scholarly journals The Relationship Between Gastrointestinal Comorbidities, Clinical Presentation and Surgical Outcome in Patients with DCM: Analysis of a Global Cohort

2020 ◽  
Vol 9 (3) ◽  
pp. 624 ◽  
Author(s):  
Aria Nouri ◽  
Jetan H. Badhiwala ◽  
So Kato ◽  
Hamed Reihani-Kermani ◽  
Kishan Patel ◽  
...  
Keyword(s):  
Surgical Outcome ◽  
Neurological Impairment ◽  
International Studies ◽  
Mri Features ◽  
Intensity Changes ◽  
The Difference ◽  
Magnetic Resonance Imaging Mri ◽  
T2 Hyperintensity ◽  
Neck Disability ◽  
Degenerative Cervical Myelopathy

Degenerative cervical myelopathy (DCM) is the most common cause of spinal cord impairment in adults, presenting most frequently in patients 50 years or older. Gastrointestinal comorbidities (GICs) commonly occur in this group; however, their relationship with DCM has not been thoroughly investigated. It is the objective of the present study to investigate the difference between patients with or without GICs who are surgically treated for DCM. A cohort of 757 patients with clinical data and 458 with magnetic resonance imaging (MRI) data from the AOSpine North America and AOSpine International studies on DCM was evaluated. GICs were obtained at presentation and included gastric, intestinal, hepatic, and pancreatic conditions. Patients were dichotomized into 2 groups: those with GICs and those without GICs. Both clinical and MRI presentation, as well as baseline neurological and functional status, were compared. Neurological and functional outcomes at 2-year follow-up were also compared. GICs were present in 121 patients (16%). These patients were less commonly male (48.76% vs. 65.4%, p = 0.001) and were slightly less neurologically impaired based on the Nurick grade (3.05 ± 1.10 vs. 3.28 ± 1.16, p = 0.044) but not based on mJOA (12.74 ± 2.62 vs. 12.48 ± 2.76, p = 0.33). They also had a worse physical health score (32.80 ± 8.79 vs. 34.65 ± 9.38 p = 0.049), worse neck disability (46.31 ± 20.04 vs. 38.23 ± 20.44, p < 0.001), a lower prevalence of upper motor neuron signs (hyperreflexia, 70.2% vs. 78.9%, p = 0.037; Babinski’s sign 24.8% vs. 37.3%, p = 0.008), and a higher rate of psychiatric comorbidities (31.4% vs. 10.4%, p < 0.0001). On MRI, GIC patients less commonly exhibited signal intensity changes (T2 hyperintensity, 49.2% vs. 75.6%, p < 0.001; T1 hypointensity, 9.7% vs. 21.1%, p = 0.036), and had a lower number of T2 hyperintensity levels (0.82 ± 0.98 vs. 1.3 ± 1.11, p = 0.001). There was no difference in surgical outcome between the groups. DCM patients with GICs are more likely to be female and have significantly more general health impairment and neck disability. However, these patients have less clinical and MRI features typical of more severe neurological impairment. This constellation of symptoms is considerably different than those typically observed in DCM, and it is therefore plausible that nutritional factors may contribute to this unique observation.

scholarly journals Comparison of the clinical and MRI features of patients with hepatic hemangioma, epithelioid hemangioendothelioma, or angiosarcoma

2019 ◽  
Author(s):  
Zhuangsheng Liu ◽  
Lilei Yi ◽  
Junhao Chen ◽  
Ruqiong Li ◽  
Keming Liang ◽  
...  
Keyword(s):  
Vascular Endothelial Cell ◽  
Measurement Data ◽  
Epithelioid Hemangioendothelioma ◽  
Vascular Tumors ◽  
Hepatic Hemangioma ◽  
Mri Findings ◽  
Mri Features ◽  
Rim Enhancement ◽  
The Difference ◽  
Magnetic Resonance Imaging Mri

