Post-traumatic upper cervical subluxation visualized by MRI: a case report

Directory of Open Access Journals (Sweden)

Demetrious James

2007-12-01

Full Text Available Abstract Background This paper describes MRI findings of upper cervical subluxation due to alar ligament disruption following a vehicular collision. Incidental findings included the presence of a myodural bridge and a spinal cord syrinx. Chiropractic management of the patient is discussed. Case presentation A 21-year old female presented with complaints of acute, debilitating upper neck pain with unremitting sub-occipital headache and dizziness following a vehicular collision. Initial emergency department and neurologic investigations included x-ray and CT evaluation of the head and neck. Due to persistent pain, the patient sought chiropractic care. MRI of the upper cervical spine revealed previously unrecognized clinical entities. Conclusion This case highlights the identification of upper cervical ligamentous injury that produced vertebral subluxation following a traumatic incident. MRI evaluation provided visualization of previously undetected injury. The patient experienced improvement through chiropractic care.

A systematic review of the need for MRI for the clearance of cervical spine injury in obtunded blunt trauma patients after normal cervical spine CT

Directory of Open Access Journals (Sweden)

Iyore AO James

2014-01-01

Full Text Available Clearance of cervical spine injury (CSI in the obtunded or comatose blunt trauma patient remains controversial. In patients with unreliable physical examination and no evidence of CSI on computed tomography (CT, magnetic resonance imaging of the cervical spine (CS-MRI is the typical follow-up study. There is a growing body of evidence suggesting that CS-MRI is unnecessary with negative findings on a multi-detector CT (MDCT scan. This review article systematically analyzes current literature to address the controversies surrounding clearance of CSI in obtunded blunt trauma patients. A literature search through MEDLINE database was conducted using all databases on the National Center for Biotechnology Information (NCBI website (www.ncbi.nlm.nih.gov for keywords: "cervical spine injury," "obtunded," and "MRI." The search was limited to studies published within the last 10 years and with populations of patients older than 18 years old. Eleven studies were included in the analysis yielding data on 1535 patients. CS-MRI detected abnormalities in 256 patients (16.6%. The abnormalities reported on CS-MRI resulted in prolonged rigid c-collar immobilization in 74 patients (4.9%. Eleven patients (0.7% had unstable injury detected on CS-MRI alone that required surgical intervention. In the obtunded blunt trauma patient with unreliable clinical examination and a normal CT scan, there is still a role for CS-MRI in detecting clinically significant injuries when MRI resources are available. However, when a reliable clinical exam reveals intact gross motor function, CS-MRI may be unnecessary.

Dynamic function MR of the cervical vertebral column

International Nuclear Information System (INIS)

Naegele, M.; Woell, B.; Reiser, M.; Koch, W.; Kaden, B.

1992-01-01

To obtain functional studies of the cervical spine, a device has been developed which allows MRI examinations to be carried out in five different degrees of flexion. T 1 and T 2 * weighted FFE sequences were used. Dynamic functional MRI was performed on 5 normals and 31 patients (5 disc herniation, 4 whiplash injuries, 6 spinal canal stenoses, 14 laminectomies and spinal fusions, 2 rheumatoid arthritis). The relationship of the spinal cord to the bony and ligamentous components in different degrees of flexion was particularly well shown in whiplash injury, spinal stenosis and postoperative situations. (orig.) [de

Detection of angiogenesis-dependent parameters by functional MRI: Correlation between histomorphology and evaluation of clinical relevance as prognostic factor for the example of cervical carcinoma

International Nuclear Information System (INIS)

Hawighorst, H.; Knopp, M.V.; Schoenberg, S.O.; Essig, M.; Kaick, G. van; Schaeffer, U.; Knapstein, P.G.; Weikel, W.

1998-01-01

Purpose: Purpose of this study is to compare functional MRI parameters with histomorphological markers of tumor microvessel density (MVD) and permeability (vascular endothelial growth factor) and to determine the ultimate value of both approaches by correlation with disease outcome in patients with primary cancer of the uterine cervix. Method: Pharmacokinetic parameters were calculated from contrast-enhanced dynamic MR imaging series in 37 patients with biopsy-proven primary cervical cancer. On the operative whole mount specimens, histomorphological markers of tumor angiogenesis (MVD, VEGF) were compared with the MRI-derived parameters. For MRI and histomorphological data, Kaplan-Meier survival curves were calculated and compared using logrank statistics. Results: Significant (p [de

The usefulness of magnetic resonance imaging (MRI) in cervical carcinoma assessment - a preliminary report

International Nuclear Information System (INIS)

Tacikowska, M.; Grzesiakowska, U.; Tacikowski, T.; Sobiczewski, P.

2002-01-01

The aim of diagnostic imaging is not so much the detection of cervical carcinoma, but the evaluation of its stage. In view of this the aim of this study included: 1) comparison of MR results with the results of histological examinations after operations with reference to the dimensions of cervical carcinoma; 2) assessment of the sensitivity and specificity of MRl in the evaluation of parametrium infiltration; 3) analysis of the sensitivity and specificity of MRI in the evaluation of infiltration of the vagina and uterus; 4) assessment of the usefulness of this method in the detection of metastases to lymph nodes.The material consisted of pelvic MRI, obtained with 2T Elscint unit in 15 patients with cervical carcinoma, aged 37 to 73 years. All patients underwent surgical treatment within 30 days after MR. During the MR examination the following sequences were performed: SE (spin echo) T1 (longitudinal relaxation time) in axial projection before administration of gadolinium (Gd-DTPA); SE T1 in axial, frontal and sagittal projections after contrast injection and FSE (fast spin echo) T2 (transversal relaxation time) in axial, frontal and sagittal projections.1) in the assessment of cervical carcinoma dimensions MRI results are highly concordant with the results of postoperative histological examination (p = 0. 9389); 2) in the assessment of parametrium infiltration sensitivity and specificity of MRI are 75% and 100%, respectively; 3) in the assessment of the infiltration of the vagina and uterine corpus the sensitivity and specificity of MRI imaging were respectively 100% and 85%; 100% and 100%; 4) in the detection of lymph node metastases MRI sensitivity was 67% and its specificity 100%. In patients with cervical carcinoma MRI is a valuable method for the assessment of tumour dimensions, parametrium infiltration, infiltration of the vagina and uterine corpus.(author)

MRI of acute cervical injury: correlation with neurologic deficit

International Nuclear Information System (INIS)

Hyun, Chang Dong; Kwon, Soon Tae; Lim, Seung Chul; Shin, Myung Jin; Han, Boo Kyung; Kim, Sang Joon; Park, Man Soo; Yoon, Hyun Ki; Suh, Dae Chul

1995-01-01

To evaluate MRI findings of spinal cord according to mechanism in acute cervical spinal injury. 25 patients under went MRI within 1 month after acute cervical trauma. Axial T1Wl (TR/TE: 500/20), gradient-echo (TR/TE: 300/14), sagittal T1Wl (TR/TE: 500/20), proton (TR/TE: 2000. 20 msec), T2Wl (TR/TE: 2000/80) were performed. In 11 patients, post-enhancement T1Wl was done. Change of spinal cord signal intensity on MRI in addition to the presence of abnormal changes of vertebral body, intervertebral disc and paraspinal soft tissue were evaluated. 15 patients had flexion injury, seven had extension injury and three had injury of unknown mechanism. Twelve patients showed iso-signal intensity on T2Wl and high signal intensity on T2Wl. Three patients showed low signal intensity on T1Wl and high signal intensity on T2Wl. Spinal cord hemorrhage occured in 10 patients. We found cord swelling in nine patients and cord compression in 12 patients. In nine patients with cord swelling, extent of cord injury was more than one segment of vertebral body. Ligamentous injury, disc injury, soft tissue injury occurred in 16 (64%), 17 (68%), 15 (60%) patients respectively. Vertebral body fracture was found in 17 patients (68%). The levels of fracture were C6 (eight patients) and C5 (five patients). MRI is valuable in exaluetion of the spinal cord, intervertebral disc, and soft tissue lesions in acute cervical spinal injury. Prognosis is worse in flexion injury than in extension injury, and is well correlated with cord hemorrhage and lesion extent

Diffusion-weighted MRI in cervical cancer

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McVeigh, Patrick Z.; Haider, Masoom A.; Syed, Aejaz M.; Milosevic, Michael; Fyles, Anthony

2008-01-01

The purpose was to investigate the potential value of apparent diffusion coefficient (ADC) measurement with MRI in the assessment of cervix cancer. Diffusion-weighted MRI was performed in 47 patients with cervical carcinoma undergoing chemoradiation therapy and 26 normal controls on a 1.5-T system with a b-value of 600 s/mm 2 . FIGO stage, tumor volume, nodal status, interstitial fluid pressure (IFP) and oxygen measurements were recorded. Response was defined as no visible tumor 3-6 months following completion of therapy. The average median ADC (mADC) of cervical carcinomas (1.09±0.20 x 10 -3 mm 2 /s) was significantly lower than normal cervix (2.09±0.46 x 10 -3 mm 2 /s) (P -3 mm 2 /s) compared to T2b (1.21 x 10 -3 mm 2 /s) and T3/T4 (1.10 x 10 -3 mm 2 /s) (P<0.001). In patients with squamous carcinomas the 90th percentile of ADC values was lower in responders than non-responders (P<0.05). Median ADC in cervix carcinoma is significantly lower compared to normal cervix. ADC may have predictive value in squamous tumors, but further long-term study will determine the ultimate clinical utility. (orig.)

Temporal discrimination, a cervical dystonia endophenotype: penetrance and functional correlates.

Science.gov (United States)

Kimmich, Okka; Molloy, Anna; Whelan, Robert; Williams, Laura; Bradley, David; Balsters, Joshua; Molloy, Fiona; Lynch, Tim; Healy, Daniel G; Walsh, Cathal; O'Riordan, Seán; Reilly, Richard B; Hutchinson, Michael

2014-05-01

The pathogenesis of adult-onset primary dystonia remains poorly understood. There is variable age-related and gender-related expression of the phenotype, the commonest of which is cervical dystonia. Endophenotypes may provide insight into underlying genetic and pathophysiological mechanisms of dystonia. The temporal discrimination threshold (TDT)-the shortest time interval at which two separate stimuli can be detected as being asynchronous-is abnormal both in patients with cervical dystonia and in their unaffected first-degree relatives. Functional magnetic resonance imaging (fMRI) studies have shown that putaminal activation positively correlates with the ease of temporal discrimination between two stimuli in healthy individuals. We hypothesized that abnormal temporal discrimination would exhibit similar age-related and gender-related penetrance as cervical dystonia and that unaffected relatives with an abnormal TDT would have reduced putaminal activation during a temporal discrimination task. TDTs were examined in a group of 192 healthy controls and in 158 unaffected first-degree relatives of 84 patients with cervical dystonia. In 24 unaffected first-degree relatives, fMRI scanning was performed during a temporal discrimination task. The prevalence of abnormal TDTs in unaffected female relatives reached 50% after age 48 years; whereas, in male relatives, penetrance of the endophenotype was reduced. By fMRI, relatives who had abnormal TDTs, compared with relatives who had normal TDTs, had significantly less activation in the putamina and in the middle frontal and precentral gyri. Only the degree of reduction of putaminal activity correlated significantly with worsening of temporal discrimination. These findings further support abnormal temporal discrimination as an endophenotype of cervical dystonia involving disordered basal ganglia circuits. © 2014 International Parkinson and Movement Disorder Society.

Cervical spinal cord injury during cerebral angiography with MRI confirmation: case report

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Bejjani, G.K.; Rizkallah, R.G.; Tzortidis, F. [Department of Neurosurgery, George Washington University Medical Center, Washington, DC (United States); Mark, A.S. [Department of Neuroradiology, Washington Hospital Center, Washington, DC (United States)

1998-01-01

We report the first case of MRI-documented cervical spinal cord injury during cerebral angiography. A 54-year-old woman underwent an angiogram for subarachnoid hemorrhage. Her head was secured in a plastic head-holder. At the end of the procedure, she was found to have a left hemiparesis. MRI revealed high signal in the cervical spinal cord. The etiology may have been mechanical due to patient positioning, or toxic, from contrast medium injection in the vessels feeding the spinal cord, or a combination of both. (orig.) With 3 figs., 26 refs.

Added value of diffusion-weighted MRI in detection of cervical cancer recurrence: comparison with morphologic and dynamic contrast-enhanced MRI sequences.

Science.gov (United States)

Lucas, Rita; Lopes Dias, João; Cunha, Teresa Margarida

2015-01-01

We aimed to evaluate the added value of diffusion-weighted imaging (DWI) to standard magnetic resonance imaging (MRI) for detecting post-treatment cervical cancer recurrence. The detection accuracy of T2-weighted (T2W) images was compared with that of T2W MRI combined with either dynamic contrast-enhanced (DCE) MRI or DWI. Thirty-eight women with clinically suspected uterine cervical cancer recurrence more than six months after treatment completion were examined with 1.5 Tesla MRI including T2W, DCE, and DWI sequences. Disease was confirmed histologically and correlated with MRI findings. The diagnostic performance of T2W imaging and its combination with either DCE or DWI were analyzed. Sensitivity, positive predictive value, and accuracy were calculated. Thirty-six women had histologically proven recurrence. The accuracy for recurrence detection was 80% with T2W/DCE MRI and 92.1% with T2W/DWI. The addition of DCE sequences did not significantly improve the diagnostic ability of T2W imaging, and this sequence combination misclassified two patients as falsely positive and seven as falsely negative. The T2W/DWI combination revealed a positive predictive value of 100% and only three false negatives. The addition of DWI to T2W sequences considerably improved the diagnostic ability of MRI. Our results support the inclusion of DWI in the initial MRI protocol for the detection of cervical cancer recurrence, leaving DCE sequences as an option for uncertain cases.

SSFSE sequence functional MRI of the human cervical spinal cord with complex finger tapping

International Nuclear Information System (INIS)

Xie Chuhai; Kong Kangmei; Guan Jitian; Chen Yexi; He Jiankang; Qi Weili; Wang Xinjia; Shen Zhiwei; Wu Renhua

2009-01-01

Purpose: Functional MR imaging of the human cervical spinal cord was carried out on volunteers during alternated rest and a complex finger tapping task, in order to detect image intensity changes arising from neuronal activity. Methods: Functional MR imaging data using single-shot fast spin-echo sequence (SSFSE) with echo time 42.4 ms on a 1.5 T GE Clinical System were acquired in eight subjects performing a complex finger tapping task. Cervical spinal cord activation was measured both in the sagittal and transverse imaging planes. Postprocessing was performed by AFNI (Analysis of Functional Neuroimages) software system. Results: Intensity changes (5.5-7.6%) were correlated with the time course of stimulation and were consistently detected in both sagittal and transverse imaging planes of the cervical spinal cord. The activated regions localized to the ipsilateral side of the spinal cord in agreement with the neural anatomy. Conclusion: Functional MR imaging signals can be reliably detected with finger tapping activity in the human cervical spinal cord using a SSFSE sequence with 42.4 ms echo time. The anatomic location of neural activity correlates with the muscles used in the finger tapping task.

MRI-guided and CT-guided cervical nerve root infiltration therapy. A cost comparison

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Maurer, M.H.; Froeling, V.; Roettgen, R.; Bucourt, M. de; Hamm, B.; Streitparth, F. [Charite University Medicine Berlin (Germany). Dept. of Diagnostic and Interventional Radiology; Bretschneider, T. [Magdeburg Univ. (Germany). Dept. of Radiology and Nuclear Medicine; Hartwig, T.; Disch, A.C. [Charite University Medicine Berlin (Germany). Center for Musculoskeletal Surgery

2014-06-15

Purpose: To evaluate and compare the costs of MRI-guided and CT-guided cervical nerve root infiltration for the minimally invasive treatment of radicular neck pain. Materials and Methods: Between September 2009 and April 2012, 22 patients (9 men, 13 women; mean age: 48.2 years) underwent MRI-guided (1.0 Tesla, Panorama HFO, Philips) single-site periradicular cervical nerve root infiltration with 40 mg triamcinolone acetonide. A further 64 patients (34 men, 30 women; mean age: 50.3 years) were treated under CT fluoroscopic guidance (Somatom Definition 64, Siemens). The mean overall costs were calculated as the sum of the prorated costs of equipment use (purchase, depreciation, maintenance, and energy costs), personnel costs and expenditure for disposables that were identified for MRI- and CT-guided procedures. Additionally, the cost of ultrasound guidance was calculated. Results: The mean intervention time was 24.9 min. (range: 12-36 min.) for MRI-guided infiltration and 19.7 min. (range: 5-54 min.) for CT-guided infiltration. The average total costs per patient were EUR 240 for MRI-guided interventions and EUR 124 for CT-guided interventions. These were (MRI/CT guidance) EUR 150/60 for equipment use, EUR 46/40 for personnel, and EUR 44/25 for disposables. The mean overall cost of ultrasound guidance was EUR 76. Conclusion: Cervical nerve root infiltration using MRI guidance is still about twice as expensive as infiltration using CT guidance. However, since it does not involve radiation exposure for patients and personnel, MRI-guided nerve root infiltration may become a promising alternative to the CT-guided procedure, especially since a further price decrease is expected for MRI devices and MR-compatible disposables. In contrast, ultrasound remains the less expensive method for nerve root infiltration guidance. (orig.)

MRI-guided and CT-guided cervical nerve root infiltration therapy. A cost comparison

International Nuclear Information System (INIS)

Maurer, M.H.; Froeling, V.; Roettgen, R.; Bucourt, M. de; Hamm, B.; Streitparth, F.; Bretschneider, T.; Hartwig, T.; Disch, A.C.

2014-01-01

Purpose: To evaluate and compare the costs of MRI-guided and CT-guided cervical nerve root infiltration for the minimally invasive treatment of radicular neck pain. Materials and Methods: Between September 2009 and April 2012, 22 patients (9 men, 13 women; mean age: 48.2 years) underwent MRI-guided (1.0 Tesla, Panorama HFO, Philips) single-site periradicular cervical nerve root infiltration with 40 mg triamcinolone acetonide. A further 64 patients (34 men, 30 women; mean age: 50.3 years) were treated under CT fluoroscopic guidance (Somatom Definition 64, Siemens). The mean overall costs were calculated as the sum of the prorated costs of equipment use (purchase, depreciation, maintenance, and energy costs), personnel costs and expenditure for disposables that were identified for MRI- and CT-guided procedures. Additionally, the cost of ultrasound guidance was calculated. Results: The mean intervention time was 24.9 min. (range: 12-36 min.) for MRI-guided infiltration and 19.7 min. (range: 5-54 min.) for CT-guided infiltration. The average total costs per patient were EUR 240 for MRI-guided interventions and EUR 124 for CT-guided interventions. These were (MRI/CT guidance) EUR 150/60 for equipment use, EUR 46/40 for personnel, and EUR 44/25 for disposables. The mean overall cost of ultrasound guidance was EUR 76. Conclusion: Cervical nerve root infiltration using MRI guidance is still about twice as expensive as infiltration using CT guidance. However, since it does not involve radiation exposure for patients and personnel, MRI-guided nerve root infiltration may become a promising alternative to the CT-guided procedure, especially since a further price decrease is expected for MRI devices and MR-compatible disposables. In contrast, ultrasound remains the less expensive method for nerve root infiltration guidance. (orig.)

Cervical mycotic aneurysm in an infant. MRI findings and endovascular treatment

International Nuclear Information System (INIS)

Ramos Taboada, Luciana; Foa Torres, Gustavo; Tejada, Graciela; Castellari, Mario; Oulton, Carlos A.

2004-01-01

A case of cervical mycotic aneurysm in a 6-month-old infant is presented. Eight days after birth the preterm newborn had a perforated necrotizing enterocolitis. Treatment included abdominal percutaneous drainage and surgery. Hemo cultures grew staphylococcus aureus methicillin resistant. Antibiotic therapy was indicated with a favorable evolution. Five months later the infant showed a lateral cervical mass nad hemorrhagic fluid in her right external auditory canal. Ultrasound and MRI were performed. MRI demonstrated a heterogeneous fluid-containing neck mass, similar in appearance to a parapharyngeal hematoma, with flow void sign. Digital substraction angiography (DSA) was performed to highlight the vascular anatomy demonstrating a mycotic aneurysm adjacent to the ascendent pharyngeal artery. The endovascular treatment with Histoacryl-Lipiodol was successful without any technical or neurological complications. Mycotic aneurysm is a very rare, but potentially fatal complication in infants. In our case report, MRI and DSA provided an accurate diagnosis leading to a rapid endovascular therapy. (author)

MRI of anterior spinal artery syndrome of the cervical spinal cord

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Takahashi, S. (Dept. of Radiology, Tohoku Univ. School of Medicine, Sendai (Japan)); Yamada, T. (Dept. of Radiology, Tohoku Univ. School of Medicine, Sendai (Japan)); Ishii, K. (Dept. of Radiology, Tohoku Univ. School of Medicine, Sendai (Japan)); Saito, H. (Dept. of Neurology, Tohoku Univ. School of Medicine, Sendai (Japan)); Tanji, H. (Dept. of Neurology, Tohoku Univ. School of Medicine, Sendai (Japan)); Kobayashi, T. (Inst. of Rehabilitation Medicine, Tohoku Univ. School of Medicine, Miyagi (Japan)); Soma, Y. (Div. of Neurology, Takeda Hospital, Aizuwakamatsu (Japan)); Sakamoto, K. (Dept. of Radiology, Tohoku Univ. School of Medicine, Sendai (Japan))

1992-12-01

Cervical spinal cord lesions in the anterior spinal artery syndrome were delineated on magnetic resonance images (MRI) in four patients. The lesion was always seen anteriorly in the cervical cord. On T2-weighted images, the lesions appeared hyperintense relative to the normal spinal cord, while on T1-weighted images, two chronic lesions appeared hypointense, with local atrophy of the cord. In one case, repeated T1-weighted images showed no signal abnormality 4 days after the ictus, but the lesion became hypointense 18 days later, when contrast enhancement was also recognized after injection of Gd-DTPA; this sequence of intensity changes was similar to that of cerebral infarction. The extent of the lesion seen MRI correlated closely with neurological findings in all cases. Although the findings may not be specific, MRI is now the modality of choice for confirming the diagnosis in patients suspected of having an anterior spinal artery syndrome. (orig.)

Usefulness of MRI detection of cervical spine and brain injuries in the evaluation of abusive head trauma

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Kadom, Nadja [Children' s National Medical Center, Department of Diagnostic Imaging and Radiology, Washington, DC (United States); Boston University Medical Center, Boston, MA (United States); Khademian, Zarir; Vezina, Gilbert; Shalaby-Rana, Eglal [Children' s National Medical Center, Department of Diagnostic Imaging and Radiology, Washington, DC (United States); Rice, Amy [Independent Consultant (Biostatistics), Chevy Chase, MD (United States); Hinds, Tanya [Children' s National Medical Center, Child and Adolescent Protection Center, Washington, DC (United States)

2014-07-15

In the evaluation of children younger than 3 years with intracranial hemorrhage it can be difficult to determine whether the cause of hemorrhage was traumatic, and if so, whether abusive head trauma (AHT) is a possibility. Cervical spine MRI is not a routine part of the nationally recommended imaging workup for children with suspected abusive head trauma. There is increasing evidence that spinal injuries are found at autopsy or MRI in abused children. However the prevalence of cervical spine injuries in children evaluated for abusive head trauma is unknown. We sought to determine both the incidence and the spectrum of cervical spine and brain injuries in children being evaluated for possible abusive head trauma. We also examined the relationship between cervical and brain MRI findings and selected study outcome categories. This study is a 3-year retrospective review of children evaluated for abusive head trauma. Inclusion criteria were: children with head trauma seen at our institution between 2008 and 2010, age younger than 36 months, availability of diagnostic-quality brain and cervical spine MRI, and child abuse team involvement because abusive head trauma was a possibility. A child abuse pediatrician and pediatric radiologists, all with board certification, were involved in data collection, image interpretation and data analysis. Statistical analysis was performed using Stata v12.1. The study included 74 children (43 boys, 31 girls) with a mean age of 164 days (range, 20-679 days). Study outcomes were categorized as: n = 26 children with accidental head trauma, n = 38 with abusive head trauma (n = 18 presumptive AHT, n = 20 suspicious for AHT), and n = 10 with undefined head trauma. We found cervical spine injuries in 27/74 (36%) children. Most cervical spine injuries were ligamentous injuries. One child had intrathecal spinal blood and two had spinal cord edema; all three of these children had ligamentous injury. MRI signs of cervical injury did not show a

Usefulness of MRI detection of cervical spine and brain injuries in the evaluation of abusive head trauma

International Nuclear Information System (INIS)

Kadom, Nadja; Khademian, Zarir; Vezina, Gilbert; Shalaby-Rana, Eglal; Rice, Amy; Hinds, Tanya

2014-01-01

In the evaluation of children younger than 3 years with intracranial hemorrhage it can be difficult to determine whether the cause of hemorrhage was traumatic, and if so, whether abusive head trauma (AHT) is a possibility. Cervical spine MRI is not a routine part of the nationally recommended imaging workup for children with suspected abusive head trauma. There is increasing evidence that spinal injuries are found at autopsy or MRI in abused children. However the prevalence of cervical spine injuries in children evaluated for abusive head trauma is unknown. We sought to determine both the incidence and the spectrum of cervical spine and brain injuries in children being evaluated for possible abusive head trauma. We also examined the relationship between cervical and brain MRI findings and selected study outcome categories. This study is a 3-year retrospective review of children evaluated for abusive head trauma. Inclusion criteria were: children with head trauma seen at our institution between 2008 and 2010, age younger than 36 months, availability of diagnostic-quality brain and cervical spine MRI, and child abuse team involvement because abusive head trauma was a possibility. A child abuse pediatrician and pediatric radiologists, all with board certification, were involved in data collection, image interpretation and data analysis. Statistical analysis was performed using Stata v12.1. The study included 74 children (43 boys, 31 girls) with a mean age of 164 days (range, 20-679 days). Study outcomes were categorized as: n = 26 children with accidental head trauma, n = 38 with abusive head trauma (n = 18 presumptive AHT, n = 20 suspicious for AHT), and n = 10 with undefined head trauma. We found cervical spine injuries in 27/74 (36%) children. Most cervical spine injuries were ligamentous injuries. One child had intrathecal spinal blood and two had spinal cord edema; all three of these children had ligamentous injury. MRI signs of cervical injury did not show a

Clinical significance of magnetic resonance imaging (MRI) in evaluation of the extension of uterine cervical cancer

International Nuclear Information System (INIS)

Matsubara, Masaru

1993-01-01

Magnetic resonance imaging (MRI) was performed in 62 patients with uterine cervical cancer and the preoperative MRI findings were compared with the pathological findings following surgery. The surgical stages of 62 patients were 2 at stage 0, 18 at stage Ia, 19 at stage Ib, 9 at stage IIa, 11 at stage IIb, 2 at stage IIIa, and 1 at stage IIIb. The MRI findings in the present study included: (1) the existence of a high intensity area (HIA) in the uterine cervix or minimum thickness of residual normal cervical tissue, (2) necrotic cavity, (3) pyometra, (4) irregular margin of the cervix, (5) parametrial invasion, (6) vaginal invasion, (7) bladder invasion, and (8) lymph node enlargement. No HIA was observed in any patient with stage 0 or stage Ia, in 8 patients with stage Ib, and in 2 patients with stage IIa, while all patients with cancer tissues greater than 10 mm in diameter had a HIA. In 39 patients in whom hysterectomy was undergone without conization, the findings of MRI correlated significantly (r=0.929, p<0.001) with the minimum thickness of residual normal cervical tissue by the pathological measurement. When the irregular margin of the cervix was regarded as a disruption of the cervical myo-metrium by cancer tissue, accuracy was 87%. Furthermore, the degrees of accuracy for parametrial invasion, vaginal invasion and bladder invasion were 92%, 90% and 94%, respectively. When lymphnodes greater than 15 mm in diameter were regarded as a positive in MRI, accuracy was 88%. The present results indicate that MRI is clinically effective in preoperatively evaluating the extension of uterine cervical cancer. (author)

The functional relevance of diffusion tensor imaging in comparison to conventional MRI in patients with cervical compressive myelopathy

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Yang, Young-Mi; Oh, Jae-Keun; Song, Ji-Sun [Hallym University Sacred Heart Hospital, College of Medicine, Hallym University, Spine Center, Anyang-si, Gyeonggi-do (Korea, Republic of); Yoo, Woo-Kyoung [Hallym University Sacred Heart Hospital, College of Medicine, Hallym University, Department of Physical Medicine and Rehabilitation, Anyang-si (Korea, Republic of); Hallym University Sacred Heart Hospital, College of Medicine, Hallym University, Hallym Institute for Translational Genomics and Bioinformatics, Anyang-si (Korea, Republic of); Yoo, Je Hyun; Kwak, Yoon Hae [Hallym University Sacred Heart Hospital, College of Medicine, Hallym University, Department of Orthopaedic surgery, Anyang-si (Korea, Republic of); Kim, Seok Woo [Hallym University Sacred Heart Hospital, College of Medicine, Hallym University, Spine Center, Anyang-si, Gyeonggi-do (Korea, Republic of); Hallym University Sacred Heart Hospital, College of Medicine, Hallym University, Department of Orthopaedic surgery, Anyang-si (Korea, Republic of)

2017-11-15

To determine the functional relevance of diffusion tensor imaging (DTI) metrics and conventional MRI (signal intensity change in T2, compression ratio) by measuring the correlation of these parameters with clinical outcome measured by the modified Japanese Orthopedic Association (mJOA) score. A total of 20 cervical myelopathy (CM) patients participated in this prospective cohort study. The severities of CM were assessed using the mJOA score. Conventional MRIs (T2-weighted images) measuring the signal changes of spinal cords and the degree of compression at the lesion level and DTI metrics [fractional anisotropy (FA), apparent diffusion coefficient (ADC)] at each lesion and below each lesion (C7/T1) level were acquired using a 3-T Achieva MRI. These parameters were correlated with the mJOA scores to determine the functional relevance. Ninety percent of CM patients showed signal changes and 30 % of patients noted a more than 40% canal compression ratio in conventional MRIs at the lesion level; however, these findings were not correlated with the mJOA score (p < 0.05). In contrast, FA values on DTI showed high sensitivity to CM (100%), which was well correlated with the mJOA score (p = 0.034, r = 0.475) below the lesion level (C7/T1). This study showed a meaningful symptomatic correlation between mJOA scores and FA values below the lesion levels in CM patients. It could give us more understanding of the pathological changes in spinal cords matched with various clinical findings in CM patients than the results from conventional MRI. (orig.)

