Coronary CT angiography gives us a good understanding of the variations and anomalies of the anatomy of the coronary arteries. This can be of immense help to the clinician planning interventional procedures.
Rabies is a neurotropic viral illness, almost always fatal, that is equally dreaded by healthcare practitioners and patients due to the dismal prognosis and limited treatment options once symptoms set in. There are hardly any reports on MRI changes in the brain in survivors of rabies encephalitis. We present the clinical course and the imaging findings on serial MRI examinations in a rare patient who survived rabies infection. Initial brain MRI done 8 days after onset of symptoms revealed bilaterally symmetrical non-enhancing areas of T1 and T2 hyperintensity in the basal ganglia, thalami, mid brain, and pons along with T2 hyperintensity and restricted diffusion in fronto-parietal cortical grey matter and left hippocampus. Subsequent MRI scans at 2 months and 5 months revealed progressive brain atrophy, leukoencephalopathy, and gliosis.
Background: Intrinsic differences between magnetic susceptibility of tissues can be used to generate a unique type of contrast in Magnetic Resonance Imaging (MRI), particularly to characterize tissues and improve the sensitivity for certain lesions, most notably hemorrhagic foci or calcification. Methods: A blinded retrospective review of all brain imaging studies done at our centre between March 2014 and February 2016. One of them reviewed the MR images with exclusion of SWI, while the other radiologist reviewed the entire set of images including SWI. Their findings were then compared to study the efficacy of SWI in better detection and characterization of lesions. Results: The study included 3710 patients with different brain lesions. SWI revealed positive lesions in at least 619 of these patients which were not picked up by the radiologist interpreting the conventional MRI protocol without SWI sequence. 21 patients with traumatic brain injury, 32 patients with cerebral microbleeds, 78 patients with brain tumors, 27 patients with venous malformations, 128 patients with intra-cranial calcifications, 277 patients with infarcts and 56 patients with extra-axial hemorrhage. Out of the 619 lesions, SWI played a significant role in lesion characterization in at least 198 patients which is about 5.33% of our total cohort of 3710 patients. Conclusion: SWI images are fast sequences requiring no more than a total scan time of about 3 minutes. Inclusion of this sequence as a part of brain pathology can play an important role in diagnosing different brain lesions without missing hemorrhagic lesions thus avoiding inappropriate therapeutic regimens with catastrophic results.
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