Magnetic Resonance Imaging of Deep Vein Thrombi Correlates with Response to Thrombolytic Therapy

1995 ◽  
Vol 73 (03) ◽  
pp. 386-391 ◽  
Author(s):  
Charles W Francis ◽  
Saara Totterman
Keyword(s):  
Magnetic Resonance ◽  
Mr Imaging ◽  
Thrombolytic Therapy ◽  
Signal Intensity ◽  
Bleeding Complications ◽  
Clot Lysis ◽  
Symptom Duration ◽  
Duration Of Symptoms ◽  
Partially Occluded ◽  
Deep Vein

SummaryFibrinolytic therapy can result in rapid lysis of deep vein thrombi (DVT), but its use is limited by the failure of many patients to respond and by the increased risk of bleeding complications in comparison with anticoagulant therapy alone. Treatment could be improved by the ability to select patients most likely to respond. Since magnetic resonance (MR) imaging may be sensitive to thrombus age and structure, properties related to thrombolytic sensitivity, we have evaluated the ability of MR imaging to predict the response of DVT to thrombolytic therapy. Nine patients with venographically documented proximal DVT were treated with streptokinase, and MR imaging using a gradient recall echo sequence was performed before and after therapy. The proximal leg veins were divided into nine segments in each patient, and thrombus was present in 55 segments. The MR appearance of the thrombus in each segment was evaluated prior to therapy, and the amount of clot lysis was determined by comparing pre- and post-treatment MR images. MR imaging accurately identified thrombus in all cases in comparison with venography and also identified proximal extension into pelvic veins that was not identified venographically. Prior to treatment, the thrombus in eight of nine patients varied in appearance in different vein segments consistent with a course of progressive extension over time. Thrombi with low MR signal occurred more often in patients with symptoms of four days or less, and were also more common in partially occluded segments (10/12, 83%) than with total occlusion (7/43, 16%) (p < .001). Clot lysis correlated with the appearance of the thrombi occurring in 9/17 (53%) segments with a uniform low signal intensity compared to 2/38 segments (5%) with areas of high or intermediate intensity (p < .001). Clot lysis was also correlated with partial vein occlusion and with symptom duration of 4 days or less. However, even among partially occluded segments and in patients with shorter duration of symptoms, clot lysis occurred significantly more often in segments with low MR signal intensity. The association of low MR signal intensity with both shorter symptom duration and incomplete vein obstruction suggests that this appearance identifies newly formed thrombi which may be responsive to thrombolytic therapy. We conclude that MR imaging may be useful in predicting response and selecting patients for thrombolytic therapy.

Abstract 511: High Signal Intensity on Diffusion Weighted Magnetic Resonance Imaging Reflects Acuity of Deep Vein Thrombus

2017 ◽  
Vol 37 (suppl_1) ◽  
Author(s):  
Toshihiro Gi ◽  
Atsushi Yamashita ◽  
Yasuyoshi Kuroiwa ◽  
Yuko Konishi ◽  
Taketoshi Asanuma ◽  
...  
Keyword(s):  
Magnetic Resonance ◽  
Mr Imaging ◽  
Signal Intensity ◽  
Fibrous Tissue ◽  
Blood Stasis ◽  
High Signal Intensity ◽  
High Signal ◽  
Venous Thrombus ◽  
Diffusion Weighted ◽  
Deep Vein

Objective: Acuity of deep vein thrombus/ thrombosis (DVT) may affect effectiveness of anti-thrombotic therapy. However, the acuity of DVT is not reliably detected by current noninvasive imaging techniques. This study investigated whether diffusion weighted magnetic resonance (MR) imaging can detect DVT and define the acuity of thrombus in patients with DVT and a rabbit model of venous thrombus. Methods: Diffusion weighted MR imaging was performed with a 1.5-T MR system in 8 patients with DVT. Venous thrombus was induced in rabbit jugular vein by endothelial denudation and 10 minutes blood stasis with a balloon catheter. The thrombus was imaged with a 3.0-T MR system at 4 hours and at 1, 2 and 3 weeks, and the jugular veins were histologically assessed. Results: All patients were detected DVT with diffusion weighted MR imaging, and the DVT showed high or mixed high and iso signal intensity on the diffusion sequence. The rabbit venous thrombi were rich in erythrocyte and fibrin at 4 hours, and showed focal organizing reaction at 1 and 2 weeks, and was replaced by fibrous tissue at 3 weeks. The rabbit thrombi showed high signal intensity on diffusion weighted MR imaging at 4 hours, mixed high and iso signal intensity at 1 and 2 weeks, or mixed iso and low signal intensity at 3 weeks. The signal intensity was positively correlated with erythrocyte and fibrin contents, and negatively correlated with macrophage and collagen contents. Conclusions: Diffusion weighted MR imaging can detect DVT and high signal intensity on the sequence may reflect acuity of DVT.

