Dynamic Contrast-enhanced breast magnetic resonance imaging findings that affect the magnetic Resonance-directed ultrasound correlation of Non-mass enhancement lesions: A Single-centre Retrospective Study

Author(s):  
Almila Coskun Bilge ◽  
Pinar Ilhan Demir ◽  
Hale Aydin ◽  
Isil Esen Bostanci

Objective: Our single-centre retrospective study aimed to evaluate the relationship between magnetic resonance (MR)-directed ultrasound (MDUS) detectability and magnetic resonance imaging (MRI) findings of non-mass enhancement (NME) lesions, regarding the morphologic and enhancement features, the distance from the skin and nipple, and the presence of concomitant landmarks. Methods: A total of 350 MRI-detected NME lesions that were determined between January 2015 and May 2019 and subsequently underwent MDUS were analyzed. The MRI findings, biopsy results, and follow-up outcomes of lesions were recorded. The correlation between the MRI findings of the lesions and MDUS detectability was analyzed. Results: One hundred fourteen (32.6%) of the 350 lesions had a counterpart in the MDUS. Respectively, 66 (37.9%), 38 (43.2%) and 59 (38.3%) of the lesions detected in MDUS were larger than 20 mm in size, with a distance of less than 20 mm to the nipple and 15 mm to the skin. The lesion size and lesion distance to the nipple and skin were significantly associated with a US correlate (p < 0.05). The MDUS detection rate was significantly higher in NME lesions with MR findings including diffuse distribution (p < 0.001), clustered-ring enhancement pattern (p < 0.001), washout kinetic curve (p = 0.006), and MR-BIRADS category 5 (p < 0.001). Multivariate logistic regression showed that only the clustered-ring enhancement pattern was significantly associated with an MDUS correlation (p < 0.001). Conclusion: Statistically significant correlations were found between the size, distance to the nipple and skin, distribution pattern, enhancement pattern and kinetic curve of the NME lesions on MRI and ultrasound detectability. Advances in knowledge: We found that clustered-ring enhancement patterns were significantly more frequent in MR-directed US detectable lesions.

Author(s):  
Ravikanth Reddy

Abstract Background Hypoxic–ischemic encephalopathy (HIE) is the most commonly diagnosed neurological abnormality affecting children leading to severe neurological deficits and a cause of neonatal mortality. HIE constitutes a diagnostic challenge in the prematurely born and full-term neonates. HIE causes severe neurological deficit in children and many a times goes unnoticed in early stages. The various patterns of central nervous system (CNS) involvement in HIE are dependent on factors, such as severity and duration of hypoxia, and brain maturity in preterm and full-term patients. Magnetic resonance imaging (MRI) has prognostic significance in detecting patterns of HIE secondary to mild-to-moderate and severe hypoxias and the imaging findings are highly dependent on the time at which imaging is done. MRI helps determine the prognosis of brain development in patients with HIE. Objective This retrospective study elucidates the spectrum of MRI findings in preterm and full-term patients with HIE on MRI. Materials and Methods This retrospective descriptive study was conducted at a tertiary care center between April 2017 and May 2019 on 50 patients with a clinical diagnosis of HIE using a General Electric (GE) 1.5-Tesla MRI scanner. Various patterns of HIE were evaluated on MRI in preterm and full-term patients. Results This retrospective study evaluated MRI findings in 50 infants diagnosed with HIE. Eighteen (36%) were preterm and 32 (64%) were full-term patients. Thirty-five (70%) were male and 15 (30%) were female patients. In the current study, developmental delay was the most commonly associated clinical entity in both preterm and full-term patients. In preterm patients, periventricular leukomalacia was the most prevalent MRI finding, and in full-term patients, subcortical and periventricular white matter hyperintensities on T2-weighted and fluid-attenuated inversion recovery (FLAIR) sequences were most commonly encountered. Conclusion MRI is the primary imaging modality of choice in preterm and full-term patients with HIE, as it helps determine the severity of hypoxic–ischemic injury by understanding the pattern of brain involvement. In the current study, distinguishable patterns of MRI findings secondary to birth asphyxia and ischemic insult were elucidated in both preterm and full-term patients who are highly dependent on the level of brain maturity at the time of imaging. Regular MRI follow-up has a prognostic significance in HIE with accurate prediction of neurodevelopmental outcome on follow-up studies.


Author(s):  
Hongzhang Zhu ◽  
Shi-Ting Feng ◽  
Xingqi Zhang ◽  
Zunfu Ke ◽  
Ruixi Zeng ◽  
...  

Background: Cutis Verticis Gyrata (CVG) is a rare skin disease caused by overgrowth of the scalp, presenting as cerebriform folds and wrinkles. CVG can be classified into two forms: primary (essential and non-essential) and secondary. The primary non-essential form is often associated with neurological and ophthalmological abnormalities, while the primary essential form occurs without associated comorbidities. Discussion: We report on a rare case of primary essential CVG with a 4-year history of normal-colored scalp skin mass in the parietal-occipital region without symptom in a 34-year-old male patient, retrospectively summarizing his pathological and Computer Tomography (CT) and magnetic resonance imaging (MRI) findings. The major clinical observations on the CT and MR sectional images include a thickened dermis and excessive growth of the scalp, forming the characteristic scalp folds. With the help of CT and MRI Three-dimensional (3D) reconstruction techniques, the characteristic skin changes could be displayed intuitively, providing more evidence for a diagnosis of CVG. At the 5-year followup, there were no obvious changes in the lesion. Conclusion: Based on our observations, we propose that not all patients with primary essential CVG need surgical intervention, and continuous clinical observation should be an appropriate therapy for those in stable condition.


