Multiple sclerosis (MS) is one of the most common chronic and disabling inflammatory and demyelinating disorders of the central nervous system (CNS). Magnetic Resonance Imaging (MRI) allows the observation of pathological changes in vivo. It has provided a number of important insights into the spatial-temporal evolution of MS pathology in vivo. Conventional MRI with T2-weighted images is useful in the assessment of oedema early in the inflammatory stage, tissue destruction with demyelination and axonal loss, and gliosis later in the chronic stage. Examination by conventional MRI usually requires more than one hour and it does not completely reveal rapid dynamic changes in blood flow. Recently introduced rapid MRI techniques, MR perfusion imaging and MR diffusion imaging, allow measurement of pathophysiological changes at the cellular level with a good temporal resolution. Nevertheless, until now there were no adequate analytical methods available within the clinical routine to differentiate between types of MS lesions using fast perfusion MRI. We present an analytical method capable of recognizing, and distinguishing, the status of MS lesions by calculating some numerical parameters from the MR perfusion images. The method has been tested on 14 patients affected by MS with different lesions and the results have been compared with those obtained with more expensive conventional MRI examinations. The proposed method made it possible to recognize the nature of the MS lesions in 100% of the examined cases without the need to perform long conventional MRI examinations, using instead perfusion MRI eco planar imaging which takes no more than two minutes. Moreover, the reduced time also allowed reduction of the quantity of contrast medium administered to the patient. Further studies may lead to the use of this technique for differential diagnoses in other white matter diseases.
Serial magnetic resonance imaging findings are described in a patient with a sporadically occurring pilocytic astrocytoma that underwent spontaneous regression over 6 years. To the authors' knowledge, this is the first report in which spontaneous involution of a pilocytic astrocytoma not associated with neurofibromatosis type 1 has been described. A literature review regarding sporadic and syndrome-associated pilocytic astrocytoma was undertaken, with particular reference to treatment and natural history.
Section 5 covers the field of 'Selected secondary movement disorders' and includes several chapters: Inherited metabolic disorders; Movements that occur in sleep; Cerebral palsy; Drug-induced movement disorders in chidren; Psychogenic movement disorders.Important additional information is then provided in 'Appendix A' on Drug appendix, 'Appendix B' on Search strategy for genetic movement disorders, which is fundamental considering the exponential rise of molecular diagnosis in neuropediatrics, and 'Appendix C', a video atlas which is a very useful tool for the clinician so as to diagnose rare diseases.The chapters are easy to read.Practical tables and diagrams and brain imaging figures are available.Hundreds of references are displayed in all chapters including very recent ones.This book will undoubtedly become a masterpiece, one of the leading resources on movement disorders which should be interesting for all clinicians and researchers in neurology and neuropediatrics who are interested in movement disorders in childhood.
Follow-up magnetic resonance (MR) studies of a child affected by Hallervorden-Spatz disease were performed over a period of 3 years. The hyperintense pallidi shown in the first examination changed to a mixed intensity target-like appearance. All the patterns observed in our patient have been described in the literature but in different subjects. Our data show these findings to be different manifestations of the same disease during its evolution.
Poster: ECR 2015 / C-0322 / CT-guided infiltrative therapies of the sacroiliac joints: long term evaluation of efficacy on wide population by: D'Orazio, L. M. Gregori, F. Smaldone, A. V. Giordano, S. Carducci, A. Splendiani, M. Gallucci; L'Aquila/IT