scholarly journals Analysis of the Cochrane Review: Thrombolysis for Acute Deep Vein Thrombosis. Cochrane Database Syst Rev. 2014,1: CD002783.

2015 ◽  
Vol 28 (1) ◽  
pp. 12 ◽  
Author(s):  
Liliana Sousa Nanji ◽  
André Torres Cardoso ◽  
João Costa ◽  
António Vaz-Carneiro
Keyword(s):  
Pulmonary Embolism ◽  
Deep Vein Thrombosis ◽  
Thrombolytic Therapy ◽  
Bleeding Complications ◽  
Controlled Trials ◽  
Vein Thrombosis ◽  
Post Thrombotic Syndrome ◽  
Recurrent Deep Vein Thrombosis ◽  
Acute Deep Vein Thrombosis ◽  
Deep Vein

<p>The standard treatment for acute deep vein thrombosis (DVT) targets to reduce immediate complications, however thrombolysis could reduce the long-term complications of post-thrombotic syndrome in the affected limb. This systematic review aimed to assess the effects of thrombolytic therapy and anticoagulation <em>versus </em>anticoagulation in people with deep vein thrombosis of the lower limb through the effects on pulmonary embolism, recurrent deep vein thrombosis, major bleeding, post-thrombotic complications, venous patency and venous function. The Cochrane Peripheral Vascular Diseases Group Trials Search Co-ordinator searched the Specialised Register (last search in April 2013) and CENTRAL (2013, Issue 4). A total of 17 randomised controlled trials (RCTs) and 1103 participants were included. In the experimental group receiving thrombolysis, complete clot lysis occurred more frequently and there was greater improvement in venous patency. The incidence of post-thrombotic syndrome decreased by a 1/3 and venous ulcers were less frequent. There were more bleeding complications and 3 strokes occurred in less recent studies, yet there seemed to be no significant effect on mortality. Data on the occurrence of pulmonary embolism and recurrent deep vein thrombosis were inconclusive. There are advantages to thrombolysis, yet the application of rigorous criteria is warranted to reduce bleeding complications. Catheter-directed thrombolysis is the current preferred method, as opposed to systemic thrombolysis in the past, and other studies comparing these procedures show that results are similar.</p><p><strong>Keywords:</strong> Randomized Controlled Trials as Topic; Thrombolytic Therapy; Venous Thrombosis.</p>

scholarly journals Impact of magnetic resonance imaging on the diagnosis of abdominal complications of paroxysmal nocturnal hemoglobinuria

Blood ◽  
1995 ◽  
Vol 85 (11) ◽  
pp. 3283-3288 ◽  
Author(s):  
D Mathieu ◽  
A Rahmouni ◽  
P Villeneuve ◽  
MC Anglade ◽  
H Rochant ◽  
...  
Keyword(s):  
Magnetic Resonance ◽  
Mr Imaging ◽  
Iron Overload ◽  
Signal Intensity ◽  
Paroxysmal Nocturnal Hemoglobinuria ◽  
Renal Cortex ◽  
Iron Storage ◽  
Abdominal Complications ◽  
Vein Thrombosis ◽  
Hepatic Vein Obstruction

