Entries in MRI (13)


Woman's Scrambled Text Message Helps Diagnose Stroke 

Goodshoot RF/Thinkstock(NEW YORK) -- Smartphone autocorrect is famous for scrambling messages into unintelligible gibberish but when one man received this garbled text from his 11-week-pregnant wife, it alarmed him:

“every where thinging days nighing,” her text read. “Some is where!”

Though that may sound like every text you’ve ever received, the woman’s husband knew her autocorrect was turned off. Fearing some medical issue, he made sure his 25-year-old wife went immediately to the emergency room.

When she got there, doctors noted that she was disoriented, couldn’t use her right arm and leg properly and had some difficulty speaking. A magnetic resonance imaging scan — MRI — revealed that part of the woman’s brain wasn’t getting enough blood. The diagnosis was stroke.

Fortunately, the story has a happy ending. A short hospital stay and some low-dose blood thinners took care of the symptoms and the rest of her pregnancy was uneventful.

The three doctors from Boston’s Harvard Medical School, who reported the case study online in this week’s Archives of Neurology, claim this is the first instance they know of where an aberrant text message was used to help diagnose a stroke. In their report, they refer to the woman’s inability to text properly as “dystextia,” a word coined by medical experts in an earlier case.

Dystextia appears to be a new form of aphasia, a term that refers to any trouble processing language, be it spoken or written. The authors of the Archives paper said that at least theoretically, incoherent text messages will be used more often to flag strokes and other neurological abnormalities that lead to the condition.

“As the accessibility of electronic communication continues to advance, the growing digital record will likely become an increasingly important means of identifying neurologic disease, particularly in patient populations that rely more heavily on written rather than spoken communication,” they wrote.

Even though jumbled texts are so common, Dr. Larry Goldstein, a neurologist who is the director of the stroke center at Duke University, said he also believes it’s possible they can be used to sound the alarm on a person’s neurological state, especially in a case like this where the text consisted of complete words that amounted to nonsense rather than the usual autocorrected muddle.

“It would have been very easy to dismiss because of the normal problems with texting but this was a whole conversation that wasn’t making sense,” Goldstein said. “I might be concerned about a patient based on a text like this if they were telling me they hadn’t intended to send a disjointed jumble but they weren’t able to correct themselves.”

In diagnosing stroke, Goldstein said both patients and medical professionals tend to discount aphasic symptoms, even in speech, but they can often be the first clue something is up. In this woman’s case, other signs were there. Her obstetrician realized in retrospect that she’d had trouble filling out a form earlier in the day. She had difficulties speaking too which might also have been picked up sooner if a recent upper respiratory infection hadn’t reduced her voice to a whisper.

But unlike this woman, most people leave their autocorrect turned on. If we relied solely on maddeningly unintelligible text messages to determine neurological state, neurologists might have lines out the door.

Copyright 2012 ABC News Radio


New Surgery Offers Hope to Kids With Dangerous Giggling Seizures

Hemera Technologies/Thinkstock(HOUSTON) -- For the first time, in an experimental pilot program at Texas Children's Hospital, doctors are using real time MRI-guided lasers to destroy lesions that cause laughing seizures in epilepsy patients.

"This MRI-guided laser ablation have increased our accuracy and our safety and our worry factor," said neurosurgeon Dr. Daniel Curry, who, along with Wilfong, is behind this potential breakthrough.

For a rare number of children, laughter can signal a potentially devastating, even fatal future, and their parents will do anything to make the laughter stop.

"The giggling when he was young was such an endearing type of a giggle that we thought it was his normal giggling," Robin Dysart of San Antonio, Texas, said about son Keagan. "Until we realized he was giggling at inappropriate times. There wouldn't be anything to laugh about."

Karen Williams of Toronto noticed the same strange behavior in her son, Mateo.

"There's a forcedness to it," she said. "It almost looks like there's something else that's possessing the laughter."

They are called gelastic seizures, and appear as spontaneous, uncontrollable and often maniacal giggles or laughter. They are short and unpredictable. The cause: a rare form of epilepsy called Hypothalamic Hamartoma (HH) in which a non-cancerous lesion wreaks havoc in a highly sensitive area near the brain's stem. Too often the laughter goes undiagnosed.

