The chameleon of neuroinflammation: magnetic resonance imaging characteristics of natalizumab-associated progressive multifocal leukoencephalopathy

2013 ◽  
Vol 19 (14) ◽  
pp. 1826-1840 ◽  
Author(s):  
Mike P Wattjes ◽  
Nancy D Richert ◽  
Joep Killestein ◽  
Marlieke de Vos ◽  
Esther Sanchez ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Progressive Multifocal Leukoencephalopathy ◽  
Imaging Findings ◽  
Resonance Imaging ◽  
Mri Findings ◽  
Comprehensive Overview ◽  
Imaging Characteristics ◽  
Demyelinating Lesions ◽  
Asymptomatic Stage

Natalizumab is a monoclonal antibody against α4-integrin approved for the treatment of multiple sclerosis (MS) due to a positive effect on clinical and magnetic resonance imaging (MRI) outcome measures. However, one relatively rare but serious side effect of this drug is a higher risk of developing progressive multifocal leukoencephalopathy (PML). Since the FDA approval, more than 300 natalizumab-associated PML cases have been documented among more than 100,000 treated MS patients. MRI is a crucial tool in the surveillance of patients treated with natalizumab in order to detect possible signs of PML in the asymptomatic stage. Although classical imaging characteristics of PML are well established, MRI findings in natalizumab-associated PML, particularly in early disease stages, show rather new and heterogeneous imaging findings including different patterns of inflammation with contrast enhancement. This review provides a comprehensive overview of the heterogeneous imaging findings in natalizumab-associated PML in the context of the underlying pathophysiology, histopathology, and the diagnostic procedure. We describe the MRI patterns of PML lesion evolution and complications including immune reconstitution inflammatory syndrome (IRIS). Finally, we present guidelines to differentiate MRI findings in PML from inflammatory demyelinating lesions, to facilitate the early diagnosis of PML in patients treated with natalizumab.

scholarly journals Balo’s Concentric Sclerosis Mimicking Tumor on Magnetic Resonance Imaging in a Young Patient

2021 ◽  
Vol 14 ◽  
pp. 117954762198967
Author(s):  
Van Trung Hoang ◽  
Cong Thao Trinh ◽  
Hoang Anh Thi Van ◽  
Thanh Tam Thi Nguyen ◽  
Vichit Chansomphou ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Demyelinating Disease ◽  
Management Strategies ◽  
Resonance Imaging ◽  
Mri Findings ◽  
Demyelinating Lesions ◽  
Baló’S Concentric Sclerosis ◽  
Magnetic Resonance Imaging Mri ◽  
Subcortical Regions

Balo’s concentric sclerosis (BCS) is a rare demyelinating disease known as Multiple Sclerosis (MS) lesion type III. It is a disease of the white matter of the brain characterized by a round lesion with variable concentric myelinated and demyelinated layers, appearing as “onion bulb.” We present a case of BCS and discuss the imaging findings and management strategies of this disease. A 26-y-old male developed headache, weakness, and numbness of limbs. Magnetic resonance imaging (MRI) showed concentric lamellar like demyelinating lesions at the subcortical regions. The patient’s neurological symptoms were consistent with the MRI findings.

Transperineal Ultrasonographic and Magnetic Resonance Imaging Findings of Vaginal Adenosis

2021 ◽  
Vol 17 ◽  
Author(s):  
Sebnem Karasu ◽  
Atilla Hikmet Cilengir ◽  
Irfan Ocal ◽  
Serpil Aydogmus
Keyword(s):  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Chronic Pelvic Pain ◽  
English Literature ◽  
Vaginal Wall ◽  
Imaging Findings ◽  
Resonance Imaging ◽  
Mri Findings ◽  
Proven Case ◽  
Magnetic Resonance Imaging Mri

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.

scholarly journals Calcaneal Apophysitis (Sever's Disease): MRI Findings

2016 ◽  
Vol 35 (2) ◽  
pp. 172-174
Author(s):  
Mehmet S Dogan ◽  
Selim Doganay ◽  
Gonca Koc ◽  
Sureyya B Gorkem ◽  
Saliha Ciraci ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Clinical Examination ◽  
Heel Pain ◽  
Imaging Modalities ◽  
Imaging Findings ◽  
Resonance Imaging ◽  
Mri Findings ◽  
Typical History ◽  
Calcaneal Apophysitis

Calcaneal apophysitis (Sever’s disease), is the most frequent cause of the heel pain in growing children. The diagnosisis generally made with a typical history and clinical examination. Imaging modalities including radiography and magnetic resonance imaging can help establish the diagnosis. In this case we report imaging findings of an 11-year-old boy diagnosed as Sever’s disease.J Nepal Paediatr Soc 2015;35(2):172-174

scholarly journals Magnetic Resonance Imaging Findings of the Asymptomatic Elbow Predict Injuries and Surgery in Major League Baseball Pitchers

