scholarly journals Elastofibroma dorsi: evaluating the sufficiency of magnetic resonance in diagnosis and the time of surgical treatment

2019 ◽  
Vol 6 (2) ◽  
pp. 388
Author(s):  
Devrim Ozer ◽  
Yavuz Arikan ◽  
Cantay Gok
Keyword(s):  
Surgical Treatment ◽  
Magnetic Resonance ◽  
Clinical Symptoms ◽  
Axial Plane ◽  
Mri Findings ◽  
Elastofibroma Dorsi ◽  
Experienced Radiologist ◽  
Mean Diameter ◽  
The Masses

Background: Elastofibroma dorsi is a rarely seen fibroelastic pseudotumor. While radiological evaluation can be best done with magnetic resonance imaging (MRI), biopsy may be additionally required in diagnosis. Surgical excision of the tumor is recommended in painful cases, however, many cases can be treated and followed with conservative methods. In our study, we evaluated the features and sufficiency of MRI in diagnosis, the growth extent of the masses and the need for surgical treatment.Methods: Eight lesions of the five patients diagnosed and followed up in our clinic between the years 2014 and 2017 were included in the study. All patients were female and had a mean age of 60.4 (50-68). Lesions were bilaterally located in three patients. Seven lesions were diagnosed with MRI and one was diagnosed with biopsy. The size of the lesions at the time of diagnosis and final follow-up and differences in the radiological features were evaluated by the same experienced radiologist using MRI. Complaints of the patients were evaluated, and their clinical examinations were performed.Results: The mean period of follow-up was 22.4 (8-42) months. The masses had a mean diameter of 59.5 (40-75)mm in the craniocaudal plane and 59.4 (40-70) x 22.4 (10-36)mm in the axial plane at the time of diagnosis and a mean diameter of 60.5 (40-75)mm in the craniocaudal plane and 61 (43-70) x 22.6 (10-36)mm in the axial plane at the final follow-up. At the final follow-up, two patients had three lesions without pain and three patients had five lesions with mild pain. No movement limitation was observed.Conclusions: Typical MRI findings were observed in all lesions (including the one that was performed biopsy) and biopsy was not planned for the lesions with typical findings. All lesions were followed by conservative management and no discontent was reported by the patients. Surgical treatment was planned in case of severe pain, rapid growth and advanced clinical symptoms. 

scholarly journals Patient-reported outcomes after surgical and non-surgical treatment of proximal hamstring avulsions in middle-aged patients

2019 ◽  
Vol 5 (1) ◽  
pp. e000511 ◽  
Author(s):  
Elsa Pihl ◽  
Olof Skoldenberg ◽  
Hans Nasell ◽  
Sven Jonhagen ◽  
Paula Kelly Pettersson ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Treatment Algorithm ◽  
Hamstring Injury ◽  
Middle Aged ◽  
Mri Findings ◽  
Aged Patients ◽  
Patient Reported ◽  
Proximal Hamstring ◽  
Non Surgical Treatment

ObjectivesIn the literature on proximal hamstring avulsions, only two studies report the outcomes of non-surgically treated patients. Our objective was to compare subjective recovery after surgical and non-surgical treatment of proximal hamstring avulsions in a middle-aged cohort.MethodsWe included 47 patients (33 surgically and 14 non-surgically treated) with a mean (SD) age of 51 (±9) years in a retrospective cohort study. Follow-up time mean (SD) of 3.9 (±1.4) years. The outcome variables were the Lower Extremity Functional Scale (LEFS) and questions from the Proximal Hamstring Injury Questionnaire. Outcome variables were adjusted in regression models for gender, age, American Society of Anestesiologits (ASA) classification and MRI findings at diagnosis.ResultsThe baseline characteristics showed no differences except for the MRI result, in which the surgically treated group had a larger proportion of tendons retracted ≥ 2 cm. The mean LEFS score was 74 (SD±12) in the surgically treated cohort and 72 (SD±16) in the non-surgically treated cohort. This was also true after adjusting for confounders. The only difference in outcome at follow-up was the total hours performing physical activity per week, p=0.02; surgically treated patients reported 2.5 hours or more (5.2 vs 2.7).ConclusionThis study on middle-aged patients with proximal hamstring avulsions was unable to identify any difference in patient-reported outcome measures between surgically and non-surgically treated patients. The vast majority of patients treated surgically had complete proximal hamstring avulsions with ≥ 2 cm of retraction. We conclude that to obtain an evidence-based treatment algorithm for proximal hamstring avulsions studies of higher scientific level are needed.

