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  • 2000-2004  (158)
  • 1920-1924
  • Magnetic resonance imaging  (158)
  • 1
    ISSN: 1279-8517
    Keywords: Spinal cord ; Dorsal horn ; Magnetic resonance imaging ; Radiologic anatomy ; Dorsal root entry zone
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract The spinal dorsal horn is known for its important functional role in the field of transmission and modulation of sensory afferents. Because of this, the dorsal horn represents a target for numerous analgesic and antispastic procedures. Thus, it would be interesting to develop imaging dedicated to this spinal structure. The purpose of this study was to investigate the radiologic anatomy of the cervical dorsal horn by magnetic resonance imaging (MRI) (1.5T). The first step consisted in the validation of the anatomic information provided by MRI on 5 human cadavers. A spin-echo sequence (T2, 2000/45) enabled the demonstration of good correlations between histologic sections and axial MRI slices performed at the corresponding cervical levels. The second step was the 〈〈in vivo〈〈 exploration of 20 subjects, aiming at the development of a gradient echo sequence (T2*) with a conventional MRI unit, compatible with a routine clinical examination. The dorsal horn was clearly identified in 77% of the axial slices performed (n = 300). The angle between the dorsal horn axis and the sagittal plane was measured as from 25.5˚ at C2 to 40˚ at C8 segments. The results of this anatomico-radiologic study of the cervical dorsal horn suggest that preoperative MRI could be useful to design the surgical approach to this structure, as performed during cervical microsurgical drezotomy (DREZ = dorsal root entry zone) for the treatment of selected cases of chronic pain or disabling spasticity in the upper limbs.
    Type of Medium: Electronic Resource
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  • 2
    Electronic Resource
    Electronic Resource
    Springer
    Surgical and radiologic anatomy 22 (2000), S. 181-190 
    ISSN: 1279-8517
    Keywords: Masseter muscle ; Architecture ; Magnetic resonance imaging
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract The authors carried out an anatomic and magnetic resonance imaging study of the architecture of the elevator muscles of the mandible in 169 cadavers. The aim of this study was to define the architectural organization of the human masseter muscle, temporalis and pterygoid muscles. Layered dissections and anatomic sections in different spatial planes showed that the masseter muscle exhibited a typical pennate structure consisting of a succession of alternating musculoaponeurotic layers. The muscle had three well-differentiated parts the superficial, intermediate and deep masseter muscles. The same pattern was constantly found 1) for the superficial masseter, two alternate musculoaponeurotic layers oriented at 60∘ in relation to the plane of occlusion, 2) for the intermediate masseter, a single musculo-aponeurotic layer oriented at 90∘ in relation to the occlusal plane, 3) for the deep masseter, three musculoaponeurotic layers whose general orientation was at 90∘ for the bounding layers and 110∘ for the intermediate layer. The MRI study confirmed the reality of this architectural arrangement.
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  • 3
    ISSN: 1432-0533
    Keywords: Key words Ki-67 labeling index ; Magnetic resonance imaging ; Optic nerve glioma ; p53 ; Pilocytic ¶astrocytoma
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Gliomas of the optic nerve, although typically of pilocytic (WHO grade I) histology, can present within the spectrum of astrocytic neoplasia including glioblastoma (WHO grade IV). In certain cases, histologic features alone make the distinction between pilocytic and diffuse astrocytomas difficult. We reviewed 22 cases of optic nerve gliomas, 19 of which were pilocytic astrocytomas (PA), and 3 of which were diffuse, non-pilocytic astrocytomas. The cases were evaluated for their clinical course, radiographic appearance, histologic grade, and proliferation indices as detected by MIB-1 (Ki-67) and p53 antibodies. Of the 19 PA, 14 showed no tumor growth by magnetic resonance imaging, and had Ki-67 and p53 labeling indices (LI) of 〈 1%. The other 5 PA exhibited aggressive behavior manifest by marked diffuse infiltrative tumor growth causing death in 2 patients, 1 of whom was diagnosed with neurofibromatosis type 1 (immunoperoxidase and radiographs not available), and marked local growth with an average time to growth of 39.3 months, a Ki-67 LI of 2–3%, and a p53 LI of 〈 1% in three others. Three of the five aggressive PA histologically demonstrated a finely reticulated pattern, a pattern that appears as an exaggeration or expansion of the normal neuroglia of the optic nerve, and may simulate a diffuse low-grade astrocytoma. Two demonstrated the coarsely reticulated pattern, with the biphasic and microcystic pattern typical of PA. Three diffuse astrocytomas (2 anaplastic astrocytomas and 1 glioblastoma) originated clinically and radiographically from the optic nerve, and revealed a Ki-67 LI of 2–12%, a p53 LI of 2–8%, and an average time to growth of 8 months. We conclude that the majority of PA of the optic nerve are non-aggressive, stabilize radiographically, and have Ki-67 and p53 LI 〈 1%. However, a subpopulation of PA has a propensity for aggressive behavior, and are identified by a Ki-67 LI of 2–3% and a p53 LI of 〈 1%. Diffuse astrocytomas have both Ki-67 and p53 LI 〉 2%. Thus, in cases of aggressive optic nerve tumors in which the histologic review of biopsy material cannot confidently confirm the diagnosis of pilocytic or diffuse fibrillary glioma, a p53 LI of 〉 1% appears to favor the diagnosis of diffuse astrocytoma.
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  • 4
    ISSN: 1432-1459
    Keywords: Key words Multiple sclerosis ; Neuropsychological ; Cognitive ; Magnetic resonance imaging ; Lesion load
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Neuropsychological deficits and the relationship to brain pathology were examined in 13 primary progressive (PP) and 12 secondary progressive (SP) multiple sclerosis patients with a similar duration of the progressive phase and comparable physical disability. A battery of neuropsychological tests to assess attention, short-term and working memory was administered to the patients, and their performance was compared to that of 20 healthy controls matched for age and premorbid IQ. Total cerebral lesion load on T2-weighted magnetic resonance imaging was measured in the patients. Both PP and SP patients performed significantly worse than controls in most of the neuropsychological tests. There were only subtle differences between SP and PP on the working memory task although magnetic resonance imaging lesion load was significantly higher in SP than in PP patients. In this exploratory study only subtle differences in cognitive impairment were detected between SP and PP patients matched for physical disability and relevant illness features. The results also suggest that the severity of cognitive impairment cannot be fully explained by the extent of abnormalities detected on conventional T2-weighted magnetic resonance images, and that other pathological abnormalities such as in normal-appearing white matter are likely to be involved.
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  • 5
    Electronic Resource
    Electronic Resource
    Springer
    Journal of neurology 247 (2000), S. 252-258 
    ISSN: 1432-1459
    Keywords: Key words Cerebral venous ¶thrombosis ; Dural sinuses ; Magnetic resonance imaging ; Heparin ; Thrombolysis
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract In contrast to arterial stroke, cerebral venous thrombosis (CVT) is an infrequent condition which presents with a wide spectrum of signs and with a highly variable mode of onset. The clinician must therefore consider it systematically in all brain syndromes and perform the appropriate neuroimaging investigations: computed tomography (CT) with computed tomography angiography and/or magnetic resonance imaging with magnetic resonance angiography and, if necessary intra-arterial angiography. Once the diagnosis is established, a wide investigation for should be carried out in search of the cause, and treatment started as soon as possible. Treatment is based on the combination of intravenous heparin (followed by oral anticoagulants for 3–6 months), symptomatic treatment (anticonvulsants, analgesics, treatment of increased intracranial pressure) and treatment of the cause. Local thrombolysis is indicated if there is deterioration due to thrombosis extension despite adequate anticoagulation. Diagnosis and treatment of CVT should be considered as an emergency because of the considerable potential for full recovery in this condition.
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  • 6
    ISSN: 1432-1459
    Keywords: Key words Leukoaraiosis ; Aged ; Atherosclerosis ; Magnetic resonance imaging ; Carotid artery
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Cerebral white matter lesions are frequently observed on magnetic resonance imaging of elderly, nondemented persons. There is evidence that white matter lesions are involved in the pathophysiology of cognitive decline and dementia. White matter lesions can be divided into those in the periventricular and those in the subcortical region. Pathological and epidemiological studies suggest that atherosclerosis is involved in the pathogenesis of these lesions. Our study reports on the association between atherosclerosis in the carotid arteries and white matter lesions in a population-based study among 1077 elderly subjects. We randomly sampled 1077 subjects aged between 60–90 years from two prospective population-based studies. All subjects underwent ultrasonography of the carotid artery. In addition, 1.5 T magnetic resonance imaging was performed; white matter lesions in the subcortical and periventricular regions were rated separately. With increasing number of plaques in the carotid artery the severity of periventricular white matter lesions increased (P trend = 0.03), but not the severity of subcortical white matter lesions (P trend = 0.19). In addition, an increase in intima media thickness was borderline significantly associated with an increased severity of periventricular white matter lesions (P trend = 0.09), but not of subcortical white matter lesions (P trend = 0.68). These findings suggest that partly dissimilar pathogenetic mechanisms are involved in the etiology of periventricular and subcortical white matter lesions.
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  • 7
    ISSN: 1432-1459
    Keywords: Key words Small subcortical ¶infarction ; Large-vessel disease ; Magnetic resonance imaging ; Silent white-matter hyperintensity ; Lacunar infarction
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Small subcortical infarctions resulting from large-vessel disease are often observed. It is important to distinguish these from pure lacunar infarction resulting from small-vessel disease because the investigations and examinations differ. We investigated the differences on brain magnetic resonance imaging (MRI) between small subcortical ¶“lacunar-like” infarcts resulting from large-vessel disease and pure lacunar infarcts. Thirteen subjects with small lacunar-like infarcts (size 〈 2 cm), resulting from large-vessel disease, ¶and 30 subjects with lacunar infarcts (〈 2 cm), without large-vessel disease were studied. We measured infarction size using a 1.5-T MRI device and evaluated silent subcortical hyperintensity lesions using the modified Scheltens’ score. Large-vessel lesion was confirmed by conventional angiography, duplex carotid scan, and magnetic resonance angiography. There was no difference in the mean age of the two groups. Cerebrovascular risk factors and atherosclerotic complications were also comparable for the two groups. Progressive stroke was more common ¶in the lacunar-like infarction group than in the lacunar infarction group ¶(P = 0.004). Scores for periventricular hyperintensity, white matter hyperintensity, basal ganglia hyperintensity, and total subcortical hyperintensity scores were significantly higher in the lacunar infarction group than in the lacunar-like infarction group. The difference in basal ganglia hyperintensity scores was remarkable (P = 0.001). The enlargement of the perivascular space was also significantly greater in the lacunar infarction group than in the lacunar-like infarction group. These findings seem to reflect differences in the pathogenesis of infarction between the two groups. Silent subcortical hyperintensity lesions and enlargement of perivascular space are useful for between distinguishing small lacunar-like infarct resulting from large-vessel disease and pure lacunar infarction. This may have significant implications for the management of patients with lacunar-sized infarctions. It suggests that the pathogenesis of lacunar-sized infarction is variable.
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  • 8
    ISSN: 1432-1459
    Keywords: Key words Multiple sclerosis ; Fatigue ; Magnetic resonance imaging ; Motor evoked potentials
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Fatique is a common symptom of multiple sclerosis (MS) even in the early phases of the disease, when neurological disability is usually still not present. To investigate the pathophysiology of fatigue we compared neurophysiological (motor evoked potentials of the four limbs, MEPs) and brain magnetic resonance imaging (MRI) findings in two groups of nondisabled MS patients, those with (n=15) and those without (n=15) fatigue. Fatigue was assessed by an interview and scored by the Fatigue Severity Scale. The two groups were matched for sex, age, disease duration, Expanded Disability Status Scale score, pyramidal Functional System (FS) score, and depression score. MEPs were abnormal in five patients with fatigue and in one patient without fatigue. A significant association was found between the patient scores on the Fatigue Severity Scale, and the burden of MRI lesions (r=0.5; P〈0.005). Significantly higher parietal lobe (P〈0.05), internal capsule (P〈0.05), and periventricular trigone (P〈0.05) lesion loads were found in patients with fatigue than in those without. Our results agree with a central nervous system origin of fatigue in MS patients. This symptom might be a consequence either of a functional deafferentation of the cortex due to cortico-subcortical interconnection damage or of a demyelination in critical sites of the CNS, such as the cortico-spinal tract.
