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  • Articles: DFG German National Licenses  (3,847)
  • 1995-1999  (3,847)
  • Engineering  (2,961)
  • Magnetic resonance imaging  (885)
  • Nuclear reactions
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  • Articles: DFG German National Licenses  (3,847)
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  • 1
    Electronic Resource
    Electronic Resource
    Springer
    Skeletal radiology 28 (1999), S. 383-389 
    ISSN: 1432-2161
    Keywords: Key words Allografts ; Osteoarticular ; Magnetic resonance imaging
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract  Objective. To investigate the magnetic resonance imaging (MRI) features of allografts at various time intervals after surgery in patients with osteoarticular allografts. Design and patients. Sixteen patients who were treated with osteoarticular allografts and who were followed over time with MRI studies as part of their long-term follow-up were retrospectively selected for this study. T1-weighted images were obtained both before and after gadolinium administration along with T2-weighted images. All images were reviewed by an experienced musculoseletal radiologist, with two other experienced radiologists used for consultation. Imaging studies were organized into three groups for ease of discussion: early postoperative period (2 days to 2 months), intermediate postoperative period (3 months to 2 years), and late postoperative period (greater than 2 years). Results. In the early postoperative period, no gadolinium enhancement of the allograft was visible in any of the MR images. A linear, thin layer of periosteal and endosteal tissue enhancement along the margin of the allograft was visible in images obtained at 3–4 months. This enhancement apeared gradually to increase in images from later periods, and appears to have stabilized in the images obtained approximately 2–3 years after allograft placement. The endosteal enhancement diminished after several years, with examinations conducted between 6 and 8 years following surgery showing minimal endosteal enhancement. However, focal enhancement was noted adjacent to areas of pressure erosion or degenerative cysts. All the cases showed inhomogeneity in the marrow signal (scattered low signal foci on T1 with corresponding bright signal on T2), and a diffuse, inhomogeneous marrow enhancement later on. Conclusion. We have characterized the basic MRI features of osteoarticular allografts in 16 patients who underwent imaging studies at various time points as part of routine follow-up. We believe that the endosteal and periosteal enhancement observed on MRI during the first few months to 2 years following surgery represents vascular ingrowth and early skeletal repair. The zone of periosteal enhancement could also include the new bone laid on the surface of the allograft through which the soft tissues bind to the cortex. The exact reason for the inhomogeneity in the marrow signal, and the diffuse, inhomogeneous marrow enhancement is not clear. This may represent saponified and/or necrotic marrow fat interspersed with the fibrovascular tissue. The features noted here should provide radiologists with useful information regarding imaging characteristics they can expect to see in other allograft replacement patients.
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  • 2
    Electronic Resource
    Electronic Resource
    Springer
    Skeletal radiology 28 (1999), S. 447-452 
    ISSN: 1432-2161
    Keywords: Key words Plantar fascia ; aponeurosis ; Fasciitis ; Fasciotomy ; Magnetic resonance imaging
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract  Objective. To determine the postoperative appearance of the plantar fascia on MR imaging after a fasciotomy has been performed, and to compare the postsurgical appearance of the fascia after an open and endoscopic procedure.〈@head-abs-p1.lf〉Design and patients. Fifteen asymptomatic volunteers (12 women, 3 men; age range 22–49 years, mean age 33 years) with prior fasciotomies for treatment of longstanding plantar fasciitis were studied. Fourteen volunteers had a unilateral release and one volunteer had bilateral releases, allowing for assessment of 16 ankles. Eight fasciotomies were performed through an open incision and eight were performed endoscopically. The average time between surgery and imaging was 24 months (range 11–46 months). The site of surgery was established from the operative reports. Proton density (PD)-weighted and T2-weighted images in three orthogonal planes were obtained on a 1.5-T magnet. In eight studies, T1-weighted sagittal and STIR sagittal images were included. The fascia in each ankle was assessed for morphology and signal intensity. Perifascial soft tissues and bone marrow were assessed for edema. Preoperative MR studies were available in five volunteers.〈@head-abs-p1.lf〉Results. There was no apparent difference in the postoperative appearance of the ankle after an open or endoscopic procedure except for scar formation in the subcutaneous fat which was common after an open procedure (P〈0.05). Three ankles had a gap in the fascia (one open, two endoscopic). The plantar fascia measured a mean of 7.0 mm (range 5–10 mm) at the fasciotomy, and 8.3 mm (range 6–12 mm) at the enthesis. At the fasciotomy, 11 of 13 ankles had an indistinct deep contour and 9 of 13 had an indistinct superficial contour. At the enthesis, 13 of 16 ankles had an indistinct deep contour and 6 of 16 had an indistinct superficial contour. Compared with preoperative MR studies there was an average reduction in the fascial thickness at the enthesis of 14% (range 9–20%), but the thickness at the fasciotomy nearly doubled. No edema was evident in the fascia, perifascial tissues, deep plantar muscles, or calcaneal bone marrow.〈@head-abs-p1.lf〉Conclusions. The average thickness of the plantar fascia in asymptomatic volunteers after surgery is nearly 2–3 times that of normal. While there is increased thickness at the site of surgery, the changes in morphology and signal intensity were most prominent at the enthesis. The key observation was absence of edema in the fascia and perifascial soft tissues. This baseline information may be of value when assessing MR studies of symptomatic patients.
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  • 3
    ISSN: 1432-2161
    Keywords: Key words Hand ; Wrist ; Magnetic resonance imaging ; Soft tissue mass ; Neoplasm ; Tumour ; Tendon diseases
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract   Objective. To assess the utility of magnetic resonance imaging (MRI) in the investigation of palpable masses in the hand or wrist.〈@head-abs-p1.lf〉Design and patients. We retrospectively reviewed the MRI examinations and case records of 134 patients referred because of a palpable mass in the hand or wrist. MRI was performed on a 1.0 T magnet using an extremity coil. Intravenous gadolinium-DTPA was injected when considered appropriate.〈@head-abs-p1.lf〉Results and conclusions. MRI demonstrated the cause of the palpable mass in 126 cases (94.02%). Soft tissue neoplasms were found in 34 cases (25.37%). The majority were benign and included giant cell tumours of tendon sheath, lipomas and hemangiomas and had a characteristic appearance. There were three malignant tumours (myxoid liposarcoma, malignant fibroushistiocytoma and rhabdomyosarcoma). Ganglia were found in 36 cases (26.86%) and non-tumour tendon pathology in 31 cases (23.13%). Less common causes included articular diseases (5.97%) and anatomical variants (4.47%). No focal lesion was present in 8 cases (5.97%). In conclusion, MRI is an accurate diagnostic technique in patients who present with a palpable mass of the hand and wrist.
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  • 4
    Electronic Resource
    Electronic Resource
    Springer
    Skeletal radiology 28 (1999), S. 96-99 
    ISSN: 1432-2161
    Keywords: Key words Computed tomography ; Granular cell tumor ; Magnetic resonance imaging ; Subcutis
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract  Three cases of granular cell tumor (GCT) of the subcutis are presented. Computed tomography showed a mass isodense with muscle with an ill-defined margin. Magnetic resonance imaging showed a mass with inhomogeneous low signal intensity on both T1- and T2-weighted images. Another characteristic feature of subcutaneous GCT is its attachment in part to muscle. Histological examination confirmed the diagnosis in all cases.
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  • 5
    ISSN: 1432-2161
    Keywords: Key words Bone tumor ; Chondrosarcoma ; CT ; Magnetic resonance imaging ; Tumor of the ankle ; Tumor of the foot
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract  The foot is an uncommon location for chondrosarcoma. The presentation, diagnosis, pathological findings, surgical treatment and follow-up of three patients with chondrosarcoma in this rare location are presented. Though nonspecific, MR imaging findings were of aid in the diagnosis and treatment planning of these patients. If the diagnosis of this tumor is rapidly made, a tumor excision instead of limb amputation may be sufficient treatment at surgery.
    Type of Medium: Electronic Resource
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  • 6
    ISSN: 1432-2161
    Keywords: Key words Joint ; Knee ; Anatomy ; Magnetic resonance imaging ; Posteromedial corner ; Intra-articular contrast
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract  Objective. The objective of this study was to illustrate the magnetic resonance (MR) image appearance of the structures of the posteromedial ”corner” of the knee with particular emphasis on the anatomy and differentiation between the medial collateral ligament and the posterior oblique ligament. Design. Six cadaveric knee specimens underwent MR imaging, before and following instillation of intra-articular contrast material. The knees were sectioned in the axial, coronal, and coronal oblique planes and the gross morphology of the posteromedial corner and surrounding structures was studied and correlated with the MR images. Patients. The human cadaveric specimens were from two female and four male patients (age at death, 72–86 years; average, 78 years). Results and conclusions. The contrast-enhanced sequences and the coronal oblique images allowed for improved visualization of the structures.
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  • 7
    Electronic Resource
    Electronic Resource
    Springer
    Der Radiologe 39 (1999), S. 889-893 
    ISSN: 1432-2102
    Keywords: Schlüsselwörter Sarkoidose ; Neurosarkoidose ; Magnetresonanztomographie ; Key words Sarcoidosis ; Neurosarcoidosis ; Magnetic resonance imaging
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Summary Neurological involvement is a significant cause of morbidity and mortality in patients with sarcoidosis. The aim of this study was to evaluate the role of magnetic resonance imaging (MRI) in the diagnosis of patients with neurosarcoidosis. The MRI brain scans of 22 patients with sarcoidosis were retrospectively reviewed, along with the clinical information provided in the request form. All patients had signs and symptoms referable to the head and were examined with gadolinium enhancement. Cranial (facial) nerve paralysis was the most common clinical manifestation identified in 10 patients. A wide spectrum of MR findings was noted: periventricular and white matter lesions on T2 W spin echo images, mimicking multiple sclerosis (46%); multiple supratentorial and infratentorial brain lesions, mimicking metastases (36%); solitary intraaxial mass, mimicking high-grade astrocytoma (9%); solitary extraaxial mass, mimicking meningioma (5%); leptomeningeal enhancement (36%). The diagnosis of neurosarcoidosis is often difficult, particularly so in patients who lack either pulmonary or systemic manifestations of sarcoidosis. MRI shows a wide spectrum of brain abnormalities associated with neurosarcoidosis. These findings, however, are not specific for sarcoidosis and one must consider appropriate clinical circumstances in arriving at the correct diagnosis. In selected cases with isolated brain involvement, meningeal or cerebral biopsy may be required.
