Anatomical Variations in the Posterior Part of the Circle of Willis and Vascular Pathology in Bilateral Thalamic Infarction
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CONCLUSIONSVascular imaging is useful to determine underlying vascular pathologies and may support the diagnosis of small vessel disease in those patients with isolated bilateral paramedian thalamic infarction, hypoplastic/absent P1 segment of the PCA, and lack of vascular pathology. (Source: Journal of Neuroimaging)
Neuroimaging Features in Congenital Trichomegaly: The Oliver‐McFarlane Syndrome
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ABSTRACT A 23‐year‐old woman presented to our hospital with 9 months history of progressive ataxia, visual loss since childhood due to retinitis pigmentosa and primary amenorrhea. On examination, there were also sparse scalp hair, very long and curled upwards eyelashes and short stature. Oliver‐McFarlane syndrome was suspected. Brain MRI disclosed cerebellar atrophy and hyperintense signal in corticospinal tracts on FLAIR and T2‐weighted images. Therefore, brain imaging must be thoroughly investigated in patients with suspected Oliver‐McFarlane syndrome, in order to determinate whether cerebellar atrophy and hyperintense signal in corticospinal tracts are part of this neurological condition. (Source: Journal of Neuroimaging)
Endovascular Treatment of Posttraumatic Carotid‐Cavernous Fistulas and Pseudoaneurysms with Covered Stents
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CONCLUSIONThese preliminary results indicate that the use of a covered stent is a feasible procedure for the treatment CCFs and pseudoaneurysms. (Source: Journal of Neuroimaging)
Reliability, Asymmetry, and Age Influence on Dynamic Cerebral Autoregulation Measured by Spontaneous Fluctuations of Blood Pressure and Cerebral Blood Flow Velocities in Healthy Individuals
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CONCLUSIONSCA parameters obtained by time‐ and frequency‐domain methods correlate well, and show good interhemispheric and test‐retest reliability. Group means from healthy controls may provide adequate norms for determining abnormal CA in cerebrovascular patients. (Source: Journal of Neuroimaging)
The Role of Sonolysis and Sonothrombolysis in Acute Ischemic Stroke: A Systematic Review and Meta‐analysis of Randomized Controlled Trials and Case‐Control Studies
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CONCLUSIONSThis novel treatment appears safe and effective. The evidence of microsphere as an enhancement of sonothrombolysis is evolving. (Source: Journal of Neuroimaging)
Posterior Reversible Encephalopathy Syndrome Following a Scorpion Sting
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We report a case of 13‐year‐old male who was stung by a scorpion and developed a severe headche, visual disturbance, and seizures and had the diagnosis of PRES with a good outcome. Numerous factors can trigger this syndrome, most commonly: acute elevation of blood pressure, abnormal renal function, and immunosuppressive therapy. There are many cases described showing the relationship between PRES and eclampsia, transplantation, neoplasia and chemotherapy treatment, systemic infections, renal disease acute, or chronic. However, this is the first case of PRES following a scorpion sting. (Source: Journal of Neuroimaging)
Perianeursymal Cyst Development after Endovascular Treatment of a Ruptured Giant Aneurysm
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(Source: Journal of Neuroimaging)
Stroke in Primary Hyperoxaluria Type I
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We report the case of a 27‐year‐old man with a history of previously undiagnosed renal disease that presented with multiple cerebrovascular infarctions. Workup for traditional causes of cerebrovascular infarction including cardiac telemetry, multiple echocardiograms, and hypercoagulative workup was negative. However, a transcranial Doppler detected circulating microemboli at the rate of 14 per hour. A serum oxalate level greater than the supersaturation point of calcium oxalate was detected, providing a potential source of the microemboli. Furthermore, serial imaging recorded rapid mineralization of the infarcted territories. In the absence of any proximal vessel irregularities, atherosclerosis, valvular abnormalities, arrhythmias, or systemic shunt as potential stroke etiology in this...
Clinical Experience of Modified Diffusion‐Weighted Imaging Protocol for Lesion Detection in Transient Global Amnesia: An 8‐Year Large‐Scale Clinical Study
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CONCLUSIONSA modified TGA DWI protocols for detecting TGA lesions are useful in large‐scale clinical practice for confirming the diagnosis of TGA patients with clinical findings. (Source: Journal of Neuroimaging)
Advanced Neuroimaging Studies in a Patient with Brain Metastases from Transitional Cell Carcinoma of the Bladder
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CONCLUSIONSResection of both lesions revealed metastatic transitional cell carcinoma. This is the first report of octreotide scan characteristics in a patient with transitional cell carcinoma with central nervous system (CNS) metastases. The octreotide avidity of these transitional cell CNS metastases suggests the presence of somatostatin receptors that may be considered as a potential therapeutic target. (Source: Journal of Neuroimaging)
Intracranial Extramedullary Hematopoiesis: A Rare Cause of Headaches
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CONCLUSIONIn summary, extramedullary hematopoiesis is a hematologic compensatory disorder that rarely occurs within the CNS and may cause neurological compromise due to compression on underlying structures. The diagnosis can be made with noninvasive imaging and treated with low dose radiation therapy. (Source: Journal of Neuroimaging)
Detectability of Neural Tracts and Nuclei in the Brainstem Utilizing 3DAC‐PROPELLER
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ABSTRACT Despite clinical importance of identifying exact anatomical location of neural tracts and nuclei in the brainstem, no neuroimaging studies have validated the detectability of these structures. The aim of this study was to assess the detectability of the structures using three‐dimensional anisotropy contrast‐periodically rotated overlapping parallel lines with enhanced reconstruction (3DAC‐PROPELLER) imaging. Forty healthy volunteers (21 males, 19 females; 19‐53 years, average 23.4 years) participated in this study. 3DAC‐PROPELLER axial images were obtained with a 3T‐MR system at four levels of the brainstem: the lower midbrain, upper and lower pons, and medulla oblongata. Three experts independently judged whether five tracts (corticospinal tract, medial lemniscus, med...
Transcranial Doppler Identifies a Malfunctioning Extraventricular Drain
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We present a case where TCD monitoring for vasospasm after subarachnoid hemorrhage identified blood flow velocity changes consistent with sudden increased intracranial pressure (ICP) due to a malfunctioning extraventricular drain. The primary team was alerted to these findings, and immediately revised her shunt with normalization of ICP and TCD. Serial TCD monitoring allowed identification of an imminently fatal complication in time to allow a life saving intervention. TCD is a portable, inexpensive, real‐time tool providing important physiologic data regarding blood flow velocities and intracranial pressure that is crucial to the care of critically ill patients. (Source: Journal of Neuroimaging)
Task‐Correlated Facial and Head Movements in Classifier‐Based Real‐Time fMRI
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CONCLUSIONMovement tasks of many types (including movements of the eyes, face, and body) can lead to false positives in classifier‐based real‐time fMRI paradigms. (Source: Journal of Neuroimaging)
2013 Annual Meeting Abstracts
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(Source: Journal of Neuroimaging)
Benign Notochordal Lesions of the Posterior Clivus: Retrospective Review of Prevalence and Imaging Characteristics
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CONCLUSIONMany notochordal lesions do not fit neatly into the diagnostic criteria for either EP or chordoma. It may be useful to consider these atypical cases along a spectrum of notochord remnant lesions. Close inspection of imaging reveals BNCTs at a similar frequency to its pathologic prevalence. BNCTs such as EP vary in size and may be easily overlooked. (Source: Journal of Neuroimaging)
CT Angiography Evaluation of Unusual Transorbital Penetrating Injury: A Toothbrush
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We present an uncommon case of a 3‐year‐old child with a penetrating orbital injury caused by a toothbrush. To the best of our knowledge, there is no report orbital injury with a toothbrush so far. (Source: Journal of Neuroimaging)
Appropriate Use of Advanced Imaging Services by Providers Who Self‐Refer is Saving Medicare Billions
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(Source: Journal of Neuroimaging)
Reproducibility of ABC/2 Method to Determine Infarct Volume and Mismatch Percentage with CT Perfusion
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CONCLUSIONSThe ABC/2 method of volume estimation on CT perfusion is a reliable and efficient approach to determine infarct and penumbra volumes. The 1–CBV/MTT × 100% formula produces a mismatch percentage assisting providers in communicating the proportion of salvageable brain and guides therapy in the setting of patients with unclear time of onset with potentially salvageable tissue who can undergo mechanical retrieval or intraarterial thrombolytics. (Source: Journal of Neuroimaging)
MRI‐based Morphometric Analysis of Posterior Cranial Fossa in the Diagnosis of Chiari Malformation Type I
