Mri case study- scleroderma

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Mri case study- scleroderma

  1. 1. MRI Case Study 2010 KKUH CAMS,KSU
  2. 2. OUTLINE  Date & Place  Patient Information  Procedure Purpose & Type  MRI Scanner System  MRI Protocol & Sequences  Finding & Images  About the disease(finding).
  3. 3. Date & Place  Date: 10-10-2010  Place: King Khalid University Hospital, Riyadh, Saudi Arabia.
  4. 4. Patient Information  Patient History:  21 yrs old female with scleroderma of the LT side of the face.  Weight: 61 kg
  5. 5. Procedure Purpose & Type  Purpose of MRI:  For soft tissue & bone assessment in face & upper neck.  Procedure:  MRI specify area (others)  MRI of the face & upper neck  Multi-planar, multi-sequence  Head first into the bore.
  6. 6. MRI Scanner System  Siemens Company  Superconducting closed MRI system  3 Tesla strength  RF Coils:  Head neck coil (phased-array coils) Closed MRI scanner Head coil
  7. 7. MRI Protocol & Sequences  Tumor protocol (suggested by the radiologist) Step Sequence TE & TR Other parameters 1 Localizer (axial, coronal and sagital) - FOV: 250 mm NEX: 1 S. Thickness: 10 mm 2 cor-localizer-T2-haste TE: 93 ms ,TR: 1500 ms BW: 20 cm FOV: 200 mm NEX: 1 S. Thickness: 4 mm -3 cor-T2-tse-FS TE: 114 ms, TR: 3682 ms BW: 15 cm echo train:17 FOV: 220 mm NEX: 3 S. Thickness: 3.5 mm 4 sag-T1-mpr-ns TE: 2.44 ms, TR: 1430 ms BW: 20 cm FOV: 250 mm NEX: 1 S. Thickness: 1.04 mm 5 AX-T2-tse FS TE: 114 ms, TR: 3682 ms BW: 15 cm echo train:17 FOV: 210 mm NEX: 3 S. Thickness: 4 mm
  8. 8. Cont. step Sequence TE & TR Other parameters 6 AX-T1-se TE: 9.4 ms, TR: 400 ms BW: 20 cm FOV: 210 mm NEX: 1 S. Thickness: 4 mm 7 COR-T1-se TE: 9.4 ms, TR: 400 ms BW: 20 cm FOV: 210 mm NEX: 1 S. Thickness: 3.5 mm 8 CM(Gadolinium), manual injection,12 ml. - - 9 AX-T1-se-FS+C TE: 10 ms, TR: 413 ms BW: 15 cm FOV: 210 mm NEX: 1 S. Thickness: 4 mm 10 COR-T1-se -FS +c TE: 10 ms, TR: 472 ms BW: 15 cm FOV: 210 mm NEX: 1 S. Thickness: 3.5 mm 11 SAG-T1-mpr-fs+c TE: 3.67 ms, TR: 1610 ms BW: 15 cm FOV: 250 mm NEX: 1 S. Thickness: 1.04 mm
  9. 9. Findings & Images  Loss of the subcutaneous fat on the LT side over the mandible.
  10. 10. Findings & Images  Abnormal soft tissue mass lesion seen overlying the LT masseter muscle  Appears high signal intensity in T2WI
  11. 11. Findings & Images  Post contrast images show:  Mild enhancement of the soft tissue mass
  12. 12. Findings & Images  LT masseter muscle is slightly smaller than the RT one
  13. 13. Findings & Images Abnormal signal intensity of the superficial part of LT parotid gland
  14. 14. Findings & Images  Post contrast images show:  Abnormal enhancement of the superficial part of the LT parotid gland
  15. 15. Findings & Images  Bilateral cervical lymph node noted the largest one on the LT side measuring approx 2.5 x 1 cm
  16. 16. Findings & Images  No clear evidence of abnormal signal intensity within the visualized bone specially on the LT side.
  17. 17. Conclusion  K/C of scleroderma with possible infiltration of the masseter muscle.  Similar area of signal alteration seen within the superficial part of the parotid gland  Possibility of neoplastic lesion cannot be rule out.  No abnormal signal intensity or enhancement within the underlying bone.
  18. 18. Scleroderma  Scleroderma is a disease that can cause thickening, hardening, or tightening of the skin, BV’s and internal organs.  F>M  Types  Localized: usually only affects the skin on the hands and face.  Systemic: more serious and affects connective tissue in many body parts, including internal organs.
  19. 19. Scleroderma  Cause:  Considered as an auto-immune disease.  Symptoms: like,  Hardening and thickening of the affected skin  Loss of hair over affected area  Change in skin color  Ulcers or sores on fingers  Telangiectasia  Muscle weakness  Dryness of eyes/mouth  Digestive, Kidney, Heart and lung problems Hardening and color change
  20. 20. Scleroderma  Treatment:  No cure for scleroderma.  Medication treat symptoms + prevent complications.  Lifestyle changes help in coping with the disease e.g.(exercise, skin creams, no smoking, no exposure to cold or stress).  Diagnosis:  Medical history, physical exam, lab tests, and radiologic imaging
  21. 21. References  About scleroderma :  http://www.umm.edu/altmed/articles/scleroderma-000147.htm  http://www.housing.k-state.edu/dining/FitCourse/toyourhealth/06- sclerodermaawareness.html  KKUH

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