[Evaluation of diagnostic value of DW sequence in differentiating infectious spondylitis from degenerative endplate type1]

Background and Objectives: DWI is one of the useable sequences in MRI which currently being used in the assessment of vertebral column especially for malignant or benign causes. Considering that few studies have been performed regarding the use of DW sequences in spondylitis differentiating of disease with degenerative changes of vertebral yet; hence we intended to found the diagnostic value of DW sequence in spondylitis differentiating of infectious from degenerative changes of end plate type 1 with designing this study

Materials and Methods: This study was carried out on patients who referred to the Pejvak MRI center with spondylitis lesions and osteochondrosis grade I, involving the vertebral column during 2012-2013; and to differentiate these lesions was used the T1, T2 and DWI sequences. Obtained results were analyzed by SPSSv16 statistical software

Results: In this study, in T1WI sequences the images of both groups was hyposignal and in T2WI sequences was hypersignal [p=0.01]. In DW sequence with b value of 50, 400 and 800 [s/mm[2]] was observed that the signal changes in higher b value was apparent and in lower b value both detection had many similarities to each other due to the annoying effect of T2 Shine-through. As well as the mean of ADC map in spondylitisis images] 1.31 +/- 0.24x 10-3 mm2 /s[was less than osteochondrosis grade I with a mean ADC map [1.79 +/- 0.24x 10-[3] mm[2] /s] P<0.001]

Conclusion: The results of this study showed images with high b value could be having a good differentiation to distinguish the spondylitis from osteocondrosis

End Plate Disproportion and Degenerative Disc Disease: A Case-Control Study

STUDY DESIGN: Case-control. PURPOSE: To determine whether a disproportion between two neighboring vertebral end plates is associated with degenerative disc disease. OVERVIEW OF LITERATURE: Recently, it has been suggested that disproportion of the end plates of two adjacent vertebrae may increase the risk of disc herniation. METHODS: Magnetic resonance (MR) images (n=160) with evidence of grades I-II lumbar degenerative disc disease (modified Pfirrmann's classification) and normal MR images of the lumbar region (n=160) were reviewed. On midsagittal sections, the difference of anteroposterior diameter of upper and lower end plates neighboring a degenerated (in the case group) or normal (in the control group) intervertebral disc was calculated (difference of end plates [DEP]). RESULTS: Mean DEP was significantly higher in the case group at the L5-S1 level (2.73+/-0.23 mm vs. 2.21+/-0.12 mm, p=0.03). Differences were not statistically significant at L1-L2 (1.31+/-0.13 mm in the cases vs. 1.28+/-0.08 mm in the controls, p=0.78), L2-L3 (1.45+/-0.12 mm in the cases vs. 1.37+/-0.08 mm in the controls, p=0.58), L3-L4 (1.52+/-0.13 mm in the cases vs. 1.49+/-0.10 mm in the controls, p=0.88), and L4-L5 (2.15+/-0.21 mm in the cases vs. 2.04+/-0.20 mm in the controls, p=0.31) levels. The difference at the L5-S1 level did not remain significant after adjusting for body mass index (BMI), which was significantly higher in the patients. CONCLUSIONS: End plate disproportion may be a significant, BMI-dependent risk factor for lumbar degenerative disc disease.

Bilateral primary breast lymphoma in a teenage girl with multi-organ involvement

We present 16 years old girl with primary breast lymphoma involving the both breasts simultaneously and co-incidence of central nervous system [CNS] involvement which originated from the breast, in addition to evidence of lymphoma in multi-organ such as skin, mediastinum and some abdominal viscera. Bilaterality has been observed in some series, but reports are few and series are often very small. Radiologic features may be indistinguishable from those of the other breast malignancies, but it can be concluded that primary involvement of the breast with lymphoma should be considered when breast mass or inflammatory changes occur in a patient without any previously diagnosed lymphoma. The clinical behavior, imaging and therapeutic procedures are discussed. The findings of this report may have clinical impact on oncologists or that may alter the disease concept of bilateral breast lymphoma.

Thrombolytic therapy for cerebral vein thrombosis in antiphospholipid syndrome secondary to systemic lupus erythematosus

A 20-year-old woman was admitted to a Gynecology Hospital in her 6[th] month of pregnancy for high blood pressure and tonic-clonic seizure. Primary diagnosis was eclampsia, and for that reason she underwent cesarean section. She also had headache on frontal and parietal areas without nausea or vomiting. There was not a focal neurological sign. Rheumatology consultation was requested. Systemic lupus erythematosus and secondary antiphospholipid [APS] was confirmed. The patient had headache that continued several days after cesarean section, therefore, brain magnetic resonance imaging [MRI] and magnetic resonance venography [MRV] were performed, and cerebral vein thrombosis was documented. Distal segment of right lateral sinus and sigmoid sinus were not appeared in brain MRV. Abnormal hypersignal intensity of right lateral sinus/coronal T2 was detected. Thrombolytic therapy with 20 mg tissue plasminogen activator on right sigmoid and transverse sinus was performed by an interventional neurologist. After this procedure, the patient's headache healed and she was discharged in a good condition