role of MRI in the diagnosis of acute osteomyelitis in the peripheral bones

The objective of the study was to review and to evaluate the value of different MRI sequences in the diagnosis of acute osteomyelitis. This study was performed on 35 patients, clinically suspected to have acute osteomyelitis. MRI showed evidences of acute osteomyelitis in 32 out of 35 patients included in this study. Two patients had septic arthritis and there was one case of Brodie's abscess. The primary MRI sign for the diagnosis of acute osteomyelitis was bone marrow signal intensity abnormalities this was best detected at T2 weighted spin echo images and with STIR images. Other MRI signs included bone cortical interruption, and associated soft tissue infection

Correlation between serum matrix metalloproteinase-9 in SLE patients with neuropsychiatric manifestations and brain magnetic resonance imaging abnormalities

Neuropsychiatric manifestations of systemic lupus erythromatosus [SLE] are common and its pathogenesis is still unclear but recent neuroimaging studies in SLE attributed it to vasculitic processes which results in cerebral ischemia. Matrix metelloproteinase-9 [MMP9] has a central role in ischemic damage of the brain, it disrupts the blood brain barrier [BBB] and it also induces a high breakdown capacity in arteriolar basement membrane leading to cerebral edema and secondary hemorrhage. Also it participates in the degradation of myelin basic protein which is a major component of both central and peripheral nervous system. This study was performed to evaluate the possible association between serum MMP9 and neuropsychiatric manifestation with cerebral MRI abnormalities in patients with SLE. Serum MMP9 levels were determined in forty patients with systemic lupus erythromatosus and twenty apparently healthy controls who underwent clinical examination, neurological examination and neuropsychological testing. Cerebral MRI scans with T[1] and T[2] weighted lesions were performed for all subjects. In addition, immunological assay and routine investigations were performed. SLE patients with neuropsychiatric manifestations [NP-SLE] had significantly higher serum MMP9 concentrations than patients without neuropsychiatric manifestations [NNP-SLE], and those with cognitive deficits had significantly higher concentrations of serum MMP9. Furthermore MMP9 levels were significantly higher in patients with T[1] and T[2] weighted lesions in cerebral MRI in NP-SLE. Elevated levels of serum MMP9 in patients with SLE may reflect neuropsychiatric involvement particularly cognitive dysfunction and MRI results favor the association between serum MMP9 levels and ischemic changes with increased risk of cerebral ischemic events in SLE patients

Corpus callosum MRI study in multiple sclerosis and small vessel ischemic stroke

Damage to corpus callosum visible by MRI in multiple sclerosis may be simulated by other CNS diseases [e.g. ischemia, SLE, Behcet's disease, other vasculitides, sarcoidosis]. Ischemic lesions, in particular, make MRI criteria much less reliable for the diagnosis of MS pateints over the age of 50. To study the difference between MRI abnormalities of the corpus callosum in patients with MS versus small vessel ischemic stroke. 76 patients were divided into 2 groups: group 1, comprising 26 patients with clinically definite, relapsing remitting, MS; and group 2, including 50 hypertensive and /or diabetic patients with history and clinical evidence of ischemic stroke proved by MRI to be of small vessel ischemic type. They were all subjected to minimental state examination [MMSE] and MRI brain study for corpus callosum lesions and atrophy. The mean MMSE score in the stroke group was 27.75 +/- 3.21 while in the MS group it was 23.62 +/- 3.76 with a significant difference between them [P < 0.05]. In both groups, the score inversely correlated with corpus callosum atrophy. The latter was significantly more in MS group [X[2] = 47.045, P <0.05]. The mean number of corpus callosum lesions was 2.3 +/- 2.4 in the stroke group and 8.1 +/- 2.6 in MS group with significant difference [P<0.05]. The predilection of location of corpus callosum lesions was significantly different in the 2 groups [P<0.05], being more inner callosal [42%] and ventriculocallosal [49%] in MS group while the outer callosal was more common in the stroke group [35%]. Corpus callosum atrophy would be used as a relatively morphological marker for cognitive decline in MS and small vessel ischemic stroke, being significantly more in MS. The more atrophic the corpus callosum is, the more weighing down of MS versus small vessel ischemic stroke in clinically and radiologically overlapping cases