Typical Magnetic Resonance Imaging Research Articles

Corpus callosum hypersignals and focal atrophy: Neuroimaging findings in globular glial tauopathy type I.

Background and purposeGlobular glial tauopathies (GGTs) have heterogeneous presentations; little evidence regarding typical clinical and magnetic resonance imaging (MRI) presentations are available.MethodsWe retrospectively assessed MRIs from three postmortem‐confirmed GGT cases, in two patients with atypical progressive aphasia and one with corticobasal syndrome.ResultsWe suggest that four principal concomitant MRI findings characterize GGT type I: a sagittal callosal hyperintense band, marked focal callosal atrophy suggesting white matter degeneration originating in cortical areas responsible for symptoms (anterior atrophy in predominantly language manifestations and posterior atrophy in predominantly apraxia), periventricular white matter lesions, and mild‐to‐moderate brain stem atrophy.ConclusionsWe observed four concomitant MRI abnormalities in patients with atypical dementia, parkinsonism, and late incomplete supranuclear gaze palsy. Two patients had atypical progressive aphasia and one had corticobasal syndrome.

Network and Field Analysis of Koch Snowflake Fractal Geometry Radiofrequency Coils for Sodium MRI

Sodium is one of the most abundant physiological cations and is a key element in many cellular processes. It has been shown that several pathologies, including degenerative brain disorders, cancers, and brain traumas, express sodium deviations from normal. Therefore, sodium magnetic resonance imaging (MRI) can prove to be valuable for physicians. However, sodium MRI has its limitations, the most significant being a signal-to-noise ratio (SNR) thousands of times lower than a typical proton MRI. Radiofrequency coils are the components of the MRI system directly responsible for signal generation and acquisition. This paper explores the intrinsic properties of a Koch snowflake fractal radiofrequency surface coil compared to that of a standard circular surface coil to investigate a fractal geometry’s role in increasing SNR of sodium MRI scans. By first analyzing the network parameters of the two coils, it was found that the fractal coil had a better impedance match than the circular coil when loaded by various anatomical regions. Although this maximizes signal transfer between the coil and the system, this is at the expense of a lower Q, indicating greater signal loss between the tissue and coil. A second version of each coil was constructed to test the mutual inductance between the coils of the same geometry to see how they would behave as a phased array. It was found that the fractal coils were less sensitive to each other than the two circular coils, which would be beneficial when constructing and using phased array systems. The performance of each coil was then assessed for B1+ field homogeneity and signal. A sodium phantom was imaged using a B1+ mapping sequence, and a 3D radial acquisition was performed to determine SNR and image quality. The results indicated that the circular coil had a more homogeneous field and higher SNR. Overall while the circular coil proved to generate a higher signal-to-noise ratio than the fractal, the Koch coil showed higher versatility when in a multichannel network which could prove to be a benefit when designing, constructing, and using a phased array coil.

Autosomal recessive spastic ataxia of Charlevoix-Saguenay

Autosomal recessive spastic ataxia of Charlevoix-Saguenay (ARSACS) is an extremely rare disease in countries other than Canada. We presented the clinical data and magnetic resonance imaging (MRI) findings of four patients diagnosed with ARSACS in our clinic. In the literature, early atrophy of the superior vermis, progressive atrophy of the cerebellar hemisphere and cervical cord, and linear hypointensity in the pons on T2-weighted images were described. According to the literature, we have described the same typical MRI findings of ARSACS.

Screening for Inherited Metabolic Disorders by Tandem Mass Spectrometry May Miss L-2 Hydroxy Glutaric Aciduria: A Report of Two Cases

AbstractL-2 hydroxy glutaric aciduria (L-2HGA) is an autosomal recessive neurometabolic disorder. It is characterized by a variety of clinical features and typical radiological features which aids in diagnosis. We report two cases that presented with unexplained intellectual impairment and seizures. Magnetic resonance imaging (MRI) brain showed characteristic features of L-2HGA. Tandem mass spectrometry was negative in both cases. Genetic analysis was done based on typical imaging features which confirmed the diagnosis of L-2HGA. For patients with unexplained developmental delay and typical MRI features, a high degree of suspicion is necessary to confirm the diagnosis with targeted genetic analysis.

