RESUMO
CAA-ri is a reversible and rare encephalopathy that may manifest in patients with CAA. In this short article, we describe CT and MRI findings of CAA-ri in a 67-year-old man presented to emergency with sudden aphasia and acute cognitive dysfunction, underlining the pivotal role of neuroimaging in the diagnostic path.
Assuntos
Angiopatia Amiloide Cerebral , Idoso , Angiopatia Amiloide Cerebral/complicações , Angiopatia Amiloide Cerebral/diagnóstico por imagem , Hemorragia Cerebral , Humanos , Inflamação/complicações , Inflamação/diagnóstico por imagem , Imageamento por Ressonância Magnética , Masculino , NeuroimagemRESUMO
OBJECTIVE: To define the prevalence of subclinical synovitis on magnetic resonance imaging (MRI) in a large cohort of patients with juvenile idiopathic arthritis (JIA) in clinical remission and to evaluate its predictive value in terms of disease flare and joint deterioration. METHODS: Ninety patients with clinically inactive JIA who underwent a contrast-enhanced (CE)-MRI of a previously affected joint were retrospectively included. Each joint was evaluated for synovitis, tenosynovitis, and bone marrow edema. Baseline and follow-up radiographs were assessed to evaluate structural damage progression. RESULTS: CE-MRI was acquired in 45 wrists, 30 hips, 13 ankles, and 2 knees. Subclinical synovitis was detected in 59 (65.5%) of 90 patients and bone marrow edema in 42 (46.7%) of 90 patients. Fifty-seven of 90 (63.3%) patients experienced a disease flare during follow-up. Forty-four of 59 (74.6%) patients with subclinical synovitis experienced a disease flare versus 13 (41.9%) of 31 patients with no residual synovitis on MRI (P = 0.002). The presence of subclinical synovitis was the best predictor of disease flare on multivariable regression analysis (hazard ratio [HR] 2.45, P = 0.003). Baseline and follow-up radiographs were available for 54 patients, and 17 (31.5%) of 54 patients experienced radiographic damage progression. The presence of bone marrow edema (HR 4.40, P = 0.045) and being >17 years old (HR 3.51, P = 0.04) were strong predictors of joint damage progression in the multivariable analysis. CONCLUSION: MRI-detected subclinical inflammation was present in a large proportion of patients with JIA despite clinical remission. Subclinical synovitis and bone marrow edema have been shown to play a role in predicting the risk of disease relapse and joint deterioration, with potential implications for patients' management of the disease.
Assuntos
Artrite Juvenil , Doenças da Medula Óssea , Sinovite , Humanos , Adolescente , Artrite Juvenil/diagnóstico por imagem , Artrite Juvenil/epidemiologia , Artrite Juvenil/patologia , Estudos Retrospectivos , Exacerbação dos Sintomas , Sinovite/diagnóstico por imagem , Sinovite/epidemiologia , Imageamento por Ressonância Magnética/métodos , Edema/diagnóstico por imagem , Edema/epidemiologiaRESUMO
The Superior Ophthalmic Vein (SOV) is the largest vein of the orbit and represents an important orbital venous drainage pathway. SOV is well identifiable on CT and MRI, and its alterations may be a clue for differential diagnosis. In this pictorial work we illustrate the most frequent conditions in which SOV appearance may be influenced by various pathologies, providing a pictorial guide for imaging interpretation.