1.Eyelid swelling and lucency in the skull radiograph.
Annals of the Academy of Medicine, Singapore 2009;38(10):928-928
Child
;
Edema
;
diagnostic imaging
;
etiology
;
Emphysema
;
diagnostic imaging
;
etiology
;
Ethmoid Bone
;
diagnostic imaging
;
injuries
;
Eyelid Diseases
;
diagnostic imaging
;
etiology
;
Humans
;
Male
;
Orbit
;
diagnostic imaging
;
Orbital Diseases
;
diagnosis
;
diagnostic imaging
;
pathology
;
Radiography
;
Skull
;
diagnostic imaging
;
pathology
;
Skull Fractures
;
complications
;
diagnostic imaging
2.Clinics in diagnostic imaging (154). Carbon monoxide (CO) poisoning.
Puay Joo LIM ; Sumer Nrupendra SHIKHARE ; Wilfred C G PEH
Singapore medical journal 2014;55(8):405-quiz 410
A 59-year-old man with a history of major depression was found by his wife to be unconscious and foaming at the mouth. On arrival at the emergency department, the patient was noted to be unresponsive. Computed tomography of the brain showed symmetrical ill-defined areas of hypoattenuation involving the medial aspects of both lentiform nuclei, while magnetic resonance images of the brain showed symmetrical increased signal in the bilateral globi pallidi on diffusion weighted, T2-weighted and fluid attenuated inversion recovery sequences. These findings were those of acute carbon monoxide poisoning. Despite aggressive treatment, the patient's condition continued to deteriorate and he eventually passed away. The various imaging findings of carbon monoxide poisoning in the brain and the differential diagnoses are discussed.
Brain
;
diagnostic imaging
;
Carbon Monoxide Poisoning
;
diagnosis
;
diagnostic imaging
;
Depressive Disorder, Major
;
complications
;
Diagnostic Imaging
;
Fatal Outcome
;
Humans
;
Magnetic Resonance Imaging
;
Male
;
Middle Aged
;
Pulmonary Edema
;
pathology
;
Radiography, Thoracic
;
Suicide, Attempted
;
Tomography, X-Ray Computed
3.Repeat transoesophageal echocardiogram is recommended in endocarditis patients with paravalvular oedema despite sensitivity to antibiotics and improving parameters.
Michael LIANG ; Gerard DEVLIN ; Dilesh JOGIA
Annals of the Academy of Medicine, Singapore 2011;40(2):102-103
Abscess
;
Adult
;
Anti-Bacterial Agents
;
therapeutic use
;
Aortic Valve
;
diagnostic imaging
;
microbiology
;
pathology
;
Echocardiography, Transesophageal
;
methods
;
Edema, Cardiac
;
diagnostic imaging
;
drug therapy
;
pathology
;
Endocarditis, Bacterial
;
diagnostic imaging
;
drug therapy
;
Gentamicins
;
therapeutic use
;
Humans
;
Male
;
Mitral Valve
;
diagnostic imaging
;
pathology
;
Tricuspid Valve
;
diagnostic imaging
;
pathology
;
Vascular Fistula
4.Study on the relationship between severe knee osteoarthritis and bone marrow edema.
Long-Wen XIAO ; Zhi-Cheng SANG
China Journal of Orthopaedics and Traumatology 2023;36(6):525-531
OBJECTIVE:
To investigate the relationship between bone marrow edema and pathological changes, symptoms and signs of severe knee osteoarthritis.
METHODS:
From January 2020 to March 2021, 160 patients with severe knee osteoarthritis who underwrent MRI of the knee at the Department of Bone and Joint, Wangjing Hospital, China Academy of Chinese Medical Sciences were included. Eighty patients with bone marrow edema were selected as the case group, including 12 males and 68 females, aged from 51 to 80 years old with an average of (66.58±8.10) years old, the duration of disease 5 to 40 months with an average of (15.61±9.25) months. Eighty patients without bone marrow edema were selected as the control group, including 15 males and 65 females, aged from 50 to 80 years old with an average of (67.82±8.05) years old, the duration of disease 6 to 37 months with an average of (15.75±8.18) months, BMI was (28.26±3.13) kg·m-2 ranged from 21.39 to 34.46 kg·m-2. The degree of bone marrow edema was evaluated by knee whole oragan magnetic resonance imaging score (WORMS). The degree of knee osteoarthritis was evaluated by Kellgren- Lawrence(K-L) grade and Western Ontario and McMaster University Osteoarthritis Index (WOMAC). The degree of joint pain was evaluated by visual analogue scale(VAS) and WOMAC pain score, the joint signs were evaluated by tenderness, percussion pain, joint swelling and joint range of motion. To explore the relationship between bone marrow edema and knee osteoarthritis, the prevalence of bone marrow edema and K-L grade were compared between the two groups. Furthermore the WORMS score and WOMAC index, pain-related score, and sign-related score correlation coefficient were analyzed to further explore the relationship between bone marrow edema and knee osteoarthritis index, joint pain symptoms and signs.
