Brain MRI Examination Research Articles

Case Report on Using Instant Hair Thickener in a Brain MRI Examination to Generate a Susceptibility Artifact

Case Report on Using Instant Hair Thickener in a Brain MRI Examination to Generate a Susceptibility Artifact

Peranan Sekuen Susceptibility Weight Imaging (SWI) Pada Pemeriksaan MRI Brain Pada Kasus Tumor

The aim of the research is to find out the role of the transverse suspectibility weighted imaging (SWI) sequence in brain MRI examination techniques in tumor cases. The research method used in this research is a qualitative descriptive study that uses a literature study approach to explore, analyze and identify information about how the Susceptibility Weighted Imaging (SWI) sequence plays a role in the Brain MRI examination process in patients who have tumors. The results and discussion of the literature review show: 1) Susceptibility-Weighted Imaging (SWI) on MRI brain has an important role in detecting blood degradation products, calcification and iron accumulation in glioblastoma. SWI allows visualization of small blood vessels, detection of iron, as well as identification of areas of calcification within the tumor, providing a more detailed picture of the nature and malignancy of glioblastoma. The Intratumoral Susceptibility Signal (ITSS) on SWI images is a visual marker associated with microhemorrhage, neoangiogenesis, and calcification, enabling tumor grading based on the frequency and distribution of these signals. In addition, Intralesional Susceptibility Signal (ILSS) also has an important role in differentiating glioblastoma from abscesses and metastases, with high levels of ILSS tending to be associated with tumor severity. Thus, the integration of SWI and ITSS and ILSS analysis can make a significant contribution to the characterization and assessment of the level of malignancy. 2) Susceptibility-Weighted Imaging (SWI) in the diagnosis of glioblastoma has the advantage of providing internal visualization of the tumor with high resolution. SWI is highly sensitive to differences in tissue susceptibility, allows the detection of neovascularization, hemorrhage, and calcification within glioblastoma, and provides detailed information about cerebral vascular anatomy. The advantages of SWI include its ability to image the Intratumoral Susceptibility Signal (ITSS) and Intralesional Susceptibility Signal (ILSS) and increase the visibility of low signal intensity structures. However, its shortcomings, namely sensitivity to artifacts, dependence on susceptibility phenomena, and subjective interpretation are aspects that need to be considered.

Stroke in a young adult: looking beyond the diffusion-weighted imaging sequence.

A 37-year-old migrainous woman was referred several hours after a sudden dysarthria lasting less than 1min. Brain MRI undertaken a few hours later showed no acute cerebral infarction on the diffusion-weighted imaging (DWI) sequence. However, an intraluminal thrombus within a distal branch of the middle cerebral artery (MCA) was seen on the T2*-weighted gradient echo images as well as hyperintense vessels related to slow flow beyond the occlusion's site. Control MRI 24h later confirmed the presence of a small infarct affecting the distal portion of the MCA territory but the thrombus was no longer visible. A comprehensive etiologic workup revealed the presence of a patent foramen ovale, as the underlying cause of the patient's stroke. Though the sensitivity of DWI sequence for acute ischemia is high, false negative exist particularly in cases of transient ischemic attack, brainstem or lacunar strokes. A careful brain MRI examination or the use of perfusion weighted imaging sequences are useful to avoid misdiagnosis particularly in young patients.

Associations of anemia and cardiovascular disease with longitudinal changes in brain MRI markers and cognitive decline in older adults: A cohort study

