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Epstein-Barr virus in an immunocompetent patient can show with diffuse/reversible brain white matter participation in severe mononucleosis;

Negative diffusion weighted imaging sequence is related with a fair improvement in grave EBV central nervous system contamination.

The medical research was contributed by: Paola Di Carlo (Dipartimento di Scienze per la Promozione della Salute, Università di Palermo, Italy) and associates. (Courtesy: BioMed Central)

Epstein-Barr virus (Epstein-Barr virus) – a herpes virus, causes infectious mononucleosis, an irregular high rate of monocytes in the blood. The central nervous system can unfavorably get affected through this virus, viz. in case of meningitis, acute encephalitis, demyelinating disease, acute cerebellar ataxia etc.

An MRI scan facilitates for small/multiple central nervous system lesions, more precisely – for swift diagnosis and therapeutic approaches; diffusion weighted imaging (DWI) is feasible more for the lesions than FLAIR (Fluid Attenuated Inversion Recovery) imaging or T2W.

The study covers the case of an immunocompetent patient with EBV encephalitis; DWI executed at the acute phase was normal, though fast spin echo T2 image demonstrated diffuse intensity developments in the white matter; the augmentation pattern proposed an inflammatory response confined to the brain microcirculation.

Following therapies were directed: corticosteroid and acyclovir; after a period of 3 weeks, signal intensities gained normalcy, and patient demonstrated clinical recovery.

Conclusion: Epstein-Barr virus in an immunocompetent patient can show with diffuse/reversible brain white matter implication in severe mononucleosis; negative diffusion weighted imaging sequence is related with a fair improvement in grave EBV central nervous system contamination. Further study is required for data to discern viral lesions from other reasons, in the acute phase of disorder.

MAVRIC supplements information on FSE images after arthroplasty; is valuable, especially on concerns related to synovitis, periprosthetic osteolysis, and related.

 

The study was collaborated by Catherine L. Hayter, Matthew F. Koff, Parina Shah, Kevin M. Koch, Theodore T. Miller and Hollis G. Potter from the Department of Radiology and Imaging, Hospital for Special Surgery, New York, NY; Applied Science Laboratory, GE Healthcare, Waukesha, WI; and Weill Cornell Medical College of Cornell University, New York, NY.

The research objective was to equate MAVRIC (multiacquisition variable-resonance image combination) with traditional fast spin-echo (FSE) method for assessment of patients that have undergone shoulder, hip or knee arthroplasty – surgical reconstruction/replacement. (Courtesy: American Journal of Roentgenology)

About 122 patients encompassed the study that had undergone arthroplasties; MRI with metal-artifact reduction MAVRIC and FSE sequences was executed.

MAVRIC and FSE images in a subjective way were marked for visualization of subsequent: prosthesis-bone interface, synovium, and hip abductors/supraspinatus tendon; existence of following was recorded – synovitis, and osteolysis/supraspinatus tendon tear.

Of results, synovium was better on MAVRIC images over FSE images of – shoulder, hip and knee.

Synovitis was discovered only on the MAVRIC images, in 12% cases with hip arthroplasty and 18% with shoulder arthroplasty.

Periprosthetic bone was considerably better on MAVRIC images, of – shoulder, hip and knee.

Osteolysis was found only on the MAVRIC images in 16% of cases of hip  arthroplasty; 22% with shoulder arthroplasty, and 24 with knee arthroplasty.

Supraspinatus tendon was considerably better on MAVRIC images; 44% cases of supraspinatus tendon tears were observed only on MAVRIC images.

Conclusion: MAVRIC supplements information on FSE images after arthroplasty; is valuable, especially on concerns related to synovitis, periprosthetic osteolysis, and related.

DWI, summed up with traditional whole-body MRI enhances lesion obviousness and diagnostic precision for lymphomas; with technical improvement, whole-body MRI with DWI can be put in use instead of PET/CT for malignant lymphoma.

 

The medical research was contributed by Jing Gu, Tao Chan, Jingbo Zhang, Anskar Y. H. Leung, Yok-Lam Kwong and Pek-Lan Khong from the Department of Diagnostic Radiology; Department of Medicine, Division of Haematology, The University of Hong Kong, Queen Mary Hospital, Hong Kong.

The research objective was to assess diagnostic performance of traditional whole-body MRI with and otherwise DWI (diffusion-weighted imaging) for 18F-FDG–avid lymphomas. (Courtesy: American Journal of Roentgenology)

The conventional protocol encompassed: T2-weighted – sequence and spectral attenuated inversion recovery (SPAIR) sequence, with frequency-selective fat suppression; the second protocol had DWI, other than similar sequences – as that of first protocol.

