ABSTRACT. Cerebrospinal fluid (CSF) spaces include ventricles and cerebral and spinal subarachnoid spaces. CSF motion is a combined effect of CSF production rate and superimposed cardiac pulsations. Knowledge of CSF dynamics has benefited considerably from the development of phase-contrast (PC) MRI. There are several disorders such as communicating and non-communicating hydrocephalus, Chiari malformation, syringomyelic cyst and arachnoid cyst that can change the CSF dynamics. The aims of this pictorial review are to outline the PC MRI technique, CSF physiology and cerebrospinal space anatomy, to describe a group of congenital and acquired disorders that can alter the CSF dynamics, and to assess the use of PC MRI in the assessment of various central nervous system abnormalities. During the last two decades, flow-sensitive MRI techniques have been increasingly applied to quantitatively and qualitatively assess cerebrospinal fluid (CSF) flow dynamics [1]. CSF flow MRI can be used to discriminate between communicating hydrocephalus and non-communicating hydrocephalus, to localise the level of obstruction in obstructive hydrocephalus, to determine whether arachnoid cysts communicate with the subarachnoid space, to differentiate between arachnoid cysts and subarachnoid space, to discriminate between syringomyelia and cystic myelomalacia, and to evaluate flow patterns of posterior fossa cystic malformations. This imaging method can also provide significant information in pre-operative evaluation of Chiari 1 malformation and normal pressure hydrocephalus and post-operative follow-up of patients with neuroendoscopic third ventriculostomy (NTV) and ventriculoperitoneal (VP) shunt [1][2][3][4][5][6][7][8][9][10][11]. In this pictorial review, we emphasise phase-contrast (PC) MRI technique, CSF physiology and cerebrospinal space anatomy, congenital and acquired disorders that can alter the cerebrospinal fluid dynamics, and the use of PC MRI in the assessment of various central nervous system (CNS) abnormalities. CSF anatomy and physiologyCSF comprises all intracerebral ventricles, spinal and brain subarachnoid spaces, such as cisterns and sulci, and the central canal of the spinal cord. The rate of CSF formation in humans is about 0.3-0.4 ml min 21 (about 500 ml day 21 ). Total CSF volume is 90-150 ml in adults and 10-60 ml in neonates. Potential sites of CSF origin include the choroid plexus, parenchyma of the brain and the spinal cord, and ependymal lining of the ventricles [12].The portion of the fluid formed in the lateral ventricles escapes by the foramen of Monro into the third ventricle and then via the aqueduct into the fourth ventricle. A little CSF occurs in the central canal of the spinal cord and may be added to the intraventricular supply. From the fourth ventricle the fluid pours into the subarachnoid spaces through the medial foramen of Magendie and the two lateral foramina of Luschka. There is no functional communication between the cerebral ventricles and the subarachnoid spaces in any region except from th...

No abstract

No abstract

Benign bone tumors are rare but are more common than primary malignant bone tumors. The early accurate diagnosis and reliable differentiation of these rare benign tumors and tumor mimickers from the even rarer malignant tumors with subsequent appropriate treatment or watchful waiting is crucial for the clinical outcome. Bone tumors are often a source of diagnostic and therapeutic uncertainty. Thus this European Society of Musculoskeletal Radiology consensus document is intended to help radiologists in their decision making and support discussion among clinicians who deal with patients with suspected or proven bone tumors. Evaluating these tumors starts with a patient history and physical examination. Radiography is the principal imaging modality and often can reliably diagnose a benign bone tumor by providing information about localization, matrix, aggressiveness, size, and (potential) multiplicity. In a significant number of cases, additional imaging is not necessary. Potentially malignant entities recognized by radiography should be referred for magnetic resonance imaging, which also serves as a preoperative local staging modality, with specific technical requirements. Indeterminate tumors, or tumors in which therapy depends on histology results, should be biopsied. For biopsy, we strongly recommend referral to a specialist regional sarcoma treatment center (RSTC), where a multidisciplinary tumor team, including a specialist pathologist, radiologist, and sarcoma surgeon, are involved. Additional staging modalities are entity specific and should be performed according to the recommendations of the RSTC.

Replacement lipomatosis of the kidney (RLK) is an advanced form of renal sinus lipomatosis, in which infection, renal calculi and long-standing hydronephrosis are accompanied by renal parenchymal atrophy. The kidneys are usually poor or non-functioning. We present CT and MRI findings of an unusual focal RLK of a 52-year-old male, who was examined with the suspicion of renal malignancy.

The annular ligament is a complex structure formed from the capsule, lateral collateral ligamentous complex, and supinator muscle that act in unison to stabilize the proximal radioulnar joint. Its posterior attachment to the ulna can be fenestrated normally. A detailed analysis of anatomy of this ligament allows us to better understand its functional role in fractures and dislocations of the elbow joint.

Pyogenic sacroiliitis (PS) is an acute form of sacroiliitis that mostly starts with very painful buttock pain. Here in this case, the followup magnetic resonance (MR) images of a 49-year-old male patient with PS is displayed. After his sacroiliitis was documented by MR images, he was treated with the combination of rifampicin plus streptomycin and moxifloxacin. Serial MR investigations were done to disclose acute and subsequent imaging changes concerning sacroiliac joint and surrounding bone structures. Although after treatment all the symptoms were completely resolved, 20 months later changes suggesting active sacroiliitis on MR images were continuing.

Ionizing radiation is known to induce mutations and cell transformations, predominantly by causing single-strand and double-strand DNA breakage, thereby leading to chromosome instability and carcinogenesis. The aim of this study was to evaluate genotoxic effects in hospital staff exposed to low-dose ionizing radiation in comparison with a selected control group, by using the cytokinesis-blocked micronucleus (CBMN) and sister chromatid exchange (SCE) tests in peripheral blood lymphocytes. The study included 40 exposed radiology staff and 30 control subjects. The frequency of micronuclei (MN) was significantly increased in radiation-exposed groups compared with control persons (p < 0.05). The frequency of SCE did not show any significant difference in the exposed individuals in comparison to the controls. Our results showed that low-level chronic occupational exposure to ionizing radiation causes an increase of MN frequency in chromosomes, even though the absorbed doses were below the permissible limits. Our studies indicate that the CBMN assay is considered to be sensitive test in contrast to SCE analysis to evaluate chromosomal damage induced by ionizing radiation.