Magnetic Resonance Imaging Findings Research Articles

The radiohumeral synovial plica: anatomy, histology, and implications in chronic lateral epicondylitis.

Our study aimed to elucidate synovial plica (SP) of the elbow histological characteristics and the anatomical relationship with adjacent structures. Subsequently, we sought to assess the relationship between SP and clinical symptoms as well as magnetic resonance imaging (MRI) features in patients with chronic lateral epicondylitis. MRI was performed on eight cadaveric elbows specimens. The MRI findings were compared with those in anatomic sections and histologic preparations. In addition, ninety-nine patients with chronic lateral epicondylitis who underwent preoperative elbow MRI and arthroscopic surgery were included. The patients were divided into SP and without SP groups. The differences in clinical symptoms and MRI features between the two groups were compared. SP is located proximal to the annular ligament that extends into the joint cavity, then moves to the lateral collateral ligament (LCL) complex, and finally attaches to the lateral epicondyle of the elbow along with the common extensor tendon (CET). The SP, ligament, and tendon blend imperceptibly without distinct boundaries. Furthermore, in a study of patients with chronic lateral epicondylitis, we found that compared to the without SP group, patients in the SP group had higher preoperative and 3-week postoperative VAS scores and more severe abnormalities in LCL complex and CET. The SP is distinct from the annular ligament and closely correlates with the LCL complex and CET enthesis at the lateral epicondyle. Chronic lateral epicondylitis patients with SP have more severe abnormalities of the LCL complex and CET, more severe pain, and longer postoperative recovery times. Question Synovial plica (SP) cause lateral elbow pain, but few studies regarding histological and imaging features of SP and its relationship to chronic lateral epicondylitis exist. Findings The presence of SP leads to more severe common extensor tendon abnormalities and higher visual analog scale scores in patients with chronic lateral epicondylitis. Clinical relevance The combination of magnetic resonance imaging and clinical symptoms to further understand the effect of SP on the clinical symptoms and postoperative recovery in chronic lateral epicondylitis can help refine treatment strategies and improve the prognosis of patients.

Diagnostic performance of MRI-guided vacuum-assisted breast biopsy (VABB): an essential but still underused technique.

Magnetic resonance imaging (MRI)-guided vacuum-assisted breast biopsy (VABB) is an increasingly requested procedure, but it implies training and experience both in its execution and in determining radiological-pathological concordance and is therefore performed in dedicated breast centers. The purpose of this study is to evaluate the diagnostic performance of MRI-guided vacuum-assisted biopsy and to determine the upgrade rate after surgery or follow-up. We retrospectively evaluated all consecutive patients with suspicious MRI findings without corresponding mammographic and ultrasonographic findings who underwent MRI-guided vacuum-assisted breast biopsy (VABB) at our Institution from November 2020 to March 2023. We determined the sensitivity (SE), specificity (SP), positive predictive value (PPV), negative predictive value (NPV) and accuracy of the procedure; we also assessed upgrade rate to malignancies using surgery or at least 1-year negative follow-up as reference standard. Fisher's exact test was used to evaluate the correlation between enhancement size and type (mass/non-mass) and histological outcomes. A total of 121 patients with 122 suspicious breast lesions have been included. 29.5% (n = 36) of these lesions were classified as malignant (B5), 23% (n = 28) were lesions with uncertain malignant potential (B3 lesions), and 47.5% (n =58) were benign (B2). Among B5 lesions, 47.22% (n =17) were ductal carcinomas in situ (DCIS) and 52.77% (n =19) were invasive carcinomas. Among patients with already diagnosed breast cancer (n = 36), MRI-guided VABB identified additional foci of disease in 36.1% (n = 13) of the cases, specifically 10 foci on the same breast and 3 in the contralateral breast. Accuracy of MRI-guided VABB was 96.7%, SE was 90%, SP was 100%, PPV was 100%, and NPV was 95.3%. 4 benign lesions (B2 and B3) were upgraded to B5 lesions after surgery or follow-up; the upgrade rate to malignancies was 3.28%. Fisher's exact test showed a significant association between enhancement size and histological outcomes (OR = 2.38, p = 0.046), while enhancement type was not significantly correlated (OR = 0.88, p = 0.841). No major complications have been reported. MRI-guided VABB has proven to be a mini-invasive, safe, and accurate procedure for the diagnostic work-up of suspected breast lesions, which can help in the management of patients aiding in the correct surgical decisional process.

