MRI and CT Findings of Intracranial Neurosyphilis

PURPOSE: To evaluate the CT and MRI findings of neurosyphilis. MATERIALS AND METHODS: We retrospectivelyreviewed the CT and MR imaging findings in five patients with intracranial neurosyphilis confirmed by CSF, VDRL,TPHA, and clinical follow-up. MR imaging was performed in all five cases, and CT in two. RESULTS: The MRI and CTfindings of intracranial neurosyphilis included infarction (n=3), focal inflammation (n=1) and encephalopathy(n=1). There was a total of ten infaretions : three of the basal ganglia, two each of the frontal lobe, watershedzone, and cerebellum, and one of the occipital lobe. Intaretion was most common in MCA territory (n=9; 50%),followed by the watershed zone (16.6%), posterior cerebral artery territory (16.6%), and posterior inferiorcerebellar artery territory (11.1%), The size of the lesion varied from 1cm to larger than one lobe. One patientshowed diffuse high signal intensity in the left temporal lobe, but on follow-up MRI, this had resolved. CONCLUSION: The most common finding of neurosyphilis, as seen on MRI and CT, was infarction in middle cerebralarterial territory.

Bone and Joint changes following Electrical Burn: Plain Radiographic findings

PURPOSE: To evaluate the plain radiographic findings of bone and joint changes following electrical burn. MATERIALS AND METHODS: This study involved 19 patients with 27 bone and joints regions which had sufferedelectrical injury. The most common input and output sites were, respectively, the hand(7/14) and foot (6/10).Three other sites were involved. Four cases involved osteomyelitis, and in four, amputation was performed. Weobserved bone and joint changes, changes following osteomyelitis and changes in the amputation stump. We analyzedthe difference between input and output changes, and when this was interesting, the average time of onset wasassessed. RESULTS: In bone and joint changes following electrical burn, the most frequent radiographic findingwas joint contracture (n=16). Other findings included osteolysis (n=8), articular abnormalites (n=6), periostitis(n=5), fracture (n=5), acro-osteolysis (n=2), and heterotopic bone formation (n=2). In cases involvingosteomyelitis(n=4), aggravation of underlying bone changes was noted. CONCLUSION: In electrical burn, variouschanges were noted in bone and joints, and input injury was more severe than that of output.

Hematogenous Candida Pneumonia in Major Burn Patients: Plain Chest Radiograph and Thin-section CT Findings

PURPOSE: To describe plain radiographic and thin-section CT findings of hematogenous candida pneumonia in major burn patients. MATERIAL AND METHOD: We reviewed nine cases of hematogenous candida pneumonia in major burn patients who had positive blood culture for candida and findings of pneumonia on plain chest radiograph. On five of nine cases, thin-section CT was done. We evaluated retrospectively nine cases for onset, the pattern, distribution, and size of lesions on plain chest radiograph and thin-section CT. RESULTS: On plain chest radiograph, randomly distributed 2-10mm nodules were seen in six cases(66%) and randomly distributed 10-15mm consolidations in remaining three cases{33% ). Lesion occured in 11th to 75th post-burn day{average, 34th post-burn day). Other findings were cardiomegaly in three cases, atelectasis in three cases, and pulmonary edema in one case. Thin-section CT showed variable shaped subpleural nodules in all five cases. The size of nodules were 1-5mm in two cases(40%) and 5-10mm(60% ) in three cases. Feeding vessel signs were seen in two cases. Other findings were atelectasis in three cases, cardiomegaly in three cases, ground-glass opacity and interlobular septal thickenings by pulmonary edema in two cases. CONCLUSION: Plain chest radiographic findings of hematogenous candida pneumonia in major burn patients are randomly distributed nodules or consolidations of variable size. Thin-section CT findings are variable shaped subpleural nodules less than 1 cm.

Radiological Findings of Vertebral Artery Dissection

PURPOSE: The vertebral artery dissection is rare and increasingly recognized as a source of stroke. The purpose of this study is to describe causes, clinical manifestations, MRI and anglographic findings. MATERIALS AND METHODS: Conventional anglograms(n=7) and magnetic resonance imaging(n=6) were retrospectively analyzed in seven patients of vertebral artery dissection. The classification of the Krayenbuhl and Yasargil for vertebral artery segmentation was used for localization of vertebral artery dissection. Additionally, etiology and clinical manifestations were also retrospectively reviewed. RESULTS: Six cases were spontaneous type and one case was traumatic type. The clinical diagnoses of 6 spontaneous arterial dissection cases were wallenberg syndrome(4 cases), subarachnoid hemorrhage(1 case), and infarction of the cerebellum corresponding to PICA territory(1 case). A linear bright signal caused by thrombus was well visualized at the dissection area on sagittal T1 weighted spin echo MR images in all 6 cases. The characteristic anglographic findings were profound narrowing in 4 cases, pearl and string sign(including dissecting aneurysm) in 3 cases, complete obstruction in 3 cases, and a double density lumen(true and false lumen) extending to proximal basilar artery in one case. Spontaneous dissections were located at the V4 segment in all 6 cases. One traumatic dissection was located at the V2 segment. CONCLUSION: The most common site of the spontaneous dissection of the vertebral artery was V4 portion and a linear bright signal caused by thrombus was well visualized on sagittal T1 weighted spin echo MR images.