AbstractBackgroundAnemia and cardiovascular disease (CVD) are two prevalent chronic conditions causing cerebral hypoxia in older adults. Although anemia and CVD often coexist in older people and potentially share underlying mechanisms, the independent effects of these two diseases with cognitive decline are largely unknown. The objective of this cohort study is to investigate the independent associations of anemia and CVD with cognitive decline in older adults, and further explore their associations with changes in MRI markers of brain aging using longitudinal MRI data.MethodThis cohort study used data from 2244 dementia‐ and stroke‐free participants in the population‐based Swedish National study on Aging and Care in Kungsholmen (age ≥60 years, female 62%). Participants were regularly followed from 2001‐2004 (baseline) through 2013‐2016. Anemia (WHO criteria) and CVD were determined at baseline. Cognitive function was assessed using a neuropsychological test battery across 12 years. A subset of participants (N = 503) underwent brain MRI examinations at baseline, and 327undertook follow‐up MRI scans after 3 and/or 6 years. Brain volumetric measures and markers of cerebral small vessel disease (cSVD) were assessed following standard methods. The associations of anemia or/and CVD with cognitive decline and changes in brain volume and cSVD markers were investigated using linear mixed‐effects models, while controlling for age, sex, lifestyle, vascular risk factors, chronic kidney disease, cancer, serum c‐reactive protein, and APOE genotype.ResultOf the 2244 participants, 5% had only anemia and 17% had only CVD. Both anemia and CVD were independently associated with a steeper decline in global cognitive composite score (anemia ‐0.01/year; 95%CI ‐0.03 to ‐0.00, CVD ‐0.02/year; 95%CI ‐0.03 to ‐0.02). Anemia was associated with faster decline in category fluency and perceptual speed, while CVD was significantly associated with an accelerated decline in all examined cognitive domains. Both anemia and CVD at baseline were associated with a steeper decline in total brain tissue volume, while CVD was additionally associated with steeper decline in volumes of hippocampus (P<0.05). Neither was significantly associated with changes in cSVD markers (i.e., white‐matter hyperintensities, lacunes).ConclusionBoth anemia and CVD are risk factors for accelerated cognitive decline and brain atrophy in older adults.

T1-weighted fast fluid-attenuated inversion-recovery sequence (T1-FFLAIR) enables the visualization and quantification of fetal brain myelination in utero

ObjectivesTo investigate the advantage of T1-weighted fast fluid-attenuated inversion-recovery MRI sequence without (T1-FFLAIR) and with compressed sensing technology (T1-FFLAIR-CS), which shows improved T1-weighted contrast, over standard used T1-weighted fast field echo (T1-FFE) sequence for the assessment of fetal myelination.Materials and methodsThis retrospective single-center study included 115 consecutive fetal brain MRI examinations (63 axial and 76 coronal, mean gestational age (GA) 28.56 ± 5.23 weeks, range 19–39 weeks). Two raters, blinded to GA, qualitatively assessed a fetal myelin total score (MTS) on each T1-weighted sequence at five brain regions (medulla oblongata, pons, mesencephalon, thalamus, central region). One rater performed region-of-interest quantitative analysis (n = 61) at the same five brain regions. Pearson correlation analysis was applied for correlation of MTS and of the signal intensity ratios (relative to muscle) with GA on each T1-weighted sequence. Fetal MRI–based results were compared with myelination patterns of postmortem fetal human brains (n = 46; GA 18 to 42), processed by histological and immunohistochemical analysis.ResultsMTS positively correlated with GA on all three sequences (all r between 0.802 and 0.908). The signal intensity ratios measured at the five brain regions correlated best with GA on T1-FFLAIR (r between 0.583 and 0.785). T1-FFLAIR demonstrated significantly better correlations with GA than T1-FFE for both qualitative and quantitative analysis (all p < 0.05). Furthermore, T1-FFLAIR enabled the best visualization of myelinated brain structures when compared to histology.ConclusionT1-FFLAIR outperforms the standard T1-FFE sequence in the visualization of fetal brain myelination, as demonstrated by qualitative and quantitative methods.Clinical relevance statementT1-weighted fast fluid-attenuated inversion-recovery sequence (T1-FFLAIR) provided best visualization and quantification of myelination in utero that, in addition to the relatively short acquisition time, makes feasible its routine application in fetal MRI for the assessment of brain myelination.Key Points• So far, the assessment of fetal myelination in utero was limited due to the insufficient contrast.• T1-weighted fast fluid-attenuated inversion-recovery sequence allows a qualitative and quantitative assessment of fetal brain myelination.• T1-weighted fast fluid-attenuated inversion-recovery sequence outperforms the standard used T1-weighted sequence for visualization and quantification of myelination in utero.Graphical abstract