A research on prediction of bat-borne disease infection through segmentation using diffusion-weighted MR imaging in deep-machine learning approach

The theme of this study is to provide a detailed description of its recent improvements in image segmentation and lesion classification in disease prognosis. Previous studies have shown that gray-white matter hyperintensities (GWMH) is one of the hallmarks of Nipah encephalitis, which sometimes occurs during the incubation period. Predicting this type of inflammation is a challenging task because it involves some unknown medical risk factors. A typical Magnetic Resonance Imaging (MRIs) is the best non-invasive system to analyze the anatomical structure of the brain. In-depth analysis of the defined pathological structure from isolated MR imaging leads to a reduction in the processing time of the prognostic model. Modern learning techniques such as Machine Learning, Computer Vision, and Deep Learning are the most promising techniques for determining the optimal outcome, computer can able to learn and extract useful information from historical data using various algorithms. Disease prognosis based on deep learning is sophisticated, so it can handle a variety of difficult tasks including image processing, classification, and feature extraction, noise and object detection. Diffusion-weighted imaging (DWI) in MRIs is a clinical prototype that can be used to diagnose brain abnormalities and to evaluate the microscopic architectural and molecular function of human organs or tissues. In this study, we summarize the results of diagnosing Nipah encephalitis using some publicly available brain encephalitis and encephalopathy databases.

Transrectal ultrasound features and biopsy outcomes of transition PI-RADS 5.

Transition Prostate Imaging and Reporting and Data System (PI-RADS) 5 is easily detected owing to typical magnetic resonance imaging features. However, it is unclear as to how transition PI-RADS 5 appears on transrectal ultrasound (TRUS). To assess TRUS features of transition PI-RADS 5 and outcomes of TRUS-guided target biopsy. Between March 2014 and November 2018, 186 male patients underwent TRUS-guided biopsy of PI-RADS 5. Of them, 82 and 104were transition and peripheral PI-RADS 5, respectively. Transition and peripheral PI-RADS 5 were compared according to echogenicity (hyperechoic or hypoechoic) and hypoechoic rim (present or absent). Each tumor was targeted with TRUS based on TRUS features. Significant (Gleason score ≥7) and insignificant (Gleason score 6) cancer detection rates (CDRs) were compared between transition and peripheral PI-RADS 5. Standard reference was biopsy examination. Fisher's exact test was used for statistical analysis. Transition PI-RADS 5 was hyperechoic in 89.0% (73/82) and had a hypoechoic rim in 97.6% (80/82), whereas peripheral PI-RADS 5 was hypoechoic in 99.0% (103/104) and had a hypoechoic rim in 26.9% (28/104) (both, P<0.0001). The significant CDRs of transition and peripheral PI-RADS 5 were 56.1% (46/82) and 65.4% (68/104), respectively (P=0.2263). However, the insignificant CDRs of these categories were 22.0% (18/82) and 8.7% (9/104), respectively (P=0.0123). Transition PI-RADS 5 tends to have hyperechoic echogenicity and a hypoechoic rim. These findings help to target the transition PI-RADS 5 using TRUS. However, transition PI-RADS 5 is confirmed more frequently as insignificant cancer than peripheral PI-RADS 5.