The efficacy of dynamic MRI in assessing a cervical myelopathy

International Nuclear Information System (INIS)

Morimoto, Tetsuya; Yamada, Tomonori; Okumura, Yoshiya; Hashimoto, Hiroshi; Hiramatsu, Kenichiro; Tsunoda, Shigeru; Sakaki, Toshisuke; Iwasaki, Satoru

1994-01-01

There are problems that are unresolved with regard to the treatment of cases presenting a post-taumatic cervical myelopathy, such as when the surgical indications are not clearly evidence and the proper timing of this surgery. In this regard, the authors have used dynamic MRI to retrospectively analyze the cervical spine of 24 previously treated dynamic MRI cases presenting a subacute myelopathy to determine the efficacy of dynamic MRI as a method of treatment. Dynamic MRI analysis protocol was as follows. For the MR imagings, each patient was placed supine with the neck in the neutral position, after which the neck was set in the extended position. Dynamic changes between the neutral position and extended position images were analyzed by focusing on the following two point: (1) the narrowing of the subarachnoid space in the T2-weighted images and (2) evidence of cord compression in the T1-weighted images. Twelve cases out of 24 were treated conservatively because of a gradual improvement in their myelopathic symptoms. The other 12 cases were treated surgically, because of no improvement in their residual myelopathic symptoms at the time when the dynamic MRI had been performed. In the majority of cases in the surgical group, the narrowing of the subarachnoid space and spinal cord compression were hightened on neck extension, whereas in the conservative group, such findings were minimal. Dynamic MRI also more clearly visualized multiple lesions and the direction of the cord compression. These findings thus provided more detailed information to plan the surgical approach and to estimate the amount of surgical decompression needed. Based on the results of this retrospective study, we thus concluded that surgical treatment appears to benefit subacute cases who show no improvement in their residual myelopathic symptoms and whose dynamic MRI results also demonstrate an increased narrowing of subarachnoid space and a heightened spinal cord compression. (author)

Accelerated Deformable Registration of Repetitive MRI during Radiotherapy in Cervical Cancer

DEFF Research Database (Denmark)

Noe, Karsten Østergaard; Tanderup, Kari; Kiritsis, Christian

2006-01-01

Tumour regression and organ deformations during radiotherapy (RT) of cervical cancer represent major challenges regarding accurate conformation and calculation of dose when using image-guided adaptive radiotherapy. Deformable registration algorithms are able to handle organ deformations, which can...... be useful with advanced tools such as auto segmentation of organs and dynamic adaptation of radiotherapy. The aim of this study was to accelerate and validate deformable registration in MRI-based image-guided radiotherapy of cervical cancer.    ...

Integration of functional and morphological MR data for preoperative 3D visualisation of tumours. Cervical carcinoma

International Nuclear Information System (INIS)

Evers, H.; Meinzer, H.P.; Hawighorst, H.; Kaick, G. van; Knapstein, P.G.

1998-01-01

Purpose: The goal of this exemplary study was to integrate morphological and functional MRI to establish computer-based, preoperative therapy planning for tumors, instancing cervical carcinoma. Results: Segmentation of organs and vessels as well as tissue differentiation yielded a morphological visualisation of anatomical structures that were overlaid with pharmacokinetic parameters derived from dynamic MRI, subsequently. Thereby, three-dimensional, arbitrary views on the functional data were displayed. Conclusions: Image analysis and visualisation of the acquired MR data establishes both a morphologic and functional evaluation of suspect lesions and adjacent organs. By integrating morphologic and functional MRI additional information can be gathered that possibly impinge on preoperative planning. (orig./AJ) [de

Evaluation of Brain and Cervical MRI Abnormality Rates in Patients With Systemic Lupus Erythematosus With or Without Neurological Manifestations

International Nuclear Information System (INIS)

Harirchian, Mohammad Hossein; Saberi, Hazhir; Najafizadeh, Seyed Reza; Hashemi, Seyed Ali

2011-01-01

Central nervous system (CNS) involvement has been observed in 14-80% of patients with systemic lupus erythematosus (SLE). Magnetic resonance imaging (MRI) is an appropriate method for evaluating CNS involvement in these patients. Clinical manifestations and MRI findings of CNS lupus should be differentiated from other mimicking diseases such as multiple sclerosis (MS). The aim of this study was to evaluate the prevalence and extent of brain and cervical cord MRI lesions of lupus patients. The relationship between neurological signs and symptoms and MRI findings were evaluated as well. Fifty SLE patients who had been referred to the rheumatology clinic of our hospital within 2009 were included in a cross sectional study. All patients fulfilled the revised 1981 American College of Rheumatology (ACR) criteria for SLE. We evaluated the neurological signs and symptoms and brain and cervical MRI findings in these patients. Forty-one patients (82%) were female and nine (18%) were male. The mean age was 30.1 ± 9.3 years. Twenty eight (56%) patients had an abnormal brain MRI. No one showed any abnormality in the cervical MRI. The lesions in 20 patients were similar to demyelinative plaques. Seventeen patients with abnormal brain MRI were neurologically asymptomatic. There was only a significant relationship between neurological motor manifestations and brain MRI abnormal findings. Unlike the brain, cervical MRI abnormality and especially asymptomatic cord involvement in MRI is quite rare in SLE patients. This finding may be helpful to differentiate SLE from other CNS disorders such as MS

Preclinical evaluation of Gd-DTPA and gadomelitol as contrast agents in DCE-MRI of cervical carcinoma interstitial fluid pressure

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Hompland Tord

2012-11-01

Full Text Available Abstract Background High interstitial fluid pressure (IFP in the primary tumor is associated with poor disease-free survival in locally advanced cervical carcinoma. A noninvasive assay is needed to identify cervical cancer patients with highly elevated tumor IFP because these patients may benefit from particularly aggressive treatment. It has been suggested that dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI with gadolinium diethylene-triamine penta-acetic acid (Gd-DTPA as contrast agent may provide useful information on the IFP of cervical carcinomas. In this preclinical study, we investigated whether DCE-MRI with contrast agents with higher molecular weights (MW than Gd-DTPA would be superior to Gd-DTPA-based DCE-MRI. Methods CK-160 human cervical carcinoma xenografts were subjected to DCE-MRI with Gd-DTPA (MW of 0.55 kDa or gadomelitol (MW of 6.5 kDa as contrast agent before tumor IFP was measured invasively with a Millar SPC 320 catheter. The DCE-MRI was carried out at a spatial resolution of 0.23 × 0.23 × 2.0 mm3 and a time resolution of 14 s by using a 1.5-T whole-body scanner and a slotted tube resonator transceiver coil constructed for mice. Parametric images were derived from the DCE-MRI recordings by using the Tofts iso-directional transport model and the Patlak uni-directional transport model. Results When gadomelitol was used as contrast agent, significant positive correlations were found between the parameters of both pharmacokinetic models and tumor IFP. On the other hand, significant correlations between DCE-MRI-derived parameters and IFP could not be detected with Gd-DTPA as contrast agent. Conclusion Gadomelitol is a superior contrast agent to Gd-DTPA in DCE-MRI of the IFP of CK-160 cervical carcinoma xenografts. Clinical studies attempting to develop DCE-MRI-based assays of the IFP of cervical carcinomas should involve contrast agents with higher MW than Gd-DTPA.

Preclinical evaluation of Gd-DTPA and gadomelitol as contrast agents in DCE-MRI of cervical carcinoma interstitial fluid pressure.

Science.gov (United States)

Hompland, Tord; Ellingsen, Christine; Rofstad, Einar K

2012-11-22

High interstitial fluid pressure (IFP) in the primary tumor is associated with poor disease-free survival in locally advanced cervical carcinoma. A noninvasive assay is needed to identify cervical cancer patients with highly elevated tumor IFP because these patients may benefit from particularly aggressive treatment. It has been suggested that dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) with gadolinium diethylene-triamine penta-acetic acid (Gd-DTPA) as contrast agent may provide useful information on the IFP of cervical carcinomas. In this preclinical study, we investigated whether DCE-MRI with contrast agents with higher molecular weights (MW) than Gd-DTPA would be superior to Gd-DTPA-based DCE-MRI. CK-160 human cervical carcinoma xenografts were subjected to DCE-MRI with Gd-DTPA (MW of 0.55 kDa) or gadomelitol (MW of 6.5 kDa) as contrast agent before tumor IFP was measured invasively with a Millar SPC 320 catheter. The DCE-MRI was carried out at a spatial resolution of 0.23 × 0.23 × 2.0 mm³ and a time resolution of 14 s by using a 1.5-T whole-body scanner and a slotted tube resonator transceiver coil constructed for mice. Parametric images were derived from the DCE-MRI recordings by using the Tofts iso-directional transport model and the Patlak uni-directional transport model. When gadomelitol was used as contrast agent, significant positive correlations were found between the parameters of both pharmacokinetic models and tumor IFP. On the other hand, significant correlations between DCE-MRI-derived parameters and IFP could not be detected with Gd-DTPA as contrast agent. Gadomelitol is a superior contrast agent to Gd-DTPA in DCE-MRI of the IFP of CK-160 cervical carcinoma xenografts. Clinical studies attempting to develop DCE-MRI-based assays of the IFP of cervical carcinomas should involve contrast agents with higher MW than Gd-DTPA.

Preclinical evaluation of Gd-DTPA and gadomelitol as contrast agents in DCE-MRI of cervical carcinoma interstitial fluid pressure

International Nuclear Information System (INIS)

Hompland, Tord; Ellingsen, Christine; Rofstad, Einar K

2012-01-01

High interstitial fluid pressure (IFP) in the primary tumor is associated with poor disease-free survival in locally advanced cervical carcinoma. A noninvasive assay is needed to identify cervical cancer patients with highly elevated tumor IFP because these patients may benefit from particularly aggressive treatment. It has been suggested that dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) with gadolinium diethylene-triamine penta-acetic acid (Gd-DTPA) as contrast agent may provide useful information on the IFP of cervical carcinomas. In this preclinical study, we investigated whether DCE-MRI with contrast agents with higher molecular weights (MW) than Gd-DTPA would be superior to Gd-DTPA-based DCE-MRI. CK-160 human cervical carcinoma xenografts were subjected to DCE-MRI with Gd-DTPA (MW of 0.55 kDa) or gadomelitol (MW of 6.5 kDa) as contrast agent before tumor IFP was measured invasively with a Millar SPC 320 catheter. The DCE-MRI was carried out at a spatial resolution of 0.23 × 0.23 × 2.0 mm 3 and a time resolution of 14 s by using a 1.5-T whole-body scanner and a slotted tube resonator transceiver coil constructed for mice. Parametric images were derived from the DCE-MRI recordings by using the Tofts iso-directional transport model and the Patlak uni-directional transport model. When gadomelitol was used as contrast agent, significant positive correlations were found between the parameters of both pharmacokinetic models and tumor IFP. On the other hand, significant correlations between DCE-MRI-derived parameters and IFP could not be detected with Gd-DTPA as contrast agent. Gadomelitol is a superior contrast agent to Gd-DTPA in DCE-MRI of the IFP of CK-160 cervical carcinoma xenografts. Clinical studies attempting to develop DCE-MRI-based assays of the IFP of cervical carcinomas should involve contrast agents with higher MW than Gd-DTPA

Dynamic function MR of the cervical vertebral column. Dynamische Funktions-MRT der Halswirbelsaeule

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Naegele, M.; Woell, B.; Reiser, M. (Radiologische Universitaetsklinik, Bonn (Germany)); Koch, W. (Orthopaedische Universitaetsklinik, Bonn (Germany)); Kaden, B. (Neurochirurgische Universitaetsklinik, Bonn (Germany))

1992-09-01

To obtain functional studies of the cervical spine, a device has been developed which allows MRI examinations to be carried out in five different degrees of flexion. T[sub 1] and T[sub 2][sup *] weighted FFE sequences were used. Dynamic functional MRI was performed on 5 normals and 31 patients (5 disc herniation, 4 whiplash injuries, 6 spinal canal stenoses, 14 laminectomies and spinal fusions, 2 rheumatoid arthritis). The relationship of the spinal cord to the bony and ligamentous components in different degrees of flexion was particularly well shown in whiplash injury, spinal stenosis and postoperative situations. (orig.).

MRI changes of cervical spine in asymptomatic and symptomatic young adults

OpenAIRE

Siivola, Sari M.; Levoska, Sinikka; Tervonen, Osmo; Ilkko, Eero; Vanharanta, Heikki; Keinänen-Kiukaanniemi, Sirkka

2002-01-01

Several work-related, psychosocial and individual factors have been verified as being related to neck and shoulder pain, but the role of pathology visualized by magnetic resonance imaging (MRI) remains unclear. In this study, the relationship between neck and shoulder pain and cervical high-field MRI findings was investigated in a sample of persons in a longitudinal survey. The study aimed to determine whether subjects with persistent or recurrent neck and shoulder pain were more likely to ha...

Value of FDG-PET vs MRI/CT in detection and staging of early uterine cervical cancer

International Nuclear Information System (INIS)

Kluge, P.; Kratzsch, A.; Horn, L.; Schmidt, F.; Einkel, J.; Sabri, O.

2003-01-01

This prospective study was performed to define the efficiency of FDG-PET in detecting primaries and in preoperatively assessing lymph node metastases of cervical cancer. Forty one patients with cervical cancer were investigated with PET (370 MBq F-18-FDG, Siemens ECAT EXACT HR+, visual evaluation) and MRI prior radical hysterectomy with pelvic, and additionally 12 cases paraortal, lymphadenectomies. Histopathological evaluation verified in all cases the evidence of cervical cancer except in one case, where the tumor was completely removed by conisation procedure. Sensitivity of PET and MRI were 95% and 85%, respectively. In 16/82 pelvic lymph node sites metastases were histologically detected (7 x micrometastases). Sensitivity, specificity, positive positive and negative predictive value were 50%, 85%, 44% and 88% for PET and 31%, 90%, 40% and 86% for MRI. Out of the 12 cases with dissection of paraortal lymph nodes, metastases were found histologically in 3 cases. PET detected 2/3 truly with no false positive result while CT detected 0/3 cases with no false positive findings. It is concluded that PET can detect cervical cancer with high accuracy. The accuracy of PET and MRI was similar for detection of pelvic metastases. Both methods have limited sensitivity due to the high incidence of micrometastases. PET was more accurate than CT in detection of paraortal metastases

Assessment of the cervical spine denticulate ligament using MRI volumetric sequence: Comparison between 1.5 Tesla and 3.0 Tesla.

Science.gov (United States)

Seragioli, Rafael; Simao, Marcelo Novelino; Simao, Gustavo Novelino; Herrero, Carlos Fernando P S; Nogueira-Barbosa, Marcello H

2018-03-01

Denticulate ligaments (DLs) are pial extensions on each side of the spinal cord, comprising about 20 to 21 pairs of fibrous structures connecting the dura mater to the spinal cord. These ligaments are significant anatomical landmarks in the surgical approach to intradural structures. To our knowledge, there is no previous study on the detection of DLs using MRI. After IRB approval, we retrospectively evaluated 116 consecutive MRI scans of the cervical spine, using the volumetric sequence 3D COSMIC, 65 and 51 studies with 1.5T and 3.0T respectively. We did not include trauma and tumor cases. Two independent radiologists assessed the detection of cervical spine DLs independently and blinded for each cervical vertebral level. We compared the frequency of detection of these ligaments in 1.5 Tesla and 3.0 Tesla MRI using Fisher exact test considering P<0.05 as significant. We evaluated interobserver agreement with Kappa coefficient. We observed high detection frequency of the cervical spine DLs using both 1.5T (70 to 91%) and 3.0T (68 to 98%). We found no statistically significant difference in the detection frequency of ligaments between the 1.5T and 3.0T MRI in all vertebral levels. Using 3.0T, radiologists identified ligaments better in higher vertebral levels than for lower cervical levels (P=0.0003). Interobserver agreement on the identification of DL was poor both for 1.5T (k=0.3744; CI 95% 0.28-0.46) and 3.0T (k=0.3044; CI 95% 0.18-0.42) MRI. Radiologists identified most of the cervical DLs using volumetric MRI acquisition. Our results suggest 1.5T and 3.0T MRI performed similarly in the detection of DLs. Copyright © 2017 Elsevier Masson SAS. All rights reserved.

Space-occupying, inflammatory and dyplastic lesions of the cranio-cervical junction seen in nuclear magnetic resonance imaging (MRI)

International Nuclear Information System (INIS)

Friedburg, H.; Schumacher, M.; Hennig, J.

1987-01-01

Lesions of the cranio-cervical junction have acquired a special place amongst lesions of the posterior cranial fossa and the upper cervical region. This is due to the unusually long period between the appearance of the first symptoms and reaching a conclusive diagnosis. Frequently such lesions cannot be detected by either normal X-rays or conventional tomographic techniques. The introduction, however, of computer tomography (CT) and, in particular, magnetic resonance imaging (MRI) has made the examination of the critical zone of the cranio-cervical junction much easier and the diagnosis of thee lesions has now become largely dependent upon those techniques. Because soft tissue contrast is intrinsic to MRI this technique, in particular, has made possible substantial improvements in the quality of images of ligaments and soft tissue than those provided by standard CT. In this paper, the advantages which are provided by MRI in the context of the diagnosis of non-bony lesions in the cranio-cervical region are presented and discussed

Cine MRI of patients with cervical myelopathy

International Nuclear Information System (INIS)

Ukita, Yasutaka

1993-01-01

Forty-six patients with cervical myelopathy were examined before and after surgery by cine magnetic resonance imaging (MRI). According to the occurrence site and degree of flow void, cerebrospinal fluid (CSF) flow void was classified into five: anterior type (flow void mainly in the anterior part of subarachnoid space), posterior type (mainly in the posteiror part), anteroposterior type (in the anterior and posterior parts), incomplete block type (flow void limited to the upper and lower parts of the block), and complete block type (no flow void). None of the 46 patients had normal CSF flow void on cine MRI before surgery. CSF flow void was seen in systolic phase on ECG (from 150 to 300 msec from R's wave) in all patients after spinal cord decompression. Postoperative CBF flow void types correlated well with surgical method, disease, and postoperative vertebral alignment. Postoperative outcome was the most excellent in the group of posterior type and the poorest in the group of anteroposterior type, showing a significant difference between the groups. Cine MRI is a useful noninvasive, dynamic method for assessing postoperative decompression effect. (N.K.)

Staging of uterine cervical cancer with MRI: guidelines of the European Society of Urogenital Radiology

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Balleyguier, Corinne [Radiology Department, Institut Gustave Roussy, Villejuif (France); Sala, E. [Radiology Department, Addenbrooke' s Hospital, Cambridge (United Kingdom); Cunha, T. da [Radiology Department, Instituto Portugues de Oncologia de Lisboa Francisco Gentil, Lisbon (Portugal); Bergman, A. [Department of Radiology, Uppsala University Hospital (Sweden); Brkljacic, B. [Department of Diagnostic and Interventional Radiology, University Hospital ' ' Dubrava' ' , Zagreb (Croatia); Danza, F. [Dipartimento di Bioimmaginie Scienze Radiologiche, Universita Cattolica del S. Cuore, Rome (Italy); Forstner, R. [Zentralroentgeninstitut, Landeskliniken Salzburg, Salzburg (Austria); Hamm, B. [Department of Radiology, Charite Humboldt Universitaet, Berlin (Germany); Kubik-Huch, R. [Institut Radiologie, Kantonsspital Baden, Baden (Switzerland); Lopez, C.; Manfredi, R. [Department of Radiology, ' ' A. Gemelli' ' University Hospital, Rome (Italy); McHugo, J. [Department of Radiology, Birmingham Women' s Hospital, Birmingham (United Kingdom); Oleaga, L. [Radiology Department, Hospital Clinic, Barcelona (Spain); Togashi, K. [Department of Diagnostic Imaging and Nuclear Medicine, Kyoto University, Graduate School of Medicine, Kyoto (Japan); Kinkel, K. [Institut de Radiologie, Clinique des Grangettes, Geneva (Switzerland)

2011-05-15

To design clear guidelines for the staging and follow-up of patients with uterine cervical cancer, and to provide the radiologist with a framework for use in multidisciplinary conferences. Methods: Guidelines for uterine cervical cancer staging and follow-up were defined by the female imaging subcommittee of the ESUR (European Society of Urogenital Radiology) based on the expert consensus of imaging protocols of 11 leading institutions and a critical review of the literature. The results indicated that high field Magnetic Resonance Imaging (MRI) should include at least two T2-weighted sequences in sagittal, axial oblique or coronal oblique orientation (short and long axis of the uterine cervix) of the pelvic content. Axial T1-weighted sequence is useful to detect suspicious pelvic and abdominal lymph nodes, and images from symphysis to the left renal vein are required. The intravenous administration of Gadolinium-chelates is optional but is often required for small lesions (<2 cm) and for follow-up after treatment. Diffusion-weighted sequences are optional but are recommended to help evaluate lymph nodes and to detect a residual lesion after chemoradiotherapy. Expert consensus and literature review lead to an optimized MRI protocol to stage uterine cervical cancer. MRI is the imaging modality of choice for preoperative staging and follow-up in patients with uterine cervical cancer. (orig.)

Diffusion Weighted MRI as a predictive tool for effect of radiotherapy in locally advanced cervical cancer

DEFF Research Database (Denmark)

Haack, Søren; Tanderup, Kari; Fokdal, Lars

Diffusion weighted MRI has shown great potential in diagnostic cancer imaging and may also have value for monitoring tumor response during radiotherapy. Patients with advanced cervical cancer are treated with external beam radiotherapy followed by brachytherapy. This study evaluates the value of DW......-MRI for predicting outcome of patients with advanced cervical cancer at time of brachytherapy. Volume of hyper-intensity on highly diffusion sensitive images and resulting ADC value for treatment responders and non-responders is compared. The change of ADC and volume of hyper-intensity over time of BT is also...

Early response of patients undergoing concurrent chemoradiotherapy for cervical cancer. A comparison of PET/CT and MRI

International Nuclear Information System (INIS)

Lee, Jeong-Eun; Huh, Seung-Jae; Nam, Heerim; Ju, Sang-Gyu

2013-01-01

The objective of this study was to investigate the efficacy of positron emission tomography/computed tomography (PET/CT) and magnetic resonance imaging (MRI) for early response evaluation of cervical cancer patients undergoing concurrent chemoradiotherapy (CCRT). Fifty-two patients were prospectively enrolled in the study. The pathologic findings were squamous cell carcinoma in 47 patients and adenocarcinoma in 5 patients. All patients underwent PET/CT and MRI scans before, during and within 1 month after completion of CCRT. The percent change in tumor volume during and after CCRT based on PET/CT and MRI images was compared. There were significant differences (p<0.001) between the initial tumor volume and tumor volume during and after CCRT as measured by both PET/CT and MRI. During CCRT, the percent volume reduction based on PET/CT images was significantly greater than the percent volume reduction calculated from MRI images (p=0.024). However, after the completion of CCRT, no significant differences were found in volume reduction as calculated based on PET/CT versus MRI images (p=0.289). The percent volume reduction of adenocarcinomas was significantly smaller than that of squamous cell carcinomas based on both PET/CT (p=0.041) and MRI images (p<0.001). Significant decreases in tumor volume were observed during and after CCRT in patients with cervical cancer. Tumor volume reduction on PET/CT images was greater than that on MRI images during CCRT. We suggest that early PET/CT as well as MRI scans could be taken during CCRT to evaluate tumor response and allow personalized treatment of cervical cancer. (author)

MRI findings of traumatic cervical disc herniation

International Nuclear Information System (INIS)

Tanaka, Hisato; Kasahara, Takaki; Akiyama, Nanae

2011-01-01

In general practice, disc hernia is increasingly being questioned about its relation with traffic injuries. In this study, we examined the image findings of cervical disc herniation for findings indicative of traumatic hernia. In 2008, we examined 35 cases of cervical disc herniation at our hospital by MRI. The patients were divided into two groups; patients with trauma history (19 cases) and those without (16 cases), and their images were compared. Disc herniation in the trauma group showed high intensity at T2, with some of the patients in this group also indicating continuous high intensity of the internal and herniated discs. Traumatic force was found to cause swelling under the laryngeal soft tissue. Cases with further flexion injury showed interspinous ligament hemorrhage. These findings strongly suggest the involvement of injury. But given that some younger patients in the non-trauma group also show high intensity at T2*, attention must be paid not to confuse swelling below the larynx with inflammation of the longus colli muscle. (author)

Assessment of the narrow cervical spinal canal: a prospective comparison of MRI, myelography and CT-myelography

International Nuclear Information System (INIS)

Reul, J.; Gievers, B.; Weis, J.; Thron, A.

