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  • 1
    Electronic Resource
    Electronic Resource
    “Top of the basilar” syndrome: A comparison of clinical and MR findings (1988)
    Springer
    Neuroradiology 30 (1988), S. 293-298 
    Details
    ISSN: 1432-1920
    Keywords: Top of the basilar artery syndrome ; Cerebral infarctions ; Magnetic resonance
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary Among 100 patients with an infarction of the brain reported on MR and clinically confirmed there were 4 with widespread lesions of the temporal and occipital lobes, thalamus, midbrain, pons and cerebellum, all supplied by arteries originating around the top of the basilar artery. Clinically these patients presented the “top of the basilar” syndrome, which is caused by a disturbance in circulation at the top of the basilar artery. Which brain areas are involved may be deduced theoretically from the vascular anatomy. These lesions can, we believe, be clearly detected using MR, because of its sensitivity to ischaemic disturbances and in the posterior fossa. We report our 4 patients here to illustrate the clinical presentation and MR findings of the “top of the basilar” syndrome.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF00328178
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  • 2
    Electronic Resource
    Electronic Resource
    Database for serial magnetic resonance imaging in multiple sclerosis (1993)
    Springer
    Neuroradiology 35 (1993), S. 362-366 
    Details
    ISSN: 1432-1920
    Keywords: Multiple sclerosis ; Magnetic resonance imaging ; Brain ; Gadolinium ; Database
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract The unique sensitivity of magnetic resonance imaging (MRI) in detecting disease activity in multiple sclerosis (MS) and the objective nature of the information obtained suggest that MRI will be a useful and reliable way of monitoring treatment trials. There is a need to develop an appropriate database which would provide a standardised means of assessment, not only of MRI, but also of essential clinical information. As part of the program of Concerted Action in Multiple Sclerosis, funded by the Commission of the European Community (CEC), we have developed a database for recording serial brain MRI results. The database consists of core, entry and follow-up sections. Both entry and follow-up parts are subdivided into clinical, MR system and MRI data. We expect that the use of this database will maximise efficiency of MRI monitoring in MS treatment trials, particularly in multicentre studies.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF00588371
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  • 3
    Electronic Resource
    Electronic Resource
    SPECT, CT and MRI in a Turkish family with huntington's disease (1993)
    Springer
    Neuroradiology 35 (1993), S. 525-528 
    Details
    ISSN: 1432-1920
    Keywords: Huntington's disease ; Computed tomography ; Magnetic resonance imaging ; Single photon emission computed tomography
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract A Turkish family with Huntington's disease documented on CT, MRI and SPECT is reported. Whereas in clinically definite cases CT and MRI are of limited value and SPECT does not add anything of value, in one asymptomatic subject SPECT showed moderate caudate nucleus hypoperfusion, underlining the hypothesis that SPECT may have a role in predicting Huntington's disease.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF00588713
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  • 4
    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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  • 5
    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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  • 6
    Electronic Resource
    Electronic Resource
    Serial quantitative MR assessment of optic neuritis in a case of neuromyelitis optica, using Gadolinium-“enhanced” STIR imaging (1991)
    Springer
    Neuroradiology 33 (1991), S. 70-71 
    Details
    ISSN: 1432-1920
    Keywords: MR imaging ; STIR ; Neuromyelitis optica ; Optic nerve ; Gadolinium-DTPA
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary A patient is presented with neuromyelitis optica. MR imaging, using a short inversion time inversion recovery (STIR) technique, clearly depicted the lesion in the left optic nerve. Subsequent serial STIR imaging, with and without Gadolinium-DTPA, allowed quantitative assessment of changes parallel to improved optic nerve function. STIR imaging is a sensitive technique to demonstrate optic nerve lesions, and enables quantitative assessment to be made of the effect of (steroid) medication.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF00593340
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  • 7
    Electronic Resource
    Electronic Resource
    Limited duration of the effect of methylprednisolone on changes on MRI in multiple sclerosis (1994)
    Springer
    Neuroradiology 36 (1994), S. 382-387 
    Details
    ISSN: 1432-1920
    Keywords: Multiple sclerosis ; Magnetic resonance imaging ; Corticosteroid ; Gadolinium
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Treatment with methylprednisolone reduces the duration and severity of clinical relapses in multiple sclerosis (MS), while reducing the number of gadolinium-enhancing lesions on T1-weighted MRI. We performed serial MRI imaging after methylprednisolone treatment to see whether suppression of enhancement persists and whether related abnormalities on T2-weighted images disappear at follow-up. Thirteen patients with definite MS received a total of 31 courses of methylprednisolone over an average period of 50 weeks. Gadolinium-enhanced MRI was obtained before and after treatment, then at monthly intervals, using a standardised repositioning and imaging protocol. Two experienced readers in conference defined the number of active (gadolinium-enhancing and new or enlarging nonenhancing) lesions. We detected 609 active lesions on 195 examinations. Directly after treatment the reduction in the number of enhancing lesions was 78%, indicating restoration of the BBB and suppression of inflammation. It was uncommon for a lesion which stopped enhancing to show enhancement on a subsequent examination. No beneficial effect was observed on the rate of disappearance of related abnormalities on T2-weighted images, indicating persistent change such as oedema, cellular infiltration or demyelination. Moreover, in 89% of cases, an increase in the number of active lesions was observed before new clinical activity, if any, was observed (on average 52% earlier). MRI enabled us to demonstrate that the duration of the effect of methylprednisolone treatment is temporary (on average 9.7 weeks).
