magnetic resonance imaging

Susceptibility-weighted imaging (SWI), an advanced MRI technique, has a high sensitivity in detecting microvascular changes, hemorrhages, and calcifications, thereby improving the diagnosis and management of various neurological pathologies. This study evaluated the frequency of abnormal findings in SWI sequence in patients with brain pathologies referred to Loghman Hakim Hospital.

This cross-sectional study was conducted on patients with various brain pathologies who underwent brain MRI with SWI sequence at Loghman Hakim Hospital from October 2021 to October 2022. The frequency of different brain pathologies in the SWI sequence was assessed.

A total of 157 brain pathologies were evaluated. In 129 cases (82.2%), the most probable lesion diagnosis was only found in the SWI sequence. Thrombosis in veins was found in all cerebral venous thrombosis (CVT) patients in SWI and other sequences. Hemorrhage in venous infarct was observed in 20% of CVT cases. In patients with vascular malformations, the diagnosis of cavernoma was made in 9 patients (81.8%) and capillary telangiectasia in 2 patients (18.2%).

The findings of this study demonstrated the significant role of SWI in evaluating various brain pathologies, especially in cases where routine MRI sequences are not diagnostic. Therefore, we recommend using SWI in routine brain MRI.

Endometrial cancer is the most common gynecological cancer. Cervical stromal invasion in patients with endometrial carcinoma is associated with local recurrence and overall survival, making accurate preoperative evaluation essential. Currently, the delayed phase of dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) is recommended for diagnosing cervical stromal invasion. However, this approach is time-consuming, and diagnostic interpretations can vary across observers and institutions.

To compare the diagnostic accuracy of arterial-phase and delayed-phase DCE-MRI for detecting cervical stromal invasion in endometrial carcinoma. Patients and

This cross-sectional study retrospectively collected data from 445 patients with endometrial cancer. Two radiologists jointly evaluated cervical stromal invasion using histopathology as the gold standard reference. The McNemar test was used to compare the sensitivity and specificity of cervical stromal invasion detection between the arterial and delayed phases of DCE-MRI. Logistic regression analysis was conducted to assess the impact of tumor location and cervical lesions on diagnostic accuracy for cervical stromal invasion using DCE-MRI.

The mean age of the study population was 53.5 years [standard deviation (SD) = 3.1]. Dynamic contrast-enhanced magnetic resonance imaging images of the cervix demonstrated distinct enhancement characteristics. For detecting cervical stromal invasion, arterial-phase DCE-MRI showed a sensitivity of 66.4% [95% confidence interval (CI): 60.0 - 74.6%] and a specificity of 87.9% (95% CI: 83.9 - 91.0%). In the delayed phase, sensitivity was 69.1% (95% CI: 60.0 - 77.1%) and specificity was 88.2% (95% CI: 84.3 - 91.2%). There was no statistically significant difference between the arterial and delayed phases (P = 1.00). Factors influencing the assessment of cervical stromal invasion included the cluster distribution of Nabothian cysts and lesions located in the lower uterine segment or the internal os (P = 0.01, P < 0.01).

The arterial phase of DCE-MRI is a feasible, time-saving, and effective approach for detecting cervical stromal invasion in endometrial carcinoma.

Brachial plexus neuropathy is a common and frequently occurring disease that may present with upper limb numbness and dysfunction, leading to a high disability rate.

To analyze the magnetic resonance imaging (MRI) features of brachial plexus neuropathy in children.

This study included 60 children who underwent MRI of the brachial plexus at our hospital from July 2019 to May 2024. The MRI scans included axial T 1 WI and T 2 WI sequences, axial and coronal T 2 -STIR sequences, and coronal 3D-FIESTA sequences. The imaging results were analyzed to identify features of brachial plexus neuropathy.

