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  • 1
    Electronic Resource
    Electronic Resource
    Effects of hyperglycaemia on visual evoked potentials in insulin-dependent diabetic patients (1992)
    Springer
    Acta diabetologica 29 (1992), S. 34-37 
    Details
    ISSN: 1432-5233
    Keywords: Visual evoked potentials ; Hyperglycaemic clamp ; Central nervous conduction
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Multimodality evoked potentials frequently reveal subclinical involvement of the central nervous system in patients with insulin-dependent diabetes mellitus. We devised this study to evaluate the possible effects of acute hyperglycaemia on visual evoked potential (VEP) parameters in type 1 diabetic patients. A hyperglycaemic clamp (250 mg/dl for 180 min) was performed in ten patients. Monocular pattern reversal VEPs (check size 15′, contrast 50%) were recorded before, and every 30 min after the start of the clamp. Basal VEP latencies and amplitudes were normal bilaterally in nine patients. No significant changes in pattern reversal and flash VEP parameters were observed after the induction or during the clamp period. None of the neurophysiological parameters evaluated during the test was related to the duration of the disease, the basal VEP latency or amplitude or the presence of retinopathy. Our data suggest that the neurophysiological abnormalities detected in insulin-dependent diabetic patients are due to structural involvement of the central nervous pathways and not to functional damage induced by acute short-term hyperglycaemia.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF00572827
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  • 2
    Electronic Resource
    Electronic Resource
    Antenatal diagnosis of vein of Galen aneurysmal malformation: MR study of fetal brain and postnatal follow-up (1996)
    Springer
    Neuroradiology 38 (1996), S. 87-90 
    Details
    ISSN: 1432-1920
    Keywords: Vein of Galen aneurysmal malformation ; Prenatal diagnosis
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract About 20 cases of prenatal diagnosis of vein of Galen aneurysmal Malformation (VGAM) have been described. We present a case diagnosed prenatally by Doppler ultrasonography. Prenatal MRI and postnatal radiological studies including post-treatment MRI and MRA, were carried out.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF00593231
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    Paper (German National Licenses)
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  • 3
    Electronic Resource
    Electronic Resource
    Antenatal diagnosis of vein of Galen aneurysmal malformation: MR study of fetal brain and postnatal follow-up (1995)
    Springer
    Neuroradiology 38 (1995), S. 87-90 
    Details
    ISSN: 1432-1920
    Keywords: Key words Vein of Galen aneurysmal malformation ; Prenatal diagnosis
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract About 20 cases of prenatal diagnosis of vein of Galen aneurysmal Malformation (VGAM) have been described. We present a case diagnosed prenatally by Doppler ultrasonography. Prenatal MRI and postnatal radiological studies including post-treatment MRI and MRA, were carried out.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF00593231
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  • 4
    Electronic Resource
    Electronic Resource
    Magnetisation transfer ratios of contrast-enhancing and nonenhancing lesions in multiple sclerosis (1996)
    Springer
    Neuroradiology 38 (1996), S. 115-119 
    Details
    ISSN: 1432-1920
    Keywords: Magnetic resonance imaging ; Magnetisation transfer ; Magnetisation transfer ratio ; Multiple sclerosis
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Magnetisation transfer (MT) is a recently introduced technique for assessing the water content of tissues in vivo and its relationship to macromolecules or membranes. It has been suggested that MT could provide indirect evidence of the characteristics of multiple sclerosis (MS) lesions (oedema, demyelination, or gliosis). Our aims were to characterise brain MS lesions and to compare the magnetisation transfer ratio (MTR) values of lesions with different patterns of contrast enhancement. In patients with MS we measured the MTR of 65 gadolinium-enhancing and 292 nonenhancing lesions. Using the equation published by Dousset et al. we studied 29 patients with clinically definite MS and 10 healthy controls. Lesions had significantly lower MT than the normal-appearing white matter of the patients or the normal white matter of healthy controls. There was no difference in the MTR of enhancing and nonenhancing lesions. Enhancement was homogeneous in 45 and ring-like in 20 lesions; MTR values were lower in the latter. These findings are presumably related to the differences in pathological features of enhancing (different amounts of proteins and inflammatory cells, oedema and demyelination) and nonenhancing (gliosis, demyelination and axonal loss) lesions.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF00604792
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  • 5
    Electronic Resource
    Electronic Resource
    Magnetisation transfer ratios of contrast-enhancing and nonenhancing lesions in multiple sclerosis (1996)
    Springer
    Neuroradiology 38 (1996), S. 115-119 
    Details
    ISSN: 1432-1920
    Keywords: Key words Magnetic resonance imaging ; Magnetisation transfer ; Magnetisation transfer ratio ; Multiple sclerosis