Asymptomatic Familial Multiple Cerebral Cavernous Malformation in a 73-Year-Old Woman

Cerebral cavernous malformations (CCMs) are dilated blood vessels which can develop sporadically or in familial form and are the commonest malformations of blood vessels in the spinal cord and brain. The familial form is an autosomal dominant gene mutation disorder. This condition can be diagnosed with magnetic resonance imaging (MRI) and computed tomography (CT) scan, but the modality of choice is MRI because of its high sensitivity. We report a case of a 73-year-old woman with an asymptomatic multiple familial cerebral cavernous malformation (FCCM) which was previously misdiagnosed as multiple cerebral metastases on CT scan. A brain MRI performed correctly diagnosed her condition as FCCM based on the typical MRI appearances. In order not to misdiagnose brain lesions like CCM on CT scan, for cerebral metastases in resource-poor settings, radiologists must recommend advanced imaging modalities like MRI for further evaluation, thereby avoiding unnecessary invasive surgical biopsies.

Diagnostic Accuracy of Single-plane Biparametric and Multiparametric Magnetic Resonance Imaging in Prostate Cancer: A Randomized Noninferiority Trial in Biopsy-naïve Men

BackgroundUrological guidelines recommend multiparametric magnetic resonance imaging (mpMRI) in men with a suspicion of prostate cancer (PCa). The resulting increase in MRI demand might place health care systems under substantial stress. ObjectiveTo determine whether single-plane biparametric MRI (fast MRI) workup could represent an alternative to mpMRI in the detection of clinically significant (cs) PCa. Design, setting, and participantsBetween April 2018 and February 2020, 311 biopsy-naïve men aged ≤75 yr with PSA ≤15 ng/ml and negative digital rectal examination were randomly assigned to 1.5-T fast MRI (n = 213) or mpMRI (n = 98). InterventionAll MRI examinations were classified according to Prostate Imaging-Reporting and Data System (PI-RADS) version 2. Men scored PI-RADS 1–2 underwent 12-core standard biopsy (SBx) and those with PI-RADS 4-5 on fast MRI or PI-RADS 3–5 on mpMRI underwent targeted biopsy in combination with SBx. Equivocal cases on fast MRI (PI-RADS 3) underwent mpMRI and then biopsy according to the findings. Outcome measurements and statistical analysisThe primary outcome was to compare the detection rate of csPCa in both study arms, setting a 10% difference for noninferiority. The secondary outcome was to assess the role of prostate-specific antigen density (PSAD) in ruling out men who could avoid biopsy among those with equivocal findings on fast MRI. Results and limitationsThe overall MRI detection rate for csPCa was 23.5% (50/213; 95% confidence interval [CI] 18.0–29.8%) with fast MRI and 32.7% (32/98; 95% CI 23.6–42.9%) with mpMRI (difference 9.2%; p = 0.09). The reproducibility of the study could have been affected by its single-center nature. ConclusionsFast MRI followed by mpMRI in equivocal cases is not inferior to mpMRI in the detection of csPCa among biopsy-naïve men aged ≤75 yr with PSA ≤15 ng/ml and negative digital rectal examination. These findings could pave the way to broader use of MRI for PCa diagnosis. Patient summaryA faster MRI (magnetic resonance imaging) protocol with no contrast agent and fewer scan sequences for examination of the prostate is not inferior to the typical MRI approach in the detection of clinically significant prostate cancer. If our findings are confirmed in other studies, fast MRI could represent a time-saving and less invasive examination for men with suspicion of prostate cancer.This trial is registered at ClinicalTrials.gov as NCT03693703.

Analysis of magnetic resonance imaging findings of fungal spondylitis

The clinical and magnetic resonance imaging(MRI) data of 8 cases of fungal spondylitis were retrospectively enrolled in the study, and the typical MRI findings were mainly discussed. The results released that fungal spondylitis should be suspected when the infection spreads along paraspinal ligament, and vertebral lesions show jumping discontinuous distribution. A blurred and incomplete outline of endplate on T1 weighted imaging sequence, loss of hyperintensity of the vertebral body, and banded like hypointensity under endplate on T2 weighted imaging sequence, indicate fungal spondylitis. These features contribute to the diagnosis and differential diagnosis of fungal spondylitis.

Components of a magnetic resonance imaging system and their relationship to safety and image quality.