Teknik Pemeriksaan Magnetic Resonance Imaging (MRI) Brain Dengan Penambahan Sequence Axial 3D-Fiesta Pada Kasus Facial Tic

Magnetic Resonance Imaging is a medical device that combines computer technology, strong magnetic fields and radio waves to emulate representations of human body parts and produce more detailed and clear images, one of which is Facial Tic on the Brain. The MRI Brain examination aims to see the anatomy and abnormalities in the brain. This study aims to determine the MRI Brain examination procedure and the role of the Axial 3D Fiesta sequence in cases of Facial Tic. Use of the 3D Fast Imaging Employing Steady State Acquisition (FIESTA) sequence for evaluation of the head nerves. The research method used is descriptive research with a case study approach. Data collection was carried out from July 2023 to August 2023 using a GE 1.5 Tesla MRI aircraft. The subject consisted of a patient with clinical Facial Tic. Data collection was carried out through observation, interviews and documentation. The research results were obtained according to theory using sagittal T1, Coronal PD/T2, Axial PD/T2/T1/FLAIR/EPI, Axial 3D incoherent GRE T1, Axial/oblique SE MT, Axial DWI, Diffusion Tensor Imaging (DTI), Axial perfusion sequences. imaging, while in the field using localizer sequences, Axial DWI, Axial T2 Flair, Axial T2, Axial T1, Axial T2* GRE, Sagittal T1, Coronal T2, and Axial 3D Fiesta

Evaluasi Perbandingan Informasi Citra MRI Brain Sekuen Diffusion Weighted Imaging Irisan Axial Pada Variasi Nilai SENSE di Instalasi Radiologi RSUD Provinsi NTB

Magnetic Resonance is a radiodiagnostic examination tool in the field of radiology, especially in the medical world. Diffusion Weighted Imaging is a method to assess molecular function and microarchitecture of the human body. DWI signal contrast can be measured with visible diffusion coefficient maps and serves as a tool for treatment response evaluation and disease progression assessment. Parallel imaging techniques involve phased array coils to process signals from a slice, then combine these slices to form an image, reducing scan time by reducing the acquired K-space lines. The formation of Sensitivity Encoding (SENSE) can shorten the insertion of K-space. This study aims to test variations of SENSE values 2.0 and 2.5 in MRI brain examinations with axial DWI sequences that are capable of visualizing anatomical information with fast scan times without compromising image quality, resulting in optimal images. This research is quantitative with an experimental approach. The sample consists of 10 patients using voluntary sampling of MRI Brain with axial DWI sequence and varying SENSE values from July to August 2023. Data were collected through questionnaires filled out by three radiology specialists at the Radiology Installation of the Provincial Hospital of West Nusa Tenggara (RSUD Provinsi NTB). The results of the Wilcoxon test showed a significant difference in anatomical information in MRI brain with axial DWI sequences between SENSE values of 2 and 2.5, with a p-value of 0.012. The mean rank value results indicated a sum of ranks of 280.00 for the SENSE 2 value, demonstrating greater optimality compared to SENSE 2.5. This study concludes that there is a significant difference in anatomical information in MRI brain with axial DWI sequences between SENSE values of 2 and 2.5. SENSE 2 tends to provide more optimal information.

Use of a Commercial 7-T MRI Scanner for Clinical Brain Imaging: Indications, Protocols, Challenges, and Solutions-A Single-Center Experience.