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CONCLUSIONSThe addition of simple morphometric measurements in the diagnostic work‐up of patients with suspected CMI may facilitate radiological diagnosis. Moreover, identification of the subset of CMI that arise from basichondrocranium underdevelopment is important for both, selection of the most appropriate therapeutic approach as well as proper CMI categorization in research studies. (Source: Journal of Neuroimaging)
Assessing the Accuracy and Reproducibility of Computer‐Assisted Analysis of 123I‐FP‐CIT SPECT Using BasGan (V2)
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CONCLUSIONBasGan‐assisted evaluations of 123I‐FP‐CIT‐SPECT were very useful, particularly in “doubtful” cases. Multicenter studies are mandatory before routine use of BasGan. (Source: Journal of Neuroimaging)
Two Different Morphologies of Chronic Unilateral Middle Cerebral Artery Occlusion: Evaluation using High‐Resolution MRI
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CONCLUSIONSHR‐MRI can characterize the morphology of pathologic segments of chronic unilateral MCA occlusions in vivo. In chronic MCA occlusion, morphological analysis using HR‐MRI may enhance the effort to assess the etiology in company with the angiographic finding. (Source: Journal of Neuroimaging)
MR and CT of Brain's Cava
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ABSTRACT The Cavum Septi Pellucidi (CSP), Cavum Vergae (CV) and Cavum Veli Interpositi, are anatomical variants located in the midline of the brain. It is important to identify these conditions to distinguish them from other entities that may require treatment. In this paper, our purpose is to describe MR and CT findings of CSP, CV and Cavum Veli Interpositi, explaining the differential diagnosis. (Source: Journal of Neuroimaging)
Optic Nerve Sonography to Monitor Treatment Efficacy in Idiopathic Intracranial Hypertension: A Case Report
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CONCLUSIONSUS of ONSD and ODE was useful to support the diagnosis of IIH and to monitor the efficacy of diet and pharmacological treatment. Further studies are required to evaluate whether this promising technique may be considered a reliable and accurate method to longitudinally evaluate patients with increased ICP secondary to IIH. (Source: Journal of Neuroimaging)
White Matter Alterations in Early Stages of Schizophrenia: A Systematic Review of Diffusion Tensor Imaging Studies
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ABSTRACT Several lines of evidence suggest that the normal integration of cerebral communication may be compromised in schizophrenia, with white matter (WM) abnormalities being integral to these functional deficits. Diffusion tensor imaging (DTI) is a neuroimaging technique which has increasingly been used to study WM through quantitative indices of its structural and orientational characteristics. Identifying the WM differences early in the course of schizophrenia may assist in prevention, early diagnosis and identification of treatment targets. In that respect, the aims of the present study were to (a) systematically review WM integrity in the early stages of schizophrenia as inferred by DTI and (b) specifically examine parameters that may affect WM: age, duration of illness and treatmen...
Anterior Inferior Cerebellar Artery Aneurysms Mimicking Vestibular Schwannomas
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CONCLUSIONSCaution is advised before suspecting a CPA mass to be a purely extra‐canalicular schwannoma, given its extreme rarity. Deafness and cerebellar ischemia may be prevented if AICA aneurysms are correctly identified preoperatively. In the absence of specific arterial imaging, two MR features may distinguish them from vestibular schwannomas: (1) the absence of internal auditory canal enlargement and (2) the “blurry dot sign,” representing blood flow artefacts on pre‐ and postcontrast studies. (Source: Journal of Neuroimaging)
Measurement of Length of Hyperdense MCA Sign in Acute Ischemic Stroke Predicts Disappearance after IV tPA
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CONCLUSIONHMCAS length >10 mm infrequently disappears with IV tPA suggesting a potential need for ancillary therapy in this group. (Source: Journal of Neuroimaging)
Correlation between Frequency of Microembolic Signals and Efficacy of Antiplatelet Therapy in Symptomatic Carotid Disease
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CONCLUSIONSOur study suggests that in patients with recent symptomatic carotid‐artery stenosis the detection of more than one microembolic signals might serve as a useful marker for the effectiveness of the antiplatelet treatment. (Source: Journal of Neuroimaging)
No Regional Gray Matter Atrophy Differences between Pediatric‐ and Adult‐Onset Relapsing‐Remitting Multiple Sclerosis
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CONCLUSIONSRegional GM differences were not found between POMS adults and MS controls matched for age or disease duration. Although of limited sample size, these findings suggest that there are no regional GM atrophy differences between RR POMS and AOMS. (Source: Journal of Neuroimaging)
Computed Tomography and Transcranial Doppler Findings in Acute and Subacute Phases of Intracerebral Hemorrhagic Stroke
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CONCLUSIONSTCD monitoring sensitively demonstrates the hemodynamic change caused by ICH but the severity of the changes does not correlate with the volume of the ICH in acute stage. The CPP, RAP, and CBFI values are more sensitive parameters than the absolute velocity values, therefore they contribute more to the understanding of hemodynamic changes developed after spontaneous ICH. (Source: Journal of Neuroimaging)
Dynamic Contrast‐Enhanced MRA at 1.5 T for Detection of Arteriovenous Shunting Before and After Onyx Embolization of Cerebral Arteriovenous Malformations
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CONCLUSIONSDynamic contrast‐enhanced MRA is a promising non‐invasive modality in identifying residual arteriovenous shunting after different stages of AVM embolization, achieving 100% agreement in this small study. Embolization with Onyx caused no significant image artifact. (Source: Journal of Neuroimaging)
White Matter Alterations in Early Stages of Schizophrenia: A Systematic Review of Diffusion Tension Imaging Studies
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ABSTRACT Several lines of evidence suggest that the normal integration of cerebral communication may be compromised in schizophrenia, with white matter (WM) abnormalities being integral to these functional deficits. Diffusion tensor imaging (DTI) is a neuroimaging technique which has increasingly been used to study WM through quantitative indices of its structural and orientational characteristics. Identifying the WM differences early in the course of schizophrenia may assist in prevention, early diagnosis and identification of treatment targets. In that respect, the aims of the present study were to (a) systematically review WM integrity in the early stages of schizophrenia as inferred by DTI and (b) specifically examine parameters that may affect WM: age, duration of illness and treatmen...
Dolichoectasia Diagnostic Methods in a Multi‐Ethnic, Stroke‐Free Cohort: Results from the Northern Manhattan Study
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CONCLUSIONSA TCV‐adjusted intracranial arterial diameter ≥2 SD is proposed as a useful DE definition. The variability in the prevalence of DE depending on the methods used underscores the need to agree on a reliable, universal definition of DE. (Source: Journal of Neuroimaging)
Cerebral Fat Embolisms Secondary to Rupture of a Tarlov Cyst
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(Source: Journal of Neuroimaging)
Endovascular Embolization by Parent Artery Reconstruction of a Symptomatic Fusiform Posterior Cerebral Artery Aneurysm Using Onyx HD‐500: A Neurointerventional Report
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CONCLUSIONSThis report illustrates the ability of a high‐density liquid embolic agent to provide immediate reconstruction of a fusiform aneurysm in a distal location. (Source: Journal of Neuroimaging)
FLAIR Distal Hyperintense Vessels as a Marker of Perfusion‐Diffusion Mismatch in Acute Stroke
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CONCLUSIONSDHV may be a surrogate marker for PDM in patients with hyperacute ischemic stroke. (Source: Journal of Neuroimaging)
Voxel‐Wise Co‐analysis of Macro‐ and Microstructural Brain Alteration in Mild Cognitive Impairment and Alzheimer's Disease Using Anatomical and Diffusion MRI
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CONCLUSIONThese results suggest that in corpus callosum and temporal regions macro‐ and microstructural variations in MCI can be congruent, providing potentially new insight into the mechanisms of brain tissue degeneration. (Source: Journal of Neuroimaging)
Application of Chemical Exchange Saturation Transfer (CEST) MRI for Endogenous Contrast at 7 Tesla
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ABSTRACT Chemical exchange saturation transfer (CEST) magnetic resonance imaging (MRI) indirectly images exchangeable solute protons resonating at frequencies different than bulk water. These solute protons are selectively saturated using low bandwidth RF irradiation and saturation is transferred to bulk water protons via chemical exchange, resulting in an attenuation of the measured water proton signal. CEST MRI is an advanced MRI technique with wide application potential due to the ability to examine complex molecular contributions. CEST MRI at high field (7 Tesla [7 T]) will improve the overall results due to increase in signal, T1 relaxation time, and chemical shift dispersion. Increased field strength translates to enhanced quantification of the metabolite of interest, allowing more f...
