Assessment of Calcaneal Spongy Bone Magnetic Resonance Characteristics in Women: A Comparison between Measures Obtained at 0.3 T, 1.5 T, and 3.0 T.

BACKGROUND: There is a growing interest in bone tissue MRI and an even greater interest in using low-cost MR scanners. However, the characteristics of bone MRI remain to be fully defined, especially at low field strength. This study aimed to characterize the signal-to-noise ratio (SNR), T2, and T2* in spongy bone at 0.3 T, 1.5 T, and 3.0 T. Furthermore, relaxation times were characterized as a function of bone-marrow lipid/water ratio content and trabecular bone density. METHODS: Thirty-two women in total underwent an MR-imaging investigation of the calcaneus at 0.3 T, 1.5 T, and 3.0 T. MR-spectroscopy was performed at 3.0 T to assess the fat/water ratio. SNR, T2, and T2* were quantified in distinct calcaneal regions (ST, TC, and CC). ANOVA and Pearson correlation statistics were used. RESULTS: SNR increase depends on the magnetic field strength, acquisition sequence, and calcaneal location. T2* was different at 3.0 T and 1.5 T in ST, TC, and CC. Relaxation times decrease as much as the magnetic field strength increases. The significant linear correlation between relaxation times and fat/water found in healthy young is lost in osteoporotic subjects. CONCLUSION: The results have implications for the possible use of relaxation vs. lipid/water marrow content for bone quality assessment and the development of quantitative MRI diagnostics at low field strength.

Treatment of intermetatarsal Morton's neuroma with alcohol injection under US guide: 10-month follow-up.

Morton's neuroma (MN) is a frequent cause of metatarsalgia. The aim of our study was to evaluate the efficacy of neuroma alcohol-sclerosing therapy (NAST) under US guide in MN after a 10-month follow-up. Forty intermetatarsal neuromas underwent alcohol-sclerosing therapy after sonographic evaluation of their dimensions and echotexture. After subcutaneous anesthesia, a sclerosing solution composed of anesthetic (carbocaine-adrenaline 70%) and ethylic alcohol (30%) was injected inside the mass under US guidance. The procedure was repeated at intervals of 15 days until the resolution of the symptoms. A total or partial symptomatic relief was obtained in 36 cases (90%). No procedure-related complications were observed. Transitory plantar pain, due to the flogistic reaction induced by the sclerosing solution, occurred in 6 cases (15%). The 10-month follow-up revealed a 20-30% mass volume reduction and an adiposus-like change in echotexture. In the 4 cases (10%) of therapeutic failure, the preliminary sonography demonstrated a hypoechoic echotexture with a strong US beam attenuation corresponding to a highly fibrous neuroma after surgical resection. The NAST is a feasible and cost-efficient procedure with high rates of therapeutic success.

Hepatic artery pseudoaneurysm in von Willebrand's disease.

We report a case of hepatic artery pseudoaneurysm which occurred in a patient with von Willebrand's disease. The patient presented with upper abdominal pain and diagnosis was made by US and CT examinations. This case emphasizes the possible association between an established coagulation disorder and pseudoaneurysm. The patient was successfully treated by coil embolization.

Pyriformis muscle syndrome: CT/MR findings in the percutaneous therapy with botulinic toxin.

PURPOSE: The aim of our study was to evaluate the diagnostic capabilities of computed tomography (CT) and magnetic resonance (MR) imaging in pyriformis syndrome (PS) and the long-term outcomes of CT-guided percutaneous treatment with botulinum. PS is a cause of sciatica and disability. The pain is usually increased by muscular contraction, palpation or prolonged sitting. MATERIAL AND METHODS: Thirty-four patients suffering from PS, suspected on the basis of clinical and electrophysiological criteria and after imaging examinations had excluded other causes of sciatic pain, had positive lidocaine tests and were treated by intramuscular injection of botulinum toxin type A (BTX-A) under CT guidance. MR sequences was performed in nine patients before treatment and after three months to evaluate the extent of muscle denervation. RESULTS: In 30 cases relief of symptoms was obtained after 5-7 days. In four patients insufficient pain relief warranted a second percutaneous treatment which proved clinically successful. No complications or side effects were recorded after BTX-A injection. The MR examination demonstrated a change in signal intensity of the muscle in seven patients due to denervation, whereas in the remaining two cases only atrophy was detected. Larger series are necessary to confirm these preliminary results. CONCLUSIONS: CT-guided BTX-A injection in the pyriformis muscle is an emergent and feasible technique that appears to yield excellent local therapeutic effects without the risk of imprecise injection.