bluuebunny/crossref_metadata_2025 huggingface dataset:
Immunogenicity of the Varicella-Zoster Vaccine in Community-Dwelling Non-robust Elderly Individuals Compared to Robust Elderly Individuals: A Prospective Cohort Study
Authors: Choi Jung-Yeon , Kang Min-gu , Park Kyoung Un , Park Wan Beom , Kim Kwang-il , Kim Eu Suk , Kim Hong Bin , Song Kyoung-Ho , Kim Cheol-Ho
Published: December 2018

To determine whether immunogenicity of the herpes zoster live-attenuated vaccine (ZVL) in elderly individuals is influenced by frailty status and cytokine levels, individuals aged at least 65 years were prospectively administered ZVL after their frailty status and cytokine levels were assessed. Humoral and cellular immunogenicity were assessed using enzyme-linked immunosorbent assays for the varicella-zoster virus–specific IgG antibody and varicella-zoster virus–specific enzyme-linked immunospot assays, before and 6 weeks after vaccination. We enrolled 69 participants (mean age, 74.3 years); 31 were non-robust. Thirty-seven participants had a greater than 2 geometric mean fold rise in IgG antibodies, 22 more participants had at least 10 spot-forming cells/106 peripheral blood mononuclear cells (from 35 to 57 participants), and 42 experienced a twofold geometric mean fold rise increase of spot-forming cells 6 weeks after vaccination. The geometric mean fold rises of the antibody titers were similar in the robust and non-robust groups; moreover, the baseline enzyme-linked immunospot assay geometric mean values were not significantly different before or 6 weeks after vaccination. We observed no significant correlations between baseline cytokine levels and immunogenicity. Approximately half of the community-dwelling elderly participants in this study experienced a twofold rise in antibodies and one-third more participants showed at least 10 spot-forming cells after ZVL administration, suggesting that the ZVL can boost immunity in non-robust (especially pre-frail) and robust elderly individuals.
Associations Between Cognitive Abilities and 20-Year Personality Changes in Older Adults in the ILSE Study: Does Health Matter?
Authors: Wettstein Markus , Tauber Benjamin , Wahl Hans-Werner
Published: December 2018

Objectives

We used data from the Interdisciplinary Longitudinal Study on Adult Development (ILSE study) to investigate whether associations of cognitive abilities with late-life personality changes are moderated by individuals’ physical health.

Method

Individuals born between 1930 and 1932 (n = 473; mean baseline age: 62.87 years) were assessed up to four times over a period of about 20 years (M = 20.34 years). Cognitive abilities were assessed based on multiple tests representing various cognitive functions. In addition, the Big Five personality traits were measured. Study participants’ health was rated by a physician based on several in-depth medical examinations.

Results

Health appeared as a significant moderator of the associations between cognitive abilities and personality trajectories: First, lower cognitive abilities were associated with an increase in neuroticism in individuals with poor health, but not in those with good health. Second, lower cognitive abilities were related with an increase in agreeableness in older adults with good health, but with a decrease in agreeableness among those with poor health. Third, better cognitive abilities were associated with stability in conscientiousness, but only among individuals with poorer health.

Discussion

Our findings suggest that once health is compromised, cognitive abilities may become a compensatory resource to prevent undesirable personality changes.
Inter-Individual Variability in Trajectories of Functional Limitations by Race/Gender
Authors: Lin Jielu
Published: December 2018

Objective

Several theories emphasize that systematic interindividual divergence is a key feature of cohort aging and evidence for accumulative social inequality over the life course. While many have documented widening health gaps with age between subgroups, such divergence is only one aspect of the broader social inequality based on race and gender. This article examines patterns of interindividual variability in trajectories of functional limitations within each race/gender.

Methods

Using data from the Health and Retirement Study (HRS)’s HRS cohort (born 1931–1941), I estimate growth curves of functional limitations with Level 2 heteroscedasticity, allowing interindividual variability to differ across 4 groups: white men, black men, white women, and black women. I examine race/gender differences in the age-based pattern of interindividual variability using an interquartile range of estimated individual trajectories.

Results

Black men, white women, and black women have greater interindividual variability in functional limitations than do white men. Interindividual variability increases systematically with age at similar rates for all groups but black women.

Discussion

Functional limitations become more heterogeneous with age for the entire cohort and for white men, white women, and black men. Future research should identify life-course processes that generate the race and gender patterning of interindividual variability in late-life health.
Case 1.19
Authors: Lee Christine U. , Glockner James F.
Published: December 2018

30-year-old woman with a long-standing history of palpitations and lightheadedness; she recently was hospitalized for severe hypertension with hypertensive retinopathy

Coronal SSFSE (Figure 1.19.1), axial fat-suppressed FSE T2-weighted (Figure 1.19.2), and diffusion-weighted (b=600 s/mm2) (Figure 1.19.3) images demonstrate a hyperintense mass in the posterior right hepatic lobe with very high central signal intensity. No associated signal dropout could be seen on IP and OP T1-weighted SPGR images (images not shown). Note the signal loss anteriorly, which is likely secondary to 3-T shading artifact (see ...
Case 2.6
Authors: Lee Christine U. , Glockner James F.
Published: December 2018

52-year-old man with cirrhosis associated with chronic hepatitis C

Axial T1-weighted IP and OP 2D SPGR images (Figure 2.6.1) demonstrate markedly decreased signal throughout the liver and pancreas compared with paraspinal muscle on the IP images. Note also the diffuse parenchymal nodularity of the liver and prominent recanalized paraumbical veins. Axial fat-suppressed T2-weighted FSE images (...
Case 2.10
Authors: Lee Christine U. , Glockner James F.
Published: December 2018

57-year-old woman with a history of PBC status post cadaveric liver transplantation 5 years ago

Axial fat-suppressed T2-weighted FSE (Figure 2.10.1) and axial diffusion-weighted (b=100 s/mm2) (Figure 2.10.2) images demonstrate diffuse, small hyperintense nodules throughout the liver. Axial portal venous phase postgadolinium 3D SPGR images (...
Case 2.14
Authors: Lee Christine U. , Glockner James F.
Published: December 2018