Usability and Potential of Geostatistics for Spatial Discrimination of Multiple Sclerosis Lesion Patterns
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CONCLUSIONSThis method in development is a promising candidate to complement standard image‐based statistics by incorporating spatial quantification. The work flow is generic and not limited to analyzing MS lesion patterns. It can be completely automated for the screening of radiological archives. (Source: Journal of Neuroimaging)
T2 Hyperintensity of Medial Lemniscus: Higher Threshold Application to ROI Measurements is More Accurate in Predicting Small Vessel Disease
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CONCLUSIONMLH seen on high threshold ROI analysis is a reliable radiologic marker in predicting SVD. ROI analysis of MLH should be performed by an experienced neuroradiologist. (Source: Journal of Neuroimaging)
Presumptive Progressive Multifocal Leukoencephalopathy in Multiple Sclerosis after Natalizumab Therapy
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CONCLUSIONSThis case represents a presumptive PML after discontinuation of natalizumab treatment—similar to the definition established for PML in HIV patients. (Source: Journal of Neuroimaging)
Unusual Imaging Findings in Brain and Spinal Cord in Two Siblings With Maple Syrup Urine Disease
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ABSTRACT Maple syrup urine disease (MSUD) is a rare metabolic disease affecting the neural tissue. While the brain abnormalities present on MRI are well known, spinal imaging features have not been studied. We herewith report an unusual finding of enlarged Virchow Robin spaces in brain and novel spinal cord changes in two biochemically diagnosed cases of MSUD. To the best of our knowledge, spinal MRI findings in cases of MSUD have not been previously reported. Knowledge of spinal MRI findings may be useful in diagnosis of this rare disorder. (Source: Journal of Neuroimaging)
Neuroblastoma with a Solitary Intraventricular Brain Metastasis Visualized on I‐123 MIBG Scan
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CONCLUSIONSOur case shows that 123I‐MIBG scintigraphy can be useful in detecting intraventricular brain metastases of neuroblastoma. Although the 123I‐MIBG scintigraphy has been reported to have a significantly superior sensitivity in monitoring asymptomatic patients with neuroblastoma compared with 131I‐MIBG scans, bone marrow histology, bone scan, CT, and urinary catecholamine levels, further studies may be necessary to evaluate its sensitivity in detecting brain lesions. (Source: Journal of Neuroimaging)
Optic Nerve and its Arterial‐Venous Vascularization: An Ultrasonologic Study in Multiple Sclerosis Patients and Healthy Controls
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CONCLUSIONSWe found no significant alteration in the arterial‐venous vascularization of both affected and unaffected ONr compared with HC. We demonstrated the possibility to detect ONr atrophy in MS patients. (Source: Journal of Neuroimaging)
Structural and Metabolic Features of Two Different Variants of Multiple Sclerosis: A PET/MRI Study
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CONCLUSIONSOur findings illustrate that metabolic features may differ between variants of MS possibly signifying different disease activity. (Source: Journal of Neuroimaging)
Flat Detector Computed Tomography Angiography with Intravenous Contrast Application: Feasibility for Visualization of Cerebral Arterial Vasculature
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CONCLUSIONSThe results suggest that the cerebral arteries can be visualized by FD‐CTA in high resolution, in many vessel segments comparable to DSA. (Source: Journal of Neuroimaging)
“Snake Fang” Sign without Carotid Stenosis on Duplex Ultrasonography Indicates High Risk of Artery‐to‐Artery Embolic Stroke
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CONCLUSIONSIn these two cases, duplex ultrasonography revealed free‐floating thrombi developed at the distal region of small plaques. Aggressive treatment should be considered in a patient with thromboembolic stroke who has the small plaque presenting “snake fang” sign even if there is no stenosis or plaque vulnerability. (Source: Journal of Neuroimaging)
Retropharyngeal Ganglioneuroma: A Case Report
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We report a case of a retropharyngeal ganglioneuroma, a rare occurrence, emphasizing its key imaging characteristics. (Source: Journal of Neuroimaging)
Influence of Hematoma Location on Acute Mortality after Intracerebral Hemorrhage
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CONCLUSIONSFor patients with lobar ICH, acute mortality is related to both hematoma size and location, with findings potentially useful for therapeutic decision making. The current findings also underscore differences between the syndromes of acute deep and lobar ICH. (Source: Journal of Neuroimaging)
Brain Metastases from Prostate Cancer: An 11‐Year Analysis in the MRI Era with Emphasis on Imaging Characteristics, Incidence, and Prognosis
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CONCLUSIONSBrain metastasis from prostate cancer remains a rare phenomenon that most frequently occurs in the setting of widely disseminated bone and soft tissue disease. Patients with nonadenocarcinoma pathology are more likely to develop brain metastases. The MRI appearance is highly variable and prognosis is poor. (Source: Journal of Neuroimaging)
Ruptured Internal Carotid Artery Aneurysm Presenting as a Sinonasal Organized Hematoma: Conventional Approach May Endanger Life
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ABSTRACT Sinonasal organized hematoma (SOH) is an uncommon benign entity with locally aggressive behavior. The conventional approach is complete resection. This approach, however, can cause massive hemorrhage and mortality in our patient due to a ruptured internal carotid artery (ICA) aneurysm hidden inside the SOH. To the best of our knowledge, this is the first case of a huge SOH with skull base invasion caused by a hidden ICA aneurysm, which usually would not be large enough to result in a sinonasal mass lesion. This case suggests that the possibility of an aneurysm should always be considered if a SOH is suspected, especially when it is huge and close to the ICA. Surgical resection may not be the first therapeutic choice unless the differential cause of a hidden aneurysm can be exclude...
Acute Marchiafava‐Bignami Disease with Extensive Diffusion Restriction and Early Recovery: Case Report and Review of the Literature
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We present an acute onset of MBD with diffusion restriction of the complete corpus callosum and symmetric bilateral extension into the semioval center, that almost completely resolved clinically as well as in MRI only 3 days later. With early detection and treatment, the prognosis of MBD may be good even in cases with severe diffusion restriction of the complete corpus callosum. (Source: Journal of Neuroimaging)
A New Classification Scheme for Spinal Vascular Abnormalities based on Angiographic Features
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CONCLUSIONThe new classification scheme provided satisfactory reliability even in the hands of less experienced observers. The scheme can be used with minimal training and other concurrent data and can be relied upon to provide consistent results. (Source: Journal of Neuroimaging)
Whole‐Brain Proton MR Spectroscopic Imaging in Parkinson's Disease
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CONCLUSIONSPD is associated with widespread alterations of brain metabolite concentrations, with a primary finding of increased creatine. Higher creatine values in our PD sample may reflect greater neuronal energy expenditure early in the disease process that is compensatory. This is the first whole brain MRS study of PD that has examined metabolite changes across a large fraction of the brain volume, including the cortical mantle. (Source: Journal of Neuroimaging)
Clinical–Radiological Severity Mismatch Phenomenon: Patients with Severe Neurological Deficits Without Matching Infarction on Computed Tomographic Scan
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CONCLUSIONSWe observed that approximately one‐fourth of patients with severe neurological deficits have clinical–radiological severity mismatch. Such patients appear to have a high rate of favorable outcomes at 1 year. (Source: Journal of Neuroimaging)
Occurrence and Prognostic Significance of Cervical Pseudodissection Phenomenon Associated with Acute Intracranial Internal Carotid Artery Occlusion
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CONCLUSIONEarly recognition of pseudodissection in the ICA is important in the setting of acute ischemic stroke to avoid delay in treatment of intracranial ICA occlusion. (Source: Journal of Neuroimaging)
Non‐Invasive Intracranial Pressure Monitoring with Transcranial Doppler in a Patient with Progressive Cerebral Venous Sinus Thrombosis
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We present a case of extensive and progressive cerebral venous sinus thrombosis in which TCD served as an excellent tool for monitoring ICP and the serial observations correlated closely with clinical status and ophthalmological findings. (Source: Journal of Neuroimaging)
