Imaging Features of Constrictive Pericarditis: Beyond Pericardial Thickening

2009 ◽  
Vol 60 (1) ◽  
pp. 40-46 ◽  
Author(s):  
Giuseppe Napolitano ◽  
Josephine Pressacco ◽  
Eleonore Paquet

Constrictive pericarditis is caused by adhesions between the visceral and parietal layers of the pericardium and progressive pericardial fibrosis that restricts diastolic filling of the heart. Later on, the thickened pericardium may calcify. Despite a better understanding of the pathophysiologic basis of the imaging findings in constrictive pericarditis and the recent advent of magnetic resonance imaging (MRI) technology, which has dramatically improved the visualization of the pericardium, the diagnosis of constrictive pericarditis remains a challenge in many cases. In patients with clinical suspicion of underlying constrictive pericarditis, the most important radiologic diagnostic feature is abnormal pericardial thickening, which can be shown readily by computed tomography (CT) and especially by MRI, and is highly suggestive of constrictive pericarditis. Nevertheless, a thickened pericardium does not always indicate constrictive pericarditis. Furthermore, constrictive pericarditis can occur without pericardial thickening.

2021 ◽  
Vol 104 (5) ◽  
pp. 872-885

Fungal infections of the central nervous system (CNS) are usually identified in immunocompromised patients but rare in immunocompetent hosts. The clinical and imaging manifestations are mainly influenced by types of fungal pathogen and immune status of the patients. The CNS fungal infections can develop through hematogenous dissemination from primary site of infection, cerebrospinal fluid seeding, or direct extension from adjacent sources of infection. Fungal infections can result in meningitis, meningoencephalitis, cerebritis, granuloma, or abscess formation, which imaging findings are often non-specific and difficult to distinguish from bacterial or tuberculous infection, non-infectious inflammatory disease, or even intracranial neoplasm. Vascular complications including vasculitis, cerebral infarction, or mycotic aneurysm are commonly present due to angioinvasion of fungal hyphae. In addition, some characteristic imaging features of fungal infections can be identified by computed tomography (CT) or magnetic resonance imaging (MRI), such as intracavitary projections in fungal abscesses and gelatinous pseudocysts in cryptococcosis that could help suggest the diagnosis. Recognizing the imaging findings of common intracranial fungal infections combined with appropriate clinical setting is crucial for allowing early diagnosis and leading to early specific treatment. The present article reviewed common imaging findings of CNS fungal infections and distinct imaging features of specific pathogens. Keywords: Fungal infection, Brain abscess, Cryptococcosis, Central nervous system (CNS), Computed tomography (CT), Diffusion weighted imaging (DWI), Magnetic resonance imaging (MRI)


BMC Neurology ◽  
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
David Fear ◽  
Misha Patel ◽  
Ramin Zand

Abstract Background Hemiplegic migraines represent a heterogeneous disorder with various presentations. Hemiplegic migraines are classified as sporadic or familial based on the presence of family history, but both subtypes have an underlying genetic etiology. Mutations in the ATP1A2 gene are responsible for Familial Hemiplegic type 2 (FHM2) or the sporadic hemiplegic migraine (SHM) counterpart if there is no family history of the disorder. Manifestations include migraine with aura and hemiparesis along with a variety of other symptoms likely dependent upon the specific mutation(s) present. Case presentation We report the case of an adult man who presented with headache, aphasia, and right-sided weakness. Workup for stroke and various infectious agents was unremarkable during the patient’s extended hospital stay. We emphasize the changes in the Magnetic Resonance Imaging (MRI) over time and the delay from onset of symptoms to MRI changes in Isotropic Diffusion Map (commonly referred to as Diffusion Weighted Imaging (DWI)) as well as Apparent Diffusion Coefficient (ADC). Conclusions We provide a brief review of imaging findings correlated with signs/symptoms and specific mutations in the ATP1A2 gene reported in the literature. Description of the various mutations and consequential presentations may assist neurologists in identifying cases of Hemiplegic Migraine, which may include transient changes in ADC and DWI imaging throughout the course of an attack.


Author(s):  
Sebnem Karasu ◽  
Atilla Hikmet Cilengir ◽  
Irfan Ocal ◽  
Serpil Aydogmus

Background: Vaginal adenosis is a rare clinicopathological entity which refers to the presence of glandular endometrial tissue in the vaginal wall. Case report: A gravida 46-year-old woman was presented to the gynecology department with symptoms of chronic pelvic pain. Maternal Diethylstilbestrol (DES) usage has been proven effective in the development of vaginal adenosis. It can also be idiopathic. Its sonographic or magnetic resonance imaging (MRI) findings have not been described in English literature previously. Conclusion: Here, we report the clinical, transperineal ultrasonographic (US) and MRI findings of a pathologically proven case of vaginal adenosis.


2016 ◽  
Vol 38 (01) ◽  
pp. 056-059
Author(s):  
Carlos Pereira

AbstractThe Kernohan-Woltman notch phenomenon is a paradoxical neurological manifestation consisting of a motor deficit ipsilateral to a primary brain injury. It has been observed in patients with brain tumors and with supratentorial hematomas. It is considered a false localizing neurological sign. Magnetic resonance imaging (MRI) scan has been the test of choice. The recognition of this phenomenon is important to prevent a surgical procedure on the opposite side of the lesion. The present case report describes a case of chronic subdural hematoma with a probable finding of the Kernohan-Woltman phenomenon, and it discusses its pathophysiology, imaging findings, treatment, and prognosis.


