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Sample records for final infarct mri

  1. Striatocapsular infarction: MRI and MR angiography

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    Croisille, P. (Dept. of Neuroradiology, Hopital Neurologique et Neurochirurgical Pierre Wertheimer, Lyon (France)); Turjman, F. (Dept. of Neuroradiology, Hopital Neurologique et Neurochirurgical Pierre Wertheimer, Lyon (France)); Croisile, B. (Dept. of Neurology, Hopital Neurologique et Neurochirurgical Pierre Wertheimer, Lyon (France)); Tournut, P. (Dept. of Neuroradiology, Hopital Neurologique et Neurochirurgical Pierre Wertheimer, Lyon (France)); Laharotte, J.C. (Dept. of Neuroradiology, Hopital Neurologique et Neurochirurgical Pierre Wertheimer, Lyon (France)); Aimard, G. (Dept. of Neurology, Hopital Neurologique et Neurochirurgical Pierre Wertheimer, Lyon (France)); Trillet, M. (Dept. of Neurology, Hopital Neurologique et Neurochirurgical Pierre Wertheimer, Lyon (France)); Duquesnel, J. (Dept. of Neuroradiology, Hopital Neurologique et Neurochirurgical Pierre Wertheimer, Lyon (France)); Froment, J.C. (Dept. of Neuroradiology, Hopital Neurologique et Neurochirurgical Pierre

    1994-08-01

    We present a case of left striatocapsular infarction manifest clinically as a transient right hemiparesis. MRI showed a left striatocapsular infarct. Striatocapsular infarction, unlike lacunar infarction, is often associated with occlusive disease of the carotid artery. In order to screen the carotid vessels, cervical MR angiography (MRA) was performed during the same examination, demonstrating a left internal carotid artery occlusion, confirmed by contrast arteriography. MRA, a noninvasive modality, can be a useful adjunct to MRI, when diagnostic information concerning the cervical carotid artery is needed. (orig.)

  2. Optic atrophy and cerebral infarcts caused by methanol intoxication: MRI

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    Hsu, H.H. [Dept. of Diagnostic Radiology, Tri-Service General Hospital, National Defense Medical Center, Taipei (Taiwan, Province of China); Chen, C.Y. [Dept. of Diagnostic Radiology, Tri-Service General Hospital, National Defense Medical Center, Taipei (Taiwan, Province of China); Chen, F.H. [Dept. of Diagnostic Radiology, Tri-Service General Hospital, National Defense Medical Center, Taipei (Taiwan, Province of China); Lee, C.C. [Dept. of Diagnostic Radiology, Tri-Service General Hospital, National Defense Medical Center, Taipei (Taiwan, Province of China); Chou, T.Y. [Dept. of Diagnostic Radiology, Tri-Service General Hospital, National Defense Medical Center, Taipei (Taiwan, Province of China); Zimmerman, R.A. [Children`s Hospital of Philadelphia, PA (United States). Dept. of Radiology

    1997-03-01

    We present the MRI findings of cerebral and optic pathway damage in the acute and subacute stages of methanol intoxication. In the acute stage, CT and MRI showed bilateral haemorrhagic necrosis of the corpus striatum and infarcts in the anterior and middle cerebral arterial territories. MRI in the subacute stage demonstrated atrophy of the optic chiasm and prechiasmatic optic nerves in addition to the cerebral infarcts. The patient survived, with total blindness. (orig.)

  3. Is enhanced MRI helpful in brainstem infarction?

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    Jeong, Y. M.; Shin, G. H.; Choi, W. S. [Kyung Hee University Hospital, Seoul (Korea, Republic of)

    1994-12-15

    To determine the role of MR contrast enhancement in evaluating time course of brainstem infarction. MR imaging with IV administration of gadopentetate dimeglumine was retrospectively reviewed in 43 patients with clinically and radiologically documented brainstem infarctions. The pattern of infarction was classified into spotty and patchy. Presence of parenchymal enhancement in infarction was evaluated. By location, there were 34 pontine, 3 midbrain, 6 medullary infarctions. The age of the infarctions ranged from 1 day to 9 months, with 5 patients scanned within 3 days and 10 scanned within 2 weeks of clinical ictus. Abnormalities on T2-weighted images were encountered in every case, with spotty pattern in 14 cases and patchy pattern in 29 cases. Parenchymal contrast enhancement was seen in 9 cases(20%), primarily occurring between days 8 and 20. MR contrast enhancement in brainstem infarction was infrequent that it may not be useful in the estimation of the age of infarction.

  4. Unexpected Coexisting Myocardial Infarction Detected by Delayed Enhancement MRI

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    Edouard Gerbaud

    2009-01-01

    Full Text Available We report a case of an unexpected coexisting anterior myocardial infarction detected by delayed enhancement MRI in a 41-year-old man following a presentation with a first episode of chest pain during inferior acute myocardial infarction. This second necrotic area was not initially suspected because there were no ECG changes in the anterior leads and the left descending coronary artery did not present any significant stenoses on emergency coronary angiography. Unrecognised myocardial infarction may carry important prognostic implications. CMR is currently the best imaging technique to detect unexpected infarcts.

  5. Brain infarcts due to scorpion stings in children: MRI

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    Fernandez-Bouzas, A.; Ballesteros-Maresma, A. [Univ. Nacional Autonoma de Mexico, Mexico (Mexico); Morales-Resendiz, M.L. [Hospital General de Queretaro, Mexico (Mexico); Llamas-Ibarra, F. [Clinica Neurologica de Queretaro, Mexico (Mexico); Martinez-Lopez, M. [Fundacion Clinica Medica Sur., Mexico (Mexico)

    2000-02-01

    We report two children with severe neurological complications after having been stung by a scorpion. Clinical and MRI findings suggested brain infarcts. The lesions seen were in pons in one child and the right hemisphere in the other. The latter also showed possible hyperemia in the infarcted area. No vascular occlusions were observed and we therefore think the brain infarcts were a consequence of the scorpion sting. The cause of the infarct may be hypotension, shock or depressed left ventricular function, all of which are frequent in severe poisoning by scorpion sting. (orig.)

  6. Contrast-enhanced MRI of murine myocardial infarction - part II

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    Coolen, B.F.; Paulis, L.E.M.; Geelen, T.; Nicolay, K.; Strijkers, G.J.

    2012-01-01

    Mouse models are increasingly used to study the pathophysiology of myocardial infarction in vivo. In this area, MRI has become the gold standard imaging modality, because it combines high spatial and temporal resolution functional imaging with a large variety of methods to generate soft tissue contr

  7. Contrast-enhanced MRI of murine myocardial infarction - part II

    NARCIS (Netherlands)

    Coolen, B.F.; Paulis, L.E.M.; Geelen, T.; Nicolay, K.; Strijkers, G.J.

    2012-01-01

    Mouse models are increasingly used to study the pathophysiology of myocardial infarction in vivo. In this area, MRI has become the gold standard imaging modality, because it combines high spatial and temporal resolution functional imaging with a large variety of methods to generate soft tissue

  8. Perfusion MRI in cerebral infarction; MR-Perfusionsuntersuchung beim Hirninfarkt

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    Hagen, T.; Bartylla, K.; Piepgras, U. [Abt. fuer Neuroradiologie, Radiologische Klinik der Universitaet des Saarlandes, Homburg (Germany); Stoll, M. [Universitaet des Saarlandes, Homburg (Germany). Neurologische Klinik

    1997-11-01

    Purpose: To investigate the hemodynamic changes in patients with acute cerebral stroke by perfusion MRI. Materials and methods: In 12 patients with acute stroke in the territory of the middle cerebral artery, perfusion MRI was performed. Peak time, mean transit time, regional cerebral blood volume and regional cerebral blood flow were calculated in the infarction, the peri-infarction area and the contralateral hemisphere. Results: In the infarction the mean blood flow was 29 ml/100 g/min, compared to about 40 ml/100 g/min in the peri-infarction area and the contralateral hemisphere. In two patients increased cortical blood flow was found in the infarction due to luxury perfusion. The cerebral blood volume was reduced in the infarction, but significantly increased, to 7.3 ml/100 g, in the peri-infarction tissue. Conclusion: Perfusion MRI allows one to differentiate various patterns of perfusion disorders in patients with acute cerebral stroke. (orig./AJ) [Deutsch] Ziel dieser Untersuchung war es, kernspintomographisch die haemodynamischen Veraenderungen in einem Patientenkollektiv mit akutem Hirninfarkt zu bestimmen. Bei 12 Patienten mit akutem Infarkt im Versorgungsbereich der A.cerebri media wurde eine kerspintomographische Perfusionsmessung durchgefuehrt. Im demarkierten Infakrtgebiet, in der Infarktumgebung und auf der nicht betroffenen kontralateralen Hemisphaere wurden die `peak time`, die `mean transit time`, das regionale zerebrale Blutvolumen und der regionale zerebrale Blutfuss berechnet. Im Infarktzentrum fand sich ein mittlerer Blutfluss von 29 ml/100 g/min, waehrend fuer die Infarktumgebung und die kontralaterale Hemisphaere ein Fluss von etwa 40 ml/100 g/min bestimmt wurde. Bei 2 Patienten fand sich im demarkierten Infarktgebiet eine kortikal gelegene Flussbeschleunigung. Das zerebrale Blutvolumen war im Infarktzentrum vermindert, in der Infarktumgebung mit 7,3 ml/100 g signifikant erhoeht. Mit der kernspintomographischen Perfusionsmessung lassen sich

  9. Contrast-enhanced MRI of murine myocardial infarction - part II.

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    Coolen, Bram F; Paulis, Leonie E M; Geelen, Tessa; Nicolay, Klaas; Strijkers, Gustav J

    2012-08-01

    Mouse models are increasingly used to study the pathophysiology of myocardial infarction in vivo. In this area, MRI has become the gold standard imaging modality, because it combines high spatial and temporal resolution functional imaging with a large variety of methods to generate soft tissue contrast. In addition, (target-specific) MRI contrast agents can be employed to visualize different processes in the cascade of events following myocardial infarction. Here, the MRI sequence has a decisive role in the detection sensitivity of a contrast agent. However, a straightforward translation of clinically available protocols for human cardiac imaging to mice is not feasible, because of the small size of the mouse heart and its extremely high heart rate. This has stimulated intense research in the development of cardiac MRI protocols specifically tuned to the mouse with regard to timing parameters, acquisition strategies, and ECG- and respiratory-triggering methods to find an optimal trade-off between sensitivity, scan time, and image quality. In this review, a detailed analysis is given of the pros and cons of different mouse cardiac MR imaging methodologies and their application in contrast-enhanced MRI of myocardial infarction. Copyright © 2012 John Wiley & Sons, Ltd.

  10. PET/MRI assessment of the infarcted mouse heart

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    Buonincontri, Guido; Methner, Carmen; Krieg, Thomas; Hawkes, Robert C.; Adrian Carpenter, T.; Sawiak, Stephen J.

    2014-01-01

    Heart failure originating from myocardial infarction (MI) is a leading cause of death worldwide. Mouse models of ischaemia and reperfusion injury (I/R) are used to study the effects of novel treatment strategies targeting MI, however staging disease and treatment efficacy is a challenge. Damage and recovery can be assessed on the cellular, tissue or whole-organ scale but these are rarely measured in concert. Here, for the first time, we present data showing measures of injury in infarcted mice using complementary techniques for multi-modal characterisation of the heart. We use in vivo magnetic resonance imaging (MRI) to assess heart function with cine-MRI, hindered perfusion with late gadolinium enhancement imaging and muscular function with displacement encoded with stimulated echoes (DENSE) MRI. These measures are followed by positron emission tomography (PET) with 18-F-fluorodeoxyglucose to assess cellular metabolism. We demonstrate a protocol combining each of these measures for the same animal in the same imaging session and compare how the different markers can be used to quantify cardiac recovery on different scales following injury.

  11. PET/MRI assessment of the infarcted mouse heart

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    Buonincontri, Guido, E-mail: gb396@cam.ac.uk [Wolfson Brain Imaging Centre, Department of Clinical Neurosciences, University of Cambridge, Cambridge (United Kingdom); Methner, Carmen; Krieg, Thomas [Department of Medicine, University of Cambridge, Cambridge (United Kingdom); Hawkes, Robert C.; Adrian Carpenter, T. [Wolfson Brain Imaging Centre, Department of Clinical Neurosciences, University of Cambridge, Cambridge (United Kingdom); Sawiak, Stephen J., E-mail: sjs80@cam.ac.uk [Wolfson Brain Imaging Centre, Department of Clinical Neurosciences, University of Cambridge, Cambridge (United Kingdom); Behavioural and Clinical Neuroscience Institute, University of Cambridge, Cambridge (United Kingdom)

    2014-01-11

    Heart failure originating from myocardial infarction (MI) is a leading cause of death worldwide. Mouse models of ischaemia and reperfusion injury (I/R) are used to study the effects of novel treatment strategies targeting MI, however staging disease and treatment efficacy is a challenge. Damage and recovery can be assessed on the cellular, tissue or whole-organ scale but these are rarely measured in concert. Here, for the first time, we present data showing measures of injury in infarcted mice using complementary techniques for multi-modal characterisation of the heart. We use in vivo magnetic resonance imaging (MRI) to assess heart function with cine-MRI, hindered perfusion with late gadolinium enhancement imaging and muscular function with displacement encoded with stimulated echoes (DENSE) MRI. These measures are followed by positron emission tomography (PET) with 18-F-fluorodeoxyglucose to assess cellular metabolism. We demonstrate a protocol combining each of these measures for the same animal in the same imaging session and compare how the different markers can be used to quantify cardiac recovery on different scales following injury.

  12. Cortical laminar necrosis in brain infarcts: serial MRI

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    Siskas, N.; Lefkopoulos, A.; Ioannidis, I.; Charitandi, A.; Dimitriadis, A.S. [Radiology Department, AHEPA University Hospital, Aristotele University of Thessaloniki (Greece)

    2003-05-01

    High-signal cortical lesions are observed on T1-weighted images in cases of brain infarct. Histological examination has demonstrated these to be ''cortical laminar necrosis'', without haemorrhage or calcification. We report serial MRI in this condition in 12 patients with brain infarcts. We looked at high-signal lesions on T1-weighted images, chronological changes in signal intensity and contrast enhancement. High-signal cortical lesions began to appear about 2 weeks after the ictus, were prominent at 1 - 2 months, then became less evident, but occasionally remained for up to 1.5 years. They gave high signal or were isointense on T2-weighted images and did not give low signal at any stage. Contrast enhancement of these lesions was prominent at 1 - 2 months, and less apparent from 3 months, but was seen up to 5 months. (orig.)

  13. Rapid initial reduction of hyperenhanced myocardium after reperfused first myocardial infarction suggests recovery of the peri-infarction zone: one-year follow-up by MRI.

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    Engblom, Henrik; Hedström, Erik; Heiberg, Einar; Wagner, Galen S; Pahlm, Olle; Arheden, Håkan

    2009-01-01

    The time course and magnitude of infarct involution, functional recovery, and normalization of infarct-related electrocardiographic (ECG) changes after acute myocardial infarction (MI) are not completely known in humans. We sought to explore these processes early after MI and during infarct-healing using cardiac MRI. Twenty-two patients with reperfused first-time MI were examined by MRI and ECG at 1, 7, 42, 182, and 365 days after infarction. Global left ventricular function and regional wall thickening were assessed by cine MRI, and injured myocardium was depicted by delayed contrast-enhanced MRI. Infarct size by ECG was estimated by QRS scoring. The reduction of hyperenhanced myocardium occurred predominantly during the first week after infarction (64% of the 1-year reduction). Furthermore, during the first week the amount of nonhyperenhanced myocardium increased significantly (Pinfarction. Also, the time course and magnitude for reduction of hyperenhanced myocardium were associated with normalization of infarct-related ECG changes.

  14. PET/MRI in the infarcted mouse heart with the Cambridge split magnet

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    Buonincontri, Guido, E-mail: gb396@cam.ac.uk [Wolfson Brain Imaging Centre, University of Cambridge, Box 65, Addenbrooke' s Hospital, Hills Road, Cambridge, CB2 0QQ (United Kingdom); Sawiak, Stephen J. [Wolfson Brain Imaging Centre, University of Cambridge, Box 65, Addenbrooke' s Hospital, Hills Road, Cambridge, CB2 0QQ (United Kingdom); Behavioural and Clinical Neuroscience Institute, University of Cambridge, Cambridge (United Kingdom); Methner, Carmen; Krieg, Thomas [Department of Medicine, University of Cambridge, Cambridge (United Kingdom); Hawkes, Robert C.; Adrian Carpenter, T. [Wolfson Brain Imaging Centre, University of Cambridge, Box 65, Addenbrooke' s Hospital, Hills Road, Cambridge, CB2 0QQ (United Kingdom)

    2013-02-21

    Chronic heart failure, as a result of acute myocardial infarction, is a leading cause of death worldwide. Combining diagnostic imaging modalities may aid the direct assessment of experimental treatments targeting heart failure in vivo. Here we present preliminary data using the Cambridge combined PET/MRI imaging system in a mouse model of acute myocardial infarction. The split-magnet design can deliver uncompromised MRI and PET performance, for better assessment of disease and treatment in a preclinical environment.

  15. Peri-infarct dysfunction in post-myocardial infarction: assessment of 3-T tagged and late enhancement MRI

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    Inoue, Yuma; Nagao, Michinobu; Higashino, Hiroshi; Hosokawa, Kohei; Kido, Teruhito; Kurata, Akira; Mochizuki, Teruhito [Ehime University Graduate School of Medicine, Department of Diagnostic and Therapeutic Radiology, Toon-city, Ehime (Japan); Yang, Xiaomei [Sichuan University, College of Electrical Engineering and Information Technology, Sichuan (China); Okayama, Hideki; Higaki, Jitsuo [Ehime University Graduate School of Medicine, Department of Integrated Medicine and Informatics, Matsuyama City (Japan); Murase, Kenya [Osaka University Medical School, Department of Medical Engineering Division of Allied Health Sciences, Osaka (Japan)

    2010-05-15

    To determine LV function at different distances from myocardial infarction (MI) by using 3-T tagged MRI and late gadolinium enhancement (LGE). Cardiac MR images were acquired from 21 patients with previous MI. The harmonic phase (HARP) method was used to calculate radial and circumferential strain (RS, CS). The two strains were synchronised by subtracting the CS from the RS at the same time, and this was defined as the efficient strain (ES). Peak strain (P-RS, P-CS, P-ES) and time to peak strain (T-RS, T-CS, T-ES) were used as estimates of contractile function. Based on the presence of LGE, myocardium was classified into infarct, border zone, adjacent and remote areas. P-RS and P-ES were significantly greater for remote than for adjacent and infarct areas. P-CS values were significantly greater for remote and border zone than for infarct areas. T-RS and T-ES were significantly shorter for remote and border zone than for infarct areas. T-CS was significantly shorter for border zone than for infarct areas. Contractile dysfunction demonstrated by peak strain was correlated with location at different distances from the infarct. In the border zone, contractile deformation was characterised as earlier T-RS, T-CS and T-ES and greater P-CS than in the infarct area. (orig.)

  16. Post myocardial infarction of the left ventricle: the course ahead seen by cardiac MRI

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    Masci, Pier Giorgio

    2012-01-01

    In the last decades, cardiac magnetic resonance imaging (MRI) has gained acceptance in cardiology community as an accurate and reproducible diagnostic imaging modality in patients with ischemic heart disease (IHD). In particular, in patients with acute myocardial infarction (MI) cardiac MRI study allows a comprehensive assessment of the pattern of ischemic injury in term of reversible and irreversible damage, myocardial hemorrhage and microvascular obstruction (MVO). Myocardial salvage index, derived by quantification of myocardium (area) at risk and infarction, has become a promising surrogate end-point increasingly used in clinical trials testing novel or adjunctive reperfusion strategies. Early post-infarction, the accurate and reproducible quantification of myocardial necrosis, along with the characterization of ischemic myocardial damage in its diverse components, provides important information to predict post-infarction left ventricular (LV) remodeling, being useful for patients stratification and management. Considering its non-invasive nature, cardiac MRI suits well for investigating the time course of infarct healing and the changes occurring in peri-infarcted (adjacent) and remote myocardium, which ultimately promote the geometrical, morphological and functional abnormalities of the entire left ventricle (global LV remodeling). The current review will focus on the cardiac MRI utility for a comprehensive evaluation of patients with acute and chronic IHD with particular regard to post-infarction remodeling. PMID:24282705

  17. Thrombotic thrombocytopenic purpura: MRI demonstration of persistent small cerebral infarcts after clinical recovery

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    Gruber, O.; Cramon, D.Y. von [Day-Care Clinic for Cognitive Neurology, University of Leipzig (Germany); Max Planck Institute of Cognitive Neuroscience, Leipzig (Germany); Wittig, I. [Day-Care Clinic for Cognitive Neurology, University of Leipzig (Germany); Wiggins, C.J. [Max Planck Institute of Cognitive Neuroscience, Leipzig (Germany)

    2000-08-01

    Abnormalities in the brain of patients with thrombotic thrombocytopenic purpura (TTP) are infrequent on MRI, often reversible and mainly limited to symptomatic stages of the disease. We report a case in which high-resolution MRI demonstrated multiple persistent small cortical infarcts after clinical remission. High-resolution MRI investigations may detect clinically latent but permanent brain damage, and complement clinical judgement in guiding therapeutic decisions. (orig.)

  18. The diagnostic role of gadolinium enhanced MRI in distinguishing between acute medullary bone infarct and osteomyelitis.

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    Umans, H; Haramati, N; Flusser, G

    2000-04-01

    The objective of the study was to evaluate the diagnostic utility of contrast enhanced magnetic resonance imaging (MRI) for distinguishing between acute medullary bone infarct and osteomyelitis. There were 11 patients (age 6-34 years) presented to our institution between December 1994 and February 1998 with a clinical differential diagnosis of acute bone infarct versus osteomyelitis and inconclusive radiographs were imaged using MRI. All but one received i.v. gadolinium. Nine of the patients had homozygous Sickle Cell disease (SCD) and two had Systemic Lupus Erythematosus (SLE), the latter requiring chronic methylprednisolone. Osteomyelitis was confirmed either by biopsy alone or by the combination of Gallium(67) scan in conjunction with positive blood cultures and clinical resolution following antibiotics. Infarcts without osteomyelitis were confirmed either by biopsy or resolution of symptoms without antibiotic therapy. All patients had at least six months clinical follow-up. The results found that seven of nine patients with SCD had acute infarct only. One patient with SCD had osteomyelitis only. Three patients (two SLE and one SCD) had both acute-on-chronic infarcts and superimposed osteomyelitis, one with an adjacent soft tissue abscess. Accurate distinction between infarct and osteomyelitis was impossible for one patient with SLE who did not receive contrast. All other cases were correctly diagnosed prospectively based on distinct patterns of MRI contrast enhancement. In all adult patients, acute infarcts demonstrated thin, linear rim enhancement on MRI while osteomyelitis revealed more geographic and irregular marrow enhancement. Two of four cases of osteomyelitis also demonstrated subtle cortical defects with abnormal signal traversing marrow and soft tissue. The single pediatric patient demonstrated elongated, serpiginous central medullary enhancement with periostitis. We concluded that the pattern of MR contrast enhancement may allow accurate distinction

  19. Difference in MRI findings and risk factors between multiple infarction without dementia and multi-infarct dementia

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    Yanagisawa, Masashi; Kaieda, Makoto; Nagatsumi, Atsushi; Terashi, Akiro [Nippon Medical School, Tokyo (Japan)

    1995-10-01

    MRI findings and risk factors for vascular dementia were evaluated with multi-variate analysis in 96 multi-infarct patients without dementia and 40 multi-infarct patients with dementia (MID). Only subjects with small infarcts in the territory of the perforator artery or deep white matter were studied. The diagnosis of MID was diagnosed according to DMS-III criteria and Hachinski`s ischemia score. Location and area of patchy high-intensity areas including small infarcts, the degree of periventricular high intensity (PVH), and the degree of brain atrophy were examined with MR images. Independent variables were: history of hypertension, diabetes mellitus, other complications; systolic and diastolic blood pressure, atherosclerotic index, hematocrit, history of smoking, level of education, and activities of daily life (ADL). Hayashi`s quantification method II was used to analyze the data. The most significant correlation was found between history of hypertension and dementia (partial correlation coefficient: 0.39). Significant correlations were also found between ADL and dementia (0.32), between thalamic infarction and dementia (0.31), and between PVH and dementia (0.27). Age, brain atrophy index, and history of diabetes mellitus contributed little to dementia. The contribution to dementia did not differ significantly between right and left patchy high-intensity areas on MR images. Location of infarcts, except for bilateral thalamic infarcts and large PVH, contributed little to dementia. Thus it would be difficult to base a prediction of the prevalence of vascular dementia on MRI findings. However, both hypertention and ADL contribute to vascular dementia and both are treatable, which may be significant for the prevention of dementia. (author).

  20. Relationship between treatment delay and final infarct size in STEMI patients treated with abciximab and primary PCI

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    Tödt Tim

    2012-02-01

    Full Text Available Abstract Background Studies on the impact of time to treatment on myocardial infarct size have yielded conflicting results. In this study of ST-Elevation Myocardial Infarction (STEMI treated with primary percutaneous coronary intervention (PCI, we set out to investigate the relationship between the time from First Medical Contact (FMC to the demonstration of an open infarct related artery (IRA and final scar size. Between February 2006 and September 2007, 89 STEMI patients treated with primary PCI were studied with contrast enhanced magnetic resonance imaging (ceMRI 4 to 8 weeks after the infarction. Spearman correlation was computed for health care delay time (defined as time from FMC to PCI and myocardial injury. Multiple linear regression was used to determine covariates independently associated with infarct size. Results An occluded artery (Thrombolysis In Myocardial Infarction, TIMI flow 0-1 at initial angiogram was seen in 56 patients (63%. The median FMC-to-patent artery was 89 minutes. There was a weak correlation between time from FMC-to-patent IRA and infarct size, r = 0.27, p = 0.01. In multiple regression analyses, LAD as the IRA, smoking and an occluded vessel at the first angiogram, but not delay time, correlated with infarct size. Conclusions In patients with STEMI treated with primary PCI we found a weak correlation between health care delay time and infarct size. Other factors like anterior infarction, a patent artery pre-PCI and effects of reperfusion injury may have had greater influence on infarct size than time-to-treatment per se.

  1. MRI Manifestation and Early Diagnosis of Bone Infarct: A Rare Complication of Steroid Therapy for Pemphigus

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    UC Parashari

    2011-07-01

    Full Text Available The objective of the study was to analyse the magnetic resonance imaging (MRI manifestation of bone infarction and explore the value of such imaging in early diagnosis. In bone infarction, aseptic osteonecrosis occurs in the metaphysis and diaphysis of long bones. The “Double line” sign in MRI is most characteristic of this lesion and is seen as high signal intensity in the inner zone along with lowsignal-intensity line in the outer zone in a T2 weighted image. In clinically suspected patients, MRI can be used for early diagnosis. Here we describe a case of pemphigus resulting from steroid therapy leading to development of bone infarction in the metadiaphyseal region of the femur and tibia.

  2. Genome-wide association studies of mri-defined brain infarcts: Meta-analysis from the charge consortium

    NARCIS (Netherlands)

    S. Debette (Stéphanie); J.C. Bis (Joshua); M. Fornage (Myriam); H.A. Schmid (Herbert); M.A. Ikram (Arfan); S. Sigurdsson (Stefan); G. Heiss (Gerardo); M.V. Struchalin (Maksim); A.V. Smith (Albert Vernon); A. van der Lugt (Aad); C. DeCarli (Charles); T. Lumley (Thomas); D.S. Knopman (David); C. Enzinger (Christian); G. Eiriksdottir (Gudny); P.J. Koudstaal (Peter Jan); A.L. DeStefano (Anita); B.M. Psaty (Bruce); C. Dufouil (Carole); D.J. Catellier (Diane); F. Fazekas (Franz); T. Aspelund (Thor); Y.S. Aulchenko (Yurii); A. Beiser (Alexa); J.I. Rotter (Jerome); C. Tzourio (Christophe); D.K. Shibata (Dean); M. Tscherner (Maria); T.B. Harris (Tamara); F. Rivadeneira Ramirez (Fernando); L.D. Atwood (Larry); K. Rice (Kenneth); R.F. Gottesman (Rebecca); M.A. van Buchem (Mark); A.G. Uitterlinden (André); M. Kelly-Hayes (Margaret); M. Cushman (Mary Ann); Y. Zhu (Yicheng); E.A. Boerwinkle (Eric); V. Gudnason (Vilmundur); A. Hofman (Albert); J.R. Romero (Jose Rafael); M.M.B. Breteler (Monique); R. Schmidt (Reinhold); L.J. Launer (Lenore); W.T. Longstreth Jr

    2010-01-01

    textabstractBackground and Purpose-Previous studies examining genetic associations with MRI-defined brain infarct have yielded inconsistent findings. We investigated genetic variation underlying covert MRI infarct in persons without histories of transient ischemic attack or stroke. We performed meta

  3. Genome-wide association studies of mri-defined brain infarcts: Meta-analysis from the charge consortium

    NARCIS (Netherlands)

    S. Debette (Stéphanie); J.C. Bis (Joshua); M. Fornage (Myriam); H.A. Schmid (Herbert); M.A. Ikram (Arfan); S. Sigurdsson (Stefan); G. Heiss (Gerardo); M.V. Struchalin (Maksim); A.V. Smith (Albert Vernon); A. van der Lugt (Aad); C. DeCarli (Charles); T. Lumley (Thomas); D.S. Knopman (David); C. Enzinger (Christian); G. Eiriksdottir (Gudny); P.J. Koudstaal (Peter Jan); A.L. DeStefano (Anita); B.M. Psaty (Bruce); C. Dufouil (Carole); D.J. Catellier (Diane); F. Fazekas (Franz); T. Aspelund (Thor); Y.S. Aulchenko (Yurii); A. Beiser (Alexa); J.I. Rotter (Jerome); C. Tzourio (Christophe); D.K. Shibata (Dean); M. Tscherner (Maria); T.B. Harris (Tamara); F. Rivadeneira Ramirez (Fernando); L.D. Atwood (Larry); K. Rice (Kenneth); R.F. Gottesman (Rebecca); M.A. van Buchem (Mark); A.G. Uitterlinden (André); M. Kelly-Hayes (Margaret); M. Cushman (Mary Ann); Y. Zhu (Yicheng); E.A. Boerwinkle (Eric); V. Gudnason (Vilmundur); A. Hofman (Albert); J.R. Romero (Jose Rafael); M.M.B. Breteler (Monique); R. Schmidt (Reinhold); L.J. Launer (Lenore); W.T. Longstreth Jr

    2010-01-01

    textabstractBackground and Purpose-Previous studies examining genetic associations with MRI-defined brain infarct have yielded inconsistent findings. We investigated genetic variation underlying covert MRI infarct in persons without histories of transient ischemic attack or stroke. We performed meta

  4. Serial CT and MRI of ischaemic cerebral infarcts: frequency and clinical impact of haemorrhagic transformation

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    Mayer, T.E.; Brueckmann, H. [Muenchen Univ. (Germany). Abt. fuer Neuroradiologie; Schulte-Altedorneburg, G. [Dept. of Radiology/Neuroradiology, University Medical School of Luebeck (Germany); Droste, D.W. [Dept. of Neurology, University Medical School of Luebeck (Germany)

    2000-04-01

    The frequency, predisposing factors and clinical consequences of haemorrhagic infarcts and damaged blood-brain barrier as shown by contrast enhancement (CE) in ischaemic cerebral infarcts are controversial. We prospectively compared the sensitivity of CT and MRI to haemorrhagic transformation (HT) and CE. We also wished to investigate the clinical significance of HT and factors possibly associated with it. We studied 36 patients with acute ischaemic infarcts in the middle cerebral artery territory during the first 2 weeks after the ictus. After CT and rating of the neurological deficit on admission, serial examinations with clinical neuromonitoring, contrast-enhanced CT and MRI were done on the same day. The occurrence and severity of HT were correlated with CE, stroke mechanism, infarct size, development of neurological deficits and antithrombotic treatment. The frequency of HT detected by MRI was 80 %. CE usually preceded HT or was seen simultaneously. MRI had a higher sensitivity than CT to HT and CE. Severity of HT was positively correlated with infarct size (P < 0.01). HT had no influence on patient's neurological status. Neither the type of antithrombotic treatment nor the stroke mechanism was associated with the severity of HT. No parenchymal haemorrhage occurred. (orig.)

  5. Riociguat reduces infarct size and post-infarct heart failure in mouse hearts: insights from MRI/PET imaging.

    Directory of Open Access Journals (Sweden)

    Carmen Methner

    Full Text Available AIM: Stimulation of the nitric oxide (NO--soluble guanylate (sGC--protein kinase G (PKG pathway confers protection against acute ischaemia/reperfusion injury, but more chronic effects in reducing post-myocardial infarction (MI heart failure are less defined. The aim of this study was to not only determine whether the sGC stimulator riociguat reduces infarct size but also whether it protects against the development of post-MI heart failure. METHODS AND RESULTS: Mice were subjected to 30 min ischaemia via ligation of the left main coronary artery to induce MI and either placebo or riociguat (1.2 µmol/l were given as a bolus 5 min before and 5 min after onset of reperfusion. After 24 hours, both, late gadolinium-enhanced magnetic resonance imaging (LGE-MRI and (18F-FDG-positron emission tomography (PET were performed to determine infarct size. In the riociguat-treated mice, the resulting infarct size was smaller (8.5 ± 2.5% of total LV mass vs. 21.8% ± 1.7%. in controls, p = 0.005 and LV systolic function analysed by MRI was better preserved (60.1% ± 3.4% of preischaemic vs. 44.2% ± 3.1% in controls, p = 0.005. After 28 days, LV systolic function by echocardiography treated group was still better preserved (63.5% ± 3.2% vs. 48.2% ± 2.2% in control, p = 0.004. CONCLUSION: Taken together, mice treated acutely at the onset of reperfusion with the sGC stimulator riociguat have smaller infarct size and better long-term preservation of LV systolic function. These findings suggest that sGC stimulation during reperfusion therapy may be a powerful therapeutic treatment strategy for preventing post-MI heart failure.

  6. Branch Atheromatous Plaque: A Major Cause of Lacunar Infarction (High-Resolution MRI Study

    Directory of Open Access Journals (Sweden)

    Jong-Won Chung

    2012-07-01

    Full Text Available Background: Lacunar infarctions account for up to 25% of all ischemic strokes and, thus, constitute a numerically important subgroup. It is important that the two pathogeneses of lacunar infarction, that is, small-vessel occlusion and branch atheromatous disease, be differentiated because prognoses and treatment strategies differ. The authors evaluated the presence of branch atheromatous plaque in parent arteries that supply lacunar infarcts by high-resolution magnetic resonance imaging (HR-MRI. Methods: HR-MRI was performed in 15 patients with (1 a clinical presentation consistent with classical lacunar syndromes; (2 an acute lacunar infarction by diffusion-weighted imaging, measuring ≤20 mm in maximal diameter; (3 a magnetic resonance angiography showing a normal middle cerebral artery or basilar artery supplying the ischemic lesion, and (4 no other obvious etiology for small-vessel distribution ischemic stroke. Results: The median time of vessel wall imaging after index events was 4 days (range, 2–15 days. Six of the 15 patients had a lacunar infarction in the middle cerebral artery territory, and 9 had a lesion in the basilar artery territory. HR-MRI detected underlying atheromatous plaques in 9 patients (60% with a lacunar infarction. In these 9 patients, asymptomatic intracranial atherosclerotic stenosis was more frequent compared to patients without branch atheromatous plaque (55.6 vs. 16.7%. In pontine infarctions, ischemic lesions that extended to the pial base of the pons were more frequent in patients with branch atheromatous plaques (83.3 vs. 33.3%, and all the ischemic lesions and atheromatous plaques were on the same side (right, n = 2; left, n = 4. All plaques responsible for acute symptomatic lacunar infarction were enhanced in contrast-enhanced T1-weighted HR-MR images. Conclusions: HR-MRI results enabled underlying symptomatic branch atheromatous disease to be detected in lacunar infarction patients. The experience gained

  7. MRI evaluation of injectable hyaluronic acid-based hydrogel therapy to limit ventricular remodeling after myocardial infarction.

    Science.gov (United States)

    Dorsey, Shauna M; McGarvey, Jeremy R; Wang, Hua; Nikou, Amir; Arama, Leron; Koomalsingh, Kevin J; Kondo, Norihiro; Gorman, Joseph H; Pilla, James J; Gorman, Robert C; Wenk, Jonathan F; Burdick, Jason A

    2015-11-01

    Injectable biomaterials are an attractive therapy to attenuate left ventricular (LV) remodeling after myocardial infarction (MI). Although studies have shown that injectable hydrogels improve cardiac structure and function in vivo, temporal changes in infarct material properties after treatment have not been assessed. Emerging imaging and modeling techniques now allow for serial, non-invasive estimation of infarct material properties. Specifically, cine magnetic resonance imaging (MRI) assesses global LV structure and function, late-gadolinium enhancement (LGE) MRI enables visualization of infarcted tissue to quantify infarct expansion, and spatial modulation of magnetization (SPAMM) tagging provides passive wall motion assessment as a measure of tissue strain, which can all be used to evaluate infarct properties when combined with finite element (FE) models. In this work, we investigated the temporal effects of degradable hyaluronic acid (HA) hydrogels on global LV remodeling, infarct thinning and expansion, and infarct stiffness in a porcine infarct model for 12 weeks post-MI using MRI and FE modeling. Hydrogel treatment led to decreased LV volumes, improved ejection fraction, and increased wall thickness when compared to controls. FE model simulations demonstrated that hydrogel therapy increased infarct stiffness for 12 weeks post-MI. Thus, evaluation of myocardial tissue properties through MRI and FE modeling provides insight into the influence of injectable hydrogel therapies on myocardial structure and function post-MI.

  8. MRI findings in patients with multiple lacunar infarcts manifesting hyperactive-type delirium

    Energy Technology Data Exchange (ETDEWEB)

    Arahata, Yutaka; Motegi, Yoshimasa; Furuse, Masahiro (Nakatsugawa Municipal General Hospital, Gifu (Japan)); Watanabe, Masaki; Takahashi, Akira

    1994-04-01

    MRI studies were carried out on 69 patients with multiple lacunar infarcts: 32 had hyperactive-type delirium and the other 37 were non-delirious controls. Between the two groups, there were no statistically significant differences in mean age and sex distribution. In the corona radiata and basal ganglia, the number of infarcts did not differ between the two groups. However, the extent of thalamic infarcts and periventricular hyperintensity (PVH), the maximal width of the third ventricle and Evans' ratio among the delirious patients were significantly larger than those in the controls. In conclusion, thalamic lesions and diffuse advanced PVH may have an intimate correlation in the development of hyperactive-type delirium in patients with multiple lacunar infarcts. (author).

  9. Assessment of baseline hemodynamic parameters within infarct progression areas in acute stroke patients using perfusion-weighted MRI

    Energy Technology Data Exchange (ETDEWEB)

    Ritzenthaler, Thomas; Cho, Tae-Hee; Derex, Laurent; Nighoghossian, Norbert [Hospices Civils de Lyon, Cerebrovascular Unit, Hopital Neurologique Pierre Wertheimer, Bron (France); Claude Bernard Lyon 1 University, Creatis-LRMN, UMR 5520-Inserm 630, Lyon (France); Wiart, Marlene; Berthezene, Yves [Claude Bernard Lyon 1 University, Creatis-LRMN, UMR 5520-Inserm 630, Lyon (France); Berthiller, Julien [Hospices Civils de Lyon, Pole Information Medicale Evaluation Recherche, Lyon (France); Universite Lyon 1, Lyon (France); Oestergaard, Leif [University of Aarhus, Center of Functionally Integrative Neuroscience, Aarhus University Hospital, Aarhus (Denmark); Hermier, Marc [Hospices Civils de Lyon, Neuroradiology Department, Hopital Neurologique Pierre Wertheimer, Lyon (France)

    2011-08-15

    The value of perfusion MRI for identifying the tissue at risk has been questioned. Our objective was to assess baseline perfusion-weighted imaging parameters within infarct progression areas. Patients with anterior circulation stroke without early reperfusion were included from a prospective MRI database. Sequential MRI examinations were performed on admission, 2-3 h (H2), 2-3 days (D2), and between 15 and 30 days after the initial MRI. Maps of baseline time-to-peak (TTP), mean transit time (MTT), cerebral blood volume (CBV), and cerebral blood flow (CBF) were calculated. Lesion extension areas were defined as pixels showing de novo lesions between each MRI and were generated by subtracting successive lesion masks: V{sub 0}, baseline diffusion-weighted imaging (DWI) lesion; V{sub 1}, lesion extension between baseline and H2 DWI; V{sub 2}, lesion extension from H2 to D2 DWI; and V{sub 3}, lesion extension from D2 DWI to final FLAIR. Repeated measures analysis was used to compare hemodynamic parameters within the baseline diffusion lesion and subsequent lesion extension areas. Thirty-two patients were included. Baseline perfusion parameters were significantly more impaired within the acute DWI lesion compared to lesion extension areas (TTP, p<0.0001; MTT, p<0.0001; CBF p<0.0001; CBV, p<0.0001). A significant decrease in MTT (p = 0.01) and TTP (p = 0.01) was found within successive lesion growth areas. A decreasing gradient of severity for TTP and MTT was observed within successive infarct growth areas. (orig.)

  10. Genome-wide association studies of mri-defined brain infarcts: Meta-analysis from the charge consortium

    OpenAIRE

    2010-01-01

    textabstractBackground and Purpose-Previous studies examining genetic associations with MRI-defined brain infarct have yielded inconsistent findings. We investigated genetic variation underlying covert MRI infarct in persons without histories of transient ischemic attack or stroke. We performed meta-analysis of genome-wide association studies of white participants in 6 studies comprising the Cohorts for Heart and Aging Research in Genomic Epidemiology (CHARGE) consortium. Methods-Using 2.2 mi...

  11. MRI in occipital lobe infarcts: classification by involvement of the striate cortex

    Energy Technology Data Exchange (ETDEWEB)

    Kitajima, M. [Department of Radiology, Kumamoto University School of Medicine, Kumamoto (Japan)]|[Department of Radiology, Kumamoto Rousai Hospital, Kumamoto (Japan); Korogi, Y.; Takahashi, M. [Department of Radiology, Kumamoto University School of Medicine, Kumamoto (Japan); Kido, T.; Ikeda, O.; Morishita, S. [Department of Radiology, Kumamoto Rousai Hospital, Kumamoto (Japan)

    1998-11-01

    We reviewed the MRI studies of 25 patients with occipital lobe infarcts to clarify the distribution of infarcts in the posterior cerebral arterial territory, focussing on their relationship to the striate cortex. Visual field defects and MRI findings were also correlated in 16 patients. On coronal and/or sagittal images, the distribution of the infarct and its relationship to the striate cortex were classified. Involvement of the cortex of both upper and lower lips of the calcarine fissure was observed in 10 patients, and involvement of the lower lip alone in 15. The upper cortical lesions were always accompanied by lower cortical lesions. The visual field defects were complete hemianopia in nine patients, superior quadrantanopia in six and hemianopia with a preserved temporal crescent in one. All patients with superior quadrantanopia had involvement of the lower cortex alone; there were no cases of inferior quadrantanopia. The characteristic vascular anatomy, and poor development of the collateral circulation in the lower cortical area, may explain the vulnerability of this area to infarcts. (orig.) With 6 figs., 21 refs.

  12. Regional assessment of LV wall in infarcted heart using tagged MRI and cardiac modelling

    Science.gov (United States)

    Jahanzad, Zeinab; Miin Liew, Yih; Bilgen, Mehmet; McLaughlin, Robert A.; Onn Leong, Chen; Chee, Kok Han; Aziz, Yang Faridah Abdul; Ung, Ngie Min; Lai, Khin Wee; Ng, Siew-Cheok; Lim, Einly

    2015-05-01

    A segmental two-parameter empirical deformable model is proposed for evaluating regional motion abnormality of the left ventricle. Short-axis tagged MRI scans were acquired from 10 healthy subjects and 10 postinfarct patients. Two motion parameters, contraction and rotation, were quantified for each cardiac segment by fitting the proposed model using a non-rigid registration algorithm. The accuracy in motion estimation was compared to a global model approach. Motion parameters extracted from patients were correlated to infarct transmurality assessed with delayed-contrast-enhanced MRI. The proposed segmental model allows markedly improved accuracy in regional motion analysis as compared to the global model for both subject groups (1.22-1.40 mm versus 2.31-2.55 mm error). By end-systole, all healthy segments experienced radial displacement by ~25-35% of the epicardial radius, whereas the 3 short-axis planes rotated differently (basal: 3.3° mid:  -1° and apical:  -4.6°) to create a twisting motion. While systolic contraction showed clear correspondence to infarct transmurality, rotation was nonspecific to either infarct location or transmurality but could indicate the presence of functional abnormality. Regional contraction and rotation derived using this model could potentially aid in the assessment of severity of regional dysfunction of infarcted myocardium.

  13. Noncontrast Computed Tomography versus Computed Tomography Angiography Source Images for Predicting Final Infarct Size in Anterior Circulation Acute Ischemic Stroke: a Prospective Cohort Study.

    Science.gov (United States)

    Mukherjee, Amritendu; Muthusami, Prakash; Mohimen, Aneesh; K, Srinivasan; B, Babunath; Pn, Sylaja; Kesavadas, Chandrasekharan

    2017-02-01

    There has been a recent debate regarding the superiority of computed tomography angiography source images (CTASIs) over noncontrast computed tomography (NCCT) to predict the final infarct size in acute ischemic stroke (AIS). We hypothesized that the parenchymal abnormality on CTASI in faster scanners would overestimate ischemic core. This prospective study assessed the correlation of Alberta Stroke Program Early CT Score (ASPECTS) on NCCT, CTASI, and computed tomography perfusion (CTP) with final infarct size in patients within 8 hours of AIS. Follow-up with NCCT or diffusion-weighted magnetic resonance imaging (MRI) was performed at 24 hours. Correlations of NCCT and CTASI with final infarct size and with CTP parameters were assessed. Subgroup analysis was performed in patients who underwent intravenous thrombolysis or mechanical thrombectomy. Inter-rater reliability was tested using Spearman's rank correlation. A P value less than .05 was considered statistically significant. A total of 105 patients were included in the final analysis. NCCT had a stronger correlation with the final infarct size than did CTASI (Spearman's ρ = .85 versus .78, P = .13). We found an overestimation of the final infarct size by CTASI in 47.6% of the cases, whereas NCCT underestimated infarct size in 60% of the patients. NCCT correlated most strongly with CBV (ρ = .93), whereas CTASI correlated most strongly with CBF (ρ = .87). Subgroup analysis showed less correlation of CTASI with final infarct size in the group that received thrombolysis versus the group that did not (ρ = .70 versus .88, P = .01). In a 256-slice scanner, the CTASI parenchymal abnormality includes ischemic penumbra and thus overestimates final infarct size-this could result in inappropriate exclusion of patients from thrombolysis or thrombectomy. Copyright © 2017 National Stroke Association. All rights reserved.

  14. Cortical laminar necrosis in brain infarcts: chronological changes on MRI

    Energy Technology Data Exchange (ETDEWEB)

    Komiyama, M. [Department of Neurosurgery, Osaka City General Hospital, 2-13-22, Miyakojima-Hondouri, Miyakojima, Osaka 534 (Japan); Nishikawa, M. [Department of Neurosurgery, Osaka City General Hospital, 2-13-22, Miyakojima-Hondouri, Miyakojima, Osaka 534 (Japan); Yasui, T. [Department of Neurosurgery, Osaka City General Hospital, 2-13-22, Miyakojima-Hondouri, Miyakojima, Osaka 534 (Japan)

    1997-07-10

    We studied the MRI characteristics of cortical laminar necrosis in ischaemic stroke. We reviewed 13 patients with cortical laminar high signal on T1-weighted images to analyse the chronological changes in signal intensity and contrast enhancement. High-density cortical lesions began to appear on T1-weighted images about 2 weeks after the ictus. At 1-2 months they were prominent. They began to fade from 3 months but could be seen up to 11 months. These cortical lesions showed isointensity or high intensity on T2-weighted images and did not show low intensity at any stage. Contrast enhancement of the laminar lesions was prominent at 1-2 months and became less apparent from 3 months, but could be seen up to 8 months. (orig.). With 6 figs., 1 tab.

  15. Genome-wide Association Studies of MRI-defined Brain Infarcts: Meta-analysis from the CHARGE Consortium

    Science.gov (United States)

    Debette, Stephanie; Bis, Joshua C.; Fornage, Myriam; Schmidt, Helena; Ikram, M. Arfan; Sigurdsson, Sigurdur; Heiss, Gerardo; Struchalin, Maksim; Smith, Albert V.; van der Lugt, Aad; DeCarli, Charles; Lumley, Thomas; Knopman, David S.; Enzinger, Christian; Eiriksdottir, Gudny; Koudstaal, Peter J.; DeStefano, Anita L.; Psaty, Bruce M.; Dufouil, Carole; Catellier, Diane J.; Fazekas, Franz; Aspelund, Thor; Aulchenko, Yurii S.; Beiser, Alexa; Rotter, Jerome I.; Tzourio, Christophe; Shibata, Dean K.; Tscherner, Maria; Harris, Tamara B.; Rivadeneira, Fernando; Atwood, Larry D.; Rice, Kenneth; Gottesman, Rebecca F.; van Buchem, Mark A.; Uitterlinden, Andre G.; Kelly-Hayes, Margaret; Cushman, Mary; Zhu, Yicheng; Boerwinkle, Eric; Gudnason, Vilmundur; Hofman, Albert; Romero, Jose R.; Lopez, Oscar; van Duijn, Cornelia M.; Au, Rhoda; Heckbert, Susan R.; Wolf, Philip A.; Mosley, Thomas H.; Seshadri, Sudha; Breteler, Monique M.B.; Schmidt, Reinhold; Launer, Lenore J.; Longstreth, WT

    2010-01-01

    Background Previous studies examining genetic associations with MRI-defined brain infarct have yielded inconsistent findings. We investigated genetic variation underlying covert MRI-infarct, in persons without histories of transient ischemic attack or stroke. We performed meta-analysis of genome-wide association studies of white participants in 6 studies comprising the Cohorts for Heart and Aging Research in Genomic Epidemiology (CHARGE) consortium. Methods Using 2.2 million genotyped and imputed SNPs, each study performed cross-sectional genome-wide association analysis of MRI-infarct using age and sex-adjusted logistic regression models. Study-specific findings were combined in an inverse-variance weighted meta-analysis, including 9401 participants with mean age 69.7, 19.4% of whom had ≥1 MRI-infarct. Results The most significant association was found with rs2208454 (minor allele frequency: 20%), located in intron 3 of MACRO Domain Containing 2 gene and in the downstream region of Fibronectin Leucine Rich Transmembrane Protein 3 gene. Each copy of the minor allele was associated with lower risk of MRI-infarcts: odds ratio=0.76, 95% confidence interval=0.68–0.84, p=4.64×10−7. Highly suggestive associations (p0.64) with rs2208454. The association with rs2208454 did not replicate in independent samples of 1822 white and 644 African-American participants, although 4 SNPs within 200kb from rs2208454 were associated with MRI-infarcts in African-American sample. Conclusions This first community-based, genome-wide association study on covert MRI-infarcts uncovered novel associations. Although replication of the association with top SNP failed, possibly due to insufficient power, results in the African American sample are encouraging, and further efforts at replication are needed. PMID:20044523

  16. Telmisartan in the diabetic murine model of acute myocardial infarction: dual contrast manganese-enhanced and delayed enhancement MRI evaluation of the peri-infarct region.

    Science.gov (United States)

    Toma, Ildiko; Kim, Paul J; Dash, Rajesh; McConnell, Michael V; Nishimura, Dwight; Harnish, Phillip; Yang, Phillip C

    2016-02-05

    A novel MRI technique, employing dual contrast manganese-enhanced MRI (MEMRI) and delayed enhancement MRI (DEMRI), can evaluate the physiologically unstable peri-infarct region. Dual contrast MEMRI-DEMRI enables comprehensive evaluation of telmisartan to salvage the peri-infarct injury to elucidate the underlying mechanism of restoring the ischemic cardiomyopathy in the diabetic mouse model. Dual contrast MEMRI-DEMRI was performed on weeks 1, 2, and 4 following initiation of telmisartan treatment in 24 left anterior descendent artery ligated diabetic mice. The MRI images were analyzed for core infarct, peri-infarct, left ventricular end-diastolic, end-systolic volumes, and the left ventricular ejection fraction (LVEF). Transmission electron microscopy (TEM) and real-time PCR were used for ex vivo analysis of the myocardium. Telmisartan vs. control groups demonstrated significantly improved LVEF at weeks 1, 2, and 4, respectively (33 ± 7 %*** vs. 19 ± 5 %, 29 ± 3 %*** vs. 22 ± 4 %, and 31 ± 2 %*** vs 18 ± 6 %, ***p Telmisartan group significantly salvaged the peri-infarct injury. The myocardial effects were validated by TEM, which confirmed the presence of the injured but viable cardiomyocyte morphology in the peri-infarct region and by flow cytometry of venous blood, which demonstrated significantly increased circulating endothelial progenitor cells (EPCs). The improved cardiac function in ischemic cardiomyopathy of diabetic mice by telmisartan is attributed to the attenuation of the peri-infarct injury by the angiogenic effects of EPCs to salvage the injured cardiomyocytes. Dual-contrast MEMRI-DEMRI technique tracked the therapeutic effects of telmisartan on the injured myocardium longitudinally.

  17. Coronary flow of the infarct artery assessed by transthoracic Doppler after primary percutaneous coronary intervention predicts final infarct size.

    Science.gov (United States)

    Trifunovic, Danijela; Sobic-Saranovic, Dragana; Beleslin, Branko; Stankovic, Sanja; Marinkovic, Jelena; Orlic, Dejan; Vujisic-Tesic, Bosiljka; Petrovic, Milan; Nedeljkovic, Ivana; Banovic, Marko; Djukanovic, Nina; Petrovic, Olga; Petrovic, Marija; Stepanovic, Jelena; Djordjevic-Dikic, Ana; Tesic, Milorad; Ostojic, Miodrag

    2014-12-01

    Coronary microcirculatory function after primary percutaneous coronary intervention (pPCI) in patients with acute myocardial infarction is important determinant of infarct size (IS). Our aim was to investigate the utility of coronary flow reserve (CFR) and diastolic deceleration time (DDT) of the infarct artery (IRA) assessed by transthoracic Doppler echocardiography after pPCI for final IS prediction. In 59 patients, on the 2nd day after pPCI for acute anterior myocardial infarction, transthoracic Doppler analysis of IRA blood flow was done including measurements of CFR, baseline DDT and DDT during adenosine infusion (DDT adeno). Killip class, myocardial blush grade, resolution of ST segment elevation, peak creatine kinase-myocardial band and conventional echocardiographic parameters were determined. Single-photon emission computed tomography myocardial perfusion imaging was done 6 weeks later to define final IS (percentage of myocardium with fixed perfusion abnormality). IS significantly correlated with CFR (r = -0.686, p 20 %), the best cut-off for CFR was <1.73 (sensitivity 65 %, specificity 96 %) and for DDT adeno ≤720 ms (sensitivity 81 %, specificity 96 %). CFR and DDT during adenosine are independent and powerful early predictors of final IS offering incremental prognostic information over conventional parameters of myocardial and microvascular damage and tissue reperfusion.

  18. One-and-a-half syndrome in pontine infarcts: MRI correlates

    Energy Technology Data Exchange (ETDEWEB)

    Seze, J. de; Lucas, C.; Vermersch, P.; Leys, D. [Department of Neurology, Stroke Unit, Hopital R. Salengro, CHRU de Lille (France); Leclerc, X.; Sahli, A. [Department of Neuroradiology, Lille University Hospital, Lille (France)

    1999-09-01

    The one-and-a-half syndrome is characterised by a lateral gaze palsy in one direction and internuclear ophthalmoplegia in the other. It is due to a unilateral lesion of the dorsal pontine tegmentum, involving the ipsilateral paramedian pontine reticular formation, internuclear fibres of the ipsilateral medical longitudinal fasciculus and, usually, the abducens nucleus. The main causes of this rare syndrome are stroke and multiple sclerosis. Few cases have been reported since the introduction of MRI. Our aim was to examine clinicoradiological correlations in six patients with a one-and-a-half syndrome due to a stroke. Ophthalmological symptoms were diplopia, oscillopsia or blurred vision. Four patients had an associated facial nerve palsy, three a hemiparesis and one a unilateral hemihypoaesthesia. MRI revealed an infarct in the pons in all patients. The cause of the infarct was a basilar artery dissection in one patient, bilateral vertebral artery dissection in a second and unknown in the other four. All patients recovered within 2 days to 8 weeks. This study showed a good correlation between the site of the lesion (superior, inferior or extensive pontine ischaemia) and clinical deficits. (orig.)

  19. Cell therapy in myocardial infarction: emphasis on the role of MRI

    Energy Technology Data Exchange (ETDEWEB)

    Ye, Yuxiang; Bogaert, Jan [University Hospital K.U.L., Department of Radiology, Leuven (Belgium)

    2008-03-15

    Despite tremendous progress in myocardial infarct (MI) treatment, mortality rates remain substantial. Permanent loss of cardiomyocytes after ischemic injury, results in irreversible loss of myocardial contractility, reduction in ventricular performance, and may initiate the development of dilated heart failure. The discovery that pluripotent progenitor cells bear the capacity to differentiate to mature cardiac cells raised the hope of cell-based regenerative medicine. Engraftment of stem cells in the damaged myocardium, repair and functional improvement appeared suddenly a nearby reality. Promising results in animal models, and preliminary studies reporting the feasibility and safety of adult stem cell therapy in MI patients led to the first double-blinded randomized, placebo-controlled trials. The initial great enthusiasm for this paradigm shift in MI treatment has been tempered by the mainly negative or modestly positive study findings. Before new, larger clinical trials can be initiated, a number of critical questions and issues need to be considered starting with a scrutinized analysis of currently available data to extending our knowledge of the mechanism of scarless myocardial regeneration. Cardiac cell therapy necessitates a multidisciplinary approach, whereby imaging, in particular MRI, and the input of the imaging specialist is crucial to the success of cardiac cell regenerative medicine. MRI is an appealing technique for cell trafficking depicting engraftment, differentiation and survival. Endomyocardial cell administration can be achieved safely with MR fluoroscopy and MRI is without any doubt the most accurate and reproducible technique to measure study end-points. (orig.)

  20. Performance of adenosine "stress-only" perfusion MRI in patients without a history of myocardial infarction : a clinical outcome study

    NARCIS (Netherlands)

    Lubbers, Daniel D.; Rijlaarsdam-Hermsen, Dorine; Kuijpers, Dirkjan; Kerkhof, Marjan; Sijens, Paul E.; van Dijkman, Paul R. M.; Oudkerk, Matthijs

    To assess the diagnostic value of adenosine "stress-only" myocardial perfusion MR for ischemia detection as an indicator for coronary angiography in patients without a prior myocardial infarction and a necessity to exclude ischemia. Adenosine perfusion MRI was performed at 1.5 T in 139 patients with

  1. Crossed cerebellar diaschisis in acute isolated thalamic infarction detected by dynamic susceptibility contrast perfusion MRI.

    Directory of Open Access Journals (Sweden)

    Alex Förster

    Full Text Available PURPOSE: Crossed cerebellar diaschisis (CCD is a state of neural depression caused by loss of connections to injured neural structures remote from the cerebellum usually evaluated by positron emission tomography. Recently it has been shown that dynamic susceptibility contrast perfusion weighted MRI (PWI may also be feasible to detect the phenomenon. In this study we aimed to assess the frequency of CCD on PWI in patients with acute thalamic infarction. METHODS: From a MRI report database we identified patients with acute isolated thalamic infarction. Contralateral cerebellar hypoperfusion was identified by inspection of time to peak (TTP maps and evaluated quantitatively on TTP, mean transit time (MTT, cerebral blood flow and volume (CBF, CBV maps. A competing cerebellar pathology or an underlying vascular pathology were excluded. RESULTS: A total of 39 patients was included. Common symptoms were hemiparesis (53.8%, hemihypaesthesia (38.5%, dysarthria (30.8%, aphasia (17.9%, and ataxia (15.4%. In 9 patients (23.1% PWI showed hypoperfusion in the contralateral cerebellar hemisphere. All of these had lesions in the territory of the tuberothalamic, paramedian, or inferolateral arteries. Dysarthria was observed more frequently in patients with CCD (6/9 vs. 6/30; OR 8.00; 95%CI 1.54-41.64, p = 0.01. In patients with CCD, the median ischemic lesion volume on DWI (0.91 cm³, IQR 0.49-1.54 cm³ was larger compared to patients with unremarkable PWI (0.51 cm³, IQR 0.32-0.74, p = 0.05. The most pronounced changes were found in CBF (0.94±0.11 and MTT (1.06±0.13 signal ratios, followed by TTP (1.05±0.02. CONCLUSIONS: Multimodal MRI demonstrates CCD in about 20% of acute isolated thalamic infarction patients. Lesion size seems to be a relevant factor in its pathophysiology.

  2. Cardiac CT and MRI guide surgery in impending left ventricular rupture after acute myocardial infarction

    Directory of Open Access Journals (Sweden)

    Shah Ashish S

    2009-08-01

    Full Text Available Abstract We report the case of a 67 year-old patient who presented with worsening chest pain and shortness of breath, four days post acute myocardial infarction. Contrast enhanced computed tomography of the chest ruled out a pulmonary embolus but revealed an unexpected small subepicardial aneurysm (SEA in the lateral left ventricular wall which was confirmed on cardiac magnetic resonance imaging. Intraoperative palpation of the left lateral wall was guided by the cardiac MRI and CT findings and confirmed the presence of focally thinned and weakened myocardium, covered by epicardial fat. An aneurysmorrhaphy was subsequently performed in addition to coronary bypass surgery and a mitral valve repair. The patient was discharged home on post operative day eight in good condition and is feeling well 2 years after surgery.

  3. Dynamic Tracking of Injected Mesenchymal Stem Cells after Myocardial Infarction in Rats: A Serial 7T MRI Study

    Science.gov (United States)

    Chen, Xiuyu; Lu, Minjie; Ma, Ning; Yin, Gang; Cui, Chen

    2016-01-01

    Purpose. To track the fate of micron-sized particles of iron oxide (MPIO) labeled mesenchymal stem cells (MSCs) in vivo in a rat myocardial infarction model using 7T magnetic resonance imaging (MRI) scanner. Materials and Methods. Male MSCs (2 × 106/50 μL) dual-labeled with MPIO and CM-DiI were injected into the infarct periphery 7 days after myocardial infarction (MI). The control group received cell-free media injection. The temporal stem cell location, signal intensity, and cardiac function were dynamically assessed using a 7T MRI at 24 h before transplantation (baseline), 3 days, 2 weeks, and 4 weeks after transplantation, respectively. Results. MR hypointensities caused by MPIOs were observed on T2⁎-weighted images at all time points after MSCs injection. Cine-MRI showed that MSCs moderated progressive left ventricular remodeling. Double staining for iron and CD68 revealed that most of the iron-positive cells were CD68-positive macrophages. Real-time PCR for rat SRY gene showed the number of survival MSCs considerably decreased after transplantation. MSC-treated hearts had significantly increased capillary density in peri-infarct region and lower cardiomyocytes apoptosis and fibrosis formation. Conclusions. Iron particles are not a reliable marker for in vivo tracking the long-term fate of MSCs engraftment. Despite of poor cell retention, MSCs moderate left ventricular remodeling after MI. PMID:27656215

  4. PET and MRI for the evaluation of regional myocardial perfusion and wall thickening after myocardial infarction

    Energy Technology Data Exchange (ETDEWEB)

    Slart, Riemer H.J.A.; Golestani, Reza; Glaudemans, Andor W.J.M. [University Medical Center Groningen, University of Groningen, Department of Nuclear Medicine and Molecular Imaging, Hanzeplein 1, P.O. Box 30001, Groningen (Netherlands); Glauche, Julius; Jansen, Jan W. [University Medical Center Groningen, University of Groningen, Department of Nuclear Medicine and Molecular Imaging, Hanzeplein 1, P.O. Box 30001, Groningen (Netherlands); University Medical Center Groningen, University of Groningen, Department of Cardiology, Groningen (Netherlands); Zeebregts, Clark J. [University Medical Center Groningen, University of Groningen, Department of Surgery, Division of Vascular Surgery, Groningen (Netherlands); Dierckx, Rudi A.J.O. [University Medical Center Groningen, University of Groningen, Department of Nuclear Medicine and Molecular Imaging, Hanzeplein 1, P.O. Box 30001, Groningen (Netherlands); Ghent University Hospital, Department of Nuclear Medicine, Ghent (Belgium); Oudkerk, Matthijs; Willems, Tineke P. [University Medical Center Groningen, University of Groningen, Department of Radiology, Groningen (Netherlands); Boersma, Hendrikus H. [University Medical Center Groningen, University of Groningen, Department of Nuclear Medicine and Molecular Imaging, Hanzeplein 1, P.O. Box 30001, Groningen (Netherlands); University Medical Center Groningen, University of Groningen, Clinical and Hospital Pharmacy, Groningen (Netherlands); Tio, Rene A. [University Medical Center Groningen, University of Groningen, Department of Cardiology, Groningen (Netherlands)

    2012-06-15

    Deterioration of left ventricular (LV) function after myocardial infarction (MI) is a major cause of heart failure. Myocardial perfusion performance may play an important role in deterioration or improvement in LV function after MI. The aim of this study was to evaluate the myocardial perfusion reserve (MPR) and stress perfusion in deteriorating and non-deteriorating LV segments in patients after MI by PET and MRI, respectively. Regional wall thickening of 352 segments in 22 patients was assessed at 4 and 24 months after MI by cardiac MRI. PET was performed to evaluate MPR and adenosine stress {sup 13}N-ammonia perfusion 24 months after MI. Segments were divided into four groups according to deterioration or improvement in wall thickening. Normal functional segments at 4 months after MI that remained stable had a significantly higher mean MPR and mean stress perfusion PET value than deteriorated segments (p < 0.001). Furthermore, dysfunctional segments that improved had a significantly higher mean stress perfusion PET value than dysfunctional segments that remained dysfunctional (p < 0.001). This study demonstrated the additional value of myocardial perfusion assessment in relation to the functional integrity of the injured myocardium. Segmental functional LV improvement after MI was associated with better regional myocardial perfusion characteristics. Furthermore, the amount of wall thickening reduction was associated with regional myocardial perfusion abnormalities in patients after MI. (orig.)

  5. CT and MRI findings of cirrhosis-related benign nodules with ischaemia or infarction after variceal bleeding

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Y.K., E-mail: jmyr@dreamwiz.co [Department of Diagnostic Radiology, Research Institute of Clinical Medicine, Chonbuk National University Hospital and Medical School, Jeon Ju (Korea, Republic of); Park, G.; Kim, C.S.; Han, Y.M. [Department of Diagnostic Radiology, Research Institute of Clinical Medicine, Chonbuk National University Hospital and Medical School, Jeon Ju (Korea, Republic of)

    2010-10-15

    Aim: To present computed tomography (CT) and magnetic resonance imaging (MRI) findings of cirrhosis-related benign nodules with ischaemia or infarction. Materials and methods: Sixteen consecutive patients (14 men and two women) who had been diagnosed with cirrhosis-related benign nodules with ischaemia or infarction after variceal bleeding based on the results of dynamic CT (n = 15) and MRI (n = 8) were included in this study. Five patients had histopathological confirmation via liver transplantation (n = 2) and percutaneous biopsy (n = 3). Images were analyzed for the enhancement pattern, signal intensities, location, and configuration of the lesions. Results: Most of the lesions were depicted as multifocal discrete or clustered nodules with some irregular patchy areas (size range 3-28 mm). They were predominantly found in subcapsular area or caudate lobe. Most nodular lesions were seen as hypoattenuating (hypointense) nodules with rim enhancement during dynamic CT or MRI. On T2-weighted images, nodular lesions were predominantly seen as target appearing hyperintense nodules. On follow-up images (range 2-24 months), most of the lesions disappeared or decreased in size. Conclusion: CT and MRI can be used to demonstrate characteristic findings of cirrhosis-related benign nodules with ischaemia or infarction. Rapid resolution of the nodules at follow-up imaging can also be helpful for diagnosing these lesions.