22-year-old man with a long history of Crohn disease involving the large and small bowel

Axial (Figure 2.14.1) and coronal (Figure 2.14.2) postgadolinium 3D SPGR images, as well as a coronal postgadolinium 2D SPGR image (Figure 2.14.3) performed during an MR enterography examination, demonstrate signal void in multiple peripheral portal vein branches....
Case 2.22
Authors: Lee Christine U. , Glockner James F.
Published: December 2018

52-year-old man with chronic liver disease

Axial fat-suppressed T2-weighted FSE images (Figure 2.22.1) and axial IP and OP T1-weighted 2D SPGR images (Figure 2.22.2) demonstrate a cirrhotic liver with innumerable hypointense nodules. Axial arterial, portal venous, and equilibrium phase postgadolinium 3D SPGR images (...
Case 2.32
Authors: Lee Christine U. , Glockner James F.
Published: December 2018

42-year-old woman with a congenital disorder

Axial fat-suppressed T2-weighted FSE (Figure 2.32.1) and 3D SSFP (Figure 2.32.2) images demonstrate hepatomegaly with innumerable diffuse microcysts throughout the liver. Axial diffusion-weighted image (b=100 s/mm2) (Figure 2.32.3) also shows hepatomegaly and a lobulated hepatic contour, and an axial postgadolinium portal venous phase 3D SPGR image (...
Case 2.35
Authors: Lee Christine U. , Glockner James F.
Published: December 2018

57-year-old man with chronic fatigue

Coronal SSFSE (Figure 2.35.1), axial fat-suppressed FSE T2-weighted (Figure 2.35.2), and axial diffusion-weighted (b=600 s/mm2) (Figure 2.35.3) images demonstrate a nodular hepatic contour and multiple heterogeneous, hyperintense, ill-defined nodules throughout the liver. These findings had appeared since a prior MRI less than a year ago....
Case 3.5
Authors: Lee Christine U. , Glockner James F.
Published: December 2018

69-year-old woman with epigastric and retrosternal pain and jaundice

Axial fat-suppressed FSE T2-weighted images (Figure 3.5.1) demonstrate extensive adenopathy in the porta hepatis, as well as heterogeneous, mildly hyperintense masses in the gallbladder and adjacent right hepatic lobe. Note the large gallstone in ...
Case 3.11
Authors: Lee Christine U. , Glockner James F.
Published: December 2018

66-year-old woman with upper abdominal pain radiating to her back, jaundice, nausea, and chills; CT demonstrated intra- and extrahepatic biliary dilatation

MIP image from 3D FRFSE MRCP (Figure 3.11.1) demonstrates diffuse intra- and extrahepatic biliary dilatation extending to the distal CBD, which shows focal narrowing. An intraductal filling defect is seen immediately above the narrowing. Axial fat-suppressed SSFP images (...
Case 3.16
Authors: Lee Christine U. , Glockner James F.
Published: December 2018

57-year-old woman who had an ERCP at an outside institution with diagnosis of PSC potentially complicated by cholangiocarcinoma

MIP image from 3D FRFSE MRCP (Figure 3.16.1) demonstrates dilatation of peripheral biliary ducts in the right and left lobes, with central obstruction. Note also the deformed gallbladder. Axial 2D fat-suppressed SSFP images (...
Case 4.1
Authors: Lee Christine U. , Glockner James F.
Published: December 2018

51-year-old man with possible cholangiocarcinoma

MIP image from 3D FRFSE MRCP (Figure 4.1.1) demonstrates that the main pancreatic duct drains into the duodenum at the minor papilla, separate from the common bile duct.

Pancreas divisum

Pancreas divisum is the most common pancreatic developmental anomaly, with an estimated prevalence of 4% to 15%. It occurs when the ducts of the dorsal and ventral pancreatic buds fail to fuse. This results in the main pancreatic duct draining into the duodenum at the minor papilla via the duct of Santorini, separate from the common bile duct, which drains into the major papilla. (With normal development, the ventral duct of Wirsung fuses with the main pancreatic duct of the body and tail and drains into the major papilla with the common bile duct.)...
Case 4.4
Authors: Lee Christine U. , Glockner James F.
Published: December 2018

56-year-old man with abdominal pain; sonography was unrevealing except for a possible mass in the pancreatic tail, and MRI was suggested for further assessment

Respiratory-triggered fat-suppressed FSE T2-weighted image (Figure 4.4.1) reveals a small hyperintense lesion in the pancreatic tail, which demonstrates mild hyperenhancement on arterial phase postgadolinium 3D SPGR image (...
Case 4.5
Authors: Lee Christine U. , Glockner James F.
Published: December 2018

58-year-old man with a history of prostate cancer and a possible pancreatic mass on CT

Axial fat-suppressed FSE T2-weighted images obtained before (Figure 4.5.1) and after (Figure 4.5.2) administration of an SPIO contrast agent demonstrate an ovoid mass in the pancreatic tail with intermediate signal intensity that becomes significantly hypointense after SPIO administration and matches the signal intensity of the spleen....
Case 4.9
Authors: Lee Christine U. , Glockner James F.
Published: December 2018

72-year-old woman with chronic abdominal pain and a previous episode of pancreatitis 5 years ago

Axial fat-suppressed 2D SSFP images (Figure 4.9.1) reveal marked diffuse dilatation of the pancreatic duct without any visible pancreatic parenchyma. Note also a large filling defect in the duct at the pancreatic head and a smaller filling defect in the body of the pancreas. MIP image from 3D FRFSE MRCP (...
Case 4.24
Authors: Lee Christine U. , Glockner James F.
Published: December 2018

66-year-old woman with loss of appetite, weight loss, fatigue, and upper abdominal pain