MRI Findings in Demyelinating Diseases of the Central Nervous System

Demyelinating diseases of the brain represent a complex group of neurological disorders characterised by the destruction of the myelin sheath surrounding nerve fibres, which disrupts neural transmission and leads to a wide range of neurological deficits1 . This article reviews the pathophysiology, radiologic features, and diagnostic criteria of key demyelinating disorders, including Multiple sclerosis (MS), Neuromyelitis optica, Myelin oligodendrocyte glycoprotein antibody-associated disease (MOGAD), Tumefactive demyelinating lesions, Acute necrotizing encephalopathy, and Krabbe disease. Advanced imaging techniques, particularly Magnetic resonance imaging (MRI), play a crucial role in the identification and differentiation of these diseases. Key MRI findings, such as T2-weighted hyperintense lesions in specific brain regions, contrast enhancement patterns, and lesion evolution, aid in diagnosis and disease monitoring. Radiologists play a vital role in early diagnosis, monitoring treatment response, and detecting complications, thereby guiding clinical management and improving patient outcomes in demyelinating brain diseases.

Hypoxic brain damage in Methadone misuse: insights from MRI imaging and comparative study.

This study aimed to investigate the potential presence of brain disorders, particularly hypoxia, via magnetic resonance imaging (MRI) in patients misusing methadone, with a comparison to regular opium users and a control group. Conducted as a cross-sectional comparative study at Kamali Hospital in Karaj, Iran, the research included male participants comprising methadone users, opium users, and controls. Inclusion criteria were stringent, focusing on substance use duration and absence of brain structural disorders. MRI scans were performed using a 1.5T MRI scanner. Qualitative MRI assessments and chi-square tests analyzed associations between substance use and hypoxia, while logistic regression examined potential confounding variables. Significant hypoxia was observed in the methadone group (16.7%, 5/24; p = 0.00057), with no cases in the opium or control groups. Logistic regression analysis showed no significant predictors of hypoxia regarding dose and duration of use. MRI findings in methadone users with hypoxia included varied ADC intensities, high signal intensities on T2-weighted and diffusion-weighted imaging (DWI) sequences, and angiogenesis patterns on TOF sequences. The co-use of methadone and alcohol was noted in three of the five hypoxia cases. Methadone misuse, particularly with alcohol, poses a significant risk of hypoxia, detectable via MRI. This study underscores the need for routine MRI monitoring, stricter regulation of non-prescribed methadone, and enhanced public health education to mitigate misuse risks. Future research should expand sample sizes and incorporate advanced imaging techniques to further elucidate methadone's neurological impact.

Prenatal imaging - role of fetal MRI.

Congenital abnormalities occur in about 3 in 100 fetuses. Prenatal ultrasound is the standard technique to detect these fetal abnormalities. In Germany, three ultrasound examinations are provided in the first, second, and third trimesters, respectively. Fetal magnetic resonance imaging (MRI) can be used as an adjunct technique to provide further information in cases of congenital abnormalities.A literature search was performed on PubMed focusing on publications that used fetal MRI as a secondary approach after prenatal ultrasound.MRI is a safe imaging method that does not harm the fetus when used during pregnancy. Some publications with experts in radiology show a very clear diagnostic advantage with respect to performing MRI on fetuses with brain abnormalities, while other publications with experts in neurosonography do not find the advantage to be that evident. Both techniques are clearly user-dependent.Fetal MRI can supplement the information obtained by fetal ultrasound and can provide additional information or exclude others. Diagnosis made by an interdisciplinary cooperation based on all available ultrasound and MRI findings is the key to optimal imaging and advice for expectant parents. · Fetal MRI poses no risk for the fetus.. · MRI aids prenatal ultrasound in the evaluation of prenatal findings.. · Tavares de Sousa M, Schönnagel BP, Denecke J et al. Prenatal imaging - role of fetal MRI. Fortschr Röntgenstr 2024; DOI 10.1055/a-2357-6997.

Magnetic resonance imaging findings of cerebral venous malformations.

