Resonance Imaging Findings In Patients Research Articles

The correlation between left atrium voltage mapping and 3D late gadolinium enhancement cardiac magnetic resonance imaging findings in patients with known atrial fibrillation

Abstract Introduction The non-invasive cardiac magnetic resonance imaging-based late gadolinium enhancement (LGE-CMR) of the left atrium (LA) fibrosis distribution and degree can be utilized for preprocedural planning and real-time guidance of AF ablation. There is an ongoing discussion with somewhat conflicting results regarding the accuracy of LGE-CMR of the LA as compared with the invasive electroanatomical mapping (EAM). Earlier data mainly encompassed post-ablation patients with an EAM involving a relatively small number of acquired points. Aim To evaluate the accuracy of LGE-CMR-based LA fibrosis using the ADAS 3D LA software among ablation-naive AF patients as compared with EAM using the CARTO-3 navigation system. Methods Patients with non-permanent AF, naive to previous ablation/cardiac surgery, who underwent CARTO-based AF ablation with preceding LGE-CMR scan were selected for the study. The 3D substrate atrial maps were generated based on the LGE-CMR (CMR-fib) using the ADAS 3D LA software and the CARTO EAM (EAM-fib). A fibrosis threshold of 1.2-1.32 was established for the CMR-fib using the Image Intensity Ratio whereas a threshold of 0.2-0.5mV was applied for the EAM-fib. The two 3D-maps were assessed for fibrosis using anatomically synchronized quantitative point by point comparison. The EAM was set as the gold standard. Results The study included 26,777 points acquired from 17 patients (aged 65.8±7.92 yrs with 6 females and 10 paroxysmal AF cases). CMR-fib showed 22.0% of LGE, while the EAM-fib demonstrated 48.8% of low voltage areas. The CMR-fib vs. EAM-fib point by point comparison concluded with an agreement of 73.1% and interrater reliability of 0.45 (p<0.001). The sensitivity and specificity were 45.0% and 99.9%, respectively, while the PPV and NPV were 99.8% and 65.6%, respectively. The Area Under the Curve (AUC) was calculated as 72.4. Increase of the EAM-fib threshold for scar (to 0.5-1.5mV) led to a further decrease in the assessment diagnostic performance and the interrater reliability. The lowest agreement was tested in the LA roof segments and the higher in the inferoseptal and posterior walls. Conclusion The LGE-CMR underestimates the presence of scar as presented by the EAM, however, those detected are mostly accurate. The low sensitivity that was demonstrated between the two methods may be attributed to the lower spatial resolution of the CMR as well as the superficial subendocardial layer mapped by EAM as compared with the averaged transmural mapping of the CMR-fib. A follow-up larger-scale study is required to assess the accuracy of LGE-CMR-based assessment of fibrosis, considering various wall thicknesses and establishing the scar threshold on the ADAS software, particularly for ablation-naive patients.

Magnetic resonance imaging findings in patients with dropped head syndrome

BackgroundDropped head syndrome (DHS) is difficult to diagnose only by clinical examination. Although characteristic images on X-rays of DHS have been studied, changes in soft tissue of the disease have remained largely unknown. Magnetic resonance imaging (MRI) is useful for evaluating soft tissue, and we therefore performed this study with the purpose of investigating the characteristic signal changes of DHS on MRI by a comparison with those of cervical spondylosis. MethodsThe study involved 35 patients diagnosed with DHS within 6 months after the onset and 32 patients with cervical spondylosis as control. The signal changes in cervical extensor muscles, interspinous tissue, anterior longitudinal ligament (ALL) and Modic change on MRI were analyzed. ResultsSignal changes of cervical extensor muscles were 51.4% in DHS and 6.3% in the control group, those of interspinous tissue were 85.7% and 18.8%, and those of ALL were 80.0% and 21.9%, respectively, suggesting that the frequency of signal changes of cervical extensor muscles, interspinous tissue and ALL was significantly higher in the DHS group (p < 0.05). The presence of Modic change of acute phase (Modic type I) was also significantly higher in the DHS group than in the control group (p < 0.001). ConclusionMRI findings of DHS within 6 months after the onset presented the characteristic signal changes in cervical extensor muscles, interspinous tissue, ALL and Modic change. Evaluation of MRI signal changes is useful for an objective evaluation of DHS.