A Novel Method for Transcranial Doppler Microembolic Signal Monitoring at the Vertebrobasilar Junction in Vertebral Artery Dissection Patients
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CONCLUSIONWe successfully detected HITS at the vertebrobasilar junction in VAD patients, which may lead not only to an appropriate choice of antithrombotic drugs but also to individual evaluation of early risk of ischemic recurrence. (Source: Journal of Neuroimaging)
Evaluating of Small Intracranial Aneurysms by 64‐Detector CT Angiography: A Comparison with 3‐Dimensional Rotation DSA or Surgical Findings
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CONCLUSIONThe diagnostic performance of 64‐detector CTA did not improve much compared with 16‐detector CTA for detecting SIAs, especially for very small aneurysms. VR‐RDSA is still necessary for patients with a history of subarachnoid hemorrhage if the CTA findings are negative. (Source: Journal of Neuroimaging)
Diffusion Anisotropy Color‐Coded Map of Cerebral White Matter: Quantitative Comparison between Orthogonal Anisotropic Diffusion‐Weighted Imaging and Diffusion Tensor Imaging
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CONCLUSIONSThe 3DAC could visualize directional information of white matter tracts as precisely DTI‐based color maps did, particularly when FA was large and/or e1 directions were orthogonal. (Source: Journal of Neuroimaging)
“Ears of the Lynx” Sign in a Marchiafava–Bignami patient: Structural Basis and Fiber‐Tracking DTI Contribution to the Understanding of this Imaging Abnormality
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We report a patient with a chronic form of Marchiafava–Bignami disease (MBD) that presented with this imaging feature. Diffusion tensor imaging (DTI) and fiber‐tracking data support that this finding is a consequence of the structural derangement, which enlarges a preexisting border zone of the bundles of fibers from the corpus callosum (CC) genu to the forceps minor and anterior corona radiata. Therefore, we assume that despite their pathological differences, damage to the anterior portion of the CC is responsible for the imaging similarities between MBD and ARHSP–TCC. (Source: Journal of Neuroimaging)
Selective Endovascular Aneurysm Neck Ligation to Treat Compressive Cranial Neuropathy
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CONCLUSIONThis technique may be considered in patients presenting with compressive cranial neuropathy and an aneurysm configuration that allows selective coiling of the inflow zone. (Source: Journal of Neuroimaging)
Virtual Histology Analysis of Carotid Atherosclerotic Plaque: Plaque Composition at the Minimum Lumen Site and of the Entire Carotid Plaque
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CONCLUSIONThe plaque composition at the minimum lumen site represents the volumetric composition of the entire carotid plaque that causes atherosclerotic cervical carotid artery stenosis. (Source: Journal of Neuroimaging)
Carotid Artery Dissection due to Elongated Styloid Process: A Self‐Stabbing Phenomenon
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We present a case of a 41‐year‐old male who presented with acute right middle cerebral artery occlusion and was found to have ESP projecting to and abutting the lateral wall of a dissected right internal carotid artery (ICA). Forced sustained head turning with maximal muscle contraction was the initiating event driving the styloid process into the wall of the ICA in a manner that can be likened to being stabbed with a pointed object. Knowing the association between ESP, Eagle syndrome, and CAD shall lead to increased awareness and appropriate diagnosis and treatment. (Source: Journal of Neuroimaging)
Variability in Diagnosing Creutzfeldt–Jakob Disease Using Standard and Proposed Diagnostic Criteria
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CONCLUSIONThis study illustrates the variability in diagnosing CJD and emphasizes the diagnostic utility of neuroimaging. It also highlights false‐positives that occur with neuroimaging. (Source: Journal of Neuroimaging)
Azygous Anterior Cerebral Artery and Associated Aneurysms: Detection and Identification Using 3‐Dimensional Time‐of‐Flight Magnetic Resonance Angiography
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CONCLUSIONSWith the VR technique, 3‐D‐TOF MRA is feasible and valuable in detecting an Az and associated aneurysm. Our MRA‐based study has proved that the Az is a rare anomaly but has a relatively high incidence of associated aneurysms. (Source: Journal of Neuroimaging)
Derivation of Transcranial Doppler Criteria for Angiographically Proven Middle Cerebral Artery Vasospasm after Aneurysmal Subarachnoid Hemorrhage
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CONCLUSIONTCD stringent criteria for moderate to severe MCA‐VSP are feasible and applicable in aSAH population. (Source: Journal of Neuroimaging)
MRI of Pallidal Involvement in Beta‐Ketothiolase Deficiency
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We report a case of a 5‐year‐old girl with BKT deficiency with isolated focal T2 hyperintensities involving the globi pallidi, which demonstrated restricted diffusion. To our knowledge, these imaging findings have not been previously reported in the setting of BKT deficiency. (Source: Journal of Neuroimaging)
Detection of Cerebral Hyperperfusion Syndrome after Carotid Endarterectomy with CT Perfusion
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We present the case of a 60‐year‐old female patient, who developed symptomatic internal carotid artery stenosis and subsequently underwent carotid endarterectomy. Four days after an uneventful surgery the patient developed confusion, seizures, and was admitted to the ICU. CT perfusion revealed reduced ispilateral time‐to‐peak and mean‐transient‐time and increased cerebral blood volume and cerebral blood flow, confirming the diagnosis of cerebral hyperperfusion syndrome. We thus propose CT perfusion as a diagnostic means for cerebral hyperperfusion syndrome, a syndrome that remains underdiagnosed. (Source: Journal of Neuroimaging)
Evaluation of MRI Criteria for Cavernous Sinus Invasion in Pituitary Macroadenoma
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CONCLUSIONSMRI criteria may be helpful in evaluating the presence of CS invasion in pituitary macroadenoma.J Neuroimaging 2012;XX:1–6. (Source: Journal of Neuroimaging)
Transcranial Doppler Velocities in a Large, Healthy Population
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CONCLUSIONOur study provides normal, reference TCD values for a large cohort of healthy subjects across a wide range of age, sex, and race groups. We observed decreased MBFV and increased PI with aging, and higher MBFV in women. There were few differences in MBFV related to side or ethnicity, but the MFBV and PI changes with age were specific to Caucasians. We provide means and standard deviations of MBFVs across various demographic groups in key intracranial arteries. Such normal TCD values across age, gender, and ethnic groups in healthy subjects represent a useful reference tool for detecting individuals with TCD values outside normal limits and at increased vascular risk. TCD studies in large multiethnic populations are still required to determine differences in brain hemodynamics acro...
Microvascular Imaging in Acute Ischemic Stroke
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CONCLUSIONPerforming bedside MVI in the early phase of AIS provides information on brain parenchyma perfusion and prognosis of AIS.J Neuroimaging 2012;XX:1–4. (Source: Journal of Neuroimaging)
Generating a Minimal Set of Templates for the Hippocampal Region in MR Neuroimages
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CONCLUSIONSThis study describes a simple and easily reproducible procedure to generate templates for the hippocampal region. It can be generalized and applied to other brain regions, which may be relevant for neuroimaging studies.J Neuroimaging 2012;XX:1–10. (Source: Journal of Neuroimaging)
Cerebral Blood Flow Dynamics of Orthostatic Transient Ischemic Attacks in a Patient with Carotid Dissection and Fibromuscular Dysplasia
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We report a patient with fibromuscular dysplasia and recurrent orthostatic transient ischemic attacks where fall in cerebral perfusion was clearly demonstrated by TCD. J Neuroimaging 2012;XX:1–4. (Source: Journal of Neuroimaging)
ICIN 2012 Dinner Reception Minneapolis, Minnesota September 6, 2012
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(Source: Journal of Neuroimaging)
Neuroimaging News and Tips
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(Source: Journal of Neuroimaging)
Early Changes in Brain FDG Metabolism during Anticancer Therapy in Patients with Pharyngeal Cancer
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CONCLUSIONSThe current study revealed that unappreciable changes in brain metabolism can occur during the early course of anticancer therapy, and persist even after therapy has terminated. Although the exact mechanism remains unclear, these changes may be related to the systemic effects of chemotherapy or radiotherapy as well as subclinical cancer‐related depressive or adjustment mood disorder. (Source: Journal of Neuroimaging)
Are Coil Compaction and Aneurysmal Growth Two Distinct Etiologies Leading to Recurrence Following Endovascular Treatment of Intracranial Aneurysm?