Our study aimed to evaluate the incidence and anatomical locations of cerebral venous malformations (CVMs), their alterations over time, and magnetic resonance imaging (MRI) findings of their relationships with each other in patients who underwent magnetic susceptibility-weighted imaging (SWI) and contrast-enhanced MRI. The drainage pattern of developmental venous anomalies (DVAs), the number of collecting veins, DVA thrombosis, signal-intensity abnormalities, and hemosiderin deposits (nodular, diffuse, or both) related to the DVA, were examined. The alterations over time in cavernomas (type and size) were assessed. The study evaluated 7,826 patients who had 8,957 magnetic SWIand contrast-enhanced brain MRIs. A total of 643 CVMs were detected in 520 patients. The frequencies of DVAs, cavernomas, and capillary telangiectasias were 5.26%, 1.28%, and 0.62%, respectively. Isolated DVAs were detected in 430 (71.5%), cavernomas in 77 (12.8%), and capillary telangiectasias in 52 (8.7%) cases of CVMs. The coexistence of DVA with cavernoma and DVA with capillary telangiectasia was found in 38 (6.3%) and 4 (0.7%) cases, respectively. DVA drainage was largely provided by a single collecting vein. Signal-intensity abnormalities associated with the DVA were observed in 7, and two patients had DVA thrombosis. Hemosiderin deposits were nodular in 14 cases, diffuse in three, and both nodular and diffuse in two. In a follow-up of 11 (7.8%) cavernomas, alterations in the type and size were detected. It is not uncommon for cavernomas to become symptomatic owing to alterations in their nature, size, and type over time, while DVAs rarely become symptomatic. Capillary telangiectasias are vascular malformations that tend to remain stable in terms of clinical and imaging features, and those with supratentorial localization are detected more frequently in the frontal lobe. On magnetic susceptibility sequences, hemosiderin deposits can be seen in the GVA region, not rarely but more frequently in nodular form, as well as in diffuse or nodular or diffuse and nodular forms.

Longitudinal Imaging Biomarkers Correlate with Progressive Motor Deficit in the Mouse Model of Charlevoix-Saguenay Ataxia.

In autosomal recessive spastic ataxia of Charlevoix-Saguenay (ARSACS) disease, severity and age of onset vary greatly, hindering to objectively measure and predict clinical progression. Thickening of the retinal nerve fiber layer is distinctive of ARSACS patients, as assessed by optical coherence tomography, whereas conventional brain magnetic resonance imaging findings include both supratentorial and infratentorial changes. Because longitudinal imaging studies in ARSACS patients are not available to define these changes as biomarkers of disease progression, we aimed to address this issue in the ARSACS mouse model. We performed longitudinal retinal OCT and brain MRI in the Sacs-/- ARSACS mouse model, alongside motor and coordination assessment in the beam walking test. We also investigated visual function and the molecular mechanisms underlying RNFL increased thickness by histology and immunofluorescence. We demonstrated that RNFL thickening by OCT gradually increases in the early stages of pathology in the Sacs-/- mouse model, reflecting the progression of motor impairment, and later reaches a plateau when thinning of the posterior corpus callosum becomes detectable by MRI. Mechanistically, we unveiled that RNFL thickening is associated with aberrant accumulation of non-phosphorylated neurofilament H and glial fibrillary acidic protein. We also uncovered mild signs of myelin pathology coherent with increased latency of visual evoked potentials, and altered retinal activation by photopic electroretinography. We show that both RNFL thickening and MRI changes may represent biomarkers of disease progression in the Sacs-/- mouse model. Our data gathers knowledge instrumental to clinical studies, holding potential as readout for treatment efficacy. ANN NEUROL 2024.

Correlation between MRI findings and functional outcomes in patients with calf muscle strain injuries: a retrospective study on 78 patients