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF00612124
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  • 8
    Electronic Resource
    Electronic Resource
    Management of obstetric brachial plexus lesions: state of the art and future developments (2000)
    Springer
    Child's nervous system 16 (2000), S. 638-644 
    Details
    ISSN: 1433-0350
    Keywords: Keywords Obstetric ; Brachial plexus ; Nerve repair
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract  Despite improving perinatal care the incidence of obstetric brachial plexus lesions (OBPL) has not declined. Most babies recover spontaneously. In 10–20% recovery is incomplete. To prevent lasting functional deficits early referral to specialized centers is necessary. If the biceps shows no function at 3 months, standardized clinical assessment and additional investigations must delineate the extent of a lesion. Detection of root avulsions by myelography and computed tomography combined with electrodiagnostics remains inconclusive in 15% of cases. Plexus reconstruction is performed during the 4th–6th months. Contractures or deformities are treated conservatively or by orthopedic surgery. Long-term rehabilitation is required. In future, aspects of prevention need attention. Improving imaging and neurophysiological techniques are promising for greater precision in detecting root avulsions and even spontaneous recovering nerves. Functional imaging will allow better understanding of central integration and plasticity. New pharmacological agents may promote nerve regeneration.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s003810000319
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  • 9
    Electronic Resource
    Electronic Resource
    Spinal cord magnetic resonance imaging in suspected multiple sclerosis (2000)
    Springer
    European radiology 10 (2000), S. 368-376 
    Details
    ISSN: 1432-1084
    Keywords: Key words: Multiple sclerosis – Magnetic resonance imaging – Spinal imaging – Diagnosis
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract. We examined the value of spinal cord magnetic resonance imaging (MRI) in the diagnostic work-up of multiple sclerosis (MS). Forty patients suspected of having MS were examined within 24 months after the start of symptoms. Disability was assessed, and symptoms were categorized as either brain or spinal cord. Work-up further included cerebrospinal fluid analysis and standard proton-density, T2-, and T1-weighted gadolinium-enhanced brain and spinal cord MRI. Patients were categorized as either clinically definite MS (n = 13), laboratory-supported definite MS (n = 14), or clinically probable MS (n = 4); four patients had clinically probable MS, and in nine MS was suspected. Spinal cord abnormalities were found in 35 of 40 patients (87.5 %), consisting of focal lesions in 31, only diffuse abnormalities in two, and both in two. Asymptomatic spinal cord lesions occurred in six patients. All patients with diffuse spinal cord abnormality had clear spinal cord symptoms and a primary progressive disease course. In clinically definite MS, the inclusion of spinal imaging increased the sensitivity of MRI to 100 %. Seven patients without a definite diagnosis had clinically isolated syndromes involving the spinal cord. Brain MRI was inconclusive, while all had focal spinal cord lesions which explained symptoms and ruled out other causes. Two other patients had atypical brain abnormalities suggesting ischemic/vascular disease. No spinal cord abnormalities were found, and during follow-up MS was ruled out. Spinal cord abnormalities are common in suspected MS, and may occur asymptomatic. Although diagnostic classification is seldom changed, spinal cord imaging increases diagnostic sensitivity of MRI in patients with suspected MS. In addition, patients with primary progressive MS may possibly be earlier diagnosed. Finally, differentiation with atypical lesions may be improved.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s003300050058
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  • 10
    Electronic Resource
    Electronic Resource
    Comparison of a conventional cardiac-triggered dual spin-echo and a fast STIR sequence in detection of spinal cord lesions in multiple sclerosis (2000)
    Springer
    European radiology 10 (2000), S. 753-758 
    Details
    ISSN: 1432-1084
    Keywords: Key words: Multiple sclerosis ; MR imaging ; Spinal cord
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract. The current optimal imaging protocol in spinal cord MR imaging in patients with multiple sclerosis includes a long TR conventional spin-echo (CSE) sequence, requiring long acquisition times. Using short tau inversion recovery fast spin-echo (fast STIR) sequences both acquisition time can be shortened and sensitivity in the detection of multiple sclerosis (MS) abnormalities can be increased. This study compares both sequences for the potential to detect both focal and diffuse spinal abnormalities. Spinal cords of 5 volunteers and 20 MS patients were studied at 1.0 T. Magnetic resonance imaging included cardiac-gated sagittal dual-echo CSE and a cardiac-gated fast STIR sequence. Images were scored regarding number, size, and location of focal lesions, diffuse abnormalities and presence/hindrance of artifacts by two experienced radiologists. Examinations were scored as being definitely normal, indeterminate, or definitely abnormal. Interobserver agreement regarding focal lesions was higher for CSE (ϰ = 0.67) than for fast STIR (ϰ = 0.57) but did not differ significantly. Of all focal lesions scored in consensus, 47 % were scored on both sequences, 31 % were only detected by fast STIR, and 22 % only by dual-echo CSE (n. s.). Interobserver agreement for diffuse abnormalities was lower with fast STIR (ϰ = 0.48) than dual-echo CSE (ϰ = 0.65; n. s.). After consensus, fast STIR showed in 10 patients diffuse abnormalities and dual-echo CSE in 3. After consensus, in 19 of 20 patients dual-echo CSE scans were considered as definitely abnormal compared with 17 for fast STIR. The fast STIR sequence is a useful adjunct to dual-echo CSE in detecting focal abnormalities and is helpful in detecting diffuse MS abnormalities in the spinal cord. Due to the frequent occurrence of artifacts and the lower observer concordance, fast STIR cannot be used alone.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s003300050998
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