X-ray diffraction (XRD) profiles of a selection of body tissues have been measured with an x-ray diffraction imaging (XDI) scanner originally developed for security screening. These, supplemented with published XRD profiles of body tissues, were used as input to a non-negative matrix factorization (NNMF) technique. The twelve measured input profiles can be accurately decomposed, with the aid of NNMF, into six differently-weighted base-tissue profiles. As more healthy and diseased body tissues are measured in vivo with the XDI scanner, it is expected that the number of base-tissue profiles required for accurate decomposition will increase. This extension is proposed as a topic for future work. It is concluded that the XDI scanner may provide, supplementary to morphological structure, significant additional information on tissue health derived from the values of the weighting coefficients with which healthy and diseased tissues are represented as sums of the base-tissue functions.
Objectives To establish the diagnostic accuracy of magnetic resonance sialography (MRS) when compared with the gold standard conventional sialography (CS) in patients with suspected salivary gland disease. Background This is a systematic review and meta-analysis to compare both studies. CS is still considered the standard modality for assessing ductal abnormalities. MRS has been applied as an alternative. Methods We searched PubMed, Cochrane CENTRAL, Scopus, Science Direct, and Web of Science for all studies that compared MRS versus CS regarding radiological outcomes and diagnostic performance as primary outcomes. Combined outcomes were pooled as risk ratios in a fixed model or diagnostic odds ratio (DOR) in a random model, using Reviewer Manager 5.3 and Meta-DiSc 1.4 for Windows. Results Eight studies (n = 285 patients) were included in the final analysis. Our results showed that MRS was effective in the detection of main duct according to patients more than CS [risk ratio = 0.84, 95% confidence interval (CI), 0.71–1, P = 0.05). However, it showed no significant difference between the two groups in detection of main duct according to glands. Moreover, there are no significant differences between MRS and CS regarding detection of sialolithiasis, sialectasis, stenosis with stones, or strictures. The diagnostic performance in the detection of sialolithiasis according to glands was as follow: the pooled sensitivity was 0.88 (95% CI, 0.75–0.95), the pooled specificity was 0.98 (95% CI, 0.93–1.00), and the pooled DOR under random effect was 181.64 (95% CI, 39.420–837). Moreover, the diagnostic performance in the detection of the stenosis with stones according to patients was as follows: the pooled sensitivity was 0.727 (95% CI, 0.498–0.893), the pooled specificity was 0.979 (95% CI, 0.889–0.99), and the diagnostic odds ratio under random effect was 78.73 (95% CI, 2.18–508.81). Conclusion There is no difference between MRS and CS in radiological findings except in case of detection of main duct according to patients, which indicates that MRS is more effective in revealing the proper information about main salivary ducts. Moreover, MRS provides a noninvasive alternative to CS especially if acute sialadenitis is present or cannulation is not successful.
PURPOSE: 1.To judge the effectiveness of MR T2 value determined by T2 relaxation mapping and false color encrypted portray or mapping of the T2 W input image. 2. To estimate the tissue water content of the lesion and perilesional region. 3. To live predict the diseases by Artificial Neural Network (ANN) and clustering by Principal Component Analysis(PCA). MATERIALS AND METHODS: A T2 relaxation map was prepared in the MR scanner of a normal patient and patients of different grades of glioma, cysts, multiple sclerosis and metastasis and an individual pixel T2 value was determined. A false color shade was prepared depending upon the T2 value to make a color encrypted plan or portray of T2 values overlay on T2 W image. A relationship of T2 value and accumulated tissue water content was established. Quantity of the brain metabolites and apparent diffusion coefficient (ADC) were determined and tabulated. ANN was tried to live predict from these data as input in the excel spread sheet. Clustering of the diseases could be done as well. CONCLUSION: Discrimination of the diseases by color coded T2 map and live prediction can be done successfully.
Specific individual face recognition in the brain has been demonstrated with analysis of three dimensional neural activation patterns – cognitive engrams – revealed by functional magnetic resonance imaging (fMRI). Individual faces can also be differentiated by biometric pattern recognition from camera images using biometric analysis. A correlation between face recognition data obtained from these two methods is now documented. A two way correspondence between face data obtained by these and other means exists, which should facilitate face recognition, the utility of interrogation, and further the understanding of cognition.