Hypertensive Encephalopathy in Children with Sickle Cell Disease.

Blood ◽  
2005 ◽  
Vol 106 (11) ◽  
pp. 3790-3790
Author(s):  
Caterina P. Minniti ◽  
Steven L. Weinstein ◽  
Zarir Khademian
Keyword(s):  
Magnetic Resonance ◽  
Sickle Cell Disease ◽  
Sickle Cell ◽  
Complete Resolution ◽  
Clinical Symptoms ◽  
Hypertensive Encephalopathy ◽  
Cell Disease ◽  
Acute Infarction ◽  
Cortical Edema

Abstract Cerebrovascular (CVA) accidents are a serious complication of Sickle Cell Disease (SCD). Acute cerebral infarction occurs in approximately 10% of children with SCD under the age of 16 years, with silent infarcts identified in an additional 22%. Children however can present with acute neurologic deterioration mimicking a CVA but demonstrate a picture consistent with hypertensive encephalopathy (HTNE). The incidence of HTNE in children with SCD is unknown with few annedoctal reports available in the literature. We retrospectively identified 83 children with SCD, who received their care at Children’s National Medical Center in Washington, DC, from 1992 to 2005, who presented with neurologic complaints that prompted Magnetic Resonance Imaging (MRI). There were 37 females and 46 males, age 13 months to 17 years, with mean age of 5 years and 8 months. Clinical and neuro-imaging data identified 8 children (7 females and 1 male) with clinical picture compatible with HTNE (BP > 2 std deviation for age), prior to neuroimaging. At the time of the hypertensive episode, the ages ranged from 6 to 16 years and 8 months, with an average of 14 years and 2 months. All patients had Hb SS. Neurologic complaints included seizure, sudden onset headache, confusion, loss of consciousness, and urinary retention. Elevated blood pressures were aggressively treated and all patient received an exchange transfusion. No specific etiology for the hypertension was determined. Initial MRI, obtained within 24–48 hours of presentation, did not show acute or prior infarction in this group. However, there was absence of diffusion restriction on T1 and T2 weighted images, and presence of cerebral cortical edema, which differentiate HTNE from acute infarction. The magnetic resonance angiogram (MRA) did not demonstrate evidence of arteriopathy. The hallmark of HTNE is a complete resolution of abnormalities of both the neurologic exam and the imaging studies at follow up. There was complete resolution of cerebral edema in all patients and mild interval prominence of the cerebral sulci, which can indicate cerebral volume loss, in three out of the 8 patients, in follow up studies obtained 10 days to 4 months later. No recurrences of the symptoms have been reported, with follow up ranging from 5 months to 8 years. None of the patients with HTNE has received chronic transfusions. We conclude that HTNE should be considered in the differential diagnosis of an acute neurologic event in a child with SCD. Accurate recording of vital signs and prompt correction of hypertension is indicated. MRI can accurately distinguish between HTNE and acute infarction, even when clinical symptoms are similar. This distinction helps physicians to establish proper treatment such as chronic transfusion following infarction.

scholarly journals Clinical symptoms and sonographic follow-up after surgical treatment of nonparasitic liver cysts

BMC Surgery ◽  
2013 ◽  
Vol 13 (1) ◽  
Author(s):  
Hubert Scheuerlein ◽  
Falk Rauchfuss ◽  
Julia Franke ◽  
Karin Jandt ◽  
Yves Dittmar ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Clinical Symptoms ◽  
Liver Cysts

Cerebral fat embolism: diffusion-weighted magnetic resonance imaging findings

2005 ◽  
Vol 46 (5) ◽  
pp. 528-533 ◽  
Author(s):  
C. W. Ryu ◽  
D. H. Lee ◽  
T. K. Kim ◽  
S. J. Kim ◽  
H. S. Kim ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
White Matter ◽  
Magnetic Resonance ◽  
B Value ◽  
Fat Embolism ◽  
Acute Stage ◽  
Resonance Imaging ◽  
Mri Findings ◽  
Diffusion Weighted

