T2 MRI at 3T of cartilage and menisci in patients with hyperuricemia: initial findings

2021 ◽  
Author(s):  
Ningfan Hu ◽  
Jiangtao Zhu ◽  
Xiaoyun Liang ◽  
Yajuan Wang ◽  
Jian Guan ◽  
...  
Keyword(s):  
T2 Mri

Was unterscheidet die Subtypen der Creutzfeldt-Jakob-Krankheit von anderen Demenzen mit initialen psychiatrischen Auffälligkeiten?

2003 ◽  
Vol 01 (01) ◽  
pp. 24-29
Author(s):  
H. Wormstall ◽  
M. Bartels ◽  
G.W. Eschweiler
Keyword(s):  
Tau Protein ◽  
Fur Protein ◽  
T2 Mri ◽  
Codon 129

ZusammenfassungSeit dem Nachweis boviner spongiformer Enzephalopathie (BSE) unter Rindern in Deutschland im November 2000 ist die Gefahr, an der neuen Variante der Creutzfeld-Jakob-Krankheit (vCJD) zu erkranken, auch hierzulande größer geworden. Diese Übersicht schildert die Differenzialdiagnostik von Demenzerkrankungen mit initialen psychiatrischen Auffälligkeiten im jüngeren und höheren Alter. Besonderer Wert wird auf die Unterschiede zwischen der sporadischen Creutzfeld-Jakob-Krankheit (sCJD) und der vCJD gelegt. Neben den klinischen und initial meist psychiatrisch geprägten Verläufen werden neuere laborchemische, molekulargenetische und neuroradiologische Aspekte dieser beiden Prionkrankheiten dargestellt. Der Liquor ist in den meisten Fällen positiv für Protein 14-3-3, Tau-Protein und Neuron-spezifische Enolase (NSE). Nur bei bestimmten molekulargenetisch am Codon 129 des Prionproteins determinierten Subgruppen der sCJD-Patienten, nicht aber bei vCJD-Patienten, finden sich im EEG periodische scharfe Wellen. In der Frühdiagnostik der sCJD kann vor allem die diffusionsgewichtete MRI eingesetzt werden. Bei den jüngeren vCJD-Patienten findet man neben den psychiatrischen Symptomen Parästhesien, erst später eine Demenz und Ataxie von mehr als 6 Monaten Dauer sowie T2-MRI-Signalhyperintensitäten im Pulvinar. Als weitere Differenzialdiagnosen der verschiedenen CJD-Subtypen wird auch die wenig bekannte Hashimoto-Enzephalopathie näher beschrieben.

No Additive Clinical or Physiological Effects of Short-term Anti-inflammatory Treatment to Physical Rehabilitation in the Early Phase of Human Achilles Tendinopathy: A Randomized Controlled Trial

2021 ◽  
pp. 036354652199190
Author(s):  
Nikolaj M. Malmgaard-Clausen ◽  
Oscar H. Jørgensen ◽  
Rikke Høffner ◽  
Peter E.B. Andersen ◽  
Rene B. Svensson ◽  
...  
Keyword(s):  
Early Phase ◽  
Controlled Trial ◽  
Rehabilitation Program ◽  
Achilles Tendinopathy ◽  
Physical Rehabilitation ◽  
Symptom Duration ◽  
Short Term ◽  
Nsaid Treatment ◽  
T2 Mri

Background: Nonsteroidal anti-inflammatory drugs (NSAIDs) are commonly used in the treatment of Achilles tendinopathy, but whether they have any additive clinical effect on physical rehabilitation in the early phase of tendinopathy remains unknown. Purpose/Hypothesis: To investigate whether an initial short-term NSAID treatment added to a physical rehabilitation program in the early phase of Achilles tendinopathy would have an additive effect. We hypothesized that the combination of NSAID and rehabilitation would be superior to rehabilitation alone. Study Design: Randomized controlled trial; Level of evidence, 1. Methods: A total of 69 patients with early phase Achilles tendinopathy (lasting <3 months) were randomly assigned to either a naproxen group (7 days of treatment; 500 mg twice daily; n = 34) or a placebo group (7 days of placebo treatment; n = 35). Both groups received an identical 12-week physical rehabilitation program. The clinical outcome of the study was evaluated using the Victorian Institute of Sports Assessment–Achilles (VISA-A) questionnaire and a numerical rating scale (NRS), and the physiological outcome was evaluated using ultrasonography, magnetic resonance imaging (MRI), and ultra-short time to echo T2* mapping MRI (UTE T2* MRI). Follow-up was performed at 1 week, 3 months, and 1 year. Time effects are presented as mean difference ± SEM. Results: No significant differences were found between the 2 treatment groups for any of the outcome measures at any time point ( P > .05). For the VISA-A score, a significant time effect was observed between baseline and 3-month follow-up (14.9 ± 2.3; P < .0001), and at 1-year follow-up, additional improvements were observed (6.1 ± 2.3; P < .01). Furthermore, the change in VISA-A score between baseline and 3-month follow-up was greater in patients with very short symptom duration (<1 month) at baseline compared with patients who had longer symptom duration (>2 months) (interaction between groups, 11.7 ± 4.2; P < .01). Despite clinical improvements, total weekly physical activity remained lower compared with preinjury levels at 3 months (–2.7 ± 0.5 h/wk; P < .0001) and 1 year (–3.0 ± 0.5 h/wk; P < .0001). At baseline, ultrasonography showed increased thickness (0.12 ± 0.03 cm; P < .0001) and vascularity (0.3 ± 0.1 cm2; P < .005) on the tendinopathic side compared with the contralateral side, but no changes over time were observed for ultrasonography, MRI, or UTE T2* MRI results. Conclusion: Clinical symptoms in early tendinopathy improved with physical rehabilitation, but this improvement was not augmented with the addition of NSAID treatment. Furthermore, this clinical recovery occurred in the absence of any measurable structural alterations. Finally, clinical improvements after a physical rehabilitation program were greater in patients with very short symptom duration compared with patients who had longer symptom duration. Registration: NCT03401177 (ClinicalTrials.gov identifier) and BFH-2016-019 (Danish Data Protection Agency)

