scholarly journals Can imaging modalities be used as follow-up criteria after brucellar sacroiliitis treatment?

2017 ◽  
Vol 11 (02) ◽  
pp. 123-128 ◽  
Author(s):  
Aybars Bilgeturk ◽  
Hanefi Cem Gul ◽  
Ahmet Karakas ◽  
Gurkan Mert ◽  
Cumhur Artuk ◽  
...  
Keyword(s):  
Bone Scintigraphy ◽  
Joint Involvement ◽  
Resonance Imaging ◽  
Active Involvement ◽  
High Resolution Mri ◽  
Active Sacroiliitis ◽  
The Mean ◽  
Therapeutic Responses ◽  
Sacroiliac Joint Involvement

Introduction: This study aimed to identify a follow-up modality that can be used to evaluate therapeutic responses in patients receiving treatment for brucellar sacroillitis and to determine whether antibiotherapy can be stopped. Methodology: A total of 32 patients with sacroiliac joint involvement demonstrated via magnetic resonance imaging or bone scintigraphy were followed up and treated. Patients received 200 mg/day of doxycycline and 600–900 mg/day of rifampicin for 3–21 months, and 1 g/day of streptomycin for 21 days. Results: The mean age of the 32 patients involved was 21.81 ± 4.09. In total, 10/32 patients did not complete therapy, and the remaining 22 patients received combination antibiotic treatment for a mean of 8.95 ± 4.34 months. Of the 22 patients, 15 underwent MRI, and 7 of them did not consent to MRI. Similarly, 17 patients were followed up by bone scintigraphy, and 5 patients did not have scintigraphy results. In 9/17 patients followed up with bone scintigraphy, sacroiliitis findings were found to reduce after a mean of 7.44 ± 3.71 months, whereas in 12/15 patients on whom MRI was performed,  there were no active sacroiliitis findings for a mean of 6.95 ± 2.83 months. Conclusions: While active involvement findings in bone scintigraphy were observed for a longer period in scintigraphy images, active sacroiliitis findings disappeared in a relatively shorter period of time with MRI. Therefore, we have demonstrated that high-resolution MRI is a very sensitive technique compared to scintigraphy.

Magnetic Resonance Imaging After Arthroscopic Microfracture of Capitellar Osteochondritis Dissecans

2012 ◽  
Vol 40 (11) ◽  
pp. 2549-2556 ◽  
Author(s):  
Corey A. Wulf ◽  
Rebecca M. Stone ◽  
M. Russell Giveans ◽  
Gregory N. Lervick
Keyword(s):  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Osteochondritis Dissecans ◽  
Articular Surface ◽  
Resonance Imaging ◽  
Arthroscopic Microfracture ◽  
The Mean ◽  
Magnetic Resonance Imaging Mri ◽  
Mri Evaluation

Background: Osteochondritis dissecans (OCD) of the capitellum affects young athletes involved in elbow load-bearing activities. Unstable lesions are best managed surgically, although debate remains regarding the optimal method. Arthroscopic treatment allows rapid recovery, but the effect on the articular surface is undetermined. Hypothesis: The clinical outcome after arthroscopic microfracture of stage III/IV capitellum OCD would be successful in terms of return to sport and restoration of function, and there would be some evidence of articular restoration or repair. Study Design: Case series; Level of evidence, 4. Methods: We reviewed records of 10 consecutive adolescent patients (age ≤18 years) with stage III or IV OCD lesions of the capitellum managed with arthroscopic microfracture. The mean age at the time of surgery was 13.9 years (range, 10.8-18.5 years); 7 patients were skeletally immature and 3 were skeletally mature. Pre- and postoperative functional assessment included active range of motion, Mayo Elbow Performance Score (MEPS), and Timmerman/Andrews elbow score. All patients underwent plain radiographic and magnetic resonance imaging (MRI) evaluation at a minimum of 12 months (mean, 27 months; range, 12-49 months) and clinical evaluation at a minimum of 24 months (mean, 42 months; range, 27-54 months) after surgery. Results: The mean range of motion improved in both flexion (135.8°→140.7°, P = .112) and extension (20.4°→–2.2°, P = .005). The mean MEPS (70.5→97, P = .007) and Timmerman/Andrews elbow scores (116.4→193.0, P = .008) improved significantly. magnetic resonance imaging (MRI) evaluation demonstrated an improvement in overall joint congruence and the formation of a reparative articular surface in 8 of 10 (80%) patients. No reoperations or major complications were encountered. Six of 8 patients involved in competitive athletics returned to the same level of participation at an average of 5.1 months. Conclusion: Arthroscopic OCD fragment excision and capitellar microfracture demonstrates good to excellent functional results in short-term follow-up. Follow-up MRI suggests potential for a reparative fibrocartilaginous articular surface. Longer term follow-up is necessary to determine durability of the technique.