The first commercially available 7-T MRI scanner (Magnetom Terra) was approved by the FDA in 2017 for clinical imaging of the brain and knee. After initial protocol development and sequence optimization efforts in volunteers, the 7-T system, in combination with an FDA-approved 1-channel transmit/32-channel receive array head coil, can now be routinely used for clinical brain MRI examinations. The ultrahigh field strength of 7-T MRI has the advantages of improved spatial resolution, increased SNR, and increased CNR but also introduces an array of new technical challenges. The purpose of this article is to describe an institutional experience with the use of the commercially available 7-T MRI scanner for routine clinical brain imaging. Specific clinical indications for which 7-T MRI may be useful for brain imaging include brain tumor evaluation with possible perfusion imaging and/or spectroscopy, radiotherapy planning; evaluation of multiple sclerosis and other demyelinating diseases, evaluation of Parkinson disease and guidance of deep brain stimulator placement, high-detail intracranial MRA and vessel wall imaging, evaluation of pituitary pathology, and evaluation of epilepsy. Detailed protocols, including sequence parameters, for these various indications are presented, and implementation challenges (including artifacts, safety, and side effects) and potential solutions are explored.

Comparison Between EPI DWI and PROPELLER DWI in Brain MR Imaging

EPI DWI is a routinely used sequence in brain imaging but it has limitations when it comes to SNR and artifact reduction. PROPELLER DWI has the benefit of improving image quality compared to EPI DWI. The aim of this study is to compare the EPI DWI sequence in brain MR imaging with the PROPELLER DWI sequence. The objective is to identify which sequence is more beneficial in brain imaging by evaluating image quality and the depiction of pathologies. A total of 101 patients (55 females and 46 males, mean age 56 years) underwent brain MRI examination on a 1.5 T scanner. EPI DWI and PROPELLER DWI sequences were acquired in every exam and were reviewed by 2 radiologists. The images were evaluated by performing a quantitative analysis based on Relative Contrast and a qualitative analysis (overall image quality, conspicuousness of lesions, artifact reduction, etc.). In both the qualitative and quantitative analysis PROPELLER DWI achieved better results than EPI DWI. PROPELLER DWI showed statistical significance in the overall image quality (P < 0.001), the elimination of susceptibility (P < 0.001) and flow pulsation artifacts (P < 0.001), as well as in the contrast between CSF with white (P < 0.001) and grey matter (P < 0.001). Also, PROPELLER DWI presented better delineation of pathologies like ischemic strokes, metastasis, tumors and vasogenic edemas than conventional EPI DWI. PROPELLER DWI was the preferred sequence during the image evaluation. Compared to EPI DWI, PROPELLER DWI managed to reduce susceptibility and flow pulsation whilst achieving higher image quality and lesion delineation and earlier depiction of ischemic strokes than the conventional EPI DWI. PROPELLER DWI may be incorporated in brain MR imaging replacing EPI DWI.

Comparison Between the Image Information of T2WI FLAIR Sequences and TSE T2WI Axial Slice Brain MRI Examination with Cases of Intracranial Tumors

This study aims to determine the most optimal results of image information generated from the two sequences, especially for diagnosing intracranial tumors. This type of research is an experiment. The research was conducted with an MRI 3 Tesla in the Radiology Installation. The data is in the form of 20 MRI Brain images from the T2WI TSE and T2WI FLAIR sequences with cases of intracranial tumors. Image evaluation from the qualitative aspect was obtained from respondents’ assessments which were analyzed by Wilcoxon different tests and cross-tabulation. While the quantitative assessment is obtained from the measurement of the Signal Noise Ratio (SNR) and analyzed by the Paired T-Test. Based on the results of the study, Ho was rejected and Ha was accepted, which means that there is a difference in image information between the T2WI TSE sequence and the T2WI FLAIR sequence on the axial section of the MRI Brain examination in cases of intracranial tumors with a p-value = 0.034 (p &lt;0.05). The T2WI TSE sequence can show good intensity and tumor boundaries, while the FLAIR T2WI sequence can show edema around the tumor well, while white matter and gray matter lesion assessments show no significant difference between the two sequences. The results of the SNR measurements showed that the Signal Noise Ratio (SNR) value of the T2WI TSE sequence was higher than that of the FLAIR T2WI sequence.

