scholarly journals Differential Diagnosis of Intraplaque Hemorrhage and Dissection on High-Resolution MR Imaging in Patients with Focal High Signal of the Vertebrobasilar Artery on TOF Imaging

Diagnostics ◽  
2021 ◽  
Vol 11 (6) ◽  
pp. 1024
Author(s):  
Jung Hwan Kim ◽  
Hyo Sung Kwak ◽  
Seung Bae Hwang ◽  
Gyung Ho Chung

Purpose: Intraplaque hemorrhage (IPH) and dissection in the vertebrobasilar artery (VBA) on time of flight (TOF) source imaging are seen as focal eccentric high-signal intensity. The purpose of this study is to identify IPH and dissection in the VBA using high-resolution magnetic resonance imaging (HR-MRI). Methods: A total of 78 patients (VBA IPH: 55; dissection: 23) with focal high-signal intensity in the VBA on simultaneous non-contrast angiography and intraplaque hemorrhage (SNAP) of HR-MRI were included in this study. The focal high-signal intensity in the VBA on SNAP was defined as >200% than that of the adjacent muscle. We analyzed the signal intensity ratio (area of focal high signal intensity area/lumen) on TOF imaging and black blood (BB) T2-weighted imaging. Results: The VBA IPH group was older than the dissection group and had more hypertension. Signal intensity of a false lumen in patients with dissection on TOF imaging was significantly higher than that of VBA IPH (p < 0.001). The signal intensity ratio between lumen and lesion on TOF imaging was significantly higher in the dissection group (p < 0.001). The signal intensity of a false lumen in patients with dissection on BB T2-weighted imaging was significantly lower than that of VBA IPH (p < 0.001). The signal intensity ratio between lumen and lesion on BB T2–weighted imaging was significantly higher in the VBA IPH group (p < 0.001). Conclusions: TOF imaging and BB T2-weighted imaging on HR-MRI in patients with focal eccentric high-signal intensity on TOF imaging can distinguish between VBA IPH and dissection.

2010 ◽  
Vol 113 (4) ◽  
pp. 890-896 ◽  
Author(s):  
Tomohito Hishikawa ◽  
Koji Iihara ◽  
Naoaki Yamada ◽  
Hatsue Ishibashi-Ueda ◽  
Susumu Miyamoto

Object The aim of this study was to assess the histopathological differences between advanced atherosclerotic carotid artery (CA) plaques with signal hyperintensity on T1-weighted MR images and those without, focusing on necrotic core size and intraplaque hemorrhage (IPH). Methods Thirty-five patients scheduled for carotid endarterectomy underwent preoperative CA MR imaging using 3D inversion-recovery-based T1-weighted imaging (magnetization-prepared rapid acquisition gradient-echo [MPRAGE]). The signal intensity of the CA plaque on MPRAGE sequences was classified as “high” when the intensity was more than 200% that of adjacent muscle. A total of 96 axial MR images obtained in 35 patients were compared with corresponding histological sections from 36 excised specimens. The area of the necrotic core in histological sections was compared between specimens with and without high signal intensity on MPRAGE sequences. The IPH was histopathologically graded according to the size of the area positive for glycophorin A as revealed by immunohistochemical staining. The difference between plaques with and without high signal intensity was investigated with respect to the degree of IPH. The relationship of the severity of IPH to size of the necrotic core was also evaluated. Results The area of the necrotic core in plaques with high signal intensity on MPRAGE sequences was significantly larger than that in plaques without high signal intensity (median 51.2% [interquartile range 43.3–66.8%] vs 49.0% [33.2–57.6%], p = 0.029). Carotid artery plaques with high signal intensity had significantly more severe IPH than plaques with lower signal intensity (p < 0.0001). The severity of IPH was significantly associated with the size of the necrotic core (p < 0.0001). Conclusions Atherosclerotic CA plaques with high signal intensity on MPRAGE sequences had large necrotic cores with IPH in patients with high-grade stenosis; MPRAGE is useful for the evaluation of CA plaque progression.


2010 ◽  
Vol 31 (8) ◽  
pp. 1403-1407 ◽  
Author(s):  
R. Bitar ◽  
A.R. Moody ◽  
S. Symons ◽  
G. Leung ◽  
S. Crisp ◽  
...  

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Piero Ruscitti ◽  
Antonio Barile ◽  
Onorina Berardicurti ◽  
Sonia Iafrate ◽  
Paola Di Benedetto ◽  
...  

AbstractAdult onset Still's disease (AOSD) is a rare systemic autoinflammatory disease, characterised by fever, arthritis, and skin rash, and joint involvement is one of its clinical manifestations. The aims of this work were to assess joint involvement, to describe main patterns of involvement, and associated clinical characteristics. In this work, we aimed at assessing the joint involvement in AOSD by using MRI, to describe main patterns and associated clinical characteristics. In addition, we aimed at assessing the global transcriptomic profile of synovial tissues in AOSD to elucidate possible pathogenic pathways involved. We also evaluated the global transcriptomic profile of synovial tissues to elucidate possible pathogenic pathways involved in the disease. Thus, AOSD patients, who underwent to MRI exam on joints, were assessed to describe patterns of joint involvement and associated clinical characteristics. Some synovial tissues were collected for RNA-sequencing purposes. The most common MRI finding was the presence of synovitis on 60.5%, mainly in peripheral affected joints, with low to intermediate signal intensity on T1-weighted images and intermediate to high signal intensity on T2-fat-saturated weighted and STIR images. Bone oedema and MRI-bone erosions were reported on 34.9% and 25.6% MRI exams, respectively. Patients with MRI-bone erosions showed a higher prevalence of splenomegaly, a more frequent chronic disease course, lower levels of erythrocyte sedimentation rate, and ferritin. In AOSD synovial tissues, a hyper-expression of interleukin (IL)-1, IL-6, and TNF pathways was shown together with ferritin genes. In conclusion, in AOSD patients, the most common MRI-finding was the presence of synovitis, characterised by intermediate to high signal intensity on T2-fat-saturated weighted and STIR images. MRI-bone erosions and bone oedema were also observed. In AOSD synovial tissues, IL-1, IL-6, and TNF pathways together with ferritin genes resulted to be hyper-expressed.


Author(s):  
Amrish O. Chourasia ◽  
Mary E. Sesto ◽  
Youngkyoo Jung ◽  
Robert S. Howery ◽  
Robert G. Radwin

Work place exertions may include muscle shortening (concentric) or muscle lengthening (eccentric) contractions. This study investigates the upper limb mechanical properties and magnetic resonance images (MRI) of the involved muscles following submaximal eccentric and concentric exertions. Twelve participants were randomly assigned to perform at 30° per second eccentric or concentric forearm supination exertions at 50% isometric maximum voluntary contraction (MVC) for 30 minutes. Measurement of mechanical stiffness, isometric MVC, localized discomfort and MRI supinator: extensor signal intensity ratio was done before, immediately after, 1 hour after and 24 hours after the bout of exercise. A 53% average decrease in mechanical stiffness after 1 hour was observed for the eccentric group (p< 0.05) compared to a 1% average decrease for the concentric group (p> 0.05). Edema, indicative of swelling, was observed 24 hrs after exercise, with an average increase in the MRI supinator: extensor signal intensity ratio of 36% for the eccentric group and less than 10% for the concentric group (p<0.05).


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