2017 ◽  
Vol 44 (2) ◽  
pp. 101-106 ◽  
Author(s):  
Burak Can Depboylu ◽  
Parmeseeven Mootoosamy ◽  
Nicola Vistarini ◽  
Ariane Testuz ◽  
Ismail El-Hamamsy ◽  
...  

Constrictive pericarditis is the final stage of a chronic inflammatory process characterized by fibrous thickening and calcification of the pericardium that impairs diastolic filling, reduces cardiac output, and ultimately leads to heart failure. Transthoracic echocardiography, computed tomography, and cardiac magnetic resonance imaging each can reveal severe diastolic dysfunction and increased pericardial thickness. Cardiac catheterization can help to confirm a diagnosis of diastolic dysfunction secondary to pericardial constriction, and to exclude restrictive cardiomyopathy. Early pericardiectomy with complete decortication (if technically feasible) provides good symptomatic relief and is the treatment of choice for constrictive pericarditis, before severe constriction and myocardial atrophy occur. We describe our surgical approach to constrictive pericarditis, summarize our results in 93 patients, and provide a brief overview of the literature.


2017 ◽  
Vol 50 (2) ◽  
pp. 115-125 ◽  
Author(s):  
Miguel Ramalho ◽  
António P. Matos ◽  
Mamdoh AlObaidy ◽  
Fernanda Velloni ◽  
Ersan Altun ◽  
...  

Abstract In the second part of this review, we will describe the ancillary imaging features of hepatocellular carcinoma (HCC) that can be seen on standard magnetic resonance imaging (MRI) protocol, and on novel and emerging protocols such as diffusion weighted imaging and utilization of hepatocyte-specific/hepatobiliary contrast agent. We will also describe the morphologic sub-types of HCC, and give a simplified non-invasive diagnostic algorithm for HCC, followed by a brief description of the liver imaging reporting and data system (LI-RADS), and MRI assessment of tumor response following locoregional therapy.


2019 ◽  
Vol 52 (5) ◽  
pp. 325-330 ◽  
Author(s):  
Aldo Maurici Araújo Alves ◽  
Ulysses Santos Torres ◽  
Fernanda Garozzo Velloni ◽  
Bruno Jucá Ribeiro ◽  
Dario Ariel Tiferes ◽  
...  

Abstract Hepatic lymphoma can be divided into its primary and secondary forms. To be classified as primary hepatic lymphoma, the disease should be limited to the liver and hilar lymph nodes, with no distant involvement (to the bone marrow or other sites). Primary hepatic lymphoma is quite rare, accounting for less than 1% of all cases of non-Hodgkin lymphoma, whereas secondary hepatic lymphoma affects nearly half of such cases. Familiarity with the imaging features of hepatic lymphoma is important for its early diagnosis and appropriate management. In this essay, we aim to review the roles of computed tomography and magnetic resonance imaging in identifying and monitoring hepatic lymphomas, using sample cases to describe and illustrate the wide spectrum of imaging findings in the primary and secondary forms of this disorder.


2020 ◽  
Vol 35 (6) ◽  
pp. 380-388
Author(s):  
Mirac Yildirim ◽  
Rahsan Gocmen ◽  
Bahadir Konuskan ◽  
Safak Parlak ◽  
Dilek Yalnizoglu ◽  
...  

Acute cerebellitis is a rare condition often considered within the group of acute postinfectious cerebellar ataxia despite its distinctive clinical and imaging features. We retrieved clinical, laboratory, and follow-up data of 15 children diagnosed with acute cerebellitis in our department between 2011 and 2019. There were 10 boys and 5 girls aged 3-15 years, median 9.5 years. The most common first symptoms were ataxia, vomiting, and headache. Magnetic resonance imaging (MRI) generally showed bilateral symmetrical T2 hyperintense changes with moderate swelling in the cerebellar cortex. Tonsillar herniation was present in 73.3% and obstructive hydrocephalus in 26.6%. Etiologic workup for infectious pathogens revealed Mycoplasma pneumoniae, influenza A virus, cytomegalovirus, and varicella zoster virus in 1 case each. Fourteen of 15 patients were treated with intravenous and/or oral steroids and 8 cases with intravenous immunoglobulin. No patient required surgical decompression. Neurologic examination median 12 months later revealed ataxia and dysmetria in 4 cases (27%), accompanied by memory difficulties, dysarthria or tremor. Follow-up magnetic resonance imaging (MRI; n = 12) showed diffuse cerebellar cortical T2-hyperintense signal changes in 11 cases and cerebellar atrophy in 9. The diagnosis of acute cerebellitis rather than acute postinfectious cerebellar ataxia should be considered when headache and vomiting accompany ataxia in a child. Acute cerebellitis heals with sequelae in about one-third of cases. The absence of fatalities in our series suggests early diagnosis, and steroid treatment can increase the chance of recovery. MRI results were not found to be predictive of outcome.


2014 ◽  
Vol 3 (10) ◽  
pp. 204798161455504 ◽  
Author(s):  
Simon Nicolay ◽  
Bert De Foer ◽  
Anja Bernaerts ◽  
Joost Van Dinther ◽  
Paul M Parizel

We report the imaging features of a case of a temporal bone meningioma extending into the middle ear cavity and clinically presenting as a serous otitis media. Temporal bone meningioma extending in the mastoid or the middle ear cavity, however, is very rare. In case of unexplained or therapy-resistant serous otitis media and a nasopharyngeal tumor being ruled out, a temporal bone computed tomography (CT) should be performed. If CT findings are suggestive of a temporal bone meningioma, a magnetic resonance imaging (MRI) examination with gadolinium will confirm diagnosis and show the exact extension of the lesion.


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