BackgroundCalf muscle strain injuries (CMSI), also known as “tennis leg,” are frequently observed in middle-aged and physically active people, including non-professional athletes. While magnetic resonance imaging (MRI) is frequently used to assess the extent of these injuries, the relationship between MRI findings and long-term functional outcomes in non-athletic populations remains underexplored. This study aimed to investigate the correlation between MRI-detected injury severity and functional outcomes using the Achilles Tendon Rupture Score (ATRS) and the Tegner Activity Scale (TAS).MethodsA retrospective review was conducted on 78 non-athletic patients diagnosed with CMSI and were followed for an average of 25.6 ± 16.1 months. Injury severity was classified into three grades: Grade 1 (edema without architectural disruption), Grade 2 (partial muscle disruption with hematoma), and Grade 3 (complete muscle disruption or tendon detachment) based on MRI examination. The functional outcomes were assessed using the ATRS and TAS. A simple linear regression analysis was conducted to assess the impact of demographic variables and MRI findings on ATRS.ResultsThe mean ATRS at the final follow-up was 92.9 ± 10.6, with 75.6% of patients achieving an excellent outcome. Despite the excellent ATRS scores, a notable reduction in TAS was evident from the pre-injury assessment (4.4 ± 1.2) to the final follow-up (3.8 ± 1.3; p < 0.001). Moreover, 44.9% of patients did not resume their pre-injury activity levels. The regression analysis demonstrated no statistically significant correlation between MRI-detected injury severity, demographic factors (age, gender, BMI), and ATRS outcomes (R² = 0.094, adjusted R² = -0.011).ConclusionMRI-detected injury severity does not significantly predict long-term functional outcomes in patients with CMSI, even though most patients achieved excellent ATRS scores. However, nearly half of the patients did not return to their pre-injury activity levels. These findings suggest that additional factors might influence recovery, and further research is needed to elucidate these factors in non-athletic patients.Level of evidenceLevel IV, Retrospective case series.

Anatomical neuromuscular variations determined by magnetic resonance imaging in chronic pelvic pain

Background: The diagnosis of neuromuscular pelvic pain is challenging. Despite the increasing use of magnetic resonance imaging (MRI) in the assessment of pudendal neuralgia, there are limited data describing radiological variations of the nerve. Additionally, the utility of MRI in the assessment of pelvic floor tension myalgia is unknown. Aims: To describe the anatomical variations of the pudendal nerve and dimensions of pelvic muscles in patients investigated for neuromuscular pelvic pain using a combined MRI protocol. Materials and methods: A retrospective audit of MRI reports for 136 patients referred to a single radiologist was conducted. Reported data included the appearances of the pudendal nerve and its perineural structures, and the maximal thicknesses of pelvic muscles. Results: Several anatomical variations were identified in the course of the pudendal nerve at or above the ischial spine. Likely/highly likely nerve compression at this level was present in 34.6% of hemipelves. Variations associated with compression included delayed separation of the sacrospinous and sacrotuberous ligaments ( p &lt; 0.0001), close apposition of ligaments ( p &lt; 0.0001), interligamentous bands ( p = 0.033), coccygeal muscle contributions to the sacrospinous ligament ( p = 0.014) and proximal ( p &lt; 0.0001) and thickened falciform ligaments ( p &lt; 0.0001). Variations below the ischial spine were uncommon. Conclusions: This study represents a quantitative and qualitative expansion to the radioanatomical basis of pudendal nerve entrapment on MRI, and highlights the limitations of MRI obtaining reproducible measurements of pelvic muscles. Images from asymptomatic controls and further prospective evaluation of treatment outcomes is required to determine the clinical significance of MRI findings in the assessment of pudendal neuralgia.

Seizure outcomes and associated factors in adults with unilateral mesial temporal lobe epilepsy undergoing surgery

ObjectiveTo analyze postoperative seizure outcomes and factors associated with unfavorable seizure control (Engel III-IV) in adults with drug-resistant unilateral mesial temporal epilepsy who underwent temporal lobectomy. MethodsThis was an observational, longitudinal, and retrospective study. A descriptive analysis of sociodemographic, clinical, and paraclinical characteristics was performed. The incidence rate of inadequate seizure control was calculated, and a Kaplan-Meier curve was reported. Cox regression analysis was conducted to identify factors associated with unfavorable outcomes. ResultsA total of 285 patients were included, 56.4% were women, and 49.12% underwent standard temporal lobectomy. Engel I were achieved in 70.87% of patients, while 6.31% experienced postsurgical complications. The estimated incidence rate of unfavorable outcomes was 3.87 cases per 100 person-years (95% CI: 3.51-4.27). Cox regression analysis indicated that patients with a temporal functional deficit zone, as identified by neuropsychological testing, had a 55.34% lower risk of an unfavorable outcome (adjusted HR: 0.4466, 95% CI: 0.236-0.854) compared to those with non-conclusive or extratemporal deficits. Concordance between video-electroencephalogram and brain magnetic resonance imaging findings in patients with right-sided lesions was also a protective factor (adjusted HR: 0.1868, 95% CI: 0.06-0.578). Discontinuation of anti-seizure treatment significantly increased the risk of an unfavorable outcome (adjusted HR: 6.718, 95% CI: 3.309-13.64). ConclusionTemporal lobe epilepsy surgery can achieve long-term seizure control in a significant proportion of patients. Neuropsychological assessment and concordance between MRI and video-EEG are essential presurgical factors for favorable outcomes. Additionally, patients should continue with antiepileptic treatment post-surgery to prevent seizure recurrence.