Idiopathic fibrosis of the quadriceps muscles is not a common entity. The clinical presentation of this entity is typical and Magnetic Resonance Imaging is done to exclude other conditions. Our case is a 27 months old boy that was referred to the rheumatologist by the orthopaedic surgeon presented with gradually progressing loss of flexion of the left knee and limping gait. No history of recent trauma or previous injection to that limb. No history of joint swelling or other joint involvement. Radiographs, ultrasound and the bone scan are normal. No bony abnormality detected and no joint effusion. The Magnetic Resonance Imaging demonstrates atrophy with intra-substance T2 and T1 hyper intense foci suggestive of fatty atrophy with fibrosis of the left side vastus muscles
Spontaneously occurred Pneumocephalus is rarely found. Extension of the air bubbles into the ventricles is far more rare. For cases, complaining of abrupt attack of intense headache, a rare condition of extra dural, subdural and subarachnoid, intracerebral, and intra ventricular pneumocephalus with defect in the sinus wall could be considered as a possible etiology. Here we present a patient with dilated frontal sinus reported with spontaneous pneumocephalus extending to ventricles and extra cerebro spinal fluid (CSF) spaces with an overview of this rare condition. PSDPneumosinus dilatants CSF -Cerebro Spinal Fluid INTRODUCTION Definition of pneumocephalus is presence of air intracranially. Spontaneous and atraumatic pneumo-cephalus is not a common aetiology (0.6%)2,3 . Pneumosinus dilatans (PSD)1,2 is a condition of abnormally hypertrophied paranasal air sinus without any radiological findings of destruction local bone cortex or thickening mucous membrane. Other common causes of pneumocephalus are barotraumas, valsalva maneuvers,3,4. A case report of spontaneous pneumocephalus extending to ventricles and extra cerebral CSF spaces along with PSD is described here. REPORT OF CASE An Indian housewife, 46 years old, was brought to in KPC Medical College and Hospital, Kolkata, India, with syncope and excruciating headache. Following a severe bout of cough due to common cold and pharyngitis, the lady developed abrupt intense headache. There was no history of recent trauma or any cranial surgical intervention. Thorough physical examination by physicians of internal medicine and neurology and consultants could not find any abnormality except that she had fever of 38.8 Celsius (102 degrees Fahrenheit) To rule out intracranial pathology CT scan was done. It showed multiple small air bubbles (Densities -1000 and above HU) in sylvian fissures subdural and extra axial CSF spaces, perisellar & peri ganglionic regions and within the ventricles.(Figures 1,2,3). Figure 1 Air bubbles are seen in the frontal subdural, sylvian fissures and right lateral ventricle. Overview Of A Case Of Spontaneous Non-Traumatic Pneumocephalus Extending To Ventricles 2 of 4 Figure 2 Air bubbles are noted within the subdural and sub arachnoid spaces, ventricles and cerebral cortex. Figure 3 Air bubbles are noted within the frontal subdural, sub arachnoid spaces, sulci of cerebral cortex and ventricles. Frontal sinus was markedly prominent (Figure 4). Figure 4 Frontal sinuses As she had fever, CSF was examined by performing a lumbar puncture procedure. All the parameters of the CSF analysis came out as within physiological limits. After admitting in HDU (high dependancy unit), she was kept in total bed rest. Oral analgesic and oxygen (1.5 L/min) were administered. For pharyngitis, first line antibiotic and to avoid further bouts of cough anti tussives were given. She was advised to avoid valsalva maneuvers. Results of all pathological examination, on admission, were within normal limits Spiral HRCT scan with multi axial reformation in bonewindow setting revealed the probable point of air leakage in the frontal sinus. No other pathologic condition like sinusitis or neoplastic lesion could be detected. On 14th days after the onset of the pneumocephalus, she was released from the hospital.
Large plaques of Multiple sclerosis (MS) or tumefactive multiple sclerosis is difficult to distinguish from Glioma, metastasis or lymphoma. Values of Apparent Diffusion Coefficient (ADC) are overlapping and no specific discrimination could be made. Like MS, Proton MR spectroscopy shows increased peak of Choline and low NAA peak in glioma, lymphoma and metastasis as well. Refractive index (RI value) can distinctly distinguish MS from the above mentioned diseases and prediction rate is high. A special software and RI and color coded palette were created to generate RI and color coded portray or mapping superimposed over the T2 weighted image in a DICOM Editor.