Increased rate of significant findings on brain MRI during the early stage of the COVID-19 pandemic.

To assess the effect of the COVID-19 pandemic on the proportion of abnormal paediatric neuroimaging findings as a surrogate marker for potential underutilisation. Consecutive paediatric brain MRIs performed between March 27th and June 19th 2019 (Tbaseline) and March 23rd and June 1st 2020 (Tpandemic) were reviewed and classified according to presence or absence and type of imaging abnormality, and graded regarding severity on a 5-point Likert scale, where grade 4 was defined as abnormal finding requiring non-urgent intervention and grade 5 was defined as acute illness prompting urgent medical intervention. Non-parametric statistical testing was used to assess for significant differences between Tpandemic vs. Tbaseline. Fewer paediatric MRI brains were performed during Tpandemic compared to Tbaseline (12.2 vs 14.7 examinations/day). No significant difference was found between the two time periods regarding sex and age (Tbaseline: 557 females (44.63%), 7.95 ± 5.49years, Tpandemic: 385 females (44.61%), 7.64 ± 6.11years; p = 1 and p = .079, respectively). MRI brain examinations during Tpandemic had a higher likelihood of being abnormal, 41.25% vs. 25.32% (p<.0001). Vascular abnormalities were more frequent during Tpandemic (11.01% vs 8.01%, p = .02), congenital malformations were less common (8.34% vs 12.34%, p = .004). Severity of MRI brain examinations was significantly different when comparing group 4 and group 5 individually and combined between Tbaseline and Tpandemic (p = .0018, p < .0001, and p <.0001, respectively). The rate of abnormality and severity found on paediatric brain MRI was significantly higher during the early phase of the pandemic, likely due to underutilisation.

Identification of optimal value of magnetic resonance planimetry and the parkinsonism index for the diagnosis of Parkinson's disease and progressive supranuclear palsy

ObjectivesParkinson's disease (PD) and progressive supranuclear palsy (PSP) are neurodegenerative conditions that have overlapping clinical and imaging features, thus making it difficult to distinguish and diagnose PSP from PD. Therefore, in this study, we aimed to investigate the optimal value of magnetic resonance planimetry and the parkinsonism index to differentiate between PSP and PD. MethodsIn this retrospective study, we recruited a total of 84 patients (27 patients with PSP, 27 patients with PD and 27 normal controls) who underwent MRI brain examinations. For each subject, we calculated the corpus callosum area, midbrain area, pons area, middle cerebellar peduncle (MCP) width and superior cerebellar peduncle (SCP) width on MRI brain images. We also calculated the pons to midbrain area (P/M) ratio, MCP/SCP ratio and magnetic resonance parkinsonism index (MRPI). ResultsReceiver operating characteristic curve (ROC) analysis was used to identify the diagnostic value of each biomarker. MRPI had a sensitivity of 70.4%, a specificity of 88.9%, and a diagnostic accuracy of 79.6% with an optimum cut off of 24.3 for differentiating PSP from PD. P/M ratio had a sensitivity of 74.1%, a specificity of 77.8%, and a diagnostic accuracy of 75.9% with an optimal cutoff of 24.3 for differentiating PSP from PD. The MCP/SCP ratio had a sensitivity of 66.7%, a specificity of 77.8%, and an accuracy of 72.2% with an optimal cut off of 4.65 for differentiating PSP from PD. ConclusionsThe study revealed that MRPI and P/M ratio are accurate markers for differentiating PSP from PD. The optimal cut-off values derived from our study can help in the early diagnosis of PD.

Brain imaging signatures in amyotrophic lateral sclerosis: Correlation with peripheral motor degeneration.