Impact of postoperative cauda equina clumping on recovery after biportal endoscopic decompression for severe lumbar stenosis.

This study determined the prevalence of cauda equina clumping among patients with Schizas grade C or higher central stenosis after decompression and compared the radiographic and clinical outcomes between patients with and without clumping. We conducted a single-center retrospective cohort study involving 98 patients who underwent biportal endoscopic spine surgery between January 2019 and June 2022. Based on postoperative magnetic resonance imaging findings, the patients were divided into the clumping (n = 40) and non-clumping (n = 58) groups. Clinical outcomes were assessed using the visual analog scale for back and leg pain, Oswestry Disability Index (ODI), and EuroQol 5-Dimension (EQ-5D-5L) questionnaire at 1, 3, 6, and 12 months postoperatively. Radiographic evaluations included measuring the cross-sectional area of the dural sac preoperatively and 1 month postoperatively using the PACS software. Postoperative cauda equina clumping was observed in 40.8% of the patients. Despite an average dural sac expansion of approximately 270%, the clumping group exhibited significantly higher radiating pain at 3 and 6 months (p < 0.05) than the non-clumping group. The ODI and EQ-5D scores were worse in the clumping group at 3 months (p < 0.05). At 12 months postoperatively, differences in clinical outcomes between the two groups were not significant. Patients in the clumping group required longer duration of postoperative medication than those in the non-clumping group (p = 0.024). Post-decompression cauda equina clumping is commonly observed in patients with severe lumbar stenosis and impacts intermediate-term clinical recovery. Although long-term outcomes at 1 year are similar, tailored postoperative care is essential for patients exhibiting clumping to effectively manage prolonged symptoms.

First case of mucormycosis (Rhizopus nigricans) in a cat

AbstractRhizopus nigricans is a species of fungus responsible for opportunistic mucormycotic infections in immunosuppressed subjects. Sparse reports of mucormycosis exist in veterinary literature; however, central nervous system involvement, resulting from R. nigricans infection has not been discussed. This report describes an 8‐year‐old, male, neutered Ragdoll with fungal meningoencephalitis secondary to intracranial colonisation of R. nigricans. Clinical signs were indicative of multifocal disease affecting the forebrain/cerebellum, and were characterised by abnormal mentation, compulsive circling, menace deficits and hypermetria. Fungal encephalitis was suspected based on magnetic resonance imaging findings and brain histology, with the diagnosis reached following postmortem examination, subsequent culture and polymerase chain reaction sequencing. This is the first report of cerebral mucormycosis in a feline patient that discusses the clinical, diagnostic and histopathological test findings.

Optimization of Extended Pelvic Lymph Node Dissection Side for Prostate Cancer.

This study aimed to show the association between tumor location and laterality of positive lymph nodes by evaluating biopsy and magnetic resonance imaging (MRI) findings, and to optimize the extended pelvic lymph node dissection (ePLND) side for prostate cancer. The study enrolled patients who underwent robot-assisted radical prostatectomy with ePLND. Tumor locations were determined according to International Society of Urological Pathology grade group 4/5 in biopsies and Prostate Imaging-Reporting and Data System category 4/5 in MRI results. The concordance of tumor location lobe and positive lymph node side with the performance of tumor location-guided ePLND for positive lymph node detection was evaluated. For 301 patients who underwent ePLND at Kyushu University Hospital, tumor locations determined by biopsy and MRI findings showed no lesion in 8 (2.7%) patients, unilateral lobe in 223 (74.1%) patients, and bilateral lobe in 70 (23.3%) patients. The accuracies for detection of any and all positive lymph nodes by tumor location-guided unilateral ePLND were 99.6% and 97.3%, respectively. Among the patients at St. Luke's International Hospital, the accuracies for detection of any and all positive lymph nodes by tumor location-guided unilateral ePLND were estimated to be 99.0% and 97.3%, respectively. This study proposed tumor location-guided ePLND according to biopsy and MRI findings. This novel strategy is expected to reduce the burden of bilateral ePLND at the cost of acceptable risk of failing to detect positive lymph nodes.

