[Pitfalls in MR imaging of neurological diseases].
MR imaging is useful for the diagnosis of neurological diseases but it has many pitfalls. The author presented one patient with syringobulbia of whom neurological examinations revealed lesions in the medulla. MR images showed slit-like lesions in the medulla and pontine tegmentum of which signal intensity was similar to that of cerebrospinal fluid. However, a sagittal scout image reveals syringomyelia in the upper cervical spinal cord that was important abnormal finding for the diagnosis of this case. In a case of hypertrophic cranial pachymeningitis, neurological examinations showed right lower cranial palsies and MR images showed lesions along the right temporal bone with T1- and T2 shortening. After injection of the contrast medium, abnormal contrast enhancement was observed in the medial side of the lesions. In the anterior cranial fossa, however, the anterior falx was thick and it showed low signal on T2-weighted images and abnormal contrast enhancement. These findings of the falx indicated that the patient had hypertrophic cranial pachymeningitis. It is important to see lesions which neurological examinations detect. However, all of the images must be seen, because in the distant location, the key findings for the diagnosis may be present.
Yagishita
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D002490:Central Nervous System / Q000473:pathology; D006801:Humans; D008279:Magnetic Resonance Imaging; D009422:Nervous System Diseases / Q000175:diagnosis* / Q000473:pathology