scholarly journals Prenatal Diagnosis of Galen Vein Aneurysm Using Ultrasonography and Magnetic Resonance Imaging and Perinatal and Long-Term Neurological Outcomes: A Case Series

2017 ◽  
Vol 39 (06) ◽  
pp. 309-314
Author(s):  
Pedro Pires ◽  
Larisse Martins ◽  
Norma Pires ◽  
Heron Werner ◽  
Adilson Ferreira ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Birth Weight ◽  
Prenatal Diagnosis ◽  
Magnetic Resonance ◽  
Gestational Age ◽  
Tertiary Care ◽  
Case Series ◽  
Resonance Imaging ◽  
The Mean

Objective To describe the prenatal diagnosis of Galen vein aneurysm (GVA) based on ultrasonography and magnetic resonance imaging (MRI) in a series of cases, as well as its postnatal outcomes and follow-up until 4 years of age. Methods A retrospective longitudinal study was performed, analyzing a database comprising seven cases of prenatal diagnosis of GVA at two Brazilian institutions from February of 2000 to May of 2012. The following data were evaluated: gestational age at diagnosis, GVA dimensions on ultrasonography, associated fetal changes, findings on fetal echocardiography, gestational age at delivery, type of delivery, birth weight, Apgar score at the 1st and 5th minutes, neonatal outcomes, and survival with follow-up until 4 years of age. Results The mean gestational age ± standard deviation on the prenatal diagnosis of GVA based on ultrasonography was 25 ± 4.9 weeks. The mean length of GVA was 3.2 ± 0.4 cm. The mean gestational age at birth was 37.5 ± 0.7 weeks, and a cesarean section was performed in 85.7% of the cases (6/7). The mean birth weight was 3,070 ± 240.4 g. The total survival rate was 42.8% (4/7), with three neonatal deaths. Of the four survivors, three presented with normal neuropsychomotor development until 4 years of age and only one showed serious neurological sequelae. Ultrasonography and MRI showed similar findings for all seven cases. Conclusions Galen Vein Aneurysm is associated with a high neonatal death rate. Therefore, its prenatal diagnosis is essential for parent counseling and follow-up at tertiary care institutions.

scholarly journals Surgical Fixation of Chondral-Only Fragments of the Knee: A Case Series With a Mean 4-Year Follow-up

2021 ◽  
Vol 9 (1) ◽  
pp. 232596712096139
Author(s):  
Andrew Gudeman ◽  
Dillen Wischmeier ◽  
Jack Farr
Keyword(s):  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Clinical Outcome ◽  
Arthroscopic Surgery ◽  
Case Series ◽  
Resonance Imaging ◽  
Outcome Scores ◽  
Surgical Fixation ◽  
The Mean

Background: Chondral-only fragments of the knee have traditionally been treated with excision, with or without cartilage restoration procedures. This is because of the historical assumption that cartilage has limited ability to heal to cancellous or subchondral bone. There is now a growing body of evidence supporting surgical fixation of these fragments. Hypothesis: We hypothesized that surgical fixation of chondral fragments would result in acceptable rates of healing with improvement in clinical outcome scores. Study Design: Case series; Level of evidence, 4. Methods: Data were collected on 15 surgically fixed chondral-only fragments in 14 patients. We retrospectively collected participant demographic information, lesion characteristics, primary mechanism (osteochondritis dissecans vs traumatic shear injury), fixation methods, reoperation information, second-look arthroscopic information, and clinical outcome scores. The mean clinical follow-up was 3.96 years, with a minimum of 1-year follow-up. All patients underwent follow-up magnetic resonance imaging at a mean of 2 years after the index procedure. Results: The mean age of our cohort was 17.7 years. We found an 80% survival rate for fixation of the fragments at a mean 4-year follow-up. There were statistically significant improvements in postoperative Knee injury and Osteoarthritis Outcome Score and Tegner scores compared with preoperative scores. Follow-up magnetic resonance imaging scans showed complete healing in 10 knees, partial healing in 2 knees, and loss of fixation in 3 knees. Second-look arthroscopic surgery of 3 knees for reasons other than fragment symptoms showed healing of the fragment, while arthroscopic surgery of 3 symptomatic knees showed loss of fixation. Conclusion: Surgical fixation of chondral-only lesions showed an 80% success rate with improvements in the KOOS and Tegner scores.