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  • 9
    ISSN: 1432-1459
    Keywords: Key words Sarcoidosis ; Spinal cord ; Magnetic resonance imaging ; Corticosteroid therapy ; Prognosis
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Spinal cord sarcoidosis is a rare disorder whose natural history and therapeutic outcome are not fully known. We examined four patients with spinal cord sarcoidosis both clinically and radiologically, particularly in relation to corticosteroid treatment. The initial manifestation was cervical myelopathy in three and uveitis in one. All four patients progressed slowly until corticosteroid therapy was initiated. The cervial spine was involved in all patients. Magnetic resonance imaging (MRI) showed spinal cord swelling with T2-weighted high intensity and linear leptomeningeal and patchy or diffuse intramedullary enhancement with gadolinium diethylene triaminepentaacetic acid. With corticosteroid therapy, dramatic improvement was seen on MRI, including disappearance or marked reduction of swelling and enhancement. Plasma levels of angiotensin-converting enzyme (ACE) were also markedly improved. In contrast, the clinical symptoms were little improved in one patient, unchanged in two, and rather worsened in one patient. Recurrence was seen on MRI at the maintenance dose in all four patients, without any dramatic change in clinical manifestation. MRI findings and plasma ACE are well correlated with active leasion of the spinal cord sarcoidosis, providing a useful marker for recurrence, but do not parallel the clinical manifestations.
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  • 10
    Electronic Resource
    Electronic Resource
    Springer
    Journal of neurology 247 (2000), S. 943-948 
    ISSN: 1432-1459
    Keywords: Key words Transverse myelitis ; Motor evoked potentials ; Somatosensory evoked potentials ; Electromyography ; Prognosis ; Magnetic resonance imaging
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract A systematic evaluation of anterior horn cell, motor and sensory pathways is possible by electromyography (EMG), motor (MEPs) and somatosensory (SEPs) evoked potentials, respectively, which may provide valuable information on acute transverse myelitis (ATM). In a prospective hospital-based study, EMG, MEP and SEP studies were carried out on admission and after 3 months in 39 patients with ATM. All the patients also underwent detailed clinical evaluation, and spinal magnetic resonance imaging (MRI) was performed in 28. Outcome was defined at the end of 3 months as poor, partial or complete recovery on the basis of functional status. Spinal MRI revealed hyperintense signal changes in T2 extending for two segments to the entire spinal cord. Central motor conduction time to tibialis anterior (CMCT-TA) was more frequently abnormal (90%), followed by tibial SEP (77%). CMCT to abductor digiti minimi (ADM) was abnormal in 30% and median SEP in 15% of patients. Evidence of denervation on EMG was present in 51% of patients. The CMCT-TA improved in 48% patients and tibial SEP in 32%. Median SEP improved in all patients, and CMCT-ADM remained prolonged in two. At 3 months 2 patients had died, and 18 had poor, 10 partial and 9 complete recovery. CMCT was correlated with miscle power, tone, reflec and MRI changes. Patients' outcome of was correlated with CMCT, SEP and EMG. These results are consistent with pronounced involvement of dorsal region of spinal cord in ATM. MEP is more frequently abnormal than SEP.
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  • 11
    Electronic Resource
    Electronic Resource
    Springer
    European radiology 10 (2000), S. 841-843 
    ISSN: 1432-1084
    Keywords: Key words: Lymphoma ; Magnetic resonance imaging ; Skeletal muscle
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract. We present the clinical and magnetic resonance imaging findings of a patient who, following treatment for pancreatic non-Hodgkin's lymphoma (NHL), relapsed with apparently isolated involvement of the right masticator space and left psoas muscles. Non-Hodgkin's lymphoma arising from the masticator space muscles is very rare. In addition, simultaneous lymphomatous involvement of multiple discrete skeletal muscle sites, in the absence of disease elsewhere, has previously only been reported in the limb or limb girdle muscles. Lymphoma should be considered as a cause of isolated enlarged skeletal muscles, even when involving such distant sites.
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  • 12
    Electronic Resource
    Electronic Resource
    Springer
    European journal of pediatrics 159 (2000), S. 555-562 
    ISSN: 1432-1076
    Keywords: Key words Epilepsy ; Cortical malformations ; Migration disorders ; Magnetic resonance imaging ; Brain development
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract In this review, a simplified scheme for classification of cortical malformations is introduced and illustrated based on the work of Barkovich et al. [8]. Detailed MRI studies identify cortical malformations as a major cause of epilepsy in children. Two aspects that are becoming increasingly important for the paediatrician are emphasised. First, knowledge of the genetic background of cortical malformations is necessary for appropriate genetic counselling. Although the majority of cortical malformations occur sporadically, recent studies have shown a familial pattern in specific epilepsy syndromes associated with cortical malformations. Second, the epilepsy becomes refractory to the common anti-epileptic drugs in many patients with cortical malformations so that epilepsy surgery should be considered. In this respect, the paediatrician can play a pivotal role in referring candidate patients for further specialised assessment. Conclusion The input of the paediatrician will become crucial to link clinical, genetic and neuro-imaging data in children with the great variety of possible cortical malformations.
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  • 13
    Electronic Resource
    Electronic Resource
    Springer
    European journal of pediatrics 159 (2000), S. S114 
    ISSN: 1432-1076
    Keywords: Key words Dietary therapy ; Magnetic resonance imaging ; Neurology ; Pathology ; Phenylketonuria ; AbbreviationsHPA hyperphenylalaninaemia ; 1H-MRS proton magnetic resonance spectroscopy ; Phe phenylalanine ; PKU phenylketonuria
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Neurological abnormalities in phenylketonuria were described before dietary treatment became possible. These included tremor, clumsiness, epilepsy, spastic paraparesis and occasionally extrapyramidal features. Neurological deterioration after childhood was recognised. Patients with neurological deterioration described recently have been late diagnosed or intellectually impaired or both. No early diagnosed patient who was well treated and of good intellectual outcome has yet shown neurological deterioration after stopping diet but it may happen. Conclusion The fascinating links between pathology, magnetic resonance imaging appearances, magnetic resonance spectroscopy results and clinical features are not yet clearly understood. Patients must understand the possible risks of stopping diet and make their choice. All patients need help, support and follow-up regardless of the choices they make over continuing diet.
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  • 14
    Electronic Resource
    Electronic Resource
    Springer
    Techniques in coloproctology 4 (2000), S. 129-131 
    ISSN: 1128-045X
    Keywords: Key words Colonscopy ; CT scanning ; Magnetic resonance imaging ; Virtual colonoscopy ; Pneumocolography
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Colonoscopy is an invasive technique, frequently incomplete and often poorly tolerated in elderly patients. New, less invasive modalities are being developed to diagnose moderate-sized adenomatous polyps and colorectal caners which involve pneumo- or hydrocolography with high-resolution surface imaging, either by CT or MR scanning. This approach has recently been supplemented by complex image post-processing to provide a form of virtual colonoscopy which takes account of projected colonic direction and which can map for mucosal anomalies. It remains to be seen how sensitive these newer techniques are and whether defined algorithms for colonic representation can be agreed upon which will prove both accurate and cost-effective both in symptomatic and screening populations.
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  • 15
    Electronic Resource
    Electronic Resource
    Springer
    The journal of headache and pain 1 (2000), S. 67-71 
    ISSN: 1129-2377
    Keywords: Key words Chronic daily headache ; Migraine ; Magnetic resonance imaging ; Red nucleus ; Substantia nigra ; Image processing
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Using BOLD-fMRI we have previously documented activation of the red nucleus (RN) and substantia nigra (SN) during spontaneously and visually activated migraine headache. These observations prompted us to study brainstem function in chronic daily headache patients using high-resolution magnetic resonance imaging (MRI) techniques. Seventeen chronic daily headache (CDH) patients, ten episodic migraine (EM) patients and fifteen controls (N) were imaged with a 3 tesla MRI system. For each subject, the relaxation rates R2, R2* and R2' were obtained for RN and SN. There was a significant decrease in R2' and R2* values for RN and SN in CDH compared to N and EM groups (p 〈 0.05), but no significant difference between the N and EM groups. A decrease in R2' and R2* indicates reduced deoxyhemoglobin and hence persistent activation of the RN and SN in CDH patients most likely secondary to ongoing headache at the time of study. The imaging data provide objective evidence of disturbed central nervous system function in CDH.
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  • 16
    ISSN: 1439-099X
    Keywords: Schlüsselwörter: Strahlentherapieplanung ; Stereotaxie ; Magnetresonanztomographie ; FLAIR-Bildgebung ; Gliome ; Metastasen ; Key Words: Radiotherapy planning ; Stereotaxie ; Magnetic resonance imaging ; FLAIR imaging ; Glioma ; Metastases
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Background: FLAIR MR imaging has shown to be a valuable imaging modality in pathologic lesions of the brain including intraaxial brain tumors. The aim of the study was to assess the value of a FLAIR technique in the planning process of stereotactic radiotherapy in patients with cerebral gliomas and metastases. Patients and Methods: Thirty-five patients with cerebral gliomas and 12 patients with a total of 39 cerebral metastases were examined by T2/PD-weighted fast spin-echo, fast FLAIR prior and after contrast and contrast enhanced T1-weighted spin-echo using identical slice parameters. The images were evaluated by using quantitative and qualitative criteria. Quantitative criteria were tumor-to-background and tumor-to-cerebrospinal fluid contrast and contrast-to-noise. The qualitative evaluation was performed as a multireader analysis concerning lesion detection, lesion delineation and image artifacts. Results: In the qualitative evaluation (Tables 3 and 6), all readers found the fast FLAIR images to be superior to fast spin-echo in the exact delineation of cerebral tumors (p 〈 0.001) and the delineation of enhancing and non enhancing tumor parts. Fast FLAIR was superior in the delineation of cortically located and small lesions but was limited in lesions adjacent to the ventricles. Fast FLAIR provided a significantly better tumor-to-CSF contrast and tumor-to-CSF contrast-to-noise (p 〈 0.001) (Tables 1, 2a, 2b, 4, 5). The tumor-to-background contrast and tumor-to-background contrast-to-noise of the fast FLAIR images were lower than that of T2-weighted spin-echo images but were significantly increased after the application of contrast media. FLAIR images had more image artifacts, but the image interpretation was not influenced. Conclusions: FLAIR MR imaging was found to be a valuable sequence in the planning protocol of stereotactic radiotherapy. The concurrent presentation of enhancing and non enhancing tumor tissue on contrast enhanced fast FLAIR imaging enables to use a single imaging sequence in the treatment protocol. This enables to load a reduced image amount into the radiotherapy planning software, is therefore time saving and reduces potential errors.