1995-01-01

This study was designed to compare the accuracy of magnetic resonance imaging (MRI), myelography and computed tomography in the assessment of degenerative cervical spinal stenosis. We prospectively examined a total of 75 spinal segments in 18 patients with suspected cervical spinal canal stenosis, using sagittal spin-echo and axial gradient-echo sequences generated by a 1.5 Tesla imager, conventional myelography, and computed tomography with intrathecal contrast medium (CT-myelography). The degree of stenosis was often overestimated using MRI. This error was most prominent in cases of severe stenosis but was significant with minor to moderate stenosis. In these cases, the clinical consequences of such an overestimation can be serious, because treatment is misdirected. The error is probably caused by pulsation of the cerebrospinal fluid and truncation artefact (Gibbs phenomenon). MRI at 1.5 Tesla is thus frequently inadequate for diagnostic assessment of degenerative cervical spinal stenosis. Myelography and myelographic CT are still useful for decisions on operative treatment, especially in cases of moderate stenosis. This may, however, not apply to imagers operating at 0.5 Tesla as below. (orig.)

Comparative benefits and limitations of 18F-FDG PET and CT-MRI in documented or suspected recurrent cervical cancer

International Nuclear Information System (INIS)

Yen, Tzu-Chen; Ma, Shih-Ya; Lai, Chyong-Huey; Huang, Kuan-Gen; Huang, Huei-Jean; Chang, Ting-Chang; Hong, Ji-Hong; Hsueh, Swei; Lin, Wuu-Jyh; Ng, Koon-Kwan

2006-01-01

The purpose of this study was to assess the comparative benefits and limitations of 18 F-fluorodeoxyglucose (FDG) PET and CT-MRI in documented or suspected recurrence of cervical cancer after primary treatment. Three patient groups were enrolled. Group A patients had biopsy-documented recurrent or persistent cervical cancer. Group B patients had suspicion of recurrent tumour on CT-MRI without biopsy proof and were potentially curable. Group C patients were in complete remission after previous definitive treatment for histologically confirmed cervical carcinoma but had elevated serum squamous cell carcinoma antigen (tumour marker) levels despite negative CT-MRI. Clinical management decisions were recorded with CT-MRI alone and with additional FDG PET. Discordances and concordances between CT-MRI and FDG PET results were identified and related to final diagnosis as based on histopathology or follow-up. A total of 150 patients (ten regions per patient) were eligible for analysis, with 58 in group A, 52 in group B and 40 in group C. For the 149 discordant regions, 126 (84.6%) had final diagnoses. Of these final diagnoses, there was additional benefit from FDG PET over CT-MRI in 73.8% (93/126), with FDG PET correcting false negatives (FNs) on CT-MRI in 74.2% (69/93) and correcting false positives (FPs) on CT-MRI in 25.8% (24/93). Among lesions confirmed by FDG PET, 75.4% (52/69) were extra-pelvic. There was additional benefit of CT-MRI compared with FDG PET in 26.2% (33/126): in nine (27.3%) CT-MRI results were shown to be true positive (TP) whereas FDG PET yielded FN results, while in 24 (72.7%) CT-MRI corrected FP results on FDG PET. Among the nine FNs on FDG PET that were identified by CT-MRI, four were extra-pelvic. Among the FPs on FDG PET that were excluded by CT-MRI, 79.2% (19/24) were extra-pelvic. For recurrent cervical cancer, the benefits of FDG PET exceed those of CT-MRI owing to the ability of FDG PET to identify extra-pelvic metastases and its higher

Prediction of prognosis in cervical myelopathy by MRI

International Nuclear Information System (INIS)

Matsuyama, Yukihiro; Sato, Koji; Iwata, Hisashi; Kameyama, Takashi; Kawakami, Noriaki; Hashizume, Yoshio

1998-01-01

In this study, 44 patients with the ossification of posterior longitudinal ligament, 34 men and 10 women, ranging in age from 38 to 76 years (mean 61) were investigated. They were classified into three categories by the cervical MRI sectional image, Boomerang-type, Triangle-type and Tear-drop-type, and the relationship between these three types and clinical symptom or the results of the surgery was examined. The patients in the Triangle-type were suffered for long term and had many lesions extended over whole interspines. As a result, their spinal cords were in the decrease in the cervical cross-sectional area, so-called in atrophy, and was not expected to improve cross-sectional area or the symptom even in postoperation. On the other hand, the Boomerang-type and the Tear-drop-type were suffered for relatively short term, had the lesion on single spine and were expected, in the excellent reversibility, to improve the cross-sectional area of the spinal cord and the symptom. (K.H.)

Electrophysiological and MRI study on poor outcome after surgery for cervical myelopathy

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Kameyama, Osamu; Kawakita, Hirofumi; Ogawa, Ryokei [Kansai Medical Univ., Moriguchi, Osaka (Japan)

1995-11-01

Occasionally, the outcome from laminoplasty for cervical spondylosis is disappointing despite an adequate operation. Before surgery, it is difficult to diagnose the pathological extent of the involvement of the spinal cord. The purpose of this study is to determine the efficacy of magnetic resonance imaging (MRI) and of the motor evoked potentials (MEPs) for the indication of the surgery and prognosis. Retrospectively, we investigated the MEPs and the MRI of 31 patients in surgery for cervical myelopathy, involving 21 with cervical spondylosis and 10 with ossification of the posterior longitudinal ligamentum, and compared the findings from those with a poor outcome (n=3l) with the findings from those with a good outcome (n=32). The MEPs from the thenar muscle and the tibialis anterior were evoked by transcranial magnetic brain stimulation. In the poor-outcome patients, the spinal canal was narrow and lumbar spinal canal stenosis was seen in 5 cases which required lumbar laminectomy. Before operation, the MEPs from the thenar muscle could not be evoked in 5 cases while there was a remarkably prolonged central motor conduction time in the other 26 cases. MRI revealed the deformed spinal cord in the involved area, and the signal intensity of the involved spinal cord in the T2 weighted image was remarkably high. The signal intensity ratio was significantly higher in the poor-outcome patients than in the good-outcome patients. This study suggested that a high signal intensity in the T2 weighted image and a prolonged conduction time or absence of MEPs largely corresponded to the clinical and other investigative features of myelopathy responsible for a poor outcome. (author).

Electrophysiological and MRI study on poor outcome after surgery for cervical myelopathy

International Nuclear Information System (INIS)

Kameyama, Osamu; Kawakita, Hirofumi; Ogawa, Ryokei

1995-01-01

Occasionally, the outcome from laminoplasty for cervical spondylosis is disappointing despite an adequate operation. Before surgery, it is difficult to diagnose the pathological extent of the involvement of the spinal cord. The purpose of this study is to determine the efficacy of magnetic resonance imaging (MRI) and of the motor evoked potentials (MEPs) for the indication of the surgery and prognosis. Retrospectively, we investigated the MEPs and the MRI of 31 patients in surgery for cervical myelopathy, involving 21 with cervical spondylosis and 10 with ossification of the posterior longitudinal ligamentum, and compared the findings from those with a poor outcome (n=3l) with the findings from those with a good outcome (n=32). The MEPs from the thenar muscle and the tibialis anterior were evoked by transcranial magnetic brain stimulation. In the poor-outcome patients, the spinal canal was narrow and lumbar spinal canal stenosis was seen in 5 cases which required lumbar laminectomy. Before operation, the MEPs from the thenar muscle could not be evoked in 5 cases while there was a remarkably prolonged central motor conduction time in the other 26 cases. MRI revealed the deformed spinal cord in the involved area, and the signal intensity of the involved spinal cord in the T2 weighted image was remarkably high. The signal intensity ratio was significantly higher in the poor-outcome patients than in the good-outcome patients. This study suggested that a high signal intensity in the T2 weighted image and a prolonged conduction time or absence of MEPs largely corresponded to the clinical and other investigative features of myelopathy responsible for a poor outcome. (author)

Reproducibility and differentiation of cervical arteriopathies using in vivo high-resolution black-blood MRI at 3 T

International Nuclear Information System (INIS)

Schwarz, Florian; Strobl, Frederik F.; Cyran, Clemens C.; Helck, Andreas D.; Hartmann, Martin; Schindler, Andreas; Reiser, Maximilian F.; Saam, Tobias; Nikolaou, Konstantin

2016-01-01

The aims of the present study are to evaluate the potential of high-resolution black-blood MRI (hr-bb-cMRI) to differentiate common cervical arteriopathies and to evaluate interobserver reproducibility. Forty-three consecutive patients with distinct cervical arteriopathies were examined with cervical hr-bb-cMRI at 3.0 Te with fat-saturated pre- and post-contrast T1w, T2w, and TOF images using dedicated carotid surface coils at our institution. Twenty-three patients had atherosclerotic disease, causing significant stenosis in 12 patients while 11 patients had moderate stenosis. Eight patients presented with cervical vasculitis, and five patients had arterial dissection. Furthermore, seven control subjects with no evidence of carotid disease were included. Two experienced readers blinded to all clinical information reviewed all MR images and classified both carotid and vertebral arteries as affected either by atherosclerosis, dissection, vasculitis, or no disease. Finally, a consensus reading was performed. On a per-vessel level, test performance parameters (sensitivity, specificity, positive predictive value, negative predictive value) were 95, 97.7, 92.9, and 98.5 % for atherosclerotic disease; 91, 100, 100, and 98.7 % for vasculitis; and 100, 100, 100, and 100 % for dissection, respectively. On a per-patient level, performance parameters were 95.7, 85.7, 97.2, and 85.7 % for the diagnosis of atherosclerosis and 100, 100, 100, and 100 % for the diagnosis of dissection and of vasculitis, respectively. Accuracy rates were all above 95 % for all entities. There was a high agreement between observers both in a per-vessel (κ = 0.83) and in a per-patient analysis (κ = 0.82). This study demonstrates that hr-bb-cMRI is able to non-invasively differentiate between the most common cervical arteriopathies with an excellent interreader reproducibility. (orig.)

Reproducibility and differentiation of cervical arteriopathies using in vivo high-resolution black-blood MRI at 3 T

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Schwarz, Florian; Strobl, Frederik F.; Cyran, Clemens C.; Helck, Andreas D.; Hartmann, Martin; Schindler, Andreas; Reiser, Maximilian F.; Saam, Tobias [Ludwig-Maximilians-University Hospital Munich, Institute for Clinical Radiology, Munich (Germany); Nikolaou, Konstantin [Ludwig-Maximilians-University Hospital Munich, Institute for Clinical Radiology, Munich (Germany); Eberhard-Karls-University Tuebingen, Diagnostic and Interventional Radiology, Tuebingen (Germany)

2016-06-15

The aims of the present study are to evaluate the potential of high-resolution black-blood MRI (hr-bb-cMRI) to differentiate common cervical arteriopathies and to evaluate interobserver reproducibility. Forty-three consecutive patients with distinct cervical arteriopathies were examined with cervical hr-bb-cMRI at 3.0 Te with fat-saturated pre- and post-contrast T1w, T2w, and TOF images using dedicated carotid surface coils at our institution. Twenty-three patients had atherosclerotic disease, causing significant stenosis in 12 patients while 11 patients had moderate stenosis. Eight patients presented with cervical vasculitis, and five patients had arterial dissection. Furthermore, seven control subjects with no evidence of carotid disease were included. Two experienced readers blinded to all clinical information reviewed all MR images and classified both carotid and vertebral arteries as affected either by atherosclerosis, dissection, vasculitis, or no disease. Finally, a consensus reading was performed. On a per-vessel level, test performance parameters (sensitivity, specificity, positive predictive value, negative predictive value) were 95, 97.7, 92.9, and 98.5 % for atherosclerotic disease; 91, 100, 100, and 98.7 % for vasculitis; and 100, 100, 100, and 100 % for dissection, respectively. On a per-patient level, performance parameters were 95.7, 85.7, 97.2, and 85.7 % for the diagnosis of atherosclerosis and 100, 100, 100, and 100 % for the diagnosis of dissection and of vasculitis, respectively. Accuracy rates were all above 95 % for all entities. There was a high agreement between observers both in a per-vessel (κ = 0.83) and in a per-patient analysis (κ = 0.82). This study demonstrates that hr-bb-cMRI is able to non-invasively differentiate between the most common cervical arteriopathies with an excellent interreader reproducibility. (orig.)

The efficacy of dynamic MRI in assessing a cervical myelopathy; A retrospective study

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Morimoto, Tetsuya; Yamada, Tomonori; Okumura, Yoshiya; Hashimoto, Hiroshi; Hiramatsu, Kenichiro; Tsunoda, Shigeru; Sakaki, Toshisuke; Iwasaki, Satoru (Nara Medical Univ., Kashihara (Japan))

1994-01-01

There are problems that are unresolved with regard to the treatment of cases presenting a post-taumatic cervical myelopathy, such as when the surgical indications are not clearly evidence and the proper timing of this surgery. In this regard, the authors have used dynamic MRI to retrospectively analyze the cervical spine of 24 previously treated dynamic MRI cases presenting a subacute myelopathy to determine the efficacy of dynamic MRI as a method of treatment. Dynamic MRI analysis protocol was as follows. For the MR imagings, each patient was placed supine with the neck in the neutral position, after which the neck was set in the extended position. Dynamic changes between the neutral position and extended position images were analyzed by focusing on the following two point: (1) the narrowing of the subarachnoid space in the T2-weighted images and (2) evidence of cord compression in the T1-weighted images. Twelve cases out of 24 were treated conservatively because of a gradual improvement in their myelopathic symptoms. The other 12 cases were treated surgically, because of no improvement in their residual myelopathic symptoms at the time when the dynamic MRI had been performed. In the majority of cases in the surgical group, the narrowing of the subarachnoid space and spinal cord compression were hightened on neck extension, whereas in the conservative group, such findings were minimal. Dynamic MRI also more clearly visualized multiple lesions and the direction of the cord compression. These findings thus provided more detailed information to plan the surgical approach and to estimate the amount of surgical decompression needed. Based on the results of this retrospective study, we thus concluded that surgical treatment appears to benefit subacute cases who show no improvement in their residual myelopathic symptoms and whose dynamic MRI results also demonstrate an increased narrowing of subarachnoid space and a heightened spinal cord compression. (author).

Utility of plain radiographs and MRI in cervical spine clearance in symptomatic non-obtunded pediatric patients without high-impact trauma.

Science.gov (United States)

Moore, Justin M; Hall, Jonathan; Ditchfield, Michael; Xenos, Christopher; Danks, Andrew

2017-02-01

The optimal imaging modality for evaluating cervical spine trauma and optimizing management in the pediatric population is controversial. In pediatric populations, there are no well-established guidelines for cervical spine trauma evaluation and treatment. Currently, there is virtually no literature regarding imaging and management of symptomatic pediatric patients who present with cervical spine trauma without high-impact mechanism. This study aims to establish an optimal imaging strategy for this subgroup of trauma patients. We performed a retrospective review of pediatric patients (aged below 18 years) who were admitted to Monash Medical Centre, Melbourne, Australia between July 2011 and June 2015, who did not suffer a high-impact trauma but were symptomatic for cervical spine injury following cervical trauma. Imaging and management strategies were reviewed and results compared. Forty-seven pediatric patients were identified who met the inclusion criteria. Of these patients, 46 underwent cervical spine series (CSS) plain radiograph imaging. Thirty-four cases underwent magnetic resonance imaging (MRI) and 9 patients underwent CT. MRI was able to detect 4 cases of ligamentous injury, which were not seen in CSS imaging and was able to facilitate cervical spine clearance in a further two patients whose CSS radiographs were abnormal. In this study, MRI has a greater sensitivity and specificity when compared to CSS radiography in a symptomatic pediatric low-impact trauma population. Our data call in to question the routine use of CSS radiographs in children.

Correlation of force control with regional spinal DTI in patients with cervical spondylosis without signs of spinal cord injury on conventional MRI

International Nuclear Information System (INIS)

Lindberg, Paavel G.; Sanchez, Katherine; Rannou, Francois; Poiraudeau, Serge; Ozcan, Fidan; Feydy, Antoine; Maier, Marc A.

2016-01-01

The aim of this study was to investigate spinal cord structure in patients with cervical spondylosis where conventional MRI fails to reveal spinal cord damage. We performed a cross-sectional study of patients with cervical spondylosis without conventional MRI findings of spinal cord damage and healthy controls. Subjects were studied using spinal diffusion tensor imaging (DTI), precision grip and foot force-tracking tasks, and a clinical examination including assessment of neurological signs. A regional analysis of lateral and medial spinal white matter across multiple cervical levels (C1-C5) was performed. DTI revealed reduced fractional anisotropy (FA) and increased radial diffusivity (RD) in the lateral spinal cord at the level of greatest compression (lowest Pavlov ratio) in patients (p < 0.05). Patients with spondylosis had greater error and longer release duration in both grip and foot force-tracking. Similar spinal cord deficits were present in patients without neurological signs. Increased error in grip and foot tracking (low accuracy) correlated with increased RD in the lateral spinal cord at the level of greatest compression (p ≤ 0.01). Spinal DTI can detect subtle spinal cord damage of functional relevance in cervical spondylosis, even in patients without signs on conventional T2-imaging and without neurological signs. (orig.)

Correlation of force control with regional spinal DTI in patients with cervical spondylosis without signs of spinal cord injury on conventional MRI

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Lindberg, Paavel G. [Universite Paris Descartes, Sorbonne Paris Cite, FR 3636 Neurosciences, Paris (France); Centre de Psychiatrie et Neurosciences, Inserm U894, Paris (France); Universite Paris Descartes, Sorbonne Paris Cite, Paris (France); Universite Paris Descartes, Service de Radiologie B, APHP, CHU Cochin, Faculte de Medecine, Paris (France); Sanchez, Katherine; Rannou, Francois; Poiraudeau, Serge [Universite Paris Descartes, Sorbonne Paris Cite, Paris (France); Service de Medecine Physique et de Readaptation, APHP, CHU Cochin, Paris (France); INSERM U1153 Epidemiologie Clinique des Maladies Osteo-Articulaires, Paris (France); Ozcan, Fidan [Universite Paris Descartes, Sorbonne Paris Cite, FR 3636 Neurosciences, Paris (France); Feydy, Antoine [Universite Paris Descartes, Sorbonne Paris Cite, FR 3636 Neurosciences, Paris (France); Universite Paris Descartes, Sorbonne Paris Cite, Paris (France); Universite Paris Descartes, Service de Radiologie B, APHP, CHU Cochin, Faculte de Medecine, Paris (France); Maier, Marc A. [Universite Paris Descartes, Sorbonne Paris Cite, FR 3636 Neurosciences, Paris (France); Universite Paris Descartes, Sorbonne Paris Cite, Paris (France); Universite Paris Diderot, Sorbonne Paris Cite, Paris (France)

2016-03-15

The aim of this study was to investigate spinal cord structure in patients with cervical spondylosis where conventional MRI fails to reveal spinal cord damage. We performed a cross-sectional study of patients with cervical spondylosis without conventional MRI findings of spinal cord damage and healthy controls. Subjects were studied using spinal diffusion tensor imaging (DTI), precision grip and foot force-tracking tasks, and a clinical examination including assessment of neurological signs. A regional analysis of lateral and medial spinal white matter across multiple cervical levels (C1-C5) was performed. DTI revealed reduced fractional anisotropy (FA) and increased radial diffusivity (RD) in the lateral spinal cord at the level of greatest compression (lowest Pavlov ratio) in patients (p < 0.05). Patients with spondylosis had greater error and longer release duration in both grip and foot force-tracking. Similar spinal cord deficits were present in patients without neurological signs. Increased error in grip and foot tracking (low accuracy) correlated with increased RD in the lateral spinal cord at the level of greatest compression (p ≤ 0.01). Spinal DTI can detect subtle spinal cord damage of functional relevance in cervical spondylosis, even in patients without signs on conventional T2-imaging and without neurological signs. (orig.)

MRI appearance of radiation-induced changes of normal cervical tissues

International Nuclear Information System (INIS)

Noemayr, A.; Lell, M.; Bautz, W.; Sweeney, R.; Lukas, P.

2001-01-01

Irradiation causes specific MRI changes in anatomic morphology and signal intensity. To avoid misinterpretation, it is important to consider the potential radiation changes of normal tissue in MRI. The aim of this study was to describe the detected radiation effects on normal cervical tissues in MRI. Pretreatment and posttreatment MRI of 52 patients with primary neck tumors were evaluated retrospectively. The MR imaging was performed before initiating radiotherapy and at the end of the treatment period. Patients underwent follow-up studies within 24 months after the end of irradiation. Edema was the main radiation-induced effect. It was detected in the epiglottis, larynx, pharynx wall, retro- and parapharyngeal space, salivary glands, muscles, and subcutaneous tissue. In some cases the bone marrow of the mandible showed edema, due to osteonecrosis. We additionally detected fluid accumulation in the mastoid cells. Radiation caused volume reduction of the parotid gland, thickening of the pharynx wall, and fatty degeneration of bone marrow. Magnetic resonance imaging is an excellent method of depicting radiation-induced changes of normal tissue. Especially T2-weighted sequences allow the detection of even slight edema. It is important to be aware of the most common radiation-induced changes in MRI and to take them into account when assessing an examination. (orig.)

Utility of preoperative ferumoxtran-10 MRI to evaluate retroperitoneal lymph node metastasis in advanced cervical cancer: Results of ACRIN 6671/GOG 0233

International Nuclear Information System (INIS)

Atri, Mostafa; Zhang, Zheng; Marques, Helga; Gorelick, Jeremy; Harisinghani, Mukesh; Sohaib, Aslam; Koh, Dow-Mu; Raman, Steven; Gee, Michael; Choi, Haesun; Landrum, Lisa; Mannel, Robert; Chuang, Linus; Yu, Jian Qin; McCourt, Carolyn Kay; Gold, Michael

2014-01-01

•We evaluated the added value of a USPIO agent (Ferumoxtran-10) to MRI evaluation of LN metastasis in loco-regionally advanced cervical cancer in a multicenter trial.•There was no significant difference in the accuracy of f-10 MRI as compared to standard MRI to detect LN metastasis in advanced cervical cancer (P > 0.05).•F-10 MRI increased sensitivity of MRI to detect metastasis in small (<8 mm) LNs but at the expense of lower specificity.•Mean size of the largest metastatic focus in the LN on pathology was 13.7 mm in the abdomen and 18.8 mm in the pelvis (P = 0.018). We evaluated the added value of a USPIO agent (Ferumoxtran-10) to MRI evaluation of LN metastasis in loco-regionally advanced cervical cancer in a multicenter trial. There was no significant difference in the accuracy of f-10 MRI as compared to standard MRI to detect LN metastasis in advanced cervical cancer (P > 0.05). F-10 MRI increased sensitivity of MRI to detect metastasis in small (<8 mm) LNs but at the expense of lower specificity. Mean size of the largest metastatic focus in the LN on pathology was 13.7 mm in the abdomen and 18.8 mm in the pelvis (P = 0.018). To assess if ferumoxtran-10 (f-10) improves accuracy of MRI to detect lymph node (LN) metastasis in advanced cervical cancer. F-10 MRI component of an IRB approved HIPAA compliant ACRIN/GOG trial was analyzed. Patients underwent f-10 MRI followed by extra-peritoneal or laparoscopic pelvic and abdominal lymphadenectomy. F-10-sensitive sequences were T2* GRE sequences with TE of 12 and 21. Seven independent blinded readers reviewed f-10-insensitive sequences and all sequences in different sessions. Region correlations were performed between pathology and MRI for eight abdomen and pelvis regions. Sensitivity and specificity were calculated at participant level. Reference standard is based on pathology result of surgically removed LNs. Among 43 women enrolled in the trial between September 2007 and November 2009, 33 women (mean age 49

Surgical results and MRI findings of cervical myelopathy treated with anterior decompression and fusion

International Nuclear Information System (INIS)

Miyazato, Takenari; Teruya, Yoshimitsu; Kinjo, Yukio

1995-01-01

We reviewed 19 patients with cervical myelopathy treated with anterior decompression and fusion. Etiology of cervical myelopathy was cervical disc herniation (CDH) in 13 patients and cervical spondylosis (CSM) in 6. Clinical recovery rate (%) was calculated from preoperative cervical myelopathy score (JOA) and the score at follow-up. Correlation between the clinical recovery rate and MRI findings (area and flatness at the narrowest part of the spinal cord), age at surgery, duration of myelopathy and pre-operative clinical score were analyzed separately in the CDH and CSM groups. Clinical recovery rate averaged 69% in the CDH group and 75% in the CSM group. In the CDH group, average clinical recovery rate in patients younger than 60 years was 80 and in patients over 60 years was 60. There was a significant negative correlation between the clinical recovery rate and age at surgery (p<0.05). No significant correlation was found between the clinical recovery rate and other factors investigated. (author)

SU-E-J-226: Efficient Use of Computed Tomography (CT) and Magnetic Resonance Imaging (MRI) for Cervical-Cancer Brachytherapy

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Damato, A; Bhagwat, M; Buzurovic, I; Cormack, R; Lee, L; Viswanathan, A [Harvard Medical School, Boston, MA (United States)

2015-06-15

Purpose: To investigate image modality selection in an environment with limited access to interventional MRI for image-guided high-dose-rate cervical-cancer brachytherapy. Methods: Records of all cervical-cancer patients treated with brachytherapy between 1/2013 and 8/2014 were analyzed. Insertions were performed under CT guidance (CT group) or with >1 fraction under 3T MR guidance (MRI group; subMRI includes only patients who also had a CT-guided insertion). Differences between groups in clinical target volume (CTV), disease stage (I/II or III/IV), number of patients with or without interstitial needles, and CTV D90 were investigated. Statistical significance was evaluated with the Student T test and Fisher test (p <0.05). Results: 46 cervical-cancer patients were included (16 MRI [3 subMRI], 30 CT). CTV: overall, 55±53 cm3; MRI, 81±61 cm3; CT, 42±44 cm3 (p = 0.017). Stage: overall, 24 I/II and 22 III/IV; MRI, 3 I/II and 13 III/IV; CT, 21 I/II and 9 III/IV (p = 0.002). Use of needles: overall, 26 without and 20 with; MRI, 5 without and 11 with; CT, 21 without and 9 with (p = 0.015). CTV D90: overall, 82±5 Gy; MRI, 81±6 Gy; CT, 82±5 Gy (p = 0.78). SubMRI: CTV and D90 (as % of nominal fraction dose) were 23±6 cm3 and 124±3% for MRI-guided insertions and 21±5 cm3 (p = 0.83) and 106±12% (p = 0.15) for CT-guided insertions. Conclusion: Statistically significant differences in patient population indicate preferential use of MRI for patients with high-stage disease and large residual CTVs requiring the use of interstitial needles. CTV D90 was similar between groups, despite the difference in patient selection. For patients who underwent both CT and MRI insertions, a larger MR CTV D90 and similar CTVs between insertions were observed. While MRI is generally preferable to CT, MRI selection can be optimized in environments without a dedicated MRI brachytherapy suite. This work was partially funded by the NIH R21 CA167800 (PI: Viswanathan; aviswanathan@partners.org)

SU-E-J-226: Efficient Use of Computed Tomography (CT) and Magnetic Resonance Imaging (MRI) for Cervical-Cancer Brachytherapy

International Nuclear Information System (INIS)

Damato, A; Bhagwat, M; Buzurovic, I; Cormack, R; Lee, L; Viswanathan, A

2015-01-01

Purpose: To investigate image modality selection in an environment with limited access to interventional MRI for image-guided high-dose-rate cervical-cancer brachytherapy. Methods: Records of all cervical-cancer patients treated with brachytherapy between 1/2013 and 8/2014 were analyzed. Insertions were performed under CT guidance (CT group) or with >1 fraction under 3T MR guidance (MRI group; subMRI includes only patients who also had a CT-guided insertion). Differences between groups in clinical target volume (CTV), disease stage (I/II or III/IV), number of patients with or without interstitial needles, and CTV D90 were investigated. Statistical significance was evaluated with the Student T test and Fisher test (p <0.05). Results: 46 cervical-cancer patients were included (16 MRI [3 subMRI], 30 CT). CTV: overall, 55±53 cm3; MRI, 81±61 cm3; CT, 42±44 cm3 (p = 0.017). Stage: overall, 24 I/II and 22 III/IV; MRI, 3 I/II and 13 III/IV; CT, 21 I/II and 9 III/IV (p = 0.002). Use of needles: overall, 26 without and 20 with; MRI, 5 without and 11 with; CT, 21 without and 9 with (p = 0.015). CTV D90: overall, 82±5 Gy; MRI, 81±6 Gy; CT, 82±5 Gy (p = 0.78). SubMRI: CTV and D90 (as % of nominal fraction dose) were 23±6 cm3 and 124±3% for MRI-guided insertions and 21±5 cm3 (p = 0.83) and 106±12% (p = 0.15) for CT-guided insertions. Conclusion: Statistically significant differences in patient population indicate preferential use of MRI for patients with high-stage disease and large residual CTVs requiring the use of interstitial needles. CTV D90 was similar between groups, despite the difference in patient selection. For patients who underwent both CT and MRI insertions, a larger MR CTV D90 and similar CTVs between insertions were observed. While MRI is generally preferable to CT, MRI selection can be optimized in environments without a dedicated MRI brachytherapy suite. This work was partially funded by the NIH R21 CA167800 (PI: Viswanathan; aviswanathan@partners.org)

MRI Prognostication Factors in the Setting of Cervical Spinal Cord Injury Secondary to Trauma.

