Prenatal diagnosis of choledochal cyst using magnetic resonance imaging： A case report

Choledochal cysts are congenital anomalies of the biliary ducts, characterized by cystic dilatation of the ducts. Prenatal diagnosis of this anomaly using ultrasonography (US) has been well documented. Magnetic resonance imaging (MRI) has recently become an important complement to US in prenatal diagnosis of fetal anomalies. We herein report a patient in whom at 24 wk' gestation US suggested a right upper quadrant abdominal cyst and in whom at 26 wk' gestation MRI more clearly delineated the cyst and its surrounding structures and suggested a choledochal cyst, which was confirmed at postnatal surgery and histopathology.     

Biventricular noncompaction detected by magnetic resonance imaging: a case report

We report a case of biventricular noncompaction in whom magnetic resonance imaging revealed prominent trabeculations in the right ventricle as in the left ventricle. A 58-year-old man was referred to our hospital complaining of appetite loss and leg edema. Chest radiography showed cardiomegaly without pulmonary congestion. The diagnosis was right ventricular heart failure with congestive liver causing elevated liver enzyme. Transthoracic echocardiography showed prominent trabeculations and deep recesses in the inferolateral wall and apex of the left ventricle with the end-diastolic dimension of 64mm and ejection fraction of 29%. Magnetic resonance imaging demonstrated right ventricular noncompaction which remained unclear on echocardiography. Prominent trabeculations in the dilated right ventricle were confirmed by right ventriculography. The ejection fraction was 23%.     

Synovial haemangioma of the knee: a case report

Synovial haemangioma is a rare but important cause of knee symptoms, which, when undiagnosed, can lead to significant morbidity. Diagnosis is frequently difficult and delayed. We report on a case of synovial haemangioma, which demonstrates the difficulties inherent in diagnosis and the morbidity associated with diagnostic delay, in a young woman. Magnetic resonance imaging (MRI) is a useful tool for diagnosis, but detection on MRI can also be problematic, as shown by this case, demonstrating the need for greater awareness of this condition by both clinicians and radiologists. Arthroscopy is important in both the diagnosis and treatment of these lesions.     

Bronchogenic cyst: a case report emphasizing the role of magnetic resonance imaging

The article describes a patient with a right paratracheal bronchogenic cyst in whom the preoperative diagnosis was unclear. The fluid component of the cyst was not readily apparent by CT or T1-weighted MR images. Very intense signal on T2-weighted MR images suggested a cystic lesion. Inhomogeneities evident on MR but not CT images provided further soft tissue characterization. These soft tissue elements correlated with a macroscopic ring of hyaline cartilage in the resected specimen. The usefulness of MRI for the differential diagnosis of mediastinal tumors is discussed.     

Magnetic resonance imaging in patients with inflammatory arthritis of the knee

Summary Magnetic resonance imaging (MRI) permits visualization of anatomic structures not appreciated by conventional radiographic imaging and may quantify inflammatory disease and its progression with greater sensitivity than available techniques. We therefore compared MRIwith clinical evaluation and with radiographic examination of 17 patients with inflammatory arthritis of the knee. We sought to determine anatomic integrity of bone, cartilage, menisci, and ligaments, and to quantify joint effusion and synovial proliferation. Patients studied had rheumatoid arthritis (10patients), juvenile rheumatoid arthritis (4patients), ankylosing spondylitis (1 patient), and monoarticular arthritis (2 patients). In all patients MRI revealed clinically important abnormalities not detected by physical or conventional radiographic exams. These included proliferative synovitis (13 patients), cartilage thinning (2 patients), cartilage erosion (8 patients), bone infarction (1 patient), meniscal injury (1 patient), and synovial invagination into bone (1 patient). Also MRI indicated inflammatory disease to be quantitatively greater than had been appreciated on clinical examination or routine X-ray studies-proliferative synovitis (12 patients), erosion (7 patients), effusion (8 patients), cartilage thinning (11 patients), and ligamentous/meniscal damage (1 patient). These findings led to reassessment of anatomic staging and influenced therapeutic decision for these patients. Thus MRI provides clinically important information about joint integrity and inflammatory disease, with a sensitivity and resolution considerably beyond conventional techniques.     