2021 ◽  
Vol 14 ◽  
pp. 117954762198967
Author(s):  
Van Trung Hoang ◽  
Cong Thao Trinh ◽  
Hoang Anh Thi Van ◽  
Thanh Tam Thi Nguyen ◽  
Vichit Chansomphou ◽  
...  

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.


2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Seiya Ota ◽  
Eiji Sasaki ◽  
Shizuka Sasaki ◽  
Daisuke Chiba ◽  
Yuka Kimura ◽  
...  

AbstractWe investigated the prevalence of magnetic resonance imaging (MRI) findings and their relationship with knee symptoms in women without radiographic evidence of knee osteoarthritis (KOA). This cross-sectional cohort study included 359 Japanese women without radiographic evidence of KOA (Kellgren‒Lawrence grade < 2). All participants underwent T2-weighted fat-suppressed MRI of their knees. Structural abnormalities (cartilage damage, bone marrow lesions [BMLs], subchondral cysts, bone attrition, osteophytes, meniscal lesions, and synovitis) were scored according to the whole-organ MRI score method. Knee symptoms were evaluated using the Knee Injury and Osteoarthritis Outcome Score. Participants were divided into early and non-KOA groups based on early KOA classification criteria. Logistic regression analysis was performed to evaluate the relationship between MRI abnormalities and knee symptoms. Cartilage damage was the most common abnormality (43.5%). The prevalences of cartilage damage, BMLs, subchondral cysts, bone attrition, meniscal lesions, and synovitis were higher in patients with early KOA than in those without. Synovitis (odds ratio [OR] 2.254, P = 0.002) and meniscal lesions (OR 1.479, P = 0.031) were positively associated with the presence of early KOA. Synovitis was most strongly associated with knee pain and might be a therapeutic target in patients with early KOA.


2020 ◽  
Vol 79 (Suppl 1) ◽  
pp. 694.2-694
Author(s):  
R. D. Vargas Ruíz ◽  
J. A. Gómez Rosero ◽  
C. Muñoz ◽  
D. Jaramillo Arroyave ◽  
L. Hernandez ◽  
...  

Background:muscle involvement is frequently reported in polyarteritis nodosa (PAN), mostly as myalgia, muscle swelling, and gait difficulty due to intramuscular arteries involvement, peripheral neuropathy, or myositis with slightly or no elevation of muscle enzymes. Magnetic resonance imaging (MRI) findings of compromised muscles have been reported in isolated cases, mainly as a limited form of PAN, however, muscular involvement patterns in MRI of patients with PAN have been recently describedObjectives:to describe MRI of legs findings in patients with PAN in a tertiary center from Medellin-Colombia.Methods:it was performed a retrospective cross-sectional descriptive study of 15 adult patients who were clinically assessed as having PAN and who had undergone MRI of legs between January 2011 and December 2019. Characteristics already informed in previous studies, affected structures (muscle, subcutaneous tissue, and bone) and pattern of hyperintensities were described as diffuse pattern (signal alterations affecting the entire area of the involved muscle), patched pattern (areas of hyperintensities alternating areas of normal muscle signal intensity), and fluffy nodular pattern or cotton-wool appearance (round hyperintense lesions with fluffy margins centered on blood vessels).Results:clinical characteristics:myalgia, especially calf pain, was the most frequent muscular complaint; other clinical manifestations were: constitutional symptoms (80%), arthralgias or arthritis (50%), mono/polyneuropathy (33%), subcutaneous nodules (33%), livedo reticularis (20%), lower limbs ulcers (13%), abdominal symptoms (13%), and purpura (7%).MRI findings:bilateral muscular edema was found in all patients (100%), fatty infiltration (20%), edema of the subcutaneous cellular tissue (20%), and muscular atrophy (13%) were also described. A diffuse pattern occurred in 46% (n=7) of patients (figure panel A), a patched pattern (figure panel B) in 46% (n=7), and a fluffy nodular pattern or cotton-wool appearance (figure panel C) in 6% (n=1). The most frequently affected muscular group was gastrocnemius and soleus (67%), followed by anterior tibialis (27%), plantar, long peroneus, first finger flexors, and long flexors only affected in 7%. Bone involvement was found in 53%, being the tibia the most affected, followed by the fibula and the calcaneus. MRI led to guide the site of muscle biopsy to prove histological medium-size vasculitis in half of the patients.Conclusion:in patients with PAN suspicion who have muscular complaints, especially calf pain, MRI arises as an important diagnostic tool, and also as a guide to muscular biopsy to prove vasculitis. The patterns associated with PAN are diffuse, patched or fluffy nodular hyperintensities in gastrocnemius and soleus with or without bone compromise.References:[1]Kang, Y. et al. Muscle involvement in polyarteritis nodosa: Report of eight cases with characteristic contrast enhancement pattern on MRI. Am. J. Roentgenol. 206, 378–384 (2016).[2]Hofman DM, Lems WF, Witkamp TD, Putte VD, Bijlsma JW. Demonstration of calf abnormalities by magnetic resonance imaging in polyarteritis nodosa. Clin Rheumatol 1992; 11:402–404.FigureDisclosure of Interests:None declared


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