Persistent Müllerian duct syndrome suggested by magnetic resonance imaging

We report the case of a 45-year-old man with persistent Müllerian duct syndrome suggested by its characteristic appearance magnetic resonance (MR) imaging. A tubular structure extending from the patient's left inguinal region to the pelvic cavity was found incidentally at surgery for a testicular tumor. T2-weighted MR images obtained after surgery revealed the characteristic three-layer structure in the left pelvic cavity with no relation to the bladder or prostate. The hyperintense inner layer, hypointense middle layer, and hyperintense outer layer were thought to represent the endometrium, junctional zone, and outer myometrium of the uterus, respectively. Cryptorchidism and transverse testicular ectopia were not associated. The structure was not resected because there had been no reports of malignancy arising from the Müllerian duct remnant.     

Diagnosis of pulmonary infarction in post-mortem computed tomography and post-mortem magnetic resonance imaging—a technical note

International Journal of Legal Medicine - Pulmonary thromboembolism may be accompanied by pulmonary infarction. Even though pulmonary thromboembolism (PTE) is a frequently found cause of death at...     

Measuring the anterior cruciate ligament’s footprints by three-dimensional magnetic resonance imaging

Purpose  

The purpose of this study was to compare 3D MR imaging and open cadaveric measurements of the ACL’s footprints to see whether 3D MR imaging measurements are accurate enough to be used for preoperative templating in anatomic ACL reconstruction.     

Brain “embolism” detected by magnetic resonance imaging During percutaneous mitral balloon commissurotomy

Purpose: The common finding of thrombi between the bifoil balloons when they were extracted after mitral dilation prompted us to look for evidence of minor brain embolisms using the sensitive technique of BMRI (brain magnetic resonance T2-weighted imaging). Methods: BMRI was performed within 48 hr before and after a percutaneous mitral balloon commissurotomy (PMBC) in each of the 63 patients in this study. Results: There was evidence (hyperintensity foci: HI) of a previous asymptomatic brain embolism in 38 of 63 patients before PMBC and a new HI appeared in 18 of 63 patients after the procedure. New HI signals were found exclusively in the white matter in 8 of 18 patients and in only 3 of 18 were HI signs larger than 1 cm. One patient, with an HI signal >1 cm in the thalamus and another <1 cm in the brain stem, presented diplopia accompanied by other minor clinical signs. The differences in HI rate among four subgroups (1, older vs younger than 43 years; 2, sinus rhythm vs atrial fibrillation; 3, echo score <8 vs >8; 4, patients from western countries vs the others) were not statistically significant, probably because the number of patients in each subgroup was low. Patients in atrial fibrillation had slightly more (not significant) HI before PMBC (15/20, 75%) than patients in sinus rhythm (23/43, 53%), but after PMBC their HI frequencies were similar (atrial fibrillation: 5/20, 25%; sinus rhythm: 13/43, 30%). Conclusion: Brain microembolism is frequent during PMBC, but is often anatomically limited and free from clinical signs in most cases. Brain embolism seems to be related mainly to the procedure itself and not the features of the patient.     

Measurement of femoral anteversion by magnetic resonance imaging — evaluation of a new technique in children and adolescents

Anteversion of the femoral neck was measured by magnetic resonance imaging (MRI) in 19 children (37 hips) preoperatively before femoral rotation osteotomies. The results of this new technique were compared with values for anteversion obtained by computed-tomographic (CT) scanning and ultrasound. In order to determine the correlation between the three different methods and to assess their reliability, the measurements were performed independently by two observers at different times. There was a high correlation (Pearson's correlation coefficient) between MRI results and CT scan (r = 0.77) as well as MRI and sonography (r = 0.81), although the mean anteversion angles obtained by computerized tomography (34.0°, range 5–82°) and ultrasound (25.6°, 10–40°) were larger than the MRI values (23.2°, 0–65°), which can be explained by the different measurement techniques. Mean inter-rater as well as intra-rater reliability was high for MRI (r = 0.97andr = 0.97) and CT (r = 0.99andr = 0.96) but slightly less for sonography (r = 0.88andr = 0.88). MRI is a novel method for evaluating femoral anteversion that does not require ionizing raiation, allows a precise anatomical measurement and reliable results. MRI is recommended for preoperative planning of pediatric femoral rotation osteotomy cases.     

Hemorrhage associated with “bone crisis” in Gaucher's disease identified by magnetic resonance imaging

Children suffering from Gaucher's disease were examined by magnetic resonance imaging (MRI) during a characteristic episode of bone crisis. An unexpectedly high intramedullary as well as subperiosteal signal was observed on both the T1 and T2-weighted sequences in 5 patients, suggesting a subacute hemorrhage or hematoma. It is conceivable that such a painful hemorrhage is an important component of the bone crisis phenomenon. Furthermore, in these cases this is a specific sign which may enable differentiation of bone crises from other types of bone pain associated with Gaucher's disease.     

Novel peptide targeting integrin αvβ3-rich tumor cells by magnetic resonance imaging

Purpose:

To investigate the targeting activity of the peptide (named P1c) derived from connective tissue growth factor (CTGF) to αvβ3‐rich tumor cells.