Magnetic resonance imaging (MRI) is a powerful diagnostic tool that can be optimized to display a wide range of clinical conditions. An MRI system consists of four major components: a main magnet formed by superconducting coils, gradient coils, radiofrequency (RF) coils, and computer systems. Each component has safety considerations. Unless carefully controlled, the MRI machine's strong static magnetic field could turn a ferromagnetic object into a harmful projectile or cause vertigo and headache. Switching magnetic fields in the gradients evokes loud noises in the scanner, which can be mitigated by ear protection. Gradients also generate varying magnetic fields that can cause peripheral nerve stimulation and muscle twitching. Magnetic fields produced by RF coils deposit energy in the body and can cause tissue heating (with the potential to cause skin burns). In this review, we provide an overview of the components of a typical clinical MRI scanner and its associated safety issues. We also discuss how the relationship between the scanning parameters can be manipulated to improve image quality while ensuring a safe operational environment for the patients and staff. Understanding the strengths and limitations of these parameters can enable users to choose optimal techniques for image acquisition, apply them in clinical practice, and improve the diagnostic accuracy of an MRI examination.

MR imaging features of multiple biliary hamartomas (Von Meyenburg Complex): A pictorial review and differential diagnosis.

Biliary hamartomas (BHs) are rare malformative cystic/cystic-like lesions of the liver affecting the biliary tree, named after Hanns von Meyenburg who described them for the first time and still known with this eponym to this day. They usually lack clinical symptoms, and abnormalities in liver function tests are unusual; thus, it is typically an incidental finding of liver imaging. Despite being benign lesions, BHs can pose clinical challenges; the first one is differential diagnosis with other more relevant pathological conditions. Therefore, knowledge of MR imaging findings of BHs is helpful for a prompt and correct diagnosis, avoiding unnecessary invasive procedures and/or an excessive number of radiological investigations. This pictorial review is aimed to depict the most typical MR imaging features of multiple biliary hamartomas (von Meyenburg Complex), in order to familiarize the diagnosis and facilitate the differentiation from other hepato-biliary cystic diseases.

Intratumoral microhemorrhage detection on susceptibility-weighted imaging can help in preoperative differentiation of cerebellopontine angle vestibular schwannomas from meningiomas: Correlation with pathology findings

Objectives: In this study, we aimed to evaluate whether intratumoral microhemorrhage detection on susceptibility-weighted imaging (SWI) could help in preoperative differentiation of cerebellopontine angle (CPA) vestibular schwannomas (VSs) from meningiomas. Patients and Methods: A total of 75 patients (32 males, 43 females; mean age: 45.5±16.7 years; range, 17 to 68 years) consisting of 61 VSs and 14 meningiomas located in the CPA cistern were retrospectively analyzed. All patients underwent contrast-enhanced magnetic resonance imaging (MRI) using the SWI sequence. All images in our study were obtained with a 12-channel phased-array head coil on a 1.5-Tesla clinical scanner. The presence of intratumoral microhemorrhages on SWI sequence was evaluated by demonstrating blooming artifacts as punctate hypointense regions. Both magnitude and phase-contrast images were used to verify microhemorrhages. All patients in our patient cohort underwent surgery and resected tumor specimens were evaluated by pathology. Results: All VS cases in our cohort exhibited multiple hypointense small foci causing blooming artifact on magnitude and processed SWI images. In the meningioma population, typical MRI signal intensity characteristics, including an intense homogenous contrast enhancement, were observed. In all the meningioma cases, except for one, there was no blooming artifact due to intratumoral hemorrhage within the mass lesions on SWI images. In only one meningioma case, SWI revealed hypointense microhemorrhages within the mass lesion. Following surgical procedures and tumor resections, pathology specimens were evaluated and absence or presence of intratumoral microhemorrhages were detected. These results were significantly correlated with the SWI findings. We obtained 100% sensitivity, 92.8% specificity, and 98.6% accuracy in terms of differentiating VSs from meningiomas located in the CPA cistern by using the SWI sequence. Conclusion: Meningiomas and VSs are the two most common masses of the CPA cistern and, in some cases, it seems to be difficult to reach an accurate diagnosis with conventional MRI sequences. The SWI can be helpful to solve this problem by demonstrating whether intratumoral microhemorrhages are present or not within mass lesions and, thus, can help to assume a probable accurate diagnosis prior to surgery

