scholarly journals MRI of the Morel-Lavallée lesion – a case series

2021 ◽  
Vol 0 (0) ◽  
Author(s):  
Tajda Srot Volavc ◽  
Mitja Rupreht
Keyword(s):  
Fluid Collection ◽  
Subcutaneous Fat ◽  
Case Series ◽  
Mass Effect ◽  
Time Frame ◽  
Proton Density ◽  
Mechanism Of Injury ◽  
Characteristic Features ◽  
Magnetic Resonance Imaging Mri ◽  
Type 3

Abstract Introduction The aim of the study was to review the appearances of Morel-Lavallée (ML) lesions on magnetic resonance imaging (MRI). Patients and methods 14 patients diagnosed with the ML lesion on MRI were analysed retrospectively (mean age = 35 years). Mechanism of injury, time frame from injury to MRI, location, shape, T1 and proton-density fat-suppression (PDFS) signal intensity (SI), presence of a (pseudo)capsule, septations or nodules within the collection, mass effect and fluid-fluid levels were analyzed. The Mellado and Bencardino classification was utilized to classify the lesions. Results In most cases, mechanism of injury was distortion. Mean time frame between the injury and MRI was 17 days. Lesions were located around the knee in 9 patients and in the peritrochanteric region in 5 patients. Collections were fusiform in 12 patients and oval in 2 patients. 9 collections were T1 hypointense and PDFS hyperintense. 4 collections had intermediate T1 and high PDFS SI. 1 collection had intermediate T1 and PDFS SI. (Pseudo)capsule was noted in 3 cases. Septations or nodules were found in 4 cases. According to the Mellado and Bencardino, collections were classified as seroma (type 1) in 9, subacute hematoma (type 2) in 1 and chronic organizing hematoma (type 3) in 4 cases. Conclusions Characteristic features of ML lesion include a fusiform fluid collection between the subcutaneous fat and the underlying fascia after shearing injury. Six types can be differentiated on MRI, with the seroma, the subacute hematoma and the chronic organizing hematoma being the commonest.

Use of Fat-Suppressed T2-Weighted MRI Images to Reduce the Magic Angle Effect in Peroneal Tendons

2018 ◽  
Vol 12 (6) ◽  
pp. 513-517 ◽  
Author(s):  
Edmund Ieong ◽  
Michael Rafferty ◽  
Monica Khanna ◽  
Miny Walker ◽  
Peter Rosenfeld
Keyword(s):  
Case Series ◽  
Proton Density ◽  
Magic Angle ◽  
Peroneal Tendon ◽  
Peroneal Tendons ◽  
Mri Scans ◽  
Angle Effect ◽  
Magnetic Resonance Imaging Mri ◽  
Weighted Sequences ◽  
Magic Angle Effect

Introduction. Peroneal tendon disorders pose a diagnostic conundrum to the clinician. Magnetic resonance imaging (MRI) is widely used to assess tendon pathology. A recognized artifact of MRI, the magic angle effect (MAE), can lead to spurious results and inappropriate management. The aim of this study is to assess whether T2 fat-suppressed sequences (T2FSs) reduce the frequency of MAE compared with proton density fat-suppressed (PDFS) images. Methods. MRI scans of 18 patients were prospectively assessed for MAE. The peroneal tendons were assessed at 5 defined levels on PDFS and T2FS images. The frequency of MAE in the peroneal tendons were compared between the 2 scan sequences. Results. In the peroneus brevis tendon, 17/72 levels, on PDFS scans, showed MAE compared with 2/72 levels on the T2FS scans, demonstrating a reduction in the MAE by 85% (P = .0003). In the peroneus longus tendon 14/72 levels, on PDFS scans, demonstrated MAE compared with 4/72 on T2FSs, demonstrating a reduction of 71% (P = .02). Conclusion. The inclusion of T2-weighted sequences is useful in MRI scanning for peroneal tendons to mitigate the MAE artifact, avoid potential misdiagnosis, and guide subsequent management of peroneal tendon disorders. Levels of Evidence: Level IV: Case series

scholarly journals Non-Hemorrhagic Adrenal Infarction during Pregnancy: The Diagnostic Imaging Keys