Left untreated, the laughing seizures caused by HH can cause long-term behavioral and cognitive damage. Some children grow up so debilitated that they live with their parents. Some have even been institutionalized.

For years, little could be done to stop the laughing seizures, short of an invasive craniotomy. Fraught with danger, the brain is separated, carved open and the lesion, deep in the brain's center, cut out. The risks are every parent's nightmare: a possible loss of sight, uncontrollable urination, stroke and even death if the kidneys shut down.

"And that's what led us to want to explore new technologies to be able to get to these deep centers in the brain, without having to do traditional surgery," said Dr. Angus Wilfong, the medical director at the Comprehensive Epilepsy Program at Texas Children's Hospital in Houston.

Copyright 2012 ABC News Radio


MRI Brain Changes Seen in Early Infants with Autism

iStockphoto/Thinkstock(NEW YORK) -- Autism may be detectable in infants as young as 6 months old, according to a study released Friday in the American Journal of Psychiatry, suggesting the condition has a stronger genetic and biological root.

The study, which tracked MRI images of 92 infants from 6 to 24 months, found that infants who went on to develop autism may have had brain abnormalities visible on MRI at 6 months of age, before the development of clinical symptoms.

The infants studied were already considered at high risk for the condition because their siblings were diagnosed with autism.

Researchers tracked brain changes in infants at 6 months, 1 year, and 2 years old.  Then, they formally tested for autism using the standard diagnostic test at 2 years old, the typical age when autism is diagnosed. 

Twenty-eight infants whose MRI results showed slower brain connections went on to be diagnosed with an autism spectrum disorder.

Previous studies have looked at brain changes in babies as young as 1 year old, but researchers said the new study is the first to track changes in infants as young as 6 months old.

According to Dr. Nancy Minshew, director of the NICHD Collaborative Program of Excellence in Autism at the University of Pittsburgh, who was not involved in the study, the current findings suggest that a child might have autism long before he or she begins to show outward signs.

“Parents and primary care physician determination of onset of autism or ASD in the second or third year of life is not an accurate assessment of onset,” said Minshew.  “This adds to the evidence that autism develops on its own, so to speak, and not because parents did something or did not do something to cause autism.”

Tracking changes could lead to earlier autism screening and intervention, which may lead to improved developmental outcomes, the authors wrote.

But, according to ABC News’ chief health and medical editor Dr. Richard Besser, the imaging results are not distinguishable enough to make a clear-cut diagnosis.

“For a diagnostic test to be of value, you want to see extensive separation between your affected and not-affected groups,” said Besser.  “There appears to be a ton of person-to-person variability.  The likelihood that this will ever lead to a diagnostic test is pretty slim.”

The study authors acknowledged that the study was only performed on infants with a family history of autism, which inherently indicated they, too, were at high risk for the condition.  The test might be limited to babies already known to be at high risk.

Copyright 2012 ABC News Radio


Radiology Tech Discovers Friend’s Brain Tumor

iStockphoto/Thinkstock(DALLAS) -- When John Ippolito, the lead radiology tech at Prime Diagnostic Imaging in Dallas, asked Alex Largent to help him test out some new MRI software, he didn’t expect that simple favor would save his friend’s life.

The day before Thanksgiving, Largent, a Fort Worth, Texas, e-commerce operations manager, went to Prime Diagnostic for tests on his back, because of pain he thought was brought on by childhood sports.

Ippolito asked to do a few scans using software that examined the brain’s nerve activity.  During the first scan, Ippolito said he thought he saw something -- a mass beyond Largent’s right eye.

“I didn’t want to alarm him in any way,” he said.  “I was extremely alarmed.  He was completely asymptomatic.  He didn’t have headaches.  No blurred vision.  And he’s young.  It was pretty alarming.”

He suggested that Largent, 28, a friend for 10 years, see a neuro-optomologist.  Largent did and returned to Prime Diagnostic for a more in-depth scan.

“Everything was surreal,” he said.  “They didn’t know what it was.  They just called it a mass.  It could’ve been a number of things.  A cyst.  A tumor.  I didn’t want to get too much into a panic.”

The mass, a little smaller than a golf ball, was eventually determined to be a brain tumor.

On Jan. 12, Largent had brain surgery to have the tumor removed at Medical City Dallas Hospital.

Dr. Caetano Coimbra, a neurosurgeon, operated on Largent.  He said Largent was a “very special case.”