Latissimus Dorsi and Teres Major Injuries

Latissimus dorsi and teres major tendon injuries are an uncommon, but under-recognized source of shoulder pain and weakness in baseball players, specifically pitchers. These injuries can be difficult to diagnose on history and physical examination, but are typically accompanied by pain and weakness to resisted adduction, extension, and internal rotation with the shoulder in the abducted and externally rotated position. Imaging is also challenging as the typical shoulder magnetic resonance imaging protocol does not have a wide enough field of view to include the insertions of the latissimus dorsi or teres major, nor their anatomic courses along the posteroinferior scapula. Treatment for latissimus/teres injuries is often based on tear severity and can include operative and nonoperative measures. Nonoperative management involves a period of shutdown from throwing with or without the use of biologic augmentation followed by a return to throwing protocol. Operative treatment involves repair of the torn latissimus and/or teres to their humeral insertion followed by an extensive rehabilitation program and progression to throwing. Return to play following successful treatment of latissimus/teres injuries is encouraging with many players returning to the same level as before their injury.

A case report of acute Marchiafava-Bignami disease: a rare clinical entity in chronic alcoholism

Marchiafava‑Bignami disease (MBD) is a rare neurological disease often associated with a chronic consumption of alcohol and malnutrition, which is characterized by a demyelination and necrosis of the corpus callosum. We present a case of a 21-year-old male with chronic alcoholism who presented with an acute altered sensorium and seizure, which were initially treated as meningoencephalitis. His persistent poor Glasgow coma scale score and ideomotor recovery with encephalitic changes on his electroencephalogram prompted urgent magnetic resonance imaging (MRI) of his brain, which revealed extensive symmetrical hyperintensities in the corpus callosum. The diagnosis of MBD was made because of the typical MRI findings and after the exclusion of other possible diagnosis. The patient was promptly treated with a parenteral thiamine and showed a good recovery at 3 months follow-up. This case highlights the importance of diagnosing and recognizing MBD in a patient with chronic alcoholism as prompt treatment could prevent irreversible damage, which could carry high morbidity.

Neuroimaging Patterns and Function in Cerebral Palsy-Application of an MRI Classification.

Background: Cerebral palsy (CP) is a disorder of movement and posture and every child with CP has a unique composition of neurological symptoms, motor severity, and associated impairments, constituting the functional profile. Although not part of the CP definition, magnetic resonance imaging (MRI) sheds light on the localization, nature, and severity of brain compromise. The MRI classification system (MRICS), developed by the Surveillance of Cerebral Palsy in Europe (SCPE), describes typical MRI patterns associated with specific timing of vulnerability in different areas of the brain. The classification has proven to be reliable and easy to use.Aims: The aim of this study is to apply the MRICS on a large dataset and describe the functional profile associated with the different MRI patterns of the MRICS.Materials and Methods: Data on children with CP born in 1999–2009 with a post-neonatal MRI from 20 European registers in the JRC-SCPE Central Registry was included. The CP classification and the MRICS was applied, and The Gross Motor Function Classification (GMFCS) and the Bimanual Fine Motor Function (BFMF) classification were used. The following associated impairments were documented: intellectual impairment, active epilepsy, visual impairment, and hearing impairment. An impairment index was used to characterize severity of impairment load.Results: The study included 3,818 children with post-neonatal MRI. Distribution of CP type, motor, and associated impairments differed by neuroimaging patterns. Functional profiles associated with neuroimaging patterns were described, and the impairment index showed that bilateral findings were associated with a more severe outcome both regarding motor impairment and associated impairments than unilateral compromise. The results from this study, particularly the differences in functional severity regarding uni- and bilateral brain compromise, may support counseling and service planning of support of children with CP.