Magnetic resonance (MR) imaging is a method of choice for assessing vascular patency and parenchymal iron overload. During the course of paroxysmal nocturnal hemoglobinuria (PNH), it is clinically relevant to differentiate abdominal vein thrombosis from hemolytic attacks. Furthermore, the study of the parenchymal MR signal intensity adds informations about the iron storage in kidneys, liver, and spleen. Twelve PNH patients had 14 MR examinations of the abdomen with spin-echo T1- and T2-weighted images and flow-sensitive gradient echo images. Vessels patency and parenchymal signal abnormalities--either focal or diffuse--were assessed. MR imaging showed acute complications including hepatic vein obstruction in five patients, portal vein thrombosis in two patients, splenic infarct in one patient. In one patient treated with androgens, hepatocellular adenomas were shown. Parenchymal iron overload was present in the renal cortex of eleven patients with previous hemolytic attacks. On the first MR study of the remaining patient with an acute abdominal pain showing PNH, no iron overload was present in the renal cortex. Follow-up MR imaging showed the onset of renal cortex iron overload related to multiple hemolytic attacks. Despite the fact that all our patients were transfused, normal signal intensity of both liver and spleen was observed in three of them. MR imaging is particularly helpful for the diagnosis of abdominal complications of PNH.

Prognostic relevance of the postoperative evolution of intramedullary spinal cord changes in signal intensity on magnetic resonance imaging after anterior decompression for cervical spondylotic myelopathy

2007 ◽  
Vol 7 (6) ◽  
pp. 615-622 ◽  
Author(s):  
Luciano Mastronardi ◽  
Ahmed Elsawaf ◽  
Raffaelino Roperto ◽  
Alessandro Bozzao ◽  
Manuela Caroli ◽  
...  
Keyword(s):  
Spinal Cord ◽  
Magnetic Resonance ◽  
Mr Imaging ◽  
Signal Intensity ◽  
Cervical Spondylotic Myelopathy ◽  
Mr Images ◽  
Intramedullary Spinal Cord ◽  
Signal Changes ◽  
T1 And T2 ◽  
T2 Weighted Images

Object Areas of intramedullary signal intensity changes (hypointensity on T1-weighted magnetic resonance [MR] images and hyperintensity on T2-weighted MR images) in patients with cervical spondylotic myelopathy (CSM) have been described by several investigators. The role of postoperative evolution of these alterations is still not well known. Methods A total of 47 patients underwent MR imaging before and at the end of the surgical procedure (intraoperative MR imaging [iMRI]) for cervical spine decompression and fusion using an anterior approach. Imaging was performed with a 1.5-tesla scanner integrated with the operative room (BrainSuite). Patients were followed clinically and evaluated using the Japanese Orthopaedic Association (JOA) and Nurick scales and also underwent MR imaging 3 and 6 months after surgery. Results Preoperative MR imaging showed an alteration (from the normal) of the intramedullary signal in 37 (78.7%) of 47 cases. In 23 cases, signal changes were altered on both T1- and T2-weighted images, and in 14 cases only on T2-weighted images. In 12 (52.2%) of the 23 cases, regression of hyperintensity on T2-weighted imaging was observed postoperatively. In 4 (17.4%) of these 23 cases, regression of hyperintensity was observed during the iMRI at the end of surgery. Residual compression on postoperative iMRI was not detected in any patients. A nonsignificant correlation was observed between postoperative expansion of the transverse diameter of the spinal cord at the level of maximal compression and the postoperative JOA score and Nurick grade. A statistically significant correlation was observed between the surgical result and the length of a patient's clinical history. A significant correlation was also observed according to the preoperative presence of intramedullary signal alteration. The best results were found in patients without spinal cord changes of signal, acceptable results were observed in the presence of changes on T2-weighted imaging only, and the worst results were observed in patients with spinal cord signal changes on both T1- and T2-weighted imaging. Finally, a statistically significant correlation was observed between patients with postoperative spinal cord signal change regression and better outcomes. Conclusions Intramedullary spinal cord changes in signal intensity in patients with CSM can be reversible (hyperintensity on T2-weighted imaging) or nonreversible (hypointensity on T1-weighted imaging). The regression of areas of hyperintensity on T2-weighted imaging is associated with a better prognosis, whereas the T1-weighted hypointensity is an expression of irreversible damage and, therefore, the worst prognosis. The preliminary experience with this patient series appears to exclude a relationship between the time of signal intensity recovery and outcome of CSM.

The detection of bone marrow involvement by lymphoma using magnetic resonance imaging.

