the most common sites responsible for SID. It was suggested that strategic disruption of frontal-subcortical circuit be an important role to produce SID in patients with subcortical strategic lesions

  7. Clinical, MRI and perfusion SPECT findings in strategic infarct dementia

    Kang, Do Young; Park, Kyung Won; Cha, Jae Kwan; Kim, Sang Ho; Kim, Jae Woo [Dong-A University College of Medicine, Busan (Korea, Republic of)

    2002-07-01

    Strategic infarct dementia (SID) is characterized by focal ischemic lesions involving specific sites that are critical for higher cortical functions. The mechanism of SID are not well understood. We evaluate lesion sites, neuropsychiatric symptoms, brain perfusion SPECT and neuropsychological findings in patients with SID. Eleven patients with SID according to NINDS-AIREN criteria for vascular dementia were included. All patients performed brain MR and MRA, Tc-99m HMPAO brain perfusion SPECT. Various sites were responsible for SID; thalamus(n=3), medial temporal lobe(n=3), medial frontal lobe(n=1), genu of internal capsule(n=1), caudate nucleus(n=1), angular gyrus(n=1) and temporooccipital lobe(n=1). The most common neuropsychiatric symptoms were apathy and indifference by K-NPI. Brain perfusion SPECT revealed ipsilateral cortical hypoperfusion, mainly in frontal and temporal lobe area, in patients with subcortical strategic infarct. On neuropsychological assessment, cognitive deficits on attention and frontal executive function were prominent. The thalamus and medial temporal lobe were the most common sites responsible for SID. It was suggested that strategic disruption of frontal-subcortical circuit be an important role to produce SID in patients with subcortical strategic lesions.

  8. Brain MRI findings in two cases with eclampsia

    Neurological complications in patients with eclampsia are varied and include headache, visual disturbances, focal neurological deficits, altered mental status and coma. Occasionally, a focal neurological deficit includes a variety of visual disturbances. The pathophysiology of CNS abnormalities in patients with eclampsia is uncertain. Our cases, combined with a review of the literature, demonstrate that there is no correlation among severity of hypertension, parity, and location of lesions at initial magnetic resonance (MR) imaging findings or between the severity of hypertension and neurological symptoms. Two typical patterns are seen on MR images of patients with eclampsia. Lesions in the region of the posterior cerebral circulation are most common and are frequently associated with visual disturbances. Although there are lesions in the deep white matter or basal ganglia, a focal neurological deficit or alterations in mental status may not develop. This demonstrates the sensitivity of MR imaging in the detection of abnormalities in patients with eclampsia, even those without neurological deficits. 13 refs., 1 tab., 2 figs

  9. Evaluation of MRI findings in non-specific inflammatory processes in the parasellar region

    We report the MRI findings on 6 patients with a non-specific inflammatory process in the parasellar region. Ophthalmoplegia developed in all patients. Only two patients complained of boring pain behind the eye and one of mild headache. The other three patients did not complain of pain. MRI clearly showed the extent of the lesions. In two patients the lesion was localized in the cavernous sinus. In the other patients, the lesions extended to the orbital apex, intrasellar and suprasellar regions, infratemporal fossa, or other neighboring regions beyond the cavernous sinus. The signal intensity of the lesions on T2WI was variable. The lesions were significantly enhanced after administration of Gd-DTPA. They were non-homogeneously enhanced in some patients. In three patients the lesions were well enhanced on the initial MRI scans. However, they were less enhanced on subsequent follow-up MRI or CT. The signal intensity and the degree of enhancement may vary substantially during the evolution of the inflammatory process or by blood flow in the cavernous sinus. Painful ophthalmoplegia is encountered in diseases of diverse pathogenesis in which the signal intensity and the extent of the lesions are variable. The MRI findings in one patient were not different from those of perineural spread from extracranial lesions, especially the one in the nasopharynx. However, MRI showed no abnormality in the nasopharynx and the base of the skull. In this patient, the clinical symptoms and MRI findings improved spontaneously. In some patients, the clinical symptoms and the extent of the pathological process were different from those in the classic Tolosa-Hunt syndrome. It could be suggested that the spectrum of non-specific inflammatory processes in the parasellar region is wider than the criteria for classic Tolosa-Hunt syndrome. (J.N.M.)

  10. Comparison of hemodynamics of intracranial aneurysms between MR fluid dynamics using 3D cine phase-contrast MRI and MR-based computational fluid dynamics

    Hemodynamics is thought to play a very important role in the initiation, growth, and rupture of intracranial aneurysms. The purpose of our study was to compare hemodynamics of intracranial aneurysms of MR fluid dynamics (MRFD) using 3D cine PC MR imaging (4D-Flow) at 1.5 T and MR-based computational fluid dynamics (CFD). 4D-Flow was performed for five intracranial aneurysms by a 1.5 T MR scanner. 3D TOF MR angiography was performed for geometric information. The blood flow in the aneurysms was modeled using CFD simulation based on the finite element method. We used MR angiographic data as the vascular models and MR flow information as boundary conditions in CFD. 3D velocity vector fields, 3D streamlines, shearing velocity maps, wall shear stress (WSS) distribution maps and oscillatory shear index (OSI) distribution maps were obtained by MRFD and CFD and were compared. There was a moderate to high degree of correlation in 3D velocity vector fields and a low to moderate degree of correlation in WSS of aneurysms between MRFD and CFD using regression analysis. The patterns of 3D streamlines were similar between MRFD and CFD. The small and rotating shearing velocities and higher OSI were observed at the top of the spiral flow in the aneurysms. The pattern and location of shearing velocity in MRFD and CFD were similar. The location of high oscillatory shear index obtained by MRFD was near to that obtained by CFD. MRFD and CFD of intracranial aneurysms correlated fairly well. (orig.)

  11. Neuroradiological findings in primary progressive aphasia: CT, MRI and cerebral perfusion SPECT

    Primary progressive aphasia (PPA) is defined as progressive decline in language for 2 or more years with preservation of activities of daily living and general cognitive functions. Whereas the clinical features of this syndrome have been well documented, the neuroradiological findings have not been studied systematically. We studied 13 patients with PPA retrospectively: 10 underwent CT, 12 MRI and 12 cerebral perfusion studies using 99mTc-HMPAO SPECT. CT and MR images were scored for focal atrophy by two independent assessors. Initial qualitative assessment of SPECT images was confirmed by quantitative analysis. CY was normal in 5 patients. Focal atrophy, affecting predominantly the left temporal lobe, was seen in 4 of 10 patients on CT, and 10 of 12 on MRI. Atrophy was localised primarily to the superior and middle temporal gyri on MRI. All 12 patients who underwent SPECT had unilateral temporal lobe perfusion defects, in 2 patients of whom MRI was normal. CT is relatively insensitive to focal abnormalities in PPA; MRI and SPECT are the imaging modalities of choice. MRI allows accurate, specific localisation of atrophy with the temporal neocortex. SPECT may reveal a functional decrease in cerebral perfusion prior to establishment of structural change. (orig.)

  12. Comparative analysis between MRI and MRA findings in patients with cerebral infarction

    The Purpose of this study was to evaluate the possibility of utilizing magnetic resonance angiography(MRA) in patients with cerebral infarction by comparative analysis of magnetic resonance imaging (MRI). MRI and MRA using 3D time-of-flight(TOF) technique with magnetization transfer and ramp(MTR) of 3D TOF with multiple overlapping thin slab acquisition(MOTSA) were performed in 39 patients with cerebral infarction. Vascular lesions detected on MRA were classified as normal,stenosis: and occlusion, and the different infarction sites were named according to their vascular territory. Correlation between MRI and MRA findings was evaluated. In 24(62%) of 39 cases, MRA showed stenosis or occlusion and 19(86%) of those corresponded to their vascular territory of infarction, as visualized on MRI. In 15(62.5%) of the 24 cases, MRA revealed additional diagnostic information such as visualization of unpredicted vascular lesions or the presence of collateral circulations. Of the 15 cases diagnosed as normal according to MRA, most of them actually and small infarctions of less than 2 cm in maximal dimension in the area of the perforating arteries. There was a strong correlation between the vascular lesion observed by MRA and the distribution of the infarct areas on MRI. Additional information was provided by MRA obtained together with conventional MRI

  13. Unexpected MRI findings in clinically suspected Legg-Calve-Perthes disease

    In the setting of clinically suspected Legg-Calve-Perthes (LCP) disease and negative/equivocal radiographs, contrast-enhanced MRI can be performed to confirm the diagnosis. To determine the frequency of unexpected causes of hip pain as identified by MRI in children with clinically suspected LCP disease and negative/equivocal radiographs. All pediatric contrast-enhanced MRI examinations of the pelvis and hips performed between January 2000 and February 2009 to evaluate for possible LCP disease in the setting of negative/equivocal radiographs were identified. MRI examinations performed to evaluate for secondary avascular necrosis were excluded. Imaging reports were retrospectively reviewed for unexpected clinically important causes of hip pain. Thirty-six pediatric patients underwent contrast-enhanced MRI examinations for clinically suspected LCP disease in the setting of negative/equivocal radiographs. Twenty-two (61%) imaging studies were normal, while four (11%) imaging studies demonstrated findings consistent with LCP disease. Ten (28%) imaging studies revealed unexpected clinically important causes of hip pain, including nonspecific unilateral joint effusion and synovitis (n = 7, juvenile chronic arthritis was eventually diagnosed in 3 patients), sacral fracture (n = 1), apophyseal injury (n = 1), and femoral head subluxation (n = 1). MRI frequently reveals unexpected clinically important causes of hip pain in children with suspected LCP disease and negative/equivocal radiographs. (orig.)

  14. MRI findings in patients with defecatory dysfunction after surgical correction of anorectal malformation

    Postoperative anorectal malformation patients frequently have defecatory dysfunction. MRI may be useful in the management of these patients. To analyze static and dynamic MRI findings in patients with defecatory dysfunction after correction of anorectal malformation (ARM), and compare differences between patients with constipation and fecal incontinence. Pelvic MRI studies of 20 constipated and 32 incontinent postoperative ARM patients were analyzed retrospectively to determine the location and morphology of the neorectum, presence of peritoneal fat herniation, presence of scarring, development of the striated muscle complex (SMC) and any other abnormalities. The two groups were then compared using χ 2-test. Eighteen patients also underwent MRI defecography to evaluate pelvic floor function and abnormalities are reported. The children with incontinence were more likely to have abnormal location of the neorectum (P = 0.031), increased anorectal angle (ARA) (P = 0.031) and peritoneal fat herniation (P = 0.032), and less likely to have dilation of the neorectum (P = 0.027), than the children with constipation. There were no significant differences between the two groups in incidence of focal stenosis of the neorectum (P = 0.797), presence of extensive scarring (P = 0.591) and developmental agenesis of the SMC (P > 0.05). MRI defecography showed 6 anterior rectoceles, 6 cystoceles and 18 pelvic floor descents. MRI is a helpful imaging modality in postoperative ARM patients with defecatory dysfunction, and it shows distinct differences between the children with constipation and incontinence and provides individualized information to guide further treatment. (orig.)

