Central nervous system infectious diseases mimicking multiple sclerosis: recognizing distinguishable features using MRI

The current diagnostic criteria for multiple sclerosis (MS) confirm the relevant role of magnetic resonance imaging (MRI), supporting the possibility of characterizing the dissemination in space (DIS) and the dissemination in time (DIT) in a single scan. To maintain the specificity of these criteria, it is necessary to determine whether T2/FLAIR visible lesions and the gadolinium enhancement can be attributed to diseases that mimic MS. Several diseases are included in the MS differential diagnosis list, including diseases with exacerbation, remitting periods and numerous treatable infectious diseases, which can mimic the MRI features of MS. We discuss the most relevant imaging features in several infectious diseases that resemble MS and examine the primary spatial distributions of lesions and the gadolinium enhancement patterns related to MS. Recognizing imaging "red flags" can be useful for the proper diagnostic evaluation of suspected cases of MS, facilitating the correct differential diagnosis by assessing the combined clinical, laboratory and MR imaging information.

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Idiopathic trigeminal neuropathy with trigeminal mass lesion on MRI: Neoplasm or not?

Cephalalgia ◽

10.1177/0333102409361215 ◽

2010 ◽

Vol 30 (8) ◽

pp. 968-974 ◽

Cited By ~ 1

Author(s):

Keita Sakurai ◽

Masaki Hara ◽

Kenji Okita ◽

Shoji Kawashima ◽

Takemori Yamawaki ◽

...

Keyword(s):

Magnetic Resonance Imaging ◽

Differential Diagnosis ◽

Trigeminal Nerve ◽

Common Symptom ◽

Resonance Imaging ◽

Specific Mass ◽

Gadolinium Enhancement ◽

Trigeminal Neuropathy ◽

Mri Features ◽

Magnetic Resonance Imaging Mri

The objective of the present study was to investigate clinical and magnetic resonance imaging (MRI) features of idiopathic trigeminal neuropathy with transient MR abnormalities mimicking a neoplasm (ITNmn). We retrospectively evaluated clinical and MRI features in two cases of ITNmn seen in our institution in comparison with those of previously reported five cases. The most common symptom was altered facial sensation and numbness limited to one or more trigeminal nerve divisions (100%). ITNmn commonly affected not only the second and third divisions (86% and 57%, respectively) but also the first division (71%). The most common findings on MRI were enlargement and gadolinium enhancement of the trigeminal nerve, which were similar to those seen in neoplasms (100%). The abnormalities spontaneously regressed in all five evaluable cases. ITNmn should be added in the differential diagnosis of non-specific mass-like lesions in trigeminal neuropathy and be observed carefully without surgical treatment.

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CLINICAL LABORATORY DIFFERENTIAL DIAGNOSIS OF ENCEPHALITIS, DISSEMINATED ENCEPHALOMYELITIS AND MULTIPLE SCLEROSIS IN CHILDREN

PEDIATRIA Journal named after G N SPERANSKY ◽

10.24110/0031-403x-2017-96-4-34-42 ◽

2017 ◽

Vol 96 (4) ◽

pp. 34-42

Author(s):

N. V. Skripchenko ◽

◽

G. P. Ivanova ◽

E. Y. Skripchenko ◽

A. V. Surovtseva ◽

...

Keyword(s):

Multiple Sclerosis ◽

Differential Diagnosis ◽

Clinical Laboratory

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MRI features of different types of sinonasan rhabdomyosarcomas: a series of eleven cases

Dentomaxillofacial Radiology ◽

10.1259/dmfr.20210030 ◽

2021 ◽

pp. 20210030

Author(s):

Junjie Zeng ◽

Lan Liu ◽

Jiayong Li ◽

Qiling Huang ◽

Leiming Pi ◽

...

