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Purpose: To document the changes observed at sequential magnetic resonance (MR) imaging of sarcoidosis lesions of the central nervous system (CNS) during treatment with corticosteroids., Materials and Methods: The abnormalities detected in 24 patients (mean follow-up, 36 months) were compared before and after therapeutic periods (n = 75) that were divided into attack (high-dose), upkeep (decreased-dose), and minimal (low-dose) periods. Parenchymal lesions were classified as type 1 (enhanced with gadolinium), type 2 (demyelinating), or type 3 (lacunar) and were assessed as regressing, stable, or progressing., Results: Seven of the 24 patients had several types of lesions. Isolated type 3 lesions (six patients) were the only lesions not associated with neurologic deficit. Type 1 lesions (13 patients) regressed in 22 of 22 attack periods and progressed in nine of 27 upkeep and minimal periods. MR imaging depicted relapses in patients with multifocal CNS involvement or long-standing CNS impairment or in those who had previously received steroid therapy. Type 2 (seven patients) and type 3 (13 patients) lesions remained stable in 68 of 68 therapeutic periods. Type 1 lesions appeared in three patients with type 2 and type 3 lesions during two upkeep and three minimal periods. Findings at follow-up MR imaging contributed to the reintroduction of high-dose corticosteroid therapy in eight patients., Conclusion: MR imaging can be used to differentiate between reversible and irreversible lesions in CNS sarcoidosis. MR imaging can be a useful tool for adjusting treatment to prevent irreversible CNS damage.

We describe a case of focal and intense contrast enhancement on hepatic CT due to superior vena caval obstruction and brachiocephalic vein obstruction. This phenomenon is explained by systemic portal venous shunting.

We report the assessment by MRI of a case of radiculomyelitis after vaccination against tetanus-poliomyelitis. In the acute stage the appearance was an isolated myelitis of the conus medullaris with contrast enhancement. The upper thoracic cord presented central areas of high signal intensity on T2 weighted images. Rapid clinical recovery was correlated with resolution of abnormal enhancement. Follow-up MR at 5 months showed persistence of slight T2 prolongation in the conus medullaris and syringohydromyela of the thoracic cord. A single lesion of the spinal cord is a rare presentation of acute disseminated encephalomyelitis, the course of such lesions, to date not previously displayed by MR, is unknown. Proper diagnosis should help prevent administration of further vaccine doses.

We report the assessment by MRI of a lumbosacral lymphomatous localization of adult T-cell leukemia/lymphoma (ATLL) with human T-cell lymphotropic virus-1 infection in an African patient. Brain MRI detected associated multifocal lesions of increased signal intensity in the subcortical white matter. These MRI abnormalities are compatible with reported necropsy findings in cases of ATLL with neurological complications.

The authors present a typical case of Mondor's disease of the superior external quadrant of the breast. They discuss two specific points: --the absence of superior-internal venous drainage; --the radiological picture given by a thrombosed vein.