Purpose: To demonstrate the diffusion-weighted (DWI) magnetic resonance imaging (MRI) findings, and the follow-up MRI findings, of cerebral fat embolism in the acute stage. Material and Methods: The initial DWI and clinical findings of six patients with cerebral fat embolism were retrospectively evaluated. The finding of DWI with a b-value of 1000 s/mm2 (b = 1000) was compared with that of DWI with a b-value of 0 s/mm2 (b = 0). In three patients who underwent follow-up MRI, the interval change of the lesion on T2-weighted images was investigated. Results: The characteristic DWI finding of cerebral fat embolism in the acute stage was multiple, hyperintense, dot-like lesions disseminated in the brain. These lesions were distributed dominantly in the bilateral border-zone areas. Some lesions had an ancillary location including the cortex, deep white matter, basal ganglia, and cerebellum. The lesions were more intense and numerous in DWI (b = 1000) than in DWI (b = 0). The findings on the follow-up T2-weighted images were multiple confluent hyperintense lesions in the white matter with progression since the initial MRI. Conclusion: DWI could be a sensitive tool for detecting cerebral fat embolism in the acute phase. It is recommended that DWI be included in the initial evaluation of cerebral fat embolism with MRI.

scholarly journals Surgical Treatment of Juvenile Femoral Head Epiphysiolysis in Children

2016 ◽  
Vol 23 (1) ◽  
pp. 40-47
Author(s):  
D. B Barsukov ◽  
A. I Krasnov ◽  
M. M Kamosko ◽  
V. E Baskov ◽  
I. Yu Pozdnikin ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Magnetic Resonance ◽  
Femoral Head ◽  
Femoral Neck ◽  
Surgical Intervention ◽  
Treatment Results ◽  
Surgical Interventions ◽  
X Ray ◽  
Endochondral Growth

To optimize the anatomical and functional surgical treatment results in patients with early (I-II) stages of juvenile femoral head epiphysiolysis both pre- and postoperative data of clinical, x-ray and magnetic-resonance examinations were analyzed for 120 patients aged 11 - 15 years. Maximum follow up period after surgical interventions, i.e. femoral head epiphysiodesis (n=60) and femoral head epiphysis fixation (n=60) made up 23 and 3 years, respectively. It was shown that surgical intervention for the fixation of femoral head epiphysis ensured reliable stability of the epiphysis preventing the latter from displacement development and progression, and did not exert significant influence upon either femoral neck and head endochondral growth or the length of the upper extremity.

scholarly journals Total Spine Magnetic Resonance Imaging for Detection of Multifocal Infection in Pyogenic Spondylodiscitis: a retrospective observational Study

2021 ◽  
Author(s):  
Jeanette Henkelmann ◽  
Timm Denecke ◽  
Philipp Pieroh ◽  
Stephanie Einhorn ◽  
Nicolas H. von der Hoeh ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Clinical Symptoms ◽  
Multiple Infection ◽  
Lumbar Region ◽  
Mri Imaging ◽  
Resonance Imaging ◽  
Mri Findings ◽  
Two Stage ◽  
Surgical Interventions

Abstract Background:Due to the unspecific symptoms of spondylodiscitis (SpD), an early radiological examination is necessary. However, controversially discussed is the need for magnetic resonance imaging of the entire spine to exclude multisegmental infections and to determine the required surgical interventions. The aims of this study were to assess the incidence of multilevel non-contiguous pyogenic SpD and compare comorbidities, pain symptoms, and subsequent surgical strategies between unifocal (uSpD) and multifocal (mSpD) SpD.Methods:We retrospectively evaluated the data of patients with confirmed, surgically treated, pyogenic SpD who had received a total spine MRI in a single spine center between 2016 and 2018. MRI findings were classified according to Pola-classification and demographics, duration of clinical symptoms (pain and neurology) and Charlson Comorbidity-Index (CCI) results were compared between uSpD und mSpD groups. Surgical therapy was evaluated in patients with mSpD. Results: uSpD was detected by MRI in 69 of 79 patients (87 %). Of these, mSpD was detected in 10 patients (13%) with 21 infected segments (cervical and/ or thoracic and/ or lumbar region). Age and CCI were similar between uSpD and mSpD and 24 of all SpD regions were clinically unapparent. All patients with uSpD were treated operatively. In seven patients with mSpD, all infected levels of the spine were treated surgically in a one-stage procedure; one patient had a two-stage procedure and one patient had surgery at the lumbar spine, and an additional infected segment of the upper thoracic spine was treated conservatively. One patient died before a planned two-stage procedure was performed.Conclusions:Due to mSpD being found in approximately 13% of SpD cases, and considering the risk of overlooking an mSpD case, MRI imaging of the total spine is recommended. The detection of multiple infection levels can have an impact on the therapeutic strategy chosen.