Synthesis, characterization and in vitro validation of a magnetic zeolite nanocomposite with T2-MRI properties towards theranostic applications

2019 ◽  
Vol 7 (21) ◽  
pp. 3351-3361 ◽  
Author(s):  
Natália Vilaça ◽  
Juan Gallo ◽  
Rui Fernandes ◽  
Francisco Figueiredo ◽  
António M. Fonseca ◽  
...  
Keyword(s):  
Magnetic Nanoparticles ◽  
Mri Contrast ◽  
Ability To Act ◽  
Magnetic Zeolite ◽  
Theranostic Applications ◽  
T2 Mri

This study focusses on the development of a magnetic zeolite nanocomposite as a suitable platform towards the design of a theranostic system. Herein, we explored its ability to act as a T2-MRI contrast enhancer when magnetic nanoparticles are incorporated in its structure.

scholarly journals Diabetic Ketoacidosis Presenting in Major Thalassemia With Pancreatic Hemosiderosis: A Case Report

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. A376-A376
Author(s):  
Calvin Kurnia Mulyadi ◽  
Bonita Effendi ◽  
Robby Pratomo ◽  
Pratiwi Kesuma ◽  
Dicky Levenus Tahapary
Keyword(s):  
Diabetic Ketoacidosis ◽  
Wide Spectrum ◽  
Ferritin Level ◽  
Thalassemia Major ◽  
Organ Damage ◽  
Current Evidence ◽  
First Episode ◽  
Prior History ◽  
Reduced Ejection Fraction ◽  
T2 Mri

Abstract Introduction: Iron overload is a common complication of thalassemia, responsible for multiple organ damage, including pancreas. The prevalence of diabetes in thalassemia was 9.7–29%,1 while the incidence of diabetic ketoacidosis (DKA) is only 0,3%.2 Case Illustration: A 26 year-old male with thalassemia major (TM) admitted due to dyspnea, which later revealed as first episode of DKA. No prior history of hyperglycemia, but the patient has unexplained weight loss. He receives combination of chelators (deferiprone, desferroxamine, deferriprox) with ferritin level 8,387 μg/mL. Serum glucose was remarkably high (690 mg/dL), with ketosis (4.2 μg/dL) and metabolic acidosis (pH 7.2; bicarbonate 5.6 mEq/L). No single insult was identified, but recurrent ventricular tachycardia was documented. T2* MRI demonstrates severe cardiac and mild pancreatic hemosiderosis. Echocardiography shows reduced ejection fraction (25.6%), atrioventricular dilatation, and hypokinetism. Discussion: Impaired glucose metabolism in TM is initially mediated by insulin resistance, but later, the interplay between defect in insulin secretion and resistance determines the various clinical picture of diabetes in TM.3 Several mechanisms have been linked: oxidative stress, induction of autoimmunity, and zinc deficiency; yet, current evidence remains inadequate.4 The T2* MRI provides the most reliable tool to predict the development of glycemic dysregulation, whereas relying solely on ferritin could lead to imprecise measurement of iron deposits.5 The presence of cardiac abnormality might responsible for the DKA and suggests the need of rescue chelation for this patient. Conclusion: DKA is a rare endocrine complications which can be prevented by routine T2* MRI screening and has wide spectrum of clinical characteristics.