Comparison of characteristics of muscle magnetic resonance imaging findings in patients with antineutrophilic cytoplasmic antibody-associated vasculitis and polyarteritis nodosa.

This study aimed to analyze the muscle magnetic resonance imaging (MRI) findings of patients with antineutrophilic cytoplasmic antibody-associated vasculitis (AAV) and polyarteritis nodosa (PAN) presenting with clinical symptoms in the extremities. Retrospective analysis was conducted on short tau inversion recovery MRI findings, with a focus on intramuscular vessels displaying abnormal perivascular signals, in 22 and eight patients with AAV and PAN, respectively. The number per unit area (4 cm2) and diameter of abnormal vessels on muscle MRI were compared between patients with AAV and those with PAN. Cut-off values, clinical sensitivity, and specificity for these indices were calculated from the receiver operating characteristic curves to distinguish between AAV and PAN, and the relationship between the indices and clinical findings in AAV was analyzed. The number of abnormal vessels per unit area was significantly higher in AAV compared to PAN (p < .05). Additionally, the diameter of the abnormal vessels was significantly higher in PAN than in AAV (p < .05). The presence of >6.44 abnormal vessels per unit area or ≤3.61 mm diameter of abnormal vessels was able to predict AAV (sensitivity, 0.955; specificity, 0.625). AAV patients with peripheral neuropathy exhibited a significantly higher number of abnormal vessels per unit area than those without peripheral neuropathy (p < .05). Muscle MRI can detect small- to medium-vessel vasculitis and be a valuable tool for distinguishing between patients with AAV and PAN experiencing clinical symptoms in the extremities.

Cardiac Magnetic Resonance Imaging Findings in Patients With Chronic Kidney Disease and End-Stage Kidney Disease: A Systematic Review and Meta-Analysis.

In this systematic review and meta-analysis, we explored the utilization of cardiac magnetic resonance imaging (CMR) to detect fibrotic changes secondary to uremic cardiomyopathy during the early stages of chronic kidney disease (CKD) and in patients with end-stage kidney disease (ESKD). Uremic myocardial fibrosis can lead to arrhythmia and heart failure, and it is important to detect these changes. CMR offers a noninvasive way to characterize the severity of cardiac remodeling. A comprehensive search of multiple electronic databases was conducted. Studies were divided according to scanner field strength (1.5 or 3 Tesla). The random effects model was used to calculate the pooled mean, 95% confidence interval (CI), standard error, and standardized mean difference (SMD). The I2 statistic was used to assess the heterogeneity between study-specific estimates. The search retrieved 779 studies. From these, 20 studies met the inclusion criteria and had 642 CKD patients (mean age of 56.8 years; 65.2% males; mean estimated glomerular filtration rate (eGFR) of 33 mL/min/1.73 m2) and 658 ESKD patients on dialysis (mean age of 55.6 years; 63.3% males; mean dialysis duration of 3.47 years). CKD patients had an increased left ventricular mass index (LVMi) compared to controls, with an SMD of 0.37 (95% CI: 0.20-0.54; I2 0%; p-value <0.05). ESKD patients also had increased LVMi compared to controls, SMD 0.88 (95% CI: 0.35-1.41; I2 79.1%; p-value 0.001). Myocardial fibrosis assessment using T1 mapping showed elevated values; the SMD of native septal T1 values between CKD and controls was 1.099 (95% CI: 0.73-1.46; I2 33.6%; p-value <0.05), and the SMD of native septal T1 values between ESKD patients and controls was 1.12 (95% CI: 0.85-1.38; I2 33.69%; p-value <0.05). In conclusion, patients with CKD and ESKD with preserved left ventricular ejection fraction (LVEF) have higher LVMi and T1 values, indicating increased mass and fibrosis. T1 mapping can be used for the early detection of cardiomyopathy and as a risk stratification tool. Large, randomized trials are needed to confirm these findings and determine the effect of long-term dialysis on cardiac fibrosis.

Magnetic Resonance Imaging Findings in Patients With Duane Retraction Syndrome.