Keyword(s):

Bone Destruction ◽

Imaging Features ◽

Resonance Imaging ◽

Bone Invasion ◽

Mri Features ◽

Different Types ◽

Magnetic Resonance Imaging Mri ◽

Haematogenous Metastasis ◽

Ethmoid Sinuses ◽

Pathological Subtypes

Objective: To retrospectively analyze magnetic resonance imaging (MRI) features of various pathological subtypes of sinonasal rhabdomyosarcoma (RMS) and explore correlations between imaging features and pathological subtypes. Methods: In total, 11 cases with embryonal, alveolar or pleomorphic sinonasal RMSs, confirmed by surgical pathology, were selected. Their characteristics and distinctive imaging features were analysed, and the correlation between pathology and imaging features was explored. Results: Bone destruction was observed in all 11 cases with RMS. Expansive growth was predominant in three alveolar and three embryonal RMS cases, and creeping growth was predominant in two alveolar, two embryonal and one pleomorphic RMS cases. Signs of residual mucosa were observed in all 11 cases, and 10 cases showed involvement of multiple sinus cavities and orbital cavities. All cases exhibited mild-to-intermediate enhancement. Conclusion: Sinonasal RMSs have the following characteristic MRI features: ethmoid sinuses and middle nasal conchae are the prevalent sites; lesions are mainly of mild enhancement; tumours exhibit signs of residual mucosa, mild-to-intermediate enhancement and frequent orbital involvement; bone invasion and bone destruction are frequently observed; and haematogenous metastasis is not as common as lymphatic metastasis. RMSs of various pathological subtypes were not significantly distinct by imaging.

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Brain and Spinal Cord MRI in Multiple Sclerosis: an Update

Neurology International Open ◽

10.1055/s-0043-118111 ◽

2017 ◽

Vol 01 (04) ◽

pp. E294-E306 ◽

Cited By ~ 1

Author(s):

Mike Wattjes ◽

Peter Raab

Keyword(s):

Multiple Sclerosis ◽

Quantitative Mri ◽

Central Vein ◽

Resonance Imaging ◽

Ultra High Field ◽

Important Differential Diagnosis ◽

Magnetic Resonance Imaging Mri ◽

Near Future ◽

Brain And Spinal Cord

AbstractMagnetic resonance imaging (MRI) plays an important role in the diagnosis of multiple sclerosis and has been incorporated into the McDonald diagnostic criteria for MS. In particular, for the exclusion of important differential diagnosis and comorbidities, new MRI markers have been established such as the “central vein sign”. In addition to diagnostic purposes, the role of MRI in MS monitoring is becoming increasingly important, particularly for pharmacovigilance. This includes treatment efficacy monitoring, prediction of treatment response and safety monitoring. Quantitative MRI methods and ultra-high-field MRI offer the opportunity for the quantitative assessment of damage in normal-appearing brain tissue. However, the standardization of these techniques with the goal of implementation in clinical routine will be one of the major challenges in the near future.

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Imaging indications and findings in evaluation of lung transplant graft dysfunction and rejection

Insights into Imaging ◽

10.1186/s13244-019-0822-7 ◽

2020 ◽

Vol 11 (1) ◽

Author(s):

Mnahi Bin Saeedan ◽

Sanjay Mukhopadhyay ◽

C. Randall Lane ◽

Rahul D. Renapurkar

Keyword(s):

Differential Diagnosis ◽

Lung Transplant ◽

Imaging Features ◽

Primary Graft Dysfunction ◽

Graft Dysfunction ◽

Contrast Imaging ◽

Post Transplantation ◽

Post Transplant ◽

End Stage

AbstractLung transplantation is a treatment option in end-stage lung disease. Complications can develop along a continuum in the immediate or longer post-transplant period, including surgical and technical complications, primary graft dysfunction, rejection, infections, post-transplant lymphoproliferative disorder, and recurrence of the primary disease. These complications have overlapping clinical and imaging features and often co-exist. Time of onset after transplant is helpful in narrowing the differential diagnosis. In the early post transplantation period, imaging findings are non-specific and need to be interpreted in the context of the clinical picture and other investigations. In contrast, imaging plays a key role in diagnosing and monitoring patients with chronic lung allograft dysfunction. The goal of this article is to review primary graft dysfunction, acute rejection, and chronic rejection with emphasis on the role of imaging, pathology findings, and differential diagnosis.