Materials and Methods:

P1c was synthesized and conjugated with ultrasuperparamagnetic iron oxide particles (USPIOs) coated with meso‐2,3‐dimercaptosuccinic acid (DMSA). The specific binding activity of P1c‐USPIOs to αvβ3 was verified by solid phase binding assay. The combination of P1c‐USPIOs with a human primary liver cancer cell (Bel 7402) with αvβ3‐positive expression and uptake of P1c‐USPIOs by cells was investigated by Prussian blue staining, transmission electron microscopy (TEM), and magnetic resonance imaging (MRI). The targeting activity of the probe in vivo was also evaluated using a small‐animal tumor model by MRI.

Results:

The cell uptake of P1c‐USPIOs was observed in a dose‐dependent manner, whereas no significant particle uptake was found in the plain USPIOs group. The differences on T2*‐weighted imaging were also found by MRI and the signal intensity (SI) was statistically reduced after coculture of Bel 7402 cells with P1c‐USPIOs at a concentration of 20–80 μg/mL compared with plain USPIOs (P < 0.05). The in vivo study showed that the signal reduction was distributed mainly in the periphery and some central areas of the tumor. The tumor‐to‐muscle CNR (contrast‐to‐noise ratio) at 12 hours after the administration of the P1c‐USPIOs was statistically significantly different compared to those at 0 hour, 1 hour, or the plain USPIO group (P < 0.05).

Conclusion:

The peptide P1c might be a good candidate as a targeting carrier for drugs or tracers. J. Magn. Reson. Imaging 2011;. © 2011 Wiley‐Liss, Inc.     

Cardiac chamber quantification using magnetic resonance imaging at 7 Tesla—a pilot study

Objectives  

Interest in cardiovascular magnetic resonance (CMR) at 7 T is motivated by the expected increase in spatial and temporal resolution, but the method is technically challenging. We examined the feasibility of cardiac chamber quantification at 7 T.     

Spinal cord Neurobehçet's disease detected on magnetic resonance imaging

Imaging studies in Neurobeh?et's disease have to date focused on the brain, with only four previous case reports of documented spinal cord involvement on MRI being published. A fifth case is documented here, together with a review of the literature.     

Positron emission tomography/magnetic resonance imaging: the next generation of multimodality imaging?

Multimodal imaging is now well-established in routine clinical practice. Especially in the field of nuclear medicine, new positron emission tomography (PET) installations comprise almost exclusively combined PET/computed tomography (CT) scanners rather than PET-only systems. However, PET/CT has certain notable shortcomings, including the inability to perform simultaneous data acquisition and the significant radiation dose to the patient contributed by CT. Magnetic resonance imaging (MRI) offers, compared with CT, better contrast among soft tissues as well as functional-imaging capabilities. Therefore, the combination of PET with MRI provides many advantages that go far beyond simply combining functional PET information with structural MRI information. Many technical challenges, including possible interference between these modalities, have to be solved when combining PET and MRI, and various approaches have been adapted to resolving these issues. Here, we present an overview of current working prototypes of combined PET/MRI scanners from different groups. In addition, besides PET/MRI images of mice, the first such images of a rat acquired with the first commercial clinical PET/MRI scanner, are presented. The combination of PET and MRI is a promising tool in preclinical research and will certainly progress to clinical application.     

Imaging in multiple myeloma: Computed tomography or magnetic resonance imaging?

Multiple myeloma (MM) is the second most common type of hematological disease with its incidence rising in the elderly. In MM, the extent of the bone disease increases both morbidity and mortality. The detection of lytic bone lesions on imaging, especially computerized tomography (CT) and magnetic resonance imaging (MRI) is crucial to separate asymptomatic from symptomatic MM patients even when no clinical symptoms are present. Although radiology is essential in the staging and management of patients with MM there is still high variability in the choice between MRI and CT. In addition, there is still suboptimal agreement among readers. The potential of medical imaging in MM is largely under-evaluated: artificial intelligence, radiomics and new quantitative methods to report CT and MRI will improve imaging usage.     

Is magnetic resonance cholangiopancreatography the new gold standard in biliary imaging?

The timing and technique of perioperative biliary imaging in relation to laparoscopic surgery remains controversial. This study assessed the predictive value of magnetic resonance cholangiopancreatography (MRCP) in the diagnosis of biliary pathology. Clinical, laboratory and investigational data were evaluated from 374 patients undergoing MRCP at two hospital sites over a 5-year period. MRCP findings were compared with endoscopic retrograde cholangiopancreatography (ERCP) or operative findings and appropriate clinical endpoints. Complete data were available for 351 of the 374 patients (94%), of whom 232 (66%) were female. Median age was 64 years. The predominant presentation was abdominal pain (n = 190). Features of pancreatitis were present in 59, cholangitis in 26 and jaundice in 109 patients. Ultrasound was the initial investigation in 312 (89%) (176-gallstone positive). Common duct dilatation was evident in 114 patients and ductal calculi in 31. ERCP was successful in 212/283 (75%) patients. Significant ERCP induced pancreatitis occurred in 12 (5.6%). Comparison between MRCP and ERCP was not possible in 85 due to failure of either technique. Nine patients underwent other investigations including intraoperative cholangiogram (IOC), percutaneous transhepatic cholangiogram (PTC) and were included. Of the 221 patients with full comparative data available the MRCP showed a sensitivity of 97.98% and specificity of 84.4%. MRCP is highly sensitive and specific for choledocholithiasis and avoids the need for invasive imaging in most patients with suspected choledocholithiasis.