  6. Large deep infarcts found in proximal middle cerebral artery steno-occlusive disease: MRI and angiographic findings

    Energy Technology Data Exchange (ETDEWEB)

    Yi, Bum Ha; Kim, Eui Jong; Choi, Woo Suk; Jang, Dae Il; Chung, Kyung Cheon; Oh, Joo Hyung; Yoon, Yup; Hong, Hoon Pyo [Kyunghee Univ. Hospital, Seoul (Korea, Republic of)

    1998-11-01

    To determine the nature of large deep-seated infarcts without cortical infarct in patients with steno-occlusive disease of the proximal middle cerebral artery (MCA) using magnetic resonance images (MRI) and angiography. By means of MRI and MR angiography (MRA), we examined 24 patients with large deep cerebral infarctions (>3cm in size) involving the basal ganglia, corona radiata and/or centrum semiovale, as well as steno-occlusive lesion of the proximal MCA. According to location, infarctions were classified into five groups, as follows:Group 1:basal ganlgia and corona radiata; 2:basal ganglia, corona radiata and centrum semiovale;3:corona radiata and centrum semiovale;4:corona radiata;5:basal ganglia only. We evaluated the topography of the lesions and correlated the results with the findings of angiography (all 24 MRA;the 13:conventional angiography). Involvement of the head of the caudate nucleus and the internal capsule were also evaluated. Fifteen of 24 cases (63%) were assigned to group 1 (4 proximal MCA(M1) occlusion and 11 stenosis), and five of 24 (21%) with M1 occlusions to group 2. Group 3 comprised only one case with M1 occlusion. Two cases with both occlusion and stenosis were included in group 4, and only one case-with M1 stenosis-in group 5. Infarctions at the caudate nucleus were seen in five cases, and at the internal capsule in two. On conventional angiography (13 cases) cortical branches of the MCA were delineated through the leptomeningeal collaterals of anterior or posterior cerebral arteries. Most large deep cerebral infarctions found in proximal MCA diseases are thought to extend cephalad to the corona radiata. When large deep-seated infarctions with proximal MCA occlusion is observed more frequently than stenosis.=20.

  7. Cerebral hemodynamics and metabolism in patients with moyamoya disease not demonstrating either cerebral infarct or hemorrhage on MRI

    Energy Technology Data Exchange (ETDEWEB)

    Kuwabara, Yasuo; Ichiya, Yuichi; Sasaki, Masayuki; Akashi, Yuko; Yoshida, Tsuyoshi; Fukumura, Toshimitsu; Masuda, Kouji; Matsushima, Toshio; Fukui, Masashi [Kyushu Univ., Fukuoka (Japan). Faculty of Medicine

    1995-12-01

    We evaluated the cerebral hemodynamics and metabolism in moyamoya patients who did not demonstrate either cerebral infarct or hemorrhage on MRI. The subjects consisted of 5 patients with moyamoya disease (4 females and one male, aged from 15 to 40 ears). The CBF, OEF and CMRO{sub 2} of the moyamoya patients did not differ from those of the normal control subjects. The CBV did increase significantly in the cerebral cortices and striatum, but not in the cerebellum. The TT was also significantly prolonged in the frontal and parietal regions. The cerebrovascular CO{sub 2} response was markedly impaired in the frontal, temporal and parietal cortices. However, it was relatively preserved in the occipital cortex, thalamus and cerebellum. Thus, the cerebral hemodynamic reserve capacity decreased even in the moyamoya patients not demonstrating either cerebral infarct or hemorrhage on MRI, and it should be considered in the management of these patients. (author).

  8. Final infarct size measured by cardiovascular magnetic resonance in patients with ST elevation myocardial infarction predicts long-term clinical outcome

    DEFF Research Database (Denmark)

    Lønborg, Jacob Thomsen; Vejlstrup, Niels Grove; Kelbæk, Henning Skov

    2013-01-01

    AIMS: Tailored heart failure treatment and risk assessment in patients following ST-segment elevation myocardial infarction (STEMI) is mainly based on the assessment of the left ventricular (LV) ejection fraction (EF). Assessment of the final infarct size in addition to the LVEF may improve...... the prognostic evaluation. To evaluate the prognostic importance of the final infarct size measured by cardiovascular magnetic resonance (CMR) in patients with STEMI. METHODS AND RESULTS: In an observational study the final infarct size was measured by late gadolinium enhancement CMR 3 months after initial...... admission in 309 patients with STEMI. The clinical endpoint was a composite of all-cause mortality and admission for heart failure. During the follow-up period of median 807 days (IQR: 669-1117) 35 events (5 non-cardiac deaths, 3 cardiac deaths, and 27 admissions for heart failure) were recorded. Patients...

  9. Cardiosphere-derived cells improve function in the infarcted rat heart for at least 16 weeks--an MRI study.

    Directory of Open Access Journals (Sweden)

    Carolyn A Carr

    Full Text Available AIMS: Endogenous cardiac progenitor cells, expanded from explants via cardiosphere formation, present a promising cell source to prevent heart failure following myocardial infarction. Here we used cine-magnetic resonance imaging (MRI to track administered cardiosphere-derived cells (CDCs and to measure changes in cardiac function over four months in the infarcted rat heart. METHODS AND RESULTS: CDCs, cultured from neonatal rat heart, comprised a heterogeneous population including cells expressing the mesenchymal markers CD90 and CD105, the stem cell marker c-kit and the pluripotency markers Sox2, Oct3/4 and Klf-4. CDCs (2 × 10(6 expressing green fluorescent protein (GFP+ were labelled with fluorescent micron-sized particles of iron oxide (MPIO. Labelled cells were administered to the infarcted rat hearts (n = 7 by intramyocardial injection immediately following reperfusion, then by systemic infusion (4 × 10(6 2 days later. A control group (n = 7 was administered cell medium. MR hypointensities caused by the MPIOs were detected at all times and GFP+ cells containing MPIO particles were identified in tissue slices at 16 weeks. At two days after infarction, cardiac function was similar between groups. By 6 weeks, ejection fractions in control hearts had significantly decreased (47 ± 2%, but this was not evident in CDC-treated hearts (56 ± 3%. The significantly higher ejection fractions in the CDC-treated group were maintained for a further 10 weeks. In addition, CDC-treated rat hearts had significantly increased capillary density in the peri-infarct region and lower infarct sizes. MPIO-labelled cells also expressed cardiac troponin I, von Willebrand factor and smooth muscle actin, suggesting their differentiation along the cardiomyocyte lineage and the formation of new blood vessels. CONCLUSIONS: CDCs were retained in the infarcted rat heart for 16 weeks and improved cardiac function.

  10. 脑干梗死与低场强MRI的表现%Analysis on clinical manifestations and low field MRI features of brainstem infarction

    Institute of Scientific and Technical Information of China (English)

    陈志萍; 吴冬春; 郑列祥

    2012-01-01

    Objective To investigate the clinical manifestations and low field magnetic resonance imaging (MRI) features of brainstem infarction. Methods The clinical characteristics combined with the corresponding low field MRI features of 44 cases with brainstem infarction were analyzed retrospectively. Results Among 44 cases,38 cases showed pons infarction.3 cases suffered midbrain infarction, and 3 cases showed oblongata infarction. The common clinical symptoms and signs were partial body movement disorder, dysarthria and wet cough. All cases had positive effectives in MRI, and MRI manifested their sizes in diameter was mainly of 6~16mm, and the shape was irregular patch. All lesions showed isointensity or short signals on T1WI, high signals on T2WI, high or lowr signals on FLAIR. Conclusion MRI is the most effective method in the diagnosis of brainstem infarction.%目的 探讨脑干梗死的临床表现及低场MRI 的诊断价值.方法 回顾性分析经临床确诊的44 例脑干梗死患者的临床及低场MRI 资料.结果 44 例脑干梗死包括:脑桥梗死38 例,中脑梗死3 例,延髓梗死3 例.临床表现为构音障碍、饮水呛咳、偏身运动障碍等.MRI 显示病灶直径以6~16 mm 为主,形态为不规则斑片状,信号特点为T1WI 呈等或低信号,T2WI 呈高信号,FLAIR 序列呈高或低信号.结论 MRI 是脑干梗死最有效的影像学诊断方法.

  11. Clinical aspects of silent cerebral infarction; MRI findings and its distribution

    Energy Technology Data Exchange (ETDEWEB)

    Ohnishi, Jiro (Kobe Univ. (Japan). School of Medicine); Kudo, Yutaka

    1991-06-01

    High-field MR scans have often showed patchy incidental findings especially in the elderly. We examined 91 patients, without episodes of cerebrovascular disorders previously, who had silent cerebral lesions noted by the 1.5 tesla superconductive system T2 weighted magnetic resonance imaging. They were divided into three subtypes by the localization of foci. The 23 subjects (25%) showed confined lesions to thalamus and/or internal capsule and/or basal ganglia (the basal ganglia type). The 39 subjects (43%) had lesions predominantly in cerebral cortex and/or subcortical white matter and/or cerebellum (the diffuse subcortical type). Finally, the 29 subjects (32%) had both features of abovementioned two groups (the mixed type). These subtypes were correlated with age, sex and some of the other risk factors, such as systolic blood pressure, diastolic blood pressure, serum total cholesterol and uric acid, for stroke. From the age extent and the correlation of subtypes to risk factors, the basal ganglia type was suspected to be based on the different origin from other two types. The authors proposed that the arteriosclerotic factor might play an important role in the incidence of the diffuse subcortical type and the mixed type silent cerebral infarctions and that the hemodynamic factor might play an important role in the incidence of the basal ganglia type. (J.P.N.).

  12. MRI pattern of infarcts in basal ganglia region in patients with tuberculous meningitis

    Energy Technology Data Exchange (ETDEWEB)

    Nair, P.P.; Kalita, J.; Misra, U.K. [Sanjay Gandhi Postgraduate Institute of Medical Sciences, Department of Neurology, Lucknow (India); Kumar, S. [Sanjay Gandhi Postgraduate Institute of Medical sciences, Department of Radiology, Lucknow (India)

    2009-04-15

    This study aimed to evaluate the pattern of infarct in basal ganglia region in tuberculous meningitis (TBM) and ischemic strokes and its sensitivity and specificity in the diagnosis of these disorders. Patients with TBM and ischemic strokes in basal ganglia region were retrospectively evaluated from our tuberculous meningitis and ischemic stroke registry. Magnetic resonance imaging findings were grouped into anterior (caudate, genu, anterior limb of internal capsule, anteromedial thalamus) and posterior (lentiform nuclei, posterior limb of internal capsule, posterolateral thalamus). The sensitivity and specificity of these patterns in diagnosing TBM and ischemic stroke were evaluated. There were 24 patients in each group. Infarct in TBM was purely anterior in eight patients and in ischemic stroke purely posterior in 18 patients. The frequency of caudate infarct was significantly higher in TBM compared to ischemic stroke (37.5% vs 8.3%). In TBM patients, purely posterior infarcts were present in seven patients; three had associated risk factors of ischemic stroke. The sensitivity of pure anterior infarct in the diagnosis of TBM was 33%, specificity 91.66%. For ischemic stroke, the sensitivity of posterior infarct was 75% and specificity 70.83%. TBM patients having infarcts in posterior region should be looked for associated risk factors of ischemic stroke. (orig.)

  13. Magnetic resonance imaging (MRI) of inflamed myocardium using iron oxide nanoparticles in patients with acute myocardial infarction - preliminary results.

    Science.gov (United States)

    Yilmaz, Ali; Rösch, Sabine; Klingel, Karin; Kandolf, Reinhard; Helluy, Xavier; Hiller, Karl-Heinz; Jakob, Peter M; Sechtem, Udo

    2013-02-20

    Superparamagnetic iron oxide nanoparticle (SPIO)-based molecular imaging agents targeting macrophages have been developed and successfully applied in animal models of myocardial infarction. The purpose of this clinical trial was to investigate whether magnetic resonance imaging (MRI) of macrophages using ferucarbotran (Resovist®) allows improved visualisation of the myocardial (peri-)infarct zone compared to conventional gadolinium-based necrosis/fibrosis imaging in patients with acute myocardial infarction. The clinical study NIMINI-1 was performed as a prospective, non-randomised, non-blinded, single agent phase III clinical trial (NCT0088644). Twenty patients who had experienced either an acute ST-elevation or non-ST-elevation myocardial infarction (STEMI/NSTEMI) were included to this study. Following coronary angiography, a first baseline cardiovascular magnetic resonance (CMR) study (pre-SPIO) was performed within seven days after onset of cardiac symptoms. A second CMR study (post-SPIO) was performed either 10 min, 4h, 24h or 48h after ferucarbotran administration. The CMR studies comprised cine-CMR, T2-weighted "edema" imaging, T2-weighted cardiac imaging and T1-weighted late-gadolinium-enhancement (LGE) imaging. The median extent of short-axis in-plane LGE was 28% (IQR 19-31%). Following Resovist® administration the median extent of short-axis in-plane T2-weighted hypoenhancement (suggestive of intramyocardial haemorrhage and/or SPIO accumulation) was 0% (IQR 0-9%; p=0.68 compared to pre-SPIO). A significant in-slice increase (>3%) in the extent of T2-weighted "hypoenhancement" (post-SPIO compared to pre-SPIO) was seen in 6/16 patients (38%). However, no patient demonstrated "hypoenhancement" in T2-weighted images following Resovist® administration that exceeded the area of LGE. T2/T2-weighted MRI aiming at non-invasive myocardial macrophage imaging using the approved dose of ferucarbotran does not allow improved visualisation of the myocardial (peri

  14. Quantification of fibrosis in infarcted swine hearts by ex vivo late gadolinium-enhancement and diffusion-weighted MRI methods

    Science.gov (United States)

    Pop, Mihaela; Ghugre, Nilesh R.; Ramanan, Venkat; Morikawa, Lily; Stanisz, Greg; Dick, Alexander J.; Wright, Graham A.

    2013-08-01

    Many have speculated that MRI signal characteristics can be used to identify regions of heterogeneous infarct associated with an arrhythmogenic substrate; however, direct evidence of this relationship is limited. The aim of this study was to demonstrate the remodelling characteristics of fibrosis by means of histology and high-resolution MR imaging. For this purpose, we performed whole-mount histology in heart samples (n = 9) collected from five swine at six weeks post-infarction and compared the extent of fibrosis in the infarcted areas delineated in these histological images with that obtained ex vivo by MRI using late gadolinium-enhancement (LGE) and diffusion-weighted imaging (DWI) methods. All MR images were obtained at a submillimetre resolution (i.e., voxel size of 0.6×0.6×1.2 mm3). Specifically, in the histology images, we differentiated moderate fibrosis (consisting of a mixture of viable and non-viable myocytes, known as border zone, BZ) from severe fibrosis (i.e., the dense scar). Correspondingly, tissue heterogeneities in the MR images were categorized by a Gaussian mixture model into healthy, BZ and scar. Our results showed that (a) both MRI methods were capable of qualitatively distinguishing sharp edges between dense scar and healthy tissue from regions of heterogeneous BZ; (b) the BZ and dense scar areas had intermediate-to-high increased values of signal intensity in the LGE images and of apparent diffusion coefficient in the DWI, respectively. In addition, as demonstrated by the Picrosirius Red and immunohistochemistry stains, the viable bundles in the BZ were clearly separated by thin collagen strands and had reduced expression of Cx43, whereas the core scar was composed of dense fibrosis. A quantitative analysis demonstrated that the comparison between BZ/scar extent in LGE and DWI to the corresponding areas identified in histology yielded very good correlations (i.e., for the scar identified by LGE, R2 was 0.96 compared to R2 = 0.93 for the

  15. Exenatide reduces final infarct size in patients with ST-segment-elevation myocardial infarction and short-duration of ischemia

    DEFF Research Database (Denmark)

    Lønborg, Jacob Thomsen; Kelbæk, Henning Skov; Vejlstrup, Niels Grove

    2012-01-01

    Exenatide has been demonstrated to be cardioprotective as an adjunct to primary percutaneous coronary intervention in patients with ST-segment-elevation myocardial infarction (STEMI). The aim of the post hoc analysis study was to evaluate the effect of exenatide in relation to system delay, defin...

  16. Coronal MRI in the diagnosis of corona radiata infarcts adjacent to the lateral ventricles

    Energy Technology Data Exchange (ETDEWEB)

    Iwamoto, Toshihiko; Abe, Shin-e; Kanaya, Kiyoshi; Kubo, Hideki; Takasaki, Masaru (Tokyo Medical Coll. (Japan))

    1992-04-01

    To clarify pathophysiology of vascular lesions in corona radiata infarcts adjacent to the body of the lateral ventricle (CRILV), 17 patients with CRILV were studied by using magnetic resonance (MR) imaging. Based on the coronal MR images obtained between the anterior and posterior commissures, the patients were divided into two groups: (I) the group having infarcts below a line extending from the upper edge of the insular cistern to the external angle of the lateral ventricle adjacent to the corpus callosum (n=11); and (II) the group having lesions above the line towards the centrum semiovale (n=6). Most of the patients in both groups were male and had hypertension. Symptoms were gradually deteriorated and stroke in the morning was frequent in both groups, althrough the time from onset to completion was longer in Group II than Group I. In comparing clinical manifestations in Groups I and II, pure motor hemiparesis was found in 5 and 3 patients, and sensorimotor stroke in 2 and one patients, respectively. Drowsiness was found in 2 for Group I, while aphasia occurred in 2 for Group II. In addition, pseudobular and asymptomatic palsy occurred in each one patient for Group I. Prognosis was favorable in both groups, except for 2 who died of aspiration pneumonia. In Group I, 11 infarcts were well-defined, less than 15 mm in diameter on CT scans and were sclerotic in the main arteries without obstruction on angiograms. In contrast, Group II had ill-defined, larger low-density areas on CT scans and trunk obstruction of the internal carotid or middle cerebral arteries on angiograms. SPECT scans showed diffuse defect in Group II, in contrast to normal to diffuse or multiple defects in Group I. In Group I, lacunar lesions seemed to be caused by ischemia of the perforators, and in Group II, terminal zone infarcts in the territory of the cortical branches or watershed infarcts seemd to be caused by main trunk obstruction. (N.K.).

  17. Utility of unenhanced fat-suppressed T1-weighted MRI in children with sickle cell disease -- can it differentiate bone infarcts from acute osteomyelitis?

    Science.gov (United States)

    Delgado, Jorge; Bedoya, Maria A; Green, Abby M; Jaramillo, Diego; Ho-Fung, Victor

    2015-12-01

    Children with sickle cell disease (SCD) are at risk of bone infarcts and acute osteomyelitis. The clinical differentiation between a bone infarct and acute osteomyelitis is a diagnostic challenge. Unenhanced T1-W fat-saturated MR images have been proposed as a potential tool to differentiate bone infarcts from osteomyelitis. To evaluate the reliability of unenhanced T1-W fat-saturated MRI for differentiation between bone infarcts and acute osteomyelitis in children with SCD. We retrospectively reviewed the records of 31 children (20 boys, 11 girls; mean age 10.6 years, range 1.1-17.9 years) with SCD and acute bone pain who underwent MR imaging including unenhanced T1-W fat-saturated images from 2005 to 2010. Complete clinical charts were reviewed by a pediatric hematologist with training in infectious diseases to determine a clinical standard to define the presence or absence of osteomyelitis. A pediatric radiologist reviewed all MR imaging and was blinded to clinical information. Based on the signal intensity in T1-W fat-saturated images, the children were further classified as positive for osteomyelitis (low bone marrow signal intensity) or positive for bone infarct (high bone marrow signal intensity). Based on the clinical standard, 5 children were classified as positive for osteomyelitis and 26 children as positive for bone infarct (negative for osteomyelitis). The bone marrow signal intensity on T1-W fat-saturated imaging was not significant for the differentiation between bone infarct and osteomyelitis (P = 0.56). None of the additional evaluated imaging parameters on unenhanced MRI proved reliable in differentiating these diagnoses. The bone marrow signal intensity on unenhanced T1-W fat-saturated MR images is not a reliable criterion to differentiate bone infarcts from osteomyelitis in children.

  18. Utility of unenhanced fat-suppressed T1-weighted MRI in children with sickle cell disease - can it differentiate bone infarcts from acute osteomyelitis?

    Energy Technology Data Exchange (ETDEWEB)

    Delgado, Jorge; Bedoya, Maria A. [The Children' s Hospital of Philadelphia, Department of Radiology, Philadelphia, PA (United States); Green, Abby M. [The Children' s Hospital of Philadelphia, Division of Oncology, Philadelphia, PA (United States); Jaramillo, Diego; Ho-Fung, Victor [The Children' s Hospital of Philadelphia, Department of Radiology, Philadelphia, PA (United States); The Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA (United States)

    2015-12-15

    Children with sickle cell disease (SCD) are at risk of bone infarcts and acute osteomyelitis. The clinical differentiation between a bone infarct and acute osteomyelitis is a diagnostic challenge. Unenhanced T1-W fat-saturated MR images have been proposed as a potential tool to differentiate bone infarcts from osteomyelitis. To evaluate the reliability of unenhanced T1-W fat-saturated MRI for differentiation between bone infarcts and acute osteomyelitis in children with SCD. We retrospectively reviewed the records of 31 children (20 boys, 11 girls; mean age 10.6 years, range 1.1-17.9 years) with SCD and acute bone pain who underwent MR imaging including unenhanced T1-W fat-saturated images from 2005 to 2010. Complete clinical charts were reviewed by a pediatric hematologist with training in infectious diseases to determine a clinical standard to define the presence or absence of osteomyelitis. A pediatric radiologist reviewed all MR imaging and was blinded to clinical information. Based on the signal intensity in T1-W fat-saturated images, the children were further classified as positive for osteomyelitis (low bone marrow signal intensity) or positive for bone infarct (high bone marrow signal intensity). Based on the clinical standard, 5 children were classified as positive for osteomyelitis and 26 children as positive for bone infarct (negative for osteomyelitis). The bone marrow signal intensity on T1-W fat-saturated imaging was not significant for the differentiation between bone infarct and osteomyelitis (P = 0.56). None of the additional evaluated imaging parameters on unenhanced MRI proved reliable in differentiating these diagnoses. The bone marrow signal intensity on unenhanced T1-W fat-saturated MR images is not a reliable criterion to differentiate bone infarcts from osteomyelitis in children. (orig.)

  19. The correlation of the thalamic lesions on MRI with cerebral cortical blood flow in patients with lacunar infarction

    Energy Technology Data Exchange (ETDEWEB)

    Nabatame, Hidehiko; Nakamura, Kazuo; Matsuda, Minoru; Fujimoto, Naoki [Shiga Medical Center, Moriyama (Japan); Fukuyama, Hidenao

    1995-07-01

    We performed MRI and measured cerebral blood flow (CBF) using {sup 123}I-IMP SPECT microsphere model in twenty three right-handed patients with lacunar infarction. Twelve of 23 patients showed chronic deterioration of dysarthria and gait disturbance. The mental function of the patients was evaluated by the Mini-Mental State (MMS) examination. The area of high intensity on T2-weighted images was quantitatively analyzed in the cerebral white matter (WM), lenticular nucleus (LN) and thalamus (THA). The score of MMS was positively correlated with the local CBF in the bilateral frontal, parietal, temporal and occipital cortices (p<0.05). Also, the area of high intensity in the left THA showed a significant negative correlation with local CBF of the bilateral frontal, parietal, temporal and occipital cortices (p<0.001). The high intensity areas of the bilateral LN, right WM and right THA had a significant but weaker negative correlation with local CBF of some cortices. These findings suggest that thalamic lesions on the dominant side play an important role in the reduction of cortical blood flow and the deterioration of mental functions in patients with lacunar infarction. (author).

  20. Evaluation of pharmacological efficacy of anti-edema agents in a rat cerebral infarction model by MRI image analysis

    Energy Technology Data Exchange (ETDEWEB)

    Izumi, Yoshio; Haida, Munetaka; Kurita, Daisaku; Shinohara, Yukito [Tokai Univ., Isehara, Kanagawa (Japan). School of Medicine; Sugiura, Takeo

    1997-04-01

    We investigated the efficacy of drugs used to treat brain edema in a rat acute cerebral infarction model by MRI image analysis. Twenty-six Sprague-Dawley rats were anesthetized with halothane, and the right middle cerebral artery was permanently occluded via a transvascular approach using a nylon 2-0 suture. At 24 hours after the occlusion, axial T{sub 2}-weighted MRI images were taken before and 2 hours after intraperitoneal administration of a test drug. After the administration of 1.7 g/kg glycerol (n=9), 3.3 g/kg mannitol (n=9) or 17 mg/kg furosemide (n=8), the high intensity area (HIA) in the whole brain amounted to 92% (p<0.01), 94% (p=0.07), or 95% (p=0.03), respectively as compared to the corresponding HIA before administration. The HIA in the cerebral cortex amounted to 87% (p<0.01), 89% (p=0.03), or 98% (p=0.47), and that in the striatum to 102%, 106%, or 87% (p<0.05), respectively. The signal intensity change (before{yields}after) was 54{yields}49 (p<0.01), 54{yields}50 (p<0.01), or 55{yields}54 in the left side normal cortex; 102{yields}97 (p<0.0l), 100{yields}98, or 98{yields}97 in the injured side cortex; and 100{yields}93 (p<0.0l), 94{yields}88 (p=0.03), or 94{yields}94 in the injured side striatum, respectively. Improvement of edema by the drugs was observed as a reduction in HIA and a decrease in signal intensity on MRI, and the changes were significant in the case of administration of each of glycerol, mannitol and furosemide. (author)

  1. 低场强 MRI 弥散加权成像(DWI)对急性脑梗塞的诊断价值%The low field MRI diffusion weighted imaging (DWI) on acuteDiagnostic value of cerebral infarction

    Institute of Scientific and Technical Information of China (English)

    赵丽蓉; 武丽红

    2013-01-01

    目的:探讨低场 MRI 对脑梗塞早期诊断价值。方法分析我院2008年2月至2009年2月,64例弥散加权成像急性脑梗塞表现,总结 DWI 对其诊断价值。结果3~6H 内弥散加权成像(DWI)诊断敏感率可以达到96%。结论低场 DWI 优于 CT 检查,为患者提供早期脑梗塞诊断,可以为临床提供可靠溶栓治疗的依据。%Objective The goal discusses low field MRI to the cerebral infarction early diagnosis value.Method analyzes my courtyard in February, 2008 - February, 2009, 64 example dissemination weighting image formation acute cerebral infarction displays, summarizes DWI to its diagnosis value. Results finally in 3-6H disseminates the weighting image formation (DWI) to diagnose sensitively rate may achieve 96%. Conclusion low field DWI surpasses the CT inspection, provides the early cerebral infarction for the patient to diagnose, may for clinical provide dissolves the hitch treatment reliably the basis.

  2. An experimental study on use of 7T MRI for evaluation of myocardial infarction in SD rats transfected with pcDNA 3.1(+)/VEGF121 plasmid

    Science.gov (United States)

    Zhang, Yan; Tian, Ruiqing; Shen, Xiangchun; Chen, Yushu; Chen, Wei; Gan, Lu; Shen, Guiquan; Ju, Haiyue; Yang, Li; Gao, Fabao

    2016-01-01

    This study aims to build the myocardial infarction model in SD rats transfected with pcDNA 3.1(+)/VEGF121 plasmid and study the effect of the transfection using 7T MRI. Twenty-four male SD rats were randomly divided into 2 groups, pcDNA 3.1(+)/VEGF121 plasmid transfection group (with improved coronary perfusion delivery) and myocardial infarction model group. Cardiac cine magnetic resonance imaging (Cine-MRI), T2-mapping and late gadolinium enhancement (LGE) cardiac imaging were performed at 24 h, 48 h, 72 h and 7 d after myocardial infarction, respectively. The signal intensity, area at risk (AAR), myocardium infarction core (MIC) and salvageable myocardial zone (SMZ) were compared. The hearts were harvested for anatomic characterization, which was related to pathological examination (TTC staining, HE staining, Masson staining and immunohistochemical staining). The Cine-MRI results showed that pcDNA 3.1(+)/VEGF121 plasmid transfection group had higher end-diastolic volume (EDV) with a reduction in MIC and SMZ, as compared with the myocardial infarction model group. MIC, SMZ and AAR of the plasmid transfection declined over time. At 7 d, the two groups did not differ significantly in AAR and T2 value. According to Western Blotting, VEGF was up-regulated, while CaSR and caspase-3 were downregulated in the plasmid transfection group, as compared with the model group. In conclusion, a good treatment effect was achieved by coronary perfusion of pcDNA 3.1(+)/VEGF121 plasmid. 7T CMR sequences provide a non-invasive quantification of the treatment efficacy. However, the assessment of myocardial injury using T2 value and AAR in the presence of edema is less accurate. The myocardial protection of the plasmid transfection group may be related to the inhibition of myocardial apoptosis, vascular endothelial cell (VEC) proliferation and collagen proliferation. The CaSR signaling pathway may contribute to reversing the apoptosis. PMID:27648128

  3. Ferritin as a reporter gene for in vivo tracking of stem cells by 1.5-T cardiac MRI in a rat model of myocardial infarction.

    Science.gov (United States)

    Campan, Manuela; Lionetti, Vincenzo; Aquaro, Giovanni D; Forini, Francesca; Matteucci, Marco; Vannucci, Laura; Chiuppesi, Flavia; Di Cristofano, Claudio; Faggioni, Michela; Maioli, Margherita; Barile, Lucio; Messina, Elisa; Lombardi, Massimo; Pucci, Angela; Pistello, Mauro; Recchia, Fabio A

    2011-06-01

    The methods currently utilized to track stem cells by cardiac MRI are affected by important limitations, and new solutions are needed. We tested human ferritin heavy chain (hFTH) as a reporter gene for in vivo tracking of stem cells by cardiac MRI. Swine cardiac stem/progenitor cells were transduced with a lentiviral vector to overexpress hFTH and cultured to obtain cardiospheres (Cs). Myocardial infarction was induced in rats, and, after 45 min, the animals were subjected to intramyocardial injection of ∼200 hFTH-Cs or nontransduced Cs or saline solution in the border zone. By employing clinical standard 1.5-Tesla MRI scanner and a multiecho T2* gradient echo sequence, we localized iron-accumulating tissue only in hearts treated with hFTH-Cs. This signal was detectable at 1 wk after infarction, and its size did not change significantly after 4 wk (6.33 ± 3.05 vs. 4.41 ± 4.38 mm(2)). Cs transduction did not affect their cardioreparative potential, as indicated by the significantly better preserved left ventricular global and regional function and the 36% reduction in infarct size in both groups that received Cs compared with control infarcts. Prussian blue staining confirmed the presence of differentiated, iron-accumulating cells containing mitochondria of porcine origin. Cs-derived cells displayed CD31, α-smooth muscle, and α-sarcomeric actin antigens, indicating that the differentiation into endothelial, smooth muscle and cardiac muscle lineage was not affected by ferritin overexpression. In conclusion, hFTH can be used as a MRI reporter gene to track dividing/differentiating stem cells in the beating heart, while simultaneously monitoring cardiac morpho-functional changes.

  4. 小脑梗死31例致残特点分析及CT、MRI确诊率比较%Mutilation characteristics analysis and CT, MRI dignosis rate comparison in 31 cerebellar infarction cases

    Institute of Scientific and Technical Information of China (English)

    杨光宇; 陈伟群; 谢道俊

    2002-01-01

    Background: Functional disturbance caused by cerebellar infarction are diversified according to lesion site and size, mutilation characteristics are different. it is difficult to diagnose because its manifestation is complicated. It can show symptoms like vestibule disease, Compartmental syndrome or be masked by brain stem or occipital lobe infarction. In recent years, Diagnosis rate of this disease increase as utilization of CT and MRI. But CT is influenced by bone structure of posterior cranial fossa, so it can't exam small infarction focus. MRI is better.

  5. MRI-ultrasound fusion biopsy for prediction of final prostate pathology

    Science.gov (United States)

    Le, Jesse D.; Stephenson, Samuel; Brugger, Michelle; Lu, David Y.; Lieu, Patricia; Sonn, Geoffrey A.; Natarajan, Shyam; Dorey, Frederick J.; Huang, Jiaoti; Margolis, Daniel J.A.; Reiter, Robert E.; Marks, Leonard S.

    2014-01-01

    PURPOSE To explore the impact of MRI-ultrasound (MRI-US) fusion prostate biopsy on prediction of final surgical pathology. MATERIALS AND METHODS 54 consecutive men undergoing radical prostatectomy at UCLA after Artemis fusion biopsy (Eigen, Grass Valley, CA) were included in this prospective IRB-approved pilot study. Using MRI-US fusion, tissue was obtained from a 12-point systematic grid (mapping biopsy, MBx) and from regions of interest detected by multi-parametric MRI (targeted biopsy, TBx). A single radiologist read all MRIs, and a single pathologist independently re-reviewed all biopsy and whole-mount pathology, blinded to prior interpretation and matched specimen. Gleason score (GS) concordance between biopsy and prostatectomy was the primary endpoint. RESULTS Mean age was 62 years, with median PSA 6.2 ng/ml. Final GS at prostatectomy was 6 (13%), 7 (70%), and 8–9 (17%). A tertiary pattern was detected in 17 (31%) men. 32/45 (71%) high-suspicion (image grade 4–5) MRI targets contained prostate cancer (CaP). The per-core cancer detection rate was 20% by MBx and 42% by TBx. The highest Gleason pattern at prostatectomy was detected by MBx in 54%, TBx in 54%, and the combination in 81% of cases. 17% were upgraded from fusion biopsy to final pathology; one case (2%) was downgraded. The combination of TBx and MBx was needed to obtain the best predictive accuracy. CONCLUSIONS In this pilot study, MR-US fusion biopsy allowed for prediction of final prostate pathology with greater accuracy than that reported previously using conventional methods (81% versus 40–65%). If confirmed, these results would have important clinical implications. PMID:24793118

  6. Does Preinterventional Flat-Panel Computer Tomography Pooled Blood Volume Mapping Predict Final Infarct Volume After Mechanical Thrombectomy in Acute Cerebral Artery Occlusion?

    Energy Technology Data Exchange (ETDEWEB)

    Wagner, Marlies, E-mail: marlies.wagner@kgu.de [Hospital of Goethe University, Institute of Neuroradiology (Germany); Kyriakou, Yiannis, E-mail: yiannis.kyriakou@siemens.com [Siemens AG, Health Care Sector (Germany); Mesnil de Rochemont, Richard du, E-mail: mesnil@em.uni-frankfurt.de [Hospital of Goethe University, Institute of Neuroradiology (Germany); Singer, Oliver C., E-mail: o.singer@em.uni-frankfurt.de [Hospital of Goethe University, Department of Neurology (Germany); Berkefeld, Joachim, E-mail: berkefeld@em.uni-frankfurt.de [Hospital of Goethe University, Institute of Neuroradiology (Germany)

    2013-08-01

    PurposeDecreased cerebral blood volume is known to be a predictor for final infarct volume in acute cerebral artery occlusion. To evaluate the predictability of final infarct volume in patients with acute occlusion of the middle cerebral artery (MCA) or the distal internal carotid artery (ICA) and successful endovascular recanalization, pooled blood volume (PBV) was measured using flat-panel detector computed tomography (FPD CT).Materials and MethodsTwenty patients with acute unilateral occlusion of the MCA or distal ACI without demarcated infarction, as proven by CT at admission, and successful Thrombolysis in cerebral infarction score (TICI 2b or 3) endovascular thrombectomy were included. Cerebral PBV maps were acquired from each patient immediately before endovascular thrombectomy. Twenty-four hours after recanalization, each patient underwent multislice CT to visualize final infarct volume. Extent of the areas of decreased PBV was compared with the final infarct volume proven by follow-up CT the next day.ResultsIn 15 of 20 patients, areas of distinct PBV decrease corresponded to final infarct volume. In 5 patients, areas of decreased PBV overestimated final extension of ischemia probably due to inappropriate timing of data acquisition and misery perfusion.ConclusionPBV mapping using FPD CT is a promising tool to predict areas of irrecoverable brain parenchyma in acute thromboembolic stroke. Further validation is necessary before routine use for decision making for interventional thrombectomy.

  7. Striatal Infarction Elicits Secondary Extrafocal MRI Changes in Ipsilateral Substantia Nigra.

    Directory of Open Access Journals (Sweden)

    Benjamin Winter

    Full Text Available Focal ischemia may induce pathological alterations in brain areas distant from the primary lesion. In animal models, exofocal neuron death in the ipsilateral midbrain has been described after occlusion of the middle cerebral artery (MCA. Using sequential magnetic resonance imaging (T2- and diffusion-weighted at 3 Tesla, we investigated acute ischemic stroke patients on days 1, 2, 6, 8, and 10 after stroke onset. Sixteen consecutive patients who had suffered a stroke involving the caudate nucleus and/or putamen of either hemisphere were recruited into the study. Four additional patients with strokes sparing the caudate nucleus and putamen but encompassing at least one-third of the MCA territory served as controls. Ischemic lesions involving striatal structures resulted in hyperintense lesions in ipsilateral midbrain that emerged between days 6 and 10 after stroke and were not present on the initial scans. In contrast, none of the control stroke patients developed secondary midbrain lesions. Hyperintense lesions in the pyramidal tract or the brain stem caused by degeneration of the corticospinal tract could be clearly distinguished from these secondary midbrain gray matter lesions and were detectable from day 2 after ischemia. Co-registration of high-resolution images with a digitized anatomic atlas revealed localization of secondary lesions primarily in the substantia nigra pars compacta. Apparent diffusion coefficient (ADC values in the secondary lesions showed a delayed sharp decline through day 10. Normalization of ADC values was observed at late measurements. Taken together, our study demonstrates that striatal infarction elicits delayed degenerative changes in ipsilateral substantia nigra pars compacta.

  8. Distribution of lipid-based nanoparticles to infarcted myocardium with potential application for MRI-monitored drug delivery

    NARCIS (Netherlands)

    Paulis, L.E.M.; Geelen, T.; Kuhlmann, M.T.; Coolen, B.F.; Schafers, M.; Nicolay, K.; Strijkers, G.J.

    2012-01-01

    Adverse cardiac remodeling after myocardial infarction ultimately causes heart failure. To stimulate reparative processes in the infarct, efficient delivery and retention of therapeutic agents is desired. This might be achieved by encapsulation of drugs in nanoparticles. The goal of this study was t

  9. Correlations between MRI and Cognitive Changes during Acute to Rehabilitation Phase of Cerebral Infarction%脑梗死患者急性期-康复期认知变化与脑MRI分析

    Institute of Scientific and Technical Information of China (English)

    徐晓云; 高伟明; 朱雯霞; 沈伟文

    2002-01-01

    Objective: To examine correlations between MRI and cognitive changes associated with cerebral infarction. Methods: Using HDS-R and Senior Cognitive Scale, we assessed 101 patients with cerebral infarction during acute to rehabilitation phase. The results were compared with their MRI. Results: At 3 weeks after onset, cognitive impairment was found in 70.3% of the patients. At 6 months after onset, 10% recovered to normal, 35.6% improved, 22.8% worsened, and 42.5% met the criteria of dementia. During acute phase, infarction focus and leukoaraiosis (LA) were related to cognitive impairment P<0.05). During rehabilitation phase, cognitive impairment was related to LA.Conclusion:Cerebral infarcti on results in significant cognitive impairment. LA is the major cause of cognitive impairment associated with cerebral infarction in rehabilitation.

  10. MRI

    Science.gov (United States)

    MRI does not use ionizing radiation. No side effects from the magnetic fields and radio waves have been reported. The most common type of contrast (dye) used is gadolinium. It is very safe. Allergic reactions rarely ...

  11. The Role of Diffusion-Weighted MRI in Differentiation of Idiopathic Acute Transverse Myelitis and Acute Spinal Cord Infarction

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Yeo Goon; Lee, Joon Woo; Kim, Jae Hyoung; Kang, Heung Sik [Dept. of Radiology, Bundang Hospital, Seoul University College of Medicine, Seoul (Korea, Republic of); Park, Kyung Seok [Dept. of Neurology, Bundang Hospital, Seoul University College of Medicine, Seoul (Korea, Republic of)

    2011-08-15

    To compare the diffusion characteristics of idiopathic acute transverse myelitis (ATM) and acute spinal cord infarction (SCI). Diffusion-weighted images (DWI) and an apparent diffusion coefficient (ADC) map were prospectively obtained from patients diagnosed with myelopathy between February 2006 and April 2009. Inclusion criteria included 1) the presence of an intramedullary T2-high signal intensity and 2) a final diagnosis of idiopathic ATM or SCI established by one neurologist. In total, 13 patients (M : F = 8 : 5; mean age, 39.5 years; range, 29-50 years) with idiopathic ATM and seven patients (M : F = 2 : 5; mean age, 58 years; range, 48-75 years) with SCI were included in this study. Two radiologists evaluated the DWIs and ADC map in consensus. The extent of the cord signal change was also evaluated on T2-weighted sagittal images. Among the 16 patients with ATM, 14 patients showed iso-signal on an ADC map, but one case showed restricted diffusion and another showed increased diffusion on the ADC map. Among the seven patients with SCI, five patients showed restricted diffusion. Idiopathic ATM usually does not demonstrate restricted diffusion, which can be a clue to differentiate it from SCI. However, idiopathic ATM with larger segment involvement can show focal diffusion restriction.

  12. CT 与 MRI 对腔隙性梗死的诊断价值分析%Analysis of compared CT with MRI in diagnosis value of lacunar infarction

    Institute of Scientific and Technical Information of China (English)

    严补生

    2015-01-01

    目的:比较C T与M RI对腔隙性梗死的诊断价值。方法选择腔隙性梗死患者40例为研究对象,均于入院3 h内行急诊螺旋CT及MRI检查。以临床诊断为准,观察CT 与MRI对腔隙性梗死病灶数量及部位诊断情况。比较CT 与MRI对发病<24 h、24~72 h、>72 h患者脑内病灶及径线<5 mm、5~10 mm和>10~15 mm病灶检出情况。结果(1)脑梗死病灶分布于额叶6例,顶叶6例,颞叶6例,枕叶4例,基底节区8例,丘脑3例,脑干3例,小脑4例。40例患者中,C T共显示21例患者存在脑梗死病灶,共显示病灶45处。M RI共显示38例患者存在脑梗死病灶,共显示病灶79处。M RI对脑梗死病灶检出率显著高于C T ,差异具有统计学意义( P<0.05)。(2)M RI对<24 h、24~72 h脑梗死病灶的检出率显著高于CT ,差异具有统计学意义(P<0.05)。两者在>72 h病灶的检出中,差异无统计学意义(P>0.05)。(3)其中MRI对径线<5 mm及5~10 mm腔隙性梗死病灶检出率显著高于CT ,差异具有统计学意义(P<0.05)。在病灶径线10~15 mm病灶的检出中,MRI及CT比较差异无统计学意义(P>0.05)。结论在腔隙性梗死的诊断中,MRI较CT更具有优势。%Objective To compare the value of CT and MRI in diagnosis of lacunar infarction.Methods 40 cases with la‐cunar cerebral infarction as the objects ,which were detected by spiral CT and MRI examination within 3 h admitted to our hos‐pital. Lesion number and site of cerebral lacunar infarction by CT and MRI were observed.The onset of cerebral infarction within 24 h ,between 24 h and 72 h ,more than 72 h;and diameter less than 5 mm ,between 5 mm and 10 mm ,between >10 and 15 mm detected by CT and MRI were compared.Results 6 cases of cerebral infarction lesions located in frontal lobe ,6 ca‐ses in parietal lobe ,6 cases in temporal lobe ,4 cases in occipital lobe ,8 cases in basal ganglia

  13. Can prostatic arterial embolisation (PAE) reduce the volume of the peripheral zone? MRI evaluation of zonal anatomy and infarction after PAE

    Energy Technology Data Exchange (ETDEWEB)

    Lin, Yen-Ting [Assistance Publique Hopitaux de Paris. Hopital Europeen Georges-Pompidou, Vascular and Oncological Interventional Radiology, Paris (France); Department of Radiology, Taichung Veterans General Hospital, Taichung City (China); Amouyal, Gregory; Pereira, Helena; Del Giudice, Costantino; Dean, Carole [Assistance Publique Hopitaux de Paris. Hopital Europeen Georges-Pompidou, Vascular and Oncological Interventional Radiology, Paris (France); Correas, Jean-Michel [Assistance Publique Hopitaux de Paris. Hopital Europeen Georges-Pompidou, Vascular and Oncological Interventional Radiology, Paris (France); Hopital Necker, Radiology Department, Paris (France); Pellerin, Olivier; Sapoval, Marc [Assistance Publique Hopitaux de Paris. Hopital Europeen Georges-Pompidou, Vascular and Oncological Interventional Radiology, Paris (France); Inserm (Institut national de la sante et de la recherche medicale) U970, Paris (France); Universite Paris Descartes, Paris (France); Thiounn, Nicolas [Assistance Publique Hopitaux de Paris, Hopital Europeen Georges-Pompidou, Urology, Paris (France)

    2016-10-15

    To assess the impact of prostatic arterial embolisation (PAE) on various prostate gland anatomical zones. We retrospectively reviewed paired MRI scans obtained before and after PAE for 25 patients and evaluated changes in volumes of the median lobe (ML), central gland (CG), peripheral zone (PZ) and whole prostate gland (WPV) following PAE. We used manual segmentation to calculate volume on axial view T2-weighted images for ML, CG and WPV. We calculated PZ volume by subtracting CG volume from WPV. Enhanced phase on dynamic contrasted-enhanced MRI was used to evaluate the infarction areas after PAE. Clinical results of International Prostate Symptom Score and International Index of Erectile Function questionnaires and the urodynamic study were evaluated before and after PAE. Significant reductions in volume were observed after PAE for ML (26.2 % decrease), CG (18.8 %), PZ (16.4 %) and WPV (19.1 %; p < 0.001 for all these volumes). Patients with clinical failure had smaller volume reductions for WPV, ML and CG (all p < 0.05). Patients with significant CG infarction after PAE displayed larger WPV, ML and CG volume reductions (all p < 0.01). PAE can significantly decrease WPV, ML, CG and PZ volumes, and poor clinical outcomes are associated with smaller volume reductions. (orig.)

  14. Value of MRI for the diagnosis of pontine infarction%磁共振成像在脑桥梗死诊断中的价值

    Institute of Scientific and Technical Information of China (English)

    殷雁; 金钰; 孙庆华; 尹琳

    2012-01-01

    目的 探讨脑桥梗死的临床与MRI特征.方法 回顾性分析96例脑桥梗死患者的临床资料,评估危险因素,分析临床与MRI特点.结果 首发临床表现复杂多样,96例患者中,头晕或眩晕79例(82.29%),肢体活动不便76例(79.17%),构音障碍54例(56.25%),中枢性面瘫49例(51.04%),感觉障碍31例(32.29%),中枢性舌瘫25例(26.04%)等表现最常见;多表现为病灶对侧的中枢性面瘫和(或)舌瘫合并肢体瘫和(或)无感觉障碍,而经典脑桥综合征3例(3.13%);病灶在脑桥上段21例(21.88%),中段62例(64.58%),下段13例(13.54%);腹内侧41例(42.71%),腹外侧22例(22.92%),中部16例(16.67%),背内侧11例(11.46%),背外侧6例(6.25%).结论 脑桥梗死常见临床表现为头晕或眩晕,肢体活动受限,构音障碍,中枢性面瘫,感觉障碍,中枢性舌瘫.交叉症状或体征在脑桥梗死患者中并不常见,经典的脑桥综合征病例少见.脑桥梗死以中段最常见,尤其是腹内侧.MRI对脑桥梗死的诊断有极其重要的意义.%Objective To study the clinical and MRI features of pontine infarction. Methods The clinical data about 96 patients with pontine infarction were retrospectively analyzed. Its risk factors were assessed. Clinical and MRI features of pontine infarction were analyzed. Results Among the 96 patients with different clinical manifestations, dizziness or vertigo was found in 79 (82. 29%),limb paralysis in 76(79. 17%) , barylalia in 54 (56. 25%) , central facial palsy in 49 (51. 04%), sensory disturbance in 31(32. 29%),central tongue palsy in 25(26.04%) respectively. Pontine infarction was usually manifested as contralateral central facial and/or tongue palsy accompanying limb paralysis and/or sensory disturbance. Three patients were diagnosed with classical pontine syndrome. Lesions were found in the upper,middle and lower pontine of 21(21. 88%) , 62(64. 58%) and 13(13. 54%)patients, respectively,and in the ventral

  15. Isolated right ventricular infarct presenting as ventricular fibrillation arrest and confirmed by delayed-enhancement cardiac MRI.

    Science.gov (United States)

    Cavalcante, João L; Al-Mallah, Mouaz; Hudson, Michael

    2010-10-01

    Malignant ventricular arrhythmias resulting from isolated right ventricular myocardial infarction (RVMI) without left ventricular myocardial ischaemia or infarction occur rarely. We present a case of a 61 year-old male with acute onset of chest pain and ventricular fibrillation cardiac arrest requiring prompt defibrillation. Subsequent 15-lead EKG, showed ST-segment elevation in the anterior and right precordial leads without ST-segment elevation in the inferior leads. Angiography documented occlusion of a large RV marginal branch. Delayed enhancement cardiac magnetic resonance imaging (DE-CMR) with gadolinium performed two days post-infarct showed isolated RVMI. Patient remained symptom free and haemodynamically stable throughout his hospital stay. The clinical presentation of isolated RV infarct can be misleading and diagnosis difficult. EKG findings can resemble acute anterior wall myocardial infarction, while its course can be accompanied by life-threatening ventricular arrhythmias. This case uniquely combines this rare clinical sequence with DE-CMR images using gadolinium to confirm isolated RVMI. A brief review of RVMI presentation and associated EKG patterns is also discussed.

  16. The role of immediate and final goals in action planning: an fMRI study.

    Science.gov (United States)

    Majdandzić, Jasminka; Grol, Meike J; van Schie, Hein T; Verhagen, Lennart; Toni, Ivan; Bekkering, Harold

    2007-08-15

    To interact effectively with our environment, we need to specify the intended outcomes (goals) of our actions. In this process, immediate goals and final goals can be regarded as different levels within a hierarchically organized system for action planning: immediate goals and movement details are selected to accomplish more remote goals. Behavioral studies support this notion of different levels of action planning, but the neurophysiological basis remains unclear. Using fMRI, we examined the neural correlates of preparing object manipulations based on either the desired end-state (the final goal) or the initial movement towards a target (the immediate goal). Subjects had to insert an object (consisting of a large and a small cube) into one of two corresponding large and small slots. The subjects were cued on either which slot to fill (Final Goal trials) or which object part to grasp (Immediate Goal trials). These actions required similar movements, but different planning. During Final Goal trials, there was differential preparatory activity along the superior frontal gyrus (bilaterally) and in left inferior parietal cortex. Immediate Goal trials evoked differential activity in occipito-parietal and occipito-temporal cortex. These findings support the notion that actions can be planned at different levels. We show that different fronto-parietal circuits plan the same action, by a relative emphasis on either selecting a sequence of movements to achieve a desired end-state, or selecting movements spatially compatible with given object properties.

  17. CT and MRI Imaging Features of Type 2 Diabetes Complicated with Cere-bral Infarction%2型糖尿病并发脑梗塞的CT及MRI影像学特征

    Institute of Scientific and Technical Information of China (English)

    樊会军; 律静; 孟建华

    2015-01-01

    目的 探讨2型糖尿病并发脑梗塞的CT及MRI影像学特征和诊断价值. 方法 回顾性分析117例糖尿病并发脑梗塞患者的CT和MRI影像学资料.结果 2型糖尿病并发脑梗塞在CT及MRI影像学上的特点以多发性腔隙性梗塞为主. 在117例患者中,87例为多发病灶,占75%;在所有病灶中最大直径在2 cm以下的占82%;圆形或卵圆形病灶占65%;基底节、丘脑部位占63%. 结论 2型糖尿病并发脑梗塞的CT及MRI影像学有其特殊的表现,应提高对该病的认识水平以避免误诊或漏诊.%Objective To investigate the imaging features and diagnostic value of CT and MRI in type 2 diabetic patients with cerebral infarction. Methods CT and MRI imaging features of 117 patients with cerebral infarction complicated by cerebral infarction were retrospectively analyzed. Results Type 2 diabetes complicated with cerebral infarction in CT and MRI imaging of multiple lacunar infarction. In 117 patients, 87cases for multiple lesions, accounting for 75%; in all lesions in maximum diameter at below 2 cm accounted for 82%; round or oval lesions accounted for 65%; basal ganglia and thala-mus accounted for 63%. Conclusion Type 2 diabetes with cerebral infarction of CT and MRI imaging has its special perfor-mance, should improve the level of awareness of the disease to avoid misdiagnosis or missed diagnosis.

  18. Hemorrhagic transformation in ischemic posterior infarction by magnetic resonance imaging (MRI); Kernspintomographische Untersuchung der haemmorrhagischen Transformation ischaemischer Posteriorinfarkte

    Energy Technology Data Exchange (ETDEWEB)

    Reimann, M.; Niehaus, L.; Lehmann, R. [Humboldt-Universitaet, Berlin (Germany). Medizinische Fakultaet Charite

    2000-08-01

    Purpose: To describe the incidence, time course, and clinical correlates of hemorrhagic transformation (HT) of ischemic stroke in the posterior cerebral artery territory. Methods: Within 42 months 48 patients with 52 occipital lobe infarctions were examined by T{sub 1}- and T{sub 2}-weighted MR imaging. The extent and distribution of secondary hemorrhage were analysed at different intervals after stroke. Volume of ischemic and hemorrhagic infarction was measured planimetrically. Results: HT was observed in 71% of the infarcts between the 5{sup th} day and up to 1 year after stroke. HT was most frequently (88%) observed in the 2{sup nd} and 3{sup rd} month. HT was present in 55% of small infarcts (<10 cm{sup 3}), in 88% of medium size (10-50 cm{sup 3}), and in all large (>50 cm{sup 3}) infarcts. In 92% HT presented with petechial bleedings within the cortex (64%) or less frequently (28%) in subcortical structures. The latter types of HT showed no progression and did not increase the clinical deficits. Space-occupying bleedings occurred in only two large defects. Conclusions: In ischemic posterior infarction, HT can frequently be detected within the first three months after stroke and is predominantly of the petechial type and seems not to be relevant with regard to clinical deficits. (orig.) [German] Ziel: MR-tomographische Untersuchung ischaemischer Posteriorinfarkte zur Erfassung der Haeufigkeit, des zeitlichen Verlaufs und der klinischen Bedeutung einer haemorrhagischen Transformation (HT). Methodik: Ueber einen Zeitraum von 42 Monaten wurden 48 Patienten mit 52 Territorialinfarkten im Versorgungsgebiet der Arteria cerebri posterior im MRT (T{sub 1}/T{sub 2}-gewichtete Spinecho-Sequenzen) untersucht. 77 MRT-Untersuchungen aus 5 verschiedenen Untersuchungszeitraeumen wurden hinsichtlich Lokalisation und Ausdehnung einer sekundaeren HT und etwaiger Veraenderungen im Verlauf analysiert. Die Infarkt- und Haemorrhagievolumina wurden planimetrisch gemessen. Ergebnisse

  19. 急性脑梗死后失语症的MRI影像学研究%Analysis of MRI Manifestation with Aphasia after Acute Cerebral Infarction

    Institute of Scientific and Technical Information of China (English)

    葛巍; 王敏; 朱文荣; 樊红彬; 耿德勤

    2012-01-01

    Aim: To reveal the relationship between aphasia and infarct lesion defined by MRI through analysis of 68 patients with aphasia performance after acute cerebral infarction. Methods: The potential patients were evaluated by the hand evaluation standard of Aphasia Battery of Chinese. Chinese Aphasia Examination was applied to classify the type of aphasia. The lesion site and volume of cerebral infarction in patients were determined by MRI. Results: All 68 cases of aphasia patients were right-handed. There were 18 global aphasia(GA) cases, 25 broca aphasia(BA) cases, 7 wernicke aphasia(WA) cases, 7 conduction aphasia cases, 7 transcortical motor aphasia(TCM) cases and 4 anomic aphasia(AA) cases. There were 32 cases with the classic language center and 36 cases with non-language center. Conclusion: The aphasia types were not agreed with the traditional aphasia anatomical localization, and the non-language center may also cause aphasia.%目的:应用MRI检查确定急性脑梗死后失语症类型与脑梗死部位之间的关系.方法:对68例急性脑梗死后具有失语症表现患者应用汉语失语成套测验中的利手评定标准进行利手判定和汉语失语症检查进行失语症的分类,用头颅MRI确定患者的脑梗死部位及病灶体积.结果:68例急性脑梗死失语症患者均为右利手,失语症类型分别为完全性失语18例,运动性失语25例,感觉性失语7例,传导性失语7例,经皮质运动性失语7例,命名性失语4例.累及经典语言中枢的有32例,36例为非语言中枢受累.结论:急性脑梗死失语症类型与传统的失语症解剖定位不完全符合,非语言中枢梗死也可引起失语症.

  20. Acute Cerebral Infarction by Venomous Snake Bite in CT and MRI%少见毒蛇咬伤致急性脑梗死的CT和MRI表现

    Institute of Scientific and Technical Information of China (English)

    李秀涛; 王立振; 胡元明

    2015-01-01

    Objective To determine the CT and MRI ifndings of acute cerebral infarction by venomous snake bitten.Methods The imaging ifndings of 7 patients with acute cerebral infarction by venomous snake bitten were analyzed retrospectively with literatures review.Results 2 case was bitten by Pit viper. 4cases were bitten by Russell's viper and 1 case was unknown viper. One leaf or multiple leaves cerebrum occurred frequently. Acute obstruct with multiple mottling, patchy, or schistose. 84 acute cerebral infarction in 21 leaves cerebrum of 7 cases, parietal lobe(26/84,30.95%),frontal lobe(19/84,22.62%),occipital lobe(21/84,25%),temporal lobe(16/84,19.05%),basal ganglia(2/84,2.38%), Infarct with hemorrhages in 1 case.Conclusion Combination with the history of venomous snake bitten, the acute cerebral infarction could be diagnosed by CT and MRI, which had great value in the clinical treatment planning for identifying the intracal hemorrhage.%目的:探讨毒蛇咬伤致急性脑梗死的CT和MRI表现特征。方法对7例毒蛇咬伤致急性脑梗死的影像学表现结合文献进行回顾性分析。结果7例患者,2例五步蛇咬伤,4例蝰蛇咬伤,1例不明毒蛇咬伤。大脑一叶或多叶脑组织内多发散在分布的斑点状、斑片状、片状急性脑梗死。7例共21个脑叶84个急性脑梗死病灶,其中顶叶7个26个病灶(26/84,30.95%)、额叶6个19个病灶(19/84,22.62%)、枕叶4个21个病灶(21/84,25%)、颞叶3个16个病灶(16/84,19.05%)、基底节1个2个病灶(2/84,2.38%),1例合并脑内出血。结论结合毒蛇咬伤史,CT和MRI检查对毒蛇咬伤致急性脑梗死可明确诊断,并明确有无出血,对临床治疗方案提供有价值的信息。

  1. The number of unrecognized myocardial infarction scars detected at DE-MRI increases during a 5-year follow-up

    Energy Technology Data Exchange (ETDEWEB)

    Themudo, Raquel; Johansson, Lars; Ebeling-Barbier, Charlotte; Ahlstroem, Haakan; Bjerner, Tomas [Uppsala University Hospital, Department of Radiology, Uppsala (Sweden); Lind, Lars [Uppsala University Hospital, Department of Medicine, Uppsala (Sweden)

    2017-02-15

    In an elderly population, the prevalence of unrecognized myocardial infarction (UMI) scars found via late gadolinium enhancement (LGE) cardiac magnetic resonance (CMR) imaging was more frequent than expected. This study investigated whether UMI scars detected with LGE-CMR at age 70 would be detectable at age 75 and whether the scar size changed over time. From 248 participants that underwent LGE-CMR at age 70, 185 subjects underwent a follow-up scan at age 75. A myocardial infarction (MI) scar was defined as late enhancement involving the subendocardium. In the 185 subjects that underwent follow-up, 42 subjects had a UMI scar at age 70 and 61 subjects had a UMI scar at age 75. Thirty-seven (88 %) of the 42 UMI scars seen at age 70 were seen in the same myocardial segment at age 75. The size of UMI scars did not differ between age 70 and 75. The prevalence of UMI scars detected at LGE-CMR increases with age. During a 5-year follow-up, 88 % (37/42) of the UMI scars were visible in the same myocardial segment, reassuring that UMI scars are a consistent finding. The size of UMI scars detected during LGE-CMR did not change over time. (orig.)

  2. Modern imaging of the infarct core and the ischemic penumbra in acute stroke patients: CT versus MRI.

    Science.gov (United States)

    Ledezma, Carlos J; Fiebach, Jochen B; Wintermark, Max

    2009-04-01

    Thrombolysis has become an approved therapy for acute stroke. However, many stroke patients do not benefit from such treatment, since the presently used criteria are very restrictive, notably with respect to the accepted time window. Even so, a significant rate of intracranial hemorrhage still occurs. Conventional cerebral computed tomography (CT) without contrast has been proposed as a selection tool for acute stroke patients. However, more-modern MRI and CT techniques, referred to as diffusion- and perfusion-weighted imaging and perfusion-CT, have been introduced, which afford a comprehensive noninvasive survey of acute stroke patients as soon as their emergency admission, with accurate demonstration of the site of arterial occlusion and its hemodynamic and pathophysiological repercussions for the brain parenchyma. The objective of this article is to present the advantages and drawbacks of CT and MRI in the evaluation of acute stroke patients.

  3. [Spinal cord infarction].

    Science.gov (United States)

    Naumann, N; Shariat, K; Ulmer, S; Stippich, C; Ahlhelm, F J

    2012-05-01

    Infarction of the spinal cord can cause a variety of symptoms and neurological deficits because of the complex vascular supply of the myelon. The most common leading symptom is distal paresis ranging from paraparesis to tetraplegia caused by arterial ischemia or infarction of the myelon. Venous infarction, however, cannot always be distinguished from arterial infarction based on the symptoms alone.Modern imaging techniques, such as computed tomography angiography (CTA) and magnetic resonance angiography (MRA) assist in preoperative planning of aortic operations to reliably identify not only the most important vascular structure supplying the spinal cord, the artery of Adamkiewicz, but also other pathologies such as tumors or infectious disorders. In contrast to CT, MRI can reliably depict infarction of the spinal cord.

  4. Improved brain MRI indices in the acute brain stem infarct sites treated with hydroxyl radical scavengers, Edaravone and hydrogen, as compared to Edaravone alone. A non-controlled study

    Directory of Open Access Journals (Sweden)

    Ono Hirohisa

    2011-06-01

    Full Text Available Abstract Background In acute stage of cerebral infarction, MRI indices (rDWI & rADC deteriorate during the first 3-7 days after the ictus and then gradually normalize in approximately 10 days (pseudonormalization time, although the tissue is already infarcted. Since effective treatments improve these indices significantly and in less than the natural pseudonormalization time, a combined analysis of these changes provides an opportunity for objective evaluation on the effectiveness of various treatments for cerebral infarction. Hydroxyl radicals are highly destructive to the tissue and aggravate cerebral infarction. We treated brainstem infarction patients in acute stage with hydroxyl radical scavengers (Edaravone and hydrogen by intravenous administration and evaluated the effects of the treatment by a serial observation and analysis of these MRI indices. The effects of the treatment were evaluated and compared in two groups, an Edaravone alone group and a combined group with Edaravone and hydrogen, in order to assess beneficial effects of addition of hydrogen. Methods The patients were divided in Edaravone only group (E group. 26 patients and combined treatment group with Edaravone and hydrogen enriched saline (EH group. 8 patients. The extent of the initial hump of rDWI, the initial dip of rADC and pseudo-normalization time were determined in each patient serially and averages of these data were compared in these two groups and also with the natural course in the literatures. Results The initial hump of rDWI reached 2.0 in the E group which was better than 2.5 of the natural course but was not as good as 1.5 of the EH group. The initial dip of rADC was 0.6 in the E group which was close to the natural course but worse than 0.8 of the EH group. Pseudonormalization time of rDWI and rADC was 9 days only in EH group but longer in other groups. Addition of hydrogen caused no side effects. Conclusions Administration of hydroxyl radical scavengers in

  5. Final Report: A CdZnTe detector for MRI-compatible SPECT Systems

    Energy Technology Data Exchange (ETDEWEB)

    Meng, Ling-Jian

    2012-12-27

    The key objective of this project is to develop the enabling technology for future MRI-compatible nuclear (e.g. SPECT) imaging system, and to demonstrate the feasibility of performing simultaneous MR and SPECT imaging studies of the same object. During the past three years, we have developed (a) a MRI-compatible ultrahigh resolution gamma ray detector and associated readout electronics, (b) a theoretical approach for modeling the effect of strong magnetic field on SPECT image quality, and (c) a maximum-likelihood (ML) based reconstruction routine with correction for the MR-induced distortion. With this support, we have also constructed a four-head MR-compatible SPECT system and tested the system inside a 3-T clinical MR-scanner located on UI campus. The experimental results obtained with this system have clearly demonstrated that sub-500um spatial resolution can be achieved with a SPECT system operated inside a 3-T MRI scanner. During the past three years, we have accomplished most of the major objectives outlined in the original proposal. These research efforts have laid out a solid foundation the development of future MR-compatible SPECT systems for both pre-clinical and clinical imaging applications.

  6. The role of immediate and final goals in action planning: An fMRI study

    NARCIS (Netherlands)

    Majdandzic, J.; Grol, M.J.; Schie, H.T. van; Verhagen, L.; Toni, I.; Bekkering, H.