Autologous Osteochondral Mosaicplasty for Centrally and Laterally Located, Advanced Capitellar Osteochondritis Dissecans in Teenage Athletes: Clinical Outcomes, Radiography, and Magnetic Resonance Imaging Findings

2018 ◽  
Vol 46 (8) ◽  
pp. 1943-1951 ◽  
Author(s):  
Tadanao Funakoshi ◽  
Daisuke Momma ◽  
Yuki Matsui ◽  
Tamotsu Kamishima ◽  
Yuichiro Matsui ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Clinical Outcomes ◽  
Osteochondritis Dissecans ◽  
Case Series ◽  
Return To Play ◽  
Joint Surface ◽  
Resonance Imaging ◽  
Level Of Evidence

Background: Autologous osteochondral mosaicplasty (ie, mosaicplasty) results in satisfactory clinical outcomes and reliable return to play for patients with large or unstable lesions due to osteochondritis dissecans (OCD) of the humeral capitellum. However, the association between the healing of the reconstructed cartilage and clinical outcomes remains unclear. Purpose: To evaluate the efficacy of mosaicplasty in teenage athletes through use of clinical scores and imaging. The secondary purpose was to compare the clinical outcomes with images of centrally and laterally located lesions. Study Design: Case series; Level of evidence, 4. Methods: This study analyzed 22 elbows (all male patients; mean age, 13.5 ± 1.2 years) with capitellar OCD managed with mosaicplasty. Patients were divided into 2 groups according to the location of the lesions: central (10 patients) and lateral (12 patients). Evaluation was performed through use of the clinical rating system of Timmerman and Andrews, plain radiographs, and magnetic resonance imaging (MRI; the cartilage repair monitoring system of Roberts). The mean follow-up period was 27.5 months (range, 24-48 months). Results: Lateral lesions were significantly larger than central lesions (147.1 ± 51.9 mm2 vs 95.5 ± 27.4 mm2, P = .01). No other significant differences were found between central and lateral lesions. Timmerman and Andrews scores for both central and lateral lesions improved significantly from 125.0 ± 30.1 points and 138.3 ± 34.5 points preoperatively to 193.5 ± 11.3 points and 186.7 ± 18.1 points, respectively, at final follow-up ( P < .0001, P < .0001). Radiography identified complete graft incorporation in all cases and the absence of severe osteoarthritic changes or displaced osteochondral fragments. In the lateral group, the radial head ratio at final follow-up (1.83 ± 0.23) was significantly larger than the preoperative findings (1.75 ± 0.14, P = .049). The quality of joint surface reconstruction was found to be acceptable for central and lateral lesions on MRI evaluation. Conclusion: Mosaicplasty resulted in satisfactory clinical outcomes and smooth cartilage surface integrity in teenage athletes with OCD on their return to competition-level sports activities irrespective of lesion location.

A Case Series of Successful Repair of Articular Cartilage Fragments in the Knee

2019 ◽  
Vol 47 (11) ◽  
pp. 2589-2595 ◽  
Author(s):  
Jessica L. Churchill ◽  
Aaron J. Krych ◽  
Mark J. Lemos ◽  
Morganne Redd ◽  
Kevin F. Bonner
Keyword(s):  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Internal Fixation ◽  
Scale Score ◽  
Case Series ◽  
Resonance Imaging ◽  
Patient Reported ◽  
Activity Scale ◽  
Chondral Fracture

