Does collagenase injection disrupt or digest the Dupuytren’s cord: a magnetic resonance imaging study

2016 ◽  
Vol 41 (6) ◽  
pp. 614-620 ◽  
Author(s):  
K. M. Crivello ◽  
H. G. Potter ◽  
E. S. Moon ◽  
S. K. Rancy ◽  
Scott W. Wolfe
Keyword(s):  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Signal Intensity ◽  
Imaging Study ◽  
Resonance Imaging ◽  
Level Of Evidence ◽  
Collagenase Injection ◽  
Intensity Changes ◽  
Full Correction ◽  
Magnetic Resonance Imaging Mri

Collagenase clostridium histolyticum has been extensively studied as a treatment modality for Dupuytren’s contracture. Its mechanism of action has been documented. It is unknown whether injected collagenase weakens the Dupuytren’s cord sufficiently to cause failure during manipulation or if there is digestion and reduction in cord volume. We examined five patients with isolated contractures of the ring or middle metacarpalphalangeal (MP) joint using magnetic resonance imaging (MRI) prior to injection with collagenase and again 1 month following injection. All patients had full correction after manipulation which was maintained at follow-up. The Dupuytren’s cord was evaluated with respect to volume, signal intensity, inflammatory changes and continuity. Additionally, signal intensity changes of the flexor tendons and neurovascular structures were recorded. MRI demonstrated cord discontinuity, significant reduction of cord volume and a significant increase in cord signal intensity after treatment with collagenase. There was a slight increase in flexor tendon signal intensity that was not significant. These findings suggest that there may be local chemical dissolution of the cord. Future studies may establish whether or not this will have prognostic implications in terms of correction and recurrence following collagenase injection. Level of evidence: IV

Could we assess the functional status, of hormone secreting, or non-secreting of the adrenal masses regarding their Magnetic Resonance Imaging (MRI) characteristics?

2021 ◽  
Vol 22 ◽  
Author(s):  
Gamze Akkus ◽  
Ferhat Piskin ◽  
Barış Karagun ◽  
Murat Sert ◽  
Mehtap Evran ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Chemical Shift ◽  
Functional Status ◽  
Signal Intensity ◽  
Adrenal Mass ◽  
Resonance Imaging ◽  
Intensity Index ◽  
Adrenal Masses ◽  
Magnetic Resonance Imaging Mri

Background: Diagnostic imaging techniques including magnetic resonance imaging (MRI) should also perform on all patients with incidentalomas. However, there is a limited study whether the quantitative measurements (signal intensity index, adrenal to spleen ratio) in MRI could predict the functional status of adrenal adenomas. Material-Method: Between 2015-2020; 404 patients (265 females, 139 males) with adrenal mass who were referred to the university hospital for further investigation were included. After detailed diagnostic hormonal evaluation, all patients underwent MRI 1.5 T device (Signa, GE Medical Systems; Milwaukee, USA). The signal intensities of the adrenal lesions on T2W images were qualitatively evaluated and noted as homogenous or heterogeneous in comparison with the liver signal intensity (SI). A chemical-shift SI index and chemical shift adrenal-to-spleen SI ratio were also calculated. Results: While 331(81.9%) of the patients had nonfunctional adrenal mass, the rest of them (n=73, 18.1%) were patients with functional (autonomous cortisol secretion-ACS, cushing syndrome-CS, pheochromocytoma, primary hyperaldosteronism-PA) adrenal masses. In phase vs phase values of patients with NFAI, Pheo(n=17), ACS (n=30), CS (n=11), and PA (n=15) were 474.04±126.7 vs 226.6±132.4, 495.3±182.8 vs 282.17±189.1, 445.2±134.8 vs 203.3±76.2, 506.8±126.5 vs 212.2±73.6 and 496.2±147.5 vs 246.6±102.1, respectively. Mean signal intensity index (SII) and adrenal to spleen ratio (ASR) of all groups (NFAI, Pheo, ACS, CS, PA) were 52.0±24.8 and 0.51, 44.9±22.5 and 0.55, 49.5±24.5 and 0.53, 56.2±16.4 and 0.43, 47.6±25.1 and 0.54, respectively. Based the current accepted measurements in the case of ASR and SII, all lesions were similar and shown as fat rich adenomas (p*= 0.552, p** = 0.45). Conclusion: The quantitative assessment (SII, ASR) of intracellular lipids in an incidentally discovered adrenal tumour could only help distinguish adrenal masses in case of adenomas or non-adenomas As initial diagnostic evaluation, clinical and laboratory assessment ,to distinguish hormone secretion, should be taken in all patients with adrenal incidentalomas.