  15. MRI findings in patients with defecatory dysfunction after surgical correction of anorectal malformation

    Cui, Yong; Shao, Guang-rui [Second Hospital of Shandong University, Department of Radiology, Jinan (China); Wang, Ruo-yi [Second Hospital of Shandong University, Department of Pediatric Surgery, Jinan (China); Zhang, Yuan [Second Hospital of Shandong University, Evidence-based Medical Center, Jinan (China); Zhang, Shu-hui [Second Hospital of Shandong University, Department of Laboratory, Jinan (China)

    2013-08-15

    Postoperative anorectal malformation patients frequently have defecatory dysfunction. MRI may be useful in the management of these patients. To analyze static and dynamic MRI findings in patients with defecatory dysfunction after correction of anorectal malformation (ARM), and compare differences between patients with constipation and fecal incontinence. Pelvic MRI studies of 20 constipated and 32 incontinent postoperative ARM patients were analyzed retrospectively to determine the location and morphology of the neorectum, presence of peritoneal fat herniation, presence of scarring, development of the striated muscle complex (SMC) and any other abnormalities. The two groups were then compared using {chi} {sup 2}-test. Eighteen patients also underwent MRI defecography to evaluate pelvic floor function and abnormalities are reported. The children with incontinence were more likely to have abnormal location of the neorectum (P = 0.031), increased anorectal angle (ARA) (P = 0.031) and peritoneal fat herniation (P = 0.032), and less likely to have dilation of the neorectum (P = 0.027), than the children with constipation. There were no significant differences between the two groups in incidence of focal stenosis of the neorectum (P = 0.797), presence of extensive scarring (P = 0.591) and developmental agenesis of the SMC (P > 0.05). MRI defecography showed 6 anterior rectoceles, 6 cystoceles and 18 pelvic floor descents. MRI is a helpful imaging modality in postoperative ARM patients with defecatory dysfunction, and it shows distinct differences between the children with constipation and incontinence and provides individualized information to guide further treatment. (orig.)

  16. Association between spondlyloarthritis features and MRI findings in patients with persistent low back pain

    Arnbak, Bodil; Jurik, Anne Grethe; Hørslev-Petersen, Kim; Hendricks, Oliver; Hermansen, Lise Tordrup; Loft, AG; Østergaard, M; Juhl Pedersen, S; Zejden, Anna; Egund, Niels; Holst, R; Manniche, Claus; Jensen, TS

    2014-01-01

    Introduction and Aim. This study was based on the assumption that clinical and MRI finding which are strongly associated with the spondyloarthritis (SpA) disease entity, also are associated with each other. Therefore the objectives were to explore the prevalence of clinical SpA features and MRI...... findings and the association between these two domains. Methods. The study sample included patients aged 18-40 years with persistent low back pain, referred to a public Spine Centre. The prevalence of and associations between clinical SpA features (incl. HLA-B27and CRP) and MRI of the entire spine and...... sacroiliac joints (SIJ) were estimated and analysed. Results. Of the 1020 patients included in the study, 52% had ≥1 clinical SpA feature. The three most common SpA features were; inflammatory back pain, good response to NSAID and family disposition (15-17% each). SIJ bone marrow oedema (BMO) occurred in 21...

  17. Primary Sjoegren's syndrome initially manifested by optic neuritis: MRI findings

    Kadota, Y.; Tokumaru, A.M.; Kohyama, S.; Okizuka, H.; Kaji, T.; Kusano, S. [Department of Radiology, National Defense Medical College, Saitama (Japan); Kamakura, K. [Department of Internal Medicine, National Defense Medical College, Saitama (Japan)

    2002-04-01

    We herein describe the MRI findings in a patient clinically diagnosed with primary Sjoegren's syndrome (SjS) initially manifested by retrobulbar optic neuritis. A 63-year-old woman suddenly had left ocular pain and progressive visual disturbance. MR T2-weighted images revealed hyperintensity in the left optic nerve, with swelling. Contrast-enhanced T1-weighted images showed no abnormal enhancement. Follow-up MRI 6 months after admission revealed no significant changes in the affected optic nerve. To our knowledge, optic neuritis as a complication of SjS has been reported in ten patients [1, 2, 3, 4, 5, 6] and MRI findings in only one of them [6]. We thought MR images were useful for visualizing optic nerve involvement in SjS and observing its course. (orig.)

  18. [Clinical course and serial brain MRI findings in a patient with Lissauer form of general paresis].

    Ishihara, Tomohiko; Ishihara, Ayako; Ozawa, Tetutaro; Sanpei, Kazuhiro; Shimohata, Takayoshi; Nishizawa, Masatoyo

    2015-01-01

    A 60-year-old man presented with progressive dementia and generalized convulsions. An initial MRI revealed a widespread high-intensity area with a mass effect in the right frontal and temporal lobes on T2-weighted images. Findings on digital subtraction angiography were normal. Serum and CSF tests showed high titers of antibodies to Treponema pallidum, which helped to distinguish neurosyphilis from glioma. He was initially treated with penicillin injection; however, it caused liver dysfunction and penicillin was switched to erythromycin. Even after antibiotic therapy for 2 months, his dementia did not improve. He underwent brain MRI four times during the treatment course, and they showed steady progression of brain atrophy in the right hemisphere. Taking these findings together, we diagnosed Lissauer form of general paresis. To the best of our knowledge, this is the first case of Lissauer form of paretic neurosyphilis, in which the progression of brain atrophy was clearly demonstrated on MRI. PMID:25904252

  19. Meningiomas with conventional MRI findings resembling intraaxial tumors: can perfusion-weighted MRI be helpful in differentiation?

    To investigate the contribution of perfusion-weighted MRI to the differentiation of meningiomas with atypical conventional MRI findings from intraaxial tumors. We retrospectively analyzed 54 meningiomas, 12 glioblastomas and 13 solitary metastases. We detected 6 meningiomas with atypical features on conventional MRI resembling intraaxial tumors. The regional cerebral blood flow (rCBV) ratios of all tumors were calculated via perfusion-weighted MRI. The signal intensity-time curves were plotted and three different curve patterns were observed. The type 1 curve resembled normal brain parenchyma or the postenhancement part was minimally below the baseline, the type 2 curve was similar to the type 1 curve but with the postenhancement part above the baseline, and the type 3 curve had the postenhancement part below the baseline accompanied by widening of the curve. Student's t-test was used for statistical analysis. On CBV images meningiomas were hypervascular and the mean rCBV ratio was 10.582.00. For glioblastomas and metastatic lesions, the rCBV ratios were 5.021.40 and 4.681.54, respectively. There was a statistically significant difference in rCBV ratios between meningiomas and glioblastomas and metastases (P<0.001). Only one of the meningiomas displayed a type 2 curve while five showed a type 3 curve. Glioblastomas and metastases displayed either a type 1 or a type 2 curve. None of the meningiomas showed a type 1 curve and none of the glioblastomas or metastases showed a type 3 curve. (orig.)

  20. Meningiomas with conventional MRI findings resembling intraaxial tumors: can perfusion-weighted MRI be helpful in differentiation?

    Hakyemez, Bahattin [Uludag University Medical School, Department of Radiology, Bursa (Turkey); Bursa State Hospital, Department of Radiology, Bursa (Turkey); Yildirim, Nalan; Erdogan, Cueneyt; Parlak, Mufit [Uludag University Medical School, Department of Radiology, Bursa (Turkey); Kocaeli, Hasan; Korfali, Ender [Uludag University Medical School, Department of Neurosurgery, Bursa (Turkey)

    2006-10-15

    To investigate the contribution of perfusion-weighted MRI to the differentiation of meningiomas with atypical conventional MRI findings from intraaxial tumors. We retrospectively analyzed 54 meningiomas, 12 glioblastomas and 13 solitary metastases. We detected 6 meningiomas with atypical features on conventional MRI resembling intraaxial tumors. The regional cerebral blood flow (rCBV) ratios of all tumors were calculated via perfusion-weighted MRI. The signal intensity-time curves were plotted and three different curve patterns were observed. The type 1 curve resembled normal brain parenchyma or the postenhancement part was minimally below the baseline, the type 2 curve was similar to the type 1 curve but with the postenhancement part above the baseline, and the type 3 curve had the postenhancement part below the baseline accompanied by widening of the curve. Student's t-test was used for statistical analysis. On CBV images meningiomas were hypervascular and the mean rCBV ratio was 10.58{+-}2.00. For glioblastomas and metastatic lesions, the rCBV ratios were 5.02{+-}1.40 and 4.68{+-}1.54, respectively. There was a statistically significant difference in rCBV ratios between meningiomas and glioblastomas and metastases (P<0.001). Only one of the meningiomas displayed a type 2 curve while five showed a type 3 curve. Glioblastomas and metastases displayed either a type 1 or a type 2 curve. None of the meningiomas showed a type 1 curve and none of the glioblastomas or metastases showed a type 3 curve. (orig.)

  1. CT and MRI findings in patients with suprasellar germ cell tumors

    This is a retrospective analysis of CT and MRI findings in suprasellar germ cell tumors. The study population was comprised of 6 patients with germinomas, one with embryonal carcinoma, and one with mature teratoma. Suprasellar germinoma tended to have intratumoral low density on CT or intensity area on MRI, indicating tumor necrosis or occasionally cyst formation. Germinoma tissue may extend into the pituitary fossa. Sagittal MRI revealed that the extension was limited to the posterior part of the pituitary gland. MRI of the teratoma did not demonstrate extension of the tumor into the pituitary fossa. No germ cell tumor in this region was seen as calcification. Germinoma in this region did not always show marked homogeneous enhancement. These neuroradiological findings failed to determine subtypes of germ cell tumors. Two patients had germinomas in both the pineal and suprasellar areas. Two years after the total removal of pineal teratoma, it recurred in the suprasellar region that was not seen on the first MRI. In these two patients, germinomas called 'double midline tumors' seemed to have originated by CSF dissemination or subependymal seeding, which was not demonstrated on neuroradiological images. The teratoma case was thought to be one form of double midline tumor, because the first tumor tissue in the pineal region had been totally and extracapsulary removed two years earlier and the suprasellar lesion could not be demonstrated on sagittal MRI or CT scans. In conclusion, not only neuroradiological findings but also clinical findings such as tumor markers may be required in preoperative diagnosis of suprasellar germ cell tumors. (N.K.)

  2. The Diagnostic Value of MRI in Brucella Spondylitis With Comparison to Clinical and Laboratory Findings

    Bagheri, Ali Baradaran; Ahmadi, Koorosh; Chokan, Niaz Mohamad Jafari; Abbasi, Bita; Akhavan, Reza; Bolvardi, Ehsan; Soroureddin, Somayeh

    2016-01-01

    Background: Brucellosis is an endemic zoonotic disease, especially in the Middle East and Mediterranean regions and can involve many organs and tissue. Osteoarticular involvement is the most common complication. Spondylitis is its most prevalent clinical form in adults, and there may be difficult in diagnosis and treatment. In present study, we aimed to assess these diagnostic value of MRI, in patients with spondylitis due to brucella, comparing with clinical and laboratory findings. Method: Patients with low back pain who were admitted to Sheikhol-raees MRI center were included in this study. None of these patients had any documented infectious disease. Diagnosis of brucellosis was made, based on MRI findings, which would be approved by serology. After confirmation with serology, the group with positive serology were compared with the negative group, in sex, age, MRI findings level of vertebral involvements, signal intensity in T1 weighted and T2 weighted. Results: Among 53 patients with diagnosis of brucella spondylitis, 33 underwent serology study, 20 were positive and 13 were negative and the others consider out of study. From these 20, 3 had tuberculosis spondylitis, whose mean age was 56 and the 67% of them were male. Mean age in the positive brucella spondylitis were 46 and 67% of them were male. In negative group mean age was 55, and of whom 57% were male. There was no statistically significant difference in MRI findings such as changes in signal intensity, disk space narrowing, Intracanalicular mass, Abscess formation. Level of invlovment in vertebrae. Conclusion: The results of this study shows that although MRI is Modality of choice in diagnosis of spondylitis, it is not enough specific to diagnosis the reasons of spondylitis.