“His tumor is in a silent area of the brain, where it’s not responsible for any critical function,” Coimbra said.

He said that even though Largent had a low-grade tumor, in 10 years, it could have grown larger, begun to press on the brain and become incredibly difficult to remove.

Largent was grateful for the discovery and said the incident made him and Ippolito closer.

“Do I say he saved my life?  Definitely,” Largent said.  “How many friends save their friend’s lives?”

Copyright 2012 ABC News Radio


Early Brain Changes May Indicate Dyslexia

Digital Vision/Thinkstock(BOSTON) -- A group of researchers say they may be close to finding a way to resolve what’s known as the “dyslexia paradox”: the fact that the earlier a child is diagnosed with dyslexia, the easier it is to treat, but because the disorder is characterized by difficulty in reading and speaking, it is not typically diagnosed until a child reaches third grade, which many experts consider to be late.

The researchers at Children’s Hospital Boston say they may now be able to detect dyslexia even before children pick up their first book, by studying MRIs to see how their brains are working.

Their study, published Monday in PNAS, took MRI brain images of 36 pre-reading level children, half of whom had a family history of dyslexia. The children, who were around age five, were asked to decide whether two similar-sounding words start with the same sound.

Many children diagnosed with dyslexia exhibit insufficient brain activities in the rear left side of the brain, which is responsible for the development of language skills, according Nadine Gaab, associate professor of pediatrics at Children’s Hospital in Boston and co-author of the study. Children with a family history of the condition are at higher risk to develop dyslexia.

The children were followed until they reached third grade, and those with a family history of the condition showed less brain activity in the back left side of the brain compared to those with no family history of dyslexia.

“The question is, are these children showing these brain changes as a result of dyslexia, or do these brain changes predate dyslexia?” said Gaab.

If these brain changes are observed before children are able to read, Gaab said there may come a time when clinicians will be able to diagnose dyslexia before the children begin to show the first signs.

But the current study suggests we’re not there yet. Although researchers found the brain changes in children with a family history of the dyslexia, the children studied have not been followed long enough yet to determine whether they are diagnosed with the condition.

Gaab said the next part of their study will determine if the children who exhibited less activity in the language area of the brain go on to receive a dyslexia diagnosis.

Copyright 2012 ABC News Radio


Study Finds MRI of Little Benefit to Women with Breast Cancer 

Photodisc/Thinkstock(NEW YORK) -- We all know by now that early detection is crucial to surviving breast cancer. A new study finds that one of the most widespread methods to find the disease does little to improve patient survival.
Though mammograms are the most common diagnostic tool, magnetic resonance imaging, better known as MRI, is also effective -- especially in women with dense breast tissue and those with the BRCA cancer mutation.
But a study in the British medical journal The Lancet finds little evidence that MRIs improve patient outcomes.  
The authors looked at 87 peer-reviewed studies over a 10-year period. Although the MRI was definitely more sensitive than mammograms in detecting invasive breast cancer, there was no proof the detection translated into better survival rates. The MRI also did not reduce the number of surgeries a woman had to undergo.
Even so, the authors say MRIs are among the most sensitive detectors of small breast cancers -- and they are useful guides in chemotherapy and radiation therapy for women having breast-conserving surgery.

Copyright 2011 ABC News Radio


New Jersey Patients' MRI Anxiety Eased by Therapy Dog

Hemera Technologies/Thinkstock(RUMSON, N.J.) -- Medical tests can be daunting, especially when they require 45 minutes of complete stillness deep in an outsized, noisy magnet.

For 16-year-old Allison Ruchman of Rumson, New Jersey, a magnetic resonance imaging (MRI) scan to investigate recurrent headaches provoked a level of fear and anxiety that left her desperately searching her mind for a distraction.  That's when Wally, her five-year-old beagle, saved the day.

"I guess Wally was the first thing that popped into my mind," said Allison, a junior at Rumson-Fair Haven High School.  "I started thinking about petting him, walking him, and then I wasn't fidgeting as much.  It just really helped me."

An MRI can provide detailed images of organs buried under flesh and bones as long as the subject stays still, according to Dr. Richard Ruchman, Allison's dad and a radiologist at Monmouth Medical Center in Long Branch, New Jersey.