    Notes: Hintergrund: Eine FLAIR-(fluid attenuated inversion recovery-)Sequenz wurde in der stereotaktischen Strahlentherapieplanung zerebraler Gliome und Metastasen im Vergleich zu konventionellen Spin-Echo-(SE-)Sequenzen eingesetzt. Überprüft wurde die Wertigkeit dieser Methode anhand der Läsionserkennbarkeit, Läsionsabgrenzung und des Tumorkontrastes. Patientengut und Methode: 35 Patienten mit zerebralen Gliomen und zwölf Patienten mit insgesamt 39 zerebralen Metastasen wurden mit einer FLAIR-Sequenz vor und nach Kontrastmittel, einer T2- und PD-gewichteten SE-(FSE-)Sequenz und einer kontrastmittelunterstützten T1-gewichteten SE-Sequenz untersucht. Eine quantitative Auswertung umfaßte Tumor-zu-Hintergrund- und Tumor-zu-Liquor-Kontrast und Kontrast-zu-Rausch-Bestimmungen. In einer qualitativen Auswertung wurden die Erkennbarkeit und Abgrenzung der Tumoren anhand einer Multireader-Analyse beurteilt. Ergebnisse: Der Tumor-zu-Hintergrund-Kontrast bei zerebralen Gliomen war auf den nativen FLAIR-Aufnahmen den konventionellen FSE-Aufnahmen unterlegen. Beide Reader fanden die FLAIR-Technik aufgrund der Liquorunterdrückung in der Läsionsabgrenzung der T2- und Protonen-gewichteten FSE-Technik hingegen überlegen. Nach Kontrastmittelgabe stieg das Signal bei anreichernden Tumoren auf den FLAIR-Bildern im Mittel um 49%, wodurch der Tumor-zu-Hintergrund-Kontrast den der konventionellen Aufnahmen signifikant (p 〈 0,001) übertraf. Durch die Kontrastmittelgabe wurde auch die Abgrenzung der infiltrativen Tumoranteile signifikant (p 〈 0,001) verbessert. Bei Patienten mit zerebralen Metastasen konnten mittels kontrastmittelunterstützter FLAIR-Aufnahmen signifikant mehr Metastasen als mit nativer FLAIR- und T2/PD-gewichteter FSE-Sequenz, jedoch weniger als mittels kontrastmittelverstärkter T1 SE-Sequenz erkannt werden. Der Nachteil lag hierbei in der geringen Detektionsrate bei sehr kleinen, subkortikal gelegenen Metastasen. Vorteil der Methode war jedoch wie bei den zerebralen Gliomen die gleichzeitige Darstellung von anreicherndem Tumor und umgebendem Ödem. Artefakte nahe der Liquorräume sind auf FLAIR-Bildern häufig, sie störten die Bildinterpretation jedoch nicht wesentlich. Signalhyperintensitäten aufgrund physiologischer Gliosezonen an den Ventrikelrändern sind ebenfalls häufig zu beobachten und müssen in die Bildinterpretation einbezogen werden. Schlußfolgerung: Zusammengefaßt bietet sich die FLAIR-Technik als eine wertvolle Bildgebungssequenz in der stereotaktischen Strahlentherapieplanung von zerebralen Tumoren an. Durch die Verwendung kontrastmittelunterstützter FLAIR-Technik kann sowohl die Definition der radiologischen als auch der makroskopischen Tumorränder auf einer einzigen Bildgebungssequenz erreicht werden. Dieses ist insbesondere für das Einladen der Bilddaten in die verwendeten Bestrahlungsplanungssysteme von Vorteil, da die Bilddatenmenge deutlich reduziert, der Arbeitsaufwand für zusätzliche Bildfusionen vermindert und mögliche Fehlerquellen bei der Bildfusion vermieden werden können.
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  • 17
    ISSN: 1437-9813
    Keywords: Key words Macrodystrophia lipomatosa ; Fibrolipomatous hamartoma ; Magnetic resonance imaging ; Median nerve
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract  Macrodystrophia lipomatosa (MDL) is a rare disease typically causing localized gigantism and is often associated with a fibrolipomatous hamartoma (FH) of the median or plantar nerve. A previously unreported case of MDL with associated FH of the median nerve is presented.
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  • 18
    ISSN: 1433-0350
    Keywords: Keywords Cavernous angioma ; Cerebral angiography ; Dynamic scan ; Magnetic resonance imaging ; Sinus pericranii
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract  Objects: Sinus pericranii is only a symptom complex, and it can have a variety of etiologies. Therefore, it is important to differentiate these etiologies preoperatively by means of radiological examinations. A 5-year-old boy was admitted with a soft and fluctuant tumor in the right parietal region near the midline. The tumor appeared when the child was in a recumbent position, distending noticeably with the Valsalva maneuver and disappearing completely when the patient was in the sitting position. Methods: Magnetic resonance imaging showed the lesion with honeycomb-like heterogeneous iso- and low-intensity signals on the T1-weighted image and with heterogeneous high- and iso- intensity signal on the T2-weighted image. Dynamic study with an injection of gadolinium diethylene-triaminopentaacetic acid demonstrated and nodular peripheral enhancement at early phase and subsequent progressive enhancement towards the center of tumor. The internal carotid angiogram was normal. The external carotid angiogram, however, showed a tumor stain fed by the superficial temporal arteries. The stain was retained until the late phase and drained into the scalp veins and into the superior sagittal sinus. Following direct injection of contrast medium into the tumor there was prolonged retention of the medium in the tumor and leakage into scalp veins and the superior sagittal sinus. The mass under the periosteum was totally removed and proved to be a cavernous angioma. Conclusions: Scalp cavernous angioma is one of the etiologies of sinus pericranii and may be diagnosed preoperatively by cerebral angiography or magnetic resonance imaging. Serial dynamic magnetic resonance imaging will be particularly helpful for this diagnosis.
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  • 19
    Electronic Resource
    Electronic Resource
    Springer
    Child's nervous system 16 (2000), S. 398-401 
    ISSN: 1433-0350
    Keywords: Keywords Primitive neuroectodermal tumor ; Diffuse leptomeningeal neoplasia ; Magnetic resonance imaging ; Pseudotumor cerebri ; Sinus thrombosis
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract  Primitive neuroectodermal tumors are easily detected by neuroradiologic imaging, as a rule. We report on two patients with early diffuse leptomeningeal primitive neuroectodermal tumors which escaped detection by contrast-enhanced magnetic resonance imaging.
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  • 20
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    Child's nervous system 16 (2000), S. 551-554 
    ISSN: 1433-0350
    Keywords: Keywords Acute myelitis of childhood ; Fibrocartilaginous embolism ; Magnetic resonance imaging ; Spinal cord infarction
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract  Fibrocartilaginous embolus causing acute spinal cord infarction is a rare cause of acute-onset paraplegia or quadriplegia. Few cases of survivors have been reported in the neurosurgical literature, with most reports involving post-mortem or biopsy findings. There is little information on MRI findings in such patients. We present the youngest patient ever reported, and discuss the important differences between fibrocartilaginous embolus and acute myelitis of childhood. A 6-year-old girl with a history of back pain presented with sudden-onset nontraumatic paraplegia, with a clinical anterior spinal artery syndrome. Initial MRI scan revealed intervertebral disc disease at L1–2 and an incidental thoracic syrinx, but no cause for her acute-onset paraplegia was identified. Cerebrospinal fluid and other investigations were all negative. Sequential MRI scans revealed development of spinal cord expansion from T10 to the conus medullaris, with increased cord signal in the anterior aspect of the spinal cord. The intervertebral disc disease was unchanged. The imaging and clinical findings were caused by fibrocartilaginous embolus, which meant there was no need for spinal cord biopsy. The report describes the clinical and imaging criteria for diagnosis of fibrocartilaginous embolus, highlighting the case for avoiding an unnecessary biopsy. The clinical pattern in the paediatric group is discussed, with features differentiating it from acute myelitis of childhood.
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  • 21
    ISSN: 1436-2813
    Keywords: Key words Lung lobectomy ; Magnetic resonance imaging ; Left ventricular geometry ; Mediastinum ; Diaphragm
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract The thoracic cage after a lung resection is filled by the remaining lobes, the elevated diaphragm, the diminished thoracic cage, and by mediastinal shifting. The changes in the thorax after a lung resection were quantified using magnetic resonance imaging. The study group consisted of 39 patients who had undergone a lobectomy, four who had undergone a pneumonectomy, and 14 controls. The left ventricular angle, ascending aortic angle, mediastinal shift, longitudinal length of the thoracic cage, the distance between the thoracic apex and the level of the aortic valve, and diaphragmatic elevation were all measured. After a right lower lobectomy, the mediastinum shifted more rightward than after a right upper lobectomy. The diaphragm became more greatly elevated after a right upper lobectomy than after a right lower lobectomy. When a chest wall resection was added to a right upper lobectomy, the mediastinal anatomical changes decreased. After a left upper lobectomy, the degree of mediastinal shifting was greater than after a left lower lobectomy. A left upper lobectomy shifted the mediastinum at the level of the right atrium. This method is easily reproducible and was found to be effective for quantifying the changes in the thorax after a lung resection.
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  • 22
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    International journal of colorectal disease 15 (2000), S. 9-20 
    ISSN: 1432-1262
    Keywords: Keywords Rectal cancer staging ; Computed tomography ; Endorectal sonography ; Magnetic resonance imaging ; Systematic review
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract  With the widespread introduction of preoperative radiotherapy for rectal cancer and the development of transanal endoscopic microsurgery for selected early lesions, preoperative radiological staging of these tumours has taken on increasing importance. This study is a systematic review to evaluate computed tomography (CT), endorectal sonography (ES) and magnetic resonance imaging (MRI) as preoperative staging modalities in rectal cancer. A Medline-based search identifying studies using CT, ES, or MRI in preoperative staging of rectal cancer between 1980 and 1998 was undertaken. The list of papers was supplemented by extensive cross-checking of citation lists. Studies were included if they met predetermined criteria. Data from the accepted studies were entered into pooled tables comparing radiological and pathological staging results for each modality both in determining bowel wall penetration and involvement of lymph nodes. Accuracy, sensitivity, specificity, positive predictive value, negative predictive value, positive likelihood ratio and negative likelihood ratio were determined for the pooled results. Eighty-three studies from 78 papers including 4897 patients met the inclusion criteria. In determining the wall penetration of the tumour the values for sensitivity for CT, ES, MRI and MRI with endorectal coil were 78%, 93%, 86% and 89%; for specificity 63%, 78%, 77% and 79%; and for accuracy 73%, 87%, 82% and 84%, respectively. In determining the nodal involvement by tumour the sensitivity values for CT, ES, MRI and MRI with endorectal coil 52%, 71%, 65% and 82%; for specificity 78%, 76%, 80% and 83%; and for accuracy 66%, 74%, 74% and 82%, respectively. MRI with an endorectal coil is the single investigation that most accurately predicts pathological stage in rectal cancer.
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  • 23
    ISSN: 1615-2573
    Keywords: Key words Three-dimensional echocardiography ; Magnetic resonance imaging ; Left ventricular volume ; Stereology
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract The objective of this study was to investigate the degree of bias with coaxial three-dimensional echocardiography in an experimental animal setup and to establish the minimum number of sections needed for estimation of left ventricular (LV) volume. Epicardial coaxial echocardiography and magnetic resonance imaging (MRI) was used to measure LV volume in 14 pigs, with chronic remodeled left ventricles induced by repeated intracoronary microembolizations. In addition, six animals underwent serial MRI at baseline, immediately after intracoronary microembolization, and after 119–165 days (mean 129 days). Coaxial echocardiography was performed by rotational acquisition of long-axis sections starting from an arbitrary angle. Planimetered MRI contours of LV endocardial borders were analyzed to investigate the relationship between the number of coaxial sections, and the precision of volume estimates. The mean ± 2SD of the differences between coaxial epicardial echocardiography with six sections and MRI were −2.5 ± 16.4 ml, 0.8 ± 13. 1 ml, and 2% ± 14% for end-diastolic volume (EDV), end-systolic volume (ESV), and ejection fraction (EF), respectively. Numerical analysis conducted on MRI contours of LV endocardial borders showed that with six coaxial sections the average coeffi-cient of error was 〈1% for the EDV and ESV. Three-dimensional echocardiography with six coaxial sections provides unbiased LV volume estimation with minimal geometric error.