    Notes: Zusammenfassung Klinische Untersuchungen an Patienten mit systemischer Sarkoidose sprechen in 5%, Autopsieberichte in 25% für eine Beteiligung des Zentralnervensystems. Ziel der Studie ist eine Beurteilung der Beitrags der Magnetresonanztomographie (MRT) in der Diagnostik der Neurosarkoidose. Die MR-Tomogramme von 22 Patienten mit gesicherter Sarkoidose und neurologischer Symptomatik wurden retrospektiv ausgewertet. Häufigstes klinisches Symptom der Neurosarkoidose war eine Fazialisparese (10 Patienten). MR-tomographisch konnte eine Vielzahl verschiedener Befunde erhoben werden: periventrikuläre und Marklagerläsionen in T2-gewichteten Bildern in 46%, multiple bzw. miliare supratentorielle und infratentorielle Läsionen in 36%, solitäre intraaxiale Raumforderungen in 9%, solitäre extraaxiale Raumforderungen in 5% und meningeale Kontrastmittelanreicherung (nodulär oder diffus) in 36%. Schlußfolgerung: Die MR-tomographischen Befunde bei Neurosarkoidose sind oft wenig spezifisch. Die Diagnose wird meist bei gleichzeitigem Nachweis sarkoidosetypischer Granulome in anderen Organen gestellt, eine isolierte zerebrale Manifestation kann erhebliche diagnostische Schwierigkeiten bereiten. Die Neurosarkoidose sollte bei unklaren zerebralen Symptomen und Befunden stets in die Differentialdiagnose einbezogen werden, weil sie behandelbar ist.
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  • 8
    ISSN: 1432-2102
    Keywords: Schlüsselwörter Kalkaneus ; Talus ; Gelenkinstabilität ; Radiologische Diagnostik ; Ultraschall ; Magnetresonanztomographie ; Sprunggelenk ; Synovialmembran ; Arthritis ; Diagnose ; Bildgebende Diagnostik ; Key words Calcaneus ; Joint instability ; Plain film radiography ; Ultrasonography ; Magnetic resonance imaging ; Subtalar joint ; Ankle joint ; Arthritis ; Synovial membrane ; Synovitis ; Diagnosis ; Differential ; Diagnostic imaging ; Rheumatic disease
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Summary Diseases of the hindfoot are associated with considerable functional impairment and therefore may hamper patients’ movements during gait considerably. Because of biomechanical overload, articular structures, tendons and ligaments are prone to early degenerative changes during the course of rheumatic diseases as visible with plain film radiography, sonography (US), or magnetic resonance imaging (MRI). Findings may occur as arthritis of major joints or in the form of fibroostitis and bursitis of the os calcis. Despite the progressive course of rheumatic diseases and characteristic imaging findings, high variability of X-ray signs may occur. Plain film radiograms and high-resolution ultrasonography play a key role in imaging rheumatic diseases of the hindfoot. MRI supports imaging diagnosis in selected cases. The principal goals of diagnostic imaging are precise and reproducible documentation of morphologic abnormalities and differentiated analysis for planning proper conservative or surgical treatment.
    Notes: Zusammenfassung Erkrankungen des Sprunggelenks und der Fußwurzel sind, da mit einer deutlichen Einschränkung der Beweglichkeit dieser Region einhergehend, für den Patienten meist sehr belastend. Bei rheumatischen Krankheitsbildern steht neben der Funktionseinschränkung vor allem in späteren Stadien die Destruktion biomechanisch stark beanspruchter Strukturen (hyaliner Knorpel, subchondraler Knochen, Bänder und Sehnen) im Vordergrund des klinischen wie auch des radiologischen Bildes. Grundsätzlich sind Arthritiden der großen Gelenke und die Calcaneopathia rheumatica zu beobachten. Trotz des meist stadienhaften Verlaufes mit charakteristischem Befallsmuster ist die bildgebende Diagnostik wegen der großen Formvariabilität der unterschiedlich ausgeprägten Veränderungen oft schwierig. Zusätzlich zu nativröntgenologischen Aufnahmen gehören die hochauflösende Sonographie, ergänzt durch die MRT, mit denen Gelenke und Sehnen direkt darstellbar sind, heute zur Standarddiagnostik. Ziel der Diagnostik ist einerseits die präzise reproduzierbare Dokumentation morphologischer Veränderungen zur Verlaufskontrolle, andererseits ihre möglichst differenzierte Analyse zur Einleitung adäquater konservativer oder operativer Therapiemaßnahmen, um Patienten zu einer aktiveren Lebensweise verhelfen zu können.
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  • 9
    Electronic Resource
    Electronic Resource
    Springer
    Neuroradiology 41 (1999), S. 729-731 
    ISSN: 1432-1920
    Keywords: Key words DIDMOAD syndrome ; Wolfram syndrome ; substantia nigra ; Magnetic resonance imaging
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Wolfram syndrome (DIDMOAD) is a rare diffuse neurodegenerative disorder characterised by diabetes insipidus, diabetes mellitus, optic atrophy, deafness, and a wide variety of abnormalities of the central nervous system, urinary tract and endocrine glands. It may be familial or sporadic. Reported features on MRI of the brain are absence of the physiological high signal of the posterior lobe of the pituitary, shrinkage of optic nerves, chiasm and tracts, atrophy of the hypothalamic region, brain stem, cerebellum, and cerebral cortex. We report a 12-year-old girl with a 5-year history without brain stem, cerebellar or cerebral atrophy. MRI showed an unusual feature: a focus of high signal on PD- and T2-weighted images in the right substantia nigra. This is consistent with previously reported neuropathological post-mortem studies, but has never been reported in vivo.
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  • 10
    Electronic Resource
    Electronic Resource
    Springer
    Neuroradiology 41 (1999), S. 785-787 
    ISSN: 1432-1920
    Keywords: Key words Pituitary adenoma ; Metastases ; subarachnoid ; Magnetic resonance imaging
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Few cases of pituitary adenoma with metastases have been reported. We report a case with histologically benign intracranial and cauda equina metastases. We compare it to the others in the literature.
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  • 11
    Electronic Resource
    Electronic Resource
    Springer
    Neuroradiology 41 (1999), S. 735-737 
    ISSN: 1432-1920
    Keywords: Key words Spinal cord ; congenital anomalies ; Magnetic resonance imaging
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract We report a rare instance of caudal agenesis occurring in siblings, with MRI. Both our patients had a club-shaped spinal cord, ending at T11. Radiological and urological findings are presented.
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  • 12
    Electronic Resource
    Electronic Resource
    Springer
    Neuroradiology 41 (1999), S. 941-942 
    ISSN: 1432-1920
    Keywords: Key words 3-Methyl glutaconic aciduria ; Magnetic resonance imaging
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract MRI in a young child with 3-methylglutaconic aciduria type 1 showed signal abnormalities in the basal ganglia which progressed despite successful treatment.
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  • 13
    ISSN: 1432-1920
    Keywords: Key words Haematoma ; subdural ; chronic ; Computed tomography ; Magnetic resonance imaging
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract We studied the frequency of various features of the appearances on high-field MRI in symptomatic patients with chronic subdural haematomas (CSDH). The ability to predict recurrence after treatment with one burr-hole procedure using MRI was evaluated. A total of 40 patients with symptomatic CSDH underwent MRI at 1.5 T. All haematomas were evacuated within a few days of the MRI examination. Symptomatic CSDH were divided into five groups according to the MRI findings: group A (11 cases), isointense or low signal on T1- and low signal on T2-weighted images; group B (18 cases), high signal on T1- and low signal on T2-weighted images; group C (5 cases), high signal on both T1- and T2-weighting; group D (1 case), low signal on T1- and high signal on T2-weighted images; group E (5 cases), heterogeneous intensity on T1- and T2-weighting throughout the haematoma cavity. The mean interval between onset of symptoms and MRI for group A was 5.0 ± 4.1 days, which was significantly shorter than that for group B (9.4 ± 4.4 days, P 〈 0.02), group C (27.8 ± 20 days, P 〈 0.005) or group E (17.8 ± 12.2 days, P 〈 0.01). Recurrence was seen in three haematomas of group A and one of group B. Reoperation was most closely correlated with diffuse low signal on T2-weighted images but not with a multiloculated appearance. Low signal on T2 weighting was surprisingly high (72.5 %) and the age of the haematomas as estimated on the MRI correlated well with the interval between the onset of symptoms and MRI. Our findings support the causative role of recurrent bleeding in the enlargement of CSDH.
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  • 14
    Electronic Resource
    Electronic Resource
    Springer
    Neuroradiology 41 (1999), S. 179-181 
    ISSN: 1432-1920
    Keywords: Key words Mucormycosis ; Pons ; Infarct ; Magnetic resonance imaging
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract We report a patient with rhinocerebral mucormycosis whose initial central nervous system involvement was isolated pontine infarction due to basilar arteritis caused by the fungus. The patient was diagnosed and followed by MRI and CT and basilar arteritis was demonstrated well on MRI studies. Involvement of the skull base was shown on CT in the later stage of the disease. The unusual initial presentation of the infection is discussed.
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  • 15
    Electronic Resource
    Electronic Resource
    Springer
    Neuroradiology 41 (1999), S. 190-194 
    ISSN: 1432-1920
    Keywords: Key words Cerebellum ; growth and development ; Magnetic resonance imaging
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract The MRI findings in rostral vermian dysplasia are described for the first time. Defective foliation and abnormal fissuration of the rostral vermis can clearly be depicted on coronal images. The abnormalities are limited to the anterior lobe of the vermis and its hemisphere extension. A hypothesis is put forward to explain the abnormalities. It is suggested that the vermian changes result from an intrauterine insult at the end of the first trimester. There appears to be a variable degree of expression and associated cerebellar and cerebral cortical abnormalities can be seen. The clinical significance of these findings remains incompletely understood but may be related to the severity of the abnormalities. It is also suggested that a mild degree of vermian rostral dysplasia may represent an incidental imaging finding.
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  • 16
    Electronic Resource
    Electronic Resource
    Springer
    Neuroradiology 41 (1999), S. 205-207 
    ISSN: 1432-1920
    Keywords: Key words Congenital varicella syndrome ; Magnetic resonance imaging
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Congenital varicella syndrome is a rare disorder which follows maternal infection in the first or early second trimester. The syndrome comprises a number of malformations including microcephaly, cortical destruction and limb hypoplasia. We describe a case where there has been long-term survival following second trimester maternal infection. The clinical findings, including the characteristic lower limb hypoplasia, are documented, as are the appearances on cranial MRI indicating an encephaloclastic porencephaly.
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  • 17
    Electronic Resource
    Electronic Resource
    Springer
    Neuroradiology 41 (1999), S. 269-270 
    ISSN: 1432-1920
    Keywords: Key words Infarct ; cerebral ; Motor cortex ; Magnetic resonance imaging
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract A patient with acute weakness of the righ arm showed a focal lesion on MRI in the left ’precentral knob', not visible on CT.
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  • 18
    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.