Duane retraction syndrome (DRS) is known to relate to the absence of the abducens nucleus, with abnormal innervation of the lateral rectus (LR) muscle by branchesof the oculomotor nerve (CN III). The purposes of this study were to investigate the morphological characteristics of the oculomotor nerve (CN III), the abducens nerve (CN VI), and the extraocular muscles in patients with clinically diagnosed Duane retraction syndrome (DRS) using MRI. In addition, we assessed the association between ocular motility, horizontal rectus muscle volumes, and CN III/VI in patients with Duane retraction syndrome (DRS). The study comprised 20 orthotropic control subjects (40 eyes) and 42 patients with Duane syndrome (48 eyes), including 20 patients with DRS Type I (24 eyes), 5 patients with DRS Type II (6 eyes), and 17 patients with DRS Type III (18 eyes). Three-dimensional (3D) T1/2 images of the brainstem and orbit were obtained to visualize the cranial nerves, especially the abducens (VI) and oculomotor (III) nerves, as well as extraocular muscles. Based on the clinical classification, among 42 patients, MRI showed that the abducens nerves (CN VI) on the affected side were absent in 24 of 24 eyes (100%; 20 patients) with Type I DRS and in 16 of 18 eyes (88%; 16 patients) with Type III DRS. However, CN VI was observed in 6 of 6 eyes (100%; 5 patients) with Type II DRS and in 2 of 18 eyes (11%) with Type III DRS. CN III was observed in all patients. The oculomotor nerves on the affected side were thicker than those on the nonaffected contralateral side in DRS Type I ( P < 0.05) and Type III ( P < 0.05), but not in DRS Type II. Smaller LR and larger MR volumes were shown in the affected eye than that in the nonaffected eye in DRS Types I and III. Based on the presence or absence of CN VI, there was a tendency for thicker oculomotor nerves in the affected eye than in the nonaffected eye in the absence groups ( P < 0.05). However, no significant difference was found in the present group. In the CN VI absence groups, similar results were found in the affected eyes than in the nonaffected eyes as in DRS Types I and III. In addition, the presence of CN VI was correlated with better abduction ( P = 0.008). The LR and MR volumes have positive correlations with the oculomotor nerve diameter in the affected eye. However, there was no correlation between the range of adduction/abduction and the LR/MR ratio in patients with or without an abducens nerve. Different types of DRS have different characteristic appearances of CN VI and CN III on MRI. Horizontal rectus muscles have morphological changes to adapt to dysinnervation of CN VI and aberrant innervation of CN III. Thus, these neuroimaging findings may provide a new diagnostic criterion for the classification of DRS, improving the comprehension of the physiopathogenics of this disease.

Evaluation of clinical signs and magnetic resonance imaging findings in patients with temporomandibular disorders

This study assessed the relationship between clinical symptoms and magnetic resonance imaging (MRI) findings in temporomandibular disorders (TMD). A total of 324 temporomandibular joints (TMJs) from 162 patients were included. The TMJs were divided into three groups based on disc positions on MRI: normal disc position, anterior disc displacement with reduction (ADDwR), and anterior disc displacement without reduction (ADDwoR). Clinical findings included TMJ pain, TMJ noise, and maximum mouth opening (MMO). The disc configuration, disc positions, condylar morphology, and joint effusion were evaluated in proton density-weighted and T2-weighted open and closed-mouth sagittal sections. Patients comprised 135 females and 27 males, with a mean age of 37.63 ± 13.86 years. The VAS score was significantly higher in ADDwoR than in ADDwR (p = 0.007). Condylar sclerosis (β coefficient: 1.449, 95% confidence interval (CI): 0.505-2.393, p = 0.003) and condylar flattening (β coefficient: 1.024, 95% CI: 0.209-1.840, p = 0.014) had higher VAS scores than the other MRI findings in multiple regression analyses. Limited mouth opening (MO) was independently associated with ADDwoR. ADDwoR had a higher risk of having limited MO than normal disc position (odds ratio: 5.268), while there were no associations between limited MO and other MRI findings. None of the MRI findings showed significant performance in predicting TMJ noise. The convex and folded disc configuration percentages, the frequencies of osteophyte formation, and grade 3 effusion were significantly higher in the ADDwoR group. More severe clinical symptoms and a higher degree of disc deformity, osteophyte formation, and high-grade effusion were shown to be associated with ADDwoR.