scholarly journals Microhemorrhagic transformation of ischemic lesions on T2*-weighted magnetic resonance imaging after Pipeline embolization device treatment

2019 ◽  
Vol 130 (6) ◽  
pp. 1997-2004 ◽  
Author(s):  
Ryuta Nakae ◽  
Masaya Nagaishi ◽  
Yosuke Kawamura ◽  
Yoshihiro Tanaka ◽  
Akio Hyodo ◽  
...  
Keyword(s):  
Intracranial Aneurysms ◽  
Hemorrhagic Transformation ◽  
Diffusion Weighted Mri ◽  
Resonance Imaging ◽  
Mr Images ◽  
Pipeline Embolization Device ◽  
Hemorrhagic Complications ◽  
Weighted Magnetic Resonance Imaging ◽  
The Mean

OBJECTIVEThe authors sought to demonstrate that hemorrhagic transformation of ischemic lesions is the main cause of delayed intracerebral hemorrhage (ICH) after Pipeline embolization device (PED) treatment and to estimate the rate of hemorrhagic transformation of new postprocedure ischemic lesions.METHODSPatients who underwent PED placement (PED group) from November 2015 to March 2017 or stent-mediated embolization (EN group) from December 2010 to October 2015 were retrospectively analyzed. Pre- and postprocedural MR images and 6-month follow-up MR images for each patient were scored for the presence of postprocedural bland ischemic and hemorrhagic lesions using diffusion-weighted MRI (DWI) and T2*-weighted MRI (T2*WI), respectively.RESULTSThe PED group comprised 28 patients with 30 intracranial aneurysms, and the EN group comprised 24 patients with 27 intracranial aneurysms. The mean number of ischemic lesions on DWI 1 day postprocedure was higher in the PED group than in the EN group (5.2 vs 2.7, p = 0.0010). The mean number of microbleeds detected on T2*WI 6 months postprocedure was higher in the PED group than in the EN group (0.6 vs 0.15, p = 0.028). A total of 36.7% of PED-treated patients exhibited new microbleeds on T2*WI at 6 months postprocedure, with at least 77.8% of these lesions representing hemorrhagic transformations of the new ischemic lesions observed on day 1 postprocedure. The rate of adjunctive coil embolization (27.3% vs 0.0%, p = 0.016) and the mean number of ischemic lesions observed 1 day postprocedure (6.6 vs 4.3, p = 0.020) were predictors of subsequent microbleeds in the PED group.CONCLUSIONSNew microbleeds detected using T2*WI at 6 months postprocedure were more common after PED treatment than after stent-mediated embolization. Approximately three-quarters of these lesions were hemorrhagic transformations of new ischemic lesions observed on day 1 postprocedure. Prevention of intraprocedural or postprocedural infarcts is necessary to reduce the risk of hemorrhagic complications following PED placement.

scholarly journals Prognostic value of focal scintigraphic findings in clinically suspected cases of tibial stress fracture

