RESUMEN
PURPOSE: Aneurysmal subarachnoid hemorrhage (SAH) can chronically affect cognitive function, and SAH has been suggested to result in regional brain damage. This study aimed to assess regional structural damage according to initial clinical status including SAH volume. METHODS: A total of 63 consecutive patients treated with coil embolization for intracranial aneurysms for more than 6 months were enrolled. Of these, 35 patients had SAH and 28 patients who were treated for unruptured aneurysms served as controls. Volumetric T1-weighted images were acquired with 1 mm isotropic voxel. The SAH volume was measured semi-automatically from the initial brain CT scan. Voxel-based group comparison was conducted to assess regional gray matter volume (GMV) changes. Voxel-based multiple regression was conducted to analyze regional GMV change and SAH volume. The clinical factors (Glasgow Coma Scale (GCS), SAH volume, systolic blood pressure, and serum laboratory findings) associated with regional GMV were also analyzed by using multiple regression. RESULTS: The SAH group had significantly lower GMV in the left hippocampus and higher GMV in the visual cortex than controls (Alphasim-corrected p < 0.05, voxel level of p < 0.001). The GMV of the bilateral hippocampi, thalami, and left medial orbital gyrus was negatively correlated with the initial SAH volume (FDR-corrected p < 0.05). SAH volume and GCS were associated with the hippocampal GMV in multiple regression (p < 0.05). CONCLUSIONS: Chronic regional GMV change after SAH was related to the severity of initial clinical status including SAH volume. This finding supports the pathophysiological hypothesis of SAH-induced microstructural brain injury.
Asunto(s)
Sustancia Gris/patología , Aneurisma Intracraneal/complicaciones , Aneurisma Intracraneal/diagnóstico por imagen , Angiografía por Resonancia Magnética , Hemorragia Subaracnoidea/diagnóstico por imagen , Hemorragia Subaracnoidea/etiología , Tomografía Computarizada por Rayos X , Biomarcadores/sangre , Estudios de Casos y Controles , Embolización Terapéutica , Femenino , Escala de Coma de Glasgow , Humanos , Interpretación de Imagen Asistida por Computador , Aneurisma Intracraneal/terapia , Masculino , Persona de Mediana Edad , Tamaño de los Órganos , Estudios Retrospectivos , Hemorragia Subaracnoidea/terapiaRESUMEN
We describe the case of a 41-year-old woman with primary Sjögren's syndrome (SS) who presented multiple recurrences of breast amyloidosis. Each recurrence of breast amyloidosis showed different sonographic features, potentially mimicking malignancy. We briefly discuss the possible cause of this variability in imaging features based on the radiologic-histologic correlation.
Asunto(s)
Amiloidosis/complicaciones , Amiloidosis/diagnóstico por imagen , Enfermedades de la Mama/complicaciones , Enfermedades de la Mama/diagnóstico por imagen , Síndrome de Sjögren/complicaciones , Adulto , Amiloidosis/patología , Amiloidosis/cirugía , Enfermedades de la Mama/patología , Enfermedades de la Mama/cirugía , Femenino , Estudios de Seguimiento , Humanos , Persona de Mediana Edad , Recurrencia , Ultrasonografía/métodosRESUMEN
Xanthogranulomatous pyelonephritis (XGP) is a rare type of chronic bacterial nephritis, which rarely involves the invasion of adjacent organs or the formation of fistulas due to tissue-destructive granulomatous reactions. Although the invasions of various adjacent organs have been reported in several cases of XGP, MRI data on their features are limited. MRI has a better soft-tissue resolution than CT. Thus, it can identify the extent of extrarenal involvement in advanced XGP, and the findings can be used in treatment planning. Herein, we report a rare case of XGP with nephropleural fistula formation diagnosed using CT and MRI.