  3. Right ventricular volume and mass determined by cine magnetic resonance imaging in HIV patients with possible right ventricular dysfunction

    Kjaer, Andreas; Lebech, Anne-Mette; Gerstoft, Jan; Hesse, Birger; Petersen, Claus Leth

    2006-01-01

    Impaired right ventricular (RV) function has been reported to occur in patients with HIV when studied by echocardiography. However, for accurate evaluation of RV function and morphology, first-pass radionuclide ventriculography (RNV) and cine magnetic resonance imaging (cine-MRI) are methods of...... ventricular ejection fraction (RVEF). To do so, we screened patients with RNV and performed an additional cine-MRI in those with reduced RVEF determined by RNV. Ninety patients with HIV were included. To evaluate the MRI measures exactly we included 18 age- and gender-matched healthy volunteers to establish...

  4. Inflammatory myofibroblastic tumour of the maxillary sinus: CT and MRI findings

    Aim: To characterize the computed tomography (CT) and magnetic resonance imaging (MRI) findings of inflammatory myofibroblastic tumours (IMTs) of the maxillary sinus. Materials and methods: The imaging findings of eight patients with IMTs of the maxillary sinus were reviewed retrospectively. Of the eight patients, four patients underwent unenhanced and contrast-enhanced CT, and one patient underwent unenhanced CT only; three patients underwent unenhanced and contrast-enhanced MRI. Results: Five cases of IMTs occurred in the left maxillary sinus, while three cases were right-sided. Four cases occupied the entire sinus, and the other four cases only partially occupied the sinus. Unenhanced CT images showed heterogeneous masses in four cases and a homogeneous mass in one case. One of the tumours showed some areas of calcification. T1-weighted MRI images showed isointense lesions. T2-weighted images showed mixed isointense and mild hyperintense lesions. All cases showed bone destruction and had infiltrated into the nasal fossa, orbit, infratemporal fossa, and other adjacent tissues. Seven cases showed mild to moderate heterogeneous enhancement on contrast-enhanced CT or T1-weighted MRI images. Conclusion: IMTs of the maxillary sinus can be characterized as a soft-tissue mass with bony destruction and infiltration of the adjacent tissues, with mild to moderate enhancement after the injection of contrast medium. CT and MRI can help to diagnose IMTs, determine the extent of the lesion and its relationship with adjacent tissues, and thus facilitate the prediction of surgical resectability.

  5. Localized hypertrophic neuropathy of the sciatic nerve in children: MRI findings

    Localized hypertrophic neuropathy (LHN) of the sciatic nerve in children is a rare condition characterized by a painless neurological deficit in the sciatic nerve territory. To demonstrate the role of MRI using a specific protocol and describe the primary findings in LHN. Imaging in four children (age 2 years to 12 years) is presented. All children presented with lower limb asymmetry. Three had a steppage gait. LHN was confirmed by electrophysiological studies and by MRI of the whole sciatic nerve with a dedicated protocol covering the lumbar spine and the lower limb. There were four direct MRI findings: (1) linear and focal hypertrophy with progressive enlargement of a peripheral nerve or plexus diameter, (2) abnormal hyperintensity of the nerve on T2-weighted images, (3) preserved fascicular configuration, and (4) variable enhancement after intravenous gadolinium administration. In addition there were atrophy and fatty infiltration of innervated muscles. MRI was helpful for determining the extent of lesions and in excluding peripheral nerve compression or tumour. MRI of the whole sciatic nerve is the method of choice for diagnosing LHN of the sciatic nerve. (orig.)

  6. Localized hypertrophic neuropathy of the sciatic nerve in children: MRI findings

    Roux, Adrien; Treguier, Catherine; Bruneau, Bertrand; Marin, Franck; Gandon, Yves; Gauvrit, Jean-Yves [University Hospital, Department of Radiology, Hopital Sud, 16 Boulevard de Bulgarie, BP 90347, Rennes cedex 2 (France); Riffaud, Laurent [University Hospital, Department of Pediatric Neurosurgery, Hopital Sud, Rennes (France); Violas, Philippe [University Hospital, Department of Pediatric Surgery, Hopital Sud, Rennes (France); Michel, Anne [University Hospital, Department of Neurological Functional Explorations, Hopital Sud, Rennes (France)

    2012-08-15

    Localized hypertrophic neuropathy (LHN) of the sciatic nerve in children is a rare condition characterized by a painless neurological deficit in the sciatic nerve territory. To demonstrate the role of MRI using a specific protocol and describe the primary findings in LHN. Imaging in four children (age 2 years to 12 years) is presented. All children presented with lower limb asymmetry. Three had a steppage gait. LHN was confirmed by electrophysiological studies and by MRI of the whole sciatic nerve with a dedicated protocol covering the lumbar spine and the lower limb. There were four direct MRI findings: (1) linear and focal hypertrophy with progressive enlargement of a peripheral nerve or plexus diameter, (2) abnormal hyperintensity of the nerve on T2-weighted images, (3) preserved fascicular configuration, and (4) variable enhancement after intravenous gadolinium administration. In addition there were atrophy and fatty infiltration of innervated muscles. MRI was helpful for determining the extent of lesions and in excluding peripheral nerve compression or tumour. MRI of the whole sciatic nerve is the method of choice for diagnosing LHN of the sciatic nerve. (orig.)

  7. MRI brain findings in ephedrone encephalopathy associated with manganese abuse: Single-center perspective

    Manganese (Mn) is a well-known toxic agent causing symptoms of parkinsonism in employees of certain branches of industry. Home production of a psychostimulant ephedrone (methcathinone), involving the use of potassium permanganate, became a new cause of intoxications in Poland. This article presents clinical symptoms, initial brain MRI findings and characteristics of changes observed in follow-up examinations in 4 patients with manganese intoxication associated with intravenous administration of ephedrone. All patients in our case series presented symptoms of parkinsonism. T1-WI MRI revealed high intensity signal in globi pallidi in all patients; hyperintense lesions in midbrain were observed in three patients, while lesions located in cerebellar hemispheres and pituitary gland in just one patient. The reduction of signal intensity in the affected brain structures was observed in follow-up studies, with no significant improvement in clinical symptoms. Brain MRI is helpful in the assessment of distribution as well as dynamics of changes in ephedrone encephalopathy. Regression of signal intensity changes visible in brain MRI is not associated with clinical condition improvement. Although brain MRI findings are not characteristic for ephedrone encephalopathy, they may contribute to diagnosing this condition

  8. MRI findings of pancreatic lymphoma and autoimmune pancreatitis: A comparative study

    Ishigami, Kousei, E-mail: Ishigamikousei@aol.co [Department of Clinical Radiology, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka, 812-8582 (Japan); Tajima, Tsuyoshi; Nishie, Akihiro; Ushijima, Yasuhiro [Department of Clinical Radiology, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka, 812-8582 (Japan); Fujita, Nobuhiro [Department of Anatomic Pathology, Graduate School of Medical Sciences, Kyushu University (Japan); Asayama, Yoshiki; Kakihara, Daisuke; Irie, Hiroyuki [Department of Clinical Radiology, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka, 812-8582 (Japan); Ito, Tetsuhide; Igarashi, Hisato [Department of Medicine and Bioregulatory Science, Graduate School of Medical Sciences, Kyushu University (Japan); Nakamura, Masafumi [Department of Surgery and Oncology, Graduate School of Medical Sciences, Kyushu University (Japan); Honda, Hiroshi [Department of Clinical Radiology, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka, 812-8582 (Japan)

    2010-06-15

    Purpose: To clarify whether there are differences in MRI findings between pancreatic lymphomas and autoimmune pancreatitis (AIP). Materials and methods: MRI of 8 patients with pancreatic lymphomas and 21 patients with AIP were retrospectively reviewed. For multifocal pancreatic lymphomas (n = 2) and AIP (n = 4), the largest 2 lesions were evaluated. Ten pancreatic lymphomas and 25 AIP were compared on three bases: the signal intensity on T2-weighted images, internal homogeneity, and presence or absence of capsule-like rim. In 8 lymphomas and 19 AIP, the enhancement pattern on dynamic MRI was compared, as well. Results: On T2-weighted images, pancreatic lymphomas comprised 5, 5 and 4 lesions with low (iso), slightly high, and moderately high intensity, respectively, while the numbers for AIP were 14, 10, and 1 (P < 0.01). Nine of 10 (90%) lymphomas appeared homogenous, and 11 of 25 (44%) AIP were homogenous (P < 0.05). A capsule-like rim was present in 9 of 25 (36%) AIP, but was not seen in lymphomas (P < 0.05). On dynamic MRI, 18 of 19 (94.7%) AIP showed persistent (n = 5) or delayed enhancement (n = 13), and 6 of 8 (75%) lymphomas showed low intensity without delayed enhancement (P < 0.001). Conclusion: MRI findings for pancreatic lymphomas and AIP were significantly different, which may be helpful for the differential diagnosis of these two diseases.

  9. Cerebral FDG-PET and MRI findings in autoimmune limbic encephalitis: correlation with autoantibody types.

    Baumgartner, Annette; Rauer, Sebastian; Mader, Irina; Meyer, Philipp T

    2013-11-01

    In parallel to the detection of new neuronal autoantibodies, the diagnosis of non-infectious limbic encephalitis has risen. Given that cerebral imaging studies show highly variable results, the present retrospective study investigates imaging findings in association with autoantibody type. An institutional database search identified 18 patients with non-infectious limbic encephalitis who had undergone [18F] fluorodeoxyglucose positron emission tomography (FDG-PET). Sixteen of these patients also underwent magnetic resonance imaging (MRI). MRI and FDG-PET images were categorized as follows: normal (0); mesiotemporal abnormality (1); normal mesiotemporal finding but otherwise abnormal (2). Neuronal autoantibodies were determined in serum and/or CSF. Autoantibodies were grouped according to the cellular localization of their target antigen: antibodies against surface antibodies (i.e., VGKC, NMDAR): 9; antibodies against intracellular antigens (i.e., Hu, Ri, GAD): 4; no autoantibodies: 5. The fraction of abnormal scans was lower for MRI (10/16) than for FDG-PET (14/18). There was a significant association between PET findings and autoantibody type: All patients with autoantibodies against intracellular antigens showed mesiotemporal findings on FDG-PET. In turn, only 2/9 patients with autoantibodies against surface antigens displayed mesiotemporal hypermetabolism. In the remaining seven patients, four scans were rated as normal and three only showed findings outside the mesiotemporal region. A similar association was found using MRI, although this did not reach statistical significance. Autoantibody type was found to be associated with FDG-PET and, to a lesser extent, with MRI imaging results. Our observations may explain the heterogeneity of imaging data in LE and based on in vivo findings support the assumption of different patho mechanisms underlying LE due to antibodies against surface and intracellular antigens, respectively. PMID:23900756

  10. Lumbar Modic Changes - A Comparison Between Findings at Low-and High-field MRI

    Bendix, Tom; Sorensen, Joan S; Henriksson, Gustaf A C; Bolstad, Jørn Espen; Narvestad, Eva K; Jensen, Tue Secher

    2012-01-01

    Study Design. A cross-sectional observational study.Objective. To investigate if there is a difference in findings of lumbar Modic changes in low-field (0.3 Tesla) magnetic resonance imaging (MRI) as compared to high field (1.5 Tesla).Summary of Background Data. It is a challenge to give patients...