Background: It is unclear whether chondral fragments without bone have the potential to heal after fixation. Controversy exists and opinions differ regarding the optimal treatment of chondral defects after pure chondral fracture. Purpose: To determine clinical and radiographic outcomes after internal fixation of traumatic chondral fragments repaired to bone in the knee. Study Design: Case series; Level of evidence, 4. Methods: A retrospective clinical and radiographic evaluation of 10 male patients with a mean age of 14.6 years (range, 10-25 years) at the time of surgery was performed. Eight of 10 patients were skeletally immature. Patients were selected by operating surgeons per the presence of a large displaced pure chondral fragment on magnetic resonance imaging and confirmed on intraoperative inspection. All patients had a diagnosed traumatic displaced pure chondral fracture of the knee (without bone) and underwent internal fixation with minimum 1-year follow-up. Validated patient-reported and surgeon-measured outcomes were collected pre- and postoperatively. All patients were evaluated at a mean 56 months postoperatively. Results: At surgery, the mean defect size that was primarily repaired with the displaced chondral fragment was 1.9 × 2.0 cm. With minimum 1-year follow-up, there were no clinical failures. All 8 patients who had subsequent magnetic resonance imaging follow-up had radiographic evidence of complete healing of the chondral fragment back to bone. At a mean follow-up of 56 months (range, 13-171 months; median, 36 months), patients had a mean International Knee Documentation Committee score of 94.74 (range, 87.4-100), a mean Marx Activity Scale score of 14.4 (range, 8-16), and a mean Tegner Activity Scale score of 7 (range, 5-9). At final follow-up, all patients except 1 returned to sports. Conclusion: The treatment of large traumatic chondral fragments is controversial. In this select series of 10 young patients who underwent primary repair with internal fixation, there were no failures clinically. Patients demonstrated excellent short-term clinical and radiographic results after fixation of these relatively large chondral fragments in the knee.

scholarly journals Therapeutic evaluation of sclerotherapy for limb venous malformations: A case series

2020 ◽  
Vol 35 (9) ◽  
pp. 663-671
Author(s):  
Tenghui Zhan ◽  
Fanggang Cai ◽  
Pingfan Guo ◽  
Yujie Lian ◽  
Hui Zhuang ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Doppler Ultrasound ◽  
Clinical Examination ◽  
Clinical Manifestations ◽  
Case Series ◽  
Venous Malformations ◽  
Resonance Imaging ◽  
Percutaneous Sclerotherapy

Objectives To examine three different methods for evaluating the effect of percutaneous sclerotherapy on limb venous malformations in a series of patients with a relatively long follow-up. Method The study was a retrospective study. Results Thirty-eight patients treated with percutaneous sclerotherapy underwent sclerotherapy, with a median number of sessions of 4 (range, 1–10). They were followed up for 1–60 months (average 12.5 months). The kappa between clinical manifestations and Doppler ultrasound was 0.684 ( P < 0.001). The kappa between clinical manifestations and magnetic resonance imaging was 0.217 ( P = 0.006). The kappa between Doppler ultrasound and magnetic resonance imaging was 0.323 ( P < 0.001). The rate of grade IV patients evaluated by clinical manifestations was significantly higher than that by Doppler ultrasound and magnetic resonance imaging. Conclusions Magnetic resonance imaging is the gold standard for VM imaging. Its consistency with clinical examination and Doppler ultrasound is poor, and Doppler ultrasound and clinical examination could be more appropriate for follow-up imaging after sclerotherapy.

Bilateral Macrostomia Associated with Aqueductal Stenosis and Glial Heterotopias

2007 ◽  
Vol 44 (5) ◽  
pp. 558-561
Author(s):  
Ernesto Pepe ◽  
Paola Petricig ◽  
Paola Peretta ◽  
Giuseppe Cinalli
Keyword(s):  
Magnetic Resonance Imaging ◽  
Prenatal Diagnosis ◽  
Magnetic Resonance ◽  
Aqueductal Stenosis ◽  
Resonance Imaging ◽  
Facial Anomalies ◽  
Magnetic Resonance Imaging Mri ◽  
Triventricular Hydrocephalus ◽  
Glial Heterotopia

We report on an Italian boy, born to normal and nonconsanguineous parents with a prenatal diagnosis of ventriculomegaly and subependymal glial heterotopias. At birth bilateral macrostomia was diagnosed without other evident facial anomalies. Magnetic resonance imaging (MRI) showed triventricular hydrocephalus and aqueductal stenosis and confirmed the nodules of glial heterotopia. The bilateral macrostomia was surgically corrected with the vermilion square flap method and W-plasty technique and follow up MRI at 6 months showed mild increase of ventricular dilatation without signs of active hydrocephalus. The association between macrostomia and hydrocephalus has been reported only in rare cases of complex malformative syndromes but never with isolated macrostomia.