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CONCLUSIONThis is one of the first studies to differentiate coil compaction and aneurysm growth as distinct etiologies for aneurysm recurrence. (Source: Journal of Neuroimaging)
External Carotid Dissection and External Carotid Proatlantal Intersegmental Artery with Subclavian Steal Prompting External Carotid and Subclavian Artery Stenting
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CONCLUSIONSThis case represents an interesting presentation of both subclavian steal and an external carotid artery to VA anastomosis. Also, the presence of a dissection of the external carotid artery represents a rare finding. (Source: Journal of Neuroimaging)
Integration of Resting‐State FMRI and Diffusion‐Weighted MRI Connectivity Analyses of the Human Brain: Limitations and Improvement
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CONCLUSIONSThis fMRI/DWI integration study suggests that functional connectivity analysis might be a more sensitive and robust approach in understanding the connectivity between cortical regions, and can be used to improve DWI‐based structural connectivity analysis. (Source: Journal of Neuroimaging)
Correlation of Sonographic and Electrophysiological Findings in a Patient with Multifocal Motor Neuropathy
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CONCLUSIONWe draw the attention on the usefulness of ultrasonography for detecting and diagnosing segmental lesions of the peripheral nerves in MMN and other immune mediated neuropathies, especially in cases where a nervous segment cannot be easily explored in terms of inching technique. (Source: Journal of Neuroimaging)
Magnetic Resonance Imaging of Ruptured Spinal Dermoid Tumors with Spread of Fatty Droplets in the Central Spinal Canal and/or Spinal Subarachnoidal Space
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CONCLUSIONSpinal dermoid tumors ruptured into central spinal canal and/or spinal subarachnoid space have unique MRI features. The absorption of lipid droplets within central spinal canal is rather difficult, and their movement is extremely slow. We propose that fatty components within the central canal of spinal cord may be partially associated with spinal dermoid tumors developmentally. (Source: Journal of Neuroimaging)
Cognitive Impairment and Its Relation to Imaging Measures in Multiple Sclerosis: A Study Using a Computerized Battery
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CONCLUSIONSBoth NAWM and NAGM volumes are related to CI in MS. The results highlight once again the urgent need to develop pharmacological strategies protecting patients from widespread neurodegeneration as possible preventive strategies of CI development. (Source: Journal of Neuroimaging)
Iodine‐123 Metaiodobenzylguanidine Scintigraphy and Iodine‐123 Ioflupane Single Photon Emission Computed Tomography in Lewy Body Diseases: Complementary or Alternative Techniques?
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CONCLUSIONSLBD usually present both myocardial sympathetic and striatal dopaminergic impairments. 123I‐FP‐CIT SPECT presents high sensitivity in the diagnosis of LBD; 123I‐MIBG scintigraphy may have a complementary role in differential diagnosis between PD and other parkinsonism. These scintigraphic methods showed similar diagnostic accuracy in differential diagnosis between DLB and other dementia. (Source: Journal of Neuroimaging)
Intracystic Gadolinium‐Enhanced MRI in the Evaluation of Residual Giant‐Cystic Craniopharyngiomas in Children: Report of Four Cases
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This report describes our experience in the use of intracystic Gadolinium (Gd)‐enhanced MR imaging to determine potential communications between the tumoral cysts and other intra‐axial spaces in 4 pediatric patients with residual giant‐cystic craniopharyngiomas in whom intracavitary bleomycin treatment was planned after the injection of .1‐.2 mL of gadopentetate dimeglumine (Gd‐DTPA). In three cases no leaks were found. In one case, whose previous water‐soluble iodinated contrast‐enhanced CT cystography was negative for leaks, intracystic Gd‐enhanced MR showed intraventricular Gd enhancement. We conclude that MR imaging after intracystic administration of Gd‐based contrast paramagnetic agents is useful in the detection of potential leaks in cases of giant residual craniop...
Evolution of CT Imaging Features of Carotid Atherosclerotic Plaques in a 1‐Year Prospective Cohort Study
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CONCLUSIONSThere are a number of imaging markers and risk factors that significantly predict the evolution of CT imaging features of carotid artery atherosclerotic disease over a 1‐year period. (Source: Journal of Neuroimaging)
High‐Level Gait Disorder: Associations with Specific White Matter Changes Observed on Advanced Diffusion Imaging
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CONCLUSIONSThe anatomical distribution associated with HLGD of the cautious/disequilibrium type involves WM pathways that convey motor‐related, cognitive and affective‐related functions. The underlying pathological process leading to these changes most probably includes demyelination.J Neuroimaging 2012;XX:1–8. (Source: Journal of Neuroimaging)
Transcranial Doppler with Bubble Study as a Method to Detect Extracardiac Right‐to‐Left Shunts in Patients with Ischemic Stroke
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CONCLUSIONSTCD‐bubble studies may prove useful in uncovering treatable causes of stroke.J Neuroimaging 2012;XX:1‐3. (Source: Journal of Neuroimaging)
Brain MRI and Magnetic Resonance Spectroscopy Findings in Patients with Hyperargininemia
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CONCLUSIONSWe present the MRI and MRS findings of a large series of HA patients. Variable degrees of brain atrophy and mild cerebellar atrophy were observed, and these findings were not specific. No metabolic abnormality was observed using MRS in this series of patients.J Neuroimaging 2012;XX:1‐6. (Source: Journal of Neuroimaging)
Validation of FDG Uptake in the Arterial Wall as an Imaging Biomarker of Atherosclerotic Plaques with 18F‐Fluorodeoxyglucose Positron Emission Tomography‐Computed Tomography (FDG‐PET/CT)
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CONCLUSIONThe prevalence of PET uptake in arterial walls in a consecutive population of asymptomatic patients is low and usually confined to one type of artery, and its clinical relevance in terms of vulnerability to ischemic events remains to be determined.J Neuroimaging 2012;XX:1‐7. (Source: Journal of Neuroimaging)
Reversible Splenial Lesion in Postpartum Cerebral Angiopathy: A Case Report
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ABSTRACT Reversible lesions on magnetic resonance imaging that transiently restrict diffusion in the splenium of the corpus callosum (SCC) without any other accompanying lesions have been reported in various clinical conditions. We offer the first report of postpartum cerebral angiopathy with reversible SCC lesions. J Neuroimaging 2012;XX:1–3. (Source: Journal of Neuroimaging)
Extending Communication for Patients with Disorders of Consciousness
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CONCLUSIONSThe results from 2 patients provide independent support of similar work by others with 3 T fMRI, and demonstrate broader clinical utility for these tests at 1.5 T despite lower signal‐to‐noise ratio. Based on the control results, mental calculation adds a robust imagery task for use in future studies of this kind.J Neuroimaging 2012;XX:1‐8. (Source: Journal of Neuroimaging)
MRI‐Based Brain Structure Volumes in Temporal Lobe Epilepsy Patients and their Unaffected Siblings: A Preliminary Study
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CONCLUSIONThe findings suggest an overlap in the neurodevelopmental genes responsible for both brain structure and the expression of the disease. Further work is ongoing to confirm these findings.J Neuroimaging 2012;XX:1‐7. (Source: Journal of Neuroimaging)
Changes in Cerebral Venous Sinuses Diameter After Lumbar Puncture in Idiopathic Intracranial Hypertension: A Prospective MRI Study
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CONCLUSIONSOur results support other studies and demonstrated narrowing of the transverse sinuses in IIH patients. The main finding of this study is the increase in cerebral sinuses diameter after LP. This observation should be considered when evaluating cerebral venous sinuses after LP. A larger scale study is warranted to validate our findings.J Neuroimaging 2012;XX:1‐4. (Source: Journal of Neuroimaging)
The Trevo Retriever Thrombectomy Device for Acute Ischemic Stroke: Is There Room for Another Tool in the Toolbox?*
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(Source: Journal of Neuroimaging)
Arterial Spin Labeling Identifies Tissue Salvage and Good Clinical Recovery After Acute Ischemic Stroke
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DISCUSSIONHyperperfusion of the initially ischemic area identified on ASL at 24 hours poststroke identifies patients with better tissue and clinical outcomes.J Neuroimaging 2012;XX:1–6. (Source: Journal of Neuroimaging)
Need for Performance Protocols in TEE and TCD for Detection of Right to Left Shunts
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CONCLUSIONSTEEs and TCDs are operator dependent and thus subject to false negatives. The lower yield and interoperator variability in TEE results appear to reflect the lack of performance protocols and engender concern about false negatives in community use. Consensus performance protocols and certification criteria for both modalities should have an impact on accuracy of shunt detection.J Neuroimaging 2012;XX:1–5. (Source: Journal of Neuroimaging)
Trevo versus Solitaire a Head‐to‐Head Comparison Between Two Heavy Weights of Clot Retrieval
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CONCLUSIONSOur study showed no significant differences between both stentrievers. Moderately high recanalization rates are possible with both, however larger series may depict safety‐related variations.J Neuroimaging 2012;XX:1–4. (Source: Journal of Neuroimaging)
Aquaporin‐4 Positron Emission Tomography Imaging of the Human Brain: First Report
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CONCLUSIONSBased on these initial results, we believe [11C]TGN‐020 PET will be valuable in determining the role of AQP‐4 in disease progression, and for the clinical assessment of water homeostasis under various settings. J Neuroimaging 2012;XX:1–6. (Source: Journal of Neuroimaging)
Cerebral Embolus Following Chiropractic Manipulation in a Patient with a Calcified Carotid Artery
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CONCLUSIONSCalcified carotid artery may be at risk for embolization following cervical spinal manipulation. Our recommendation is that, patients with extensively calcified carotid arteries should refrain from aggressive neck maneuvers and cervical spine manipulation therapy to avoid liberation of cerebral embolus. J Neuroimaging 2011;XX:1–2. (Source: Journal of Neuroimaging)
The Extent of Perfusion Deficit Does Not Relate to the Visibility of Acute Ischemic Lesions on Fluid‐Attenuated Inversion Recovery Imaging
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CONCLUSIONVisibility of FLAIR lesions in acute stroke imaging is influenced by lesion size and time from symptom onset to MRI, but not by the amount of perfusion deficit calculated by time‐to‐peak (TTP) measurements. J Neuroimaging 2012;XX:1–4. (Source: Journal of Neuroimaging)
Prevalence of Symptomatic Intracranial Atherosclerosis in Caucasians: A Prospective, Multicenter, Transcranial Doppler Study
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CONCLUSIONSSIA was identified in almost 10% of patients admitted with symptoms of ACI. These preliminary findings support further collaborative initiatives among stroke physicians to increase the yield of SIA detection in Caucasian patients with ACI. J Neuroimaging 2012;XX:1–6. (Source: Journal of Neuroimaging)
Neuroimaging News and Tips
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(Source: Journal of Neuroimaging)
RadCases. Neuroimaging, by Roy Riascos and Eliana Bonafante
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(Source: Journal of Neuroimaging)
A Pictorial Essay of Brain Perfusion‐CT: Not Every Abnormality Is a Stroke!