In this study, all 60 children underwent MRI of the brachial plexus. It was found that 34 (56.67%) cases were diagnosed as brachial plexus nerve injury via imaging, including 12 (20.00%) cases on the left side, 18 (30.00%) cases on the right side, and 4 (6.67%) cases on both sides. The imaging diagnoses were consistent with the clinical diagnoses in 32 cases and inconsistent in 2 cases. Meanwhile, 4 (6.67%) cases were diagnosed as other types of brachial plexus neuropathy, including 1 (1.67%) case of neurofibroma, 2 (3.33%) cases of neurosheathoma on the left side, and 1 (1.67%) case of right radicular sleeve cyst. The results were consistent with the clinical diagnoses in 3 cases and inconsistent in 1 case. Additionally, 7 (11.67%) cases were diagnosed as non-brachial plexus neuropathy, while 15 (25.00%) cases showed no obvious abnormality of the brachial plexus nerve. The sensitivity, specificity, and positive/negative predictive values were 100.00% (14/14), 78.95% (15/19), 91.11% (41/45), and 100.00% (15/15), respectively.The imaging features of brachial plexus nerve injury included thickening and thinning of nerve roots, high signals on T 2 fat-suppression sequences, small cystic low signals at the level of the intervertebral foramen, cystic dilatation of nerve roots, formation of spinal cysts, and irregularly shaped long T 1 and T 2 signals at the C 6 intervertebral foramen. The imaging features of neurofibroma included spike-shaped isometric T 1 and T 2 signals in the cervical soft tissues and high signals on T 2 fat-suppression sequences, with relatively homogeneous signals, a clear boundary, and an irregular morphology of the lesion wrapping around the brachial plexus nerve. Additionally, the imaging features of neurosheathoma included space-occupying lesions, predominantly oval-shaped isometric T 1 and slightly longer T 2 signals, located at the lateral upper edge of the thorax, the lower part of the posterior clavicle, and the left side of the brachial plexus.

The MRI can effectively show the location, range, and type of lesions, providing a valuable imaging reference for the early diagnosis and treatment of brachial plexus neuropathy in children.

Recently, magnetic nanoparticles coated with different ligands have been utilized in diagnosis, drug delivery, and therapy. This study aimed to synthesize,  characterize, and apply Fe3O4 coated with Poly Dopamine (PDA) as an MR imaging nanoprobe and its application in metronidazole-resistant helicobacter pylori (H.pylori).

Fe3O4 nanoparticles were characterized and their cytotoxicity was determined in MCF-7 cell lines. Then, coated and non-coated nanoparticles were injected intravenously into  9 xenograft BALB/C mice, and the signal intensity of the T2-weighted MR was assessed. Iron concentrations were measured by ICP-AES, and histopathological assessment was done on harvested critical organs. Finally, The standard disk diffusion method was also used to identify the H.pylori resistance to metronidazole. The minimum inhibitory concentrations and the minimum bactericidal concentration of uncoated and coated iron oxide nanoparticles were investigated.

The MTT assay showed low cytotoxicity at 512 µg/ml. T2 relaxation times of tumors were lower compared to normal tissues. ICP-AES results indicated that the NPs accumulated mostly in the spleen and liver. The histopathology study demonstrated that the vital organ tissues had less morphologic abnormality and apoptotic changes. The minimum inhibitory and minimum bactericidal concentrations of ION@PDA were 16-64 µg/ml and 16-128 µg/ml, respectively. 

Due to the high permeability of nanoprobes in tumors, less cytotoxicity, and its inhibitory effects on metronidazole-resistant H.pylori, ION@PDA may be used as a nano contrast agent in MR imaging for the detection of MCF-7 cells.

Hemiplegic Cerebral Palsy (HCP) causes significant motor impairments, due to disrupted Functional Connectivity (FC) between brain regions. Low-Frequency Repetitive Transcranial Magnetic Stimulation (LF-rTMS) has emerged as a potential therapeutic technique for restoring FC and motor recovery.
This study aimed to evaluate the effects of LF-rTMS on FC in children with spastic HCP.
This Randomized Controlled Trial (RCT) included ten children with spastic HCP, aged 4 to 13 years. Six children received 12 sessions of LF-rTMS, while four in the control group underwent 12 sessions of sham stimulation. Functional Magnetic Resonance Imaging (fMRI) was used to assess intra- and interhemispheric FC during passive knee movements of the affected limb.
LF-rTMS induced region-specific reductions in interhemispheric FC, particularly between the contralesional ventral premotor area (cPMv) and both the ipsilesional primary somatosensory cortex (iS1) (for effect size: T=-2.60, P-value=0.048, FDR-corrected) and the ipsilesional primary motor area (iM1) (T=-2.45, P-value=0.048, FDR-corrected). These findings suggest modulation of interhemispheric motor-sensory pathways. Concurrently, localized increases in FC were observed in contralesional regions, and FC decreased between the ipsilesional Supplementary Motor Area (SMA) and the secondary somatosensory cortex (S2) (T=-3.11, P-value=0.041, FDR-corrected). 
LF-rTMS may modulate FC and hold promise as a rehabilitative intervention for improving motor function in children with HCP.