  11. MRI findings of an intermuscular lipoma in a 2-year-old

    Grandbois, Lindsey; Vade, Aruna; Lim-Dunham, Jennifer [Loyola University Medical Center, Department of Radiology, Maywood, IL (United States); Al-Masri, Hytham [Mount Sinai Hospital, Department of Pathology, Chicago, IL (United States)

    2006-09-15

    We report the MRI findings of a large deep intermuscular lipoma in a 2-year-old child with a painless palpable shoulder mass, and its differentiation from liposarcoma and other soft-tissue masses. To our knowledge, the imaging features of deep lipomas in children have not been reported. (orig.)

  12. MRI findings of small cell neuroendocrime carcinoma of the uterine cervix: A case report

    Small cell neuroendocrine carcinoma of the uterine cervix is a rare primary neoplasm, accounting for less than 5% of all uterine cervical cancers. The tumor is known to have an aggressive behavior and poor prognosis. In this article, we present the MRI findings of 5 cases of pathologically-proven small cell neuroendocrine carcinoma of the uterine cervix, including diffusion-weighted images

  13. MRI findings of small cell neuroendocrime carcinoma of the uterine cervix: A case report

    Won, You Sun; Yi, Boem Ha; Lee, Hae Kyung; Lee, Min Hee; Choi, Seo Youn; Kwak, Jeong Ja [Soonchunhyang University College of Medicine, Bucheon Hospital, Bucheon (Korea, Republic of)

    2015-10-15

    Small cell neuroendocrine carcinoma of the uterine cervix is a rare primary neoplasm, accounting for less than 5% of all uterine cervical cancers. The tumor is known to have an aggressive behavior and poor prognosis. In this article, we present the MRI findings of 5 cases of pathologically-proven small cell neuroendocrine carcinoma of the uterine cervix, including diffusion-weighted images.

  14. MRI findings on iatrogenic spinal infection following various pain management procedures

    The aim of this study was to investigate and report magnetic resonance imaging (MRI) findings of iatrogenic spinal infection (ISI). We retrospectively reviewed the clinical and MRI findings on 18 patients diagnosed with ISI. The MRI findings were evaluated for the number of spinal segments showing inflammation in the longitudinal span and affected vertebral bodies and discs, the presence of abscess in the epidural or paravertebral space, paravertebral myositis, and skip lesions. Among the 18 patients, the range of the longitudinal span of spinal inflammation was 2-11 (mean = 5.84) vertebral segments. 17 of the 18 patients had three or more contiguous vertebral segments. The osteomyelitis and disc destruction was apparent in 77.8% and 66.7% of the patients, and 78% of patients with osteomyelitis showed involvement of one or two vertebrae; 91.7% of patients with disc destruction showed involvement of single disc. The incidence of epidural or paravertebral abscesses, and paravertebral myositis were 88.9%, and 94.4%. There were no spinal skip lesions. MRI findings of those are wide longitudinal span of infection, involvement of no more than one or two vertebral bodies and a single disc, large abscesses, extensive myositis and no skip lesions, can be a useful ISI-diagnostic tool.

  15. MRI findings on iatrogenic spinal infection following various pain management procedures

    Kim, Yu Jin; Lee, Jee Young; Kim, Bong Man [Dept. of Radiology, Dankook University Hospital, Cheonan (Korea, Republic of); Min, Sang Hyuk [Dept. of Orthopedic Surgery, Dankook University Hospital, Cheonan (Korea, Republic of)

    2014-12-15

    The aim of this study was to investigate and report magnetic resonance imaging (MRI) findings of iatrogenic spinal infection (ISI). We retrospectively reviewed the clinical and MRI findings on 18 patients diagnosed with ISI. The MRI findings were evaluated for the number of spinal segments showing inflammation in the longitudinal span and affected vertebral bodies and discs, the presence of abscess in the epidural or paravertebral space, paravertebral myositis, and skip lesions. Among the 18 patients, the range of the longitudinal span of spinal inflammation was 2-11 (mean = 5.84) vertebral segments. 17 of the 18 patients had three or more contiguous vertebral segments. The osteomyelitis and disc destruction was apparent in 77.8% and 66.7% of the patients, and 78% of patients with osteomyelitis showed involvement of one or two vertebrae; 91.7% of patients with disc destruction showed involvement of single disc. The incidence of epidural or paravertebral abscesses, and paravertebral myositis were 88.9%, and 94.4%. There were no spinal skip lesions. MRI findings of those are wide longitudinal span of infection, involvement of no more than one or two vertebral bodies and a single disc, large abscesses, extensive myositis and no skip lesions, can be a useful ISI-diagnostic tool.

  16. MRI findings of ovarian tumors : differentiation of benign from malignant lesions

    To evaluate the usefulness of MRI findings in the differentiation of benign from malignant ovarian lesions. Using MR findings, 29 surgically proven ovarian masses in 22 patients (14 bilateral tumors) were evaluated Twenty-one benign tumors in 16 patients(5 simple cysts, 4 mucinous cystadenomas, 4 serous cystadenomas, 4 endometriomas, 3 cystic teratomas and 1 tuboovarian abscess), and eight malignant tumors in six patients(4 serous papillary cystadenocarcinomas and 4 mucinous cystadenocarcinomas) were included. MRI was performed with SE T1WI, FSE T2WI and Gd-T1WI. MRI findings of lesion size, thickness of wall and of internal septations, number of internal septations, nodularities, and ancillary findings such as adhesion in the pelvic cavity, dissemination, ascites and 1ymphadenopathy were retrospectively analyzed. Malignant ovarian lesions were larger(18cm : 11cm) and had more internal septations, more solid components and nodularities(63% : 5%) than benign lesions. On T1WI, cystic lesions, both benign and malignant, showed low signal intensity. Hemorrhage, fat components and mucin containing lesions showed high signals and solid components and nodularities were isointense with muscle on T1WI. Solid components and nodularities were well-enhanced after gadolinium enhancement. Adhesion(50% : 10%), dissemination(38% : 0%) and ascites(63% : 24%) were more frequent in malignant lesions. MRI, especially with gadolinium-enhanced T1WI is useful in the differentiation of benign from malignant ovarian lesions

  17. Whole-heart cine MRI in a single breath-hold. A compressed sensing accelerated 3D acquisition technique for assessment of cardiac function

    Purpose: The aim of this study was to perform functional MR imaging of the whole heart in a single breath-hold using an undersampled 3 D trajectory for data acquisition in combination with compressed sensing for image reconstruction. Materials and Methods: Measurements were performed using an SSFP sequence on a 3 T whole-body system equipped with a 32-channel body array coil. A 3 D radial stack-of-stars sampling scheme was utilized enabling efficient undersampling of the k-space and thereby accelerating data acquisition. Compressed sensing was applied for the reconstruction of the missing data. A validation study was performed based on a fully sampled dataset acquired by standard Cartesian cine imaging of 2 D slices on a healthy volunteer. The results were investigated with regard to systematic errors and resolution losses possibly introduced by the developed reconstruction. Subsequently, the proposed technique was applied for in-vivo functional cardiac imaging of the whole heart in a single breath-hold of 27 s. The developed technique was tested on three healthy volunteers to examine its reproducibility. Results: By means of the results of the simulation (temporal resolution: 47 ms, spatial resolution: 1.4 x 1.4 x 8 mm, 3 D image matrix: 208 x 208 x 10), an overall acceleration factor of 10 has been found where the compressed sensing reconstructed image series shows only very low systematic errors and a slight in-plane resolution loss of 15 %. The results of the in-vivo study (temporal resolution: 40.5 ms, spatial resolution: 2.1 x 2.1 x 8 mm, 3 D image matrix: 224 x 224 x 12) performed with an acceleration factor of 10.7 confirm the overall good image quality of the presented technique for undersampled acquisitions. Conclusion: The combination of 3 D radial data acquisition and model-based compressed sensing reconstruction allows high acceleration factors enabling cardiac functional imaging of the whole heart within only one breath-hold. The image quality in the simulated dataset and the in-vivo measurement highlights the great potential of the presented technique for an efficient assessment of cardiac functional parameters. (orig.)

  18. Whole-heart cine MRI in a single breath-hold. A compressed sensing accelerated 3D acquisition technique for assessment of cardiac function

    Wech, T.; Koestler, H. [Wuerzburg Univ. (Germany). Inst. of Radiology; Wuerzburg Univ. (Germany). Comprehensive Heart Failure Center; Pickl, W.; Tran-Gia, J.; Ritter, C.; Hahn, D. [Wuerzburg Univ. (Germany). Inst. of Radiology; Beer, M. [Wuerzburg Univ. (Germany). Inst. of Radiology; Graz Univ. (Austria). University Hospital Radiology

    2014-01-15

    Purpose: The aim of this study was to perform functional MR imaging of the whole heart in a single breath-hold using an undersampled 3 D trajectory for data acquisition in combination with compressed sensing for image reconstruction. Materials and Methods: Measurements were performed using an SSFP sequence on a 3 T whole-body system equipped with a 32-channel body array coil. A 3 D radial stack-of-stars sampling scheme was utilized enabling efficient undersampling of the k-space and thereby accelerating data acquisition. Compressed sensing was applied for the reconstruction of the missing data. A validation study was performed based on a fully sampled dataset acquired by standard Cartesian cine imaging of 2 D slices on a healthy volunteer. The results were investigated with regard to systematic errors and resolution losses possibly introduced by the developed reconstruction. Subsequently, the proposed technique was applied for in-vivo functional cardiac imaging of the whole heart in a single breath-hold of 27 s. The developed technique was tested on three healthy volunteers to examine its reproducibility. Results: By means of the results of the simulation (temporal resolution: 47 ms, spatial resolution: 1.4 x 1.4 x 8 mm, 3 D image matrix: 208 x 208 x 10), an overall acceleration factor of 10 has been found where the compressed sensing reconstructed image series shows only very low systematic errors and a slight in-plane resolution loss of 15 %. The results of the in-vivo study (temporal resolution: 40.5 ms, spatial resolution: 2.1 x 2.1 x 8 mm, 3 D image matrix: 224 x 224 x 12) performed with an acceleration factor of 10.7 confirm the overall good image quality of the presented technique for undersampled acquisitions. Conclusion: The combination of 3 D radial data acquisition and model-based compressed sensing reconstruction allows high acceleration factors enabling cardiac functional imaging of the whole heart within only one breath-hold. The image quality in the simulated dataset and the in-vivo measurement highlights the great potential of the presented technique for an efficient assessment of cardiac functional parameters. (orig.)