VR image from 3D contrast-enhanced MRA (Figure 4.24.1) shows marked irregularity of the distal splenic artery. Axial diffusion-weighted image (b=600 s/mm2) (Figure 4.24.2) reveals a hyperintense mass in the pancreatic tail. Axial arterial phase postgadolinium 3D SPGR images (...
Case 4.28
Authors: Lee Christine U. , Glockner James F.
Published: December 2018

63-year-old man with abdominal pain

VR image from 3D FRFSE MRCP (Figure 4.28.1) demonstrates focal dilatation of the pancreatic duct in the tail of the pancreas. Note also moderate diffuse intrahepatic biliary dilatation. Axial fat-suppressed SSFP images (Figure 4.28.2) reveal a mass enlarging the pancreatic body, dilatation of the pancreatic duct proximally in the tail, and atrophy of the pancreatic tail. Axial equilibrium phase postgadolinium 3D SPGR images (...
Case 5.4
Authors: Lee Christine U. , Glockner James F.
Published: December 2018

59-year-old man with a recent diagnosis of renal cell carcinoma and CT that showed an incidental splenic lesion

Axial fat-suppressed FSE T2- weighted images before (Figure 5.4.1A) and after (Figure 5.4.1B) administration of ferumoxides (Feridex) show a large mass in the anterior spleen with mild heterogeneity and signal intensity similar to that of the adjacent spleen. Postcontrast images (...
Case 5.10
Authors: Lee Christine U. , Glockner James F.
Published: December 2018

77-year-old man with a history of renal insufficiency and weight loss

Coronal SSFSE (Figure 5.10.1) and axial fat-suppressed FRFSE images (Figure 5.10.2) show large mildly hyperintense masses in the spleen. These are hypovascular on portal venous phase 3D SPGR images (...
Case 5.14
Authors: Lee Christine U. , Glockner James F.
Published: December 2018

20-year-old woman with a history of hemoglobinopathy

Axial fat-suppressed FSE T2-weighted image (Figure 5.14.1) and axial in-phase SPGR image (Figure 5.14.2) show a small spleen with decreased T2-signal intensity and markedly decreased signal on the in-phase image. Axial postgadolinium 2D SPGR image (...
Case 5.17
Authors: Lee Christine U. , Glockner James F.
Published: December 2018

50-year-old man with a history of hepatitis C and cirrhosis

Axial in-phase and out-of-phase 2D SPGR images (Figure 5.17.1) show a cirrhotic liver with moderate splenomegaly. The spleen contains multiple hypointense nodules that show signal loss on in-phase images relative to out-of-phase images. The low-signal-intensity lesions are also seen on axial fat-suppressed FSE T2-weighted image (...
Case 6.1
Authors: Lee Christine U. , Glockner James F.
Published: December 2018

24-year-old postpartum woman with right-sided pelvic discomfort, fever, and elevated white blood cell count several days after normal vaginal delivery; abdominal pelvic noncontrast CT showed a right adrenal mass, and MRI was performed for further characterization

Coronal SSFSE image (Figure 6.1.1) demonstrates a large right adrenal cystic lesion with imperceptible margins and no nodules or septations. Axial fat-suppressed FSE T2-weighted image (...
Case 7.6
Authors: Lee Christine U. , Glockner James F.
Published: December 2018

62-year-old woman with ADPKD and new onset anorexia, weight loss, night sweats, and fever

Coronal SSFP (Figure 7.6.1) and axial fat-suppressed SSFP (Figure 7.6.2) images reveal enlarged, polycystic kidneys. There is a relatively hypointense mass in the lower pole of the left kidney. Axial diffusion-weighted image (b=800 s/mm...
Case 7.26
Authors: Lee Christine U. , Glockner James F.
Published: December 2018

62-year-old woman with acute on chronic renal failure and a history of bipolar disorder

Axial fat-suppressed SSFP (Figure 7.26.1) and coronal SSFSE (Figure 7.26.2) images reveal innumerable small cysts throughout both kidneys. Coronal SSFSE images (Figure 7.26.3) of a second patient with less severe disease demonstrate multiple small cysts involving both kidneys....
Case 7.29
Authors: Lee Christine U. , Glockner James F.
Published: December 2018

72-year-old man with left flank pain and a history of bleeding diathesis, for which he takes warfarin

Axial FSE T2-weighted image (Figure 7.29.1) reveals a posterior left perinephric mass with heterogeneous increased signal intensity. Axial diffusion- weighted image (b=800 s/mm2) and the corresponding ADC map (...
Case 8.4
Authors: Lee Christine U. , Glockner James F.
Published: December 2018

35-year-old woman with urge and stress incontinence

Axial FSE T2-weighted images with (Figure 8.4.1) and without (Figure 8.4.2) fat suppression demonstrate a crescentic cystic lesion wrapping around the posterolateral margin of the urethra. Axial postgadolinium 2D SPGR image (Figure ...
Case 8.14
Authors: Lee Christine U. , Glockner James F.
Published: December 2018

77-year-old man with intermittent, increasing gross hematuria

Axial fat-suppressed T2-weighted FSE images (Figure 8.14.1) show marked diffuse thickening of the bladder wall, with relatively low mural signal intensity. A volume-rendered image from 3D FRFSE noncontrast MR urography (Figure 8.14.2) reveals mild left hydronephrosis and hydroureter with severe distortion of the bladder lumen by the thickened walls (note also the left renal cyst)....
Case 8.22
Authors: Lee Christine U. , Glockner James F.
Published: December 2018

62-year-old man with previous radical cystectomy and neobladder formation for urothelial cell carcinoma

Coronal oblique arterial phase 3D SPGR images from gadolinium MR urography (Figure 8.22.1) demonstrate multiple enhancing nodules in the distal ureter, as well as a small nodule in the renal pelvis. These lesions appear as filling defects on 10-minute delayed images (...
Case 8.24
Authors: Lee Christine U. , Glockner James F.
Published: December 2018

65-year-old woman with a congenitally absent left kidney and hematuria

Axial fat-suppressed FSE T2-weighted images (Figure 8.24.1) show a soft tissue mass involving much of the renal pelvis and causing hydronephrosis, most marked in the upper pole. Axial postgadolinium 3D SPGR images (...
Case 9.3
Authors: Lee Christine U. , Glockner James F.
Published: December 2018

39-year-old man with early satiety and postprandial discomfort

Coronal T1-weighted FSE images (Figure 9.3.1) show herniation of the stomach through the diaphragmatic hiatus, as well as a large quantity of peritoneal fat and a portion of the transverse colon.