It is important to develop reliable non-contrast magnetic resonance angiography (MRA) protocols for patients with renal impairment who are at risk of developing nephrogenic systemic fibrosis (NSF) from gadolinium-contrast-enhanced MRA. This study used a NATIVE-true fast imaging with steady-state free precession (TrueFISP) protocol to investigate whether noncontrast MRA at 3T is a viable alternative to contrast-enhanced MRA in patients with renal insufficiency. Thirteen patients without renal compromise were scanned using an optimized NATIVE-TrueFISP protocol with respiratory triggering. While images acquired with NATIVE TrueFISP correlated well with contrast-enhanced MRA, future research should determine how to optimize visualization of segmental and accessory vessels. Overall, NATIVE TrueFISP is a promising technique that can be used to evaluate the renal vasculature in patients with renal disease.
Listeria monocytogenes is a gram-positive bacillus, that uncommonly affects hosts who are immunodepressed. Listeriosis of central nervous system is unusual and temporal lobe involvement is even more rare; it consists of meningitis, meningoencephalitis, rhomboencephalitis, cerebritis and brain abscesses. Our case describes Listeria encephalitis with hydrocephalus and brain abscess in a 46-year-old woman, affected by crioglobulinemia and hepatitis C. The final diagnosis was based on clinical findings, blood culture, cerebrospinal fluid results and, obviously, on cranial computerized tomography (CT) and magnetic resonance imaging (MRI) findings. CT seems useful both for disease detection and follow-up of potential complications, like hydrocephalus. MRI should be considered not only for detection of small necrotic lesions, but also to distinguish these lesions and then avoiding delay of appropriate treatment. In this regard, diffusion-weighted images seem to play a pivotal role to reveal and to characterize the lesions.
Bilateral enlargement of the superior ophthalmic veins may be seen in carotid cavernous fistula, cavernous thrombosis, Graves’ orbitopathy, orbital pseudotumor, parasellar tumors, orbital varices, arteriovenous malformations, or cerebral edema. Bilateral enlargement of the superior ophthalmic veins may also be cryptogenic or idiopathic in nature. Unilateral enlargement of the superior ophthalmic vein may be seen in carotid cavernous fistula, Graves’ orbitopathy, orbital pseudotumor, parasellar tumors, orbital varices and arteriovenous malformations. Bilateral superior ophthalmic vein enlargement may rarely occur in cavernous thrombosis, Graves’ disease, or carotid cavernous fistula or cerebral edema (1-3). A detailed description of carotid cavernous fistula is contained elsewhere. Briefly carotid cavernous fistula is abnormal communication between the cavernous sinus and carotid arterial system. Carotid cavernous fistula can be classified by cause (traumatic vs. spontaneous, velocity of blood flow (high vs. low flow), and anatomy (direct vs. dural, internal carotid vs. external carotid or both) (4). Carotid cavernous fistula presents as spontaneous red eye, chemosis of the conjunctiva, abducens nerve paresis or mild orbital congestion with proptosis, cranial or orbital bruit, pulsatile exophthalmos (4, 5).
BACKGROUND AND PURPOSE: Most studies of contrast-induced nephropathy (CIN) or radiocontrast nephropathy (RCN) have been derived from intra-arterial administration of contrast and percutaneous coronary intervention, the results of which may not be easily applicable in radiology, where most contrast administration is via the intravenous route. The purpose of this study is to document the rate of CIN/RCN in patients undergoing computed tomography angiography (CTA) of the head and/or neck, who were given contrast via the intravenous route. MATERIALS AND METHODS: This is a retrospective study involving a random sample of 594 patients with normal serum creatinine and normal estimated glomerular filtration rate who had CTA of the head and/or neck. RESULTS: Two hundred and twenty eight patients (38.39%) had a decrease in serum creatinine, 212 patients (35.69%) had no change in serum creatinine, and 154 patients (25.93%) had an increase in serum creatinine after contrast administration. There were 2 patients (0.3%) who had greater than 0.5 mg/dL increase in 48-hour serum creatinine, 40 (6.7%) patients who had 25% or greater increase in serum creatinine, and 2 patients (0.3%) who had greater than 0.5 mg/dL increase serum creatinine and 25% or greater increase in serum creatinine 48 hours after contrast administration. CONCLUSION: The rate of CIN/RCN is 0.3-6.7% depending on the definition used. CIN/RCN is a rare complication in patients given intravenous contrast. The intravenous administration of contrast for CTA of the head and neck is safe, and may be used in routine evaluation of stroke and trauma.
Posterior shoulder dislocation associated with fracture of the acromion is a rare injury with only three cases published in literature. Up to 79% of posterior shoulder dislocations can be missed with 65% of patients having associated complications. We present a case of posterior shoulder dislocation associated with fracture of the acromion and describe the mechanism of injury, diagnosis, and management.