1987 ◽  
Vol 5 (2) ◽  
pp. 225-230 ◽  
Author(s):  
A F Shields ◽  
B A Porter ◽  
S Churchley ◽  
D O Olson ◽  
F R Appelbaum ◽  
...  
Keyword(s):  
Bone Marrow ◽  
Magnetic Resonance ◽  
Mr Imaging ◽  
Signal Intensity ◽  
Imaging System ◽  
Pulse Sequence ◽  
Spin Echo ◽  
Bone Marrow Involvement ◽  
Marrow Fat ◽  
Spin Echo Sequence

We used magnetic resonance (MR) to image the bone marrow of 31 patients with lymphoma. Images were obtained of the femoral, pelvic, and vertebral marrow with a 0.15 tesla imaging system using a T1-weighted spin echo sequence (TR600/TE 40). With this pulse sequence, normal marrow produces a high intensity signal that reflects the presence of marrow fat (short T1 relaxation time). We previously reported MR imaging of patients with leukemia in relapse and found a diffusely and symmetrically decreased marrow signal intensity due to the replacement of normal marrow fat by cellular material with a long T1. Unlike leukemia, patients with lymphomatous marrow involvement often had patchy, often discrete, areas of low signal intensity, representing focal marrow infiltration. Five of six patients in this study with lymphoma detected by histologic examination also had marrow lesions seen on MR. An additional four patients had marrow lesions detected by MR that were not detected on initial marrow biopsies; two of these had marrow involvement proven on subsequent biopsies, one had disease isolated to the vertebrae that was never pathologically documented, and one had progression of disease in the marrow documented by MR without biopsy confirmation. These results indicate that marrow involvement with lymphoma can be detected by MR imaging and that MR can complement bone marrow biopsy.

scholarly journals Efficiency of Fat Suppression in T1-Weighted Inner Ear Magnetic Resonance Imaging: Multipoint Dixon Method Versus Hybrid Techniques

2021 ◽  
Vol 17 ◽  
Author(s):  
Pinar Cakmak ◽  
Duygu Herek ◽  
Ahmet Baki Yagci ◽  
Ergin Sagtas ◽  
Furkan UFUK ◽  
...  
Keyword(s):  
Spinal Cord ◽  
Magnetic Resonance ◽  
Image Quality ◽  
Mr Imaging ◽  
Inner Ear ◽  
Signal Intensity ◽  
Signal To Noise Ratio ◽  
Fat Suppression ◽  
Signal To Noise ◽  
Hybrid Techniques

Background:: Temporal bone is a region where fat suppression is difficult due to the inhomogeneity of various structures with different molecular properties. Introduction: We aimed to determine the most effective fat suppression sequence in order to increase the visibility of the inner ear region. Methods: The hybrid techniques and T1-Weighted mDIXON images of 40 patients with Magnetic Resonance (MR) imaging of the inner ear were prospectively compared by two experienced radiologists in terms of fat suppression efficacy. In all fat-suppressed sequences, the signal to noise ratio (SNR), the spinal cord signal intensity / mean fat signal intensity ratio and spinal cord signal to noise ratio were calculated. Suppression efficacy of MR techniques for fat areas in the inner ear were visually graded. Results: Qualitative assessment of image quality due to fat suppression in the inner ear; the Dixon technique showed significantly better than SPAIR and SPIR techniques (p<0.0001). Mean signal intensity of the inner ear fat and SNR for Dixon technique were significantly lower than that for SPIR and SPAIR techniques (p<0.0001). Inter-observer agreement for the measurement of the inner ear fat mean signal intensity values and mean SNR values for fat suppression techniques were excellent. Conclusion: The Dixon technique has higher image quality and fat suppression efficiency than the hybrid techniques in MR imaging of the inner ear.

scholarly journals Correlation between Preoperative Magnetic Resonance Imaging Signal Intensity Changes and Clinical Outcomes in Patients Surgically Treated for Cervical Myeloradiculopathy

2017 ◽  
Vol 11 (2) ◽  
pp. 174-180 ◽  
Author(s):  
Chaitanya Baban Chikhale ◽  
Ketan Shripad Khurjekar ◽  
Ashok Kumar Shyam ◽  
Parag Kantilal Sancheti
Keyword(s):  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Signal Intensity ◽  
Neurological Status ◽  
Resonance Imaging ◽  
Duration Of Symptoms ◽  
Japanese Orthopedic Association ◽  
Canal Stenosis ◽  
Operative Outcomes ◽  
The Mean

