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PURPOSE: Previous functional neuroimaging studies showed that the brainstem may have an important role in migraine and recently, DTI studies demonstrated that structural alterations in migraineurs may extend beyond the normal appearing brain tissue. The aim of our study was to find out if DTI may detect any abnormality during the spontaneous migraine attacks. METHODS: The DTI images obtained in a 3T system during spontaneous migraine episodes. Patients with any systemic or metabolic disorder and abnormal signal intensity in conventional sequences were excluded. We measured the FA and ADC values of red nuclei, periaquaductal gray matter, thalami, posterior limbs of internal capsules and subcortical white matter. Fifteen healthy volunteers served as control group. RESULTS: Fourteen patients enrolled in the study. The only site where we found an abnormality was the red nuclei, where the ADC values in migraineurs were statistically higher than in healthy volunteers. There was no statistical correlation between the DTI measurements and patients' ages, duration of disease, frequency of attacks and localization of pain. CONCLUSION: Our findings supported the findings of previous functional neuroimaging studies, which concluded that the brainstem might have a role in the pathogenesis of a migraine episode. We think that the increase of ADC values in red nuclei may reflect vasogenic edema, which cannot be detected in conventional sequences. However, the exact underlying mechanism for this observation is unclear and we do not know whether these changes are responsible for triggering an attack or if they are the consequents of the attack itself.

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BACKGROUND: Routine lumbar spine magnetic resonance imaging (MRI) may not show any evidence of the cause of sciatica in some cases. The relationship between nerve root compression detected on lumbar MRI and sciatica is also sometimes uncertain. PURPOSE: To ascertain whether axial (and, when necessary, sagittal and coronal) short-tau inversion recovery or fat-saturated T2-weighted MRI findings can be used to study the level of sciatica in patients with a non-yielding routine MRI examination. MATERIAL AND METHODS: A total of 215 patients with unilateral sciatica underwent MRI. All patients were asked to complete pain drawing forms describing their pain dermatomal distributions. Perineural edema/inflammation corresponding to the pain location indicated by the pain drawings was sought on short-tau inversion recovery or fat-saturated T2-weighted images. RESULTS: Routine MRI findings revealed that 110 of the 215 patients had nerve root compromise related to the patients' symptoms. Routine MRI could not ascertain the cause of these symptoms in the remaining 105 patients. In 31 (29.5%) of these 105 patients, short-tau inversion recovery or fat-saturated T2-weighted magnetic resonance images revealed perineural edema/inflammation surrounding the nerve roots related to the pain locations indicated in the pain drawings. CONCLUSION: Axial (and, when required, sagittal and coronal) short-tau inversion recovery or fat-saturated T2-weighted magnetic resonance images may be helpful for revealing additional findings in cases of unexplained sciatica in standard magnetic resonance imaging. However, the value of this imaging may be not great enough to justify routine use of these additional sequences to study the level of sciatica.

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BACKGROUND: Percutaneous vertebroplasty (PV) has recently become a very common procedure for vertebral compression fractures. Extravasation of cement, a common event associated with vertebroplasty, may lead to cement emboli in the lungs. PURPOSE: To determine the frequency of pulmonary cement embolism after percutaneous vertebroplasty. MATERIAL AND METHODS: Between 2002 and 2006, 128 percutaneous vertebroplasties were performed in 73 patients (56 women and 17 men) in our institution. Postprocedural chest radiographs were obtained for all patients and assessed for the presence of pulmonary cement emboli. RESULTS: Pulmonary cement embolism was detected on chest radiographs and confirmed with chest computed tomography (CT) in four patients treated with percutaneous vertebroplasty for osteoporotic collapse and one patient treated for multiple myeloma. The imaging finding of pulmonary cement embolism was solitary or multiple fine radiodense lines with occasional branching patterns. The frequency of pulmonary cement embolism was 6.8%. CONCLUSION: An incidence of pulmonary cement embolism of 6.8% during PV was found. Close clinical follow-up, postprocedural chest radiographs, and chest CT scans, if necessary, are important for the detection of pulmonary cement embolism at an early stage.

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Myositis ossificans is a benign, localized, self-limiting ossifying soft tissue mass with unknown pathogenesis. It may be confused with a malignant tumor of bone or soft tissues, especially in the early stages of the disease. In this report, we present a case of myositis ossificans affecting unilateral psoas muscle, which to our knowledge is a very uncommon location. There was no history of trauma. We describe the imaging findings and clues to early diagnosis of myositis ossificans.

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Fibrous dysplasia is a developmental disorder caused by abnormal proliferation and maturation of fibroblasts resulting in replacement of mature bone by structurally weak, immature woven bone. Clival involvement in monostotic fibrous dysplasia is extremely unusual, and has rarely been reported previously. We report a case of monostotic fibrous dysplasia of the clivus with special emphasis on the imaging findings and differential diagnosis.

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Lipoma is a rare cause of adult intussusception. We present the CT findings of an adult patient with jejunojejunal intussusception secondary to submucosal lipoma as the lead point in this case report.

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Spontaneous retroperitoneal hemorrhage is a rare intraabdominal bleeding. In this report we present a case of a nontraumatic retroperitoneal hemorrhage secondary to spontaneous subcapsular renal hematoma. A 54-year-old patient who was under warfarin therapy, developed subcapsular right renal hematoma. Subcapsular and retroperitoneal hemorrhage were low signal on T1- and T2-weighted images consistent with acute stage of blood. The source of subcapsular hematoma was shown to be the rupture of hemorrhagic renal cyst on MRI. Extension of hemorrhage into the retroperitoneal space anterior to right psoas muscle was also successfully shown on MRI. Patient underwent nephrectomy and retroperitoneal blood was evacuated.

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Inflammation of an epiploic appendage is considered to be a rare cause of acute abdomen. Recently, it has been reported that typical computed tomography (CT) findings of primary epiploic appendagitis (PEA) provide a definitive diagnosis in most of the cases. However, since these papers are only few, they are easily overlooked by the practicing radiologists. Our purpose is to add four new cases to the existing literature and to perform a review of the literature.

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