Magnetic resonance imaging (MRI) and clinical features of different parts of the pancreas involved in acute pancreatitis: a cross-sectional study.

Patients with acute pancreatitis (AP) have different sites of pancreatic involvement. The aim of this study was to investigate the differences in magnetic resonance imaging (MRI) findings and clinical features of different sites of involvement (subtypes) in AP, with a view to complement and complete the classification of AP based on anatomical imaging features. We consecutively collected data from inpatients with AP from January 2018 to October 2022 at a tertiary care hospital. The patients with AP were classified into three subtypes by MRI: type I mainly involved the head of the pancreas; type II mainly involved the body and tail of the pancreas; and type III involved the entire pancreas (head, body, and tail simultaneously). We examined the MRI findings and clinical features of the three subtypes, including their prevalence, gender, etiology, age, assessment of severity, prevalence of hypertension, diabetes mellitus, coronary artery disease, laboratory markers, prognosis, necrosis, and the incidence of complications. The three subgroups were analyzed using one-way analysis of variance (ANOVA), Kruskal-Wallis H-test, Chi-squared test or Fisher's exact probability method depending on the data distribution, and logistic regression and linear regression were used to determine the risk factors for poor short-term prognosis of AP and the number of days in hospital. Results were considered statistically significant at P<0.05. Among the 240 patients recruited, the mean age was 51±15 years (range, 12-89 years); 146 (60.83%) were male and 94 (39.17%) were female. Biliary pancreatitis accounted for 45.00% (108/240), hyperlipidemic pancreatitis for 33.75% (81/240), alcoholic pancreatitis for 8.75% (21/240), and unknown etiology for 12.5% (30/240). Some 81.25% (195/240) of the cases were edematous pancreatitis, whereas 18.75% (45/240) were necrotizing pancreatitis. Overall, 75 patients (31.25%) had type I AP, 108 patients (45.00%) had type II AP, and 57 patients (23.75%) had type III AP. These three subtypes were significantly different in terms of etiology, incidence of diabetes, C-reactive protein (CRP), severity, incidence of necrosis, local complications, clinical and imaging severity scores, and prognosis (P<0.05). Total pancreatic involvement (Type III) was the most severe subtype, with hyperlipidemia as the main cause. Regression analysis revealed that subtype classification is an important risk factor for prognosis. We classified AP into three subtypes based on different sites of involvement and revealed the MRI features and clinical characteristics of each subtype of AP. The subtype classification helps to characterize AP from the imaging dimension and predict the prognosis. The results of this study could be a target for future studies to adopt new classification methods.

Diagnostic Accuracy of Magnetic Resonance Imaging in the Diagnosis of Anterior Cruciate Ligament Injury taking Arthroscopy as Gold Standard

Objective: To determine the diagnostic accuracy of magnetic resonance imaging (MRI) in the diagnosis of anterior cruciate ligament injury, using arthroscopy as the gold standard. Methodology: It was a descriptive, cross-sectional study that included 154 patients with suspected anterior cruciate ligament injury from the Department of Orthopaedics, Imran Idrees Teaching Hospital, Sialkot. All patients underwent arthroscopy and the presence or absence of ACL (anterior cruciate ligament) injury was noted. MRI findings were compared with arthroscopy findings. Results: Among the 94 MRI-positive patients, 88 (True Positive) had ACL injury while 06 (False Positive) had no ACLinjury on arthroscopy. Out of 60 MRI-negative patients, 08 (False Negative) had ACL injury on arthroscopy while 52 (True Negative) had no ACL injury. Overall sensitivity, specificity, PPV (positive predictive value), NPV (negative predictive value) and DA (diagnostic accuracy) of MRI in the diagnosis of ACLinjury, taking arthroscopy as the gold standard was 91.67%, 89.66%, 83.62%, 86.67% and 90.91% respectively. Conclusion: The study concluded that MRI is a very sensitive and precise diagnostic modality. It has significantly improved the ability to diagnose ACL injuries, allowing for more accurate and reliable assessments. Additionally, the use of MRI has been instrumental in reducing the number of purely diagnostic arthroscopies, thereby minimizing the need for invasive procedures and enhancing patient care. Keywords: Knee injury, Magnetic Resonance Imaging, Arthroscopy, Anterior cruciate ligament.

