Background
Myelopathy, a pathological condition related to the spinal cord can broadly be categorized into compressive and non-compressive aetiologies. Magnetic resonance imaging remains the modality of choice when suspecting non-compressive myelopathy as it helps to localize the affected segment and exclude compression as the cause of myelopathy. This review deals with the imaging approach for non-compressive myelopathies.
Main body
Demyelinating disorders are the most common cause of non-compressive myelopathy and often show confounding features. Other causes include inflammatory, ischemic, metabolic, and neoplastic disorders. Non-compressive myelopathy can broadly be classified into acute and non-acute onset which can further be categorized according to the distribution of the signal abnormalities, including length of cord involvement, specific tract involvement, enhancement pattern, and the region of the spinal cord that is affected.
Conclusions
Imaging plays a critical role in the evaluation of clinically suspected cases of myelopathy and MR imaging (with or without contrast) remains the preferred modality. Compressive causes must be excluded as a cause of myelopathy. Despite a multitude of causes, the most common imaging appearance is a nonspecific T2 hyperintense signal in the spinal cord, and thus, a pragmatic diagnostic approach along with appropriate clinical and biochemical correlation is essential for arriving at an accurate diagnosis.
Scar endometriosis usually affects the abdominal wall or the perineum. Virtually all cases are linked with some form of surgical manipulation. Although the clinical diagnosis of scar endometriosis may be straightforward with classical symptomology, imaging with ultrasound and MRI are important for the determination of its extent, which is imperative for adequate preoperative planning. In addition, assessment of perineal scar endometriosis also requires the identification of anal sphincter complex involvement, which can significantly impact the surgical approach. Radiology plays a vital role in its diagnosis in atypical clinical scenarios.Contribution: This series of four cases describes the morphology and highlights the importance of imaging in the surgical management of scar endometriosis; three with abdominal wall involvement and one with the involvement of perineum.
Benign liver neoplasms are commonly encountered in clinical practice. Lesions like typical hemangioma may be confidently diagnosed on ultrasound, but for the majority of other liver lesions, multiphasic computed tomography (CT) and magnetic resonance imaging (MRI) are usually warranted. In lesions like adenomas, making the diagnosis alone is not sufficient; rather subcategorization is important to optimally manage these cases. Additionally, commonly observed variant lesions like the inflammatory subtype of hepatocellular adenoma and focal nodular hyperplasia mimic each other, which exacerbates the diagnostic dilemma. When observing cystic lesions, mucinous cystic neoplasm of the liver (MCN-L) needs to be differentiated from the more common non-neoplastic etiologies like hydatid cysts. Radiologists should also be acquainted with features of rare hepatic neoplasms like angiomyolipoma, paraganglioma, and inflammatory pseudotumor. In this review, we discuss the salient features and differentiating points to suggest the most likely diagnosis.
Diaphragmatic structure and function assessment can be performed using grayscale as well as M-mode ultrasound. This article discusses the application of M-mode ultrasound in the assessment of diaphragmatic dysfunction.
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