Science.gov (United States)

Martínez-Pérez, Rafael; Cepeda, Santiago; Paredes, Igor; Alen, Jose F; Lagares, Alfonso

2017-05-01

Several studies have looked for an association between radiologic findings and neurologic outcome after cervical trauma. In the current literature, there is a paucity of evidence proving the prognostic role of soft tissue damage or bony integrity. Our objective is to determine radiologic findings related to neurologic prognosis in patients after incomplete acute traumatic cervical spinal cord injury, regardless of initial neurologic examination results. We retrospectively reviewed patients with acute traumatic cervical spinal cord injury who had a magnetic resonance imaging (MRI) performed within the first 96 hours. Clinical and epidemiologic data were recorded from the medical records along with several radiologic findings from the initial computed tomographic scan and MRI. Data were analyzed using a non-parametric test. Significant prognostic factors were analyzed through a stepwise multivariable logistic regression, adjusted by neurologic status at baseline. The receiver-operating characteristic curve was used to test the discriminative capacity of the model. Eighty-six patients (68 males and 18 females) were included for the analysis. Mean age was 49 years. Ligamentum flavum injury, intramedullary edema larger than 36 mm, and facet dislocation were demonstrated to be associated with a lack of neurologic improvement at follow-up. Multivariable analysis showed that edema larger than 36 mm and facet dislocation were strong predictors of clinical outcome, regardless of the initial neurologic examination result. Early MRI has an intrinsic prognostic value. Ligamentous injury and larger edema are strong predicting factors of a bad neurologic outcome at long-term follow-up. Copyright © 2017 Elsevier Inc. All rights reserved.

CORRELATION BETWEEN CERVICAL SAGITTAL ALIGNMENT AND FUNCTIONAL CAPACITY IN CERVICAL SPONDYLOSIS

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Marcel Machado da Motta

Full Text Available ABSTRACT Objective: To correlate the radiographic parameters of sagittal cervical alignment with quality of life and functional capacity in patients with cervical spondylosis under conservative treatment. Methods: This is an observational and prospective study in patients with cervical spondylosis under conservative treatment and without indication for surgery. The 52 patients included were divided into three groups: axial pain, radiculopathy, and cervical myelopathy. The radiographic parameters considered were cervical lordosis (CL, cervical sagittal vertical axis (CSVA, T1 slope (TS and the discrepancy between TS and CL (TS-CL. Quality of life and functional capacity were evaluated by the Neck Disability Index (NDI questionnaire. Pain was assessed by the Visual Analogue Scale (VAS. The correlation between the radiographic parameters and the clinical scores was evaluated by the Pearson correlations coefficient. Results: There was no difference in cervical radiographic parameters between the three groups. In the total of the sample, the mean value of the CSVA was 17.8o (±8.3o, CL, 22.4° (± 8.8°; TS, 29.3° (±6.6°, and TS-CL, 7.0° (±7.4°. Significant inverse correlation (r= -0.3, p=0.039 was observed between NDI and CL, but there was no significant correlation between CL and VAS. CSVA (p=0.541, TS (p=0.287 and TS-CL (p=0.287 had no significantly correlated with NDI or VAS. Conclusion: Considering patients with cervical spondylosis not candidates for surgery, the only sagittal parameter that correlated with functional capacity was LC. In these patients, the correlation between cervical alignment and quality of life needs to be better characterized.

Diagnosis of cervical spinal cord disorders with MRI

International Nuclear Information System (INIS)

Suyama, Naohito; Iizuka, Tadashi

1991-01-01

From September 1987 through May 1989, magnetic resonance imaging (MRI) has been performed in 58 patients with myelopathy and 9 patients with spinal cord injuries. This study was designed to determine the rate of spinal cord stricture and changes of signal intensities. Increased signal intensity on T2-weighted images was more frequently observed than decreased intensity on T1-weighted images in the group of myelopathy (19/58 vs 10/58). In the group of spinal cord injuries, however, there was no significant difference in the incidence between increased intensity on T2-weighted images (4/9) and decreased intensity on T1-weighted images (7/9). Twelve patients with chronic compressive spinal myelopathy tended to have an increased intensity on T2-weighted images. In such cases, although JOA scores were low before surgery, signal intensity returned to that without marked signal changes. In chronic compressive cervical myelopathy, the degree of preoperative compression was the same as the postoperative JOA scores. Regarding cervical spinal injury, there was a good correlation between the size of low signal area and the degree of paralysis. (N.K.)

Multi-parametric MRI in cervical cancer. Early prediction of response to concurrent chemoradiotherapy in combination with clinical prognostic factors

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Yang, Wei; Chen, Bing; Wang, Ai Jun; Zhao, Jian Guo [The General Hospital of Ningxia Medical University, Department of Radiology, Yinchuan (China); Qiang, Jin Wei [Fudan University, Department of Radiology, Jinshan Hospital, Shanghai (China); Tian, Hai Ping [The General Hospital of Ningxia Medical University, Department of Pathology, Yinchuan (China)

2018-01-15

To investigate the prediction of response to concurrent chemoradiotherapy (CCRT) through a combination of pretreatment multi-parametric magnetic resonance imaging (MRI) with clinical prognostic factors (CPF) in cervical cancer patients. Sixty-five patients underwent conventional MRI, diffusion-weighted imaging (DWI), and dynamic contrast-enhanced MRI (DCE-MRI) before CCRT. The patients were divided into non- and residual tumour groups according to post-treatment MRI. Pretreatment MRI parameters and CPF between the two groups were compared and prognostic factors, optimal thresholds, and predictive performance for post-treatment residual tumour occurrence were estimated. The residual group showed a lower maximum slope of increase (MSI{sub L}) and signal enhancement ratio (SER{sub L}) in low-perfusion subregions, a higher apparent diffusion coefficient (ADC) value, and a higher stage than the non-residual tumour group (p < 0.001, p = 0.003, p < 0.001, and p < 0.001, respectively). MSI{sub L} and ADC were independent prognostic factors. The combination of both measures improved the diagnostic performance compared with individual MRI parameters. A further combination of these two factors with CPF exhibited the highest predictive performance. Pretreatment MSI{sub L} and ADC were independent prognostic factors for cervical cancer. The predictive capacity of multi-parametric MRI was superior to individual MRI parameters. The combination of multi-parametric MRI with CPF further improved the predictive performance. (orig.)

MRI of the cervical spine with T1-weighted multislice flash sequences

International Nuclear Information System (INIS)

Schubeus, P.; Sander, B.; Schoerner, W.; Tosch, U.; Lanksch, W.R.; Felix, R.; Klinikum Rudolf Virchow, Berlin

1990-01-01

A study has been carried out to evaluate contrast and image quality of cervical structures using multislice 2D-flash sequences with long repetition times (TR = 400 ms.) and short echo delay times (TE = 5.8 ms.). The examinations were carried out using ten normals with an MRI of 1.5 Tesla and flip angles of 10, 20, 30, 50, 70 and 90deg. The best contrast between intervertebral disc and surrounding tissue was obtained between 50 and 70deg, best contrast between compact bone and CSF with 10deg. In order to demonstrate degenerative changes of the cervical spine, it appears sensible to use a combination of these angles. The described sequences produce good images of the cervical structures with little image degradation. Compared to T 1 -weighted spin-echo sequences, the method has a number of significant advantages, such as variations in image contrast, higher maximal number of slices, continuous imaging and less imaging time. (orig.) [de

Correlation of standardized uptake value and apparent diffusion coefficient in integrated whole-body PET/MRI of primary and recurrent cervical cancer.

Science.gov (United States)

Grueneisen, Johannes; Beiderwellen, Karsten; Heusch, Philipp; Buderath, Paul; Aktas, Bahriye; Gratz, Marcel; Forsting, Michael; Lauenstein, Thomas; Ruhlmann, Verena; Umutlu, Lale

2014-01-01

To evaluate a potential correlation of the maximum standard uptake value (SUVmax) and the minimum apparent diffusion coefficient (ADCmin) in primary and recurrent cervical cancer based on integrated PET/MRI examinations. 19 consecutive patients (mean age 51.6 years; range 30-72 years) with histopathologically confirmed primary cervical cancer (n = 9) or suspected tumor recurrence (n = 10) were prospectively enrolled for an integrated PET/MRI examination. Two radiologists performed a consensus reading in random order, using a dedicated post-processing software. Polygonal regions of interest (ROI) covering the entire tumor lesions were drawn into PET/MR images to assess SUVmax and into ADC parameter maps to determine ADCmin values. Pearson's correlation coefficients were calculated to assess a potential correlation between the mean values of ADCmin and SUVmax. In 15 out of 19 patients cervical cancer lesions (n = 12) or lymph node metastases (n = 42) were detected. Mean SUVmax (12.5 ± 6.5) and ADCmin (644.5 ± 179.7 × 10(-5) mm2/s) values for all assessed tumor lesions showed a significant but weak inverse correlation (R = -0.342, p correlation between SUVmax and ADCmin (R = -0.692, p correlation. These initial results of this emerging hybrid imaging technique demonstrate the high diagnostic potential of simultaneous PET/MR imaging for the assessment of functional biomarkers, revealing a significant and strong correlation of tumor metabolism and higher cellularity in cervical cancer lesions.

Study of cervical cord injury without radiological abnormality using MRI at injury

International Nuclear Information System (INIS)

Park, Jin-Soo; Ei, Terumi; Uchida, Yoko; Kodai, Yujiro; Yasumatsu, Hideo; Yoshino, Kazutaka; Hirakawa, Takashi.

1994-01-01

This study was undertaken, using MRI at the time of injury, to examine cervical cord injury without radiological abnormality. The subjects were 30 patients (24 men and 6 women) seen during the 4-year period 1989-1993, who ranged in age from 31 to 83 years (an average age of 62.8 years). Of these patients, 10 had a slightly irregular alignment of the vertebral body on plain X-rays. These 10 patients were examined using MRI early after sustaining trauma (within 24 hours in 9 and 48 hours in one). As a result, spinal cord was seen as isointensity on T1-weighted images and hyperintensity on T2-weighted images, corresponding to irregular alignment. These findings suggest that reduction of a dislocation may transiently occur due to patient transfer or natural elasticity, as plain X-rays indicated no evidence of bone abnormalities. Thus injuries like dislocations may have occurred at the time of trauma, and structural changes of the vertebral body may be responsible for the occurrence of cervical spinal cord. Spinal cord injuries, even if not evidenced on plain X-rays, should not be categorized as non-osseous injuries. (N.K.)

Individualised 3D printed vaginal template for MRI guided brachytherapy in locally advanced cervical cancer

DEFF Research Database (Denmark)

Lindegaard, Jacob Christian; Lænsø Madsen, Mads; Hansen, Anders Traberg

2016-01-01

Intracavitary–interstitial applicators for MRI guided brachytherapy are becoming increasingly important in locally advanced cervical cancer. The 3D printing technology enables a versatile method for obtaining a high degree of individualisation of the implant. Our clinical workflow is presented...

Anterolisthesis and retrolisthesis of the cervical spine in cervical spondylotic myelopathy in the elderly

International Nuclear Information System (INIS)

Kawasaki, Motohiro; Tani, Toshikazu; Ushida, Takahiro; Ishida, Kenji

2007-01-01

Degenerative spondylolisthesis of the cervical spine has received insufficient attention in contrast to that of the lumbar spine. The authors analyzed the functional significance of anterior and posterior degenerative spondylolisthesis (anterolisthesis and retrolisthesis) of the cervical spine to elucidate its role in the development of cervical spondylotic myelopathy (CSM) in the elderly. A total of 79 patients aged 65 or older who eventually had surgical treatment for CSM were evaluated radiographically. Altogether, 24 patients (30%) had displacement of 3.5 mm or more (severe spondylolisthesis group), 31 had displacement of 2.0-3.4 mm (moderate spondylolisthesis group), and 24 had less than 2.0 mm displacement (mild spondylolisthesis group). The severe spondylolisthesis group consisted of 14 patients with anterolisthesis (anterolisthesis group) and 10 patients with retrolisthesis (retrolisthesis group). Patients with severe spondylolisthesis had a high incidence (93%) of degenerative spondylolisthesis at C3/4 or C4/5 and significantly greater cervical mobility than those with mild spondylolisthesis. The anterolisthesis group, but not the retrolisthesis group, had a significantly wider spinal canal than the mild spondylolisthesis group, although the degree of horizontal displacement and cervical mobility did not differ significantly between the anterolisthesis and retrolisthesis groups. Severe cord compression seen on T1-weighted magnetic resonance imaging (MRI) scans and high-intensity spinal cord signals seen on T2-weighted MRI scans corresponded significantly to the levels of the spondylolisthesis. Degenerative spondylolisthesis is not a rare radiographic finding in elderly patients with CSM, which tends to cause intense cord compression that is seen on MRI scans. Greater mobility of the upper cervical segments may be a compensatory reaction for advanced disc degeneration of the lower cervical segments, leading to the development of degenerative

The usefulness of MRI and PET imaging for the detection of parametrial involvement and lymph node metastasis in patients with cervical cancer

International Nuclear Information System (INIS)

Park, Won; Park, Young-Je; Huh, Seung-Jae

2005-01-01

The purpose of this study is to elucidate the usefulness of magnetic resonance imaging (MRI) and positron emission tomography (PET) for the detection of parametrial involvement and lymph node metastasis in patients with cervical cancer. Thirty-six patients with cervical cancer were retrospectively enrolled. MRI and PET scans were performed for all patients within a week before radical surgery. The criterion for malignancy on MRI was >1 cm short axis diameter of the suspected lymph node. On PET, only fluorodeoxyglucose (FDG) uptake was significantly higher than the background and, if this FDG uptake showed on at least two consecutive axial slices, then the lesion was considered as a malignancy. We compared the extent of tumor on the surgical findings with the International Federation of Gynecology and Obstetrics (FIGO) staging, MRI and PET scans. The accuracy of FIGO and MRI staging was 67 and 84.4%, respectively. The accuracy for detecting pelvic lymph node metastasis was better for PET than for MRI (78 versus 67%, respectively). All FDG uptake lymph nodes were confirmed as metastatic lymph nodes by pathological evaluation; this included five lymph nodes <1 cm in diameter. MRI provides an improved evaluation of local tumor extension, but PET is more useful for the evaluation of pelvic lymph nodes than MRI; however, PET still misses microscopic disease. Further studies are necessary to evaluate the usefulness of PET/computed tomography (CT) for the accuracy of the disease extension and the cost-effectiveness of MRI, PET or PET/CT in patients with cervical cancer. (author)

Local experience in cervical cancer imaging: Comparison in tumour assessment between TRUS and MRI.

Science.gov (United States)

Ordeanu, Claudia; Pop, Diana Cristina; Badea, Radu; Csutak, Csaba; Todor, Nicolae; Ordeanu, Calin; Kerekes, Reka; Coza, Ovidiu; Nagy, Viorica; Achimas-Cadariu, Patriciu; Irimie, Alexandru

2015-01-01

The aim of study was to analyze the accuracy of TRUS (transrectal ultrasound) vs. MRI (magnetic resonance imaging) and clinical gynecological examination estimation in the evaluation of tumor dimensions. The patients inclusion criterion included primarily pathologically squamous cell carcinoma, but excluded were patients who had not undergone BT (brachytherapy) and treated with palliative intent. We offer two types of treatment for locally advanced cervical cancer: (a) radiochemotherapy followed by surgery and (b) exclusive radiochemotherapy. Imaging tests follow the presence of tumor and tumor size (width and thickness). Each examination was performed by a different physician who had no knowledge of the others' findings. All patients underwent MRI prior to EBRT (external beam radiation therapy) while 18 of them also at the time of the first brachytherapy application. For the analysis we used the r-Pearson correlation coefficient. In 2013, 26 patients with cervical cancer were included. A total of 44 gynecological examinations were performed, 44 MRIs and 18 TRUSs. For the comparisons prior to EBRT the correlation coefficient between TRUS vs. MRI was r = 0.79 for AP and r = 0.83 for LL, for GYN vs. MRI was r = 0.6 for AP and r = 0.75 for LL. Prior to BT for GYN vs. MRI, r values were 0.60 and 0.63 for AP and LL, respectively; for GYN vs. TRUS, r values were 0.56 and 0.78 for AP and LL, respectively. A high correlation between the three examinations was obtained. As such, TRUS can be considered a suitable method in the evaluation of tumor dimensions.

High-resolution T{sub 2}-weighted cervical cancer imaging: a feasibility study on ultra-high-field 7.0-T MRI with an endorectal monopole antenna

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Hoogendam, Jacob P.; Verheijen, Rene H.M.; Zweemer, Ronald P. [University Medical Centre Utrecht, Department of Gynaecological Oncology, UMC Utrecht Cancer Centre, PO Box 85500, Utrecht (Netherlands); Kalleveen, Irene M.L.; Castro, Catalina S.A. de; Raaijmakers, Alexander J.E.; Bosch, Maurice A.A.J. van den; Klomp, Dennis W.J.; Veldhuis, Wouter B. [University Medical Centre Utrecht, Department of Radiology, Utrecht (Netherlands)

2017-03-15

We studied the feasibility of high-resolution T{sub 2}-weighted cervical cancer imaging on an ultra-high-field 7.0-T magnetic resonance imaging (MRI) system using an endorectal antenna of 4.7-mm thickness. A feasibility study on 20 stage IB1-IIB cervical cancer patients was conducted. All underwent pre-treatment 1.5-T MRI. At 7.0-T MRI, an external transmit/receive array with seven dipole antennae and a single endorectal monopole receive antenna were used. Discomfort levels were assessed. Following individualised phase-based B{sub 1} {sup +} shimming, T{sub 2}-weighted turbo spin echo sequences were completed. Patients had stage IB1 (n = 9), IB2 (n = 4), IIA1 (n = 1) or IIB (n = 6) cervical cancer. Discomfort (ten-point scale) was minimal at placement and removal of the endorectal antenna with a median score of 1 (range, 0-5) and 0 (range, 0-2) respectively. Its use did not result in adverse events or pre-term session discontinuation. To demonstrate feasibility, T{sub 2}-weighted acquisitions from 7.0-T MRI are presented in comparison to 1.5-T MRI. Artefacts on 7.0-T MRI were due to motion, locally destructive B{sub 1} interference, excessive B{sub 1} under the external antennae and SENSE reconstruction. High-resolution T{sub 2}-weighted 7.0-T MRI of stage IB1-IIB cervical cancer is feasible. The addition of an endorectal antenna is well tolerated by patients. (orig.)

Improve definition of titanium tandems in MR-guided high dose rate brachytherapy for cervical cancer using proton density weighted MRI

International Nuclear Information System (INIS)

Hu, Yanle; Esthappan, Jacqueline; Mutic, Sasa; Richardson, Susan; Gay, Hiram A; Schwarz, Julie K; Grigsby, Perry W

2013-01-01

For cervical cancer patients treated with MR-guided high dose rate brachytherapy, the accuracy of radiation delivery depends on accurate localization of both tumors and the applicator, e.g. tandem and ovoid. Standard T2-weighted (T2W) MRI has good tumor-tissue contrast. However, it suffers from poor uterus-tandem contrast, which makes the tandem delineation very challenging. In this study, we evaluated the possibility of using proton density weighted (PDW) MRI to improve the definition of titanium tandems. Both T2W and PDW MRI images were obtained from each cervical cancer patient. Imaging parameters were kept the same between the T2W and PDW sequences for each patient except the echo time (90 ms for T2W and 5.5 ms for PDW) and the slice thickness (0.5 cm for T2W and 0.25 cm for PDW). Uterus-tandem contrast was calculated by the equation C = (S u -S t )/S u , where S u and S t represented the average signal in the uterus and the tandem, respectively. The diameter of the tandem was measured 1.5 cm away from the tip of the tandem. The tandem was segmented by the histogram thresholding technique. PDW MRI could significantly improve the uterus-tandem contrast compared to T2W MRI (0.42±0.24 for T2W MRI, 0.77±0.14 for PDW MRI, p=0.0002). The average difference between the measured and physical diameters of the tandem was reduced from 0.20±0.15 cm by using T2W MRI to 0.10±0.11 cm by using PDW MRI (p=0.0003). The tandem segmented from the PDW image looked more uniform and complete compared to that from the T2W image. Compared to the standard T2W MRI, PDW MRI has better uterus-tandem contrast. The information provided by PDW MRI is complementary to those provided by T2W MRI. Therefore, we recommend adding PDW MRI to the simulation protocol to assist tandem delineation process for cervical cancer patients

Imaging of Herniated Discs of the Cervical Spine: Inter-Modality Differences between 64-Slice Multidetector CT and 1.5-T MRI

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Yi, Ji Sook; Cha, Jang Gyu [Dept. of Radiology, Soonchunhyang University Bucheon Hospital, Bucheon (Korea, Republic of); Han, Jong Kyu [Dept. of Radiology, Soonchunhyang University Cheonan Hospital, Cheonan (Korea, Republic of); Kim, Hyun Joo [Dept. of Radiology, Soonchunhyang University Seoul Hospital, Seoul (Korea, Republic of)

2015-08-15

To assess inter-modality variability when evaluating cervical intervertebral disc herniation using 64-slice multidetector-row computed tomography (MDCT) and magnetic resonance imaging (MRI). Three musculoskeletal radiologists independently reviewed cervical spine 1.5-T MRI and 64-slice MDCT data on C2-3 though C6-7 of 51 patients in the context of intervertebral disc herniation. Interobserver and inter-modality agreements were expressed as unweighted kappa values. Weighted kappa statistics were used to assess the extents of agreement in terms of the number of involved segments (NIS) in disc herniation and epicenter measurements collected using MDCT and MRI. The interobserver agreement rates upon evaluation of disc morphology by the three radiologists were in fair to moderate agreement (k = 0.39-0.53 for MDCT images; k = 0.45-0.56 for MRIs). When the disc morphology was categorized into two and four grades, the inter-modality agreement rates were moderate (k-value, 0.59) and substantial (k-value, 0.66), respectively. The inter-modality agreements for evaluations of the NIS (k-value, 0.78) and the epicenter (k-value, 0.79) were substantial. Also, the interobserver agreements for the NIS (CT; k-value, 0.85 and MRI; k-value, 0.88) and epicenter (CT; k-value, 0.74 and MRI; k-value, 0.70) evaluations by two readers were substantial. MDCT tended to underestimate the extent of herniated disc lesions compared with MRI. Multidetector-row computed tomography and MRI showed a moderate-to-substantial degree of inter-modality agreement for the assessment of herniated cervical discs. MDCT images have a tendency to underestimate the anterior/posterior extent of the herniated disc compared with MRI.

Reproducibility, temporal stability, and functional correlation of diffusion MR measurements within the spinal cord in patients with asymptomatic cervical stenosis or cervical myelopathy.

