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  • 1
    ISSN: 1279-8517
    Keywords: MRI ; White matter ; Brain anatomy ; 3-D
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Résumé Une connaissance très précise de l'anatomie cérébrale est nécessaire à l'appréciation d'une lésion à ce niveau. Si les sillons permettent l'identification très précise des aires corticales, il en est tout autrement pour les faisceaux de substance blanche. Le but de ce travail est un essai d'évaluation topographique de certains grands faisceaux en s'aidant de l'imagerie 3-D en IRM (étude faite avec un sigma 1.5 T GE et le programme Voxtool de General Electric pour l'évaluation de la surface du cerveau). Cette étude est intéressante lorsque des anomalies de la substance blanche sont observées chez des patients présentant un syndrome de dysconnexion ou des déficits neuropsychologiques visuels ou du langage. Elle peut aussi servir à titre pédagogique dans les domaines clinique, anatomique ou radiologique. Elle devrait aussi aider à la compréhension de certaines activités cérébrales en pathologie ou pour comprendre le résultat des explorations fonctionnelles (PET, IRM fonctionnelle). En effet, il est exceptionnel qu'une activité corticale soit isolée et la mise en jeu de zones corticales différentes ne peut se faire que par le jeu des connexions établies par les fibres de la substance blanche du cerveau. Le but de ce travail est de proposer un petit atlas 3-D qui en montre la topographie pour les plus importants d'entre eux.
    Notes: Summary An accurate knowledge of cerebral anatomy is important in order to evaluate the precise location of a cerebral lesion. Cortical structures are identified by knowledge of the adjacent gyri and sulci; however, white matter tracts are difficult to differentiate from one another due to the lack of clear anatomic landmarks. Therefore, even if MRI shows obvious white matter abnormalities, in some cases it is difficult accurately to localize the lesion. The purpose of this study is to evaluate the location of the main white matter tracts by using three-dimensional MR imaging. MRI study was performed by 1.5 Tesla (Signa: General Electric). Computer assisted analysis with Voxtool software (General Electric) was used to generate both surface brain and tomographic images. The exact anatomic basis of white matter signal abnormalities is important when analyzing patients with disconnective syndromes or neuropsychological deficits such as conduction aphasia, visuospatial deficit etc. This preliminary attempt at constructing a three-dimensional MRI white matter atlas of the brain may be helpful for evaluating the anatomico-clinical correlations in these patients, and also as teaching materials for the clinical (neurologic, neurosurgical), anatomic and radiographic disciplines.
    Type of Medium: Electronic Resource
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  • 2
    ISSN: 1432-1920
    Keywords: Key words Radiculopathy ; lumbar ; injection periradicular
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract We evaluated periradicular injection of corticosteroids performed by neuroradiologists under fluoroscopic guidance in the treatment of lumbosacral nerve root pain in 40 patients (average age 48 years) presenting with lumbosciatica or radiculopathy not responding to conservative treatment. Patients with root pain due to infectious, neoplastic or inflammatory diseases were excluded, as were patients who needed immediate surgery. Pain was evaluated using a visual analogue scale (VAS) 10 and 90 days after the injection. After 10 days a substantial decrease in root pain was observed, with a statistically significant decrease in mean VAS. This decrease was observed in 90 % of patients, and it persisted after 90 days in 85 %. Side effects were rare, mild and disappeared spontaneously. They were related to the drug injected (corticosteroids).
    Type of Medium: Electronic Resource
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  • 3
    ISSN: 1432-1920
    Keywords: Key words Brain metastases ; Magnetic resonance imaging ; Magnetisation transfer ; Contrast enhancement
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Our purpose was to compare prospectively the sensitivity of contrast-enhanced magnetisation transfer (MT) MRI and gradient-echo (GE) T1-weighted images in metastatic disease of the brain. We studied 52 patients with brain metastases, using conventional T1-weighted GE and MT spin-echo (SE) images after the same standard dose of gadolinium. Axial 5-mm reconstructions of GE data were compared with 5-mm MT images in the same plane. Metastases were counted independently by two neuroradiologists. In 12 patients (23 %) MT imaging showed more metastases than GE images (P = 0.03). We detected 68 more metastases with the former technique.
    Type of Medium: Electronic Resource
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  • 4
    ISSN: 1432-1920
    Keywords: Key words Amyotrophic lateral sclerosis ; Primary lateral sclerosis ; Magnetic resonance imaging
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Our aim was to investigate the corticospinal tracts (CST) in motor neurone disease, using MRI, and to correlate findings with clinical data. We studied 31 patients with amyotrophic (ALS) and eight with primary lateral sclerosis (PLS). The signal from the CST was classified into four grades on T2-weighted images, and compared to T2-weighted images of 37 age-matched control subjects. No abnormalities were seen in the CST on T1-weighted images and were rarely evident on proton-density weighting. Variable high signal in the CST was found on T2-weighted images in 35 patients, and in 29 control subjects. Our grades 0 and 1 were more frequent in control subjects, grades 2 and 3 more frequent in patients. We found no correlation between the high signal and clinical data, including the duration of the illness. We therefore conclude that this technique is neither sensitive nor specific except in grade 3 which is quite specific for ALS. In half the patients we found atrophy of the superior parietal gyrus, which merits further study.
    Type of Medium: Electronic Resource
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  • 5
    ISSN: 1432-1920
    Keywords: Key words Chordoma ; clivus ; Magnetic resonance imaging ; Differential diagnosis
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract We present six proven cases of chordoma of the clivus studied by CT and MRI, with special attention to the extent of the tumour and to the signal intensity after intravenous gadolinium. MRI is the best technique for assessing the extent of the tumour but CT is important for showing osteolysis. Our aim was to determine differential diagnostic neuroradiological criteria. Reliable signs of chordoma of the skull base are: posterior extension to the pontine cistern; a lobulated, “honeycomb” appearance after gadolinium; the swollen appearance of the bone in the early stages; bone erosion on CT and frequent extension to critical structures such as the circle of Willis, cavernous sinuses and brain stem.
    Type of Medium: Electronic Resource
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