RESULTS:
There was 68.75% (55/80) of the patients in the case group were in K-L grade Ⅳ, and 52.5% (42/80) in the control group, indicating a higher proportion of patients with grade Ⅳ in the case group than the control group (χ2=4.425, P<0.05). In the case group, there was a strong correlation between bone marrow edema WORMS score and knee osteoarthritis WOMAC index. (r=0.873>0.8, P<0.001), a moderate correlation between WORMS score and VAS score and WOMAC pain score(r=0.752, 0.650>0.5, P<0.001), a moderate correlation between WORMS score and percussion pain score (r=0.784>0.5, P<0.001), and a weak correlation between WORMS score and VAS and tenderness score, joint swelling score and joint range of motion score (r=0.194, 0.259, 0.296<0.3, P<0.001).
CONCLUSION
Our study suggests that severe knee osteoarthritis is associated with an increased risk of bone marrow edema. Bone marrow edema can also lead to knee osteoarthritis joint pain, with percussion pain being a positive sign, but tenderness, joint swelling and limitation of activity are not significantly related to bone marrow edema.
Male
;
Female
;
Humans
;
Osteoarthritis, Knee/pathology*
;
Bone Marrow/pathology*
;
Knee Joint/diagnostic imaging*
;
Bone Marrow Diseases/etiology*
;
Pain/pathology*
;
Arthralgia
;
Edema/pathology*
5.Study on correlation between bone marrow edema and osteoporosis in patients with severe knee osteoarthritis.
Long-Wen XIAO ; Zhi-Cheng SANG
China Journal of Orthopaedics and Traumatology 2023;36(4):371-375
OBJECTIVE:
To explore relationship between bone marrow edema(BME) and osteoporosis in patients with severe knee osteoarthritis.
METHODS:
Unmatched case-control study was conducted. Totally 160 patients with severe knee osteoarthritis who had undergone knee magnetic resonance imaging (MRI) and bone mineral density examination (BMD) from January 2020 to March 2021 were included. Eighty patients complicated with BME were included in BME group, and 80 patients without BME were selected as NBME group. In BME group, there were 12 males and 68 females, aged from 51 to 80 years old with an average of(66.58±8.10) years old;the courses of disease ranged from 5 to 40 months with an average of (15.61±9.25) months;body mass index(BMI) ranged from 21.81 to 34.70 with an average of (27.79±3.00) kg·m-2;25 patients classified to grade Ⅲ and 55 patients grade Ⅳ according to Kellgren- Lawrence(K-L). In NBME group, there were 15 males and 65 females, aged from 50 to 80 years old with an average of(67.82±8.05) years old;the course of disease ranged from 6 to 37 months with an average of(15.75±8.18) months;BMI ranged from 21.39 to 34.46 with an average of (28.26±3.13) kg·m-2;25 patients were K-L Ⅲ and 55 patients with K-L Ⅳ. The degree of bone marrow edema was evaluated by knee whole oragan magnetic resonance imaging score(WORMS). Osteoporosis was diagnosed and BMD was evaluated by DXA T value. To explore the relationship between bone marrow edema and osteoporosis by comparing prevalence rate of osteoporosis between two groups, and to further explore relationship between BME and BMD by Spearman correlation analysis of BME WORMS score and DXA T value in BME group.
RESULTS:
The complete case data were obtained on the first diagnosis, and there was no significant difference in sex, age, courses of disease and BMI between two groups (P>0.05). The proportion of K-L Ⅳ in BME group was significantly higher than that in NBME (P<0.05). The prevalence rate of osteoporosis in BME group was significantly higher than in NBME group with the same K-L grade (P<0.001), and there was a strong negative correlation between BME WORMS score and DXA BMD T value (r=-0.812, |r|=0.812 >0.8, P<0.001).