scholarly journals Dorsal Spinal Ligamentum Flavum Thickening: A Magnetic Resonance Imaging Study

2018 ◽  
Vol 12 (1) ◽  
pp. 47-51 ◽  
Author(s):  
Amarnath Chelladurai ◽  
Suhasini Balasubramaniam ◽  
Sarenya Preyah Anbazhagan ◽  
Sathyan Gnanasihamani ◽  
Sukumar Ramaswami
Keyword(s):  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Ligamentum Flavum ◽  
Imaging Study ◽  
Mean Value ◽  
Resonance Imaging ◽  
Magnetic Resonance Imaging Mri ◽  
Compressive Myelopathy ◽  
Relationship Of ◽  
Dorsal Spinal

<sec><title>Study Design</title><p>A retrospective radiological study of the ligamentum flavum (LF).</p></sec><sec><title>Purpose</title><p>We determined the relationship of dorsal spinal LF thickening with age and sex using magnetic resonance imaging (MRI). We also determined whether LF thickening has a predominant tendency to occur at a specific dorsal level and on a specific side.</p></sec><sec><title>Overview of Literature</title><p>Many researchers have studied LF thickness at dorsal levels in patients with compressive myelopathy. However, there is a dearth of literature pertaining to the study of dorsal LF thickness in patients without myelopathy.</p></sec><sec><title>Methods</title><p>LF thickness was measured at dorsal levels from T1 to T12 on both sides using MRI in 100 individuals. The patients were divided into three groups based on age: 20 to 40, 41 to 60, and &gt;60 years. On axial T2-weighted imaging at the mid-disc level, LF thickness was measured perpendicular to the lamina border, either at half the length of LF or at maximum thickness, whichever was greater.</p></sec><sec><title>Results</title><p>We found that LF thickness does not increase significantly with increasing age and there was no significant disparity in LF thickness between the sides and sexes. We also found that there was a significant increase in LF thickness at the T10–T11 level (mean value, 3.27±0.94 mm).</p></sec><sec><title>Conclusions</title><p>LF thickness does not appear to have any side/sex dominance. LF thickening has a predominant tendency to occur specifically at the T10–T11 level. This may be due to maximum tensile strength and mobility at this level. Because there is an increased tendency for LF thickening at the T10–T11 level, this may be used as a reference point for counting the vertebral levels.</p></sec>

scholarly journals Diagnostic value of magnetic resonance imaging in the analysis of ameloblastoma: report of two cases

2019 ◽  
Vol 22 (3) ◽  
pp. 425-431
Author(s):  
Neiandro Santos Galvão ◽  
Antonione Santos Bezerra Pinto ◽  
Alan Leandro Carvalho Farias ◽  
André Luiz Ferreira Costa ◽  
Sérgio Lúcio Pereira de Castro Lopes ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Differential Diagnosis ◽  
Magnetic Resonance ◽  
Signal Intensity ◽  
Diagnostic Value ◽  
Resonance Imaging ◽  
Intermediate Signal Intensity ◽  
Additional Information ◽  
Imaging Characteristics ◽  
Magnetic Resonance Imaging Mri

Ameloblastoma is an odontogenic tumor that shares clinical and imaging characteristics with other lesions of the jaws, such as odontogenic keratocyst, which makes the diagnosis difficult. However, in addition to radiographic and tomographic examinations, Magnetic Resonance Imaging (MRI) has been increasingly used, contributing with relevant additional information about the differentiation between solid and liquid components of the lesion. This case report was conducted to present two variations of ameloblastoma and discuss the radiographic, tomographic and MRI contribution in the differential diagnosis between ameloblastoma and odontogenic keratocyst.The signal intensity in T1-weighted MRI revealed internal fluid content in both cases, which was important in the differential diagnosis with other intraosseous lesions such as odontogenic keratocysts. This is probably due to the presence of keratin that increases the viscosity of the content and also for an intermediate signal intensity signal in T2-weighted MRI. Therefore, MRI revealed important internal characteristics of the reported lesions, which was very useful in the establishment of the differential diagnosis with other lesions.

