We report a case of cardiac lymphoma in a 40-year-old man, who had a mediastinal mass which was diagnosed as sclerosing mediastinitis pathologically. The mediastinal mass caused right pulmonary arterial stenosis. The patient developed myocardial hypertrophy and echocardiography showed restrictive physiology and severely decreased left ventricle ejection fraction, 6 months later. MRI showed global left ventricular myocardial hypertrophy and diffuse late gadolinium hyperenhancement after administration of contrast material. Thus, non-ischemic cardiomyopathy was suspected on MRI. However, pathology confirmed the myocardial abnormality as lymphoma after myocardial biopsy. Because a basal part of the left ventricle and global subendocardial myocardium were not involved on contrast-enhanced delayed MRI, the MRI abnormalities could be differentiated from amyloidosis and other myocardial diseases. The peculiar non-mass forming diffuse hypertrophy pattern of cardiac lymphoma has not been known in the MRI literature.
Adult ; Amyloidosis ; Biopsy ; Cardiomyopathies ; Constriction, Pathologic ; Echocardiography ; Gadolinium ; Heart Ventricles ; Humans ; Hypertrophy ; Lymphoma ; Mediastinitis ; Myocardium ; Sclerosis

Anoperineal tuberculosis is a rare extrapulmonary form of the disease and may present as abscess. We report a case of anoperineal tuberculous abscess, which showed low signal intensity on T1-weighted images, high signal intensity on T2-weighted images and diffusion restriction on diffusion weighted images.
Abscess ; Diffusion ; Tuberculosis

Calcific tendinitis of hand and foot is rare and frequently misdiagnosed because of its rare incidence and its similar clinical presentation to other conditions such as infection. Awareness of the typical location as well as familiarity with the imaging findings is essential for making a correct diagnosis of this rare condition. We report four cases of calcific tendinitis of hand and foot, occurring in the flexor hallucis brevis, abductor digiti minimi, and abductor pollicis brevis.
Foot ; Hand ; Incidence ; Recognition (Psychology) ; Tendinopathy ; Tendons

We report the radiological findings of regional enhancement of the liver adjacent to the right adrenal pheochromocytoma. CT and MRI showed focal strong enhancement of adjacent liver tissue in the arterial phase. However during the delayed phase, the lesion showed iso-attenuation with normal hepatic parenchyma and not delineated. The lesion did not show abnormal signal intensity on neither T1 nor T2 weighted images and indistinguishable from normal parenchyma. The enhancing hepatic lesion was spontaneously regressed on postoperative follow up CT which was taken several months after the adrenalectomy.
Adrenalectomy ; Follow-Up Studies ; Liver ; Pheochromocytoma

Simultaneous bilateral spontaneous rupture of the quadriceps tendon is a very rare condition and only a few cases have been reported in the literature. The etiology is not clear yet. But it occurs infrequently in patients with chronic metabolic disorders, such as secondary hyperparathyroidism due to chronic renal failure. We describe a case of simultaneous spontaneous bilateral quadriceps tendon tupture in a 36-year-old male patient with secondary hyperaprathyroidism due to chronic renal failure.
Adult ; Humans ; Hyperparathyroidism ; Hyperparathyroidism, Secondary ; Kidney Failure, Chronic ; Male ; Rupture ; Rupture, Spontaneous ; Tendons

The proximity of thoracic aortic aneurysm to the left subclavian artery (LSA) has made the coverage of LSA during thoracic endovascular aortic repair (TEVAR) be essential. Despite controversy concerning the safety of LSA coverage and the indications for LSA revascularizations, the cerebral hemodynamic change after LSA coverage has not been demonstrated. We prospectively examined two patients who would undergo TEVAR with LSA coverage by using 2D cine phase contrast MR imaging. After LSA coverage, the left subclavian steal was properly compensated by the increased flow volumes of both carotid arteries and right vertebral artery, which is the major collateral supply. The total brain supply after TEVAR did not lessen, which showed good correlation with uneventful clinical outcome. Therefore, 2D phase contrast MR imaging can be recommended as a useful technique to evaluate the hemodynamic change of the LSA coverage during TEVAR and to triage the candidate for LSA revascularization.
Aortic Aneurysm ; Aortic Aneurysm, Thoracic ; Brain ; Carotid Arteries ; Hemodynamics ; Humans ; Magnetic Resonance Imaging ; Magnetic Resonance Spectroscopy ; Magnetics ; Magnets ; Prospective Studies ; Subclavian Artery ; Subclavian Steal Syndrome ; Triage ; Vertebral Artery