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Magnetisation transfer (MT) is a recently introduced technique for assessing the water content of tissues in vivo and its relationship to macromolecules or membranes. It has been suggested that MT could provide indirect evidence of the characteristics of multiple sclerosis (MS) lesions (oedema, demyelination, or gliosis). Our aims were to characterise brain MS lesions and to compare the magnetisation transfer ratio (MTR) values of lesions with different patterns of contrast enhancement. In patients with MS we measured the MTR of 65 gadolinium-enhancing and 292 nonenhancing lesions. Using the equation published by Dousset et al. we studied 29 patients with clinically definite MS and 10 healthy controls. Lesions had significantly lower MT than the normal-appearing white matter of the patients or the normal white matter of healthy controls. There was no difference in the MTR of enhancing and nonenhancing lesions. Enhancement was homogeneous in 45 and ring-like in 20 lesions; MTR values were lower in the latter. These findings are presumably related to the differences in pathological features of enhancing (different amounts of proteins and inflammatory cells, oedema and demyelination) and nonenhancing (gliosis, demyelination and axonal loss) lesions.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF00604792
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    Paper (German National Licenses)
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  • 6
    Electronic Resource
    Electronic Resource
    Interobserver agreement for diagnostic MRI criteria in suspected multiple sclerosis (1999)
    Springer
    Neuroradiology 41 (1999), S. 347-350 
    Details
    ISSN: 1432-1920
    Keywords: Key words Multiple sclerosis ; Magnetic resonance imaging ; Interobserver variation
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract MRI is the paraclinical test most widely used to support the diagnosis of multiple sclerosis (MS). We evaluated interobserver agreement in applying diagnostic criteria to MRI obtained at first presentation. Five experienced observers scored 25 sets of images consisting of unenhanced T2- and gadolinium-enhanced T1-weighted images (approximately half the sets were normal). We scored frontal, parietal, temporal, occipital, infratentorial and basal ganglia lesions and the total number of lesions on T2-weighted images; periventricular, callosal, juxtacortical and ovoid lesions and those 〉 5 mm in maximum diameter; contrast-enhancing and hypointense lesions. Based on a combination of imaging findings patients were classified as compatible or not compatible with MS according to composite criteria. Observer concordance was characterised by weighted kappa values (ϰ) and mean average difference to the median (MADM) scores. Using the raw scores, there was poor agreement for the total number of lesions on T2-weighted images, and for occipital, oval, juxtacortical and hypointense lesions. Moderate agreement was found for frontal, callosal, basal ganglia and large lesions on T2 weighting. Good agreement was attained for parietal, temporal, infratentorial and periventricular lesions. After dichotomisation according to accepted cut-off values, most criteria performed better, especially the number of lesions on T2-weighted images (P 〈 0.05). Good agreement was found for the criteria of Paty and Fazekas and moderate agreement for those of Barkhof. While experienced observers may not agree on the total number of lesions, they show quite good agreement for commonly used cut-off points and elements in the composite criteria. This validates the use of MRI in the diagnosis of MS, and the use of dichotomised and composite criteria.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s002340050762
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  • 7
    Electronic Resource
    Electronic Resource
    Visual analysis of serial T2-weighted MRI in multiple sclerosis: intra- and interobserver reproducibility (1999)
    Springer
    Neuroradiology 41 (1999), S. 882-888 
    Details
    ISSN: 1432-1920
    Keywords: Key words Multiple sclerosis ; Magnetic resonance imaging
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract We evaluated the effect of consensus formation and training on the agreement between observers in scoring the number of new and enlarging multiple sclerosis (MS) lesions on serial T2-weighted MRI studies. The baseline and month 9 MRI studies of 16 patients with a range of MRI activity were used (dual-echo conventional spin-echo sequence, TR 2000, TE 34 and 90 ms, 5 mm contiguous slices, in-plane resolution 1 mm). First, the serial studies were visually analysed for the presence of new and enlarging lesions, on two occasions, by five experienced observers, without adopting any consensus strategy and in isolation. Next, the observers met to identify the common sources of inconsistencies in reporting between observers and formulate consensus rules. Finally, a further independent reading session was performed on the same MRI dataset, this time applying the consensus rules. Agreement between observers was assessed using kappa scores. Without the consensus rules, interobserver kappa scores for the first and second reading sessions for new lesions were only 0.51 and 0.39 respectively; agreement for enlarging lesions was even worse. The mean intraobserver kappa score for new lesions was higher at 0.72, reflecting the fact that the observers were consistently applying their individual assessment strategies. Application of the consensus rules did not lead to a significant improvement in inter observer kappas; the kappa scores adopting the guidelines were 0.46 and 0.21 for new and enlarging lesions respectively. Consensus guidelines thus did not improve the reproducibility of visual analysis of serial T2-weighted MRI, and the level of agreement between observers remained only moderate. Suboptimal repositioning is likely to be a major source of residual variability and this suggests a future role for image registration strategies; until then, a single observer, or pair of observers working in consensus, should be used in MS studies.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s002340050860