    2007-01-01

    To interact effectively with our environment, we need to specify the intended outcomes (goals) of our actions. In this process, immediate goals and final goals can be regarded as different levels within a hierarchically organized system for action planning: immediate goals and movement details are

  7. MRI and CT for diagnosis of early lacunar infarction%MRI和CT两种不同影像学检查方法对早期腔隙性脑梗塞的临床诊断价值分析

    Institute of Scientific and Technical Information of China (English)

    张艳平

    2016-01-01

    Objective To investigate the clinical diagnostic value of MRI and CT in early lacunar infarction.Methods Clinical data of 326 cases of early lacunar infarction underwent CT,MRI examination in our hospital from March 2012 to June 2015 was retrospectively analyzed.Analyzed the diagnosis of all patients by CT and MRI,compared lesion detection rate of two methods,satisfaction on examination time and cost.Results The study reviewed 326 cases of early lacunar infarction,excluding 7 cases on whose image views of experts were not consistent.In other 319 cases,268 lesions were found after plain CT scan,with lesion size about 0.5-1 cm;472 lesions were found after MRI examination,whose size were mostly less than 0.5 cm;there was statistically significant difference between two examination methods (P<0.05).In 319 cases,231 cases were quite satisfied with MRI,with the satisfaction degree of 72.4%;235 cases were quite satisfied with CT,with the satisfaction degree of 73.7%;there was no statistically significant difference between two examination methods (P>0.05).Conclusions In clinical diagnosis of early lacunar infarction patients,MRI is more sensitive than CT,without radiation,with a higher safety factor.But the satisfaction degree on CT of 319 cases is slightly higher than that on MRI,in addition to MRI taking more than ten minutes,some heart and lung failure patients can not tolerate MRI,the main factor is that cost of MRI is much higher than that of CT,showing low-cost and high detection rate account for a large proportion in the heart of patients.Enhancing the sensitivity of CT and reducing the cost of MRI are the next focus of our work.%目的 探讨MRI和CT两种不同影像学对早期腔隙性脑梗塞的临床诊断价值.方法 回顾分析我院2012年3月至2015年6月收治已确诊早期腔隙性脑梗塞并均已经行CT、MRI检查的患者共326例,分析所有患者CT及MRI的诊断结果,对比两种检查方式的病灶检出率,比较患者

  8. Cardiac function, perfusion, metabolism and innervation following autologous stem cell therapy for acute ST-elevation myocardial infarction. A FINCELL-INSIGHT sub-study with PET and MRI

    Directory of Open Access Journals (Sweden)

    Maija T. Mäki

    2012-01-01

    Full Text Available Purpose: Beneficial mechanisms of bone marrow cell (BMC therapy for acute ST-segment elevation myocardial infarct (STEMI are largely unknown in humans. Therefore, we evaluated the feasibility of serial positron emission tomography (PET and MRI studies to provide insight into the effects of BMCs on the healing process of ischemic myocardial damage. Methods: Nineteen patients with successful primary reteplase thrombolysis (mean 2.4 hours after symptoms for STEMI were randomized for BMC therapy (2.9 x 106 CD34+ cells or placebo after bone marrow aspiration in a double-blind, multi-center study. Three days post-MI, coronary angioplasty and paclitaxel eluting stent implantation preceded either BMC or placebo therapy. Cardiac PET and MRI studies were performed 7-12 days after therapies and repeated after six months, and images were analyzed at a central core laboratory. Results: In BMC treated patients, there was a decrease in [11C]-HED defect size (-4.9±4.0% vs. -1.6±2.2%, p=0.08 and an increase in [18F]-FDG uptake in the infarct area at risk (0.06±0.09 vs. -0.05±0.16, p=0.07 compared to controls, as well as less left ventricular dilatation (-4.4±13.3 mL/m2 vs. 8.0±16.7 mL/m2, p=0.12 at six-months follow-up. However, BMC treatment was inferior to placebo in terms of changes in rest perfusion in the area at risk (-0.09±0.17 vs. 0.10±0.17, p=0.03 and infarct size (0.4±4.2 g vs. -5.1±5.9 g, p=0.047, and no effect was observed on ejection fraction (EF (p=0.37. Conclusions: After the acute phase of STEMI, BMC therapy showed only minor trends of long-term benefit in patients with rapid successful thrombolysis. There was a trend of more decrease in innervation defect size and enhanced glucose metabolism in the infarct related myocardium and also a trend of less ventricular dilatation in the BMC treated group compared to placebo. However, no consistently better outcome was observed in the BMC treated group compared to placebo.

  9. Splenic infarction

    Science.gov (United States)

    Splenic infarction is the death of tissue (necrosis) in the spleen due to a blockage in blood flow. ... Common causes of splenic infarction include: Blood clots Blood diseases such as sickle cell anemia Infections such as endocarditis

  10. Digital subtraction angiography in cerebral infarction

    Energy Technology Data Exchange (ETDEWEB)

    Cho, Sin Young; Kim, Ji Hun; Suh, Hong Kil; Kim, Hyo Heon; Kwack, Eun Young; Lee, Il Seong [College of Medicine Hallym University, Seoul (Korea, Republic of)

    1995-01-15

    The usefulness and radiographic findings of the angiography in cerebral infarction are well known. We attempted to evaluate the angiographic causes, findings, and the usefulness of DSA in cerebral infarction. The authors reviewed retrospectively DSA images of 51 patients who were diagnosed as having cerebral infarction by brain CT and/or MRI and clinical settings. DSA was performed in all 51 patients, and in 3 patients, conventional angiogram was also done. Both carotid DSA images were obtained in AP, lateral, oblique projections, and one or both vertebral DSA images in AP and lateral. The authors reviewed the patient's charts for symptoms, operative findings and final diagnosis, and analysed DSA findings of cerebral atherosclerosis with focus on 6 major cerebral arteries. Among the 51 patients of cerebral infarction 43 patients (84.3%) had cerebral atherosclerosis, 1 dissecting aneurysm, 1 moyamoya disease and 6 negative in angiogram. DSA findings of cerebral atherosclerosis were multiple narrowing in 42 patients (97.7%), tortuosity in 22 (51.2%), dilatation in 14, occlusion in 12, avascular region in 8, collaterals in 7, ulcer in 6, and delayed washout of contrast media in 3. In cerebral atherosclerosis, internal carotid artery was involved in 37 patients (86.0%), middle cerebral artery in 29 (67.4%) posterior cerebral artery in 28, anterior cerebral artery in 26, vertebral artery in 22, and basilar artery in 15. Intracranial involvement of cerebral atherosclerosis (64.9%) was more common than extracranial involvement (16.2%). In cerebral infarction MRA may be the screening test, but for more precise evaluation of vascular abnormality and its extent, DSA should be considered.

  11. Pediatric multifocal liver lesions evaluated by MRI

    Directory of Open Access Journals (Sweden)

    Majed Almotairi

    2015-01-01

    Full Text Available Objective: The purpose of this study is to present our experience with MRI evaluation of multifocal liver lesions in children and describe the MRI characteristics of these lesions. Patients and Methods: A retrospective review of consecutive MRI exams performed for the evaluation of multiple liver lesions between 1 January 2007 and 31 December 2012 was done to note the number of lesions, the size of the largest lesion, MR signal characteristics, and background liver. Final diagnosis was assigned to each case based on pathology in the available cases and a combination of clinical features, imaging features, and follow-up in the remaining cases. Results: A total of 48 children (22 boys, 26 girls; age between 3 months and 18 years with average age 10.58 years and median age 11 years were included in the study. Totally 51 lesion diagnoses were seen in 48 children that included 17 focal nodular hyperplasia (FNH, 8 hemangiomas, 7 metastases, 6 regenerative nodules, 3 adenomas, 3 abscesses, and one each of angiomyolipoma, epithelioid hemangioendothelioma, focal fatty infiltration, hepatocellular carcinoma, hepatic infarction, nodular regenerative hyperplasia, and hepatic cyst. Background liver was normal in 33, cirrhotic in 10, fatty in 3, and siderotic in 2 children. Most FNH, hemangiomas, and regenerative nodules showed characteristic MRI features, while metastases were variable in signal pattern. Conclusion: Many commonly seen multifocal liver lesions in children have characteristic MRI features. MRI can help to arrive at reasonable differential diagnoses for multifocal liver lesions in children and guide further investigation and management.

  12. Multimodality imaging of pulmonary infarction

    Energy Technology Data Exchange (ETDEWEB)

    Bray, T.J.P., E-mail: timothyjpbray@gmail.com [Department of Radiology, Papworth Hospital NHS Foundation Trust, Ermine Street, Papworth Everard, Cambridge CB23 3RE (United Kingdom); Mortensen, K.H., E-mail: mortensen@doctors.org.uk [Department of Radiology, Papworth Hospital NHS Foundation Trust, Ermine Street, Papworth Everard, Cambridge CB23 3RE (United Kingdom); University Department of Radiology, Addenbrookes Hospital, Cambridge University Hospitals NHS Foundation Trust, Hills Road, Box 318, Cambridge CB2 0QQ (United Kingdom); Gopalan, D., E-mail: deepa.gopalan@btopenworld.com [Department of Radiology, Papworth Hospital NHS Foundation Trust, Ermine Street, Papworth Everard, Cambridge CB23 3RE (United Kingdom)

    2014-12-15

    Highlights: • A plethora of pulmonary and systemic disorders, often associated with grave outcomes, may cause pulmonary infarction. • A stereotypical infarct is a peripheral wedge shaped pleurally based opacity but imaging findings can be highly variable. • Multimodality imaging is key to diagnosing the presence, aetiology and complications of pulmonary infarction. • Multimodality imaging of pulmonary infarction together with any ancillary features often guide to early targeted treatment. • CT remains the principal imaging modality with MRI increasingly used alongside nuclear medicine studies and ultrasound. - Abstract: The impact of absent pulmonary arterial and venous flow on the pulmonary parenchyma depends on a host of factors. These include location of the occlusive insult, the speed at which the occlusion develops and the ability of the normal dual arterial supply to compensate through increased bronchial arterial flow. Pulmonary infarction occurs when oxygenation is cut off secondary to sudden occlusion with lack of recruitment of the dual supply arterial system. Thromboembolic disease is the commonest cause of such an insult but a whole range of disease processes intrinsic and extrinsic to the pulmonary arterial and venous lumen may also result in infarcts. Recognition of the presence of infarction can be challenging as imaging manifestations often differ from the classically described wedge shaped defect and a number of weighty causes need consideration. This review highlights aetiologies and imaging appearances of pulmonary infarction, utilising cases to illustrate the essential role of a multimodality imaging approach in order to arrive at the appropriate diagnosis.

  13. Hypereosinophilia with Multiple Thromboembolic Cerebral Infarcts and Focal Intracerebral Hemorrhage

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Eun Ju; Lee, Young Jun; Lee, Seung Ro; Park, Dong Woo; Kim, Hyun Young [Hanyang University College of Medicine, Seoul (Korea, Republic of)

    2009-10-15

    We report a case of hypereosinophilia causing multiple areas of cerebral infarcts. A 52-year-old Korean man presented with dysarthria and weakness in both arms. A brain MRI revealed multiple acute infarcts in the distal border zone with focal intracerebral hemorrhage, whereas a cerebral angiogram was not remarkable. The eosinophil count was 5,500/{mu}L and was accompanied by elevated cardiac enzyme levels. The pattern of cerebral infarcts and laboratory results suggest a thromboembolic infarction associated with hypereosinophilia.

  14. Cardiac MRI. T2-mapping versus T2-weighted dark-blood TSE imaging for myocardial edema visualization in acute myocardial infarction

    Energy Technology Data Exchange (ETDEWEB)

    Nassenstein, K.; Nensa, F.; Schlosser, T.; Umutlu, L.; Lauenstein, T. [University Hospital Essen (Germany). Dept. of Diagnostic and Interventional Radiology and Neuroradiology; Bruder, O. [Elisabeth Hospital, Essen (Germany). Dept. of Cardiology and Angiology; Maderwald, S.; Ladd, M.E. [Duisburg-Essen Univ., Essen (Germany). Erwin L. Hahn Institute for Magnetic Resonance Imaging

    2014-02-15

    Purpose: To assess the diagnostic accuracy of T2 mapping for the detection of myocardial edema in acute myocardial infarction (AMI), and to compare this diagnostic accuracy with that of the current standard for myocardial edema imaging, which is T2w dark-blood TSE imaging. Materials and Methods: 29 patients with AMI were examined at 1.5 T. For the visualization of myocardial edema, T2 maps, calculated from three T2w SSFP images, and T2w dark-blood TSE images were acquired in standard short- and long-axis views. Cine SSFP images were acquired for the analysis of left ventricular (LV) function and late gadolinium enhancement images (LGE) for the visualization of myocardial necrosis. The T2 maps as well as the T2w dark-blood TSE images were evaluated twice independently from the cine SSFP and LGE images. The presence or absence of myocardial edema was rated visually for each LV segment. As the standard of reference, the infarct zone was defined based on the cine SSFP and the LGE images. Results: In this segment-based analysis, T2 mapping showed a sensitivity of 82 % and a specificity of 94 % for the detection of edema in the infarct zone. T2w dark-blood TSE imaging revealed a sensitivity of 50 % and a specificity of 98 %. T2 mapping showed a higher intra-rater agreement compared to T2w dark-blood TSE imaging ({kappa}: 0.87 vs. 0.76). Conclusions: T2 mapping allows for the visualization of myocardial edema in AMI with a high sensitivity and specificity, and features better diagnostic accuracy in terms of a higher sensitivity compared to T2w dark-blood TSE imaging. (orig.)

  15. MRI-assisted cervix cancer brachytherapy pre-planning, based on application in paracervical anaesthesia: final report

    Directory of Open Access Journals (Sweden)

    Petric Primoz

    2014-09-01

    Full Text Available Background. Optimal applicator insertion is a precondition for the success of cervix cancer brachytherapy (BT. We aimed to assess feasibility and efficacy of MRI-assisted pre-planning, based on applicator insertion in para-cervical anaesthesia (PCA.

  16. Comparison of visual scoring and quantitative planimetry methods for estimation of global infarct size on delayed enhanced cardiac MRI and validation with myocardial enzymes

    Energy Technology Data Exchange (ETDEWEB)

    Mewton, Nathan, E-mail: nmewton@gmail.com [Hopital Cardiovasculaire Louis Pradel, 28, Avenue Doyen Lepine, 69677 Bron cedex, Hospices Civils de Lyon (France); CREATIS-LRMN (Centre de Recherche et d' Applications en Traitement de l' Image et du Signal), Universite Claude Bernard Lyon 1, UMR CNRS 5220, U 630 INSERM (France); Revel, Didier [Hopital Cardiovasculaire Louis Pradel, 28, Avenue Doyen Lepine, 69677 Bron cedex, Hospices Civils de Lyon (France); CREATIS-LRMN (Centre de Recherche et d' Applications en Traitement de l' Image et du Signal), Universite Claude Bernard Lyon 1, UMR CNRS 5220, U 630 INSERM (France); Bonnefoy, Eric [Hopital Cardiovasculaire Louis Pradel, 28, Avenue Doyen Lepine, 69677 Bron cedex, Hospices Civils de Lyon (France); Ovize, Michel [Hopital Cardiovasculaire Louis Pradel, 28, Avenue Doyen Lepine, 69677 Bron cedex, Hospices Civils de Lyon (France); INSERM Unite 886 (France); Croisille, Pierre [Hopital Cardiovasculaire Louis Pradel, 28, Avenue Doyen Lepine, 69677 Bron cedex, Hospices Civils de Lyon (France); CREATIS-LRMN (Centre de Recherche et d' Applications en Traitement de l' Image et du Signal), Universite Claude Bernard Lyon 1, UMR CNRS 5220, U 630 INSERM (France)

    2011-04-15

    Purpose: Although delayed enhanced CMR has become a reference method for infarct size quantification, there is no ideal method to quantify total infarct size in a routine clinical practice. In a prospective study we compared the performance and post-processing time of a global visual scoring method to standard quantitative planimetry and we compared both methods to the peak values of myocardial biomarkers. Materials and methods: This study had local ethics committee approval; all patients gave written informed consent. One hundred and three patients admitted with reperfused AMI to our intensive care unit had a complete CMR study with gadolinium-contrast injection 4 {+-} 2 days after admission. A global visual score was defined on a 17-segment model and compared with the quantitative planimetric evaluation of hyperenhancement. The peak values of serum Troponin I (TnI) and creatine kinase (CK) release were measured in each patient. Results: The mean percentage of total left ventricular myocardium with hyperenhancement determined by the quantitative planimetry method was (20.1 {+-} 14.6) with a range of 1-68%. There was an excellent correlation between quantitative planimetry and visual global scoring for the hyperenhancement extent's measurement (r = 0.94; y = 1.093x + 0.87; SEE = 1.2; P < 0.001) The Bland-Altman plot showed a good concordance between the two approaches (mean of the differences = 1.9% with a standard deviation of 4.7). Mean post-processing time for quantitative planimetry was significantly longer than visual scoring post-processing time (23.7 {+-} 5.7 min vs 5.0 {+-} 1.1 min respectively, P < 0.001). Correlation between peak CK and quantitative planimetry was r = 0.82 (P < 0.001) and r = 0.83 (P < 0.001) with visual global scoring. Correlation between peak Troponin I and quantitative planimetry was r = 0.86 (P < 0.001) and r = 0.85 (P < 0.001) with visual global scoring. Conclusion: A visual approach based on a 17-segment model allows a rapid

  17. Migrainous infarction

    DEFF Research Database (Denmark)

    Laurell, K; Artto, V; Bendtsen, L

    2011-01-01

    Migrainous infarction (MI), i.e. an ischemic stroke developing during an attack of migraine with aura is rare and the knowledge of its clinical characteristics is limited. Previous case series using the International Classification of Headache Disorders (ICHD) included......Migrainous infarction (MI), i.e. an ischemic stroke developing during an attack of migraine with aura is rare and the knowledge of its clinical characteristics is limited. Previous case series using the International Classification of Headache Disorders (ICHD) included...

  18. Acute bone crises in sickle cell disease: the T1 fat-saturated sequence in differentiation of acute bone infarcts from acute osteomyelitis

    Energy Technology Data Exchange (ETDEWEB)

    Jain, R. [Department of Radiology, College of Medicine, Sultan Qaboos University, Muscat (Oman)], E-mail: rajeevjn@yahoo.com; Sawhney, S. [Department of Radiology, College of Medicine, Sultan Qaboos University, Muscat (Oman); Rizvi, S.G. [Department of Community Medicine and Public Health, College of Medicine, Sultan Qaboos University, Muscat (Oman)

    2008-01-15

    Aim: To prove the hypothesis that acute bone infarcts in sickle cell disease are caused by sequestration of red blood cells (RBCs) in bone marrow, and to evaluate the unenhanced T1 fat-saturated (fs) sequence in the differentiation of acute bone infarction from acute osteomyelitis in patients with sickle-cell disease. Materials and methods: Two studies were undertaken: an experimental study using in-vitro packed red blood cells and normal volunteers, and a retrospective clinical study of 86 magnetic resonance imaging (MRI) studies. For the experimental study containers of packed RBCs were placed between the knees of four healthy volunteers with a saline bag under the containers as an additional control, and were scanned with the pre-contrast T1-fs sequence. Signal intensity (SI) ratios were obtained for packed RBCs:skeletal muscle and packed RBCs:saline. For the clinical study, the SIs of normal bone marrow, packed RBCs, bone and/or soft-tissue lesions, and normal skeletal muscle of 74 patients (86 MRI studies) were measured using unenhanced, T1 fat-saturated MRI. The ratios of the above SIs to normal skeletal muscle were calculated and subjected to statistical analysis. Results: Fifty-one of 86 MRI studies were included in the final analysis. The ratios of SIs for normal bone marrow, packed red cells, bone infarction, acute osteomyelitis, and soft-tissue lesions associated with bone infarct, compared with normal skeletal muscle were (mean {+-} SD) 0.9 {+-} 0.2, 2.1 {+-} 0.7, 1.7 {+-} 0.5, 1.0 {+-} 0.3, and 2.2 {+-} 0.7, respectively. The difference in the ratio of SIs of bone infarcts and osteomyelitis was significant (p = 0.003). The final diagnoses were bone infarction (n = 50), acute osteomyelitis (n = 1), and co-existent bone infarction and osteomyelitis (n = 2). Seven patients who had suspected osteomyelitis underwent image-guided aspiration. Conclusion: Acute bone infarcts in sickle cell disease are caused by sequestration of red blood cells in the bone

  19. Proton and sodium MRI assessment of myocardial viability

    NARCIS (Netherlands)

    Agour, E.N.E.

    2012-01-01

    Objective - Ischemic heart disease is a leading cause of morbidity and mortality worldwide. The current gold standard for assessment of infarct size is late Gd-enhanced MRI (LGE-MRI) However, in particular during the early phase, infarct size is often over-estimated, most likely because of edema. In

  20. Comparison of infarct size changes with delayed contrast-enhanced magnetic resonance imaging and electrocardiogram QRS scoring during the 6 months after acutely reperfused myocardial infarction

    DEFF Research Database (Denmark)

    Bang, L.E.; Ripa, R.S.; Grande, P.

    2008-01-01

    that has infarcted. There are no comparison of serial changes on ECG and DE-MRI measuring infarct size. AIM: The general aim of this study was to describe the acute, healing, and chronic phases of the changes in infarct size estimated by the ECG and DE-MRI. The specific aim was to compare estimates......INTRODUCTION: Magnetic resonance imaging using the delayed contrast-enhanced (DE-MRI) method can be used for characterizing and quantifying myocardial infarction (MI). Electrocardiogram (ECG) score after the acute phase of MI can be used to estimate the portion of left ventricular myocardium...... of the Selvester QRS scoring system and DE-MRI to identify the difference between the extent of left ventricle occupied by infarction in the acute and chronic phases. METHODS: In 31 patients (26 men, age 56 +/- 9) with reperfused ST-elevation MI (11 anterior, 20 inferior), standard 12-lead ECG and DE-MRI were...

  1. Cerebellar infarct patterns: The SMART-Medea study.

    Science.gov (United States)

    De Cocker, Laurens J L; Geerlings, Mirjam I; Hartkamp, Nolan S; Grool, Anne M; Mali, Willem P; Van der Graaf, Yolanda; Kloppenborg, Raoul P; Hendrikse, Jeroen

    2015-01-01

    Previous studies on cerebellar infarcts have been largely restricted to acute infarcts in patients with clinical symptoms, and cerebellar infarcts have been evaluated with the almost exclusive use of transversal MR images. We aimed to document the occurrence and 3D-imaging patterns of cerebellar infarcts presenting as an incidental finding on MRI. We analysed the 1.5 Tesla MRI, including 3D T1-weighted datasets, of 636 patients (mean age 62 ± 9 years, 81% male) from the SMART-Medea study. Cerebellar infarct analyses included an assessment of size, cavitation and gliosis, of grey and white matter involvement, and of infarct topography. One or more cerebellar infarcts (mean 1.97; range 1-11) were detected in 70 out of 636 patients (11%), with a total amount of 138 infarcts identified, 135 of which showed evidence of cavitation. The average mean axial diameter was 7 mm (range 2-54 mm), and 131 infarcts (95%) were smaller than 20 mm. Hundred-thirty-four infarcts (97%) involved the cortex, of which 12 in combination with subcortical white matter. No infarcts were restricted to subcortical branches of white matter. Small cortical infarcts involved the apex of a deep (pattern 1) or shallow fissure (pattern 2), or occurred alongside one (pattern 3) or opposite sides (pattern 4) of a fissure. Most (87%) cerebellar infarcts were situated in the posterior lobe. Small cerebellar infarcts proved to be much more common than larger infarcts, and preferentially involved the cortex. Small cortical infarcts predominantly involved the posterior lobes, showed sparing of subcortical white matter and occurred in characteristic topographic patterns.

  2. Focal cortical thinning is caused by remote subcortical infarcts: spooky action at a distance.

    Science.gov (United States)

    Smith, Eric E; Arboix, Adrià

    2012-11-13

    In this issue of Neurology®, Duering et al.(1) present compelling proof-of-principle evidence that small subcortical infarcts have remote consequences on gray matter volume. Using MRI scans acquired before and after an incident subcortical infarct, they were able to show that the appearance of a new subcortical infarct was associated with cortical thinning in connected brain regions.

  3. Cerebellar cortical infarct cavities and vertebral artery disease

    Energy Technology Data Exchange (ETDEWEB)

    Cocker, Laurens J.L. de [University Medical Center Utrecht, Department of Radiology, Utrecht (Netherlands); Kliniek Sint-Jan Radiologie, Brussels (Belgium); Compter, A.; Kappelle, L.J.; Worp, H.B. van der [University Medical Center Utrecht, Department of Neurology and Neurosurgery, Brain Center Rudolf Magnus, Utrecht (Netherlands); Luijten, P.R.; Hendrikse, J. [University Medical Center Utrecht, Department of Radiology, Utrecht (Netherlands)

    2016-09-15

    Cerebellar cortical infarct cavities are a newly recognised entity associated with atherothromboembolic cerebrovascular disease and worse physical functioning. We aimed to investigate the relationship of cerebellar cortical infarct cavities with symptomatic vertebrobasilar ischaemia and with vascular risk factors. We evaluated the MR images of 46 patients with a recent vertebrobasilar TIA or stroke and a symptomatic vertebral artery stenosis ≥50 % from the Vertebral Artery Stenting Trial (VAST) for the presence of cerebellar cortical infarct cavities ≤1.5 cm. At inclusion in VAST, data were obtained on age, sex, history of vertebrobasilar TIA or stroke, and vascular risk factors. Adjusted risk ratios were calculated with Poisson regression analyses for the relation between cerebellar cortical infarct cavities and vascular risk factors. Sixteen out of 46 (35 %) patients showed cerebellar cortical infarct cavities on the initial MRI, and only one of these 16 patients was known with a previous vertebrobasilar TIA or stroke. In patients with symptomatic vertebrobasilar ischaemia, risk factor profiles of patients with cerebellar cortical infarct cavities were not different from patients without these cavities. Cerebellar cortical infarct cavities are seen on MRI in as much as one third of patients with recently symptomatic vertebral artery stenosis. Since patients usually have no prior history of vertebrobasilar TIA or stroke, cerebellar cortical infarct cavities should be added to the spectrum of common incidental brain infarcts visible on routine MRI. (orig.)

  4. MRI of osteonecrosis

    Energy Technology Data Exchange (ETDEWEB)

    Saini, A. [Department of Radiology, Royal National Orthopaedic Hospital NHS Trust, Stanmore, Middlesex (United Kingdom); Saifuddin, A. [Department of Radiology, Royal National Orthopaedic Hospital NHS Trust, Stanmore, Middlesex (United Kingdom)]. E-mail: asaifuddin@aol.com

    2004-12-01

    Osteonecrosis is a relatively common condition, which may be idiopathic or secondary to a variety of clinical situations. It may involve the subarticular region of a joint, when it is commonly referred to as ischaemic necrosis, or the metaphyseal regions of long bones, when it is referred to as bone infarction. In both situations, early lesions may be radiographically occult. However, magnetic resonance imaging (MRI) is very sensitive in identifying and characterizing osteonecrosis. This review illustrates the varied MRI features of osteonecrosis that enable a confident diagnosis to be made. Complications and differential diagnosis are also considered.

  5. Comparison of arterial spin labeling and dynamic susceptibility contrast perfusion MRI in patients with acute stroke.

    Directory of Open Access Journals (Sweden)

    Yen-Chu Huang

    Full Text Available BACKGROUND: The aim of this study was to evaluate whether arterial spin labeling (ASL perfusion magnetic resonance imaging (MRI can reliably quantify perfusion deficit as compared to dynamic susceptibility contrast (DSC perfusion MRI. METHODS: Thirty-nine patients with acute ischemic stroke in the anterior circulation territory were recruited. All underwent ASL and DSC MRI perfusion scans within 30 hours after stroke onset and 31 patients underwent follow-up MRI scans. ASL cerebral blood flow (CBF and DSC time to maximum (T(max maps were used to calculate the perfusion defects. The ASL CBF lesion volume was compared to the DSC Tmax lesion volume by Pearson's correlation coefficient and likewise the ASL CBF and DSC T(max lesion volumes were compared to the final infarct sizes respectively. A repeated measures analysis of variance and least significant difference post hoc test was used to compare the mean lesion volumes among ASL CBF, DSC T(max >4-6 s and final infarct. RESULTS: Mean patient age was 72.6 years. The average time from stroke onset to MRI was 13.9 hours. The ASL lesion volume showed significant correlation with the DSC lesion volume for T(max >4, 5 and 6 s (r = 0.81, 0.82 and 0.80; p5 s (29.2 ml, p6 s (21.8 ml, p5 or 6 s were close to mean final infarct size. CONCLUSION: Quantitative measurement of ASL perfusion is well correlated with DSC perfusion. However, ASL perfusion may overestimate the perfusion defects and therefore further refinement of the true penumbra threshold and improved ASL technique are necessary before applying ASL in therapeutic trials.

  6. Lacunar infarction:a hemodynamic analysis of 102 cases

    Institute of Scientific and Technical Information of China (English)

    张春玲

    2006-01-01

    Objective To study cerebrovascular lesion and lacunar infarction (LI) and to explore the pathogenesis of LI based on neuroradiological imaging. Methods Brain MRI,CT angiography (CTA) and CT perfusion (CTP) were performed in all 102 patients with LI. Results MRI showed single LI in 3 cases, multiple LI in 99 cases. CTA showed severe stenosis or occlusion of internal

  7. Diagnosis of acute cerebral infarction using diffusion-weighted imaging by low field (0.2 T) magnetic resonance image

    Energy Technology Data Exchange (ETDEWEB)

    Okuyama, Tohru; Sasamori, Yumiko; Takahashi, Hachisaburou; Mikami, Juniti; Ishii, Yuuko; Okada, Kinya; Shirafuji, Naoko; Kashiwakura, Takeshi [Takahashi Neurosurgical Hospital, Sapporo (Japan)

    2000-09-01

    The purpose of this study is to confirm the diagnosis of acute cerebral infarction on diffusion-weighted imaging using low field (0.2 T) magnetic resonance image (MRI). Acute cerebral infarctions in 51 patients were examined on diffusion-weighted imaging using low field MRI within 48 hours after clinical symptoms. Diffusion-weighted imaging was examined using line scan method. Twenty-four cases were cortical infarction, and twenty-two cases were perforating infarction. In five cases out of 51 cases, ischemic regions were not detected as abnormal high signal intensity area on diffusion-weighted imaging. Four cases of no abnormal detection were transient ischemic attack, and the other one was a perforating infarction. The earliest detection time in cortical infarction cases was 1 hour and 20 minutes. On the other hand, the earliest detection time in perforating infarction cases was 3 hours. Detective ability for acute cerebral infarction on diffusion-weighted imaging by low field MRI was depending on both size and lesion of infarction. That is to say, either small size or brain stem infarction was hard to detect. Thin slice and vertical slice examination for the infarction may improve to diagnose in low field MRI. Our conclusion is acute cerebral infarction was able to be diagnosed on diffusion-weighted imaging by low field as well as high field MRI. (author)

  8. Spinal cord infarction: a rare cause of paraplegia.

    Science.gov (United States)

    Patel, Sonali; Naidoo, Khimara; Thomas, Peter

    2014-06-25

    Spinal cord infarction is rare and represents a diagnostic challenge for many physicians. There are few reported cases worldwide with a prevalence of 1.2% of all strokes. Circulation to the spinal cord is supplied by a rich anastomosis. The anterior spinal artery supplies the anterior two thirds of the spinal cord and infarction to this area is marked by paralysis, spinothalamic sensory deficit and loss of sphincter control depending on where the lesion is. Treatment of spinal cord infarction focuses on rehabilitation with diverse outcomes. This report presents a case of acute spinal cord infarction with acquisition of MRI to aid diagnosis.

  9. Brain MRI of diabetes Mellitus

    Energy Technology Data Exchange (ETDEWEB)

    Araki, Yutaka; Tanaka, Hisashi; Ohtani, Masatoshi; Yamamoto, Hiroshi; Yamamoto, Tadashi; Tsukaguchi, Isao (Osaka Rosai Hospital, Sakai (Japan))

    1993-11-01

    One hundred and fifty-nine patients with diabetes mellitus (DM) and 2,566 patients without DM were studied on brain MRI. The results taught us that the incidence of cerebral atrophy was significantly higher in DM patients than in controls. Unexpectedly, the incidence of cerebral infarction showed no significant difference between the two groups. (author).

  10. MRI of the placenta - a short review.

    Science.gov (United States)

    Dekan, Sabine; Linduska, Nina; Kasprian, Gregor; Prayer, Daniela

    2012-05-01

    While ultrasound is still the gold standard method of placental investigation, magnetic resonance imaging (MRI) has certain benefits. In advanced gestational age, obese women, and posterior placental location, MRI is advantageous due to the larger field of view and its multiplanar capabilities. Some pathologies are seen more clearly in MRI, such as infarctions and placental invasive disorders. The future development is towards functional placental MRI. Placental MRI has become an important complementary method for evaluation of placental anatomy and pathologies contributing to fetal problems such as intrauterine growth restriction.

  11. MRI evaluation of vascular dementia

    Institute of Scientific and Technical Information of China (English)

    Yicheng Liu; Hongxing Zhang; Wei Huang; Wenjun Wan; Hongfen Peng

    2006-01-01

    OBJECTTVE: To explain the association between vascular dementia and the cranial MRI manifestations, and recognize the value of cranial MRI in the early diagnosis of vascular dementia and the assessment of disease conditions.DATA SOURCES: Pubmed database was searched to identify articles about the cranial MRI manifestations of patients with vascular dementia published in English from January 1992 to June 2006 by using the key words of "MRI, vascular dementia". Others were collected by searching the name of journals and title of articles in the Chinese full-text journal database.STUDY SELECTTON: The collected articles were primarily checked, those correlated with the cranial MRI manifestations of patients with vascular dementia were selected, while the obviously irrelative ones were excluded, and the rest were retrieved manually, the full-texts were searched.DATA EXTRACTION: Totally 255 articles were collected, 41 of them were involved, and the other 214 were excluded.DATA SYNTHESIS: MRI can be taken as one of the effective methods for the early diagnosis and disease evaluation of vascular dementia. White matter lesions are the important risk factors of vascular dementia.Vascular dementia is accompanied by the atrophy of related brain sites, but further confirmation is needed to investigate whether there is significant difference. MRI can be used to quantitatively investigate the infarcted sites and sizes of patients with vascular dementia after infarction, but there is still lack of systematic investigation on the association of the infarcted sites and sizes with the cognitive function of patients with vascular dementia.CONCLUSTON: Cranial MRI can detect the symptoms of vascular dementia at early period, so that corresponding measures can be adopted to prevent and treat vascular dementia in time.

  12. MRI in psychiatry

    Energy Technology Data Exchange (ETDEWEB)

    Mulert, Christoph [UKE, Hamburg (Germany). Psychiatry Neuroimaging Branch; Shenton, Martha E. (ed.) [Harvard Medical School, Boston, MA (United States). Dept. of Psychiatry and Radiology

    2014-07-01

    This is the first comprehensive textbook on the use of MRI in psychiatry covering imaging techniques, brain systems and a review of findings in different psychiatric disorders. The book is divided into three sections, the first of which covers in detail all the major MRI-based methodological approaches available today, including fMRI, EEG-fMRI, DTI, and MR spectroscopy. In addition, the role of MRI in imaging genetics and combined brain stimulation and imaging is carefully explained. The second section provides an overview of the different brain systems that are relevant for psychiatric disorders, including the systems for perception, emotion, cognition, and reward. The final part of the book presents the MRI findings that are obtained in all the major psychiatric disorders using the previously discussed techniques. Numerous carefully chosen images support the informative text, making this an ideal reference work for all practitioners and trainees with an interest in this flourishing field.

  13. Plasma thrombomodulin changes in acute cerebral infarction or hypertension patients An observation for verification

    Institute of Scientific and Technical Information of China (English)

    Pu Feng; Hui Zhang; Bingyi Yang; Yonggang Zheng; Jinhui Xie; Ying Wang; Jinchuan Li

    2008-01-01

    BACKGROUND: Thrombomodulin concentration greatly increases in plasma when vascular endothelial cells are injured, and it is one of the specific molecular markers for endothelial injury.OBJECTIVE: To analyze the plasma levels of thrombomodulin after cerebral infarction or hypertension, and to compare levels with those from healthy control subjects.DESIGN: A case-controlled observation. SETTING: Yuquan Hospital of Tsinghua University.PARTICIPANTS: Patients with hypertension (n = 37) and acute cerebral infarction (n = 26) were selected from the outpatient and inpatient Department of Neurology, Yuquan Hospital of Tsinghua University from February 2003 to February 2006. The cerebral infarction group consisted of 24 males and 2 females, 36–77 years of age, with a mean age of 62 years. All patients fulfilled the diagnosis criteria for cerebral infarction, according to the diagnostic standards revised by the Second National Academic Meeting for Cerebrovascular Disease, and were confirmed by CT or MRI. The hypertension group consisted of 27 males and 10 females, 36–77 years of age, with a mean age of 56 years. These patients fulfilled the diagnostic criteria for hypertension set by WHO. In addition, 43 healthy physical examinees were selected as the control group, consisting of 23 males and 20 females, 35–67 years of age.Informed consent was obtained from all participants.METHODS: In the cerebral infarction group, thrombomodulin plasma levels were determined by enzyme-linked immunoabsorbent assay at days 1, 3, 7, and 14 after attack. Thrombomodulin plasma levels were determined only once in the hypertension group and the control group. The results from the cerebral infarction group were compared with those from the hypertension group and the control group. MAIN OUTCOME MEASURES: Level of thrombomodulin in plasma.RESULTS: All 63 patients and 43 healthy volunteers were included in the final analysis of results. ① At 7 days after the attack, the plasma levels of

  14. Chest MRI

    Science.gov (United States)

    Nuclear magnetic resonance - chest; Magnetic resonance imaging - chest; NMR - chest; MRI of the thorax; Thoracic MRI ... healthy enough to filter the contrast. During the MRI, the person who operates the machine will watch ...

  15. Determinants and impact of microvascular obstruction in successfully reperfused ST-segment elevation myocardial infarction. Assessment by magnetic resonance imaging

    Energy Technology Data Exchange (ETDEWEB)

    Bogaert, Jan; Kalantzi, Maria; Dymarkowski, Steven [Gasthuisberg University Hospital, Department of Radiology, Leuven (Belgium); Rademakers, Frank E.; Janssens, Stefan [Gasthuisberg University Hospital, Department of Cardiology, Leuven (Belgium)

    2007-10-15

    Microvascular obstruction (MVO) is an important and independent determinant of post-infarct remodeling. Fifty-two patients with a successfully reperfused ST-segment elevation acute myocardial infarction (MI) were studied with MRI in the first week and at 4 months post-infarction. On early (i.e., 2-5 min) post-contrast MRI, MVO was detected in 32 patients with an MVO to infarct ratio of 36.3 {+-} 24.9%. On late (i.e., 10-25 min) post-contrast MRI, MVO was detected in only 27 patients, with an MVO to infarct ratio of 15.9 {+-} 13.9%. MVO infarcts (n = 32) were associated with higher cardiac enzymes (troponin I, P = 0.016), and lower pre-revascularization thrombolysis in myocardial infarction (TIMI) flow (P = 0.018) than non-MVO infarcts (n = 20). Infarct size was larger in MVO infarcts (25.0 {+-} 14.3 g) than non-MVO infarcts (12.5 {+-} 7.9 g), P = 0.0007. Systolic wall thickening in the infarct and peri-infarct area, and left ventricular (LV) ejection fraction (EF) were worse in MVO (46.1 {+-} 7.2%) than non-MVO infarcts (50.5 {+-} 6.6%, P = 0.038). At 4 months, MVO infarcts showed more adverse remodeling and lack of functional improvement, whereas non-MVO infarcts improved significantly (LV EF at 4 months, MVO, 47.5 {+-} 7.8%, P = 0.31; non-MVO, 55.2 {+-} 10.3%, P = 0.0028). In the majority of patients with successfully reperfused ST-segment elevation MI, MVO is observed, whose present and maximal extent can be best evaluated on early post-contrast MRI. Presence of MVO is associated with more extensive infarctions, and characterized by greater adverse LV remodeling and lack of functional recovery. (orig.)

  16. MR imaging findings in diabetic muscle infarction.

    Science.gov (United States)

    Bajaj, Gitanjali; Nicholas, Richard; Pandey, Tarun; Montgomery, Corey; Jambhekar, Kedar; Ram, Roopa

    2014-10-01

    Diabetic muscle infarction is a rare, often unrecognized complication seen in patients with poorly controlled Diabetes Mellitus. The diagnosis is often missed and leads to unnecessary invasive investigations and inappropriate treatment. The patients usually present with unilateral thigh pain and swelling. MRI typically demonstrates diffuse swelling and increased T2 signal intensity within the affected muscles. The condition is self-limiting and is treated conservatively with bed rest and analgesics. Recurrences have been reported in the same or contralateral limb. We report a case of diabetic muscle infarction with spontaneous resolution of symptoms and imaging abnormality with recurrence on the contralateral side.

  17. Microscopic and macroscopic infarct complicating pediatric epilepsy surgery.

    Science.gov (United States)

    Rubinger, Luc; Hazrati, Lili-Naz; Ahmed, Raheel; Rutka, James; Snead, Carter; Widjaja, Elysa

    2017-03-01

    There is some suggestion that microscopic infarct could be associated with invasive monitoring, but it is unclear if the microscopic infarct is also visible on imaging and associated with neurologic deficits. The aims of this study were to assess the rates of microscopic and macroscopic infarct and other major complications of pediatric epilepsy surgery, and to determine if these complications were higher following invasive monitoring. We reviewed the epilepsy surgery data from a tertiary pediatric center, and collected data on microscopic infarct on histology and macroscopic infarct on postoperative computed tomography (CT) or magnetic resonance imaging (MRI) done one day after surgery and major complications. Three hundred fifty-two patients underwent surgical resection and there was one death. Forty-two percent had invasive monitoring. Thirty patients (9%) had microscopic infarct. Univariable analyses showed that microscopic infarct was higher among patients with invasive monitoring relative to no invasive monitoring (20% vs. 0.5%, respectively, p microscopic infarct had transient right hemiparesis, and two with both macroscopic and microscopic infarct had unexpected persistent neurologic deficits. Thirty-two major complications (9.1%) were reported, with no difference in major complications between invasive monitoring and no invasive monitoring (10% vs. 7%, p = 0.446). In the multivariable analysis, invasive monitoring increased the odds of microscopic infarct (odds ratio [OR] 15.87, p = 0.009), but not macroscopic infarct (OR 2.6, p = 0.173) or major complications (OR 1.4, p = 0.500), after adjusting for age at surgery, sex, age at seizure onset, operative type, and operative location. Microscopic infarct was associated with invasive monitoring, and none of the patients had permanent neurologic deficits. Macroscopic infarct was not associated with invasive monitoring, and two patients with macroscopic infarct had persistent neurologic deficits. Wiley

  18. Assessment of ischemic penumbra in patients with hyperacute stroke using amide proton transfer (APT) chemical exchange saturation transfer (CEST) MRI.

    Science.gov (United States)

    Tietze, Anna; Blicher, Jakob; Mikkelsen, Irene Klaerke; Østergaard, Leif; Strother, Megan K; Smith, Seth A; Donahue, Manus J

    2014-02-01

    Chemical exchange saturation transfer (CEST)-derived, pH-weighted, amide proton transfer (APT) MRI has shown promise in animal studies for the prediction of infarction risk in ischemic tissue. Here, APT MRI was translated to patients with acute stroke (1-24 h post-symptom onset), and assessments of APT contrast, perfusion, diffusion, disability and final infarct volume (23-92 days post-stroke) are reported. Healthy volunteers (n = 5) and patients (n = 10) with acute onset of symptoms (0-4 h, n = 7; uncertain onset diffusion- and perfusion-weighted MRI, fluid-attenuated inversion recovery (FLAIR) and CEST. Traditional asymmetry and a Lorentzian-based APT index were calculated in the infarct core, at-risk tissue (time-to-peak, TTP; lengthening) and final infarct volume. On average (mean ± standard deviation), control white matter APT values (asymmetry, 0.019 ± 0.005; Lorentzian, 0.045 ± 0.006) were not significantly different (p > 0.05) from APT values in normal-appearing white matter (NAWM) of patients (asymmetry, 0.022 ± 0.003; Lorentzian, 0.048 ± 0.003); however, ischemic regions in patients showed reduced (p = 0.03) APT effects compared with NAWM. Representative cases are presented, whereby the APT contrast is compared quantitatively with contrast from other imaging modalities. The findings vary between patients; in some patients, a trend for a reduction in the APT signal in the final infarct region compared with at-risk tissue was observed, consistent with tissue acidosis. However, in other patients, no relationship was observed in the infarct core and final infarct volume. Larger clinical studies, in combination with focused efforts on sequence development at clinically available field strengths (e.g. 3.0 T), are necessary to fully understand the potential of APT imaging for guiding the hyperacute management of patients.

  19. Novel adjunctive treatments of myocardial infarction

    DEFF Research Database (Denmark)

    Schmidt, Michael Rahbek; Pryds, Kasper; Bøtker, Hans Erik

    2014-01-01

    Myocardial infarction is a major cause of death and disability worldwide and myocardial infarct size is a major determinant of prognosis. Early and successful restoration of myocardial reperfusion following an ischemic event is the most effective strategy to reduce final infarct size and improve...... by endovascular infusion of cold saline all reduce infarct size and may confer clinical benefit for patients admitted with acute myocardial infarcts. Equally promising, three follow-up studies of the effect of remote ischemic conditioning (RIC) show clinical prognostic benefit in patients undergoing coronary...... clinical outcome, but reperfusion may induce further myocardial damage itself. Development of adjunctive therapies to limit myocardial reperfusion injury beyond opening of the coronary artery gains increasing attention. A vast number of experimental studies have shown cardioprotective effects of ischemic...

  20. MRI and low back pain

    Science.gov (United States)

    Backache - MRI; Low back pain - MRI; Lumbar pain - MRI; Back strain - MRI; Lumbar radiculopathy - MRI; Herniated intervertebral disk - MRI; Prolapsed intervertebral disk - MRI; Slipped disk - MRI; Ruptured ...

  1. The 'silence' of silent brain infarctions may be related to chronic ischemic preconditioning and nonstrategic locations rather than to a small infarction size.

    Science.gov (United States)

    Feng, Chao; Bai, Xue; Xu, Yu; Hua, Ting; Liu, Xue-Yuan

    2013-01-01

    Silent brain infarctions are the silent cerebrovascular events that are distinguished from symptomatic lacunar infarctions by their 'silence'; the origin of these infarctions is still unclear. This study analyzed the characteristics of silent and symptomatic lacunar infarctions and sought to explore the mechanism of this 'silence'. In total, 156 patients with only silent brain infarctions, 90 with only symptomatic lacunar infarctions, 160 with both silent and symptomatic lacunar infarctions, and 115 without any infarctions were recruited. Vascular risk factors, leukoaraiosis, and vascular assessment results were compared. The National Institutes of Health Stroke Scale scores were compared between patients with only symptomatic lacunar infarctions and patients with two types of infarctions. The locations of all of the infarctions were evaluated. The evolution of the two types of infarctions was retrospectively studied by comparing the infarcts on the magnetic resonance images of 63 patients obtained at different times. The main risk factors for silent brain infarctions were hypertension, age, and advanced leukoaraiosis; the main factors for symptomatic lacunar infarctions were hypertension, atrial fibrillation, and atherosclerosis of relevant arteries. The neurological deficits of patients with only symptomatic lacunar infarctions were more severe than those of patients with both types of infarctions. More silent brain infarctions were located in the corona radiata and basal ganglia; these locations were different from those of the symptomatic lacunar infarctions. The initial sizes of the symptomatic lacunar infarctions were larger than the silent brain infarctions, whereas the final sizes were almost equal between the two groups. Chronic ischemic preconditioning and nonstrategic locations may be the main reasons for the 'silence' of silent brain infarctions.

  2. The 'silence' of silent brain infarctions may be related to chronic ischemic preconditioning and nonstrategic locations rather than to a small infarction size

    Directory of Open Access Journals (Sweden)

    Chao Feng

    2013-01-01

    Full Text Available OBJECTIVE: Silent brain infarctions are the silent cerebrovascular events that are distinguished from symptomatic lacunar infarctions by their 'silence'; the origin of these infarctions is still unclear. This study analyzed the characteristics of silent and symptomatic lacunar infarctions and sought to explore the mechanism of this 'silence'. METHODS: In total, 156 patients with only silent brain infarctions, 90 with only symptomatic lacunar infarctions, 160 with both silent and symptomatic lacunar infarctions, and 115 without any infarctions were recruited. Vascular risk factors, leukoaraiosis, and vascular assessment results were compared. The National Institutes of Health Stroke Scale scores were compared between patients with only symptomatic lacunar infarctions and patients with two types of infarctions. The locations of all of the infarctions were evaluated. The evolution of the two types of infarctions was retrospectively studied by comparing the infarcts on the magnetic resonance images of 63 patients obtained at different times. RESULTS: The main risk factors for silent brain infarctions were hypertension, age, and advanced leukoaraiosis; the main factors for symptomatic lacunar infarctions were hypertension, atrial fibrillation, and atherosclerosis of relevant arteries. The neurological deficits of patients with only symptomatic lacunar infarctions were more severe than those of patients with both types of infarctions. More silent brain infarctions were located in the corona radiata and basal ganglia; these locations were different from those of the symptomatic lacunar infarctions. The initial sizes of the symptomatic lacunar infarctions were larger than the silent brain infarctions, whereas the final sizes were almost equal between the two groups. CONCLUSIONS: Chronic ischemic preconditioning and nonstrategic locations may be the main reasons for the 'silence' of silent brain infarctions.

  3. Intracoronary cardiosphere-derived cells after myocardial infarction: evidence of therapeutic regeneration in the final 1-year results of the CADUCEUS trial (CArdiosphere-Derived aUtologous stem CElls to reverse ventricUlar dySfunction).

    Science.gov (United States)

    Malliaras, Konstantinos; Makkar, Raj R; Smith, Rachel R; Cheng, Ke; Wu, Edwin; Bonow, Robert O; Marbán, Linda; Mendizabal, Adam; Cingolani, Eugenio; Johnston, Peter V; Gerstenblith, Gary; Schuleri, Karl H; Lardo, Albert C; Marbán, Eduardo

    2014-01-21

    This study sought to report full 1-year results, detailed magnetic resonance imaging analysis, and determinants of efficacy in the prospective, randomized, controlled CADUCEUS (CArdiosphere-Derived aUtologous stem CElls to reverse ventricUlar dySfunction) trial. Cardiosphere-derived cells (CDCs) exerted regenerative effects at 6 months in the CADUCEUS trial. Complete results at the final 1-year endpoint are unknown. Autologous CDCs (12.5 to 25 × 10(6)) grown from endomyocardial biopsy specimens were infused via the intracoronary route in 17 patients with left ventricular dysfunction 1.5 to 3 months after myocardial infarction (MI) (plus 1 infused off-protocol 14 months post-MI). Eight patients were followed as routine-care control patients. In 13.4 months of follow-up, safety endpoints were equivalent between groups. At 1 year, magnetic resonance imaging revealed that CDC-treated patients had smaller scar size compared with control patients. Scar mass decreased and viable mass increased in CDC-treated patients but not in control patients. The single patient infused 14 months post-MI responded similarly. CDC therapy led to improved regional function of infarcted segments compared with control patients. Scar shrinkage correlated with an increase in viability and with improvement in regional function. Scar reduction correlated with baseline scar size but not with a history of temporally remote MI or time from MI to infusion. The changes in left ventricular ejection fraction in CDC-treated subjects were consistent with the natural relationship between scar size and ejection fraction post-MI. Intracoronary administration of autologous CDCs did not raise significant safety concerns. Preliminary indications of bioactivity include decreased scar size, increased viable myocardium, and improved regional function of infarcted myocardium at 1 year post-treatment. These results, which are consistent with therapeutic regeneration, merit further investigation in future trials

  4. CT findings of early acute cerebral infarction

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Tae Hoon; Choi, Woo Suk; Ryu, Kyung Nam [Kyung Hee University Hospital, Seoul (Korea, Republic of)

    1992-11-15

    The CT findings of the acute cerebral infarction are well known. However the CT findings of early stroke within 24 hours of the onset have not been sufficiently reported. The purpose of this study is to evaluate early acute cerebral infarction on CT within 24 hours after ictus. The early and accurate CT diagnosis could lead to the appropriate therapy and improved outcome of the patients. Authors retrospectively analyzed 16 patients with early acute cerebral infarction. Acute cerebral infarction was confirmed by follow-up CT in 11 patients, SPECT in 4 patients, and MRI in 1 patient. The CT findings of early acute cerebral infarction include effacement of cortical sulci or cistern (n = 16, 100%), hyperattenuation of MCA (n = 3), obscuration of lentiform nucleus (n = 6), loss of insular ribbon (n = 6) and subtle low density in hemisphere (n = 5). The most frequent finding was effacement of cortical sulci in our study, and it was thought to be the most important sign of early acute cerebral infarction.

  5. Hyperintense Acute Reperfusion Marker on FLAIR in Posterior Circulation Infarction.

    Directory of Open Access Journals (Sweden)

    Alex Förster

    Full Text Available In the present study, we aimed to investigate the frequency of blood brain barrier injury in posterior circulation infarction as demonstrated by the hyperintense acute reperfusion marker (HARM on fluid attenuated inversion recovery images (FLAIR.From a MRI report database we identified patients with posterior circulation infarction who underwent MRI, including perfusion-weighted images (PWI, within 12 hours after onset and follow-up MRI within 24 hours and analyzed diffusion-weighted images (DWI, PWI, FLAIR, and MR angiography (MRA. On FLAIR images, the presence of HARM was noted by using pre-specified criteria (focal enhancement in the subarachnoid space and/or the ventricles.Overall 16 patients (median age of patients 68.5 (IQR 55.5-82.75 years with posterior circulation infarction were included. Of these, 13 (81.3% demonstrated PCA occlusion, and 3 (18.7% patients BA occlusion on MRA. Initial DWI demonstrated ischemic lesions in the thalamus (68.8%, splenium (18.8%, hippocampus (75%, occipital lobe (81.3%, mesencephalon (18.8%, pons (18.8%, and cerebellum (50%. On follow-up MRA recanalization was noted in 10 (62.5% patients. On follow-up FLAIR images, HARM was observed in 8 (50% patients. In all of these, HARM was detected remote from the acute ischemic lesion. HARM was more frequently observed in patients with vessel recanalization (p = 0.04, minor infarction growth (p = 0.01, and smaller ischemic lesions on follow-up DWI (p = 0.05.HARM is a frequent finding in posterior circulation infarction and associated with vessel recanalization, minor infarction growth as well as smaller infarction volumes in the course. Neuroradiologists should be cognizant of the fact that HARM may be present on short interval follow-up FLAIR images in patients with acute ischemic infarction who initially underwent MRI and received intravenous gadolinium-based contrast agents.

  6. Temporal evolution of ischemic lesions in nonhuman primates: a diffusion and perfusion MRI study.

    Directory of Open Access Journals (Sweden)

    Xiaodong Zhang

    Full Text Available Diffusion-weighted imaging (DWI and perfusion MRI were used to examine the spatiotemporal evolution of stroke lesions in adult macaques with ischemic occlusion.Permanent MCA occlusion was induced with silk sutures through an interventional approach via the femoral artery in adult rhesus monkeys (n = 8, 10-21 years old. The stroke lesions were examined with high-resolution DWI and perfusion MRI, and T2-weighted imaging (T2W on a clinical 3T scanner at 1-6, 48, and 96 hours post occlusion and validated with H&E staining.The stroke infarct evolved via a natural logarithmic pattern with the mean infarct growth rate = 1.38 ± 1.32 ml per logarithmic time scale (hours (n = 7 in the hyperacute phase (1-6 hours. The mean infarct volume after 6 hours post occlusion was 3.6±2.8 ml (n = 7, by DWI and increased to 3.9±2.9 ml (n = 5, by T2W after 48 hours, and to 4.7±2.2ml (n = 3, by T2W after 96 hours post occlusion. The infarct volumes predicted by the natural logarithmic function were correlated significantly with the T2W-derived lesion volumes (n = 5, r = 0.92, p = 0.01 at 48 hours post occlusion. The final infarct volumes derived from T2W were correlated significantly with those from H&E staining (r = 0.999, p < 0.0001, n = 4. In addition, the diffusion-perfusion mismatch was visible generally at 6 hours but nearly diminished at 48 hours post occlusion.The infarct evolution follows a natural logarithmic pattern in the hyperacute phase of stroke. The logarithmic pattern of evolution could last up to 48 hours after stroke onset and may be used to predict the infarct volume growth during the acute phase of ischemic stroke. The nonhuman primate model, MRI protocols, and post data processing strategy may provide an excellent platform for characterizing the evolution of acute stroke lesion in mechanistic studies and therapeutic interventions of stroke disease.

  7. Impaired Sacculocollic Reflex in Lateral Medullary Infarction

    OpenAIRE

    Seonhye eKim; Hyo-Jung eKim; Ji Soo eKim

    2011-01-01

    Objective: The aim of this study was to determine saccular dysfunction by measuring cervical vestibular-evoked myogenic potentials (cVEMP) and to correlate abnormality of cVEMP with results of other vestibular function tests in lateral medullary infarction (LMI). Methods: We recorded cVEMP in 21 patients with LMI documented on MRI. cVEMP was induced by a short tone burst and was recorded in contracting sternocleidomastoid muscle while patients turned their heads forcefully to the contralatera...

  8. Intestinal ischemia and infarction

    Science.gov (United States)

    ... medlineplus.gov/ency/article/001151.htm Small intestinal ischemia and infarction To use the sharing features on this page, please enable JavaScript. Intestinal ischemia and infarction occurs when there is a narrowing ...

  9. Sickle cell disease with orbital infarction and epidural hematoma

    Energy Technology Data Exchange (ETDEWEB)

    Naran, A.D.; Fontana, L. [Dept. of Diagnostic Radiology, New York Methodist Hospital, Brooklyn, NY (United States)

    2001-04-01

    Although bone infarction is a common feature in sickle cell disease, the involvement of the orbit is an unusual complication. Intracranial bleeding is another uncommon and serious complication. Few cases of orbital infarction alone have been reported. We report imaging findings (CT, bone scan, MRI) in a 16-year-old boy with sickle cell disease with orbital infarction and epidural hematoma. The precise cause of epidural hematoma is not well known, but it is probably related to vaso-occlusive episodes and the tearing of small vessels. (orig.)

  10. Classification of myocardial infarction

    DEFF Research Database (Denmark)

    Saaby, Lotte; Poulsen, Tina Svenstrup; Hosbond, Susanne Elisabeth

    2013-01-01

    The classification of myocardial infarction into 5 types was introduced in 2007 as an important component of the universal definition. In contrast to the plaque rupture-related type 1 myocardial infarction, type 2 myocardial infarction is considered to be caused by an imbalance between demand...... and supply of oxygen in the myocardium. However, no specific criteria for type 2 myocardial infarction have been established....

  11. Orbital wall infarction mimicking periorbital cellulitis in a patient with sickle cell disease

    Energy Technology Data Exchange (ETDEWEB)

    Ozkavukcu, Esra; Fitoz, Suat; Erden, Ilhan [Ankara University School of Medicine, Department of Radiology, Ankara (Turkey); Yagmurlu, Banu [Kirikkale University School of Medicine, Department of Radiology, Kirikkale (Turkey); Ciftci, Ergin [Ankara University School of Medicine, Department of Paediatric Infectious Diseases, Ankara (Turkey); Ertem, Mehmet [Ankara University School of Medicine, Department of Paediatric Haematology, Ankara (Turkey)

    2007-04-15

    Orbital wall infarction and subperiosteal haematomas are unusual manifestations of sickling disorders. Here we report an 11-year-old girl with sickle cell anaemia having multiple skull infarctions including the orbital bony structures associated with subperiosteal haematomas. The diagnosis was made by MRI, which showed bone marrow changes and associated haemorrhagic collections. The patient was successfully managed without surgical intervention. (orig.)

  12. MRI Scans

    Science.gov (United States)

    Magnetic resonance imaging (MRI) uses a large magnet and radio waves to look at organs and structures inside your body. Health care professionals use MRI scans to diagnose a variety of conditions, from ...

  13. Shoulder MRI

    Science.gov (United States)

    ... MRI scanners are air-conditioned and well-lit. Music may be played through the headphones to help ... that magnetic resonance imaging harms the fetus, pregnant women usually are advised not to have an MRI ...

  14. Moyamoya disease: diagnostic accuracy of MRI.

    Science.gov (United States)

    Yamada, I; Suzuki, S; Matsushima, Y

    1995-07-01

    Our purpose was to evaluate the diagnostic accuracy of MRI in moyamoya disease. We studied 30 patients with this disease, comparing MRI and angiographic findings. The diagnostic value of MRI was evaluated for occlusive lesions, collateral vessels, and parenchymal lesions. In all patients bilateral occlusion or stenosis of the supraclinoid internal carotid artery and proximal anterior and middle cerebral arteries was clearly shown by MRI, and staging of the extent of occlusion agreed with angiographic staging in 44 (73%) of 60 arteries. MRI, particularly coronal images, clearly showed basal cerebral moyamoya vessels in 54 hemispheres, and 45 of a total of 71 large leptomeningeal and transdural collateral vessels were identified. MRI also showed parenchymal lesions in 48 (80%) hemispheres, and the extent of occlusion in the anterior and posterior circulations respectively correlated with white matter and cortical and/or subcortical infarcts.

  15. The time of maximum post-ischemic hyperperfusion indicates infarct growth following transient experimental ischemia.

    Directory of Open Access Journals (Sweden)

    Susanne Wegener

    Full Text Available After recanalization, cerebral blood flow (CBF can increase above baseline in cerebral ischemia. However, the significance of post-ischemic hyperperfusion for tissue recovery remains unclear. To analyze the course of post-ischemic hyperperfusion and its impact on vascular function, we used magnetic resonance imaging (MRI with pulsed arterial spin labeling (pASL and measured CBF quantitatively during and after a 60 minute transient middle cerebral artery occlusion (MCAO in adult rats. We added a 5% CO2 - challenge to analyze vasoreactivity in the same animals. Results from MRI were compared to histological correlates of angiogenesis. We found that CBF in the ischemic area recovered within one day and reached values significantly above contralateral thereafter. The extent of hyperperfusion changed over time, which was related to final infarct size: early (day 1 maximal hyperperfusion was associated with smaller lesions, whereas a later (day 4 maximum indicated large lesions. Furthermore, after initial vasoparalysis within the ischemic area, vasoreactivity on day 14 was above baseline in a fraction of animals, along with a higher density of blood vessels in the ischemic border zone. These data provide further evidence that late post-ischemic hyperperfusion is a sequel of ischemic damage in regions that are likely to undergo infarction. However, it is transient and its resolution coincides with re-gaining of vascular structure and function.

  16. Hyperfixation of Tc-99m ECD in subacute cortical infarction

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Jae Seung; Kweon, Sun Uck; Ryu, Jin Sook; Moon, Dae Hyuk; Lee, Hee Kyung [College of Medicine, Ulsan Univ., Seoul (Korea, Republic of)

    2001-07-01

    It has been known that hyperfixation of Tc-99m ECD (HF) is not shown in subacute cerebral infarction because the brain distribution of Tc-99m ECD reflects not only perfusion but also the metabolic status of brain tissue. However, we observed several cases with HF in the subacute pure cortical infarction. To find out the cause of HF in subacute cortical infarction. We assessed the difference in associated cerebral hemodynamics and clinical findings between the subacute cortical infarctions with and without HF. We reviewed 16 patients (63.8{+-}8.6 yr, M/F: 15/1) with pure cortical infarction not involving adjacent subcortical white matter on MRI. All patients underwent acetazolamide stress brain perfusion SPECT using Tc-99m ECD and MRI at subacute period (7.3{+-}4.4 days from ictus). Uptake of Tc-99m ECD in infarcted cortex was assessed visually comparing the contralateral side. To assess the difference in associate clinical findings between the infarctions with and without HF, rCVR of the cerebral territory including infarcted cortex, extent of Gd-enhancement on MRI. Intervals between SPECT and ictus, and the presence of associated ICA stenosis were evaluated. Infarctions were focal (n=8) or multifocal (n=8) and located in frontoparietal cortices on MRI. Twelve patients were accompanied with ipsilateral ICA stenosis. Resting SPECT showed increased cortical uptake (=HF) in 7 patients and decreased in 9. rCVR of the MCA territory was preserved in all of the 7 patients with HF, compared with 4 of the 9 patients without HF (p=0.03). Gd-enhancement was minimal in all of the 7 patients with HF, compared with of the 0 patients without HF (p=0.03). Presence of ipsilateral ICA stenosis and intervals from ictus were not different (p>0.1) Subacute cerebral cortical infarction with HF was more frequently associated with preserved rCVR and minimal destruction of the blood-brain barrier than that without HF. Our findings suggest that HF may result from luxury perfusion of

  17. MRI Study of Hypoperfusion in Contralateral Cerebellar Hemisphere after Supratentorial Cerebral Infarction%幕上脑梗死后对侧小脑半球低灌注的磁共振成像研究

    Institute of Scientific and Technical Information of China (English)

    王琳琳; 程敬亮; 张勇; 王斐斐; 孟云; 张文博; 杨子涛; 杨运俊

    2011-01-01

    Objective To evaluate the value of MR perfusion weighted imaging( PWI ) for the changes of contralateral cerebellar hemisphere after acute infarction of unilateral supratentorial middle cerebral artery blood-supply area. Materials and Methods Collect 38 patients of supratentorial acute cerebral infarction with bilateral cerebellar hemisphere perfusion weighted imaging, to judge perfusion change of lesions contralateral cerebellum after supratentorial cerebral infarction by measuring the bilateral cerebellum involving relative cerebral blood volume (rCBV), relative cerebral blood flow (rCBF)and relative mean transit time (rMTI) and relative time to peak(rTTP). Results 38 patients, 16 cases(42% ) involving contralateral cerebellum the rTTP prolonged and compared with ipsilateral extend about ( 133.28± 70.25 ) %; compared with ipsilateral rMTT extend about ( 82.78 ± 91.22 ) %, but without statistical significance ( P = 0.112, P > 0. 05 ); compared with ipsilateral rCBF decrease about (53.74 ±41.56)% ;compared with ipsilateral rCBV decrease about ( 100.58 ±91.72) %. to measured cerebral hemisphere infarcted volume in DWI imaging, to calculate correlation of primary inrarction focal volume with lesions contralateral cerebellum hypoperfusion. Conclusion Partial patients with supratentorial cerebral infarction can cause contralateral cerebellum hypoperfusion, and related with the volume of primary focal infarction, indicating that these patients may crossed cerebellar diaschisis.%目的 探讨磁共振灌注成像评价急性期单侧幕上大脑中动脉区脑梗死后对侧小脑半球灌注量改变的诊断价值.资料与方法 搜集 38 例幕上急性期脑梗死患者进行双侧小脑半球磁共振灌注成像(perfusion-weightedimaging,PWI),通过测量双侧小脑半球相对脑血容量(relalive cerebral blood volume,rCBV)、相对脑血流量(relalivecerebral blood flow,rCBF)和平均通过时间(relalive mean transit time

  18. Combined PET/MRI

    DEFF Research Database (Denmark)

    Bailey, D. L.; Pichler, B. J.; Gückel, B.

    2015-01-01

    This paper summarises key themes and discussions from the 4th international workshop dedicated to the advancement of the technical, scientific and clinical applications of combined positron emission tomography (PET)/magnetic resonance imaging (MRI) systems that was held in Tübingen, Germany, from...... February 23 to 27, 2015. Specifically, we summarise the three days of invited presentations from active researchers in this and associated fields augmented by round table discussions and dialogue boards with specific topics. These include the use of PET/MRI in cardiovascular disease, paediatrics, oncology......, neurology and multi-parametric imaging, the latter of which was suggested as a key promoting factor for the wider adoption of integrated PET/MRI. Discussions throughout the workshop and a poll taken on the final day demonstrated that attendees felt more strongly that PET/MRI has further advanced in both...

  19. Spontaneous carotid artery dissection causing a juvenile cerebral infarction

    Energy Technology Data Exchange (ETDEWEB)

    Trattnig, S.; Huebsch, P.; Schindler, E.

    1988-11-01

    The case of a 19-year-old patient is presented who was admitted with aphasia and hemiparesis due to basal ganglia infarction as a result of spontaneous dissection of the internal carotid artery. The difficulties in diagnosing this disease with CT and MRI in the acute stage are demonstrated. Angiography is still imperative in order to ascertain that a carotid dissection has occurred.