Frequency Of Magnetic Resonance Imaging Findings In Patients With Lower Back Pain

Aims and objectives: To assess the MRI findings in patients who had lower back pain. Lower back pain affects most of the adults at some time in their lives. Background: The most common anomaly is lumbar disc degeneration, which can be caused by degenerative disc changes, narrowing of spaces in lumber spinal, cancer, infection, or trauma. In the evaluation of patients with lower back pain, Magnetic Resonance Imaging (MRI) has been the best modality to determine because this one is radiation free, non-invasive imaging modality with great both resolution (spatial and contrast).[1] Goal of this research was to find out the findings on MRI in patients who had lower back pain. Methods: This Descriptive cross-sectional study a total of 63 patients was conducted at the Radiology Department of Punjab Diagnostic Centre, Gujranwala, who had a lumbar spine MRI for severe and persistent lower back pain, radiculopathy, claudication (neurogenic) , or other symptoms and indications that could indicate low back discomfort. The age range of patients was 16 to 68 years. Non-contrast MRI scans was done. SPSS was used for statistical analysis. Magnetic Resonance Imaging (MRI) scan findings for patients who had lower back pain were determined.&#x0D; Results: Out of 63 patients there were (57.1%) 36 male patients and (42.9%) 27 female patients participated in this study. In Lumber spine straightening out of 63 patients in which there 23 patients (63.5%) noted (10) female and (13) male respectively. In 40 cases, the most well-known category was disc bulging at the L4/L5 level (63.4 percent) and L5/S1level was noted in 31 cases (49.1%) followed by L3-L4 level was noted in 11 cases (17.5%) in order of decreasing frequency. And Disc herniation was seen at total 16 patients (25.4percent) respectively. Disc herniation was more common at L4/L5 level. Disc desiccation was the most well-known category at L5/S1 in 35 cases (55.6%), L4/L5 level was noted in 24 cases (38.1%), L3/L4 level was noted in 14 cases (22.2%) and L2/L3 was noted in 7cases (11.1%) in order of decreasing frequency. Indentation of anterior theca was observed in 41.3% (26) of the total cases. In 76.2% (48) patients compression of the nerve root was seen out of total cases. Stenosis of the spinal canal was seen in 38.1% (24) out of the total cases.

Chronic stage magnetic resonance imaging findings in patients with shoulder injury related to vaccine administration (SIRVA)

PurposeIdentify chronic shoulder MRI findings in patients with known shoulder injury related to vaccine administration (SIRVA).Materials and methodsTwo fellowship-trained musculoskeletal radiologists retrospectively reviewed the MRI of nine patients with clinically established SIRVA. MRI was performed at least 4 weeks after vaccination and included intravenous contrast-enhanced sequences. MRI was reviewed for the presence of erosions, tendonitis, capsulitis, synovitis, bone marrow oedema, joint effusion, bursitis, cartilage defects, rotator cuff lesions, and lymphadenopathy. The number and location of focal lesions were recorded.ResultsErosions of the greater tuberosity were present in 8/9 (89%), tendonitis of the infraspinatus muscle tendon in 7/9 (78%), capsulitis, synovitis, and bone marrow oedema in 5/9 (56%) cases, respectively. Effusion was found in three, and subdeltoid bursitis, rotator cuff lesions as well as cartilage defects in one patient, respectively. None of our included subjects showed axillary lymphadenopathy.ConclusionIn this case series, greater humeral tuberosity erosions, infraspinatus muscle tendonitis, capsulitis, synovitis, and bone marrow oedema were common MRI findings in chronic SIRVA.