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  • 19
    ISSN: 1432-1920
    Keywords: Key words Haemangioma ; capillary ; Magnetic resonance imaging
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Contrast-enhancing intracranial masses are rarely found in infants with extracranial capillary haemangiomas (CH). We aimed to assess their nature and progression in three patients undergoing CT and/or MRI. The changes in size of both extra- and intracranial lesions were recorded. In a fourth case, a single examination was obtained. All patients harboured one or two enhancing intracranial nodular, meningeal-based lesions. Diffuse leptomeningeal enhancement of the cerebellar surface was also seen in one, which disappeared at follow-up. In all but one of the cases, the intracranial lesions were on the same side as the extracranial CH. These lesions and the extracranial CH demonstrated parallel changes in size (suggesting that both represent CH) during follow-up of 1–2 years: the size of intracranial lesions and the extracranial CH decreased in two cases, whereas it was unchanged in the third. One patient had a persistent trigeminal artery, while another had cerebellar atrophy with high signal in the cortex on T2-weighted images. In some cases, extracranial CH are part of PHACE syndrome; the association with intracranial CH might represent a peculiar phenotype of this rare vascular phakomatosis. As extracranial CH are known to regress spontaneously in the majority of cases, a conservative approach is recommended also for presumed intracranial CH; surgery should be avoided unless follow-up studies demonstrate growth.
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  • 20
    ISSN: 1432-1920
    Keywords: Key words Haemorrhage intraventricular ; Magnetic resonance imaging
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract MRI of intraventricular haemorrhage (IVH) has not been studied formally. We aimed to describe the degradation rate and patterns shown on 1.5 T MRI in IVH, comparing them to other coexisting brain hemorrhage. We studied 50 consecutive cases using T1-, proton-density, and T2-weighted images. IVH was seen in two forms: layered (free-flowing in ventricles) (37 cases) and/or clotted (31). Both were best shown by proton-density image. Layered IVH was seen in the dependent portions of the lateral ventricles with fluid (“blood-CSF”) levels, degrading more slowly than both clotted IVH and intraparenchymal hemorrhages (IPH) (acute blood products persisting for several more days; P 〈 0.05). Clotted IVH degraded at a rate comparable to IPH. IVH cleared rapidly and did not form hemosiderin. Subarachnoid hemorrhage (SAH) cleared faster and was less conspicuous than IVH. Hypertensive (22), aneurysmal (11), traumatic (2), idiopathic (9), or vascular malformation-related (6) IVH were seen. IVH coexisted with IPH (30) or SAH (12), or both (12). The high rate of layering with blood-CSF levels in IVH is most likely due to different densities of blood components and CSF and the fibrinolytic capability of the latter. Delayed degradation of layered IVH probably reflects high intra-ventricular oxygen and glucose content. Further study is necessary to determine if MRI characteristics of IVH are helpful in excluding other intraventricular diseases such as neoplasia and pyocephalus.
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  • 21
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    Springer
    Neuroradiology 41 (1999), S. 497-500 
    ISSN: 1432-1920
    Keywords: Key words Cephalocele ; basal ; intrasphenoid ; Magnetic resonance imaging
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract The intrasphenoid form of basal cephalocele is uncommon. We describe the clinical, CT and MRI findings in two cases presenting in middle age with persistent cerebrospinal fluid rhinorrhoea. Emphasis is placed upon the imaging findings which aid in discrimination of intrasphenoidal cephalocele from more common causes of a sphenoid sinus mass.
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  • 22
    ISSN: 1432-1920
    Keywords: Key words Ear ; Labyrinth ; Anticoagulants ; Haemorrhage ; Magnetic resonance imaging ; Computed tomography
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract We report a patient who experienced a severe vertiginous episode with bilateral tinnitus and progressive right-sided hearing loss. She had Marfan's disease and was on anticoagulant treatment. The fluid in the labyrinth gave higher signal than cerebrospinal fluid on T1-weighted images, suggesting haemorrhage. The radiological follow-up is discussed.
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  • 23
    ISSN: 1432-1920
    Keywords: Key words Sclerosis ; hippocampal ; Magnetic resonance imaging ; Epilepsy
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract We report a retrospective analysis of MRI in 206 patients with intractable seizures and describe the findings in bilateral mesial temporal sclerosis (MTS) on fast spin-echo (FSE) and fast fluid-attenuated inversion-recovery (fFLAIR) sequences. Criteria for MTS were atrophy, signal change and loss of the digitations of the head of the hippocampus. In patients with bilateral MRI signs of MTS, correlation with clinical electro, volumetric MRI data and neuropsychological tests, when available, was performed. Bilateral MTS was observed in seven patients. Bilateral loss of the digitations and signal change on fFLAIR was seen in all seven. In three, bilateral atrophy was obvious. In two patients, mild bilateral atrophy was observed and in two others, the hippocampi were: asymmetrical, with obvious atrophy on only one side. Volumetric data confirmed bilateral symmetrical atrophy in five patients, and volumes were at the lowest of the normal range in the other two. The EEG showed temporal abnormalities in all patients, unilateral in five and bilateral in two. All patients had memory impairment and neuropsychological data confirmed visual and verbal memory deficits; two patients failed the Wada test on both sides. High-resolution T2-weighted FSE and fFLAIR sequences allow diagnosis of bilateral MTS, which has important therapeutic and prognostic implications.
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  • 24
    ISSN: 1432-1920
    Keywords: Key words Malignant fibrous histiocytoma ; Magnetic resonance imaging ; Intracranial haemorrhage
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract We present CT and MRI of an intracranial malignant fibrous histiocytoma in a 5-year-old girl with headache and vomiting. This case is unusual particular by virtue of its radiological appearances and the young age of the patient.
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  • 25
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    Neuroradiology 41 (1999), S. 520-522 
    ISSN: 1432-1920
    Keywords: Key words Persistent hyperplastic primary vitreous ; Leukocoria ; Magnetic resonance imaging
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Persistent hyperplastic primary vitreous (PHPV), a developmental cause of leukocoria, is due to incomplete regression of the fetal blood supply to the eye. We report the MRI features of PHPV of the dorsal type to facilitate differential diagnosis from other causes of leukocoria, namely retinoblastoma, which may have major therapeutic consequences.
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  • 26
    ISSN: 1432-1920
    Keywords: Key words Disc ; intervertebral ; prolapsed ; Migration ; Magnetic resonance imaging
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract We report three patients with a sequestrated disc fragment posterior to the thecal sac. The affected disc was lumbar in two cases and thoracic in the third. Disc fragment migration is usually limited to the anterior extra dural space. Migration of a disc fragment behind the dural sac is seldom encountered. MRI appears to be the method of choice to make this diagnosis. The disc fragments gave low signal on T1- and slightly high signal on T2-weighted images and showed rim contrast enhancement. The differential diagnosis includes abscess, metastatic tumour and haematoma.
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  • 27
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    Neuroradiology 41 (1999), S. 654-656 
    ISSN: 1432-1920
    Keywords: Key words Angle cerebellopontine ; Papilloma choroid plexus ; Magnetic resonance imaging
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract We present a rare cerebellopontine angle choroid plexus papilloma arising at the foramen of Luschka, without an associated intraventricular component. Distinct features of the tumour on MRI, of multiple recurrences with cystic features, are described, with a review of the literature.
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  • 28
    ISSN: 1432-1920
    Keywords: Key words Hydrocephalus ; Ventriculostomy ; Magnetic resonance imaging ; Pulse sequences
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract We describe the use of three-dimensional Fourier transform constructive imaging in the steady state (CISS) MRI in the assessment of patients with hydrocephalus. We have found it of value both as a diagnostic investigation and in the follow-up of patients treated by third ventriculostomy.
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  • 29
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    Neuroradiology 41 (1999), S. 175-178 
    ISSN: 1432-1920
    Keywords: Key words Infarct ; cerebral ; Computed tomography ; Magnetic resonance imaging ; diffusion-weighted
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract We compared CT and MRI obtained within the first 3 h of onset of a cerebral infarct. Echo-planar diffusion-weighted MRI delineated the infarcted areas most clearly, and subtle low-density areas on CT were consistent with those shown to be abnormal by diffusion-weighted MR. The signal changes of affected areas on fast spin-echo proton-density, T2-weighted and fast FLAIR images were subtler than the low density on CT.
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  • 30
    ISSN: 1432-1920
    Keywords: Key words Shunt ; portosystemic ; Globus pallidus ; Manganese ; Magnetic resonance imaging
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract We report two toddlers with portosystemic shunts who had symmetrical high-signal globus pallidus lesions on T1- but not T2-weighted MRI, and measurement of whole blood manganese at 2 years of age. These cases suggest that portosystemic shunts can cause elevation of blood manganese and result in manganese accumulation in the globus pallidus, causing high signal on T1-weighted images even in asymptomatic toddlers.
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  • 31
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    Neuroradiology 41 (1999), S. 428-432 
    ISSN: 1432-1920
    Keywords: Key words Tuberous sclerosis ; Magnetic resonance imaging ; Focal cortical dysplasia ; Cortical dysgenesis
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract There is immense variability in the clinical presentation of tuberous sclerosis and many incomplete forms (formes frustes) exist. To investigate the imaging characteristics of cortical tubers seen in tuberous sclerosis unaccompanied by other stigmata, we reviewed MRI and CT of six patients who met the criteria for a definitive diagnosis of TS, established solely by the presence of a histologically confirmed cortical tuber. Five of the patients had a solitary cortical tuber and the last had three lesions, one of which was resected and confirmed histologically. The other two lesions were included in our study. CT showed five tubers as low density, but three were not identified. No calcified or dense lesions were observed. MRI revealed peripheral components and inner cores of seven cortical tubers in five patients, with differing signal characteristics. The subcortical cores, with T1 and T2 prolongation, were separated from the overlying cortex. Abnormal inhomogeneous high signal was observed in both the cortex and subcortical white matter on proton-density weighted or FLAIR images. A radially orientated white-matter band was observed in one patient, and central depression of the expanded gyri in another. In one patient, a cortical tuber was atypical, with a thick cortex on T1-weighted images and a blurred grey/white matter junction with diffusely increased signal on T2-weighted images. Cortical tubers without other stigmata of tuberous sclerosis are shown to be distinct from focal cortical dysplasia.
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  • 32
    ISSN: 1432-1920
    Keywords: Key words Dural arteriovenous fistula ; Craniocervical junction ; Magnetic resonance imaging ; Venous hypertension
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract We report a 62-year-old woman who presented with a myelopathy at the lower thoracic level. Left vertebral angiography revealed a dural arteriovenous fistula (DAVF) at the craniocervical junction, draining into an anterior spinal vein. Below the T 7 level, the spinal cord gave high signal on T 2-weighted images and enhanced with Gd-DTPA. The patient was successfully treated by simple clipping of vein draining the DAVF. The abnormal signal intensity and contrast enhancement rapidly regressed, except in the conus medullaris. Regression of the parenchymal abnormality on serial MRI following treatment corresponded closely with postoperative improvement of neurological function.