Occult myopathy of the vastus intermedius muscles detected by magnetic resonance imaging in subclinical dermatomyositis: report of two cases

The thigh muscles of two patients with dermatomyositis (DM) without muscle weakness or conspicuous creatine kinase elevations were studied by magnetic resonance imaging (MRI). Myositis limited to the vastus intermedius muscles (VIM) was detected in both patients, and in one, the diagnosis was confirmed by the findings of a biopsy specimen. Focal myositis of the VIM in early-stage DM, which otherwise would remain hidden by the relatively small muscle size and deep location, can be detected by MRI.     

A case of post-streptococcal reactive arthritis in which lesions were detected with [18F]-fluorodeoxyglucose positron emission tomography-CT imaging and magnetic resonance imaging

Abstract

A 55-year-old man with lumbago and polyarthralgia was admitted to our hospital. Laboratory data showed elevated levels of anti-streptolysin O and C-reactive protein. Throat swab culture revealed β-hemolytic streptococcal infection. Magnetic resonance imaging detected effusion of the lumbar bone and the left hip joint. Positron emission tomography-computed tomography (PET-CT) demonstrated increased fluorodeoxyglucose activity in the bilateral shoulder and hip joints and the interspinal ligament between L2 and L3. He was diagnosed as having post-streptococcal reactive arthritis (PSReA) and treated with amoxicillin hydrate. Polyarthralgia improved and did not relapse. To our knowledge, no results of PET-CT have previously been reported in patients with PSReA. We propose that PET-CT might be a useful tool for diagnosing PSReA.     

Pseudocoarctation of the aorta: A magnetic resonance imaging correlation

We present here the clinical and angiographic features in a patient with pseudocoarctation of the aorta and aortic valvular stenosis. An MRI study performed to delineate the aorta provided valuable correlations and highlighted the potential of this noninvasive modality for the diagnosis of pseudocoarctation of the aorta. © 1993 Wiiey-Liss, Inc.     

A case of asymptomatic fusiform aneurysm of the superior vena cava detected by magnetic resonance imaging

A rare case of fusiform aneurysm of the superior vena cava (SVC) in a 65-year-old Japanese woman is presented herein. Aneurysm of the SVC was detected incidentally as widening of the upper mediastinum on chest radiography and was further defined using magnetic resonance imaging, venography and chest computed tomography. Based on previous reports, conservative management was planned with anticoagulation therapy as prophylaxis against thrombotic complications rather than surgical resection for aneurysm.     

Locking of the knee caused by localized pigmented villonodular synovitis: a case report

Abstract

Pigmented villonodullar synovitis (PVS) occurs in two forms: diffuse PVS and localized pigmented villonodular synovitis. In this report, a 40-year-old woman presented with a history of recurrent episodes of knee locking and pain. Arthroscopy revealed a nodular pedunculated mass occupying the area anterior to the intercondylar notch of the femur. Histological examination of the tissue confirmed the diagnosis of PVS. After surgery, the patient’s symptoms of pain and recurrent locking promptly resolved.     

Locking of the knee caused by localized pigmented villonodular synovitis: a case report

Pigmented villonodullar synovitis (PVS) occurs in two forms: diffuse PVS and localized pigmented villonodular synovitis. In this report, a 40-year-old woman presented with a history of recurrent episodes of knee locking and pain. Arthroscopy revealed a nodular pedunculated mass occupying the area anterior to the intercondylar notch of the femur. Histological examination of the tissue confirmed the diagnosis of PVS. After surgery, the patients symptoms of pain and recurrent locking promptly resolved.     

Assessment of inflamed synovial membrane in the knee joint by dynamic magnetic resonance imaging

Abstract

Dynamic magnetic resonance imaging (dynamic MRI) was used to examine the synovial membrane in the knee joints of 15 patients with rheumatoid arthritis (RA) in order to investigate the relationship between pathological and MRI findings. Signal intensities in the regions of interest (ROI), identified as the synovial membrane of the suprapatellar pouch, were measured on MR images. Signal intensities at various times after the injection of contrast medium Gd–diethylenetriaminopentoacetic acid (Gd–DTPA) were normalized relative to the signal intensity at 80?s, and designated as the normalized signal intensity (NSI). Pathological findings were quantified, and the types of inflamed synovial membrane were classified as either acute or chronic. A significant difference in NSI was observed between acute and chronic types (P < 0.05). Dynamic MRI was capable of classifying acute and chronic RA by measuring NSI 20?s after contrast medium injection. Dynamic MRI was therefore shown to be useful for assessing regional synovial inflammation.     