  19. MRI findings in early stage of osteoporotic compression fracture of vertebral body

    A MRI study was performed in 29 cases of osteoporotic spinal compression fractures. In the acute stage (within one week after injury), T1-weighted images showed low intensity, T2-weighted images showed high intensity. But, T1-weighted images showed a relatively wide area of injured site, on the other hand, T2-weighted images showed the injured area itself. Therefore T2-weighted images precisely reflected the injured area. From these MRI findings, the method of conservative treatment can be determined. (author)

  20. HASTE MRCP and MRI findings in alveolar echinococcosis of the liver

    Alveolar echinococcosis is a rare mass-producing inflammatory process of the liver. Experience with MRI, and particularly magnetic resonance cholangiopancreatography (MRCP), demonstrates that features of this disease are limited. The HASTE (half-Fourier acquisition single-shot turbo spin echo) MRCP and MRI findings of alveolar echinococcosis of the liver are presented in this report. HASTE MRCP was used to define the biliary system and the biliary system-mass relationship. It was found that results were comparable with those of invasive techniques such as endoscopic retrograde cholangiopancreatography and percutaneous transhepatic cholangiography. Copyright (2001) Blackwell Science Pty Ltd

  1. MRI findings of extramedullary hematopoiesis of the spleen in patient with idiopathic myelofibrosis : 2 case report

    MRI findings of extramedullary hematopoiesis of the spleen have not been described in the literature. We report the MRI features of this condition, as seen in two patients and confirmed by fine needle biopsy. Three small masses (≤ 3 cm) were isointense on T1WI, hyperintense on T2WI, and enhance after the injection of gadolinium. Two 6 cm-sized masses were by hypointense on both T1WI and T2WI, and showed no contrast enhancement. (author). 9 refs., 2 figs

  2. Tuberculous adenitis: comparison of CT and MRI findings with histopathological features

    Our aim was to investigate the relationship between the various histopathological features and the CT and MRI findings in routinely submitted histopathological specimens for the diagnosis of tuberculous lymphadenopathy. Twelve formalin-fixed, paraffin-embedded tissue blocks from ten patients who were clinically suspected of having tuberculous lymphadenopathy were evaluated. We assessed the presence of histopathological features including granuloma formation, caseous necrosis, and presence of Langhans-type giant cells, calcifications, fibrosis or normal lymphoid tissue. We performed polymerase chain reaction (PCR)-based assay for mycobacterial DNA and Ziehl-Neelsen staining for acid-fast bacilli (AFB). Findings were compared with those of CT and MRI, including signal intensities on unenhanced MR images, lymph node homogeneity, attenuation values on contrast-enhanced CT and enhancement patterns on MRI. Based on CT and MRI findings, four lymph node types could be defined: (1) homogeneous nodes, visible on both pre- and post-contrast images and corresponding histopathologically to granulation tissue without or with minimal caseation necrosis (n = 2); (2) heterogeneous nodes, showing heterogeneous enhancement patterns with central non-enhancing areas and corresponding to minor or moderate intranodal caseation/liquefaction necrosis (n = 3); (3) nodes showing peripheral rim enhancement and corresponding to moderate or extensive intranodal caseation/liquefaction necrosis (n = 5); (4) heterogeneous nodes showing intranodal hyperdensities on CT and hypointense areas on T1- and T2-weighted images and corresponding to fibrosis and calcifications (n = 2). On CT and MRI, the findings reflect different stages of the tuberculous process. Imaging findings depend on the presence and the degree of granuloma formation, caseation/liquefaction necrosis, fibrosis and calcifications. (orig.)

  3. Tuberculous adenitis: comparison of CT and MRI findings with histopathological features

    Backer, A.I. de [General Hospital Sint-Lucas, Department of Radiology, Ghent (Belgium); Mortele, K.J. [Harvard Medical School, Department of Radiology, Division of Abdominal Imaging and Intervention, Brigham and Women' s Hospital, Boston, MA (United States); Heuvel, E. van den [University Hospital of Antwerp, Department of Pathology, Edegem (Belgium); Vanschoubroeck, I.J. [Ziekenhuisnetwerk Antwerpen, Stuivenberg, Department of Internal Medicine, Antwerp (Belgium); Kockx, M.M. [Ziekenhuisnetwerk Antwerpen, Stuivenberg, Department of Pathology, Antwerp (Belgium); Vyvere, M. van de [Ziekenhuisnetwerk Antwerpen, Stuivenberg, Department of Microbiology, Antwerp (Belgium)

    2007-04-15

    Our aim was to investigate the relationship between the various histopathological features and the CT and MRI findings in routinely submitted histopathological specimens for the diagnosis of tuberculous lymphadenopathy. Twelve formalin-fixed, paraffin-embedded tissue blocks from ten patients who were clinically suspected of having tuberculous lymphadenopathy were evaluated. We assessed the presence of histopathological features including granuloma formation, caseous necrosis, and presence of Langhans-type giant cells, calcifications, fibrosis or normal lymphoid tissue. We performed polymerase chain reaction (PCR)-based assay for mycobacterial DNA and Ziehl-Neelsen staining for acid-fast bacilli (AFB). Findings were compared with those of CT and MRI, including signal intensities on unenhanced MR images, lymph node homogeneity, attenuation values on contrast-enhanced CT and enhancement patterns on MRI. Based on CT and MRI findings, four lymph node types could be defined: (1) homogeneous nodes, visible on both pre- and post-contrast images and corresponding histopathologically to granulation tissue without or with minimal caseation necrosis (n = 2); (2) heterogeneous nodes, showing heterogeneous enhancement patterns with central non-enhancing areas and corresponding to minor or moderate intranodal caseation/liquefaction necrosis (n = 3); (3) nodes showing peripheral rim enhancement and corresponding to moderate or extensive intranodal caseation/liquefaction necrosis (n = 5); (4) heterogeneous nodes showing intranodal hyperdensities on CT and hypointense areas on T1- and T2-weighted images and corresponding to fibrosis and calcifications (n = 2). On CT and MRI, the findings reflect different stages of the tuberculous process. Imaging findings depend on the presence and the degree of granuloma formation, caseation/liquefaction necrosis, fibrosis and calcifications. (orig.)

  4. MRI findings in 6 cases of children by inadvertent ingestion of diphenoxylate-atropine

    Purpose: Compound diphenoxylate (diphenoxylate-atropine) poisoning can cause toxic encephalopathy in children, and magnetic resonance imaging (MRI) of the brain in this condition has not been reported. This study is to analyze brain MRI findings and to investigate the relations between MRI features and possible pathophysiological changes in children. Methods: Six children accidentally swallowed compound diphenoxylate, 4 males, 2 females, aged 20-46 months, average 33 months. Quantity of ingested diphenoxylate-atropine was from 6 to 30 tablets, each tablet contains diphenoxylate 2.5 mg and atropine 0.025 mg. These patients were referred to our hospital within 24 h after diphenoxylate-atropine ingestion, and underwent brain MRI scan within 24-72 h after emergency treatment. The characteristics of conventional MRI were analyzed. Results: These pediatric patients had various symptoms of opioid intoxication and atropine toxicity. Brain MRI showed abnormal low signal intensity on T1-weighted images (T1WI) and abnormal high signal intensity on T2-weighted images (T2WI) and fluid-attenuated inversion recovery (FLAIR) imaging in bilateral in all cases; abnormal high signal intensity on T1WI, T2WI and FLAIR in 4 cases. Encephalomalacia was observed in 3 cases during follow-up. Conclusion: In the early stage of compound diphenoxylate poisoning in children, multiple extensive edema-necrosis and hemorrhagic-necrosis focus were observed in basic nucleus, pallium and cerebellum, these resulted in the corresponding brain dysfunction with encephalomalacia. MRI scan in the early stage in this condition may provide evidences of brain impairment, and is beneficial for the early diagnosis, treatment and prognosis assessment.

  5. Correlation between MRI and double-balloon urethrography findings in the diagnosis of female periurethral lesions

    This study aims to evaluate the correlation of MRI findings with double-balloon urethrography (DBU) in diagnosing female urethral diverticula and other periurethral lesions. In this retrospective study, females with clinically suspected periurethral lesions who underwent both MRI and DBU between 2008 and 2012 were evaluated. MRI was performed on a 1.5 Tesla unit using a pelvic phased array coil. Protocol included small FOV pelvic images, multiplanar T2-w, T1-w with and without contrast injection. DBU was performed by a dedicated catheter. Images were evaluated in consensus by two readers. Diverticula were evaluated by, size, number, complexity, location and connection to urethra, and other periurethral lesions were evaluated by size, location and connection. Supplement clinical and surgical data were retrieved from medical records and telephone interviews. Seventeen females (mean age 44 years, range 20–69) were included in the study. Diverticula were diagnosed by both modalities (9 cases), by neither (6 cases, 88% correlation) by MRI alone (1 case) and by DBU alone (1 case). Among diverticula, correlation of number, complexity, location and demonstration of connection to urethra was 89%, 67%, 67%, and 56%, respectively. Alternative diagnosis solely by MRI included vaginal wall cysts (3 cases), endometriosis (1 case) and ectopic ureter (1 case). No periurethral lesion was found by either modality in 2 cases. The correlation between MRI and DBU in diagnosing female periurethral lesions is very good for anatomical delineation of diverticula. MRI, which does not involve radiation, may also indicate alternative diagnoses that can contribute to proper patient management

  6. MRI findings in 6 cases of children by inadvertent ingestion of diphenoxylate-atropine

    Xiao Lianxiang [Shandong University School of Medicine, Shandong Medical Imaging Research Institute , No. 44 West Wenhua Road, Jinan 250012 (China); Lin Xiangtao, E-mail: yishui1982@126.com [Shandong University School of Medicine, Shandong Medical Imaging Research Institute, No. 44 West Wenhua Road, Jinan 250012 (China); Cao Jinfeng [Shandong University School of Medicine, Shandong Medical Imaging Research Institute , No. 44 West Wenhua Road, Jinan 250012 (China); Wang Xueyu [Division of Pediatrics, Shandong Provincial Hospital, Shandong University, No. 324 Jingwu Road, Jinan 250021 (China); Wu Lebin [Shandong Medical Imaging Research Institute, No. 324 Jingwu Road, Jinan 250021 (China)

    2011-09-15

    Purpose: Compound diphenoxylate (diphenoxylate-atropine) poisoning can cause toxic encephalopathy in children, and magnetic resonance imaging (MRI) of the brain in this condition has not been reported. This study is to analyze brain MRI findings and to investigate the relations between MRI features and possible pathophysiological changes in children. Methods: Six children accidentally swallowed compound diphenoxylate, 4 males, 2 females, aged 20-46 months, average 33 months. Quantity of ingested diphenoxylate-atropine was from 6 to 30 tablets, each tablet contains diphenoxylate 2.5 mg and atropine 0.025 mg. These patients were referred to our hospital within 24 h after diphenoxylate-atropine ingestion, and underwent brain MRI scan within 24-72 h after emergency treatment. The characteristics of conventional MRI were analyzed. Results: These pediatric patients had various symptoms of opioid intoxication and atropine toxicity. Brain MRI showed abnormal low signal intensity on T1-weighted images (T1WI) and abnormal high signal intensity on T2-weighted images (T2WI) and fluid-attenuated inversion recovery (FLAIR) imaging in bilateral in all cases; abnormal high signal intensity on T1WI, T2WI and FLAIR in 4 cases. Encephalomalacia was observed in 3 cases during follow-up. Conclusion: In the early stage of compound diphenoxylate poisoning in children, multiple extensive edema-necrosis and hemorrhagic-necrosis focus were observed in basic nucleus, pallium and cerebellum, these resulted in the corresponding brain dysfunction with encephalomalacia. MRI scan in the early stage in this condition may provide evidences of brain impairment, and is beneficial for the early diagnosis, treatment and prognosis assessment.