About 17 patients encompassed the study, with – newly identified, pathologically proved, untreated lymphoma; detached from diffusion weighted images, subsequent were evaluated first: T2-weighted and T2-weighted SPAIR images; it were assessed with the DW images, later.

18F-FDG PET/CT was the reference standard; following were estimated on a per-lesion basis: false-positive, true-positive and false-negative values.

Through with Ann Arbor staging system, tumor staging based on T2-weighted and T2-weighted SPAIR imaging, with and otherwise diffusion weighted imaging (DWI) were equated by.

Following trends were observed, by inclusion of DWI: true-positive lesions (increased from 89% to 97%); false-positive lesions (increased from 3% to 6%); false-negative lesions (decreased from 11% to 3%).

About diagnostic sensitivity – it was considerably enhanced by DWI; in comparison to T2-weighted and T2-weighted SPAIR imaging, about 47% of lesions were obvious on DWI; most were from lymph nodes in the abdominal/pelvic regions and bone marrow; no deviation was established amid T2-weighted and T2-weighted SPAIR imaging with and otherwise DWI in lymphoma staging.

Conclusion: inclusion of DWI to traditional whole-body MRI augmented lesion obviousness, diagnostic precision for lymphomas; with technical improvement, whole-body MRI with DWI can be utilized in place of PET/CT for malignant lymphoma.

Combination with contrast administration, 2D SENSE is effective in enhancing CNR and SNR in 3T whole-heart coronary MRA: study reports

 

The medical research study was contributed by Jing Yu (Johns Hopkins University, Baltimore, MD), and associates. (Courtesy: American Journal of Roentgenology)

The research objective was to enhance blood-myocardium CNR (contrast-to-noise ratio) and blood-pool SNR (signal-to-noise ratio) of slow-infusion 3T whole heart coronary MR angiography.

In 2-dimensional sensitivity coding (SENSE), the number of obtained k-space lines is lessened, facilitating less radiofrequency (RF) stimulation per cardiac cycle and a longer TR (time between volumes); the former can be utilized for signal enhancement with higher RF angle; the latter culminates to noise reduction, because of lower data-sampling transmission rate.

Both effects put up equally to signal-to-noise ratio gain in coronary MR angiography, when temporal/spatial resolution and acquisition time remain even. (vide: Cardiology)

Numeric simulation was done to forecast signal-to-noise ratio gain, and for optimal 2D SENSE pulse sequence parameters; about 11 patients passed through traditional unimproved and the suggested 2D SENSE contrast-augmented coronary MRA acquisition; subsequent were evaluated through: blood-myocardium contrast-to-noise ratio, blood-pool signal-to-noise ratio, visible vessel length/vessel sharpness and number of side branches.

Coherent with numeric simulation, through 2D SENSE, in contrast-augmented coronary MR angiography ensued in considerable enhancement in aortic blood-pool signal-to-noise ratio and contrast-to-noise ratio in the patient sample.

Coronary artery coverage, vessel sharpness and image quality score were not enhanced with the suggested approach, except for visualization of a longer length of left anterior descending coronary artery.

Conclusion: compounded with contrast administration, 2D SENSE was found effectual in enhancing CNR and SNR in 3T whole-heart coronary MRA; further study of cardiac motion compensation is required to utilize CNR and SNR benefits, and for submillimeter spatial resolution.

Complicated carotid atheroma can be observed amidst symptomatic patients with low-grade stenosis – related with increasing age and male sex.

MR-interpreted intraplaque hemorrhage may be beneficial to tell apart peril for patients with low-grade carotid stenosis.

 

The medical research was conducted by Helen M. C. Cheung, MD; Alan R. Moody, FRCP, FRCR; Navneet Singh, MD; Richard Bitar, MD, PhD, FRCPC; James Zhan, MD, PhD and General Leung, MSc, PhD, from the Department of Medical Imaging, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, ON, Canada.

The research objective was to ascertain if elaborated plaque is feasible through MR interpreted intraplaque hemorrhage (IPH) – even within symptomatic cases with low-grade carotid stenosis.

Symptomatic patients with bilateral carotid stenosis classified for MRI, were thought about.

Risk factors, medicament, and the brain region causing symptoms were registered; risk factors considered were: sex, age, diabetes, smoking, hypertension, atrial fibrillation, myocardial infarction, coronary artery disease, hyperlipidemia, cerebrovascular disease; and about medications: statins, aspirin, antihypertensive and diabetes drugs, etc.