<sec><title>Study Design</title><p>This was a single surgeon, single center-based retrospective study with prospective data collection.</p></sec><sec><title>Purpose</title><p>To assess the correlation between T2-weighted magnetic resonance imaging (MRI) signal intensity (SI) changes and factors such as age, duration of symptoms, baseline modified Japanese Orthopedic Association (mJOA) score and to determine its prognostic value in predicting recovery after surgery.</p></sec><sec><title>Overview of Literature</title><p>Whether intramedullary cord T2-weighted MRI SI changes can predict operative outcomes of cervical myeloradiculopathy remains debatable, with only a few prospective studies analyzing the same.</p></sec><sec><title>Methods</title><p>Forty-six consecutive patients who underwent cervical myeloradiculopathy were included and were followed up for an average of 1 year. Preoperative T2-weighted MRI SI grading was performed for all patients. The correlation between MRI SI changes and age, duration of symptoms, preoperative mJOA score, and mJOA score at 1-year follow-up were analyzed.</p></sec><sec><title>Results</title><p>Fifteen patients had single-level (21.73%) or double-level (10.86%) prolapsed discs; 54.34% had degenerative cervical spondylosis with canal stenosis or multilevel disc prolapse and 13.07% had ossified posterior longitudinal ligaments. The mean age was 56.17±9.53 years (range, 35–81 years). The mean baseline mJOA score was 10.83±2.58 (range, 6–16), which postoperatively improved to 13.59±2.28 (range, 8–17; <italic>p</italic>&lt;0.001). There was a statistically significant correlation between mJOA score at 1 year and MRI T2 SI grading (<italic>p</italic>=0.017).</p></sec><sec><title>Conclusions</title><p>Patients with longer symptom durations had high grades of intramedullary cord T2-weighted MRI SI changes. Age and preoperative neurological status were not significantly correlated with the existence of intramedullary cord SI changes. However, patients without or with mild and diffuse intramedullary cord T2-weighted MRI SI changes had better postoperative neurological recovery than those with sharp and focal SI changes.</p></sec>

scholarly journals Hemorrhage of cavernous malformations during pregnancy and in the peripartum period: causal or coincidence?

2006 ◽  
Vol 21 (1) ◽  
pp. 1-4 ◽  
Author(s):  
Sam Safavi-Abbasi ◽  
Iman Feiz-Erfan ◽  
Robert F. Spetzler ◽  
Louis Kim ◽  
Seref Dogan ◽  
...  
Keyword(s):  
Magnetic Resonance ◽  
Mr Imaging ◽  
Cesarean Section ◽  
Lower Extremity ◽  
Signal Intensity ◽  
Mr Images ◽  
Cavernous Malformations ◽  
Peripartum Period ◽  
Risk Of Hemorrhage ◽  
Thoracic Lesion

✓There is growing evidence to suggest that pregnancy may increase the risk of hemorrhage from cavernous malformations (CMs). In the present case, a 21-year-old primigravida was admitted to the authors' neurosurgical service after a cesarean section. Three weeks before admission she had experienced rapidly progressive bilateral lower-extremity paresthesias. Spinal magnetic resonance (MR) imaging revealed the presence of an intramedullary thoracic lesion. On T2-weighted MR images, heterogeneous signal intensity with a rim of decreased intensity was demonstrated in the spine. The mass was successfully resected, and 1 year later the patient's symptoms had resolved completely. This is the fourth reported case of a spinal intramedullary CM that became symptomatic during pregnancy. The pathogenesis and management of this entity are reviewed.

Using the T2-weighted magnetic resonance imaging signal intensity ratio and clinical manifestations to assess the prognosis of patients with cervical ossification of the posterior longitudinal ligament

2010 ◽  
Vol 13 (3) ◽  
pp. 319-323 ◽  
Author(s):  
Lin-Feng Wang ◽  
Ying-Ze Zhang ◽  
Yong Shen ◽  
Yan-Ling Su ◽  
Jia-Xin Xu ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Spinal Cord ◽  
Magnetic Resonance ◽  
Mr Imaging ◽  
Signal Intensity ◽  
Intensity Ratio ◽  
Clinical Manifestations ◽  
Posterior Longitudinal Ligament ◽  
Signal Intensity Ratio ◽  
Resonance Imaging

