MR findings in globoid cell leucodystrophy

The MR findings in an adult patient with globoid cell leucodystrophy (GLD) or Krabbe's disease are presented. MRI showed a bilateral periventricular hyperintensity of the parieto-occipital white matter on the T2-weighted images. A hyperintense signal was seen bilaterally along the corticospinal tract. There was no immediate nor delayed contrast enhancement. The MR findings in this case of GLD are rather atypical.

Magnetic resonance imaging in central pontine myelinolysis

The MRI findings at 1.5 Tesla of central pontine myelinolysis in 2 alcoholic patients are reported. The lesion was confined to the pons in both cases, with strong hyperintensity on T2-weighted and hypointensity on T1-weighted images. In both cases MRI revealed typical symmetrical sparing of the ventrolateral tracts in the pons.

MRI of intraparenchymal hematoma: responsible mechanisms

The MRI appearance and evolution of hemorrhage remains a difficult entity. A typical example of the MR visualization of an intracerebral bleeding in the basal ganglia and the internal capsule at 1.5 T is presented. The sequential biochemical and physical changes in an hemorrhage are described.

MRI findings in tuberculous meningo-encephalitis

MRI findings in 3 cases of cerebral tuberculosis are reported. MR features consisted in meningeal enhancement, enhancement of the basilar cisterns and brainstem abscesses. T1 weighted images after intravenous administration of gadolinium appeared most efficient in the demonstration of the lesions.

Gadolinium-DOTA enhanced fast imaging of liver tumors at 1.5 T

Twenty patients [15 men, 5 women, 19-71 years old (mean 52 years)] highly suspected of having tumoral liver pathology were prospectively studied with motion compensated T2-weighted spin echo (SE) [repetition time (TR) 2,200 ms, echo time (TE) 90 ms] and Gd-DOTA enhanced gradient echo fast low angle shot [TR 60 ms, TE 10 ms, angle 30 degrees) sequences. The final diagnoses were hemangioma (five), hepatocellular carcinoma (four), focal nodular hyperplasia (one), adenoma (one), metastasis (two), abscess (two), echinococcal cyst (one), tumor of unknown origin (three), cirrhosis (one). Contrast enhanced images were obtained during the early vascular phases after intravenous bolus injection of Gd-DOTA at a dose of 0.1 mmol/kg (0.2 ml/kg). After Gd-DOTA, positive contrast enhancement was seen in 11 cases, negative enhancement in 4, and nonenhancement in 6. Contrast patterns were similar to contrast enhanced CT. In terms of visibility of lesions, the unenhanced motion-compensated T2 SE sequences were superior to the nonenhanced gradient echo sequences in 12 patients and equal in 8. After gadolinium enhancement, T2-weighted SE images were superior to the postcontrast gradient echo images in eight cases, equal in eight and inferior in four cases.

CT and MRI in spinal meningeal cyst. Report of a case

A case of meningeal cyst of the spinal canal in the lumbosacral region is described. A CT scan showed a soft tissue mass associated with bone erosion. Myelography and computerised tomographic myelography revealed a cyst filling with contrast and thus CSF containing. The diagnosis of meningeal cyst was confirmed in a non-invasive way by MRI showing a mass with the same signal intensities as CSF on both T1 and T2 weighted images. Final characterisation of meningeal cysts in one of the three categories comprising spinal extradural meningeal cyst without spinal nerve root fibers (type I), spinal extradural meningeal cyst with spinal nerve root fibers (type II) and intradural meningeal cyst (type III) is impossible without operative inspection and histological examination.

[Moyamoya. Diagnosis using MRI and NMR angiography]

A case of Moya-Moya disease confirmed by cerebral angiography in a 10-year-old girl is reported. Hypertrophic collateral circulation is easily visualized by MRI. MR angiography very accurately demonstrated the vascular obstruction and the collateral circulation. As MR angiography is not invasive, it promises to become a valuable alternative to conventional angiography in the diagnosis of Moya-Moya.