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  • 24
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    Neurological sciences 21 (2000), S. 103-108 
    ISSN: 1590-3478
    Keywords: Key wordsL-2-Hydroxyglutaric aciduria ; Magnetic resonance imaging ; Leukodystrophy
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract L-2-Hydroxyglutaric aciduria is a rare inborn error of metabolism, marked by a large and persistent increase of L-2-hydroxyglutaric acid in urine, blood and cerebrospinal fluid (CSF). We present clinical, biochemical and neuroradiological findings of seven Italian patients aged 4–19 years presenting at different stages of the disease. The disorder was characterized by a progressive neurological syndrome with cerebellar and pyramidal signs, mental deterioration, epilepsy and subcortical leukoencephalopathy on magnetic resonance imaging (MRI). We observed a good correlation between the severity of the disease and the extent of lesions on MRI. We report the result of the first positive prenatal diagnosis.
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  • 25
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    European archives of psychiatry and clinical neuroscience 250 (2000), S. 76-78 
    ISSN: 1433-8491
    Keywords: Key words Septum pellucidum ; Developmental ¶disorder ; Schizophrenia ; Magnetic resonance imaging ; Cavum veli interpositi ; Cavum septi pellucidi
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract The case of monocygotic twins discordant for a psychotic disorder is presented. An anomaly of the septum pellucidum, a so-called cavum veli interpositi was found in the psychotic twin while his brother showed no such anomaly. Previous studies have shown a higher prevalence of septum pellucidum anomalies in schizophrenic patients. Abnormalities of the septum pellucidum may be associated with disturbed neuronal development in distinct limbic brain areas which cannot yet be visualized yet by brain imaging techniques. The finding of the cavum veli interpositi in the psychotic twin could be incidental; however, it may indicate a dysgenic process in early brain development and, thus, play a significant role in the etiology of psychosis.
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  • 26
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    Neuroradiology 42 (2000), S. 30-33 
    ISSN: 1432-1920
    Keywords: Key words Granuloma cryptococcal ; Magnetic resonance imaging ; Pulse sequences
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract We report an intracerebral cryptococcal granuloma in a patient who presented with recent memory disturbance and deteriorating mental status followed by temporary loss of consciousness. To our knowledge, this is the first reported case of an intracerebral cryptococcal granuloma examined by a combination of conventional MRI, fluid-attenuated inversion-recovery and diffusion-weighted imaging and in which the surgical specimen was analysed histochemically.
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  • 27
    ISSN: 1432-1920
    Keywords: Key words Hemimegalencephaly ; Positron emission tomography ; Magnetic resonance imaging
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract We report hemimegalencephaly in a 44-year-old woman with mental retardation, epilepsy and a mild hemiparesis. In addition to typical findings on MRI, 2-deoxy-2[18F]fluorodeoxyglucose positron-emission tomography (PET) demonstrated glucose hypometabolism of the affected hemisphere. The results of PET have been coregistered with morphological information from the MRI studies by image fusion.
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  • 28
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    Neuroradiology 42 (2000), S. 753-755 
    ISSN: 1432-1920
    Keywords: Key words Encephalitis, tick-borne ; Magnetic resonance imaging ; Basal ganglia ; Thalamus
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract The tick-borne encephalitis (TBE) virus gives rise to epidemic encephalitis. Mild forms usually manifest as influenza-like episodes or are clinically silent. MRI is usually normal in TBE. We describe severe TBE in a patient who presented with fever and altered mental status after a tick bite and a specific antibody response to TBE. MRI revealed pronounced signal abnormalities in the basal ganglia and thalamus, without contrast enhancement. These findings coincide well with neuropathological studies of severe nerve cell degeneration with inflammatory cell infiltrates, neuronophagia and reactive astrocytosis in the deep grey matter. We review the literature and discuss the relevant differential diagnosis.
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  • 29
    ISSN: 1432-1920
    Keywords: Key words Spinal cord, central canal ; Syringomyelia ; Magnetic resonance imaging
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract The central canal of the spinal cord is present at birth and becomes progressively obliterated. Cadaver studies have shown that it may persiste partially or completely. To our knowledge, this entity has not been described on MRI. We reviewed 794 MRI studies of the spinal cord, and found 12 patients (aged 14 to 65 years) who had an intramedullary cavity. The cavity was at the junction of the ventral 1/3 and dorsal 2/3 of the spinal cord, except at the level of the lumbar enlargement, where it was central. It was filiform in most cases, although sometimes fusiform (3 to 4 mm in diameter), and had regular contours. The cavity were thoracic in 69 % of cases. The clinical features were totally unrelated to the image, and there were no anatomical factors (Chiari malformation, dysraphism) predisposing to syringomyelia. The images were perfectly compatible with a persistent central canal, which we interpret as a variant of normal anatomy. Therefore it is important to regard these findings as normal, to avoid unnecessary treatment and follow-up.
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  • 30
    ISSN: 1432-1920
    Keywords: Key words Multiple sclerosis ; Spinal cord ; Magnetic resonance imaging ; Pulse sequences
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract We compared the sensitivity of T2-weighted spin-echo (FSE) and fast short-tau inversion-recovery (fSTIR) sequences in detection of multiple sclerosis of the spinal cord in 100 consecutive patients with clinically confirmed multiple sclerosis (MS); 86 patients underwent also brain MRI. In all, 310 focal lesions were detected on fSTIR and 212 on T2-weighted FSE, spinal cord lesions were seen better on fSTIR images, with a higher contrast between the lesion and the normal spinal cord. In 24 patients in whom cord plaques were shown with both sequences, the cranial study was normal or inconclusive. Assessment of spinal plaques can be particularly important when MRI of the brain is inconclusive, and in there situations fSTIR can be helpful.
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  • 31
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    Neuroradiology 42 (2000), S. 905-907 
    ISSN: 1432-1920
    Keywords: Key words Alkaptonuria ; Ochronosis ; Spine ; Magnetic resonance imaging
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract We present the MRI features of the lumbar spine in a patient with ochronosis.
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  • 32
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    Neuroradiology 42 (2000), S. 917-922 
    ISSN: 1432-1920
    Keywords: Key words Mouth, cysts ; Neck, cysts ; Glands, salivary ; Magnetic resonance imaging
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract We reviewed the MRI of 20 patients with a ranula (8 simple and 12 plunging) and ten with other cystic masses in the floor of the mouth and/ or suprahyoid portion of the neck (three haemangiomas, two neuromas, one monomorphic adenoma, one lipoma, two lateral cervical cysts and one dermoid cyst). Histological diagnoses were obtained in all cases with the exception of one presumed haemangioma. Ranulas were all well-defined, homogeneous masses giving low signal on T1-and markedly high signal on T2-weighted images. While simple ranulas were all confined to the sublingual space, plunging ranulas were centered on the submandibular space and tended to spill into one or more adjacent spaces. They extended into the sublingual space anteriorly (producung a so-called tail sign) in eight of 12 cases and into the parapharyngeal space superiorly in five. Although they sometimes filled a considerable part of the parapharyngeal space, displacement of surrounding muscles or vessels was usually slight, which was thought to reflect the nature of extravasation pseudocysts. All other cystic masses in our study had one or more MRI finding different from those of ranulas and could be easily differentiated from them.
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  • 33
    ISSN: 1432-1920
    Keywords: Key words Cavernous sinus ; Magnetic resonance imaging ; Computed tomography
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Aspergillosis of the cavernous sinus is rare, especially in immuno competent individuals. We report three such cases secondary to paranasal sinus aspergillosis, with imaging findings.
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  • 34
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    Neuroradiology 42 (2000), S. 112-114 
    ISSN: 1432-1920
    Keywords: Key words Hypophosphataemia ; Brain ; Myelinolysis, extrapontine ; Computed tomography ; Magnetic resonance imaging
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract We report a 38-year-old woman with extreme hypophosphataemia in whom CT and MRI disclosed bilateral lesions within the basal ganglia, thalamus and occipital lobes. After adequate substitution of phosphate the lesions grossly resolved and the patient recovered. This case is the first to demonstrate that profound changes of serum phosphate may be associated with reversible brain lesions.
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  • 35
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    Neuroradiology 42 (2000), S. 99-103 
    ISSN: 1432-1920
    Keywords: Key words Hypertension arterial ; Medulla oblongata ; Compression ; Neurovascular ; Magnetic resonance imaging
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Neurovascular compression (NVC) of the left ventrolateral medulla (VLM) has been implicated as a cause of essential hypertension. We investigated whether high-resolution MRI of the posterior cranial fossa could identify patients with essential hypertension who may benefit from surgery. A retrospective analysis of imaging and clinical records from 162 patients was performed. There were 38 patients with essential hypertension and 124 who were normotensive. Contact or compression of the VLM was present in 42.1 % (16/38) of the hypertensive group on the left and 47.3 % (18/38) on the right. In the normotensive group it was seen in 32.2 % (40/124) on the left and 26.6 % (33/124) on the right. There was no significant difference between the hypertensive and control groups with regard to contact or compression of the left VLM. The results support the contention that neurovascular compression (NVC) of the left or right VLM is a common finding on MRI in normotensive individuals. We therefore believe that high-resolution MRI cannot be used as a screening tool to identify patients who may benefit from surgery.
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  • 36
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    Neuroradiology 42 (2000), S. 368-370 
    ISSN: 1432-1920
    Keywords: Key words Decompression illness ; Caisson disease ; Spinal cord ; Magnetic resonance imaging
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract We report a case of decompression illness in which the patient developed paraparesis during scuba diving after rapid ascent. MRI of the spine revealed a focal intramedullary lesion consistent with the symptoms. The pathophysiological and radiological aspects of spinal decompression illness are discussed.
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  • 37
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    Neuroradiology 42 (2000), S. 529-531 
    ISSN: 1432-1920
    Keywords: Key words Meninges ; Hypotension ; spontaneous intracranial ; Magnetic resonance imaging
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract We report a case of spontaneous intracranial hypotension diagnosed with unenhanced cranial MRI, showing laminar subdural fluid and engorgement of the hypophysis and perisellar sinuses. Cerebrospinal fluid pressure was low. MRI was normal after resolution of symptoms. Prior reports emphasise the enhancing pachymeninges seen in this syndrome. We maintain that, when subdural collections and perisellar engorgement are detected on unenhanced MRI in the proper clinical setting, contrast enhancement may not be necessary for the diagnosis.
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  • 38
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    Neuroradiology 42 (2000), S. 532-534 
    ISSN: 1432-1920
    Keywords: Key words Cyst ; Rathke's cleft ; Hypophysitis ; Magnetic resonance imaging
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract We report a symptomatic Rathke's cleft cyst associated with hypophysitis in a 61-year-old woman. We demonstrate the MRI features and discuss the pathophysiology. To the best of our knowledge this is the first description of a Rathke's cleft cyst shrinking after high-dose steroid therapy.
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  • 39
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    Neuroradiology 42 (2000), S. 9-13 
    ISSN: 1432-1920
    Keywords: Key words Haemochromatosis ; Magnetic resonance imaging ; Computed tomography ; Transcranial ultrasound ; Nucleus, lentiformis
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Haemochromatosis is characterised by deposition of iron-containing pigment in various organs, but little is known about possible deposition in the brain and its clinical impact. We therefore investigated 14 patients with hereditary haemochromatosis with MRI, CT and transcranial ultrasound (TCS) and examined them neurologically. In six of the patients dense lesions were found within the lentiform nucleus on CT, all of whom displayed hyperechogenic lesions in the same area on TCS, as did one other patient. In these patients the relative signal intensities of the lentiform nucleus measured by MRI relaxometry were higher. No patient had clinical signs of basal ganglia disorders.
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  • 40
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    Neuroradiology 42 (2000), S. 40-42 
    ISSN: 1432-1920
    Keywords: Key words Veins, cerebral, anomalies ; Angiography ; Magnetic resonance imaging
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract I report a 30-year-old woman with congenital cerebral venous dysgenesis with absence of the internal cerebral and basal veins and most of the cortical veins. Unlike the more common bilateral picture, she had involvement only on the left side, which delayed presentation and gave relatively mild symptoms. The embryological mechanism and differential diagnosis of unilateral absence of the internal cerebral, basal and cortical veins are discussed.