Abstract Background Comparisons of hepatic epithelioid hemangioendothelioma (HEHE), hepatic hemangioma, and hepatic angiosarcoma (HAS) have rarely been reported. The purpose of our study was to analyze the clinical and magnetic resonance imaging (MRI) findings of these conditions.Methods A total of 57 patients (25 with hemangioma, 13 with HEHE, and 19 with HAS) provided hepatic vascular endothelial cell data between June 2006 and May 2017. The measurement data were represented as means±SDs. Between-group comparisons were performed using independent-samples t-tests. Count data were represented as frequencies or rates, and χ2- or Fisher’s exact tests were performed.Results The proportions of cases with circumscribed margins were 88% (22/25), 84.6% (11/3), and 31.6% (6/19) for hemangioma, HEHE, and HAS, respectively (P<0.001). HAS lesions were less likely to have circumscribed margins. The proportions of lesions with hemorrhaging were 4% (1/25), 44.4% (4/13), and 36.8% (7/13) for hemangioma, HEHE, and HAS, respectively (P=0.014). HEHE and HAS cases were more likely to show heterogeneous signals on T1-weighted (T1WI) MRI. HEHE and HAS cases were more likely to show heterogeneous signals on T2-weighted (T2WI) MRI. Centripetal enhancement was the most common pattern in vascular tumors, with proportions of 100%, 46.2% (6/13), and 68.4% (13/19) for hemangioma, HEHE, and HAS, respectively. The difference in enhancement pattern between HEHE and HAS was not significant, but rim enhancement was more common for HEHE (46.2%, 6/13).Conclusions Our study revealed clinical and imaging differences between HEHE and HAS. The platelet count (PLT) and coagulation function of the HAS group decreased, whereas the alpha-fetoprotein (AFP) level increased. The 5-year survival rate for HAS was significantly lower than that of HEHE. A higher malignancy degree indicated a more blurred lesion margin, easier occurrence of hemorrhaging, and more heterogeneous plain T1WI and T2WI signals.

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

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.

177 The Relationship Between MRI Signal Intensity Changes, Clinical Presentation, and Surgical Outcome in Degenerative Cervical Myelopathy: Analysis of a Global Cohort

Neurosurgery ◽  
2017 ◽  
Vol 64 (CN_suppl_1) ◽  
pp. 246-246
Author(s):  
Aria Nouri ◽  
Allan R Martin ◽  
So Kato ◽  
Hamed Reihani-Kermani ◽  
Lauren Riehm ◽  
...  
Keyword(s):  
Cervical Myelopathy ◽  
Surgical Outcome ◽  
Neurological Recovery ◽  
Recovery Ratio ◽  
Baseline Severity ◽  
Signal Change ◽  
Signal Changes ◽  
T2 Hyperintensity ◽  
Degenerative Cervical Myelopathy ◽  
The Relationship

Abstract INTRODUCTION Several reports have investigated the relationship between MRI signal changes and the extent of spinal cord dysfunction and potential for postoperative neurological recovery in patients with Degenerative Cervical Myelopathy (DCM). However, there remains ambiguity if these signal changes relate with baseline severity, and predict neurological recovery after surgical treatment. The present study aims to address this knowledge gap by investigating a large global cohort of DCM patients. METHODS 419 MRIs from two prospective multicenter studies were examined. Images were assessed for the presence, levels, and location of cord signal changes and compared with clinical data (signs/symptoms, mJOA, Nurick). Inter-rater reliability for signal changes was calculated. Signal changes were also evaluated for prediction of 2-year post-operative outcome using 2 approaches: (1) Hirabayashi recovery ratio, (2) a dichotomized mJOA score of <16 and = 16 at 2-years representing a suboptimal and optimal neurological outcome, respectively. RESULTS >MRIs were categorized by signal change: no signal change (28.9%), T2 hyperintensity-only (T2-only, 51.8%), and T2-hyperintensity and T1-hypointensity (T1+T2, 19.3%). T2-hyperintensity was present at multiple levels in 27% of patients overall. There was moderate/substantial agreement (Kappa: 0.60) for T2-hyperintensity, and fair agreement for T1-hypointensity (Kappa: 0.31) identification among 3 raters. Baseline severity increased from no signal change to T2-only to T2+T1 (P < 0.0001), and there was an incremental increase in the frequency of signs/symptoms. The presence of T1-hypointensity correlated with reduced recovery ratio (P = 0.03) and likelihood of an optimal surgical outcome (P = 0.005). Greater number of T2-hyperintensity levels was also associated with worse baseline severity (P < 0.0001) and recovery ratio (P = 0.001). CONCLUSION This is the largest study of DCM patients to show an increasing stepwise impairment from no signal change to T2-hypertensity to T1-hypointensity. While T2-hyperintensity alone does not predict outcomes, T1-hypointensity indicates more permanent injury, portending decreased functional recovery. Multilevel T2-hyperintensity suggests additional tissue injury, correlating with worse impairment and recovery potential.