Science.gov (United States)

Ellingson, Benjamin M; Salamon, Noriko; Woodworth, Davis C; Yokota, Hajime; Holly, Langston T

2018-05-01

OBJECTIVE The purpose of this study was to quantify the reproducibility, temporal stability, and functional correlation of diffusion MR characteristics in the spinal cord in patients with cervical stenosis with or without myelopathy. The association between longitudinal diffusion tensor imaging (DTI) measurements and serial neurological function assessment was explored at both the group and individual level. METHODS Sixty-six nonoperatively treated patients with cervical stenosis were prospectively followed (3 months to > 5 years) using synchronous serial MRI and functional outcome assessment. A total of 183 separate MRI examinations were performed, separated by at least 3 months, and each patient had a minimum of 2 MRI scans (range 2-5 scans). Anatomical and DTI measurements were performed within the spinal cord at the C1-2 region as well as at the area of highest compression. Coefficients of variance (COVs) were compared across measurements in both reference tissue and areas of compression for anatomical measurements, fractional anisotropy (FA), and mean diffusivity (MD). The correlation between diffusion MR measures at the site of compression and evaluations of neurological function assessed using the modified Japanese Orthopaedic Association (mJOA) scale at multiple time points was evaluated. RESULTS The COVs for anatomical measurements (Torg ratio and canal diameter) were between 7% and 10%. The median COV for FA measurements at the site of compression was 9%, and for reference tissue at C1-2 it was 6%. The median COV for MD at the site of compression was approximately 12%, and for reference tissue at C1-2 it was 10%. The FA and MD measurements of C1-2 averaged 0.61 and 0.91 μm 2 /msec, respectively, whereas the FA and MD measurements at the site of compression averaged 0.51 and 1.26 μm 2 /msec, respectively. Both FA (slope = 0.037; R 2 = 0.3281, p slope = -0.074; R 2 = 0.1101, p = 0.0084) were significantly correlated with the mJOA score. The FA decreased

Quantification of C2 cervical spine rotatory fixation by X-ray, MRI and CT

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Gradl, Georg [Chirurgische Klinik und Poliklinik der Universitaet Rostock, Abteilung Unfall- und Wiederherstellungschirurgie, Rostock (Germany); Maier-Bosse, Tamara; Staebler, Axel [Institut fuer Radiologische Diagnostik der Universitaet Muenchen, Klinikum Grobetahadern, Munich (Germany); Penning, Randolph [Institut fuer Rechtsmedizin der Universitaet Muenchen, Munich (Germany)

2005-02-01

Atlanto-axial rotatory displacement is known to be a cause of childhood torticollis and may as well be responsible for chronic neck pain after rear-end automobile collisions. The objective was to determine whether quantification of C2 malrotation is possible by plain radiographs in comparison to CT as the golden standard. MR imaging was evaluated as to whether it was of equal value in the detection of bony landmarks. C2 vertebra of five human cadaveric cervical spine specimens, ligamentously intact, were rotated using a Steinmann pin in steps of 5 up to 15 right and 15 left. Plain radiographs, CT and MRI images were taken in each rotational step. Data were analyzed for quantification of C2 rotation by three independent examiners. A rotation of 5 led to a spinous process deviation (SPD) from the midline of 3 mm as measured on an a.p. plain radiograph. A coefficient of rotation was calculated (1.62 mm{sup -1}). Data analyzed by three examiners revealed a small coefficient of variation (0.03). MRI and CT measurements showed comparable results for the quantification of rotation; however, in both techniques the 15 rotation was underestimated. Quantification of upper cervical spine malrotation was possible on plain radiographs using the SPD and a rotation coefficient. MRI and CT were equally successful in the assessment of C2 malrotation. (orig.)

Quantification of C2 cervical spine rotatory fixation by X-ray, MRI and CT

International Nuclear Information System (INIS)

Gradl, Georg; Maier-Bosse, Tamara; Staebler, Axel; Penning, Randolph

2005-01-01

Atlanto-axial rotatory displacement is known to be a cause of childhood torticollis and may as well be responsible for chronic neck pain after rear-end automobile collisions. The objective was to determine whether quantification of C2 malrotation is possible by plain radiographs in comparison to CT as the golden standard. MR imaging was evaluated as to whether it was of equal value in the detection of bony landmarks. C2 vertebra of five human cadaveric cervical spine specimens, ligamentously intact, were rotated using a Steinmann pin in steps of 5 up to 15 right and 15 left. Plain radiographs, CT and MRI images were taken in each rotational step. Data were analyzed for quantification of C2 rotation by three independent examiners. A rotation of 5 led to a spinous process deviation (SPD) from the midline of 3 mm as measured on an a.p. plain radiograph. A coefficient of rotation was calculated (1.62 mm -1 ). Data analyzed by three examiners revealed a small coefficient of variation (0.03). MRI and CT measurements showed comparable results for the quantification of rotation; however, in both techniques the 15 rotation was underestimated. Quantification of upper cervical spine malrotation was possible on plain radiographs using the SPD and a rotation coefficient. MRI and CT were equally successful in the assessment of C2 malrotation. (orig.)

Long term outcomes from CT-guided indirect cervical nerve root blocks and their relationship to the MRI findings. A prospective study

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Bensler, Susanne; Sutter, Reto; Pfirrmann, Christian W.A.; Peterson, Cynthia K. [Orthopedic University Hospital Balgrist, Department of Radiology, Zurich (Switzerland); University of Zurich, Faculty of Medicine, Zurich (Switzerland)

2015-11-15

To investigate long-term pain reduction and 'improvement' in patients with indirect cervical nerve-root-blocks in comparison to MRI findings. One hundred and twelve patients with MRI confirmed cervical radiculopathy and an indirect cervical nerve-root-block were included. Two radiologists independently evaluated the MRI examinations. 12 different MRI abnormalities at the level and side of infiltration were compared to pain relief and 'improvement' at 1-month, 3-months and 1-year post injection. The proportion of patients reporting clinically relevant 'improvement' was 36.7 % at 1-month, 53.9 % at 3-months and 68.1 % at 1-year. At 1-month post injection, a statistically significantly lower percentage of patients eventually requiring surgery reported improvement and lower NRS change scores compared to those who did not undergo surgery (p = 0.001). Patients with extrusion of the disc were around 4-times more likely to have surgery. At 1-year post-injection the presence of nerve-root compromise was significantly linked to treatment outcome (p = 0.011). Patients with nerve root compression were more likely to report improvement at 1 year. Patients with disc extrusions have less pain relief and are 4 times more likely to go to surgery than patients with disc protrusions. (orig.)

Role of MRI in detecting involvement of the uterine internal os in uterine cervical cancer: Systematic review of diagnostic test accuracy

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Boer, Peter de, E-mail: p.deboer@amc.uva.nl [Department of Radiation Oncology, Academic Medical Centre (AMC), University of Amsterdam (UvA), Meibergdreef 9, 1105 AZ Amsterdam (Netherlands); Adam, Judit A. [Department of Radiology, AMC, UvA (Netherlands); Department of Nuclear Medicine, AMC, UvA (Netherlands); Buist, Marrije R. [Department of Gynaecology and Obstetrics, AMC, UvA (Netherlands); Vijver, Marc J. van de [Department of Pathology, AMC, UvA (Netherlands); Rasch, Coen R. [Department of Radiation Oncology, Academic Medical Centre (AMC), University of Amsterdam (UvA), Meibergdreef 9, 1105 AZ Amsterdam (Netherlands); Stoker, Jaap; Bipat, Shandra [Department of Radiology, AMC, UvA (Netherlands); Stalpers, Lukas J.A. [Department of Radiation Oncology, Academic Medical Centre (AMC), University of Amsterdam (UvA), Meibergdreef 9, 1105 AZ Amsterdam (Netherlands)

2013-09-15

Purpose: In patients with uterine cervical cancer, pretreatment recognition of uterine extension is crucial in treatment decision-making for fertility-sparing surgery and for target delineation in radiotherapy. Although MRI is generally considered the most reliable method, its value for detecting involvement of the uterine internal os is unclear. Methods: Medline, Embase and Cochrane databases were systematically searched (January 1997–December 2012) for MRI studies that measured the accuracy of involvement of the uterine internal os compared to histopathology as reference standard in patients with uterine cervical cancer. Data were assessed using the QUADAS tool. Accuracy concerned either involvement (yes/no) of the uterine internal os, or measuring invasion distance toward the uterine corpus. Results: Two retrospective and two prospective studies described 366 patients diagnosed with uterine cervical cancer FIGO stage IIB or below, in whom 64 (17%) had uterine internal os involvement. For three studies the summary estimates of specificity, sensitivity, negative predictive value (NPV), positive predictive value (PPV), and accuracy were 91%, 97%, 99%, 79% and 95%, respectively; one study had an area under the curve (AUC) of 0.8. Conclusion: MRI has a high level of accuracy; however, data are limited and for validation a large prospective study is needed that compares actual measurements on MRI with histopathological examination.

Long term outcomes from CT-guided indirect cervical nerve root blocks and their relationship to the MRI findings. A prospective study

International Nuclear Information System (INIS)

Bensler, Susanne; Sutter, Reto; Pfirrmann, Christian W.A.; Peterson, Cynthia K.

2015-01-01

To investigate long-term pain reduction and 'improvement' in patients with indirect cervical nerve-root-blocks in comparison to MRI findings. One hundred and twelve patients with MRI confirmed cervical radiculopathy and an indirect cervical nerve-root-block were included. Two radiologists independently evaluated the MRI examinations. 12 different MRI abnormalities at the level and side of infiltration were compared to pain relief and 'improvement' at 1-month, 3-months and 1-year post injection. The proportion of patients reporting clinically relevant 'improvement' was 36.7 % at 1-month, 53.9 % at 3-months and 68.1 % at 1-year. At 1-month post injection, a statistically significantly lower percentage of patients eventually requiring surgery reported improvement and lower NRS change scores compared to those who did not undergo surgery (p = 0.001). Patients with extrusion of the disc were around 4-times more likely to have surgery. At 1-year post-injection the presence of nerve-root compromise was significantly linked to treatment outcome (p = 0.011). Patients with nerve root compression were more likely to report improvement at 1 year. Patients with disc extrusions have less pain relief and are 4 times more likely to go to surgery than patients with disc protrusions. (orig.)

Alterations in Cortical Sensorimotor Connectivity following Complete Cervical Spinal Cord Injury: A Prospective Resting-State fMRI Study.

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Akinwunmi Oni-Orisan

Full Text Available Functional magnetic resonance imaging (fMRI studies have demonstrated alterations during task-induced brain activation in spinal cord injury (SCI patients. The interruption to structural integrity of the spinal cord and the resultant disrupted flow of bidirectional communication between the brain and the spinal cord might contribute to the observed dynamic reorganization (neural plasticity. However, the effect of SCI on brain resting-state connectivity patterns remains unclear. We undertook a prospective resting-state fMRI (rs-fMRI study to explore changes to cortical activation patterns following SCI. With institutional review board approval, rs-fMRI data was obtained in eleven patients with complete cervical SCI (>2 years post injury and nine age-matched controls. The data was processed using the Analysis of Functional Neuroimages software. Region of interest (ROI based analysis was performed to study changes in the sensorimotor network using pre- and post-central gyri as seed regions. Two-sampled t-test was carried out to check for significant differences between the two groups. SCI patients showed decreased functional connectivity in motor and sensory cortical regions when compared to controls. The decrease was noted in ipsilateral, contralateral, and interhemispheric regions for left and right precentral ROIs. Additionally, the left postcentral ROI demonstrated increased connectivity with the thalamus bilaterally in SCI patients. Our results suggest that cortical activation patterns in the sensorimotor network undergo dynamic reorganization following SCI. The presence of these changes in chronic spinal cord injury patients is suggestive of the inherent neural plasticity within the central nervous system.

MRI signal intensity as a maker of impairment in incomplete cervical spinal cord injuries

International Nuclear Information System (INIS)

Chiba, Hidefumi; Aoki, Haruhito; Hamabe, Masaki; Sasao, Yutaka; Miura, Takehiko

1998-01-01

Incomplete cervical spinal cord injuries such as central cord syndrome may result in prolonged spasticity of the limbs, especially disabilities of the upper extremities, even if the patient is able to walk. In this study, relationship between cord impairment and clinical outcome was investigated using MRI. Results showed that small foci of low signal intensity in T 1 -weighted imaging combined with foci of high signal intensity in T 2 -weighted imaging in follow-up MRI are closely related to the severity of sequelae. Small foci of low signal intensity in T 1 -weighted imaging are considered in the literature to indicate myelomalacia or cyst formation with gliosis. (author)

Two-dimensional MRI at 1.5 and 0.5 T versus CT myelography in the diagnosis of cervical radiculopathy

International Nuclear Information System (INIS)

Bartlett, R.J.V.; Rowland Hill, C.A.; Devlin, R.; Gardiner, E.D.

1996-01-01

A prospective comparison was made of standard two-dimensional MRI sequences, at both high and midfield strength, with CT myelography in 23 patients with cervical spondylosis. MRI is adequate for assessment of cord compression, where high field strength is superior to midfield strength. MRI using 4-mm sections is inadequate for presurgical assessment of root compression. It remains to be proven whether thin-section white-CSF volume sequences or gadolinium-enhanced volume studies can replace CT myelography. (orig.). With 6 tabs

Normal morphology of the cervical spinal cord and spinal canal using MRI in Japanese

International Nuclear Information System (INIS)

Kato, Fumihiko; Yukawa, Yasutsugu; Suda, Kota; Yamagata, Masatsune; Ueta, Takayoshi

2010-01-01

The purpose of this study was to establish standard MRI values for the cervical spinal canal, dural tube, and spinal cord in healthy Japanese subjects and to define developmental stenosis of the cervical spinal canal based on MRI data. To establish standard values for ''finger grip and release in 10 seconds (G and R test)'' and ''10 second step test'' in healthy Japanese subjects. There were approximately 100 volunteers representing each gender and generation, including persons aged in their 20s to 70s. The sagittal diameter of the spinal canal, and the sagittal diameter and axial area of the dural tube and spinal cord were measured on MRIs of 1,211 subjects. From this data, we calculated the spinal cord occupation rate in the dural tube for defining developmental stenosis of the cervical spinal canal. ''Finger grip and release in 10 seconds (G and R test)'' and ''10 second step test'' were also examined on 1,211 subjects. The spinal canal diameter in sagittal images for all ages at the C5/6 intervertebral disc level was 11.7±1.6 mm in males and 11.6±1.5 mm in females, while that at the C5 vertebral body level was 12.9±1.4 mm in males and 12.5±1.3 mm in females. Dural tube diameter in sagittal images for all ages at the C5/6 intervertebral disc level was 9.5±1.8 mm in males and 9.6±1.6 mm in females, while that at the C5 vertebral body level was 11.2±1.4 mm in males and 11.1±1.4 mm in females. Dural tube area in axial images for all ages at the C5/6 intervertebral disc level was 155.7±32.1 mm 2 in males and 149.6±29.0 mm 2 in females, while that at the C5 vertebral body level was 187.4±32.6 mm 2 in males and 177.0±32.7 mm 2 in females. Spinal cord diameter in sagittal images for all ages at the C5/6 intervertebral disc level was 5.9±1.0 mm in males and 5.8±0.9 mm in females, while that at the C5 vertebral body level was 6.5±0.7 mm in males and 6.4±0.7 mm in females. Spinal cord area in axial images for all ages at the C5/6 intervertebral disc level

Cervical MRI scan

Science.gov (United States)

... the bones and cartilage in the neck ( cervical spondylosis ) Abnormal results may also be due to: Bone ... Park AL. Degenerative disorders of the thoracic and lumbar spine. In: Azar FM, Beaty JH, Canale ST, ...

Preclinical evaluation of Gd-DTPA and gadomelitol as contrast agents in DCE-MRI of cervical carcinoma interstitial fluid pressure

OpenAIRE

Hompland Tord; Ellingsen Christine; Rofstad Einar K

2012-01-01

Abstract Background High interstitial fluid pressure (IFP) in the primary tumor is associated with poor disease-free survival in locally advanced cervical carcinoma. A noninvasive assay is needed to identify cervical cancer patients with highly elevated tumor IFP because these patients may benefit from particularly aggressive treatment. It has been suggested that dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) with gadolinium diethylene-triamine penta-acetic acid (Gd-DTPA) as c...

MRI-guided percutaneous cervical discectomy and discolysis with oxygen-ozone mixture for treatment of cervical disc herniation: an initial experience

International Nuclear Information System (INIS)

Liu Ming; Li Chengli; Lu Yubo; Huang Jie; Song Jiqing; Li Lei; Bao Shougang; Cao Qianqian; Wu Lebin

2010-01-01

Objective: To explore the value of MR imaging-guided percutaneous cervical discectomy and discolysis with oxygen-ozone mixture for treatment of cervical disc herniation. Methods: Eight herniated cervical discs in 7 patients were diagnosed by MRI, inclluding 5 discs of lateral protruding type, 2 discs of paramedian protruding type and one disc of central protruding type. All patients underwent MR imaging-guided percutaneous cervical discectomy and discolysis with oxygen-ozone mixture. The procedures were guided by a set of 0.23 T open MR system mounted with iPath 200 optical tracking system. The herniated portion of the disc was punctured with a 14 G MR-comparible needle in the healthy side via anterolateral oblique route. The interventional steps were as follows: firstly, cut herniated part with percutaneous discectomy probe and inject 2ml oxygen-ozone mixture of 60 μg/ml; secondly, retreat the needle to the disc center, resect nucleus pulposus, and inject 2 ml oxygen-ozone mixture of 60 μg/ml; secondly, retreat the needle to the disc center, resect nucleus pulposus, and inject 2 ml oxygen-ozone mixture of 60 μg/ml. All patients were followed up for 6 months, with 4 patients by telephone and 3 patients in outpatient clinic. The effect of treatment was evaluated according to Williams postoperative assessment standard. Results: All procedures were performed successfully. The clinical outcome was evaluated as excellent in 5 cases, good in 1 cases and fair in 1 case. The total ratio of excellent and good was 85.7%. No serious complication occurred expect 1 case with intraoperative paroxysmal pain. Conclusion: MR imaging-guided percutaneous cervical discectomy and discolysis with oxygen-ozone mixture was a safe, effective and minimally invasive method for the treatment of cervical disc herniation. (authors)

A study on the clinical significance of magnetic resonance imaging (MRI) findings in patients with cervical spondylotic myelopathy

International Nuclear Information System (INIS)

Toyooka, Satoshi

1997-01-01

This study was designed to evaluate magnetic resonance (MR) images of the cervical compressive myelopathy. It was also meant to serve as a review of clinical symptoms and an investigation of the usefulness of MRI. Comparative studies were carried out on 110 cases concerning the shape and signal intensity of the spinal cord, anterior epidural venous plexus MR images and clinical symptoms. The shape of the spinal cord and pre- and post-surgical conditions revealed by MRI correlated with clinical symptoms. As for the signal intensity of the spinal cord, in cases in which both high (T2-weighted image) and low (T1-weighted image) signals detected prior to surgery continued after surgery, as well as cases with high and low signals appearing after surgery, had the lower improvement than average. Low signal intensity on T1-weighted images are assumed to indicate irreversible changes of the spinal cord. High signal intensity on T2-weighted images is assumed to indicate both reversible and irreversible changes of the spinal cord. Epidural venous plexus can also be observed in healthy people and is not directly bound to clinical manifestations. Nevertheless, changes in the shape of the epidural venous plexus and signal intensity can reflect venous plexus compression and circulatory changes caused by compression. In the application of MRI to cervical compressive myelopathies, images of changes in the shape and signal intensity of the spinal cord and anterior epidural venous plexus images were considered important observations linked to clinical symptoms. MRI is an essential non-invasive imaging technique for the diagnosis of cervical compressive myelopathy, estimation of prognosis and postoperative follow-up. More investigations of compressive factors, circulatory dynamics of the spinal cord and high quality image are necessary. (author)

Clinical significance of MRI/18F-FDG PET fusion imaging of the spinal cord in patients with cervical compressive myelopathy

International Nuclear Information System (INIS)

Uchida, Kenzo; Nakajima, Hideaki; Watanabe, Shuji; Yoshida, Ai; Baba, Hisatoshi; Okazawa, Hidehiko; Kimura, Hirohiko; Kudo, Takashi

2012-01-01

18 F-FDG PET is used to investigate the metabolic activity of neural tissue. MRI is used to visualize morphological changes, but the relationship between intramedullary signal changes and clinical outcome remains controversial. The present study was designed to evaluate the use of 3-D MRI/ 18 F-FDG PET fusion imaging for defining intramedullary signal changes on MRI scans and local glucose metabolic rate measured on 18 F-FDG PET scans in relation to clinical outcome and prognosis. We studied 24 patients undergoing decompressive surgery for cervical compressive myelopathy. All patients underwent 3-D MRI and 18 F-FDG PET before surgery. Quantitative analysis of intramedullary signal changes on MRI scans included calculation of the signal intensity ratio (SIR) as the ratio between the increased lesional signal intensity and the signal intensity at the level of the C7/T1 disc. Using an Advantage workstation, the same slices of cervical 3-D MRI and 18 F-FDG PET images were fused. On the fused images, the maximal count of the lesion was adopted as the standardized uptake value (SUV max ). In a similar manner to SIR, the SUV ratio (SUVR) was also calculated. Neurological assessment was conducted using the Japanese Orthopedic Association (JOA) scoring system for cervical myelopathy. The SIR on T1-weighted (T1-W) images, but not SIR on T2-W images, was significantly correlated with preoperative JOA score and postoperative neurological improvement. Lesion SUV max was significantly correlated with SIR on T1-W images, but not with SIR on T2-W images, and also with postoperative neurological outcome. The SUVR correlated better than SIR on T1-W images and lesion SUV max with neurological improvement. Longer symptom duration was correlated negatively with SIR on T1-W images, positively with SIR on T2-W images, and negatively with SUV max . Our results suggest that low-intensity signal on T1-W images, but not on T2-W images, is correlated with a poor postoperative neurological

Functional MRI of the kidneys

OpenAIRE

Zhang, Jeff L.; Rusinek, Henry; Chandarana, Hersh; Lee, Vivian S.

2013-01-01

Renal function is characterized by different physiologic aspects, including perfusion, glomerular filtration, interstitial diffusion and tissue oxygenation. MRI shows great promise in assessing these renal tissue characteristics noninvasively. The last decade has witnessed a dramatic progress in MRI techniques for renal function assessment. This article briefly describes relevant renal anatomy and physiology, reviews the applications of functional MRI techniques for the diagnosis of renal dis...

Novel use of ViewRay MRI guidance for high-dose-rate brachytherapy in the treatment of cervical cancer.

Science.gov (United States)

Ko, Huaising C; Huang, Jessie Y; Miller, Jessica R; Das, Rupak K; Wallace, Charles R; De Costa, Anna-Maria A; Francis, David M; Straub, Margaret R; Anderson, Bethany M; Bradley, Kristin A

To characterize image quality and feasibility of using ViewRay MRI (VR)-guided brachytherapy planning for cervical cancer. Cervical cancer patients receiving intracavitary brachytherapy with tandem and ovoids, planned using 0.35T VR MRI at our institution, were included in this series. The high-risk clinical target volume (HR-CTV), visible gross tumor volume, bladder, sigmoid, bowel, and rectum contours for each fraction of brachytherapy were evaluated for dosimetric parameters. Typically, five brachytherapy treatments were planned using the T2 sequence on diagnostic MRI for the first and third fractions, and a noncontrast true fast imaging with steady-state precession sequence on VR or CT scan for the remaining fractions. Most patients received 5.5 Gy × 5 fractions using high-dose-rate Ir-192 following 45 Gy of whole-pelvis radiotherapy. The plan was initiated at 5.5 Gy to point A and subsequently optimized and prescribed to the HR-CTV. The goal equivalent dose in 2 Gy fractions for the combined external beam and brachytherapy dose was 85 Gy. Soft-tissue visualization using contrast-to-noise ratios to distinguish normal tissues from tumor at their interface was compared between diagnostic MRI, CT, and VR. One hundred and forty-two fractions of intracavitary brachytherapy were performed from April 2015 to January 2017 on 29 cervical cancer patients, ranging from stages IB1 to IVA. The median HR-CTV was 27.78 cc, with median D 90 HR-CTV of 6.1 Gy. The median time from instrument placement to start of treatment using VR was 65 min (scan time 2 min), compared to 105 min using diagnostic MRI (scan time 11 min) (t-test, p < 0.01). The contrast-to-noise ratio of tumor to cervix in both diagnostic MRI and VR had significantly higher values compared to CT (ANOVA and t-tests, p < 0.01). We report the first clinical use of VR-guided brachytherapy. Time to treatment using this approach was shorter compared to diagnostic MRI. VR also provided significant

MRI findings before and after abdominal radical trachelectomy (ART) for cervical cancer: A prospective study and review of the literature

International Nuclear Information System (INIS)

Bourgioti, C.; Koutoulidis, V.; Chatoupis, K.; Rodolakis, A.; Koureas, A.; Thomakos, N.; Moulopoulos, L.A.

2014-01-01

Aim: To report the authors' experience with dedicated pelvic magnetic resonance imaging (MRI) in young women with early-stage cervical cancer treated with abdominal radical trachelectomy (ART). Materials and methods: During a 5-year period, 21 patients, with biopsy-confirmed cervical carcinoma, International Federation of Gynaecology and Obstetrics (FIGO) stage ≤IB1, were considered for trachelectomy. All patients underwent pelvic MRI within 30 days prior to surgery. Tumour size, endocervical extension, extrauterine spread, and nodal status were noted. Postoperative MRI findings were reviewed in 16 patients. Results: Nineteen of the 21 patients were treated with ART. In two patients, trachelectomy was aborted intraoperatively and radical hysterectomy was performed; preoperative MRI findings were consistent with surgicopathological examination in both patients. MRI correctly assessed tumour size in 18/21 patients, coming within 5 mm of the surgical specimen. Tumour size was underestimated in two cases because of circumferential growth (n = 1) or technical difficulties (n = 1). False-positive MRI result was due to post-biopsy inflammation (n = 1). MRI accurately identified absence of internal os involvement in 17/19 ART patients; false-positive MRI for internal os involvement were due to endocervical polyp (n = 1) and coexisting Nabothian cysts (n = 1). No trachelectomy patient had extrauterine disease or malignant nodes at MRI or final histology. Post-trachelectomy complications included hydrosalpinges (n = 3), lymphocysts (n = 2), isthmic stenosis (n = 1), and tumour relapse (n = 2). Conclusions: Dedicated pelvic MRI is helpful in assessing tumour size and endocervical extension in young women, candidates for ART. Hydrosalpinx may occur after ART and it may influence fertility potential

Connective tissue of cervical carcinoma xenografts: associations with tumor hypoxia and interstitial fluid pressure and its assessment by DCE-MRI and DW-MRI.

Science.gov (United States)

Hompland, Tord; Ellingsen, Christine; Galappathi, Kanthi; Rofstad, Einar K

2014-01-01

Abstract Background. A high fraction of stroma in malignant tissues is associated with tumor progression, metastasis, and poor prognosis. Possible correlations between the stromal and physiologic microenvironments of tumors and the potential of dynamic contrast-enhanced (DCE) and diffusion-weighted (DW) magnetic resonance imaging (MRI) in quantification of the stromal microenvironment were investigated in this study. Material and methods. CK-160 cervical carcinoma xenografts were used as preclinical tumor model. A total of 43 tumors were included in the study, and of these tumors, 17 were used to search for correlations between the stromal and physiologic microenvironments, 11 were subjected to DCE-MRI, and 15 were subjected to DW-MRI. DCE-MRI and DW-MRI were carried out at 1.5 T with a clinical MR scanner and a slotted tube resonator transceiver coil constructed for mice. Fraction of connective tissue (CTFCol) and fraction of hypoxic tissue (HFPim) were determined by immunohistochemistry. A Millar SPC 320 catheter was used to measure tumor interstitial fluid pressure (IFP). Results. CTFCol showed a positive correlation to IFP and an inverse correlation to HFPim. The apparent diffusion coefficient assessed by DW-MRI was inversely correlated to CTFCol, whereas no correlation was found between DCE-MRI-derived parameters and CTFCol. Conclusion. DW-MRI is a potentially useful method for characterizing the stromal microenvironment of tumors.