Metastatic vertebral tumor misdiagnosed in magnetic resonance imaging as benign degenerative bone marrow changes: a case report

Many disorders including congenital, degenerative, inflammatory, and neoplastic lesions are associated with low back pain. It is essential to differentiate between malignant disease and the more common causes of back pain. We report a man with low back and right groin pain as a result of metastatic breast carcinoma which was misdiagnosed in magnetic resonance imaging as benign degenerative changes.     

The use of endoscopic ultrasonography and other imaging modalities in the preoperative staging of rectal villous tumours: A case of overstaging by magnetic resonance imaging

A case of a 60-year-old man with recurrent rectal villous adenoma is described. Preoperative staging with endoscopic ultrasound (EUS) and magnetic resonance imaging (MRI) revealed very discordant results. EUS showed a tumour present in the mucosa with no submucosal invasion, while MRI revealed invasion of the muscularis propria consistent with an invasive stage T2 carcinoma. Based on the MRI findings, the patient underwent a low anterior resection of the tumour. The surgical pathology specimen revealed a villous adenoma with low-grade dysplasia but no carcinoma and no extension into the muscularis propria. The present case highlights the uncertainty that currently exists as to which imaging modality provides the greatest accuracy in the staging of rectal cancer and in guiding the type of surgical procedure performed. Two recent meta-analyses and a systematic review of the literature point to EUS as the imaging modality of choice for determining muscularis propria and perirectal tissue invasion, as well as nodal involvement.     

Assessment of inflamed synovial membrane in the knee joint by dynamic magnetic resonance imaging

Dynamic magnetic resonance imaging (dynamic MRI) was used to examine the synovial membrane in the knee joints of 15 patients with rheumatoid arthritis (RA) in order to investigate the relationship between pathological and MRI findings. Signal intensities in the regions of interest (ROI), identified as the synovial membrane of the suprapatellar pouch, were measured on MR images. Signal intensities at various times after the injection of contrast medium Gd–diethylenetriaminopentoacetic acid (Gd–DTPA) were normalized relative to the signal intensity at 80s, and designated as the normalized signal intensity (NSI). Pathological findings were quantified, and the types of inflamed synovial membrane were classified as either acute or chronic. A significant difference in NSI was observed between acute and chronic types (P 0.05). Dynamic MRI was capable of classifying acute and chronic RA by measuring NSI 20s after contrast medium injection. Dynamic MRI was therefore shown to be useful for assessing regional synovial inflammation.     

Acute pseudoseptic arthritis after viscosupplementation of the knee: a case report

Intra-articular injections of hyaluronan are generally well tolerated; the most common adverse event associated with their use is an inflammatory reaction or a flare at the injection site. Naturally derived sodium hyaluronates have not been associated with pseudosepsis; we describe a case of severe arthritis mimicking acute septic arthritis after naturally hyaluronan. A 70-year-old woman had a medial femorotibial and patellofemoral compartment knee osteoarthritis. Hyaluronic acid injection was indicated because of the persistence of a pain while walking and restricted ability to walk 100 m, as well as the installation of a flessum. She was admitted for an evaluation of a joint effusion occurring within 48 h after the first hyaluronic acid intra-articular injection (first course), with no fever or chills. Joint fluid was found to be cloudy and contained 24,000 cells per mm(3). A knee aspiration was performed to evaluate the possibility of a joint infection. The examination of synovial fluid under phase contrast and polarizing microscopes showed no crystals, and culture on standard media was negative. Acute septic arthritis was considered to be the most likely diagnosis, and probabilistic antibiotic therapy was started. The result of the bacteriological examinations also returned negative. The absence of general signs, particularly fever and chills, with fast effusion regression in less than 4 days did not plead in favor of a septic origin. In front of this beam of arguments, antibiotic therapy was stopped after 4 days. The nonsteroidal anti-inflammatory drug (Nimésulide) was given. The clinical and laboratory test abnormalities were normalized within 2 weeks. Our case has the particularity to occur after using Curavisc, which is known as producing no allergenic reactions. Moreover, the described reaction occurred with the very first infiltration within the very first course.