scholarly journals Infantile Abdominal and Pelvic Lipoblastomas: A Case Series

2019 ◽  
Vol 07 (01) ◽  
pp. e104-e109
Author(s):  
Riccardo Guanà ◽  
Salvatore Garofalo ◽  
Luisa Ferrero ◽  
Maria Grazia Cortese ◽  
Luca Lonati ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Head And Neck ◽  
Case Series ◽  
Fat Cells ◽  
Ovarian Mass ◽  
Resonance Imaging ◽  
Mesenchymal Tumors ◽  
In Infants And Children

Lipoblastomas are rare benign mesenchymal tumors that arise from embryonal fat cells.They are usually discovered in infants and children under 3 years of age, and mostly occur in the trunk (from 10 to 60%, depending on the study) and extremities (from 40 to 45%), while head and neck localizations are rare, with only five cases described to date.We report on three cases of lipoblastomas in infants younger than 4 years, with unusual localizations: one intra-abdominal, discovered during a laparotomy for an intussusception; one pelvic, misdiagnosed as an ovarian mass; and one gluteal with a pelvic extension.All children underwent magnetic resonance imaging as preoperative workup. All tumors were completely resected with free surgical margins and ultrasonographic follow-up was uneventful for all patients.

Magnetic Resonance Imaging After Arthroscopic Microfracture of Capitellar Osteochondritis Dissecans

2012 ◽  
Vol 40 (11) ◽  
pp. 2549-2556 ◽  
Author(s):  
Corey A. Wulf ◽  
Rebecca M. Stone ◽  
M. Russell Giveans ◽  
Gregory N. Lervick
Keyword(s):  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Osteochondritis Dissecans ◽  
Articular Surface ◽  
Resonance Imaging ◽  
Arthroscopic Microfracture ◽  
The Mean ◽  
Magnetic Resonance Imaging Mri ◽  
Mri Evaluation

Background: Osteochondritis dissecans (OCD) of the capitellum affects young athletes involved in elbow load-bearing activities. Unstable lesions are best managed surgically, although debate remains regarding the optimal method. Arthroscopic treatment allows rapid recovery, but the effect on the articular surface is undetermined. Hypothesis: The clinical outcome after arthroscopic microfracture of stage III/IV capitellum OCD would be successful in terms of return to sport and restoration of function, and there would be some evidence of articular restoration or repair. Study Design: Case series; Level of evidence, 4. Methods: We reviewed records of 10 consecutive adolescent patients (age ≤18 years) with stage III or IV OCD lesions of the capitellum managed with arthroscopic microfracture. The mean age at the time of surgery was 13.9 years (range, 10.8-18.5 years); 7 patients were skeletally immature and 3 were skeletally mature. Pre- and postoperative functional assessment included active range of motion, Mayo Elbow Performance Score (MEPS), and Timmerman/Andrews elbow score. All patients underwent plain radiographic and magnetic resonance imaging (MRI) evaluation at a minimum of 12 months (mean, 27 months; range, 12-49 months) and clinical evaluation at a minimum of 24 months (mean, 42 months; range, 27-54 months) after surgery. Results: The mean range of motion improved in both flexion (135.8°→140.7°, P = .112) and extension (20.4°→–2.2°, P = .005). The mean MEPS (70.5→97, P = .007) and Timmerman/Andrews elbow scores (116.4→193.0, P = .008) improved significantly. magnetic resonance imaging (MRI) evaluation demonstrated an improvement in overall joint congruence and the formation of a reparative articular surface in 8 of 10 (80%) patients. No reoperations or major complications were encountered. Six of 8 patients involved in competitive athletics returned to the same level of participation at an average of 5.1 months. Conclusion: Arthroscopic OCD fragment excision and capitellar microfracture demonstrates good to excellent functional results in short-term follow-up. Follow-up MRI suggests potential for a reparative fibrocartilaginous articular surface. Longer term follow-up is necessary to determine durability of the technique.

scholarly journals When the Wave Breaks You: Magnetic Resonance Imaging Findings After Surfing Injuries