2019 ◽  
Vol 7 (1) ◽  
pp. 232596711881841 ◽  
Author(s):  
Grant H. Garcia ◽  
Anirudh K. Gowd ◽  
Brandon C. Cabarcas ◽  
Joseph N. Liu ◽  
John R. Meyer ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Major League Baseball ◽  
Operative Procedure ◽  
Imaging Findings ◽  
Resonance Imaging ◽  
Mri Findings ◽  
Major League ◽  
Mri Scans ◽  
Baseball Pitchers

Background: Repetitive pitching produces significant stress on the elbow that may result in structural abnormalities discernable on magnetic resonance imaging (MRI) without causing symptoms. Purpose: To determine whether there exists an association between subclinical MRI findings in asymptomatic elbows of Major League Baseball (MLB) players and future placement on the disabled list (DL) or future operative procedure. Study Design: Cohort study; Level of evidence, 3. Methods: MRI scans of the elbows of professional-level baseball pitchers, taken during routine presigning imaging at a single organization from 2005 to 2017, were retrospectively reviewed. Publicly available databases were queried to exclude pitchers with an injury before the earliest session of elbow MRI. Three blinded reviewers reviewed all MRI scans independently to evaluate for the presence of chondral damage to the joint, loose bodies, ulnar collateral ligament (UCL) heterogeneity or tears, flexor pronator mass defects, and signs of posteromedial (PM) impingement. Binary imaging findings were related to future placement on the DL for elbow complaints and future elbow surgery. Results: A total of 41 pitchers had asymptomatic MRI findings with no prior DL placement. For players who eventually went on the DL, there were a statistically greater number of players with UCL heterogeneity ( P = .021), humeral-sided partial UCL tears ( P = .031), and PM impingement ( P = .004) on preinjury MRI compared with players who remained healthy. PM impingement was related to future elbow-related surgery ( P = .003). Pitchers with UCL heterogeneity were associated with reduced career strike zone percentage, innings pitched, and fastball percentage ( P < .05 for all). Conclusion: UCL heterogeneity, PM impingement, and humeral-sided partial tears were correlated with future DL placement for elbow-related reasons in MLB pitchers. Asymptomatic PM impingement may be a precursor to future surgery.

scholarly journals Prediction of the Outcome of Cochlear Implantation in the Patients with Congenital Cytomegalovirus Infection based on Magnetic Resonance Imaging Characteristics

2019 ◽  
Vol 8 (2) ◽  
pp. 136
Author(s):  
Jae Han ◽  
Yun Bae ◽  
Seul Song ◽  
Jae-Jin Song ◽  
Ja-Won Koo ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Cochlear Implantation ◽  
Brain Mri ◽  
Brain Magnetic Resonance Imaging ◽  
Control Group ◽  
Resonance Imaging ◽  
Mri Findings ◽  
Congenital Cytomegalovirus ◽  
Imaging Characteristics

The goal of this study was to elucidate radiologic biomarker that can predict the outcome of cochlear implantation (CI) in congenital cytomegalovirus (cCMV) related deafness. A retrospective survey of speech perception after CI and an evaluation of brain magnetic resonance imaging (MRI) findings were performed in 10 cochlear implantees with cCMV-related prelingual deafness. Specifically, a special attention was paid to the degree of white matter (WM) abnormality shown in brain MRI, which was used to divide our cohort into two groups: The mild and severe pathology groups. Age-matched prelingual deaf patients with idiopathic sensorineural hearing loss were selected as controls. Subjects in mild pathology groups showed higher a Category of Auditory Performance (CAP) score (5.2 ± 0.8) than those with severe pathologies (3.4 ± 1.5) (P = 0.041). Importantly, speech performance from subjects with mild pathology was comparable to that of the control group (mean CAP score of 5.2 ± 0.8 vs. 5.1 ± 1.2) (P = 0.898). Mild pathologies related to the limited WM lesion in MRI not accompanied by severe MRI pathologies, such as diffuse WM abnormality, myelination delay, ventriculomegaly, migration abnormality, and cerebellar hypoplasia, can be tolerated and do not adversely affect the CI outcome in cCMV deafness.

scholarly journals Epithelioid Myofibroblastoma in an Old-Male Breast: A Case Report with MRI Findings

2015 ◽  
Vol 2015 ◽  
pp. 1-4 ◽  
Author(s):  
Seyma Yildiz ◽  
Zuhal Gucin ◽  
Ezgi Basak Erdogan
Keyword(s):  
Magnetic Resonance Imaging ◽  
Prostate Cancer ◽  
Case Report ◽  
Magnetic Resonance ◽  
Postmenopausal Women ◽  
Final Diagnosis ◽  
Resonance Imaging ◽  
Mri Findings ◽  
Imaging Characteristics ◽  
Magnetic Resonance Imaging Mri

Myofibroblastoma of the breast (MFB) is a very rare benign stromal tumor. In recent years, increase in mammographic screenings has resulted in increased diagnosis of MFB. Most cases are old males and postmenopausal women. MFB may be confused as malignant, clinically, morphologically, or by imaging. Immunohistochemistry is essential for final diagnosis in these cases. We report a case of a pathologically diagnosed MFB in an 80-year-old male patient who had coexisting prostate cancer and describe its imaging characteristics, especially magnetic resonance imaging (MRI). In this paper, histopathological and MRI findings of the MFB were discussed.