Endplate and Facet Joint Changes in Cervical Spondylotic Myelopathy

Modic changes (MC) of the vertebral endplates and facet joint degeneration are common causes of neck pain. No previous study has shown the prevalence of and relationship between MC and facet joint changes in cervical spondylotic myelopathy (CSM). The objective of this article was to study the endplate and facet joint changes in CSM. Magnetic resonance imaging of the cervical spine in 103 patients with CSM was retrospectively evaluated. The scans were evaluated by 2 raters, who classified spinal segments according to the Modic classification and the degree of facet degeneration. In patients <50 years old, there were no MC in 61.5%. In patients with MC, Modic type II at C4-C5 was observed most frequently. MC were found in 71.4% of patients ≥50 years old. In patients with MC, Modic type II at C3-C4 was observed most frequently. Degenerative changes of the facet joints were found frequently in both patients <50 years old (77.5%) and patients ≥50 years (90.2%), and grade I degeneration was observed most frequently in both groups. There was a significant correlation between MC and facet joint changes. MC in the cervical spine are common magnetic resonance imaging findings in patients with CSM ≥50 years old. Degenerative facet joint changes are found in the majority of patients with CSM regardless of age. We found a significant correlation between MC and facet joint changes at the same level, indicating that both imaging findings are involved in a common pathophysiological pathway.

Correlation of clinical signs and magnetic resonance imaging findings in patients with lumbar spondylosis.

The purpose of the study was to contribute further to this debated topic by investigating the correlation of magnetic resonance imaging (MRI) findings with the clinical picture in lumbar spondylosis patients. This multicenter retrospective study (as part of the epidemiological project of the TLAR-OASG [Turkish League Against Rheumatism-Osteoarthritis Study Group]) included 514 patients (101 males, 413 females; mean age: 63.6±10.8 years; range, 40 to 85 years) who were diagnosed as lumbar spondylosis by clinical examination and direct X-ray between December 2016 and June 2018. Demographic characteristics of patients, Visual Analog Scale for pain, presence of radiating pain, Roland-Morris disability questionnaire, straight leg raise test, deep tendon reflexes, neurogenic intermittent claudication symptoms, any decrease of muscle strength, and abnormality of sensation were recorded. Lumbar MRI findings of the patients were recorded as positive or negative in terms of disc herniation, intervertebral disc degeneration, root compression, osteophytes, spinal stenosis. Statistical analysis was done to assess the correlation between the clinical symptoms, physical examination, and MRI findings. Correlation analysis of the MRI results and the clinical findings showed a significant correlation between straight leg raise test and root compression (p<0.001, r=0.328) and a significant correlation between neurogenic intermittent claudication and spinal stenosis (p<0.001, r=0.376). Roland-Morris disability questionnaire had a significant correlation with all MRI findings (p<0.05, r<0.200). The results of this study corroborate the notion that diligent patient history and physical examination are more valuable than MRI findings, even though a higher incidence of abnormal MRI findings have been obtained in patients with disability and dermatomal radiating pain.

New magnetic resonance imaging findings in patients with polymyalgia rheumatica

New magnetic resonance imaging findings in patients with polymyalgia rheumatica

Incidental Lumbar Spinal Magnetic Resonance Imaging Findings of Patients with a Prediagnosis of Degenerative Spinal Disease

Incidental Lumbar Spinal Magnetic Resonance Imaging Findings of Patients with a Prediagnosis of Degenerative Spinal Disease

Magnetic Resonance Imaging Findings in Patients with Tarsal Tunnel Syndrome.

Tarsal tunnel syndrome (TTS) is a common entrapment syndrome whose diagnosis can be difficult. We compared preoperative magnetic resonance imaging (MRI) and operative findings in 23 consecutive TTS patients (28 sides) whose mean age was 74.5 years. The 1.5T MRI sequence was 3D T2* fat suppression. We compared the MRI findings with surgical records and intraoperative videos to evaluate them. MRI- and surgical findings revealed that a ganglion was involved on one side (3.6%), and the other 27 sides were diagnosed with idiopathic TTS. MRI visualized the nerve compression point on 23 sides (82.1%) but failed to reveal details required for surgical planning. During surgery of the other five sides (17.9%), three involved varices, and on one side each, there was connective tissue entrapment or nerve compression due to small vascular branch strangulation. MRI studies were useful for nerve compression due to a mass lesion or idiopathic factors. Although MRI revealed the compression site, it failed to identify the specific involvement of varices and small vessel branches and the presence of connective tissue entrapment.

Comparison of magnetic resonance imaging findings in patients with intermittent closed lock and acute closed lock of the temporomandibular joint: a cross-sectional retrospective study.