Surgical management of intracranial arachnoid cysts in pediatric patients: radiological and clinical outcome

2021 ◽  
pp. 1-11
Author(s):  
Matthias Schulz ◽  
Yasin Oezkan ◽  
Andreas Schaumann ◽  
Miriam Sieg ◽  
Anna Tietze ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Clinical Symptoms ◽  
Pediatric Population ◽  
Mass Effect ◽  
Reoperation Rate ◽  
Arachnoid Cysts ◽  
Cyst Volume ◽  
Intracranial Cysts ◽  
Intracranial Lesions

OBJECTIVE Congenital intracranial cysts account for a significant portion of intracranial lesions in the pediatric population. The efficiency of surgical treatment in a pediatric cohort with intracranial arachnoid cysts (ACs) at different locations regarding clinical symptoms and mass effect was evaluated. METHODS A retrospective study of all children who underwent surgical treatment of an intracranial AC during an 11-year period (2007–2018) was performed. Demographics, clinical symptoms, and radiological cyst size pre- and postoperatively, as well as the reoperation rate and possible treatment complications, were analyzed. RESULTS A total of 116 intracranial cysts at 8 different anatomical locations were surgically treated in 113 children (median age 5 years and 10 months) predominantly by endoscopic technique (84%). The complication rate was 3%, and the reoperation rate was 16%. Preoperative cyst enlargement was significantly more common in infants (p < 0.0001), as was the need for reoperation (p = 0.023). After a median radiological follow-up of 26 months, > 50% reduction of cyst volume was seen in 53 cysts (46%), and 47 cysts (40%) showed a 10%–50% reduction. Acute clinical symptoms improved: nausea and vomiting, accelerated head growth, and headaches improved at 100%, 92% and 89%, respectively. However, chronic symptoms responded less favorably after a median clinical follow-up of 26 months. CONCLUSIONS The strategy of predominantly endoscopic treatment with navigation planning is efficient to alleviate clinical symptoms and to significantly reduce the mass effect of pediatric intracranial cysts at different anatomical locations. The subgroup of infants requires close pre- and postoperative monitoring.

Association between a black band on the inner membrane of a chronic subdural hematoma on T2*-weighted magnetic resonance images and enlargement of the hematoma

2003 ◽  
Vol 99 (5) ◽  
pp. 824-830 ◽  
Author(s):  
Toshio Imaizumi ◽  
Yoshifumi Horita ◽  
Toshimi Honma ◽  
Jun Niwa
Keyword(s):  
Surgical Treatment ◽  
Magnetic Resonance ◽  
Chronic Subdural Hematoma ◽  
Magnetic Resonance Images ◽  
Mr Images ◽  
Inner Membrane ◽  
Content Type ◽  
Black Band ◽  
Fine Print

