scholarly journals Added value of 3D-DRIVE and SWI Magnetic Resonance Imaging Sequences in Intraventricular Neurocysticercosis (IVNCC): An Institutional Experience from Northeast India

2021 ◽  
Vol 28 (2) ◽  
pp. 21
Author(s):  
Deb K. Boruah ◽  
Bidyut Bikash Gogoi ◽  
Kuntal Kanti Das ◽  
Kalyan Sarma ◽  
Pranjal Phukan ◽  
...  

Background: Prompt diagnosis and early treatment institution are important in intraventricular neurocysticercosis(IVNCC) as compared to the parenchymal or racemose form because it is associated with a poorer patient prognosis. Intraventricular neurocysticercosis is often missed on CT scan or conventional cranial magnetic resonance imaging because of similar density or signal intensity of cysticercus lesion with cerebrospinal fluid. Thestudy aims to evaluate the added value of 3D-DRIVE and SWI MRI sequences in isolated intraventricular cysticercosis with acute neurological presentation.Methods and Materials: This retrospective study was carried out on diagnosed 10patients with isolated intraventricular neurocysticercosis(IVNCC) presented to a tertiary care hospital with an acute onset of symptoms or acute neurological deficit between June 2019 to May 2021. Relevant neurological examination, CSF analysis, a serological test of neurocysticercosis and MRI scan of the brain were performed.Result: Tenpatients of isolated intraventricular neurocysticercosis (3 males and 7 females) having 3 pediatric and7 adults were included in this study sample.The common neurological complications of the isolated intraventricular neurocysticercosis in this study are observed as obstructive hydrocephalus in 8(80%) patients and ependymitis in 7(70%) patients.IVNCC with distinctly visualized scolex (visibility score 2) identified in 2(20%) patients in T2WI, 8 (80%)patients in 3D-DRIVE and 3(30%) patients in SWI sequences. The cyst wall of IVNCC was distinctly visualized (visibility score 2) in 1(10%) patient in T2WI, 8(80%) patientsin 3D-DRIVE and 6(60%) patients in SWI sequence.Conclusion: Heavily T2-weighted steady-state and SWI sequences should be added to routine MRI sequences that helps to identify IVNCC and should be used in patients with unexplained hydrocephalus, especially in endemic regions of Neurocysticercosis.

2018 ◽  
Vol 31 (4) ◽  
pp. 362-371 ◽  
Author(s):  
Ravi Datar ◽  
Asuri Narayan Prasad ◽  
Keng Yeow Tay ◽  
Charles Anthony Rupar ◽  
Pavlo Ohorodnyk ◽  
...  

Background White matter abnormalities (WMAs) pose a diagnostic challenge when trying to establish etiologic diagnoses. During childhood and adult years, genetic disorders, metabolic disorders and acquired conditions are included in differential diagnoses. To assist clinicians and radiologists, a structured algorithm using cranial magnetic resonance imaging (MRI) has been recommended to aid in establishing working diagnoses that facilitate appropriate biochemical and genetic investigations. This retrospective pilot study investigated the validity and diagnostic utility of this algorithm when applied to white matter signal abnormalities (WMSAs) reported on imaging studies of patients seen in our clinics. Methods The MRI algorithm was applied to 31 patients selected from patients attending the neurometabolic/neurogenetic/metabolic/neurology clinics at a tertiary care hospital. These patients varied in age from 5 months to 79 years old, and were reported to have WMSAs on cranial MRI scans. Twenty-one patients had confirmed WMA diagnoses and 10 patients had non-specific WMA diagnoses (etiology unknown). Two radiologists, blinded to confirmed diagnoses, used clinical abstracts and the WMSAs present on patient MRI scans to classify possible WMA diagnoses utilizing the algorithm. Results The MRI algorithm displayed a sensitivity of 100%, a specificity of 30.0% and a positive predicted value of 74.1%. Cohen’s kappa statistic for inter-radiologist agreement was 0.733, suggesting “good” agreement between radiologists. Conclusions Although a high diagnostic utility was not observed, results suggest that this MRI algorithm has promise as a clinical tool for clinicians and radiologists. We discuss the benefits and limitations of this approach.


2016 ◽  
Vol 6 ◽  
pp. 36 ◽  
Author(s):  
Deb K Boruah ◽  
Dhaval D Dhingani ◽  
Sashidhar Achar ◽  
Arjun Prakash ◽  
Antony Augustine ◽  
...  

Objective: The aim of this study was to evaluate the magnetic resonance imaging (MRI) findings of caudal regression syndrome (CRS) and concomitant anomalies in pediatric patients. Materials and Methods: A hospital-based cross-sectional retrospective study was conducted. The study group comprised 21 pediatric patients presenting to the Departments of Radiodiagnosis and Pediatric Surgery in a tertiary care hospital from May 2011 to April 2016. All patients were initially evaluated clinically followed by MRI. Results: In our study, 21 pediatric patients were diagnosed with sacral agenesis/dysgenesis related to CRS. According to the Pang's classification, 2 (9.5%) patients were Type I, 5 (23.8%) patients were Type III, 7 (33.3%) patients were Type IV, and 7 (33.3%) patients were of Type V CRS. Clinically, 17 (81%) patients presented with urinary incontinence, 6 (28.6%) with fecal incontinence, 9 patients (42.9%) had poor gluteal musculatures and shallow intergluteal cleft, 7 (33.3%) patients had associated subcutaneous mass over spine, and 6 (28.6%) patients presented with distal leg muscle atrophy. MRI showed wedge-shaped conus termination in 5 (23.8%) patients and bulbous conus termination in 3 (14.3%) patients above the L1 vertebral level falling into Group 1 CRS while 7 (33.3%) patients had tethered cord and 6 (28.6%) patients had stretched conus falling into Group 2 CRS. Conclusion: MRI is the ideal modality for detailed evaluation of the status of the vertebra, spinal cord, intra- and extra-dural lesions and helps in early diagnosis, detailed preoperative MRI evaluation and assessing concomitant anomalies and guiding further management with early institution of treatment to maximize recovery.