PURPOSE: To compare the arterial and venous detection sites of triggering methods in contrast-enhanced-MR-venography (CE-MRV) for the evaluation of intracranial venous system. MATERIALS AND METHODS: 41 healthy patients underwent CE-MRV with autotriggering at either the cavernous segment of internal carotid artery with an inserted time-delay of 6 seconds (n = 20) or the superior sagittal sinus without any time-delay (n = 21). 0.1 mmol/kg gadolinium-based contrast material (Magnevist(R), Schering, Germany) was intravenously injected by hand injection. A sagittal fast-spoiled-gradient-echo-sequence ranging from one ear to the other was performed (TR/TE5.2/1.5, Matrix 310x310, 124 sections in the 15-cm-thick volume). 17 predefined venous structures were evaluated on all venograms by two neuroradiologists and defined as completely visible, partially visible, or none visible. RESULTS: The rate of completely visible structures were 272 out of 323 (84%) in the arterial triggering CE-MRV and 310 out of 340 (91%) in the venous triggering CE-MRV. The venous triggering CE-MRV demonstrated an overall superior visualization of the cerebral veins than the arterial triggering CE-MRV (Fisher exact test, p < 0.006). CONCLUSION: CE-MRV using venous autotriggering method provides higher-quality images of the intracranial venous structures compared to that of arterial.
Carotid Artery, Internal ; Caves ; Cerebral Veins ; Ear ; Hand ; Humans ; Superior Sagittal Sinus

PURPOSE: The purpose of this study was to describe arterial spin labeling MR image findings of status epilepticus. MATERIALS AND METHODS: A retrospective chart review within our institute revealed six patients who had been clinically diagnosed as status epilepticus and had also undergone MR imaging that included ASL in addition to routine sequences. RESULTS: Six patients with status epilepticus were studied by conventional MR and arterial spin labeling imaging. All patients showed increased regional CBF correlating with EEG pathology. Notably, in two patients, conventional MRI and DWI showed no abnormal findings whereas pCASL demonstrated regional increased CBF in both patients. CONCLUSION: Arterial spin labeling might offer additional diagnostic capabilities in the evaluation of patients with status epilepticus.
Electroencephalography ; Humans ; Retrospective Studies ; Status Epilepticus

PURPOSE: To investigate the pharmacologic modulation of motor task-dependent physiologic responses by antiplatelet agent, clopidogrel, during hand motor tasks in healthy subjects. MATERIALS AND METHODS: Ten healthy, right-handed subjects underwent three functional magnetic resonance (fMRI) sessions: one before drug administration, one after high dose drug administration and one after reaching drug steady state. For the motor task fMRI, finger flexion-extension movements were performed. Blood oxygenation level dependent (BOLD) contrast was collected for each subject using a 3.0 T VHi (GE Healthcare, Milwaukee, USA) scanner. T2*-weighted echo planar imaging was used for fMRI acquisition. The fMRI data processing and statistical analyses were carried out using SPM2. RESULTS: Second-level analysis revealed significant increases in the extent of activation in the contralateral motor cortex including primary motor area (M1) after drug administration. The number of activated voxels in motor cortex was 173 without drug administration and the number increased to 1049 for high dose condition and 673 for steady-state condition respectively. However, there was no significant difference in the magnitude of BOLD signal change in terms of peak T value. CONCLUSION: The current results suggest that cerebral motor activity can be modulated by clopidogrel in healthy subjects and that fMRI is highly senstive to evidence such changes.
Delivery of Health Care ; Echo-Planar Imaging ; Fingers ; Hand ; Magnetic Resonance Imaging ; Magnetic Resonance Spectroscopy ; Magnetics ; Magnets ; Motor Activity ; Motor Cortex ; Oxygen ; Ticlopidine

PURPOSE: The objective of this study was to investigate the differences of hippocampal volume and shape as well as the functional change between long life experienced taxi drivers and controls of Korean population. MATERIALS AND METHODS: Three-dimensional T1-weighted images and blood oxygen level dependent functional MRI(fMRI) were obtained from 8 subjects, consisting of 4 experienced (20-30 years) taxi drivers and 4 age-matched controls. The hippocampal volume and shape were analyzed with three-dimensional T1-weighted images. In addition, neuronal activities of brain were analyzed using a blood oxygen level dependent fMRI between the two groups. RESULTS: The hippocampal volume showed no statistically significant difference between the two groups (p > 0.05). The left hippocampi of the taxi drivers were slightly elongated with larger head and tail portions than those of the controls (p < 0.05, uncorrected). For the functional MRI, fusiform gyrus was specifically activated in taxi drivers, compared with the control group. CONCLUSION: The structural and functional changes of taxi driver's hippocampus indicate the functional differentiation as a result of occupational dependence on spatial navigation. In other words, the continuous usage of spatial navigation performance may diminish degeneration of hippocampus and the related brain regions.
Brain ; Head ; Hippocampus ; Magnetic Resonance Imaging ; Neurons ; Orientation ; Oxygen