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  • 41
    ISSN: 1432-1920
    Keywords: Key words Nijmegen breakage syndrome ; Anomalies of brain ; Magnetic resonance imaging
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract We present the results ¶of MRI examinations in ten patients with documented Nijmegen ¶breakage syndrome (NBS), aged 1.75–19 years. T1-, Proton-Density- and T2-weighted spin-echo sequences were performed in three planes. All patients showed microcephaly with decreased size of the frontal lobes and narrow frontal horns. In four patients agenesis of the posterior part of the corpus callosum was found, with colpocephaly and temporal horns dilatation. In one patient callosal hypoplasia was accompanied by abnormal cerebrospinal fluid spaces and wide cerebral cortex, suspicious of pachygyria. Sinusitis was present in all ten patients, as a result of primary immunodeficiency. As in ataxia teleangiectasia and other breakage syndromes, patients with NBS show an inherited susceptibility to malignancy and hypersensitivity to X- and γ-radiation. CT is therefore contraindicated in these patients and MRI should be the method of choice for diagnostic imaging.
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  • 42
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    Neuroradiology 42 (2000), S. 54-55 
    ISSN: 1432-1920
    Keywords: Key words Brain, hypoxia ; Blood-aqueous barrier ; Magnetic resonance imaging
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract The MRI findings of a patient with diffuse cortical hypoxic brain damage (Adams pattern III) are presented. Besides intense cortical contrast enhancement, a peculiar leakage of contrast medium at the anterior chambers of the eye was observed. The pathogenetic mechanism of this enhancement is discussed.
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  • 43
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    Neuroradiology 42 (2000), S. 738-741 
    ISSN: 1432-1920
    Keywords: Key words Lymphoma ; Central nervous system ; Immunocytoma, cerebral ; Magnetic resonance imaging ; Magnetic resonance spectroscopy
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract We report on a young woman with a primary cerebral immunocytoma. Most primary cerebral nervous system lymphomas (PCNSL) are highly malignant undifferentiated B-cell tumours, there are few data on the clinical course, MRI and spectroscopy findings of this rare PCNSL subtype. MRI revealed a radially enhancing tumour with mild perifocal oedema. MR spectroscopy indicated low cell turnover. Slow clinical progression, no significant changes with treatment, and imaging findings were consistent with a low-grade malignant tumour.
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  • 44
    ISSN: 1432-1920
    Keywords: Key words Rhombencephalosynapsis ; Magnetic resonance imaging
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Rhombencephalosynapsis is an unusual disorder characterised by maldevelopment of the rhombencephalon, sometimes with supratentorial midline anomalies. We report MRI findings in a 39-year-old woman, the oldest in the literature. MRI demonstrated hypoplasia of the cerebellar vermis, with fusion of the cerebellar hemispheres and abnormally oriented folia. Supratentorial anomalies were also seen.
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  • 45
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    Neuroradiology 42 (2000), S. 280-284 
    ISSN: 1432-1920
    Keywords: Key words Oedema ; intramedullary ; Spinal cord ; Magnetic resonance imaging
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Transient but very intense oedema of the cervical spinal cord was observed in two patients with obstruction of the cerebrospinal fluid (CSF) pathways. Both presented with hydrocephalus, one due to an infratentorial obstructing mass and the other due to postmeningitic adhesive obstruction of the outlet foramina of the fourth ventricle. In animal experiments with obstruction of CSF pathways (due to outlet foramina obstruction or to downward tentorial herniation) flattening and stretching of the ependymal cells along the central canal is observed, followed by disruption and splitting of the ependymal lining and then by extracellular oedema of the subependymal tissue. Without treatment, frank cavity formation develops in a fourth stage. In our two patients, however, most probably because of appropriate decompressive therapy, the oedema disappeared completely without a residual spinal cord lesion.
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  • 46
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    Neuroradiology 42 (2000), S. 81-84 
    ISSN: 1432-1920
    Keywords: Key words Haemorrhage, intracerebral ; Haemosiderin ; Magnetic resonance imaging
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Intracerebral haemorrhage may be visible indefinitely on MRI, due to persistence of haemosiderin in macrophages around the lesion, but it is not clear whether all haemorrhages produce haemosiderin or, if not, what proportion cannot be identified as former haemorrhages on routine MRI. We performed routine MRI (spin-echo T2- and proton-density weighted images) in 116 survivors of moderate to severe head injury, 1–5 years after injury. We reviewed the images blindly and correlated them with CT in the acute stage, to determine how many haemorrhages from the acute stage were identifiable by virtue of haemosiderin deposition on late MRI. Of 106 haemorrhages in 78 patients on CT at the time of injury, 96 (90 %) were visible as haemosiderin on late MRI. Of the old haemorrhages without haemosiderin, seven of ten were in patients where another haemorrhage with haemosiderin was still visible elsewhere in the brain. No patient or haemorrhage features explained the formation or absence of haemosiderin. Thus about 10 % of definite haematomas show no trace of haemosiderin on routine spin-echo MRI. Radiologists should be alerted to supplement routine spin-echo with gradient-echo sequences if there is a reason to suspect, or specifically exclude, prior haemorrhage.
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  • 47
    ISSN: 1432-1920
    Keywords: Key words Optic glioma ; Magnetic resonance imaging
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Serial MRI over 60 months demonstrated regression after biopsy of a pilocytic opticochiasmatic astrocytoma in a 20-year-old woman with no signs of neurofibromatosis, together with improvement in vision. The patient did not receive radio- or chemotherapy. Close MRI follow-up of optic gliomas is recommended. Aggressive treatment should be limited to cases with clear clinical and radiological progression.
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  • 48
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    Neuroradiology 42 (2000), S. 360-362 
    ISSN: 1432-1920
    Keywords: Key words Cyst, cavum septi pellucidi ; Magnetic resonance imaging
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract A 20-year-old woman with secondary amenorrhoea and an empty sella turcica was found to have a cyst of the cavum septi pellucidi (CSP) on MRI. The cyst had regressed spontaneously on follow-up MRI.
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    Neuroradiology 42 (2000), S. 403-405 
    ISSN: 1432-1920
    Keywords: Key words Worster-Drought syndrome ; Perisylvian syndrome ; Magnetic resonance imaging
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract We describe a patient with the Worster-Drought syndrome (congenital suprabulbar paresis), thought to be a failure of development of the corticobulbar tracts. MRI showed bilateral perisylvian cortical dysplasia.
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    Neuroradiology 42 (2000), S. 406-412 
    ISSN: 1432-1920
    Keywords: Key words Lymphoma, primary central nervous system ; Chemotherapy ; Magnetic resonance imaging
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract On MRI, primary brain tumors are commonly seen as contrast-enhancing masses surrounded by areas of abnormal signal on T2-weighted images. Following successful treatment tumors may no longer show contrast enhancement. The residual abnormalities are assumed to be represent “edema” and infiltrating tumor cells. We report nine patients with primary lymphoma of the central nervous system who had complete responses to intravenous methotrexate, but did not receive intrathecal chemotherapy or cranial irradiation. After complete resolution of contrast-enhancing lesions, persistent abnormalities on T2-weighted images in the region of prior tumor were initially assumed to reflect residual viable tumor. As they remained unchanged for years, however, this may not hold true in the cases in which primary central nervous system lymphoma responds to chemotherapy alone.
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  • 51
    ISSN: 1432-1920
    Keywords: Key words Lymphomatosis intravascular ; Infarcts, brain haemorrhagic ; Venous occlusion ; Magnetic resonance imaging ; Magnetic resonance angiography
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract We report a case of intravascular lymphomatosis of the brain with 8 months' follow-up and fatal outcome. Several MRI investigations revealed variegated, rapidly changing infarct-like lesions and invasion of the walls of the superior sagittal sinus and deep veins. When disturbances of the venous outflow are detected with multifocal infarct-like lesions, intravascular lymphomatosis should be considered in the differential diagnosis. Brain biopsy may ensure the proper diagnosis ante mortem, but failure of biopsy is frequent, as in our case.
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  • 52
    ISSN: 1432-1920
    Keywords: Key words Spine lumbar ; Nucleus pulposus, herniated ; Magnetic resonance imaging
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract A lumbar intervertebral disc with a herniated nucleus pulposus (HNP) often exhibits a decrease in the height of the intervertebral space. Our purpose was to ascertain whether the loss of volume of an HNP is sufficient to cause a perceptible decrease in the height of the intervertebral space. MRI of 44 patients with 51 HNPs were reviewed. The volumes of the herniated material and of the intervertebral discs were calculated for every level from L 1–2 to L 5–S 1. The average volume of the HNP was 503 ± 301 mm3. The average volumes of all 220 intervertebral discs and of the 127 normal-appearing discs were 14 442 ± 4200 mm3 and 17 476 ± 2885 mm3 respectively. The average volume of the HNP represented 3.5 % of the parent disc. An average HNP caused a decrease in intervertebral space height of 0.35 mm (0.56 pixels). Therefore, the loss of the volume of the HNP does not cause a significant decrease in the intervertebral space height. The average calculated decrease in the disc height is less than that reported in normal diurnal variation.
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  • 53
    ISSN: 1432-1920
    Keywords: Key words Dermoid tumor ; spinal ; Syringomyelia ; Fat ; free ; Meningitis ; Magnetic resonance imaging
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Cranial and spinal MRI was carried out at 0.5 or 1.5 T in five patients with spinal dermoid tumours. Free fatty material was appreciated within the normally communicating cerebrospinal fluid pathways in all five cases and in one case fat droplets were also observed within a dilated central canal of the spinal cord. While dissemination of lipid within the subarachnoid space and ventricles is easily understandable, the presence of lipid droplets within the central canal is more difficult to explain, since the central canal is only potential in the adult. When a dermoid tumor is suspected, we recommend MRI of the entire central nervous system, to detect possible leakage of fat from rupture of a cystic portion of the tumour.
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  • 54
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    Neuroradiology 42 (2000), S. 586-590 
    ISSN: 1432-1920
    Keywords: Key words Spine ; Subdural haematoma ; Magnetic resonance imaging
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract We present MRI findings in three patients with acute spontaneous subdural haematomas of the spine. Acute haematomas (1–3 days) were isointense or gave slightly high signal on T1- and heterogeneous signal on T2-weighted images. MRI precisely defined the level and extent of the haematoma preoperatively. The MRI was prospectively correctly interpreted as acute subdural haematomas in all patients. As a specific, noninvasive modality, MRI is the preferred imaging technique in this rare clinical entity.
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  • 55
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    Neuroradiology 42 (2000), S. 746-748 
    ISSN: 1432-1920
    Keywords: Key words Granulation, arachnoid ; Sinuses, venous ; Computed tomography ; Magnetic resonance imaging ; Magnetic resonance venography
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract We report CT, MRI and angiographic findings of an arachnoid granulation in the straight sinus in a young man. Its density and signal intensity were isodense and isointense with cerebrospinal fluid on CT and MRI, respectively. The lesion appeared as a filling defect on MR venography and conventional angiography.
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  • 56
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    Neuroradiology 42 (2000), S. 874-880 
    ISSN: 1432-1920
    Keywords: Key words Gadolinium-containing contrast medium ; Myelocisternography ; Cerebrospinal fluid leakage ; Magnetic resonance imaging
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Knowledge of the exact site of leakage of cerebrospinal fluid CSF leakage is important for planning surgery. We report our experience with myelocisternography with Gd-DTPA. We decided that intrathecal use of this contrast medium was justified in selected cases when other techniques have failed. After we had given detailed information to four patients with CSF leakage, they underwent five examinations. The images were interpreted by comparing those before and after injection. In all cases the contrast medium arrived at the basal cisterns, giving high contrast against adjacent structures. All patients tolerated the examination without complications or any indication of side effects.