  20. Trismus as manifestation of bilateral internal capsule genu infarction

    NARCIS (Netherlands)

    Aries, M.J.H.; Vroomen, Patrick C. A. J.; van der Hoeven, Johannes H.; De Keyser, Jacques

    Acute trismus can have different causes. We describe the presentation, course and radiological findings of a 34-year-old man who developed acute trismus and MRI findings consistent with the combination of an old and fresh infarction in the genu of the internal capsule. We believe it is important to

  1. Clinical utility and limitation of MRI in neuroradiology

    Energy Technology Data Exchange (ETDEWEB)

    Aoki, Shigeki (Tokyo Metropolitan Komagome Hospital (Japan)); Machida, Tohru; Shirouzu, Ichirou; Ohkubo, Toshiyuki; Sasaki, Yasushi

    1992-11-01

    Magnetic resonance imaging (MRI) has several advantages over computed tomography in the neuroradiological field: it provids biochemical information, images in any plane without bone artifacts, and superior contrast between gray matter and white matter. It is, however, of limited availability because of longer imaging time, poor spatial resolution, and poor visualization of calcification and the bone. In this review, pathophysiology that shows relatively characteristic signal intensity is described, including hemorrhage, fat, protein-rich cyst, calcification, iron, and posterior pituitary gland. The utility and limitation of MRI are discussed in terms of the following diseases and lesion sites: small tumors in the skull base; demyelination of white matter or degenerative disease; cerebral infarction or cerebral ischemic disease; intramedullary lesion; meningeal lesion; and pediatric diseases such as medullary sheath formation and malformation. Finally, recent advance and future perspectives of MRI are presented, focusing on 3-dimensional imaging, MR angiography, fat-suppression MR imaging, MR spectroscopy, intravoxel incoherent motion imaging, imaging time, and spatial resolution. (N.K.) 82 refs.

  2. Comparison of Selvester QRS score with magnetic resonance imaging measured infarct size in patients with ST elevation myocardial infarction

    DEFF Research Database (Denmark)

    Carlsen, Esben A; Bang, Lia E; Ahtarovski, Kiril A;

    2012-01-01

    Recent studies have shown that the Selvester QRS score is significantly correlated with delayed enhancement-magnetic resonance imaging (DE-MRI) measured myocardial infarct (MI) size in reperfused ST elevation MI (STEMI). This study further tests the hypothesis that Selvester QRS score correlates ...

  3. Prediction of subacute infarct lesion volumes by processing apparent diffusion coefficient maps based on apparent diffusion coefficient cut-off values in patients with acute stroke

    Institute of Scientific and Technical Information of China (English)

    郭翔

    2014-01-01

    Objective To explore the feasibility of prediction of subacute infarct lesion volumes by processing ADC maps based on ADC cut-off values in patients with acute stroke.Methods MRI was performed in 20 patients with clinically diagnosed acute infarct less than 6 h after stroke onset.The MRI included a DWI and conventional MRI.The follow-up MR examinations of all the patients

  4. Influence of time to treatment and other risk factors on infarct size and transmurality in the case of ST-elevated myocardial infarction managed by primary angioplasty and assessed by delayed enhancement magnetic resonance imaging

    Directory of Open Access Journals (Sweden)

    Anil Kumar

    2015-01-01

    Full Text Available Objectives: To evaluate the association between time to treatment and to check the effect of various risk factors such as diabetes mellitus, hypertension (HTN, smoking, family history of coronary artery disease (CAD and obesity on infarct size (IS, transmurality and ST-segment resolution (STR with DE-MRI (delayed enhancement magnetic resonance imaging on 3-month follow-up in patients treated for ST-elevated myocardial infarction (STEMI, with primary percutaneous coronary intervention (PPCI. Background: Early PPCI decreases IS and transmurality but increases STR. Materials and Methods: Fifty consecutive patients with STEMI treated with reperfusion therapy in the form of PPCI and underwent cardiac MRI at 3-month interval follow-up. The primary endpoint is final IS and transmurality as assessed by DE-MRI at 3-month follow-up. Results: IS and transmurality increase and STR decreases with increase in duration to percutaneous coronary intervention from the onset of symptoms. Similarly, the effect of various confounding factors such as diabetes mellitus, HTN, smoking, family history of CAD and obesity on IS, transmurality and STR was assessed which did not affect immediate prognosis during treatment. Conclusion: Primary angioplasty is the treatment modality of choice in the case of STEMI when available. Time to treatment directly influences STR, final IS and transmurality, that is, the earlier the intervention done, more will be STR and lesser will be final IS and transmurality. There is no significant effect of confounding variables such as cardiac risk factors except family history of CAD on immediate prognosis during treatment.

  5. Long-term MRI findings of patients with embolized cerebral aneurysms

    Energy Technology Data Exchange (ETDEWEB)

    Pyysalo, Liisa M.; Niskakangas, Tero T.; Oehman, Juha E. (Tampere Univ. Hospital, Dept. of Neurosurgery, Tampere (Finland)), email: liisa.pyysalo@uta.fi; Keski-Nisula, Leo H.; Kaehaerae, Veikko J. (Medical Imaging Center, Tampere (Finland))

    2011-02-15

    Background: Long-term follow-up studies after endovascular treatment for intracranial aneurysm are still rare and inconclusive. Parenchymal infarctions related to aneurysms have mostly been studied in patients with subarachnoidal hemorrhage (SAH) but infarction rates in patients with endovascularly treated unruptured aneurysms have been little studied. Purpose: To determine the frequency of permanent parenchymal lesions as detected in magnetic resonance imaging (MRI) in patients treated with endovascular coiling and to assess aneurysm-related infarctions after the initial treatment period. Material and Methods: A total of 64 patients (32 with primarily ruptured aneurysms) with 69 embolized aneurysms were examined neurologically and by MRI and magnetic resonance angiography (MRA) more than 9 years after the initial endovascular treatment. Results: A total of 14 out of 32 (44%) SAH patients and 11 (34%) patients with unruptured aneurysms had parenchymal lesions in MRI. Infarctions were detected in 10 (31%) SAH patients and the majority (9/10, 90%) of them were aneurysm-related. All aneurysm-related infarctions were detected at the acute hospitalization stage. A total of six (55%) out of 11 infarctions in patients with unruptured aneurysms were aneurysm-related and two of them appeared after the treatment period. Patients with infarction had poorer clinical outcome than patients with no ischemic lesions in MRI. Conclusion: Nineteen percent of patients with unruptured and 41% with ruptured aneurysms had aneurysmrelated parenchymal lesions in MRI. Most of these were detected during acute treatment period. Aneurysmrelated infarctions after treatment period are uncommon

  6. MRI assessment of acute myocardial infarction with transplantation of autologous mesenchymal stem cells in swine:an experimental study%MRI评价骨髓问质干细胞治疗猪急性心肌梗死效果的实验研究

    Institute of Scientific and Technical Information of China (English)

    陆敏杰; 赵世华; 钱海燕; 蒋世良; 韦云青; 闫朝武; 杨跃进; 刘玉清

    2008-01-01

    目的 应用MRI评价经冠状动脉途径移植猪自体骨髓间质干细胞(BM-MSCs)治疗急性心肌梗死(AMI)的治疗效果.方法 8月龄中华小型猪14只[(27±3)kg],平均分成移植组与对照组.胶圈套扎左前降支第一对角支分叉以远90 min后松开,建成AMI模型.心肌梗死后1周进行细胞移植,将干细胞悬液(移植组:1×106/ml × 10 ml)或无血清培养液(DMEM)(对照组10 ml)经微导管注入前降支.AMI术后1周(基线)和MSCs移植后6周(终点)各行1次MR扫描,评价移植前后心脏形态、功能、心肌灌注及延迟增强.第2次MR扫描后立即处死动物,分别行冰冻切片、石蜡切片和电镜观察.结果 与对照组比较,移植组在移植6周后左心室整体功能较前明显改善,实验组与对照组比较,左心室平均射血分数(EF)值从(42.7±7.5)%升至(50.1±10.1)%(P<0.01),左心室节段运动异常数平均减少4个(P<0.01)、梗死面积减少3.2 cm2(P<0.01),心脏重量指数增加4.1 g/m2(P<0.05).病理证实移植组梗死区和梗死周边的病变情况显著轻于对照组,有大量存活心肌,纤维化程度显著减轻;并且可见核大、边集,胞质丰富的幼稚细胞;在梗死区和梗死周边区组织的冰冻切片上可见4-6-二脒基二苯基吲哚(DAPI)阳性的移植细胞存活.免疫荧光检测进一步表明大部分DAPI阳性细胞表达心肌特异性肌钙蛋白T(troponin T),并且表达间隙连接蛋白43(connexin 43).部分DAPI阳性细胞表达平滑肌肌动蛋白(smooth muscle actin)和血管性血友病因子(Von Willebrand),移植组梗死周边区毛细血管密度显著高于对照组[分别为(8.7±2.0)、(4.9±1.3)个/高倍镜](P<0.01).结论 MRI可作为猪BM-MSCs在体移植前后评价其治疗效果的可靠影像检查方法 .%Objective To investigate the effects of autologous bone marrow-derived mesenchymal stem cells (MSCs)transplantation on acute myocardial infarction in swine models using MRI. Methods

  7. Prognostic value and determinants of a hypointense infarct core in T2-weighted cardiac magnetic resonance in acute reperfused ST-elevation-myocardial infarction.

    Science.gov (United States)

    Eitel, Ingo; Kubusch, Konrad; Strohm, Oliver; Desch, Steffen; Mikami, Yoko; de Waha, Suzanne; Gutberlet, Matthias; Schuler, Gerhard; Friedrich, Matthias G; Thiele, Holger

    2011-07-01

    A hypointense core of infarcted myocardium in T2-weighted cardiovascular MRI (CMR) has been used as a noninvasive marker for intramyocardial hemorrhage. However, the clinical significance of such findings not yet been established. The aim of this study was to evaluate determinants and prognostic impact of a hypointense infarct core in T2-weighted CMR images, studied in patients after acute, reperfused ST-elevation-myocardial infarction. We analyzed 346 patients with ST-elevation-myocardial infarction undergoing primary angioplasty core in T2-weighted images, and late microvascular obstruction. Patients were categorized into 2 groups defined by the presence or absence of a hypointense core. The primary end point of the study was occurrence of major adverse cardiovascular events defined as death, reinfarction, and congestive heart failure within 6 months after infarction. A hypointense core was present in 122 (35%) patients and was associated with larger infarcts, greater amount of microvascular obstruction, less myocardial salvage, and impaired left ventricular function (P core was a strong univariable predictor of major adverse cardiovascular events (hazard ratio, 2.59; confidence interval, 1.27 to 5.27) and was significantly associated with an increased major adverse cardiovascular events rate (16.4% versus 7.0%, P = 0.006) 6 months after infarction. A hypointense infarct core within the area at risk of reperfused infarcted myocardium in T2-weighted CMR is closely related to infarct size, microvascular obstruction, and impaired left ventricular function, with subsequent adverse clinical outcome.

  8. Pontine infarction with pure motor hemiparesis or hemiplegia: A prospective study

    Science.gov (United States)

    Ling, Li; Zhu, Liangfu; Zeng, Jinsheng; Liao, Songjie; Zhang, Suping; Yu, Jian; Yang, Zhiyun

    2009-01-01

    Background The study aimed to prospectively observe the clinical and neuroimaging features of pontine infarction with pure motor hemiparesis (PMH) or hemiplegia at early stage. Methods In 118 consecutive selected patients with the first-ever ischemic stroke within 6 hours after onset, fifty of them presented with PMH or hemiplegia and had negative acute computed tomography (CT) scans, then magnetic resonance imaging (MRI) confirmed the corresponding infarcts in pons or cerebrum. The clinical and neuroimaging features of the pontine infarctions were compared with those of cerebral infarctions. Results The pontine infarction with PMH or hemiplegia accounted for 10.2% (12/118) of all first-ever ischemic stroke patients and 24% (12/50) of the patients with both PMH or hemiplegia and acute negative CT scans. Compared to the patients with cerebral infarction, the patients with pontine infarction had more frequency of diabetes mellitus (50.0% vs 5.3%, P = 0.001), nonvertiginous dizziness at onset (58.3% vs 21.1%, P = 0.036) and a progressive course (33.3% vs 2.6%, P = 0.011). Conclusion The pontine infarction may present as PMH or hemiplegia with more frequency of nonvertiginous dizziness, a progressive course and diabetes mellitus. MRI can confirm the infarct location in the basal pons at early stage after stroke onset. PMID:19527495

  9. 皮层下动脉硬化性脑病100例临床CT分析%CT and MRI T2WI, and FLAIR and DWI in diagnostic value of cerebral lacunar infarction and its prognosis analysis

    Institute of Scientific and Technical Information of China (English)

    罗青毅; 邹习忠; 冉强; 董志鹏

    2014-01-01

    目的:探讨皮层下动脉硬化性脑病颅脑ct诊断的意义和价值。方法结合我院临床诊断为皮层下动脉硬化性脑病, ct表现为侧脑室周围脑白质脱髓鞘改变的100例病例,按Goto分类法,将侧脑室前角周围脑白质脱髓鞘改变程度不同分为三型的标准,进行临床和影像综合分析。结果按Goto分类法Ⅰ型和Ⅱ型63例,临床表现轻,Ⅲ型37例,症状重,常偏瘫和言语不清,ct表现伴有脑萎缩(96例),腔隙性脑梗死(74例),伴大面积脑梗死(8例)、脑出血(7例)、脑积水和蛛网膜下腔积液(12例)。结论 ct检查对皮层下动脉硬化性脑病的诊断具有重要的价值,对于临床在预防、诊断和治疗皮层下动脉硬化性脑病方面具有重要意义。%Objectiveto explore the value of ct in diagnosis of subcortical arteriosclerotic encephalopathy (sae). Methods100 patients were deifnitely diagnosed as SAE by clinic. CT showed low density of surrounding bilateral ventricle. Demyelinating encephalopathy of frontal horn of bilateral ventricle were divided into three types according to the classiifcation of Goto.Results clinical presentations showed mild in typesⅠ andⅡ in 63 patients, severe symptoms were found in 37 patients, including hemiplegia, and barylalia. ct appeared cerebral atrophy in 96 patients; cerebral lacunar infarction in 74; diffuse cerebral infarction in 8; hemorrhage in 7; and hydrocephalus and hydrops of subarachnoid space in 12.Conclusion ct was very valuable on diagnosis and evaluation of subcortical arteriosclerotic encephalopathy.

  10. MRI of the Prostate

    Science.gov (United States)

    ... News Physician Resources Professions Site Index A-Z Magnetic Resonance Imaging (MRI) - Prostate Magnetic resonance imaging (MRI) of the prostate ... limitations of MRI of the Prostate? What is MRI of the Prostate? Magnetic resonance imaging (MRI) is ...

  11. Responses of serum inflammatory factor high-sensitivity C-reactive protein, interleukin-6, and tumor necrosis factor-alpha in elderly males with cerebral infarction Non-randomized concurrent control

    Institute of Scientific and Technical Information of China (English)

    Guiping Jiao; Xinjie Tan; Zhiliu Yuan; Chunling Li; Jing Wang; Wen Mo

    2008-01-01

    BACKGROUND: Cerebral infarction is poorly treated due to neuronal necrosis and secondary pathophysiological changes; for example, free radical production and inflammatory reactions.OBJECTIVE: To detect the levels of high-sensitivity C-reactive protein (hs-CRP), interleukin-6 (IL-6), and tumor nccrosis factor-α (TNF-α) in elderly males with cerebral infarction.DESIGN: Non-randomized current control study.SETTING: Cadre Medical Department, Guizhou Provincial People's Hospital.PARTICIPANTS: Forty elderly males (65-89 years old) with cerebral infarction were selected from Cadre Medical Department, Guizhou Provincial People's Hospital from February 2004 to December 2006. All patients met the diagnostic criteria of cerebral infarction modified at the 4th National Cerebrovascular Disease Academic Meeting, and were diagnosed on the basis of CT or MRI tests. Furthermore, 35 elderly male inpatients (65-87 years old) without cerebral infarction were selected as the control group. Included subjects provided confirmed consent and did not have heart disease, diabetes mellitus, lipid disorder, acute trauma, infection, rheumatism, or other inflammatory diseases. The study was approved by the local ethics committee. There were no significant differences in age, blood pressure, and lipid levels between the cerebral infarction group and the control group (P>0.05), and this suggested that the baseline data of both groups were comparable.METHODS: Fasting venous blood was drawn from cerebral infarction patients 24 hours after cerebral infarction attack and from control subjects 24 hours after hospitalization. A latex-enhanced immunoturbidimetric assay and an enzyme-linked immunosorbent assay were used to detect the levels of hs-CRP, IL-6, and TNF-α in the serum.MAIN OUTCOME MEASURES: The levels of hs-CRP, IL-6, and TNF-α in the serum in both groups.RESULTS: Forty cerebral infarction patients and thirty-five control subjects were included in the final analysis without any loss

  12. Predisposing factors in posterior circulation infarcts: a vascular morphological assessment

    Energy Technology Data Exchange (ETDEWEB)

    Coban, Goekcen; Cifci, Egemen; Yildirim, Erkan; Agildere, Ahmet Muhtesem [Baskent University Faculty of Medicine, Department of Radiology, Konya (Turkey)

    2015-05-01

    The aim of the study is to assess the effect of shape, diameter, elongation and deviation criteria of basilar artery (BA), convergence angle and diameter variations of vertebral arteries, and concurrent chronic diseases on posterior circulation infarcts. Between January 2010 and May 2013, 186 patients who underwent brain and diffusion magnetic resonance imaging (MRI) with suspected cerebrovascular accident and were diagnosed with posterior circulation infarct and 120 infarct negative control subjects were included in this case-control retrospective study. Vertebral artery (VA) and BA diameter, right (R) and left (L) VA angles at the level of bifurcation, and BA elongation-deviation, and shape of BA were assessed in a total of 306 subjects. Ischemic lesions in the posterior circulation were classified according to their anatomical location and vascular perfusion areas. No significant difference was noted between the control and patient groups with respect to BA diameter (p = 0.676). The most effective risk factors for posterior circulation infarcts were as follows: BA elongation of 2 or 3, BA transverse location of 2 or 3, increase in left VA angle, and history of hypertension, hypercholesterolemia, and diabetes mellitus. Our results suggest that prominent elongation and deviation, C and J shape of BA, and increased L VA angle may be the predictors of at-risk patients in posterior circulation infarcts. Reporting marked morphological BA and VA variations detected at routine brain MRI will aid in selection of patients. Timely detection and treatment of at-risk patients may be life-saving. (orig.)

  13. 常染色体显性遗传性脑动脉病伴皮层下梗死和白质脑病的颅脑MRI表现%The cranial MRI appearance of cerebral autosomal dominant arteriopathy with subcortical infarcts and leukoencephalopathy in a family

    Institute of Scientific and Technical Information of China (English)

    张金平; 孙冰莲; 余永强; 潘华; 汤永祥; 钱振; 高萍; 刘丰; 李惠芬

    2008-01-01

    目的 提高对常染色体显性遗传性脑动脉病伴皮层下梗死和白质脑病(CADASIL)的颅脑MRI表现的认识.方法 对一家系2代5例患者进行头颅常规MR和MR血管成像(MRA)检查.对经Notch3基因检查或皮肤组织活检超微病理检查确诊的3例和经MRI与临床诊断的1例CADASIL的MRI资料进行分析.结果 MR检查的5例中4例CADASIL均获得明确诊断,1例排除诊断.4例CADASIL均见两侧颞叶、额叶和顶叶大致对称性皮层下与侧脑室旁白质病灶,呈长T1、长T2信号,但枕叶累及甚少且皮层不受累;O'Sullivan征阳性4例,皮层下腔隙性损害(SLLs)征阳性2例;3例半卵圆中心可见多发圆形或卵圆形囊性梗死即"黑洞",4例均见多发圆点状血管周间隙即"胡椒罐盖"样征象;4例全部显示胼胝体单发或多发斑片状显著长T1、长T2信号,其中2例伴萎缩;内囊前肢与外囊均受累,呈"人"字征;基底节和脑干可见单发或多发陈旧性腔隙性梗死灶;1例伴右侧小脑小片状梗死灶;4例全部有轻度至中度的脑干、小脑和大脑萎缩;MRA颅内Ⅰ-Ⅲ级较大动脉均未见明显异常.结论 CADASIL的颅脑MRI表现具有一定的特征性,可为CADASIL的初诊和筛选提供重要依据.%Objective To recognize the cranial MRI appearance in cerebral autosomal dominant arteriopathy with subcortical infarcts and leukoencephalopathy(CADASIL). Methods Five patients with CADASIL from two generations in a family underwent routine MRI and MRA examinations.Three patients with CADASIL were confirmed by the Notch3 genetic testing and the vascular pathological Results and one was diagnosed on basis of MR and clinical manifestations. The imaging data from 4 patients with CADASIL were analyzed.Results Four cases achieved preliminary diagnosis of CADASIL and one was excluded by MRI.In 4 patients with CADASIL,bilateral symmetrical,confluent white matter lesions in the subcortical and Deriventricular regions were seen frequently

  14. MRI zoo

    DEFF Research Database (Denmark)

    Laustsen, Christoffer

    The basic idea was to use MRI to produce a sequence of 3D gray scale image slices of various animals, subsequentlyimaged with a clinical CT system. For this purpose, these animals were used: toad, lungfish, python snake and a horseshoe crab. Each animal was sacrificed according to standard....... MRI was done using a Philips Achieva 1.5 T system and CT was performed using a Siemens Somatom system. Axial and sagittal slices were acquired using standard T1w and T2w MRI sequences, and visualization was made using the Mistar software (Apollo Imaging Technology, Melbourne, Australia). Images were...

  15. Omental Infarction Mimicking Cholecystitis

    Directory of Open Access Journals (Sweden)

    David Smolilo

    2015-01-01

    Full Text Available Omental infarction can be difficult to diagnose preoperatively as imaging may be inconclusive and patients often present in a way that suggests a more common surgical pathology such as appendicitis. Here, a 40-year-old Caucasian man presented to casualty with shortness of breath and progressive right upper abdominal pain, accompanied with right shoulder and neck pain. Exploratory laparoscopy was eventually utilised to diagnose an atypical form of omental infarction that mimics cholecystitis. The vascular supply along the long axis of the segment was occluded initiating necrosis. In this case, the necrotic segment was adherent with the abdominal wall, a pathology not commonly reported in cases of omental infarction.

  16. Dynamic MRI of ferumoxide-labeled bone mesenchymal stem cells after transplantation in infarcted myocardium%MRI对自体骨髓间质干细胞移植于缺血心肌后动态监测价值的实验研究

    Institute of Scientific and Technical Information of China (English)

    刘琼; 魏英杰; 王青峙; 赵世华; 陆敏杰; 蒋世良; 闫朝武; 张岩; 孟亮; 唐跃; 孟宪敏

    2009-01-01

    大于正常心肌区MSCs注射点,且2组间信号强度减弱幅度分别为(26.88±7.27)%和(15.00±4.51)%,差异有统计学意义(F:20.08,P=0.0003).正常心肌区MSCs注射点心肌组织中荧光标记的细胞核分布密度高于梗死边缘区.MSCs注射点[分别为(106±25)和(143±31)个/高倍镜(f=-2.47,P=0.0293)].梗死边缘区MSCs注射点组织中毛细血管分布密度高于该区对照点[分别为(13.4±4.0)和(9.4±3.1)个/高倍镜,f=2.49,P=0.0229].MSCs移植于心肌组织中3周后,普鲁十蓝染色阳性的铁颗粒仅位于部分移植MSCs细胞核周围.结论 MRI可在一定时间内实现对移植干细胞的示踪并反映移植MSCs在心肌局部的数量变化趋势,但是对于移植细胞的半定量监测存在局限性.移植干细胞所在的微环境是影响其牛存时间的重要因素之一.%Objective To investigate the ability of magnetic resonance imaging (MRI) in tracking magnetically labeled mesenchymal stem cells (MR-MSCs) in a swine myocardial infarction (MI) model.Methods Adult Chinese mini-pigs (n = 6) were subjected to open-chest experimental MI operation.Their antegeneic bone marrow-derived mesenchymal stem cells ( MSCs ) was cultured and doubly labeled with ferumoxides and DAPL On the 14 th day after MSCs transplantation, the size and location of the myocardial infarction were assessed by using delayed-enhancement MRI (DE-MRI). Then the labeled MSCs were injected intramyocardially into peri-infarct zone and normal myocardium. At 24 hrs and 3 weeks after injection, the contrast and the volume of the MR-MSCs hypointense lesion from the MR images were acquired, and the contrast was determined using the difference in signal intensity between the hypointense and normal myocardium divided by signal intensity of the normal region.After humane euthanasia, the heart was excised and histology corresponding to MRI slices that demonstrated MR-MSCs lesions was performed.Repeated-measures ANOVA and a paired t test were used

  17. Pediatric MRI

    Data.gov (United States)

    U.S. Department of Health & Human Services — The NIH Study of Normal Brain Development is a longitudinal study using anatomical MRI, diffusion tensor imaging (DTI), and MR spectroscopy (MRS) to map pediatric...

  18. Knee MRI

    Science.gov (United States)

    ... air-conditioned and well-lit. Some scanners have music to help you pass the time. When the ... that magnetic resonance imaging harms the fetus, pregnant women usually are advised not to have an MRI ...

  19. A clinical study of brainstem infarction identified on magnetic resonance imaging

    Energy Technology Data Exchange (ETDEWEB)

    Watanabe, Masaki; Takahashi, Akira (Nagoya Univ. (Japan). Faculty of Medicine); Arahata, Yutaka; Motegi, Yoshimasa; Furuse, Masahiro

    1993-04-01

    We conducted a clinical study of 155 cases that were confirmed to have brainstem infarctions on MRI (T[sub 1]-weighted image showed a low signal and T[sub 2]-weighted image showed a high signal, measuring in excess of 2 x 2 mm). The majority of the brainstem infarction was located in the pontine base in 132 cases (85.2%). Of these, 19 cases had double lesions including infarctions in the pontine base. Second infarctions frequently occurred in the cerebral peduncle or medical medulla oblongata, unilateral to the pontine infarctions. In addition to 98 symptomatic cases, there were 57 cases of 'asymptomatic' brainstem infarction. They comprised 24 cases accompanying other symptomatic cerebrovascular diseases in the supratentorium and 33 cases of transient subjective complaints such as headache or vertigo-dizziness. Complication by supratentorial infarctions was significantly frequent in cases of brainstem infarction (p<0.001), 122 of 155 cases (78.7%), especially in the pontine base (88.6%); while in the control cases (without brainstem infarction) only 65 of 221 cases (29.4%). These findings are considered to show the widespread progress of arteriosclerosis in brainstem infarction, especially in ones in the pontine base. (author).

  20. USPIO-enhanced 3D-cine self-gated cardiac MRI based on a stack-of-stars golden angle short echo time sequence: Application on mice with acute myocardial infarction.

    Science.gov (United States)

    Trotier, Aurélien J; Castets, Charles R; Lefrançois, William; Ribot, Emeline J; Franconi, Jean-Michel; Thiaudière, Eric; Miraux, Sylvain

    2016-08-01

    To develop and assess a 3D-cine self-gated method for cardiac imaging of murine models. A 3D stack-of-stars (SOS) short echo time (STE) sequence with a navigator echo was performed at 7T on healthy mice (n = 4) and mice with acute myocardial infarction (MI) (n = 4) injected with ultrasmall superparamagnetic iron oxide (USPIO) nanoparticles. In all, 402 spokes were acquired per stack with the incremental or the golden angle method using an angle increment of (360/402)° or 222.48°, respectively. A cylindrical k-space was filled and repeated with a maximum number of repetitions (NR) of 10. 3D cine cardiac images at 156 μm resolution were reconstructed retrospectively and compared for the two methods in terms of contrast-to-noise ratio (CNR). The golden angle images were also reconstructed with NR = 10, 6, and 3, to assess cardiac functional parameters (ejection fraction, EF) on both animal models. The combination of 3D SOS-STE and USPIO injection allowed us to optimize the identification of cardiac peaks on navigator signal and generate high CNR between blood and myocardium (15.3 ± 1.0). The golden angle method resulted in a more homogeneous distribution of the spokes inside a stack (P cine images could be obtained without electrocardiogram or respiratory gating in mice. It allows precise measurement of cardiac functional parameters even on MI mice. J. Magn. Reson. Imaging 2016;44:355-365. © 2016 Wiley Periodicals, Inc.

  1. Neuroimaging diagnosis for cerebral infarction An 8-year bibliometric analysis

    Institute of Scientific and Technical Information of China (English)

    Yan Du; Xiaoxia Yang; Hong Song; Bo Chen; Lin Li; Yue Pan; Qiong Wu; Jia Li

    2012-01-01

    OBJECTIVE:To identify global research trends in neuroimaging diagnosis for cerebral infarction using a bibliometric analysis of the Web of Science.DATA RETRIEVAL:We performed a bibliometric analysis of data retrieval for neuroimaging diagnosis for cerebral infarction containing the key words "CT,magnetic resonance imaging,MRI,transcranial Doppler,transvaginal color Doppler,digital subtraction angiography,and cerebral infarction" using the Web of Science.SELECTION CRITERIA:Inclusion criteria were:(a) peer-reviewed articles on neuroimaging diagnosis for cerebral infarction which were published and indexed in the Web of Science; (b) original research articles and reviews; and (c) publication between 2004-2011.Exclusion criteria were:(a) articles that required manual searching or telephone access; and (b) corrected papers or book chapters.MAIN OUTCOME MEASURES:(1)Annual publication output; (2) distribution according to country;(3) distribution according to institution; (4) top cited publications; (5) distribution according to journals; and (6) comparison of study results on neuroimaging diagnosis for cerebral infarction.RESULTS:Imaging has become the predominant method used in diagnosing cerebral infarction.The most frequently used clinical imaging methods were digital subtraction angiography,CT,MRI,and transcranial color Doppler examination.Digital subtraction angiography is used as the gold standard.However,it is a costly and time-consuming invasive diagnosis that requires some radiation exposure,and is poorly accepted by patients.As such,it is mostly adopted in interventional therapy in the clinic.CT is now accepted as a rapid,simple,and reliable non-invasive method for use in diagnosis of cerebrovascular disease and preoperative appraisal.Ultrasonic Doppler can be used to reflect the hardness of the vascular wall and the nature of the plaque more clearly than CT and MRI.CONCLUSION:At present,there is no unified standard of classification of cerebral infarction

  2. Spinal Cord Infarction

    Science.gov (United States)

    ... arteries that supply it. It is caused by arteriosclerosis or a thickening or closing of the major ... infarction is caused by a specific form of arteriosclerosis called atheromatosis, in which a deposit or accumulation ...

  3. Cerebral Infarction Arising from Takotsubo Cardiomyopathy: Case Report and Literature Review.

    Science.gov (United States)

    Otani, Yoshihiro; Tokunaga, Koji; Kawauchi, Satoshi; Inoue, Satoshi; Watanabe, Kyoichi; Kiriyama, Hideki; Sakane, Kosuke; Maekawa, Kiyoaki; Date, Isao; Matsumoto, Kengo

    2016-10-01

    Although most patients with takotsubo cardiomyopathy have a favorable outcome, complications are not uncommon. Recent studies have reported an increase in incidence of cardioembolic complications; however, the association between takotsubo cardiomyopathy and stroke, in particular thromboembolic cerebral infarction, remains unclear. We reported a 44-year-old woman who had a cerebral infarction resulting from takotsubo cardiomyopathy. She had felt chest discomfort a few days prior to infarction, and later developed left hemiparesis. Head magnetic resonance imaging (MRI) revealed acute infarction in the right insular cortex and occlusion of the right middle cerebral artery at the M2 segment. Echocardiogram revealed a takotsubo-like shape in the motion of the left ventricular wall, and coronary angiography showed neither coronary stenosis nor occlusion. Cerebral infarction resulting from takotsubo cardiomyopathy was diagnosed and treatment with anticoagulant was started. MRI on the eighth day after hospitalization showed recanalization of the right middle cerebral artery and no new ischemic lesions. The findings of the 19 previously published cases who had cerebral infarction resulting from takotsubo cardiomyopathy were also reviewed and showed the median interval between takotsubo cardiomyopathy and cerebral infarction was approximately 1 week and cardiac thrombus was detected in 9 of 19 patients. We revealed that thromboembolic events occurred later than other complications of takotsubo cardiomyopathy and longer observation might be required due to possible cardiogenic cerebral infarction. Anticoagulant therapy is recommended for patients with takotsubo cardiomyopathy with cardiac thrombus or a large area of akinetic left ventricle.

  4. Examining the subcortical infarcts in the era of acute multimodality CT imaging

    Directory of Open Access Journals (Sweden)

    Mindy Tan

    2016-12-01

    Full Text Available Background: Lacunar infarcts have been characterized as small subcortical infarcts, resulting from in situ microatheroma or lipohyalinosis in small vessels. Based on this hypothesis, such infarcts should not be associated with large areas of perfusion deficits extending beyond subcortical regions to involve cortical regions. By contrast, selected small subcortical infarcts, as defined by MR imaging in the subacute or chronic stage, may initially have large perfusion deficits or related large vessel occlusions. These infarcts with ‘lacunar’ phenotype may also be caused by disease in the parent vessel and may have very different stroke mechanisms from small vessel disease. Our aim was to describe differences in imaging characteristics between patients with small subcortical infarction with ‘lacunar phenotype’ from those with lacunar mechanism. Methods: Patients undergoing acute CT Perfusion/angiography (CTP/CTA within 6 hours of symptom onset and follow-up magnetic resonance imaging (MRI for ischaemic stroke were included (2009-2013. A lacunar infarct was defined as a single subcortical infarct (SSI ≤20 mm on follow-up MRI. Presence of perfusion deficits, vessel occlusion and infarct dimensions were compared between lacunar infarcts and other topographical infarct types. Results: Overall, 182 patients (mean age 66.4±15.3 years, 66% male were included. SSI occurred in 31 (17% patients. Of these, 12 (39% patients had a perfusion deficit compared with those with any cortical infarction (120/142, 67%, and the smallest SSI with a perfusion deficit had a diameter of <5mm. The majority of patients with SSI (8/12, 66.7% had a relevant vessel occlusion. A quarter of SSIs had a large-artery stroke mechanism evident on acute CTP/CTA. Lacunar mechanism was present in 3/8 patients with corona radiata, 5/10 lentiform nucleus, 5/6 posterior limb of internal capsule PLIC, 3/5 thalamic infarcts and 1/2 miscellaneous locations. There was a trend toward

  5. Depression after myocardial infarction.

    Science.gov (United States)

    Ziegelstein, R C

    2001-01-01

    Depression is an independent risk factor for increased postmyocardial infarction morbidity and mortality, even after controlling for the extent of coronary artery disease, infarct size, and the severity of left ventricular dysfunction. This risk factor takes on added significance when one considers that almost half of patients recovering from a myocardial infarction have major or minor depression and that major depression alone occurs in about one in five of these individuals. Despite the well-documented risk of depression, questions remain about the mechanism of the relationship between mood disturbance and adverse outcome. The link may be explained by an association with lower levels of social support, poor adherence to recommended medical therapy and lifestyle changes intended to reduce the risk of subsequent cardiac events, disturbances in autonomic tone, enhanced platelet activation and aggregation, and systemic immune activation. Unfortunately, questions about the pathophysiologic mechanism of depression in this setting are paralleled by uncertainties about the optimal treatment of depression for patients recovering from a myocardial infarction and by a lack of knowledge about whether treating depression lowers the associated increased mortality risk. Ongoing research studies will help to determine the benefits of psychosocial interventions and of antidepressant therapy for patients soon after myocardial infarction. Although the identification of depression as a risk factor may by itself be a reason to incorporate a comprehensive psychological evaluation into the routine care of patients with myocardial infarction, this practice should certainly become standard if studies show that treating depression reduces the increased mortality risk of these patients.

  6. Distribution of brain infarction in children with tuberculous meningitis and correlation with outcome score at 6 months

    Energy Technology Data Exchange (ETDEWEB)

    Andronikou, Savvas [University of Stellenbosch, Department of Radiology, Tygerberg Hospital, P.O. Box 19063, Tygerberg (South Africa); Wilmshurst, Jo; Hatherill, Mark [University of Cape Town, Pediatric Neurology, Red Cross Children' s Hospital, School of Child and Adolescent Health, Cape Town (South Africa); VanToorn, Ronald [University of Stellenbosch, Department of Pediatric Neurology, Tygerberg Hospital, Cape Town (South Africa)

    2006-12-15

    Prognostic indicators for tuberculous meningitis (TBM) offer realistic expectations for parents of affected children. Infarctions affecting the basal ganglia are associated with a poor outcome. To correlate the distribution of infarction in children with TBM on CT with an outcome score (OS). CT brain scans in children with TBM were retrospectively reviewed and the distribution of infarctions recorded. The degree of correlation with OS at 6 months was determined. There was a statistically significant association between all sites of infarction (P = 0.0001-0.001), other than hemispheric (P = 0.35), and outcome score. There was also a statistically significant association between all types of infarction (P = 0.0001-0.02), other than hemispheric (P = 0.05), and overall poor outcome. The odds ratio for poor outcome with bilateral basal ganglia and internal capsule infarction was 12. The odds ratio for poor outcome with 'any infarction' was 4.91 (CI 2.24-10.74), with 'bilateral infarctions' 8.50 (CI 2.49-28.59), with basal ganglia infarction 5.73 (CI 2.60-12.64), and for hemispheric infarction 2.30 (CI 1.00-5.28). Infarction is associated with a poor outcome unless purely hemispheric. MRI diffusion-weighted imaging was not part of this study, but is likely to play a central role in detecting infarctions not demonstrated by CT. (orig.)

  7. The clinic discuss of prognosis and treatment or brainstem infarction combined coma

    Institute of Scientific and Technical Information of China (English)

    Niu Junying; Wanglei; YinShimin; Zheng Yishan; Shijie Qu; Zhanfen

    2000-01-01

    Objective Discuss the relationship between the position, bound of brainstem infarction and .consciousness clog,determinan the prognosis and curative effect. Background and Methods Total brainstem infarction 14 patients,9 male and 5 female,43 to 80 years old.all patients had been checked by CT or MRI,brainstem foliun scanning 6 cases,checked by MRI 8 canes micbrain infarction 2 cases,pon infarction 5 cases,medulla infasction 7 cases the midbrain infarction were rise rapid,inmediately coma,the mydrasis in defect side,opposite body mucsle tension heighten.then both lower limbs straight,both pathology sign masculine.the two cases are all alive .tocked-in syndrom has appeared in 1 case of pon infarction ,and died of combined illness 1 year later. 1 case defect affect centrum of breath and hearlbeat, coma,breath rhythm malajustment,breath stop.threr were no consciousness clog in the other 3 cases ,vertigo,force head position to trouble side, nystagmus, trouble side face hypalgesia,and all cureed .2 cases of medulla infarction appeared quactriplegia ,swallow hardness,anarthriad and so on, 5 others were hemi Watlenberg syndrom,all wcre cured. Results and Discussion coma or no in brainstem infaciton was related with position.it is reparted that midbrain infarction coma was 7.6 persent of brainstem infarction. consciousness clog is distinctness which defect position in midbrain lateral-back, pon ventro defect, not involved ARAS ,lwas locked-in synxdom. brainstem infarction combined combined with freedom breath clog,in medulla was 16.1percent,midorain was 1 1.6 percent, pons ws 83.96 percent the prognosis was.all right in lightly brainsterm infarction, lf involved in both medulla, ventro pon,the prognosis was bad, and lose quadriplegia. CT brainstern foliun scanning would enhanced scanning lay, and helpful for chech up the pathological chanoes of brainstem.

  8. Imaging characteristics of cerebral autosomal dominant arteriopathy with subcortical infarcts and leucoencephalopathy (CADASIL)

    Science.gov (United States)

    Stojanov, Dragan; Aracki-Trenkic, Aleksandra; Vojinovic, Slobodan; Ljubisavljevic, Srdjan; Benedeto-Stojanov, Daniela; Tasic, Aleksandar; Vujnovic, Sasa

    2015-01-01

    Cerebral autosomal dominant arteriopathy with subcortical infarcts and leucoencephalopathy (CADASIL) is an autosomal dominant vascular disorder. Diagnosis and follow-up in patients with CADASIL are based mainly on magnetic resonance imaging (MRI). MRI shows white matter hyperintensities (WMHs), lacunar infarcts and cerebral microbleeds (CMBs). WMHs lesions tend to be symmetrical and bilateral, distributed in the periventricular and deep white matter. The anterior temporal lobe and external capsules are predilection sites for WMHs, with higher specificity and sensitivity of anterior temporal lobe involvement compared to an external capsule involvement. Lacunar infarcts are presented by an imaging signal that has intensity of cerebrospinal fluid in all MRI sequences. They are localized within the semioval center, thalamus, basal ganglia and pons. CMBs are depicted as focal areas of signal loss on T2 images which increases in size on the T2*-weighted gradient echo planar images (“blooming effect”). PMID:25725137

  9. Imaging Characteristics of Cerebral Autosomal Dominant Arteriopathy with Subcortical Infarcts and Leucoencephalopathy (CADASIL

    Directory of Open Access Journals (Sweden)

    Dragan Stojanov

    2015-02-01

    Full Text Available Cerebral autosomal dominant arteriopathy with subcortical infarcts and leucoencephalopathy (CADASIL is an autosomal dominant vascular disorder. Diagnosis and follow-up in patients with CADASIL are based mainly on magnetic resonance imaging (MRI. MRI shows white matter hyperintensities (WMHs, lacunar infarcts and cerebral microbleeds (CMBs. WMHs lesions tend to be symmetrical and bilateral, distributed in the periventricular and deep white matter. The anterior temporal lobe and external capsules are predilection sites for WMHs, with higher specificity and sensitivity of anterior temporal lobe involvement compared to an external capsule involvement. Lacunar infarcts are presented by an imaging signal that has intensity of cerebrospinal fluid in all MRI sequences. They are localized within the semioval center, thalamus, basal ganglia and pons. CMBs are depicted as focal areas of signal loss on T2 images which increases in size on the T2*-weighted gradient echo planar images (“blooming effect”.

  10. Detection and characterization of acute myocardial infarction in man with use of gated magnetic resonance.

    Science.gov (United States)

    McNamara, M T; Higgins, C B; Schechtmann, N; Botvinick, E; Lipton, M J; Chatterjee, K; Amparo, E G

    1985-04-01

    To evaluate the capability of magnetic resonance imaging (MRI) in the detection and characterization of alterations in signal intensity and T2 relaxation time in acutely infarcted relative to normal myocardium 16 adult patients and normal volunteers were studied by electrocardiographically gated proton MRI. The seven volunteers were entirely asymptomatic and had no history of cardiovascular abnormality. The nine patients had each suffered an acute myocardial infarction within 5 to 12 days before the MRI studies. The diagnosis in each patient was confirmed by electrocardiographic (ECG) criteria and elevated levels of fractionated creatine kinase (CK) isoenzymes. Electrocardiographically gated MRI was performed with a superconducting system operating at 0.35 tesla. MRI demonstrated infarcted myocardium as a region of high signal intensity relative to that of adjacent normal myocardium; regions of high intensity corresponded anatomically to the site of infarction as defined by the ECG changes. The mean percent difference between normal and infarcted myocardium was substantially greater on 56 msec images (70.2 +/- 21.3%) compared with 28 msec images (27.1 +/- 13.6%). Region of interest analysis revealed that infarcted myocardium had a significantly (p less than .01) prolonged T2 relaxation time (mean T2 = 80.9 msec) relative to that in normal myocardium (mean T2 = 42.3 msec) and relative to the mean T2 of left ventricular myocardium in the volunteers (mean T2 = 42.4 msec). An additional finding for each patient with myocardial infarction was a high intraluminal flow signal on 56 msec images, but this was also observed in normal subjects and is therefore a nonspecific finding.(ABSTRACT TRUNCATED AT 250 WORDS)

  11. Behavioral Disorders in Association with Posterior Callosal and Frontal Cerebral Infarction

    Directory of Open Access Journals (Sweden)

    J. P. Lejeune

    1993-01-01

    Full Text Available Behavioral disorders were a prominent clinical feature after the surgical treatment of an anterior communicating artery aneurysm rupture in a 44-year-old man. Callosal apraxia was associated with an alien hand. The latter remained 1 year after surgery while diagonistic apraxia disappeared after 3 months. Other callosal signs included left agraphia, tactile anomia and auditory suppression. MRI revealed posterior callosal infarction and a right frontal infarct. The association of diagonistic apraxia and alien hand is rarely reported.

  12. Influences of percutaneous coronary intervention on myocardial activity in myocardial infarction patients with different viable myocardium

    Institute of Scientific and Technical Information of China (English)

    李丽琪

    2013-01-01

    Objective To evaluate the effect of percutaneous coronary intervention (PCI) on left ventricular function in patients with different types of myocardial infarction and to explore the correlation factors for the left ventricular function.Methods A total of 43 patients diagnosed as acute myocardial infarction were enrolled in this study.The perfusion and delayed enhancement magnetic resonance imaging (DE-MRI) was applied to observe the fol-

  13. MRI Artifacts

    Directory of Open Access Journals (Sweden)

    Abed Al Nasser Assi

    2009-12-01

    Full Text Available   "nMagnetic resonance imaging (MRI has become more and more frequently used in medical imaging diagnostic in recent years. Radiologists and technicians working at these systems are relatively often confronted with image artifacts related to the radiowave with strong magnetic in the scanner. Many artifacts may be corrected or modulated through an understanding of their cause. This requires familiarity with scanner design; theory of operation; and image acquisition. The purpose of this review article is to present the most relevant artifacts that arise in MRI scanner, to provide some physical background on the formation of artifacts, and to suggest strategies to reduce or avoid these artifacts. The most frequent artifacts that can occur during MRI scanning are Motion related artifacts; Para-magnetic artifacts; Phase Wrap artifacts; Frequency artifacts; Susceptibility artifacts; Clipping artefact; Chemical Shift artifact and "Zebra" artefact .    "n  

  14. Portable MRI

    Energy Technology Data Exchange (ETDEWEB)

    Espy, Michelle A. [Los Alamos National Laboratory

    2012-06-29

    This project proposes to: (1) provide the power of MRI to situations where it presently isn't available; (2) perform the engineering required to move from lab to a functional prototype; and (3) leverage significant existing infrastructure and capability in ultra-low field MRI. The reasons for doing this: (1) MRI is the most powerful tool for imaging soft-tissue (e.g. brain); (2) Billions don't have access due to cost or safety issues; (3) metal will heat/move in high magnetic fields; (4) Millions of cases of traumatic brain injury in US alone; (5) even more of non-traumatic brain injury; (6) (e.g. stroke, infection, chemical exposure); (7) Need for early diagnostic; (8) 'Signature' wound of recent conflicts; (9) 22% of injuries; (10) Implications for post-traumatic stress disorder; and (11) chronic traumatic encephalopathy.

  15. Skull infarction and epidural hematomas in a patient with sickle cell anemia.

    Science.gov (United States)

    Resar, L M; Oliva, M M; Casella, J F

    1996-11-01

    Epidural hematomas are unusual manifestations of sickling disorders. We report a patient with sickle cell anemia and multiple skull infarctions associated with epidural hematomas. The association of skull infarctions and epidural hematomas in sickling hemoglobinopathies is reviewed. A 14-year-old boy with hemoglobin SS presented with lower back pain, left hip pain, headache, and fever. A bone scan was used to evaluate the patient for possible osteomyelitis. Head computed tomography (CT) and magnetic resonance imaging (MRI) were employed to delineate intracranial pathology. The bone scan showed multiple areas of decreased uptake in the skull consistent with acute infarction before abnormalities were present on physical examination. CT scan showed a bony contour deformity of the right frontal bone, suggestive of infarction. A right frontal extra-axial collection of blood was also observed below the bony abnormality. MRI further delineated bilateral frontal and left parietal collections adjacent to the bony abnormalities consistent with subacute epidural hematomas. This case emphasizes the need to recognize skull infarctions and epidural hematomas as rare but potential complications of sickle cell disease. The diagnosis was facilitated by MRI, which has not been used in previous cases of skull infarctions. Moreover, our patient was successfully managed without surgical intervention.

  16. Breast MRI scan

    Science.gov (United States)

    MRI - breast; Magnetic resonance imaging - breast; Breast cancer - MRI; Breast cancer screening - MRI ... radiologist) see some areas more clearly. During the MRI, the person who operates the machine will watch ...

  17. MRI Safety during Pregnancy

    Science.gov (United States)

    ... News Physician Resources Professions Site Index A-Z MRI Safety During Pregnancy Magnetic resonance imaging (MRI) Illness ... during the exam? Contrast material MRI during pregnancy Magnetic resonance imaging (MRI) If you are pregnant and your doctor ...

  18. MRI (Magnetic Resonance Imaging)

    Science.gov (United States)

    ... and Procedures Medical Imaging MRI (Magnetic Resonance Imaging) MRI (Magnetic Resonance Imaging) Share Tweet Linkedin Pin it More sharing options ... usually given through an IV in the arm. MRI Research Programs at FDA Magnetic Resonance Imaging (MRI) ...

  19. MRI of the Chest

    Medline Plus

    Full Text Available ... the limitations of MRI of the Chest? What is MRI of the Chest? Magnetic resonance imaging (MRI) ... ray, CT and ultrasound. top of page How is the procedure performed? MRI examinations may be performed ...

  20. Stepwise optimization of the procedure for assessment of circulating progenitor cells in patients with myocardial infarction.

    Directory of Open Access Journals (Sweden)

    Yu-Xin Cui

    Full Text Available BACKGROUND: The number and functional activity of circulating progenitor cells (CPCs is altered in diabetic patients. Furthermore, reduced CPC count has been shown to independently predict cardiovascular events. Validation of CPCs as a biomarker for cardiovascular risk stratification requires rigorous methodology. Before a standard operation protocol (SOP can be designed for such a trial, a variety of technical issues have to be addressed fundamentally, which include the appropriate type of red blood cell lysis buffer, FMO or isotype controls to identify rare cell populations from background noise, optimal antibody dilutions and conditions of sample storage. We herein propose improvements in critical steps of CPC isolation, antigenic characterization and determination of functional competence for final application in a prospective investigation of CPCs as a biomarker of outcome following acute myocardial infarction. METHODS AND FINDINGS: In this validation study, we refined the standard operating procedure (SOP for flow cytometry characterisation and functional analysis of CPCs from the first 18 patients of the Progenitor Cell Response after Myocardial Infarction Study (ProMIS. ProMIS aims to verify the prognostic value of CPCs in patients with either ST elevation or non-ST elevation myocardial infarction with or without diabetes mellitus, using cardiac magnetic resonance imaging (MRI for assessment of ventricular function as a primary endpoint. Results indicate crucial steps for SOP implementation, namely timely cell isolation after sampling, use of appropriate lysis buffer to separate blood cell types and minimize the acquisition events during flow cytometry, adoption of proper fluorophore combination and antibody titration for multiple antigenic detection and introduction of counting beads for precise quantification of functional CPC activity in migration assay. CONCLUSION AND SIGNIFICANCE: With systematic specification of factors influencing

  1. Focal laminar cortical infarcts following aneurysmal subarachnoid haemorrhage

    Energy Technology Data Exchange (ETDEWEB)

    Weidauer, Stefan; Lanfermann, Heinrich; Zanella, Friedhelm [University of Frankfurt, Institute of Neuroradiology, Frankfurt (Germany); Vatter, Hartmut; Beck, Juergen; Raabe, Andreas; Seifert, Volker [University of Frankfurt, Department of Neurosurgery, Frankfurt (Germany)

    2008-01-15

    The aim of this prospective study was to analyse small band-like cortical infarcts after subarachnoid haemorrhage (SAH) using magnetic resonance imaging (MRI) with reference to additional digital subtraction angiography (DSA). In a 5-year period between January 2002 and January 2007 10 out of 188 patients with aneurysmal SAH were evaluated (one patient Hunt and Hess grade I, one patient grade II, four patients grade III, two patients grade IV, and two patients grade V). The imaging protocol included serially performed MRI with diffusion- and perfusion-weighted images (DWI/PWI) at three time points after aneurysm treatment, and cerebral vasospasm (CVS) was analysed on follow-up DSA on day 7{+-}3 after SAH. The lesions were located in the frontal lobe (n=10), in the insular cortex (n=3) and in the parietal lobe (n=1). The band-like infarcts occurred after a mean time interval of 5.8 days (range 3-10 days) and showed unexceptional adjacent thick sulcal clots. Seven out of ten patients with cortical infarcts had no or mild CVS, and in the remaining three patients DSA disclosed moderate (n=2) or severe (n=1) CVS. The infarct pattern after aneurysmal SAH includes cortical band-like lesions. In contrast to territorial infarcts or lacunar infarcts in the white matter which develop as a result of moderate or severe proximal and/or distal vasospasm visible on angiography, the cortical band-like lesions adjacent to sulcal clots may also develop without evidence of macroscopic vasospasm, implying a vasospastic reaction of the most distal superficial and intraparenchymal vessels. (orig.)

  2. Spinal cord infarction is an unusual complication of intracranial neuroendovascular intervention.

    Science.gov (United States)

    Matsubara, Noriaki; Miyachi, Shigeru; Okamaoto, Takeshi; Izumi, Takashi; Asai, Takumi; Yamanouchi, Takashi; Ota, Keisuke; Oda, Keiko; Wakabayashi, Toshihiko

    2013-12-01

    Spinal cord infarction is an unusual complication of intracranial neuroendovascular intervention. The authors report on two cases involving spinal cord infarction after endovascular coil embolization for large basilar-tip aneurysms. Each aneurysm was sufficiently embolized by the stent/balloon combination-assisted technique or double catheter technique. However, postoperatively, patients presented neurological symptoms without cranial nerve manifestation. MRI revealed multiple infarctions at the cervical spinal cord. In both cases, larger-sized guiding catheters were used for an adjunctive technique. Therefore, guiding catheters had been wedged in the vertebral artery (VA). The wedge of the VA and flow restriction may have caused thromboemboli and/or hemodynamic insufficiency of the spinal branches from the VA (radiculomedullary artery), resulting in spinal cord infarction. Spinal cord infarction should be taken into consideration as a complication of endovascular intervention for lesions of the posterior circulation.

  3. Multifocal diabetic muscle infarction: a rare complication of poorly controlled diabetes mellitus.

    Science.gov (United States)

    Chebbi, Wafa; Jerbi, Saida; Klii, Rym; Alaya, Wafa; Mestiri, Sarra; Zantour, Baha; Sfar, Mohamed Habib

    2014-01-01

    Diabetic muscle infarction (DMI) is a rare complication of long-standing poorly controlled diabetes mellitus. We herein describe the case of a 56-year-old man with a 10-year history of poorly controlled type 2 diabetes mellitus with multiple microvascular and macrovascular complications who presented with the sudden onset of left thigh pain and swelling. MRI suggested muscle infarction. A muscle biopsy demonstrated coagulation necrosis in the skeletal muscle with inflammation and infarction in the walls of small blood vessels. Physicians should consider DMI in the differential diagnosis of patients with diabetes who present with painful, swollen muscles without systemic signs of infection.

  4. Migraine Infarction. Case Report

    Directory of Open Access Journals (Sweden)

    Yoany Mesa Barrera

    2015-03-01

    Full Text Available Migraine is considered like a risk factor for ischemic ictus in adult young people. In spite of the criteria established for the treatment of the migraine infarct, they are not always fulfilled strictly, permitting certain flexibility in the aforementioned treatment. The case of a patient with a background of migraine with auras, who suffers an ischemic cerebral migraine infarct at the course of a migraine crisis, is presented. The ictus was manifested like an especial right hemiparesis of the female sex in fertile age. The prognosis is good with low risk of recurrence, with unstable disorders and dysarthria. The laboratories studies were normal and the cerebral infarct was detected in the magnetic resonance, at the half left cerebral artery's territory. The patient had favorable evolution without sequel.

  5. Occipital lobe infarctions are different

    OpenAIRE

    Naess, Halvor; Waje-Andreassen, Ulrikke; Thomassen, Lars

    2007-01-01

    Objectives We hypothesized that occipital lobe infarctions differ from infarctions in other locations as to etiology, risk factors and prognosis among young adults. Methods Location, etiology, risk factors and long-term outcome were evaluated among all young adults 15–49 years suffering from cerebral infarction in Hordaland County, Norway between 1988 and 1997. Results The following variables were more frequent among patients with occipital lobe infarction compared with patients with infarcti...

  6. Cholinergic stimulation with pyridostigmine improves autonomic function in infarcted rats.

    Science.gov (United States)

    de La Fuente, Raquel N; Rodrigues, Bruno; Moraes-Silva, Ivana C; Souza, Leandro E; Sirvente, Raquel; Mostarda, Cristiano; De Angelis, Kátia; Soares, Pedro P; Lacchini, Silvia; Consolim-Colombo, Fernanda; Irigoyen, Maria-Cláudia

    2013-09-01

    In the present study we evaluated the effects of short-term pyridostigmine bromide (0.14 mg/mL) treatment started early after myocardial infarction (MI) on left ventricular (LV) and autonomic functions in rats. Male Wistar rats were divided into control, pyridostigmine, infarcted and infarcted + pyridostigmine-treated groups. Pyridostigmine was administered in the drinking water, starting immediately after MI or sham operation, for 11 days. Left ventricular function was evaluated indirectly by echocardiography and directly by LV catheterization. Cardiovascular autonomic control was evaluated by baroreflex sensitivity (BRS), heart rate variability (HRV) and pharmacological blockade. All evaluations started after 7 days pyridostigmine treatment and were finalized after 11 days treatment. Pyridostigmine prevented the impairment of +dP/dT and reduced the MI area in infarcted + pyridostigmine compared with infarcted rats (7 ± 3% vs 17 ± 4%, respectively). Mean blood pressure was restored in infarcted + pyridostigmine compared with infarcted rats (103 ± 3 vs 94 ± 3 mmHg, respectively). In addition, compared with the infarcted group, pyridostigmine improved BRS, as evaluated by tachycardic (1.6 ± 0.2 vs 2.5 ± 0.2 b.p.m./mmHg, respectively) and bradycardic (-0.42 ± 0.01 vs -1.9 ± 0.1 b.p.m./mmHg) responses, and reduced the low frequency/high frequency ratio of HRV (0.81 ± 0.11 vs 0.24 ± 0.14, respectively). These improvements are probably associated with increased vagal tone and reduced sympathetic tone in infarcted + pyridostigmine compared with infarcted rats. In conclusion, the data suggest that short-term pyridostigmine treatment started early after MI can improve BRS, HRV and parasympathetic and sympathetic tone in experimental rats. These data may have potential clinical implications because autonomic markers have prognostic significance after MI.

  7. Infarct healing is a dynamic process following acute myocardial infarction

    Directory of Open Access Journals (Sweden)

    Pokorney Sean D

    2012-09-01

    Full Text Available Abstract Background The role of infarct size on left ventricular (LV remodeling in heart failure after an acute ST-segment elevation myocardial infarction (STEMI is well recognized. Infarct size, as determined by cardiovascular magnetic resonance (CMR, decreases over time. The amount, rate, and duration of infarct healing are unknown. Methods A total of 66 patients were prospectively enrolled after reperfusion for an acute STEMI. Patients underwent a CMR evaluation within 1 week, 4 months, and 14 months after STEMI. Results Mean infarct sizes for the 66 patients at baseline (acute necrosis, early follow-up (early scar, and late follow-up (late scar were 25 ± 17 g, 17 ± 12 g, and 15 ± 11 g, respectively. Patients were stratified in tertiles, based on infarct size, with the largest infarcts having the greatest absolute decrease in mass at early and late scar. The percent reduction of infarct mass was independent of initial infarct size. There was an 8 g or 32% decrease in infarct mass between acute necrosis and early scar (p  Conclusions Infarct healing is a continuous process after reperfusion for STEMI, with greatest reduction in infarct size in the first few months. The dynamic nature of infarct healing through the first year after STEMI indicates that decisions based on infarct size, and interventions to reduce infarct size, must take into consideration the time frame of measurement.

  8. MRI zoo

    DEFF Research Database (Denmark)

    Laustsen, Christoffer

    The basic idea was to use MRI to produce a sequence of 3D gray scale image slices of various animals, subsequentlyimaged with a clinical CT system. For this purpose, these animals were used: toad, lungfish, python snake and a horseshoe crab. Each animal was sacrificed according to standard proced...

  9. Chronic non-transmural infarction has a delayed recovery of function following revascularization

    Directory of Open Access Journals (Sweden)

    Palmer John

    2010-01-01

    Full Text Available Abstract Background The time course of regional functional recovery following revascularization with regards to the presence or absence of infarction is poorly known. We studied the effect of the presence of chronic non-transmural infarction on the time course of recovery of myocardial perfusion and function after elective revascularization. Methods Eighteen patients (mean age 69, range 52-84, 17 men prospectively underwent cine magnetic resonance imaging (MRI, delayed contrast enhanced MRI and rest/stress 99m-Tc-tetrofosmin single photon emission computed tomography (SPECT before, one and six months after elective coronary artery bypass grafting (CABG or percutaneous coronary intervention (PCI. Results Dysfunctional myocardial segments (n = 337/864, 39% were classified according to the presence (n = 164 or absence (n = 173 of infarction. Infarct transmurality in dysfunctional segments was largely non-transmural (transmurality = 31 ± 22%. Quantitative stress perfusion and wall thickening increased at one month in dysfunctional segments without infarction (p Conclusions Dysfunctional segments without infarction represent repetitively stunned or hibernating myocardium, and these segments improved both perfusion and function within one month after revascularization with no improvement thereafter. Although dysfunctional segments with non-transmural infarction improved in perfusion at one month, functional recovery was mostly seen between one and six months, possibly reflecting a more severe ischemic burden. These findings may be of value in the clinical assessment of regional functional recovery in the time period after revascularization.

  10. Therapeutic imaging window of cerebral infarction revealed by multisequence magnetic resonance imaging An animal and clinical study

    Institute of Scientific and Technical Information of China (English)

    Hong Lu; Hui Hu; Zhanping He; Xiangjun Han; Jing Chen; Rong Tu

    2012-01-01

    In this study, we established a Wistar rat model of right middle cerebral artery occlusion and observed pathological imaging changes (T2-weighted imaging [T2WI], T2FLAIR, and diffusion-weighted imaging [DWI]) following cerebral infarction. The pathological changes were divided into three phases: early cerebral infarction, middle cerebral infarction, and late cerebral infarction. In the early cerebral infarction phase (less than 2 hours post-infarction), there was evidence of intracellular edema, which improved after reperfusion. This improvement was defined as the ischemic penumbra. In this phase, a high DWI signal and a low apparent diffusion coefficient were observed in the right basal ganglia region. By contrast, there were no abnormal T2WI and T2FLAIR signals. For the middle cerebral infarction phase (2–4 hours post-infarction), a mixed edema was observed. After reperfusion, there was a mild improvement in cell edema, while the angioedema became more serious. A high DWI signal and a low apparent diffusion coefficient signal were observed, and some rats showed high T2WI and T2FLAIR signals. For the late cerebral infarction phase (4–6 hours post-infarction), significant angioedema was visible in the infarction site. After reperfusion, there was a significant increase in angioedema, while there was evidence of hemorrhage and necrosis. A mixed signal was observed on DWI, while a high apparent diffusion coefficient signal, a high T2WI signal, and a high T2FLAIR signal were also observed. All 86 cerebral infarction patients were subjected to T2WI, T2FLAIR, and DWI. MRI results of clinic data similar to the early infarction phase of animal experiments were found in 51 patients, for which 10 patients (10/51) had an onset time greater than 6 hours. A total of 35 patients had MRI results similar to the middle and late infarction phase of animal experiments, of which eight patients (8/35) had an onset time less than 6 hours. These data suggest that defining the

  11. Influence of ST-segment recovery on infarct size and ejection fraction in patients with ST-segment elevation myocardial infarction receiving primary percutaneous coronary intervention

    DEFF Research Database (Denmark)

    Hallén, Jonas; Ripa, Maria Sejersten; Johanson, Per;

    2010-01-01

    In patients with ST-segment elevation myocardial infarction treated with fibrinolytics, electrocardiogram-derived measures of ST-segment recovery guide therapy decisions and predict infarct size. The comprehension of these relationships in patients undergoing mechanical reperfusion is limited. We...... studied 144 patients treated with primary percutaneous coronary intervention. We aimed to define the association between infarct size as determined by cardiac magnetic resonance imaging and different metrics of ST-segment recovery. Electrocardiograms were assessed at baseline and 90 minutes after primary.......781). In conclusion, an electrocardiogram obtained early after primary percutaneous coronary intervention analyzed by a simple algorithm provided prognostic information on the final infarct size and cardiac function....

  12. MRI of the cardiomyopathies

    Energy Technology Data Exchange (ETDEWEB)

    Di Cesare, Ernesto E-mail: ernesto.dicesare@cc.univaq.it

    2001-06-01

    We examined the potentialities of Magnetic resonance imaging (MRI) in the evaluation of the main cardiomyopathies: hypertrophic, dilated, restrictive and arrhythmogenic right ventricular. The hypertrophic cardiomyopathy is generally adequately investigated by echocardiography, that well defines the myocardial thickening and the obstruction of the left ventricular output. However, by echocardiography we still have difficulties in the evaluation of the apex of the left ventricle and the right ventricle involvement. MRI provides a complete evaluation of the heart with a clear evidence also of the echocardiographic dark zones by means of a clear evidence of the apex of the right ventricle. The dilated form is also well investigated by MRI that provides a clear evaluation of the volumes, mass and ejection fraction by means of the 3D analysis including conditions of the ventricular remodelling. Moreover, this technique helps in the differential diagnosis of acute myocarditis. In the acute phase of myocarditis (first 2 weeks), in fact, the myocardium produces high signal intensity on the T2 weighted sequences due to the presence of oedema. The third form of cardiomyopathy is the restrictive one, characterised by reduced diastolic filling and diastolic volume, normality of the systolic function and parietal thickness, interstitial fibrosis and enlargement of both atria. The mean potentiality of MRI is related to the differential diagnosis with constrictive pericarditis. Only in the former, the pericardium appears irregularly thickened with areas exceeding 4 mm of pericardial thickness. Finally, the right ventricular arrhythmogenic cardiomyopathy represents the main indication to MRI evaluation. With this imaging modality we are can obtain a clear morpho-functional evaluation of the right ventricle and distinguish the intramyocardial adipose substitution characterised by areas of high signal in the myocardium.

  13. 3D cardiac wall thickening assessment for acute myocardial infarction

    Science.gov (United States)

    Khalid, A.; Chan, B. T.; Lim, E.; Liew, Y. M.

    2017-06-01

    Acute myocardial infarction (AMI) is the most severe form of coronary artery disease leading to localized myocardial injury and therefore irregularities in the cardiac wall contractility. Studies have found very limited differences in global indices (such as ejection fraction, myocardial mass and volume) between healthy subjects and AMI patients, and therefore suggested regional assessment. Regional index, specifically cardiac wall thickness (WT) and thickening is closely related to cardiac function and could reveal regional abnormality due to AMI. In this study, we developed a 3D wall thickening assessment method to identify regional wall contractility dysfunction due to localized myocardial injury from infarction. Wall thickness and thickening were assessed from 3D personalized cardiac models reconstructed from cine MRI images by fitting inscribed sphere between endocardial and epicardial wall. The thickening analysis was performed in 5 patients and 3 healthy subjects and the results were compared against the gold standard 2D late-gadolinium-enhanced (LGE) images for infarct localization. The notable finding of this study is the highly accurate estimation and visual representation of the infarct size and location in 3D. This study provides clinicians with an intuitive way to visually and qualitatively assess regional cardiac wall dysfunction due to infarction in AMI patients.

  14. MRI and CT findings of intracranial neurosyphilis

    Energy Technology Data Exchange (ETDEWEB)

    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.

  15. [Segmental testicular infarction].