The Relationship Between MRI Signal Intensity Changes, Clinical Presentation, and Surgical Outcome in Degenerative Cervical Myelopathy

Spine ◽  
2017 ◽  
Vol 42 (24) ◽  
pp. 1851-1858 ◽  
Author(s):  
Aria Nouri ◽  
Allan R. Martin ◽  
So Kato ◽  
Hamed Reihani-Kermani ◽  
Lauren E. Riehm ◽  
...  
Keyword(s):  
Cervical Myelopathy ◽  
Surgical Outcome ◽  
Signal Intensity ◽  
Clinical Presentation ◽  
Intensity Changes ◽  
Degenerative Cervical Myelopathy ◽  
The Relationship

scholarly journals Comparison of the clinical and MRI features of patients with hepatic hemangioma, epithelioid hemangioendothelioma, or angiosarcoma

2020 ◽  
Author(s):  
Zhuangsheng Liu ◽  
Lilei Yi ◽  
Junhao Chen ◽  
Ruqiong Li ◽  
Keming Liang ◽  
...  
Keyword(s):  
Vascular Endothelial Cell ◽  
Epithelioid Hemangioendothelioma ◽  
Vascular Tumors ◽  
Hepatic Hemangioma ◽  
Vascular Endothelial ◽  
Mri Findings ◽  
Mri Features ◽  
Rim Enhancement ◽  
The Difference ◽  
Magnetic Resonance Imaging Mri

Abstract Background Comparisons of hepatic epithelioid hemangioendothelioma (HEHE), hepatic hemangioma, and hepatic angiosarcoma (HAS) have rarely been reported. The purpose of our study was to analyze the clinical and magnetic resonance imaging (MRI) findings of these conditions. Methods A total of 57 patients (25 with hemangioma, 13 with HEHE, and 19 with HAS) provided hepatic vascular endothelial cell data between June 2006 and May 2017. Results The proportions of cases with circumscribed margins were 88% (22/25), 84.6% (11/3), and 31.6% (6/19) for hemangioma, HEHE, and HAS, respectively (P<0.001). HAS lesions were less likely to have circumscribed margins. The proportions of lesions with hemorrhaging were 4% (1/25), 44.4% (4/13), and 36.8% (7/13) for hemangioma, HEHE, and HAS, respectively (P=0.014). HEHE and HAS cases were more likely to show heterogeneous signals on T1-weighted (T1WI) MRI. HEHE and HAS cases were more likely to show heterogeneous signals on T2-weighted (T2WI) MRI. Centripetal enhancement was the most common pattern in vascular tumors, with proportions of 100%, 46.2% (6/13), and 68.4% (13/19) for hemangioma, HEHE, and HAS, respectively. The difference in enhancement pattern between HEHE and HAS was not significant, but rim enhancement was more common for HEHE (46.2%, 6/13). Conclusions Our study revealed clinical and imaging differences between HEHE and HAS. The platelet count (PLT) and coagulation function of the HAS group decreased, whereas the alpha-fetoprotein (AFP) level increased. The 5-year survival rate for HAS was significantly lower than that of HEHE. A higher malignancy degree indicated a more blurred lesion margin, easier occurrence of hemorrhaging, and more heterogeneous plain T1WI and T2WI signals.

