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BACKGROUND: Schizencephaly is a rare developmental malformation of the central nervous system associated with cell migration disturbances. Schizencephaly can be uni- or bilateral and is divided into two morphological types. The cleft is defined as type I ("closed lips") if there are fused clefts in cerebral mantle. In type II ("open lips") the clefts are separated and filled with cerebrospinal fluid connecting lateral ventricle with the subarachnoid space. MATERIAL/METHODS: We retrospectively analysed data of patients hospitalized in the Clinical Pediatric Neurology Department of Provincial Hospital No. 2 in Rzeszow between 1998-2011. Clinical data and imaging exams were analysed in the group of children with confirmed schizencephaly. RESULTS: Schizencephaly was recognized in 32 children. Diagnosis was made in children at the ages between 2 weeks and 15 years - the majority of older children were born before the year 2000. Diagnostic imaging, most often magnetic resonance imaging, was performed in all of the children. In most cases coexistence of other CNS malformations was discovered. In only one patient there were no neurological symptoms, most of the children presented different developmental disorders and neurological symptoms - most often cerebral palsy and epilepsy. In the group of children with bilateral and type II schizencephaly certain symptoms occurred more often. CONCLUSIONS: Schizencephaly is a rare central nervous system developmental disorder, which is very often associated with other severe brain malformations and in most of the cases subsequent multiple neurological symptoms. The method of choice in diagnosis of schizencephaly is magnetic resonance, which shows the degree and type of cleft, coexisting abnormalities and allows differential diagnosis. With the increased availability of this method it is possible to recognize schizencephaly more often and earlier.
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BACKGROUND: Shoulder joint is a common site of musculoskeletal pain caused, among other things, by rotator cuff tears due to narrowing of subacromial space, acute trauma or chronic shoulder overload. Magnetic resonance imaging (MRI) is an excellent modality for imaging of soft tissues of the shoulder joint considering a possibility of multiplanar image acquisition and non-invasive nature of the study. The aim of this study was to evaluate the prevalence of partial and complete rotator cuff tears in magnetic resonance images of patients with shoulder impingement syndrome and to review the literature on the causes and classification of rotator cuff tears. MATERIAL/METHODS: We retrospectively analyzed the results of 137 shoulder MRI examinations performed in 57 women and 72 men in Magnetic Resonance facility of the Department of Radiology and Diagnostic Imaging at the St. Jadwiga the Queen Regional Hospital No. 2 in Rzeszow between June 2010 and February 2013. Examinations were performed using Philips Achieva 1.5T device, including spin echo and gradient echo sequences with T1-, T2- and PD-weighted as well as fat saturation sequences in transverse, frontal and sagittal oblique planes. Patients were referred from hospital wards as well as from outpatient clinics of the subcarpathian province. RESULTS: The most frequently reported injuries included partial supraspinatus tendon tear and complete tearing most commonly involved the supraspinatus muscle tendon. The smallest group comprised patients with complete tear of subscapularis muscle tendon. Among 137 patients in the study population, 129 patients suffered from shoulder pain, including 57 patients who reported a history of trauma. There was 44% women and 56% men in a group of patients with shoulder pain. Posttraumatic shoulder pain was predominantly reported by men, while women comprised a larger group of patients with shoulder pain not preceded by injury. CONCLUSIONS: Rotator cuff injury is a very common pathology in patients with shoulder impingement syndrome. Isolated supraspinatus tendon injury or complete tearing is most frequent, rather than in conjunction with injuries to other rotator cuff tendons. We did not observe isolated complete tears of infraspinatus and subscapular muscle tendons.
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BACKGROUND: Magnetic resonance cholangiopancreatography is a relatively noninvasive technique of biliary and pancreatic duct imaging. MRCP technique utilizes T2-weighted sequences, in which bile is characterized by high signal intensity, whilst signal intensity of surrounding tissues is reduced. The purpose of this publication was to assess the diagnostic value of magnetic resonance cholangiopancreatography in the diagnostics of biliary dilatation. MATERIAL/METHODS: MRCP examinations of 148 patients (48 men and 100 women; the average age was 56) performed on a 1.5T Achieva Philips device in the Provincial Hospital in Rzeszow between November 2011 and April 2013 were included in retrospective analysis. Examined group was divided into three subgroups: patients after cholecystectomy, patients with cholecystolithiasis and patients without gallbladder concretions. The definitive cause of biliary dilatation was determined mainly on the basis of MRCP and ECPW examinations, and, in individual cases, during intraoperative cholangiography and laparatomy. RESULTS: Signal loss corresponding to probable concretions was identified in 34 cases. In the group of patients with cholecystolithiasis the cause of biliary dilatation was usually (45%) cholelithiasis. MRCP image was typical in 4 out of 9 malignant cases. The cause of biliary dilatation was usually (20%) a neoplasm in the group of patients without gallstones. Benign causes of biliary dilatation, apart from cholelithiasis, were identified in 16 individuals, including 4 cases in which the diagnosis was identified using MRCP, whereas in the remaining 12 cases ECPW examination proved conclusive to the final diagnosis. CONCLUSIONS: Magnetic resonance cholangiopancreatography enables reliable diagnosis of causes of biliary dilatation as long as they involve presence of gallbladder deposits and tumors. In benign causes of biliary dilatation, apart from cholelithiasis, MRCP picture is often atypical and therefore, the final identification of the cause of biliary dilatation is possible when this imagining method is combined with ERCP and additional tests.