CONCLUSION
Osteoporosis is one of the risk factors of bone marrow edema in patients with severe knee osteoarthritis, and the lower the bone mineral density is, the easier it is to be complicated with bone marrow edema.
Male
;
Female
;
Humans
;
Osteoarthritis, Knee/diagnostic imaging*
;
Bone Marrow/pathology*
;
Case-Control Studies
;
Bone Marrow Diseases/etiology*
;
Osteoporosis/complications*
;
Edema/etiology*
;
Magnetic Resonance Imaging/methods*
6.Relationship Between Cytogenetic Complexity and Peritumoral Edema in High-Grade Astrocytoma.
Kyung Ho JEONG ; Young Jin SONG ; Jin Yeong HAN ; Ki Uk KIM
Annals of Laboratory Medicine 2016;36(6):583-589
BACKGROUND: The purpose of the study is to reveal the association of cytogenetic compltyexi and peritumoral edema volume (PTEV) and its prognostic significance in high-grade astrocytoma patients by culturing patient tumor cells. METHODS: Twenty-seven high-grade astrocytoma patients were divided into three groups according to karyotype complexity: normal, non-complex karyotype (NCK), and complex karyotype (CK). Endothelial growth factor receptor (EGFR) amplification was detected by FISH, and its association with chromosome 7 abnormalities was analyzed. Mean PTEV of each group was compared by ANOVA to evaluate the relationship between PTEV and cytogenetic complexity. RESULTS: The PTEV of patients in normal (n=6), NCK (n=8), and CK (n=13) groups were 24.52±17.73, 34.26±35.04, and 86.31±48.7 cm3, respectively (P=0.005). Ten out of 11 patients with EGFR amplification showed abnormalities in chromosome 7. The mean PTEV of EGFR-amplified and non-amplified groups were 80.4±53.7 and 41.3±37.9 cm3, respectively (P=0.035). The average survival of patients with PTEV less than 90 cm3 was 30.52±26.11 months, while in patients with PTEVs over or equal to 90 cm3, it was 10.83±5.53 months (P=0.007). CONCLUSIONS: The results show an association of complex karyotype with the PTEV of high-grade astrocytoma. EGFR amplification plays a significant role in the formation of peritumoral edema, causing PTEV to increase, which is related with survival. This implies that cytogenetic karyotype can be applied as a prognostic factor.
Adult
;
Aged
;
Astrocytoma/diagnostic imaging/mortality/*pathology
;
Brain Neoplasms/diagnostic imaging/mortality/*pathology
;
Chromosome Aberrations
;
Chromosomes, Human, Pair 7
;
Edema/diagnostic imaging/pathology
;
Female
;
Humans
;
In Situ Hybridization, Fluorescence
;
Kaplan-Meier Estimate
;
Karyotype
;
Magnetic Resonance Imaging
;
Male
;
Middle Aged
;
Neoplasm Grading
;
Prognosis
;
Receptors, Vascular Endothelial Growth Factor/metabolism
;
Tumor Cells, Cultured
;
Young Adult
7.A case of Guillain-Barre syndrome complicated with posterior reversible encephalopathy syndrome.
Ying YANG ; Jian-hua FENG ; Yu-wen DAI
Chinese Journal of Pediatrics 2013;51(6):477-478
Biomarkers
;
blood
;
Brain
;
diagnostic imaging
;
pathology
;
Brain Edema
;
etiology
;
pathology
;
Child
;
Diagnosis, Differential
;
Electroencephalography
;
Guillain-Barre Syndrome
;
complications
;
diagnosis
;
therapy
;
Humans
;
Magnetic Resonance Imaging
;
Male
;
Posterior Leukoencephalopathy Syndrome
;
complications
;
diagnosis
;
therapy
;
Radiography
8.Observation of post-MCAO cortical inflammatory edema in rats by 7.0 Tesla MRI.
