Minimum ADC values in glioblastoma multiforme could be used as a preoperative parameter to estimate the status of MGMT promoter methylation and the survival of patients.
A 70-year-old man was admitted to our emergency department for sudden onset of abnormal involuntary movements involving his upper and lower left limbs. Hemichoreal movements were restricted to his left limbs, associated with rare episodes of hemiballism (video). There were no cranial nerve alterations, no sensory loss or limb weakness. The patient reported mild hypertension under treatment. There was no history of diabetes mellitus or epilepsy, no prior exposure to neuroleptics or recent change in therapy. He denied any similar previous episode or family history of movement disorders.Chest radiography, electrocardiography, and laboratory tests including glucose, glycated hemoglobin, coagulation parameters, and immunoglobulin electrophoresis were normal. Brain non-contrast CT scan on admission showed no signs of acute ischemia (Fig. 1a). A supra-aortic-trunk Doppler sonography revealed an irregular surface plaque, partly ulcerated, on the origin of the right internal carotid artery with stenosis of about 90 %, confirmed at CT angiography (Fig. 1b).
Crohn's disease affects more than 500000 individuals in the United States, and about 25% of cases are diagnosed during the pediatric period. Imaging of the bowel has undergone dramatic changes in the past two decades. The endoscopy with biopsy is generally considered the diagnostic reference standard, this combination can evaluates only the mucosa, not inflammation or fibrosis in the mucosa. Actually, the only modalities that can visualize submucosal tissues throughout the small bowel are the computed tomography (CT) enterography (CTE) with the magnetic resonance enterography (MRE). CT generally is highly utilized, but there is growing concern over ionizing radiation and cancer risk; it is a very important aspect to keep in consideration in pediatric patients. In contrast to CTE, MRE does not subject patients to ionizing radiation and can be used to detect detailed morphologic information and functional data of bowel disease, to monitor the effects of medical therapy more accurately, to detect residual active disease even in patients showing apparent clinical resolution and to guide treatment more accurately.
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