Mri case study- scleroderma

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Presented by:Shatha J. Al Mushayt

MRI Case Study 2010KKUH

CAMS,KSU

OUTLINEDate & PlacePatient InformationProcedure Purpose & TypeMRI Scanner SystemMRI Protocol & SequencesFinding & ImagesAbout the disease(finding).

Date & PlaceDate: 10-10-2010

Place: King Khalid University Hospital, Riyadh, Saudi Arabia.

Patient InformationPatient History:

21 yrs old female with scleroderma of the LT side of the face.

Weight: 61 kg

Procedure Purpose & TypePurpose 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.

MRI Scanner SystemSiemens CompanySuperconducting closed MRI system 3 Tesla strength

RF Coils: Head &neck coil (phased-array coils)

Closed MRI scanner

Head coil

MRI Protocol & Sequences

Tumor protocol (suggested by the radiologist) Step Sequence TE & TR Other parameters

1 Localizer (axial, coronal and sagital) - FOV: 250 mmNEX: 1

S. Thickness: 10 mm2 cor-localizer-T2-haste TE: 93

ms ,TR: 1500 ms

BW: 20 cmFOV: 200 mm

NEX: 1S. Thickness: 4 mm

-3 cor-T2-tse-FS TE: 114 ms, TR: 3682 ms

BW: 15 cmecho train:17FOV: 220 mm

NEX: 3S. Thickness: 3.5 mm

4 sag-T1-mpr-ns TE: 2.44 ms, TR: 1430 ms

5 AX-T2-tse FS TE: 114 ms, TR: 3682 ms

BW: 15 cmecho train:17FOV: 210 mm

Cont.step Sequence TE & TR Other parameters

6 AX-T1-se TE: 9.4 ms, TR: 400 ms

7 COR-T1-se TE: 9.4 ms, TR: 400 ms

8 CM(Gadolinium), manual injection,12 ml.

9 AX-T1-se-FS+C TE: 10 ms, TR: 413 ms

10 COR-T1-se -FS +c TE: 10 ms, TR: 472 ms

11 SAG-T1-mpr-fs+c TE: 3.67 ms, TR: 1610 ms

Findings & ImagesLoss of the

subcutaneous fat on the LT side over the mandible.

Findings & ImagesAbnormal soft

tissue mass lesion seen overlying the LT masseter muscle

Appears high signal intensity in T2WI

Findings & ImagesPost contrast images

Mild enhancement of the soft tissue mass

Findings & ImagesLT masseter muscle

is slightly smaller than the RT one

Findings & ImagesAbnormal signal

intensity of the superficial part of LT parotid gland

Findings & ImagesPost contrast images

Abnormal enhancement of

the superficial part of the LT parotid gland

Findings & ImagesBilateral cervical

lymph node noted the largest one on the LT side measuring approx 2.5 x 1 cm

Findings & ImagesNo clear evidence of abnormal signal

intensity within the visualized bone specially on the LT side.

ConclusionK/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.

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.

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

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

THANKYOU

ReferencesAbout scleroderma : http://www.umm.edu/altmed/articles/scleroderma-000147.htm

http://www.housing.k-state.edu/dining/FitCourse/toyourhealth/06-sclerodermaawareness.html

Mri case study- scleroderma

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