Intracavernous aneurysm. Superior demonstration by magnetic resonance angiography

A case of intracavernous aneurysm in a 56-year-old woman is reported. The superiority of MRI and MRA in the diagnosis is shown.

[Computerized tomography and magnetic resonance imaging of the pelvis in a patient with neurofibromatosis]

A case of intrapelvic neurofibroma is presented in a patient with neurofibromatosis. Magnetic resonance imaging proved to be very sensitive in the demonstration and delineation of the tumoral pelvic mass and the detection of smaller subcutaneous lesions. Direct coronal and sagittal images provided important information to the surgeon to evaluate the cranial and caudal extension and the anatomic boundaries of the lesion.

Magnetic resonance imaging in acoustic neurinoma. Comparison with CT

MRI and CT were performed in 16 patients with 17 acoustic neurinomas. MRI was superior to CT in the detection of small acoustic neurinomas, in the demonstration of intracanalicular extension and in the differentiation with cerebellopontine angle meningiomas. Overall advantages of MRI over CT included better tissue contrast, absence of bone artifacts and easy multiplanar imaging.

The role of radiology in Campylobacter enterocolitis

A series of 18 patients with diarrhoea and positive stool cultures for Campylobacter jejuni is presented. The most important radiological features were thickening of ileal mucosal folds, of interhaustral indentations and of the ileocaecal valve, lymphoid hyperplasia and microulcerations. Radiology, as well as endoscopy, are both nonspecific in Campylobacter jejuni enterocolitis. The importance of radiology is to exclude more typical features of other causes of inflammatory bowel diseases. Moreover, before the result of the stool culture is available, the radiological features should suggest the suspicion of an acute infectious enterocolitis by Campylobacter jejuni as possible diagnosis.

Detection of liver metastases with superparamagnetic iron oxide in 15 patients: results of MR imaging at 1.5 T

The first clinical results of using superparamagnetic ferrite particles as a tissue-specific contrast agent for MR of the liver are reported at high fields (1.5 T). Fifteen patients with proved secondary liver malignancies were studied with plain and contrast-enhanced MR. Superparamagnetic iron oxide was administrated IV in a dose of 20 mumol/kg. Intermediate TR, 820/30, 60 (TR/TE), and long TR, 2200/22, 70, spin-echo sequences were used before and 1 hr after injection of contrast material. Before injection, the largest number of lesions (437) was detected with the T2-weighted sequence. Lesion-to-liver contrast, expressed as the difference between the tumor and liver signal-to-noise, improved after ferrite administration in both sequences from -1 to 20 and from 7 to 15 for the 820/30, 60 sequence and from 9 to 34 and 15 to 21 for the 2200/22, 70 sequence. Despite this significant improvement in terms of the number of lesions detected, contrast-enhanced images did not show significantly more metastases than the unenhanced T2-weighted images did (383, 421, 407, and 407 vs as many as 437, respectively). In this limited study at 1.5 T, the benefit of ferrite enhancement was only marginal when postcontrast images were compared with heavily T2-weighted precontrast scans.

[Spontaneous dissection of the cervical internal carotid artery. Diagnosis by MRI]

A case of spontaneous dissection of the cervical internal carotid artery documented by angiography and MRI is reported. Angiography showed an irregular stenosis of the upper part of the cervical internal carotid artery extending up to the base of the skull, suggestive of spontaneous dissection. The diagnosis was confirmed beyond doubt by MRI which showed a sub-intimal collection of blood with a typical hyperintense appearance.

CT demonstration of right hepatic lobe atrophy

Postoperative bile duct obstruction with subsequent stone formation and infection led to atrophy of the ipsilateral lobe and portal vein obstruction, which promoted further atrophic changes. The compensatory increase in hepatic arterial blood flow resulted in an early enhancement of the atrophic lobe on CT after intravenous contrast medium injection.

Computed tomography in paraprosthetic sigmoid fistula

A patient with a paraprosthetic-sigmoid fistula following complicated aortic abdominal surgery is reported. Computed tomography confirmed the diagnosis by demonstrating inflammatory tissue around the left limb of the prosthesis in close contact with the sigmoid.