2018 ◽  
Vol 51 (4) ◽  
pp. 225-230 ◽  
Author(s):  
Wagner Castropil ◽  
Amisa Guimarães ◽  
Carlos Alberto Buchpiguel
Keyword(s):  
Bone Scintigraphy ◽  
Stress Fracture ◽  
Recovery Time ◽  
Region Of Interest ◽  
Tracer Uptake ◽  
Control Group ◽  
Resonance Imaging ◽  
Tibial Stress Fracture ◽  
The Mean ◽  
Fracture Control

Abstract Objective: To investigate the correlation between tracer uptake on bone scintigraphy and recovery time in patients with tibial stress fracture. Materials and Methods: We evaluated two groups of athletes: those with clinical suspicion and a radiological diagnosis of tibial stress fracture (TSF group, n = 21); and those with no symptoms or evidence of fracture (control group, n = 10). All subjects underwent bone scintigraphy and magnetic resonance imaging with a maximum interval of 7 days between the assessments. Results: Using the region of interest technique, we obtained a quantitative evaluation index, comparing affected and unaffected legs. The mean uptake of 99mTc-MDP was significantly higher in the TSF group than in the control group (2.54 ± 0.77 vs. 1.05 ± 0.11; p < 0.001). Conclusion: In our sample of athletes, determining the bone scintigraphy uptake indices provided an objective method to estimate the appropriate recovery time after a tibial stress fracture.

scholarly journals Prenatal Diagnosis of Galen Vein Aneurysm Using Ultrasonography and Magnetic Resonance Imaging and Perinatal and Long-Term Neurological Outcomes: A Case Series

2017 ◽  
Vol 39 (06) ◽  
pp. 309-314
Author(s):  
Pedro Pires ◽  
Larisse Martins ◽  
Norma Pires ◽  
Heron Werner ◽  
Adilson Ferreira ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Birth Weight ◽  
Prenatal Diagnosis ◽  
Magnetic Resonance ◽  
Gestational Age ◽  
Tertiary Care ◽  
Case Series ◽  
Resonance Imaging ◽  
The Mean

Objective To describe the prenatal diagnosis of Galen vein aneurysm (GVA) based on ultrasonography and magnetic resonance imaging (MRI) in a series of cases, as well as its postnatal outcomes and follow-up until 4 years of age. Methods A retrospective longitudinal study was performed, analyzing a database comprising seven cases of prenatal diagnosis of GVA at two Brazilian institutions from February of 2000 to May of 2012. The following data were evaluated: gestational age at diagnosis, GVA dimensions on ultrasonography, associated fetal changes, findings on fetal echocardiography, gestational age at delivery, type of delivery, birth weight, Apgar score at the 1st and 5th minutes, neonatal outcomes, and survival with follow-up until 4 years of age. Results The mean gestational age ± standard deviation on the prenatal diagnosis of GVA based on ultrasonography was 25 ± 4.9 weeks. The mean length of GVA was 3.2 ± 0.4 cm. The mean gestational age at birth was 37.5 ± 0.7 weeks, and a cesarean section was performed in 85.7% of the cases (6/7). The mean birth weight was 3,070 ± 240.4 g. The total survival rate was 42.8% (4/7), with three neonatal deaths. Of the four survivors, three presented with normal neuropsychomotor development until 4 years of age and only one showed serious neurological sequelae. Ultrasonography and MRI showed similar findings for all seven cases. Conclusions Galen Vein Aneurysm is associated with a high neonatal death rate. Therefore, its prenatal diagnosis is essential for parent counseling and follow-up at tertiary care institutions.

scholarly journals Surgical Fixation of Chondral-Only Fragments of the Knee: A Case Series With a Mean 4-Year Follow-up