Fisher exact test was utilized for to equate MR interpreted intraplaque hemorrhage preponderance in the carotid arteries ipsilateral/contralateral to the symptomatic side. Multivariable regression was put in use to collate the MR-interpreted intraplaque hemorrhage prevalence, while resolving for medications and risk factors.

434 carotid arteries, about 217 patients were let in; MR-interpreted IPH was observed in 13% of carotid arteries ipsilateral, and 7% of arteries contralateral to symptoms.

Increasing age and male sex were related with MR-interpreted IPH after ascertaining for medications and risk factors.

Conclusion: elaborated carotid atheroma can be observed amidst symptomatic patients with low-grade stenosis; related with increasing age and male sex. MR-interpreted intraplaque hemorrhage may be beneficial to tell apart hazard for patients with low-grade carotid stenosis.

Recognition of involvement of the Fornix by varied morbid processes may help in understanding the clinical signs of amnesia.

 

The CME paper in Radiology has been contributed by Adam G. Thomas, MRCP, FRCR; Panos Koumellis, MRCP, FRCR and Robert A. Dineen, PhD from the Department of Radiology, University Hospitals of Leicester, Leicester Royal Infirmary, Infirmary Close, Leicester, England; and Department of Neuroradiology, Nottingham University Hospitals, Queen’s Medical Centre, Nottingham, England. (Courtesy: RSNA Journal)

The fornix/trigonum cerebrale is a distinct white matter tract bundle, which is important for regular cognitive performance.

Even though evidently envisioned at MR imaging, its participation in pathologic processes is frequently neglected.

Some disease processes demonstrate an orientation for participation of the fornix; in other conditions, its engagement is an uncommon but discerned finding.

As constituent of the Papez circuit, it is important in memory formation, with disorder/injury ensuing in anterograde amnesia; many distinct morbid conditions can bear upon the fornix.

Midline tumors (gliomas/lymphoma) can penetrate it; as constituent of the limbic system, it may be influenced by herpes simplex encephalitis.

Participation by instigative conditions (multiple sclerosis) may exemplify its significance in global cognitive function. Discernment of forniceal atrophy may help in evaluation of mesial temporal sclerosis; metabolous conditions (Wernicke encephalopathy) have been accounted to involve it.

Initial findings of its participation in memory come up from surgical trauma, but as a midline structure, it is sensitive to the shearing forces of diffuse axonal injury. Infarction of the fornix is uncommon, but can ensue in severe amnesic syndromes.

Its part in degenerative conditions is a subject of interest for research, of: Alzheimer disease, schizophrenia etc.

Identification of participation of the fornix by several morbid processes may help in interpreting the clinical signs of amnesia.

Multimodality imaging approach is useful in complex/ambiguous cases; cognition of pertinent radiologic features and prime clinical information is vital for convinced lesion delineation and discrimination.

 

The CME paper in Radiology has been contributed by Gavin Low, MBChB, MRCS, FRCR; Anukul Panu, MD; Noam Millo, MD and Edward Leen, MD, FRCR from the Department of Radiology and Diagnostic Imaging, University of Alberta Hospital, Edmonton, AB, Canada; and Department of Imaging Science, Imperial College London, Hammersmith Hospital, London, England. (Courtesy: RSNA Journal)

Cystic pancreatic lesions depict miscellaneous group of entities, which can be widely categorized as either non-neoplastic or neoplastic.

Neoplastic lesions comprise subsequent: pancreatic neuroendocrine tumor, solid pseudopapillary tumor, pancreatic adenocarcinoma, pancreatic lymphoma, pancreatoblastoma, metastases to the pancreas, and uncommon sundry neoplasms.

On the other, Non-neoplastic lesions embody: fatty infiltration-replacement, focal pancreatitis, intrapancreatic accessory spleen, congenital anomalies and infrequent sundry lesions.

These solid lesions can be assessed through following modalities: computed tomography, MRI, ultrasonography, endoscopic ultrasound, SPECT/CT, and PET/CT – all have own capability and restraints.

Precise diagnosis can be difficult, and utilization of multimodality imaging pattern is a great deal beneficial in complex/ambiguous cases.

Facts about pertinent clinical data and prime radiologic attributes is vital for sure-footed lesion distinction and delineation.

Knowledge about typical appearances of irregularities of the portal venous system facilitates for more convinced diagnosis, and timely interventions.