This study aimed to estimate the disc status in intermittent closed lock (ICL) and permanent closed lock (CL) temporomandibular disorders (TMDs) to test the hypothesis that the disc morphology and degree of anterior disc displacement affect the outcomes of these disorders. All patients were clinically examined according to the Diagnostic Criteria for Temporomandibular Disorders Axis I protocol, and magnetic resonance imaging (MRI) confirmed ICL and CL. Fifty-six joints of 56 patients with ICL and 110 joints of 110 patients with acute CL with a locking period of less than 3months were included. Patients with acute CL were further classified into two groups: those with CL that could be successfully manipulated (CLs group) and those with acute CL without the possibility of unlocking (CLu group). MRI was used to assess the degree of anterior displacement, lateral displacement of the disc, disc deformity, and joint effusion. MRI findings were compared among the joints in the ICL, CLs, and CLu groups. The degree of anterior displacement and disc deformity prevalence significantly differed among the ICL, CLs, and CLu groups. No significant intergroup differences were observed in terms of lateral displacement or joint effusion. These results suggest that anteriorly displaced discs and deformation of discs associated with TMD progression affect disc reducibility.

A study of magnetic resonance imaging findings in patients with encephalopathies in pediatric age group

Introduction: Magnetic resonance (MR) imaging is used with increasing frequency to evaluate the child and neonatal brain because it can provide important diagnostic and prognostic information that is needed for optimal treatment and appropriate counselling. Moreover, to accurately interpret the findings, specific knowledge is needed about the normal MR imaging appearances of the physiologic processes of myelination, cell migration and sulcation, as well as patterns of injury, in the neonatal brain at various stages of gestational development. Materials and Methods  Inclusion Criteria: Patients of pediatric age group (neonate to 14 years of age) having seizure and confusion, undergoing magnetic resonance imaging for suspicion of encephalopathy and diagnosed as the same in magnetic resonance imaging.  Exclusion Criteria: Patients with central nervous system pathologies other than encephalopathies. Patients having metallic implants and pacemaker. Patients having claustrophobia.  Study type: Retrospective study (Record based study) Results and Conclusion: In the study, most common type of encephalopathy was hypoxic-ischemic encephalopathy (48.7%) followed by hypoglycemic encephalopathy (36.5%) followed by metabolic encephalopathy. Out of 20 patients having MRI findings of HIE, 60% patients had diffusion restriction and FLAIR hyperintensity predominantly in basal ganglia region. Out of 15 patients having hypoglycemic encephalopathy, 66.6% patients had restricted diffusion predominantly in cerebral cortex. Out of 6 patients having metabolic encephalopathy, 66.6% patient had restricted diffusion predominantly in centrum semiovale. Despite recent advances in the MR imaging–based characterization of these conditions clinical history must be reviewed carefully for information that may helpful identify the cause of injury.

Clinical and magnetic resonance imaging findings in patients with and without improvement after mandibular manipulation and conservative physical therapy for temporomandibular joint disorders

This study compared clinical and magnetic resonance imaging (MRI) findings in patients with anterior disk displacement without reduction (ADDWOR) who improved to anterior disk displacement with reduction (ADDWR) vs. patients who did not improve after mandibular manipulation (MM) and conservative self-administered physical therapy (CSAPT). Of 15 patients diagnosed with ADDWOR by MRI, 7 improved to ADDWR (WOR-WR) and 8 did not improve (WOR-WOR). The clinical and MRI findings before and after therapy were compared in each group. Significant differences between the groups included age, period of awareness of trismus, and maximum mouth opening (MMO). The MRI findings revealed significant differences in the degree of ADD and morphology of the disk and condyle. MMO significantly improved in the WOR-WR group between initial and follow-up visits. Patients who were successfully treated with MM and CSAPT tended to be <30 years old, with a longer period of awareness of trismus, MMO <40 mm, a slight or moderate degree of ADD, no deformity of the disk, and no morphologic change in the condyle. Patients with ADDWOR who are treated with MM and CSAPT require an accurate clinical examination and MRI before treatment.