It is now a well-established fact that paraspinal muscle integrity plays a critical role in low back pain. We aimed  to determine the association of the cross-sectional area (CSA), muscle disc ratio (muscularity), and muscle fat ratio of the paraspinal muscles with chronic low back pain (CLBP) of varied pathologies, and  the effect of aging and BMI.

The CSAs of the muscles did not differ significantly between the two groups except for multifidus (p<0.05) and psoas (p<0.001) at L1-L2, and psoas (p<0.001) at L2-L3. There was significant difference in CSA of disc at L3-L4, L4-L5, L5-S1 (p<0.05), muscle fat ratio (p<0.01) and muscularity of multifidus and psoas (p<0.05) from L1 to L5 levels. There was no correlation of age and BMI with the CSA. Aging led to fatty infiltration in both the groups. The CSAs of muscles and discs were comparable (p>0.05) among subgroups except at few spinal levels. Muscularity among the subgroups varied at different levels. The muscle fat ratio were comparable (p>0.05).

Muscularity and composition rather than overall CSA of important spinal stabilizers  are associated with CLBP. Age and BMI has no correlation to CSA of paraspinal muscles. Various disc and muscle parameters do not differ much among common lumbar pathologies.

Recent evidence suggests a potential association between Modic Changes (MC) and inflammation in nonspecific low back pain patients. Inflammation, characterized by the activation of immune cells and the release of pro-inflammatory molecules, is known to play. This research aims to investigate the clinical and laboratory features suggestive of inflammation in patients with MC on lumbar MRI. 

A retrospective analysis was conducted on 169 patients with MC identified on lumbar Magnetic Resonance Imaging (MRI). Laboratory investigations were also obtained, including Erythrocyte Sedimentation Rate (ESR) and C-Reactive Protein (CRP) levels. The MC were categorized based on their MRI signal patterns. The presence of inflammatory markers and their association with clinical features was assessed using appropriate statistical methods. 

The majority of patients exhibited type 2 MC (n=139, 82.4%), followed by type 1 MC (n=28, 16.5%) and type 3 MC (n=2, 1.1%). Among the clinical features, patients with type 1 MC had a significantly higher prevalence of nocturnal low back pain (OR=6.76 [95%CI: 2.25-20.24], p<0.001) and morning low back stiffness (OR= 4.27 [95%CI: 1.42-12.85], p=0.006). Additionally, patients with type 1 MC were more likely to have elevated CRP levels (OR=2.61 [95%CI: 1.18-5.78]).

Although the majority of patients had type 2 MC (82.4%), type 1 MC was strongly associated with higher CRP levels, morning stiffness, and nocturnal pain. These associations suggest that type 1 MC may represent a more inflammatory and clinically severe form of the condition, emphasizing the importance of recognizing it in clinical practice.

Radiomics with single Region of Interest (ROI) and single-sequence Magnetic Resonance Imaging (MRI) may facilitate the segmentation reproducibility and radiomics workflow due to a time-consuming and complicated delineation of that in multi-sequence MRI images. This study aimed to evaluate the performance of the radiomics approach in grading glioma based on a single-ROI delineation as Gross Tumor Volume (GTV) in a single – sequence as contrast-enhanced T1-weighted MRI. This retrospective study was conducted on contrast-enhanced T1 weighted (CE T1W) MRI images of 60 grade II and 60 grade III glioma patients. The GTV regions were manually delineated. Radiomics features were extracted per patient. The segmentation reproducibility of the robust features was evaluated in several repetitions of GTV delineation. Finally, a linear Support Vector Machine (SVM) assessed the classification performance of the robust features. Four significant robust features were selected for training the model (P-value<0.05). The average Intraclass Correlation Coefficient (ICC) of the four features was 0.96 in several repetitions of GTV delineation. The linear SVM model differentiated grades II and III of glioma with an Area Under the Curve (AUC) of 0.9 in the training group.  High predicting power for glioma grading can be achieved with radiomics analysis by a single-ROI delineated on a single-sequence MRI image (CE T1W). In addition, single-ROI segmentation can increase radiomics reproducibility.

