Based on the results of this case series, it appears that the strength of the magnet affects the artifact from the Co-Cr endplates. The open 0.2-T MR imaging unit reduces artifact at adjacent levels after cervical disc arthroplasty without a significant reduction in the image quality. Magnetic resonance imaging can be used to evaluate the adjacent segments after disc arthroplasty if magnet strength is addressed, providing another means to assess the long-term efficacy of this novel treatment.
A 56-year-old woman presented with involuntary left arm and leg movements. MRI with gadolinium revealed a heterogeneously enhancing, extra-axial mass at the right frontoparietal convexity, causing mass effect, vasogenic edema, and dural thickening (figure). Intraoperatively the mass was noted to invade nearby cortex, sulci, and the superior sagittal sinus. Meningioma was suspected. Pathology revealed a lymphohistiocytic infiltrate with histiocytes positive for CD 68 and S100 demonstrating emperipolesis (lymphocytophagocytosis) consistent with Rosai-Dorfman disease (figure). The patient had no CNS recurrence or systemic involvement after 12 months of follow-up.Rosai-Dorfman, sinus histiocytosis with massive lymphadenopathy, is a rare disease of the lymphoid tissues with systemic involvement in up to 25% of cases. Neurologic involvement is rare, occurring in 4% of patients in one series. There are approximately 80 cases of CNS involvement in the literature, and the majority of these cases are brain lesions presenting with focal deficits, seizures, or headaches due to mass effects. Sagittal and axial T1-weighted MR images, hematoxylin and eosinstained specimen, and S100-stained specimen Sagittal (A) and axial (B) T1-weighted MR images revealing a contrast-enhancing extra-axial mass lesion with indentation of the cortex, dural thickening, underlying vasogenic edema, and a projection into an intersulcal region. Hematoxylin and eosin-stained specimen (C) shows a lymphohistiocytic infiltrate with histiocytes demonstrating emperipolesis (lymphocytophagocytosis). S100-stained specimen (D) shows histiocytes positive for S100.
In essence, a drop in the N-acetyl aspartate peak indicative of axonal loss in concert with elevations in lipid myoinositol and choline/creatine ratios (nonspecific markers of myelin breakdown) is found, indicating that a possible demyelinating process is complexed with the vasculitic pathology neuro-Behçet is traditionally ascribed to.
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