Object. The cause and indication for enlargement of chronic subdural hematomas (CSDHs) have remained unresolved. The authors observed a black band on the inner membrane of a CSDH on T2*-weighted magnetic resonance (MR) images obtained in patients with symptoms. After surgical treatment, the band disappeared. The T2*-weighted sequence of MR imaging is an excellent diagnostic tool for detecting ferromagnetic substances, but it is rarely performed in cases of a CSDH. The authors speculate that the black band may be associated with the development of CSDH. Methods. To investigate how the black band observed on T2*-weighted MR images contributes to the development of a CSDH, 59 lesions in 50 patients with CSDH (41 men and nine women, mean age 70 ± 11 years [range 48–93 years]) were investigated prospectively. The incidence of black bands on the first T2*-weighted MR image obtained in patients with symptomatic CSDH was 97% (31 of 32 CSDHs), which was significantly higher than that associated with asymptomatic CSDH (11% [three of 27 CSDHs], p < 0.001). The black bands associated with symptomatic CSDH disappeared soon after surgical treatment in 31 CSDHs and became fainter in another. In two instances the CSDH recurred with reappearance of the band. Twenty-four of 27 asymptomatic CSDHs had no accompanying black band. Follow-up MR images demonstrated a later formation of bands in two of 24 asymptomatic CSDHs that enlarged to symptomatic size. Logistic regression analysis revealed that the heterogeneity and thickness of the CSDH on computerized tomography scans were independently and significantly associated with the black band. Conclusions. The dynamics of the black band may depend on the enlargement or shrinkage of the CSDH.

Subacute Pituitary Apoplexy: Clinical and Magnetic Resonance Imaging Characteristics

Neurosurgery ◽  
1990 ◽  
Vol 27 (2) ◽  
pp. 214-219 ◽  
Author(s):  
Roberta P. Glick ◽  
James A. Tiesi
Keyword(s):  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Pituitary Apoplexy ◽  
Clinical Symptoms ◽  
Resonance Imaging ◽  
Mri Scan ◽  
Imaging Characteristics ◽  
Invaluable Tool ◽  
Magnetic Resonance Imaging Mri

Abstract Between 1987 and 1988, we utilized magnetic resonance imaging (MRI) in the diagnosis of seven cases of “subacute” pituitary apoplexy. that is, intra-adenomatous pituitary hemorrhage associated with clinical symptoms atypical of acute pituitary apoplexy. These symptoms lasted longer than 24 hours and included visual changes in four patients, headache in five, and seizures, endocrine dysfunction, and oculomotor palsy in one each. Estimates of the ages of the hemorrhages were also possible based on characteristics on the MRI scan and ranged from 48 hours to more than 14 days. Four of our seven patients underwent transsphenoidal decompression at which time the presence of intratumoral hemorrhage was confirmed. The remaining three patients have been followed as outpatients with serial MRI examinations and have shown improvement in clinical symptoms and stabilization of the radiological picture. From our series of patients, it is now apparent that the MRI scan is an invaluable tool in identifying this subacute form of intra-adenomatous pituitary hemorrhage and has proven especially useful as a means of therapeutic planning and follow-up care in patients presenting with symptoms not typical of classic pituitary apoplexy.

scholarly journals Perioperative ultrasound imaging versus magnetic resonance imaging in management of lumbosacral spinal dysraphisms

2019 ◽  
Vol 34 (1) ◽  
Author(s):  
Wael Abd Elrahman Ali Elmesallamy
Keyword(s):  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Ultrasound Imaging ◽  
Resonance Imaging ◽  
University Hospitals ◽  
Mri Findings ◽  
True Negative ◽  
Magnetic Resonance Imaging Mri ◽  
Cystic Masses

Abstract Objectives The purpose of this study was to correlate lumbosacral spinal ultrasound (LUS) and magnetic resonance imaging (MRI) findings in patients with lumbosacral spinal dysraphisms to evaluate the value of LUS in diagnosis, intraoperative use, and during follow-up of those patients. Methods A total of 24 patients aged up to 6 years old were operated for lumbosacral spinal dysraphisms at the Neurosurgery Department of Zagazig University hospitals during the period from January 2017 to August 2018. All patients were investigated preoperatively, intraoperatively, and on follow-up by LUS to compare the data with preoperative and follow-up MRI of the spine. Results The median age was 11 months at the time of surgery. The most common anatomical description from the LUS study was thickened filum (18 cases). Using MRI findings as the standard reference, the sensitivity of LUS in detecting a thickened filum was 77.8% preoperatively and 62.5% postoperatively, with a specificity of 100%. The sensitivity and specificity of detecting conus level, solid masses, and cystic masses were 100%. Conclusions Lumbosacral spinal dysraphisms can be evaluated well by ultrasound imaging in age group up to 6 years old with 100% specificity (true negative) in comparison with MRI.

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