Large hiatal hernia with intrathoracic stomach...
Case 9.8
Authors: Lee Christine U. , Glockner James F.
Published: December 2018

79-year-old woman admitted to the hospital with obstructive uropathy and acute renal failure; cystoscopy showed a bladder mass obstructing the ureters. She also reports intermittent nausea and vomiting; a recent endoscopy noted duodenal stenosis

Coronal fat-suppressed 2D SSFP images (Figure 9.8.1) and coronal reformatted postcontrast CT images (...
Case 9.9
Authors: Lee Christine U. , Glockner James F.
Published: December 2018

35-year-old woman with chronic illness

Axial gadolinium-enhanced 3D SPGR images (Figure 9.9.1) demonstrate marked mural thickening and enhancement of the terminal ileum. At least 2 additional focal areas of involvement are seen in the distal ileum. The coronal 3D SPGR image (...
Case 9.12
Authors: Lee Christine U. , Glockner James F.
Published: December 2018

89-year-old woman with abdominal pain and nausea and vomiting; abdominal MRA was requested to assess for mesenteric ischemia

Coronal SSFSE images (Figure 9.12.1) demonstrate protrusion of a loop of ileum into the right inguinal canal. Axial fat-suppressed 2D SPGR images (Figure ...
Case 9.14
Authors: Lee Christine U. , Glockner James F.
Published: December 2018

60-year-old man with anemia and progressive fatigue

Coronal SSFP (Figure 9.14.1) and postgadolinium 3D SPGR (Figure 9.14.2) images show a focal nonobstructive mass in the cecum, with mural thickening and hyperenchancement.

Cecal adenocarcinoma

Colorectal carcinoma is the second leading cause of cancer death (after lung cancer) in the United States. Incidence rates have remained relatively stable over the past 30 years while the mortality rate has decreased, particularly in women. Most colorectal cancers arise from adenomatous polyps, which are common in middle-aged and elderly patients. Screening and autopsy studies describe an incidence of more than 30%, although less than 1% of these polyps become malignant....
Case 9.16
Authors: Lee Christine U. , Glockner James F.
Published: December 2018

54-year-old woman with a history of epigastric pain. MRA was requested to assess for mesenteric ischemia

Coronal SSFSE images (Figure 9.16.1) demonstrate a dilated, fluid-filled appendix without appreciable periappendiceal inflammation.

Appendiceal mucocele

Appendiceal mucocele is a generic term describing an appendix distended by mucus. A rare condition, appendiceal mucocele has a prevalence of 0.2% to 0.3% in appendectomy specimens. Mucoceles have been divided into 4 histologic subtypes: mucus retention cyst (the diagnosis in this case), mucosal hyperplasia, mucinous cystadenoma, and invasive mucinous cystadenocarcinoma. Most benign mucoceles are asymptomatic and are incidental findings at abdominal imaging or physical examination. Lesions may become symptomatic with superinfection, intussusception, or torsion....
Case 9.22
Authors: Lee Christine U. , Glockner James F.
Published: December 2018

23-year-old man with a history of Crohn disease and previous ileocecal resection, now with abdominal pelvic pain, bloody diarrhea, and a suspected perianal fistula

Axial postgadolinium 3D SPGR images (Figure 9.22.1) demonstrate moderate thickening of the sigmoid colon consistent with Crohn colitis and severe diffuse thickening and heterogeneous enhancement of the rectum. Note the prominent perirectal and right inguinal adenopathy, as well as perirectal fibrofatty proliferation that is likely secondary to chronic inflammation....
Case 10.2
Authors: Lee Christine U. , Glockner James F.
Published: December 2018

15-year-old girl with imperforate hymen

Sagittal oblique (Figure 10.2.1) and axial (Figure 10.2.2) FSE T2-weighted images demonstrate cystic lesions along the anterior wall of the mid-distal vagina.

Gartner duct cysts

Gartner duct cysts represent remnants of the mesonephric or wolffian ducts that involute in the absence of a Y chromosome. These cysts arise from the anterolateral wall of the vagina above the level of the pubic symphysis and usually contain simple fluid. There is a small increased incidence of developmental anomalies of the genitourinary tract associated with the presence of Gartner duct cysts, and some authors have advocated large field-of-view coronal acquisitions to include the kidneys when a cyst is discovered on pelvic MRI. Logistically, this is often difficult to manage unless you simply include a large field-of-view 3-plane localizer in your routine female pelvis protocol....
Case 10.5
Authors: Lee Christine U. , Glockner James F.
Published: December 2018

81-year-old woman with abnormal Papanicoulaou smear

Sagittal FSE T2-weighted images (Figure 10.5.1) obtained after instillation of vaginal US gel demonstrate a large, mildly heterogeneous, well-defined lesion in the anterior proximal vagina. Sagittal arterial phase postgadolinium 3D SPGR images (Figure 10.5.2) reveal moderate diffuse enhancement of the lesion. Axial 3D SPGR image obtained 7 minutes after contrast injection (...
Case 10.6
Authors: Lee Christine U. , Glockner James F.
Published: December 2018

40-year-old woman with metastatic breast cancer and an abnormal vaginal examination

Axial FSE T2-weighted images (Figure 10.6.1) reveal a crescentic, mildly hyperintense mass involving the right anterolateral vaginal wall. Sagittal arterial phase postgadolinium 3D SPGR image (Figure 10.6.2) shows intense enhancement of the lesion in the midanterior vagina....
Case 10.24
Authors: Lee Christine U. , Glockner James F.
Published: December 2018

36-year-old woman with abnormal obstetric US

Coronal oblique SSFSE images (Figure 10.24.1) demonstrate the placenta completely covering the cervical os.