scholarly journals The ivy sign

2014 ◽  
Vol 18 (1) ◽  
Author(s):  
Nasreen Mahomed ◽  
Evance Chisama ◽  
Sanjay Prabhu
Keyword(s):  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Moyamoya Disease ◽  
Signal Intensity ◽  
Perivascular Spaces ◽  
Resonance Imaging ◽  
Leptomeningeal Enhancement ◽  
Weighted Magnetic Resonance Imaging ◽  
Mri Sequences ◽  
Magnetic Resonance Imaging Mri

The ivy sign refers to diffuse bilateral leptomeningeal enhancement on post- contrastT1-weighted magnetic resonance imaging (MRI) and increased signal intensity in bilateralsubarachnoid spaces and perivascular spaces on T2-weighted fluid attenuation inversionrecovery (FLAIR) MRI sequences in patients with moyamoya disease.

scholarly journals Radiologist Identification of Occult Dorsal Wrist Ganglion Cysts on MRI

2019 ◽  
Vol 08 (04) ◽  
pp. 276-279
Author(s):  
Gregory Versteeg ◽  
Kanu Goyal
Keyword(s):  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Resonance Imaging ◽  
Radiology Report ◽  
Level Of Evidence ◽  
Ganglion Cysts ◽  
Magnetic Resonance Imaging Mri ◽  
Dorsal Ganglion ◽  
Dorsal Wrist Ganglion

Background Occult dorsal ganglion cysts (ODGC) require imaging or an operation for detection. It is currently unknown how often a radiologist identifies an ODGC on magnetic resonance imaging (MRI) and whether surgeon indication for MRI aids the radiologist in detection. Questions/Purposes The aim of the study was to investigate the following questions: how accurately do radiologists identify ODGC on MRIs? What factors may be associated with missed ODGCs? Patients and Methods We retrospectively studied patients who underwent an operation for an ODGC and had a preoperative wrist MRI. Radiology report and surgeon's notes were evaluated to determine whether identification of the ODGC was noted and whether the surgeon indicated that the MRI was to evaluate for an ODGC. MRIs were reviewed, dimensions of cysts measured and volume of cyst calculated. Results Twenty-four patients and 25 MRIs were analyzed. The radiologist identified the ODGC in 19 cases (76%). Fifteen of the 25 MRIs (60%) ordered had ODGC listed in the requisition comment by the ordering surgeon. Thirteen of these 15 (87%) ODGCs were seen by the radiologist. Ten of the 25 MRIs (40%) ordered did not mention ODGC in the requisition. Six of these 10 (60%) ODGCs were seen by the radiologist. The volume of the ODGCs missed by radiologists was smaller (mean, 0.049 cm3) than those the radiologists identified (mean, 0.31 cm3; p = 0.004). Conclusions Radiologists will not always identify the ODGC on an MRI, but they were more likely to if the surgeon was concerned for one. Hand surgeons should report suspicion of an ODGC on MRI requisition and review all imaging independently. Level of Evidence This is a Level III, prognostic study.

Cavum septum pellucidum in schizophrenia, affective disorder and healthy controls: a magnetic resonance imaging study

1993 ◽  
Vol 23 (2) ◽  
pp. 319-322 ◽  
Author(s):  
George J. Jurjus ◽  
Henry A. Nasrallah ◽  
Stephen C. Olson ◽  
Steven B. Schwarzkopf
Keyword(s):  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Imaging Study ◽  
Septum Pellucidum ◽  
Healthy Controls ◽  
Resonance Imaging ◽  
Cavum Septum Pellucidum ◽  
Clinical Difference ◽  
Magnetic Resonance Imaging Mri ◽  
Mri Study

SynopsisMany structural brain abnormalities have been described in schizophrenia, consistent with a neurodevelopmental model for this disease. We report here a study of the cavum septum pellucidum (CSP) in schizophrenia compared to control groups, as well as the clinical correlates of this congenital anomaly in schizophrenia. We conducted a magnetic resonance imaging (MRI) study to compare rates of CSP in schizophrenia (N = 67) v. psychiatric controls (bipolar and schizoaffective, N = 60) and healthy controls (N = 37). Of the controls 18·9 %, and of all psychotic subjects 18·1 % had a CSP of any size and there was no difference in the frequency of large CSP among the groups. Males had higher rates of CSP than females (25% v. 9·7%, P = 0·01) in all groups. Schizophrenics had higher CSP rates than affective patients (25%, v. 10%, P = 0·02). No clinical difference was found between schizophrenics with or without CSP.