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Unusual MR Imaging Features in CT Hyperdense Posterior Fossa Dermoids: Report of Two Cases

Indian Journal of Neurosurgery ◽

10.1055/s-0039-3402594 ◽

2020 ◽

Vol 09 (01) ◽

pp. 63-66

Author(s):

Anbazhagan Sathiaprabhu ◽

Nichanametla Sravani ◽

Krishnan Nagarajan ◽

Sekar Sabarish ◽

Kapil Patil

Keyword(s):

Magnetic Resonance ◽

Posterior Fossa ◽

Magnetization Transfer ◽

The Body ◽

Resonance Spectroscopy ◽

Imaging Features ◽

Signal Loss ◽

Mri Features ◽

Magnetic Resonance Imaging Mri ◽

T2 Hyperintensity

AbstractDermoids, either intracranial or in the rest of the body, usually have typical imaging findings due to their fat contents as fat density in computed tomography (CT) and T1- and T2-hyperintensity in magnetic resonance imaging (MRI). Variable imaging appearances have been described due to soft tissue contents, hair, calcification, or even tooth. Posterior fossa dermoids have been reported as a specific variant that shows hyperdensity in CT and mixed signal intensity in MRI. We report two cases of posterior fossa CT hyperdense dermoids that showed unusual MRI features in the form of signal loss in magnetization transfer images and lipid peak in magnetic resonance spectroscopy. Both patients underwent surgical resection and histopathological confirmation and the causes of this unusual imaging appearance are discussed.

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Leber’s hereditary optic neuropathy associated with a multiple-sclerosis-like picture in a man

Multiple Sclerosis Journal ◽

10.1177/1352458511404033 ◽

2011 ◽

Vol 17 (6) ◽

pp. 763-766 ◽

Cited By ~ 10

Author(s):

Antonella La Russa ◽

Rita Cittadella ◽

Virginia Andreoli ◽

Paola Valentino ◽

Francesca Trecroci ◽

...

Keyword(s):

Multiple Sclerosis ◽

Spinal Cord ◽

Optic Neuropathy ◽

Brain Mri ◽

Resonance Imaging ◽

Gadolinium Enhancement ◽

Demyelinating Lesions ◽

Male Patients ◽

Magnetic Resonance Imaging Mri ◽

Symptoms And Signs

A 35-year-old young man displayed Leber’s optic neuropathy (LHON) due to T14484C and multiple sclerosis (MS) phenotype that was dominated by symptoms and signs of spinal cord impairment. Magnetic resonance imaging (MRI) revealed demyelinating lesions extending from D6 to D11 in the spinal cord with gadolinium enhancement, while only three linear demyelinating lesions were seen on brain MRI. In the literature, a major involvement of the spinal cord was already reported in three of four male patients with the 14484 LHON mutation who developed MS, but the reasons of this peculiar association remain unknown, and further research in this area is needed.

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The interleukin-1 gene family in multiple sclerosis susceptibility and disease course

Multiple Sclerosis Journal ◽

10.1191/1352458503ms974oa ◽

2003 ◽

Vol 9 (6) ◽

pp. 535-539 ◽

Cited By ~ 19

Author(s):

Tineke Hooper-van Veen ◽

Hans M Schrijver ◽

Antoon Zwiers ◽

J Bart A Crusius ◽

Dirk L Knol ◽

...

Keyword(s):

Multiple Sclerosis ◽

Gene Polymorphisms ◽

Interleukin 1 ◽

Progression Rate ◽

Disease Course ◽

Resonance Imaging ◽

Multiple Sclerosis Susceptibility ◽

Specific Allele ◽

Magnetic Resonance Imaging Mri

Multiple sclerosis (MS) is a chronic disease of presumed autoimmune origin with a considerable polygenic influence. We have previously observed that a specific allele combination in genes of the interleukin-1 (IL-1) family influenced the progression rate in MS. We have considerably expanded our patient population (492 MS patients and 228 controls). In the present study, we investigated the role of the IL- 1A - 889, IL-1B - 511, IL-1B+3953 and IL-1RN VNTR gene polymorphisms in MS. In addition, we performed preliminary analyses on longitudinal magnetic resonance imaging (MRI) data. We found no associations between the polymorphisms and susceptibility to MS or clinical features. In addition, we observed no significant effect of the polymorphisms on brain or lesion volumes, Based on our data and those from the literature, one can conclude that there is currently no evidence to support a role for the IL-1 genes in MS.