Adult Primary Brain Neoplasm, Including 2016 World Health Organization Classification

In 2016, the World Health Organization (WHO) central nervous system (CNS) classification scheme incorporated molecular parameters in addition to traditional microscopic features for the first time. Molecular markers add a level of objectivity that was previously missing for tumor categories heavily dependent on microscopic observation for pathologic diagnosis. This article provides a brief discussion of the major 2016 updates to the WHO CNS classification scheme and reviews typical MR imaging findings of adult primary CNS neoplasms, including diffuse infiltrating gliomas, ependymal tumors, neuronal/glioneuronal tumors, pineal gland tumors, meningiomas, nerve sheath tumors, solitary fibrous tumors, and lymphoma.

Hippocampal Involvement With Vigabatrin-Related MRI Signal Abnormalities in Patients With Infantile Spasms: A Novel Finding.

In a subset of infants exhibiting typical vigabatrin-related magnetic resonance imaging (MRI) changes, the authors observed additional hippocampal signal abnormalities. The authors investigated occurrence and significance of additional signal abnormalities. A retrospective review of infantile spasms patients with typical vigabatrin-related MRI abnormalities was performed. Atypical features included signal changes unilaterally or at previously unreported sites. Comparisons were made between patients with and without atypical features. In all, 26/55 (47%) exhibited typical vigabatrin-related MRI changes, with additional signal abnormalities in the hippocampi in 6 of 26. On follow-up, evolution of hippocampal signal changes paralleled changes at typical locations in 4 patients. Two patients, clinically well, without follow-up MRI. Patients with and without additional hippocampal signal changes did not differ with respect to clinical factors, including seizure status. One patient had unilateral thalamic/cerebral peduncle signal abnormality along with typical vigabatrin changes. Hippocampal changes seen in subset of patients with typical vigabatrin-related changes may be attributable to vigabatrin exposure in the appropriate circumstance.

An Elderly Case Of Type 2 Diabetes Who Showed Chorea Without Typical Brain Magnetic Resonance Imaging Findings

An Elderly Case Of Type 2 Diabetes Who Showed Chorea Without Typical Brain Magnetic Resonance Imaging Findings

Prognostic validation and clinical implications of the EANO ESMO classification of leptomeningeal metastasis from solid tumors.

The EANO ESMO guidelines have proposed a classification of leptomeningeal metastases (LM) from solid cancers based on clinical, magnetic resonance imaging (MRI), and cerebrospinal fluid (CSF) cytology presentation. MRI patterns are classified as linear, nodular, both, or neither. Type I LM is defined by positive CSF cytology (confirmed LM) whereas type II LM is defined by typical clinical and MRI signs (probable or possible LM). Here we explored the clinical utility of these LM subtypes. We retrospectively assembled data from 254 patients with newly diagnosed LM from solid tumors. Survival curves were derived using the Kaplan-Meier method and compared by Log-rank test. Median age at LM diagnosis was 56 years. Typical clinical LM features were noted in 225 patients (89%); 13 patients (5%) were clinically asymptomatic. Tumor cells in the CSF were observed in 186 patients (73%) whereas the CSF was equivocal in 24 patients (9.5%) and negative in 44 patients (17.5%). Patients with confirmed LM had inferior outcome compared with patients with probable or possible LM (P = 0.006). Type I patients had inferior outcome than type II patients (P = 0.002). Nodular disease on MRI was a negative prognostic factor in type II LM (P = 0.014), but not in type I LM. Administration of either intrathecal pharmacotherapy (P = 0.020) or systemic pharmacotherapy (P = 0.0004) was associated with improved outcome in type I LM, but not in type II LM. The EANO ESMO LM subtypes are highly prognostic and should be considered for stratification and overall design of clinical trials.

Acute Neurological Symptoms After a Liver Transplant

Acute Neurological Symptoms After a Liver Transplant