Brain Structure Changes Associated With Methamphetamine Abuse in Brain Magnetic Resonance Imaging

Background: Amphetamines constitute a group of central nervous system stimulators with an increasing frequency of usage and destructive outcomes on the metabolism, perfusion, and structure of the brain. This study aimed at evaluating the structural brain changes following amphetamines abuse, using Magnetic Resonance Imaging (MRI).Methods: This cross sectional study was conducted on the individuals, who were admitted to the toxicology Emergency Room (ER) with continuous amphetamines abuse for at least six months and a positive methamphetamine urine test. Positive Diagnostic and Statistical Manual of Mental Disorders (DSM-IV) criteria for dependency and addiction to methamphetamine were also considered as the inclusion criteria. Following informed consent, the demographic information, and data on methamphetamine use were collected. An MRI was performed for all participants as soon as relative recovery. A matched control group also underwent MRI simultaneously.Results: Forty male (20 cases of methamphetamine addicts and 20 healthy individuals) with a mean±SD age of 28.1±5.11 years were investigated. The mean±SD age of starting methamphetamine abuse was 25.6±10 years. About (75%), (n=15) of the patients abused methamphetamine 6-9 months, while others had abused it for more than 10 months. All cases used to abuse methamphetamine at least once a week, with (85%) of them inhaling it. The results showed that the only change in the brain MRI of methamphetamine abusers was hyperintensities increase in deep and periventricular white matter (only positive MRI in 3 cases, P=0.231). Oral consumption and higher doses had induced greater changes in the brain structure.Conclusion: Methamphetamine dependency may increase deep and periventricular white matter hyperintensities

Evaluation of .meniscal fluenceincidence and other menisco-ligamentous injuries in the knee MRIs of patients reffering to Imam Reza MRI center in Mashhad

Background and Aim: Meniscal flounceis a rare, wavy shaped folding along the free edge of the meniscus that observed in .MRI images. This is a feature of transient distortion of a normal meniscus but it can be regarded as a pseudo- meniscal tear. The aimof the currentstudy was to evaluate the incidence of this normal variant. Materials and Methods: A total number of1001 knee MRI images. were prospectively studied to checkmeniscal flounceand meniscoligamentous injuries in patients referred to. Kosar MRI center of Imam Reza hospital in Mashhad (2009-2011). Results: In this study the most common meniscoligamentousinjury was diagnosedin the right medial meniscus (17.8%). The most common accompanying injuries were theright medial meniscal tear and the right anterior cruciate ligament. The incidence of meniscal fluencewas 1%. Conclusion: The meniscal flounce observed in MRI images should be carefully interpreted because it can simulatea meniscal tear. This underscores the importance of correlating diagnostic images with clinical signs and symptoms and also avoidance of unnecessary MRI requisition inpatients whom some low probable diagnostic doubt exists

The Role of Doppler Sonography in Distinguishing Malignant from Benign Breast Lesions

The use of color Doppler ultrasound (CDUS) for characterizing breast lesions has increased in recent years. The aim of this study was to assess the value of CDUS and resistance index (RI), in evaluating solid breast masses. Methods: In total, 38 cases with one or more solid breast masses were enrolled. CDUS was performed for each participant, evaluating RI, and all of them underwent a tissue biopsy. The results were categorized and compared with pathology results. Results: Malignant breast lesions were more vascular than the benign lesions. Blood vessels were detected in 97.4% of the malignant group and only 35% of the benign group. The mean values of RI in benign lesions and malignant lesions were 0.65 ± 0.065 (range, 0.52–0.89) and 0.71 ± 0.093 (range, 0.57–0.75), respectively. The difference was just short of statistical significance (p = 0.061). Conclusion: Hypervascularity of a breast mass is the most reliable sign in Doppler ultrasound to predict its possibility of malignancy. However, it appears that the use of RI alone has little value in differentiating between malignant and benign breast lesions. Pathological findings are still the gold standard for diagnosing the type of breast nodules

Diagnostic Value of Conventional and Doppler Ultrasound Findings in Liver Fibrosis in Patients with Chronic Viral Hepatitis