Arachnoid cysts (ACs) are non-neoplastic, intracranial cerebrospinal fluid (CSF)-filled cavities lined with arachnoid membranes. Most of them are found incidentally and are asymptomatic. The aim of this study was to describe the clinical and demographic characteristics of ACs and to investigate the frequency of complications. ACs were classified as cerebral and cerebellar, and were evaluated according to location and size using the Galassi classification. Evaluation was made of 103 patients with AC admitted to the pediatric neurology department. The patients comprised 62.1% boys and 37.9% girls with a mean age of 10.1 ± 4.9 years. Headache was present in 33% of patients, epileptic seizures in 22.3%, and neuromotor developmental delay in 14%. Spontaneous intracranial hemorrhage (ICH) was observed in 6 patients (5.8%), with 3 (50%) having a cyst diameter ≥ 5 cm. ACs frequently involved the retrocerebellar and temporal lobes. Epilepsy was diagnosed in 26 patients (25.2%) and in only one of them, epileptic discharge and AC originated from the same region. The risk of bleeding was found to be higher in patients with cyst diameter ≥ 5 cm (P = 0.032). Although ACs are generally considered harmless, a cyst size ≥ 5 cm is important in terms of the risk of bleeding and should be followed up regularly. Although it has been reported in the literature that ACs may be associated with epilepsy, no significant correlation was found between seizure type and electroencephalography (EEG) recordings in this study.

Carpal tunnel syndrome (CTS) is a common peripheral nerve entrapment disorder that is diagnosed using clinical signs and symptoms and confirmed via nerve conduction studies (NCSs). While NCS is a semi-invasive procedure, magnetic resonance imaging (MRI) is a non-invasive diagnostic tool that detects macroscopic nerve abnormalities and evaluates a patient's surgical or medication treatment options. This study assessed magnetic resonance neurography (MRN)’s diagnostic and grading value by comparing it to electrodiagnostic studies in patients with CTS and healthy individuals. This was a cross-sectional study on 27 wrists with CTS and 27 healthy wrists. After history taking and physical examination, we employed an NCS to confirm and determine the severity of CTS, then MRN and diffusion tensor imaging (DTI) were used to calculate apparent diffusion coefficient (ADC), fractional anisotropy (FA), and cross-sectional area (CSA). 18 patients with CTS (27 median nerves) and 15 healthy controls (27 median nerves) were evaluated. The mean FA in the CTS group was significantly lower (0.38 ± 0.05 vs. 0.45 ± 0.06, P < 0.001). The mean CSA and ADC were higher in patients with CTS but not statistically significant. FA’s diagnostic cut-off was 0.42, with a sensitivity of 70.4% and a specificity of 63%. MRN with DTI can be an effective and non-invasive diagnostic technique for the detection of CTS. The FA measure demonstrated adequate sensitivity and specificity for differentiating patients with CTS from healthy individuals.

Brain magnetic resonance imaging (MRI) is crucial to determine the prognosis of multiple sclerosis (MS). The use of simple and accessible techniques that can be used for examining and managing the cognitive status and disability of patients with MS is one of the important concerns. This study aimed to investigate the relationship between corpus callosum index in brain MRI and clinical subgroups of MS, severity of cognitive disorders, and disability in multiple sclerosis.

This cross-sectional study was conducted to determine the relationship between CCI and clinical subgroups of MS, the severity of cognitive disorders, and disability in patients with MS referred to Imam Hossein Hospital in 2020. The maximum length of the corpus callosum (anterior, posterior diameter) was measured, and the height of the corpus callosum was measured on a line perpendicular to its long axis. Corpus callosum index (CCI), symbol digit modalities test (SDMT), and expanded disability status scale (EDSS) were assessed in patients. A significance level of less than 0.05 was considered.

