Purpose:To longitudinally evaluate cartilage matrix changes by using magnetic resonance (MR) imaging T1 r (T1 relaxation time in rotating frame) and T2 quantifi cation and to study the relationship between meniscal damage and cartilage degeneration in anterior cruciate ligament (ACL)-reconstructed knees. Materials and Methods:This was an institutional review board-approved, HIPAAcompliant study. Informed consent was obtained. Twelve patients with acute ACL injuries were imaged with 3.0-T MR imaging at baseline (after injury and prior to ACL reconstruction) and 1 year after ACL reconstruction. Ten age-matched healthy subjects were studied as controls. Cartilage T1 r and T2 were quantifi ed in full thickness, superfi cial, and deep layers of defi ned subcompartments at baseline and follow-up in ACL-injured knees and were compared with measures acquired in matched regions of control knees. Meniscal lesions were graded by using modifi ed subscores of the Whole-Organ Magnetic Resonance Imaging Score system. Results:T1 r values of the posterolateral tibial cartilage in ACLinjured knees were signifi cantly elevated at baseline compared with T1 r values of control knees and were not fully recovered at 1-year follow-up. T1 r values of weight-bearing medial femorotibial cartilage in ACL-injured knees were signifi cantly elevated at 1-year follow-up compared with those of control knees. No signifi cant differences in T2 values between ACL-injured and control knees were found. Patients with lesions in the posterior horn of the medial meniscus showed a greater increase of T1 r and T2 from baseline to follow-up in adjacent cartilage than patients without lesions in the medial meniscus. Conclusion:Quantitative MR imaging T1 r and T2 enable detection of changes in the cartilage matrix of ACL-reconstructed knees as early as 1 year after ACL reconstruction.q RSNA, 2010

Even in the absence of manifest stroke, AF is a risk factor for cognitive impairment and hippocampal atrophy. Therefore, cognition and measures of structural brain integrity should be considered in the evaluation of novel treatments for AF.

These data suggest that low-grade inflammation as assessed by high-sensitivity C-reactive protein is associated with cerebral microstructural disintegration that predominantly affects frontal pathways and corresponding executive function.

Introduction Aneurysmal bone cysts (ABCs) are expansive and destructive lesions positive for osteoclast markers, resembling benign giant cell tumors (GCTs). Treatment options include surgical resection, curettage and cavity filling, embolization, injection of fibrosing agents, or radiotherapy. Particularly in children and adolescents with spinal ABCs, these options may be unsatisfactory, and innovative forms of treatment are needed. Denosumab is a human monoclonal antibody that inhibits osteoclast function by blocking the cytokine receptor activator of the nuclear factor-kappa B ligand. Satisfactory results with denosumab in treating GCTs and immunohistochemical similarities suggest that it may also have positive effects on ABCs. Methods and ResultsThis report is the first description of the therapeutic use of denosumab in two patients with spinal ABCs. Two boys (aged 8 and 11) had recurrent ABCs at C5 after surgery with intralesional tumor resection. Treatment options were discussed by the interdisciplinary tumor board. Arterial embolization was attempted, but failed due to an absence of appropriate afferent arteries. After the families had received extensive information and provided written consent, denosumab therapy was initiated as an individualized treatment, despite the absence as yet of scientific evidence. After the start of denosumab therapy, both patients recovered from pain and neurologic symptoms significantly and are now in a healthy condition with no severe side effects. Magnetic resonance imaging check-ups after 2 or 4 months of denosumab treatment, respectively, showed tumor regression in both patients. Discussion Longer follow-up and clinical studies are warranted to establish the value of denosumab in the treatment of ABCs.