CNS Vasculitis in Autoimmune Disease: MR Imaging Findings and Correlation with Angiography.

CNS Vasculitis in Autoimmune Disease: MR Imaging Findings and Correlation with Angiography.

Magnetic resonance imaging (MRI) findings in pediatric epilepsy

Magnetic resonance imaging (MRI) findings in pediatric epilepsy

Spectrum of Intracranial Hemorrhages in Cerebral Venous Thrombosis: A Pictorial Case Series and Review of Pathophysiology and Management.

We aim to provide a pictorial representation of the broad spectrum of intracranial hemorrhages associated with cerebral venous thrombosis (CVT), emphasizing atypical locations and rare intracerebral hemorrhage (ICH) types. We also hypothesize the pathophysiology leading to atypical locations of the ICH in CVT and the outcomes with anticoagulation therapy. ICH complicates about 40% of cases with CVT and is known to cause various types of ICH, including subarachnoid hemorrhage (SAH) and subdural hemorrhage (SDH). A combination of hemorrhages is also reported. Patients with computed tomography and magnetic resonance imaging findings consistent with CVT examined between January 2011 and June 2014 were included in this retrospective review. Demographic and clinical data and imaging findings were reviewed with particular attention to the type and location of ICH and sinus involvement. Treatment details and 3-month outcomes, assessed using the modified Rankin Scale, were analyzed. Eleven patients (9 males), ranging in age from 22 years to 58 years, were included. The most common clinical presentations were headache (n = 8) and seizures (n = 7). Intraparenchymal hemorrhages were most common (n = 7), followed by SDH and SAH (n = 4), intraventricular hemorrhage (IVH; n = 3), and juxtacortical hemorrhage (n = 1). All patients who received anticoagulation therapy (n = 11) experienced complete resolution of their symptoms, and the median modified Rankin Scale was 0. The spectrum of intracranial hemorrhages seen in association with CVT is broad, encompassing atypical locations like basal ganglia, external capsule, and cerebellar hemispheres, and involves multiple intracranial compartments-IVH, SAH, and SDH. While SAH and SDH are seen with superior sagittal sinus thrombosis, ICH is common with lateral sinus thrombosis, and IVH with deep venous thrombosis.

MR imaging findings of hepatic pseudolymphoma: common and rare features.

MR imaging findings of hepatic pseudolymphoma: common and rare features.

Image characteristics of retained medullary cord in secondary neurulation arrest: an observational study

Retained medullary cord (RMC) is a recently defined term denoting closed spinal dysraphism arising from the failure of regression in secondary neurulation. Despite the acknowledgment of this condition, there needs to be more literature elucidating the radiologic manifestations of RMC. This study aimed to describe the MR imaging findings of RMC. A retrospective analysis was conducted on spinal MRI scans of pediatric patients with surgically confirmed RMC, from January 2014 to August 2023. The investigation focused on evaluating the following image characteristics: level and morphology of the cord-like structure (C-LS), the signal intensity in the far distal C-LS, nerve root-like structures originating from the C-LS, intradural fatty lesions, and arachnoid cysts. This study included 38 patients (19 girls, mean age 7.3 months) who showed a low-lying cord in all cases. The morphology of C-LS was either smooth tapered (50%) or hourglass with fusiform cystic dilatation (50%). The C-LS exhibited aberrant T2 hypointense signal compared to the juxta-proximal level. T2 hypointense signal vestigial nerves emanating from the C-LS and intradural fatty masses were observed (89.5%). Sacral arachnoid cysts in extradural location were identified in eight patients. The characteristic MR features of RMC revealed an extremely low-lying distal C-LS with smooth tapering or hourglass-shaped cystic dilatation of the caudal part, accompanied by an intradural fatty stalk and the aberrant signal vestigial nerve. This study suggests those radiologic findings can be RMC instead of the previously called terminal syrinx with low-lying conus.