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  • 8
    Electronic Resource
    Electronic Resource
    Diffusion-weighted imaging in multiple sclerosis (1999)
    Springer
    Italian journal of neurological sciences 20 (1999), S. S246 
    Details
    ISSN: 1126-5442
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Diffusion-weighted imaging (DWI) provides a unique form of magnetic resonance (MR) contrast that enables the diffusional motion of water molecules to be quantitatively measured. As a consequence, DWI provides information about the orientation, size and geometry of brain structures. Cellular structures in the central nervous system restrict water molecular motion, and the apparent diffusion coefficient (ADC) is reduced compared to diffusion in bulk water. Pathological processes that modify tissue integrity, thus removing some of the “restricting” barriers, can result in increased ADC. Preliminary studies in multiple sclerosis (MS) using DWI showed that the ADC is higher in macroscopic lesions than in the normal appearing white matter (NAWM). The ADC is also dependent on the direction in which diffusion is measured, thus making comparison of ADC values meaningless without taking into account the measurement direction. One measurement of diffusion that is independent of the orientation of structures is provided by measuring the ADC in three orthogonal directions, and then averaging the results to form the mean diffusivity, ${\overline D}$ . We obtained DW scans from 35 patients with relapsing-remitting MS and 24 healthy volunteers. ${\overline D}$ was measured inside T2-visible lesions and regions located in different areas of the NAWM. ${\overline D}$ histograms from a large portion of the brain were created. MS lesions had a significantly higher ${\overline D}$ than NAWM. T1-hypointense lesions had the highest diffusion values, consistent with more severe tissue disruption. ${\overline D}$ was higher in the NAWM from patients than in the white matter from healthy controls. We also found significant differences between ${\overline D}$ histogram-derived measures from patients and controls, confirming the presence of diffuse damage in the brain of patients with MS.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s100729970005
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  • 9
    Electronic Resource
    Electronic Resource
    Introduction (1999)
    Springer
    Italian journal of neurological sciences 20 (1999), S. S227 
    Details
    ISSN: 1126-5442
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s100729970001
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  • 10
    Electronic Resource
    Electronic Resource
    Magnetization transfer imaging to monitor the evolution of multiple sclerosis (1999)
    Springer
    Italian journal of neurological sciences 20 (1999), S. S232 
    Details
    ISSN: 1126-5442
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Magnetization transfer imaging (MTI) is a magnetic resonance imaging (MRI) technique that is now used in multiple sclerosis (MS) studies, and is thought to have a higher pathological specificity than conventional T2-weighted imaging. This review outlines the major contributions given by MTI for the understanding of MS evolution. MTI studies of individual MS lesions confirm the pathological heterogeneity of T2-weighted MRI abnormalities and the potential role of unenhanced T1-weighted hypointensities as specific markers of localized severe white matter disruption. Correlative cross-sectional and longitudinal studies using MIT and gadolinium (Gd)-enhanced MRI reveal that MTI findings may vary in lesions with different patterns of enhancement, and that MTI abnormalities are closely related to the onset and recovery of blood-brain barrier disruption in new MS plaques. MTI lesion load (LL) is highly correlated with T2-weighted MRI lesion load, but it has a limited reliability as a measure of MS lesion burden. On the other hand, measures obtained from MT scans using whole-brain histogram analysis are highly correlated with the extent of MS abnormalities on conventional MRI scans, and predict patients' clinical disability well, since they are sensitive to both macro- and microscopic MS lesion burden in the whole brain and in specific regions. These data suggest that (a) MTI is sensitive to different stages of lesion pathology and pathological evolution in MS patients; and (b) MT histogram analysis can provide a more global assessment of MS lesion burden, since it encompasses both macro- and microscopic MS pathology.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s100729970003
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