2019 ◽  
Vol 12 (1) ◽  
pp. 88-93
Author(s):  
Bhumin J. Patel ◽  
Madison R. Heath ◽  
Christian S. Geannette ◽  
Peter D. Fabricant ◽  
Harry G. Greditzer
Keyword(s):  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Tertiary Care ◽  
Case Series ◽  
Final Analysis ◽  
Body Part ◽  
The United States ◽  
Resonance Imaging ◽  
Level Of Evidence ◽  
Picture Archiving And Communication

Background: There are approximately 2.1 million recreational surfers in the United States. However, little has been reported on surfing-related injuries and, to date, no study has utilized magnetic resonance imaging (MRI) to characterize injury patterns. Objective: To use MRI to perform a descriptive analysis of surfing injuries in patients who presented to an urban tertiary care musculoskeletal hospital. This was not a hypothesis-driven study. Study Design: Case series. Level of Evidence: Level 4. Methods: A retrospective review of the picture archiving and communication system as well as the electronic medical record was performed to identify patients with surfing-related injuries who presented to a tertiary care musculoskeletal hospital for treatment. The search included participants over a 10-year period who presented between January 1, 2009, and August 1, 2018. Descriptive data analyses were performed to determine frequency of body part injured, diagnosis, and operative versus nonoperative treatment. Results: The search yielded 109 patients with surfing-related injuries and MRIs. A total of 90 patients presented within 6 months of their surfing injury and were included in the final analysis. The median age was 36 years (range, 12-66 years). A majority of the patients included were male (74%; n = 67). Acute surfing injuries were diagnosed via imaging in 72% (n = 65) of patients. The joints injured most commonly were the shoulder (46%; n = 30) and the knee (28%; n = 18). Only 17% (n = 11) of acute surfing injuries required surgery, while 83% (n = 54) were treated nonoperatively. Conclusion: The most common surfing-related injuries occurred in the shoulder and knee. Clinical Relevance: This study helps characterize the risk of injury for surfers and informs healthcare providers on common surfing injuries.

Evaluating Perineural Spread to the Intratemporal Facial Nerve on Magnetic Resonance Imaging

2019 ◽  
Vol 160 (6) ◽  
pp. 1087-1094 ◽  
Author(s):  
Marc-Elie Nader ◽  
Lawrence E. Ginsberg ◽  
Diana Bell ◽  
Dianna B. Roberts ◽  
Paul W. Gidley
Keyword(s):  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Facial Nerve ◽  
Head And Neck ◽  
Sensitivity And Specificity ◽  
Tertiary Care ◽  
Case Series ◽  
Resonance Imaging ◽  
Perineural Spread ◽  
Oncologic Treatment

Objectives To determine the sensitivity and specificity of magnetic resonance imaging (MRI) for the detection of perineural spread (PNS) along the intratemporal facial nerve (ITFN) in patients with head and neck cancers. Study Design Case series with chart review. Setting Tertiary care center. Subjects and Methods We included 58 patients with head and neck malignancies who underwent sacrifice of the ITFN between August 1, 2002, and November 30, 2015. Demographics, preoperative facial nerve function, prior oncologic treatment, and timing between MRI and surgery were recorded. Histopathology slides and preoperative MRI were reviewed retrospectively by a neuropathologist and a neuroradiologist, respectively, both blinded to clinical data. The mastoid segment of the facial nerve (referred to as the descending facial nerve [DFN]) and stylomastoid foramen (SMF) were evaluated separately. A grading system was devised when radiographically assessing PNS along the DFN. Results Histopathologic evidence of PNS was found in 21 patients (36.2%). The sensitivity and specificity of MRI in detecting PNS to the DFN were 72.7% and 87.8%, respectively. MRI showed higher sensitivity but slightly lower specificity when evaluating the SMF (80% and 82.8%, respectively). Prior oncologic treatment did not affect the false-positive rate ( P = .7084). Sensitivity was 100% when MRI was performed within 2 weeks of surgery and was 62.5% to 73.3% when the interval was greater than 2 weeks. This finding was not statistically significant (SMF, P = .7076; DFN, P = .4143). Conclusion MRI shows fair to good sensitivity and good specificity when evaluating PNS to the ITFN.

Sign in / Sign up

Export Citation Format

Share Document