Placenta previa

MRI is not generally required to make the diagnosis of placenta previa, but it can be helpful in complicated cases and in patients for whom sonography is less than optimal. The placenta is named after the Greek term ...
Case 11.4
Authors: Lee Christine U. , Glockner James F.
Published: December 2018

21-year-old woman with sudden onset of severe abdominal pain

Sagittal images from a 3-plane SSFSE localizer (Figure 11.4.1) demonstrate an enlarged low-signal-intensity ovary with a large adjacent tubular cystic structure. Axial fat-suppressed FSE T2-weighted images (Figure 11.4.2) again reveal a large hypointense left ovary containing a few small follicles, as well as an adjacent large cystic structure medially with a thickened edematous wall and a small amount of associated free fluid. Axial postgadolinium 2D SPGR images (...
Case 11.10
Authors: Lee Christine U. , Glockner James F.
Published: December 2018

57-year-old asymptomatic woman with a pelvic mass palpated during routine physical examination

Axial fat-suppressed FSE T2-weighted images (Figure 11.10.1) reveal a large cystic lesion in the pelvis, with a partial septation anteriorly. Coronal FSE T2-weighted image (Figure 11.10.2) shows similar findings. An axial FSE T1-weighted image (...
Case 11.14
Authors: Lee Christine U. , Glockner James F.
Published: December 2018

82-year-old woman with a distended, mildly painful abdomen and palpable pelvic mass

Axial fat-suppressed FSE T2-weighted images (Figure 11.14.1) demonstrate a large complex mass in the central pelvis containing both cystic and solid elements. Coronal postgadolinium 2D SPGR images (Figure 11.14.2...
Case 11.15
Authors: Lee Christine U. , Glockner James F.
Published: December 2018

70-year-old woman with a history of ovarian carcinoma

Coronal SSFSE images (Figure 11.15.1) demonstrate a large, predominantly solid right adnexal mass, with a simple-appearing cystic lesion in the left ovary. Note the abdominal pelvic ascites and small solid nodules between the diaphragm and liver, as well as confluent omental masses below the transverse colon on the most anterior image. Axial diffusion-weighted images (b=600 s/mm...
Case 12.1
Authors: Lee Christine U. , Glockner James F.
Published: December 2018

36-year-old man with a history of previous orchiectomy for testicular carcinoma

Coronal fat-suppressed 2D SSFP images (Figure 12.1.1) reveal large, septated, predominantly cystic retroperitoneal masses in the periaortic and aortocaval regions of the midabdomen. Axial postgadolinium 3D SPGR images (Figure 12.1.2...
Case 12.8
Authors: Lee Christine U. , Glockner James F.
Published: December 2018

56-year-old man with obstructive urinary symptoms and a urethral stricture on a retrograde urethrogram

Axial FSE T1-weighted image (Figure 12.8.1) reveals a hypointense lesion centrally in the mid–penile urethra. The lesion is markedly hypointense on coronal oblique fat-suppressed T2-weighted FSE images (...
Case 12.10
Authors: Lee Christine U. , Glockner James F.
Published: December 2018

53-year-old man with a penile mass

Sagittal fat-suppressed FSE T2-weighted images (Figure 12.10.1) demonstrate a lobulated ill-defined mass in the tip of the penis involving both the corpora cavernosa and the corpus spongiosum. Sagittal postgadolinium 2D SPGR images (Figure 12.10.2) reveal heterogeneous enhancement of the lesion without clear visualization of the tunica albuginea....
Case 12.12
Authors: Lee Christine U. , Glockner James F.
Published: December 2018

54-year-old man with a history of a prior cystectomy for bladder urothelial cell carcinoma

Axial FSE T2-weighted images (Figure 12.12.1) reveal multiple hypointense masses in both corpora cavernosa (more prominent in the left than in the right) and in the base of the corpus spongiosum....
Case 12.13
Authors: Lee Christine U. , Glockner James F.
Published: December 2018

46-year-old asymptomatic man with a palpable mass above the prostate on digital rectal examination

Sagittal (Figure 12.13.1) and axial (Figure 12.13.2) FSE T2-weighted images reveal a complex multicystic lesion involving the right side of the seminal vesicle. Axial T1-weighted FSE image (...
Case 12.25
Authors: Lee Christine U. , Glockner James F.
Published: December 2018

7-year-old boy with urinary retention and a pelvic mass

Axial T2-weighted 3D FSE images (Figure 12.25.1) reveal a heterogeneous high-signal-intensity mass replacing the prostate. Axial (Figure 12.25.2), coronal (Figure 12.25.3), and sagittal (Figure 12.25.4) postgadolinium 2D SPGR images demonstrate a large prostate mass with heterogeneous enhancement and regions of necrosis....
Case 13.1
Authors: Lee Christine U. , Glockner James F.
Published: December 2018

80-year-old man with a left lower lobe adenocarcinoma, for which he is receiving radiotherapy, presents with cough and shortness of breath; MRI was requested to evaluate for pulmonary embolus

Coronal oblique images from 3D contrast-enhanced pulmonary MRA (Figure 13.1.1) reveal filling defects in the left main pulmonary artery and both lobar arteries....
Case 13.17
Authors: Lee Christine U. , Glockner James F.
Published: December 2018

38-year-old man with progressive chest pressure and dyspnea

Systolic (Figure 13.17.1A) and early diastolic (Figure 13.17.1B) frames from a 3-chamber cine SSFP acquisition demonstrate thickening of the basal anteroseptal wall. Note in systole the dark jet of mitral insufficiency directed posteriorly. Short-axis MDE images (...
Case 13.22
Authors: Lee Christine U. , Glockner James F.
Published: December 2018

69-year-old woman with a chronic abnormality on echocardiogram and mildly reduced left ventricular function