Tomography ◽  
2021 ◽  
Vol 7 (4) ◽  
pp. 533-544
Author(s):  
Pierre Chagué ◽  
Antoine Marchi ◽  
Alix Fechner ◽  
Ghina Hindawi ◽  
Hadrien Tranchart ◽  
...  
Keyword(s):  
Radiation Exposure ◽  
Adrenal Glands ◽  
Clinical Laboratory ◽  
Fluid Collection ◽  
Case Series ◽  
Imaging Findings ◽  
University Hospitals ◽  
Patient Reports ◽  
Magnetic Resonance Imaging Mri ◽  
Adrenal Infarction

Background: non-hemorrhagic adrenal infarction (NHAI) is a rare cause of acute abdominal/flank pain during pregnancy; in order to ensure prompt and appropriate treatment, this diagnosis should not be overlooked. This case series highlights pertinent imaging findings, including ultrasounds (USs), computed tomography (CT), and magnetic resonance imaging (MRI) of recent NHAI cases. Methods: we compiled all consecutive NHAI cases from two university hospitals over a two-year period and checked the relevant clinical, laboratory, and imaging findings. Relevant articles on NHAI published from January 2010 to March 2021 were analyzed. Results: six cases were found in our database. CT-scans typically showed enlarged, hypodense, and non-enhanced adrenal glands. Unenhanced MRIs allowed for diagnoses and showed enlarged adrenal glands in the signal hyperintensity on T2 and diffusion-weighted imaging, without any signal hyperintensity on T1. In two of our six cases, USs showed swollen adrenal glands with fluid collection. Conclusion: NHAI and its differential diagnosis—in cases of acute pain during pregnancy—highlight the crucial roles of integrated radiological examination and cooperation between obstetricians and radiologists, both of whom should consider the location of the pain, the accessibility and tolerance of MRI, and the radiation exposure of CT. Despite its supposed poor sensitivity, an US performed because the patient reports pain should also be used to examine the adrenal gland regions. Non-enhanced MRI is clearly of value and access to it in emergencies is important to avoid radiation exposure

scholarly journals Haemangioma of Cavernous Sinus- A Case Series

2020 ◽  
Author(s):  
Neeraj Jain ◽  
Mohit Bhargava ◽  
Sunil Kumar Puri
Keyword(s):  
Cavernous Sinus ◽  
Slow Growth ◽  
Case Series ◽  
Proton Density ◽  
Operative Morbidity ◽  
Extrinsic Compression ◽  
Incomplete Removal ◽  
Neoplastic Lesions ◽  
Vascular Channels ◽  
Magnetic Resonance Imaging Mri

Extra-axial cavernous sinus haemangioma are rare extra-axial parasellar lesions. These are non-neoplastic lesions, but can behave in a manner like that of neoplastic lesions as their slow growth with progressive enlargement of thin-walled vascular channels may result in extrinsic compression on adjacent retro-orbital neural structures. It is important to diagnose these lesions preoperatively as surgery in these lesions is often complicated by incomplete removal, severe intraoperative haemorrhage and significant operative morbidity and mortality. A parasellar lesion showing homogeneous markedly increased signal on T2 or proton density weighted images with progressive centripetal “filling-in” with contrast on dynamic Magnetic Resonance Imaging (MRI) should suggest the diagnosis. We are presenting three interesting cases of cavernous sinus haemangioma.

Comparison Between 18F-Dopa and 18F-Fet PET/CT in Patients with Suspicious Recurrent High Grade Glioma: A Literature Review and Our Experience

2019 ◽  
Vol 12 (3) ◽  
pp. 220-228 ◽  
Author(s):  
Laura Evangelista ◽  
Lea Cuppari ◽  
Luisa Bellu ◽  
Daniele Bertin ◽  
Mario Caccese ◽  
...  
Keyword(s):  
Case Series ◽  
High Grade Glioma ◽  
High Grade ◽  
True Negative ◽  
Fet Pet ◽  
Positron Emission ◽  
Pet Ct ◽  
Magnetic Resonance Imaging Mri ◽  
Definition Of ◽  
Sensitivity Specificity