This study aimed to explore the clinical significance of brain imaging signatures in the context of clinical neurological deficits in association with upper and lower motor neuron degeneration in amyotrophic lateral sclerosis (ALS). We performed brain MRI examinations to quantitatively evaluate (1) gray matter volume and (2) white matter tract fractional anisotropy (FA), axial diffusivity (AD), radial diffusivity (RD), and mean diffusivity (MD). Image-derived indices were correlated with (1) global neurological deficits of MRC muscle strength sum score, revised amyotrophic lateral sclerosis functional rating scale (ALSFRS-R), and forced vital capacity (FVC), and (2) focal scores of University of Pennsylvania Upper motor neuron score (Penn score) and the summation of compound muscle action potential Z scores (CMAP Z sum score). There were 39 ALS patients and 32 control subjects matched for age and gender. Compared to controls, ALS patients had a lower gray matter volume in the precentral gyrus of the primary motor cortex, which was correlated with FA of corticofugal tracts. The gray matter volume of the precentral gyrus was correlated with FVC, MRC sum score, and CMAP Z sum score, while the FA of the corticospinal tract was linearly associated with CMAP Z sum score and Penn score on multivariate linear regression model. This study indicated that clinical assessment of muscle strength and routine measurements on nerve conduction studies provided surrogate markers of brain structural changes for ALS. Furthermore, these findings suggested parallel involvement of both upper and lower motor neurons in ALS.

Assessment of the Central Nervous System in Children with Fetal Alcohol Spectrum Disorder (FASD) Using Magnetic Resonance (MR) Techniques

The study aimed to assess central nervous systems in children diagnosed with Fetal Alcohol Spectrum Disorder (FASD), using the techniques of magnetic resonance (MRI). The analyses considered 200 children, both female and male, aged 6–17 years, diagnosed with FASD, as well as 32 healthy children of both sexes, aged 6–16 years. Brain anomalies as well as linear and surface area measurements of the brain and corpus callosum were assessed. 1H MRS and DWI signals were evaluated in the frontal lobes, basal ganglia, hippocampi, and cerebellum. Several brain anomalies were found in children with FASD. Qualitative assessment showed the thinning of the corpus callosum in 40% of the cases and cerebral ventricular asymmetry in 32% of the children. The mean thickness of the corpus callosum isthmus and the mean length of the corpus callosum were statistically lower in children with FASD. Higher Lip/Cr concentration and DWI values as well as lower NAA/Cr, Cho/Cr, and mI/Cr concentrations were found in multiple studied brain regions. The analysis of the present findings in the study group showed that brain MRI examinations of children with FASD more often identified a decreased corpus callosum and 1H MRS and DWI abnormalities, particularly in the region of basal ganglia.

Long Term Use of Benzodiazepines and Delayed Awakeness from General Anesthesia: A Case Report

We present two delayed awaken cases that underwent general anesthesia and showed altered mentality with unresponsiveness in the postanesthesia care unit (PACU) after successful extubation in the operating room. Both patients had been taking benzodiazepines chronically before surgery. In case 1, extubation was carried out without any problems and arrived at the PACU. After 15 minutes, she suddenly developed hyperventilation, shivering, and a state of consciousness that does not respond to verbal command. Eyes were kept closed and she showed decreased pain withdrawal response in all extremities. After 90 minutes at PACU, she was able to obey simple verbal instructions. All symptoms showed gradual improvement within 5-6 hours. In case 2, 20 minutes after transferal to PACU, the patient showed drowsy mentality with no response to verbal or pain stimuli. Altered mental state lasted 3 days and motor weakness of extremities lasted 5 days. Brain MRI and other examinations showed no abnormalities. They were discharged without any neurological complications.