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  • 57
    ISSN: 1432-1920
    Keywords: Key words Pituitary ; Hypophysitis, granulomatous ; Magnetic resonance imaging
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Idiopathic granulomatous hypophysitis is a rare inflammatory disease of unknown aetiology; few cases are reported. We review the clinical presentation and radiological characteristics of these cases and our own experience with three new surgical cases, to determine diagnostic criteria. MRI of three cases revealed sellar lesions extending into the chiasmatic cistern. Their shape varied, from dumbbell to spherical and elliptical. All were isointense with the brain on T1-weighted images and gave heterogeneously high signal on T2-weighted images. Contrast enhancement was homogeneous in one case and heterogeneous in another. The pituitary stalk could not be identified. There was no dural enhancement. The sphenoid sinus mucosa was thickened in two cases and normal in one.
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  • 58
    ISSN: 1432-1920
    Keywords: Key words Carcinoma nasopharyngeal ; Radionecrosis ; Magnetic resonance imaging ; Pulse sequences
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract We examined nine patients with histologically proven nasopharyngeal carcinoma (NPC), treated with radiotherapy, using dynamic susceptibility contrast MRI (DSC-MRI). In eight there was clinical evidence of radionecrosis of the temporal lobe, and one was examined for local recurrence in the nasopharynx. All patients had either high-signal finger-like or cystic lesions in the temporal lobes on T2-weighted images. Heterogeneous contrast enhancement occurred in all patients. Relative regional cerebral blood volume (rrCBV) mapping revealed marked hypoperfusion in all patients. One underwent bilateral temporal lobectomy and radionecrosis was confirmed histologically.
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  • 59
    ISSN: 1432-1920
    Keywords: Key words Magnetisation transfer ; Normal-pressure hydrocephalus ; Magnetic resonance imaging
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract We measured the magnetisation transfer ratios (MTR) of normal-appearing rostral (PR) and caudal (PC) periventricular white matter, the genu (CG) and the splenium (CS) of the corpus callosum and the thalamus (TH) in 12 patients with normal-pressure hydrocephalus (NPH) and compared them with 16 healthy control subjects. We found a significantly lower MTR in the NPH group than in the normal group for PR, PC, CG, and CS but not for TH. MT measurements give additional information which cannot be gained by conventional MRI, suggesting that NPH is associated with diffuse white matter damage, even in normal-appearing cerebral white matter.
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  • 60
    ISSN: 1432-1920
    Keywords: Key words Acquired immunodeficiency syndrome ; Magnetic resonance imaging ; Contrast-enhancement
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Our purpose was to determine whether triple-dose delayed contrast-enhanced images would improve lesion detection in patients with symptomatic human immunodeficiency virus (HIV) infection. We reviewed 33 MRI studies on 29 patients. Single-dose immediate T 1-weighted spin-echo (1x-T 1) images were compared with delayed triple-dose images (D3x-T 1). Two neuroradiologists decided which technique showed more lesions, increased lesion conspicuity and/or altered the radiologic diagnosis. The D3x-T 1 technique improved lesion detection in 14 of 29 patients (48 %). In two patients (7 %), the improvement changed the radiologic diagnosis by showing new meningeal lesions.
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  • 61
    ISSN: 1432-1920
    Keywords: Key words Spinal cord ; Schwannoma ; Magnetic resonance imaging
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Intramedullary spinal schwannomas are uncommon. We report a solitary cervical intramedullary schwannoma shown by MRI and treated surgically, and review 12 previous cases with MRI. MRI findings and pathogenesis are discussed.
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  • 62
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    Neuroradiology 42 (2000), S. 285-289 
    ISSN: 1432-1920
    Keywords: Key words Lymphoma ; malignant ; Sinus ; maxillary ; Magnetic resonance imaging ; Computed tomography.
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract We reviewed the CT and MRI of seven patients with primary malignant lymphoma of the maxillary sinus to find if there are characteristic imaging findings suggestive of the disease. The images were analysed for appearance, size, signal, internal characteristics, extent of tumour, bone change and lymph node enlargement. In two patients, the tumour first presented with mucosal thickening. In the remaining five, the tumours were an expansile mass 4–6 cm in diameter at the time of detection. Although it was difficult to distinguish tumour from mucosa or obstructed fluid on CT, T2-weighted MRI enabled us to separate tumour from normal mucosa or fluid. In two patients, the tumours were heterogeneous. Calcification and haemorrhage were observed in one patient. Periantral soft-tissue infiltration was always present, even when tumour appeared as slight mucosal thickening. Posterior extension was seen in all patients. Permeative and lytic bone destruction accompanied most cases of periantral soft-tissue infiltration; mixed destruction and sclerosis was also observed. Mucosal thickening with periantral soft-tissue infiltration may suggest malignant lymphoma of the maxillary sinus in its early form. Various types of bone change may accompany the periantral soft-tissue infiltration.
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  • 63
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    Neuroradiology 42 (2000), S. 346-351 
    ISSN: 1432-1920
    Keywords: Key words Epilepsy ; Mesial temporal sclerosis ; Thalamus ; Magnetic resonance imaging
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract We reviewed the preoperative images of 28 patients with pathologically proven mesial temporal sclerosis, to assess thalamic asymmetry and signal change. A further 25 nonsurgical patients with temporal lobe epilepsy and unequivocal, unilateral changes of mesial temporal sclerosis, and 20 controls, were also reviewed. None of the control group had unequivocal asymmetry of the thalamus. There was an ipsilateral asymmetrically small thalamus in five (18 %) of the surgical group and in three (12 %) of the nonsurgical patients. In four cases there was thalamic signal change. In three patients with thalamic volume loss there was ipsilateral hemiatrophy. All patients with an asymmetrically small thalamus had an asymmetrically small fornix and all but one a small ipsilateral mamillary body.
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  • 64
    ISSN: 1432-1920
    Keywords: Key words Tumour malignant rhabdoid ; Computed tomography ; Magnetic resonance imaging
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract We report a mass in the left cerebral hemisphere of a 20-year-old man. Histological, ultrastructural and immunohistochemical features of the tumour were consistent with primary malignant rhabdoid tumour. The age of presentation, imaging features prior to histological examination, and prognosis in this case were unusual.
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  • 65
    ISSN: 1432-1920
    Keywords: Key words Corpus callosum ; White matter lesions ; Cerebral ischaemia ; Magnetic resonance imaging
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Many studies of white matter high signal (WMHS) on T2-weighted MRI have disclosed that it is related to cerebral ischaemia and to brain atrophy. Atrophy of the corpus callosum (CC) has also been studied in relation to ischaemia. Our objective was to test the hypothesis that CC atrophy could be due to ischaemia. We therefore assessed CC, WMHS and brain atrophy in patients with risk factors without strokes (the risk factor group) and in those with infarcts (the infarct group), to investigate the relationships between these factors. We studied 30 patients in the infarct group, 14 in the risk factor group, and 29 normal subjects. Using axial T1-weighted MRI, cortical atrophy and ventricular enlargement (brain atrophy) were visually rated. Using axial T2-weighted MRI, WMHS was assessed in three categories: periventricular symmetrical, periventricular asymmetrical and subcortical. Using the mid-sagittal T1-weighted image, the CC was measured in its anterior, posterior, midanterior and midposterior portions. In the normal group, no correlations were noted between parameters. In the infarct group, there were significant correlations between CC and brain atrophy, and between CC atrophy and WMHS. After removing the effects of age, gender and brain atrophy, significant correlations were noted between some CC measures and subcortical WMHS. In the risk factor group, there were significant correlations between CC and brain atrophy and between CC atrophy and WMHS. After allowance for age, gender and brain atrophy, significant correlations between some CC measures and periventricular WMHS remained. The hypothesis that CC atrophy could be due to cerebral ischaemia was supported by other analyses. Namely, for correlations between the extent of infarcts and partial CC atrophy in patients with anterior middle cerebral artery (MCA) and with posterior MCA infarcts, there were significant correlations between the extent of infarct and midanterior CC atrophy in the former, and posterior CC atrophy in the latter. Our findings could indicate that CC atrophy is associated with cerebral ischaemia.
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  • 66
    ISSN: 1432-1920
    Keywords: Key words Brain, growth and development ; Klippel-Trenaunay syndrome ; Magnetic resonance imaging
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract We examined 11 patients, clinically and radiographically diagnosed as having the Klippel-Trenaunay syndrome (KTS) by MRI. There were four females and seven males, aged 3–51 years (mean 21 years). Two had clear asymmetry of the cerebral and cerebellar hemispheres. The thickness of the grey matter was normal, without sulcation abnormalities, but the thickness of the white matter was increased; the size of the ipsilateral ventricle was normal. These patients had hypertrophy of the leg and a cutaneous haemangioma on the same side as the brain abnormality. No patient had an intracranial vascular malformation, unilateral megalencephaly, cerebral atrophy or hydrocephalus. The prevalence of cerebral hemihypertrophy in our series of patients with KTS was thus 18 %.
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  • 67
    ISSN: 1432-1920
    Keywords: Key words Dysplasia focal cortical ; Epilepsy, temporal lobe ; Magnetic resonance imaging ; Single-photon emission tomography
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract We describe serial studies of focal cortical dysplasia causing temporal lobe seizures and progressive aphasia in a 54-year-old woman. Initially, MRI volumetry of the temporal lobes showed significant left cortical thickening corresponding to an elevated aminoacid uptake in the left temporoparietal and inferior frontal cortex on SPECT using 3-[123I]iodo-α-methyl-l-tyrosine (IMT). After 1 year there was severe shrinkage of the left temporal lobe, possibly the result of recurrent complex partial seizures.
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  • 68
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    Neuroradiology 42 (2000), S. 448-450 
    ISSN: 1432-1920
    Keywords: Key words Fluid, cerebrospinal, contrast enhancement ; Meningitis, spirochaetal ; Magnetic resonance imaging
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract We report two patients with meningitis due to spirochaetal infection, both of whom showed diffusely enhancing meninges around the brain and spinal cord. In addition, there was enhancement of the cerebrospinal fluid after intravenous administration of Gd-DTPA.
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  • 69
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    Neuroradiology 42 (2000), S. 458-461 
    ISSN: 1432-1920
    Keywords: Key words Spine, primary neoplasms ; Magnetic resonance imaging
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract We present two rare lumbar lesions with similar MRI features: high signal on T1-weighted and proton density images and low signal on T2-weighted images; a melanotic schwannoma, and a giant-cell tumour-like lesion. Melanin in the first case and haemosiderin and metahaemoglobin in the second were responsible for the MRI characteristics.
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  • 70
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    Neuroradiology 42 (2000), S. 466-468 
    ISSN: 1432-1920
    Keywords: Key words Orbit ; Schwannoma ; Magnetic resonance imaging
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract The literature on MRI of orbital schwannomas is limited. The appearances in three patients with an orbital schwannoma were reviewed. A superior orbitotomy through a subfrontal craniotomy revealed a schwannoma in all cases. MRI characteristics of very low signal on T 1-weighted images and homogeneous postcontrast enhancement may be helpful for differentiating schwannomas from other intraconal masses.
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  • 71
    ISSN: 1432-1920
    Keywords: Key words Infarcts ; brain ; Basal ganglia ; Cerebellum ; Magnetic resonance imaging ; T1 shortening
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Our purpose was to investigate nonhaemorrhagic infarcts with a short T1 in the cerebellum and basal ganglia. We carried out repeat MRI on 12 patients with infarcts in the cerebellum or basal ganglia with a short T1. Cerebellar cortical lesions showed high signal on T1-weighted spin-echo images beginning at 2 weeks, which became prominent from 3 weeks to 2 months, and persisted for as long as 14 months after the ictus. The basal ganglia lesions demonstrated slightly high signal from a week after the ictus, which became more intense thereafter. Signal intensity began to fade gradually after 2 months. High signal could be seen at the periphery until 5 months, and then disappeared, while low or isointense signal, seen in the central portion from day 20, persisted thereafter.