2018 ◽  
Vol 27 (150) ◽  
pp. 180062 ◽  
Author(s):  
Chiara Romei ◽  
Laura Turturici ◽  
Laura Tavanti ◽  
Jelle Miedema ◽  
Sara Fiorini ◽  
...  

Thin-slices multi-detector computed tomography (MDCT) plays a key role in the differential diagnosis of interstitial lung disease (ILD). However, thin-slices MDCT has a limited ability to detect active inflammation, which is an important target of newly developed ILD drug therapy. Magnetic resonance imaging (MRI), thanks to its multi-parameter capability, provides better tissue characterisation than thin-slices MDCT.Our aim was to summarise the current status of MRI applications in ILD and to propose an ILD-MRI protocol. A systematic literature search was conducted for relevant studies on chest MRI in patients with ILD.We retrieved 1246 papers of which 55 original papers were selected for the review. We identified 24 studies comparing image quality of thin-slices MDCT and MRI using several MRI sequences. These studies described new MRI sequences to assess ILD parenchymal abnormalities, such as honeycombing, reticulation and ground-glass opacity. Thin-slices MDCT remains superior to MRI for morphological imaging. However, recent studies with ultra-short echo-time MRI showed image quality comparable to thin-slices MDCT. Several studies demonstrated the added value of chest MRI by using functional imaging, especially to detect and quantify inflammatory changes.We concluded that chest MRI could play a role in ILD patients to differentiate inflammatory and fibrotic changes and to assess efficacy of new ILD drugs.


2019 ◽  
Vol 9 ◽  
pp. 25 ◽  
Author(s):  
Karthik Muthusamy ◽  
Sniya Valsa Sudhakar ◽  
Maya Thomas ◽  
Sangeetha Yoganathan ◽  
Christhunesa S. Christudass ◽  
...  

Context: Krabbe disease shows considerable heterogeneity in clinical features and disease progression. Imaging phenotypes are equally heterogeneous but show distinct age-based patterns. It is important for radiologists to be familiar with the imaging spectrum to substantially contribute toward early diagnosis, prognostication, and therapeutic decisions. Aims: The study aims to describe different magnetic resonance imaging (MRI) patterns observed in a cohort of children with Krabbe disease and to assess correlation with age-based clinical phenotypes. Materials and Methods: This is a retrospective descriptive study done at the Departments of Radiodiagnosis and Neurological Sciences of our institution, a tertiary care hospital in Southern India. Imaging features of children diagnosed with Krabbe disease over a 10-year period (2009–2018) were collected and analyzed. Results: A total of 38 MRI brain studies from 27 patients were analyzed. Four distinct MRI patterns were recognizable among the different clinical subtypes. All patients from the early and late infantile group showed deep cerebral and cerebellar white matter and dentate hilum involvement. Optic nerve thickening was, however, more common in the former group. Adult-onset subtype showed isolated involvement of corticospinal tract, posterior periventricular white matter, and callosal splenium with the absence of other supra- and infra-tentorial findings. Juvenile subgroup showed heterogeneous mixed pattern with 78% showing adult subtype pattern and 22% showing patchy involvement of deep cerebral white matter with dentate hilum signal changes. Conclusion: Krabbe disease shows distinct imaging features which correspond to different clinical age-based subtypes. This article reemphasizes these distinct imaging phenotypes, highlights a novel imaging appearance in juvenile Krabbe, and also alludes to the rare variant of saposin deficiency. Awareness of these patterns is essential in suggesting the appropriate diagnosis and guiding conclusive diagnostic workup. Large multicenter longitudinal studies are needed to further define the role of imaging in predicting the clinical course and thus to guide therapeutic options.


2021 ◽  
pp. 43-46
Author(s):  
Sweta Swaika ◽  
Akshara Gupta

Introduction- Mucormycosis is a lethal intrusive opportunistic fungal infection with increased morbidity and mortality. Its most common form is Rhino-Orbital-Cerebral Mucormycosis (ROCM). It has been described more in immunosuppressed people and currently in patients with recent history of/ concomitant Covid-19 infection. Magnetic Resonance Imaging (MRI) has been used to delineate extent of infection and spread and preoperative planning. MRI shows varied T1 and T2 signal intensity lesions with nonenhancement in necrosed tissues and extension of infection into adjacent structures. This prospective study aimed at delineating the spectrum of MRI findings in ROCM patients. Methods and results- A prospective study of 31 patients with ROCM was done in Department of Radiology, Superspeciality hospital, Gajra Raja Medical College, Gwalior in May and June 2021 during second wave of COVID-19 pandemic. We found that 64.5% patients in study group had previously / recently diagnosed diabetes mellitus and 77.4% cases had recently treated or concomitant COVID-19 infection. All the patients had sinonasal involvement at the time of imaging. The other areas of involvement were orbit and its contents, some of adjacent soft tissues, cavernous sinus and cerebral parenchyma, hard palate and cavernous ICA in order of frequency. Conclusion- ROCM is a grave infection which readily causes perivascular, perineural and soft tissue infiltration within a short span of time, hence most of the patients in this study had extension beyond the sinuses at the time of imaging. MRI is an essential tool for early identification of extrasinus extension of disease, detection of intracranial and vascular complications and presurgical planning.


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