Two-chamber end-diastolic (Figure 13.22.1) and end-systolic (Figure 13.22.2) frames from a cine SSFP acquisition demonstrate thinning of the mid-apical left ventricular myocardium with extensive trabeculations within the left ventricular cavity....
Case 13.26
Authors: Lee Christine U. , Glockner James F.
Published: December 2018

62-year-old asymptomatic man with a heart murmur on physical examination; echocardiography revealed a cardiac mass, and MRI was requested for further characterization

Sagittal oblique black-blood double (Figure 13.26.1) and triple (Figure 13.26.2) inversion recovery FSE images through the RVOT demonstrate a well-circumscribed ovoid mass with markedly increased signal intensity on the T2-weighted triple inversion recovery image. Axial proton density-weighted double inversion recovery images (...
Case 13.27
Authors: Lee Christine U. , Glockner James F.
Published: December 2018

36-year-old woman with hemoptysis and abnormal findings on CT

Axial proton density-weighted double inversion recovery FSE images (Figure 13.27.1) demonstrate a heterogeneous mass infiltrating the right atrium, the right atrioventricular groove, and the base of the right ventricle. Horizontal long-axis (Figure ...
Case 14.12
Authors: Lee Christine U. , Glockner James F.
Published: December 2018

52-year-old woman with an enlarging mass in her lower abdomen

Axial FSE T1-weighted image (Figure 14.12.1) and fat-suppressed T2-weighted images (Figure 14.12.2) reveal a large pelvic mass that is mildly hypointense relative to skeletal muscle on the T1-weighted image and heterogeneously hyperintense on the T2-weighted images with a region of focal scarring anteriorly. Axial postgadolinium 2D SPGR images (...
Case 14.13
Authors: Lee Christine U. , Glockner James F.
Published: December 2018

65-year-old woman with a pelvic mass

Axial (Figure 14.13.1A) and coronal (Figure 14.13.1B) T1-weighted FSE images and axial (Figure 14.13.2A) and coronal (Figure 14.13.2B) fat-suppressed T2-weighted FSE images demonstrate a dumbbell-shaped lesion extending from the pelvis through the left sciatic notch. The mass consists almost entirely of fat but does have several thin septations. Axial and coronal postgadolinium 2D SPGR images (...
Case 14.16
Authors: Lee Christine U. , Glockner James F.
Published: December 2018

57-year-old woman with leg numbness, hip pain, and diminished energy

Axial fat-suppressed FSE T2-weighted images (Figure 14.16.1) demonstrate a large pelvic mass displacing the bladder anteriorly with heterogeneous mildly increased signal intensity. Note also several small serpiginous flow voids within the lesion as well as a Foley catheter balloon in the collapsed bladder. Axial (...
Case 14.17
Authors: Lee Christine U. , Glockner James F.
Published: December 2018

30-year-old woman with a history of neurofibromatosis and a painful right thigh mass

Axial (Figure 14.17.1A) and coronal (Figure 14.17.1B) FSE T1-weighted images and axial (Figure 14.17.2A) and coronal (Figure 14.17.2B) fat-suppressed FSE T2-weighted images reveal a large heterogeneous mass in the right pelvis extending into the groin with high signal intensity on T2-weighted images and regions of low and high signal intensity on T1-weighted images. Axial (...
Case 14.25
Authors: Lee Christine U. , Glockner James F.
Published: December 2018

60-year-old man with a history of prostate carcinoma

Axial (Figure 14.25.1A and 14.25.1B) and coronal (Figure 14.25.1C) T1-weighted FSE images and axial (Figure 14.25.2A and 14.25.2B) and coronal (Figure 14.25.2C) fat-suppressed T2-weighted FSE images reveal innumerable small lesions involving the lumbar spine, pelvic bones, and proximal femurs, which show decreased T1-signal intensity and increased T2-signal intensity relative to normal marrow....
Case 15.1
Authors: Lee Christine U. , Glockner James F.
Published: December 2018

71-year-old woman with a right breast mass and trouble using her right arm

The MIP image at peak enhancement with CAD color overlay (Figure 15.1.1A) demonstrates a large fungating mass in the right breast that has marked enhancement and involves the right side of the chest wall and right axilla. These findings are also evident on the MIP image without the CAD color overlay (...
Case 15.6
Authors: Lee Christine U. , Glockner James F.
Published: December 2018

55-year-old woman with bilateral augmentation mammoplasties 30 years ago, now with a palpable asymmetry in the right breast

Sagittal 2D IR image with fat suppression and selective water suppression of the right breast (Figure 15.6.1) demonstrates a well-circumscribed area of silicone signal and the linguine sign. ...
Case 15.7
Authors: Lee Christine U. , Glockner James F.
Published: December 2018

65-year-old woman with bilateral breast implants placed 25 years ago presents with increasing capsular contracture

Axial (Figure 15.7.1) and bilateral sagittal (right, Figure 15.7.2A; left, Figure 15.7.2B) IR images with fat suppression and selective water suppression demonstrate silicone outside of the fibrous capsule bilaterally. Intracapsular rupture of both implants is indicated by the teardrop signs and subcapsular line signs in both breasts....
Case 16.8
Authors: Lee Christine U. , Glockner James F.
Published: December 2018

67-year-old woman with mild abdominal discomfort after eating

Anterior (Figure 16.8.1A) and oblique (Figure 16.8.1B) VR images from 3D CE MRA and anterior (Figure 16.8.2A) and oblique (Figure 16.8.2B) images from an immediate delayed acquisition demonstrate near occlusion of the abdominal aorta just below the renal artery origins with massive dilatation of the superior mesenteric artery and the inferior mesenteric artery and a large arc of Riolan supplying the infrarenal aorta....
Case 16.12
Authors: Lee Christine U. , Glockner James F.
Published: December 2018