"MRI is really crucial now for the diagnosis of diseases, especially ones involving the brain and the spine.  The problem is, it's very motion sensitive," Ruchman said.  "When people are anxious, it's a lot harder for them to stay still.  When people calm down, we're able to get a much better test."

Based on her own experience, Allison, whose headaches have since stopped, wondered whether other people waiting to have an MRI might also benefit from Wally's calming companionship.  So the Ruchmans put their heads together to design an experiment that would suss out whether 15 minutes with the cuddly beagle, already certified as a therapy dog, could reduce MRI-related anxiety.

Based on self-reports from 34 patients who received an MRI, those who spent 15 minutes with Wally before the scan were significantly less anxious during the test than those who spent 15 minutes in a quiet waiting room.  Wally's stress-reducing influence led the Ruchmans and colleagues to conclude that pet therapy could help patients stay still for longer, which, in turn, could boost MRI image quality.

The benefits of pet therapy have previously been reported across several fields of medicine, from pediatrics to end-of-life care.  But the Ruchmans hope their study, which they will present at the American Roentgen Ray Society annual meeting this week in Chicago, will broaden the use of pets in medicine.

Copyright 2011 ABC News Radio


Dogs May Help to Reduce Pre-MRI Anxiety

Duncan Smith/Photodisc(NEW YORK) -- Individuals who tend to become anxious when getting an MRI, may want to think about spending some time with a therapy dog the next time they have to do so.

According to the findings from a study done at the Monmouth Medical Center and presented at an American Roentgen Ray Society meeting, Dogs may prove helpful in getting rid of anxiety in patients that have to undergo an MRI.

The project was conceived and researched by 15-year-old Allison Ruchman, who suffered from anxiety and claustrophobia prior to her MRI and found that her tension was relieved by creating a mental image of her dog. The theory was then tested on other patients who were allowed to interact with a therapy dog prior to doing an MRI, and the study found that therapy dogs were helpful in reducing anxiety in the patients.

Copyright 2011 ABC News Radio


Political Views Tied to Brain Structure

Digital Vision/Thinkstock(LONDON) --  Amid the looming prospect of a government shutdown, the clock is ticking for Democrats and Republicans to strike a deal. But new research suggests brain differences might make it hard for the parties to see eye to eye.

Using MRI scans, scientists at University College London found structural differences in the brains of people with liberal and conservative political views. The study was published Thursday in Current Biology.

"Previously, some psychological traits were known to be predictive of an individual's political orientation," lead author Ryota Kanai from University College London's Institute of Cognitive Neuroscience said in a statement. "Our study now links such personality traits with specific brain structure."

The researchers used a survey to probe the political views of 90 University students who later underwent brain scans. People with self-reported liberal views tended to have a larger anterior cingulate cortex -- a brain area involved in processing conflicting information. And those with conservative views were more likely to have a larger amygdala -- a region important for recognizing threats.

"Individuals with a large amygdala are more sensitive to fear," and might therefore be "more inclined to integrate conservative views into their belief system," Kanai and colleagues wrote. "On the other hand, our finding of an association between anterior cingulate cortex volume and political attitudes may be linked with tolerance to uncertainty" -- which may allow people to "accept more liberal views."

This is not the first study to link political attitudes with biological differences. A 2005 twin study revealed a role for genetics, and a 2010 study showed that genetic variations can interact with environmental factors to influence political views.

Copyright 2011 ABC News Radio


Third of MRI, X-Ray Tests 'Wasteful' Spending

Photo Courtesy - Getty Images(PHILADELPHIA) - A new study suggests that if your doctor orders you to take an MRI or X-ray, they may simply be protecting themselves from being sued, reports WebMD.

A new survey by the Children's Hospital of Philadelphia found that among Pennsylvania orthopaedists, one in five order such imaging tests to avoid a potential lawsuit, not to help in a diagnosis.

According to researcher John Flynn, associate chief of orthopaedic surgery at Children's Hospital of Philadelphia, the study offers "a glimpse behind the curtain of what's happening in your doctor's mind."

Flynn and colleagues found that the so-called "defensive tests" made up 35 percent of total test costs, or as much as $325,000 among the 640 orthopaedists surveyed.

Flynn said the spending is wasteful and contributes to the estimated one-third of national health care spending considered unnecessary.

Copyright 2011 ABC News Radio

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