Functional MRI of the patellofemoral joint: comparison of ultrafast MRI, motion-triggered cine MRI and static MRI

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Muhle, C. [Klinik fuer Radiologische Diagnostik, Univ. Kiel (Germany); Brossmann, J. [Klinik fuer Radiologische Diagnostik, Univ. Kiel (Germany); Melchert, U.H. [Klinik fuer Radiologische Diagnostik, Univ. Kiel (Germany); Schroeder, C. [Radiologische Abt., Universitaets-Kinderklinik, Christian-Albrechts-Universitaet, Kiel (Germany); Boer, R. de [Philips Medical Systems, Best (Netherlands); Spielmann, R.P. [Klinik fuer Radiologische Diagnostik, Univ. Kiel (Germany); Heller, M. [Klinik fuer Radiologische Diagnostik, Univ. Kiel (Germany)

1995-12-31

To evaluate the feasibility and usefulness of ultrafast MRI (u), patellar tracking from 30 of flexion to knee extension (0 ) was analysed and compared with motion-triggered cine MRI (m) and a static MRI technique (s). The different imaging methods were compared in respect of the patellofemoral relationship, the examination time and image quality. Eight healthy subjects and four patients (in total 18 joints) with patellar subluxation or luxation were examined. Significant differences between the static MRI series without quadriceps contraction and the functional MRI studies (motion-triggered cine MRI and ultrafast MRI) were found for the patellar tilt angle. In the dynamic joint studies there was no statistical difference of the regression coefficients between the motion-triggered cine MRI studies and the ultrafast MRI studies. The findings of the functional MRI studies compared with the static MRI images were significantly different for the lateralisation of the patella, expressed by the lateral patellar displacement and bisect offset. No significant differences in patellar lateralisation were found between motion-triggered cine MRI and ultrafast MRI. Ultrafast MRI was superior to motion-triggered cine MRI in terms of the reduction in imaging time and improvement of the image quality. (orig.)

Functional MRI of the patellofemoral joint: comparison of ultrafast MRI, motion-triggered cine MRI and static MRI

International Nuclear Information System (INIS)

Muhle, C.; Brossmann, J.; Melchert, U.H.; Schroeder, C.; Boer, R. de; Spielmann, R.P.; Heller, M.

1995-01-01

To evaluate the feasibility and usefulness of ultrafast MRI (u), patellar tracking from 30 of flexion to knee extension (0 ) was analysed and compared with motion-triggered cine MRI (m) and a static MRI technique (s). The different imaging methods were compared in respect of the patellofemoral relationship, the examination time and image quality. Eight healthy subjects and four patients (in total 18 joints) with patellar subluxation or luxation were examined. Significant differences between the static MRI series without quadriceps contraction and the functional MRI studies (motion-triggered cine MRI and ultrafast MRI) were found for the patellar tilt angle. In the dynamic joint studies there was no statistical difference of the regression coefficients between the motion-triggered cine MRI studies and the ultrafast MRI studies. The findings of the functional MRI studies compared with the static MRI images were significantly different for the lateralisation of the patella, expressed by the lateral patellar displacement and bisect offset. No significant differences in patellar lateralisation were found between motion-triggered cine MRI and ultrafast MRI. Ultrafast MRI was superior to motion-triggered cine MRI in terms of the reduction in imaging time and improvement of the image quality. (orig.)

How one institution overcame the challenges to start an MRI-based brachytherapy program for cervical cancer

Directory of Open Access Journals (Sweden)

Matthew M. Harkenrider

2017-03-01

Full Text Available Purpose : Adaptive magnetic resonance imaging (MRI-based brachytherapy results in improved local control and decreased high-grade toxicities compared to historical controls. Incorporating MRI into the workflow of a department can be a major challenge when initiating an MRI-based brachytherapy program. This project aims to describe the goals, challenges, and solutions when initiating an MRI-based cervical cancer brachytherapy program at our institution. Material and methods : We describe the 6-month multi-disciplinary planning phase to initiate an MRI-based brachytherapy program. We describe the specific challenges that were encountered prior to treating our first patient. Results : We describe the solutions that were realized and executed to solve the challenges that we faced to establish our MRI-based brachytherapy program. We emphasize detailed coordination of care, planning, and communication to make the workflow feasible. We detail the imaging and radiation physics solutions to safely deliver MRI-based brachytherapy. The focus of these efforts is always on the delivery of optimal, state of the art patient care and treatment delivery within the context of our available institutional resources. Conclusions : Previous publications have supported a transition to MRI-based brachytherapy, and this can be safely and efficiently accomplished as described in this manuscript.

Utility of MRI for cervical spine clearance after blunt traumatic injury: a meta-analysis

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Malhotra, Ajay; Wu, Xiao; Kalra, Vivek B.; Liu, Renu; Forman, Howard P. [Yale School of Medicine, Department of Radiology and Biomedical Imaging, Tompkins East 2, 333 Cedar St, Box 208042, New Haven, CT (United States); Nardini, Holly K.G. [Yale University, Research and Education Librarian, Harvey Cushing/John Hay Whitney Medical Library, New Haven, CT (United States); Abbed, Khalid M. [Yale School of Medicine, Minimally Invasive Spine Surgery and Spine Tumor Surgery, New Haven, CT (United States)

2017-03-15

To quantify the rate of unstable injuries detected by MRI missed on CT in blunt cervical spine (CS) trauma patients and assess the utility of MRI in CS clearance. We undertook a systematic review of worldwide evidence across five major medical databases and performed a meta-analysis. Studies were included if they reported the number of unstable injuries or gave enough details for inference. Variables assessed included severity, CT/MRI specifications, imaging timing, and outcome/follow-up. Pooled incidences of unstable injury on follow-up weighted by inverse-of-variance among all included and obtunded or alert patients were reported. Of 428 unique citations, 23 proved eligible, with 5,286 patients found, and 16 unstable injuries reported in five studies. The overall pooled incidence is 0.0029 %. Among studies reporting only obtunded patients, the pooled incidence is 0.017 %. In alert patients, the incidence is 0.011 %. All reported positive findings were critically reviewed, and only 11 could be considered truly unstable. There is significant heterogeneity in the literature regarding the use of imaging after a negative CT. The finding rate on MRI for unstable injury is extremely low in obtunded and alert patients. Although MRI is frequently performed, its utility and cost-effectiveness needs further study. (orig.)

Utility of MRI for cervical spine clearance after blunt traumatic injury: a meta-analysis

International Nuclear Information System (INIS)

Malhotra, Ajay; Wu, Xiao; Kalra, Vivek B.; Liu, Renu; Forman, Howard P.; Nardini, Holly K.G.; Abbed, Khalid M.

2017-01-01

To quantify the rate of unstable injuries detected by MRI missed on CT in blunt cervical spine (CS) trauma patients and assess the utility of MRI in CS clearance. We undertook a systematic review of worldwide evidence across five major medical databases and performed a meta-analysis. Studies were included if they reported the number of unstable injuries or gave enough details for inference. Variables assessed included severity, CT/MRI specifications, imaging timing, and outcome/follow-up. Pooled incidences of unstable injury on follow-up weighted by inverse-of-variance among all included and obtunded or alert patients were reported. Of 428 unique citations, 23 proved eligible, with 5,286 patients found, and 16 unstable injuries reported in five studies. The overall pooled incidence is 0.0029 %. Among studies reporting only obtunded patients, the pooled incidence is 0.017 %. In alert patients, the incidence is 0.011 %. All reported positive findings were critically reviewed, and only 11 could be considered truly unstable. There is significant heterogeneity in the literature regarding the use of imaging after a negative CT. The finding rate on MRI for unstable injury is extremely low in obtunded and alert patients. Although MRI is frequently performed, its utility and cost-effectiveness needs further study. (orig.)

Dynamic Contrast-Enhanced MRI of Cervical Cancers: Temporal Percentile Screening of Contrast Enhancement Identifies Parameters for Prediction of Chemoradioresistance

International Nuclear Information System (INIS)

Andersen, Erlend K.F.; Hole, Knut Håkon; Lund, Kjersti V.; Sundfør, Kolbein; Kristensen, Gunnar B.; Lyng, Heidi; Malinen, Eirik

2012-01-01

Purpose: To systematically screen the tumor contrast enhancement of locally advanced cervical cancers to assess the prognostic value of two descriptive parameters derived from dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI). Methods and Materials: This study included a prospectively collected cohort of 81 patients who underwent DCE-MRI with gadopentetate dimeglumine before chemoradiotherapy. The following descriptive DCE-MRI parameters were extracted voxel by voxel and presented as histograms for each time point in the dynamic series: normalized relative signal increase (nRSI) and normalized area under the curve (nAUC). The first to 100th percentiles of the histograms were included in a log-rank survival test, resulting in p value and relative risk maps of all percentile–time intervals for each DCE-MRI parameter. The maps were used to evaluate the robustness of the individual percentile–time pairs and to construct prognostic parameters. Clinical endpoints were locoregional control and progression-free survival. The study was approved by the institutional ethics committee. Results: The p value maps of nRSI and nAUC showed a large continuous region of percentile–time pairs that were significantly associated with locoregional control (p < 0.05). These parameters had prognostic impact independent of tumor stage, volume, and lymph node status on multivariate analysis. Only a small percentile–time interval of nRSI was associated with progression-free survival. Conclusions: The percentile–time screening identified DCE-MRI parameters that predict long-term locoregional control after chemoradiotherapy of cervical cancer.

A radiological study on the cervical spine in rheumatoid arthritis

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Taketomi, Eiji; Sakoh, Takashi; Sunahara, Nobuhiko [Kagoshima Univ. (Japan). Faculty of Medicine

1995-03-01

The cervical spine was examined with the magnetic resonance imaging (MRI) and the conventional roentgenograms in 95 patients with rheumatoid arthritis. The MRI findings of upper cervical disorders were compared with various values determined in roentgenograms: the atlanto-dental interval (ADI), the space available for the spinal cord (SAC), and the Ranawat and Redlund-Johnell values. In patients with vertical setting (VS), MRI showed medullary compression in all those with abnormal Redlund-Johnell values and Ranawat values of 7 mm or less. In patients with anterior atlanto-axial subluxation, compression of the upper cervical cord was observed in all patients with SAC of 13 mm or less. In subaxial lesion of the cervical spine, MRI was found to be as good as roentgenograms in evaluating plate erosion and disc space narrowing and MRI showed extradural pannus. (author).

A radiological study on the cervical spine in rheumatoid arthritis

International Nuclear Information System (INIS)

Taketomi, Eiji; Sakoh, Takashi; Sunahara, Nobuhiko

1995-01-01

The cervical spine was examined with the magnetic resonance imaging (MRI) and the conventional roentgenograms in 95 patients with rheumatoid arthritis. The MRI findings of upper cervical disorders were compared with various values determined in roentgenograms: the atlanto-dental interval (ADI), the space available for the spinal cord (SAC), and the Ranawat and Redlund-Johnell values. In patients with vertical setting (VS), MRI showed medullary compression in all those with abnormal Redlund-Johnell values and Ranawat values of 7 mm or less. In patients with anterior atlanto-axial subluxation, compression of the upper cervical cord was observed in all patients with SAC of 13 mm or less. In subaxial lesion of the cervical spine, MRI was found to be as good as roentgenograms in evaluating plate erosion and disc space narrowing and MRI showed extradural pannus. (author)

CERVICAL SPONDYLOTIC MYELOPATHY WITH FUNCTIONAL ...

African Journals Online (AJOL)

CERVICAL SPONDYLOTIC MYELOPATHY WITH FUNCTIONAL DISABILITY. LONG TERM RESULTS CONCERNING 18 PATIENTS OPERATED ON BY ANTERIOR APPROACH IN GABON MYELOPATHIES CERVICARTHROSIQUES INVALIDANTES. RESULTATS A LONG TERME DE 18 PATIENTS OPERES PAR VOIE ...

Nerve Transfers for Improved Hand Function Following Cervical Spinal Cord Injury

Science.gov (United States)

the cervical spine resulting in diminished or complete loss of arm and/or hand function. Cervical SCI patients consistently rank hand function as the...most desired function above bowel and bladder function, sexual function, standing, and pain control. The overall goal of the proposed study is to...evaluate the efficacy of nerve transfers to treat patients with cervical SCIs. Over the last decade, nerve transfers have been used with increasing

Change in T2-Fat Saturation MRI Correlates With Outcome in Cervical Cancer Patients

International Nuclear Information System (INIS)

Ma, Daniel J.; Zhu Jianming; Grigsby, Perry W.

2011-01-01

Purpose: To compare pretreatment and midtreatment tumor intensity as measured by T2 fat-saturation (T2-FS) MRI and its association with treatment response in cervical cancer patients. Methods and Materials: Weekly MRI scans were performed for brachytherapy planning on 23 consecutive patients with clinical Stage IB1 to IIIB cervical cancer treated with definitive chemoradiotherapy. These scans were performed on a 1.5-T clinical scanner using a specialized pelvic coil. Mean signal intensity from T2-FS imaging was calculated for each tumor voxel. Average tumor intensity and tumor volume were recorded pre- and midtreatment (at Weeks 0 and 4). All patients subsequently underwent routine follow-up, including periodic clinical examinations and fluorodeoxyglucose–positron emission tomography imaging. Results: Mean follow-up for surviving patients was 14.5 months. Mean tumor volume at presentation was 49.6 cc, and mean midtreatment tumor volume was 16.0 cc. There was no correlation between initial tumor volume and pretreatment signal intensity (r = 0.44), nor was there a correlation between pre- or midtreatment tumor volume with disease-free survival (p = 0.18, p = 0.08 respectively.) However, having at least a 30% drop in signal intensity from pretreatment to midtreatment was correlated with having disease resolution on posttreatment fluorodeoxyglucose–positron emission tomography imaging (p = 0.05) and with disease-free survival (p = 0.03.) Estimated disease-free survival at 22 months was 100% for patients with at least a 30% drop in tumor signal intensity compared with 33% for patients above this selected threshold (p = 0.004). Conclusions: Longitudinal changes in T2-FS tumor intensity during chemoradiation correlated with disease-free survival in cervical cancer patients. Persistently high midtreatment tumor intensities correlated with a high risk of treatment failure, whereas large decreases in tumor intensity correlated with a favorable outcome.

Trauma related changes in cervical spine and spinal cord in myelography and MRI; Zmiany pourazowe kregoslupa i rdzenia w odcinku szyjnym, w mielografii i w obrazie NMR

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Wozniak, E.; Bronarski, J.; Kiwerski, J.; Krasuski, M. [Akademia Medyczna, Warsaw (Poland)]|[Stoleczny Zespol Rehabilitacji, Konstancin (Poland)

1993-12-31

Myelographic and MRI results in 14 patients treated in 1992 because of cervical spine injury with neurological complications have been presented. Myelography proves to be useful in posttraumatic spine diagnostics but in some cases does not render sufficient information, especially if the trauma superimposes previously existing pathological changes. MRI is exceptionally valuable diagnostic modality in cervical spine injuries offering an advantage of both early and late evaluation of the post-traumatic spinal cord changes. (author). 12 refs, 6 figs, 2 tabs.

MRI-assisted versus conventional treatment planning in brachytherapy of cervical and endometrial carcinoma: The impact of individual anatomy on dose distribution in target volume and organs at risk

International Nuclear Information System (INIS)

Wulf, Joern; Sauer, Otto A.; Herbolsheimer, Michael; Oppitz, Ulrich; Flentje, Michael

1996-01-01

Objective: Dose prescription and definition of target volume in brachytherapy of cervical and endometrial cancer are calculated to standard points as Manchester point A or point My(ometrium) in most centers. Calculation of doses to organs at risk mainly relies on ICRU-report 38. But standard dose prescription neglects individual patient anatomy. While MRI and CT had widespread impact on individual planning in external beam radiotherapy, there is still a minor influence on brachytherapy. The impact of individual anatomy on dose distribution in target volume and organs at risk demonstrates the objective of individual brachytherapy planning. Materials and Methods: 8 patients with cervical and 4 patients with endometrial carcinoma underwent MRI of the pelvis with in-situ applicators (ring-tandem applicators for cervical carcinoma and modified Heyman-capsules for endometrial carcinoma). T1w slices were angulated coronal and sagittal to get rectangular reproductions to applicator axis. Orthogonal or isocentric X-ray films for conventional treatment planning were done. MRI-information on target and organs at risk was transformed into coordinates relative to applicator axis and dose calculation on the database of conventional treatment planning was performed by Nucletron Planning System PLATO. Isodoses were projected into MRI slices. Prescribed dose to patients with cervical cancer was 8.5 Gy to point A resp. 10 Gy to point My (2cm below fundal myometrium and 2cm lateral applicator axis) in endometrial cancer. Results: Dose prescription to Manchester point A or point My represented in only 50% of cases uterine serosa. Instead of 2cm lateral of applicator axis, uterine surface ranged from 1.0 cm to 3.9 cm at the level of point A (mean 2.25 cm coronal and 1.77 cm sagittal) and from 1.5 cm to 4.4 cm at the level of point My (mean 2.7 cm coronal and 2.1 cm sagittal). Uterine volume ranged from 69 cc to 277 cc, mean volume was 150cc. Dose-volume histograms of patients with

Pharmacokinetic parameters derived from dynamic contrast enhanced MRI of cervical cancers predict chemoradiotherapy outcome

International Nuclear Information System (INIS)

Andersen, Erlend K.F.; Hole, Knut Håkon; Lund, Kjersti V.; Sundfør, Kolbein; Kristensen, Gunnar B.; Lyng, Heidi; Malinen, Eirik

2013-01-01

Purpose: To assess the prognostic value of pharmacokinetic parameters derived from pre-chemoradiotherapy dynamic contrast enhanced magnetic resonance imaging (DCE-MRI) of cervical cancer patients. Materials and methods: Seventy-eight patients with locally advanced cervical cancer underwent DCE-MRI with Gd-DTPA before chemoradiotherapy. The pharmacokinetic Brix and Tofts models were fitted to contrast enhancement curves in all tumor voxels, providing histograms of several pharmacokinetic parameters (Brix: A Brix , k ep , k el , Tofts: K trans , ν e ). A percentile screening approach including log-rank survival tests was undertaken to identify the clinically most relevant part of the intratumoral parameter distribution. Clinical endpoints were progression-free survival (PFS) and locoregional control (LRC). Multivariate analysis including FIGO stage and tumor volume was used to assess the prognostic significance of the imaging parameters. Results: A Brix , k el , and K trans were significantly (P e was significantly positively correlated with PFS only. k ep showed no association with any endpoint. A Brix was positively correlated with K trans and ν e , and showed the strongest association with endpoint in the log-rank testing. k el and K trans were independent prognostic factors in multivariate analysis with LRC as endpoint. Conclusions: Parameters estimated by pharmacokinetic analysis of DCE-MR images obtained prior to chemoradiotherapy may be used for identifying patients at risk of treatment failure

Separation of type and grade in cervical tumours using non-mono-exponential models of diffusion-weighted MRI

International Nuclear Information System (INIS)

Winfield, Jessica M.; Collins, David J.; Morgan, Veronica A.; DeSouza, Nandita M.; Orton, Matthew R.; Ind, Thomas E.J.; Attygalle, Ayoma; Hazell, Steve

2017-01-01

Assessment of empirical diffusion-weighted MRI (DW-MRI) models in cervical tumours to investigate whether fitted parameters distinguish between types and grades of tumours. Forty-two patients (24 squamous cell carcinomas, 14 well/moderately differentiated, 10 poorly differentiated; 15 adenocarcinomas, 13 well/moderately differentiated, two poorly differentiated; three rare types) were imaged at 3 T using nine b-values (0 to 800 s mm -2 ). Mono-exponential, stretched exponential, kurtosis, statistical, and bi-exponential models were fitted. Model preference was assessed using Bayesian Information Criterion analysis. Differences in fitted parameters between tumour types/grades and correlation between fitted parameters were assessed using two-way analysis of variance and Pearson's linear correlation coefficient, respectively. Non-mono-exponential models were preferred by 83 % of tumours with bi-exponential and stretched exponential models preferred by the largest numbers of tumours. Apparent diffusion coefficient (ADC) and diffusion coefficients from non-mono-exponential models were significantly lower in poorly differentiated tumours than well/moderately differentiated tumours. α (stretched exponential), K (kurtosis), f and D* (bi-exponential) were significantly different between tumour types. Strong correlation was observed between ADC and diffusion coefficients from other models. Non-mono-exponential models were preferred to the mono-exponential model in DW-MRI data from cervical tumours. Parameters of non-mono-exponential models showed significant differences between types and grades of tumours. (orig.)

Separation of type and grade in cervical tumours using non-mono-exponential models of diffusion-weighted MRI

Energy Technology Data Exchange (ETDEWEB)

Winfield, Jessica M.; Collins, David J.; Morgan, Veronica A.; DeSouza, Nandita M. [The Royal Marsden NHS Foundation Trust, MRI Unit, Sutton, Surrey (United Kingdom); The Institute of Cancer Research, Cancer Research UK Cancer Imaging Centre, Division of Radiotherapy and Imaging, London (United Kingdom); Orton, Matthew R. [The Institute of Cancer Research, Cancer Research UK Cancer Imaging Centre, Division of Radiotherapy and Imaging, London (United Kingdom); Ind, Thomas E.J. [The Royal Marsden NHS Foundation Trust, Gynaecology Unit, London (United Kingdom); Attygalle, Ayoma; Hazell, Steve [The Royal Marsden NHS Foundation Trust, Department of Histopathology, London (United Kingdom)

2017-02-15

Assessment of empirical diffusion-weighted MRI (DW-MRI) models in cervical tumours to investigate whether fitted parameters distinguish between types and grades of tumours. Forty-two patients (24 squamous cell carcinomas, 14 well/moderately differentiated, 10 poorly differentiated; 15 adenocarcinomas, 13 well/moderately differentiated, two poorly differentiated; three rare types) were imaged at 3 T using nine b-values (0 to 800 s mm{sup -2}). Mono-exponential, stretched exponential, kurtosis, statistical, and bi-exponential models were fitted. Model preference was assessed using Bayesian Information Criterion analysis. Differences in fitted parameters between tumour types/grades and correlation between fitted parameters were assessed using two-way analysis of variance and Pearson's linear correlation coefficient, respectively. Non-mono-exponential models were preferred by 83 % of tumours with bi-exponential and stretched exponential models preferred by the largest numbers of tumours. Apparent diffusion coefficient (ADC) and diffusion coefficients from non-mono-exponential models were significantly lower in poorly differentiated tumours than well/moderately differentiated tumours. α (stretched exponential), K (kurtosis), f and D* (bi-exponential) were significantly different between tumour types. Strong correlation was observed between ADC and diffusion coefficients from other models. Non-mono-exponential models were preferred to the mono-exponential model in DW-MRI data from cervical tumours. Parameters of non-mono-exponential models showed significant differences between types and grades of tumours. (orig.)

Investigating the Mechanical Function of the Cervix during Pregnancy using Finite Element Models derived from High Resolution 3D MRI

Science.gov (United States)

Fernandez, M.; House, M.; Jambawalikar, S.; Zork, N.; Vink, J.; Wapner, R.; Myers, K.

2015-01-01

Preterm birth is a strong contributor to perinatal mortality, and preterm infants that survive are at risk for long-term morbidities. During most of pregnancy appropriate mechanical function of the cervix is required to maintain the developing fetus in utero. Premature cervical softening and subsequent cervical shortening are hypothesized to cause preterm birth. Presently, there is a lack of understanding of the structural and material factors that influence the mechanical function of the cervix during pregnancy. In this study we build finite element (FE) models of the pregnant uterus, cervix, and fetal membrane based on magnetic resonance imagining (MRI) data in order to examine the mechanical function of the cervix under the physiologic loading conditions of pregnancy. We calculate the mechanical loading state of the cervix for two pregnant patients: 22 weeks gestational age with a normal cervical length and 28 weeks with a short cervix. We investigate the influence of 1) anatomical geometry 2) cervical material properties, and 3) fetal membrane material properties, including its adhesion properties, on the mechanical loading state of the cervix under physiologically relevant intrauterine pressures. Our study demonstrates that membrane-uterus interaction, cervical material modeling, and membrane mechanical properties are factors that must be deliberately and carefully handled in order to construct a high quality mechanical simulation of pregnancy. PMID:25970655

7 Tesla 22-channel wrap-around coil array for cervical spinal cord and brainstem imaging.

Science.gov (United States)

Zhang, Bei; Seifert, Alan C; Kim, Joo-Won; Borrello, Joseph; Xu, Junqian

2017-10-01

Increased signal-to-noise ratio and blood oxygenation level-dependent sensitivity at 7 Tesla (T) have the potential to enable high-resolution imaging of the human cervical spinal cord and brainstem. We propose a new two-panel radiofrequency coil design for these regions to fully exploit the advantages of ultra-high field. A two-panel array, containing four transmit/receive and 18 receive-only elements fully encircling the head and neck, was constructed following simulations demonstrating the B1+ and specific absorption rate (SAR) benefits of two-panel over one-panel arrays. This array was compared with a previously reported posterior-only array and tested for safety using a phantom. Its anatomical, functional, and diffusion MRI performance was demonstrated in vivo. The two-panel array produced more uniform B1+ across the brainstem and cervical spinal cord without compromising SAR, and achieved 70% greater receive sensitivity than the posterior-only array. The two-panel design enabled acceleration of R = 2 × 2 in two dimensions or R = 3 in a single dimension. High quality in vivo anatomical, functional, and diffusion images of the human cervical spinal cord and brainstem were acquired. We have designed and constructed a wrap-around coil array with excellent performance for cervical spinal cord and brainstem MRI at 7T, which enables simultaneous human cervical spinal cord and brainstem functional MRI. Magn Reson Med 78:1623-1634, 2017. © 2016 International Society for Magnetic Resonance in Medicine. © 2016 International Society for Magnetic Resonance in Medicine.

Utility of preoperative ferumoxtran-10 MRI to evaluate retroperitoneal lymph node metastasis in advanced cervical cancer: Results of ACRIN 6671/GOG 0233

Directory of Open Access Journals (Sweden)

Mostafa Atri

2015-01-01

Conclusion: Addition of f-10 increased MRI sensitivity to detect LN metastasis in advanced cervical cancer. Increased sensitivity did not reach statistical significance and was at the expense of lower specificity.

Utility of preoperative ferumoxtran-10 MRI to evaluate retroperitoneal lymph node metastasis in advanced cervical cancer: Results of ACRIN 6671/GOG 0233.