 

Submitted over as an education exhibit at 2009 RSNA annual meeting, contributions in this segment are being made by Wai-Kit Lee, MBBS; Silvia D. Chang, MD; Vinay A. Duddalwar, MD; Jules M. Comin, MBBS; Warren Perera, MBBS; Wing-Fai E. Lau, MBBS; Elhamy K. Bekhit, MBBS and Oliver F. Hennessy, MD from the Department of Medical Imaging, St Vincent’s Hospital, University of Melbourne, Victoria, Australia; Department of Radiology, Vancouver Coastal Health, University of British Columbia, Vancouver, BC, Canada; Department of Radiology, Keck School of Medicine, University of Southern California, Los Angeles, California; Department of Radiology, Peter MacCallum Cancer Centre, University of Melbourne, Victoria, Australia; and Department of Medical Imaging, Royal Children’s Hospital, University of Melbourne, Parkville, Victoria, Australia.

The article is available in the online journal of Radiological Society of North America.

Irregularities of the portal venous system are miscellaneous group of conditions, which can bring about considerable mortality and morbidity; it may even take on to intricacies on surgery, or percutaneous mediation, regarding the portal venous system.

High-resolved MRI, computed tomography and ultrasonography allow for detailed, non-invasive assessment of the portal venous system, and make possible recognition of functional and structural irregularities; still, comprehension about embryologic development of anatomic variants and standard venous anatomy is required for to precisely translate imaging discoveries.

Facts of the typical appearances of irregularities of the portal venous system facilitates for more convinced diagnosis, allowing timely treatment and more communicated guidance of percutaneous mediations and surgical approaches, for enhanced outcome.

Advanced MR imaging is feasible for elusive developments in joint cartilage microstructure, for key markers of early osteoarthritis (OA), corroborates medical researchers from NYU Langone Medical Center’s Departments of Orthopaedic Surgery and Radiology.

 

The study is available in the July publication of the Journal of the American Academy of Orthopaedic Surgeons. Through these methods, on examination for identification of OA earlier, doctors can opt from eventual joint reconstruction to long-term preservation, for management of the disease.

Lead author, Laith Jazrawi (MD, associate professor of orthopaedic surgery) said, imaging technology is powerful and delicate for elusive changes in complex balance of water, chondrocytes/collagen fibers and protein molecules, which make up joint cartilage, and is feasible for indication to future OA.

With increased trend of joint pain/arthralgia, amongst growing population, researchers felt the possibility to bring these imaging techniques for the advantage of patients, from the labs.

Conventional MR imaging is the standard approach to evaluate quality of cartilage in patients with arthralgia, or noted arthritis that concentrates on morphological entirety of the cartilage, and in the lab – orthopedic surgeons, rheumatologists and radiologists have, in sync, utilized biochemical imaging methods and MRI to evaluate cartilage affected by OA.

Injured cartilage demonstrates obvious changes in subsequent: micro/macro-structure of collagen, concentration of water & collagen molecules, and specific proteins.

The results support utilization of MRI methods in assessment of younger patients with joint pain, to recognize the onset of OA, for prior treatment, to keep a check on the disease.

On the concluding note, Michael P. Recht (MD, Louise Marx, professor of radiology and chairman of the Department of Radiology) said, the optimization/development of MRI techniques have unearthed new opportunities for better understanding and treatment of arthritis, prior irrevocable morphological and structural shift has occurred.

How well your MRI unit is braced up for basic and specialized scans?

 

Magnetic Resonance Imaging, is a type of tomography, where proton density images (2D/3D) are generated through with nuclear magnetic resonance/reverberations, for detailed visualization of internal structures of the body, viz. organs, bones, muscles etc.

The MRI technology does not utilize ionizing radiation, similar to CT scan, or X-ray devices; an MRI scan is extensively used for detailed examination of brain/spinal cord; quantitative diffusion weighted MR imaging is feasible for patients with low grade ductal carcinoma in citu, with high specificity; multiparametric MRI procedure which encompasses DWI provides for a sensitive method, to discover local recurrence of tumor after high dose rate brachytherapy, through with radioactive implants.

On the other, MR enterography demonstrates well than computed tomography in pediatric Crohn’s disease, for intestinal abnormalities, and for characteristic manifestation of extraintestinal disorders. Besides, a recent study even corroborated about MR neurography, after failed tarsal tunnel release, for accurate morphologic data about the spread and location of nerve injury, for pre-operative diagnosis and assessment.

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