A total of 85 patients with a mean age of 40.73 ± 8.45 years were assessed, and 65.9% were women. The CCI value was significantly lower in women (P-value: 0.001). The mean value of EDSS in all participants was 2.64±2.49. There was a statistically significant difference between the different subgroups of MS with the EDSS score, age of disease onset, SDMT score, CCI index, and mean disease duration (all P-values<0.05). There was a significant negative correlation between the CCI index and age (P:0.02, r:-0.24), duration of the disease (P:0.001, r:-0.38), EDSS (P:0.001, r:-0.71), while the correlation between SDMT and CCI was positive (P:0.001, r:0.67).

CCI is a quick and cost-beneficial parameter to evaluate cognitive disorders and disability in patients with MS.

Multiple sclerosis (MS) is one of the most common and debilitating neurological diseases. Brain magnetic resonance imaging (MRI) is critical to determine the prognosis of MS. Using simple and accessible techniques is one of the researchers' concerns. So far, limited studies have been conducted on evaluating the relationship between the Bi-caudate ratio (BCR) and white matter atrophy in brain MRI of patients with MS. Therefore, in this study, we decided to evaluate this relationship.

In this cross-sectional study, which was conducted to determine the relationship between BCR and white matter atrophy in brain MRI patients with MS, patients with MS who were evaluated by MRI at Imam Hossein Hospital (Tehran-Iran) in 2022 were assessed. BCR is determined by dividing the shortest distance between two caudate nuclei by the length of the brain at the imaging. The symbol digit modalities test (SDMT) was used to check the cognitive function of patients, and the relationship between BCR and MS-related parameters was evaluated. Expanded disability status score (EDSS) was also evaluated. A significance level was considered less than 0.05.

Eighty-five patients with a mean age of 40.73 ± 8.45 years and female gender was more prevalent (65.9%). The mean EDSS in all participants was 2.64 ± 2.49, and the mean BCR was 0.11 ± 0.03. EDSS score, age of the disease onset, SDMT score, and BCR were significantly different between different MS types (secondary progressive MS, primary progressive MS, and relapsing-remitting MS) (P-values<0.05). There was a statistically significant relationship between age, disease duration, EDSS score, onset age of the disease, and SDMT score with BCR (P<0.05). There was a statistically significant difference in the amount of BCR between sexes (P<0.045).

BCR is a valuable method for evaluating the condition of multiple sclerosis, and it can be used as a simple and accessible technique for evaluating MS conditions.

Multiple sclerosis (MS) is a demyelinating neurodegenerative disease affecting the central nervous system (CNS). While most cases are sporadic, familial MS (FMS) constitutes approximately 12.6% of the MS population and is characterized by affected family members. This study aims to investigate the difference between clinical and radiological findings of patients with FMS and sporadic MS (SMS) living in Guilan Province, Iran.

In this cross-sectional study, by evaluating their medical records, we examined 113 patients with SMS and 79 patients with FMS who registered in the nationwide MS registry of Iran (NMSRI)-Guilan. The radiologic data were analyzed using OsiriX software, version 12.0.

Compared to the FMS group, the SMS group showed significantly higher age at onset (31.48±9.55 vs 28.92±9.46, P=0.034), higher occurrence of diplopia (29.2% vs 16.4%, P=0.042), higher expanded disability status scale (EDSS) score (2.20±2.61 vs 1.09±2.08, P=0.002), more lesions (31.59±25.36 vs 22.83±17.17, P=0.017), higher frequency of lesions in the periventricular region (98.2% vs 89.8%, P=0.017) and the lower average size of the smallest lesions (4.65±2.57 vs 8.12±8.58, P<0.001). EDSS score showed significant associations with type of MS (SMS or FMS) (β=0.78, P=0.016), onset age (β=0.09, P<0.001) and disease duration (β=0.13, P=0.001).

FMS differs from SMS with an earlier onset, predominantly relapsing-remitting phenotype, lower diplopia incidence, lower EDSS scores, fewer periventricular lesions and larger smallest lesions.