Science.gov (United States)

Atri, Mostafa; Zhang, Zheng; Marques, Helga; Gorelick, Jeremy; Harisinghani, Mukesh; Sohaib, Aslam; Koh, Dow-Mu; Raman, Steven; Gee, Michael; Choi, Haesun; Landrum, Lisa; Mannel, Robert; Chuang, Linus; Yu, Jian Qin Michael; McCourt, Carolyn Kay; Gold, Michael

To assess if ferumoxtran-10 (f-10) improves accuracy of MRI to detect lymph node (LN) metastasis in advanced cervical cancer. F-10 MRI component of an IRB approved HIPAA compliant ACRIN/GOG trial was analyzed. Patients underwent f-10 MRI followed by extra-peritoneal or laparoscopic pelvic and abdominal lymphadenectomy. F-10-sensitive sequences were T2* GRE sequences with TE of 12 and 21. Seven independent blinded readers reviewed f-10-insensitive sequences and all sequences in different sessions. Region correlations were performed between pathology and MRI for eight abdomen and pelvis regions. Sensitivity and specificity were calculated at participant level. Reference standard is based on pathology result of surgically removed LNs. Among 43 women enrolled in the trial between September 2007 and November 2009, 33 women (mean age 49 ±11 years old) with advanced cervical cancer (12 IB2, 3 IIA, 15 IIB and 3 IIIB, 29 squamous cell carcinomas, 32 grade 2 or 3) were evaluable. Based on histopathology, LN metastasis was 39% in abdomen and 70% in pelvis. Sensitivity of all sequence review in pelvis, abdomen, and combined were 83%, 60%, and 86%, compared with 78%, 54%, and 80% for f-10 insensitive sequences ( P : 0.24, 0.44 and 0.14, respectively). Mean diameter of the largest positive focus on histopathology was 13.7 mm in abdomen and 18.8 mm in pelvis ( P = 0.018). Specificities of all sequence review in pelvis, abdomen, and combined were 48%, 75%, and 43%, compared with 75%, 83%, and 73% ( P : 0.003, 0.14, 0.002 respectively) for f-10 insensitive sequences. Addition of f-10 increased MRI sensitivity to detect LN metastasis in advanced cervical cancer. Increased sensitivity did not reach statistical significance and was at the expense of lower specificity.

Comparison of MRI pulse sequences for investigation of lesions of the cervical spinal cord

International Nuclear Information System (INIS)

Campi, A.; Pontesilli, S.; Gerevini, S.; Scotti, G.

2000-01-01

Small spinal cord lesions, even if clinically significant, can be due to the low sensitivity of some pulse sequences. We compared T2-weighted fast (FSE), and conventional (CSE) spin-echo and short-tau inversion-recovery (STIR)-FSE overlooked on MRI sequences to evaluate their sensitivity to and specificity for lesions of different types. We compared the three sequences in MRI of 57 patients with cervical spinal symptoms. The image sets were assessed by two of us individually for final diagnosis, lesion detectability and image quality. Both readers arrived at the same final diagnoses with all sequences, differentiating four groups of patients. Group 1 (30 patients, 53 %), with a final diagnosis of multiple sclerosis (MS). Demyelinating lesions were better seen on STIR-FSE images, on which the number of lesions was significantly higher than on FSE, while the FSE and CSE images showed approximately equal numbers of lesions; additional lesions were found in 9 patients. The contrast-to-noise ratio (CNR) of 17 demyelinating lesions was significantly higher on STIR-FSE images than with the other sequences. Group 2, 19 patients (33 %) with cervical pain, 15 of whom had disc protrusion or herniation: herniated discs were equally well delineated with all sequences, with better myelographic effect on FSE. In five patients with intrinsic spinal cord abnormalities, the conspicuity and demarcation of the lesions were similar with STIR-FSE and FSE. Group 3, 4 patients (7 %) with acute myelopathy of unknown aetiology. In two patients, STIR-FSE gave better demarcation of lesions and in one a questionable additional lesions. Group 4, 4 patients (7 %) with miscellaneous final diagnoses. STIR-FSE had high sensitivity to demyelinating lesions, can be considered quite specific and should be included in spinal MRI for assessment of suspected demyelinating disease. (orig.)

Role of 3T multiparametric-MRI with BOLD hypoxia imaging for diagnosis and post therapy response evaluation of postoperative recurrent cervical cancers

International Nuclear Information System (INIS)

Mahajan, Abhishek; Engineer, Reena; Chopra, Supriya; Mahanshetty, Umesh; Juvekar, S.L.; Shrivastava, S.K.; Desekar, Naresh; Thakur, M.H.

2015-01-01

•In operated cervix cancer, the accuracy of diagnosing vaginal vault/local recurrent lesions was higher at combined multiparametric MR imaging and conventional MR imaging (100%) than at conventional MR imaging (70%) or multiparametric MR imaging (96.7%) alone.•We found a significant correlation between percentage tumor regression and pre-treatment parameters: NEI (p = 0.02), the maximum slope (p = 0.04), mADC value (p = 0.001) and amount of hypoxic fraction present in the pretherapy MRI (p = 0.01).•Multiparametric and BOLD hypoxia MR Imaging are feasible and reliable in diagnosing post-operative recurrence in cervical cancer and should be applied when there is clinical suspicion of post-operative recurrence.•Quantitative image features obtained at multiparametric-MRI with BOLD hypoxia imaging has potential to be an appropriate and reliable biologic target for radiation dose painting to optimize therapy in future. In operated cervix cancer, the accuracy of diagnosing vaginal vault/local recurrent lesions was higher at combined multiparametric MR imaging and conventional MR imaging (100%) than at conventional MR imaging (70%) or multiparametric MR imaging (96.7%) alone. We found a significant correlation between percentage tumor regression and pre-treatment parameters: NEI (p = 0.02), the maximum slope (p = 0.04), mADC value (p = 0.001) and amount of hypoxic fraction present in the pretherapy MRI (p = 0.01). Multiparametric and BOLD hypoxia MR Imaging are feasible and reliable in diagnosing post-operative recurrence in cervical cancer and should be applied when there is clinical suspicion of post-operative recurrence. Quantitative image features obtained at multiparametric-MRI with BOLD hypoxia imaging has potential to be an appropriate and reliable biologic target for radiation dose painting to optimize therapy in future. To assess the diagnostic value of multiparametric-MRI (MPMRI) with hypoxia imaging as a functional marker for characterizing and detecting

Non-contiguous spinal injury in cervical spinal trauma: evaluation with cervical spine MRI

International Nuclear Information System (INIS)

Choi, Soo Jung; Shin, Myung Jin; Kim, Sung Moon; Bae, Sang Jin

2004-01-01

We wished to evaluate the incidence of non-contiguous spinal injury in the cervicothoracic junction (CTJ) or the upper thoracic spines on cervical spinal MR images in the patients with cervical spinal injuries. Seventy-five cervical spine MR imagings for acute cervical spinal injury were retrospectively reviewed (58 men and 17 women, mean age: 35.3, range: 18-81 years). They were divided into three groups based on the mechanism of injury; axial compression, hyperflexion or hyperextension injury, according to the findings on the MR and CT images. On cervical spine MR images, we evaluated the presence of non-contiguous spinal injury in the CTJ or upper thoracic spine with regard to the presence of marrow contusion or fracture, ligament injury, traumatic disc herniation and spinal cord injury. Twenty-one cases (28%) showed CTJ or upper thoracic spinal injuries (C7-T5) on cervical spinal MR images that were separated from the cervical spinal injuries. Seven of 21 cases revealed overt fractures in the CTJs or upper thoracic spines. Ligament injury in these regions was found in three cases. Traumatic disc herniation and spinal cord injury in these regions were shown in one and two cases, respectively. The incidence of the non-contiguous spinal injuries in CTJ or upper thoracic spines was higher in the axial compression injury group (35.5%) than in the hyperflexion injury group (26.9%) or the hyperextension (25%) injury group. However, there was no statistical significance (ρ > 0.05). Cervical spinal MR revealed non-contiguous CTJ or upper thoracic spinal injuries in 28% of the patients with cervical spinal injury. The mechanism of cervical spinal injury did not significantly affect the incidence of the non-contiguous CTJ or upper thoracic spinal injury

Non-contiguous spinal injury in cervical spinal trauma: evaluation with cervical spine MRI

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Choi, Soo Jung; Shin, Myung Jin; Kim, Sung Moon [University of Ulsan College of Medicine, Seoul (Korea, Republic of); Bae, Sang Jin [Sanggyepaik Hospital, Inje University, Seoul (Korea, Republic of)

2004-12-15

We wished to evaluate the incidence of non-contiguous spinal injury in the cervicothoracic junction (CTJ) or the upper thoracic spines on cervical spinal MR images in the patients with cervical spinal injuries. Seventy-five cervical spine MR imagings for acute cervical spinal injury were retrospectively reviewed (58 men and 17 women, mean age: 35.3, range: 18-81 years). They were divided into three groups based on the mechanism of injury; axial compression, hyperflexion or hyperextension injury, according to the findings on the MR and CT images. On cervical spine MR images, we evaluated the presence of non-contiguous spinal injury in the CTJ or upper thoracic spine with regard to the presence of marrow contusion or fracture, ligament injury, traumatic disc herniation and spinal cord injury. Twenty-one cases (28%) showed CTJ or upper thoracic spinal injuries (C7-T5) on cervical spinal MR images that were separated from the cervical spinal injuries. Seven of 21 cases revealed overt fractures in the CTJs or upper thoracic spines. Ligament injury in these regions was found in three cases. Traumatic disc herniation and spinal cord injury in these regions were shown in one and two cases, respectively. The incidence of the non-contiguous spinal injuries in CTJ or upper thoracic spines was higher in the axial compression injury group (35.5%) than in the hyperflexion injury group (26.9%) or the hyperextension (25%) injury group. However, there was no statistical significance ({rho} > 0.05). Cervical spinal MR revealed non-contiguous CTJ or upper thoracic spinal injuries in 28% of the patients with cervical spinal injury. The mechanism of cervical spinal injury did not significantly affect the incidence of the non-contiguous CTJ or upper thoracic spinal injury.

Clinical significance of MRI/{sup 18}F-FDG PET fusion imaging of the spinal cord in patients with cervical compressive myelopathy

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Uchida, Kenzo; Nakajima, Hideaki; Watanabe, Shuji; Yoshida, Ai; Baba, Hisatoshi [University of Fukui, Department of Orthopaedics and Rehabilitation Medicine, Faculty of Medical Sciences, Eiheiji, Fukui (Japan); Okazawa, Hidehiko [University of Fukui, Department of Biomedical Imaging Research Center, Eiheiji, Fukui (Japan); Kimura, Hirohiko [University of Fukui, Departments of Radiology, Faculty of Medical Sciences, Eiheiji, Fukui (Japan); Kudo, Takashi [Nagasaki University, Department of Radioisotope Medicine, Atomic Bomb Disease and Hibakusha Medicine Unit, Atomic Bomb Disease Institute, Nagasaki (Japan)

2012-10-15

{sup 18}F-FDG PET is used to investigate the metabolic activity of neural tissue. MRI is used to visualize morphological changes, but the relationship between intramedullary signal changes and clinical outcome remains controversial. The present study was designed to evaluate the use of 3-D MRI/{sup 18}F-FDG PET fusion imaging for defining intramedullary signal changes on MRI scans and local glucose metabolic rate measured on {sup 18}F-FDG PET scans in relation to clinical outcome and prognosis. We studied 24 patients undergoing decompressive surgery for cervical compressive myelopathy. All patients underwent 3-D MRI and {sup 18}F-FDG PET before surgery. Quantitative analysis of intramedullary signal changes on MRI scans included calculation of the signal intensity ratio (SIR) as the ratio between the increased lesional signal intensity and the signal intensity at the level of the C7/T1 disc. Using an Advantage workstation, the same slices of cervical 3-D MRI and {sup 18}F-FDG PET images were fused. On the fused images, the maximal count of the lesion was adopted as the standardized uptake value (SUV{sub max}). In a similar manner to SIR, the SUV ratio (SUVR) was also calculated. Neurological assessment was conducted using the Japanese Orthopedic Association (JOA) scoring system for cervical myelopathy. The SIR on T1-weighted (T1-W) images, but not SIR on T2-W images, was significantly correlated with preoperative JOA score and postoperative neurological improvement. Lesion SUV{sub max} was significantly correlated with SIR on T1-W images, but not with SIR on T2-W images, and also with postoperative neurological outcome. The SUVR correlated better than SIR on T1-W images and lesion SUV{sub max} with neurological improvement. Longer symptom duration was correlated negatively with SIR on T1-W images, positively with SIR on T2-W images, and negatively with SUV{sub max}. Our results suggest that low-intensity signal on T1-W images, but not on T2-W images, is correlated

Uterine cervical cancer. Usefulness of MR imaging after the initial radiation therapy

International Nuclear Information System (INIS)

Monzen, Yoshio; Mori, Hiromu; Matsumoto, Akira; Yoshida, Shintaro; Wakisaka, Masaki; Komatsu, Eiji; Tashiro, Makoto; Hori, Yuko.

1995-01-01

To evaluate the usefulness of magnetic resonance imaging (MRI) in diagnosing residual or recurrent tumors of cervical cancer after radiation therapy, we investigated the time difference between MRI and gynecologic findings in the diagnosis of residual or recurrent tumor in 12 patients with invasive cervical cancer. We defined a positive finding for residual or recurrent tumor as an uterine cervical mass isointense to muscle on T1-weighted images and hyperintense on T2-weighted images, and when a positive biopsy specimen was obtained. Two patients were diagnosed as having a residual or recurrent tumor by MRI. Positivity was demonstrated four and seven months later, respectively. MRI was more useful in the earlier diagnosis of residual or recurrent tumor of cervical cancer after radiation therapy than uterine biopsy. There was one patient whose differentiation from residual tumor or radiation-induced necrosis or inflammation on MRI was difficult. MRI and gynecologic check-up at a regular interval after radiation therapy was needed to distinguish them. One patient was diagnosed as having a recurrent tumor by gynecologic finding three months earlier than by MRI. Follow-up MRI examinations at a regular interval in addition to gynecologic examination is necessary for the early detection of recurrent cervical cancer after radiation therapy. (author)

Imaging of cervical carcinomas

International Nuclear Information System (INIS)

Soyer, P.; Michel, G.; Masselot, J.

1990-01-01

Recently, magnetic resonance imaging (MRI) and transrectal or transvaginal ultrasound (TRUS, TVUS) had an important place in imaging techniques of cervical carcinomas and raise the question of modifying the imaging strategies. For the diagnosis of primitive tumor, those techniques cannot take the place of clinical examination and gross examination. In the assessment of parametrial involvement, TRUS which has better accuracy than clinical examination, and MRI which is considered as the most accurate technique, have an important role to play. In the follow-up and the detection of recurrences, MRI is actually considered as the best imaging technique. The authors, according to recent data in literature and their own experience, present basic concepts of imaging strategies for staging and follow-up of cervical carcinomas [fr

Translating Response During Therapy into Ultimate Treatment Outcome: A Personalized 4-Dimensional MRI Tumor Volumetric Regression Approach in Cervical Cancer

International Nuclear Information System (INIS)

Mayr, Nina A.; Wang, Jian Z.; Lo, Simon S.; Zhang Dongqing; Grecula, John C.; Lu Lanchun; Montebello, Joseph F.; Fowler, Jeffrey M.; Yuh, William T.C.

2010-01-01

Purpose: To assess individual volumetric tumor regression pattern in cervical cancer during therapy using serial four-dimensional MRI and to define the regression parameters' prognostic value validated with local control and survival correlation. Methods and Materials: One hundred and fifteen patients with Stage IB 2 -IVA cervical cancer treated with radiation therapy (RT) underwent serial MRI before (MRI 1) and during RT, at 2-2.5 weeks (MRI 2, at 20-25 Gy), and at 4-5 weeks (MRI 3, at 40-50 Gy). Eighty patients had a fourth MRI 1-2 months post-RT. Mean follow-up was 5.3 years. Tumor volume was measured by MRI-based three-dimensional volumetry, and plotted as dose(time)/volume regression curves. Volume regression parameters were correlated with local control, disease-specific, and overall survival. Results: Residual tumor volume, slope, and area under the regression curve correlated significantly with local control and survival. Residual volumes ≥20% at 40-50 Gy were independently associated with inferior 5-year local control (53% vs. 97%, p <0.001) and disease-specific survival rates (50% vs. 72%, p = 0.009) than smaller volumes. Patients with post-RT residual volumes ≥10% had 0% local control and 17% disease-specific survival, compared with 91% and 72% for <10% volume (p <0.001). Conclusion: Using more accurate four-dimensional volumetric regression analysis, tumor response can now be directly translated into individual patients' outcome for clinical application. Our results define two temporal thresholds critically influencing local control and survival. In patients with ≥20% residual volume at 40-50 Gy and ≥10% post-RT, the risk for local failure and death are so high that aggressive intervention may be warranted.

MRI of cervical carcinoma: before and after chemotherapy

International Nuclear Information System (INIS)

Kim, Jung Sik; Suh, Soo Jhi; Choi, Tae Jin; Lee, Tae Sung; Suh, Young Wook

1992-01-01

To evaluate usefulness of MR in assessment of tumor response to the chemotherapy, we prospectively studied cases of cervical carcinoma with more than 2.5cm in diameter or stage IIb or more. Three courses of chemotherapy were performed with cisplatin and 5 F-U. MR images were obtained both before and after chemotherapy. Nine of 13 patients were undertaken radical hysterectomy after chemotherapy and MR amination. MR volumetry, stage and depth of stromal invasion were compared before and after chemotherapy. And in 9 patients who underwent radical hysterectomy, comparison of pathologic and MR imaging findings were also done. The results were following. 1) All tumors dectrased in volume (m = 80.5%). 2) Five tumors (38.5%) reduced in stage, IB → CIS (1); IIA → CIS (1), IIA → IB (2), IIB → IB (1). 3) Depth of stromal invasion in MRI correlated well with that of histopathologic specimen in 7 of the 9 patients. Conclusively MR imaging is useful in assessment of tumor response to chemotherapy

Thermal Stimulation Alters Cervical Spinal Cord Functional Connectivity in Humans.

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Weber, Kenneth A; Sentis, Amy I; Bernadel-Huey, Olivia N; Chen, Yufen; Wang, Xue; Parrish, Todd B; Mackey, Sean

2018-01-15

The spinal cord has an active role in the modulation and transmission of the neural signals traveling between the body and the brain. Recent advancements in functional magnetic resonance imaging (fMRI) have made the in vivo examination of spinal cord function in humans now possible. This technology has been recently extended to the investigation of resting state functional networks in the spinal cord, leading to the identification of distinct patterns of spinal cord functional connectivity. In this study, we expand on the previous work and further investigate resting state cervical spinal cord functional connectivity in healthy participants (n = 15) using high resolution imaging coupled with both seed-based functional connectivity analyses and graph theory-based metrics. Within spinal cord segment functional connectivity was present between the left and right ventral horns (bilateral motor network), left and right dorsal horns (bilateral sensory network), and the ipsilateral ventral and dorsal horns (unilateral sensory-motor network). Functional connectivity between the spinal cord segments was less apparent with the connectivity centered at the region of interest and spanning spinal cord functional network was demonstrated to be state-dependent as thermal stimulation of the right ventrolateral forearm resulted in significant disruption of the bilateral sensory network, increased network global efficiency, and decreased network modularity. Copyright © 2017 IBRO. Published by Elsevier Ltd. All rights reserved.

Implementing MRI-based target delineation for cervical cancer treatment within a rapid workflow environment for image-guided brachytherapy: A practical approach for centers without in-room MRI.

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Trifiletti, Daniel M; Libby, Bruce; Feuerlein, Sebastian; Kim, Taeho; Garda, Allison; Watkins, W Tyler; Erickson, Sarah; Ornan, Afshan; Showalter, Timothy N

2015-01-01

Magnetic resonance imaging (MRI)-based intracavitary brachytherapy offers several advantages over computed tomography (CT)-based brachytherapy, but many centers are unable to offer it at the time of brachytherapy because of logistic and/or financial considerations. We have implemented a method of integrating MRI into a CT-guided, high-dose-rate intracavitary brachytherapy workflow in clinics that do not have immediately available MRI capability. At our institution, patients receiving high-dose-rate intracavitary brachytherapy as a component of the definitive treatment of cervical cancer have a Smit sleeve placed during the first brachytherapy fraction in a dedicated suite with in-room CT-on-rails. After the first fraction of brachytherapy, an MRI is obtained with the Smit sleeve, but no applicator, in place. For each subsequent fraction, CT scans are coregistered to the MRI scan by the Smit sleeve. The gross target volume is defined by MRI and overlaid on the CT images for each brachytherapy treatment for dose optimization. This MRI-integrated workflow adds workflow is a feasible compromise to preserve an efficient workflow while integrating MRI target delineation, and it provides many of the advantages of both MRI- and CT-based brachytherapy. The future collection and analysis of clinical data will serve to compare the proposed approach to non-MRI containing techniques. Copyright © 2015 American Brachytherapy Society. Published by Elsevier Inc. All rights reserved.

Kinematic MRI of the cervical spine in patients with degenerative disease

International Nuclear Information System (INIS)

Muhle, C.; Wiskirchen, J.; Brinkmann, G.; Falliner, A.; Weinert, D.; Reuter, M.; Heller, M.

1995-01-01

Kinematic MRI of the cervical spine was done from 50 of inclination to 30 of reclination. Depending on the maximum inclination and reclination the range of motion was divided into 9 equal angle positions. At each angle position sagittal T 2 ' weighted gradient echo sequences were performed. In relation to the neutral position a physiological narrowing of the ventral epidural space was seen in healthy volunteers at inclination (50 ) in up to 50% and respectively widening at reclination (30 ) in up to 10%. An increase of spinal canal stenosis or even spinal cord compression was seen at inclination in 5 patients (22%) and in 15 patients (65%) at reclination. No change of spinal canal stenosis was found in three patients (13%). (orig./MG) [de

Cervical external immobilization devices: evaluation of magnetic resonance imaging issues at 3.0 Tesla.

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Diaz, Francis L; Tweardy, Lisa; Shellock, Frank G

2010-02-15

Laboratory investigation, ex vivo. Currently, no studies have addressed the magnetic resonance imaging (MRI) issues for cervical external immobilization devices at 3-Tesla. Under certain conditions significant heating may occur, resulting in patient burns. Furthermore, artifacts can be substantial and prevent the diagnostic use of MRI. Therefore, the objective of this investigation was to evaluate MRI issues for 4 different cervical external immobilization devices at 3-Tesla. Excessive heating and substantial artifacts are 2 potential complications associated with performing MRI at 3-Tesla in patients with cervical external immobilization devices. Using ex vivo testing techniques, MRI-related heating and artifacts were evaluated for 4 different cervical devices during MRI at 3-Tesla. Four cervical external immobilization devices (Generation 80, Resolve Ring and Superstructure, Resolve Ring and Jerome Vest/Jerome Superstructure, and the V1 Halo System; Ossur Americas, Aliso Viejo, CA) underwent MRI testing at 3-Tesla. All devices were made from nonmetallic or nonmagnetic materials. Heating was determined using a gelled-saline-filled skull phantom with fluoroptic thermometry probes attached to the skull pins. MRI was performed at 3-Tesla, using a high level of RF energy. Artifacts were assessed at 3-Tesla, using standard cervical imaging techniques. The Generation 80 and V1 Halo devices exhibited substantial temperature rises (11.6 degrees C and 8.5 degrees C, respectively), with "sparking" evident for the Generation 80 during the MRI procedure. Artifacts were problematic for these devices, as well. By comparison, the 2 Resolve Ring-based cervical external immobilization devices showed little or no heating (Tesla.

Molecular imaging in cervical cancer

International Nuclear Information System (INIS)

KHAN, Sairah R.; ROCKALL, Andrea G.; BARWICK, Tara D.

2016-01-01

Despite the development of screening and of a vaccine, cervix cancer is a major cause of cancer death in young women worldwide. A third of women treated for the disease will recur, almost inevitably leading to death. Functional imaging has the potential to stratify patients at higher risk of poor response or relapse by improved delineation of disease extent and tumor characteristics. A number of molecular imaging biomarkers have been shown to predict outcome at baseline and/or early during therapy in cervical cancer. In future this could help tailor the treatment plan which could include selection of patients for close follow up, adjuvant therapy or trial entry for novel agents or adaptive clinical trials. The use of molecular imaging techniques, FDG PET/CT and functional MRI, in staging and response assessment of cervical cancer is reviewed.

Comparison of FDG PET and CT/MRI in the diagnosis of cervical lymph node metastasis of head and neck cancer: a level-by-level based study

International Nuclear Information System (INIS)

Yang, You Jung; Kim, J. S.; Kim, S. Y.; Nam, S. Y.; Lee, W. W.; Ryu, J. S.; Yeo, J. S.; Moon, D. H.

2002-01-01

We compared diagnostic accuracy of FDG PET and CT/MRI for regional lymph node metastasis of head and neck cancer according to the level of cervical lymph node. Thirty-two patients (M/F=27/5, 56±10yr) with head and neck cancer (glottic cancer; 16, tongue cancer; 9, others; 7) uncerwent FDG PET and CT/MRI (29/3) within 1 month before elective surgery with neck dissection (bilateral in 21, unilateral in 11). Whole body and additional regional neck images were acquired 1 hr after injection of FDG (555 MBq). PET images were visually interpreted according to the cervical lymph node level by 2 nuclear physicians independently without CT/MRI information. The findings of PET and CT/MRI were confirmed by the surgical pathology(153 levels of 43 neck dissections). There were 32 positive levels and 121 negative levels for metastatic lymph node lesions in pathology. The diagnostic sensitivity of PET [88%(28/32)] was significantly higher than that of CT/MRI [63%(20/32)] (p=0.021), whereas the specificity of PET [93%(113/121)] was similar to that of CT/MRI [92%(111/121)] (p>0.05). FDG PET was more sensitive than conventional CT/MRI in detecting metastatic lymph node of head and neck cancer

Cervical facet oedema: prevalence, correlation to symptoms, and follow-up imaging

International Nuclear Information System (INIS)

Nevalainen, M.T.; Foran, P.J.; Roedl, J.B.; Zoga, A.C.; Morrison, W.B.

2016-01-01

Aim: To evaluate the prevalence of cervical facet oedema in patients referred for magnetic resonance imaging (MRI) to investigate neck pain and/or radiculopathy, and to investigate whether there is a correlation between the presence of oedema and patients' symptoms. Materials and methods: A retrospective report review of 1885 patients undergoing cervical spine MRI between July 2008 and June 2015 was performed. Exclusion criteria included acute trauma, surgery, neoplastic disease, or infection in the cervical spine. One hundred and seventy-three MRI studies with cervical facet oedema were evaluated by each of the two radiologists. In these patients, the grade of bone marrow oedema (BMO) and corresponding neuroforaminal narrowing at the cervical facets was assessed. Correlation with symptoms was performed based on pre-MRI questionnaire. Results: The prevalence of cervical facet oedema was 9%; the most commonly affected levels were C3–4, C4–5, and C2–3. A total of 202 cervical facets were evaluated: mild BMO was seen in 35%, moderate in 41%, and severe in 24% of cases. Surrounding soft-tissue oedema was observed in 36%, 69%, and 92% of the BMO grades, respectively. The correlations between unilateral radiculopathy and ipsilateral facet BMO grades were 79%, 83%, and 73% (chi-square, p<0.001), respectively. Furthermore, neuroforaminal narrowing on the corresponding level was found in 35%, 38%, and 11% of cases, respectively. At follow-up imaging, facet oedema was most likely to remain unchanged or to decrease. Conclusion: The prevalence of cervical facet oedema is 9%. Cervical facet oedema is associated with ipsilateral radiculopathy. Neuroforaminal narrowing, however, is not associated with facet oedema. - Highlights: • Association between the cervical facet oedema and cervical radiculopathy was studied. • Prevalence of the cervical facet oedema was 9%. • Facet oedema was associated with radiculopathy regardless of the degree of oedema. • Neuroforaminal

Functional activity of the sensorimotor cortex and cerebellum relates to cervical dystonia symptoms.