Rapidly Progressive Dementia: A Clinicopathologic Correlation

1996 ◽  
Vol 9 (4) ◽  
pp. 209-213
Author(s):  
John C. Adair ◽  
Ronald L. Schwartz ◽  
Thomas A. Eskin ◽  
Anthony T. Yachnis ◽  
Kenneth M. Heilman
Keyword(s):  
Magnetic Resonance Imaging ◽  
Differential Diagnosis ◽  
Magnetic Resonance ◽  
Progressive Multifocal Leukoencephalopathy ◽  
Resonance Imaging ◽  
Mri Findings ◽  
Progressive Dementia ◽  
Clinicopathologic Correlation ◽  
Dementia Syndrome ◽  
Magnetic Resonance Imaging Mri

We evaluated a 66-year-old man with a rapidly progressive, akinetic-rigid dementia syndrome. Despite extensive testing, which included magnetic resonance imaging (MRI), we were unable to make the correct antemortem diagnosis. Autopsy demonstrated spontaneous progressive multifocal leukoencephalopathy. This report illustrates that even in the absence of characteristic MRI findings, this uncommon cause of dementia should be considered in the differential diagnosis of rapidly progressive, akinetic-rigid syndromes with dementia.

scholarly journals Morel-Lavallee Syndrome: A Rare Tumefactive Lesion

2020 ◽  
Author(s):  
Mohamed Labied ◽  
Siham Salam ◽  
Salma Jabri ◽  
Dalal Laoudiyi ◽  
Kamilia Chbani ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Lower Leg ◽  
Differential Diagnoses ◽  
Fibrous Capsule ◽  
Imaging Findings ◽  
Resonance Imaging ◽  
Imaging Characteristics ◽  
French Surgeon ◽  
Over Time

First described by the French surgeon Maurice Morel-Lavallee in 1853, Morel-Lavallee syndrome (MLS) is a serolymphatic effusion resulting from tangential injury to richly vascularized tissues. The imaging characteristics may be variable over time due to lesion progression and the eventual organization of a fibrous capsule. We report a case of extensive MLS in the lower leg of a 12-year-old child. We discuss the ultrasound and magnetic resonance imaging findings and describe the differential diagnoses.

scholarly journals Magnetic Resonance Imaging Characteristics of Tumefactive Demyelinating Lesions

2015 ◽  
Vol 08 (05) ◽  
pp. 321-326
Author(s):  
Jiro Akimoto ◽  
Tomohiro Suda ◽  
Ryo Hashimoto ◽  
Hirokazu Fukuhara ◽  
Michihiro Kohno
Keyword(s):  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Resonance Imaging ◽  
Imaging Characteristics ◽  
Demyelinating Lesions

scholarly journals Computed tomography and magnetic resonance imaging findings of nasal chondromesenchymal hamartoma in a young child: a case report

2020 ◽  
Vol 48 (8) ◽  
pp. 030006052092043
Author(s):  
Ya-qiong Cui ◽  
Li-li Wang ◽  
Gang Huang ◽  
Lian-ping Zhao
Keyword(s):  
Magnetic Resonance Imaging ◽  
Computed Tomography ◽  
Magnetic Resonance ◽  
Malignant Neoplasm ◽  
Radical Excision ◽  
Imaging Findings ◽  
Resonance Imaging ◽  
Radiographic Appearance ◽  
Imaging Characteristics ◽  
Nasal Chondromesenchymal Hamartoma

Nasal chondromesenchymal hamartoma (NCMH) is a rare destructive benign neoplasm that predominantly develops in infants and young children. The lesion is usually located in the nasal cavity, often in the adjacent paranasal sinuses and orbital region and especially in the ethmoid sinus. Because the imaging characteristics of NCMH often mimic the features of malignant tumors, it is clinically important to study the radiographic appearance of this disease. Therefore, we herein present the computed tomography and magnetic resonance imaging findings of NCMH occurring in a 7-year-old girl. The mass was resected via an endoscopic surgical approach and definitively diagnosed as NCMH based on histologic and immunohistochemical analysis. However, signs of tumor recurrence manifested 45 months after surgery. NCMH can be locally aggressive with an expansive and destructive radiographic appearance, which highly implies a malignant neoplasm. Hence, an accurate diagnosis is essential to avoid potentially harmful therapies, and detailed computed tomography or magnetic resonance imaging should be performed prior to surgery. Selective arterial embolization is also an important part of preoperative management because the degree of enhancement may not be adequate to determine the blood supply of the tumor. Moreover, complete radical excision cannot guarantee that the lesion will not recur.

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