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  • 33
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    Neuroradiology 41 (1999), S. 844-846 
    ISSN: 1432-1920
    Keywords: Key words Brain ; Echinococcosis alveolar ; Magnetic resonance imaging
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Cerebral alveolar echinococcosis is rare. We report a case with multiple intracranial masses which show cauliflower-like contrast enhancement pattern on MRI. The lesions originated from hepatic involvement with invasion of the inferior vena cava.
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  • 34
    ISSN: 1432-1920
    Keywords: Key words Progressive multifocal leukoencephalopathy ; Acquired immunodeficiency syndrome ; Single-photon emission ; tomography ; Magnetic resonance imaging
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract We describe a patient with AIDS who presented with focal neurological symptoms, and who had contrast-enhancing brain lesions on MRI which demonstrated increased thallium-201 uptake on SPECT. These findings were consistent with lymphoma; however, brain biopsy established a diagnosis of progressive multifocal leukoencephalopathy (PML). To our knowledge, this is the first reported case of PML with increased thallium-201 uptake on brain SPECT.
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  • 35
    ISSN: 1432-1920
    Keywords: Key words Parkinson's disease ; Differential diagnosis ; Magnetic resonance imaging ; Signal intensity
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract A reduction in signal in the basal ganglia on T2-weighted images is said to correlate with a poor response to L-DOPA and may help to identify patients with nonidiopathic parkinsonism. Our aim in this prospective study was to use the contrast-to-noise ratio of the MRI signal on T2-weighted images in various parts of the basal ganglia in 43 patients with de novo parkinsonism. Signal intensity measurements were compared to the response to the dopamine agonist apomorphine and dopamine-D2 receptor binding obtained by 3-iodo-6-methoxybenzamine single-photon emission computed tomography (IBZM-SPECT). A reduced contrast-to-noise ratio in the putamen correlated significantly with a negative response to apomorphine and reduced striatal IBZM binding. No additional signal intensity measurement correlated with response to apomorphine or specific IBZM binding. However, there was a considerable overlap of contrast-to-noise ratios between patients with a positive or negative response to apomorphine or normal and reduced IBZM binding. We suggest that semiquantitative assessment of signal intensity in the putamen shows a significant reduction in patients with probably nonidiopathic parkinsonism compared with patients with probably idiopathic parkinsonism. However, this method does not exclude idiopathic parkinsonism in a given patient.
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  • 36
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    Neuroradiology 41 (1999), S. 140-143 
    ISSN: 1432-1920
    Keywords: Key words Haemangiomas ; head and neck ; Magnetic resonance imaging ; Magnetic resonance angiography
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract We evaluated the clinical effectiveness of contrast-enhanced three-dimensional (3D) magnetic resonance angiography (MRA) for diagnosing head and neck haemangiomas. We studied six patients using a magnetization prepared rapid acquisition gradient-echo (MP-RAGE) sequence on a 1.5-T system. Conventional T1- and T2-weighted and contrast-enhanced images were also obtained. The images were compared with histological findings. In four cavernous haemangiomas, a mass was partially visible as an enhancing lesion on the early phase of MRA, and was completely visible as a larger enhancing lesion in the late phase, showing slow blood flow. In two capillary haemangiomas, a mass was completely visible in the early phase showing fast flow. In all patients, MRA clearly showed both the haemangiomas and the external carotid artery branches. MRA allowed assessment of the relationship between the haemangiomas and the feeding arteries, and of the haemodynamics.
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  • 37
    ISSN: 1432-1920
    Keywords: Key words Hypernatraemia ; Myelinolysis ; extrapontine ; Computed tomography ; Magnetic resonance imaging
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract The neuroimaging findings in an infant with hypernatremic dehydration are presented. Brain parenchymal haemorrhage and extensive multiple infarcts were present in the acute stage. Follow-up CT showed bilateral, symmetrical changes presumed to indicate extrapontine myelinolysis in the thalamus and globus pallidus. MRI confirmed sparing of the pons. Only three previous cases of neuroimaging abnormalities due to hypernatraemia have been described in the radiological literature.
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  • 38
    ISSN: 1432-1920
    Keywords: Key words Hereditary caeruloplasmin deficiency ; Magnetic resonance imaging
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract We present two patients with hypocaeruloplasminaemia and a heteroallelic caeruloplasmin gene mutation (HypoCPGM). These patients had diabetes mellitus and tremor of the hands, respectively. T2-weighted fast spin-echo MRI showed mildly reduced intensity of the putamen, much more marked on echo-planar imaging.
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  • 39
    ISSN: 1432-1920
    Keywords: Key words Pituitary adenoma ; Meningioma diaphragma sellae ; Magnetic resonance imaging
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Diaphragma sellae meningiomas are unusual tumours often not distinguished from pituitary macroadenomas. Preoperative differentiation is essential, because the trans-sphenoidal approach is used for surgical removal of adenomas, while meningiomas are approached via a craniotomy. We reviewed five patients in whom a diaphragma sellae meningioma was initially diagnosed as a nonsecreting pituitary macroadenoma. MRI criteria for differential diagnosis are discussed. The main findings considered are visibility of the pituitary gland, contrast enhancement, the centre of the lesion and sellar enlargement. These criteria, applied to a blind review, allow correct identification of the tumours.
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  • 40
    ISSN: 1432-1920
    Keywords: Key words Stroke ; ischaemic ; Magnetic resonance imaging ; Diffusion
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract We examined the diagnostic use of isotropic diffusion-weighted (DW) MRI in 140 consecutive patients suspected of or diagnosed as having an ischaemic stroke. Isotropic DW imaging could demonstrate the lesion responsible for the clinical deficit in patients with multiple cerebral infarts at an early stage, even small lesions without a perifocal oedema or mass effect. Accurate diagnosis by DW images may, however, be difficult about 2 weeks after the onset of stroke.
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  • 41
    ISSN: 1432-1920
    Keywords: Key words Neuroma acoustic ; Magnetic resonance imaging ; Haemorrhage
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract A 55-year-old man with hearing loss presented with vertigo and vomiting. CT tomography and MRI demonstrated a cerebellopontine angle mass with foci of haemorrhage. An angiomatous tumour, with large abnormal veins adhering to the capsule, was completely removed. Histologically, the tumour was an acoustic neuroma with abnormal vascularisation and limited intratumoral haemorrhage.
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  • 42
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    Neuroradiology 41 (1999), S. 799-801 
    ISSN: 1432-1920
    Keywords: Key words Endolymphatic sac ; adenocarcinoma ; Hearing loss ; sensorineural ; Magnetic resonance imaging
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract A 30-year-old man presented with sudden left deafness and vertigo. CT showed an osteolytic retrolabyrinthine tumour of the left temporal bone. High signal from the tumour and labyrinth was seen on fat-suppressed T 1-weighted images. At surgery, a haemorrhagic papillary-cystic adenocarcinoma of the endolymphatic sac was found.
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  • 43
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    Neuroradiology 41 (1999), S. 788-794 
    ISSN: 1432-1920
    Keywords: Key words Paraganglioma spinal ; Magnetic resonance imaging
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract We report the clinical MRI and histopathological features of five consecutive cases of spinal paraganglioma. Three intradural tumours were found in the typical location (two at the L4, one at the S2 level); one intradural extramedullary tumour arose at an unusual level, from the ventral C2 root, and one extradural tumour growing along the L5 nerve root sheath had an aggressive growth pattern with early, local paraspinal recurrence and, eventually, intradural metastatic spread. This type of growth pattern has not been described previously. Paragangliomas of the spinal canal are more common than previously thought and can be located anywhere along the spine, although the lumbosacral level is the most common. Their appearance on MRI can not disinguish them from other tumours in the spinal canal. Even though paragangliomas in general are benign and slowly growing their growth pattern can vary and be more aggressive, to the point of metastatic spread.
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  • 44
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    Neuroradiology 41 (1999), S. 840-843 
    ISSN: 1432-1920
    Keywords: Key words Proteus syndrome ; Magnetic resonance imaging
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract The Proteus syndrome is a rare hamartoneoplastic syndrome that may affect the brain, skull, and extracranial head and neck. We present a case with severe, characteristic findings. Brain abnormalities are not common in Proteus syndrome; when present, hemimegalencephaly and migrational disorders are typically seen, commonly with an associated seizure disorder. Maxillary and mandibular dysmorphism may occur, including unilateral condylar hyperplasia. Subcutaneous fatty, fibrous, lymphangiomatous masses commonly seen in this syndrome may involve the neck and face, leading to disfigurement and potential airway compromise.
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  • 45
    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.
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  • 46
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    Neuroradiology 41 (1999), S. 904-909 
    ISSN: 1432-1920
    Keywords: Key words Epidural abscess spinal ; Magnetic resonance imaging ; Spine
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Our purpose was to determine if specific MRI findings in spinal epidural abscess (SEA), at the time of diagnosis, are associated with the clinical outcome. The clinical records and MRI studies of 18 patients with SEA were reviewed and follow-up was obtained from the outpatient medical record, telephone interview, or both. The association between findings on contrast-enhanced MRI and clinical outcome (weakness, neck or back pain, and incomplete functional recovery) was evaluated. With univariate analysis, narrowing of 50 % or more of the central spinal canal (P = 0.03), peripheral contrast-enhancement (P = 0.05), and abnormal spinal cord signal intensity (P = 0.05) were associated with weakness at follow-up. Persistent neck or back pain was associated with spinal canal narrowing (P = 0.02), peripheral contrast-enhancement (P = 0.02), and an abscess longer than 3 cm (P = 0.04) on MRI. Incomplete clinical recovery was associated with both abscess length (P = 0.01) and the severity of canal narrowing (P = 0.01). Abscess length, enhancement pattern, and severity of canal narrowing can be incorporated in a grading system that can be used to predict outcome.
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  • 47
    ISSN: 1432-1920
    Keywords: Key words Encephalitis ; Rasmussen's ; Magnetic resonance imaging ; Magnetic resonance spectroscopy
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract The greater sensitivity of magnetic resonance spectroscopy (MRS) compared with MRI to brain abnormalities in Rasmussen's encephalitis was demonstrated in a 3-year-old boy. The patient, with symptoms, signs and morphological findings consistent with Rasmussen's encephalitis, was followed with MRI and MRS over 30 months. That metabolic changes can be disclosed by MRS before the development of symptoms or signs was demonstrated as pathological spectra were found not only in the diseased left hemisphere but also in the morphologically normal right hemisphere before any neurological disturbance of that side.
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  • 48
    ISSN: 1432-1920
    Keywords: Key words Moyamoya disease ; Magnetic resonance imaging ; Diffusion-weighted imaging ; Perfusion imaging
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract We describe the use of diffusion-weighted imaging and perfusion MRI using a contrast-medium bolus in the preoperative investigation for young man presenting with a cerebral ischaemic episode as a manifestation of moyamoya disease.