How white matter hyperintensities impacts Alzheimer’s disease and frontotemporal dementia across underrepresented Latin American samples

AbstractBackgroundWhite matter hyperintensities (WMH) are frequently observed on MRI scans of older people. Usually interpreted as a sign of cerebrovascular disease (CVD), they are also associated with increased risk of cognitive impairment and dementia. While WMH and CVD are highly prevalent in Alzheimer’s disease (AD), this has been less studied in behavioral variant frontotemporal dementia (bvFTD), letting alone their study in underrepresented populations with increased CVD. Here, we investigated WMH in AD and bvFTD patients in Latin America (Argentina, Chile and Colombia), a region with high prevalence of CVD. We analyzed total volume and regional distribution of WMH and its association with cognitive impairment and brain lacunes, a marker of CVD.MethodA total of 66 patients (43 AD, 23 bvFTD) and 66 controls (CN) from the ReDLat consortium underwent high‐resolution brain MRI and neuropsychological examination. WMH were extracted from Flair images using automated segmentation algorithms to perform analyses of total volume and spatial distribution. Brain lacunes were visually quantified from T1 and Flair images. Group differences in total and regional WMH volume and associations with different cognitive domains, age, and brain lacunes were examined.ResultTotal and regional WMH volumes were significant larger in AD patients compared to CN and to bvFTD. No differences were found between CN and bvFTD. Only in AD, regional WMH load correlated with worse performance in a particular executive functioning task. No differences were found in the proportion of lacunes among groups nor in the total load of WMH of subjects with or without lacunes. In CN and AD, but not FTD, there was a positive correlation between total WMH volume and age, with a differential topographic distribution with a selective involvement of the bilateral cingulum‐hippocampus bundle in AD.ConclusionEnhanced WMH was observed in AD but not in FTD. WMH loading in specific brain regions contribute to domain‐specific cognitive deficits in AD. WMH could be partially independent of vascular pathology (it was unrelated to brain lacunes) suggesting a specific neurodegenerative origin in AD. The typical earlier onset of brain abnormalities in FTD could mask the age‐related increase in WMH.

Evaluation of pituitary gland dimensions by age and gender in healthy individuals in the Turkish population

Aim: Evaluating pituitary gland dimensions in varying age ranges and genders is essential for determining average values in MRI examinations. Therefore, the main objective of our study is to create normative data for pituitary gland size in the Turkish population.&#x0D; Material and Method: Anteroposterior (AP), transverse (TR), and craniocaudal (CC) dimensions of the pituitary glands of 200 patients over 18 years of age, who underwent Brain MRI examination in our centre between November 2022 and March 2023, did not have any known endocrine disease, did not use hormonal therapy, were not pregnant or breastfeeding, had no history of radiotherapy or chemotherapy were measured from their sagittal and axial MRI sequences. The Kolmogorov-Smirnov test was used for normality analyses. The Mann-Whitney U test was used to compare the non-normally distributed numerical variables between the two groups. Spearman correlation was applied to determine the relationship between age and pituitary gland measurement values.&#x0D; Results: Anteroposterior and craniocaudal measurements of the pituitary gland of female patients included in the study were significantly higher than males (p=0.011 and p

Efficiency of Nanoparticles (Micromage-B) in the Complex Treatment of Multiple Sclerosis

Multiple sclerosis (MS) is a serious neurological problem because of its high prevalence, chronic course, frequent disability, and propensity to affect young people. The immunopathogenesis hypothesis underlies the origin of MS. Selective sorption activity of biocompatible magnetite nanoparticles against surface proteins of cell membranes, circulating immune complexes, lymphocytotoxic antibodies, complement system, the effect of increasing phagocytic activity and leukocyte phagocytosis completion index allows the effective use of these nanodevices for immunocorrection. The main goal of the study is to slow down the progression of MS, improve the neurological status and general condition of the patient, and reduce the dynamics of the spread of demyelinating foci in the brain. Materials and methods: a patient diagnosed with multiple sclerosis, secondary progressive type of course, cerebro-spinal form, clinical aggravation stage; EDSS neurological status and disability assessment scales; contrast-enhanced MRI of the brain. An oral form of the nanodevice Micromage-B was used as an immunosorbent and immunomodulator. The choice of the regimen and dosage of Micromage-B was personalized. Assessment of the general condition and neurological status was performed every 7 days for 6 months. Contrast-enhanced MRI of the brain was performed at the 5th month of the study. As a result of using Micromage-B in MS treatment, objective improvement of neurological status, reduction of stiffness and rapid fatigability of the lower extremities were observed. Gait and coordination improved, hand tremors decreased, depression and signs of concentration disorders disappeared, appetite restored, and speech improved. During the entire period of Micromage-B application, positive dynamics in the normalization of the neurological status was observed. After 6 months of treatment, the total score dropped by 165 to 35. It was found that the maximum positive effect was observed in the evaluation of the pyramidal system and coordination. The EDSS Disability Scale score decreased from 6.0 to 5.0. Contrast-enhanced MRI brain examination for the first time showed a decrease in the number of new foci of demyelination in the brain by the 4th month of Micromage-B administration. The positive dynamics of normalization of the neurological status correlated with the results of brain MRI. The process of recovery of central nervous system activity in MS is not only due to the immunosuppressive properties of magnetite nanoparticles, but is probably caused by the activation of remyelination mechanisms and oligodendrocyte differentiation through enzymatic methylation. Considering the above, the use of biocompatible nanodevices in the complex treatment of MS is a promising direction. The scheme and method of using biocompatible magnetite nanoparticles to improve the effectiveness of MS treatment require further improvement and study.