Magnetic Resonance Imaging Findings in Patients with Low Back Pains and its Associations with Demographic Variables and Body Mass Index in Onitsha Nigeria

Background: Low back pain (LBP) is arguably the most prevalent musculoskeletal condition found among both developed and developing nations. This study was designed to evaluate the MRI findings in patients with LBP and its association with the patients' age, gender, and anthropometric variables in Onitsha, Anambra State, Nigeria. Materials and Methods: This was a retrospective cross-sectional study carried out from June 2021 to August 2021 at the MRI unit of the radiology department of a private diagnostic center in Onitsha Anambra state, Nigeria. A total of 76 MRI reports were selected based on the inclusion criteria of this study, which include reports with LBP clinical indication, radiological findings, and complete patient demographic (age and gender) and anthropometry (weight and height) variables. Results: The majority 42 (53.3%), were males when compared with their female counterparts 34 (44.7%). A greater number, 22(28.9%) of the patients were within the age bracket of 51-60 years, and the least 2(2.6%) were within the age group of 21-30 years. Most 29(38.12%) of the patients had degenerative disc disease, and the least 2(2.63%) had osteoporosis. Conclusion: Male preponderance was noted in this study and majority of the case was seen in people within the sixth decade of life. Degenerative disc disease was the most common pathological entity identified in those presented for MRI due to LBP in our setting. There was a statistically significant mean difference in the MRI findings by age. There was no statistically significant mean difference in the MRI findings by gender.

Disseminated small cortical lesions of stroke‐like episodes in a patient with MELAS with an m.3271 T &gt; C mutation

Disseminated small cortical lesions of stroke‐like episodes in a patient with <scp>MELAS</scp> with an m.3271 T &gt; C mutation

Magnetic resonance imaging findings in patients with polymyalgia rheumatica.

To describe the prevalence of magnetic resonance imaging (MRI) findings in patients with the clinical diagnosis of polymyalgia rheumatica (PMR). Sixteen consecutive patients with untreated PMR, meeting the American College of Rheumatology criteria, underwent MRI examinations of the shoulder(s), hip(s), or both, depending on clinical complaints. Six patients also underwent MRI of the spine. We evaluated 24 shoulders, among which we identified subacromial-subdeltoid bursitis in 21 (87.5%), glenohumeral joint effusion in 17 (70.8%), and fluid distention of the long head of the biceps tendon sheath in 15 (62.5%). Peritendinitis and capsular edema were observed in 21 (87.5%) and 17 (70.8%) shoulders, respectively. We also evaluated 17 hips, identifying hip joint effusion in 12 (70.6%), trochanteric bursitis in 11 (64.7%), peritendinitis in 17 (100%), and capsular edema in 14 (82.4%). All six of the patients who underwent MRI of the spine were found to have interspinous bursitis. Subacromial-subdeltoid bursitis, glenohumeral joint effusion, and hip joint effusion are common findings in patients with PMR. In addition, such patients appear to be highly susceptible to peritendinitis and capsular edema. There is a need for case-control studies to validate our data and to determine the real impact that these findings have on the diagnosis of PMR by MRI.

Preoperative Magnetic Resonance Imaging Localization of the Normal Pituitary Gland in Nonfunctioning Pituitary Adenoma Patients Using the Radiological Sign of “Internal Carotid Artery Notch”

Asymmetric features of nonfunctioning pituitary adenoma (NFPA) are poorly understood. We investigated the asymmetry in NFPA on magnetic resonance imaging. We reviewed preoperative magnetic resonance imaging findings of patients initially treated for NFPA. The internal carotid artery (ICA) often seemed to cause an indentation in the external shape of the tumor (i.e., the ICA notch). Two cases with a normal pituitary gland located at the midline were excluded. The remaining 66 cases were examined. The side where the normal gland was located was defined as the normal pituitary side and the opposite side as the cavernous sinus side. The Knosp grade was significantly higher on the cavernous sinus side (P<0.001), and the vertical distance of the ICA was significantly greater on the cavernous sinus side (P<0.001). The ICA notch was found in 87.9% of all cases on the normal pituitary side, but in only 45.5% on the cavernous sinus side (P<0.001). In cases with a single-side ICA notch (34 of 68), the ICA notch was found in 91.2% of cases and on the cavernous sinus side in 8.8% (P<0.001). Magnetic resonance imaging of NFPA frequently shows asymmetry. The tumor does not extend laterally on the normal pituitary side but extends laterally more freely on the cavernous sinus side. The ICA notch is often found on the normal pituitary side where the position of ICA does not move. This may be useful as a preoperative sign to indicate the normal pituitary side.