Objective. To search brain perfusion MRI (pMRI) changes in Behcet's disease (BD) with or without neurological involvement. Materials and Method. The pMRI were performed in 34 patients with BD and 16 healthy controls. Based on neurologic examination and post-contrast MRI, 12 patients were classified as Neuro-Behcet (group 1, NBD) and 22 patients as BD without neurological involvement (group 2). Mean transit time (MTT), time to peak (TTP), relative cerebral blood volume (rCBV), and relative cerebral blood flow (rCBF) were obtained and compared to those of healthy control group (group 3). Results. There was a significant difference in the MTT and rCBF within the pons and parietal cortex in groups 1 and 2. rCBV increased in cerebral pedicle in group 1 compared with groups 2 and 3. In the temporal lobe white matter, prolonged MTT and decreased rCBF were found in groups 1 and 2. In the corpus striatum, internal capsule, and periventricular white matter, rCBF increased in group 1 compared with group 3 and decreased in groups 1 and 2. Conclusion. Brain pMRI is a very sensitive method to detect brain involvement in patients with BD and aids the clinical diagnosis of NBD, especially in patients with negative MRI findings.
Pulmonary alveolar microlithiasis (PAM) is a rare, chronic lung disease characterised by extensive intra-alveolar calcium and phosphorus deposition throughout the parenchyma of both lungs. The etiology and pathogenesis of the disease is unclear. In our case, PAM with pregnancy was presented; respiratory distress had been observed during the first and second trimesters. In the following weeks, premature activity developed and the foetus was not able to stay alive. This is the third case of PAM in pregnancy described in the literature. A 36 year-old female was referred to our emergency department complaining that she had suffered from dyspnoea on a couple of occasions since the first trimestry of her last pregnancy. On suspecting a pulmonary embolism, dynamic thorax multidetector computed tomography (MDCT) was performed after the delivery. MDCT revealed typical PAM findings. In PAM, radiological signs are not compatible with clinical symptoms; thus, the clinical symptoms are not as dramatic as imaging findings. However, it should be taken into consideration that this disease, with no effective treatment, may rarely progress into end stage pulmonary disease due to conditions which alter pulmonary functions, such as pregnancy.
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