  7. Correlation between MRI and double-balloon urethrography findings in the diagnosis of female periurethral lesions

    Portnoy, Orith, E-mail: Orith.Portnoy@sheba.health.gov.il [Department of Diagnostic Imaging, Sheba Medical Center, Tel Hasomer, affiliated to Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv (Israel); Kitrey, Noam, E-mail: nkitrey@gmail.com [Department of Urology, Sheba Medical Center, Tel Hasomer, affiliated to Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv (Israel); Eshed, Iris, E-mail: iris.eshed@sheba.health.gov.il [Department of Diagnostic Imaging, Sheba Medical Center, Tel Hasomer, affiliated to Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv (Israel); Apter, Sara, E-mail: saraapter@gmail.com [Department of Diagnostic Imaging, Sheba Medical Center, Tel Hasomer, affiliated to Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv (Israel); Amitai, Marianne M., E-mail: michal.amitai@sheba.health.gov.il [Department of Diagnostic Imaging, Sheba Medical Center, Tel Hasomer, affiliated to Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv (Israel); Golomb, Jacob, E-mail: Jacob.golomb@yahoo.com [Department of Urology, Sheba Medical Center, Tel Hasomer, affiliated to Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv (Israel)

    2013-12-01

    This study aims to evaluate the correlation of MRI findings with double-balloon urethrography (DBU) in diagnosing female urethral diverticula and other periurethral lesions. In this retrospective study, females with clinically suspected periurethral lesions who underwent both MRI and DBU between 2008 and 2012 were evaluated. MRI was performed on a 1.5 Tesla unit using a pelvic phased array coil. Protocol included small FOV pelvic images, multiplanar T2-w, T1-w with and without contrast injection. DBU was performed by a dedicated catheter. Images were evaluated in consensus by two readers. Diverticula were evaluated by, size, number, complexity, location and connection to urethra, and other periurethral lesions were evaluated by size, location and connection. Supplement clinical and surgical data were retrieved from medical records and telephone interviews. Seventeen females (mean age 44 years, range 20–69) were included in the study. Diverticula were diagnosed by both modalities (9 cases), by neither (6 cases, 88% correlation) by MRI alone (1 case) and by DBU alone (1 case). Among diverticula, correlation of number, complexity, location and demonstration of connection to urethra was 89%, 67%, 67%, and 56%, respectively. Alternative diagnosis solely by MRI included vaginal wall cysts (3 cases), endometriosis (1 case) and ectopic ureter (1 case). No periurethral lesion was found by either modality in 2 cases. The correlation between MRI and DBU in diagnosing female periurethral lesions is very good for anatomical delineation of diverticula. MRI, which does not involve radiation, may also indicate alternative diagnoses that can contribute to proper patient management.

  8. Synchronous rectal and prostate cancer – The impact of MRI on incidence and imaging findings

    Highlights: •Prostate and rectal cancers are two of the most common cancers in male. •Synchronous diagnosis of prostate and rectal cancer is a rare identity. •Strong increase in the synchronous diagnosis likely due to improved diagnostic methods. •Pre-treatment MRI for rectal cancer has led to increased synchronous diagnosis. -- Abstract: Objective: To evaluate the incidence of synchronous diagnosis of rectal and prostate cancer and to identify how the role of magnetic resonance imaging (MRI) for preoperative staging of rectal cancer has affected the incidence. Methods: Regional data from the Swedish Colorectal Cancer Registry and the Regional Cancer Registry in Stockholm-Gotland area (two million inhabitants) between the years 1995–2011 were used. Patients were included when the rectal cancer was diagnosed prior to the prostate cancer. Medical records and pre-treatment MRI were retrospectively reviewed. Results: Of 29,849 patients diagnosed with either disease, synchronous diagnosis was made in 29 patients (0.1%). Two patients were diagnosed in the years 1995–1999, seven patients between the years 2000–2005 and 20 patients between the years 2006–2011. The most common presentation, for the prostate cancer was incidental finding during staging for rectal cancer, n = 20, and of those led MRI to the diagnosis in 14 cases. At retrospective review, all patients had focal lesions in the prostate on MRI and patients with higher suspicion of malignancy on MRI had more locally advanced disease. Conclusion: Synchronous rectal and prostate cancer are a rare entity, but a strong increase in synchronous diagnosis is seen which may be attributed to improved diagnostic methods, including the use of pre-treatment MRI in routine work-up for rectal cancer

  9. Desmoplastic fibroma of bone in a toe: Radiographic and MRI findings

    Desmoplastic fibroma is a rare benign primary bone tumor that is histologically similar to the soft tissue desmoid tumor. It most often involves the mandible, large long bone or iliac bone. Desmoplastic fibroma in a toe has been extremely rarely reported. Authors report a rare case of desmoplastic fibroma of bone occurring in the distal phalanx of a foot, with descriptions of the radiographic and MRI findings, correlation of the radiologic and pathologic findings, and discussion on the differential diagnosis of the tumor.

  10. Desmoplastic fibroma of bone in a toe: Radiographic and MRI findings

    Kim, Ok Hwa; Kim, Seon Jeong; Kim Ji Yeon; Ryu, Ji Hwa [Inje University, Haeundae Paik Hospital, Busan (Korea, Republic of); Choo, Hye Jung [Dept. of Radiology, Inje University, Busan Paik Hospital, Busan (Korea, Republic of); Lee, In Sook [Dept. of Radiology, Busan National University Hospital, Busan (Korea, Republic of); Suh, Kyung Jin [Dept. of Radiology, Dongguk University, Gyeongju Hospital, Gyeongju (Korea, Republic of)

    2013-12-15

    Desmoplastic fibroma is a rare benign primary bone tumor that is histologically similar to the soft tissue desmoid tumor. It most often involves the mandible, large long bone or iliac bone. Desmoplastic fibroma in a toe has been extremely rarely reported. Authors report a rare case of desmoplastic fibroma of bone occurring in the distal phalanx of a foot, with descriptions of the radiographic and MRI findings, correlation of the radiologic and pathologic findings, and discussion on the differential diagnosis of the tumor.

  11. Cognitive function and MRI findings in very low birth weight infants

    Imamura, Atsuko; Takagishi, Yuka; Takada, Satoru; Uetani, Yoshiyuki; Nakamura, Toru; Nakamura, Hajime [Kobe Univ. (Japan). School of Medicine; Inagaki, Yuko

    1996-07-01

    Twenty-two very low birth weight infants at preschool ages of 5-6 years were studied to clarify the correlation between cognitive function and MRI findings. Cognitive function was evaluated by the Wechsler Intelligence Scale for Children-Revised (WISC-R) and the Frostig developmental test of visual perception. Ventricular enlargement, assessed by the bioccipital index (B.I.) measured on MRI, was correlated to cognitive disorders. Children with periventricular high intensity areas (T{sub 2}-weighted images) extending from the posterior periventricular region to the parietal lobe tend to highly suffer from cerebral palsy and visuoperceptual impairment. These results indicate that the disorders of cognitive function in very low birth weight infants were caused by a damage of association fibers in periventricular areas which was detectable by MRI. (author)

  12. Brain MRI findings of welders : high signal intensity in T1WI secondary to manganese exposure

    Kim, K. W.; Lim, M. A.; Shon, M. Y.; Lee, S. H.; Ha, D. G.; Kwon, K. R.; Kim, S. S.; Hong, Y. S.; Lee, Y. H. [Sunlin Presbyterian Hospital, Pohang (Korea, Republic of); Cheong, H. K. [Dongguk University, Seoul (Korea, Republic of)

    1998-03-01

    To evaluate the clinical and brain MRI findings of welders and to determine the utility of MRI in the assessment of occupational manganese exposure. All welders complained of fatigue, headache, anorexia, and decreased libido. The palmomental reflex was positive in five (28%), Myerson`s sign in four (22%), and intention tremor in three (17%). Mean blood Mn was 5.18 (range, 1.77-9.34) {mu}g/dl, mean urine Mn was 5.84 (range, 1.07 -22) {mu}g/l, serum Fe was elevated in one welder, and serum Cd in two. T1WI of brain MRI revealed high signal intensities in the globus pallidus, the putamen, the substantia nigra, the tectum, the caudate nucleus, the subthalamic nucleus, the hypothalamus and the pituitary gland. These intensities correlated closely with blood Mn levels, suggesting their potential role in estimating the accumulation of Mn in the brain. (author). 25 refs., 2 tabs., 5 figs.

  13. Cognitive function and MRI findings in very low birth weight infants

    Twenty-two very low birth weight infants at preschool ages of 5-6 years were studied to clarify the correlation between cognitive function and MRI findings. Cognitive function was evaluated by the Wechsler Intelligence Scale for Children-Revised (WISC-R) and the Frostig developmental test of visual perception. Ventricular enlargement, assessed by the bioccipital index (B.I.) measured on MRI, was correlated to cognitive disorders. Children with periventricular high intensity areas (T2-weighted images) extending from the posterior periventricular region to the parietal lobe tend to highly suffer from cerebral palsy and visuoperceptual impairment. These results indicate that the disorders of cognitive function in very low birth weight infants were caused by a damage of association fibers in periventricular areas which was detectable by MRI. (author)

  14. COMPARATIVE EVALUATION OF USG AND MRI FINDINGS IN ENDOMETRIAL MASSES: A PICTORIAL ASSAY

    Shailesh G

    2014-09-01

    Full Text Available : Ultrasonography has been the gold standard in imaging of pelvis. The transvaginal sonography gives good details of lesions involving both endometrium and myometrium but still sometimes fail to give exact diagnosis. Computed tomography is of not much help in assessing endometrial-myometrial lesions. Magnetic Resonance Imaging has been now established as a prime tool to evaluate the involvement of endometrium and myometrium in lesion which are embedded in both and hence ultrasound may not be diagnostic alone, as per various studies worldwide. We selected three different patients of gynecological complaints coming to our Department of Radiology at Terna Sahyadri Speciality Hospital run by Terna Medical College in Navi Mumbai, India, and having undergone ultrasound and MRI scans and the diagnosis were confirmed by histopathology. We studied the cases and compared the ultrasound and MRI findings and concluded that indeed the MRI is an important modality to assess such lesions and helps in planning of treatment by gynecologists.

  15. Brain CT and MRI findings of a long-term case of subacute sclerosing panencephalitis

    Aoshiba, Kazunori; Ota, Kohei; Komatsuzaki, Satoshi; Kobayashi, Itsuro; Maruyama, Shoichi

    1987-11-01

    Our study involved a long-term case (ten years) of subacute sclerosing panencephalitis. The case began with a 23 year-old experiencing visual deterioration. During the course of his illness, amnesia, autism and abnormal behavior were observed without any myoclonus. On the electroencephalogram, periodic synclonous discharge was shown in the early stage of his illness and subsequently disappeared. The brain CT and the MRI disclosed diffuse lesions in both cortical and subcortical areas of the cerebral hemispheres. The location and spread of lesions were more clearly revealed by the MRI than the brain CT. These findings suggest that the MRI is more useful than the brain CT in the diagnosis of subacute sclerosing panencephalitis.