    Science.gov (United States)

    Ripa Saldías, L; Guarch Troyas, R; Hualde Alfaro, A; de Pablo Cárdenas, A; Ruiz Ramo, M; Pinós Paul, M

    2006-02-01

    We report the case of a 47 years old man previously diagnosed of left hidrocele. After having a recent mild left testicular pain, an ultrasonografic study revealed a solid hipoecoic testicular lesion rounded by a big hidrocele, suggesting a testicular neoplasm. Radical inguinal orchiectomy was made and pathologic study showed segmental testicular infarction. No malignancy was found. We review the literature of the topic.

  16. Impact of low signal intensity assessed by cine magnetic resonance imaging on detection of poorly viable myocardium in patients with prior myocardial infarction.

    Science.gov (United States)

    Ota, Shingo; Tanimoto, Takashi; Orii, Makoto; Hirata, Kumiko; Shiono, Yasutsugu; Shimamura, Kunihiro; Matsuo, Yoshiki; Yamano, Takashi; Ino, Yasushi; Kitabata, Hironori; Yamaguchi, Tomoyuki; Kubo, Takashi; Tanaka, Atsushi; Imanishi, Toshio; Akasaka, Takashi

    2015-05-13

    Late gadolinium enhancement magnetic resonance imaging (LGE-MRI) has been established as a modality to detect myocardial infarction (MI). However, the use of gadolinium contrast is limited in patients with advanced renal dysfunction. Although the signal intensity (SI) of infarct area assessed by cine MRI is low in some patients with prior MI, the prevalence and clinical significance of low SI has not been evaluated. The aim of this study was to evaluate how low SI assessed by cine MRI may relate to the myocardial viability in patients with prior MI. Fifty patients with prior MI underwent both cine MRI and LGE-MRI. The left ventricle was divided into 17 segments. The presence of low SI and the wall motion score (WMS) of each segment were assessed by cine MRI. The transmural extent of infarction was evaluated by LGE-MRI. LGE was detected in 329 of all 850 segments (39%). The low SI assessed by cine MRI was detected in 105 of 329 segments with LGE (32%). All segments with low SI had LGE. Of all 329 segments with LGE, the segments with low SI showed greater transmural extent of infarction (78 [72 - 84] % versus 53 [38 - 72] %, P cine MRI may be effective for detecting poorly viable myocardium in patients with prior MI.

  17. CT features of renal infarction

    Energy Technology Data Exchange (ETDEWEB)

    Suzer, Okan; Shirkhoda, Ali; Jafri, S. Zafar; Madrazo, Beatrice L.; Bis, Kostaki G.; Mastromatteo, James F

    2002-10-01

    Purpose: To demonstrate the different patterns of renal infarction to avoid pitfalls. To present 'flip-flop enhancement' pattern in renal infarction. Materials and methods: Retrospective review of a total of 41 renal infarction in 37 patients were done. These patients underwent initial CT and the diagnosis of renal infarction was confirmed with either follow up CT or at surgery. Results: Twenty-three patients had wedge-shaped focal infarcts, nine patients had global and five patients had multifocal infarcts of the kidneys. Cortical rim sign was seen predominantly with global infarcts. In five patients, a 'flip-flop enhancement' pattern was observed. In two patients, planned renal biopsies due to tumefactive renal lesions were cancelled because of 'flip-flop enhancement' pattern on follow up CTs. Conclusion: Although most of our cases were straightforward for the diagnosis of renal infarction, cases with tumefactive lesions and global infarctions without the well-known cortical rim sign were particularly challenging. We describe a new sign, flip-flop enhancement pattern, which we believe solidified the diagnosis of renal infarction in five of our cases. The authors recommend further investigations for association of flip-flop enhancement and renal infarction.

  18. Computed tomography of splenic infarcts

    Energy Technology Data Exchange (ETDEWEB)

    Triller, J.; Bona, E.; Barbier, P.

    1985-04-01

    Splenic infarcts are represented by wedge-shaped, oval or linear areas. Haemorrhagic infarcts are characterised by being hyperdense. Disseminated infarction occurs predominantly in myeloproliferative diseases. During the early stages, the infarct appears as an ill-defined hypodense defect, with non-homogeneous contrast enhancement. During the acute and sub-acute stage, the density of the infarct is low and there is no contrast enhancement. During the chronic stage, its density increases and there is slight contrast enhancement. Complications following splenic infarcts, such as abscesses, bleeding and rupture can be demonstrated by CT with great accuracy. Problems in differential diagnosis may occur if there are atypical manifestations of the infarct, with respect to abscess or leukaemic infiltrations.

  19. Battlefield MRI

    Energy Technology Data Exchange (ETDEWEB)

    Espy, Michelle [Los Alamos National Lab. (LANL), Los Alamos, NM (United States)

    2015-06-01

    Magnetic Resonance Imaging is the best method for non-invasive imaging of soft tissue anatomy, saving countless lives each year. It is regarded as the gold standard for diagnosis of mild to moderate traumatic brain injuries. Furthermore, conventional MRI relies on very high, fixed strength magnetic fields (> 1.5 T) with parts-per-million homogeneity, which requires very large and expensive magnets.

  20. Differentiation between acute and chronic myocardial infarction by means of texture analysis of late gadolinium enhancement and cine cardiac magnetic resonance imaging.

    Science.gov (United States)

    Larroza, Andrés; Materka, Andrzej; López-Lereu, María P; Monmeneu, José V; Bodí, Vicente; Moratal, David

    2017-07-01

    The purpose of this study was to differentiate acute from chronic myocardial infarction using machine learning techniques and texture features extracted from cardiac magnetic resonance imaging (MRI). The study group comprised 22 cases with acute myocardial infarction (AMI) and 22 cases with chronic myocardial infarction (CMI). Cine and late gadolinium enhancement (LGE) MRI were analyzed independently to differentiate AMI from CMI. A total of 279 texture features were extracted from predefined regions of interest (ROIs): the infarcted area on LGE MRI, and the entire myocardium on cine MRI. Classification performance was evaluated by a nested cross-validation approach combining a feature selection technique with three predictive models: random forest, support vector machine (SVM) with Gaussian Kernel, and SVM with polynomial kernel. The polynomial SVM yielded the best classification performance. Receiver operating characteristic curves provided area-under-the-curve (AUC) (mean±standard deviation) of 0.86±0.06 on LGE MRI using 72 features; AMI sensitivity=0.81±0.08 and specificity=0.84±0.09. On cine MRI, AUC=0.82±0.06 using 75 features; AMI sensitivity=0.79±0.10 and specificity=0.80±0.10. We concluded that texture analysis can be used for differentiation of AMI from CMI on cardiac LGE MRI, and also on standard cine sequences in which the infarction is visually imperceptible in most cases. Copyright © 2017 Elsevier B.V. All rights reserved.

  1. Placental pathologies in fetal MRI with pathohistological correlation.

    Science.gov (United States)

    Linduska, N; Dekan, S; Messerschmidt, A; Kasprian, G; Brugger, P C; Chalubinski, K; Weber, M; Prayer, D

    2009-06-01

    The purpose of this study was to evaluate whether currently available fetal Magnetic Resonance Imaging (MRI/MR) techniques are sufficient for the assessment of placental pathologies. We hypothesized that placental pathologies as detected and evaluated by MRI, would correlate with histological findings. In a retrospective study, 45 singleton pregnancies from 19 to 35 gestational weeks, with placental pathologies on MR scans, were included. MRI was performed on a 1.5T unit using T2-, T1-, and diffusion-weighted and echo-planar sequences. Pathologies were categorized into infarction with/without hemorrhagic components, subchorionic/intervillous thrombi/hemorrhages, retroplacental hematoma, massive perivillous fibrin deposition, and chorioamnionitis. Pathohistological examination was performed postnatally within a median of seven days between MR examination and delivery. Pathologically, 26 placentas showed infarctions (96.2% on MR scans), two retroplacental hematomas were detected by MRI and confirmed by pathology, and 9 of 14 subchorionic hematomas were confirmed. Six of eight intervillous hemorrhages were seen on MRI, and three of six cases of severe chorioamnionitis were diagnosed prenatally. Placental hemorrhages (retroplacental hematoma, intervillous thrombi, subchorionic hematoma), and ischemic lesions could be detected with fetal MRI, while chorioamnionitis and even massive perivillous fibrin deposition showed few signal changes, probably reflecting small macroscopic changes in the placenta. Fetal MRI, therefore, seems to be a promising tool for the assessment of placental insufficiency.

  2. Relation between cardiovascular disease risk markers and brain infarcts detected by magnetic resonance imaging in an elderly population.

    Science.gov (United States)

    Nylander, Ruta; Lind, Lars; Wikström, Johan; Lindahl, Bertil; Venge, Per; Larsson, Anders; Ärnlöv, Johan; Berglund, Lars; Ahlström, Håkan; Johansson, Lars; Larsson, Elna-Marie

    2015-02-01

    Established cardiovascular risk markers, such as hypertension, are associated with increased risk of brain infarcts. The newer markers N-terminal pro-brain natriuretic peptide, troponin I, C-reactive protein, and cystatin C may affect the risk of cardiovascular events and potentially, thereby, also stroke. We investigated the association between established and new risk markers for cardiovascular disease and brain infarcts detected by magnetic resonance imaging (MRI) at age 75. Four hundred six randomly selected subjects from the Prospective Investigation of the Vasculature in Uppsala Seniors study were examined with MRI of the brain at age 75. Blood samples, measurements, and dedicated questionnaires at age 70 were used for analysis of risk markers. A history of diseases had been obtained at age 70 and 75. MRI was evaluated regarding lacunar and cortical infarcts. Univariate associations between outcomes and risk markers were assessed with logistic regression models. One or more infarcts were seen in 23% of the subjects (20% had only lacunar infarcts, 1% had only cortical infarcts, and 2% had both). Hypertension (odds ratio [OR] 2.6, 95% confidence interval [CI] 1.4, 4.7) and obesity (OR 1.3; CI 1.0, 1.8) were significantly associated with increased risk of brain infarction. The newer risk markers were not significantly associated with the brain infarcts. The new markers were not associated with the predominantly lacunar infarcts in our 75-year-old population, why troponin I and NT-proBNP may be associated mainly with cardioembolic infarcts as shown recently. Copyright © 2015 National Stroke Association. Published by Elsevier Inc. All rights reserved.

  3. Multiorgan with renal infarction following treatment of cerebral infarction.

    Science.gov (United States)

    Kim, Ji Hee; Kang, Chung; Moon, Hyo Jeong; Joo, Min Cheol

    2013-08-01

    Acute renal infarction is a rare disease and it is often difficult to make a clinical diagnosis due to the non-specific clinical presentations and lack of the physicians' awarenesses. We experienced a case of a 72-year-old man who was diagnosed as multiorgan with renal infarction during the bridge therapy of cerebral infarction with atrial fibrillation. Computed tomogram (CT) with intravenous contrast of the abdomen and pelvis revealed left renal infarction with renal artery occlusion, multifocal splenic infarction, and ischemic colitis on rectum and sigmoid colon. The patient was treated with low molecular weight heparin for 10 days, his symptoms were improved and laboratory findings were normalized. Follow-up CT was performed on the 43th day, there were persisted left renal infarction with atrophic change shown and the splenic perfusion was improved.

  4. Influence of pre-infarction angina, collateral flow, and pre-procedural TIMI flow on myocardial salvage index by cardiac magnetic resonance in patients with ST-segment elevation myocardial infarction

    DEFF Research Database (Denmark)

    Lønborg, Jacob Thomsen; Kelbæk, Henning Skov; Vejlstrup, Niels Grove

    2012-01-01

    BACKGROUND: In patients with ST-segment elevation myocardial infarction (STEMI) pre-infarction angina, pre-procedural TIMI flow and collateral flow to the myocardium supplied by the infarct related artery are suggested to be cardioprotective. We evaluated the effect of these factors on myocardial...... salvage index (MSI) and infarct size adjusting for area at risk in patients with STEMI treated with primary percutaneous coronary intervention. METHODS AND RESULTS: Cardiac magnetic resonance (CMR) was used to measure myocardial area at risk within 1-7 days and final infarct size 90±21 days after...

  5. Brain MRI findings of neuropsychiatric lupus

    Energy Technology Data Exchange (ETDEWEB)

    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.

  6. A minimally invasive method for induction of myocardial infarction in an animal model using tungsten spirals.

    Science.gov (United States)

    Peukert, Daniel; Laule, Michael; Kaufels, Nicola; Schnorr, Jörg; Taupitz, Matthias; Hamm, Bernd; Dewey, Marc

    2009-06-01

    Most animal models use surgical thoracotomy with ligation of a coronary artery to induce myocardial infarction. Incision of the chest wall and myocardium affect remodeling after myocardial infarction. The aim of our study was to evaluate a new minimally invasive technique for inducing acute myocardial infarction in pigs. To this end, coronary angiography using a 6-F cardiac catheter was performed in 20 pigs. The cardiac catheter was advanced into the left circumflex artery (LCX) under electrocardiographic monitoring and small tungsten spirals were deployed in the vessel. LCX occlusion was verified by coronary angiography. Two days later, magnetic resonance imaging (MRI) was performed to estimate the extent of infarction. Thereafter, all animals were euthanized and the hearts stained with 2,3,5-triphenyltetrazolium chloride for histologic measurement of infarct size. Tungsten spirals were successfully placed in the LCX in all 20 pigs. About 13 of the 20 animals survived until the end of the experiment. The mean infarct size in the area supplied by the LCX was 4.4 +/- 2.3 cm(3) at MRI and 4.3 +/- 2.2 cm(3) at histology (r = 0.99, P < 0.001). No other myocardial regions showed infarction in any of the 13 pigs. Five of nine pigs requiring defibrillation due to ventricular fibrillation died because defibrillation was unsuccessful. One animal each died from pericarditis and pneumonia. Our results show that the minimally invasive method presented here enables reliable induction of myocardial infarction in a fairly straightforward manner. The 25% mortality rate associated with induction of myocardial infarction in our study is comparable to that reported by other investigators.

  7. MRI of the Chest

    Medline Plus

    Full Text Available ... News Physician Resources Professions Site Index A-Z Magnetic Resonance Imaging (MRI) - Chest Magnetic resonance imaging (MRI) of the chest ... limitations of MRI of the Chest? What is MRI of the Chest? Magnetic resonance imaging (MRI) is ...

  8. CT and MRI findings of cerebral ischemic lesions in the cortical and perforating arterial system

    Energy Technology Data Exchange (ETDEWEB)

    Kameyama, Masakuni; Udaka, Fukashi; Nishinaka, Kazuto; Kodama, Mitsuo; Urushidani, Makoto; Kawamura, Kazuyuki; Inoue, Haruhisa; Kageyama, Taku [Sumitomo Hospital, Osaka (Japan)

    1995-07-01

    It is clinically useful to divide the location of infarction into the cortical and perforating arterial system. Computerized tomography (CT) and magnetic resonance imaging (MRI) now make the point of infarction a simple and useful task in daily practice. The diagnostic modality has also demonstrated that risk factors and clinical manifestations are different for infarction in the cortical as opposed to the perforating system. In this paper, we present various aspects of images of cerebral ischemia according to CT and/or MRI findings. With the advance of imaging mechanics, diagnostic capability of CT or/and MRI for cerebral infarction has markedly been improved. We must consider these points on evaluating the previously reported results. In addition, we always consider the pathological background of these image-findings for the precise interpretation of their clinical significance. In some instances, dynamic study such as PET or SPECT is needed for real interpretations of CT and/or MRI images. We paid special reference to lacunar stroke and striatocapsular infarct. In addition, `branch atheromatous disease (Caplan)` was considered, in particular, for their specific clinical significances. Large striatocapsular infarcts frequently show cortical signs and symptoms such as aphasia or agnosia in spite of their subcortical localization. These facts, although have previously been known, should be re-considered for their pathoanatomical mechanism. (author).

  9. Clinical studies of cerebral arteriosclerosis in diabetic subjects. Analysis with brain MRI study

    Energy Technology Data Exchange (ETDEWEB)

    Ohashi, Makoto; Tanahashi, Hideo (Osaka Rosai Hospital, Sakai (Japan)); Nomura, Makoto; Yamada, Yoshio; Abe, Hiroshi

    1994-11-01

    In order to investigate the clinical characteristics of cerebral arteriosclerosis in diabetic subjects, brain MRI studies were conducted in diabetic patients and healthy subjects. The subjects were 93 diabetic patients without symptoms and signs of cerebral infarction (49 males and 44 females) with a mean age of 59 years and 73 healthy subjects (43 males and 30 females) with a mean age of 57 years. The MRI studies were performed on a General Electric 1.5-T signa system. The spin-echo technique (T2-weighted image) was used with a pulse repetition time (TR) of 2,500 msec and echo time (TE) of 80 msec. The quantitative evaluation of cerebral infarction was assessed using personal computer and image-scanner. By MRI, the incidence of cerebral infarction in diabetic patients was significantly higher than that in healthy subjects (30.1% vs. 13.7%, respectively, p<0.05). The mean age of the diabetic patients with cerebral infarctions was higher than that of those without cerebral infarctions. Hypertension and diabetic nephropathy were present more frequently in the subjects with cerebral infarctions. These data suggest that it is important to delay the onset and slow the progression of cerebral infarction in diabetic patients by strict blood glucose control and management of blood pressure. (author).

  10. National registry of myocardial infarction

    Directory of Open Access Journals (Sweden)

    Amin Daemi

    2016-07-01

    Full Text Available The Registry of Myocardial Infarctions (MI Registry is a national registry in Iran that collects and reports the data on myocardial infarctions. Its main advantage is that it covers the whole country and is mandatory for hospitals to register the MI cases in it. Then, the qualified individuals at the provincial and national levels can get intended reports and make appropriate decisions. Such reports, further to the policy makers and managers, can be very valuable for researchers. The registry is a unique and comprehensive source of data that can provide priceless reports which can be used in management, policy making, resource allocation, and for research purposes. The data of MI patients from all around the country are entered into the registry by the hospitals in which the MI patients are admitted. The data include the demographic information (name, gender, date of birth, literacy, nationality, health insurance, city, and province, admission data (date and time of the first signs of the attack, date and time of admission in the hospital emergency department, date and time of admission in cardiac care unit-CCU, name of the doctor, and the number of patient’s medical record, medical history (coronary heart disease, hypertension, diabetes, high cholesterol, number of cigarettes if smoking, history of CABG and/or PCI and its date, clinical condition (the patient’s condition in terms of rhythm and heart block according to the diagnosis of the doctor, interventions (thrombolytic therapy, CABG, PCI, and date and time of each intervention if applied, laboratory results (positive or negative Troponin T and Troponin I, amount of CPKMB, maximum Troponin T and Troponin I, and date and time of each laboratory test, and the discharge information (the patient’s status when discharged from CCU-stable or dead, prescribed drugs, final diagnosis, and date and time of discharge.

  11. Physiological Correlates of Intellectual Function in Children with Sickle Cell Disease: Hypoxaemia, Hyperaemia and Brain Infarction

    Science.gov (United States)

    Hogan, Alexandra M.; Pit-ten Cate, Ineke M.; Vargha-Khadem, Faraneh; Prengler, Mara; Kirkham, Fenella J.

    2006-01-01

    Lowered intelligence relative to controls is evident by mid-childhood in children with sickle cell disease. There is consensus that brain infarct contributes to this deficit, but the subtle lowering of IQ in children with normal MRI scans might be accounted for by chronic systemic complications leading to insufficient oxygen delivery to the brain.…

  12. Validation of infarct size and location from the ECG by inverse body surface mapping

    NARCIS (Netherlands)

    W. Arnold Dijk; J.W. Van Dam (Jan Willem); N.H.J.J. van der Putten (Niek); A.C. Maan (Arie); M.J.J. De Jongste (Mike)

    2012-01-01

    textabstractThis paper describes the incorporation of body surface mapping algorithms to detect the position and size of acute myocardial infarctions using standard 12 lead ECG recording. The results are compared with the results from cardiac MRI scan analysis. In case patient specific volume

  13. Correlating plasma endothelin-1 and beta-endorphin levels to nine risk factors of acute cerebral infarction

    Institute of Scientific and Technical Information of China (English)

    Daoyou Zhou; Jun Liu; Yingrong Lao; Yigang Xing; Yan Huang

    2008-01-01

    ].Among them,7 patients were smokers,and 6 were alcohol users.All controls had no history of stroke,hypertension,or diabetes mellitus.Informed consents of laboratory measurements were obtained from all subjects,and this study was approved by the Hospital Ethics Committee.METHODS:①Following admission,all subjects were scored by Barthel Index Scale(BIS)and Hamilton Depression Scale.Meanwhile,hypertension,diabetes mellitus,gender,smoking,drinking,and other conditions were recorded.CT/MRI examination was conducted to identify the focus site.②On the 2nd day after admission,ET-1 and β-EP plasma levels were measured with an automatic ET-1 and β-EP analysis kit.MAIN OUTCOME MEASURES:ET-1 and β-EP plasma levels and their correlation to acute cerebral infarction-related factors.RESULTS:Sixty-nine patients with acute cerebral infarction,and an additional 59 healthy individuals participated in the final analysis.①ET-1 [(63.80±27.65)ng/L vs.(46.50±9.36)rig/L,P<0.05] and β-EP [(94.18±33.94)mg/L vs.(51.87±23.43)mg/L,P<0.05] levels of the patient group were obviously higher than respective values of the control group.②The ET-I and β-EP levels of patients with cerebral infarction did not correlate to hypertension,diabetes mellitus,BIS,depression,cerebral infarct focus,disease course,gender,smoking or drinking(P>0.05).CONCLUSION:The ET-1 and β-EP levels of patients with acute cerebral infarction increased,but they were not obviously associated with disease course,blood pressure,blood glucose,BIS,or other common cerebral infarction-related factors.

  14. AN INTERESTING CASE OF DIABETIC MUSCLE INFARCTION

    Directory of Open Access Journals (Sweden)

    Srichandhanreddy

    2014-08-01

    Full Text Available Diabetic muscle infarction is rare complications of diabetes that occurs in patients with type 1 diabetes (70% of total cases or in patients with poorly controlled type 2 diabetes. Here is a 55 year old male patient was admitted with diabetic ketoacidosis and coma. Two days later following recovery he gave history of pain in the right thigh since 10 days. There was no history of trauma, fever, weight loss. On examination vitals are stable, systemic examination: clinically normal. Examination of right thigh lower one third, showed a tender mass of about 3.4 x8.2 cms, FNAC of which showed muscle fibres with hemorrhagic back ground. MRI scan suggesting of myositis involving vastus group of muscles. This patient had normal renal functions and normal fundus. This patient responded to conservative management and antibiotics. CONCLUSION: A high index of suspicion is needed to make a timely diagnosis of diabetic muscle Infarction, and avoid the use of steroids or surgical intervention.

  15. Knee MRI scan

    Science.gov (United States)

    MRI - knee ... radiologist see certain areas more clearly. During the MRI, the person who operates the machine will watch ... less anxious. Your provider may suggest an "open" MRI, in which the machine is not as close ...

  16. MRI of the Chest

    Medline Plus

    Full Text Available ... MRI of the Chest? What is MRI of the Chest? Magnetic resonance imaging (MRI) is a noninvasive ... of page What are some common uses of the procedure? MR imaging of the chest is performed ...

  17. Play the MRI Game

    Science.gov (United States)

    ... Teachers' Questionnaire MRI Play MRI the Magnetic Miracle Game About the game In the MRI imaging technique, strong magnets and ... last will in Paris. Play the Blood Typing Game Try to save some patients and learn about ...

  18. MRI of the Chest

    Medline Plus

    Full Text Available ... MRI of the Chest? What is MRI of the Chest? Magnetic resonance imaging (MRI) is a noninvasive ... of page What are some common uses of the procedure? MR imaging of the chest is performed ...

  19. MRI of the Chest

    Medline Plus

    Full Text Available ... You may resume your usual activities and normal diet immediately after the exam. On very rare occasions, ... Magnetic Resonance Imaging (MRI) Safety MRI Safety During Pregnancy Images related to Magnetic Resonance Imaging (MRI) - Chest ...

  20. Occipital lobe infarctions are different

    OpenAIRE

    Halvor Naess; Ulrikke Waje-Andreassen; Lars Thomassen

    2007-01-01

    Halvor Naess, Ulrikke Waje-Andreassen, Lars ThomassenDepartment of Neurology, Haukeland University Hospital, University of Bergen, N-5021 Bergen, NorwayObjectives: We hypothesized that occipital lobe infarctions differ from infarctions in other locations as to etiology, risk factors and prognosis among young adults.Methods: Location, etiology, risk factors and long-term outcome were evaluated among all young adults 15–49 years suffering from cerebral infarction in Hordaland County, Norw...

  1. Electrocardiogram changes in acute cerebral infarction patients

    Institute of Scientific and Technical Information of China (English)

    Jing Fang; Weihong Yan

    2006-01-01

    BACKGROUND: Comparison of different stroke locations had been focused in past researches in electrocardiogram (ECG) changes of cerebral stroke patients. Some researches neglected the heart disease in the illness history.OBJECTIVE: To discuss ECG changes in different infarction locations and size of acute cerebral infarction and compare with healthy people.DESIGN: Contrast observation.SETrING: Shanghai Ninth People's Hospital.PARTICIPANTS: A total of 57 patients with cerebral infarction were selected from the Neurological Department of Ninth People's Hospital of Shanghai from March 2003 to September 2005. They were diagnosed according to the criteria revised in the 4th National Cerebral Disease Conference and brain images. Patients who had heart disease were excluded. There were 32 males and 25 females, who were 65-84 years old. Among them, 23 cases were involved in right hemisphere, 34 cases in left one, 23 in base ganglion, 11 in brain stem, 9in frontal lobe and 14 in other parts. According to their infarction size (plus size in every different scan), they were divided into three different groups: large-size group (n = 10) with size larger than 3.5 cm3, medium-sizegroup (n = 13) with size between 1.5-3.5 cm3, and small-size group (n = 34) with size smaller than 1.5 cm3.Another 50 healthy subjects were regarded as control group. There were 29 males and 21 females aged 40-82 years. All these cases knew and agreed of the examination.METHODS: Patients received 12-lead ECG examinations within the first 6-24 hours of onset while control group received it at the same time. The HR, PR, QTc, QRS, T wave and ST changes were compared between the two groups.MAIN OUTCOME MEASURES: The ECG changes and differences in two hemispheres, in different infarction lccations and sizes. RESULTS: All 57 patients and 50 healthy subjects were involved in the final analysis. ① ECG changes in infarction group and control group. There were no differences in HR, QRS time and cases with

  2. Clinical research on acute cerebral infarction by diffusion-weighted MRI (DWI) plus magnetic resonance spectroscopy (MRS)%核磁共振弥散加权成像联合波谱成像评价急性脑梗死药物疗效的价值研究

    Institute of Scientific and Technical Information of China (English)

    韩立秀; 张振华; 张鹏; 张子宪; 胡屹伟

    2014-01-01

    目的:核磁共振弥散加权成像(Diffusion-weighted MRI,DWI)及氢质子波谱成像(H Magnetic Resonance Spectroscopy,MRS)观察两组急性脑梗死患者治疗前后影像学改变和临床症状体征改善的情况,评价两组临床治疗方案治疗急性脑梗死的疗效。方法:选择发病24h内的急性脑梗死患者40例,随机分为研究组(20例)及对照组(20例)。对两组病人治疗前及治疗2周后用美国国立卫生研究院脑卒中量表评分(NIHSS评分)及应用磁共振弥散加权成像(DWI)及MRS在兴趣区上测量氮-乙酰天冬氨酸(NAA)与肌酸(Cr)比值(NAA/Cr);胆碱复合物(Cho)与肌酸(Cr)比值(Cho/Cr)及乳酸(Lac)与肌酸(Cr)比值(Lac/Cr),并对治疗前后结果进行统计学分析。结果:治疗2周后两组病人 NIHSS评分较治疗前均有所降低,研究组较对照组下降明显(P<0.05),两组病人NAA/Cr较治疗前升高,但研究组较对照组升高明显(P<0.05)。两组病人CHO/Cr及 Lac/Cr 均较治疗前降低,但研究组较对照组降低明显(P<0.05),以上结果分析差异均有统计学意义。结论:应用 MRS 联合DWI能更好的指导临床治疗,脑蛋白水解物(施普善)是一种有效的治疗急性脑梗死的神经保护剂。%To observe clinical effects on the different treatment of the acute cerebral infarction combined with diffusion-weighted MRI (DWI) and magnetic resonance spectroscopy (MRS). Methods: 40 patients who had onset of acute cerebral infarction within 24 hours were randomly divided into treatment group (n=20) or the control group (n=20). National institute of health stroke scale (NIHSS) and application in interest on MRS area measurement N-acetylaspartate (NAA) and creatine (Cr) ratio (NAA/Cr);Choline complex (Cho) and creatine (Cr) ratio (Cho/Cr) and lactic acid (Lac) and creatine (Cr) ratio (Lac/Cr)were compared beteen two groups. Results

  3. Occipital lobe infarctions are different

    Directory of Open Access Journals (Sweden)

    Halvor Naess

    2007-09-01

    Full Text Available Halvor Naess, Ulrikke Waje-Andreassen, Lars ThomassenDepartment of Neurology, Haukeland University Hospital, University of Bergen, N-5021 Bergen, NorwayObjectives: We hypothesized that occipital lobe infarctions differ from infarctions in other locations as to etiology, risk factors and prognosis among young adults.Methods: Location, etiology, risk factors and long-term outcome were evaluated among all young adults 15–49 years suffering from cerebral infarction in Hordaland County, Norway between 1988 and 1997.Results: The following variables were more frequent among patients with occipital lobe infarction compared with patients with infarctions located elsewhere: younger age (P < 0.001, female sex (P = 0.016, prothrombotic state (P = 0.005 and lack of hypertension (P = 0.001. There was no difference as to long-term mortality or recurrence of cerebral infarction. Conclusion: Occipital lobe infarctions differ from infarctions in other locations among young adults. This may have important etiologic and therapeutical implications that need further studies.Keywords: cerebral infarction, occipital lobe, young adults

  4. Animal MRI Core

    Data.gov (United States)

    Federal Laboratory Consortium — The Animal Magnetic Resonance Imaging (MRI) Core develops and optimizes MRI methods for cardiovascular imaging of mice and rats. The Core provides imaging expertise,...

  5. Ferumoxytol-enhanced magnetic resonance imaging assessing inflammation after myocardial infarction.

    Science.gov (United States)

    Stirrat, Colin G; Alam, Shirjel R; MacGillivray, Thomas J; Gray, Calum D; Dweck, Marc R; Raftis, Jennifer; Jenkins, William Sa; Wallace, William A; Pessotto, Renzo; Lim, Kelvin Hh; Mirsadraee, Saeed; Henriksen, Peter A; Semple, Scott Ik; Newby, David E

    2017-10-01

    Macrophages play a central role in the cellular inflammatory response to myocardial infarction (MI) and predict subsequent clinical outcomes. We aimed to assess temporal changes in cellular inflammation and tissue oedema in patients with acute MI using ultrasmallsuperparamagnetic particles of iron oxide (USPIO)-enhanced MRI. Thirty-one patients were recruited following acute MI and followed up for 3 months with repeated T2 and USPIO-enhanced T2*-mapping MRI. Regions of interest were categorised into infarct, peri-infarct and remote myocardial zones, and compared with control tissues. Following a single dose, USPIO enhancement was detected in the myocardium until 24 hours (pinfarcted, but not the non-infarcted, myocardium. Following repeated doses, USPIO uptake in the infarct zone peaked at days 2-3, and greater USPIO uptake was detected in the infarct zone compared with remote myocardium until days 10-16 (pmyocardial oedema peaked at days 3-9 and remained increased in the infarct zone throughout the 3-month follow-up period (pMyocardial macrophage activity can be detected using USPIO-enhanced MRI in the first 2 weeks following acute MI. This observed pattern of cellular inflammation is distinct, and provides complementary information to the more prolonged myocardial oedema detectable using T2 mapping. This imaging technique holds promise as a non-invasive method of assessing and monitoring myocardial cellular inflammation with potential application to diagnosis, risk stratification and assessment of novel anti-inflammatory therapeutic interventions. Trial registration number: 14663. Registered on UK Clinical Research Network (http://public.ukcrn.org.uk) and also ClinicalTrials.gov (https://clinicaltrials.gov/ct2/show/NCT02319278?term=DECIFER&rank=2). © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  6. Myocardial infarction and cerebral infarction in a Danish suburban community

    DEFF Research Database (Denmark)

    Lyngborg, K; Marquardsen, J; Trautner, F

    1985-01-01

    A comparison was made of 485 cases of cerebral infarction (CI), registered prospectively in Frederiksberg, Copenhagen, with 495 cases of myocardial infarction (AMI), recorded retrospectively in the same population. The overall annual incidence of AMI was 6.5 per 1,000 population for males, 3...

  7. The cerebral intravascular enhancement sign is not specific: a contrast-enhanced MRI study

    Energy Technology Data Exchange (ETDEWEB)

    Bakshi, R.; Kinkel, W.R.; Bates, V.E.; Mechtler, L.L.; Kinkel, P.R. [Lucy Dent Imaging Center, University at Buffalo, NY (United States)

    1999-02-01

    The intravascular enhancement (IVE) sign, also known as the ``arterial enhancement sign``, is an abnormal finding in the brain on contrast-enhanced MRI studies. IVE has been described in arterial cerebrovascular disorders, most commonly in acute or subacute arterial ischemic infarcts. However, the specificity of this sign has not been established. We describe four patients with disorders other than arterial strokes in whom gadolinium-enhanced high-field (1.5 T) MRI suggested IVE. The conditions were herpes simplex viral encephalitis, idiopathic cerebellitis, pneumococcal meningitis, and superior sagittal sinus thrombosis with venous infarction. IVE in these cases may be due to multiple factors, including arterial, venous, perivascular, and leptomeningeal or sulcal contrast medium accumulation. Our observations suggest that arterial ischemia, previously described as the cardinal cause of IVE, probably does not explain all instances, and urge caution in interpreting this sign as a specific MRI manifestation of acute arterial infarction or ischemia. (orig.) With 4 figs., 1 tab., 44 refs.

  8. Magnetic resonance perfusion imaging evaluation in perfusion abnormalities of the cerebellum after supratentorial unilateral hyperacute cerebral infarction

    Institute of Scientific and Technical Information of China (English)

    Pan Liang; Yunjun Yang; Weijian Chen; Yuxia Duan; Hongqing Wang; Xiaotong Wang

    2012-01-01

    Magnetic resonance imaging (MRI) data of 10 patients with hyperacute cerebral infarction (≤ 6 hours) were retrospectively analyzed. Six patients exhibited perfusion defects on negative enhancement integral maps, four patients exhibited perfusion differences in pseudo-color on mean time to enhance maps, and three patients exhibited perfusion differences in pseudo-color on time to minimum maps. Dynamic susceptibility contrast-enhanced perfusion weighted imaging revealed a significant increase in region negative enhancement integral in the affected hemisphere of patients with cerebral infarction. The results suggest that dynamic susceptibility contrast-enhanced perfusion weighted imaging can clearly detect perfusion abnormalities in the cerebellum after unilateral hyperacute cerebral infarction.

  9. The use of magnetic resonance and MR angiography in the detection of cerebral infarction: A complication of pediatric bacterial meningitis

    Directory of Open Access Journals (Sweden)

    Stošić-Opinćal Tatjana

    2005-01-01

    Full Text Available Bacground. Association of both cerebral infarction and acute bacterial meningitis is more common in younger patients than in the elderly. The rate of mortality and the frequency of sequel are very high inspite of the use of modern antibiotic therapy. In more than 30% of the cases of childhood bacterial meningitis, both arterial and venous infarctions can occur. The aim of this study was to present the role of the use of magnetic resonance (MRI, and MR angiography (MRA in the detection of bacterial meningitis in children complicated with cerebral infarctions. Method. In the Centre for MR, the Clinical Centre of Serbia, 25 patients with the diagnosis of bacterial meningitis, of which 9 children with cerebral infarction whose clinical conditon deteriorated acutely, despite the antibiotic therapy, underwent MRI and MR angiography examination on a 1T scanner. Examination included the conventional spin-echo techniques with T1-weighted saggital and coronal, and T2- weighted axial and coronal images. Coronal fluid attenuated inversion recovery (FLAIR and the postcontrast T1-weighted images in three orthogonal planes were also used. The use MR angiography was accomplished by the three-dimensional time-of-flight (3D TOF technique. Results. The findings included: multiple hemorrhagic infarction in 4 patients, multiple infarctions in 3 patients, focal infarction in 1 patient and diffuse infarction (1 patient. Common sites of involvement were: the frontal lobes, temporal lobes and basal ganglia. The majority of infarctions were bilateral. In 3 of the patients empyema was found, and in 1 patient bitemporal abscess was detected. In 8 of the patients MR angiography confirmed inflammatory vasculitis. Conclusion. Infarction is the most common sequel of severe meningitis in children. Since the complication of cerebral infarction influences the prognosis of meningitis, repetitive MRI examinations are very significant for the evaluation of the time course of

  10. MRI of 'brain death'

    Energy Technology Data Exchange (ETDEWEB)

    Nishino, Shigeki; Itoh, Takahiko; Tuchida, Shohei; Kinugasa, Kazushi; Asari, Shoji; Nishimoto, Akira (Okayama Univ. (Japan). School of Medicine); Sanou, Kazuo

    1990-12-01

    Magnetic resonance imaging (MRI) was undertaken for two patients who suffered from severe cerebrovascular diseases and were clinically brain dead. The MRI system we used was Resona (Yokogawa Medical Systems, superconductive system 0.5 T) and the CT apparatus was Toshiba TCT-300. Initial CT and MRI were undertaken as soon as possible after admission, and repeated sequentially. After diagnosis of brain death, we performed angiography to determine cerebral circulatory arrest, and MRI obtained at the same time was compared with the angiogram and CT. Case 1 was a 77-year-old man who was admitted in an unconscious state. CT and MRI on the second day after hospitalization revealed cerebellar infarction. He was diagnosed as brain dead on day 4. Case 2 was a 35-year-old man. When he was transferred to our hospital, he was in cardiorespiratory arrested. Cardiac resuscitation was successful but no spontaneous respiration appeared. CT and MRI on admission revealed right intracerebral hemorrhage. Angiography revealed cessation of contrast medium in intracranial vessels in both of the patients. We found no 'flow signal void sign' in the bilateral internal carotid and basilar arteries on MRI images in both cases after brain death. MRI, showing us the anatomical changes of the brain, clearly revealed brain herniations, even though only nuclear findings of 'brain tamponade' were seen on CT. But in Case 1, we could not see the infarct lesions in the cerebellum on MR images obtained after brain death. This phenomenon was caused by the whole brain ischemia masking the initial ischemic lesions. We concluded that MRI was useful not only the anatomical display of lesions and brain herniation with high contrast resolution but for obtaining information on cerebral circulation of brain death. (author).

  11. [Streptokinase in impending heart infarct].

    Science.gov (United States)

    Kiemeneij, F; Schuilenburg, R M

    1989-02-18

    A patient is described with an impending myocardial infarction due to presence of an intracoronary thrombus in an otherwise normal left anterior descending artery. This case illustrates that intracoronary and intravenous administration of streptokinase can be of value in the treatment of impending myocardial infarction.

  12. Neuroprotective efficacy of methylene blue in ischemic stroke: an MRI study.

    Directory of Open Access Journals (Sweden)

    Qiang Shen

    Full Text Available Methylene blue (MB has unique energy-enhancing and antioxidant properties and is FDA-approved drug to treat methemoglobinemia and cyanide poisoning. This study evaluated the efficacy of MB to treat ischemic stroke in rats using longitudinal MRI and behavioral measures. Rats were subjected to 60-minute middle-cerebral-artery occlusion. In a randomized double-blinded design, vehicle or MB was administered after reperfusion. The initial lesion volumes at 30 minutes post-ischemia were not significantly different between the two groups (P = 0.92. The final infarct volumes two days after stroke increased in the vehicle group but decreased in the MB group, yielding a 30% difference in infarct volume (P = 0.03. Tracking tissue fate on a pixel-by-pixel basis showed that MB salvaged more initial core pixels compared to controls (22±3% versus 11±3%, P = 0.03, and more mismatch pixels compared to controls (83±3% versus 61±8%, P = 0.02. This study demonstrates MB treatment minimizes ischemic brain injury and improves functional outcomes.

  13. A large left atrial myxoma causing multiple cerebral infarcts.

    Science.gov (United States)

    Kebede, Saba; Edmunds, Eiry; Raybould, Adrian

    2013-11-27

    A 52-year-old man presented with a history of sudden onset diplopia. On neurological examination, the only abnormality was a right-sided oculomotor (third nerve) palsy. A brain CT was performed and reported as showing no abnormality. He was discharged to be investigated as an outpatient. He presented 1 month later with a new expressive dysphasia and confusional state. MRI was performed which revealed multiple cerebral infarcts. He was discharged on secondary stroke prevention medication. Six months elapsed, before a transthoracic echocardiogram was performed. This showed a large left atrial myxoma. The patient underwent an emergency resection and made a good postoperative recovery. This case report showed the importance of considering a cardiogenic source of emboli in patients who present with cerebral infarcts. Performing echocardiography early will help to detect treatable conditions such as atrial myxoma, and prevent further complications.

  14. Effects of Lacunar Infarctions on Cognitive Impairment in Patients with Cerebral Autosomal-Dominant Arteriopathy with Subcortical Infarcts and Leukoencephalopathy

    Science.gov (United States)

    Choi, Jay Chol; Kang, Sa-Yoon; Kang, Ji-Hoon; Na, Hae Ri; Park, Ji-Kang

    2011-01-01

    Background and Purpose Cerebral autosomal-dominant arteriopathy with subcortical infarcts and leukoencephalopathy (CADASIL) is an inherited microangiopathy caused by mutations in the Notch3 gene. Although previous studies have shown an association between lacunar infarction and cognitive impairment, the relationship between MRI parameters and cognition remains unclear. In this study we investigated the influence of MRI parameters on cognitive impairment in CADASIL. Methods We applied a prospective protocol to 40 patients. MRI analysis included the normalized volume of white-matter hyperintensities (nWMHs), number of lacunes, and number of cerebral microbleeds. Cognition was assessed with the aid of psychometric tests [Mini-Mental State Examination (MMSE), Alzheimer's Disease Assessment Scale-cognition (ADAS-cog), Trail-Making Test, and Stroop interference (Stroop IF)]. Results A multivariate regression analysis revealed that the total number of lacunes influenced the performance in the MMSE, ADAS-cog, and Stroop IF, while nWMHs had a strong univariate association with ADAS-cog and Stroop IF scores. However, this association disappeared in the multivariate analysis. Conclusions These findings demonstrate that the number of lacunes is the main predictive factor of cognitive impairment in CADASIL. PMID:22259617

  15. Sodium MRI in human heart: a review.

    Science.gov (United States)

    Bottomley, Paul A

    2016-02-01

    This paper offers a critical review of the properties, methods and potential clinical application of sodium ((23)Na) MRI in human heart. Because the tissue sodium concentration (TSC) in heart is about ~40 µmol/g wet weight, and the (23)Na gyromagnetic ratio and sensitivity are respectively about one-quarter and one-11th of that of hydrogen ((1)H), the signal-to-noise ratio of (23)Na MRI in the heart is about one-6000th of that of conventional cardiac (1)H MRI. In addition, as a quadrupolar nucleus, (23)Na exhibits ultra-short and multi-component relaxation behavior (T1 ~ 30 ms; T2 ~ 0.5-4 ms and 12-20 ms), which requires fast, specialized, ultra-short echo-time MRI sequences, especially for quantifying TSC. Cardiac (23)Na MRI studies from 1.5 to 7 T measure a volume-weighted sum of intra- and extra-cellular components present at cytosolic concentrations of 10-15 mM and 135-150 mM in healthy tissue, respectively, at a spatial resolution of about 0.1-1 ml in 10 min or so. Currently, intra- and extra-cellular sodium cannot be unambiguously resolved without the use of potentially toxic shift reagents. Nevertheless, increases in TSC attributable to an influx of intra-cellular sodium and/or increased extra-cellular volume have been demonstrated in human myocardial infarction consistent with prior animal studies, and arguably might also be seen in future studies of ischemia and cardiomyopathies--especially those involving defects in sodium transport. While technical implementation remains a hurdle, a central question for clinical use is whether cardiac (23)Na MRI can deliver useful information unobtainable by other more convenient methods, including (1)H MRI.

  16. Compressed sensing for body MRI.

    Science.gov (United States)

    Feng, Li; Benkert, Thomas; Block, Kai Tobias; Sodickson, Daniel K; Otazo, Ricardo; Chandarana, Hersh

    2017-04-01

    The introduction of compressed sensing for increasing imaging speed in magnetic resonance imaging (MRI) has raised significant interest among researchers and clinicians, and has initiated a large body of research across multiple clinical applications over the last decade. Compressed sensing aims to reconstruct unaliased images from fewer measurements than are traditionally required in MRI by exploiting image compressibility or sparsity. Moreover, appropriate combinations of compressed sensing with previously introduced fast imaging approaches, such as parallel imaging, have demonstrated further improved performance. The advent of compressed sensing marks the prelude to a new era of rapid MRI, where the focus of data acquisition has changed from sampling based on the nominal number of voxels and/or frames to sampling based on the desired information content. This article presents a brief overview of the application of compressed sensing techniques in body MRI, where imaging speed is crucial due to the presence of respiratory motion along with stringent constraints on spatial and temporal resolution. The first section provides an overview of the basic compressed sensing methodology, including the notion of sparsity, incoherence, and nonlinear reconstruction. The second section reviews state-of-the-art compressed sensing techniques that have been demonstrated for various clinical body MRI applications. In the final section, the article discusses current challenges and future opportunities. 5 J. Magn. Reson. Imaging 2017;45:966-987. © 2016 International Society for Magnetic Resonance in Medicine.

  17. Callosal alien hand sign following a right parietal lobe infarction.

    Science.gov (United States)

    Kim, Young-Do; Lee, Eek-Sung; Lee, Kwang-Soo; Kim, Joong-Seok

    2010-06-01

    Callosal alien hand syndrome is characterized primarily by intermanual conflict and is associated with an anterior callosal lesion. We report a patient who presented with topographical disorientation and the callosal type alien hand sign. An MRI of the brain showed a right parietal lobe infarction. This is a rare example of callosal alien hand sign associated with a right parietal lesion. The right parietal lobe appeared to be responsible for the callosal hand sign in this patient, possibly due to interference with peristriate outflow pathways toward the parietal zones, where visual somatosensory interactions are likely to occur. Copyright 2009 Elsevier Ltd. All rights reserved.

  18. MYOCARDIAL INFARCTION TYPE 2. MYTH OR REALITY?

    OpenAIRE

    V. V. Zhelnov; N. V. Dyatlov; L. I. Dvoretsky

    2016-01-01

    According to The Third Definition of Myocardial Infarction there are five types of myocardial infarction depending on pathogenesis. This review provides actual data about myocardial infarction type 2 mechanism including diagnosis management, epidemiological characteristic and patient prognosis. Previously published data shows discordant information about myocardial infarction type 2 frequency, treatment and diagnostic options. Our clinical observation illustrates these severities in diagnosis...

  19. [Hemicape-like sensory disturbance caused by cortical infarction in the postcentral gyrus].

    Science.gov (United States)

    Yamashita, Chikara; Kawamura, Nobutoshi; Torii, Takako; Ohyagi, Yasumasa; Kira, Jun-ichi

    2012-01-01

    We report a case of a small cortical infarction in the postcentral gyrus that presented an isolated hemicape-like sensory disturbance. A 47-year-old man suddenly developed numbness and paresthesia in the left neck, shoulder, arm, and upper trunk. Examination revealed hypoesthesia to touch and pain in these areas along with a hemicape-like distribution. The sensitivity to cold and vibration was normal, and two-point discrimination and graphesthesia were preserved. The patient had a normal visual field, muscle strength, and reflexes, and there were no neuropsychological deficits. Magnetic resonance imaging (MRI) demonstrated a fresh, small cerebral infarction in the right postcentral gyrus, which was superior medial to the precentral knob. The area of infarction in this patient corresponds well with the area of the upper trunk, neck, head, shoulder, and arm in the sensory homunculus drawn by Penfield and Rassumussen. The spinal MRI was normal. Transesophageal echocardiography disclosed a patent foramen ovale with a right-to-left-shunt. The patient was diagnosed as having acute cerebral infarction, probably due to paradoxical embolism, and was treated with warfarin. A small localized infarct in the postcentral gyrus can present an isolated sensory disturbance with an atypical hemicape-like distribution.

  20. Infarction Distribution Pattern in Acute Stroke May Predict the Extent of Leptomeningeal Collaterals

    Science.gov (United States)

    Verma, Rajeev Kumar; Gralla, Jan; Klinger-Gratz, Pascal Pedro; Schankath, Adrian; Jung, Simon; Mordasini, Pasquale; Zubler, Christoph; Arnold, Marcel; Buehlmann, Monika; Lang, Matthias F.

    2015-01-01

    Objective The aim of this study was to evaluate whether the distribution pattern of early ischemic changes in the initial MRI allows a practical method for estimating leptomeningeal collateralization in acute ischemic stroke (AIS). Methods Seventy-four patients with AIS underwent MRI followed by conventional angiogram and mechanical thrombectomy. Diffusion restriction in Diffusion weighted imaging (DWI) and correlated T2-hyperintensity of the infarct were retrospectively analyzed and subdivided in accordance with Alberta Stroke Program Early CT score (ASPECTS). Patients were angiographically graded in collateralization groups according to the method of Higashida, and dichotomized in 2 groups: 29 subjects with collateralization grade 3 or 4 (well-collateralized group) and 45 subjects with grade 1 or 2 (poorly-collateralized group). Individual ASPECTS areas were compared among the groups. Results Means for overall DWI-ASPECTS were 6.34 vs. 4.51 (well vs. poorly collateralized groups respectively), and for T2-ASPECTS 9.34 vs 8.96. A significant difference between groups was found for DWI-ASPECTS (p<0.001), but not for T2-ASPECTS (p = 0.088). Regarding the individual areas, only insula, M1-M4 and M6 showed significantly fewer infarctions in the well-collateralized group (p-values <0.001 to 0.015). 89% of patients in the well-collateralized group showed 0–2 infarctions in these six areas (44.8% with 0 infarctions), while 59.9% patients of the poor-collateralized group showed 3–6 infarctions. Conclusion Patients with poor leptomeningeal collateralization show more infarcts on the initial MRI, particularly in the ASPECTS areas M1 to M4, M6 and insula. Therefore DWI abnormalities in these areas may be a surrogate marker for poor leptomeningeal collaterals and may be useful for estimation of the collateral status in routine clinical evaluation. PMID:26327519

  1. Infarction Distribution Pattern in Acute Stroke May Predict the Extent of Leptomeningeal Collaterals.

    Directory of Open Access Journals (Sweden)

    Rajeev Kumar Verma

    Full Text Available The aim of this study was to evaluate whether the distribution pattern of early ischemic changes in the initial MRI allows a practical method for estimating leptomeningeal collateralization in acute ischemic stroke (AIS.Seventy-four patients with AIS underwent MRI followed by conventional angiogram and mechanical thrombectomy. Diffusion restriction in Diffusion weighted imaging (DWI and correlated T2-hyperintensity of the infarct were retrospectively analyzed and subdivided in accordance with Alberta Stroke Program Early CT score (ASPECTS. Patients were angiographically graded in collateralization groups according to the method of Higashida, and dichotomized in 2 groups: 29 subjects with collateralization grade 3 or 4 (well-collateralized group and 45 subjects with grade 1 or 2 (poorly-collateralized group. Individual ASPECTS areas were compared among the groups.Means for overall DWI-ASPECTS were 6.34 vs. 4.51 (well vs. poorly collateralized groups respectively, and for T2-ASPECTS 9.34 vs 8.96. A significant difference between groups was found for DWI-ASPECTS (p<0.001, but not for T2-ASPECTS (p = 0.088. Regarding the individual areas, only insula, M1-M4 and M6 showed significantly fewer infarctions in the well-collateralized group (p-values <0.001 to 0.015. 89% of patients in the well-collateralized group showed 0-2 infarctions in these six areas (44.8% with 0 infarctions, while 59.9% patients of the poor-collateralized group showed 3-6 infarctions.Patients with poor leptomeningeal collateralization show more infarcts on the initial MRI, particularly in the ASPECTS areas M1 to M4, M6 and insula. Therefore DWI abnormalities in these areas may be a surrogate marker for poor leptomeningeal collaterals and may be useful for estimation of the collateral status in routine clinical evaluation.

  2. Isolated acute nontraumatic cortical subarachnoid hemorrhage: Etiologies based on MRI findings

    Energy Technology Data Exchange (ETDEWEB)

    Cho, Eun; Kang, Myung Jin; Kim, Sang Hyeon [Dept. of Radiology, Dong-A University Medical Center, Busan (Korea, Republic of)

    2016-06-15

    The purpose of this study was to identify common underlying etiologies that may be responsible for isolated acute nontraumatic cortical subarachnoid hemorrhage (cSAH) by analysis of magnetic resonance imaging (MRI) findings of the brain. From August 2005 to February 2014, 15 cSAH patients were admitted to our institution. All patients with cSAH underwent brain MRI and magnetic resonance angiography as a part of their initial evaluation. An analysis of the patients' medical history, clinical presentations, and brain MRI findings was retrospectively performed. Among the combined pathologies that were suspected causes of cSAH, 11 patients showed acute or subacute cerebral infarctions at the ipsilateral hemisphere of cSAH on the diffusion-weighted images. Four of 11 patients had only cerebral infarction, but the other 7 had combined vasculopathy of extra- and intracranial arteries. Four of 15 patients who did not have cerebral infarction, had intracranial artery stenosis, or showed possible cerebral amyloid angiopathy, or no abnormal findings on the brain MRI. Ischemic stroke, such as cerebral infarction or vasculopathy of the extra and intracranial arteries is regarded as a common underlying etiology of the cSAH based on MRI findings.

  3. Critical Care Needs in Patients with Diffusion-Weighted Imaging Negative MRI after tPA--Does One Size Fit All?

    Directory of Open Access Journals (Sweden)

    Roland Faigle

    Full Text Available Patients who receive intravenous (IV tissue plasminogen activator (tPA for ischemic stroke are currently monitored in an intensive care unit (ICU or a comparable stroke unit for at least 24 hours due to the high frequency of neurological exams and vital sign checks. The present study evaluates ICU needs in patients with diffusion-weighted imaging (DWI negative MRI after IV tPA.A retrospective chart review was performed for 209 patients who received IV tPA for acute stroke. Data on stroke risk factors, physiologic parameters, stroke severity, MRI characteristics, and final diagnosis were collected. The timing and nature of ICU interventions, if needed, was recorded. Multivariable logistic regression was used to determine factors associated with subsequent ICU needs.Patients with cerebral infarct on MRI after tPA had over 9 times higher odds of requiring ICU care compared to patients with DWI negative MRI (OR 9.2, 95% CI 2.49-34.15. All DWI negative patients requiring ICU care did so by the end of tPA infusion (p = 0.006. Among patients with DWI negative MRI, need for ICU interventions was associated with higher NIH Stroke Scale (NIHSS scores (p<0.001, uncontrolled hypertension (p<0.001, seizure at onset (p = 0.002, and reduced estimated glomerular filtration rate (eGFR (p = 0.010.Only a small number of DWI negative patients required ICU care. In patients without critical care needs by the end of thrombolysis, post-tPA MRI may be considered for triaging DWI negative patients to a less resource intense monitoring environment.

  4. Depression following myocardial infarction

    DEFF Research Database (Denmark)

    Larsen, Karen Kjær

    2013-01-01

    Myocardial infarction (MI) is a severe life event that is accompanied by an increased risk of depression. Mounting evidence suggests that post-MI depression is associated with adverse outcomes, but the underlying mechanisms of this association remain unclear, and no previous studies have examined...... whether the mental burden of MI is so heavy that it increases the risk of suicide. Although post-MI depression is common and burdensome, the condition remains under-recognised and under-treated. The development of new strategies to improve the quality of care for people with post-MI depression requires...... thorough understanding of the mechanisms that influence the prognosis as well as knowledge of the present care provided. The purpose of this PhD thesis is accordingly subdivided into four specific aims: 1. To estimate the prevalence of depression in people with MI after three months, and to estimate...

  5. Acute capsular infarction

    Energy Technology Data Exchange (ETDEWEB)

    Kashihara, M.; Matsumoto, K.

    1985-05-01

    Sixty-three patients with lacunar-type of acute capsular infarction were treated in our service during the last 2 years. Their lesions were identified by computed tomography (CT) and classified into six types according to their locations: anterior, lateral, posterior, superior, inferior and multiple. The lesions were thought to be in the watershed areas of the regional arterial supplies, and the areas were considered to be prone to ischemia. The clinical course of each type showed characteristic features of ischemic strokes. In the majority of the patients with the lateral type, reversible ischemic neurological deficit (RIND) was seen as the predominant symptom, transient ischemic attack (TIA) was noted in the patients with the superior type, and major completed stroke was observed in those with posterior type.

  6. infarction in rats

    Directory of Open Access Journals (Sweden)

    Keyvan Yousefi

    2014-03-01

    Full Text Available Introduction: Nowadays, finding new therapeutic compounds from natural products for treatment and prevention of a variety of diseases including cardiovascular disorders is getting a great deal of attention. This approach would result in finding new drugs which are more effective and have fewer side effects than the conventional medicines. The present study was designed to investigate the anti-inflammatory effect of the methanolic extract of Marrubium vulgare, a popular traditional medicinal herb, on isoproterenol-induced myocardial infarction (MI in rat model. Methods: Male Wistar rats were assigned to 6 groups of control, sham, isoproterenol, and treatment with 10, 20, and 40 mg/kg/12h of the extract given orally concurrent with MI induction. A subcutaneous injection of isoproterenol (100 mg/kg/day for two consecutive days was used to induce MI. Then, histopathological changes and inflammatory markers were evaluated. Results: Isoproterenol injection increased inflammatory response, as shown by a significant increase in peripheral neutrophil count, myocardial myeloperoxidase (MPO activity and serum levels of creatinine kinase-MB (CK-MB and TNF-α (pM.vulgare extract serum CK-MB was subsided by 55.4%, 52.2% and 69%, respectively. Also treatment with the extract (40 mg/kg significantly reduced (p<0.001 MPO activity in MI group. The levels of TNF-α was also considerably declined in the serums of MI group (p<0.001. In addition, peripheral neutrophil count, was significantly lowered by all doses of the extract (p<0.001. Interstitial fibrosis significantly was attenuated in treated groups compared with control MI group.Conclusion:The results of study demonstrate that the M. vulgare extract has strong protective effects against isoproterenol-induced myocardial infarction and it seems possible that this protection is due to its anti-inflammatory effects.

  7. A rare case of pontomedullary infarction presenting with peripheral-type facial palsy.

    Science.gov (United States)

    Ahn, Seong-Ki; Hur, Dong Gu; Jeon, Sea-Yuong; Park, Jung Je; Kang, Hung-Soo; Park, Ki-Jong

    2010-12-01

    Ipsilateral facial palsy (FP) of the peripheral-type can result from lesions involving the inferomedial tegmentum of the pons. However, cases of a medullary lesion with peripheral-type FP have rarely been reported. The authors experienced an 83-year-old man with a pontomedullary infarction who presented with ipsilateral peripheral-type FP. Brain diffusion MRI revealed a hyper-intense signal on the left dorsolateral portion of the upper medulla and pontomedullary junction. This case suggests that clinicians should take into account the possibility of a central lesion and brainstem infarction, even when patients present with peripheral-type FP.

  8. Infarct volume predicts critical care needs in stroke patients treated with intravenous thrombolysis

    Energy Technology Data Exchange (ETDEWEB)

    Faigle, Roland; Marsh, Elisabeth B.; Llinas, Rafael H.; Urrutia, Victor C. [Johns Hopkins University School of Medicine, Department of Neurology, Baltimore, MD (United States); Wozniak, Amy W. [Johns Hopkins University, Department of Biostatistics, Bloomberg School of Public Health, Baltimore, MD (United States)

    2014-10-26

    Patients receiving intravenous thrombolysis with recombinant tissue plasminogen activator (IVT) for ischemic stroke are monitored in an intensive care unit (ICU) or a comparable unit capable of ICU interventions due to the high frequency of standardized neurological exams and vital sign checks. The present study evaluates quantitative infarct volume on early post-IVT MRI as a predictor of critical care needs and aims to identify patients who may not require resource intense monitoring. We identified 46 patients who underwent MRI within 6 h of IVT. Infarct volume was measured using semiautomated software. Logistic regression and receiver operating characteristics (ROC) analysis were used to determine factors associated with ICU needs. Infarct volume was an independent predictor of ICU need after adjusting for age, sex, race, systolic blood pressure, NIH Stroke Scale (NIHSS), and coronary artery disease (odds ratio 1.031 per cm{sup 3} increase in volume, 95 % confidence interval [CI] 1.004-1.058, p = 0.024). The ROC curve with infarct volume alone achieved an area under the curve (AUC) of 0.766 (95 % CI 0.605-0.927), while the AUC was 0.906 (95 % CI 0.814-0.998) after adjusting for race, systolic blood pressure, and NIHSS. Maximum Youden index calculations identified an optimal infarct volume cut point of 6.8 cm{sup 3} (sensitivity 75.0 %, specificity 76.7 %). Infarct volume greater than 3 cm{sup 3} predicted need for critical care interventions with 81.3 % sensitivity and 66.7 % specificity. Infarct volume may predict needs for ICU monitoring and interventions in stroke patients treated with IVT. (orig.)

  9. [Influences of percutaneous coronary intervention on myocardial activity in myocardial infarction patients with different viable myocardium].

    Science.gov (United States)

    Li, Li-qi; Liu, Xiao-hong; Zhang, Jin; Lai, Chun-lin; He, Ye-xin

    2013-10-01

    To evaluate the effect of percutaneous coronary intervention (PCI) on left ventricular function in patients with different types of myocardial infarction and to explore the correlation factors for the left ventricular function. A total of 43 patients diagnosed as acute myocardial infarction were enrolled in this study. The perfusion and delayed enhancement magnetic resonance imaging (DE-MRI) was applied to observe the following parameters before the PCI and at month 6 after the procedure: infarct mass, left ventricular ejection fraction (LVEF) and abnormal wall motion score. The subjects were divided into the following three groups by the transmural extent of myocardial infarction manifested in the DE-MRI: the transmural enhancement group, the nontransmural group and the mixed group. Laboratory test was done to detect the level of endothelin (ET), matrix metal enzyme 9 (MMP-9) and high sensitive C reactive protein (hsCRP) before PCI and at month 6 after the procedure. The t test was used to compare the differences among the groups and the multiple regression analysis was taken to explore the correlation factors for the left ventricular function. Compared with the parameters before PCI, the infarct mass after PCI significantly decreased in the nontransmural group and the mixed group [(4.0 ± 2.9) g/cm(3) vs (9.8 ± 5.6) g/cm(3) and (6.0 ± 3.5) g/cm(3) vs (11.8 ± 6.2)g/cm(3), all P infarct mass was an independent correlation factor for LVEF before PCI (RR = 0.318, P myocardial infarction, which is correlated with the amount of survival myocardium and the inflammatory factors.

  10. Crossed cerebellar diaschisis after stroke identified noninvasively with cerebral blood flow-weighted arterial spin labeling MRI

    Science.gov (United States)

    Strother, Megan K.; Buckingham, Cari; Faraco, Carlos C.; Arteaga, Daniel; Lu, Pengcheng; Xu, Yaomin; Donahue, Manus J.

    2015-01-01

    Background and Purpose Crossed cerebellar diaschisis (CCD) is most commonly investigated using hemodynamic PET and SPECT imaging. However, noninvasive MRI offers advantages of improved spatial resolution, allowing hemodynamic changes to be compared directly with structural findings and without concerns related to ionizing radiation exposure. The aim of this study was to evaluate relationships between CCD identified from cerebral blood flow (CBF)-weighted arterial spin labeling (ASL) MRI with cerebrovascular reactivity (CVR)-weighted blood oxygenation level dependent (BOLD) MRI, Wallerian degeneration, clinical motor impairment, and corticospinal tract involvement. Methods Subjects (n=74) enrolled in an ongoing observational stroke trial underwent CBF-weighted ASL and hypercapnic CVR-weighted BOLD MRI. Hemispheric asymmetry indices for basal cerebellar CBF, cerebellar CVR, and cerebral peduncular area were compared between subjects with unilateral supratentorial infarcts (n=18) and control subjects without infarcts (n=16). CCD required (1) supratentorial infarct and (2) asymmetric cerebellar CBF (>95% confidence interval relative to controls). Results In CCD subjects (n=9), CVR (p=0.04) and cerebral peduncular area (p < 0.01) were significantly asymmetric compared to controls. Compared to infarct subjects not meeting CCD criteria (n=9), CCD subjects had no difference in corticospinal tract location for infarct (p=1.0) or motor impairment (p=0.08). Conclusions CCD correlated with cerebellar CVR asymmetry and Wallerian degeneration. These findings suggest that noninvasive MRI may be a useful alternative to PET or SPECT to study structural correlates and clinical consequences of CCD following supratentorial stroke. PMID:26724658

  11. Diffusion and Perfusion MRI in Acute Cerebral Ischemia

    Institute of Scientific and Technical Information of China (English)

    Tchoyoson CC Lim; Chong-Tin Tan

    2001-01-01

    Reeent advances in magnetic resonance imaging (MRI), in particular diffusion weighted imaging (DWI) and perfusion weighted imaging (PWI), have allowed clinicians to have the ability to differentiate between irreversible cerebral infarction and the potentially reversible ischemic penumbra. This article examines the principles and practice of DWI and PWI. With continued advances in thrombolysis and other therapy for acute cerebral ischemia, neuroimaging is poised to play an increasingly important role in decisionmaking in aeute stroke.

  12. Right Ventricular Function After Acute Myocardial Infarction Treated With Primary Percutaneous Coronary Intervention (from the Glycometabolic Intervention as Adjunct toPrimary Percutaneous Coronary Intervention in ST-Segment Elevation Myocardial Infarction III Trial)

    NARCIS (Netherlands)

    Gorter, Thomas M; Lexis, Chris P H; Hummel, Yoran M; Lipsic, Erik; Nijveldt, Robin; Willems, Tineke P; van der Horst, Iwan C C; van der Harst, Pim; van Melle, Joost P; van Veldhuisen, Dirk J

    2016-01-01

    Right ventricular (RV) dysfunction is a powerful risk marker after acute myocardial infarction (MI). Primary percutaneous coronary intervention (PCI) has markedly reduced myocardial damage of the left ventricle, but reliable data on RV damage using cardiac magnetic resonance imaging (MRI) are scarce

  13. Magnetic Resonance Imaging (MRI) -- Head

    Medline Plus

    Full Text Available ... the limitations of MRI of the Head? What is MRI of the Head? Magnetic resonance imaging (MRI) ... ray, CT and ultrasound. top of page How is the procedure performed? MRI examinations may be performed ...

  14. Magnetic Resonance Imaging (MRI) -- Head

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    Full Text Available ... Site Index A-Z Magnetic Resonance Imaging (MRI) - Head Magnetic resonance imaging (MRI) of the head uses ... of the Head? What is MRI of the Head? Magnetic resonance imaging (MRI) is a noninvasive medical ...

  15. Twenty-four hours hypothermia has temporary efficacy in reducing brain infarction and inflammation in aged rats

    DEFF Research Database (Denmark)

    Sandu, Raluca Elena; Buga, Ana Maria; Balseanu, Adrian Tudor

    2016-01-01

    inflammation and infarct size. However, after 1 week, the infarct size became even larger than in controls and after 2 weeks there was no beneficial effect on regenerative processes such as neurogenesis. Behaviorally, hypothermia also had a limited beneficial effect. Finally, after hydrogen sulfide...