MRI features of responsible contacts in vascular compressive trigeminal neuralgia and prediction modeling

2021 ◽  
pp. 028418512098397
Author(s):  
Yufei Zhao ◽  
Jianhua Chen ◽  
Rifeng Jiang ◽  
Xue Xu ◽  
Lin Lin ◽  
...  
Keyword(s):  
Trigeminal Neuralgia ◽  
Predictive Model ◽  
Trigeminal Nerve ◽  
Roc Curve ◽  
Neurovascular Compression ◽  
Diagnostic Efficiency ◽  
Mri Features ◽  
Vascular Origin ◽  
Magnetic Resonance Imaging Mri ◽  
Mri Characteristics

Background Multiple neurovascular contacts in patients with vascular compressive trigeminal neuralgia often challenge the diagnosis of responsible contacts. Purpose To analyze the magnetic resonance imaging (MRI) features of responsible contacts and establish a predictive model to accurately pinpoint the responsible contacts. Material and Methods Sixty-seven patients with unilateral trigeminal neuralgia were enrolled. A total of 153 definite contacts (45 responsible, 108 non-responsible) were analyzed for their MRI characteristics, including neurovascular compression (NVC) grading, distance from pons to contact (Dpons-contact), vascular origin of compressing vessels, diameter of vessel (Dvessel) and trigeminal nerve (Dtrigeminal nerve) at contact. The MRI characteristics of the responsible and non-responsible contacts were compared, and their diagnostic efficiencies were further evaluated using a receiver operating characteristic (ROC) curve. The significant MRI features were incorporated into the logistics regression analysis to build a predictive model for responsible contacts. Results Compared with non-responsible contacts, NVC grading and arterial compression ratio (84.44%) were significantly higher, Dpons-contact was significantly lower at responsible contacts ( P < 0.001, 0.002, and 0.033, respectively). NVC grading had a highest diagnostic area under the ROC curve (AUC) of 0.742, with a sensitivity of 64.44% and specificity of 75.00%. The logistic regression model showed a higher diagnostic efficiency, with an AUC of 0.808, sensitivity of 88.89%, and specificity of 62.04%. Conclusion Contact degree and position are important MRI features in identifying the responsible contacts of the trigeminal neuralgia. The logistic predictive model based on Dpons-contact, NVC grading, and vascular origin can qualitatively improve the prediction of responsible contacts for radiologists.

Is intervertebral disc degeneration related to segmental instability? An evaluation with two different grading systems based on clinical imaging

2017 ◽  
Vol 59 (3) ◽  
pp. 327-335 ◽  
Author(s):  
David Volkheimer ◽  
Fabio Galbusera ◽  
Christian Liebsch ◽  
Sabine Schlegel ◽  
Friederike Rohlmann ◽  
...  
Keyword(s):  
Intervertebral Disc Degeneration ◽  
Statistical Significance ◽  
Axial Rotation ◽  
Spinal Motion ◽  
X Ray ◽  
Grading Systems ◽  
Flexion Extension ◽  
The Difference ◽  
Magnetic Resonance Imaging Mri

Background Several in vitro studies investigated how degeneration affects spinal motion. However, no consensus has emerged from these studies. Purpose To investigate how degeneration grading systems influence the kinematic output of spinal specimens. Material and Methods Flexibility testing was performed with ten human T12-S1 specimens. Degeneration was graded using two different classifications, one based on X-ray and the other one on magnetic resonance imaging (MRI). Intersegmental rotation (expressed by range of motion [ROM] and neutral zone [NZ]) was determined in all principal motion directions. Further, shear translation was measured during flexion/extension motion. Results The X-ray grading system yielded systematically lesser degeneration. In flexion/extension, only small differences in ROM and NZ were found between moderately degenerated motion segments, with only NZ for the MRI grading reaching statistical significance. In axial rotation, a significant increase in NZ for moderately degenerated segments was found for both grading systems, whereas the difference in ROM was significant only for the MRI scheme. Generally, the relative increases were more pronounced for the MRI classification compared to the X-ray grading scheme. In lateral bending, only relatively small differences between the degeneration groups were found. When evaluating shear translations, a non-significant increase was found for moderately degenerated segments. Motion segment segments tended to regain stability as degeneration progressed without reaching the level of statistical significance. Conclusion We found a fair agreement between the grading schemes which, nonetheless, yielded similar degeneration-related effects on intersegmental kinematics. However, as the trends were more pronounced using the Pfirrmann classification, this grading scheme appears superior for degeneration assessment.