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ABSTRACT Perfusion‐CT (PCT) of the brain is a rapidly evolving imaging technique used to assess blood supply to the brain parenchyma. PCT is readily available at most imaging centers, resulting in steadily increasing use of this imaging technique. Though PCT was initially introduced and still most widely used to evaluate patients with acute ischemic stroke, a wide variety of other pathologic processes demonstrate abnormal perfusion maps. Therefore, it is important for the radiologist to recognize altered perfusion patterns observed in diseases other than typical ischemic stroke. The goal of this article is to show the perfusion maps and review the perfusion patterns observed in some subtypes of atypical stroke and in neurological entities other than stroke, so that they are recognized an...
Black Blood MRI in Suspected Large Artery Primary Angiitis of the Central Nervous System
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CONCLUSIONSOur pilot study demonstrates that vessel wall CE is a frequent finding in PACNS and its mimics. Larger trials will be necessary to evaluate the utility of BB‐MRI in the diagnostic workup of PACNS.J Neuroimaging 2012;XX:1‐5. (Source: Journal of Neuroimaging)
Peripheral Nerve Sheath Tumors. Benign or Malignant? The Role of MRI and Ultrasonography in A Case Report
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ABSTRACT A 31‐year‐old male patient admitted to another hospital for investigation of a localized painful hump in the medial surface of his left leg. The clinical examination revealed a painful palpable lump in the medial surface of left thigh that was initially thought to be a hematoma due to a history of recent trauma. However, an ultrasound was requested to exclude deep venous thrombosis (DVT). The US examination revealed a heterogeneous, fusiform lesion with elongated proximal and distal projections in close proximity to superficial femoral artery and vein and could not definitely exclude the DVT hypothesis. In a second ultrasound examination performed in our department, a neurogenic origin of the lesion was proposed. A consequent MRI examination confirmed the presence of a fusifor...
Hippocampal Magnetization Transfer Ratio at 3T: Validation of Automated Postprocessing and Comparison of Quantification Metrics
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CONCLUSIONExcellent scan‐rescan reproducibility (ICC > .9, COV < 10%) was observed for specific MTR histogram metrics and the mean MTR approach. These results are comparable to the volumetric approach. Future studies can examine the possibility that MTR changes precede morphological changes as this study suggests that both MTR and volumetric measurements of the hippocampus can be used as reliable imaging tools. J Neuroimaging 2011;XX:1‐7. (Source: Journal of Neuroimaging)
Sterile Brain Abscess due to Juvenile Xanthogranuloma:DWI Characteristics
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ABSTRACTJuvenile xanthogranuloma (JXG) is a disorder of non‐Langerhans cell histiocytosis that usually displays as a self‐limiting course in children. Rare systemic involvement implies poor prognosis. Although conventional and spectroscopic magnetic resonance imaging (MRI) findings of JXG in CNS have been described, diffusion imaging of intracranial JXG has not been reported. Our case report is the first manuscript to describe diffusion restriction of a cerebral lesion seen in the setting of JXG. Since diffusion restriction has not been described in the setting of JXG but it is more commonly associated with infectious cerebral abscess, this finding has had significant impact in the management. Central nervous system (CNS) lesion of our patient has also had additional imaging features s...
MRS in Early and Presymptomatic Carriers of a Novel Octapeptide Repeat Insertion in the Prion Protein Gene
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ABSTRACTTo evaluate the proton magnetic resonance (MR) spectroscopy (1H MRS) changes in carriers of a novel octapeptide repeat insertion in the prion protein gene (PRNP) and family history of frontotemporal dementia with ataxia. Four at‐risk mutation carriers and 13 controls were compared using single voxel, short TE, 1H MRS from the posterior cingulate gyrus. The mutation carriers had an increased choline/creatine, P= .003 and increased myoinositol/creatine ratio, P= .003. 1H MRS identified differences in markers of glial activity and choline metabolism in pre‐ and early‐symptomatic carriers of a novel PRNP gene octapeptide insertion. These findings expand the possible diagnostic utility of 1H MRS in familial prion disorders. (Source: Journal of Neuroimaging)
Dural Arteriovenous Fistula Involving the Anterior Condylar Canal
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We present the imaging features of angiography and MR angiography of a 54‐year‐old man, who presented progressive right synchronous tinnitus due to a DAVF of the anterior condylar confluent, successfully treated by transvenous embolization. J Neuroimaging 2012;XX:1–4. (Source: Journal of Neuroimaging)
Double‐Barrel Stent‐Assisted Coiling of a Basilar Artery Fenestration Aneurysm
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CONCLUSIONIn the case presented, a double‐barrel stent configuration enabled dense coil embolization of the aneurysm as well as preservation of both basilar fenestration limbs and both distal vertebral arteries. J Neuroimaging 2012;XX:1–4. DOI: 10.1111/j.1552‐6569.2012.00720.x (Source: Journal of Neuroimaging)
In vivo Detection of Cortical Microinfarcts on Ultrahigh‐Field MRI
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CONCLUSIONSDIR and 3D‐FLAIR images may open a way to visualize CMIs. J Neuroimaging 2012;XX:1–5. (Source: Journal of Neuroimaging)
Regional and Voxel‐Wise Comparisons of Blood Flow Measurements Between Dynamic Susceptibility Contrast Magnetic Resonance Imaging (DSC‐MRI) and Arterial Spin Labeling (ASL) in Brain Tumors
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The objective of the current study was to evaluate the regional and voxel‐wise correlation between dynamic susceptibility contrast (DSC) and arterial spin labeling (ASL) perfusion magnetic resonance imaging (MRI) measurement of cerebral blood flow (CBF) in patients with brain tumors. Thirty patients with histologically verified brain tumors were evaluated in the current study. DSC‐MRI was performed by first using a preload dose of gadolinium contrast, then collecting a dynamic image acquisition during a bolus of contrast, followed by posthoc contrast agent leakage correction. Pseudocontinuous ASL was collected using 30 pairs of tag and control acquisition using a 3‐dimensional gradient‐echo spin‐echo (GRASE) acquisition. All images were registered to a high‐resolution anatomica...
Long‐term Clinical and Angiographic Outcomes in Patients with Spontaneous Cervico‐Cranial Arterial Dissections Treated with Stent Placement
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CONCLUSIONSThis study demonstrates the feasibility, safety, and intermediate term effectiveness of endovascular stent reconstruction of spontaneous, cervico‐cranial arterial dissection.J Neuroimaging 2012;XX:1–10. (Source: Journal of Neuroimaging)
Cerebral Microbleeds After Use of Extracorporeal Membrane Oxygenation in Children
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ABSTRACTCerebral microbleeds (CMB) on gradient‐recalled echo (GRE) magnetic resonance imaging (MRI) are rarely seen in children, yet have been described following vascular procedures in adults. Extracorporeal membrane oxygenation (ECMO) has been associated with vascular injury and neurological events in children, but there have been no reports to date of GRE MRI findings in children treated with ECMO. We reviewed MRI scans for all vascular neurology consultations in children treated with ECMO at an academic medical center over a 5‐year period. In 6 of 12 cases, GRE was acquired as others were unstable or had contraindications to MRI. All 6 of 6 (100%) GRE cases (mean age 2.1 years, 7 female, 5 male) demonstrated CMB. CMB were multiple (>3 lesions), situated in cortical or lobar regi...