Quantitative assessment of cerebrospinal fluid flow and volume in enlargement of the subarachnoid spaces of infancy using MRI.

The etiology of enlarged subarachnoid spaces of infancy is unknown; however, there is radiologic similarity with normal pressure hydrocephalus. Adults with normal pressure hydrocephalus have been shown to have altered cerebrospinal (CSF) flow through the cerebral aqueduct. To explore potential similarity between enlarged subarachnoid spaces of infancy and normal pressure hydrocephalus, we compared MRI-measured CSF flow through the cerebral aqueduct in infants with enlarged subarachnoid spaces of infancy to infants with normal brain MRIs. This was an IRB approved retrospective study. Clinical brain MRI examinations including axial T2 imaging and phase contrast through the aqueduct were reviewed for infants with enlarged subarachnoid spaces of infancy and for infants with a qualitatively normal brain MRI. The brain and CSF volumes were segmented using a semi-automatic technique (Analyze 12.0) and CSF flow parameters were measured (cvi42, 5.14). All data was assessed for significant differences while controlling for age and sex using analysis of covariance (ANCOVA). Twenty-two patients with enlarged subarachnoid spaces (mean age 9.0months, 19 males) and 15 patients with normal brain MRI (mean age 18.9months, 8 females) were included. Volumes of the subarachnoid space (P < 0.001), lateral (P < 0.001), and third ventricles (P < 0.001) were significantly larger in infants with enlarged subarachnoid spaces of infancy. Aqueductal stroke volume significantly increased with age (P = 0.005), regardless of group. CSF volumes were significantly larger in infants with enlarged subarachnoid spaces of infancy versus infants with a normal MRI; however, there was no significant difference in CSF flow parameters between the two groups.

Brain Magnitude Resonance Imaging Examination Protocol in Epilepsy Patients: A Narrative Literature Review

MRI is becoming the choice for performing high-resolution structural imaging in epilepsy. Selection of brain MRI sequences with appropriate clinical epilepsy is very important to show abnormalities clearly so that the diagnosis can be made. The epilepsy protocol includes T1 and T2 weights, as well as fluid-attenuated inversion recovery (FLAIR). This literature review aims to describe the protocol for brain MRI examination in epilepsy patients. There is one special sequence that is used as a parameter for brain MRI examination in cases of epilepsy, namely fast spin-echo inversion recovery (FSE-IR), which is a modification of conventional inversion recovery and is used to suppress signals from certain tissues associated with T2 weighting. The coronal T2 propeller sequence is the sequence for showing pathology in the hippocampus. Coronal FSE-IR is useful for evaluating the hippocampus from the coronal side by eliminating the white signal to increase the contrast between white matter and gray matter. In conclusion, each sequence in the MRI examination protocol has a specific goal, namely to reveal pathology on the MRI slice and establish a diagnosis.