  16. Evaluation of heart perfusion in patients with acute myocardial infarction using dynamic contrast-enhanced magnetic resonance imaging

    DEFF Research Database (Denmark)

    Nielsen, Gitte; Fritz-Hansen, Thomas; Dirks, Christina G

    2004-01-01

    with acute transmural myocardial infarction were studied using a Turbo-fast low angle shot (FLASH) MRI sequence to monitor the first pass of an extravascular contrast agent (CA), gadolinium diethylene triamine pentaacetic acid (Gd-DTPA). Quantitation of perfusion, expressed as Ki (mL/100 g/minute), in five...

  17. Abdominal MRI scan

    Science.gov (United States)

    Nuclear magnetic resonance - abdomen; NMR - abdomen; Magnetic resonance imaging - abdomen; MRI of the abdomen ... radiologist see certain areas more clearly. During the MRI, the person who operates the machine will watch ...

  18. MRI of the Chest

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    Full Text Available ... about pregnancy and MRI. If you have claustrophobia (fear of enclosed spaces) or anxiety, you may want ... projectiles within the MRI scanner room and may cause you and/or others nearby harm. These items ...

  19. MRI of the Chest

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    Full Text Available ... internal body structures. MRI does not use ionizing radiation (x-rays). Detailed MR images allow physicians to ... tomography (CT) scans, MRI does not utilize ionizing radiation. Instead, radiofrequency pulses re-align hydrogen atoms that ...

  20. MRI of the Chest

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    Full Text Available ... clearer and more detailed than with other imaging methods. This detail makes MRI an invaluable tool in ... might be obscured by bone with other imaging methods. The contrast material used in MRI exams is ...

  1. MRI of the Chest

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    Full Text Available ... conditions. MRI uses a powerful magnetic field, radio frequency pulses and a computer to produce detailed pictures ... with claustrophobia. Newer open MRI units provide very high quality images for many types of exams. Older ...

  2. MRI of the Chest

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    Full Text Available ... or headphones during the exam. MRI scanners are air-conditioned and well-lit. Music may be played ... the limitations of MRI of the Chest? High-quality images are assured only if you are able ...

  3. MRI of the Chest

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    Full Text Available ... clearer and more detailed than with other imaging methods. This detail makes MRI an invaluable tool in ... might be obscured by bone with other imaging methods. The contrast material used in MRI exams is ...

  4. MRI of the Chest

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    Full Text Available ... have this exam in the first trimester of pregnancy unless the potential benefit from the MRI exam ... See the Safety page for more information about pregnancy and MRI. If you have claustrophobia (fear of ...

  5. MRI of the Chest

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    Full Text Available ... top of page What are the benefits vs. risks? Benefits MRI is a noninvasive imaging technique that ... risking the side effects of conventional (catheter) angiography . Risks The MRI examination poses almost no risk to ...

  6. MRI of the Chest

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    Full Text Available ... or potentially pose a risk, depending on their nature and the strength of the MRI magnet. Many ... of the body being studied. If a contrast material will be used in the MRI exam, a ...

  7. MRI of the Chest

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    Full Text Available ... is done because a potential abnormality needs further evaluation with additional views or a special imaging technique. ... MRI an invaluable tool in early diagnosis and evaluation of cardiovascular conditions. MRI has proven valuable in ...

  8. MRI of the Chest

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    Full Text Available ... MRI. If you have claustrophobia (fear of enclosed spaces) or anxiety, you may want to ask your ... or headphones during the exam. MRI scanners are air-conditioned and well-lit. Music may be played ...

  9. MRI of the Chest

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    Full Text Available ... News Physician Resources Professions Site Index A-Z Magnetic Resonance Imaging (MRI) - Chest Magnetic resonance imaging (MRI) of ... Although there is no reason to believe that magnetic resonance imaging harms the fetus, pregnant women usually are ...

  10. MRI of the Chest

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    Full Text Available ... claustrophobia. Newer open MRI units provide very high quality images for many types of exams; however, older ... MRI units may not provide this same image quality. Certain types of exams cannot be performed using ...

  11. MRI of the Chest

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    Full Text Available ... is done because a potential abnormality needs further evaluation with additional views or a special imaging technique. ... MRI an invaluable tool in early diagnosis and evaluation of cardiovascular conditions. MRI has proven valuable in ...

  12. MRI of the Chest

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    Full Text Available ... MRI scanners are air-conditioned and well-lit. Music may be played through the headphones to help ... that magnetic resonance imaging harms the fetus, pregnant women usually are advised not to have an MRI ...

  13. MRI of the Chest

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    ... MRI scanners are air-conditioned and well-lit. Music may be played through the headphones to help ... that magnetic resonance imaging harms the fetus, pregnant women usually are advised not to have an MRI ...

  14. Should primary percutaneous coronary intervention be always the first option for patients with an ST elevation myocardial infarction?

    Institute of Scientific and Technical Information of China (English)

    LI Jian-ping; HUO Yong

    2010-01-01

    @@ Acute ST elevation myocardial infarction, caused by the acute occlusion of a coronary artery, is a life-threating emergency. Reperfusion therapy, namely, using the mechanical or chemical method to open the infarction related artery (IRA), has become the key treatment for such patients. As the duration of a coronary occlusion is the main determinant of final infarct size, and the latter determines the outcome of acute myocardial infarction (AMI) patients, the time issue has long been the most important topic in reperfusion therapy. Besides the time issue, several other factors must be considered: the efficiency of the reperfusion therapy, and the availability of the reperfusion therapy.

  15. Fractional arm weakness as presentation of stroke due to posterior borderzone infarct: A report of two cases

    Directory of Open Access Journals (Sweden)

    Hassan Kaukab

    2010-01-01

    Full Text Available A 41-year-old male presented with acute onset weakness of the left hand. Magnetic resonance imaging (MRI of the brain showed hyperacute infarct in the right middle cerebral artery (MCA-posterior cerebral artery (PCA watershed territory. Magnetic resonance angiography (MRA, Doppler ultrasonography, and digital subtraction angiography revealed severe right internal carotid artery (ICA stenosis. The patient underwent carotid endarterectomy. The second patient was a 48-year-old male with acute onset right wrist drop. MRI of brain showed acute infarct in the left MCA-PCA watershed territory. MRA of brain and neck, Doppler ultrasonography of the neck vessels, and echocardiography were normal. Both the cases were not initially considered strokes by the referring physicians. Isolated hand palsy is a rare presentation of stroke, often mistaken for peripheral lesion. Fractional limb weakness as a presentation of acute ischemic stroke due to borderzone infarction involving parietal lobe is a rarely reported entity.

  16. MRI-conditional pacemakers: current perspectives

    Directory of Open Access Journals (Sweden)

    Ferreira AM

    2014-05-01

    Full Text Available António M Ferreira,1,2 Francisco Costa,2 António Tralhão,2 Hugo Marques,3 Nuno Cardim,1 Pedro Adragão1,2 1Cardiology Department, Hospital da Luz, 2Cardiology Department, Hospital Santa Cruz- CHLO, 3Radiology Department, Hospital da Luz, Lisbon, Portugal Abstract: Use of both magnetic resonance imaging (MRI and pacing devices has undergone remarkable growth in recent years, and it is estimated that the majority of patients with pacemakers will need an MRI during their lifetime. These investigations will generally be denied due to the potentially dangerous interactions between cardiac devices and the magnetic fields and radiofrequency energy used in MRI. Despite the increasing reports of uneventful scanning in selected patients with conventional pacemakers under close surveillance, MRI is still contraindicated in those circumstances and cannot be considered a routine procedure. These limitations prompted a series of modifications in generator and lead engineering, designed to minimize interactions that could compromise device function and patient safety. The resulting MRI-conditional pacemakers were first introduced in 2008 and the clinical experience gathered so far supports their safety in the MRI environment if certain conditions are fulfilled. With this technology, new questions and controversies arise regarding patient selection, clinical impact, and cost-effectiveness. In this review, we discuss the potential risks of MRI in patients with electronic cardiac devices and present updated information regarding the features of MRI-conditional pacemakers and the clinical experience with currently available models. Finally, we provide some guidance on how to scan patients who have these devices and discuss future directions in the field. Keywords: pacemakers, magnetic resonance imaging, MRI, MRI-conditional devices, safety

  17. MRI in acute poliomyelitis

    Energy Technology Data Exchange (ETDEWEB)

    Kornreich, L. [Imaging Department, The Schneider Children`s Medical Centre of Israel, Kaplan Street, Petah Tiqva 49202 (Israel)]|[Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv (Israel); Dagan, O. [The Intensive Care Unit, The Schneider Children`s Medical Centre of Israel, Beilinson Medical Campus, Petah Tiqva (Israel)]|[Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv (Israel); Grunebaum, M. [Imaging Department, The Schneider Children`s Medical Centre of Israel, Kaplan Street, Petah Tiqva 49202 (Israel)]|[Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv (Israel)

    1996-05-01

    MRI can be used in the diagnosis of anterior horn infection and for assessing the extent of disease. There are no specific MRI signs to differentiate between the various possible pathogens. This is demonstrated in the present case of poliomyelitis, in which MRI of the spine played an important role in establishing the diagnosis. (orig.). With 1 fig.

  18. MRI of the Chest

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    Full Text Available ... field of the MRI unit, metal and electronic items are not allowed in the exam room. In addition to affecting the MRI images, ... damaged pins, hairpins, metal zippers and similar metallic items, which can distort ... In most cases, an MRI exam is safe for patients with metal implants, except ...

  19. fMRI Neuroinformatics

    DEFF Research Database (Denmark)

    Nielsen, Finn Årup; Christensen, Mark Schram; Madsen, Kristoffer M.

    2006-01-01

    Functional magnetic resonance imaging (fMRI) generates vast amounts of data. The handling, processing, and analysis of fMRI data would be inconceivable without computer-based methods. fMRI neuroinformatics is concerned with research, development, and operation of these methods. Reconstruction...

  20. Photoacoustic tomography of ex vivo mouse hearts with myocardial infarction

    Science.gov (United States)

    Holotta, Markus; Grossauer, Harald; Kremser, Christian; Torbica, Pavle; Völkl, Jakob; Degenhart, Gerald; Esterhammer, Regina; Nuster, Robert; Paltauf, Günther; Jaschke, Werner

    2011-03-01

    In the present study, we evaluated the applicability of ex vivo photoacoustic imaging (PAI) on small animal organs. We used photoacoustic tomography (PAT) to visualize infarcted areas within murine hearts and compared these data to other imaging techniques [magnetic resonance imaging (MRI), micro-computed tomography] and histological slices. In order to induce ischemia, an in vivo ligation of the left anterior descending artery was performed on nine wild-type mice. After varying survival periods, the hearts were excised and fixed in formaldehyde. Samples were illuminated with nanosecond laser pulses delivered by a Nd:YAG pumped optical parametric oscillator. Ultrasound detection was achieved using a Mach-Zehnder interferometer (MZI) working as an integrating line detector. The voxel data were computed using a Fourier-domain based reconstruction algorithm, followed by inverse Radon transforms. The results clearly showed the capability of PAI to visualize myocardial infarction and to produce three-dimensional images with a spatial resolution of approximately 120 μm. Regions of affected muscle tissue in PAI corresponded well with the results of MRI and histology. Photoacoustic tomography utilizing a MZI for ultrasound detection allows for imaging of small tissue samples. Due to its high spatial resolution, good soft tissue contrast and comparatively low cost, PAT offers great potentials for imaging.

  1. Orbital wall infarction in child with sickle cell disease.

    Science.gov (United States)

    Janssens, C; Claeys, L; Maes, P; Boiy, T; Wojciechowski, M

    2015-12-01

    We present the case of a 17-year-old boy, known with homozygous sickle cell disease, who was admitted because of generalised pain. He developed bilateral periorbital oedema and proptosis, without pain or visual disturbances. In addition to hyperhydration, oxygen and analgesia IV antibiotics were started, to cover a possible osteomyelitis. Patients with sickle cell disease are at risk for vaso-occlusive crises, when the abnormally shaped red blood cells aggregate and block the capillaries. Such a crisis typically presents at a location with high bone marrow activity, as the vertebrae and long bones. At an early age, the bone marrow is still active at other sites, for example the orbital wall, and thus infarction can also occur there. Thus, in young persons with sickle cell disease, it is important to consider orbital wall infarction in the differential diagnosis, since the approach is different from osteomyelitis. If the disease is complicated by an orbital compression syndrome, corticosteroids or surgical intervention may be necessary to preserve the vision. In our patient, an MRI of the orbitae demonstrated periorbital oedema with bone anomalies in the orbital and frontal bones, confirming orbital wall infarction. Ophthalmological examination revealed no signs of pressure on the nervus opticus. The patient recovered gradually with conservative treatment.

  2. A Case of Skull Base Osteomyelitis with Multiple Cerebral Infarction

    Directory of Open Access Journals (Sweden)

    Haruka Miyabe

    2016-01-01

    Full Text Available Skull base osteomyelitis is classically documented as an extension of malignant otitis externa. Initial presentation commonly includes aural symptoms and cranial nerve dysfunctions. Here we present a case that emerged with multiple infarctions in the right cerebrum. A male in his 70s with diabetes mellitus and chronic renal failure presented with left hemiparesis. Imaging studies showed that blood flow in the carotid artery remained at the day of onset but was totally occluded 7 days later. However, collateral blood supply prevented severe infarction. These findings suggest that artery-to-artery embolization from the petrous and/or cavernous portion of the carotid artery caused the multiple infarctions observed on initial presentation. Osteomyelitis of the central skull base was diagnosed on the basis of the following findings taken together: laboratory results showing high levels of inflammation, presence of Pseudomonas aeruginosa in the otorrhea and blood culture, multiple cranial nerve palsies that appeared later, the bony erosion observed on CT, and the mass lesion on MRI. Osteomyelitis was treated successfully by long-term antibiotic therapy; however, the patient experienced cefepime-induced neurotoxicity during therapy. The potential involvement of the internal carotid artery in this rare and life-threatening disease is of particular interest in this case.

  3. Peri-procedural silent cerebral infarcts after left atrial appendage occlusion.

    Science.gov (United States)

    Laible, M; Möhlenbruch, M; Horstmann, S; Pfaff, J; Geis, N A; Pleger, S; Schüler, S; Rizos, T; Bendszus, M; Veltkamp, R

    2017-01-01

    To determine the rate of peri-interventional silent brain infarcts after left atrial appendage occlusion (LAAO). In this prospective, uncontrolled single-center pilot study, consecutive patients with atrial fibrillation undergoing LAAO between July 2013 and January 2016 were included. The Amplatzer Cardiac Plug, WATCHMAN or Amulet device was used. A neurological examination and cranial magnetic resonance imaging (MRI) were performed within 48 h before and after the procedure. MRI was evaluated for new diffusion-weighted imaging (DWI) hyperintensities, cerebral microbleeds (CMBs) and white-matter lesions (WMLs). Left atrial appendage occlusion was performed in 21 patients (mean age, 73.2 ± 9.5 years). Main reasons for LAAO were previous intracerebral hemorrhage (n = 11) and major systemic bleeding (n = 6). No clinically overt stroke occurred peri-interventionally. After the intervention, one patient had a small cerebellar hyperintensity on DWI (4.8%; 95% confidence interval, 0.0-14.3) that was not present on the MRI 1 day before the procedure. Among 11 patients with available MRI just before LAAO, there were no significant changes in the number of CMBs and the severity of WMLs after LAAO. This study of peri-interventional MRI in LAAO suggests a low rate of silent peri-procedural infarcts in this elderly population. Confirmation in larger studies is needed. © 2016 EAN.

  4. Neuropsychological correlates of a right unilateral lacunar thalamic infarction

    Science.gov (United States)

    Werf, Y; Weerts, J; Jolles, J; Witter, M; Lindeboom, J; Scheltens, P.

    1999-01-01

    OBJECTIVES—To report on a patient with a lacunar infarction in the right intralaminar nuclei of the thalamus. The role of the thalamic intralaminar nuclei in cognitive function is as yet insufficiently known. The patient described has shown signs of apathy and loss of initiative, in combination with cognitive deficits, which have persisted essentially unaltered up to the present day since an abrupt onset 17 years ago.
METHODS—High resolution MRI was performed to show the extent of the lesion; a combination of published and experimental neuropsychological techniques was administered to show the nature of the cognitive defects; Single photon emission computed tomography (SPECT) was employed to obtain a measure of cortical perfusion.
RESULTS—Brain MRI disclosed an isolated lacunar infarction in the dorsal caudal intralaminar nuclei of the thalamus. Neuropsychological evaluation indicated problems with attention and concentration, executive disturbances, and memory deficits both in the visual and verbal domains. The memory deficits could not be attributed to problems in the early stages of information processing, and are hence regarded as resulting from a failure of retrieval rather than encoding or storage. Brain SPECT disclosed a hypoperfusion of the right frontal cortex.
CONCLUSION—The data indicate that the cognitive profile is the result of a dysfunction of executive functions. This is corroborated by the finding of decreased blood flow in the right frontal cortex, and by evidence from the neuroanatomical literature. Thus the dysexecutive symptoms are thought to be caused by disconnection of the prefrontal cortex from the brainstem activating nuclei through the strategic localisation of the right thalamic infarction.

 PMID:9886448

  5. Utilization of chemical shift MRI in the diagnosis of disorders affecting pediatric bone marrow.

    Science.gov (United States)

    Winfeld, Matthew; Ahlawat, Shivani; Safdar, Nabile

    2016-09-01

    MRI signal intensity of pediatric bone marrow can be difficult to interpret using conventional methods. Chemical shift imaging (CSI), which can quantitatively assess relative fat content, may improve the ability to accurately diagnose bone marrow abnormalities in children. Consecutive pelvis and extremity MRI at a children's hospital over three months were retrospectively reviewed for inclusion of CSI. Medical records were reviewed for final pathological and/or clinical diagnosis. Cases were classified as normal or abnormal, and if abnormal, subclassified as marrow-replacing or non-marrow-replacing entities. Regions of interest (ROI) were then drawn on corresponding in and out-of-phase sequences over the marrow abnormality or over a metaphysis and epiphysis in normal studies. Relative signal intensity ratio for each case was then calculated to determine the degree of fat content in the ROI. In all, 241 MRI were reviewed and 105 met inclusion criteria. Of these, 61 had normal marrow, 37 had non-marrow-replacing entities (osteomyelitis without abscess n = 17, trauma n = 9, bone infarction n = 8, inflammatory arthropathy n = 3), and 7 had marrow-replacing entities (malignant neoplasm n = 4, bone cyst n = 1, fibrous dysplasia n = 1, and Langerhans cell histiocytosis n = 1). RSIR averages were: normal metaphyseal marrow 0.442 (0.352-0.533), normal epiphyseal marrow 0.632 (0.566-698), non-marrow-replacing diagnoses 0.715 (0.630-0.799), and marrow-replacing diagnoses 1.06 (0.867-1.26). RSIR for marrow-replacing entities proved significantly different from all other groups (p < 0.05). ROC analysis demonstrated an AUC of 0.89 for RSIR in distinguishing marrow-replacing entities. CSI techniques can help to differentiate pathologic processes that replace marrow in children from those that do not.

  6. Spontaneous spinal epidural hematoma with hemiparesis mimicking acute cerebral infarction: Two case reports

    Science.gov (United States)

    Matsumoto, Hiroaki; Miki, Takanori; Miyaji, Yuki; Minami, Hiroaki; Masuda, Atsushi; Tominaga, Shogo; Yoshida, Yasuhisa; Yamaura, Ikuya; Matsumoto, Shigeo; Natsume, Shigeatsu; Yoshida, Kozo

    2012-01-01

    Context Acute hemiparesis is a common initial presentation of ischemic stroke. Although hemiparesis due to spontaneous spinal epidural hematoma (SSEH) is an uncommon symptom, a few cases have been reported and misdiagnosed as cerebral infarction. Design Case reports of SSEH with acute hemiparesis. Findings In these two cases, acute stroke was suspected initially and administration of intravenous alteplase therapy was considered. In one case, the presentation was neck pain and in the other case, it was Lhermitte's sign; brain magnetic resonance imaging (MRI) and magnetic resonance angiography were negative for signs of ischemic infarction, hemorrhage, or arterial dissection. Cervical MRI was performed and demonstrated SSEH. Conclusion Clinicians who perform intravenous thrombolytic treatment with alteplase need to be aware of this possible contraindication. PMID:22925753

  7. Lung MRI for experimental drug research

    Energy Technology Data Exchange (ETDEWEB)

    Beckmann, Nicolau [Discovery Technologies, Novartis Institutes for BioMedical Research, Lichtstr. 35, WSJ-386.2.09, CH-4002 Basel (Switzerland)], E-mail: nicolau.beckmann@novartis.com; Cannet, Catherine [Discovery Technologies, Novartis Institutes for BioMedical Research, Lichtstr. 35, WSJ-386.2.09, CH-4002 Basel (Switzerland); Karmouty-Quintana, Harry [Discovery Technologies, Novartis Institutes for BioMedical Research, Lichtstr. 35, WSJ-386.2.09, CH-4002 Basel (Switzerland); Meakins-Christie Laboratories, McGill University, Montreal, Canada H2X 2P2 (Canada); Tigani, Bruno; Zurbruegg, Stefan [Discovery Technologies, Novartis Institutes for BioMedical Research, Lichtstr. 35, WSJ-386.2.09, CH-4002 Basel (Switzerland); Ble, Francois-Xavier [Discovery Technologies, Novartis Institutes for BioMedical Research, Lichtstr. 35, WSJ-386.2.09, CH-4002 Basel (Switzerland); Respiratory Diseases Department, Novartis Institutes for BioMedical Research, CH-4056 Basel (Switzerland); Faculty of Pharmacy, University Louis Pasteur-Strasbourg-I, F-67401 Illkirch (France); Cremillieux, Yannick [University of Lyon-1, Laboratory of Nuclear Magnetic Resonance, Centre National de la Recherche Scientifique (CNRS), F-69622 Villeurbanne (France); Trifilieff, Alexandre [Respiratory Diseases Department, Novartis Institutes for BioMedical Research, CH-4056 Basel (Switzerland)

    2007-12-15

    Current techniques to evaluate the efficacy of potential treatments for airways diseases in preclinical models are generally invasive and terminal. In the past few years, the flexibility of magnetic resonance imaging (MRI) to obtain anatomical and functional information of the lung has been explored with the scope of developing a non-invasive approach for the routine testing of drugs in models of airways diseases in small rodents. With MRI, the disease progression can be followed in the same animal. Thus, a significant reduction in the number of animals used for experimentation is achieved, as well as minimal interference with their well-being and physiological status. In addition, under certain circumstances the duration of the observation period after disease onset can be shortened since the technique is able to detect changes before these are reflected in parameters of inflammation determined using invasive procedures. The objective of this article is to briefly address MRI techniques that are being used in experimental lung research, with special emphasis on applications. Following an introduction on proton techniques and MRI of hyperpolarized gases, the attention is shifted to the MRI analysis of several aspects of lung disease models, including inflammation, ventilation, emphysema, fibrosis and sensory nerve activation. The next subject concerns the use of MRI in pharmacological studies within the context of experimental lung research. A final discussion points towards advantages and limitations of MRI in this area.

  8. [A case of central alveolar hypoventilation syndrome associated with cerebral infarction].

    Science.gov (United States)

    Yamada, A; Kamoda, M; Ikezoe, K; Tsukaguchi, M; Katanaka, J; Deguchi, K; Miki, H; Takeuchi, H

    1993-03-01

    Central alveolar hypoventilation syndrome (CAH), or Ondine's curse, is a very rare disease characterized by dysfunction of respiratory center in the brain stem. Here, we report a case of CAH associated with cerebral infarction. A 59-year-old man developed right facial sensory deficit at age 56. Then, the facial sensory deficit spread to the left side and dysarthria and dysphagia also developed. Since age 58, he often developed respiratory failure and consciousness disturbance. Arterial blood gas analysis revealed alveolar hypoventilation and respiratory acidosis. Disorders of peripheral organs such as lung, airway, thorax and neuromuscular diseases were ruled out. Brain MRI showed cerebral infarction in the brain stem. We diagnosed him as CAH associated with brain stem infarction.

  9. Causes of cerebral small vessel disease : a prospective population-based MRI study

    NARCIS (Netherlands)

    E.J. van Dijk (Ewoud)

    2004-01-01

    markdownabstract__Abstract__ In the 1970s, the introduction of computed tomography (CT) and magnetic resonance imaging (MRI) in medicine, made it possible to image the living brain. These images showed that cerebral white matter lesions and asymptomatic lacunar brain infarcts are extremely common i

  10. MRI/MRA evaluation of sickle cell disease of the brain

    Energy Technology Data Exchange (ETDEWEB)

    Zimmerman, Robert A. [Childrens Hospital, Department of Radiology, Philadelphia, PA (United States)

    2005-03-01

    Sickle cell disease is a major cause of pediatric stroke. Understanding the disease that affects the brain as infarctions, both clinically apparent and silent, requires an understanding of how the blood vessels are affected, the way in which both the brain and the blood vessels are imaged by MRI and MRA and the mechanism of injury. (orig.)

  11. Evaluation of heart perfusion in patients with acute myocardial infarction using dynamic contrast-enhanced magnetic resonance imaging

    DEFF Research Database (Denmark)

    Hansen, Thomas Fritz; Dirks, Christina G; Jensen, Gorm B;

    2004-01-01

    PURPOSE: To investigate the diagnostic ability of quantitative magnetic resonance imaging (MRI) heart perfusion in acute heart patients, a fast, multislice dynamic contrast-enhanced MRI sequence was applied to patients with acute myocardial infarction. MATERIALS AND METHODS: Seven patients...... slices, each having 60 sectors, provided an estimation of the severity and extent of the perfusion deficiency. Reperfusion was assessed both by noninvasive criteria and by coronary angiography (CAG). RESULTS: The Ki maps clearly delineated the infarction in all patients. Thrombolytic treatment...... was clearly beneficial in one case, but had no effect in the two other cases. Over the time-course of the study, normal perfusion values were not reestablished following thrombolytic treatment in all cases investigated. CONCLUSION: This study shows that quantitative MRI perfusion values can be obtained from...

  12. Myocardial infarction and cerebral infarction in a Danish suburban community

    DEFF Research Database (Denmark)

    Lyngborg, K; Marquardsen, J; Trautner, F

    1985-01-01

    A comparison was made of 485 cases of cerebral infarction (CI), registered prospectively in Frederiksberg, Copenhagen, with 495 cases of myocardial infarction (AMI), recorded retrospectively in the same population. The overall annual incidence of AMI was 6.5 per 1,000 population for males, 3...... with advancing age; for each sex and diagnosis the relationship can thus be expressed as a simple mathematical formula, which may facilitate comparisons of incidence patterns in different communities. Theories explaining the similarities and differences of the age-incidence curves for AMI and CI are discussed....

  13. Bilateral thalamic infarction with psychiatric symptoms: case report

    Directory of Open Access Journals (Sweden)

    Betül Tekin Güveli

    2016-04-01

    Full Text Available Introduction: Thalamus is a mass of gray matter, which plays a role in the transmission of sensory and motor information to the primary sensory and motor centers of the cerebral cortex, cerebellum and basal ganglia. Vascular lesions of thalamus may occur in different syndromes depending on the affected nuclei. In this report, a case with acute evolving personality and behavior changes and detected bilateral thalamic infarction will be presented. Case: A 40-year-old male patient was brought to the psychiatric ER with complaints of acute excessive sleep and behavioral changing. His neurological examination was normal except for limited cooperation and dysarthria. There was hyperintensity in bilateral paramedian thalamic regions in diffusion MRI and hypointensity in the right side in the ADC. During clinical observation the patient occasionally had visual hallucinations and attempted suicide. The psychiatrist diagnosed the patient with psychotic disorder due to his general medical condition and olanzapine 10 mg / day was prescribed. Etiological tests were normal. The patient was discharged after clinical improvement on the tenth day of hospitalization. Conclusion: Bilateral thalamic infarcts are very rare in all ischemic cerebrovascular diseases and typically result in changing of consciousness, gaze palsy and memory. The most common etiological cause of bilateral thalamic infarct is cardioembolism and the prognosis is generally good. Thalamic infarcts have a clinical spectrum varying according to the location of the lesion and may even just be present with psychiatric symptoms. In acute or subacute personality and behavior changes in a patient with no history of psychiatric disorders, thalamic lesions should be considered.

  14. [Myocardial infarction caused by exertion].

    Science.gov (United States)

    Bernard, F; Weber, S

    1997-01-01

    Myocardial infarction is the main cause of sudden death during physical exercise, particularly in subjects over 40 and may even occur in high-performance young athletes. Sports and physical activity have a beneficial effect in preventing cardiovascular diseases, but certain rules of prudence must be followed to avoid the risk of a severe coronary event. Myocardial infarction always occurs in particularly susceptible subjects with several risk factors, predominantly smoking, hypercholesterolemia, family history of atherosclerosis. Dietary factors, either before, during or after the exercise, are always found. Distribution of coronary lesions differs with age. Before 40 years, the coronary network is normal in 40% of the cases. The infarction is partially explained by platelet hyperaggregahility and coronary spasms at exercise or in the post-exercise period.

  15. Idiopathic Renal Infarction Mimicking Appendicitis

    Science.gov (United States)

    Lisanti, Francesco; Scarano, Enrico

    2017-01-01

    Renal infarction is a rare cause of referral to the emergency department, with very low estimated incidence (0.004%–0.007%). Usually, it manifests in patients aged 60–70 with risk factors for thromboembolism, mostly related to heart disease, atrial fibrillation in particular. We report a case of idiopathic segmental renal infarction in a 38-year-old patient, presenting with acute abdominal pain with no previous known history or risk factors for thromboembolic diseases. Because of its aspecific clinical presentation, this condition can mimic more frequent pathologies including pyelonephritis, nephrolithiasis, or as in our case appendicitis. Here we highlight the extremely ambiguous presentation of renal infarct and the importance for clinicians to be aware of this condition, particularly in patients without clear risk factors, as it usually has a good prognosis after appropriate anticoagulant therapy. PMID:28203466

  16. Renal infarction complicating fibromuscular dysplasia.

    Science.gov (United States)

    Gavalas, M; Meisner, R; Labropoulos, N; Gasparis, A; Tassiopoulos, A

    2014-01-01

    Fibromuscular dysplasia (FMD) is a nonatherosclerotic, noninflammatory vascular disease that most commonly affects the renal and extracranial carotid arteries. We present 3 cases of renal infarction complicating renal artery FMD in 42-, 43-, and 46-year-old females and provide a comprehensive review of the literature on this topic. In our patients, oral anticoagulation therapy was used to treat all cases of infarction, and percutaneous angioplasty was used nonemergently in one case to treat refractory hypertension. All patients remained stable at 1-year follow-up. This is consistent with outcomes in previously published reports where conservative medical management was comparable to surgical and interventional therapies. Demographic differences may also exist in patients with renal infarction and FMD. A higher prevalence of males and a younger age at presentation have been found in these patients when compared to the general population with FMD.

  17. MRI of the Chest

    Medline Plus

    Full Text Available ... technologist if you have any devices or metal in your body. Guidelines about eating and drinking before ... flow to the heart) and myocardial infarct (scar in the heart muscle due to prior obstruction of ...

  18. MRI of the Chest

    Medline Plus

    Full Text Available ... heart) and myocardial infarct (scar in the heart muscle due to prior obstruction of blood flow). determine ... ribs and sternum) and chest wall soft tissue (muscles and fat). assess for pericardial (thin sac around ...

  19. MRI of the Chest

    Medline Plus

    Full Text Available ... heart) and myocardial infarct (scar in the heart muscle due to prior obstruction of blood flow). determine ... ribs and sternum) and chest wall soft tissue (muscles and fat). assess for pericardial (thin sac around ...

  20. Orbital infarction in sickle cell disease.

    Science.gov (United States)

    Blank, J P; Gill, F M

    1981-06-01

    Bone infarction is a common occurrence in sickle cell disease. Described are three cases in which frontal headache, proptosis, and lid edema were seen with infarction of the orbital bone. Radionuclide scanning was useful in distinguished bone infarction from orbital infection in one case.

  1. Automatic composition of MRI and SPECT images

    Energy Technology Data Exchange (ETDEWEB)

    Nishimura, Hiromi [Research Inst. of Brain and Blood Vessels, Akita (Japan)

    1999-12-01

    The new method to automatically compose MRI image and SPECT image was devised to support the SPECT image which was inferior in the morphological information. This method is a kind of the coordinate transformation to obtain maximal agreement between images using cross correlation of MRI image and SPECT image as the evaluation function to show the degree of the agreement. For the calculation of the cross correlation, MRI T1 weighted image and the morphological information of SPECT image treated by the spatial quadratic differentiation (Laplacian) were used. This method does not require to fix the control point in the tomographic imaging, and can be also applied to PET other than SPECT. This is also useful to follow up the chronological change of a patient by composition among SPECT images and among PET images. Since this method is focused on the internal structure of brain, it is also useful for cases such as cerebral infarction which brain structure has little change. But this method is still under the trial and the examination of the accuracy remained. (K.H.)

  2. ROLE OF MRI IN EVALUATION OF SEIZURES

    Directory of Open Access Journals (Sweden)

    Avadhesh Pratap Singh

    2015-12-01

    Full Text Available BACKGROUND Seizure is a paroxysmal alteration in neurologic function resulting from abnormal excessive neuronal electrical activity. Epilepsy is a chronic condition characterized by recurrent seizures unprovoked by an acute systemic or neurologic insult.1 An epileptic seizure is a clinical manifestation of abnormal, excessive neuronal activity arising in the grey matter of the cerebral cortex. MATERIALS AND METHODS Prospective studies of 100 patients with clinical impression of seizures were examined by 1.5 Tesla magnetic resonance imaging. RESULT A total of 100 patients satisfying the inclusion criteria were included in the study. The age range of patients was from neonate to elderly with male predominance, male 64 (64% and female 36 (36%. GTCS was the most common clinical diagnosis constituting (80% cases. The common abnormalities were cerebral infarction with gliosis (16%, infections – NCC (7% and tuberculoma (10%, cerebral atrophy (1%, developmental cortical malformations (2%, venous thrombosis (4%, low-grade glioma (9%, meningioma (3%. CONCLUSION MRI is the investigation of choice in patients with seizure disorder. The sensitivity of MRI in detecting abnormalities in patients with seizure disorder is in part associated to the underlying pathologies and by the MRI techniques and experience of the interpreting physician. Accurate diagnosis of the cause of seizure is crucial for finding an effective treatment. With its high spatial resolution, excellent inherent soft tissue contrast, multiplanar imaging capability and lack of ionizing radiation, MR imaging has emerged as a versatile tool in the evaluation of patients with seizure disorder.

  3. Monkey cortex through fMRI glasses.

    Science.gov (United States)

    Vanduffel, Wim; Zhu, Qi; Orban, Guy A

    2014-08-06

    In 1998 several groups reported the feasibility of fMRI experiments in monkeys, with the goal to bridge the gap between invasive nonhuman primate studies and human functional imaging. These studies yielded critical insights in the neuronal underpinnings of the BOLD signal. Furthermore, the technology has been successful in guiding electrophysiological recordings and identifying focal perturbation targets. Finally, invaluable information was obtained concerning human brain evolution. We here provide a comprehensive overview of awake monkey fMRI studies mainly confined to the visual system. We review the latest insights about the topographic organization of monkey visual cortex and discuss the spatial relationships between retinotopy and category- and feature-selective clusters. We briefly discuss the functional layout of parietal and frontal cortex and continue with a summary of some fascinating functional and effective connectivity studies. Finally, we review recent comparative fMRI experiments and speculate about the future of nonhuman primate imaging.

  4. Bilateral internal carotid artery occlusion. Comparison among MRI, hemodynamics and clinical feature

    Energy Technology Data Exchange (ETDEWEB)

    Yamamoto, Yasumasa; Tsuda, Harumi; Nabatame, Hidehiko; Akiguchi, Ichiro; Kameyama, Masakuni

    1987-10-01

    Four cases of bilateral internal carotid occlusion are reported with respect to clinical features, hemodynamics and various image diagnosis. MRI is applied to three cases. The patients comprised 2.08 % of all cerebral occlusive diseases treated during the past five years at our clinic. One case is of abrupt onset and three cases are progressing profiles. In one of these cases, collateral circulation is supplied mainly by leptomeningeal anastomosis of the posterior cerebral artery and posterior pericallosal artery branching from the basilar artery. In two of them, they are supplied through the circle of Willis. Middle cerebral artery occlusion, occlusion supra occlusionem, however, causes decisive ischemic lesion in its teritory. Applying MRI, complicated ischemic lesions, such as lacunar infarction, paraventricular lesion, deep white matter lesion and border zone infarction can clearly be identified. In the case of total aphasia, the lesions responsible are demonstrated clearly by MRI, but only vaguely by X-ray CT.

  5. [Temporomandibular joint: MRI diagnostics].

    Science.gov (United States)

    Kress, B; Schmitter, M

    2005-09-01

    MRI of the temporomandibular joint (TMJ) requires 1.5 T. The radiologist must be familiar with the anatomy and pathology of the TMJ. This review gives a description of MRI protocols for the TMJ, and MRI anatomy and pathology of the TMJ (open and closed mouth) by means of MR images and drawings. Diagnosing of the TMJ related diseases depends on standardized clinical and MR examinations. Therefore close interdisciplinary cooperation between dentist and radiologist is necessary.

  6. MRI brain imaging.

    Science.gov (United States)

    Skinner, Sarah

    2013-11-01

    General practitioners (GPs) are expected to be allowed to request MRI scans for adults for selected clinically appropriate indications from November 2013 as part of the expansion of Medicare-funded MRI services announced by the Federal Government in 2011. This article aims to give a brief overview of MRI brain imaging relevant to GPs, which will facilitate explanation of scan findings and management planning with their patients. Basic imaging techniques, common findings and terminology are presented using some illustrative case examples.

  7. Magnetic Resonance Imaging (MRI) -- Head

    Medline Plus

    Full Text Available ... News Physician Resources Professions Site Index A-Z Magnetic Resonance Imaging (MRI) - Head Magnetic resonance imaging (MRI) of the head ... limitations of MRI of the Head? What is MRI of the Head? Magnetic resonance imaging (MRI) is ...

  8. Renal infarction secondary to ketamine abuse.

    Science.gov (United States)

    Chen, Chin-Li; Chen, Jin-Li; Cha, Tai-Lung; Wu, Sheng-Tang; Tang, Shou-Hung; Tsao, Chih-Wei; Meng, En

    2013-07-01

    Renal infarction is an uncommon condition that resulted from inadequate perfusion of the kidney and is easily missed diagnosed due to its nonspecific clinical presentations. Major risk factors for renal infarction are atrial fibrillation, previous embolism, and ischemic and valvular heart disease. Progressive decrease in renal function or even death can occur if renal infarction is not diagnosed accurately and promptly. Ketamine abuse may cause variable urinary tract injury. However, renal infarction caused by ketamine abuse has never been reported. To our knowledge, this is the first documented case of renal infarction following nasal insufflation of ketamine.

  9. Superior cerebellar artery infarction in endovascular treatment for tentorial dural arteriovenous fistulas

    Energy Technology Data Exchange (ETDEWEB)

    Zhang Jingbo; Lv Xianli; Jiang Chuhan; Li Youxiang [Beijing Neurosurgical Institute and Beijing Tiantan Hospital, Capital Medical University, 6, Tiantan, Xili, Chongwen, 100050, Beijing (China); Wu Zhongxue, E-mail: ttyyzjb@sina.co [Beijing Neurosurgical Institute and Beijing Tiantan Hospital, Capital Medical University, 6, Tiantan, Xili, Chongwen, 100050, Beijing (China)

    2010-06-15

    Background: Superior cerebellar artery (SCA) syndrome shows ipsilateral cerebellar ataxia and Horner's syndrome, contralateral superficial sensory disturbance, as well as nystagmus toward the impaired side, vertigo, and nausea. Occasionally, unilateral lesions may produce bilateral hypogeusia and contralateral hypoacusia. Objective: To report 2 patients with unilateral lower midbrain ischemic lesions of the inferior colliculus level caused by transarterial embolization for tentorial dural arteriovenous fistulas (TDAVFs). Methods: Hospital records for 21 patients with TDAVFs mainly treated by endovascular techniques between 2005 and 2008 were reviewed. Two patients with MRI evidence of unilateral SCA territory infarction were investigated. Results: Of 21 patients, 2 treated transarterially with Onyx-18 (a nonahesive liquid embolic agent) developed infarctions in the territory of SCA. One patient had lateral SCA infarction characterized by ipsilateral gait ataxia, contralateral hemihypoesthesia, with additional ipsilateral ocular motor palsy and bilateral gustatory loss. And the other patient had medial SCA infarction characterized by ipsilateral ataxia contralateral hemihypoesthesia with additional contralateral hypoacusia. Conclusion: SCA infarction can be caused by transarterial injection of Onyx-18 via SCA or the posterior cerebral artery (PCA) for TDAVFs and additionally presented with gustatory loss and deafness, which is generally not a feature of the SCA syndrome.

  10. Neonatal Myocardial Infarction or Myocarditis?

    NARCIS (Netherlands)

    de Vetten, Leanne; Bergman, Klasien A.; Elzenga, Nynke J.; van Melle, Joost P.; Timmer, Albertus; Bartelds, Beatrijs

    2011-01-01

    We report a 29 week-gestation preterm infant who presented during his second week of life with cardiogenic shock. Clinical presentation and first diagnostics suggested myocardial infarction, but echocardiographic features during follow-up pointed to a diagnosis of enteroviral myocarditis. The child

  11. Spousal Adjustment to Myocardial Infarction.

    Science.gov (United States)

    Ziglar, Elisa J.

    This paper reviews the literature on the stresses and coping strategies of spouses of patients with myocardial infarction (MI). It attempts to identify specific problem areas of adjustment for the spouse and to explore the effects of spousal adjustment on patient recovery. Chapter one provides an overview of the importance in examining the…

  12. Pregnancy-related myocardial infarction

    NARCIS (Netherlands)

    Lameijer, H.; Lont, M. C.; Buter, H.; van Boven, A. J.; Boonstra, P. W.; Pieper, P. G.

    Introduction The risk of acute myocardial infarction in young women is low, but increases during pregnancy due to the physiological changes in pregnancy, including hypercoagulability. Ischaemic heart disease during pregnancy is not only associated with increased maternal morbidity and mortality, but

  13. MRI detection of brain metastases at initial staging of small-cell lung cancer

    Energy Technology Data Exchange (ETDEWEB)

    Pol, M. van de [Dept. of Neurology, Univ. Hospital, Maastricht (Netherlands); Oosterhout, A.G. van [Dept. of Neurology, Univ. Hospital, Maastricht (Netherlands); Wilmink, J.T. [Dept. of Diagnostic Radiology, Univ. Hospital, Maastricht (Netherlands); Velde, G.P.M. ten [Dept. of Pulmonology, Univ. Hospital, Maastricht (Netherlands); Twijnstra, A. [Dept. of Neurology, Univ. Hospital, Maastricht (Netherlands)

    1996-04-01

    We prospectively investigated 40 patients with small-cell carcinoma of the lung (SCLC) for signs of brain metastasis by neurological examination and MRI of the brain, to determine the significance of MRI for staging. MRI could not be completed in one patient, who was excluded from the study. The MRI studies of the remaining patients showed no abnormalities in 12, cerebral infarcts in 2 and brain metastases in 11 patients, of whom 3 no relevant symptoms. Nonenhancing white matter lesions were found in 14 patients. In 3 of the 4 patients with an abnormal neurological examination at diagnosis, nonenhancing white matter lesions later developed into contrast enhancing lesions compatible with breain metastases; in 2, this occurred during the course of the chemotherapy. MRI did not change the clinical staging in patients with asymptomatic brain metastases. (orig.)

  14. Neonatal deep white matter venous infarction and liquefaction: a pseudo-abscess lesion

    Energy Technology Data Exchange (ETDEWEB)

    Ruess, Lynne; Rusin, Jerome A. [Nationwide Children' s Hospital, Department of Radiology, Columbus, OH (United States); The Ohio State University College of Medicine and Public Health, Columbus, OH (United States); Dent, Carly M.; Tiarks, Hailey J.; Yoshida, Michelle A. [Nationwide Children' s Hospital, Department of Radiology, Columbus, OH (United States)

    2014-11-15

    Deep white matter hemorrhagic venous infarction with subsequent cavitation due to necrosis and liquefaction has been described in neonates and may be associated with infection and meningitis. In our experience, the MRI pattern of these lesions is confused with the pattern seen with cerebral abscesses. The purpose of our study was to characterize the MRI findings of post infarction necrosis and liquefaction after hemorrhagic deep white matter venous infarction in infants and to distinguish these lesions from cerebral abscesses. An institutional review board approved a retrospective review of imaging records to identify all patients with cerebral venous infarction at a children's hospital during a 10-year period. Nine infants had deep white matter hemorrhagic venous infarction with white matter fluid signal cavitary lesions. A diagnosis of cerebral abscess was considered in all. The imaging and laboratory findings in these patients are reviewed and compared to descriptions of abscesses found in the literature. There were six female and three male infants. The mean age at presentation was 20 days (range: 0-90 days), while the corrected age at presentation was less than 30 days for all patients. Seven patients presented with seizures and signs of infection; one infant presented with lethargy and later proved to have protein C deficiency. MRI was performed 0-12 days from presentation in these eight patients. Another patient with known protein C deficiency underwent MRI at 30 days for follow-up of screening US abnormalities. There were a total of 38 deep cerebral white matter fluid signal cavitary lesions: 25 frontal, 9 parietal, 2 temporal, 2 occipital. Larger lesions had dependent debris. All lesions had associated hemorrhage and many lesions had evidence of adjacent small vessel venous thrombosis. Lesions imaged after gadolinium showed peripheral enhancement. Three lesions increased in size on follow-up imaging. Three patients, two with meningitis confirmed via

  15. Metabolic Changes in Rats with Photochemically Induced Cerebral Infarction and the Effects of Batroxobin: A Study by Magnetic Resonance Imaging, 1H- and 31P- Magnetic Resonance Spectroscopy

    Institute of Scientific and Technical Information of China (English)

    管兴志; 吴卫平; 匡培根; 匡培梓; 高杨; 管林初; 李丽云; 毛希安; 刘买利

    2001-01-01

    Metabolic changes in rats with photochemically induced cerebral infarction and the effects of batroxobin were investigated 1, 3, 5 and 7 days after infarction by means of magnetic resonance imaging (MRI), 1H- and 31P- magnetic resonance spectroscopy (MRS). A region of T2 hyperintensity was observed in left temporal neocortex in infarction group and batroxobin group 1, 3, 5 and 7 days after infarction. The volume of the region gradually decreased from 1 day to 7 days after infarction. The ratio of NAA/Cho+Cr in the region of T2 hyperintensity in the infarction group was significantly lower than that in the corresponding region in the sham-operated group 3, 5 and 7 days after infarction respectively (P<0.05). Lac appeared in the region of T2 hyperintensity in the infarction group 1, 3, 5 and 7 days after infarction, but it was not observed in the corresponding region in sham-operated group at all time points. Compared with the sham-operated group, the ratios of bATP/PME+PDE and PCr/PME+PDE of the whole brain in the infarction group were significantly lower 1, 3 and 5 days after infarction respectively (P<0.05), and the ratio of bATP/PCr also was significantly lower 1 day after infarction (P<0.05). Batroxobin significantly decreased the volume of the region of T2 hyperintensity 1 and 3 days after infarction (P<0.05), significantly increased the ratio of NAA/Cho+Cr in the region 5 and 7 days after infarction (P<0.05), significantly decreased the ratios of Lac/Cho+Cr and Lac/NAA in the region 5 and 7 days after infarction (P<0.05), and significantly increased the ratios of bATP/PME+PDE and bATP/PCr in the whole brain 1 day after infarction (P<0.05). The results indicated that the infracted region had severe edema, increased Lac and apparent neuronal dysfunction and death, and energy metabolism of the whole brain decreased after focal infarction, and that batroxobin effectively ameliorated the above-mentioned abnormal changes.

  16. Longitudinal Assessment of Motor Recovery of Contralateral Hand after Basal Ganglia Infarction Using Functional Magnetic Resonance Imaging

    Directory of Open Access Journals (Sweden)

    Yue Fu

    2016-01-01

    Full Text Available We used functional fMRI to study the brain activation during active finger movements at different time points during the recovery phase following basal ganglia infarction. Four hemiplegic patients with basal ganglia infarction were serially evaluated at different time points spanning the acute and chronic phase using fMRI. To evaluate motor recovery, the patients were asked to perform functional tasks arranged in a block design manner with their hand. On follow-up (chronic phase, three patients achieved significant recovery of motor function of affected limbs. Activation of bilateral sensorimotor cortex (SMC was observed in two of these patients, while activation of cerebellum was observed in all patients. No remarkable recovery of motor function was noted in one patient with left basal ganglia infarction. In this patient, the activation domain was located in SMC of both sides in acute phase and in ipsilateral SMC in chronic phase. Contralateral SMC appears to be involved in the functional rehabilitation following basal ganglia infarction. The cerebellum may act as an intermediary during functional recovery following basal ganglia infarction. The activation domain associated with active finger movement may be bilateral in acute phase; one patient was ipsilateral in the chronic stage.

  17. Association between baseline peri-infarct magnetic resonance spectroscopy and regional white matter atrophy after stroke

    Energy Technology Data Exchange (ETDEWEB)

    Yassi, Nawaf; Campbell, Bruce C.V.; Davis, Stephen M.; Bivard, Andrew [Melbourne Brain Centre rate at The Royal Melbourne Hospital, Departments of Medicine and Neurology, Parkville, Victoria (Australia); Moffat, Bradford A.; Steward, Christopher; Desmond, Patricia M. [The University of Melbourne, Department of Radiology, The Royal Melbourne Hospital, Parkville (Australia); Churilov, Leonid; Donnan, Geoffrey A. [The University of Melbourne, Florey Institute of Neuroscience and Mental Health, Parkville (Australia); Parsons, Mark W. [University of Newcastle and Hunter Medical Research Institute, Priority Research Centre for Translational Neuroscience and Mental Health, Newcastle (Australia)

    2016-01-15

    Cerebral atrophy after stroke is associated with poor functional outcome. The prediction and prevention of post-stroke brain atrophy could therefore represent a target for neurorestorative therapies. We investigated the associations between peri-infarct metabolite concentrations measured by quantitative MRS and brain volume change in the infarct hemisphere after stroke. Twenty patients with ischemic stroke were enrolled. Patients underwent 3T-MRI within 1 week of onset, and at 1 and 3 months. At the baseline scan, an MRS voxel was placed manually in the peri-infarct area and another in the corresponding contralateral region. Volumetric analysis of T1 images was performed using two automated processing packages. Changes in gray and white matter volume were assessed as percentage change between 1 and 3 months. Mean concentrations (institutional units) of N-acetylaspartic acid (NAA) (6.1 vs 7.0, p = 0.039), total creatine (Cr+PCr) (5.4 vs 5.8, p = 0.043), and inositol (4.5 vs 5.0, p = 0.014), were significantly lower in the peri-infarct region compared with the contralateral hemisphere. There was a significant correlation between baseline peri-infarct NAA and white matter volume change in the infarct hemisphere between 1 and 3 months, with lower NAA being associated with subsequent white matter atrophy (Spearman's rho = 0.66, p = 0.010). The baseline concentration of Cr+PCr was also significantly correlated with white matter atrophy in the infarct hemisphere (Spearman's rho = 0.59, p = 0.027). Both of these associations were significant after adjustment for the false discovery rate and were validated using the secondary volumetric method. MRS may be useful in the prediction of white matter atrophy post-stroke and in the testing of novel neurorestorative therapies. (orig.)

  18. Association between baseline peri-infarct magnetic resonance spectroscopy and regional white matter atrophy after stroke.

    Science.gov (United States)

    Yassi, Nawaf; Campbell, Bruce C V; Moffat, Bradford A; Steward, Christopher; Churilov, Leonid; Parsons, Mark W; Donnan, Geoffrey A; Desmond, Patricia M; Davis, Stephen M; Bivard, Andrew

    2016-01-01

    Cerebral atrophy after stroke is associated with poor functional outcome. The prediction and prevention of post-stroke brain atrophy could therefore represent a target for neurorestorative therapies. We investigated the associations between peri-infarct metabolite concentrations measured by quantitative MRS and brain volume change in the infarct hemisphere after stroke. Twenty patients with ischemic stroke were enrolled. Patients underwent 3T-MRI within 1 week of onset, and at 1 and 3 months. At the baseline scan, an MRS voxel was placed manually in the peri-infarct area and another in the corresponding contralateral region. Volumetric analysis of T1 images was performed using two automated processing packages. Changes in gray and white matter volume were assessed as percentage change between 1 and 3 months. Mean concentrations (institutional units) of N-acetylaspartic acid (NAA) (6.1 vs 7.0, p = 0.039), total creatine (Cr+PCr) (5.4 vs 5.8, p = 0.043), and inositol (4.5 vs 5.0, p = 0.014), were significantly lower in the peri-infarct region compared with the contralateral hemisphere. There was a significant correlation between baseline peri-infarct NAA and white matter volume change in the infarct hemisphere between 1 and 3 months, with lower NAA being associated with subsequent white matter atrophy (Spearman's rho = 0.66, p = 0.010). The baseline concentration of Cr+PCr was also significantly correlated with white matter atrophy in the infarct hemisphere (Spearman's rho = 0.59, p = 0.027). Both of these associations were significant after adjustment for the false discovery rate and were validated using the secondary volumetric method. MRS may be useful in the prediction of white matter atrophy post-stroke and in the testing of novel neurorestorative therapies.

  19. Myocardial connective tissue growth factor (CCN2/CTGF attenuates left ventricular remodeling after myocardial infarction.

    Directory of Open Access Journals (Sweden)

    Jørgen Gravning

    Full Text Available AIMS: Myocardial CCN2/CTGF is induced in heart failure of various etiologies. However, its role in the pathophysiology of left ventricular (LV remodeling after myocardial infarction (MI remains unresolved. The current study explores the role of CTGF in infarct healing and LV remodeling in an animal model and in patients admitted for acute ST-elevation MI. METHODS AND RESULTS: Transgenic mice with cardiac-restricted overexpression of CTGF (Tg-CTGF and non-transgenic littermate controls (NLC were subjected to permanent ligation of the left anterior descending coronary artery. Despite similar infarct size (area of infarction relative to area at risk 24 hours after ligation of the coronary artery in Tg-CTGF and NLC mice, Tg-CTGF mice disclosed smaller area of scar tissue, smaller increase of cardiac hypertrophy, and less LV dilatation and deterioration of LV function 4 weeks after MI. Tg-CTGF mice also revealed substantially reduced mortality after MI. Remote/peri-infarct tissue of Tg-CTGF mice contained reduced numbers of leucocytes, macrophages, and cells undergoing apoptosis as compared with NLC mice. In a cohort of patients with acute ST-elevation MI (n = 42 admitted to hospital for percutaneous coronary intervention (PCI serum-CTGF levels (s-CTGF were monitored and related to infarct size and LV function assessed by cardiac MRI. Increase in s-CTGF levels after MI was associated with reduced infarct size and improved LV ejection fraction one year after MI, as well as attenuated levels of CRP and GDF-15. CONCLUSION: Increased myocardial CTGF activities after MI are associated with attenuation of LV remodeling and improved LV function mediated by attenuation of inflammatory responses and inhibition of apoptosis.

  20. Diffusion MRI and its role in neuropsychology

    Science.gov (United States)

    Mueller, Bryon A; Lim, Kelvin O; Hemmy, Laura; Camchong, Jazmin

    2015-01-01

    Diffusion Magnetic Resonance Imaging (dMRI) is a popular method used by neuroscientists to uncover unique information about the structural connections within the brain. dMRI is a non-invasive imaging methodology in which image contrast is based on the diffusion of water molecules in tissue. While applicable to many tissues in the body, this review focuses exclusively on the use of dMRI to examine white matter in the brain. In this review, we begin with a definition of diffusion and how diffusion is measured with MRI. Next we introduce the diffusion tensor model, the predominant model used in dMRI. We then describe acquisition issues related to acquisition parameters and scanner hardware and software. Sources of artifacts are then discussed, followed by a brief review of analysis approaches. We provide an overview of the limitations of the traditional diffusion tensor model, and highlight several more sophisticated non-tensor models that better describe the complex architecture of the brain’s white matter. We then touch on reliability and validity issues of diffusion measurements. Finally, we describe examples of ways in which dMRI has been applied to studies of brain disorders and how identified alterations relate to symptomatology and cognition. PMID:26255305

  1. Diffusion MRI and its Role in Neuropsychology.

    Science.gov (United States)

    Mueller, Bryon A; Lim, Kelvin O; Hemmy, Laura; Camchong, Jazmin

    2015-09-01

    Diffusion Magnetic Resonance Imaging (dMRI) is a popular method used by neuroscientists to uncover unique information about the structural connections within the brain. dMRI is a non-invasive imaging methodology in which image contrast is based on the diffusion of water molecules in tissue. While applicable to many tissues in the body, this review focuses exclusively on the use of dMRI to examine white matter in the brain. In this review, we begin with a definition of diffusion and how diffusion is measured with MRI. Next we introduce the diffusion tensor model, the predominant model used in dMRI. We then describe acquisition issues related to acquisition parameters and scanner hardware and software. Sources of artifacts are then discussed, followed by a brief review of analysis approaches. We provide an overview of the limitations of the traditional diffusion tensor model, and highlight several more sophisticated non-tensor models that better describe the complex architecture of the brain's white matter. We then touch on reliability and validity issues of diffusion measurements. Finally, we describe examples of ways in which dMRI has been applied to studies of brain disorders and how identified alterations relate to symptomatology and cognition.

  2. Acute inferior myocardial infarction with right ventricular infarction is more prone to develop cardiogenic shock.

    Science.gov (United States)

    Bari, M A; Roy, A K; Islam, M Z; Aditya, G; Bhuiyan, A S

    2015-01-01

    Cardiogenic shock is rare in isolated acute inferior myocardial infarction but there is relationship of cardiogenic shock with inferior myocardial infarction if associated with right ventricular infarction. A prospective study was carried out to see the association of cardiogenic shock with inferior myocardial infarction if associated with right ventricular infarction. This study was conducted from January 2011 to November 2011. A total of 100 cases were selected as study population which was taken from the Department of Cardiology, Mymensingh Medical College Hospital, Mymensingh, Bangladesh. Among them 50 were in Group A and 50 were in Group B. Group A was the patients of acute myocardial infarction with right ventricular infarction. Group B was the patients of acute myocardial infarction without right ventricular infarction. It revealed that 9(18%) in Group A and 3(6%) in Group B developed cardiogenic shock which is statistically significant (pcardiogenic shock.

  3. Stem cell mobilization induced by subcutaneous granulocyte-colony stimulating factor to improve cardiac regeneration after acute ST-elevation myocardial infarction: result of the double-blind, randomized, placebo-controlled stem cells in myocardial infarction (STEMMI) trial

    DEFF Research Database (Denmark)

    Ripa, Rasmus Sejersten; Jørgensen, Erik; Wang, Yongzhong

    2006-01-01

    of subcutaneous G-CSF injections on left ventricular function in patients with ST-elevation myocardial infarction. METHODS AND RESULTS: Seventy-eight patients (62 men; average age, 56 years) with ST-elevation myocardial infarction were included after successful primary percutaneous coronary stent intervention ... hours after symptom onset. Patients were randomized to double-blind treatment with G-CSF (10 microg/kg of body weight) or placebo for 6 days. The primary end point was change in systolic wall thickening from baseline to 6 months determined by cardiac magnetic resonance imaging (MRI). An independent core...

  4. Longitudinal strain is a marker of microvascular obstruction and infarct size in patients with acute ST-segment elevation myocardial infarction.

    Directory of Open Access Journals (Sweden)

    Loïc Bière

    Full Text Available OBJECTIVES: We assessed the value of speckle tracking imaging performed early after a first ST-segment elevation myocardial infarction (STEMI in order to predict infarct size and functional recovery at 3-month follow-up. METHODS: 44 patients with STEMI who underwent revascularization within 12 h of symptom onset were prospectively enrolled. Echocardiography was performed 3.9 ± 1.2 days after myocardial reperfusion, assessing circumferential (CGS, radial (RGS, and longitudinal global (GLS strains. Late gadolinium-enhanced cardiac magnetic imaging (CMR, for assessing cardiac function, infarct size, and microvascular obstruction (MVO, was conducted 5.6 ± 2.5 days and 99.4 ± 4.6 days after myocardial reperfusion. RESULTS: GLS was evaluable in 97% of the patients, while CGS and RGS could be assessed in 85%. Infarct size significantly correlated with GLS (R = 0.601, p-6.0% within the infarcted area exhibited 96% specificity and 61% sensitivity for predicting the persistence of akinesia (≥ 3 segments at 3-month follow-up. CONCLUSIONS: Speckle-tracking strain imaging performed early after a STEMI is easy-to-use as a marker for persistent akinetic territories at 3 months. In addition, GLS correlated significantly with MVO and final infarct size, both parameters being relevant post-MI prognostic factors, usually obtained via CMR.

  5. Cyclosporin variably and inconsistently reduces infarct size in experimental models of reperfused myocardial infarction: a systematic review and meta-analysis.

    Science.gov (United States)

    Lim, W Y; Messow, C M; Berry, C

    2012-04-01

    Cyclosporin is an immunosuppressant that has recently been proposed as a treatment to prevent reperfusion injury in acute myocardial infarction (MI). We aimed to determine the overall efficacy of cyclosporin in experimental studies of acute reperfused MI. We conducted a systematic review and stratified meta-analysis of published studies describing the efficacy of cyclosporin in experimental models of acute reperfused MI. We included all in vivo publications of cyclosporin where infarct size was measured. A literature search identified 29 potential studies of which 20 fulfilled the eligibility criteria. In these studies (involving four species of animals), cyclosporin reduced myocardial infarct size by a standardized mean (95% confidence interval) difference of -1.60 (-2.17, -1.03) compared with controls. Cyclosporin failed to demonstrate a convincing benefit in studies involving pigs. Despite this observation, the overall efficacy of cyclosporin did not differ across species (P= 0.358). The dose of cyclosporin given did not affect final infarct size (P= 0.203). Funnel plots of these data suggested heterogeneity among the studies. Cyclosporin had variable effects on infarct size compared with placebo. Cyclosporin had no effect on myocardial infarct size in swine, raising a question over the potential cardioprotective effects of cyclosporin in man. © 2011 The Authors. British Journal of Pharmacology © 2011 The British Pharmacological Society.

  6. Magnetic Resonance Imaging (MRI) -- Head

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    Full Text Available ... information on the chemicals present in the body's cells, may also be performed during the MRI exam ... medically necessary. MRI may not always distinguish between cancer tissue and fluid, known as edema . MRI typically ...

  7. Magnetic Resonance Imaging (MRI) -- Head

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    Full Text Available ... MRI of the Head? What is MRI of the Head? Magnetic resonance imaging (MRI) is a noninvasive ... of page What are some common uses of the procedure? MR imaging of the head is performed ...

  8. Magnetic Resonance Imaging (MRI) -- Head

    Medline Plus

    Full Text Available ... information on the chemicals present in the body's cells, may also be performed during the MRI exam ... medically necessary. MRI may not always distinguish between cancer tissue and fluid, known as edema . MRI typically ...

  9. Magnetic Resonance Imaging (MRI) -- Head

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    Full Text Available ... MRI of the Head? What is MRI of the Head? Magnetic resonance imaging (MRI) is a noninvasive ... of page What are some common uses of the procedure? MR imaging of the head is performed ...

  10. The use of susceptibility-weighted imaging to detect cerebral microbleeds after lacunar infarction.

    Science.gov (United States)

    Shao, L; Wang, M; Ge, X-H; Huang, H-D; Gao, L; Qin, J-C

    2017-07-01

    To study the value of susceptibility-weighted imaging (SWI) technology to detect cerebral microbleeds (CMBs) in senile cerebral lacunar infarction patients; and to evaluate the complicated cerebral hemorrhage risk after patients with CMBs took aspirin, an antiplatelet medication or received anticoagulant therapy. MRI scanning, using GRE-T2*WI, SWI and FSE sequences (T1WI, T2WI, and T2FLAIR), was performed on the three groups: (1) a cerebral lacunar infarction group; (2) cerebral lacunar infarction with cerebral microbleeds (CMBs) group; and (3) a healthy elderly group. A total of 60 cases were in each group (180 total patients). In addition, the lacunar infarction group and lacunar infarction with CMBs groups were both treated with formal antiplatelet or anticoagulant therapy, according to medical guidelines. Patients were followed for 12 months, during which time their cerebral hemorrhages and post-event effects were observed. The relativity of CMBs, antiplatelet therapy, anticoagulant therapy and cerebral hemorrhage transformation was analyzed and defined. The two groups of research patients with lacunar infarctions were scanned with relevant sequences. The SWI scanning sequence showed the highest positive rate of CMBs, followed by GRE-T2*WI and other conventional scanning sequences. T1WI, T2WI and T2FLAIR showed a relatively lower positive rate of CMBs. In the cerebral lacunar infarction group and healthy elderly group, 34 cases in the SWI sequence showed 84 positive sites; 18 cases in the GRE-T2*WI sequence showed 40 positive sites; 2 cases in the T1WI sequence showed 4 positive sites; and 6 cases in the T2WI sequence showed 11 positive sites. After a chi-squared test, the differences between the sequences were statistically significant (p CMBs. The normal control group only showed mild hemorrhaging. The degree of lacunar infarction was significantly related to the severity of CMBs (p CMBs had received formal antiplatelet therapy and anticoagulation therapy

  11. CT angiography and CT perfusion improve prediction of infarct volume in patients with anterior circulation stroke

    Energy Technology Data Exchange (ETDEWEB)

    Seeters, Tom van; Schaaf, Irene C. van der; Dankbaar, Jan Willem; Horsch, Alexander D.; Niesten, Joris M.; Luitse, Merel J.A.; Mali, Willem P.T.M.; Velthuis, Birgitta K. [University Medical Center Utrecht, Department of Radiology, Utrecht (Netherlands); Biessels, Geert Jan; Kappelle, L.J. [University Medical Center Utrecht, Department of Neurology, Brain Center Rudolf Magnus, Utrecht (Netherlands); Majoie, Charles B.L.M. [Academic Medical Center, Department of Radiology, Amsterdam (Netherlands); Vos, Jan Albert [St. Antonius Hospital, Department of Radiology, Nieuwegein (Netherlands); Schonewille, Wouter J. [St. Antonius Hospital, Department of Neurology, Nieuwegein (Netherlands); Walderveen, Marianne A.A. van [Leiden University Medical Center, Department of Radiology, Leiden (Netherlands); Wermer, Marieke J.H. [Leiden University Medical Center, Department of Neurology, Leiden (Netherlands); Duijm, Lucien E.M. [Catharina Hospital, Department of Radiology, Eindhoven (Netherlands); Keizer, Koos [Catharina Hospital, Department of Neurology, Eindhoven (Netherlands); Bot, Joseph C.J. [VU University Medical Center, Department of Radiology, Amsterdam (Netherlands); Visser, Marieke C. [VU University Medical Center, Department of Neurology, Amsterdam (Netherlands); Lugt, Aad van der [Erasmus MC University Medical Center, Department of Radiology, Rotterdam (Netherlands); Dippel, Diederik W.J. [Erasmus MC University Medical Center, Department of Neurology, Rotterdam (Netherlands); Kesselring, F.O.H.W. [Rijnstate Hospital, Department of Radiology, Arnhem (Netherlands); Hofmeijer, Jeannette [Rijnstate Hospital, Department of Neurology, Arnhem (Netherlands); Lycklama a Nijeholt, Geert J. [Medical Center Haaglanden, Department of Radiology, The Hague (Netherlands); Boiten, Jelis [Medical Center Haaglanden, Department of Neurology, The Hague (Netherlands); Rooij, Willem Jan van [St. Elisabeth Hospital, Department of Radiology, Tilburg (Netherlands); Kort, Paul L.M. de [St. Elisabeth Hospital, Department of Neurology, Tilburg (Netherlands); Roos, Yvo B.W.E.M. [Academic Medical Center, Department of Neurology, Amsterdam (Netherlands); Meijer, Frederick J.A. [Radboud University Medical Center, Department of Radiology, Nijmegen (Netherlands); Pleiter, C.C. [St. Franciscus Hospital, Department of Radiology, Rotterdam (Netherlands); Graaf, Yolanda van der [University Medical Center Utrecht, Julius Center for Health Sciences and Primary Care, Utrecht (Netherlands); Collaboration: Dutch acute stroke study (DUST) investigators

    2016-04-15

    We investigated whether baseline CT angiography (CTA) and CT perfusion (CTP) in acute ischemic stroke could improve prediction of infarct presence and infarct volume on follow-up imaging. We analyzed 906 patients with suspected anterior circulation stroke from the prospective multicenter Dutch acute stroke study (DUST). All patients underwent baseline non-contrast CT, CTA, and CTP and follow-up non-contrast CT/MRI after 3 days. Multivariable regression models were developed including patient characteristics and non-contrast CT, and subsequently, CTA and CTP measures were added. The increase in area under the curve (AUC) and R{sup 2} was assessed to determine the additional value of CTA and CTP. At follow-up, 612 patients (67.5 %) had a detectable infarct on CT/MRI; median infarct volume was 14.8 mL (interquartile range (IQR) 2.8-69.6). Regarding infarct presence, the AUC of 0.82 (95 % confidence interval (CI) 0.79-0.85) for patient characteristics and non-contrast CT was improved with addition of CTA measures (AUC 0.85 (95 % CI 0.82-0.87); p < 0.001) and was even higher after addition of CTP measures (AUC 0.89 (95 % CI 0.87-0.91); p < 0.001) and combined CTA/CTP measures (AUC 0.89 (95 % CI 0.87-0.91); p < 0.001). For infarct volume, adding combined CTA/CTP measures (R{sup 2} = 0.58) was superior to patient characteristics and non-contrast CT alone (R{sup 2} = 0.44) and to addition of CTA alone (R{sup 2} = 0.55) or CTP alone (R{sup 2} = 0.54; all p < 0.001). In the acute stage, CTA and CTP have additional value over patient characteristics and non-contrast CT for predicting infarct presence and infarct volume on follow-up imaging. These findings could be applied for patient selection in future trials on ischemic stroke treatment. (orig.)