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  • 72
    ISSN: 1432-1920
    Keywords: Key words Progressive supranuclear palsy ; Magnetic resonance imaging ; Diffusion-weighted imaging
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract We measured the apparent diffusion coefficient (ADC), using diffusion-weighted imaging (DWI) and signal intensity on T2-weighted MRI in the cerebral white matter of patients with progressive supranuclear palsy (PSP) and age-matched normal subjects. In PSP, ADC in the prefrontal and precentral white matter was significantly higher than in controls. There was no significant difference in signal intensity on T2-weighted images. The ADC did correlate with signal intensity. The distribution of the elevation of ADC may be the consequence of underlying pathological changes, such as neurofibrillary tangles or glial fibrillary tangles in the cortex. Our findings suggest that ADC measurement might be useful for demonstrating subtle neuropathological changes.
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  • 73
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    Neuroradiology 42 (2000), S. 881-884 
    ISSN: 1432-1920
    Keywords: Key words Virchow-Robin spaces ; Midbrain ; Hydrocephalus ; Magnetic resonance imaging
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract We describe two patients with mild ventricular dilatation, shown to have cystic spaces in the midbrain, which we interpreted as greatly enlarged Virchow-Robin spaces. We discuss the pathophysiology and the possible relations to the mild hydrocephalus.
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  • 74
    ISSN: 1432-1920
    Keywords: Key words Multiple sclerosis ; Magnetic resonance imaging ; Immunoglobulin G
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract We conducted a double-blind, placebo-controlled study in 13 patients (aged 22 to 54 years) with relapsing-remitting multiple sclerosis (MS). They were randomly assigned to receive a loading dose of immunoglobulin IgG, 0.4 g/kg body weight/day for 5 consecutive days, followed by single booster doses of 0.4 g/kg/day, or placebo, once a month for 9 months. MRI was obtained before and during the 3rd and 6th months of treatment; examinations in the 9th and 12th months were planned. Qualitative and quantitative blinded assessments were performed. There were seven patients who received active treatment and six who received placebo. Statistical analysis was performed by the Wilcoxon test. A decrease in the size and number of lesions was observed on MRI in five patients (71 %) in the treatment group, and in two (33 %) of the placebo group at 3-month follow-up. At 6 months follow-up MRI, a decrease in the amount of lesions was observed in all patients treated with IV IgG, and in two (33 %) of the placebo group; four patients (66 %) receiving placebo showed an increase. Quantitative analysis showed a statistically significant decrease in the volume of lesions in treatment group at both 3 and 6 month follow-up. There was no statistically significant change in the placebo group.
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  • 75
    ISSN: 1432-1920
    Keywords: Key words Chemotherapy ; Cytarabine ; Cyclophosphamide ; Adriamycin ; Leukoencephalopathy ; Magnetic resonance imaging
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract We describe a young woman with Burkitt's lymphoma, treated with intravenous adriamycine and cyclophosphamide and intrathecal cytarabine. She developed a reversible posterior leukoencephalopathy syndrome (RPLS) with typical MRI findings. Diffusion-weighted images during the first days after the onset of symptoms predicted a small irreversible lesion in the frontal lobe, verified on T2-weighted images 1 month later. The patient showed full recovery after high-dose steroid treatment.
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  • 76
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    Neuroradiology 42 (2000), S. 913-916 
    ISSN: 1432-1920
    Keywords: Key words Subacute sclerosing panencephalitis ; Magnetic resonance imaging
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract The most common pattern in subacute sclerosing panencephalitis, is in the cerebral hemisphere white matter on T2-weighted images with or without atrophy. Brain-stem lesions are rare. We report brain-stem involvement in two children with subacute sclerosing panencephalitis. A peculiar pattern, with involvement of the pons with extension to both middle cerebellar peduncles and substantia nigra but sparing the pontine tegmentum, is suggested.
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  • 77
    ISSN: 1432-1920
    Keywords: Key words Cerebral palsy ; Birth asphyxia ; Magnetic resonance imaging ; Single-photon emission computed tomography
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract We describe the findings on single-photon emission computed tomography (SPECT) in patients with perinatal asphyxia at term, with perirolandic cortico-subcortical changes on MRI, and to correlate them with clinical features. SPECT of 7 patients was obtained after injection of 185–370 MBq of Tc-99m-ECD (ethyl cysteinate dimer). The patients had spastic quadriplegia (7/7) with perinatal asphyxia (6/7) at term (7/7). The results were correlated with the MRI findings. Hypoperfusion of the perirolandic cortex was clearly seen on SPECT in all patients, even in two with subtle changes on MRI. SPECT demonstrated a more extensive area of involvement than MRI, notably in the cerebellum (in 4), the thalamus (in 7) and basal ganglia (in 5), where MRI failed to show any abnormalities.
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  • 78
    ISSN: 1432-1920
    Keywords: Key words Nasu-Hakola disease ; Membranous lipodystrophy ; Magnetic resonance imaging
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract We report radiological features of a biopsy-proven early infantile form of Nasu-Hakola disease in two Tunisian sisters with new bony and cerebral findings.
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  • 79
    ISSN: 1432-1920
    Keywords: Key words Pineal region ; Cysts pineal ; Pineocytomas ; Magnetic resonance imaging
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Pineal lesions are rare. Tumours in this location comprise 0.4–1 % of intracranial tumours. They grow mainly as solid-mass lesions, and cystic tumours are not common. On MRI, a cystic configuration is associated usually with non-neoplastic pineal lesions rather than with a tumour, but analysis does not allow cystic pineal tumours to be distinguished from glial cysts with certainty. We compared neuroradiological and pathological data from 13 cystic pineal lesions, analysing preoperative MRI. Formalin-fixed, paraffin-embedded surgical specimens were stained routinely and immunocytochemically, using the streptavidin-biotin-complex method. Histology revealed six pineocytomas, four glial cysts, an arachnoid cyst, a low-grade astrocytoma and a teratoma. Signal characteristics of pineocytomas were similar in many respects to those of glial pineal cysts. Histomorphological analysis allowed unambiguous discrimination between pineocytomas and glial pineal cysts.
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  • 80
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    Neuroradiology 42 (2000), S. 509-514 
    ISSN: 1432-1920
    Keywords: Key words Pineal ; tumours ; Pineocytoma ; Pineoblastoma ; Computed tomography ; Magnetic resonance imaging
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract We reviewed neuroradiological images in two histologically proven cases of pineocytoma and three of pineoblastoma to delineate the characteristic features of these rare tumours. CT revealed isodense or slightly hyperdense masses with central or peripheral calcification; enhancement with contrast medium tended to be homogeneous in pineocytomas and heterogeneous in pineoblastomas. In the pineocytomas, T1-weighted images revealed rounded, sometimes or slightly lobulated low-signal masses with strong, homogeneous contrast enhancement. Their margin was clear, without invasion of adjacent structures. In the pineoblastomas, however, T1-weighted images revealed multilobulated tumours with heterogeneous contrast enhancement. All three pineoblastomas had poorly defined margins with adjacent structures such as the posterior thalamus or corpus callosum, suggesting a more invasive nature. T2-weighted images revealed nonspecific high signal lesions in all five case.
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  • 81
    ISSN: 1432-1920
    Keywords: Key words Stroke ; Magnetic resonance imaging ; Pulse sequences
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract We evaluated the feasibility and use of diffusion-weighted and fluid-attenuated inversion-recovery pulse sequences performed as an emergency for patients with acute ischaemic stroke. A 5-min MRI session was designed as an emergency diagnostic procedure for patients admitted with suspected acute ischaemic stroke. We reviewed routine clinical implementation of the procedure, and its sensitivity and specificity for acute ischaemic stroke over the first 8 months. We imaged 91 patients (80 min to 48 h following the onset of stroke). Clinical deficit had resolved in less than 3 h in 15 patients, and the remaining 76 were classified as stroke (59) or stroke-like (17) after hospital discharge. Sensitivity of MRI for acute ischaemic stroke was 98 %, specificity 100 %. MRI provided an immediate and accurate picture of the number, site, size and age of ischaemic lesions in stroke and simplified diagnosis in stroke-like episodes. The feasibility and high diagnostic accuracy of emergency MRI in acute stroke strongly support its routine use in a stroke centre.
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  • 82
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    Neuroradiology 42 (2000), S. 14-18 
    ISSN: 1432-1920
    Keywords: Key words Bone marrow, transplantation ; Toxoplasmosis, cerebral ; Magnetic resonance imaging
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Toxoplasma encephalitis was confirmed by biopsy in three patients with bone marrow (BMT) or peripheral blood stem-cell transplantation (PBSCT). All had MRI before antimicrobial therapy. The intensity of contrast enhancement was very variable. One patient had one large, moderately enhancing cerebral lesion and several smaller almost nonenhancing lesions. The second had small nodular and haemorrhagic lesions without any enhancement. The third had late cerebral toxoplasmosis and showed multiple lesions with marked contrast enhancement. The moderate or absent contrast enhancement in the two patients in the early phase of cerebral toxoplasmosis may be related to a poor immunological response, with a low white blood cell count in at least one patient. Both received higher doses of prednisone than the patient with late infection, leading to a reduced inflammatory response. In patients with a low leukocyte count and/or high doses of immunosuppressive therapy, typical contrast enhancement may be absent.
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  • 83
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    Neuroradiology 42 (2000), S. 48-50 
    ISSN: 1432-1920
    Keywords: Key words Gaucher's disease ; Magnetic resonance imaging
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract We present the cranial MRI findings in a 6-month-old girl with biopsy-proven acute neuropathic Gaucher's disease, which include unilateral cerebral atrophy and dural thickening with contrast enhancement.
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  • 84
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    Neuroradiology 42 (2000), S. 795-802 
    ISSN: 1432-1920
    Keywords: Key words Corpus callosum ; Ischaemia ; Demyelination ; Magnetic resonance imaging
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract MRI has facilitated diagnostic assessment of the corpus callosum. Diagnostic classification of solitary or multiple lesions of the corpus callosum has not attracted much attention, although signal abnormalities are not uncommon. Our aim was to identify characteristic imaging features of lesions frequently encountered in practice. We reviewed the case histories of 59 patients with lesions shown on MRI. The nature of the lesions was based on clinical features and/or long term follow-up (ischaemic 20, Virchow-Robin spaces 3, diffuse axonal injury 7, multiple sclerosis 11, hydrocephalus 5, acute disseminated encephalomyelitis 5, Marchiafava-Bignami disease 4, lymphoma 2, glioblastoma hamartoma each 1). The location in the sagittal plane, the relationship to the borders of the corpus callosum and midline and the size were documented. The 20 ischaemic lesions were asymmetrical but adjacent to the midline; the latter was involved in new or large lesions. Diffuse axonal injury commonly resulted in large lesions, which tended to be asymmetrical; the midline and borders of the corpus callosum were always involved. Lesions in MS were small, at the lower border of the corpus callosum next to the septum pellucidum, and crossed the midline asymmetrically. Acute disseminated encephalomyelitis and the other perivenous inflammatory diseases caused relatively large, asymmetrical lesions. Hydrocephalus resulted in lesions of the upper part of the corpus callosum, and mostly in its posterior two thirds; they were found in the midline. Lesions in Marchiafava-Bignami disease were large, often symmetrically in the midline in the splenium and did not reach the edge of the corpus callosum.
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  • 85
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    Neuroradiology 42 (2000), S. 852-855 
    ISSN: 1432-1920
    Keywords: Key words Larmor ; Joseph ; Magnetic resonance imaging ; Neurology history
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract The origin of many of the eponymous terms in modern medicine is unknown to many people who utter them daily. As a contribution to understanding the historical background of MRI, we provide a brief account of the life and work of Joseph Larmor, the Irish scientist, whose name is frequently used by chemists, physicists and radiologists alike.