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BACKGROUND: Gray matter heterotopia (GMH) is a malformation of the central nervous system characterized by interruption of normal neuroblasts migration between the 7(th) and 16(th) week of fetal development. The aim of the study was the analysis of clinical symptoms, prevalence rate and the most common concurrent central nervous system (CNS) developmental disorders as well as assessment of characteristic morphological changes of gray matter heterotopia in children hospitalized in our institution between the year 2001 and 2012. MATERIAL/METHODS: We performed a retrospective analysis of patients' data who were hospitalized in our institution between the year 2001 and 2012. We assessed clinical data and imaging exams in children diagnosed with gray matter heterotopia confirmed in MRI (magnetic resonance imaging). RESULTS: GMH occurred in 26 children hospitalized in our institution between the year 2001 and 2012. Among children with gray matter heterotopia most common clinical symptoms were: epilepsy, intellectual disability and hemiparesis. The commonest location of heterotopic gray matter were fronto-parietal areas of brain parenchyma, mostly subependymal region. Gray matter heterotopia occurred with other developmental disorders of the central nervous system rather than solely and in most cases it was bilateral. Schizencephaly and abnormalities of the corpus callosum were the most often developmental disorders accompanying GMH. CONCLUSIONS: 1. Subependymal gray matter heterotopia was more common than subcortical GMH. Subependymal GMH showed tendency to localize in the region of the bodies of the lateral ventricles. The least common was laminar GMH. 2. Gray matter heterotopia occurred more often with other developmental disorders of the central nervous system rather than solely. The most frequent concurrent disorders of the central nervous system were: schizencephaly, developmental abnormalities of the corpus callosum, arachnoid cyst, abnormalities of the septum pellucidum and the fornix. 3. GMH foci were more often bilateral than unilateral. 4. In the diagnostics of cell migration abnormalities, gray matter heterotopia included, MR imaging remains the method of choice.
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BACKGROUND: Spinal infection (discitis; spondylodiscitis) presents a wide spectrum of pathologies. The method of choice for spondylodiscitis imaging is magnetic resonance (MR). It provides detailed anatomical information, especially concerning epidural space and spinal cord. The main aim of this article is the description and evaluation of spondylodiscitis morphological variation visible in magnetic resonance imaging. MATERIAL/METHODS: In this article we retrospectively analysed the patients diagnosed at the Department of Radiology of the Provincial Hospital No 2 in Rzeszów between October 2009 and October 2011. The subjects involved a group of five women aged 41-74 (mean 56.3 years) and eight men aged 46-69 (mean 61,3 years). All patients had spondylodiscitis symptoms. All patients underwent MRI examination before and after the contrast enhancement. In three patients additional CT examination was performed. RESULTS: Following the MRI procedure all patients were diagnosed with typical symptoms of spondylodiscitis. It also revealed a number of pathologies resulting from morphological spondylodiscitis variation. Other pathologies found on the MR images of the study group patients involved epidural intra-canal spinal pathological masses causing spinal cord compression, lung abscess, pyothorax, paravertebral abscesses and epidural empyemas, abscess between adjacent vertebral bodies, abscesses beneath anterior longitudinal ligament, and iliopsoas muscle abscesses. In all cases a destruction of vertebral bodies with end plates loss restriction and cortical layer discontinuity was observed. Moreover, one person was diagnosed with pathological vertebral body fractures and liquefactive necrosis of the vertebral body. CONCLUSIONS: Spondylodiscitis manifests itself in a great number of morphological variations visible on the radiological images. Apart from ordinary features of vertebral bodies and discs, progressive spinal destruction is observed together with reactive bone changes and soft tissue infiltration. The latter leads to a number of complications e.g. abscesses or even fistulas and also to the formation of obstacles in radiological images. The knowledge of radiological images together with overall evaluation of clinical and laboratory features enables a proper diagnosis.