2021 ◽  
Vol 9 (1) ◽  
pp. 232596712096139
Author(s):  
Andrew Gudeman ◽  
Dillen Wischmeier ◽  
Jack Farr
Keyword(s):  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Clinical Outcome ◽  
Arthroscopic Surgery ◽  
Case Series ◽  
Resonance Imaging ◽  
Outcome Scores ◽  
Surgical Fixation ◽  
The Mean

Background: Chondral-only fragments of the knee have traditionally been treated with excision, with or without cartilage restoration procedures. This is because of the historical assumption that cartilage has limited ability to heal to cancellous or subchondral bone. There is now a growing body of evidence supporting surgical fixation of these fragments. Hypothesis: We hypothesized that surgical fixation of chondral fragments would result in acceptable rates of healing with improvement in clinical outcome scores. Study Design: Case series; Level of evidence, 4. Methods: Data were collected on 15 surgically fixed chondral-only fragments in 14 patients. We retrospectively collected participant demographic information, lesion characteristics, primary mechanism (osteochondritis dissecans vs traumatic shear injury), fixation methods, reoperation information, second-look arthroscopic information, and clinical outcome scores. The mean clinical follow-up was 3.96 years, with a minimum of 1-year follow-up. All patients underwent follow-up magnetic resonance imaging at a mean of 2 years after the index procedure. Results: The mean age of our cohort was 17.7 years. We found an 80% survival rate for fixation of the fragments at a mean 4-year follow-up. There were statistically significant improvements in postoperative Knee injury and Osteoarthritis Outcome Score and Tegner scores compared with preoperative scores. Follow-up magnetic resonance imaging scans showed complete healing in 10 knees, partial healing in 2 knees, and loss of fixation in 3 knees. Second-look arthroscopic surgery of 3 knees for reasons other than fragment symptoms showed healing of the fragment, while arthroscopic surgery of 3 symptomatic knees showed loss of fixation. Conclusion: Surgical fixation of chondral-only lesions showed an 80% success rate with improvements in the KOOS and Tegner scores.

scholarly journals Time course of radiographic hip joint changes in patients with early axial spondyloarthritis

2021 ◽  
Vol 15 (1) ◽  
pp. 46-50
Author(s):  
E. M. Agafonova ◽  
D. G. Rumyantseva ◽  
A. V. Smirnov ◽  
Sh. Erdes
Keyword(s):  
Hip Joint ◽  
Time Course ◽  
Axial Spondyloarthritis ◽  
Disease Onset ◽  
Underlying Disease ◽  
Joint Involvement ◽  
Base Line ◽  
Radiological Progression ◽  
The Mean

The diagnosis of coxitis remains one of the most difficult problems in the management of patients with axial spondyloarthritis (axSpA). In Russia, almost every two patients with axSpA were found to have hip joint (HJ) damage. However, until a certain time, there have been no methods to estimate the rate of progression of radiographic HJ changes in clinical practice. We have previously developed a formula for calculating the rate of coxitis progression, which simplifies the assessment of radiographic HJ changes and allows a physician to make a timely decision about changing therapy if rapidly progressing coxitis is detected.Objective: to estimate the rate of radiological progression of coxitis during a 24-month follow-up of patients with early axSpA.Patients and methods. Examinations were made in 38 patients (20 women and 18 men) who had been followed up for at least 2 years without radiographic and ultrasound signs of HJ joint involvement. The patients' mean age was 28.8±5.5 years; the disease duration was 22.7±15.7 months. HLA-B27 was positive in 35 (92%) patients. The summary stage of radiographic coxitis (ssRC) was used to assess HJ damage; the previously developed formula was applied to estimate the rate of radiological progression of coxitis (R-rpC).Results and discussion. The median cervical-capsular distance (CCD) was 5.2 mm at baseline and 4.9 mm at 2 years (p7 mm increase in the CCD. The mean ssRC was 0.34±0.75 scores at base line, 0.86±0.78 scores at 1 year; and this indicator increased up to 1.24±1.36 scores at 2 years (p=0.004). During 2 years of follow-up, there was no coxitis progression (the difference between ssRC2 and ssRC1 was 0) in 24 (63%) patients; ΔssRC increased by 1 score in 5 (13%); by 2 scores in 6 (16%), and by 4 scores in 3 (8%). On patient inclusion to the investigation, R-rpC averaged 0.5 (it was conventionally assumed that patients had no signs of HJ damage at the disease onset (ssRC=0). During therapy for the underlying disease, the mean R-rpC was 0.3 and 0.2 score/year within the first and second years, respectively. The mean R-rpC in the ΔssRC >0 group was as many as 0.85 score/year at one-year follow-up and 0.53 score/year at two-year follow-up.Conclusion. The developed procedure for estimating the progression of coxitis using ssRC is easy to use and can identify patients at high risk for coxitis progression.