ObjectThe aim of this study was to investigate the clinical significance of both the signal intensity ratio obtained from MR imaging and clinical manifestations on the prognosis of patients with cervical ossification of the posterior longitudinal ligament.MethodsThe authors retrospectively reviewed the records of 58 patients with cervical ossification of the posterior longitudinal ligament who underwent cervical laminoplasty from February 1999 to July 2007. Magnetic resonance imaging (1.5-T) was performed in all patients before surgery. Sagittal T2-weighted images of the cervical spinal cord compressed by the ossified posterior longitudinal ligament showed increased intramedullary signal intensity, whereas the sagittal images obtained at the C7–T1 disc levels were of normal intensity. The signal intensity ratio between regions of intramedullary increased signal intensity and the normal C7–T1 disc level was calculated based on the signal intensity values generated from the MR imaging workstation. Patients were divided into 3 groups according to their signal intensity ratio (high, intermediate, and low signal intensity groups).ResultsThere were significant differences between the 3 groups regarding recovery rate (p < 0.001), age (p = 0.022), duration of disease (p = 0.001), Babinski sign (p < 0.001), ankle clonus (p < 0.001), and both pre- and postoperative Japanese Orthopaedic Association score (p < 0.001). There was no significant difference in sex among the 3 groups (p = 0.391).ConclusionsPatients with low signal intensity ratios that changed on T2-weighted imaging experienced a good surgical outcome. Low increased signal intensity might reflect mild neuropathological alteration in the spinal cord and greater recuperative potential. An increased signal intensity ratio with positive pyramidal signs indicates less recuperative potential of the spinal cord and a poor surgical outcome.

scholarly journals Thoracic calcifications on magnetic resonance imaging: correlations with computed tomography

2019 ◽  
Vol 45 (4) ◽  
Author(s):  
Juliana Fischman Zampieri ◽  
Gabriel Sartori Pacini ◽  
Matheus Zanon ◽  
Stephan Philip Leonhardt Altmayer ◽  
Guilherme Watte ◽  
...  
Keyword(s):  
Magnetic Resonance ◽  
Mr Imaging ◽  
Signal Intensity ◽  
Ct Scans ◽  
Rio Grande Do Sul ◽  
Resonance Imaging ◽  
Mr Images ◽  
Hyperintense Lesion ◽  
Neoplastic Lesions ◽  
T1 And T2

ABSTRACT Objective: To identify the characteristics of thoracic calcifications on magnetic resonance (MR) imaging, as well as correlations between MR imaging and CT findings. Methods: This was a retrospective study including data on 62 patients undergoing CT scans and MR imaging of the chest at any of seven hospitals in the Brazilian states of Rio Grande do Sul, São Paulo, and Rio de Janeiro between March of 2014 and June of 2016 and presenting with calcifications on CT scans. T1- and T2-weighted MR images (T1- and T2-WIs) were semiquantitatively analyzed, and the lesion-to-muscle signal intensity ratio (LMSIR) was estimated. Differences between neoplastic and non-neoplastic lesions were analyzed. Results: Eighty-four calcified lesions were analyzed. Mean lesion density on CT was 367 ± 435 HU. Median LMSIRs on T1- and T2-WIs were 0.4 (interquartile range [IQR], 0.1-0.7) and 0.2 (IQR, 0.0-0.7), respectively. Most of the lesions were hypointense on T1- and T2-WIs (n = 52 [61.9%] and n = 39 [46.4%], respectively). In addition, 19 (22.6%) were undetectable on T1-WIs (LMSIR = 0) and 36 (42.9%) were undetectable on T2-WIs (LMSIR = 0). Finally, 15.5% were hyperintense on T1-WIs and 9.5% were hyperintense on T2-WIs. Median LMSIR was significantly higher for neoplastic lesions than for non-neoplastic lesions. There was a very weak and statistically insignificant negative correlation between lesion density on CT and the following variables: signal intensity on T1-WIs, LMSIR on T1-WIs, and signal intensity on T2-WIs (r = −0.13, p = 0.24; r = −0.18, p = 0.10; and r = −0.16, p = 0.16, respectively). Lesion density on CT was weakly but significantly correlated with LMSIR on T2-WIs (r = −0.29, p < 0.05). Conclusions: Thoracic calcifications have variable signal intensity on T1- and T2-weighted MR images, sometimes appearing hyperintense. Lesion density on CT appears to correlate negatively with lesion signal intensity on MR images.

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