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  • 86
    ISSN: 1432-1920
    Keywords: Key words Infarct ; cerebral ; contrast enhancement ; Infarct ; haemorrhagic transformation ; Magnetic resonance imaging ; Computed tomography
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract The frequency, predisposing factors and clinical consequences of haemorrhagic infarcts and damaged blood-brain barrier as shown by contrast enhancement (CE) in ischaemic cerebral infarcts are controversial. We prospectively compared the sensitivity of CT and MRI to haemorrhagic transformation (HT) and CE. We also wished to investigate the clinical significance of HT and factors possibly associated with it. We studied 36 patients with acute ischaemic infarcts in the middle cerebral artery territory during the first 2 weeks after the ictus. After CT and rating of the neurological deficit on admission, serial examinations with clinical neuromonitoring, contrast-enhanced CT and MRI were done on the same day. The occurrence and severity of HT were correlated with CE, stroke mechanism, infarct size, development of neurological deficits and antithrombotic treatment. The frequency of HT detected by MRI was 80 %. CE usually preceded HT or was seen simultaneously. MRI had a higher sensitivity than CT to HT and CE. Severity of HT was positively correlated with infarct size (P 〈 0.01). HT had no influence on patient's neurological status. Neither the type of antithrombotic treatment nor the stroke mechanism was associated with the severity of HT. No parenchymal haemorrhage occurred.
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  • 87
    ISSN: 1432-1920
    Keywords: Key words Cerebral autosomal dominant arteriopathy ; Magnetic resonance imaging
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Clinical data and MRI findings are presented on 18 subjects from two families with neuropathologically confirmed CADASIL. DNA analysis revealed mutations in exon 4 of Notch 3 gene in both families. All family members with mutations in Notch 3 gene had extensive abnormalities on MRI, principally lesions in the white matter of the frontal lobes and in the external capsules. Of several family members in whom a diagnosis of CADASIL was suspected on the basis of minor symptoms, one had MRI changes consistent with CADASIL; none of these cases carried a mutation in the Notch 3 gene. MRI and clinical features that may alert the radiologist to the diagnosis of CADASIL are reviewed. However, a wide differential diagnosis exists for the MRI appearances of CADASIL, including multiple sclerosis and small-vessel disease secondary to hypertension. The definitive diagnosis cannot be made on MRI alone and requires additional evidence, where available, from a positive family history and by screening DNA for mutations of Notch 3 gene.
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  • 88
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    Neuroradiology 42 (2000), S. 526-528 
    ISSN: 1432-1920
    Keywords: Key words Vasculitis ; cerebral ; Acquired immunodeficiency syndrome ; Magnetic resonance imaging
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Cerebral ischaemia caused by inflammatory vasculopathies has been described as complication of human immunodeficiency virus (HIV) infection. Imaging studies have shown ischaemic lesions and changes of the vascular lumen, but did not allow demonstration of abnormalities within the vessel wall itself. Two HIV-infected men presented with symptoms of a transient ischaemic attack. Initial MRI of the first showed no infarct; in the second two small lacunar lesions were detected. In both cases, multiplanar 3-mm slice contrast-enhanced T1-weighted images showed aneurysmal dilatation, with thickening and contrast enhancement of the wall of the internal carotid and middle cerebral (MCA) arteries. These findings were interpreted as indicating cerebral vasculitis. In the first patient the vasculopathy progressed to carotid artery occlusion, and he developed an infarct in the MCA territory, but then remained neurologically stable. In the second patient varicella zoster virus (VZV) infection was the probable cause of vasculitis. The clinical deficits and vasculitic MRI changes regressed with antiviral and immunosuppressive therapy.
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  • 89
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    Neuroradiology 42 (2000), S. 543-547 
    ISSN: 1432-1920
    Keywords: Key words Inner ear ; Virtual endoscopy ; Volume rendering ; Computed tomography ; Magnetic resonance imaging
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract To assess the role of virtual endoscopy (VE) in the examination of intracisternal structures and of the inner ear, we studied the anatomy of the labyrinth and internal auditory canal using the original CT slices and VE on the unaffected side in three female and three male patients, age range 3–46 years, with contralateral retrocochlear hearing loss. We also examined seven patients with different pathological findings. VE was performed using an advanced postprocessing program with high- resolution 3D data sets of CT (1–1.5 mm thickness, pitch 1.25) and MRI-CISS-3D (constructive interference in steady state) images of the basal cisterns (1.5 T, slice thickness 0.7–1 mm). VE provides an endoscopic-like view from a given point within the basal cisterns of vessels and nerves (on MRI) or of the structures of the inner ear (on CT). The complex anatomy and pathological changes in the inner ear can be faithfully shown. The main advantage is not basic diagnostic information but demonstration of topographically complex situations, such as the canalicular system of the inner ear, for discussion, preoperative planning and teaching.
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  • 90
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    Neuroradiology 42 (2000), S. 551-563 
    ISSN: 1432-1920
    Keywords: Key words Acquired immune deficiency syndrome ; Spine ; infections ; Spine ; neoplasms ; Magnetic resonance imaging
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Our purpose was to describe the range of MRI findings in infectious and neoplastic involvement of the spine and spinal cord in symptomatic patients with the acquired immunodeficiency syndrome (AIDS). MRI studies in 55 patients with AIDS and neurological signs and symptoms thought to be related to the spine or spinal cord were reviewed. We categorized the findings according to the spinal compartment involved. There were 29 patients with extradural, 11 with intradural-extramedullary and 9 with intramedullary disease. In 6 patients more than one compartment was involved simultaneously, and patients presented with multiple lesions in the same compartment. The most common causes of extradural disease were bone lesions (28); an epidural mass was seen in 14 and spondylodiscitis in 4 patients. Cytomegalovirus polyradiculitis was the most common cause of intradural-extramedullary disease (in 10 cases); herpes radiculitis was seen in two, and tuberculous infection in another two. In three cases leptomeningeal contrast enhancement was due to lymphoma. Human immunodeficiency virus (HIV) myelitis was seen in two patients, presumed vacuolar myelopathy in two, toxoplasma myelitis in four, intramedullary lymphoma in one, and herpes myelitis in one. Familiarity with the various potential pathological entities that can affect the spine and spinal cord in the AIDS population and their imaging characteristics is crucial for initiation of further diagnostic tests and appropriate medical or surgical treatment.
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  • 91
    ISSN: 1432-1920
    Keywords: Key words Spine ; surgery ; Infection ; Magnetic resonance imaging
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract We evaluated the role of MRI in the diagnosis of postoperative spondylodiscitis. Spondylodiscitis is a serious complication of surgery, and the diagnosis frequently depends on a combination of clinical, laboratory and imaging findings. We compared the MRI findings in six patients with biopsy- or surgery-proven spondylodiscitis with those in 38 asymptomatic postoperative patients. Contrast enhancement and signal changes in the intervertebral disc or the vertebral endplates are not specific for spondylodiscitis, being also seen in the asymptomatic patients. However, absence of Modic type 1 changes, of contrast enhancement of the disc or of enhancing paravertebral soft tissues suggests that the patient does not have spondylodiscitis. MRI appears more useful for exclusion than for confirmation of postoperative spondylodiscitis.
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  • 92
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    Neuroradiology 42 (2000), S. 612-615 
    ISSN: 1432-1920
    Keywords: Key words Gliomatosis cerebri ; Magnetic resonance imaging ; Magnetic resonance spectroscopy
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Two cases of gliomatosis cerebri are presented in which there was markedly decreased N-acetyl aspartate and an elevated lactate-lipid area in the MR proton spectra.
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  • 93
    ISSN: 1432-1920
    Keywords: Key words Microangiopathy ; cerebral ; Brain ; ischaemia ; Purpura ; thrombotic thrombocytopenic ; Magnetic resonance imaging
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Abnormalities in the brain of patients with thrombotic thrombocytopenic purpura (TTP) are infrequent on MRI, often reversible and mainly limited to symptomatic stages of the disease. We report a case in which high-resolution MRI demonstrated multiple persistent small cortical infarcts after clinical remission. High-resolution MRI investigations may detect clinically latent but permanent brain damage, and complement clinical judgement in guiding therapeutic decisions.
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  • 94
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    Neuroradiology 42 (2000), S. 679-681 
    ISSN: 1432-1920
    Keywords: Key words Spinal cord, neoplasm ; Solitary fibrous tumour ; Magnetic resonance imaging
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract We report an intramedullary primary solitary fibrous tumour of the cervical spinal cord in a 33-year-old man. The tumour predominantly consisted of monomorphic spindle cells with a storiform pattern. MRI demonstrated an inhomogeneously enhancing cervical intramedullary tumour. The patient was well without recurrence 18 months after surgery.
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  • 95
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    Neuroradiology 42 (2000), S. 682-684 
    ISSN: 1432-1920
    Keywords: Key words Acute disseminated encephalomyelitis ; Magnetic resonance imaging ; Cyst ; Japanese encephalitis vaccine
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract We report a case of acute disseminated encephalomyelitis (ADEM) with a residual cystic lesion on MRI. This seemed to be induced by Japanese encephalitis vaccination. Despite complete clinical improvement with high-dose steroid therapy, the cystic lesion has persisted for 3 years on MRI. There have been no previous reports of residual cystic lesions in ADEM.
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  • 96
    ISSN: 1432-1920
    Keywords: Key words Encephalopathy, Wernicke's ; Magnetic resonance imaging
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract We report a 13-year-old girl with leukaemia and Wernicke's encephalopathy induced by total parenteral nutrition. MRI showed unusual bilateral lesions of the caudate nuclei and cerebral cortex, as well as typical lesions surrounding the third ventricle and aqueduct. After intravenous thiamine, the patient improved, and the abnormalities on MRI disappeared.
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  • 97
    ISSN: 1432-1920
    Keywords: Key words Morphine sulphate intoxication ; Leukoencephalopathy ; Neurotoxicity ; Magnetic resonance imaging
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract We report a 14-year-old girl with an unusual pattern of leukoencephalopathy after intentional intoxication with morphine sulphate tablets. Toxicological analysis showed exceedingly high levels of morphine and its metabolites. MRI disclosed a leukoencephalopathy with high signal from the centrum semiovale, corpus callosum and cerebellar white matter on T2-weighted images. These findings could be only partially explained by a hypoxic-ischaemic event; neurotoxic effects must be considered in this atypical leukoencephalopathy.
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  • 98
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    Neuroradiology 42 (2000), S. 849-851 
    ISSN: 1432-1920
    Keywords: Key words Brittle hair ; Tay's syndrome ; Dysmyelination ; Magnetic resonance imaging ; Magnetic resonance spectroscopy
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Tay's syndrome is a trichothiodystrophy associated with congenital ichthyosis. We report the findings on MRI and spectroscopy in a young girl with sparse, short, ruffled hair, dry skin and delayed milestones. T2-weighted images showed prominent diffuse confluent increase in signal symmetrically in all the supratentorial white matter. These findings are similar to those in a previously described case, and consistent with dysmyelination. Spectroscopy showed increased myoinositol and decreased choline.
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  • 99
    ISSN: 1432-1920
    Keywords: Key words Aqueduct ; stenosis ; Fistula ; arteriovenous ; dural ; Magnetic resonance imaging ; Embolisation
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract We report aqueduct compression by venous ectasia in a 65-year-old man with a dural arterio-venous fistula in the posterior cranial fossa draining into a superior vermian vein. Conventional and phase-contrast MRI showed the aqueduct stenosis and the causative dilated vein.
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  • 100
    ISSN: 1432-1920
    Keywords: Key words Infarct ; cerebral ; Phaeohyphomycosis ; Computed tomography ; Magnetic resonance imaging
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Phaeohyphomycosis is an uncommon disorder caused by a variety of saprophytic fungi having distinctive morphologic features. Central nervous system infection typically occurs in the absence of predisposing factors and usually manifest symptoms and signs of abscess formation. We describe an otherwise healthy young man whose presentation with cerebral phaeohyphomycosis was subacute meningitis and stroke. Neuroimaging studies revealed multiple parenchymal lesions having the characteristics of recent infarcts; several vascular territories were involved. The nature of these lesions was confirmed histologically at autopsy. To our knowledge, such radiologic appearances have not previously been reported in this condition.
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