EXTENSIVE WHITE MATTER CHANGES AFTER STEREOTACTIC RADIOSURGERY FOR BRAIN ARTERIOVENOUS MALFORMATIONS

Neurosurgery ◽  
2008 ◽  
Vol 63 (6) ◽  
pp. 1064-1070 ◽  
Author(s):  
René van den Berg ◽  
Dennis R. Buis ◽  
Frank J. Lagerwaard ◽  
Geert J. Lycklama à Nijeholt ◽  
W. Peter Vandertop
Keyword(s):  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Signal Intensity ◽  
Arteriovenous Malformations ◽  
High Signal Intensity ◽  
High Signal ◽  
Resonance Imaging ◽  
White Matter Changes ◽  
Intensity Changes ◽  
Brain Avms

Abstract OBJECTIVE Perinidal high-signal-intensity changes on T2-weighted magnetic resonance imaging can be seen surrounding radiosurgically treated brain arteriovenous malformations (AVM). Occasionally, these signal intensity changes develop far beyond the irradiated volume. A retrospective analysis of both the pre- and postradiosurgery magnetic resonance imaging and angiographic studies was performed to analyze the cause of these extensive perinidal white matter changes. METHODS The pre- and postradiosurgical magnetic resonance imaging and angiographic studies of 30 patients with T2 high-signal-intensity changes surrounding a brain AVM were analyzed retrospectively. Patients were divided into 2 groups on the basis of the extension of the signal intensity changes within or beyond the 10-Gy isodose area. The angiographic analysis was focused on the venous drainage pattern (deep versus superficial), venous stenosis, and the number of draining veins before and after radiosurgery. In addition, the obliteration rate was determined for the 2 subgroups. RESULTS Fourteen patients (47%) showed high-signal-intensity changes far beyond the 10-Gy isodose area. A single draining vein was more often present in these patients with extensive T2 hyperintensity signal changes than in the other group. Obliteration was achieved in 12 (88%) of 14 patients with extensive signal intensity changes, as opposed to 8 (50%) of 16 patients in the other group. CONCLUSION High-signal-intensity changes after radiosurgery for brain AVMs, far beyond the 10-Gy isodose area on T2-weighted images, are especially seen in brain AVMs draining through a single vein. The higher occlusion rate of brain AVMs under these circumstances is well appreciated.

scholarly journals Basic knowledge for hepatic MRI interpretation

2019 ◽  
Vol 2 (1) ◽  
pp. 9-12
Author(s):  
Wanwarang Teerasamit
Keyword(s):  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Signal Intensity ◽  
Tissue Characterization ◽  
Basic Knowledge ◽  
Liver Lesions ◽  
Resonance Imaging ◽  
Mr Contrast Agents ◽  
Magnetic Resonance Imaging Mri ◽  
Weighted Sequences

Nowadays, Magnetic resonance imaging (MRI) has an important role for diagnosis of liver lesions due to excellent tissue characterization, radiation-free technique and continuous development of MRI technology, causing an increased use of MRI. This article focuses on basic knowledge of MRI liver interpretation for non-radiologist. The basic techniques including T1-weighted and T2-weighted sequences as well as additional techniques such as 2D dual GRE in-phase and opposed-phase, fat suppression or heavily T2-weighted sequences were introduced. Types of MR contrast agents for liver including extracellular and hepatocyte-specific agents were also described.   Figure 1  เป็นภาพ MRI ของตับเทคนิค T1W โดยอวัยวะส่วนใหญ่ที่ปรากฏในภาพจะให้ลักษณะ signal intensity ไปในทางhypointense ซึ่งจะเห็นว่าม้าม (spleen=S) ดำกว่าตับ (liver=L) และตับจะดำกว่าตับอ่อน (pancreas=P) โดยลูกศรสีดำชี้ให้เห็น signal intensity ของน้ำไขสันหลังที่เป็นลักษณะ hypointense

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