Increased MRI-based cortical grey/white-matter contrast in sensory and motor regions in schizophrenia and bipolar disorder

2016 ◽  
Vol 46 (9) ◽  
pp. 1971-1985 ◽  
Author(s):  
K. N. Jørgensen ◽  
S. Nerland ◽  
L. B. Norbom ◽  
N. T. Doan ◽  
R. Nesvåg ◽  
...  
Keyword(s):  
Bipolar Disorder ◽  
White Matter ◽  
Linear Models ◽  
Subcortical White Matter ◽  
Precentral Gyrus ◽  
Average Group ◽  
Medication Dose ◽  
Weighted Magnetic Resonance Imaging ◽  
The Difference ◽  
Magnetic Resonance Imaging Mri

BackgroundSchizophrenia and bipolar disorder share genetic risk factors and one possible illness mechanism is abnormal myelination. T1-weighted magnetic resonance imaging (MRI) tissue intensities are sensitive to myelin content. Therefore, the contrast between grey- and white-matter intensities may reflect myelination along the cortical surface.MethodMRI images were obtained from patients with schizophrenia (n = 214), bipolar disorder (n = 185), and healthy controls (n = 278) and processed in FreeSurfer. The grey/white-matter contrast was computed at each vertex as the difference between average grey-matter intensity (sampled 0–60% into the cortical ribbon) and average white-matter intensity (sampled 0–1.5 mm into subcortical white matter), normalized by their average. Group differences were tested using linear models covarying for age and sex.ResultsPatients with schizophrenia had increased contrast compared to controls bilaterally in the post- and precentral gyri, the transverse temporal gyri and posterior insulae, and in parieto-occipital regions. In bipolar disorder, increased contrast was primarily localized in the left precentral gyrus. There were no significant differences between schizophrenia and bipolar disorder. Findings of increased contrast remained after adjusting for cortical area, thickness, and gyrification. We found no association with antipsychotic medication dose.ConclusionsIncreased contrast was found in highly myelinated low-level sensory and motor regions in schizophrenia, and to a lesser extent in bipolar disorder. We propose that these findings indicate reduced intracortical myelin. In accordance with the corollary discharge hypothesis, this could cause disinhibition of sensory input, resulting in distorted perceptual processing leading to the characteristic positive symptoms of schizophrenia.

Progress of leukoaraiosis is inhibited by correction of platelet hyper-aggregability

2005 ◽  
Vol 17 (4) ◽  
pp. 689-698 ◽  
Author(s):  
Shigekiyo Fujita ◽  
Tetsuro Kawaguchi ◽  
Toshiyuki Uehara ◽  
Kazuhito Fukushima
Keyword(s):  
Group Versus ◽  
Adenosine Diphosphate ◽  
White Matter Hyperintensity ◽  
Number Of Patients ◽  
Mri Scans ◽  
The Mean ◽  
The Difference ◽  
Magnetic Resonance Imaging Mri ◽  
Observation Period

Background: Platelet hyper-aggregability is an important risk factor for leukoaraiosis. In this study we investigated whether aggravation of leukoaraiosis can be controlled by means of long-term correction of platelet hyper-aggregability.Methods:Twenty-one patients with leukoaraiosis and uncorrected platelet hyper-aggregability were compared with 21 controls matched for age, grade of leukoaraiosis and observation period whose platelet hyper-aggregability was corrected. Platelet aggregability was estimated by an optical analytical method with a nine-stage display using two different concentrations each of adenosine diphosphate (ADP) and collagen (the double ADP method).Results:The mean observation period between two magnetic resonance imaging (MRI) scans for both groups was 4.1 years. In the non-corrected group, moderate to severe aggravation of leukoaraiosis was observed in a large number of patients. In the corrected group, only a small number of patients showed generally mild aggravation of leukoaraiosis. The number of patients showing aggravation of periventricular hyperintensity (PVH) was 7 in 21 in the non-corrected group versus 1 in 21 (p=0.022) in the corrected group, and for aggravation of deep white-matter hyperintensity, these values were 9 in 21 versus 4 in 21, respectively. Thus, the difference was more significant if the degree of aggravation was taken into account.Conclusion:The progress of leukoaraiosis is greatly inhibited by long-term correction of platelet hyper-aggregability.

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