  12. Risk Factors for Silent Lacunar Infarction in Patients with Transient Ischemic Attack

    Science.gov (United States)

    Li, Ying; Liu, Nan; Huang, Yonghua; Wei, Wei; Chen, Fei; Zhang, Weiwei

    2016-01-01

    Background Lacunar infarctions represent 25% of ischemic strokes. Lacunar stroke and transient ischemic attack (TIA) share a number of symptoms. This study aimed to assess the potential risk factors for lacunar infarction in patients with TIA. Material/Methods This was a retrospective study performed at the Beijing Military General Hospital in patients with TIA admitted between March 2010 and December 2011. Patients were grouped according to lacunar vs. no lacunar infarction. All patients were diagnosed using diffusion-weighted imaging (DWI) on brain magnetic resonance imaging (MRI). Brain angiography (computed tomography and MRI) was used to measure intracranial stenosis. Carotid artery stenosis was measured by ultrasound. Results Patients with TIA and lacunar infarction (n=298) were older than those without lacunar infarction (n=157) (69.4±10.0 vs. 58.9±9.0 years, P<0.001) and showed a higher frequency of males (51.7% vs. 41.4%, P=0.037), hypertension (75.3% vs. 45.9%, P<0.001), diabetes (32.6% vs. 21.0%, P=0.010), hyperlipidemia (53.4% vs. 29.3%, P<0.001), carotid stenosis (73.2% vs. 40.1%, P<0.001), and intracranial stenosis (55.6% vs. 31.9%, P<0.001), but a lower frequency of alcohol drinking (8.1% vs. 14.0%, P=0.045). Lacunar infarction mostly involved the anterior circulation (62.8%). Multivariate analysis showed that age (odds ratio (OR)=1.085, 95% confidence interval (95%CI): 1.054–1.117, P<0.001), hypertension (OR=1.738, 95%CI: 1.041–2.903, P=0.035), hyperlipidemia (OR=2.169, 95%CI: 1.307–3.601, P=0.003), and carotid stenosis (OR=1.878, 95%CI: 1.099–3.206, P=0.021) were independently associated with lacunar infarction. Conclusions Age, hypertension, hyperlipidemia, and carotid stenosis were independently associated with silent lacunar infarction in patients with TIA. PMID:26864634

  13. MRI of the Chest

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    Full Text Available ... contrast material except when absolutely necessary for medical treatment. See the MRI Safety page for more information about pregnancy and MRI. If you have claustrophobia (fear of enclosed spaces) or anxiety, you may want to ask your physician for ...

  14. MRI of the Chest

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    Full Text Available ... metallic items, which can distort MRI images removable dental work pens, pocket knives and eyeglasses body piercings In most cases, an MRI exam is safe for patients with metal implants, except for a few types. People with the ...

  15. MRI of the Chest

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    Full Text Available Toggle navigation Test/Treatment Patient Type Screening/Wellness Disease/Condition Safety En Español More Info Images/Videos About Us News Physician ... Magnetic resonance imaging (MRI) is a noninvasive medical test that physicians use to diagnose medical conditions. MRI ...

  16. MRI of the Chest

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    Full Text Available ... other internal body structures. MRI does not use ionizing radiation (x-rays). Detailed MR images allow physicians to ... computed tomography (CT) scans, MRI does not utilize ionizing radiation. Instead, radiofrequency pulses re-align hydrogen atoms that ...

  17. MRI of the brain in diabetes mellitus

    Energy Technology Data Exchange (ETDEWEB)

    Araki, Y. [Osaka Rosai Hospital (Japan). Dept. of Radiology; Nomurak, M. [Osaka Rosai Hospital (Japan). Dept. of Medicine; Tanaka, H. [Osaka Rosai Hospital (Japan). Dept. of Radiology; Yamamoto, H. [Osaka Rosai Hospital (Japan). Dept. of Radiology; Yamamoto, T. [Osaka Rosai Hospital (Japan). Dept. of Radiology; Tsukaguchi, I, [Osaka Rosai Hospital (Japan). Dept. of Radiology; Nakamura, H. [Osaka Univ. Medical School (Japan). Dept. of Radiology

    1994-02-01

    We studied the MRI appearances of the brain in 159 patients with diabetes mellitus (DM) and 2566 age-matched individuals without DM (controls). The images were reviewed for cerebral infarcts, hemorrhage, atrophy and subcortical arteriosclerotic encephalopathy. Cerebral atrophy was significantly more frequent in patients with DM than in controls (P > 0.005) from the sixth to the eighth decade. The frequency of atrophy was 41.2% in the 6th decade, 60.0 % in the 7th and 92.3 % in the 8th decade in DM, and 19.8 %, 38.9 % and 56.8 % respectively in controls. Unexpectedly, there was no statistically significant difference in the incidences of cerebrovascular diseases at any age. (orig.)

  18. D-dimer levels and cerebral infarction in critically ill cancer patients.

    Science.gov (United States)

    Ryu, Jeong-Am; Bang, Oh Young; Lee, Geun-Ho

    2017-08-30

    D-dimer levels have been used in the diagnosis of a variety of thrombosis-related diseases. In this study, we evaluated whether measuring D-dimer levels can help to diagnose cerebral infarction (CI) in critically ill cancer patients. We retrospectively evaluated all cancer patients who underwent brain magnetic resonance imaging (MRI) between March 2010 and February 2014 at the medical oncology intensive care unit (ICU) of Samsung Medical Center. Brain MRI scanning was performed when CI was suspected due to acute neurological deficits. We compared D-dimer levels between patients ultimately diagnosed as having or not having CI and analyzed diffusion-weighted imaging (DWI) lesion patterns. A total of 88 patients underwent brain MRI scanning due to clinical suspicion of CI; altered mental status and unilateral hemiparesis were the most common neurological deficits. CI was ultimately diagnosed in 43 (49%) patients. According to the DWI patterns, multiple arterial infarctions (40%) were more common than single arterial infarctions (9%). Cryptogenic stroke etiologies were more common (63%) than determined etiologies. There was no significant difference in D-dimer levels between patients with and without CI (P = 0.319). Although D-dimer levels were not helpful in diagnosing CI, D-dimer levels were associated with cryptogenic etiologies in critically ill cancer patients; D-dimer levels were higher in the cryptogenic etiology group than in the determined etiology group or the non-infarction group (P = 0.001). In multivariate analysis, elevated D-dimer levels (> 8.89 μg/mL) were only associated with cryptogenic stroke (adjusted OR 5.46; 95% confidence interval, 1.876-15.857). Abnormal D-dimer levels may support the diagnosis of cryptogenic stroke in critically ill cancer patients.

  19. Assessment of myocardial infarction in mice by Late Gadolinium Enhancement MR imaging using an inversion recovery pulse sequence at 9.4T

    Directory of Open Access Journals (Sweden)

    Herlihy Amy H

    2008-01-01

    Full Text Available Abstract Purpose To demonstrate the feasibility of using an inversion recovery pulse sequence and to define the optimal inversion time (TI to assess myocardial infarction in mice by late gadolinium enhancement (LGE MRI at 9.4T, and to obtain the maximal contrast between the infarcted and the viable myocardium. Methods MRI was performed at 9.4T in mice, two days after induction of myocardial infarction (n = 4. For cardiovascular MR imaging, a segmented magnetization-prepared fast low angle shot (MP-FLASH sequence was used with varied TIs ranging from 40 to 420 ms following administration of gadolinium-DTPA at 0.6 mmol/kg. Contrast-to-noise (CNR and signal-to-noise ratio (SNR were measured and compared for each myocardial region of interest (ROI. Results The optimal TI, which corresponded to a minimum SNR in the normal myocardium, was 268 ms ± 27.3. The SNR in the viable myocardium was significantly different from that found in the infarcted myocardium (17.2 ± 2.4 vs 82.1 ± 10.8; p = 0.006 leading to a maximal relative SI (Signal Intensity between those two areas (344.9 ± 60.4. Conclusion Despite the rapid heart rate in mice, our study demonstrates that LGE MRI can be performed at 9.4T using a protocol similar to the one used for clinical MR diagnosis of myocardial infarction.

  20. MRI and MR angiography of vertebral artery dissection

    Energy Technology Data Exchange (ETDEWEB)

    Mascalchi, M. [Cattedra di Radiologia, Universita di Pisa (Italy); Bianchi, M.C. [Servizio di Neuroradiologia, Ospedale S. Chiara, Pisa (Italy); Mangiafico, S. [Servizio di Neuroradiologia, Ospedale di Careggi, Firenze (Italy); Ferrito, G. [Servizio di Neuroradiologia, Ospedali Riuniti, Livorno (Italy); Puglioli, M. [Servizio di Neuroradiologia, Ospedale S. Chiara, Pisa (Italy); Marin, E. [Servizio di Radiologia, Ospedale S. M. Nuova, Firenze (Italy); Mugnai, S. [Clinica Neurologica, Universita di Firenze (Italy); Canapicchi, R. [Servizio di Neuroradiologia, Ospedale S. Chiara, Pisa (Italy); Quilici, N. [Servizio di Neuroradiologia, Ospedali Riuniti, Livorno (Italy); Inzitari, D. [Clinica Neurologica, Universita di Firenze (Italy)

    1997-05-01

    A review of 4,500 angiograms yielded 11 patients with dissection of the vertebral arteries who had MRI and (in 4 patients) MR angiography (MRA) in the acute phase of stroke. One patient with incidental discovery at arteriography of asymptomatic vertebral artery dissection and two patients with acute strokes with MRI and MRA findings consistent with vertebral artery dissection were included. Dissection occurred after neck trauma or chiropractic manipulation in 4 patients and was spontaneous in 10. Dissection involved the extracranial vertebral artery in 9 patients, the extra-intracranial junction in 1, and the intracranial artery in 4. MRI demonstrated infarcts in the brain stem, cerebellum, thalamus or temporo-occipital regions in 7 patients with extra- or extra-intracranial dissections and a solitary lateral medullary infarct in 4 patients (3 with intracranial and 1 with extra-intracranial dissection). In 2 patients no brain abnormality related to vertebral artery dissection was found and in one MRI did not show subarachnoid haemorrhage revealed by CT. Intramural dissecting haematoma appeared as crescentic or rounded high signal on T1-weighted images in 10 patients examined 3-20 days after the onset of symptoms. The abnormal vessel stood out in the low signal cerebrospinal fluid in intracranial dissections, whereas it was more difficult to detect in extracranial dissections because of the intermediate-to-high signal of the normal perivascular structures and slow flow proximal and distal to the dissection. In two patients examined within 36 h of the onset, mural thickening was of intermediate signal intensity on T1-weighted images and high signal on spin-density and T2-weighted images. MRA showed abrupt stenosis in 2 patients and disappearance of flow signal at and distal to the dissection in 5. Follow-up arteriography, MRI or MRA showed findings consistent with occlusion of the dissected vessel in 6 of 8 patients. (orig.). With 7 figs., 3 tabs.

  1. Atrial infarction is a unique and often unrecognized clinical entity

    Directory of Open Access Journals (Sweden)

    Rosana G. G. Mendes

    1999-03-01

    Full Text Available A patient with heart failure and acute atrial fibrillation received the final diagnosis of atrial infarction associated with ventricular infarction based on clinical findings of ischemia in association with atrial fibrillation and heart failure (mechanisms probably involved: contractile dysfunction and loss of atrial contribution. Although a transesophageal echocardiography, which could refine the diagnosis of anatomic abnormalities, was not performed, all evidence led to the diagnosis of atrial involvement. Electrocardiographic findings were consistent with Liu's major criterion 3. Therapy with digitalis, quinidine and angiotensin-converting enzyme inhibitors was chosen, as the patient had acute pulmonary edema. The use of beta-blockers and verapamil was restricted. No other complications, such as thrombo-embolism or atrial rupture, were noted.

  2. Ultrasound- and MRI-Guided Prostate Biopsy

    Science.gov (United States)

    ... News Physician Resources Professions Site Index A-Z Ultrasound- and MRI-Guided Prostate Biopsy Ultrasound- and MRI- ... Ultrasound-and MRI-guided Prostate Biopsy? What is Ultrasound- and MRI-guided Prostate Biopsy? Ultrasound- and MRI- ...

  3. Myocardial infarction and subsequent pregnancy

    Directory of Open Access Journals (Sweden)

    Tedoldi Citânia Lúcia

    2000-01-01

    Full Text Available We report the case of a 40-year-old woman with 2 previous myocardial infarctions, revascularization surgery, and an ongoing pregnancy complicated with preeclampsia and fetal hypoxia. Her follow-up performed by a multidisciplinary team made possible the birth through cesarean section of a premature infant of the female sex with a very low birth weight, but without severe respiratory distress of the hyaline membrane disease type. Three months after the delivery, mother and daughter were healthy.

  4. Myocardial infarction in young adults

    OpenAIRE

    Egred, M; Viswanathan, G; Davis, G.

    2005-01-01

    Although myocardial infarction (MI) mainly occurs in patients older than 45, young men or women can suffer MI. Fortunately, its incidence is not common in patients younger than 45 years. However, the disease carries a significant morbidity, psychological effects, and financial constraints for the person and the family when it occurs at a young age. The causes of MI among patients aged less than 45 can be divided into four groups: (1) atheromatous coronary artery disease; (2) non-atheromatous ...

  5. Acute bithalamic infarct manifesting as sleep-like coma: A diagnostic challenge.

    Science.gov (United States)

    Honig, Asaf; Eliahou, Ruth; Eichel, Roni; Shemesh, Ari Aharon; Ben-Hur, Tamir; Auriel, Eitan

    2016-12-01

    Bilateral thalamic infarction (BTI) typically presents as a sleep-like coma (SLC) without localizing signs, posing a diagnostic challenge that may lead the treating physician to search for toxic or metabolic causes and delay treatment. We review our experience with BTI of different etiologies, and emphasize the critical role of timely imaging, diagnosis, and management in a series of 12 patients with a presentation of SLC and acute BTI who were managed in our Medical Centers from 2006-2015. In 11/12, urgent head CT scans showed normal brain tissue, while diffusion-weighted (DWI) MRI revealed symmetric bilateral thalamic hyperintense lesions with variable degrees of brainstem involvement. In 1/12, CT scans revealed a contralateral subacute stroke from a thalamic infarct 1month earlier with a unilateral hyperintense lesion on DWI-MRI. From clinical and imaging findings (DWI-MRI, CT angiography and venography), etiology was attributed to embolic causes (cardio-embolism, artery-to-artery mechanism), small vessel disease, or deep sinus vein thrombosis secondary to dural arteriovenous (AV) fistula. Three patients had good outcomes after prompt diagnosis and optimal treatment in <3hours (intravenous tissue plasminogen activator in two patients cardio-embolic etiology and neuro-endovascular repair in one patient with venous infarction due to a dural AV fistula). The diagnosis was made beyond the therapeutic window in seven patients, who were left with significant neurological sequelae. Higher awareness of BTI presenting as SLC is warranted. Optimal patient management includes urgent DWI-MRI. In cases of BTI, further imaging workup is indicated to provide a comprehensive assessment for etiology. Early diagnosis and prompt, targeted intervention are crucial.

  6. Scintigraphic evaluation of routine filterwire distal protection in percutaneous coronary intervention for acute ST-segment elevation myocardial infarction: a randomized controlled trial

    DEFF Research Database (Denmark)

    Kaltoft, Anne; Nielsen, Søren Steen; Terkelsen, Christian Juhl

    2009-01-01

    AIM: Distal embolization during primary percutaneous coronary intervention (PCI) for ST-elevation myocardial infarction (STEMI) may result in reduced myocardial perfusion, infarct extension and impaired prognosis. In a prospective randomized trial, we assessed the effect of routine filterwire...... distal protection on scintigraphic estimated infarct size. METHODS AND RESULTS: The effect of routine filterwire distal protection was evaluated in 344 patients with STEMI ... by Sestamibi SPECT) were similar. Final infarct size was not statistically different in the distal protection and the control groups (median [IQR], 6% [1-19] and 5% [1-14], P = .23). Also, secondary endpoints were similar in the two treatment groups. CONCLUSION: Distal protection with a filterwire performed...

  7. Mortality rate in type 2 myocardial infarction

    DEFF Research Database (Denmark)

    Saaby, Lotte; Poulsen, Tina Svenstrup; Diederichsen, Axel Cosmus Pyndt

    2014-01-01

    , all hospitalized patients having cardiac troponin I measured were considered. The diagnosis of a myocardial infarction was according to the universal definition, and specified criteria were used in the classification of type 2 myocardial infarction. Follow-up was at least 1 year, with mortality......BACKGROUND: The classification of myocardial infarction into 5 types was introduced in 2007. The prognostic impact of this universal definition, with particular focus on type 2 myocardial infarction, has not been studied prospectively in unselected hospital patients. METHODS: During a 1-year period...... as the end point. RESULTS: A total of 3762 consecutive patients were studied, of whom 488 (13%) had a myocardial infarction. In 119 patients a type 2 myocardial infarction was diagnosed. After a median of 2.1 years (interquartile range, 1.6-2.5 years), 150 patients had died, with a mortality rate of 49% (58...

  8. Medical image of the week: artery of Percheron infarction

    Directory of Open Access Journals (Sweden)

    Ta TT

    2017-03-01

    Full Text Available No abstract available. Article truncated after 150 words. A 55-year-old African-American man presented to the Emergency Department for acute altered mental status which started 4 hours ago. His medical history was significant for heart failure with reduced ejection fraction, diabetes mellitus, marijuana and opioid use. On admission, the patient appeared to be in a deep sleep, unarousable, with grimacing to noxious stimuli. He occasionally moved all extremities. He was intubated for airway protection. Initial CT head non-contrast demonstrated a previous right MCA infarct, with no new acute hemorrhage. MRI/MRA brain revealed complete infarction of the artery of Percheron (AOP, likely due to a left ventricular thrombus (Figure 1. The patient remained somnolent throughout hospitalization with minimal neurologic improvement, and was ultimately transferred to a long-term care facility after a tracheostomy and PEG placement. The artery of Percheron is a rare, normal intracranial vascular variant in which a single arterial trunk originates from the posterior cerebral artery, giving rise …

  9. Acute infarction of corpus callosum due to transient obstructive hydrocephalus.

    Science.gov (United States)

    Kaymakamzade, Bahar; Eker, Amber

    2016-01-01

    Acute ischemia of the corpus callosum (CC) is not a well-known feature in patients with acute hydrocephalus. Herein, we describe a case with acute CC infarction due to another rare entity; transient obstructive hydrocephalus. A 66-year-old male was admitted with sudden onset right-sided hemiparesia. CT demonstrated a hematoma on the left basal ganglia with extension to all ventricles. The following day, the patient's neurological status progressed to coma and developed bilateral pyramidal signs. MRI demonstrated obstructive hydrocephalus and acute diffuse infarction accompanied by elevation of the CC. On the same day there was improvement in his neurological status with significant decrease in ventricular size and complete resolution of the clot in the third ventricle. The mechanism of signal abnormalities is probably related with the neural compression of the CC against the falx. Presumably, the clot causing obstruction in the third ventricle dissolved or decayed by the help of fibrinolytic activity of CSF, which was raised after IVH and caused spontaneous improvement of hydrocephalus. Bilateral neurological symptoms suggest diffuse axonal damage and normalization of the intracranial pressure should be performed on the early onset of clinical detorioration in order to prevent axonal injury.

  10. Visual localisation in patients with occipital infarction.

    OpenAIRE

    Ross Russell, R W; Bharucha, N

    1984-01-01

    Visually directed pointing has been examined in a group of patients with occipital lobe infarction and in an age-matched control group. The visual field ipsilateral to the infarct showed normal localisation; there was no evidence that right sided infarction produced a bilateral disturbance. In quadrantanopia the spared quadrant on the affected side showed abnormal localisation in a few patients but this was not consistently associated with right or left sided defects. The majority of patients...

  11. The best of nuclear cardiology and MRI in 2004; Essentiel de 2004 en cardiologie nucleaire et IRM

    Energy Technology Data Exchange (ETDEWEB)

    Daou, D. [Hopital Lariboisiere, Groupe de Cardiologie Nucleaire et IRM, 75 - Paris (France)

    2005-05-15

    In this review, we limit ourselves to original studies based on scintigraphic or MRI techniques performed in man. During the year 2004 we have learned several lessons from various interesting studies reported below, regarding different areas of cardiology including myocardial ischemia, myocarditis, myocardial infarction and myocardial viability. (author)

  12. MRI in perianal fistulae

    Directory of Open Access Journals (Sweden)

    Khera Pushpinder

    2010-01-01

    Full Text Available MRI has become the method of choice for evaluating perianal fistulae due to its ability to display the anatomy of the sphincter muscles orthogonally, with good contrast resolution. In this article we give an outline of the classification of perianal fistulae and present a pictorial assay of sphincter anatomy and the MRI findings in perianal fistulae. This study is based on a retrospective analysis of 43 patients with a clinical diagnosis of perianal fistula. MRI revealed a total of 44 fistulae in 35 patients; eight patients had only perianal sinuses.

  13. Computational modeling of acute myocardial infarction.

    Science.gov (United States)

    Sáez, P; Kuhl, E

    2016-01-01

    Myocardial infarction, commonly known as heart attack, is caused by reduced blood supply and damages the heart muscle because of a lack of oxygen. Myocardial infarction initiates a cascade of biochemical and mechanical events. In the early stages, cardiomyocytes death, wall thinning, collagen degradation, and ventricular dilation are the immediate consequences of myocardial infarction. In the later stages, collagenous scar formation in the infarcted zone and hypertrophy of the non-infarcted zone are auto-regulatory mechanisms to partly correct for these events. Here we propose a computational model for the short-term adaptation after myocardial infarction using the continuum theory of multiplicative growth. Our model captures the effects of cell death initiating wall thinning, and collagen degradation initiating ventricular dilation. Our simulations agree well with clinical observations in early myocardial infarction. They represent a first step toward simulating the progression of myocardial infarction with the ultimate goal to predict the propensity toward heart failure as a function of infarct intensity, location, and size.

  14. Brain MRI in Parkinson's disease

    NARCIS (Netherlands)

    Meijer, F.J.A.; Goraj, B.M.

    2014-01-01

    In this review article, conventional brain MRI and advanced MRI techniques in Parkinson`s disease (PD) are discussed, with emphasis on clinical relevance. Conventional brain MRI sequences generally demonstrate limited abnormalities specific for PD and in clinical practice brain MRI is mainly used to

  15. Magnetic Resonance Imaging (MRI) -- Head

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    Full Text Available ... News Physician Resources Professions Site Index A-Z Magnetic Resonance Imaging (MRI) - Head Magnetic resonance imaging (MRI) of the head uses a powerful ... the Head? What is MRI of the Head? Magnetic resonance imaging (MRI) is a noninvasive medical test that ...

  16. Three-dimensional maximum principal strain using cardiac computed tomography for identification of myocardial infarction

    Energy Technology Data Exchange (ETDEWEB)

    Tanabe, Yuki; Kido, Teruhito; Kurata, Akira; Sawada, Shun; Suekuni, Hiroshi; Kido, Tomoyuki; Yokoi, Takahiro; Miyagawa, Masao; Mochizuki, Teruhito [Ehime University Graduate School of Medicine, Department of Radiology, Toon City, Ehime (Japan); Uetani, Teruyoshi; Inoue, Katsuji [Ehime University Graduate School of Medicine, Department of Cardiology, Pulmonology, Hypertension and Nephrology, Toon City, Ehime (Japan)

    2017-04-15

    To evaluate the feasibility of three-dimensional (3D) maximum principal strain (MP-strain) derived from cardiac computed tomography (CT) for detecting myocardial infarction (MI). Forty-three patients who underwent cardiac CT and magnetic resonance imaging (MRI) were retrospectively selected. Using the voxel tracking of motion coherence algorithm, the peak CT MP-strain was measured using the 16-segment model. With the trans-mural extent of late gadolinium enhancement (LGE) and the distance from MI, all segments were classified into four groups (infarcted, border, adjacent, and remote segments); infarcted and border segments were defined as MI with LGE positive. Diagnostic performance of MP-strain for detecting MI was compared with per cent systolic wall thickening (%SWT) assessed by MRI using receiver-operating characteristic curve analysis at a segment level. Of 672 segments excluding16 segments influenced by artefacts, 193 were diagnosed as MI. Sensitivity and specificity of peak MP-strain to identify MI were 81 % [95 % confidence interval (95 % CI): 74-88 %] and 86 % (81-92 %) compared with %SWT: 76 % (60-95 %) and 68 % (48-84 %), respectively. The area under the curve of peak MP-strain was superior to %SWT [0.90 (0.87-0.93) vs. 0.80 (0.76-0.83), p < 0.05]. CT MP-strain has a potential to provide incremental value to coronary CT angiography for detecting MI. (orig.)

  17. Cerebellar infarct patterns: The SMART-Medea study

    Directory of Open Access Journals (Sweden)

    Laurens J.L. De Cocker, MD

    2015-01-01

    Conclusions: Small cerebellar infarcts proved to be much more common than larger infarcts, and preferentially involved the cortex. Small cortical infarcts predominantly involved the posterior lobes, showed sparing of subcortical white matter and occurred in characteristic topographic patterns.

  18. 后循环梗死:病变分布和CT血管造影%Posterior circulation infarction: distribution of lesions and CT angiography

    Institute of Scientific and Technical Information of China (English)

    吉利; 刘贤; 宋玉强; 王倩

    2014-01-01

    Objective To investigate the correlation between the distribution of lesions on MRI and the findings of computerized tomography angiography (CTA) in patients with posterior circulation infarction.Methods Patients with acute posterior circulation infarction were enrolled in the study.The sites of the infarcts were divided into proximal,middle and distal infarctions according to the results of MRI.All the patients received head and neck CTA.The correlation between the distribution of posterior circulation infarcts and the sites of vertebrobasilar system lesions was analyzed.Results A total of 203 patients with acute posterior circulation infarction were enrolled.Their primary clinical symptoms and signs were unilateral limb weakness (n =77,37.93%),dizziness (n =129,63.55%),dysarthria (n =31,15.27%),nausea and vomiting (n =61,30.05%),headache (n =79,38.92%),gait abnormal (n =50,24.63%),nystagmus (n=34,16.75%),and ataxia (n=21,10.34%).Proximal infarction (n=35,17.24%):medullary infarction (n =28,13.79%),posterior inferior cerebellar artery infarction (n =7,3.45%); middle infarction (n =95,46.79%):pontine infarction (n =80,39.4%),anterior inferior cerebellar infarction (n =15,7.39%); distal infarction (n=73,35.96%):middle cerebral infarction (n=6,2.96%),superior cerebellar infarction (n =16,7.88%),thalamic infarction (n =34,(16.75%),occipital lobe infarction (n =10,4.93%),temporal lobe infarction (n =7,3.44%).Extracranial vertebral artery lesions were most common in the distal infarction group.It reached 53.42%,and was significantly higher than 22.86% in the proximal infarction group (P =0.003) and 33.68% in the middle infarction group (P =0.010).Intracranlal vertebral artery lesions were most common in the proximal infarction group.It reached 57.14%,and then followed by the middle infarction (41.05%).They were all significantly higher than 15.07% in the distal infarction group (all P =0.000).Basilar artery lesions

  19. Cognition and brain abnormalities on MRI in pituitary patients

    Energy Technology Data Exchange (ETDEWEB)

    Brummelman, Pauline [Department of Endocrinology, University of Groningen, University Medical Center Groningen (Netherlands); Sattler, Margriet G.A. [Department of Radiation Oncology, University of Groningen, University Medical Center Groningen (Netherlands); Department of Radiation Oncology, Netherlands Cancer Institute – Antoni van Leeuwenhoek Hospital, Amsterdam (Netherlands); Meiners, Linda C. [Department of Radiology, University of Groningen, University Medical Center Groningen (Netherlands); Berg, Gerrit van den; Klauw, Melanie M. van der [Department of Endocrinology, University of Groningen, University Medical Center Groningen (Netherlands); Elderson, Martin F. [Department of Endocrinology, University of Groningen, University Medical Center Groningen (Netherlands); LifeLines Cohort Study and Biobank, University of Groningen, University Medical Center Groningen (Netherlands); Dullaart, Robin P.F. [Department of Endocrinology, University of Groningen, University Medical Center Groningen (Netherlands); Koerts, Janneke [Department of Clinical and Developmental Neuropsychology, University of Groningen, Groningen (Netherlands); Werumeus Buning, Jorien, E-mail: j.werumeus.buning@umcg.nl [Department of Endocrinology, University of Groningen, University Medical Center Groningen (Netherlands); Tucha, Oliver [Department of Clinical and Developmental Neuropsychology, University of Groningen, Groningen (Netherlands); Wolffenbuttel, Bruce H.R. [Department of Endocrinology, University of Groningen, University Medical Center Groningen (Netherlands); LifeLines Cohort Study and Biobank, University of Groningen, University Medical Center Groningen (Netherlands); Bergh, Alfons C.M. van den [Department of Radiation Oncology, University of Groningen, University Medical Center Groningen (Netherlands); Beek, André P. van, E-mail: a.p.van.beek@umcg.nl [Department of Endocrinology, University of Groningen, University Medical Center Groningen (Netherlands)

    2015-02-15

    Highlights: • Cognitive impairments are frequently observed in treated NFA patients. • NFA patients with cognitive impairments do not show brain abnormalities on MRI more frequently than patients without cognitive impairments. • The absence of brain abnormalities on brain MRI does not exclude impairments of cognition. - Abstract: Purpose: The extent to which cognitive dysfunction is related to specific brain abnormalities in patients treated for pituitary macroadenoma is unclear. Therefore, we compared brain abnormalities seen on Magnetic Resonance Imaging (MRI) in patients treated for nonfunctioning pituitary macroadenoma (NFA) with or without impairments in cognitive functioning. Methods: In this cross-sectional design, a cohort of 43 NFA patients was studied at the University Medical Center Groningen. White matter lesions (WMLs), cerebral atrophy, (silent) brain infarcts and abnormalities of the temporal lobes and hippocampi were assessed on pre-treatment and post-treatment MRI scans. Post-treatment cognitive examinations were performed using a verbal memory and executive functioning test. We compared our patient cohort with large reference populations representative of the Dutch population. Results: One or more impairments on both cognitive tests were frequently observed in treated NFA patients. No treatment effects were found with regard to the comparison between patients with and without impairments in executive functioning. Interestingly, in patients with one or more impairments on verbal memory function, treatment with radiotherapy had been given more frequently (74% in the impaired group versus 40% in the unimpaired group, P = 0.025). Patients with or without any brain abnormality on MRI did not differ in verbal memory or executive functioning. Conclusions: Brain abnormalities on MRI are not observed more frequently in treated NFA patients with impairments compared to NFA patients without impairments in verbal memory or executive functioning

  20. Diagnostic accuracy of whole-brain CT perfusion in the detection of acute infratentorial infarctions

    Energy Technology Data Exchange (ETDEWEB)

    Bollwein, Christine; Sommer, Wieland H.; Thierfelder, Kolja M.; Reiser, Maximilian F. [Ludwig-Maximilians-University Hospital of Munich, Institute for Clinical Radiology, Munich (Germany); Plate, Annika; Straube, Andreas; Baumgarten, Louisa von [Ludwig-Maximilians-University Hospital of Munich, Department of Neurology, Munich (Germany); Janssen, Hendrik [South Nuremberg Hospital, Department of Neuroradiology, Nuremberg (Germany)

    2016-11-15

    Although the diagnostic performance of whole-brain computed tomographic perfusion (WB-CTP) in the detection of supratentorial infarctions is well established, its value in the detection of infratentorial strokes remains less well defined. We examined its diagnostic accuracy in the detection of infratentorial infarctions and compared it to nonenhanced computed tomography (NECT), aiming to identify factors influencing its detection rate. Out of a cohort of 1380 patients who underwent WB-CTP due to suspected stroke, we retrospectively included all patients with MRI-confirmed infratentorial strokes and compared it to control patients without infratentorial strokes. Two blinded readers evaluated NECT and four different CTP maps independently for the presence and location of infratentorial ischemic perfusion deficits. The study was designed as a retrospective case-control study and included 280 patients (cases/controls = 1/3). WB-CTP revealed a greater diagnostic sensitivity than NECT (41.4 vs. 17.1 %, P = 0.003). The specificity, however, was comparable (93.3 vs. 95.0 %). Mean transit time (MTT) and time to drain (TTD) were the most sensitive (41.4 and 40.0 %) and cerebral blood volume (CBV) the most specific (99.5 %) perfusion maps. Infarctions detected using WB-CTP were significantly larger than those not detected (15.0 vs. 2.2 ml; P = 0.0007); infarct location, however, did not influence the detection rate. The detection of infratentorial infarctions can be improved by assessing WB-CTP as part of the multimodal stroke workup. However, it remains a diagnostic challenge, especially small volume infarctions in the brainstem are likely to be missed. (orig.)

  1. Lesion segmentation from multimodal MRI using random forest following ischemic stroke.

    Science.gov (United States)

    Mitra, Jhimli; Bourgeat, Pierrick; Fripp, Jurgen; Ghose, Soumya; Rose, Stephen; Salvado, Olivier; Connelly, Alan; Campbell, Bruce; Palmer, Susan; Sharma, Gagan; Christensen, Soren; Carey, Leeanne

    2014-09-01

    Understanding structure-function relationships in the brain after stroke is reliant not only on the accurate anatomical delineation of the focal ischemic lesion, but also on previous infarcts, remote changes and the presence of white matter hyperintensities. The robust definition of primary stroke boundaries and secondary brain lesions will have significant impact on investigation of brain-behavior relationships and lesion volume correlations with clinical measures after stroke. Here we present an automated approach to identify chronic ischemic infarcts in addition to other white matter pathologies, that may be used to aid the development of post-stroke management strategies. Our approach uses Bayesian-Markov Random Field (MRF) classification to segment probable lesion volumes present on fluid attenuated inversion recovery (FLAIR) MRI. Thereafter, a random forest classification of the information from multimodal (T1-weighted, T2-weighted, FLAIR, and apparent diffusion coefficient (ADC)) MRI images and other context-aware features (within the probable lesion areas) was used to extract areas with high likelihood of being classified as lesions. The final segmentation of the lesion was obtained by thresholding the random forest probabilistic maps. The accuracy of the automated lesion delineation method was assessed in a total of 36 patients (24 male, 12 female, mean age: 64.57±14.23yrs) at 3months after stroke onset and compared with manually segmented lesion volumes by an expert. Accuracy assessment of the automated lesion identification method was performed using the commonly used evaluation metrics. The mean sensitivity of segmentation was measured to be 0.53±0.13 with a mean positive predictive value of 0.75±0.18. The mean lesion volume difference was observed to be 32.32%±21.643% with a high Pearson's correlation of r=0.76 (p<0.0001). The lesion overlap accuracy was measured in terms of Dice similarity coefficient with a mean of 0.60±0.12, while the contour

  2. MRI of the Chest

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    Full Text Available ... information on the chemicals present in the body's cells, may also be performed during the MRI exam ... in diagnosing a broad range of conditions, including cancer, heart and vascular disease, heart valve abnormalities, bone ...

  3. MRI of the Chest

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    Full Text Available ... it may cause some medical devices to malfunction. Most orthopedic implants pose no risk, but you should ... or if you have asthma. The contrast material most commonly used for an MRI exam contains a ...

  4. MRI of the Chest

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    Full Text Available ... magnetic field of the MRI unit, metal and electronic items are not allowed in the exam room. ... tell the technologist if you have medical or electronic devices in your body. These objects may interfere ...

  5. MRI of the Chest

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    Full Text Available ... to a CD or uploaded to a digital cloud server. MRI of the chest gives detailed pictures ... artery ( dissection ). See the MRA page for more information. top of page How should I prepare? You ...

  6. MRI of the Chest

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    Full Text Available ... your regular medications as usual. Leave jewelry at home and wear loose, comfortable clothing. You may be ... Jewelry and other accessories should be left at home, if possible, or removed prior to the MRI ...

  7. MRI of the Chest

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    Full Text Available ... imaging (MRI) exam. View full size with caption Pediatric Content Some imaging tests and treatments have special pediatric considerations. The teddy bear denotes child-specific content. ...

  8. Extradural spinal meningioma: MRI

    Energy Technology Data Exchange (ETDEWEB)

    Sato, N. [Department of Diagnostic Radiology, Yale University School of Medicine, P. O. Box 20 8042, New Haven, CT 06520-8042 (United States); Sze, G. [Department of Diagnostic Radiology, Yale University School of Medicine, P. O. Box 20 8042, New Haven, CT 06520-8042 (United States)

    1997-06-01

    We report a case of extradural spinal meningioma with pathologically proven features of malignant transformation. The MRI findings of extradural spinal meningioma and differences in the findings from intradural meningiomas are discussed. (orig.). With 1 fig.

  9. MRI of the Chest

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    Full Text Available ... contrast for an MRI. If you have a history of kidney disease or liver transplant, it will ... Radiology (ACR) and the Radiological Society of North America (RSNA), comprising physicians with expertise in several radiologic ...

  10. MRI of the Chest

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    Full Text Available ... a CD or uploaded to a digital cloud server. MRI of the chest gives detailed pictures of ... suggestion into the following text box: Comment: E-mail: Area code: Phone no: Thank you! Do you ...

  11. MRI of the Chest

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    Full Text Available ... pictures of organs, soft tissues, bone and virtually all other internal body structures. MRI does not use ... include: jewelry, watches, credit cards and hearing aids, all of which can be damaged pins, hairpins, metal ...

  12. MRI of the Chest

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    Full Text Available ... distinguish between cancer tissue and fluid, known as edema . MRI typically costs more and may take more ... with caption Pediatric Content Some imaging tests and treatments have special pediatric considerations. The teddy bear denotes ...

  13. MRI of the Chest

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    Full Text Available ... prior to your scheduled examination. Infants and young children usually require sedation or anesthesia to complete an MRI exam without moving. Whether a child requires sedation depends on the child's age, intellectual ...

  14. MRI of the Chest

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    Full Text Available ... scanner, play the noises that the child might hear during the MRI exam, answer any questions and ... These items include: jewelry, watches, credit cards and hearing aids, all of which can be damaged pins, ...

  15. MRI of the Chest

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    Full Text Available ... MRI scanners are air-conditioned and well-lit. Music may be played through the headphones to help ... the same effect. A very irregular heartbeat may affect the quality of images obtained using techniques that ...

  16. MRI of the Chest

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    Full Text Available ... Us News Physician Resources Professions Site Index A-Z Magnetic Resonance Imaging (MRI) - Chest Magnetic resonance imaging ( ... the child can watch a movie while the scan is being performed. Thus, the child remains motionless ...

  17. MRI of the Chest

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    Full Text Available ... may cause some medical devices to malfunction. Most orthopedic implants pose no risk, but you should always ... metal objects. In general, metal objects used in orthopedic surgery pose no risk during MRI. However, a ...

  18. MRI of the Chest

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    Full Text Available ... devices or metal in your body. Guidelines about eating and drinking before your exam vary between facilities. ... fitting and has no metal fasteners. Guidelines about eating and drinking before an MRI exam vary with ...

  19. MRI of the Chest

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    Full Text Available ... scanner. top of page How does the procedure work? Unlike conventional x-ray examinations and computed tomography ( ... clearer and more detailed than with other imaging methods. This detail makes MRI an invaluable tool in ...

  20. MRI of the Chest

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    Full Text Available ... exam time. top of page What will I experience during and after the procedure? Most MRI exams ... uncomfortable to remain still during MR imaging. Others experience a sense of being closed-in (claustrophobia) while ...

  1. MRI of the Chest

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    Full Text Available ... will hear and feel loud tapping or thumping sounds when the coils that generate the radiofrequency pulses ... use headphones to reduce the intensity of the sounds made by the MRI machine. You may be ...

  2. MRI of the Chest

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    ... surgery pose no risk during MRI. However, a recently placed artificial joint may require the use of ... evaluation with additional views or a special imaging technique. A follow-up examination may also be necessary ...

  3. MRI of the Breast

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    ... surgery pose no risk during MRI. However, a recently placed artificial joint may require the use of ... evaluation with additional views or a special imaging technique. A follow-up examination may also be necessary ...

  4. MRI of the Chest

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    Full Text Available ... Infants and young children usually require sedation or anesthesia to complete an MRI exam without moving. Whether ... A physician or nurse specializing in sedation or anesthesia for children should be available during the exam ...

  5. MRI of the Chest

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    Full Text Available ... metallic items, which can distort MRI images removable dental work pens, pocket knives and eyeglasses body piercings ... from the contrast material, including nausea, headache and pain at the site of injection. Similarly, patients are ...

  6. MRI of the Chest

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    Full Text Available ... during an MRI scan, but this is rare. Tooth fillings and braces usually are not affected by ... from the contrast material, including nausea, headache and pain at the site of injection. Similarly, patients are ...

  7. MRI of the Chest

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    Full Text Available ... magnetic field is produced by passing an electric current through wire coils in most MRI units. Other ... that are detected by the coils. The electric current does not come in contact with the patient. ...

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    Full Text Available ... any recent surgeries. Some conditions, such as severe kidney disease, may prevent you from being given gadolinium contrast ... an MRI. If you have a history of kidney disease or liver transplant, it will be necessary to ...

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    Full Text Available ... provides movie-like sequential imaging of the cardiovascular system that is important to assess the health and ... the magnet. Some MRI units, called short-bore systems , are designed so that the magnet does not ...

  10. MRI of the Chest

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    Full Text Available ... intercom. Many MRI centers allow a friend or parent to stay in the room as long as they are also screened for safety in the magnetic environment. Children will be given appropriately sized earplugs or headphones ...

  11. MRI of the Chest

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    Full Text Available ... MRI examinations may require you to receive an injection of contrast material into the bloodstream. The radiologist , ... the potential risks. Pregnant women should not receive injections of gadolinium contrast material except when absolutely necessary ...

  12. MRI of the Chest

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    Full Text Available ... allergies and whether there’s a possibility you are pregnant. The magnetic field is not harmful, but it ... if there is any possibility that they are pregnant. MRI has been used for scanning patients since ...

  13. MRI of the Chest

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    Full Text Available ... copied to a CD or uploaded to a digital cloud server. MRI of the chest gives detailed ... the technologist if you have medical or electronic devices in your body. These objects may interfere with ...

  14. MRI of the Chest

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    Full Text Available ... data suggest that it is safe to continue breastfeeding after receiving intravenous contrast. For further information please ... that magnetic resonance imaging harms the fetus, pregnant women usually are advised not to have an MRI ...

  15. MRI of the Chest

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    Full Text Available ... evaluation with additional views or a special imaging technique. A follow-up examination may also be necessary ... vs. risks? Benefits MRI is a noninvasive imaging technique that does not involve exposure to ionizing radiation. ...

  16. MRI of the Chest

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    Full Text Available ... tissue and fluid, known as edema . MRI typically costs more and may take more time to perform ... accredited facilities database . This website does not provide cost information. The costs for specific medical imaging tests, ...

  17. MRI of the Chest

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    Full Text Available ... used in tattoos may contain iron and could heat up during an MRI scan, but this is ... to get a better understanding of the possible charges you will incur. Web page review process: This ...

  18. MRI of the Chest

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    Full Text Available ... may follow your regular daily routine and take food and medications as usual. Some MRI examinations may ... to iodine or x-ray contrast material, drugs, food, or the environment, or if you have asthma. ...

  19. MRI of the Chest

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    Full Text Available ... information on the chemicals present in the body's cells, may also be performed during the MRI exam ... in diagnosing a broad range of conditions, including cancer, heart and vascular disease, heart valve abnormalities, bone ...

  20. MRI of the Chest

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    Full Text Available ... is not harmful, but it may cause some medical devices to malfunction. Most orthopedic implants pose no ... Chest? Magnetic resonance imaging (MRI) is a noninvasive medical test that physicians use to diagnose medical conditions. ...

  1. MRI of the Chest

    Medline Plus

    Full Text Available ... to assess the anatomy and function of the heart and its blood flow. Tell your doctor about ... chest cavity, including the mediastinum , chest wall, pleura, heart and vessels, from almost any angle. MRI also ...

  2. MRI of the Chest

    Medline Plus

    Full Text Available ... MRI scanners are air-conditioned and well-lit. Music may be played through the headphones to help ... from the contrast material, including nausea, headache and pain at the site of injection. Similarly, patients are ...

  3. MRI of the Chest

    Medline Plus

    Full Text Available ... magnetic field of the MRI unit, metal and electronic items are not allowed in the exam room. ... tell the technologist if you have medical or electronic devices in your body. These objects may interfere ...

  4. MRI of the Chest

    Medline Plus

    Full Text Available ... and should not enter the MRI scanning area: cochlear (ear) implant some types of clips used for ... follow-up exam is done because a potential abnormality needs further evaluation with additional views or a ...

  5. MRI of the Chest

    Medline Plus

    Full Text Available ... MRI scanners are air-conditioned and well-lit. Music may be played through the headphones to help ... very rare occasions, a few patients experience side effects from the contrast material, including nausea, headache and ...

  6. MRI of the Chest

    Medline Plus

    Full Text Available ... of the chest uses a powerful magnetic field, radio waves and a computer to produce detailed pictures ... medical conditions. MRI uses a powerful magnetic field, radio frequency pulses and a computer to produce detailed ...

  7. MRI of the Chest

    Medline Plus

    Full Text Available ... it is useful to bring that to the attention of the scheduler before the exam and bring ... does the equipment look like? The traditional MRI unit is a large cylinder-shaped tube surrounded by ...

  8. MRI of the Chest

    Medline Plus

    Full Text Available ... may follow your regular daily routine and take food and medications as usual. Some MRI examinations may ... to iodine or x-ray contrast material, drugs, food, or the environment, or if you have asthma. ...

  9. MRI of the Chest

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    Full Text Available ... provides movie-like sequential imaging of the cardiovascular system that is important to assess the health and ... the magnet. Some MRI units, called short-bore systems , are designed so that the magnet does not ...

  10. MRI of the Chest

    Medline Plus

    Full Text Available ... x-ray may be taken to detect and identify any metal objects. In general, metal objects used in orthopedic surgery pose no risk during MRI. However, a recently placed artificial joint ...

  11. MRI of the Chest

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    Full Text Available ... metal in your body. Guidelines about eating and drinking before your exam vary between facilities. Unless you ... has no metal fasteners. Guidelines about eating and drinking before an MRI exam vary with the specific ...

  12. MRI of the Chest

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    Full Text Available ... Unless you are told otherwise, take your regular medications as usual. Leave jewelry at home and wear ... your regular daily routine and take food and medications as usual. Some MRI examinations may require you ...

  13. MRI of the Chest

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    Full Text Available ... be examined on a computer monitor, transmitted electronically, printed or copied to a CD or uploaded to ... magnetic field of the MRI unit, metal and electronic items are not allowed in the exam room. ...

  14. MRI of the Chest

    Medline Plus

    Full Text Available ... electronic devices they may have. top of page What does the equipment look like? The traditional MRI ... to the total exam time. top of page What will I experience during and after the procedure? ...

  15. Acute ST-segment elevation myocardial infarction as the first manifestation of essential thrombocytosis successfully treated with thrombectomy alone.

    Science.gov (United States)

    Khaheshi, Isa; Memaryan, Mehdi; Taherkhani, Maryam; Serati, Alireza; Movahed, Mohammad Reza

    2016-10-01

    A patient with no conventional cardiovascular risk factors presented with inferior ST-elevation myocardial infarction which was finally diagnosed as a case of essential thrombocytosis. This case demonstrated that thrombectomy alone was sufficient for the treatment of his coronary occlusion. Furthermore, this case report highlights the importance of evaluating rare causes of myocardial infarction other than atherosclerosis and that internists and cardiologists should be aware of essential thrombocytosis as a known cause of myocardial infarction, particularly in patients with no underlying cardiovascular risk factors.

  16. MRI of plantar fasciitis

    Energy Technology Data Exchange (ETDEWEB)

    Roger, B.; Grenier, P. [Service de Radiologie Polyvalente Diagnostique et Interventionelle, Hopital de la Pitie, 83, boulevard de l`Hopital, F-75651 Paris Cedex 13 (France)

    1997-12-01

    At present, MRI is the only imaging method that can precisely visualize lesions of the superficial plantar aponeurosis, whether they be musculoaponeurositides, enthesopathies or tears, and whether they be acute or chronic, with or without complications. By its direct visualization of the lesion, MRI enables an accurate assessment of the injury to be made and thereby better orients the therapeutic strategy. (orig.) With 11 figs., 15 refs.

  17. Prophylactic lidocaine for myocardial infarction.

    Science.gov (United States)

    Martí-Carvajal, Arturo J; Simancas-Racines, Daniel; Anand, Vidhu; Bangdiwala, Shrikant

    2015-08-21

    Coronary artery disease is a major public health problem affecting both developed and developing countries. Acute coronary syndromes include unstable angina and myocardial infarction with or without ST-segment elevation (electrocardiogram sector is higher than baseline). Ventricular arrhythmia after myocardial infarction is associated with high risk of mortality. The evidence is out of date, and considerable uncertainty remains about the effects of prophylactic use of lidocaine on all-cause mortality, in particular, in patients with suspected myocardial infarction. To determine the clinical effectiveness and safety of prophylactic lidocaine in preventing death among people with myocardial infarction. We searched the Cochrane Central Register of Controlled Trials (CENTRAL) (2015, Issue 3), MEDLINE Ovid (1946 to 13 April 2015), EMBASE (1947 to 13 April 2015) and Latin American Caribbean Health Sciences Literature (LILACS) (1986 to 13 April 2015). We also searched Web of Science (1970 to 13 April 2013) and handsearched the reference lists of included papers. We applied no language restriction in the search. We included randomised controlled trials assessing the effects of prophylactic lidocaine for myocardial infarction. We considered all-cause mortality, cardiac mortality and overall survival at 30 days after myocardial infarction as primary outcomes. We performed study selection, risk of bias assessment and data extraction in duplicate. We estimated risk ratios (RRs) for dichotomous outcomes and measured statistical heterogeneity using I(2). We used a random-effects model and conducted trial sequential analysis. We identified 37 randomised controlled trials involving 11,948 participants. These trials compared lidocaine versus placebo or no intervention, disopyramide, mexiletine, tocainide, propafenone, amiodarone, dimethylammonium chloride, aprindine and pirmenol. Overall, trials were underpowered and had high risk of bias. Ninety-seven per cent of trials (36

  18. Blood Pressure and Heart Rate Measures Associated With Increased Risk of Covert Brain Infarction and Worsening Leukoaraiosis in Older Adults.

    Science.gov (United States)

    Leung, Lester Y; Bartz, Traci M; Rice, Kenneth; Floyd, James; Psaty, Bruce; Gutierrez, Jose; Longstreth, W T; Mukamal, Kenneth J

    2017-08-01

    In people without previous stroke, covert findings on serial magnetic resonance imaging (MRI) of incident brain infarcts and worsening leukoaraiosis are associated with increased risk for ischemic stroke and dementia. We evaluated whether various measures of blood pressure (BP) and heart rate are associated with these MRI findings. In the CHS (Cardiovascular Health Study), a longitudinal cohort study of older adults, we used relative risk regression to assess the associations of mean, variability, and trend in systolic BP, diastolic BP, and heart rate measured at 4 annual clinic visits between 2 brain MRIs with incident covert brain infarction and worsening white matter grade (using a 10-point scale to characterize leukoaraiosis). We included participants who had both brain MRIs, no stroke before the follow-up MRI, and no change in antihypertensive medication status during follow-up. Among 878 eligible participants, incident covert brain infarction occurred in 15% and worsening white matter grade in 27%. Mean systolic BP was associated with increased risk for incident covert brain infarction (relative risk per 10 mm Hg, 1.28; 95% confidence interval, 1.12-1.47), and mean diastolic BP was associated with increased risk for worsening white matter grade (relative risk per 10 mm Hg, 1.45; 95% confidence interval, 1.24-1.69). These findings persisted in secondary and sensitivity analyses. Elevated mean systolic BP is associated with increased risk for covert brain infarction, and elevated mean diastolic BP is associated with increased risk for worsening leukoaraiosis. These findings reinforce the importance of hypertension in the development of silent cerebrovascular diseases, but the pathophysiologic relationships to BP for each may differ. © 2017 American Heart Association, Inc.

  19. Establishing motion control in children with autism and intellectual disability: Applications for anatomical and functional MRI.

    Science.gov (United States)

    Cox, Alison D; Virues-Ortega, Javier; Julio, Flavia; Martin, Toby L

    2017-01-01

    Excessive motion makes magnetic resonance imaging (MRI) extremely challenging among children with autism spectrum disorder (ASD). The medical risks of sedation establish the need for behavioral interventions to promote motion control among children with ASD undergoing MRI scans. We present a series of experiments aimed at establishing both tolerance of the MRI environment and a level of motion control that would be compatible with a successful MRI. During Study 1, we evaluated the effects of prompting and contingent reinforcement on compliance with a sequence of successive approximations to an MRI using a mock MRI. During Study 2, we used prompting and progressive differential reinforcement of other behaviors (DRO) to promote motion control in a mock MRI for increasing periods of time. Finally, during Study 3, some of the participants underwent a real MRI scan while a detailed in-session motion analysis informed the quality of the images captured. © 2016 Society for the Experimental Analysis of Behavior.

  20. Investigation of survival time and disability characteristics in 5 subjects with bilateral thalamus infarction near median line%双侧中线旁丘脑梗死5例致残特点及生存期调查

    Institute of Scientific and Technical Information of China (English)

    翟明; 刘江; 钟静玫; 林岚

    2002-01-01

    @@ Background:Bilateral thalamus infarction near median line is uncommon in clinic.Reports concerned with this conditions were more less.It is characterized by conscious disorder and Korsakoff syndrome.The main caused may be the injury of intralaminar nuclei,dorsomedial nuclei,and injury of cortical matter,mammalillary bodies,fasciculus thalamicus around cerebral chamer III.Comprehensing the disability characteristics in pateints with bilateral thalamus infarction near median line is important for direction of rehabilitation.While study of survival time will improve evaluation of prognosis. Design:Patients recruited from June 1997~ October 2000 were analyzed. Unit:Intraneural Department of First People's Hospital of Yunnan Province. Subjects:55 subjects with MRI proved bilateral thalamus infarction near median line entered study.These patients included 3 women,2 men(age ranging from 50 to 77 years old,mean age:68.6 years).The period from onset to admission ranged from 5 hours to 2 days.All subejcts experienced acute bilateral thalamus infarction near median line.All had hypertension previously,1 had diabetes,2 had auricular fibrillation. Intervention:All patients received management which was conducted according to protocol for treatment of ischemic cerebrovascular diseases. Patients clinical characteristics were summari-zed and analyzed.Follow up was conducted to determine the survival period. Main evaluation indexes:Survival time and conscious disorder were evaluated. Result:All patients showed different level of conscious disorder.3 cases developed thalamic dementia,2 developed vision numb,In 1 case,condition progressively deteriorated manifesting as moderate coma progressed to deep coma,and bilateral mydriasis.Finally,this patients died of central respiratory and circulatory failure after 8 days.4 cases with favorable prognosis discharged,3 out of them died within 1 year after discharge.Survival subject suffered from reduced memory was followed up till now

  1. Posttraumatic pseudolipoma: MRI appearances

    Energy Technology Data Exchange (ETDEWEB)

    Theumann, N.; Abdelmoumene, A.; Wintermark, M.; Schnyder, P.; Gailloud, M.C.; Resnick, D. [CHUV, Department of Diagnostic and Interventional Radiology, Lausanne (Switzerland)

    2005-09-01

    The goal of this study was to describe the MRI characteristics of posttraumatic pseudolipomas. Ten patients with previous history of blunt trauma or local surgery were investigated with MRI at the level of their deformity. The etiology was blunt trauma in eight patients and postoperative trauma in two. For all patients medical documentation, in the form of clinical history and physical examination, confirmed that a visible hematoma was present acutely at the same location following the injury and that the contour deformity subsequently appeared. All patients underwent liposuction. Preoperative bilateral MRI examinations were performed on all patients. The mean clinical follow-up was 17.8 months. MRI examinations were interpreted in consensus by two experienced musculoskeletal radiologists with attention to fatty extension (subcutaneous fatty thickness and anatomical extension), asymmetry compared with the asymptomatic side, the presence or absence of fibrous septae or nonfatty components, and patterns of contrast enhancement. Ten posttraumatic pseudolipomas were identified. Clinically, they showed as subcutaneous masses with the consistency of normal adipose tissue. Their locations were the abdomen (n=1), hip (n=1), the upper thigh (n=6), the knee (n=1), and the ankle (n=1). On MRI examinations, using the contralateral side as a control, pseudolipomas appeared as focal fatty masses without a capsule or contrast enhancement. Posttraumatic pseudolipomas may develop at a site of blunt trauma or surgical procedures often antedated by a soft tissue hematoma. Characteristic MRI findings are unencapsulated subcutaneous fatty masses without contrast enhancement. (orig.)

  2. Towards in vivo focal cortical dysplasia phenotyping using quantitative MRI.

    Science.gov (United States)

    Adler, Sophie; Lorio, Sara; Jacques, Thomas S; Benova, Barbora; Gunny, Roxana; Cross, J Helen; Baldeweg, Torsten; Carmichael, David W

    2017-01-01

    Focal cortical dysplasias (FCDs) are a range of malformations of cortical development each with specific histopathological features. Conventional radiological assessment of standard structural MRI is useful for the localization of lesions but is unable to accurately predict the histopathological features. Quantitative MRI offers the possibility to probe tissue biophysical properties in vivo and may bridge the gap between radiological assessment and ex-vivo histology. This review will cover histological, genetic and radiological features of FCD following the ILAE classification and will explain how quantitative voxel- and surface-based techniques can characterise these features. We will provide an overview of the quantitative MRI measures available, their link with biophysical properties and finally the potential application of quantitative MRI to the problem of FCD subtyping. Future research linking quantitative MRI to FCD histological properties should improve clinical protocols, allow better characterisation of lesions in vivo and tailored surgical planning to the individual.

  3. Silent ST segment elevation myocardial infarction with multi-segmental renal infarction: an unusual presentation.

    Science.gov (United States)

    Chang, Hung-Yu; Yang, Yung-Nien

    2011-01-01

    A 36-year-old diabetic man came to our institution presenting with constant left flank pain. Left renal embolic infarction was found by abdominal computed tomography. Silent ST segment elevation myocardial infarction was noted on 12-lead electrocardiogram. Emergent coronary angiography revealed large thrombus burdens with complete occlusion at the left anterior descending artery ostium, which may be the embolic origin. Silent ST segment elevation myocardial infarction with acute flank pain and multiple segmental renal infarction is an unusual presentation. High vigilance may prevent delay of the "golden hour" to treat acute myocardial infarction.

  4. Magnetic resonance imaging of human cerebral infarction: Enhancement with Gd-DTPA

    Energy Technology Data Exchange (ETDEWEB)

    Imakita, S.; Nishimura, T.; Naito, H.; Yamada, N.; Yamamoto, K.; Takamiya, M.; Yamada, Y.; Sakashita, Y.; Minamikawa, J.; Kikuchi, H.

    1987-09-01

    Five patients (1 female and 4 males) with cerebral infarction of 4 h to 27 months duration were studied 9 times with magnetic resonance (MR) using Gd-DTPA. Spinecho (SE) MR images (MRI) were obtained before and after the administration of Gd-DTPA, and correlative CT scans were performed on the same day. In 2 cases, 4 h and 27 months after the ictus, there was no enhancement with Gd-DTPA. There was faint enhancement in 2 cases with cerebral infarction of about 24 h duration and obvious enhancement in all cases in the subacute stage. Compared with enhanced CT, MR using Gd-DTPA demonstrated more obvious enhancement of infarcted areas. MR enhancement using Gd-DTPA showed a gradual increase and the accumulated Gd-DTPA in infarcted areas slowly diffused to the periphery. MR enhancement with Gd-DTPA is similar to that of enhanced CT, but may be more sensitive in the detection of blood brain barrier breakdown.

  5. [Magnetic resonance spectroscopic study of memory impairment after cerebral infarction treated with electroacupuncture].

    Science.gov (United States)

    Zhang, Jianbo; Shen, Yunxia

    2015-07-01

    To study the impacts of electroacupuncture (EA) on memory impairment after cerebral infarction through the observation of hydrogen proton magnetic resonance spectroscopy (1H-MRS) of brain tissue metabolites in the patients of cerebral infarction. Sixty cases of memory impairment after cerebral infarction were randomized into an observation group and a control group, 30 cases in each one. The conventional rehabilitation training and medication were applied to all the patients. In the observation group, beside the basic treatment, EA was applied to bilateral Ezhongxian (MS 1), Dingzhongxian (MS 5), Dingniehouxiexian (MS 7), Hegu (LI 4), Taichong (LR 3), Zusanli (ST 36), Taixi (KI 3), Xuanzhong (GB 39) and Fengchi (GB 20). The treatment was given once a day, 5 times a week, for 8 weeks. The clinical memory scale was used for the score evaluation before and after treatment in all the patients. The magnetic resonance image (MRI) and 1H-MRS scanning were applied to the head. The ratio of N-acetyl aspartate (NAA) and creatine (Cr) and the ratio of choline (Cho) and Cr were determined in the foci of cerebral infarction. Eight weeks later, the scores of clinical memory scale were all increased after treatment as compared with those before treatment in the two group (all Prehabilitation training, EA improves the metabolism of brain tissue and memory function of the patients. The efficacy of this therapy is better than that of medication combined with rehabilitation training.

  6. OCCLUSION OF ARTERY OF PERCHERON: A RARE AETIOLOGY OF BILATERAL THALAMIC INFARCT

    Directory of Open Access Journals (Sweden)

    Mane Makarand, Mane Priyanka, Mohite Rajsinh , Bhattad Prashant, Bangar Kushal, Mahajani Anup

    2015-10-01

    Full Text Available The Artery of Percheron, a rare anatomical variant of brain vascularisation, arises from the posterior cerebral artery. Occlusion of this artery leads to bilateral paramedian thalamic infarct leads to dysfunction of central nervous system. Incidence of bilateral thalamic infarct secondary to occlusion of artery of Percheron is unknown because of its rarity. Here we report a case of 35 year old female presented with altered state of consciousness and the underlying cause was occlusion of Artery of Percheron which leads to bilateral thalamic infarct detected on MRI scanning. It showed hyperintensities on T2W1 and FLAIR, and hypointensity on T1W1, restricted to bilateral ventromedial thalami showing corresponding area of high signal intensity on diffusion weighted images and hypointensity on apparent diffusion coefficient images indicating diffusion restriction, suggestive of infarct. On further investigation magnetic resonance arteriogram (MRA of the brain demonstrated a single common artery arising from the left P1 segment which divided into two branches distally supplying bilateral thalami. Patient became alright after 2 weeks of medical line of treatment.

  7. A Case of Turner Syndrome with Multiple Embolic Infarcts

    Directory of Open Access Journals (Sweden)

    Cindy W. Yoon

    2016-09-01

    Full Text Available Only a few cases of Turner syndrome (TS with ischemic stroke have been reported. Various arteriopathies of the cerebral arteries, including fibromuscular dysplasia, congenital hypoplasia, moyamoya syndrome, and premature atherosclerosis have been assumed to be the cause of ischemic stroke in TS. There has been no case report of a TS patient presenting with an embolic stroke pattern without any cerebral arteriopathy. A 28-year-old woman with TS was referred to our hospital because of abnormal brain magnetic resonance imaging (MRI findings. She underwent brain MRI at the referring hospital because she experienced sudden-onset diffuse headache. Diffusion-weighted imaging revealed multiple acute embolic infarcts in different vascular territories. Intracranial and extracranial arterial disease was not detected on cerebral magnetic resonance angiography and carotid sonography. Embolic source workups, including transthoracic and transesophageal echocardiography, Holter monitoring, and transcranial Doppler shunt study, were all negative. Hypercoagulability and vasculitis panels were also negative. Our patient was diagnosed with cryptogenic embolic stroke. This is the first report of a TS patient with an embolic stroke pattern. Our case shows that ischemic stroke in TS could be due to embolism as well as the various cerebral arteriopathies documented in previous reports.

  8. A Case of Turner Syndrome with Multiple Embolic Infarcts.

    Science.gov (United States)

    Yoon, Cindy W; Lee, Eungseok; Yoon, Byung-Nam; Park, Hee-Kwon; Rha, Joung-Ho

    2016-01-01

    Only a few cases of Turner syndrome (TS) with ischemic stroke have been reported. Various arteriopathies of the cerebral arteries, including fibromuscular dysplasia, congenital hypoplasia, moyamoya syndrome, and premature atherosclerosis have been assumed to be the cause of ischemic stroke in TS. There has been no case report of a TS patient presenting with an embolic stroke pattern without any cerebral arteriopathy. A 28-year-old woman with TS was referred to our hospital because of abnormal brain magnetic resonance imaging (MRI) findings. She underwent brain MRI at the referring hospital because she experienced sudden-onset diffuse headache. Diffusion-weighted imaging revealed multiple acute embolic infarcts in different vascular territories. Intracranial and extracranial arterial disease was not detected on cerebral magnetic resonance angiography and carotid sonography. Embolic source workups, including transthoracic and transesophageal echocardiography, Holter monitoring, and transcranial Doppler shunt study, were all negative. Hypercoagulability and vasculitis panels were also negative. Our patient was diagnosed with cryptogenic embolic stroke. This is the first report of a TS patient with an embolic stroke pattern. Our case shows that ischemic stroke in TS could be due to embolism as well as the various cerebral arteriopathies documented in previous reports.

