Background Though abnormal iron deposition has been reported in specific brain regions in multiple sclerosis (MS), no data exist about whether the overall quantity of iron in the brain is altered or not. We aimed to determine whether the noted aberrant iron deposition in MS brains was a problem of overall load or regional distribution in a cohort of MS patients. Methods An experienced neuroradiologist, a radiology software engineer, and four neurologists analysed data from quantitative susceptibility maps reconstructed from 3-T magnetic resonance brain images of 30 MS patients and 15 age- and sex-matched healthy controls. Global brain iron load was calculated, and the regional iron concentrations were assessed in 1,000 regions of interest placed in MS lesions in different locations, normal appearing white matter, thalami, and basal ganglia. Results Global brain iron load was comparable between patients and controls after adjustment for volume (p = 0.660), whereas the regional iron concentrations were significantly different in patients than in control (p ≤ 0.031). There was no significant correlation between global iron load and clinical parameters, whereas regional iron concentrations correlated with patients’ age, disease duration, and disability grade (p ≤ 0.039). Conclusions The aberrant iron deposition noted in MS seems to be a problem of regional distribution rather than an altered global brain iron load.

Background The new guidelines limited the use of lung biopsy in the evaluation of lung fibrosis because of its hazards. The differential diagnosis of interstitial pulmonary fibrosis (IPF) or usual interstitial pneumonia (UIP) is challenging because of overlapping multi-detector computed tomography (MDCT) morphologic features between interstitial and non-interstitial fibrosing lung diseases. Scar carcinoma is a serious complication that needs to be excluded in certain conditions. Aim of the work: To achieve a multi-disciplinary algorithm for the diagnosis of fibrosing lung diseases to limit the need for lung biopsy by combining the clinico-laboratory and radiological roles. Results This study included two major steps. The first step (prevalence/significance analysis of the contributing parameters for the diagnosis of fibrosing lung diseases) was retrospectively conducted on 150 patients pathologically proved with fibrosing lung disease during the period between January/2016 and April/2018. Based on a P-value < 0.001, honeycombing bronchiectasis was significant to IPF. Basal traction bronchiectasis/bronchiolectasis was relevant to fibrosing non-specific interstitial pneumonia (NSIP). "Head cheese" CT-sign, history of allergen exposure, blood eosinophilia, and broncho-alveolar lavage (BAL) lymphocytosis were relevant to chronic hypersensitivity pneumonitis (HP). Upper peripheral lung fibrosis was significant to pulmonary tuberculosis (TB) and pleuroparenchymal fibroelastosis (PPFE). Cavitations, tree-in-bud, and calcific nodules were relevant to TB, while the "platy-thorax" CT-sign was relevant to PPFE. The upper peribronchovascular fibrosis was relevant to sarcoidosis and progressive massive fibrosis (PMF); additionally, calcific changes were relevant to PMF. Bright T2-signal, diffusion weighted-image (DWI) restriction in magnetic-resonance imaging (MRI), and high standardized uptake value (SUV) in positron emission tomography (PET-CT) were significant to scar carcinoma. Eventually, an algorithm was created. The second step (validation analysis) prospectively targeted 100 patients initially diagnosed with lung fibrosis during the period from June/2018 to June/2022. It revealed 83.3–100% sensitivity, 96.3–100% specificity, 85.7–100% PPV, 96.4–100% NPV, and 96–100% accuracy, with balanced accuracy = 0.91–1. Four consulting radiologists and two consulting pulmonologists participated in this study. Conclusions A valid stepwise multi-disciplinary algorithm was proposed for the diagnosis of interstitial and non-interstitial fibrosing lung diseases to limit the need and hazards of lung biopsy. It contributed significant clinico-laboratory data, MDCT features, T2-WI and DWI-MRI findings as well as PET/CT results.

Purpose Stroke is a principal cause of disability worldwide. In motor stroke, the tools for stratification and prognostication are plentiful. Conversely, in stroke causing mainly visual and cognitive problems, there is still no gold standard modality to use. The purpose of this study was to explore the fMRI recruitment pattern in chronic posterior cerebral artery (PCA) stroke patients and to investigate fMRI as a biomarker of disability in these patients. Methods The study included 10 chronic PCA stroke patients and another 10 age-matched volunteer controls. The clinical presentation, cognitive state, and performance in visual perceptual skills battery (TVPS-3) were determined for both patients and control groups. Task-based fMRI scans were acquired while performing a passive visual task. Individual and group analyses of the fMRI scans as well as correlation analysis with the clinical and behavioral data were done. Results At the level of behavioral assessment there was non-selective global impairment in all visual skills subtests. On visual task-based fMRI, patients recruited more brain areas than controls. These activations were present in the ipsilesional side distributed in the ipsilesional cerebellum, dorsolateral prefrontal cortex mainly Brodmann area (BA) 9, superior parietal lobule (somatosensory associative cortex, BA 7), superior temporal gyrus (BA 22), supramarginal gyrus (BA 40), and contralesional associative visual cortex (BA 19). Spearman’s rank correlation was computed to assess the relationship between the TVPS scores and the numbers of fMRI neuronal clusters in each patient above the main control activations, there was a negative correlation between the two variables, r(10) = −0.85, p ≤ 0.001. Conclusion In chronic PCA stroke patients with residual visual impairments, the brain attempts to recruit more neighboring and distant functional areas for executing the impaired visual skill. This intense recruitment pattern in poorly recovering patients appears to be a sign of failed compensation. Consequently, fMRI has the potential for clinically relevant prognostic assessment in patients surviving PCA stroke; however, as this study included no longitudinal data, this potential should be further investigated in longitudinal imaging studies, with a larger cohort, and multiple time points.