Dynamic Contrast-Enhanced Magnetic Resonance Imaging of Advanced Cervical Carcinoma: The Advantage of Perfusion Parameters From the Peripheral Region in Predicting the Early Response to Radiotherapy

2018 ◽  
Vol 28 (7) ◽  
pp. 1342-1349 ◽  
Author(s):  
Zhaoguang Zhang ◽  
Zhengang Wang ◽  
Rongrong Zhao
Keyword(s):  
Cervical Carcinoma ◽  
Central Region ◽  
Early Response ◽  
Peripheral Region ◽  
Resonance Imaging ◽  
Dynamic Contrast Enhanced ◽  
Advanced Cervical Carcinoma ◽  
Contrast Enhanced ◽  
The Mean

ObjectiveThis study aimed to investigate the importance of perfusion parameters from the peripheral region in predicting the early response to radiotherapy for advanced cervical carcinoma by using dynamic contrast-enhanced (DCE) perfusion magnetic resonance imaging (MRI).MethodsOne hundred eight patients with advanced cervical carcinoma were enrolled into this study. Dynamic contrast-enhanced perfusion MR examinations were performed for all the patients before radiotherapy. Perfusion parameters were obtained from the central region and the peripheral region of tumor respectively. After radiotherapy, the patients were classified into responders and nonresponders according to tumor shrinkage on the basis of follow-up MRI examination. The mean follow-up time lasted 12 months. The perfusion parameters were compared between the 2 groups. The relationship between perfusion parameters from 2 different regions of tumor and treatment effect was analyzed.ResultsThe mean value of volume transfer constant (Ktrans), rate constant (Kep) or extravascular extracellular volume fraction (Ve) from the peripheral region was higher than that from the central region of tumor, respectively (P = 0.01, 004, 0.03). Responders had higher Ktransperipheral (Ktrans from the peripheral region) and Ktranscentral (Ktrans from the central region) values than nonresponders (P = 0.04, 0.01). Responders had higher Kepperipheral (Kep from the peripheral region) than nonresponders (P = 0.03). Responders had lower Veperipheral (Ve from the peripheral region) than nonresponders (P = 0.04). At logistic regression analysis, the perfusion parameters that had predicting value were Ktransperipheral, Veperipheral, Kepperipheral and Ktranscentral according to diagnostic potency.ConclusionsCompared with perfusion parameters from the central region of tumor, perfusion parameters from the peripheral region are more valuable in predicting the early response to radiotherapy for advanced cervical carcinoma.

A Survey of Chronic Pain Due to Spinal Dural Arteriovenous Fistulae

Neurosurgery ◽  
2015 ◽  
Vol 77 (1) ◽  
pp. 113-118 ◽  
Author(s):  
Toru Sasamori ◽  
Kazutoshi Hida ◽  
Toshiya Osanai ◽  
Shunsuke Yano ◽  
Toshitaka Seki ◽  
...  
Keyword(s):  
Chronic Pain ◽  
Rating Scale ◽  
Numeric Rating Scale ◽  
Leg Pain ◽  
Spontaneous Pain ◽  
Resonance Imaging ◽  
Spinal Cord Atrophy ◽  
The Mean ◽  
Numeric Rating