The main outcome of virus-related hepatitis is progression to liver fibrosis. Therefore, early diagnosis is very important in the treatment and management of patients. Although liver biopsy is the gold standard test for assessment of liver fibrosis, it is expensive and has some disadvantages such as sampling errors, interobserver variability, and a significant mortality and morbidity rate. Moreover, this method is invasive and has side effects, especially if it needs repeated sampling. In order to come up with a reliable noninvasive modality in place of biopsy, we studied the value of grayscale ultrasonography (US) and Doppler ultrasonography (DS) for the diagnosis of liver fibrosis in patients with chronic viral hepatitis. Patients and methods: Sixty patients, 43 with chronic hepatitis B and 17 with chronic hepatitis C, were enrolled in this study. Grayscale US and DS were performed for all patients in the week prior to liver biopsy. Ultrasonographic findings were recorded according to a US scoring system, and they were compared with histological findings after liver biopsy. Results: A total of 35 male (mean age: 36.1 ± 10.1 years) and 25 female (mean age: 36.1 ± 10.4 years) patients were studied. Forty-three patients had chronic hepatitis B and the others had chronic hepatitis C. The overall grayscale US score was abnormal (ranged from 1 to 7) in 63.3% of patients and normal (0) in the other patients. The mean portal vein velocity ranged from 8.1 cm/s to 31.7 cm/s (mean: 17.1 ± 5.1 cm/s). The right hepatic vein diameter ranged from 2.8 mm to 8 mm (mean: 5.1 ± 1.2 mm). The total DS score was abnormal (1 or 2) in 66.7% of patients. Quantitative US parameters that were related more significantly to the histopathological staging scores of liver fibrosis were mean portal vein velocity, right hepatic vein diameter, and gallbladder wall thickness. The total grayscale US score, DS score, and accumulation of US and DS scores (US–DS score) were significantly different between patients with liver fibrosis and those without fibrosis (p = 0.03, p = 0.03, and p < 0.001, respectively). We found that the total grayscale US score, DS score, and US–DS score are significantly correlated with liver fibrosis stages. Conclusion: Based on these findings, one can conclude that US may be an accurate, noninvasive alternative modality for the diagnosis of liver fibrosis, with fewer side effects than biopsy. It may be especially useful for repetitive follow-up of patients

Is Meconium Obstruction Distinguishable from Intestinal Obstruction through Ultrasound?

Background: Since the treatment of meconium ileus is very different from other types of intestinal obstruction, it is very important to distinguish these two entities. The aim of this study was to assess sonographic findings to differentiate meconium ileus from other types of obstruction. Methods: This study was performed in Dr. Sheikh and Akbar hospitals, Mashhad Medical University of Science, Iran, during 2017- 2018. The imaging signs of 25 newborns (aged 2-8 days) with delayed passage of meconium were documented. These neonates were suspicious of low type intestinal obstruction. In cases with the simple form of meconium ileus and the small left colon syndrome, ultrasonic guided Gastrografin enema was performed for the treatment. In the patients with the failure of medical treatment and in other surgical cases, the appropriate surgical procedure was performed. Results: The subjects in this study were diagnosed with small bowel atresia (n=9), a simple form of meconium ileus (n=6), a complicated form of meconium ileus (n=3), small left colon syndrome (n=3), bowel atresia and duplication (n=1), and Hirschsprung’s disease (n=3). The ultrasound findings were as follows: a totally or partially micro-colon in almost all patients, collapsed small bowel in right lower quadrant in all of the patients with bowel atresia, hypoechoic meconium in rectosigmoid in small left colon syndrome and Hirschsprung’s disease, hypoechoic tubular or beaded intraluminal inspissated meconium within terminal ileum, and the floating air bubbles (sonographic soap bubble sign) within fluids on proximal dilated loops in meconium ileus cases. Conclusion: Although plain abdominal radiography confirmed bowel obstructions in all patients with delayed passage of meconium, it had a low level of specificity in the diagnosis and cause of obstruction.  Abdominal ultrasound had a high level of accuracy in the correct diagnosis of meconium obstructions and its differentiation from other intestinal obstructions. Accordingly, it eliminates the need to do a diagnostic contrast enema in order to differentiate these entities

Structural Findings in the Brain MRI of Patients with Acute Carbon Monoxide Poisoning

Background: Carbon monoxide (CO) poisoning may lead to hypoxic/anoxic injury and eventually ischemic encephalopathy. Magnetic resonance imaging (MRI) has a well-recognized role in assessment of the severity of brain damage caused by CO poisoning. In this study, we aimed to present and analyze the structural abnormalities in the brain MRI and especially in diffusion weighted MRI (DWI) images in a series of patients with acute CO poisoning. Methods: This cross-sectional observational study was performed on patients with moderate to severe CO poisoning admitted to Mashhad Medical Toxicology Center of Imam Reza Hospital, Mashhad, Iran, during autumn and winter 2013. After stabilization, patients underwent brain MRI. T1 weighted, T2 weighted and FLAIR images in sagittal, axial and coronal sections, and DWI in axial sections were performed for each patient. Results: Eighteen patients (77.8% men) were enrolled in this study with median age of 29.5 years. Eleven patients (61.1%) had abnormal MRI signals and in 7 cases no abnormality or nonspecific abnormalities were detected. The most common involved region in brain MRI was white matter (38.9%) followed by globus pallidus (33.3%). Patients with signal abnormality in brain MRI had significantly longer duration of exposure to CO compared to those without signal changes (10.6 ± 6.2 h vs. 3.4 ± 2.8 h, P = 0.011). Nine patients had restricted diffusion in DWI. Patients with restricted diffusion in DWI had also longer duration of exposure to CO compared to patients with normal DWI (12.1 ± 5.5 h vs. 3.5 ± 2.9 h, P = 0.001). Conclusion: The white matter and globus pallidus were the most common affected regions in brain following acute CO poisoning. Signal abnormalities and restricted diffusion in MRI were correlated with duration of exposure to CO but not with the carboxyhemoglobin levels