Background: Multiple sclerosis is often a longitudinal disease continuum with an initial relapsing-remitting phase (RRMS) and later secondary progression (SPMS). Most currently approved therapies are not sufficiently effective in SPMS. Early detection of SPMS conversion is therefore critical for therapy selection. Important decision-making tools may include testing of partial cognitive performance and magnetic resonance imaging (MRI). Aim of the work: To demonstrate the importance of cognitive testing and MRI for the prediction and detection of SPMS conversion. Elaboration of strategies for follow-up and therapy management in practice, especially in outpatient care. Material and methods: Review based on an unsystematic literature search. Results: Standardized cognitive testing can be helpful for early SPMS diagnosis and facilitate progression assessment. Annual use of sensitive screening tests such as Symbol Digit Modalities Test (SDMT) and Brief Visual Memory Test-Revised (BVMT-R) or the Brief International Cognitive Assessment for MS (BICAMS) test battery is recommended. Persistent inflammatory activity on MRI in the first three years of disease and the presence of cortical lesions are predictive of SPMS conversion. Standardized MRI monitoring for features of progressive MS can support clinically and neurocognitively based suspicion of SPMS. Discussion: Interdisciplinary care of MS patients by clinically skilled neurologists, supported by neuropsychological testing and MRI, has a high value for SPMS prediction and diagnosis. The latter allows early conversion to appropriate therapies, as SPMS requires different interventions than RRMS. After drug switching, clinical, neuropsychological, and imaging vigilance allows stringent monitoring for neuroinflammatory and degenerative activity as well as treatment complications.
Infrared thermal imaging technology is another new branch for medical imaging after traditional medical imaging technologies such as X-ray, ultrasound and magnetic resonance (MRI). It has the advantages of noninvasive, nondestructive, simple and fast. Its application can radiate multiple clinical departments. This paper mainly expounds the principle, influencing factors of medical infrared thermography and its application in radiation protection and other medical fields.
Acute abdomen is a frequent clinical picture in emergency diagnostics. Pathologic changes of the female genital organs play an important role. Gynecologic emergencies threaten fertility and are potentially life-threatening. Many differential diagnoses must be considered in the diagnostic process, depending on the age of the patient and any pregnancy. In particular, acute gastrointestinal symptoms often cannot be differentiated from gynecologic emergencies on clinical examination. Here, imaging makes a significant contribution to narrowing the differential diagnosis, making treatment decisions, and monitoring therapy. This review article will discuss the central role of imaging in the context of common gynecologic emergencies.
The suspicion of mediastinal alterations, always includes in its initial study, the chest radiography. The identification of mediastinal alterations in the X-ray is a priority. The knowledge of the mediastinal references and the identification of their alterations allows the suspicion of a pathology specific to each of the mediastinal spaces. When the semiology of mediastinal lesions, their location and the three most frequent pathologies are taken into account, the possibility of having an etiological diagnosis increases[1]. This is a review article based on a detailed literature search, in which radiological mediastinal references are studied, with emphasis on the epidemiological data of each one of them.
The temporomandibular joint (TMJ) is considered a bicondylar diarthrosis type joint. Imaging evaluation is a fundamental part of its assessment, which should include both bony and soft tissue characteristics and the relationship between them. Magnetic resonance imaging (MRI) represents the gold standard for the study of soft tissues; however, up to now, its main application continues to be the visualization of the articular disc. For this reason, the present article aimed to point out the information available in the literature regarding the visualization of the joint capsule in MRI and to evaluate it as an independent structure.
Gout is an arthritis characterized by the deposition of sodium monoacid crystals in the synovial membrane, articular cartilage, and periarticular tissues that leads to an inflamatory process. In most cases, the diagnosis is established by clinical criteria and analysis of the synovial fluid for MSU crystals. However, gout may manifest in atypical ways and make diagnosis difficult. In these situations, imaging studies play a fundamental role in helping to confirm the diagnosis or even exclude other differential diagnoses. Conventional radiography is still the most commonly used method in the follow-up of these patients, but it is a very insensitive test, because it only detects late changes. In recent years, advances in imaging methods have emerged in relation to gout. Ultrasound has proven to be a highly accurate test in the diagnosis of gout, identifying MSU deposits in articular cartilage and periarticular tissues, and detecting and characterizing tophi, tendinopathies, and tophi enthesopathies. Computed tomography is an excellent exam for the detection of bone erosions and evaluation of spinal involvement. Dual-energy computed tomography, a new method that provides information on the chemical composition of tissues, allows identification of MSU deposits with high accuracy. MRI can be useful in the evaluation of deep tissues not accessible by ultrasound. In addition to diagnosis, with the emergence of drugs that aim to reduce the tophaceous burden, imaging examinations become a useful tool in the follow-up treatment of gout patients.
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