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  • 49
    ISSN: 1432-1920
    Keywords: Key words Nerves ; cranial ; Nerve ; trigeminal ; Schwannoma ; Neurofibroma ; Magnetic resonance imaging
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract We reviewed the clinical and MRI findings in primary nerve-sheath tumours of the trigeminal nerve. We retrospectively reviewed the medical records, imaging and histological specimens of 10 patients with 11 primary tumours of the trigeminal nerve. We assessed whether tumour site, size, morphology or signal characteristics were related to symptoms and signs or histological findings. Histological proof was available for 8 of 11 tumours: six schwannomas and two plexiform neurofibromas. The other three tumours were thought to be schwannomas, because they were present in patients with neurofibromatosis type 2 and followed the course of the trigeminal nerve. Uncommon MRI appearances were observed in three schwannomas and included a large intratumoral haemorrhage, a mainly low-signal appearance on T2-weighted images and a rim-enhancing, multicystic appearance. Only four of nine schwannomas caused trigeminal nerve symptoms, including two with large cystic components, one haemorrhagic and one solid tumor. Of the five schwannomas which did not cause any trigeminal nerve symptoms, two were large. Only one of the plexiform neurofibromas caused trigeminal nerve symptoms. Additional neurological symptoms and signs, not related to the trigeminal nerve, could be attributed to the location of the tumour in three patients.
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  • 50
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    Neuroradiology 41 (1999), S. 134-136 
    ISSN: 1432-1920
    Keywords: Key words Demyelination ; Methotrexate ; Magnetic resonance imaging ; Ommaya reservoir
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract We describe the imaging findings in an unusual case of biopsy-proven, methotrexate-induced leukoencephalopathy complicating a malfunctioning Ommaya reservoir in a patient with lymphoma.
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  • 51
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    Neuroradiology 41 (1999), S. 358-359 
    ISSN: 1432-1920
    Keywords: Key words Amyloid ; Pituitary adenoma ; Magnetic resonance imaging
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract We report a patient with a pituitary adenoma with extensive amyloid formation. T2-weighted MRI was most characteristic for amyloid deposition.
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  • 52
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    Neuroradiology 41 (1999), S. 584-587 
    ISSN: 1432-1920
    Keywords: Key words Angiolipoma ; Spinal cord ; Magnetic resonance imaging
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract We report an intramedullary angiolipoma with spinal cord compression studied by MRI, angiography and CT. Angiolipomas of the spine are rare benign tumours containing vascular and mature adipose elements. They are epidural in more than 90 % of the cases; only three cases of intramedullary angiolipoma are described. The clinical picture is nonspecific, but MRI and CT suggest the diagnosis.
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  • 53
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    Neuroradiology 41 (1999), S. 666-669 
    ISSN: 1432-1920
    Keywords: Key words One-and-a-half syndrome ; Infarcts pontine ; Magnetic resonance imaging
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract The one-and-a-half syndrome is characterised by a lateral gaze palsy in one direction and internuclear ophthalmoplegia in the other. It is due to a unilateral lesion of the dorsal pontine tegmentum, involving the ipsilateral paramedian pontine reticular formation, internuclear fibres of the ipsilateral medical longitudinal fasciculus and, usually, the abducens nucleus. The main causes of this rare syndrome are stroke and multiple sclerosis. Few cases have been reported since the introduction of MRI. Our aim was to examine clinicoradiological correlations in six patients with a one-and-a-half syndrome due to a stroke. Ophthalmological symptoms were diplopia, oscillopsia or blurred vision. Four patients had an associated facial nerve palsy, three a hemiparesis and one a unilateral hemihypoaesthesia. MRI revealed an infarct in the pons in all patients. The cause of the infarct was a basilar artery dissection in one patient, bilateral vertebral artery dissection in a second and unknown in the other four. All patients recovered within 2 days to 8 weeks. This study showed a good correlation between the site of the lesion (superior, inferior or extensive pontine ischaemia) and clinical deficits.
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  • 54
    ISSN: 1432-1920
    Keywords: Key words Pituitary ; adenoma ; Growth hormone-secreting ; Acromegaly ; Magnetic resonance imaging
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Preoperative serum growth hormone (GH) level is one of the most important determinants of outcome. Our aim was to assess MRI findings which may correlate with pretreatment GH levels in GH-secreting adenomas. We retrospectively studied 29 patients with acromegaly caused by a pituitary adenoma. Tumor size (height, width, thickness and volume), suprasellar extension, sphenoid or cavernous sinus invasion, signal intensity and contrast enhancement were studied. Linear regression analysis or Fisher's exact probability test was used for statistical analysis. Factors related to high GH levels were the maximum dimension of the tumour (r = 0.496, P 〈 0.01), its volume (r = 0.439, P 〈 0.05), spenoid sinus invasion (P 〈 0.01) and intracavernous carotid artery (encasement (P 〈 0.01). The other items were not related to serum GH levels. Since we believe surgery is the first choice of treatment and the cavernous sinus is difficult of access with a conventional surgical approach, preoperative assessment of invasion into the cavernous sinus is critical for predicting the surgical outcome. Low GH levels (5–50 ng/ml) were found with tumours medial to the intercarotid line and high levels (more than 101 ng/ml) with invasive tumours with carotid artery encasement. Variable GH levels were noted with tumours extending beyond the intercarotid line. Because functioning adenomas invading the cavernous sinus tend to have markedly high hormone levels, and only patients with carotid artery encasement showed markedly elevated GH levels, we believe carotid artery encasement a reliable MRI indicator of cavernous sinus invasion.
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  • 55
    ISSN: 1432-1920
    Keywords: Key words Olive ; degeneration ; Head injurgy ; Pontine hemorrhage ; Magnetic resonance imaging
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract We studied serial MRI appearances of transneuronal degeneration in the inferior olives, retrospectively analysing follow-up images of five patients, three with head injury and two with brain stem haemorrhage. We performed 13 MRI studies 4 days to 2 years 7 months after the accident. All but one of the patients exhibited bilateral olivary high signal on T2-weighted images. The interval between causal event and appearance of olivary changes was 2–4 months, images 4 days to 1.5 months after the accidents revealing no changes. Olivary enlargement was observed in four patients 2–4 months after ictus.
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  • 56
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    Neuroradiology 41 (1999), S. 27-29 
    ISSN: 1432-1920
    Keywords: Key words Pituitary ; cyst ; Rathke's cleft cyst ; Pituitary ; Magnetic resonance imaging
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract We present a pituitary cyst discovered on MRI in an amenorrheic patient that regressed over months. Although the precise etiology of the cyst is unproven, documentation of pituitary cyst regression has not to our knowledge been described previously.
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  • 57
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    Neuroradiology 41 (1999), S. 55-59 
    ISSN: 1432-1920
    Keywords: Key words Oculocerebrocutaneous syndrome ; Delleman-Oorthuys syndrome ; Magnetic resonance imaging
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract We describe two cases of the so-called oculocerebrocutaneous syndrome, also known as the Delleman-Oorthuys syndrome. Both patients had characteristic congenital anomalies of the orbit, central nervous system and skin. The ocular and cerebral lesions were studied with CT and MRI.
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  • 58
    ISSN: 1432-1920
    Keywords: Key words Mitochondrial diseases ; Leigh's disease ; Kearns-Sayre disease ; Computed tomography ; Magnetic resonance imaging
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Mitochondrial diseases result from structural, biochemical or genetic defects of mitochondria, which contain the respiratory chain. They usually affect children and young adults. We report the CT and MRI findings in 17 patients under 14 years of age, the youngest reported to date, with various mitochondrial diseases. Although imaging studies may be normal negative in the early stages, follow-up usually shows many abnormalities, which depend on clinical status and the disease. We have recognised a spectrum of findings that can be divided into four patterns: nonspecific myelin lesions (8/17); grey-matter nuclei involvement (6/17); a leukodystrophic pattern; and calcification of the brain (1/17), although mixed forms, particularly myelin and grey-matter lesions are frequent.
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  • 59
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    Neuroradiology 41 (1999), S. 943-945 
    ISSN: 1432-1920
    Keywords: Key words Chorea ; Sydenham's ; Magnetic resonance imaging ; Magnetic resonance spectroscopy
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract We present the MRI and proton spectroscopy findings in a child with clinical diagnosis of Sydenham's chorea. MRI showed high signal in the caudate nuclei and putamina on T2-weighted images. We believe that the spectra showed an abnormality in the number and/or function of neurons, lipids from cellular breakdown (cytolytic effect of antibodies), aminoacids (related to the presence of antibodies in the neostriatum), and sugars (also related to the presence of antibodies). The spectroscopy features correlate well with the histopathology and biochemistry of this rare disorder.
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  • 60
    ISSN: 1432-1920
    Keywords: Key words Neurofibromatosis type 1 (NF1) ; Optic glioma ; Magnetic resonance imaging
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract We report two children with neurofibromatosis type 1 showing enhancing masses on MRI suggesting neoplasms in the chiasm and hypothalamic region. In both patients no visual or endocrinal dysfunction was present. On serial MRI spontaneous partial remission was found, implying that a cautious approach to therapeutic management of similar cases should be taken.
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  • 61
    ISSN: 1432-1920
    Keywords: Key words Behçet's syndrome ; Central nervous system ; Magnetic resonance imaging ; Brain ; vasculitis ; Multiple sclerosis
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Two neuroradiologists reviewed MRI studies of 34 patients with neuro-Behçet's disease (NBD), 22 with multiple sclerosis (MS) and 7 with systemic lupus erythematosus (SLE) with central nervous system involvement, masked to the clinical diagnosis, age and sex of the patients. Of the patients with NBD 12 were in an acute attack; the others had chronic disease. MRI was assessed using a set of criteria, looking at atrophy, the site of discrete parenchymal lesions, regions of predominant involvement and the extent of the lesion(s). The observers also made a guess at the clinical diagnosis. The brain stem and/or basal ganglia were the most predominantly involved sites in all patients with acute NBD; 75 % of these lesions were large and confluent, mainly extending from the brain stem to the diencephalon and basal ganglia. However, in chronic cases, the predominant involvement was in the brain stem and/or basal ganglia in only 36 %, and in cerebral hemisphere white matter in another 36 %; 27 % of these patients showed no parenchymal lesion. Hemisphere white-matter lesions were equally distributed between periventricular and other areas in NBD, while in MS more were periventricular, and in SLE more were nonperiventricular. Brain-stem atrophy was seen in 21 % of patients with NBD, with a specificity of 96.5 %. In the absence of cortical atrophy, its specificity was 100 %. The attempt at making a radiological diagnosis was successful in all cases of acute NBD and 95.5 % of patients with MS, but in only 40 % of patients with chronic NBD. Most of this latter groups MRI studies were interpreted as MS. An extensive lesion involving the brain stem and basal ganglia seemed to be diagnostic of acute NBD. However, hemisphere white-matter lesions could not be differentiated from those in MS.