Abstract BACKGROUND: Chronic pain due to spinal dural arteriovenous fistulae (SDAVF) during follow-up is a serious issue because it can affect patients' quality of life. The severity of posttreatment chronic leg pain in patients with SDAVF is unclear. OBJECTIVE: To investigate the prevalence, severity, and characteristics of chronic leg pain in patients with SDAVF and to examine the clinical factors associated with chronic pain. METHODS: We conducted a survey of their chronic posttreatment leg pain in 49 SDAVF patients. It consisted of a numeric rating scale and a neuropathic pain symptom inventory (NPSI). Of the 49 patients, 32 (65.3%) completed the questionnaire. There were 24 males and 8 females whose mean age was 69.1 years. The mean follow-up period was 86.3 months. RESULTS: Chronic leg pain was reported by 26 (81.3%) of 32 patients; 14 experienced pain before treatment and 12 had new-onset posttreatment pain. The pain was reported as moderate to severe by 21 (80.8%) of 26 patients; the mean numeric rating scale and NPSI scores were 6.0 ± 2.3 and 17.4 ± 10.3, respectively. The NPSI subscores were significantly higher for spontaneous pain and paresthesia/dysesthesia than for paroxysmal pain. We found no significant clinical factors related to chronic posttreatment pain; on magnetic resonance imaging scans we identified spinal cord atrophy in 8 patients with chronic pain. CONCLUSION: Most of our SDAVF patients reported moderate to severe chronic leg pain characterized by spontaneous pain and paresthesia/dysesthesia. Spinal cord atrophy on magnetic resonance imaging scans was a characteristic in patients with chronic pain.

scholarly journals Switching from branded to generic glatiramer acetate: 15-month GATE trial extension results

2017 ◽  
Vol 23 (14) ◽  
pp. 1909-1917 ◽  
Author(s):  
Krzysztof Selmaj ◽  
Frederik Barkhof ◽  
Anna N Belova ◽  
Christian Wolf ◽  
Evelyn RW van den Tweel ◽  
...  
Keyword(s):  
Glatiramer Acetate ◽  
Efficacy And Safety ◽  
Resonance Imaging ◽  
Open Label ◽  
Double Blind ◽  
Disability Status ◽  
Mri Scans ◽  
The Mean ◽  
Magnetic Resonance Imaging Mri

Background: Open-label 15-month follow-up of the double-blind, placebo-controlled Glatiramer Acetate clinical Trial to assess Equivalence with Copaxone® (GATE) trial. Objective: To evaluate efficacy, safety, and tolerability of prolonged generic glatiramer acetate (GTR) treatment and to evaluate efficacy, safety, and tolerability of switching from brand glatiramer acetate (GA) to GTR treatment. Methods: A total of 729 patients received GTR 20 mg/mL daily. Safety was assessed at months 12, 15, 18, 21, and 24 and Expanded Disability Status Scale and magnetic resonance imaging (MRI) scans at months 12, 18, and 24. The presence of glatiramer anti-drug antibodies (ADAs) was tested at baseline and months 1, 3, 6, 9, 12, 18, and 24. Results: The mean number of gadolinium-enhancing lesions in the GTR/GTR and GA/GTR groups was similar at months 12, 18, and 24. The change in other MRI parameters was also similar in the GTR/GTR and GA/GTR groups. The annualized relapse rate (ARR) did not differ between the GTR/GTR and GA/GTR groups, 0.21 and 0.24, respectively. The incidence, spectrum, and severity of reported adverse events did not differ between the GTR/GTR and GA/GTR groups. Glatiramer ADA titers were similar in the GTR/GTR and GA/GTR groups. Conclusion: Efficacy and safety of GTR is maintained over 2 years. Additionally, switching from GA to GTR is safe and well tolerated.

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