Extramedullary plasmacytomas are solitary focus plasma cell neoplasms arising in extraosseous tissues. Although the diagnosis of plasmacytomas requires evidence of no underlying multiple myeloma, these tumors can be an early presentation of, or progress to, multiple myeloma. They are infrequent tumors with no specific imaging findings, and are often initially misdiagnosed as other tumor entities. The correct diagnosis requires certain histopathologic and hematologic criteria to be fulfilled. In this case report we present a 74-year-old woman without known history of malignancy, with radiological evidence of a mass in the sphenoid sinus, extending to the clivus and the cavernous sinus on both sides, and entrapping both internal carotid arteries. The sphenoid sinus tumor proved to be an extramedullary focus of plasma cell tumor and the patient was subsequently diagnosed with multiple myeloma.
PURPOSE: To produce an enhancement-like effect of the brain lesions of computed tomography (CT) scan images mathematically, without intravenous (IV) injection of iodinated contrast materials. The aim is to reduce the dose of radiation and toxic effect of the iodinated contrast chemicals. INTRODUCTION: To improve the visibility of internal body structures, CT scan contrast agents or contrast media (CM) are used. Ionic or non ionic Iodinated contrast is the most commonly used compounds for contrast enhancement. MATERIALS AND METHODS: 16 slice multi-detector CT was used to assess CT Number in Hounsfield (HU) and electron density of pixel of various brain lesions and brain tumors before and after administration of CM. CT number with corresponding gray scale values (out of 256 shades) of various brain lesions before and after IV contrast were tabulated. A statistical relationship was determined for the magnitude of changes in the pixel CT values of brain tumors before and after the contrast material was added. Enhancement-like effects of the lesions could be reproduced mathematically with the help of neural networks by live and intelligent prediction without the IV contrast injection. With the help of K-mean clustering, the data were classified. A mapping function was generated that corresponded between these independent components and the cross-sectional data by using the neural network after training the network with a sample dataset. The training sample for the network was selected using neural net work. A mapping of the lesion was done overlaid on the plain (non contrast) image. CONCLUSION: An attempt was successfully made to simulate enhancement like effect in various brain lesions statistically utilizing neural networks without using IV contrast.
PURPOSETo generate or simulate an artificial or virtual MR spectroscopic effect of normal state of brain or any pathology from the signal intensity or the image shades to give some idea to the radiologists about the various chemical components of brain lesion and its chemical or physical environment. By this radiologist can suggest the neurosurgeon or physician about management and treatment when a facility of MR spectroscopy is not available. OBSERVATIONIt has been observed that there is a relationship between the T2 value of cerebral tissue, signal intensity and gray shade value of pixel with the specific pattern and amplitude of the peak of metabolites of MR Spectroscopy (MRS) of normal or pathological brain. The T2 value of brain tissue, log of spectral plot of signal of the image and signal intensity level ( all as independent Numeric Variables) are consistent with the various amplitude of peaks of metabolites like lipid, lactate, N acetyl aspartate (NAA), choline, creatine (as dependent variables) as MR spectroscopic graph . A data set of position of the metabolites and amplitude of the peaks and valleys is found to be unique of a particular T2 value, signal intensity or gray shade value of tissue in normal and disease state (independent Category Variables). MATERIALS AND METHODS: MRI and MRS are done in patients of normal and pathological cases. T2 mapping is done and gray shade was generated from the mapping. The T2 value of tissue and corresponding gray shade value(GSV) of pixel of a T2 MR image and the amplitude of the peaks of various metabolites like lipid, lactate, NAcetyl Aspartate (NAA),choline, creatine of corresponding MRS etc are measured (quantified). Data sets of both normal and disease state were prepared. The datasets are examined by a Neural Net work (mathematical) program. Live prediction of the amplitude of the metabolite peak (NAA or Choline etc) can be generated as dependent numeric variable against the signal intensity (independent category variable) and other known independent numeric variables. RESULTS: The various values obtained are put into an Excel data sheet and are analyzed. A neural Net work program live predicts the unknown variables. Ultimately a graph of spectrum of peaks of the metabolites can be generated in the excel dataset of the values of the amplitude in the Y axis, plotting against the location of the metabolites in the X axis. DISCUSSION-: This graph resembles the MRS graph of the peaks of the normal or abnormal brain tissue.