Assessment of Iron Overload in a Cohort of Sri Lankan Patients with Transfusion Dependent Beta Thalassaemia and its Correlation with Pathogenic Variants in HBB, HFE, SLC40A1, and TFR2 Genes

2021 ◽  
Author(s):  
Ruwangi Dissanayake ◽  
Nayana Samarasinghe ◽  
Samantha Waidyanatha ◽  
Sajeewani Pathirana ◽  
Vajira HW Dissanayake ◽  
...  
Keyword(s):  
Iron Overload ◽  
Serum Ferritin ◽  
Sri Lankan ◽  
Pathogenic Variants ◽  
Increased Risk ◽  
The Mean ◽  
One Year ◽  
Next Generation Sequencing Ngs ◽  
T2 Mri ◽  
Generation Sequencing

Abstract Background. Iron overload (IO) is a complication in transfusion dependent beta thalassaemmia (TDT). Pathogenic variants in genes involving iron metabolism may confer increased risk of IO. The objective of this study was to determine the magnitude of the cardiac and hepatic IO and determine whether pathogenic variants in HFE, SLC40A1 and TFR2 genes increase the risk of IO in a cohort of TDT patients in Sri Lanka.Materials and Methods. Fifty-seven (57) patients with TDT were recruited for this study. Serum ferritin was done once in 3 months for one year in all. Those who were ≥ 8 years of age underwent T2* MRI of the liver and heart. Fifty-two (52) patients underwent next generation sequencing (NGS) to identify pathogenic variants in HBB, HFE, SLC40A1 and TFR2 genes.Results. The mean age (SD) of this cohort was 9.5 (±4.6) years. It comprised of 30 (52.6%) boys and 27 (47.4%) girls. The mean serum ferritin was 3405 (±2670.5) ng/dl. Hepatic IO was seen in 38 (95%) patients and cardiac IO was seen in 17 (42.5%) patients. All patients with cardiac IO were asymptomatic and had normal echocardiogrammes. There was no statistically significant correlation between serum ferritin and hepatic or cardiac IO.32 (61.5%), 18 (34.6%), 2 (3.8%) of patients were homozygotes, compound heterozygotes and heterozygotes for pathogenic variants in the HBB gene. 9 (17.3%) and 3 (5.8%) patients were heterozygotes for pathogenic variants of HFE and SLC40A1 genes respectively. There were no pathogenic variants for the TfR2 gene. The heterozygotes of the pathogenic variants of the HFE and SLC40A1 genes were not at increased risk of IO.Conclusions. Cardiac T2* MRI helps to detect cardiac IO prior to the onset of symptoms when the echocardiogramme is normal. It is important to perform hepatic and cardiac MRI T2* to detect IO in patients with TDT.

scholarly journals Cortical superficial siderosis and bleeding risk in cerebral amyloid angiopathy

Neurology ◽  
2019 ◽  
Vol 93 (24) ◽  
pp. e2192-e2202 ◽  
Author(s):  
Andreas Charidimou ◽  
Gregoire Boulouis ◽  
Steven M. Greenberg ◽  
Anand Viswanathan
Keyword(s):  
Cerebral Amyloid Angiopathy ◽  
Meta Analysis ◽  
Bleeding Risk ◽  
Superficial Siderosis ◽  
Amyloid Angiopathy ◽  
Class Iii ◽  
Cerebral Amyloid ◽  
T2 Mri ◽  
Cortical Superficial Siderosis

ObjectiveTo assess the association of cortical superficial siderosis (cSS) presence and extent with future bleeding risk in cerebral amyloid angiopathy (CAA).MethodsThis was a meta-analysis of clinical cohorts of symptomatic patients with CAA who had T2*-MRI at baseline and clinical follow-up for future intracerebral hemorrhage (ICH). We pooled data in a 2-stage meta-analysis using random effects models. Covariate-adjusted hazard ratios (adjHR) from multivariable Cox proportional hazard models were used.ResultsWe included data from 6 eligible studies (n = 1,239). cSS pooled prevalence was 34% (95% confidence interval [CI] 26%–41%; I2 87.94%; p < 0.001): focal cSS prevalence was 14% (95% CI 12%–16%; I2 6.75%; p = 0.37), and disseminated cSS prevalence was 20% (95% CI 13%–26%; I2 90.39%; p < 0.001). During a mean follow-up of 3.1 years (range 1–4 years), 162/1,239 patients experienced a symptomatic ICH-pooled incidence rate 6.9% per year (95% CI 3.9%–9.8% per year; I2 83%; p < 0.001). ICH incidence rates per year according to cSS status were 3.9% (95% CI 1.7%–6.1%; I2 70%; p = 0.018) for patients without cSS, 11.1% (95% CI 7%–15.2%; I2 56.8%; p = 0.074) for cSS presence, 9.1% (95% CI 5.5%–12.8%; I2 0%; p = 0.994) for focal cSS, and 12.5% (95% CI 5.3%–19.7%; I2 73.2%; p = 0.011) for disseminated cSS. In adjusted pooled analysis, any cSS presence was independently associated with increased future ICH risk (adjHR 2.14; 95% CI 1.19–3.85; p < 0.0001). Focal cSS was linked with ICH risk (adjHR 2.11; 95% CI 1.31–2.41; p = 0.002), while disseminated cSS conferred the strongest bleeding risk (adjHR 4.28; 95% CI 2.91–6.30; p < 0.0001).ConclusionIn patients with CAA, cSS presence and extent are the most important MRI prognostic risk factors for future ICH, likely useful in treatment planning.Classification of evidenceThis study provides Class III evidence that in symptomatic CAA survivors with baseline T2*-MRI, cSS (particularly if disseminated, i.e., affecting >3 sulci) increases the risk of future ICH.

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