Purpose: The aims of the present study were to: 1- critically assess the utility of L-3,4- dihydroxy-6-18Ffluoro-phenyl-alanine (18F-DOPA) and O-(2-18F-fluoroethyl)-L-tyrosine (18F-FET) Positron Emission Tomography (PET)/Computed Tomography (CT) in patients with high grade glioma (HGG) and 2- describe the results of 18F-DOPA and 18F-FET PET/CT in a case series of patients with recurrent HGG. Methods: We searched for studies using the following databases: PubMed, Web of Science and Scopus. The search terms were: glioma OR brain neoplasm and DOPA OR DOPA PET OR DOPA PET/CT and FET OR FET PET OR FET PET/CT. From a mono-institutional database, we retrospectively analyzed the 18F-DOPA and 18F-FET PET/CT of 29 patients (age: 56 ± 12 years) with suspicious for recurrent HGG. All patients underwent 18F-DOPA or 18F-FET PET/CT for a multidisciplinary decision. The final definition of recurrence was made by magnetic resonance imaging (MRI) and/or multidisciplinary decision, mainly based on the clinical data. Results: Fifty-one articles were found, of which 49 were discarded, therefore 2 studies were finally selected. In both the studies, 18F-DOPA and 18F-FET as exchangeable in clinical practice particularly for HGG patients. From our institutional experience, in 29 patients, we found that sensitivity, specificity and accuracy of 18F-DOPA PET/CT in HGG were 100% (95% confidence interval- 95%CI - 81-100%), 63% (95%CI: 39-82%) and 62% (95%CI: 39-81%), respectively. 18F-FET PET/CT was true positive in 4 and true negative in 4 patients. Sensitivity, specificity and accuracy for 18F-FET PET/CT in HGG were 100%. Conclusion: 18F-DOPA and 18F-FET PET/CT have a similar diagnostic accuracy in patients with recurrent HGG. However, 18F-DOPA PET/CT could be affected by inflammation conditions (false positive) that can alter the final results. Large comparative trials are warranted in order to better understand the utility of 18F-DOPA or 18F-FET PET/CT in patients with HGG.

scholarly journals Expert opinion paper on cardiac imaging after ischemic stroke

2021 ◽  
Author(s):  
Renate B. Schnabel ◽  
Stephan Camen ◽  
Fabian Knebel ◽  
Andreas Hagendorff ◽  
Udo Bavendiek ◽  
...  
Keyword(s):  
Ischemic Stroke ◽  
Expert Opinion ◽  
Cardiac Imaging ◽  
Controlled Trial ◽  
Case Series ◽  
Stroke Care ◽  
Imaging Method ◽  
Cardiac Evaluation ◽  
Magnetic Resonance Imaging Mri ◽  
Ischemic Attack

AbstractThis expert opinion paper on cardiac imaging after acute ischemic stroke or transient ischemic attack (TIA) includes a statement of the “Heart and Brain” consortium of the German Cardiac Society and the German Stroke Society. The Stroke Unit-Commission of the German Stroke Society and the German Atrial Fibrillation NETwork (AFNET) endorsed this paper. Cardiac imaging is a key component of etiological work-up after stroke. Enhanced echocardiographic tools, constantly improving cardiac computer tomography (CT) as well as cardiac magnetic resonance imaging (MRI) offer comprehensive non- or less-invasive cardiac evaluation at the expense of increased costs and/or radiation exposure. Certain imaging findings usually lead to a change in medical secondary stroke prevention or may influence medical treatment. However, there is no proof from a randomized controlled trial (RCT) that the choice of the imaging method influences the prognosis of stroke patients. Summarizing present knowledge, the German Heart and Brain consortium proposes an interdisciplinary, staged standard diagnostic scheme for the detection of risk factors of cardio-embolic stroke. This expert opinion paper aims to give practical advice to physicians who are involved in stroke care. In line with the nature of an expert opinion paper, labeling of classes of recommendations is not provided, since many statements are based on expert opinion, reported case series, and clinical experience.

scholarly journals Breast involvement of hematological malignancies: imaging and clinical findings

2021 ◽  
Vol 52 (1) ◽  
Author(s):  
Gamze Durhan ◽  
Figen Demirkazık
Keyword(s):  
Hematological Malignancies ◽  
Clinical Findings ◽  
Accurate Diagnosis ◽  
Radiological Findings ◽  
Breast Masses ◽  
Appropriate Treatment ◽  
Magnetic Resonance Imaging Mri ◽  
Type 3 ◽  
And Diffusion