  16. Brain CT and MRI findings of a long-term case of subacute sclerosing panencephalitis

    Our study involved a long-term case (ten years) of subacute sclerosing panencephalitis. The case began with a 23 year-old experiencing visual deterioration. During the course of his illness, amnesia, autism and abnormal behavior were observed without any myoclonus. On the electroencephalogram, periodic synclonous discharge was shown in the early stage of his illness and subsequently disappeared. The brain CT and the MRI disclosed diffuse lesions in both cortical and subcortical areas of the cerebral hemispheres. The location and spread of lesions were more clearly revealed by the MRI than the brain CT. These findings suggest that the MRI is more useful than the brain CT in the diagnosis of subacute sclerosing panencephalitis. (author)

  17. Striated nephrogram as an incidental finding in MRI examination of children

    A highly striated contrast pattern of the kidneys occasionally appears in abdominal MRI examinations of children following the administration of gadolinium. As this phenomenon is well known but has not yet been explicitly described in literature, we investigated how frequently and in which clinical context this occurred. 855 abdominal MRI examinations with contrast media of 362 children between 2006 and 2014 were analysed retrospectively. A striated renal parenchyma was found in a total of nine children and eleven examinations (1.3 % of examinations) and did only occur at a field strength of 3 Tesla. Of these children, seven had previously had tumors and chemotherapy. In two children there was no evidence of a previously serious condition with medications or a kidney disease. All of them had a normal renal function. A noticeably striated nephrogram in the later phase of an MRI examination following administration of gadolinium may appear as an incidental finding in examinations at 3 Tesla without pathological relevance.

  18. Brain MRI findings of welders : high signal intensity in T1WI secondary to manganese exposure

    To evaluate the clinical and brain MRI findings of welders and to determine the utility of MRI in the assessment of occupational manganese exposure. All welders complained of fatigue, headache, anorexia, and decreased libido. The palmomental reflex was positive in five (28%), Myerson's sign in four (22%), and intention tremor in three (17%). Mean blood Mn was 5.18 (range, 1.77-9.34) μg/dl, mean urine Mn was 5.84 (range, 1.07 -22) μg/l, serum Fe was elevated in one welder, and serum Cd in two. T1WI of brain MRI revealed high signal intensities in the globus pallidus, the putamen, the substantia nigra, the tectum, the caudate nucleus, the subthalamic nucleus, the hypothalamus and the pituitary gland. These intensities correlated closely with blood Mn levels, suggesting their potential role in estimating the accumulation of Mn in the brain. (author). 25 refs., 2 tabs., 5 figs

  19. MRI of double-bundle ACL reconstruction: evaluation of graft findings

    To demonstrate the magnetic resonance imaging (MRI) findings of double-bundle (DB) anterior cruciate ligament (ACL) reconstruction grafts. Sixty-six patients with DB ACL reconstruction were evaluated with MRI 2 years postoperatively. Graft thickness was measured separately by two musculoskeletal radiologists. The MRI findings of graft disruption, signal intensity (SI) changes, cystic degeneration, arthrofibrosis, and impingement were analyzed. The statistical significance of the association between MRI findings was calculated. The mean anteromedial (AM) graft thickness was reduced 9% and the mean posterolateral (PL) graft thickness was reduced 18% from the original graft thickness. Disruption was seen in 3% of AM grafts and 6% of PL grafts and a partial tear in 8 and 23%, respectively. Both grafts were disrupted in 3% of patients. Increased SI was seen in 14% of intact AM grafts and in 60% of partially torn AM grafts (p = 0.032). In PL grafts the increased SI was seen in 51% of the intact grafts and in 93% of the partially torn grafts (p = 0.005). Cystic degeneration was seen in 8% of AM grafts and in 5% of PL grafts. Diffuse arthrofibrosis was seen in 5% of patients and a localized cyclops lesion in 3% of patients. Impingement of the AM graft was seen in 8% of patients. Both grafts were disrupted in 3% of patients. Also, the frequencies of other complications were low. The use of orthogonal sequences in the evaluation of the PL graft SI seems to cause volume-averaging artefacts. (orig.)

  20. MRI of double-bundle ACL reconstruction: evaluation of graft findings

    Kiekara, Tommi; Paakkala, Antti [Tampere University Hospital, Medical Imaging Centre, Tampere (Finland); Jaervelae, Timo [Sports Clinic and Hospital Mehilaeinen, Tampere (Finland); Huhtala, Heini [University of Tampere, School of Health Sciences, Tampere (Finland)

    2012-07-15

    To demonstrate the magnetic resonance imaging (MRI) findings of double-bundle (DB) anterior cruciate ligament (ACL) reconstruction grafts. Sixty-six patients with DB ACL reconstruction were evaluated with MRI 2 years postoperatively. Graft thickness was measured separately by two musculoskeletal radiologists. The MRI findings of graft disruption, signal intensity (SI) changes, cystic degeneration, arthrofibrosis, and impingement were analyzed. The statistical significance of the association between MRI findings was calculated. The mean anteromedial (AM) graft thickness was reduced 9% and the mean posterolateral (PL) graft thickness was reduced 18% from the original graft thickness. Disruption was seen in 3% of AM grafts and 6% of PL grafts and a partial tear in 8 and 23%, respectively. Both grafts were disrupted in 3% of patients. Increased SI was seen in 14% of intact AM grafts and in 60% of partially torn AM grafts (p = 0.032). In PL grafts the increased SI was seen in 51% of the intact grafts and in 93% of the partially torn grafts (p = 0.005). Cystic degeneration was seen in 8% of AM grafts and in 5% of PL grafts. Diffuse arthrofibrosis was seen in 5% of patients and a localized cyclops lesion in 3% of patients. Impingement of the AM graft was seen in 8% of patients. Both grafts were disrupted in 3% of patients. Also, the frequencies of other complications were low. The use of orthogonal sequences in the evaluation of the PL graft SI seems to cause volume-averaging artefacts. (orig.)

  1. Negative predictive value of multiparametric MRI for prostate cancer detection: Outcome of 5-year follow-up in men with negative findings on initial MRI studies

    Highlights: • We assess the negative predictive value of multiparametric MRI for prostate cancer. • Patients with positive prostate biopsy findings were defined as false-negative. • Patients with negative initial prostate biopsy findings were followed up for 5 years. • The negative predictive value was 89.6% for significant prostate cancer. • MRI is a useful tool to rule out significant prostate cancer before biopsy. - Abstract: Objective: To assess the clinical negative predictive value (NPV) of multiparametric MRI (mp-MRI) for prostate cancer in a 5-year follow-up. Materials and methods: One hundred ninety-three men suspected of harboring prostate cancer with negative MRI findings were included. Patients with positive transrectal ultrasound (TRUS)-guided biopsy findings were defined as false-negative. Patients with negative initial TRUS-guided biopsy findings were followed up and only patients with negative findings by digital rectal examination, MRI, and repeat biopsy and no increase in PSA at 5-year follow-up were defined as “clinically negative”. The clinical NPV of mp-MRI was calculated. For quantitative analysis, mean signal intensity on T2-weighted images and the mean apparent diffusion coefficient value on ADC maps of the initial MRI studies were compared between peripheral-zone (PZ) cancer and the normal PZ based on pathologic maps of patients who had undergone radical prostatectomy. Results: The clinical NPV of mp-MRI was 89.6% for significant prostate cancer. Small cancers, prostatitis, and benign prostatic hypertrophy masking prostate cancer returned false-negative results. Quantitative analysis showed that there was no significant difference between PZ cancer and the normal PZ. Conclusion: The mp-MRI revealed a high clinical NPV and is a useful tool to rule out clinically significant prostate cancer before biopsy

  2. Negative predictive value of multiparametric MRI for prostate cancer detection: Outcome of 5-year follow-up in men with negative findings on initial MRI studies

    Itatani, R., E-mail: banguliao@gmail.com [Department of Diagnostic Radiology, Graduate School of Medical Sciences, Kumamoto University, 1-1-1, Honjo, Kumamoto 860-8556 (Japan); Department of Radiology, Kumamoto Chuo Hospital, 1-5-1, Tainoshima, Kumamoto 862-0965 (Japan); Namimoto, T. [Department of Diagnostic Radiology, Graduate School of Medical Sciences, Kumamoto University, 1-1-1, Honjo, Kumamoto 860-8556 (Japan); Atsuji, S.; Katahira, K.; Morishita, S. [Department of Radiology, Kumamoto Chuo Hospital, 1-5-1, Tainoshima, Kumamoto 862-0965 (Japan); Kitani, K.; Hamada, Y. [Department of Urology, Kumamoto Chuo Hospital, 1-5-1, Tainoshima, Kumamoto 862-0965 (Japan); Kitaoka, M. [Department of Pathology, Kumamoto Chuo Hospital, 1-5-1, Tainoshima, Kumamoto 862-0965 (Japan); Nakaura, T. [Department of Diagnostic Radiology, Amakusa Medical Center, Kameba 854-1, Amakusa, Kumamoto 863-0046 (Japan); Yamashita, Y. [Department of Diagnostic Radiology, Graduate School of Medical Sciences, Kumamoto University, 1-1-1, Honjo, Kumamoto 860-8556 (Japan)

    2014-10-15

    Highlights: • We assess the negative predictive value of multiparametric MRI for prostate cancer. • Patients with positive prostate biopsy findings were defined as false-negative. • Patients with negative initial prostate biopsy findings were followed up for 5 years. • The negative predictive value was 89.6% for significant prostate cancer. • MRI is a useful tool to rule out significant prostate cancer before biopsy. - Abstract: Objective: To assess the clinical negative predictive value (NPV) of multiparametric MRI (mp-MRI) for prostate cancer in a 5-year follow-up. Materials and methods: One hundred ninety-three men suspected of harboring prostate cancer with negative MRI findings were included. Patients with positive transrectal ultrasound (TRUS)-guided biopsy findings were defined as false-negative. Patients with negative initial TRUS-guided biopsy findings were followed up and only patients with negative findings by digital rectal examination, MRI, and repeat biopsy and no increase in PSA at 5-year follow-up were defined as “clinically negative”. The clinical NPV of mp-MRI was calculated. For quantitative analysis, mean signal intensity on T2-weighted images and the mean apparent diffusion coefficient value on ADC maps of the initial MRI studies were compared between peripheral-zone (PZ) cancer and the normal PZ based on pathologic maps of patients who had undergone radical prostatectomy. Results: The clinical NPV of mp-MRI was 89.6% for significant prostate cancer. Small cancers, prostatitis, and benign prostatic hypertrophy masking prostate cancer returned false-negative results. Quantitative analysis showed that there was no significant difference between PZ cancer and the normal PZ. Conclusion: The mp-MRI revealed a high clinical NPV and is a useful tool to rule out clinically significant prostate cancer before biopsy.

