MRI finding of a papillary muscle cyst: a differential diagnosis.

Cystic lesions of the papillary muscle in the form of myxoma, hydatid cyst, papillary fibroelastoma, blood-filled cysts and endodermal heterotopia are rare causes of embolic stroke. In view of the potential complications caused by these lesions, surgery is often advocated but there is no consensus on which patients qualify. We examined a differential diagnosis of a papillary muscle cystic lesion in a patient presenting with features of embolic disease and identified the imaging features on MRI that directed management.

Psychiatric manifestations and magnetic resonance imaging in HIV-negative neurosyphilis.

Neurosyphilis can mimic virtually any psychiatric disorder. Since there are no studies measuring the relationship between its psychiatric manifestations and neuroradiological findings, we performed magnetic resonance imaging (MRI) on 20 newly diagnosed patients with neurosyphilis and 20 healthy volunteers. MRI abnormalities occurred in 13 neurosyphilis patients. These included foci of increased signal intensity of T2-weighted images, and generalized cerebral atrophy. Two control subjects showed minor focal changes. In the neurosyphilis patients, frontal lesions showed statistically significant associations with the overall degree of psychiatric morbidity as measured by the brief psychiatric rating scale (p < 0.05). Temporo-parietal lesions showed a near significant association with cognitive impairment as measured by the Mini mental-state examination (p = 0.06). Atrophy measures correlated significantly with cognitive impairment. The results suggest that the site of brain lesions may be important in determining the nature of the psychiatric symptoms in neurosyphilis.