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  • 62
    ISSN: 1432-1920
    Keywords: Key words Virchow-Robin spaces ; Magnetic resonance imaging ; Childhood migraine
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Virchow-Robin spaces (VRS) are pia-lined extensions of the subarachnoid space which surround penetrating arteries as they enter the brain on its surface. Using high-resolution MRI, which shows small penetrating arteries, we studied a possible association of accentuated VRS in children with tension-type headache (TTH) or migraine. We studied 58 children aged 3–14 years (mean 10.8 years) with a clinical diagnosis of migraine (31) or TTH (27), who underwent cerebral MRI, and 30 headache-free patients of the same age (mean 10.2 years) and 30 adult migraineurs with postpubertal onset of symptoms, who served as controls. The images were reviewed for structural abnormalities in the regions of the small penetrating arteries. Accentuated VRS were found in 61 % of the children with migrainous headaches and in 22 % of children of those with TTH. Prominent VRS were seen in 27 % of the control children and in only 13 % of the adults. Small infarcts and gliosis were rare in children with or without headache, but were seen in 30 % of the adult migraineurs. Our findings show that accentuated VRS are significantly more common in children with migraine than in those with TTH or headache-free controls. Detection of accentuated VRS may therefore enhance differential diagnosis of primary headaches in children, contributing to an improvement in management.
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  • 63
    ISSN: 1432-1920
    Keywords: Key words Temporal bone ; abnormalities ; Magnetic resonance imaging ; Pulse sequences
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract We prospectively studied 163 patients referred for MRI of the temporal bone. A presumed diagnosis was made using only one of three sequences: a single thick (12 mm) slice fast T2-sequence, 3D fourier transform constructive interference in steady state (3DFT-CISS) sequence and a gadolinium-enhanced T1-weighted sequence. The visibility of the cochlea, vestibule and superior, lateral and posterior semicircular canals of normal temporal bones was assessed on the T2-weighted images: they were almost always visible (98–100 %), with exception of the superior semicircular canal, seen in only 35 % of cases. The images were interpreted as abnormal in 34 patients (21 %). Using only the fast T2-weighted, 3DFT-CISS and gadolinium-enhanced T1-weighted sequences a presumed false positive diagnosis was made in 5, 1 and 0 cases and a false negative diagnosis in 2, 2 and 4 cases respectively. The overall reliability of the thick-section fast T2-weighted images is limited. This study suggests that a combination of gadolinium-enhanced T1-weighted and 3DFT-CISS images can be considered the gold standard for temporal bone MRI and neither sequence performed separately is as accurate as both together.
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  • 64
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    Neuroradiology 41 (1999), S. 440-442 
    ISSN: 1432-1920
    Keywords: Key words Optic chiasm ; Sarcoidosis ; Magnetic resonance imaging
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract We report MRI findings of a pathologically proven primary sarcoid granuloma of chiasmal origin that mimicked an optic pathway glioma
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  • 65
    ISSN: 1432-1920
    Keywords: Key words Spine ; dysraphism ; Fistula ; arteriovenous ; Magnetic resonance imaging ; Magnetic resonance angiography
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Spinal dural arteriovenous fistulae are extremely rare in spinal dysraphism. A fistulous malformation within a lipomyelomeningocele has not been reported previously. A 50-year-old man presented with progressive paraparesis and bladder dysfunction. MRI revealed a large lumbar lipomyelomeningocele. A vascular malformation was indicated by abnormal signal in the thoracolumbar spinal cord and dilated perimedullary veins. Phase-contrast MRA demonstrated only the slow-flow veins of the fistula and an intradural ascending vein. Contrast-enhanced ultra-fast MRA gave excellent delineation of all parts of the fistula within the dysraphic lesion.
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  • 66
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    Neuroradiology 41 (1999), S. 588-590 
    ISSN: 1432-1920
    Keywords: Key words Nitrous oxide anaesthesia ; Macrocytic anaemia ; Myeloneuropathy ; Magnetic resonance imaging
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract The neurological condition triggered by anaesthesia with nitrous oxide involves the cyanocobalamine pathway and is characterised by progressive demyelination and axonal lesions of the peripheral nerves and cervicothoracic spinal cord (posterior and anterolateral columns) giving a peripheral neuropathy and very frequently subacute combined degeneration of the spinal cord. It is possible to show these demyelinating lesions by MRI of the spine, allowing early diagnosis and follow-up. We describe a case of myeloneuropathy with onset a few hours after nitrous oxide anaesthesia in a patient with macrocytic anaemia and possible subclinical vitamin B12 deficiency and MRI evidence of a lesion of the cervical spinal cord. Neurological and haematological improvement followed cyanocobalamine replacement.
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  • 67
    ISSN: 1432-1920
    Keywords: Key words Brain ; neoplasms ; Skull base ; neoplasms ; Magnetic resonance imaging
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract We present the MRI findings in two patients with “fibro-osseous lesions” involving the central nervous system. A left temporal lobe mass was present in one patient and an extra-axial mass at the skull base in the other. In both cases, calcification was present, with low signal intensity on T1- and T2-weighted images.
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  • 68
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    Neuroradiology 41 (1999), S. 832-834 
    ISSN: 1432-1920
    Keywords: Key words Pituitary tumor ; Cyst Rathke's cleft ; Pituitary apoplexy ; Magnetic resonance imaging
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract We report a Rathke's cleft cyst which presented as pituitary apoplexy, a rare presentation. A 46-year-old woman suffered sudden headache and visual loss. T1-weighted MRI 3 weeks after this apoplectic episode demonstrated a cystic lesion between the anterior and posterior lobes of the pituitary, with some high-signal material layering in it. The mass showed spontaneous regression on an image 3 weeks later. Trans-sphenoidal surgery confirmed the diagnosis of a Rathke's cleft cyst with a haematoma within it.
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  • 69
    ISSN: 1432-1920
    Keywords: Key words Spinal subdural haematoma ; Magnetic resonance imaging ; Computed tomography
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Chronic spinal subdural haematoma is a uncommon. We describe the CT and MRI appearances of chronic spinal and intracranial subdural haematomas following minor trauma. The aetiology, pathogenesis and differential diagnosis are discussed.
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  • 70
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    Neuroradiology 41 (1999), S. 129-133 
    ISSN: 1432-1920
    Keywords: Key words Cryptococcosi ; Acquired immunodeficiency syndrome ; Computed tomography ; Magnetic resonance imaging
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract CT and MRI in one case of Cryptococcus neoformans infection showed contrast-enhancing parenchymal lesions resembling granulomata or abscesses. After an initial phase without contrast enhancement, the full extent of the lesions was visible within 2 weeks of presentation. The enhancing masses were assumed to represent intracerebral cryptococcomas. Despite evidence of massive meningeal infection on cerebrospinal fluid (CSF) examination, no radiological signs of meningitis, invasion of the Virchow-Robin spaces or ventriculitis could be demonstrated. With antimycotic treatment the contrast enhancement disappeared and cystic, partly calcified lesions remained. Recurrence of meningeal infection without radiological correlates was apparent in this stage. In a second case of proven cryptococcus meningitis, dilation of Virchow-Robin spaces or cysts in the adjacent parenchyma were the main abnormalities on MRI. Enhancing masses were not detected. These cases may represent two different reactions of the immunocompromised hosts to infection with C. neoformans: widening of the perivascular spaces as a correlate of the more typical meningeal infection and enhancing parenchymal lesions as a sign of further invasion from the CSF spaces. Enhancement of cryptococcomas, indicating an inflammatory response in the surrounding brain, is not typical in patients with impairment of immune function.
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  • 71
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    Neuroradiology 41 (1999), S. 158-162 
    ISSN: 1432-1920
    Keywords: Key words Midbrain ; tumours ; Magnetic resonance imaging
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract We diagnosed 60 cases of midbrain tumours by MRI between 1993 to 1997. There were 39 males and 21 females, aged 2–64 years, mean 25.6 years. We found 38 patients with true intramedullary midbrain tumours, 11 predominantly in the tectum, 20 in the tegmentum and 7 with a downward extension to the pons; there were 7 within the cerebral aqueduct. There were 22 patients with infiltrating midbrain tumours extending from adjacent structures, 11 cases each from the thalamus and pineal region. All patients received surgical treatment. Gross total resection was achieved in 42 cases, subtotal (〉 75 %) resection in 18. Pathological diagnoses included 16 low-grade and 15 high-grade astrocytomas; 5 oligodendroastrocytomas; 2 ependymomas; 11 glioblastomas; and 11 pineal parenchymal or germ-cell tumours. Midbrain tumours are a heterogeneous group of neoplasms, with wide variation in clinical and MRI features, related to the site and type of tumour. MRI not only allows precise analysis of their growth pattern, but also can lead to a correct preoperative diagnosis in the majority of cases.
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  • 72
    ISSN: 1432-1920
    Keywords: Key words Cerebral infarcts ; Magnetic resonance imaging ; Contrast enhancement
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract We compared contrast enhancement on T1-weighted MRI of acute cerebral infarcts after conventional bolus administration and continuous infusion of gadolinium. We examined 12 patients with a history of acute stroke with contrast-enhanced MRI once a week for a 1 month. Only ischaemic lesions were investigated after cerebral haemorrhage had been excluded by CT. Each MRI study included T2- and proton density-weighted sequences for determination of the size and site of the infarct, immediate postinjection T1-weighted imaging after bolus administration of 0.1 mmol/kg gadolinium-DPTA and delayed T1-weighted imaging after additional continuous infusion of 0.1 mmol/kg over 2 h. A total of 42 MRI studies was performed. In the first week after the onset of stroke, most infarcts (8 of 10) did not enhance after bolus administration, whereas all showed distinct contrast enhancement after the infusion. In the following weeks all but two infarcts showed contrast enhancement after bolus administration; after continuous infusion contrast enhancement could be seen in all cases. While contrast enhancement after bolus administration showed the typical gyriform pattern, enhanced areas were more extensive after the infusion and usually covered the entire infarcted area shown on T2- and proton density-weighted images. We presume that the disturbed blood-brain barrier in ischaemic areas favours delivery of contrast medium to the infarcted tissue if it is offered continuously so that a steady state can develop.
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  • 73
    ISSN: 1432-1920
    Keywords: Key words Dystonia ; Polycythaemia ; Globus pallidus ; Magnetic resonance imaging
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract We report a child who concurrently developed polycythaemia, dystonia, and T 1 shortening in the globus pallidus, medial cerebral peduncle and superior cerebellar peduncles on MRI. With spontaneous resolution of the polycythaemia after about 21/2 years, the dystonia and MRI abnormalities also resolved. Although the physiological cause of the T 1 shortening is not known, this appears to be another cause of T 1 shortening in the basal ganglia.