  3. The paediatric wrist revisited - findings of bony depressions in healthy children on radiographs compared to MRI

    Avenarius, Derk M.F.; Eldevik, Petter [University Hospital North Norway, Department of Radiology, Tromsoe (Norway); Ording Mueller, Lil-Sofie [University Hospital North Norway, Department of Radiology, Tromsoe (Norway); Great Ormond Street Hospital for Children, Department of Radiology, London (United Kingdom); Owens, Catherine M. [Great Ormond Street Hospital for Children, Department of Radiology, London (United Kingdom); University College London, Institute of Child Health, London (United Kingdom); Rosendahl, Karen [Haukeland University Hospital, Department of Radiology, Bergen (Norway); University of Bergen, Department of Surgical Sciences, Bergen (Norway); Great Ormond Street Hospital for Children, Department of Radiology, London (United Kingdom)

    2012-07-15

    The presence of erosions is used for diagnosis and monitoring of disease activity in juvenile idiopathic arthritis (JIA). Assessment of carpal bone erosions in children is challenging due to lack of normal references. To define normal appearances of bony depressions in the wrist on radiographs and MRI. MRI and radiography of the wrist were performed in 88 healthy children, 5-15 years of age. We assessed the number of bony depressions within the carpals/proximal metacarpals on both modalities, separately and combined. A total of 75 carpal depressions were identified on radiography compared to 715 on MRI. The number of bony depressions identified radiographically showed no statistically significant difference across age-groups. Within the metacarpals, there was no significant difference between bony depressions identified by MRI or radiography, except at the bases of the second metacarpal. Bony depressions that resemble erosions are normal findings in the wrist in children. MRI identifies more depressions than radiographs in the carpus. Some bony depressions occur at typical locations and should be accounted for when assessing the wrist in JIA to avoid overstaging. (orig.)

  4. MRI findings in children with neurofibromatosis type 1: a prospective study

    To determine the frequency and nature of MRI lesions in children with neurofibromatosis type I (NF1), 50 patients aged 8 to 16 years were evaluated prospectively with cranial MRI. Forty-one children were asymptomatic with respect to central nervous system pathology, and 50% were macrocephalic. Sixteen patients (32%) had normal MRI examinations. Thirty-two patients (64%) had high intensity lesions of T2-weighted images and 16 patients (32%) had hyperintense lesions on T1-weighted images. Seven patients (14%) had ventricular dilatation (associated with increased intracranial pressure in 2) and 11 patients (22%) had optic pathway lesions (optic glioma in 7). MRI was superior to CT in differentiating optic sheath thickening and optic nerve tortuosity from optic glioma in four patients. An intracranial tumour (ependymoma) and sphenoid wing dysplasia were evident in individual patients. Findings previously unreported in NF1 included an aqueductal web resulting in hydrocephalus, intracular neurofibroma resulting in retinal detachment, and asymptomatic enlargement of the septum pellucidum. T1 and T2 signal abnormalities in isolation were not associated with neurological deficits or the occurrence of macrocephaly, and all lesions that required intervention were suspected clinically. Macrocephaly in the absence of increased intracranial pressure or accelerated head growth is not an indication for neuroimaging in children with NF1. However, the majority of children (68%) had disease-specific abnormalities and thus MRI may provide a useful adjunct to clinical evaluation in the diagnosis of equivocal cases. (orig.)

  5. The paediatric wrist revisited - findings of bony depressions in healthy children on radiographs compared to MRI

    The presence of erosions is used for diagnosis and monitoring of disease activity in juvenile idiopathic arthritis (JIA). Assessment of carpal bone erosions in children is challenging due to lack of normal references. To define normal appearances of bony depressions in the wrist on radiographs and MRI. MRI and radiography of the wrist were performed in 88 healthy children, 5-15 years of age. We assessed the number of bony depressions within the carpals/proximal metacarpals on both modalities, separately and combined. A total of 75 carpal depressions were identified on radiography compared to 715 on MRI. The number of bony depressions identified radiographically showed no statistically significant difference across age-groups. Within the metacarpals, there was no significant difference between bony depressions identified by MRI or radiography, except at the bases of the second metacarpal. Bony depressions that resemble erosions are normal findings in the wrist in children. MRI identifies more depressions than radiographs in the carpus. Some bony depressions occur at typical locations and should be accounted for when assessing the wrist in JIA to avoid overstaging. (orig.)

  6. Cortical restricted diffusion as the predominant MRI finding in sporadic Creutzfeldt-Jakob disease

    Talbott, Sabrina D.; Sattenberg, Ronald J.; Heidenreich, Jens O. (Dept. of Radiology, Univ. of Louisville, Louisville (United States)), e-mail: sdtalb02@gwise.louisville.edu; Plato, Brian M (Dept. of Neurology, Univ. of Louisville, Louisville (United States)); Parker, John (Dept. of Pathology and Laboratory Medicine, Univ. of Louisville, Louisville (United States))

    2011-04-15

    Creutzfeldt-Jakob disease is a rare and fatal neurodegenerative disorder with MR findings predominantly limited to the grey matter of the cortex and the basal ganglia. Sporadic Creutzfeldt-Jakob disease can produce a spectrum of MR imaging findings of the brain, most notably on DWI and FLAIR sequences. Involvement of the basal ganglia and neocortex is the most common finding, but isolated involvement of the cortex can also be seen. We describe the clinical history and MRI findings of three patients with sporadic Creutzfeldt-Jakob disease confirmed by brain biopsy or autopsy and review the literature of imaging manifestations of this disease

  7. A retrospective review of pituitary MRI findings in children on growth hormone therapy

    Tsai, Sarah L.; Lawrence, Sarah [University of Ottawa, Division of Endocrinology, Children' s Hospital of Eastern Ontario, Ottawa (Canada); Laffan, Eoghan [Children' s University Hospital, Pediatric Radiology, Dublin 1 (Ireland)

    2012-07-15

    Patients with congenital hypopituitarism might have the classic triad of pituitary stalk interruption syndrome, which consists of: (1) an interrupted or thin pituitary stalk, (2) an absent or ectopic posterior pituitary (EPP), and (3) anterior pituitary hypoplasia or aplasia. To examine the relationship between pituitary anatomy and the degree of hormonal dysfunction. This study involved a retrospective review of MRI findings in all children diagnosed with congenital growth hormone deficiency from 1988 to 2010 at a tertiary-level pediatric hospital. Of the 52 MRIs reviewed in 52 children, 26 children had normal pituitary anatomy and 26 had one or more elements of the classic triad. Fourteen of fifteen children with multiple pituitary hormone deficiencies had structural anomalies on MRI. Twelve of 37 children with isolated growth hormone deficiency had an abnormal MRI. Children with multiple pituitary hormone deficiencies were more likely to have the classic triad than children with isolated growth hormone deficiency. A normal MRI was the most common finding in children with isolated growth hormone deficiency. (orig.)

  8. A retrospective review of pituitary MRI findings in children on growth hormone therapy

    Patients with congenital hypopituitarism might have the classic triad of pituitary stalk interruption syndrome, which consists of: (1) an interrupted or thin pituitary stalk, (2) an absent or ectopic posterior pituitary (EPP), and (3) anterior pituitary hypoplasia or aplasia. To examine the relationship between pituitary anatomy and the degree of hormonal dysfunction. This study involved a retrospective review of MRI findings in all children diagnosed with congenital growth hormone deficiency from 1988 to 2010 at a tertiary-level pediatric hospital. Of the 52 MRIs reviewed in 52 children, 26 children had normal pituitary anatomy and 26 had one or more elements of the classic triad. Fourteen of fifteen children with multiple pituitary hormone deficiencies had structural anomalies on MRI. Twelve of 37 children with isolated growth hormone deficiency had an abnormal MRI. Children with multiple pituitary hormone deficiencies were more likely to have the classic triad than children with isolated growth hormone deficiency. A normal MRI was the most common finding in children with isolated growth hormone deficiency. (orig.)

  9. Isolated lipoma of filum terminale in adults: MRI findings and clinical correlation

    Fat within the filum terminale is frequently seen on routine magnetic resonance imaging (MRI) of the lumbosacral spine (LSS), with prevalence of 1–5%. The objective of this study was to determine the prevalence and MRI features of isolated lipoma of filum terminale (LFT) in adult population and its correlation with the patient clinical presentations. Prospective analysis of all lumbosacral MRI performed at King Abdullah University Hospital during a 21-month period. A total of 37 patients with LFT were included. Patients were divided into two groups. Group A patients have neurological deficit manifested by either motor, sensory or sphincter abnormality. Group B patients have normal neurological examination. Clinical findings were correlated with: A: thickness of LFT, B: length of LFT, C: distance of LFT from conus medullaris (CM), D: age of the patient. The prevalence of isolated LFT in our study was 3.2%. There was no significant correlation between the thickness or length of LFT and the presence of neurological deficit. The distance of LFT from CM was also not correlated with the patient clinical presentation. No significant difference in the age between the two groups. LFT in adult likely represent an incidental finding on routine lumbosacral MRI. Special attention for LFT in children is mandatory as it may indicate clinical tethering in otherwise normal appearing LSS.

  10. The MRI findings of iris metastasis in patients with breast cancer.

    Mutlu, Hasan; Akça, Zeki; Büyükçelik, Abdullah; Oztürk, Mustafa; Taşdemir, Mustafa; Kubilay Yazıcıoğlu, Alper; Kaplan, Bünyamin; Uçar, Kadir

    2012-12-01

    Breast cancer and lung cancer are the most common tumors that metastasize to iris. The metastasis of iris was generally diagnosed on ophthalmologic examination. In this case, we reported iris metastasis of patients with adenocarcinoma of breast cancer and MRI findings. We report a case of a 51-year-old. She was diagnosed breast cancer two years ago. After adjuvant chemotherapy, radiotherapy and trastuzumab, she was admitted to hospital with the complaints of headache on February 2012. The magnetic resonance imaging (MRI ) revealed multiple brain metastasis. Whole brain radiotherapy and palliative chemotherapy were applied to the patients. In follow-up, on ophthalmological examination, there was a solid lesion on iris. The orbital MRI was performed and it revealed the thickness on iris of left eye. After diagnostic procedure final pathological rewiev reported that invasive ductal carcinom metastasis. Iris metastasis may be considered by MRI findings following: The thickness on iris and contrast enhanced lesion. This reason may be resulted that the fine niddle aspiration biopsy for diagnosis of iris metastasis is not need. PMID:23378695

  11. THE MRI FINDINGS OF IRIS METASTASIS IN PATIENTS WITH BREAST CANCER

    Mutlu, Hasan; Akça, Zeki; Büyükçelik, Abdullah; Öztürk, Mustafa; Taşdemir, Mustafa; Kubilay Yazıcıoğlu, Alper; Kaplan, Bünyamin; Uçar, Kadir

    2012-01-01

    Breast cancer and lung cancer are the most common tumors that metastasize to iris. The metastasis of iris was generally diagnosed on ophthalmologic examination. In this case, we reported iris metastasis of patients with adenocarcinoma of breast cancer and MRI findings. We report a case of a 51-year-old. She was diagnosed breast cancer two years ago. After adjuvant chemotherapy, radiotherapy and trastuzumab, she was admitted to hospital with the complaints of headache on February 2012. The magnetic resonance imaging (MRI ) revealed multiple brain metastasis. Whole brain radiotherapy and palliative chemotherapy were applied to the patients. In follow-up, on ophthalmological examination, there was a solid lesion on iris. The orbital MRI was performed and it revealed the thickness on iris of left eye. After diagnostic procedure final pathological rewiev reported that invasive ductal carcinom metastasis. Iris metastasis may be considered by MRI findings following: The thickness on iris and contrast enhanced lesion. This reason may be resulted that the fine niddle aspiration biopsy for diagnosis of iris metastasis is not need. PMID:23378695

  12. Prevalence of cartilaginous tumours as an incidental finding on MRI of the knee

    Stomp, Wouter; Reijnierse, Monique; Bloem, Johan L. [Lei