Ying XIONG ; Wen-zhen ZHU ; Qiang ZHANG ; Wei WANG
Journal of Huazhong University of Science and Technology (Medical Sciences) 2014;34(1):120-124
This study aimed to investigate inflammatory edema after cerebral ischemia through 7.0T MRI and proton magnetic resonance spectroscopy (MRS). All SD rats were randomly divided into sham operated group and middle cerebral artery occlusion (MCAO)-1 day, -3 day and -7 day groups. MRI scan of the brain was performed on a 7.0 Tesla MRI scanner. The volume of positive signals in the ischemic side was detected by using a T2 weighted spinecho multislice sequence; the changes in the height of water-peak were measured with point resolved spectroscopy (PRESS) sequences; cortical edema was detected by using wet-dry weight method; the degrees of nerve injury were evaluated by Bederson neurological score system; double-labeling immunofluorescence technique was used to explore the molecular mechanisms of post-ischemia cerebral edema. The results showed that high T2WI signals were observed in MCAO-1 day, -3 day and -7 day groups, and the water-peak height and water-peak area of MCAO groups were higher than those of sham operated group (P<0.05). Neurological score results were consistent with the degree of brain edema, and a large number of microglia accumulated in the ischemic cortex. Our results suggested that non-invasive MRI technology with the advantage of high spatial resolution and tissue resolution can comprehensively and dynamically observe inflammatory edema after cerebral ischemia from a three-dimensional space, and contribute to evaluation and treatments in clinic.
Animals
;
Brain
;
diagnostic imaging
;
pathology
;
Brain Edema
;
diagnostic imaging
;
etiology
;
Brain Ischemia
;
complications
;
CD11b Antigen
;
metabolism
;
Immunohistochemistry
;
Infarction, Middle Cerebral Artery
;
complications
;
Inflammation
;
diagnostic imaging
;
etiology
;
Magnetic Resonance Imaging
;
methods
;
Magnetic Resonance Spectroscopy
;
Male
;
Microglia
;
metabolism
;
Microscopy, Confocal
;
Microscopy, Fluorescence
;
Radiography
;
Rats
;
Rats, Sprague-Dawley
;
Reproducibility of Results
;
Time Factors
9.Clinical analysis of 4 children with negative pressure pulmonary edema.
Jiehua CHEN ; Shu WANG ; Hongling MA ; Wenjian WANG ; Dan FU ; Wenxian HUANG ; Jikui DENG ; Huiying TANG ; Yanxia HE ; Yuejie ZHENG
Chinese Journal of Pediatrics 2014;52(2):122-127
OBJECTIVETo analyze the clinical characteristics of negative pressure pulmonary edema (NPPE).
METHODA retrospective investigation of the clinical manifestation, imageology, clinical course and outcome of 4 children with NPPE seen between June 2012 and July 2013 in a children's hospital. The causation of the airway obstruction was also explored.
RESULTAll the 4 cases were boys, the range of age was 40 days to 9 years. They had no history of respiratory and circulatory system disease. In 3 cases the disease had a sudden onset after the obstruction of airway, and in one the onset occurred 1.5 hours after removing the airway foreign body. All these cases presented with tachypnea, dyspnea, and cyanosis, none had fever. Three cases had coarse rales. Chest radiography was performed in 3 cases and CT scan was performed in 1 case, in all of them both lungs displayed diffuse ground-glass-like change and patchy consolidative infiltrates. Three cases were admitted to the ICU, duration of mechanical ventilation was less than 24 hours in 2 cases and 39 hours in one. Oxygen was given by mask to the remaining one in emergency department, whose symptoms were obviously improved in 10 hours. None was treated with diuretics, glucocorticoids or inotropic agents. Chest radiographs were taken within 24 hours of treatment in 2 cases and 24-48 hours in the other 2; almost all the pulmonary infiltrates were resolved. All the 4 cases were cured. The causes of airway obstruction were airway foreign bodies in two cases, laryngospasm in one and laryngomalacia in the other.
CONCLUSIONNPPE is a life-threatening emergency, which is manifested by rapid onset of respiratory distress rapidly (usually in several minutes, but might be hours later) after relief of the airway obstruction, with findings of pulmonary edema in chest radiograph. The symptoms resolve rapidly by oxygen therapy timely with or without mechanical ventilation. In children with airway obstruction, NPPE should be considered.
Acute Disease ; Airway Obstruction ; complications ; Child ; Child, Preschool ; Foreign Bodies ; complications ; Humans ; Infant ; Intensive Care Units ; Intubation, Intratracheal ; methods ; Laryngismus ; complications ; Larynx ; Lung ; diagnostic imaging ; pathology ; Male ; Oxygen Inhalation Therapy ; Positive-Pressure Respiration ; methods ; Pulmonary Edema ; diagnosis ; etiology ; therapy ; Radiography, Thoracic ; Retrospective Studies ; Tomography, X-Ray Computed