Despite the clinical advances made in magnetic resonance imaging with high static magnetic fields (1.5T and more), open MRI with low field (0.2-0.5T) has recently attracted the attention of researchers. Low-field MRI (LF-MRI) has both advantages and disadvantages over high-field units. It enables the scanning of anxious patients and children who cannot tolerate enclosed high-field scanners due to discomfort. The open configuration of the LF-MRI provides a spacious examination environment. It also allows the safe imaging of metallic devices owing to the lower static field and radiofrequency. While image quality is degraded compared to high-field MRI due to a lower signal-to-noise ratio, technological advances may help address this limitation. This review aims to provide a comprehensive outline of the current applications, technical aspects, and evidence supporting the diagnostic accuracy of Low-Field MRI.

A literature search was conducted in Google Scholar and PubMed from 2021 to the oresent using the search term "low field MRI" limited to the title. Studies were excluded if only on high-field MRI, not in English, or conference abstracts without full text. After applying exclusion criteria, 32 relevant articles remained for analysis.

The results showed that portable low-field MRI expanded the availability of MRI beyond fixed facilities. One study found that 0.55T MRI had an accuracy similar to 1.5T for microbleed detection, suggesting its potential as an efficient alternative for stroke diagnosis. The literature has demonstrated the utility of low-field MRI in applications such as musculoskeletal, breast, and abdominal imaging.

In conclusion, these studies demonstrated the potential of low-field MRI as a cost-efficient alternative to high-field MRI for several clinical applications. The reduced costs and accessibility afforded by low-field designs have positioned this technology to increase diagnostic MRI access globally. However, further validation of diagnostic performance and cost-utility analyses accounting for accuracy are still needed.

Hepatocellular carcinoma (HCC) is a major global health concern, ranking sixth among prevalent cancers worldwide and third in cancer-related deaths. Despite diagnostic advancements, prognosis remains challenging. Traditional methods rely on postoperative pathology, limiting preoperative decision-making. Radiomics offers a solution by extracting imaging data to predict outcomes before surgery, aiding personalized treatment decisions.

A PubMed search spanning from May 2019 to June 2024 was conducted to identify relevant peer-reviewed articles using the keywords: "radiomics," "MRI," "hepatocellular carcinoma," "HCC," "radiomics features," "liver cancer imaging," "tumor segmentation," "treatment response," and "HCC prognosis." The search yielded a total of 850 articles. After an initial screening based on titles and abstracts, 150 full-text articles were reviewed, and 35 articles were selected for inclusion in this review. The review focused on highlighting the utility of radiomics features on MRI across various aspects of HCC management.

This review highlights MRI radiomics' extensive utility in managing HCC. It aids in diagnosis, treatment decision-making, and prognosis prediction by analyzing imaging data noninvasively. MRI radiomics informs differential diagnosis, histological grading, microvascular invasion assessment, gene expression prediction, therapeutic monitoring, and prognostic evaluation. Its transformative potential offers clinicians a comprehensive toolset for personalized care and improved patient outcomes in HCC management.

MRI radiomics holds promise as a noninvasive tool for improving the diagnosis and treatment of HCC. Its ability to extract comprehensive imaging data enables clinicians to make personalized treatment decisions, potentially improving patient outcomes. Further research and clinical validation are warranted to fully integrate MRI radiomics into routine clinical practice for HCC management.

We present a case with an intrathoracic caudate lobe in a 45-year-old woman who referred with a complaint of nonspecific chest pain. She denied previous history of trauma or surgery. Computed tomography (CT) pulmonary angiography showed a paravertebral, soft tissue mass which raised suspicion of a pleural tumor. In the coronal plane, the mass was protruding to the abdomen and had similar density with liver. Magnetic resonance imaging confirmed the diagnosis.

Computed Tomography (CT) and Magnetic Resonance Imaging (MRI) are arguably the most prominent and most widely used healthcare diagnostic modalities for a wide range of applications. There are certain specific applications for which a particular modality is specifically used or has been adopted over a period of time because of reasons like good diagnostic accuracy, fast diagnosis, etc. One such application for CT has been “Spinal Fracture Diagnosis” and for MRI has been “Brain Tumor Detection”. This study presents case studies from different time periods to demonstrate the evolution of these respective applications and emphasizes the role of Artificial Intelligence (AI) based techniques like machine learning, deep learning, etc. for advancements in the diagnostic process. The case studies will enable the new researchers to understand the background and the work done in the respective time period. The time period of the studies referred to is between the years 2000 and 2023 (Present date). The purpose of this study is to enlighten the reader about the evolution of spinal fractures and brain tumor diagnosis which are understood to be primary applications of CT and MRI, respectively and, encourage further study into topics pertaining to AI-based tools used in diagnostic modalities for applications like automatic detection and prediction, smart decision making, early detection, etc.