  9. A Case of Turner Syndrome with Multiple Embolic Infarcts

    Science.gov (United States)

    Yoon, Cindy W.; Lee, Eungseok; Yoon, Byung-Nam; Park, Hee-Kwon; Rha, Joung-Ho

    2016-01-01

    Only a few cases of Turner syndrome (TS) with ischemic stroke have been reported. Various arteriopathies of the cerebral arteries, including fibromuscular dysplasia, congenital hypoplasia, moyamoya syndrome, and premature atherosclerosis have been assumed to be the cause of ischemic stroke in TS. There has been no case report of a TS patient presenting with an embolic stroke pattern without any cerebral arteriopathy. A 28-year-old woman with TS was referred to our hospital because of abnormal brain magnetic resonance imaging (MRI) findings. She underwent brain MRI at the referring hospital because she experienced sudden-onset diffuse headache. Diffusion-weighted imaging revealed multiple acute embolic infarcts in different vascular territories. Intracranial and extracranial arterial disease was not detected on cerebral magnetic resonance angiography and carotid sonography. Embolic source workups, including transthoracic and transesophageal echocardiography, Holter monitoring, and transcranial Doppler shunt study, were all negative. Hypercoagulability and vasculitis panels were also negative. Our patient was diagnosed with cryptogenic embolic stroke. This is the first report of a TS patient with an embolic stroke pattern. Our case shows that ischemic stroke in TS could be due to embolism as well as the various cerebral arteriopathies documented in previous reports.

  10. Multifocal bone and bone marrow lesions in children - MRI findings

    Energy Technology Data Exchange (ETDEWEB)

    Raissaki, Maria; Demetriou, Stelios; Spanakis, Konstantinos; Skiadas, Christos; Karantanas, Apostolos H. [University of Crete, Faculty of Medicine, Department of Radiology, University Hospital of Heraklion, Heraklion, Crete (Greece); Katzilakis, Nikolaos; Stiakaki, Eftichia [University of Crete, Faculty of Medicine, Department of Pediatric Hematology-Oncology, University Hospital of Heraklion, Heraklion, Crete (Greece); Velivassakis, Emmanouil G. [University Hospital of Heraklion, Orthopedic Clinic, Heraklion, Crete (Greece)

    2017-03-15

    Polyostotic bone and bone marrow lesions in children may be due to various disorders. Radiographically, lytic lesions may become apparent after loss of more than 50% of the bone mineral content. Scintigraphy requires osteoblastic activity and is not specific. MRI may significantly contribute to the correct diagnosis and management. Accurate interpretation of MRI examinations requires understanding of the normal conversion pattern of bone marrow in childhood and of the appearances of red marrow rests and hyperplasia. Differential diagnosis is wide: Malignancies include metastases, multifocal primary sarcomas and hematological diseases. Benign entities include benign tumors and tumor-like lesions, histiocytosis, infectious and inflammatory diseases, multiple stress fractures/reactions and bone infarcts/ischemia. (orig.)

  11. [Characteristics of therapy of acute myocardial infarction in diabetes].

    Science.gov (United States)

    Motz, W; Kerner, W

    2012-05-01

    Therapy of acute myocardial infarction (STEMI and NSTEMI) in diabetics does not principally differ from that of non-diabetic patients. Due to the higher mortality in diabetics reperfusion measures, such as direct percutaneous coronary intervention (PCI), should be rapidly performed. An intensive drug treatment with thrombocyte aggregation inhibitors, angiotensin-converting enzyme (ACE) inhibitors and beta-receptor blocking agents must be carried out according to the current guidelines. An important factor is the high risk of renal failure due to the contrast dye administered during PCI in the presence of pre-existing diabetic kidney damage which should be limited to 100 ml if possible. Direct PCI should be limited to the infarcted vessel. After stabilization a comprehensive strategy to cure coronary artery disease, whether with PCI or coronary artery bypass graft (CABG) should be finalized. If severe coronary 3-vessel disease is present, CABG should be favored in diabetic patients. After surviving an acute myocardial infarction differentiated metabolic monitoring is mandatory.

  12. [Case of cerebellar and spinal cord infarction presenting with acute brachial diplegia due to right vertebral artery occlusion].

    Science.gov (United States)

    Fujii, Takayuki; Santa, Yo; Akutagawa, Noriko; Nagano, Sukehisa; Yoshimura, Takeo

    2012-01-01

    A 73-year-old man was admitted for evaluation of sudden onset of dizziness, bilateral shoulder pain, and brachial diplegia. Neurological examination revealed severe bilateral weakness of the triceps brachii, wrist flexor, and wrist extensor muscles. There was no paresis of the lower limbs. His gait was ataxic. Pinprick and temperature sensations were diminished at the bilateral C6-C8 dermatomes. Vibration and position senses were intact. An MRI of the head revealed a right cerebellar infarction and occlusion of the right vertebral artery. An MRI of the cervical spine on T₂ weighted imaging (T₂WI) showed cord compression at the C3/4-C5/6 level secondary to spondylotic degeneration without any intramedullary signal changes of the cord. On the following day, however, high-signal lesions on T₂WI appeared in the C5-C6 spinal cord, suggesting cord infarction. Unilateral vertebral artery occlusion does not usually result in cervical cord infarction because of anastomosis of arteries. Because of the long-term mechanical compression in our case, it was likely that cervical cord ischemia was present before the onset of symptoms. On the basis of chronic cord compression, our case suggests that occlusion of a unilateral vertebral artery could cause cervical cord infarction.

  13. MRI for myocarditis; MRT bei Myokarditis

    Energy Technology Data Exchange (ETDEWEB)

    Gutberlet, M.; Luecke, C.; Krieghoff, C.; Hildebrand, L.; Steiner, J.; Adam, J.; Grotthoff, M.; Lehmkuhl, L. [Herzzentrum, Universitaet Leipzig, Abteilung fuer Diagnostische und Interventionelle Radiologie, Leipzig (Germany); Lurz, P.; Eitel, I.; Thiele, H. [Herzzentrum, Universitaet Leipzig, Abteilung Kardiologie, Leipzig (Germany)

    2013-01-15

    Cardiovascular magnetic resonance imaging (CMRI) has become the primary tool for the non-invasive assessment in patients with suspected myocarditis, especially after exclusion of acute coronary syndrome (ACS) for the differential diagnosis. Various MRI parameters are available which have different accuracies. Volumetric and functional ventricular assessment and the occurrence of pericardial effusion alone demonstrate only a poor sensitivity and specificity. The calculation of the T2-ratio (edema assessment), the early or global relative myocardial enhancement (gRE) and the late gadolinium enhancement (LGE), which represents irreversibly injured myocardium, are more specific parameters. All MRI parameters demonstrate the best accuracy in infarct-like acute myocarditis, whereas in chronic myocarditis sensitivity and specificity are less accurate. Therefore, a multisequential (at least two out of three parameters are positive) approach is recommended. The assessment of the value of newer, more quantitative MRI sequences, such as T1 and T2-mapping is still under investigation. (orig.) [German] Die kardiale MRT stellt die primaere nichtinvasive bildgebende Modalitaet bei Verdacht auf Myokarditis dar, insbesondere auch nach Ausschluss eines akuten Koronarsyndroms (ACS) zur Differenzialdiagnose. Verschiedene MR-Parameter mit unterschiedlicher Wertigkeit stehen zur Verfuegung. Die Beurteilung der Volumetrie und Ventrikelfunktion weisen ebenso wie der Nachweis eines Perikardergusses alleine nur eine geringe Sensitivitaet und Spezifitaet auf. Die spezifischeren MRT-Inflammationsparameter stellen die T2-Ratio (Oedemnachweis), die fruehe Kontrastmittelanreicherung bzw. das globale relative Enhancement (gRE) und die spaete Kontrastmittelanreicherung, das so genannte Late-Gadolinium-Enhancement (LGE) als Zeichen eines irreversiblen Myokardschadens dar. Alle MR-Parameter zeigen die beste diagnostische Genauigkeit bei einer ''infarktaehnlichen'' akuten

  14. Myocardial perfusion at fatal infarction

    DEFF Research Database (Denmark)

    Hvid-Jacobsen, K; Møller, J T; Kjøller, E;

    1992-01-01

    In a consecutive study of myocardial scintigraphy in acute ischemic syndrome, four patients had 99mTc-hexamibi injected intravenously before they developed fatal cardiogenic shock. Planar scintigraphy was performed after death. Slices of the hearts after autopsy were analyzed for scintigraphic......, where 83%-92% of the myocardium showed ischemia as defined by a 99mTc-hexamibi uptake below an arbitrary limit on half maximum uptake. Myocardial hypoperfusion might thus aggravate the functional impairment at myocardial infarction and lead to cardiogenic shock....

  15. Cerebral infarction in childhood bacterial meningitis

    OpenAIRE

    Snyder, R.D.; Stovring, J; Cushing, A H; Davis, L. E.; Hardy, T. L.

    1981-01-01

    Forty-nine children with complicated bacterial meningitis were studied. Thirteen had abnormalities on computed tomography compatible with the diagnosis of brain infarction; one had a brain biopsy with the histological appearance of infarction. Factors exist in childhood bacterial meningitis which are associated with the development of brain infraction.

  16. Experimental Approaches to Acute Myocardial Infarction

    NARCIS (Netherlands)

    D.B. Uitterdijk (André)

    2015-01-01

    markdownabstractAbstract This thesis is dedicated to i) novel methods and optimization studies to improve the diagnosis of myocardial ischemia and myocardial infarction as well as fundamental studies that precede novel therapies for myocardial infarction. In part ii) 2 novel, adjunctive therapies f

  17. Double infarction in one cerebral hemisphere.

    Science.gov (United States)

    Bogousslavsky, J

    1991-07-01

    Thirty-two patients whose first stroke was due to double infarct in one cerebral hemisphere were identified among 1,911 consecutive patients from the Lausanne Stroke Registry. The double infarct involved territories of the superficial middle cerebral artery, superficial posterior cerebral artery, lenticulostriate, anterior choroidal artery, or borderzone. The most common combination involved territories of the anterior middle cerebral artery plus the posterior middle cerebral artery. In the patients with the double infarct, the prevalence of potential cardiac sources of embolism (19%) was similar to that found in the registry in general, but the double infarct was closely associated with tight (greater than or equal to 90% of the lumen diameter) stenosis or occlusion (75%) of the internal carotid artery. The most common neurological picture mimicked large infarction in the middle cerebral artery territory, but nearly half of the patients with double infarct in one cerebral hemisphere had a specific clinical syndrome, which was not found in the 1,879 remaining patients from the registry, including hemianopia-hemiplegia (in 6), acute conduction aphasia-hemiparesis (in 2), and acute transcortical mixed aphasia (in 6), in relation to characteristic combinations of infarcts. These unique clinical and etiological correlates warrant the recognition of double infarct in one cerebral hemisphere from other acute ischemic strokes.

  18. Do episodes of anger trigger myocardial infarction?

    DEFF Research Database (Denmark)

    Möller, J; Hallqvist, J; Diderichsen, Finn

    1999-01-01

    Our objectives were to study anger as a trigger of acute myocardial infarction (MI) and to explore potential effect modification by usual behavioral patterns related to hostility.......Our objectives were to study anger as a trigger of acute myocardial infarction (MI) and to explore potential effect modification by usual behavioral patterns related to hostility....

  19. Experimental Approaches to Acute Myocardial Infarction

    NARCIS (Netherlands)

    D.B. Uitterdijk (André)

    2015-01-01

    markdownabstractAbstract This thesis is dedicated to i) novel methods and optimization studies to improve the diagnosis of myocardial ischemia and myocardial infarction as well as fundamental studies that precede novel therapies for myocardial infarction. In part ii) 2 novel, adjunctive therapies

  20. Gastric infarction following gastric bypass surgery

    Science.gov (United States)

    Do, Patrick H; Kang, Young S; Cahill, Peter

    2016-01-01

    Gastric infarction is an extremely rare occurrence owing to the stomach’s extensive vascular supply. We report an unusual case of gastric infarction following gastric bypass surgery. We describe the imaging findings and discuss possible causes of this condition. PMID:27200168

  1. Lung infarction following pulmonary embolism. A comparative study on clinical conditions and CT findings to identify predisposing factors

    Energy Technology Data Exchange (ETDEWEB)

    Kirchner, J.; Obermann, A.; Stueckradt, S.; Tueshaus, C. [General Hospital Hagen (Germany). Radiology; Goltz, J.; Kickuth, R. [University Hospital Wuerzburg (Germany). Radiology; Liermann, D. [University Hospital Marienhospital Herne (Germany). Radiology

    2015-06-15

    The aim of this study was to identify factors predisposing to lung infarction in patients with pulmonary embolism (PE). We performed a retrospective analysis on 154 patients with the final diagnosis of PE being examined between January 2009 and December 2012 by means of a Toshiba Aquilion 64 CT scanner. The severity of clinical symptoms was defined by means of a clinical index with 4 classes. The pulmonary clot load was quantified using a modified severity index of PE as proposed by Miller. We correlated several potential predictors of pulmonary infarction such as demographic data, pulmonary clot burden, distance of total vascular obstruction and pleura, the presence of cardiac congestion, signs of chronic bronchitis or emphysema with the occurrence of pulmonary infarction. Computed tomography revealed 78 areas of pulmonary infarction in 45/154 (29.2%) patients. The presence of infarction was significantly higher in the right lung than in the left lung (p < 0.001). We found no correlation between pulmonary infarction and the presence of accompanying malignant diseases (r=-0.069), signs of chronic bronchitis (r=-0.109), cardiac congestion (r=-0.076), the quantified clot burden score (r=0.176), and the severity of symptoms (r=-0.024). Only a very weak negative correlation between the presence of infarction and age (r=-0.199) was seen. However, we could demonstrate a moderate negative correlation between the distance of total vascular occlusion and the occurrence of infarction (r=-0.504). Neither cardiac congestion nor the degree of pulmonary vascular obstruction are main factors predisposing to pulmonary infarction in patients with PE. It seems that a peripheral total vascular obstruction more often results in infarction than even massive central clot burden.

  2. Combined MRI and MRS improves pre-therapeutic diagnoses of pediatric brain tumors over MRI alone

    Energy Technology Data Exchange (ETDEWEB)

    Shiroishi, Mark S.; Nelson, Marvin D. [Children' s Hospital Los Angeles/Keck School of Medicine of USC, Department of Radiology, Los Angeles, CA (United States); Panigrahy, Ashok [Children' s Hospital Los Angeles/Keck School of Medicine of USC, Department of Radiology, Los Angeles, CA (United States); Children' s Hospital of Pittsburgh of University of Pittsburgh Medical Center, Department of Pediatric Radiology, Pittsburgh, PA (United States); Moore, Kevin R. [Primary Children' s Medical Center, Department of Radiology, Salt Lake City, UT (United States); Gilles, Floyd H. [Children' s Hospital Los Angeles/Keck School of Medicine of USC, Department of Pathology, Los Angeles, CA (United States); Gonzalez-Gomez, Ignacio [All Children' s Hospital, Department of Pathology, St. Petersburg, FL (United States); Blueml, Stefan [Children' s Hospital Los Angeles/Keck School of Medicine of USC, Department of Radiology, Los Angeles, CA (United States); Rudi Schulte Research Institute, Santa Barbara, CA (United States)

    2015-09-15

    The specific goal of this study was to determine whether the inclusion of MRS had a measureable and positive impact on the accuracy of pre-surgical MR examinations of untreated pediatric brain tumors over that of MRI alone in clinical practice. Final imaging reports of 120 pediatric patients with newly detected brain tumors who underwent combined MRI/MRS examinations were retrospectively reviewed. Final pathology was available in all cases. Group A comprised 60 subjects studied between June 2001 and January 2005, when MRS was considered exploratory and radiologists utilized only conventional MRI to arrive at a diagnosis. For group B, comprising 60 subjects studied between January 2005 and March 2008, the radiologists utilized information from both MRI and MRS. Furthermore, radiologists revisited group A (blind review, time lapse >4 years) to determine whether the additional information from MRS would have altered their interpretation. Sixty-three percent of patients in group A were diagnosed correctly, whereas in 10 % the report was partially correct with the final tumor type mentioned (but not mentioned as most likely tumor), while in 27 % of cases the reports were wrong. For group B, the diagnoses were correct in 87 %, partially correct in 5 %, and incorrect in 8 % of the cases, which is a significant improvement (p < 0.005). Re-review of combined MRI and MRS of group A resulted 87 % correct, 7 % partially correct, and 7 % incorrect diagnoses, which is a significant improvement over the original diagnoses (p < 0.05). Adding MRS to conventional MRI significantly improved diagnostic accuracy in preoperative pediatric patients with untreated brain tumors. (orig.)

  3. Delayed-enhancement magnetic resonance imaging at 3.0 T using 0.15 mmol/kg of contrast agent for the assessment of chronic myocardial infarction

    Energy Technology Data Exchange (ETDEWEB)

    Yang, Jun, E-mail: yangjunyhd@163.com [Yuhuangding Hospital, Yantai, Shandong Province (China); Ma, Heng, E-mail: mahengyhd@163.com [Yuhuangding Hospital, Yantai, Shandong Province (China); Liu, Jing, E-mail: liujingyhd@163.com [Yuhuangding Hospital, Yantai, Shandong Province (China); Wang, Chunxiao, E-mail: chunxiaoyhd@163.com [Yuhuangding Hospital, Yantai, Shandong Province (China); Shi, Yinghong, E-mail: yinghongyhd@163.com [Yuhuangding Hospital, Yantai, Shandong Province (China); Xie, Haizhu, E-mail: haizhuyhd@163.com [Yuhuangding Hospital, Yantai, Shandong Province (China); Huo, Futao, E-mail: kailinusa@126.com [Yuhuangding Hospital, Yantai, Shandong Province (China); Liu, Fengli, E-mail: fengliyhd@126.com [Yuhuangding Hospital, Yantai, Shandong Province (China); Lin, Kai, E-mail: kai-lin@northwestern.edu [Department of Radiology, Northwestern University, Chicago, IL (United States)

    2014-05-15

    Objective: A recent international, multicenter, double-blinded, randomized trial shows delayed-enhanced magnetic resonance imaging (DE-MRI) using contrast doses of ≥0.2 mmol/kg is effective in the detection and assessment of myocardial infarction (MI), and 0.1 mmol/kg is not enough; intermediate doses between 0.1 and 0.2 mmol/kg have not been tested. The aim of this study was to prospectively test the performance of DE-MRI using 0.15 mmol/kg of contrast agent for the detection of MI. Materials and methods: A total of 31 consecutive patients with chronic MI underwent DE-MRI at 3.0 T using both 0.15 mmol/kg and 0.2 mmol/kg of contrast agent in random order and on separate days. Infarction segment and infarction size were compared on DE-MRI images using a 17-segment model. Bland–Altman analysis was used to analyze correlation and agreement between global infarct sizes. Results: DE-MRI showed enhanced myocardium in all the 31 patients with chronic MI. There was no significant difference between the 0.15 mmol/kg and 0.2 mmol/kg images in all 31 patients based on the infarction segment (7.87 ± 2.72 vs. 7.81 ± 2.64, respectively; p = 0.33). There was no significant difference between the infarction size obtained from 0.15 mmol/kg acquisition and that from 0.2 mmol/kg acquisition (16.3 ± 7.8% vs. 16.4 ± 7.9%, respectively; p = 0.87). A strong correlation between the infarction size obtained from 0.15 mmol/kg acquisition and that from 0.2 mmol/kg acquisition was indicated through Bland–Altman analysis. Conclusion: DE-MRI at 3.0 T using 0.15 mmol/kg of contrast agent is effective for the assessment of MI.

  4. Chronological changes in nonhaemorrhagic brain infarcts with short T1 in the cerebellum and basal ganglia

    Energy Technology Data Exchange (ETDEWEB)

    Komiyama, M.; Nakajima, H.; Nishikawa, M.; Yasui, T. [Dept. of Neurosurgery, Osaka City General Hospital, Miyakojima-Hondouri, Miyakojima, Osaka (Japan)

    2000-07-01

    Our purpose was to investigate nonhaemorrhagic infarcts with a short T1 in the cerebellum and basal ganglia. We carried out repeat MRI on 12 patients with infarcts in the cerebellum or basal ganglia with a short T1. Cerebellar cortical lesions showed high signal on T1-weighted spin-echo images beginning at 2 weeks, which became prominent from 3 weeks to 2 months, and persisted for as long as 14 months after the ictus. The basal ganglia lesions demonstrated slightly high signal from a week after the ictus, which became more intense thereafter. Signal intensity began to fade gradually after 2 months. High signal could be seen at the periphery until 5 months, and then disappeared, while low or isointense signal, seen in the central portion from day 20, persisted thereafter. (orig.)

  5. Lacunar Infarction Associated with Anabolic Steroids and Polycythemia: A Case Report

    Directory of Open Access Journals (Sweden)

    George W.J. Harston

    2014-02-01

    Full Text Available Lacunar infarction is traditionally ascribed to lipohyalinosis or microatheroma. We report the case of 40-year-old man, without traditional risk factors for ischemic stroke, who presented to the Emergency Department with recurrent episodes of transient right-sided weakness and paresthesia. Lacunar infarction was confirmed on diffusion-weighted MRI and blood tests showed a marked polycythemia. Quantitative magnetic resonance perfusion imaging demonstrated dramatically abnormal perfusion throughout both cerebral hemispheres, and transcranial Doppler revealed reduced cerebral artery velocities, both consistent with the proposed mechanism of hyperviscosity. His symptoms settled with treatment of the polycythemia and workup did not find another cause of ischemic stroke. We propose that hyperviscosity secondary to steroid-induced polycythemia caused ischemia in this case and not lipohyalinosis or microatheroma, to which lacunar disease is commonly attributed.

  6. Autobiogutobiographical amnesia and cognltive disorder resulgting from bilateral severe thalamic infarction Two cases reports

    Institute of Scientific and Technical Information of China (English)

    Ytt Kai; Yu Feng Qi; Lei Zheng Lin; Zhang Jun

    2000-01-01

    Objective To report two cases of patients with bilateral severe thalamic infarction.which showed autobiographical amnesia and cognitive disorders and to shed light on the mechanisms underlying thc retrograde amenesia. Method The two cases were studied clinically, CT and MRI were performed also, Language and neuropsychological tests were evaluated. Results Two patients with a chronic amnesia and cogntive disorders resulting from bilateral paramedian thalamic infarction showed a pattern of retrograde amnesia personally relevent autobiographical memory were prefoundly impaired .Whereas about the famous people and public events were relatively impaired. The patients almost had no thalamic aphasia.The events the one described showed spontaneously confabulated. Conclusion We think a probable explanation that the disorders at the thematic retrieval fiomwork ievel of memory and the information reconstruction due to a disconnetion of frontal and medial temperal memory systems.

  7. Acute bilateral cerebellar infarction in the territory of the medial branches of posterior inferior cerebellar arteries.

    Science.gov (United States)

    Gurer, G; Sahin, G; Cekirge, S; Tan, E; Saribas, O

    2001-10-01

    The most frequent type of cerebellar infarcts involved the posterior inferior cerebellar artery (PICA) and superior cerebellar artery territories but bilateral involvement of lateral or medial branches of PICA is extremely rare. In this report, we present a 55-year-old male who admitted to hospital with vomiting, nausea and dizziness. On examination left-sided hemiparesia and ataxic gait were detected. Infarct on bilateral medial branch of PICA artery territories was found out with cranial magnetic resonance imaging (MRI) technique and 99% stenosis of the left vertebral artery was found out with digital subtraction arteriography. The patient was put on heparin treatment. After 3 weeks, his complaints and symptoms had disappeared except for mild gait ataxia.

  8. Contrast MR imaging of acute cerebral infarction

    Energy Technology Data Exchange (ETDEWEB)

    Kogame, Saeko; Syakudo, Miyuki; Inoue, Yuichi (Osaka City Univ. (Japan). Faculty of Medicine) (and others)

    1992-04-01

    Thirty patients with acute and subacute cerebral infarction (13 and 17 deep cerebral infarction) were studied with 0.5 T MR unit before and after intravenous injection of Gd-DTPA. Thirteen patients were studied within 7 days after neurological ictus, 17 patients were studied between 7 and 14 days. Two types of abnormal enhancement, cortical arterial and parenchymal enhancement, were noted. The former was seen in 3 of 4 cases of very acute cortical infarction within 4 days after clinical ictus. The latter was detected in all 7 cases of cortical infarction after the 6th day of the ictus, and one patient with deep cerebral infarction at the 12th day of the ictus. Gd-DTPA enhanced MR imaging seems to detect gyral enhancement earlier compared with contrast CT, and depict intra-arterial sluggish flow which was not expected to see on contrast CT scans. (author).

  9. Background and Mathematical Analysis of Diffusion MRI Methods.

    Science.gov (United States)

    Ozcan, Alpay; Wong, Kenneth H; Larson-Prior, Linda; Cho, Zang-Hee; Mun, Seong K

    2012-03-01

    The addition of a pair of magnetic field gradient pulses had initially provided the measurement of spin motion with nuclear magnetic resonance (NMR) techniques. In the adaptation of DW-NMR techniques to magnetic resonance imaging (MRI), the taxonomy of mathematical models is divided in two categories: model matching and spectral methods. In this review, the methods are summarized starting from early diffusion weighted (DW) NMR models followed up with their adaptation to DW MRI. Finally, a newly introduced Fourier analysis based unifying theory, so-called Complete Fourier Direct MRI, is included to explain the mechanisms of existing methods.

  10. Acute multiple infarction involving the anterior circulation.

    Science.gov (United States)

    Bogousslavsky, J; Bernasconi, A; Kumral, E

    1996-01-01

    To evaluate the frequency and clinical, topographic, and etiologic patterns of acute multiple infarction involving the anterior circulation. Data analysis from a prospective acute stroke registry in a community-based primary care center. Among 751 patients with first ischemic stroke in the anterior circulation over a 4-year period, 40 patients (5%) had acute multiple infarcts involving the anterior circulation. On computed tomography and magnetic resonance imaging with gadolinium enhancement, there were four topographic patterns of infarction: (1) superficial infarcts (11 patients [28%]); (2) superficial and deep infarcts (12 patients [30%]); (3) deep infarcts (three patients [8%]); and (4) infarcts involving the anterior and the posterior circulation (14 patients [35%]). Both cerebral hemispheres were involved in one fourth of the cases. A specific clinical picture was found in up to 20% of the patients. This included global aphasia with left hemianopia, hemisensory loss or hemiparesis (in right-handed patients), transcortical mixed aphasia with hemianopia, and acute pure cognitive impairment ("dementia"). Large-artery disease was found in 13 patients (33%); a cardiac source of embolism was found in 11 patients (28%); and both were found in three patients (8%). Bilateral infarcts were related to cardioembolism (four patients) and bilateral large-artery disease (three patients). One month after stroke, one fourth of the patients were independent, one third had some disability, and 40% were either dead or completely dependent. Acute multiple infarcts involving the anterior circulation may be bilateral more frequently than is currently thought, and they are often associated with posterior circulation infarcts. They mainly involve the pial hemispheral territories, commonly being caused by cardioembolism or bilateral carotid atheroma. They may be associated with a specific neurologic-neuropsychological dysfunction pattern in up to one fifth of the patients, allowing

  11. 胼胝体梗死的临床与影像学分析%Clinical and imaging analysis of corpus callosum infarction

    Institute of Scientific and Technical Information of China (English)

    李新辉; 王玉洁; 白璇; 辛岳

    2011-01-01

    Objective To investigate the clinical and imaging characteristics in patients with corpus callosum infarction.Methods The clinical data of 416 patients meetingthe diagnosis of cerebral infarction Were collected,in which,8 patients Were confirmed as corpus callosum infarction by MRI.Results Corpus callosum infarction accounted for 1.9% of all patients with cerebral infarction.CT scan did not show the corpus callosum infaretiom in 7 patients.The nonenhanced MRI revealed the lesions.The enhanced MRI revealed the lesion in another patient.The infarction foci were not only involved in the corpus callosum(knee,body or splenium),but also cornplicated with frontal lobe,occipital lobe and thalamus infractions.The clinical manifesta tions of the corpus callosum infarction were different due to the specific lesion sites.The simple infarction in the body of the corpus callosum mainly presented as contralateral paraparesis.atria,and left limb apra.xia;the infarction in the knee of the corpus callosum mainly presented as lower limb paralysis or contralateral paraparesis;the infarction in the splenium of the corpus callosum presented as limb paralysis and dizziness;the lacunar infarct in the corpus callosum had no obvious clinical manifestations.The patients who complicated with frontal lobe and thalamus infarction had behavioral and psychological syrnptonm,including mental retardation,language abnormalities.and incontinence.Conelusions Corpus callosum infarction is not common.MRI is the basis of diagaosis.The clinical manifestation is lack of specificity.and it is agsociated with the location of corpus callosum infarction and whether it comolicates with the infarction on other part.%目的 探讨胼胝体梗死患者的临床和影像学特点.方法 收集符合脑梗死诊断的416例患者的临床资料,其中8例经过MRI证实为胼胝体梗死.结果 胼胝体梗死占全部脑梗死患者的1.9%.7例CT扫描未显示胼胝体梗死,经非增强MRI检查显示病灶,另1

  12. MR image features predicting hemorrhagic transformation in acute cerebral infarction: a multimodal study

    Energy Technology Data Exchange (ETDEWEB)

    Liu, Chunming; Xu, Liang; Dong, Longchun; Liu, Zhenxing; Yang, Jun; Liu, Jun [Tianjin Union Medicine Centre, Department of Radiology, Tianjin (China); Dong, Zhengchao [Columbia University, Translational Imaging and MRI Unit, Department of Psychiatry, New York, NY (United States); New York State Psychiatric Institute, New York, NY (United States); Khursheed, Aiman [Tianjin Medical University, International Medical School, Tianjin (China)

    2015-11-15

    The aims of this study were to observe magnetic resonance imaging (MRI) features and the frequency of hemorrhagic transformation (HT) in patients with acute cerebral infarction and to identify the risk factors of HT. We first performed multimodal MRI (anatomical, diffusion weighted, and susceptibility weighted) scans on 87 patients with acute cerebral infarction within 24 hours after symptom onset and documented the image findings. We then performed follow-up examinations 3 days to 2 weeks after the onset or whenever the conditions of the patients worsened within 3 days. We utilized univariate statistics to identify the correlations between HT and image features and used multivariate logistical regression to correct for confounding factors to determine relevant independent image features of HT. HT was observed in 17 out of total 87 patients (19.5 %). The infarct size (p = 0.021), cerebral microbleeds (CMBs) (p = 0.004), relative apparent diffusion (rADC) (p = 0.023), and venous anomalies (p = 0.000) were significantly related with HT in the univariate statistics. Multivariate analysis demonstrated that CMBs (odd ratio (OR) = 0.082; 95 % confidence interval (CI) = 0.011-0.597; p = 0.014), rADC (OR = 0.000; 95 % CI = 0.000-0.692; p = 0.041), and venous anomalies (OR = 0.066; 95 % CI = 0.011-0.403; p = 0.003) were independent risk factors for HT. The frequency of HT is 19.5 % in this study. CMBs, rADC, and venous anomalies are independent risk factors for HT of acute cerebral infarction. (orig.)

  13. Multidimensional diffusion MRI

    Science.gov (United States)

    Topgaard, Daniel

    2017-02-01

    Principles from multidimensional NMR spectroscopy, and in particular solid-state NMR, have recently been transferred to the field of diffusion MRI, offering non-invasive characterization of heterogeneous anisotropic materials, such as the human brain, at an unprecedented level of detail. Here we revisit the basic physics of solid-state NMR and diffusion MRI to pinpoint the origin of the somewhat unexpected analogy between the two fields, and provide an overview of current diffusion MRI acquisition protocols and data analysis methods to quantify the composition of heterogeneous materials in terms of diffusion tensor distributions with size, shape, and orientation dimensions. While the most advanced methods allow estimation of the complete multidimensional distributions, simpler methods focus on various projections onto lower-dimensional spaces as well as determination of means and variances rather than actual distributions. Even the less advanced methods provide simple and intuitive scalar parameters that are directly related to microstructural features that can be observed in optical microscopy images, e.g. average cell eccentricity, variance of cell density, and orientational order - properties that are inextricably entangled in conventional diffusion MRI. Key to disentangling all these microstructural features is MRI signal acquisition combining isotropic and directional dimensions, just as in the field of multidimensional solid-state NMR from which most of the ideas for the new methods are derived.

  14. MRI of the lung

    Energy Technology Data Exchange (ETDEWEB)

    Kauczor, Hans-Ulrich (ed.) [University Clinic Heidelberg (Germany). Diagnostic and Interventional Radiology

    2009-07-01

    For a long time, only chest X-ray and CT were used to image lung structure, while nuclear medicine was employed to assess lung function. During the past decade significant developments have been achieved in the field of magnetic resonance imaging (MRI), enabling MRI to enter the clinical arena of chest imaging. Standard protocols can now be implemented on up-to-date scanners, allowing MRI to be used as a first-line imaging modality for various lung diseases, including cystic fibrosis, pulmonary hypertension and even lung cancer. The diagnostic benefits stem from the ability of MRI to visualize changes in lung structure while simultaneously imaging different aspects of lung function, such as perfusion, respiratory motion, ventilation and gas exchange. On this basis, novel quantitative surrogates for lung function can be obtained. This book provides a comprehensive overview of how to use MRI for imaging of lung disease. Special emphasis is placed on benign diseases requiring regular monitoring, given that it is patients with these diseases who derive the greatest benefit from the avoidance of ionizing radiation. (orig.)

  15. MRI in Japanese encephalitis

    Energy Technology Data Exchange (ETDEWEB)

    Kumar, S. [Sanjay Gandhi Post Graduate Inst. of Medical Sciences, Lucknow (India). Dept. of Radiology; Misra, U.K. [Sanjay Gandhi Post Graduate Inst. of Medical Sciences, Lucknow (India). Dept. of Neurology; Kalita, J. [Sanjay Gandhi Post Graduate Inst. of Medical Sciences, Lucknow (India). Dept. of Neurology; Salwani, V. [Sanjay Gandhi Post Graduate Inst. of Medical Sciences, Lucknow (India). Dept. of Radiology; Gupta, R.K. [Sanjay Gandhi Post Graduate Inst. of Medical Sciences, Lucknow (India). Dept. of Radiology; Gujral, R. [Sanjay Gandhi Post Graduate Inst. of Medical Sciences, Lucknow (India). Dept. of Radiology

    1997-03-01

    We document the MRI features in seven patients with Japanese encephalitis. MRI was carried out on a 1.5 T system within 10-60 days of onset. In all the patients MRI revealed bilateral thalamic lesions, haemorrhagic in five. Signal changes were present in the cerebrum in four patients, the midbrain and cerebellum in three each, the pons in two and the basal ganglia in one. The lesions were haemorrhagic in three of the four patients with lesions in the cortex, two of the three with lesions in the midbrain and cerebellum, but the pontine lesions were haemorrhagic in both patients. Spinal cord involvement was seen in one of the three patients who underwent MRI. In two patients MRI was repeated 3 years after the onset, showing marked reduction in abnormal signal; and all the lesions gave low signal on both T1- and T2-weighted images. Bilateral thalamic involvement, especially haemorrhagic, may be considered characteristic of Japanese encephalitis, especially in endemic areas. (orig.)

  16. Reliability of Two Diameters Method in Determining Acute Infarct Size. Validation as New Imaging Biomarker.

    Directory of Open Access Journals (Sweden)

    Jochen B Fiebach

    Full Text Available In order to select patients most likely to benefit for thrombolysis and to predict patient outcome in acute ischemic stroke, the volumetric assessment of the infarcted tissue is used. However, infarct volume estimation on Diffusion weighted imaging (DWI has moderate interrater variability despite the excellent contrast between ischemic lesion and healthy tissue. In this study, we compared volumetric measurements of DWI hyperintensity to a simple maximum orthogonal diameter approach to identify thresholds indicating infarct size >70 ml and >100 ml.Patients presenting with ischemic stroke with an NIHSS of ≥ 8 were examined with stroke MRI within 24 h after symptom onset. For assessment of the orthogonal DWI lesion diameters (od-values the image with the largest lesion appearance was chosen. The maximal diameter of the lesion was determined and a second diameter was measured perpendicular. Both diameters were multiplied. Od-values were compared to volumetric measurement and od-value thresholds identifying a lesion size of > 70 ml and > 100 ml were determined. In a selected dataset with an even distribution of lesion sizes we compared the results of the od value thresholds with results of the ABC/2 and estimations of lesion volumes made by two resident physicians.For 108 included patients (53 female, mean age 71.36 years with a median infarct volume of 13.4 ml we found an excellent correlation between volumetric measures and od-values (r2 = 0.951. Infarct volume >100 ml corresponds to an od-value cut off of 42; > 70 ml corresponds to an od-value of 32. In the compiled dataset (n = 50 od-value thresholds identified infarcts > 100 ml / > 70 ml with a sensitivity of 90%/ 93% and with a specificity of 98%/ 89%. The od-value offered a higher accuracy in identifying large infarctions compared to both visual estimations and the ABC/2 method.The simple od-value enables identification of large DWI lesions in acute stroke. The cutoff of 42 is useful to

  17. MRI evaluation and follow-up of bone necrosis after meningococcal infection and disseminated intravascular coagulation

    Energy Technology Data Exchange (ETDEWEB)

    Damry, N. (Dept. of Radiology, Hopital Universitaire des Enfants Reine Fabiola, Brussels (Belgium)); Schurmans, T. (Dept. of Peadiatrics, Hopital Universitaire des Enfants Reine Fabiola, Brussels (Belgium)); Perlmutter, N. (Dept. of Radiology, Hopital Universitaire des Enfants Reine Fabiola, Brussels (Belgium))

    1993-10-01

    Disseminated intravascular coagulation (DIC) is a serious complication of meningococcal septicaemia. It often results in infarction of various tissues namely the skin, adrenal glands, kidneys, brain and, much less commonly, bones. We describe a patient who presented bone lesions after meningococcal septicaemia. In addition to plain radiography and scintigraphy the lesions were evaluated with MRI and have proved to be extensive and still progressive, approxximately 18 months after the onset of the disease. (orig.)

  18. Passive ventricular mechanics modelling using MRI of structure and function.

    Science.gov (United States)

    Wang, V Y; Lam, H I; Ennis, D B; Young, A A; Nash, M P

    2008-01-01

    Patients suffering from dilated cardiomyopathy or myocardial infarction can develop left ventricular (LV) diastolic impairment. The LV remodels its structure and function to adapt to pathophysiological changes in geometry and loading conditions and this remodeling process can alter the passive ventricular mechanics. In order to better understand passive ventricular mechanics, a LV finite element model was developed to incorporate physiological and mechanical information derived from in vivo magnetic resonance imaging (MRI) tissue tagging, in vivo LV cavity pressure recording and ex vivo diffusion tensor MRI (DTMRI) of a canine heart. MRI tissue tagging enables quantitative evaluation of cardiac mechanical function with high spatial and temporal resolution, whilst the direction of maximum water diffusion (the primary eigenvector) in each voxel of a DTMRI directly correlates with the myocardial fibre orientation. This model was customized to the geometry of the canine LV during diastasis by fitting the segmented epicardial and endocardial surface data from tagged MRI using nonlinear finite element fitting techniques. Myofibre orientations, extracted from DTMRI of the same heart, were incorporated into this geometric model using a free form deformation methodology. Pressure recordings, temporally synchronized to the tissue tagging MRI data, were used to simulate the LV deformation during diastole. Simulation of the diastolic LV mechanics allowed us to estimate the stiffness of the passive LV myocardium based on kinematic data obtained from tagged MRI. This integrated physiological model will allow more insight into the regional passive diastolic mechanics of the LV on an individualized basis, thereby improving our understanding of the underlying structural basis of mechanical dysfunction in pathological conditions.

  19. MRI of oriental cholangiohepatitis

    Energy Technology Data Exchange (ETDEWEB)

    Wani, N.A., E-mail: ahmad77chinar@gmail.co [Department of Radiodiagnosis and Imaging, Sher-I-Kashmir Institute of Medical Sciences (SKIMS), Srinagar (India); Robbani, I.; Kosar, T. [Department of Radiodiagnosis and Imaging, Sher-I-Kashmir Institute of Medical Sciences (SKIMS), Srinagar (India)

    2011-02-15

    Oriental cholangiohepatitis (OCH) also called recurrent pyogenic cholangitis is characterized by intrahepatic duct calculi, strictures, and recurrent infections. In turn cholangitis can result in multiple hepatic abscesses, further biliary strictures, and in severe cases, progressive hepatic parenchymal destruction, cirrhosis, and portal hypertension. Magnetic resonance cholangiopancreatography (MRCP) and conventional T1-weighted (T1 W) and T2-weighted (T2 W) magnetic resonance imaging (MRI) findings have been described in patients with OCH. MRCP findings include duct dilation, strictures, and calculi. MRCP can help to localize the diseased ducts and determine the severity of involvement. T1 and T2 W sequences reveal the parenchymal changes of atrophy, abscess formation, and portal hypertension in addition to calculi. Post-treatment changes are also well depicted using MRI. Comprehensive, non-invasive assessment is achieved by using conventional MRI and MRCP in OCH providing a roadmap for endoscopic or surgical management.

  20. Serial MRI study of the enhanced therapeutic effects of liposome-encapsulated citicoline in cerebral ischemia.

    Science.gov (United States)

    Ramos-Cabrer, Pedro; Agulla, Jesús; Argibay, Bárbara; Pérez-Mato, María; Castillo, José

    2011-02-28

    Liposome encapsulation of active principles enhances their bioavailability to the brain. We investigated whether encapsulation of citicoline in liposomes increases its therapeutic effects in ischemia, performing a longitudinal MRI study of lesion volumes and edema in an animal model of stroke. Nineteen rats were submitted to permanent occlusion of the middle cerebral artery and treated with: (1) saline, (2) intraperitoneal citicoline (500mg/kg), (3) intravenous citicoline (48mg/kg), and (4) intravenous liposome-encapsulated citicoline (48mg/kg). Lesion volumes were measured by MRI at days 0, 1, 3 and 7 following surgery. Encapsulation in liposomes increased the therapeutic effects of citicoline, as reflected by a 32% reduction of the infarct sizes at day 7, in contrast with controls where infarct sizes at day 7 increased by 39%, respect to values at day 0. Intravenously injected citicoline reduced infarct sizes by 9% while intraperitoneal citicoline resulted in an increase of infarct sizes by 10%. A slight (not significant) reduction of edema formation was observed for animals treated with citicoline, in all of its delivery forms. Liposome-encapsulated citicoline causes a noticeable reduction in lesion volumes as compared to free citicoline (either i.p. or i.v.) at days 1, 3 and 7 following permanent stroke.

  1. Right hand predominant constructional apraxia due to right hemisphere infarction without corpus callosum lesions.

    Science.gov (United States)

    Kobayashi, Zen; Watanabe, Mayumi; Karibe, Yuri; Nakazawa, Chika; Numasawa, Yoshiyuki; Tomimitsu, Hiroyuki; Shintani, Shuzo

    2014-01-01

    A 74-year-old right-handed woman without cognitive impairment suddenly developed nonfluent aphasia. Brain MRI showed acute infarction in the right frontal lobe and insula without involvement of the corpus callosum. A neurological examination demonstrated not only transcortical motor aphasia, but also ideomotor apraxia and right hand predominant constructional apraxia (CA). To date, right hand predominant CA has only been reported in patients with corpus callosum lesions. The right hand predominant CA observed in our patient may be associated with the failure to transfer information on the spatial structure from the right hemisphere to the motor cortex of the left hemisphere.

  2. Methylenetetrahydrofolate reductase homozygous mutation in a young boy with cerebellar infarction.

    Science.gov (United States)

    Spalice, Alberto; Del Balzo, Francesca; Perla, Francesco Massimo; Properzi, Enrico; Carducci, Carla; Antonozzi, Italo; Iannetti, Paola

    2009-06-08

    Posterior circulation vascular occlusive disease in children is a rare and uncommonly reported event. Among the numerous risk factors, the methylenetetrahydrofolate reductase (MTHFR) mutation is considered to be a common genetic cause of thrombosis in adults and children. Recently, a link between the MTHFR mutation and cerebrovascular disorders was reported in children. Diffusion tensor imaging (DTI) is a great improvement on magnetic resonance imaging (MRI), making the in vivo anatomical and pathological study of the brain and its fibers possible. In our patient cerebellar infarction was associated with MTHFR mutation and, in a standard neurological examination, DTI revealed normal white matter tracts.

  3. Preliminary observations of increased diffusional kurtosis in human brain following recent cerebral infarction.

    Science.gov (United States)

    Jensen, Jens H; Falangola, Maria F; Hu, Caixia; Tabesh, Ali; Rapalino, Otto; Lo, Calvin; Helpern, Joseph A

    2011-06-01

    By application of the MRI method of diffusional kurtosis imaging, a substantially increased diffusional kurtosis was observed within the cerebral ischemic lesions of three stroke subjects, 13-26 h following the onset of symptoms. This increase is interpreted as probably reflecting a higher degree of diffusional heterogeneity in the lesions when compared with normal-appearing contralateral tissue. In addition, for two of the subjects with white matter infarcts, the increase had a strong fiber tract orientational dependence. It is proposed that this effect is consistent with a large drop in the intra-axonal diffusivity, possibly related to either axonal varicosities or alterations associated with the endoplasmic reticulum.

  4. MRI of active otosclerosis

    Energy Technology Data Exchange (ETDEWEB)

    Ziyeh, S. [Section of Neuroradiology, Universitaetsklinik Freiburg, Breisacherstrasse 64, D-79106 Freiburg (Germany); Berlis, A. [Section of Neuroradiology, Universitaetsklinik Freiburg, Breisacherstrasse 64, D-79106 Freiburg (Germany); Ross, U.H. [Department of Otolaryngology, Universitaetsklinik, Freiburg (Germany); Reinhardt, M.J. [Department of Nuclear Medicine, Universitaetsklinik, Freiburg (Germany); Schumacher, M. [Section of Neuroradiology, Universitaetsklinik Freiburg, Breisacherstrasse 64, D-79106 Freiburg (Germany)

    1997-06-01

    Our aim was to determine whether MRI reliably shows pathology in patients with active otosclerosis (otospongiosis). We studied five patients with clinical and audiometric signs of this disorder and positive findings on high-resolution CT and tympanocochlear scintigraphy. Contrast enhancement of otospongiotic lesions was found in all affected ears, and could be topographically related to demineralised otospongiotic foci on CT. In lesions in the lateral wall of the labyrinth MRI sometimes showed the pathology better than CT, where partial-volume effects could be troublesome. (orig.). With 3 figs., 1 tab.

  5. Introduction to Interventional MRI

    Institute of Scientific and Technical Information of China (English)

    Jarmo Ruohonen; William G.Bradley; Jr.MD

    2002-01-01

    An increasing number of interventional procedures are done under imaging guidance. These include biopsies, drainages and injections. Likewise, imaging guidance and monitoring have enabled the use of sophisticated techniques for minimally invasive therapy of tumors. Since MRI provides the best tissue contrast and lesion sensitivity,the use of MR-guided procedures (MRGP) is quickly gaining momentum. Special hardware and software solutions have been developed that allow more efficient interventional use of the MR scanner.This introduction summarizes the basic concepts of interventional MRI and outlines some of the applications of today and tomorrow.

  6. Safety of anticoagulation after hemorrhagic infarction.

    Science.gov (United States)

    Pessin, M S; Estol, C J; Lafranchise, F; Caplan, L R

    1993-07-01

    Cerebral hemorrhagic infarction visualized on CT, secondary to embolic stroke in an anticoagulated individual, is usually associated with clinically stable or improving neurologic signs; fear of transforming the hemorrhagic infarction into a hematoma, however, usually prompts cessation of anticoagulation until the blood has cleared on CT, despite the recognized risk of recurrent embolism during this non-anticoagulated period. We now report our experience with 12 patients with hemorrhagic infarction who remained anticoagulated. Eleven men and one woman, ages 33 to 77, developed hemorrhagic infarction while on heparin, warfarin, or both, for prevention of recurrent embolism. Patients were either continued on uninterrupted anticoagulation from stroke onset (n = 6), or anticoagulation was withheld for several days and then resumed (n = 4), or it was withheld for 5 and 14 days (n = 2) after stroke onset and then continued uninterrupted despite the CT appearance of hemorrhagic infarction. Eleven patients had a definite cardioembolic source for stroke (atrial fibrillation, seven; ventricular thrombus, two; and ventricular dyskinesia, two). One patient had carotid occlusion with local intra-arterial embolism. Hemorrhagic infarcts varied in size and were located in the middle cerebral artery territory in 11 patients and posterior cerebral artery territory in one. All patients remained clinically stable or improved on anticoagulation. Serial CTs showed fading hemorrhagic areas. When the risk of recurrent embolism is high, anticoagulation may be safely used in some patients with hemorrhagic infarction.

  7. Ultrasound- and MRI-Guided Prostate Biopsy

    Science.gov (United States)

    ... Index A-Z Ultrasound- and MRI-Guided Prostate Biopsy Ultrasound- and MRI-guided prostate biopsy uses imaging ... Biopsy? What is Ultrasound- and MRI-guided Prostate Biopsy? Ultrasound- and MRI-guided prostate biopsies are performed ...

  8. MRI in human immunodeficiency virus-associated cerebral vasculitis

    Energy Technology Data Exchange (ETDEWEB)

    Berkefeld, J.; Lanfermann, H. [Frankfurt Univ. (Germany). Abt. fuer Neuroradiologie; Enzensberger, W. [Klinik fuer Neurologie, Klinikum der Johann Wolfgang Goethe-Univ. Frankfurt am Main (Germany)

    2000-07-01

    Cerebral ischaemia caused by inflammatory vasculopathies has been described as complication of human immunodeficiency virus (HIV) infection. Imaging studies have shown ischaemic lesions and changes of the vascular lumen, but did not allow demonstration of abnormalities within the vessel wall itself. Two HIV-infected men presented with symptoms of a transient ischaemic attack. Initial MRI of the first showed no infarct; in the second two small lacunar lesions were detected. In both cases, multiplanar 3-mm slice contrast-enhanced T1-weighted images showed aneurysmal dilatation, with thickening and contrast enhancement of the wall of the internal carotid and middle cerebral (MCA) arteries. These findings were interpreted as indicating cerebral vasculitis. In the first patient the vasculopathy progressed to carotid artery occlusion, and he developed an infarct in the MCA territory, but then remained neurologically stable. In the second patient varicella zoster virus (VZV) infection was the probable cause of vasculitis. The clinical deficits and vasculitic MRI changes regressed with antiviral and immunosuppressive therapy. (orig.)

  9. Quality assurance in functional MRI

    DEFF Research Database (Denmark)

    Liu, Thomas T; Glover, Gary H; Mueller, Bryon A

    2015-01-01

    Over the past 20 years, functional magnetic resonance imaging (fMRI) has ben- efited greatly from improvements in MRI hardware and software. At the same time, fMRI researchers have pushed the technical limits of MRI systems and greatly in- fluenced the development of state-of-the-art systems....... Minimizing image noise and maximizing system stability is critical in fMRI because the blood oxygenation level- dependent (BOLD) signal changes that are used for most fMRI studies represent only a small fraction of the total MR signal. In addition, multiple imaging volumes must be acquired over time to track...... cognitive processes. As a result, MRI scanners must have excellent time-series stability to accurately measure BOLD signal changes over the course of a long time series (typically on the order of 10 min per scan). fMRI studies are particularly demanding on the scanner hardware because they utilize fast...

  10. Magnetic Resonance Imaging (MRI) -- Head

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    Full Text Available ... about pregnancy and MRI. If you have claustrophobia (fear of enclosed spaces) or anxiety, you may want ... projectiles within the MRI scanner room and may cause you and/or others nearby harm. These items ...

  11. Magnetic Resonance Imaging (MRI) -- Head

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    Full Text Available ... content. Related Articles and Media MR Angiography (MRA) Magnetic Resonance, Functional (fMRI) - Brain Head and Neck Cancer Treatment Brain Tumor Treatment Magnetic Resonance Imaging (MRI) Safety Alzheimer's Disease Head Injury Brain ...

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    Full Text Available ... conditions. MRI uses a powerful magnetic field, radio frequency pulses and a computer to produce detailed pictures ... with claustrophobia. Newer open MRI units provide very high quality images for many types of exams. Older ...

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    Full Text Available ... The teddy bear denotes child-specific content. Related Articles and Media MR Angiography (MRA) Magnetic Resonance, Functional (fMRI) - Brain Head and Neck Cancer Treatment Brain Tumor Treatment Magnetic Resonance Imaging (MRI) ...

  14. Magnetic Resonance Imaging (MRI) -- Head

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  16. Magnetic Resonance Imaging (MRI) -- Head

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    Full Text Available ... or headphones during the exam. MRI scanners are air-conditioned and well-lit. Music may be played ... the limitations of MRI of the Head? High-quality images are assured only if you are able ...

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    Full Text Available ... to remain perfectly still and follow breath-holding instructions while the images are being recorded. If you ... Images related to Magnetic Resonance Imaging (MRI) - Head Videos related to Magnetic Resonance Imaging (MRI) - Head Sponsored ...

  18. Magnetic Resonance Imaging (MRI) Safety

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    ... Resources Professions Site Index A-Z Magnetic Resonance Imaging (MRI) Safety What is MRI and how does ... the area being scanned include: Metallic spinal rod Plates, pins, screws, or metal mesh used to repair ...

  19. Magnetic Resonance Imaging (MRI) -- Head

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    Full Text Available ... bore which can be more comfortable for larger size patients or patients with claustrophobia. Other MRI machines ... Gallery Magnetic Resonance Imaging (MRI) procedure View full size with caption Pediatric Content Some imaging tests and ...

  20. Magnetic Resonance Imaging (MRI) -- Head

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    Full Text Available ... Us News Physician Resources Professions Site Index A-Z Magnetic Resonance Imaging (MRI) - Head Magnetic resonance imaging ( ... if possible, or removed prior to the MRI scan. Because they can interfere with the magnetic field ...

  1. Magnetic Resonance Imaging (MRI) -- Head

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    Full Text Available ... have this exam in the first trimester of pregnancy unless the potential benefit from the MRI exam ... See the Safety page for more information about pregnancy and MRI. If you have claustrophobia (fear of ...

  2. Magnetic Resonance Imaging (MRI) -- Head

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    Full Text Available ... top of page What are the benefits vs. risks? Benefits MRI is a noninvasive imaging technique that ... than 30 minutes from the onset of symptoms. Risks The MRI examination poses almost no risk to ...

  3. Magnetic Resonance Imaging (MRI) -- Head

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    Full Text Available ... or potentially pose a risk, depending on their nature and the strength of the MRI magnet. Many ... is positioned around the head. If a contrast material will be used in the MRI exam, a ...

  4. Magnetic Resonance Imaging (MRI) -- Head

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    Full Text Available ... is done because a potential abnormality needs further evaluation with additional views or a special imaging technique. ... MRI an invaluable tool in early diagnosis and evaluation of many conditions, including tumors. MRI enables the ...

  5. Magnetic Resonance Imaging (MRI) -- Head

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    Full Text Available ... MRI scanners are air-conditioned and well-lit. Music may be played through the headphones to help ... Brain Tumor Treatment Magnetic Resonance Imaging (MRI) Safety Alzheimer's Disease Head Injury Brain Tumors Images related to ...

  6. Magnetic Resonance Imaging (MRI) -- Head

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    Full Text Available ... claustrophobia. Newer open MRI units provide very high quality images for many types of exams; however, older ... MRI units may not provide this same image quality. Certain types of exams cannot be performed using ...

  7. Magnetic Resonance Imaging (MRI) -- Head

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    Full Text Available ... claustrophobia. Newer open MRI units provide very high quality images for many types of exams. Older open MRI units may not provide this same image quality. Certain types of exams cannot be performed using ...

  8. Magnetic Resonance Imaging (MRI) -- Head

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    Full Text Available ... is done because a potential abnormality needs further evaluation with additional views or a special imaging technique. ... MRI an invaluable tool in early diagnosis and evaluation of many conditions, including tumors. MRI enables the ...

  9. Magnetic Resonance Imaging (MRI) -- Head

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    Full Text Available ... imaging technique that does not involve exposure to ionizing radiation. MRI can help physicians evaluate the structures of the brain and can also provide functional information (fMRI) in ...

  10. Magnetic Resonance Imaging (MRI) -- Head

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    ... MRI scanners are air-conditioned and well-lit. Music may be played through the headphones to help ... that magnetic resonance imaging harms the fetus, pregnant women usually are advised not to have an MRI ...

  11. Magnetic Resonance Imaging (MRI) -- Head

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    Full Text Available ... MRI scanners are air-conditioned and well-lit. Music may be played through the headphones to help ... that magnetic resonance imaging harms the fetus, pregnant women usually are advised not to have an MRI ...

  12. Hyperbaric oxygen therapy for cerebral blood flow and electroencephalogram in patients with acute cerebral infarction Choice for therapeutic occasion

    Institute of Scientific and Technical Information of China (English)

    Lei Chen; Fei Li; Dexiang Gu

    2007-01-01

    BACKGROUND: Hyperbaric oxygen (HBO) therapy increases blood oxygen content, changes cerebral blood flow (CBF) and cerebral metabolism. Its therapeutic effects on cerebrovascular disease have been fully confirmed, but the occasion for HBO therapy is still unclear.OBJECTIVE: To observe the therapeutic effects of HBO therapy at different time on CBF and electroencephalogram (EEG) in patients with acute cerebral infarction (CI).DESIGN: Randomized controlled trial.SETTING: Department of Neurology, Shidong Hospital, Yangpu District of Shanghai.PARTICIPANTS: Ninety-six inpatients with acute CI, admitted to Department of Neurology, Shidong Hospital, Yangpu District of Shanghai from January 2001 to December 2006, were involved in this experiment. The involved participants met the diagnosis criteria of acute CI and confirmed by skull CT or MRI. They all were patients with moderate CI (16- 30 points) according to neurologic deficit score formulated by Chinese Medical Association. Informed consents of detected items and therapeutic regimen were obtained from all the involved participants. They were randomized into two groups with 48 in each:early-stage treatment group and advanced-stage treatment group. Among the 48 patients in the early-stage treatment group, 21 male and 27 female, aged 53 -68 years, 22 patients were found with basal ganglia infarction, 10 with brain lobe infarction, 16 with multiple infarction, 27 accompanied with hypertension and 2 accompanied with diabetes mellitus. Among the 48 patients in the advanced-stage treatment group, 23 male and 25 female, aged 52 - 71 years, 25 patients were found with basal ganglia infarction, 10 with brain lobe infarction, 12 with multiple infarction, 1 with brain stem infarction, 28 accompanied with hypertension and 1 accompanied with diabetes mellitus.METHODS: After admission, patients of two groups received routine drug treatment. ① Patients in the early-stage treatment group and advanced-stage treatment group began to

  13. Timing of ischemic onset estimated from the electrocardiogram is better than historical timing for predicting outcome after reperfusion therapy for acute anterior myocardial infarction: a DANish trial in Acute Myocardial Infarction 2 (DANAMI-2) substudy

    DEFF Research Database (Denmark)

    Sejersten, Maria; Ripa, Rasmus S; Grande, Peer

    2007-01-01

    BACKGROUND: Acute treatment strategy and subsequently prognosis are influenced by the duration of ischemia in patients with ST-elevation acute myocardial infarction (AMI). However, timing of ischemia may be difficult to access by patient history (historical timing) alone. We hypothesized...... that an electrocardiographic acuteness score is better than historical timing for predicting myocardial salvage and prognosis in patients with anterior AMI treated with fibrinolysis or primary percutaneous coronary intervention. METHODS: One hundred seventy-five patients with anterior infarct without electrocardiogram (ECG...... the Aldrich score to determine the initially predicted myocardial infarct size and the Selvester score to determine the final QRS-estimated myocardial infarct size. RESULTS: The mean amount of myocardium salvage depended on ECG timing (43% [+/-38%] for "early" vs 1% [+/-56%] for "late"; P

  14. A Case of Familial Hemophagocytic Lymphohistiocytosis Type 4 With Involvement of the Central Nervous System Complicated With Infarct.

    Science.gov (United States)

    Ciraci, Saliha; Ozcan, Alper; Ozdemir, Mustafa M; Chiang, Samuel C C; Tesi, Bianca; Ozdemir, Akif M; Karakukcu, Musa; Patiroglu, Turkan; Acipayam, Can; Doganay, Selim; Gumus, Hakan; Unal, Ekrem

    2017-08-01

    Familial hemophagocytic lymphohistiocytosis (HLH) is a fatal disease affecting infants and very young children. Central nervous system involvement of HLH can cause catastrophic results. We present a case with cranial involvement of familial HLH type 4 who showed diffuse infiltration of white matter complicated with intracranial thrombosis. A 5-year-old girl from a consanguineous couple presented with fever and pancytopenia, and was referred to our hematology unit. Examination revealed fever, lymphadenopathy, and hepatosplenomegaly. Ultrasound examination revealed hepatosplenomegaly and free intra-abdominal fluid. HLH was revealed on bone marrow aspiration biopsy. Defective natural killer and T lymphocyte cytotoxicity using degranulation tests was determined. In the genetic analysis, syntaxin gene mutation was found. On T2-weighted and T2-fluid-attenuated inversion recovery magnetic resonance imaging (MRI), diffuse hyperintense signal changes of cerebral white matter, indicating white matter demyelination, were observed. A second brain MRI showed an acute infarct involving the left temporooccipital region. Immunosuppressive therapy according to the HLH 2004 protocol was started. The infarct resolved but white matter lesions were stable on the brain MRI that was performed 1 month later. Brain MRI taken 4 months after the first examination showed stable cerebral white matter lesions, but hyperintense signal changes appeared in the cerebellar white matter and were regarded as progression. The patient died because of infection despite immunosuppressive therapy. Physicians managing patients with HLH must be vigilant about the possibility of central nervous system involvement including stroke.

  15. Segmental Renal Infarction due to Blunt Trauma.

    Science.gov (United States)

    Alevizopoulos, Aristeidis; Hamilton, Lauren; Stratu, Natalia; Rix, Gerald

    2016-05-01

    Segmental renal infarction is a rare situation which has been reported so far in the form of case reports. It's caused usually by cardiac conditions, such as atrial fibrillation, and systemic diseases (e.g. systemic lupus erythematous). We are presenting a case of a 31 year old healthy male, who sustained a left segmental renal infarction, following a motorbike accident. We report his presentation, management and outcome. We also review the literature in search of the optimal diagnostic and treatment pathway. To our knowledge, this is the first report of segmental renal infarction due to blunt trauma.

  16. Pure dysarthria due to an insular infarction.

    Science.gov (United States)

    Hiraga, Akiyuki; Tanaka, Saiko; Kamitsukasa, Ikuo

    2010-06-01

    Cortical infarction presenting with pure dysarthria is rarely reported. Previous studies have reported pure dysarthria due to cortical stroke at the precentral gyrus or middle frontal gyrus. We report a 72-year-old man who developed pure dysarthria caused by an acute cortical infarction in the insular cortex. The role of the insula in language has been difficult to assess clinically because of the rarity of pure insular strokes. Our patient showed pure dysarthria without aphasia, indicating that pure dysarthria can be the sole manifestation of insular infarctions.

  17. [Circadian rhythm in myocardial infarct].

    Science.gov (United States)

    Enciso, R; Ramos, M A; Badui, E; Hurtado, R

    1988-01-01

    In order to determine if the beginning of the Myocardial Infarction (MI) is at random along the day or if it follows a circadian rhythm, we analyzed the clinical charts of 819 patients admitted to the Coronary Care Unite. Among them, 645 were male and 174 female. It was established that the beginning of the MI follows a circadian rhythm with maximal frequency between 8 and 9 a.m. and minimal at 0 hours (p greater than 0.01). This rhythm is sex independent. In patients younger than 45 years as well as those who received beta-block agents in less than 24 hours previous the MI no circadian rhythm was observed.

  18. Myocardial infarction in the young

    Directory of Open Access Journals (Sweden)

    Cengel A

    2009-01-01

    Full Text Available An increasing number of patients under 40 years of age are being hospitalized with the diagnosis of acute myocardial infarction. This is partly due to the increased prevalance of risk factors for atherosclerosis in the younger age group; especially increased incidence of impaired fasting glucose, high triglyceride, low high-density lipoprotein levels and increased waist to hip ratio. However, non-atherosclerotic coronary artery disease or hypercoagulability should also be investigated or at least suspected in the younger patients. The pathophysiology of different clinical conditions and disease states which cause acute coronary syndromes in the young patients are reviewed, and the diagnostic modalities and therapatic options for these conditions are briefly discussed by searching for "premature atherosclerosis", "hypercoagulable states", "risk factors for atherosclerosis in youth", "novel risk factors for atherosclerosis", "non-atherosclerotic coronary artery diseases" in PubMed.

  19. Myocardial infarction and nocturnal hypoxaemia

    Directory of Open Access Journals (Sweden)

    Penčić Biljana

    2007-01-01

    Full Text Available Introduction: There is an increased risk of cardiovascular morbidity and mortality in patients with nocturnal intermittent hypoxaemia. Objecive. The aim of this study was to evalute the influence of nocturnal hypoxaemia on ventricular arrhythmias and myocardial ischaemia in patients with myocardial infarction (MI. Method. We studied 77 patients (55.8±7.9 years with MI free of complications, chronic pulmonary diseases, abnormal awake blood gases tension. All patients underwent overnight pulse oximetry and 24-hour electrocardiography. Patients were divided into two groups according to nocturnal hypoxaemia. Total number of ventricular premature complex (VPC; maximal VPC/h; incidence of VPC Lown class>2 and occurrence of ST-segment depression were analyzed for nocturnal (10 PM to 6 AM, daytime (6 AM to 22 PM periods and for the entire 24 hours. Results. Both groups were similar in age, gender, standard risk factors, myocardial infarction size and did not differ in VPC during the analyzed periods. The number of nocturnal maximal VPC/h was insignificantly greater in group 1 (with hypoxaemia compared to group 2 (without hypoxaemia, (p=0.084. Maximal VPC/h did not differ significantly either for daytime or for 24 hours among the groups. Nocturnal VPC Lown>2 were significantly more frequent in group 1 (25% vs 0%, p=0.002. The incidence of VPC Lown>2 was similar during the daytime, and during 24 hrs in both groups. Occurrence of ST-segment depression did not differ between groups 1 and 2. Conclusion. Nocturnal hypoxaemia was associated with complex nocturnal ventricular arrhythmias in patients with MI. .

  20. Atypical Unilateral Posterior Reversible Encephalopathy Syndrome Mimicking a Middle Cerebral Artery Infarction.

    Science.gov (United States)

    Çamlıdağ, İlkay; Cho, Yang-Je; Park, Mina; Lee, Seung Koo

    2015-01-01

    Posterior reversible encephalopathy syndrome (PRES) is usually a reversible clinical and radiological entity associated with typical features on brain MR or CT imaging. However, the not-so-uncommon atypical radiological presentations of the condition are also present and they may go unrecognised as they are confused with other conditions. Here, we report a very rare case of atypical, unilateral PRES in a 49-year-old uremic, post-transplant female patient who presented with seizures. Initial MRI showed high-grade occlusion of the left middle cerebral artery (MCA) and lesions suggestive of subacute infarction in the ipsilateral frontotemporoparietal lobe. Patient symptoms had resolved a day after the onset without any specific treatment but early follow-up CT findings suggested hemorrhagic transformation. Follow-up MRI performed 2 years later showed complete disappearence of the lesions and persisting MCA occlusion.