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  • 74
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    Neuroradiology 41 (1999), S. 443-446 
    ISSN: 1432-1920
    Keywords: Key words Langerhans cell histiocytosis ; Magnetic resonance imaging
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Langerhans cell histiocytosis (LCH) is a disease of unknown cause characterised by proliferation of histiocytic granulomas in tissues; the primary cerebral manifestation is diabetes insipidus caused by hypothalamic infiltration. We present a patient in whom, except for the absence of high signal on T 1 weighting in the posterior pituitary, consistent with central diabetes insipidus, MRI showed no evidence of hypothalamic involvement by histiocytosis, despite the long duration of the disease. However, there was bilateral, symmetrical involvement of the cerebellum and globus pallidus in addition to a calvarial lesion. High signal in the cerebellar white matter on T 2-weighted images may represent demyelination, gliosis and cell loss, as previously reported on pathologic examination.
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  • 75
    ISSN: 1432-1920
    Keywords: Key words Epidermoid tumour ; Diffusion-weighted imaging ; Magnetic resonance imaging
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Cerebellopontine angle epidermoid tumour generally has a typical appearance with conventional MRI sequences. The lesion is irregular in shape and gives slightly higher signal than cerebrospinal fluid on T1- and T2-weighted images, with a characteristic marbled inner pattern on T1-weighted images. Diffusion-weighted imaging (DWI) can be useful for the diagnosis of an atypical epidermoid tumour. Our case report illustrates the usefulness of DWI for postoperative assessment of residual foci of tumour. The specific appearance of an epidermoid tumour is illustrated, with emphasis on apparent diffusion coefficient (ADC) measurements.
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  • 76
    ISSN: 1432-1920
    Keywords: Key words Porphyria ; acute intermittent ; Encephalopathy ; porphyric ; Myelinolysis ; central pontine ; Necrosis ; cortical laminar ; Magnetic resonance imaging
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Acute intermittent porphyria (AIP) is an autosomal-dominant disease caused by a deficiency of porphobilinogen (PBG) deaminase. Patients with AIP present with neurological syndromes such as autonomic neuropathy, peripheral axonal neuropathy or central nervous system dysfunction. We report serial MRI of a patient with AIP who had cortical and subcortical cerebral changes. A 29-year-old woman with a 6-month history of AIP had an attack with severe hyponatraemia and generalised convulsions, treated with haem arginate and supportive therapy. MRI showed central pontine and extrapontine myelinolysis and cortical laminar necrosis. These are not common in AIP, but are likely to have been caused by rapid correction of hyponatraemia and by vasospasm, which could be induced by AIP.
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  • 77
    ISSN: 1432-1920
    Keywords: Key words Stroke ; Magnetic resonance imaging ; Diffusion-weighted imaging
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Diffusion-weighted MRI (DWI) is becoming important for assessment of acute stroke. Until recently single-shot DWI required expensive technology such as echo-planar imaging (EPI) available only at some research sites. A new medium-field (1.0 T) short-bore MR imager has been developed with which DWI data sets can be acquired. We prospectively studied 169 patients on this 1.0 T commercial system. After conventional imaging, DWI was performed with a single-shot multi-slice sequence with b values 0 an 900 s/mm2, and with the gradients switched in three directions. The apparent diffusion coefficients were calculated with online calculation software. There were 50 patients with totally normal MRI, and 17 had strokes, these strokes were detected as areas of high signal on the images at a maximal b value. There was a drop in the ADC in ischaemic regions: in subacute infarcts, the values were between 0.41 and 0.531 × 10− 3 mm2/s. In old infarcts the ADC was 1.15 × 10− 3 mm2/s. Cerebrospinal fluid (CSF) gave low signal whereas areas in the brain had more intermediate intensities (CSF: 3.00; deep white matter: 0.75, cortical grey matter: 0.80, basal ganglia (thalamus): 0.70 and cerebellar white matter: 0.65 × 10− 3 mm2/s. Anisotropy was detected as areas of restricted diffusion along the tracts. These preliminary data show that DWI can be aquired successfully on a medium-field short-bore system. This should allow the technique to be implemented at more sites, therefore facilitating the diagnosis of acute stroke and rendering early intervention feasible.
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  • 78
    ISSN: 1432-1920
    Keywords: Key words Brain ischaemia ; Brain ; infarct ; Magnetic resonance imaging ; Magnetic resonance angiography ; Pulse sequences
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract In the hyperacute phase of stroke, occluded vessels can be seen as high signal on fast-FLAIR images or as absence of flow-related enhancement in maximum-intensity projection (MIP) MR angiography (MRA). To compare these techniques, we examined 53 patients within 6 h of a stroke, using a standardised MRI protocol including fast-FLAIR and 3D time-of-flight TOF MR to detect vessel occlusion or reduced flow corresponding to the suspected ischaemic territory. Brain infarcts were confirmed on MRI after 1–5 days in 41 cases (77 %). The overall accuracy of 3D-TOF MRA was 68 % and sensitivity, specificity, positive and negative predictive values were 67 %, 71 %, 87 %, and 43 % respectively. Values for the fast-FLAIR sequence were: 65 %, 85 %, 93 % and 44 %, with an overall accuracy of 70 %. The fast-FLAIR sequence was thus able to show occluded vessels or reduced flow with about the same accuracy as 3D-TOF MRA and enabled better prediction of the ischaemic area.
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  • 79
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    Neuroradiology 41 (1999), S. 723-728 
    ISSN: 1432-1920
    Keywords: Key words Skull ; Eosinophilic granuloma ; Histiocytosis Langerhans-cell ; Computed tomography ; Magnetic resonance imaging ; Scintigraphy
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract We reviewed the imaging of four pathologically proven calvarial eosinophil granulomas. The diameter of the lesions ranged from 13 to 40 mm; three were biconvex, but the other had a collar-stud appearance. Two lesions were in the frontal and two in the parietal bone. On bone-window CT, a bevelled edge was seen in three cases and button sequestration in one, but no sclerotic rim was shown. Although one lesion had a low-density area, the lesions were slightly denser than grey matter. They were isointense with grey or white matter on T1-weighted MRI and gave heterogeneous high signal on proton-density and T2-weighted images. All enhanced markedly, with a less strongly enhancing portion within them. A tail of dural enhancement and reactive change in the overlying galea or temporal muscle were seen in all cases.
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  • 80
    ISSN: 1432-1920
    Keywords: Key words Behçet's syndrome ; Magnetic resonance imaging ; Pulse sequences
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract We compared the sensitivity of a fluid-attenuated inversion-recovery (FLAIR) sequence with that of a conventional dual-echo spin-echo (SE) sequence) to brain lesions in 20 patients with Behçet's syndrome. They underwent 25 MRI examinations. The images were independently analysed for the number, type and anatomical location of lesions shown. There were 18 abnormal studies (13 initial and 5 follow-up). The FLAIR sequence detected significantly more lesions than the SE TE 80 (P 〈 0.05) and SE TE 20 (P 〈 0.01) sequences. It was particularly useful for demonstrating lesions in the juxtacortical white matter, which accounted for over half the lesions detected on the FLAIR images. Of patients presenting with nonspecific symptoms such as headache, seven had normal and five had abnormal studies. All patients presenting with focal neurological signs had abnormal imaging. We found supratentorial and, in particular, juxtacortical lesions to be more frequent than previously described.
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  • 81
    ISSN: 1432-1920
    Keywords: Key words Melanotic neuroectodermal tumour ; Anterior fontanelle ; Magnetic resonance imaging
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract We describe a 4-month-old girl presenting with a melanotic neuroectodermal tumour of infancy at the anterior fontanelle. According to the neuroimaging findings, this tumour was found to lie epidurally, adherent to the dura mater, with thickening of the adjacent frontal bone. The tumour was dense on CT, while MRI showed a major part of the tumour to be isointense with cerebral cortex on both T1- and T2-weighted images. The neuroimaging and clinical features are briefly discussed.
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  • 82
    ISSN: 1432-1920
    Keywords: Key words Creutzfeldt-Jakob disease ; Magnetic resonance imaging ; Globus pallidus
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract We report a 49-year-old woman with Creutzfeldt-Jakob disease (CJD). In addition to typical high-signal lesions on proton-density and T 2-weighted images there was high signal in the globus pallidus bilaterally on T 1-weighted images. The latter feature has not been described previously and probably due to deposition of prion protein, as found at autopsy.
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  • 83
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    Neuroradiology 41 (1999), S. 279-282 
    ISSN: 1432-1920
    Keywords: Key words Osteoblastoma ; Computed tomography ; Magnetic resonance imaging
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract We report a young man with low back pain suspected to have a disc protrusion. Imaging suggested a tumour of the dorsal portion of the fifth lumbar vertebral body. Operation suggested a giant-cell tumour and subsequent histology showed an osteoblastoma. All typical imaging features of osteoblastoma are demonstrated in this rather uncommon location. Contrast-enhancing bone-marrow oedema on MRI, with mild enhancement of the tumour, together with the CT appearances were the clues to the diagnosis.
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  • 84
    ISSN: 1432-1920
    Keywords: Key words Speech ; apraxia ; Infarct ; cerebral ; Magnetic resonance imaging
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract It has been postulated that the precentral gyrus in the left insula is responsible for co-ordination of speech. We report a paitent with this disturbance who showed an acute infarct limited to this region.
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  • 85
    ISSN: 1432-1920
    Keywords: Key words Brain ; anatomy ; Magnetic resonance imaging
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract We assessed combining of surface-anatomy scanning (SAS) MRI and MR venography (MRV). We obtained SAS images with a half-Fourier single-shot fast spin-echo sequence, then MRV of the identical section with a two-dimensional phase-contrast technique. We then added the two sets of images. The combined images, which were obtained within 10 min, provided information about the surface anatomy and cortical veins. This simple technique is useful for demonstrating brain surface structures, especially in patients from whom one plans to excise a lesion.
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  • 86
    ISSN: 1432-1920
    Keywords: Key words Spinocerebellar ataxia type 6 ; Olivopontocerebellar atrophy ; Magnetic resonance imaging
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Spinocerebellar ataxia type 6 (SCA6) is an autosomal dominant, slowly progressive cerebellar ataxia without multisystem involvement. We report a 57-year-old woman with genetically confirmed SCA6 who showed clinical features of olivopontocerebellar atrophy. Conventional T2-weighted and FLAIR MRI demonstrated high signal in the middle cerebellar peduncles, in addition to mild atrophy of the pons and cerebellum.