31-year-old man with a history of hypertension that was diagnosed at age 10

Sagittal oblique VR images (Figure 16.12.1) and a partial volume MIP image (Figure 16.12.2) from 3D CE MRA reveal severe focal narrowing of the proximal descending thoracic aorta just distal to the origin of the left subclavian artery. Note also enlarged internal mammary and intercostal arteries representing sources of collateral blood flow to the descending aorta....
Case 16.17
Authors: Lee Christine U. , Glockner James F.
Published: December 2018

66-year-old woman with new-onset hypertension and weight loss; laboratory investigations revealed anemia, an elevated erythrocyte sedimentation rate, and an increased C-reactive protein level

Sagittal oblique image from navigator-gated, ECG-gated, fat-suppressed 3D SSFP acquisition of the thoracic aorta (Figure 16.17.1) reveals a large irregular filling defect in the posterior arch and proximal descending aorta. Sagittal oblique ECG-gated double (...
Case 17.2
Authors: Lee Christine U. , Glockner James F.
Published: December 2018

70-year-old man with newly diagnosed prostate cancer; prostate MRI was requested for preoperative staging

Axial FSE T1-weighted image (Figure 17.2.1) and sagittal FSE T2-weighted image (Figure 17.2.2) demonstrate a normally functioning endorectal prostate coil with high signal intensity along the margin of the coil, dropping off as the distance from the coil increases. Axial pregadolinium (...
Case 17.3
Authors: Lee Christine U. , Glockner James F.
Published: December 2018

24-year-old woman with suspected renal abscess

Axial images from SSFSE 3-plane scout sequence (Figure 17.3.1) show localized artifact in the posterior left lower abdomen. The artifact is much more prominent on axial IP (Figure 17.3.2A) and OP (Figure 17.3.2B...
Case 17.4
Authors: Lee Christine U. , Glockner James F.
Published: December 2018

82-year-old man with increasing prostate-specific antigen following prostatectomy

Axial FSE T1-weighted images performed on a 3-T system (Figure 17.4.1) demonstrate prominent artifact arising from surgical clips in the pelvis. This artifact is accentuated on corresponding axial 3D SPGR images (Figure 17.4.2...
Case 17.9
Authors: Lee Christine U. , Glockner James F.
Published: December 2018

24-year-old woman with suspected renal abscess

Axial arterial (Figure 17.9.1A), portal venous (Figure 17.9.1B), and equilibrium phase (Figure 17.9.1C) postgadolinium 3D SPGR images demonstrate an apparent small ring-enhancing lesion in the posterior right hepatic lobe. Axial precontrast 3D SPGR images (...
Case 17.15
Authors: Lee Christine U. , Glockner James F.
Published: December 2018

53-year-old woman with chronic kidney disease

Coronal SSFSE image (Figure 17.15.1) demonstrates massive enlargement of the right kidney, which contains multiple fatty lesions as well as several round nodules. The left kidney is surgically absent. Coronal respiratory-triggered FSE T2-weighted image (Figure ...
Case 17.16
Authors: Lee Christine U. , Glockner James F.
Published: December 2018

55-year-old woman with fecal incontinence

Sagittal SSFSE images from a dynamic proctography examination (Figure 17.16.1) demonstrate heterogeneous abnormal signal throughout the bladder. Sagittal SSFP images (following administration of rectal contrast) (Figure 17.16.2) show no abnormality within the bladder.
Case 17.22
Authors: Lee Christine U. , Glockner James F.
Published: December 2018

51-year-old woman with a complex cystic lesion in the left kidney

Axial precontrast 3D SPGR images (Figure 17.22.1) reveal an exophytic lesion in the lower pole of the left kidney containing a posterior region with low signal intensity, a thin septation encompassing a small lateral nodule with markedly high signal intensity, and an anterior component with moderately high signal intensity. Axial venous phase postgadolinium images in the same location (...
Case 17.26
Authors: Lee Christine U. , Glockner James F.
Published: December 2018

82-year-old woman with giant cell arteritis

Coronal MIP image from 3D CE MRA (Figure 17.26.1) demonstrates poor bolus timing (for the requested examination of the thoracic aorta). Anterior (Figure 17.26.2A) and posterior (Figure 17.26.2B) VR images show slightly improved visualization of the thoracic aorta....
Case 17.31
Authors: Lee Christine U. , Glockner James F.
Published: December 2018

49-year-old woman with a history of invasive right breast cancer with extensive ductal carcinoma in situ; she has undergone mastectomy and reconstruction with a saline implant

Axial water image (Figure 17.31.1A) from a T2-weighted FSE acquisition using a modified 3-point Dixon (IDEAL) method for fat suppression demonstrates water signal in a right breast implant. There is also a minimal amount of right pleural fluid. Axial FSE IR image with fat suppression and selective water suppression (silicone image) (...
Farnesol inhibits planktonic cells and antifungal-tolerant biofilms of Trichosporon asahii and Trichosporon inkin
Authors: Cordeiro Rossana de Aguiar , Pereira Lívia Maria Galdino , de Sousa José Kleybson , Serpa Rosana , Andrade Ana Raquel Colares , Portela Fernando Victor Monteiro , Evangelista Antônio José de Jesus , Sales Jamille Alencar , Aguiar Ana Luiza Ribeiro , Mendes Patrícia Bruna Leite , Brilhante Raimunda Sâmia Nogueira , Sidrim José Júlio da Costa , Castelo-Branco Débora de Souza Collares Maia , Rocha Marcos Fabio Gadelha
Published: December 2018