Pineal Gland (PG) is a midline brain structure and part of the epithalamus, a dorsal posterior segment of the diencephalon. Most findings on the role of this structure in brain function are relevant to melatonin secretion, and only a few reports are available on its involvement in brain cognition.

Due to some suggestions on the role of the diencephalon areas, including the PG, in the human memory system, we used data from two previous MRI studies on 32 and 295 healthy individuals, in order to identify first, if the PG shows activations in fMRI and during a memory retrieval task as well as showing functional connectivity with other brain structures, and second, if there are any associations between the PG volume and the memory scores of the individuals.

Using a standard PG atlas, our results showed significant activations in PG during memory retrieval, with the strength of these activations increasing with the increment of the cognitive load of the task. Also, PG showed functional connectivity with other brain structures during fMRI, the pattern of which also changed with the cognitive load of the retrieval. Finally, the volume of the PG showed significant associations with the scores of the memory tests.

Our knowledge of the PG still needs improvement, and we hope our findings here could be a help for that as well as a help to better understand the mechanisms of memory storage and retrieval in humans.

The co-occurrence of multiple sclerosis (MS) and cervical spondylosis (CS) may not only intensify symptoms but also complicate the management of these disorders. Magnetic resonance imaging (MRI) is the preferred modality for detecting spinal cord lesions; however, there is limited evidence assessing myelopathy in concurrent CS and MS.

This study aims to evaluate the association between CS and its effects on the spinal cord, as well as their impact on enhancing MS cervical lesions.

This cross-sectional study was conducted on 104 MS patients between 2019 and 2021. Data collected included age, gender, duration and phenotype of MS, and the Extended Disability Status Scale (EDSS). Magnetic resonance imaging images were obtained and analyzed for the presence of cervical spondylosis and demyelinated cervical plaques (active/inactive). Multiple sclerosis plaques were evaluated based on their extension, enhancement, and cervical location. Cervical spondylosis was categorized into four grades using the Muhle scale. Additionally, the spinal cord cross-sectional area (SC - CSA) was measured at the C2 - C3 cervical spine level.

The severity of cervical spondylosis was associated with older age (P-value < 0.001), longer duration of MS (P-value = 0.04), more severe EDSS scores (P-value = 0.03), and a lower C2 - C3 CS-CSA (P-value < 0.001). However, no significant associations were found with gender (P-value = 0.90), MS plaques activity (P-value = 0.25), or extension (P-value = 0.13).

The study findings indicate that the severity of CS is associated with age, MS duration, EDSS, and the C2 - C3 cervical spine cross-sectional area. However, the study did not find evidence supporting a relationship between CS and the extension or activity of MS plaques.

Endometrial stromal sarcoma (ESS) is an uncommon condition that accounts for approximately 0.2% of all reproductive tract malignancies. Among the various subtypes of ESS, low-grade extrauterine endometrial stromal sarcoma (LG-EESS) is even rarer and has only been reported in a limited number of case studies.

We reported a case of LG-EESS in a 35-year-old woman with a five-year history of stage IV endometriosis. The patient presented with chronic abdominopelvic pain and dysmenorrhea. Transvaginal ultrasound showed bilateral tubo-ovarian complexes with multicystic structures, while MRI revealed solid lesions with T1 iso signal, T2 hypersignal, and diffusion restriction, indicating metastatic implantation extending to the peritoneum and subhepatic region. A core needle biopsy confirmed LG-EESS, and immunohistochemistry showed CD10 positivity, aiding in the diagnosis and distinguishing it from other tumors.

Our case highlights the potential utility of preoperative diagnostic imaging, particularly MRI, in the evaluation of LG-EESS. Additionally, it emphasizes the importance of considering the possibility of extrauterine ESS, as this tumor exhibits histopathological features and clinical behavior similar to its uterine counterpart.