Contribution of High‐b‐Value Diffusion‐Weighted Imaging in Determination of Brain Ischemia in Transient Ischemic Attack Patients
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CONCLUSIONHigh‐b‐value DWI did not improve the conspicuity and distinction of the ischemic lesions.J Neuroimaging 2012;XX:1–6. (Source: Journal of Neuroimaging)
Neuroimaging of Pediatric Intracranial Infection—Part 2: TORCH, Viral, Fungal, and Parasitic Infections
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ABSTRACTIn the second half of this 2‐part review, the neuroimaging features of the most common viral, fungal, and parasitic infections of the pediatric central nervous system are discussed. Brief discussions of epidemiology and pathophysiology will be followed by a review of the imaging findings and potential differential considerations. J Neuroimaging 2012;22:e52–e63. (Source: Journal of Neuroimaging)
Neuroimaging of Pediatric Intracranial Infection—Part 1: Techniques and Bacterial Infections
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ABSTRACTConventional and advanced neuroimaging have become central to the diagnosis of infectious diseases of the pediatric central nervous system. Imaging modalities used by (pediatric) neuroradiologists include cranial ultrasound, computed tomography, and magnetic resonance imaging, including advanced techniques such as diffusion weighted or tensor imaging, perfusion weighted imaging, susceptibility weighted imaging, and 1H magnetic resonance spectroscopy. In this first of a two part review, imaging techniques in general and the imaging findings of bacterial infections of the intracranial compartment including epidural empyema, subdural empyema, meningitis, cerebritis, cerebral abscess, and pyogenic intraventricular empyema (ventriculitis) are discussed. J Neuroimaging 2012;22:e42–e51....
The Unique Features of Traumatic Brain Injury in Children. Review of the Characteristics of the Pediatric Skull and Brain, Mechanisms of Trauma, Patterns of Injury, Complications, and their Imaging Findings—Part 2
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ABSTRACTTraumatic brain injury (TBI) is a major cause of morbidity and mortality in children. The unique biomechanical, hemodynamical, and functional characteristics of the developing brain and the age‐dependent variance in trauma mechanisms result in a wide range of age specific traumas and patterns of brain injuries. Detailed knowledge of the main primary and secondary pediatric injuries, which enhance sensitivity and specificity of diagnosis, will guide therapy and may give important information about the prognosis. In recent years, anatomical but also functional imaging methods have revolutionized neuroimaging of pediatric TBI. The purpose of this article is (1) to comprehensively review frequent primary and secondary brain injuries and (2) to give a short overview of two special typ...
Usefulness of CT Angiography for Therapeutic Decision Making in Thrombolyzing Intubated Patients with Suspected Basilar Artery Thrombosis
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CONCLUSIONIn patients with BAT, intubated before assessment by neurologist, CTA might help in confirming the diagnosis and facilitating therapeutic decision making for initiating thrombolysis. J Neuroimaging 2012;XX:1–4. (Source: Journal of Neuroimaging)
HTLV‐I‐Associated Myelopathy/Tropical Spastic Paraparesis: Semiautomatic Quantification of Spinal Cord Atrophy from 3‐Dimensional MR Images
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CONCLUSIONSSemiautomatic spinal cord volume quantification is a sensitive technique for quantifying the extent of spinal cord involvement in HAM/TSP. J Neuroimaging 2012;XX:1–5. (Source: Journal of Neuroimaging)
Leukoencephalopathies in Mitochondrial Disorders: Clinical and MRI Findings
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ABSTRACTThe second most frequently affected organ in mitochondrial disorders (MIDs) is the central nervous system (CNS). One of the most frequent CNS abnormalities on imaging is the affection of the white matter (WMLs) for which the term, leukoencephalopathies in mitochondrial disorders (LEM), is proposed. The morphology of LEM on imaging is quite variable even within the same type of MID and the same family. LEM can be a subtle or prominent feature on imaging and may go along with or without clinical neurologic or neuropsychological manifestations. WMLs are most likely due to the underlying metabolic defect of the respiratory chain or concomitant oxidative stress, resulting in neuronal death and replacement of neurons by glial cells. WMLs in MIDs frequently give rise to misinterpretation,...
Temporal Lobe Epilepsy with Amygdala Enlargement: A Morphologic and Functional Study
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CONCLUSIONSTLE + AE is different from MTLE + HS from morphologic and functional points of view, and the enlarged amygdala per se is potentially an epileptic focus in patients with partial epilepsy. J Neuroimaging 2012;XX:1–9. (Source: Journal of Neuroimaging)
Usefulness of CT Angiography for Therapeutic Decision Making in Thrombolyzing Intubated Patients with Suspected Basilar Artery Thrombosis
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CONCLUSIONIn patients with BAT, intubated before assessment by neurologist, CTA might help in confirming the diagnosis and facilitating therapeutic decision making for initiating thrombolysis. J Neuroimaging 2012;XX:1–4. (Source: Journal of Neuroimaging)
HTLV‐I‐Associated Myelopathy/Tropical Spastic Paraparesis: Semiautomatic Quantification of Spinal Cord Atrophy from 3‐Dimensional MR Images
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CONCLUSIONSSemiautomatic spinal cord volume quantification is a sensitive technique for quantifying the extent of spinal cord involvement in HAM/TSP. J Neuroimaging 2012;XX:1–5. (Source: Journal of Neuroimaging)
The Unique Features of Traumatic Brain Injury in Children. Review of the Characteristics of the Pediatric Skull and Brain, Mechanisms of Trauma, Patterns of Injury, Complications, and their Imaging Findings—Part 2
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ABSTRACTTraumatic brain injury (TBI) is a major cause of morbidity and mortality in children. The unique biomechanical, hemodynamical, and functional characteristics of the developing brain and the age‐dependent variance in trauma mechanisms result in a wide range of age specific traumas and patterns of brain injuries. Detailed knowledge of the main primary and secondary pediatric injuries, which enhance sensitivity and specificity of diagnosis, will guide therapy and may give important information about the prognosis. In recent years, anatomical but also functional imaging methods have revolutionized neuroimaging of pediatric TBI. The purpose of this article is (1) to comprehensively review frequent primary and secondary brain injuries and (2) to give a short overview of two special typ...
Leukoencephalopathies in Mitochondrial Disorders: Clinical and MRI Findings
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ABSTRACTThe second most frequently affected organ in mitochondrial disorders (MIDs) is the central nervous system (CNS). One of the most frequent CNS abnormalities on imaging is the affection of the white matter (WMLs) for which the term, leukoencephalopathies in mitochondrial disorders (LEM), is proposed. The morphology of LEM on imaging is quite variable even within the same type of MID and the same family. LEM can be a subtle or prominent feature on imaging and may go along with or without clinical neurologic or neuropsychological manifestations. WMLs are most likely due to the underlying metabolic defect of the respiratory chain or concomitant oxidative stress, resulting in neuronal death and replacement of neurons by glial cells. WMLs in MIDs frequently give rise to misinterpretation,...
Temporal Lobe Epilepsy with Amygdala Enlargement: A Morphologic and Functional Study
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CONCLUSIONSTLE + AE is different from MTLE + HS from morphologic and functional points of view, and the enlarged amygdala per se is potentially an epileptic focus in patients with partial epilepsy. J Neuroimaging 2012;XX:1–9. (Source: Journal of Neuroimaging)
The Unique Features of Traumatic Brain Injury in Children. Review of the Characteristics of the Pediatric Skull and Brain, Mechanisms of Trauma, Patterns of Injury, Complications and Their Imaging Findings—Part 1
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ABSTRACTTraumatic head/brain injury (TBI) is a leading cause of death and life‐long disability in children. The biomechanical properties of the child's brain and skull, the size of the child, the age‐specific activity pattern, and higher degree of brain plasticity result in a unique distribution, degree, and quality of TBI compared to adult TBI. A detailed knowledge about the various types of primary and secondary pediatric head injuries is essential to better identify and understand pediatric TBI. The goals of this review article are (1) to discuss the unique epidemiology, mechanisms, and characteristics of TBI in children, and (2) to review the anatomical and functional imaging techniques that can be used to study common and rare pediatric traumatic brain injuries and their complicat...