Abstract Background Breast involvement of hematological malignancies is a very rare entity. Accurate diagnosis is essential for appropriate treatment. The aim of this study was to clarify the clinical and radiological findings of hematological malignancy breast involvement and to describe possible pitfalls in diagnosis. Results The images of 20 patients with breast involvement of hematological malignancies were retrospectively evaluated on ultrasonography, mammography, and magnetic resonance imaging (MRI) and the findings were reported. Bilaterality was seen only in cases with secondary involvement, and there was no marked difference between primary and secondary breast involvement of hematological malignancies. All patients underwent ultrasonography examination. According to ultrasonography, breast masses were most frequently irregular in shape (11/20, 55%) with non-circumscribed margins (11/20, 55%). Posterior acoustic enhancement was noted in 14 cases (70%). Posterior shadowing was not observed in any of the patients. Mammography was available in 10 patients. Microcalcification was not observed in any patient on mammography. MRI was available in four patients. Hyperintensity in T2-weighted images, type 2 or type 3 dynamic curve, and diffusion restriction were observed in all cases. Conclusions Hematological malignancies may mimic both benign breast lesions and breast carcinoma. Familiarity with the radiological features of hematological malignancies can help accurate diagnosis.

scholarly journals Actinomyces meyeriPopliteal Cyst Infection and Review of the Literature

2017 ◽  
Vol 2017 ◽  
pp. 1-5
Author(s):  
Bharath Raj Palraj ◽  
Ala S. Dababneh
Keyword(s):  
Fluid Collection ◽  
Left Knee ◽  
Joint Fluid ◽  
Popliteal Cyst ◽  
Degenerative Arthritis ◽  
Posterior Aspect ◽  
Medial Meniscectomy ◽  
Complex Fluid ◽  
Magnetic Resonance Imaging Mri ◽  
Mri Study

A 66-year-old, Caucasian male presented with pain and swelling involving the left knee of one-week duration. Arthrocentesis was negative for evidence of septic arthritis. Magnetic resonance imaging (MRI) study of the left knee showed degenerative arthritis, partial tear of medial meniscus, and a complex fluid collection along the posteromedial aspect of the left knee suggestive of popliteal cyst. He underwent arthroscopy with partial medial meniscectomy. Intraoperative joint fluid was noted to be cloudy but cultures were negative. Arthroscopic procedure provided him with temporary relief but the pain and swelling in the posterior aspect of the left knee recurred in 6 weeks. Repeat MRI showed complex fluid collection in the posterolateral aspect of left knee. Ultrasound guided aspiration of the fluid collection revealed purulent material and cultures grewActinomyces meyeri. He was treated with 6 weeks of intravenous penicillin regimen followed by 18 months of oral penicillin.

scholarly journals Axillary Nerve Position in Humeral Avulsions of the Glenohumeral Ligament

2018 ◽  
Vol 6 (12) ◽  
pp. 232596711881104 ◽  
Author(s):  
Desmond J. Bokor ◽  
Sumit Raniga ◽  
Petra L. Graham
Keyword(s):  
Safety Margin ◽  
Case Series ◽  
Free Edge ◽  
Axillary Nerve ◽  
Level Of Evidence ◽  
Glenohumeral Ligament ◽  
Preoperative Magnetic Resonance ◽  
Magnetic Resonance Imaging Mri ◽  
Potential Damage ◽  
Hagl Lesion

Background: The axillary nerve is at risk during repair of a humeral avulsion of the glenohumeral ligament (HAGL). Purpose: To measure the distance between the axillary nerve and the free edge of a HAGL lesion on preoperative magnetic resonance imaging (MRI) and compare these findings to the actual intraoperative distance measured during open HAGL repair. Study Design: Case series; Level of evidence, 4. Methods: A total of 25 patients with anterior instability were diagnosed as having a HAGL lesion on MRI and proceeded to open repair. The proximity of the axillary nerve to the free edge of the HAGL lesion was measured intraoperatively at the 6-o’clock position relative to the glenoid face. Preoperative MRI was then used to measure the distance between the axillary nerve and the free edge of the HAGL lesion at the same position. Distances were compared using paired t tests and Bland-Altman analyses. Results: The axillary nerve lay, on average, 5.60 ± 2.51 mm from the free edge of the HAGL lesion at the 6-o’clock position on preoperative MRI, while the mean actual intraoperative distance during open HAGL repair was 4.84 ± 2.56 mm, although this difference was not significant ( P = .154). In 52% (13/25) of patients, the actual intraoperative distance of the axillary nerve to the free edge of the HAGL lesion was overestimated by preoperative MRI. In 36% (9/25), this overestimation of distance was greater than 2 mm. Conclusion: The observed overestimations, although not significant in this study, suggest a smaller safety margin than might be expected and hence a substantially higher risk for potential damage. We recommend that shoulder surgeons exercise caution in placing capsular sutures in the lateral edge when contemplating arthroscopic repair of HAGL lesions, as the proximity of the nerve to the free edge of the HAGL tear is small enough to be injured by arthroscopic suture-passing instruments.