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Four Individuals with a Homozygous Mutation in Exon 1f of the PLEC Gene and Associated Myasthenic Features

Genes ◽

10.3390/genes11070716 ◽

2020 ◽

Vol 11 (7) ◽

pp. 716

Author(s):

Magdalena Mroczek ◽

Hacer Durmus ◽

Ana Töpf ◽

Yesim Parman ◽

Volker Straub

Keyword(s):

Homozygous Mutation ◽

Resonance Imaging ◽

Facial Weakness ◽

Repetitive Nerve Stimulation ◽

Turkish Origin ◽

Mri Features ◽

Muscle Magnetic Resonance Imaging ◽

Magnetic Resonance Imaging Mri ◽

Muscle Biopsies

We identified the known c.1_9del mutation in the PLEC gene in four unrelated females from consanguineous families of Turkish origin. All individuals presented with slowly progressive limb-girdle weakness without any dermatological findings, and dystrophic changes observed in their muscle biopsies. Additionally, the neurological examination revealed ptosis, facial weakness, fatigability, and muscle cramps in all four cases. In two patients, repetitive nerve stimulation showed a borderline decrement and a high jitter was detected in all patients by single-fiber electromyography. Clinical improvement was observed after treatment with pyridostigmine and salbutamol was started. We further characterize the phenotype of patients with limb-girdle muscular dystrophy R17 clinically, by muscle magnetic resonance imaging (MRI) features and by describing a common 3.8 Mb haplotype in three individuals from the same geographical region. In addition, we review the neuromuscular symptoms associated with PLEC mutations and the role of plectin in the neuromuscular junction.

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Clinical and imaging characteristics of osteitis condensans ilii as compared with axial spondyloarthritis

Rheumatology ◽

10.1093/rheumatology/keaa175 ◽

2020 ◽

Vol 59 (12) ◽

pp. 3798-3806 ◽

Cited By ~ 3

Author(s):

Denis Poddubnyy ◽

Henning Weineck ◽

Torsten Diekhoff ◽

Imke Redeker ◽

Nino Gobejishvili ◽

...

Keyword(s):

Differential Diagnosis ◽

Back Pain ◽

Axial Spondyloarthritis ◽

Clinical Laboratory ◽

Lower Percentage ◽

Imaging Features ◽

Lower Prevalence ◽

Sacroiliac Joints ◽

Mri Characteristics ◽

Osteitis Condensans Ilii

Abstract Objectives Osteitis condensans ilii (OCI) has become an important differential diagnosis for axial spondyloarthritis (axSpA). The objective of this matched case–control study was to investigate demographic, clinical, laboratory and MRI characteristics of OCI as compared with axial spondyloarthritis (axSpA). Methods A total of 60 patients diagnosed with OCI were included in the final analysis. From 27 of these patients, MRIs of the sacroiliac joints were available. OCI patients were matched with a 1:1 ratio by back pain duration to patients with definite axSpA in order to compare clinical, laboratory and MRI characteristics. Results The OCI patients were nearly all females (96.7 vs 46.7%), had a significantly lower prevalence of inflammatory back pain (39.5 vs 88.9%), a significantly lower percentage of HLA-B27 positives (35.2 vs 80.0%) and a lower prevalence of the majority of other SpA features as compared with axSpA patients. Interestingly, there was no difference in the prevalence of osteitis in the sacroiliac joints (92.6 vs 85.2% in OCI and axSpA, respectively, P = 0.44), but there was a difference in the prevalence of erosions (7.4 vs 66.7%, respectively, P = 0.0001). In addition, in OCI nearly all lesions were localized in the anterior part of the sacroiliac joints while in axSpA lesions were localized predominantly in the middle part of the joint (for osteitis: 96 vs 4% in OCI and 28.6 vs 71.4% in axSpA; P = 0.0002 for the inter-group difference). Conclusion Clinical and imaging features of OCI compared with axSpA are described that should help in differential diagnosis.

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