Malini A. Lawande

Carboxyl decorated Fe3O4 nanoparticles for MRI diagnosis and localized hyperthermia

We report the development of carboxyl decorated iron oxide nanoparticles (CIONs) by a facile soft-chemical approach for magnetic resonance imaging (MRI) and hyperthermia applications. These superparamagnetic CIONs (~10 nm) are resistant to protein adsorption under physiological medium and exhibit good colloidal stability, magnetization and cytocompatibility with cell lines. Analysis of the T2-weighted MRI scans of CIONs in water yields a transverse relaxivity (r2) value of 215 mM(-1) s(-1). The good colloidal stability and high r2 value make these CIONs as promising candidates for high-efficiency T2 contrast agent in MRI. Further, these biocompatible nanoparticles show excellent self-heating efficacy under external AC magnetic field (AMF). The infrared thermal imaging confirmed the localized heating of CIONs under AMF. Thus, these carboxyl decorated Fe3O4 nanoparticles can be used as a contrast agent in MRI as well as localized heat activated killing of cancer cells. Furthermore, the active functional groups (COOH) present on the surface of Fe3O4 nanoparticles can be accessible for routine conjugation of biomolecules/drugs through well-developed bioconjugation chemistry.

Central Nervous System Tuberculosis: Pathophysiology and Imaging Findings

With the onset of the human immunodeficiency virus pandemic, the incidence of tuberculosis, including central nervous system (CNS) tuberculosis, has increased in developed countries. It is no longer a disease confined to underdeveloped and developing countries. The imaging appearance has become more complex with the onset of multidrug-resistant tuberculosis. Imaging plays an important role in the early diagnosis of CNS tuberculosis and may prevent unnecessary morbidity and mortality. This article presents an extensive review of typical and atypical imaging appearances of intracranial tuberculosis, and discusses pathogenesis, patterns of involvement, and advances in imaging of intracranial tuberculosis.

Antenatal Diagnosis of Iniencephaly: Sonographic and MR Correlation: A Case Report

Iniencephaly is an uncommon and fatal neural tube defect involving the occiput and inion, this occurs together with rachischisis of the cervical and thoracic spine, and retroflexion of the head. We report the ultrasound (US) and magnetic resonance (MR) imaging findings of a case of iniencephaly with clubfeet and arthrogryposis. The diagnosis of iniencephaly is easy to make on ultrasound due to the typical star-gazing fetus. However, the details of the fetal brain and spinal cord may not be adequately delineated on US. We found MR imaging to be superior for depicting central nervous system abnormalities. MR imaging has evolved as an imaging modality and it is complementary to fetal US, yet US remains the screening modality of choice.

Multiple Hemangiomas Involving the Vertebral Column

Hemangiomas are benign, slow-growing skeletal and soft tissue tumors that commonly involve the bony spine. When found in the spine, they are usually asymptomatic, but can sometimes be associated with local pain and/or neurological deficits. We report the case of a middle-aged Indian male with multiple hemangiomas involving almost all the vertebrae contiguously from C2 to S1 vertebral levels. These were discovered incidentally when a magnetic resonance scan was performed for backache. To the best of our knowledge, such extensive involvement of the spine has not been reported previously.

MRI diagnosis of hypertrophic osteoarthropathy from a remote childhood malignancy

Hypertrophic osteoarthropathy (HOA) is a clinico-radiological syndrome characterized by digital clubbing, periosteal proliferation, bone pain, synovitis and arthralgia, all of these being commonly symmetrical. It is occasionally associated with nasopharyngeal lymphoepitheliomas and may develop before or after development of lung metastases in these patients. We report a case of a healthy 22-year-old female who presented to our institution with pain and swelling in the thighs and legs. She had a history of childhood nasopharyngeal lymphoepithelioma. Radiographs of the knees were negative. Magnetic resonance imaging (MRI) showed features suggestive of bilateral periostitis. Because of the propensity of the rare childhood nasopharyngeal lymphoepithelioma to present with HOA, this entity was included in the differential diagnosis. A subsequent chest radiograph and CT demonstrated a lung and mediastinal mass that were histologically confirmed to be metastatic. To the best of our knowledge, HOA and metastases from nasopharyngeal lymphoepithelioma occurring after such a long time interval have not been previously reported. Early demonstration and consideration of HOA on the basis of MRI, lead to expeditious and appropriate subsequent investigation.

Pre- and post-therapy MR imaging in fibrodysplasia ossificans progressiva

Fibrodysplasia ossificans progressiva, also known as myositis ossificans progressiva, is characterized by congenital skeletal malformations and progressive ectopic bone formation in connective tissues. The disorder presents as rapidly growing masses usually in the neck or paraspinal region with stiffness in the adjoining joints. The preosseous lesions involve the fascia, ligaments, tendons, and skeletal muscle. These lesions occasionally resolve but more often progress to form ectopic ossification. We present a boy who had a characteristic clinical presentation. Magnetic resonance (MR) imaging conducted in the preosseous stage of the lesion revealed the pathology, resulting in early therapy and resolution of the preosseous lesion without progression to ossification. To the best of our knowledge, post-therapy follow-up MR imaging in such a case has not been reported.

Acute encephalopathy with biphasic seizures and late reduced diffusion

Acute encephalopathy with biphasic seizures and reduced diffusion (AESD) is a syndrome of encephalopathy characterized by biphasic seizures and altered consciousness in the acute stage followed in the subacute stage by restricted diffusion in the subcortical white matter on magnetic resonance imaging. The etiology of AESD has been attributed to viral infection like influenza A and human herpes virus 6. The exact pathogenesis of AESD is uncertain. Here we report a case of AESD, diagnosed based on clinicoradiological correlation.

Pictorial essay: Role of magnetic resonance imaging in evaluation of brachial plexus pathologies

Brachial plexopathies, traumatic and nontraumatic, often present with vague symptoms. Clinical examination and electrophysiological studies are useful but may not localize the lesion accurately. Magnetic resonance imaging (MRI) with its multiplanar imaging capability and soft tissue contrast resolution plays an important role in evaluation of the abnormal brachial plexus.

Pre-therapy and post-therapy MRI and MRS findings in non-ketotic hyperglycinemia

Non-ketotic hyperglycinemia (NKH) is an uncommon metabolic disorder with an autosomal recessive inheritance due to abnormal glycine metabolism. We present the pre-therapy and post-therapy magnetic resonance imaging, biochemical and clinical features of a child with NKH with manifestation in the early neonatal period. The initial diagnosis of NKH was made on the biochemical evidence of elevated cerebrospinal fluid (CSF) glycine levels and CSF: plasma glycine ratio. Pre-therapy magnetic resonance imaging revealed thinned out corpus callosum, intracranial hemorrhages, prominent ventricular system, few cystic changes in bilateral gangliocapsular region and abnormal T2 hyperintensities in the white matter. Magnetic resonance spectroscopy did not reveal glycine peak in our case. Post-therapy, there was clinical improvement and reduction in CSF glycine levels. In the follow up scan, myelination had progressed with residual leukomalacic changes and volume loss of white matter.