Trichosporon species have been considered important agents of opportunistic systemic infections, mainly among immunocompromised patients. Infections by Trichosporon spp. are generally associated with biofilm formation in invasive medical devices. These communities are resistant to therapeutic antifungals, and therefore the search for anti-biofilm molecules is necessary. This study evaluated the inhibitory effect of farnesol against planktonic and sessile cells of clinical Trichosporon asahii (n = 3) andTrichosporon inkin (n = 7) strains. Biofilms were evaluated during adhesion, development stages and after maturation for metabolic activity, biomass and protease activity, as well as regarding morphology and ultrastructure by optical microscopy, confocal laser scanning microscopy, and scanning electron microscopy. Farnesol inhibited Trichosporon planktonic growth by 80% at concentrations ranging from 600 to 1200 μM for T. asahii and from 75 to 600 μM for T. inkin. Farnesol was able to reduce cell adhesion by 80% at 300 μM for T. asahii and T. inkin at 600 μM, while biofilm development of both species was inhibited by 80% at concentration of 150 μM, altering their structure. After biofilm maturation, farnesol decreased T. asahii biofilm formation by 50% at 600 μM concentration and T. inkin formation at 300 μM. Farnesol inhibited gradual filamentation in a concentration range between 600 and 1200 μM. Farnesol caused reduction of filament structures of Trichosporon spp. at every stage of biofilm development analyzed. These data show the potential of farnesol as an anti-biofilm molecule.
Podocytopathy in the mesangial proliferative immunoglobulin A nephropathy: new insights into the mechanisms of damage and progression
Authors: Trimarchi Hernán , Coppo Rosanna
Published: December 2018

Immunoglobulin A nephropathy (IgAN) was defined as a mesangiopathic disease, since the primary site of deposition of IgA immune material is the mesangium, and proliferation of mesangial cells and matrix excess deposition are the first histopathologic lesions. However, the relentless silent progression of IgAN is mostly due to the development of persistent proteinuria, and recent studies indicate that a major role is played by previous damage of function and anatomy of podocytes. In IgAN, the podocytopathic changes are the consequence of initial alterations in the mesangial area with accumulation of IgA containing immune material. Podocytes are therefore affected by interactions of messages originally driven from the mesangium. After continuous insult, podocytes detach from the glomerular basement membrane. This podocytopathy favours not only the development of glomerular focal and segmental sclerosis, but also the progressive renal function loss. It is still debated whether these lesions can be prevented or cured by corticosteroid/immunosuppressive treatment. We aimed to review recent data on the mechanisms implicated in the podocytopathy present in IgAN, showing new molecular risk factors for progression of this disease. Moreover, these observations may indicate that the target for new drugs is not only focused on decreasing the activity of mesangial cells and inflammatory reactions in IgAN, but also on improving podocyte function and survival.
Prospective Evaluation of Multinational Association of Supportive Care in Cancer Risk Index Score for Gynecologic Oncology Patients With Febrile Neutropenia
Authors: Gunderson Camille C. , Erickson Britt K. , Wilkinson-Ryan Ivy , Vesely Sara K. , Leath Charles A. , Gehrig Paola A. , Moore Kathleen N.
Published: December 2018

Background:

The Multinational Association of Supportive Care of Cancer (MASCC) risk-index score has been validated as a stratification tool for febrile neutropenia (FN) risk in a heterogeneous group of cancer patients; recently, it has been deemed a suitable tool in gynecologic oncology patients in a retrospective study. This is a prospective multi-institutional study wherein we sought to validate MASCC score for stratifying FN morbidity in gynecologic oncology patients.

Methods:

IRB approval was obtained at 4 institutions for prospective data collection of gynecologic cancer patients admitted with FN from 3/1/2013 to 9/1/2014. Participating institutions have a policy of inpatient management of FN patients receiving chemotherapy. Deidentified data was compiled and processed at the leading institution.

Results:

In total, 31 patients met inclusion criteria. Most had advanced stage disease (67%). 100% of patients were receiving chemotherapy (57% for primary, 43% for recurrent disease). 55% had a positive culture. Median MASCC score was 21 (range, 10 to 26); 58% of patients were considered low risk. High risk patients more often had one (11% vs. 38%, P=0.09) or multiple (6% vs. 23%, P=0.28) severe complications, ICU admission (0% vs. 15%, P=0.17), and delay in next chemotherapy cycle (33% vs. 54%, P=0.25). No patients died from FN during the study period.

Conclusions:

This pilot data suggests that MASCC score may be a promising tool for determining suitability of outpatient management of FN in gynecologic oncology patients. Larger studies are warranted to achieve statistically significant results, which may enable us to effectively utilize this risk stratification tool for cost containment and avoidance of nosocomial infections.
DETERMINING THE EFFECT OF DIABETES DURATION ON RETINAL AND CHOROIDAL THICKNESSES IN CHILDREN WITH TYPE 1 DIABETES MELLITUS
Authors: Niestrata-Ortiz Magdalena , Fichna Piotr , Stankiewicz Witold , Stopa Marcin
Published: December 2018

Purpose:

Determining the effect of diabetes mellitus duration on retinal and choroidal thicknesses in children with Type 1 diabetes mellitus (T1DM).

Methods:

Children (aged 6–18 years) with Type 1 diabetes and no diabetic retinopathy and age-matched controls were examined using Topcon spectral domain optical coherence tomography. Choroidal thickness and retinal thickness in macula area were measured. The study group was divided into 3 subgroups depending on diabetes mellitus duration—Group 1: <5 years (n = 52), Group 2: 5 to 10 years (n = 39), and Group 3: >10 years (n = 30).

Results:

One hundred and twenty-one diabetic children and 32 controls were included. The central choroidal thickness increased from 305.5 μm (SD: 61.7 μm) in the control group to 309.2 μm (SD: 70.1 μm) in Group 1, 315.2 μm (SD: 64.3 μm) in Group 2, and 367.4 μm (SD: 66.0 μm) in Group 3. Group 3 differed significantly from Group 1 (P = 0.0002), Group 2 (P = 0.0014), and the control group (P = 0.0003). The choroid-to-retina thickness ratio was lowest in controls, 1.01 (SD: 0.17), and highest in Group 3, 1.21 (SD: 0.2). Group 3 differed significantly from Group 1, Group 2, and the control group with P = 0.0002, P = 0.0014, and P = 0.0001, respectively. No retina thickening was found.

Conclusion:

Changes in the choroid may occur before the development of diabetic retinopathy and seem to progress with increasing diabetes mellitus duration despite the absence of diabetic retinopathy and without associated retina thickening. Choroidal thickness could be valuable for screening in diabetic children.