Behçet’s disease: Spectrum of MDCT chest and pulmonary angiography findings in patients with chest complaints

AbstractObjectiveThe aim of the work was directed to evaluate the value of multi-detector computed tomography pulmonary angiography study in evaluation of known patients with Behcet’s disease.Materials and methodsThis study was done retrospectively and included eighteen known patients with Behcet’s disease and referred for MDCT pulmonary angiography.ResultsPulmonary artery aneurysm was the most common finding as it was found in 16 patients, followed by pulmonary embolism which was found in 14 patients, 12 patients with pulmonary hypertension, right ventricular strain in 6 patients, intracardiac thrombus in 4 patients, dilated bronchial arteries in 8 patients, venous occlusion in 4 patients, mosaic attenuation of the lung in 12 patients, pulmonary infarcts in 4 patients, and pleural effusion in 4 patients.ConclusionMDCT pulmonary angiography is an important diagnostic imaging tool for diagnosis of vascular complications in patients with Behcet’s disease

MRI features of some uncommon causes of painful knee

Aim of the work: The purpose of this study is to describe the MRI features of some uncommon causes of knee pain. Materials and methods: This is a retrospective study. We reviewed our database including the last 1000 knee MRI examinations done within the period from January 2012 till June 2013. This revision revealed 12 cases with reported variable uncommon diagnoses explaining knee pain. Unenhanced MRI of the knee was performed and included sagittal T1, T2, T2∗ and proton density fat suppression (PDFS), axial T2 and coronal PDFS. Some cases had complementary CT assessment. Results: The selected 12 cases included the following; three cases of supero-lateral Hoffa’s pad of fat edema expressing edema signal at the superolateral aspect of the Hoffa’s pad of fat. Three cases with fabella syndrome with chondral and subchondral edema signal at the posterior aspect of the lateral femoral condyle. Two cases with symptomatic bipartite patella showing marrow edema around the patellar synostosis. One case with proximal tibio-fibular synostosis evident on MRI as bony fusion. Two cases with quadriceps (suprapatellar) fat-pad impingement syndrome manifested as edema signal within the supra-patellar fat-pad and lastly one case with lipoma arborescence seen as frond like projections with fat signal protruding into the supra-patellar bursa. Conclusion: MRI is a useful tool in evaluation of some uncommon causes of painful knee

The role of MRI and MRS in the diagnosis of non hydrocephalic macrocrania in infancy and early childhood

The aim of this study was to determine the key MRI findings in different disease causing macrocrania in early childhood that will help in early detection and diagnosis. Patients and methods: This study was conducted on 20 patients (their age ranged from 3.5 months to 5 years) referred to the radiodiagnosis department in the period between February 2013 and June 2014. All patients were subjected to conventional MRI. MRS was done in 8 cases using PRESS 3D multi-voxel chemical shift imaging. Results: The patients subdivided into 7 groups. Glutaric aciduria type 1 (40%) MRI showed wide operculum sign; MRS done in 4 patients showed elevated choline with preserved NAA peak. Benign macrocrania of infancy (15%), and MRI showed enlarged cranio-cortical and inter-hemispheric subarachnoid spaces beyond 5 mm, mildly dilated ventricles. Van der Knaap disease (15%) showed bilateral symmetrical confluent white matter dysmyelination with bilateral fronto-temporal subcortical cystic changes .MRS done in 2 patients showed increase in Cho/NAA ratios. Mucopolysaccharidosis (10%) showed dilated Virchow Robin spaces. MRS done in one patient showed decreased NAA, and increased choline/creatine ratio. Canavan disease (10%) MRI showed bilateral symmetrical extensive white matter dysmyelination. MRS showed markedly elevated NAA. Alexander disease (5%) showed bilateral symmetrical white matter dysmyelination with frontal predilection. MRS revealed increased NAA/Cr, increased myo-inositol/Cr, and lactate doublet. Gangliosidosis (5%) MRI showed bilateral symmetrical T2 and FLAIR hyperintense putamen. CT showed bilateral symmetric thalamic hyperdensities. Conclusion: MRI can diagnose different causes of non hydrocephalic macrocrania. MRS is helpful in differentiating benign macrocrania of infancy from dysmyelinating diseases and is specific in Canavan Disease