Epilepsy in Propionic Acidemia: Case Series of 14 Saudi Patients

2018 ◽  
Vol 33 (11) ◽  
pp. 713-717 ◽  
Author(s):  
Afnan AlGhamdi ◽  
Muhammad Talal Alrifai ◽  
Abdullah I. Al Hammad ◽  
Fuad Al Mutairi ◽  
Abdulrahman Alswaid ◽  
...  
Keyword(s):  
Autosomal Recessive ◽  
Case Series ◽  
Brain Magnetic Resonance Imaging ◽  
Propionic Acidemia ◽  
Resonance Imaging ◽  
Mri Findings ◽  
Epileptiform Discharges ◽  
Magnetic Resonance Imaging Mri ◽  
Autosomal Recessive Manner ◽  
Delayed Myelination

Propionic acidemia is an inborn error of metabolism that is inherited in an autosomal recessive manner. It is characterized by a deficient propionyl-CoA carboxylase due to mutations in either of its beta or alpha subunits. In the literature, there is a clear association between propionic acidemia and epilepsy. In this cohort, we retrospectively reviewed the data of 14 propionic acidemia patients in Saudi Arabia and compared the findings to those of former studies. Six of the 14 (43%) patients developed epileptic seizure, mainly focal seizures. All patients were responsive to conventional antiepileptic drugs as their seizures are controlled. The predominant electroencephalographic (EEG) findings were diffuse slowing in 43% and multifocal epileptiform discharges in 14% of the patients. In 1 patient, burst suppression pattern was detected, a pattern never before reported in patients with propionic acidemia. Brain magnetic resonance imaging (MRI) findings mainly consisted of signal changes of the basal ganglia (36%), generalized brain atrophy (43%), and delayed myelination (43%).The most common genotype in our series is the homozygous missense mutation in the PCCA gene (c.425G>A; p. Gly142Asp). However, there is no clear genotype–seizure correlation. We conclude that seizure is not an uncommon finding in patients with propionic acidemia and not difficult to control. Additional studies are needed to further elaborate on genotype–seizure correlation.

scholarly journals Snake-Eye Myelopathy and Surgical Prognosis: Case Series and Systematic Literature Review

2020 ◽  
Vol 9 (7) ◽  
pp. 2197 ◽  
Author(s):  
Marco Maria Fontanella ◽  
Luca Zanin ◽  
Riccardo Bergomi ◽  
Marco Fazio ◽  
Costanza Maria Zattra ◽  
...  
Keyword(s):  
Prognostic Factor ◽  
Literature Review ◽  
Meta Analysis ◽  
Prognostic Significance ◽  
Case Series ◽  
Neurological Deficits ◽  
Poor Prognostic Factor ◽  
Surgical Data ◽  
Magnetic Resonance Imaging Mri ◽  
Degenerative Cervical Myelopathy

The prognostic value of “snake-eyes” sign in spinal cord magnetic resonance imaging (MRI) is unclear and the correlation with different pathological conditions has not been completely elucidated. In addition, its influence on surgical outcome has not been investigated in depth. A literature review according to PRISMA (Preferred reporting items for systematic review and meta-analysis protocols) guidelines on the prognostic significance of “snake-eyes” sign in operated patients was performed. Clinical, neuroradiological, and surgical data of three institutional patients, were also retrospectively collected. The three patients, with radiological evidence of “snake-eyes” myelopathy, underwent appropriate surgical treatment for their condition, with no new post-operative neurological deficits and good outcome at follow-up. The literature review, however, reported conflicting results: the presence of “snake-eyes” sign seems a poor prognostic factor in degenerative cervical myelopathy, even if some cases can improve after surgery. “Snake-eyes” myelopathy represents a rare form of myelopathy; pathophysiology is still unclear. The frequency of this myelopathy may be greater than previously thought and according to our literature review it is mostly a negative prognostic factor. However, from our experience, prognosis might not be so dire, especially when tailored surgical intervention is performed; therefore, surgery should always be considered and based on the complete clinical, neurophysiological, and radiological data.

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