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  • 87
    ISSN: 1432-1920
    Keywords: Key words Ankylosing spondylitis ; Cauda equina syndrome ; Computed tomography ; Magnetic resonance imaging
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract We present the radiological features of a 42-year-old man with long-standing inactive ankylosing spondylitis (AS), demonstrating that arachnoiditis is a cause of a cauda equina syndrome (CES) in this disease. CT showed a dorsal arachnoid diverticulum causing scalloped erosion of the laminae, and punctate and curvilinear dural calcification. MRI revealed adhesion and convergence of the cauda equina dorsally into the arachnoid pouch, causing the dural sac to appear empty canal. To the best of our knowledge, dural calcification on CT is a new finding in AS, which may be related to the CES. Our findings support the hypothesis that chronic adhesive arachnoiditis with subsequent loss of meningeal elasticity may be the main cause of CES in AS.
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  • 88
    ISSN: 1432-1920
    Keywords: Key words Myxoma ; atrial ; Infarct ; cerebral ; Magnetic resonance imaging
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract We describe a cerebral infarct caused by atrial myxoma. A 30-year-old woman with an atrial myxoma presented with a right hemisensory deficit. MRI carried out before and after removal of the myxoma, showed multiple small bilateral white-matter infarcts which increased in number up to the surgery. A lesion in the left thalamus, which enlarged and showed contrast enhancement 4 months before surgery, resembled an old cerebral infarct by the time the myxoma was removed. The number of lesions stopped increasing after surgery. We suggest that atrial myxomas should be removed even in asymptomatic patients, to prevent cerebral infarcts due to embolism of tumour or thrombus.
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  • 89
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    Neuroradiology 41 (1999), S. 625-629 
    ISSN: 1432-1920
    Keywords: Key words Neurofibromatosis ; Magnetic resonance imaging ; Spinal tumours
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract In neurofibromatosis type 1 (NF1) spinal tumours cause neurological symptoms in about 2 % of patients. Among over 1400 patients with NF1 we saw symptomatic spinal tumours in 23 (1.6 %). MRI of the entire spinal canal was obtained in 54 patients aged 5–56 years with NF1. The number, site, morphology and signal characteristics of the spinal tumours were recorded and analysed. There were 24 patients with symptoms such as sensory impairment or paralysis; 30 patients had no neurological deficits. Of the 24 symptomatic patients, 23 (96 %) had spinal tumours, while we saw spinal tumours in 12 (40 %) of the 30 patients without neurological deficits. No spinal segment was preferred in symptomatic or asymptomatic patients. Most intraspinal extramedullary tumours were primarily extradural and intraforaminal. MRI showed intramedullary tumours in 3 patients (6 %), intraspinal extramedullary tumours in 18 (33 %) and intraforaminal tumours in 31 (57 %). Only neurological deficits in patients with NF1 should prompt further diagnostic clarification. In patients with neurological symptoms there may be a multiplicity of masses in the spinal canal, which can lead to difficulties in attaching symptoms to a certain tumour. In patients who do not satisfy the NIH criteria, it can be a helpful observation that spinal tumours in NF1 are primarily intraforaminal, extending into the spinal canal, while in NF2 they are mostly intraspinal intradural tumours.
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  • 90
    ISSN: 1432-1920
    Keywords: Key words Pleomorphic xanthoastrocytoma ; Computed tomography ; Magnetic resonance imaging
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract We describe a pleomorphic xanthoastrocytoma (PXA) in a young girl whose frontal lobe location, solid structure, dural tail and MRI signal characteristics led to a preoperative diagnosis of meningioma. PXA should be considered in differential diagnosis of tumours affecting young patients with neuroradiological characteristics suggestive of meningioma.
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  • 91
    ISSN: 1432-1920
    Keywords: Key words Marchiafava-Bignami disease ; Magnetic resonance imaging
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract We report a 61-year-old alcoholic man who presented with subacute physical deterioration and severe dysarthria. MRI, suggestive of corpus callosum demyelination with associated white matter involvement in both cerebral hemispheres, indicated the diagnosis of Marchiafava-Bignami disease. During his stay in hospital the patient showed remarkable improvement, and was discharged 22 days after admission. On MRI 2 months later, the extracallosal lesions had disappeared. This case raises questions about some previous ideas on this disease, such as the prognosis of its acute forms and the significance of the extracallosal lesions seen on neuroimaging.
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  • 92
    ISSN: 1432-1920
    Keywords: Key words Encephalopathy ; Magnetic resonance imaging ; Human herpes virus-6
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Acute necrotising encephalopathy of childhood (ANE) is an uncommon disease which predominantly affects infants and young children living in Japan and Taiwan. A multifocal encephalopathy with symmetrical lesions in the thalamus, tegmentum of the brain stem, cerebral periventricular white matter and cerebellar medulla is characteristic. We present the imaging features in a 4-year-old Japanese boy who had been living in Germany for 21/2 years before presentation.
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  • 93
    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.
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  • 94
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    Neuroradiology 41 (1999), S. 847-849 
    ISSN: 1432-1920
    Keywords: Key words Granulomatosis ; Wegener's ; Meninges ; Magnetic resonance imaging
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Involvement of the brain and meninges is rare in Wegener's granulomatosis (WG); it has been reported in 1.2–8 % of patients. Meningeal involvement in WG has been reported in imaging as being confined to the duramater, and is thought to represent granulomatous infiltration. We present a case of WG with abnormal pial enhancement and involvement of the perivascular spaces on MRI, pathologically proven to represent granulomatous infiltration due to the primary disease rather than to infection.
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  • 95
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    Neuroradiology 41 (1999), S. 899-900 
    ISSN: 1432-1920
    Keywords: Key words Hypophysitis lymphocytic ; Pituitary tumour ; Diabetes insipidus ; Magnetic resonance imaging
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract We report an unusual case of lymphocytic hypophysitis, which proved to be cystic at surgery.
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  • 96
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    Child's nervous system 15 (1999), S. 209-211 
    ISSN: 1433-0350
    Keywords: Key words Anterior sacral meningocele ; Epidermoid tumor ; Magnetic resonance imaging
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract A 2-year-old girl presented with an anterior sacral meningocele completely occupied by an epidermoid tumor. Preoperative magnetic resonance imaging had shown the meningocele with contents of the same intensity as cerebrospinal fluid. Surgery via a posterior sacral approach disclosed the tumor beneath an unexpected membrane inside the meningocele. Additionally, the presence of pus inside epidermoid tumor suggested that possible episodes of asymptomatic meningitis or other infection might have occurred before treatment, these being the major complication in anterior sacral meningocele. Therefore, we recommend that surgical treatment should be performed at the earliest possible stage in childhood, once the diagnosis is established, and dural plasty carried out to prevent infectious complications.
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  • 97
    ISSN: 1432-1084
    Keywords: Key words: Liver ; diseases ; Peliosis ; Computed tomography ; Angiography ; Magnetic resonance imaging
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract. Peliosis hepatis is an uncommon liver condition characterized by blood-filled cavities. We report the CT, angiographic and MR features of a case of peliosis hepatis with no obvious etiology and spontaneously regressing hemorrhagic necrosis. Helical CT showed multiple peripheral low-density regions with foci of spontaneous high density suggesting the presence of blood component. On MR imaging, the multiple peripheral lesions were hypointense on T1-weighted and hyperdense on T2-weighted images, with bright foci on all sequences suggesting subacute blood. Angiography showed no evidence of tumor or vascular malformation; multiple nodular vascular lesions filling in the parenchymal phase and persisting in the venous phase suggested blood-filled cavities. Pathological examination showed blood-filled spaces with no endothelial lining, characteristic of the parenchymal type of peliosis. Knowledge of the imaging features of hemorrhagic necrosis due to peliosis hepatis is important since it can be responsive to antibiotic therapy. Furthermore, differentiating hemorrhagic necrosis from hepatic abscess avoids dangerous and sometimes fatal percutaneous drainage.
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  • 98
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    European radiology 9 (1999), S. 457-459 
    ISSN: 1432-1084
    Keywords: Key words: Retroperitoneal neoplasms ; Retroperitoneal space ; Computed tomography ; Magnetic resonance imaging ; Ultrasonography
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract. We report a rare case of pseudomyxoma retroperitonei in a 58-year-old woman with a past history of severe appendicitis. The imaging showed a multicystic mass similar to pseudomyxoma peritonei, but the tumor was located in the retroperitoneal space.
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  • 99
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    Experimental brain research 125 (1999), S. 417-425 
    ISSN: 1432-1106
    Keywords: Key words Motor learning ; Motor cortex ; Magnetic resonance imaging ; Musicians ; Hand motor skill
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract  In this study, we investigated blood-flow-related magnetic-resonance (MR) signal changes and the time course underlying short-term motor learning of the dominant right hand in ten piano players (PPs) and 23 non-musicians (NMs), using a complex finger-tapping task. The activation patterns were analyzed for selected regions of interest (ROIs) within the two examined groups and were related to the subjects’ performance. A functional learning profile, based on the regional blood-oxygenation-level-dependent (BOLD) signal changes, was assessed in both groups. All subjects achieved significant increases in tapping frequency during the training session of 35 min in the scanner. PPs, however, performed significantly better than NMs and showed increasing activation in the contralateral primary motor cortex throughout motor learning in the scanner. At the same time, involvement of secondary motor areas, such as bilateral supplementary motor area, premotor, and cerebellar areas, diminished relative to the NMs throughout the training session. Extended activation of primary and secondary motor areas in the initial training stage (7–14 min) and rapid attenuation were the main functional patterns underlying short-term learning in the NM group; attenuation was particularly marked in the primary motor cortices as compared with the PPs. When tapping of the rehearsed sequence was performed with the left hand, transfer effects of motor learning were evident in both groups. Involvement of all relevant motor components was smaller than after initial training with the right hand. Ipsilateral premotor and primary motor contributions, however, showed slight increases of activation, indicating that dominant cortices influence complex sequence learning of the non-dominant hand. In summary, the involvement of primary and secondary motor cortices in motor learning is dependent on experience. Interhemispheric transfer effects are present.
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  • 100
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    Experimental brain research 124 (1999), S. 271-272 
    ISSN: 1432-1106
    Keywords: Key words Brain ; Magnetic resonance imaging ; Microemboli ; Microischemia ; N-tert-butyl-α-phenylnitrone ; Rabbit
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract  Dementia due to cerebral ischemic lesions is relatively common in the elderly. Since many of these lesions are probably caused by emboli, studying emboli-induced cerebral lesions in rabbits should, hopefully, provide information that is useful when searching for a means of preventing and treating vascular dementia in humans. Using magnetic resonance imaging we have found that N-tert-butyl-α-phenyl-nitrone (a free radical scavenger) reduced the number of emboli-induced cerebral microinfarctions in the rabbit cortex but did not have any impact on the number of infarctions found in the subcortical structures. The results suggest that significant amount of free radicals are produced in the ischemic foci located in the cortex, but not in the ischemic foci located in the subcortical structures. This finding may be of importance when considering treatments for cerebral ischemia in humans.
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