Reversible Cytotoxic Edema in TPN‐Related Hepatic Encephalopathy
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We describe a case of TPN‐related HE presenting with diffuse cytotoxic edema which reversed after liver transplantation. J Neuroimaging 2012;XX:1–3. (Source: Journal of Neuroimaging)
Diffusion Tensor Imaging of Basal Ganglia and Thalamus in Amyotrophic Lateral Sclerosis
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CONCLUSIONSThe increased MD in basal ganglia and thalamus and decreased FA in globus pallidus and thalamus are indicative of neuronal loss or dysfunction in these structures. J Neuroimaging 2012;XX:1–7. (Source: Journal of Neuroimaging)
Diffusion Tensor Imaging Analysis of Tumefactive Giant Brain Lesions in Multiple Sclerosis
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CONCLUSIONSWithin the spectrum of acute MS lesions, TGL present DTI metrics of an intense acute inflammatory process. Analysis of TGL progression proposes that DTI metrics sensitively detects micro‐structural changes in TGL from acute inflammation towards lesion recovery and reorganization. J Neuroimaging 2012;XX:1–7. (Source: Journal of Neuroimaging)
Imaging Spectrum of Pediatric Corpus Callosal Pathology: A Pictorial Review
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ABSTRACT A wide spectrum of pediatric corpus callosal diseases can occur in the pediatric age group. Cross‐sectional magnetic resonance imaging plays an important role in the diagnosis of these patients. We reviewed our imaging record and collected cases of corpus callosal pathology. The purpose of this review is to illustrate the imaging features of various corpus callosal lesions encountered in children. J Neuroimaging 2012;XX:1–15. (Source: Journal of Neuroimaging)
Reversible Cytotoxic Edema in TPN‐Related Hepatic Encephalopathy
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We describe a case of TPN‐related HE presenting with diffuse cytotoxic edema which reversed after liver transplantation. J Neuroimaging 2012;XX:1–3. (Source: Journal of Neuroimaging)
Diffusion Tensor Imaging of Basal Ganglia and Thalamus in Amyotrophic Lateral Sclerosis
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CONCLUSIONSThe increased MD in basal ganglia and thalamus and decreased FA in globus pallidus and thalamus are indicative of neuronal loss or dysfunction in these structures. J Neuroimaging 2012;XX:1–7. (Source: Journal of Neuroimaging)
Diffusion Tensor Imaging Analysis of Tumefactive Giant Brain Lesions in Multiple Sclerosis
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CONCLUSIONSWithin the spectrum of acute MS lesions, TGL present DTI metrics of an intense acute inflammatory process. Analysis of TGL progression proposes that DTI metrics sensitively detects micro‐structural changes in TGL from acute inflammation towards lesion recovery and reorganization. J Neuroimaging 2012;XX:1–7. (Source: Journal of Neuroimaging)
Imaging Spectrum of Pediatric Corpus Callosal Pathology: A Pictorial Review
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ABSTRACT A wide spectrum of pediatric corpus callosal diseases can occur in the pediatric age group. Cross‐sectional magnetic resonance imaging plays an important role in the diagnosis of these patients. We reviewed our imaging record and collected cases of corpus callosal pathology. The purpose of this review is to illustrate the imaging features of various corpus callosal lesions encountered in children. J Neuroimaging 2012;XX:1–15. (Source: Journal of Neuroimaging)
Middle Cerebellar Peduncles and Pontine T2 Hypointensities in ARSACS
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CONCLUSIONNot only pontine but also middle cerebellar peduncle hypointensity lesions observed in T2‐weighted and FLAIR images could be specific findings for ARSACS even in cases with variable clinical phenotypes. J Neuroimaging 2012;XX:1–4. (Source: Journal of Neuroimaging)
White Matter Lesions Progression in Migraine with Aura: A Clinical and MRI Longitudinal Study
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CONCLUSIONSOur study demonstrates that in migraine with aura WMLs number can progress over time and suggests an association between aura features and WMLs progression. Studies with a higher number of patients are required to confirm these findings. J Neuroimaging 2012;XX:1–6. (Source: Journal of Neuroimaging)
The Optic Radiation and the Cerebellar Peduncles in Adolescents with First‐Admission Schizophrenia —A Diffusion Tensor Imaging Study
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CONCLUSIONSOur findings of altered fiber integrity in the optic radiations in adolescents with schizophrenia are in line with gray matter alterations in the visual cortices previously reported in the same sample and are in accordance with other studies that found decreased fractional anisotropy in these regions. These findings support the view that the visual system plays an important role in the pathogenesis of schizophrenia and may enhance our understanding of associations between the visual cortex and symptoms of the disorder. J Neuroimaging 2012;XX:1–6. (Source: Journal of Neuroimaging)
Middle Cerebellar Peduncles and Pontine T2 Hypointensities in ARSACS
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CONCLUSIONNot only pontine but also middle cerebellar peduncle hypointensity lesions observed in T2‐weighted and FLAIR images could be specific findings for ARSACS even in cases with variable clinical phenotypes. J Neuroimaging 2012;XX:1–4. (Source: Journal of Neuroimaging)
White Matter Lesions Progression in Migraine with Aura: A Clinical and MRI Longitudinal Study
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CONCLUSIONSOur study demonstrates that in migraine with aura WMLs number can progress over time and suggests an association between aura features and WMLs progression. Studies with a higher number of patients are required to confirm these findings. J Neuroimaging 2012;XX:1–6. (Source: Journal of Neuroimaging)
Traumatic Subperiostial Emphysema Caused by Hyperpneumatization of the Temporal and Occipital Bone
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We report a case in which the patient suffered periodically from a palpable mass in the parietal‐occipital region which originated from extensive occipital bone pneumatization. Computed tomography examination revealed extensive temporal and occipital pneumatization and subperiosteal pneumatoceles, which was corrected by surgery.J Neuroimaging 2012;XX:1–3. (Source: Journal of Neuroimaging)
Aortic Interruption Presenting with Recurrent Ischemic Strokes in an Adult
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ABSTRACTPresentation of an interrupted aortic arch (IAA) in adulthood is extremely rare. Nonhemorrhagic stroke has not been reported previously in any adult with IAA. We, herein, describe a formerly asymptomatic 52‐year‐old male presenting with recurrent vertebrobasilar circulation ischemic strokes resulting from accelerated atherosclerotic arteriopathy secondary to IAA associated upper body hypertension. Surgical correction of IAA led to treatment of hypertension and cessation of ischemic attacks together with regression of collateral arterial networks as shown by computer tomography angiography.J Neuroimaging 2012;XX:1–3. (Source: Journal of Neuroimaging)
Vertebral Artery Ostial Stenosis: Prevalence by Digital Subtraction Angiography, MR Angiography, and CT Angiography
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CONCLUSIONThe prevalence of VOS as determined by DSA is low and increases with patient age and correlates with factors such as anterior infarct (18.4%), posterior infarct (33.3%), carotid atherosclerosis (30.8%), and vertebrobasilar insufficiency (33%). Patients being evaluated for reasons less closely correlated with atherosclerotic disease, such as arteriovenous malformation (AVM) or hemorrhage showed a lower prevalence of VA stenosis (brain aneurysm or AVM 5/121, 4.1%, brain hemorrhage 5/153, 3.3%). Routine clinical MRA significantly overestimates VOS prevalence, and findings suggest that CTA underestimates the degree and prevalence of VOS.J Neuroimaging 2012;XX:1–8. (Source: Journal of Neuroimaging)
Endovascular Treatment of Cerebral Aneurysms at a Low‐Volume Institution: A Viable Alternative?
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J Neuroimaging 2012;XX:1–2. (Source: Journal of Neuroimaging)
Traumatic Subperiostial Emphysema Caused by Hyperpneumatization of the Temporal and Occipital Bone
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We report a case in which the patient suffered periodically from a palpable mass in the parietal‐occipital region which originated from extensive occipital bone pneumatization. Computed tomography examination revealed extensive temporal and occipital pneumatization and subperiosteal pneumatoceles, which was corrected by surgery.J Neuroimaging 2012;XX:1–3. (Source: Journal of Neuroimaging)
Aortic Interruption Presenting with Recurrent Ischemic Strokes in an Adult
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ABSTRACTPresentation of an interrupted aortic arch (IAA) in adulthood is extremely rare. Nonhemorrhagic stroke has not been reported previously in any adult with IAA. We, herein, describe a formerly asymptomatic 52‐year‐old male presenting with recurrent vertebrobasilar circulation ischemic strokes resulting from accelerated atherosclerotic arteriopathy secondary to IAA associated upper body hypertension. Surgical correction of IAA led to treatment of hypertension and cessation of ischemic attacks together with regression of collateral arterial networks as shown by computer tomography angiography.J Neuroimaging 2012;XX:1–3. (Source: Journal of Neuroimaging)