Science.gov (United States)

Burciu, Roxana G; Hess, Christopher W; Coombes, Stephen A; Ofori, Edward; Shukla, Priyank; Chung, Jae Woo; McFarland, Nikolaus R; Wagle Shukla, Aparna; Okun, Michael S; Vaillancourt, David E

2017-09-01

Cervical dystonia (CD) is the most common type of focal dystonia, causing abnormal movements of the neck and head. In this study, we used noninvasive imaging to investigate the motor system of patients with CD and uncover the neural correlates of dystonic symptoms. Furthermore, we examined whether a commonly prescribed anticholinergic medication in CD has an effect on the dystonia-related brain abnormalities. Participants included 16 patients with CD and 16 healthy age-matched controls. We collected functional MRI scans during a force task previously shown to extensively engage the motor system, and diffusion and T1-weighted MRI scans from which we calculated free-water and brain tissue densities. The dystonia group was also scanned ca. 2 h after a 2-mg dose of trihexyphenidyl. Severity of dystonia was assessed pre- and post-drug using the Burke-Fahn-Marsden Dystonia Rating Scale. Motor-related activity in CD was altered relative to controls in the primary somatosensory cortex, cerebellum, dorsal premotor and posterior parietal cortices, and occipital cortex. Most importantly, a regression model showed that increased severity of symptoms was associated with decreased functional activity of the somatosensory cortex and increased activity of the cerebellum. Structural imaging measures did not differ between CD and controls. The single dose of trihexyphenidyl altered the fMRI signal in the somatosensory cortex but not in the cerebellum. Symptom severity was not significantly reduced post-treatment. Findings show widespread changes in functional brain activity in CD and most importantly that dystonic symptoms relate to disrupted activity in the somatosensory cortex and cerebellum. Hum Brain Mapp 38:4563-4573, 2017. © 2017 Wiley Periodicals, Inc. © 2017 Wiley Periodicals, Inc.

Is MRI helpful in assessing the distance of the tumour from the internal os in patients with cervical cancer below FIGO Stage IB2?

International Nuclear Information System (INIS)

Bhosale, P.R.; Iyer, R.B.; Ramalingam, P.; Schmeler, K.M.; Wei, W.; Bassett, R.L.; Ramirez, P.T.; Frumovitz, M.

2016-01-01

Aim: To determine the ability of magnetic resonance imaging (MRI) in detecting tumour-free margins from the internal os (IO). Materials and methods: A database search yielded 79 women with early-stage cervical cancer who underwent radical hysterectomy and preoperative MRI. The sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and accuracy of MRI in assessment of ≤5 and >5 mm IO involvement were calculated with histopathological surgical specimen findings considered to be the reference standard. A main and subset analysis was performed. The subset analysis included only those patients who would have been considered for radical trachelectomy. Results: For predicting a distance between the tumour and the IO of ≤5 mm, MRI had a sensitivity of 73%, a specificity of 98.3%, a PPV of 95%, a NPV of 88.1%, and an accuracy of 89.8% for the main analysis, and sensitivity of 81.8%, a specificity of 93.2% a PPV of 69.2% a NPV of 96.5% and an accuracy of 91.4% for the subset analysis. Conclusion: MRI has high specificity, NPV, and accuracy in detecting tumour from the IO, making MRI suitable for treatment planning in patients desiring trachelectomy to preserve fertility. - Highlights: • Cervical cancer patients who underwent hysterectomy were analyzed on MRI and pathology for involvement of the internal os. • Distance of the tumor from the internal-os was measured on MRI and Pathology and findings were tabulated as > and ≤ 5 mm from the internal os. • MRI has the ability to identify tumor involvement of the internal os. • MRI can help select patients who can undergo trachelectomy safely.

Cine phase-contrast MRI measurement of CSF flow in the cervical spine: a pilot study in patients with spinal cord injury

Science.gov (United States)

Negahdar, MJ; Shakeri, M.; McDowell, E.; Wells, J.; Vitaz, T.; Harkema, S.; Amini, A.

2011-03-01

MRI velocimetry (also known as phase-contrast MRI) is a powerful tool for quantification of cerebrospinal fluid (CSF) flow in various regions of the brain and craniospinal junction and has been accepted as a diagnostic tool to assist with the diagnosis of certain conditions such as hydrocephalus and chiari malformations. Cerebrospinal fluid is continually produced in the ventricles of the brain, flows through the ventricular system and then out and around the brain and spinal cord and is reabsorbed over the convexity of the brain. Any disease process which either impedes the normal pattern of flow or restricts the area where flow occurs can change the pattern of these waveforms with the direction and velocity of flow being determined by the pressure transmitted from the pulsation of the heart and circulation of blood within the central nervous system. Therefore, we hypothesized that phase-contrast MRI could eventually be used as a diagnostic aid in determining the degree of spinal cord compression following injury to the cervical or thoracic spine. In this study, we examined CSF flow in 3 normal subjects and 2 subjects with non-acute injuries in the cervical spine using Cine phasecontrast MRI. CSF flow analysis was performed using an in-house developed software. The flow waveform was calculated in both normal subjects (n=3) as well as subjects with spinal cord injury in the cervical spine (n=2). The bulk flow at C2 was measured to be 0.30 +/- 0.05 cc, at 5 cm distal to C2, it was 0.19+/- 0.07 cc, and at 10 cm distal to C2, it was 0.17+/- 0.05 cc. These results were in good agreement with previously published results. In patients with spinal cord injury, at the site of injury in the cervical spine, bulk flow was found to be 0.08 +/- 0.12 cc, at 5 cm proximal to the site of injury it was found to be 0.18 +/- 0.07 cc, and at 5 cm distal to the site of injury, it was found to be 0.12 +/- 0.01 cc.

Clinical application of functional MRI

International Nuclear Information System (INIS)

Taniwaki, Takayuki

2010-01-01

Described is the present state of clinical application of fMRI in the preoperative assessment of brain tumors, and plasticity in and pathophysiology of central diseases. For the tumor resection, fMRI is useful for risk assessment of postoperative nerve dysfunction, for selection of the patient rather suitable for brain mapping at the invasive surgery than at the pre-operation and for guidance of the operation itself. Preoperative fMRI alone can neither distinguish the regions of the primary and secondary functions nor exhibit the relation between the tumor and white matter fibers but there are compensatory means for these drawbacks. Benefit of preoperative fMRI has not yet been based on the evidence on double blind trials. Combination of fMRI imaging and electroencephalography (EEG) finding has shown that, in generalized epilepsy, extensive and stimulated activation occurs in both frontal/occipital regions and in thalamus area, respectively, and that the concomitant lowered activities are conceivably the reflection of burst discharge in normal brain functions. Plasticity in the human brain has been demonstrated by fMRI in cerebral vascular diseases, multiple sclerosis and amyotrophic lateral sclerosis. Pathogenesis of Parkinson disease and depression has been better understood by fMRI investigations revealing regions with elevated and reduced activities. Studies of attention deficit hyperactivity disorder have shown similar change of activities with functional reductions of the right dorsolateral frontal anterior area and of dorsal frontal cingulate gyrus, together with stimulated wider regions to given tasks. As above, fMRI has greatly contributed to our understanding of diseases of central nervous system and is to be expected to expand wider in this field. (T.T.)

Research progress of functional MRI in depression

International Nuclear Information System (INIS)

Xie Shenghui; Niu Guangming; Han Xiaodong; Qiao Pengfei

2013-01-01

The mood disorders of depression are associated with abnormalities of brain structure and function, and exploring their pathological mechanism has important significance for the choice of treatment and the curative effect evaluation. In recent years, the research of MRI on brain structure and function of depression has made great progress, especially in functional magnetic resonance imaging (fMRI). fMRI can detect the functional change in real time, and also can display the activity of brain and changes in the nerve pathways in patients with depression. This article summarizes the present research situation and progress of MRI in the diagnosis of depression. (authors)

Quality assurance in functional MRI

DEFF Research Database (Denmark)

Liu, Thomas T; Glover, Gary H; Mueller, Bryon A

2015-01-01

Over the past 20 years, functional magnetic resonance imaging (fMRI) has ben- efited greatly from improvements in MRI hardware and software. At the same time, fMRI researchers have pushed the technical limits of MRI systems and greatly in- fluenced the development of state-of-the-art systems...... consistent data throughout the course of a study, and consistent stability across time and sites is needed to allow data from different time periods or acquisition sites to be optimally integrated....

MRI in the assessment of the supportive soft tissues of the cervical spine in acute trauma in children

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Keiper, M.D.; Zimmerman, R.A.; Bilaniuk, L.T. [Department of Radiology, Children`s Hospital of Philadelphia, PA (United States)

1998-06-01

We carried out a retrospective analysis of imaging and clinical findings in 52 children with a history of cervical spinal trauma. No patient had evidence of a fracture on plain films or CT. All had MRI at 1.5 T because of persistent or delayed symptoms, unexplained findings of injury or instability, or as further assessment of the extent of soft-tissue injury. Clinical follow-up ranged from 6 months to 3.5 years. MRI was evaluated for its influence on therapy and outcome. MRI was positive in 16 (31 %) of 52 patients. Posterior soft-tissue or ligamentous injury was the most common finding in the 10 patients with mild to moderate trauma, while acute disc bulges and longitudinal ligament disruption, each seen in one case, were uncommon. MRI was superior to CT for assessment of the extent of soft-tissue injury and for identification of spinal cord injuries and intracanalicular hemorrhage in the six patients with more severe trauma. MRI specifically influenced the management of all four patients requiring surgery by extending the level of posterior stabilization. No patients with normal MRI or any of the 10 with radiographically stable soft-tissue injury on MRI, developed delayed clinical or radiographic evidence of instability or deformity. (orig.) With 2 figs., 2 tabs., 24 refs.

Magnetic resonance imaging of traumatic cervical injury

International Nuclear Information System (INIS)

Juhng, S. K.; Lee, K. S.; Sohn, K. J.; Choi, S. S.; Won, J. J.

1994-01-01

To evaluate magnetic resonance imaging (MRI) findings of cevical injuries. MRI studies of 34 patients with cervical spinal injuries were analyzed retrospectively. All MRI scans were obtained with an 1.0T superconductive MRI scanner (Siemens Magnetom 42SPE) and their findings were analyzed regarding the spinal cord, bony spine, ligaments, and intervertebral disks. A variety of abnormal findings were detected: 25 cord abnormalities including cord compression (15 cases), cord edema (4 cases), syringomyelia (4 cases), myelomalacia (1 case), and hemorrhagic contusion (1 case), 18 ligamentous injuries, 22 disk herniations (9 post-traumatic, 13 chronic degenerative), 11 spine fractures, and 4 subluxations. MRI is useful in evaluating the spinal cord itself, in depicting ligamentous injuries, in establishing the presence of disc herniation, and in assessing the alignment of cervical spine

Magnetic resonance imaging of traumatic cervical injury

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Juhng, S. K.; Lee, K. S.; Sohn, K. J.; Choi, S. S.; Won, J. J. [Wonkwang University School of Medicine, Iri (Korea, Republic of)

1994-04-15

To evaluate magnetic resonance imaging (MRI) findings of cevical injuries. MRI studies of 34 patients with cervical spinal injuries were analyzed retrospectively. All MRI scans were obtained with an 1.0T superconductive MRI scanner (Siemens Magnetom 42SPE) and their findings were analyzed regarding the spinal cord, bony spine, ligaments, and intervertebral disks. A variety of abnormal findings were detected: 25 cord abnormalities including cord compression (15 cases), cord edema (4 cases), syringomyelia (4 cases), myelomalacia (1 case), and hemorrhagic contusion (1 case), 18 ligamentous injuries, 22 disk herniations (9 post-traumatic, 13 chronic degenerative), 11 spine fractures, and 4 subluxations. MRI is useful in evaluating the spinal cord itself, in depicting ligamentous injuries, in establishing the presence of disc herniation, and in assessing the alignment of cervical spine.

Possibilities of multiparametric MRI in the differential diagnosis of histological types of cervical cancer in the preoperative period

Directory of Open Access Journals (Sweden)

E. V. Tarachkova

2016-01-01

Full Text Available Magnetic resonance imaging (MRI is sensitive and specific method of study in patients with cervical cancer (CC. A number of studies have demonstrated the possibility to determine histological type (squamous cell cancer and adenocarcinoma and the degree of differentiation of this type of tumor by using the apparent diffusion coefficient maps (ADC-map compiled on the basis of diffusion-weighted images (DWI (p <0.05. We have tested whether a more accurate assessment of the histological type and tumor grade in the preoperative stage is possible, by using a wide range of MRI techniques. According to multiparametric MRI, which included T2-weighted imaging (WI, DWI with reconstruction of ADC-maps and dynamic MRI with contrast enhancement, performed in 90 patients with histologically verified cervical cancer, it was shown that adenocarcinoma is characterized by a high intensity and less heterogeneity of MRI signal in fat-suppressed T2WI images as compared to squamous cell carcinoma. Furthermore, patients with adenocarcinomas who underwent dynamic MRI with contrast enhancement had curves with gradually higher change in MRI-signal intensity on T1WI images in 15 seconds after detection of the magnetic resonance contrast agent (MRCA in tumor, continuous increase in MRI signal intensity (when observing for about 2.5 minutes after detection of MRCA in tumor, while in case of squamous cell cancer – a lower variation in MRI signal intensity in T1WI mode to 10-20 second after detection of MRCA in the tumor followed by a biphasic course of the curve, dependence of MRI-signal on time and formation of the “plateau” or the same signal decrease down to 125 sec (about 2.5 min as well as less signal heterogenecity in the period from 10-20 sec to 125 sec (about 2.5 min after MRCA detection in tumor. The differences were statistically significant (p <0.05, and had sensitivity and specificity up to 0.76 and 0.75, respectively for particular signs. According

Value of preoperative cervical discography

International Nuclear Information System (INIS)

Kwon, Jong Won; Kim, Sung Hyun; Lee, Joon Woo

2006-01-01

The aim of this study was to describe the method and the value of cervical discography as correlated with the MR findings. Twenty-one discs in 11 consecutive patients who underwent cervical discography were analyzed. MR and CT discography (CTD) were performed in all patients. Discography was performed after swallowing barium for visualizing the pharynx and the esophagus to prevent penetration. We also analyzed the preceding causes of the subjects' cervical pain. The results of the pain provocation test were classified into concordant pain, discordant pain and a negative test. MRI was analyzed according to the T2-signal intensity (SI) of the disc, disc height, annular bulging and disc herniation. The CTD was analyzed for degeneration or radial tear of the disc, epidural leakage of the contrast agent and pooling of the contrast agent at the periphery of the disc. The pain provocation tests were correlated with the MR and CTD findings. We used the chi-square test to analyze the results. Concordant pain was observed in 14 cases, discordant pain in 3 cases and there were negative tests in 4 cases. There were no complications related to the procedure. Four patients had undergone anterior cervical fusion and four patients that developed after traffic injuries. The decreased T2-SI and annular bulging on MRI, disc degeneration and peripheral pooling of the contrast agent on CT were significantly correlated with pain provocation. When the diagnosis of disc disease is difficult with performing MRI, cervical discography with using swallowed barium solution to reduce the penetration of the esophagus or hypopharynx may play be helpful. The decreased T2-SI and annular bulging on MRI correlated significantly with a positive result on the pain provocation test

Clinical functional MRI. Persurgical functional neuroimaging. 2. ed.

International Nuclear Information System (INIS)

Stippich, Christoph

2015-01-01

The second, revised edition of this successful textbook provides an up-to-date description of the use of preoperative fMRI in patients with brain tumors and epilepsies. State of the art fMRI procedures are presented, with detailed consideration of practical aspects, imaging and data processing, normal and pathological findings, and diagnostic possibilities and limitations. Relevant information on brain physiology, functional neuroanatomy, imaging technique, and methodology is provided by recognized experts in these fields. Compared with the first edition, chapters have been updated to reflect the latest developments and in particular the current use of diffusion tensor imaging (DTI) and resting-state fMRI. Entirely new chapters are included on resting-state presurgical fMRI and the role of DTI and tractography in brain tumor surgery. Further chapters address multimodality functional neuroimaging, brain plasticity, and pitfalls, tips, and tricks.

Clinical functional MRI. Persurgical functional neuroimaging. 2. ed.

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Stippich, Christoph (ed.) [Univ. Hospitals Basel (Switzerland). Division of Diagnostic and Inventional Neuroradiology

2015-06-01

The second, revised edition of this successful textbook provides an up-to-date description of the use of preoperative fMRI in patients with brain tumors and epilepsies. State of the art fMRI procedures are presented, with detailed consideration of practical aspects, imaging and data processing, normal and pathological findings, and diagnostic possibilities and limitations. Relevant information on brain physiology, functional neuroanatomy, imaging technique, and methodology is provided by recognized experts in these fields. Compared with the first edition, chapters have been updated to reflect the latest developments and in particular the current use of diffusion tensor imaging (DTI) and resting-state fMRI. Entirely new chapters are included on resting-state presurgical fMRI and the role of DTI and tractography in brain tumor surgery. Further chapters address multimodality functional neuroimaging, brain plasticity, and pitfalls, tips, and tricks.

Diffusion, confusion and functional MRI

International Nuclear Information System (INIS)

Le Bihan, Denis

2012-01-01

Diffusion MRI has been introduced in 1985 and has had a very successful life on its own. While it has become a standard for imaging stroke and white matter disorders, the borders between diffusion MRI and the general field of fMRI have always remained fuzzy. First, diffusion MRI has been used to obtain images of brain function, based on the idea that diffusion MRI could also be made sensitive to blood flow, through the intra-voxel incoherent motion (IVIM) concept. Second, the IVIM concept helped better understand the contribution from different vasculature components to the BOLD fMRI signal. Third, it has been shown recently that a genuine fMRI signal can be obtained with diffusion MRI. This 'DfMRI' signal is notably different from the BOLD fMRI signal, especially for its much faster response to brain activation both at onset and offset, which points out to structural changes in the neural tissues, perhaps such as cell swelling, occurring in activated neural tissue. This short article reviews the major steps which have paved the way for this exciting development, underlying how technical progress with MRI equipment has each time been instrumental to expand the horizon of diffusion MRI toward the field of fMRI. (authors)

Outcome of Cloward technique in cervical disc prolapse.

Science.gov (United States)

Rehman, Lal; Qayoom Khan, Hina Abdul; Hashim, A Sattar M

2010-11-01

To determine the association of pre-operative assessment of MRI findings, neurological status and symptoms with postoperative Cloward surgical outcome in cervical disc prolapse. Descriptive study. The Neurosurgery Department of Jinnah Postgraduate Medical Centre (JPMC), Karachi, from May 2008 to May 2009. Patients presenting with neck pain, brachialgia, limb weakness and spasticity were clinically examined for pre-operative neurological status of power, reflexes and sensation. The exclusion criteria were, cervical disc prolapsed patients, planned for smith-Robinson and micro-discectomy, traumatic cervical disc prolapse and cervical spondylosis. Neuroradiological investigations included cervical spine X-rays and MRI. All patients were surgically treated for cervical prolapsed intervertebral disc with anterior cervical discectomy and interbody fusion with Cloward technique. Postoperative neck immobilization was done with cervical collar for 7-8 weeks. Drain was removed on first postoperative day while check plain cervical X-rays were taken on third day. Results were analysed using chi-square test with significance at p cervical disc prolapse were C 5-6 (43.3%) and C 6-7 (23.3%); 26 (86.6%) patients had disc herniation causing thecal effacement with cord compression and 04 (13.3%) patients showed ischemia of cord. Single-level Cloward surgery done in 26 (86.3%) patients while two-level Cloward surgery performed in 04 (13.3%) only. About 83.3% patients improved and 13.3% did not while 01 patient was re-operated. No complications and mortality was related to the surgical procedure. Statistically different variables identified, related to outcome were pre-operative neurological status (p=0.001) and spinal cord involvement on MRI (p=0.001). Cloward technique for cervical disc prolase was simple and safe surgical procedure with favourable results and few complications; 100% fusion occurred after Cloward surgery, even without instrumentation. Outcome was significantly

Improving Survival and Promoting Respiratory Motor Function After Cervical Spinal Cord Injury

Science.gov (United States)

2017-09-01

AWARD NUMBER: W81XWH-15-1-0378 TITLE: Improving Survival and Promoting Respiratory Motor Function After Cervical Spinal Cord Injury PRINCIPAL...TITLE AND SUBTITLE CordCorInjury 5a. CONTRACT NUMBER Improvi g Survival and Promoting Respiratory Motor Function After Cervical Spinal Cord...care. However, despite these drastic interventions, the cervical injured patient is still susceptible to death due to respiratory complications

IClinfMRI Software for Integrating Functional MRI Techniques in Presurgical Mapping and Clinical Studies.

Science.gov (United States)

Hsu, Ai-Ling; Hou, Ping; Johnson, Jason M; Wu, Changwei W; Noll, Kyle R; Prabhu, Sujit S; Ferguson, Sherise D; Kumar, Vinodh A; Schomer, Donald F; Hazle, John D; Chen, Jyh-Horng; Liu, Ho-Ling

2018-01-01

Task-evoked and resting-state (rs) functional magnetic resonance imaging (fMRI) techniques have been applied to the clinical management of neurological diseases, exemplified by presurgical localization of eloquent cortex, to assist neurosurgeons in maximizing resection while preserving brain functions. In addition, recent studies have recommended incorporating cerebrovascular reactivity (CVR) imaging into clinical fMRI to evaluate the risk of lesion-induced neurovascular uncoupling (NVU). Although each of these imaging techniques possesses its own advantage for presurgical mapping, a specialized clinical software that integrates the three complementary techniques and promptly outputs the analyzed results to radiology and surgical navigation systems in a clinical format is still lacking. We developed the Integrated fMRI for Clinical Research (IClinfMRI) software to facilitate these needs. Beyond the independent processing of task-fMRI, rs-fMRI, and CVR mapping, IClinfMRI encompasses three unique functions: (1) supporting the interactive rs-fMRI mapping while visualizing task-fMRI results (or results from published meta-analysis) as a guidance map, (2) indicating/visualizing the NVU potential on analyzed fMRI maps, and (3) exporting these advanced mapping results in a Digital Imaging and Communications in Medicine (DICOM) format that are ready to export to a picture archiving and communication system (PACS) and a surgical navigation system. In summary, IClinfMRI has the merits of efficiently translating and integrating state-of-the-art imaging techniques for presurgical functional mapping and clinical fMRI studies.

Utility of preoperative ferumoxtran-10 MRI to evaluate retroperitoneal lymph node metastasis in advanced cervical cancer: Results of ACRIN 6671/GOG 0233☆

Science.gov (United States)

Atri, Mostafa; Zhang, Zheng; Marques, Helga; Gorelick, Jeremy; Harisinghani, Mukesh; Sohaib, Aslam; Koh, Dow-Mu; Raman, Steven; Gee, Michael; Choi, Haesun; Landrum, Lisa; Mannel, Robert; Chuang, Linus; Yu, Jian Qin (Michael); McCourt, Carolyn Kay; Gold, Michael

2014-01-01

Rationale and objectives To assess if ferumoxtran-10 (f-10) improves accuracy of MRI to detect lymph node (LN) metastasis in advanced cervical cancer. Materials and methods F-10 MRI component of an IRB approved HIPAA compliant ACRIN/GOG trial was analyzed. Patients underwent f-10 MRI followed by extra-peritoneal or laparoscopic pelvic and abdominal lymphadenectomy. F-10-sensitive sequences were T2* GRE sequences with TE of 12 and 21. Seven independent blinded readers reviewed f-10-insensitive sequences and all sequences in different sessions. Region correlations were performed between pathology and MRI for eight abdomen and pelvis regions. Sensitivity and specificity were calculated at participant level. Reference standard is based on pathology result of surgically removed LNs. Results Among 43 women enrolled in the trial between September 2007 and November 2009, 33 women (mean age 49 ± 11 years old) with advanced cervical cancer (12 IB2, 3 IIA, 15 IIB and 3 IIIB, 29 squamous cell carcinomas, 32 grade 2 or 3) were evaluable. Based on histopathology, LN metastasis was 39% in abdomen and 70% in pelvis. Sensitivity of all sequence review in pelvis, abdomen, and combined were 83%, 60%, and 86%, compared with 78%, 54%, and 80% for f-10 insensitive sequences (P: 0.24, 0.44 and 0.14, respectively). Mean diameter of the largest positive focus on histopathology was 13.7 mm in abdomen and 18.8 mm in pelvis (P = 0.018). Specificities of all sequence review in pelvis, abdomen, and combined were 48%, 75%, and 43%, compared with 75%, 83%, and 73% (P: 0.003, 0.14, 0.002 respectively) for f-10 insensitive sequences. Conclusion Addition of f-10 increased MRI sensitivity to detect LN metastasis in advanced cervical cancer. Increased sensitivity did not reach statistical significance and was at the expense of lower specificity. PMID:25774381

Magnetic resonance imaging of the cervical spine in rheumatoid arthritis

International Nuclear Information System (INIS)

Okada, Susumu; Igarashi, Yoshiaki; Kato, Tomizo; Kawamura, Haruya; Yoshino, Shinichi

1985-01-01

11 patients of rheumatoid arthritis with radiological changes of the cervical vertebrae were studied by 0.5 tesla super conducting MRI unit. Clear images were obtained in all patients. The degree of upper cervical cord compression is appreciated easily. MRI is thought to be the most usefull technique in the diagnosis of this disease. (author)

Narrow cervical canal in 1211 asymptomatic healthy subjects: the relationship with spinal cord compression on MRI.

Science.gov (United States)

Nakashima, Hiroaki; Yukawa, Yasutsugu; Suda, Kota; Yamagata, Masatsune; Ueta, Takayoshi; Kato, Fumihiko

2016-07-01

Narrow cervical canal (NCC) has been a suspected risk factor for later development of cervical myelopathy. However, few studies have evaluated the prevalence in asymptomatic subjects. The purpose of this study was to investigate the prevalence of NCC in a large cohort of asymptomatic volunteers. This study was a cross-sectional study of 1211 asymptomatic volunteers. Approximately 100 men and 100 women representing each decade of life from the 20s to the 70s were included in this study. Cervical canal anteroposterior diameters at C5 midvertebral level on X-rays, and the prevalence of spinal cord compression (SCC) and increased signal intensity (ISI) changes on MRI were evaluated. Receiver operating characteristic analysis was performed to determine the cut-off value of the severity of canal stenosis resulting in SCC. NCC (<14 mm) was observed in 123 (10.2 %) subjects. SCC and ISI were found in 64 (5.3 %) and 28 (2.3 %) subjects, respectively. The prevalence of NCC was significantly higher in females and older subjects, but the occurrence of severe NCC (<12 mm) did not increase with age. The canal size in subjects with SCC or ISI was significantly smaller than in those without SCC (p < 0.0001). The cut-off values of cervical canal stenosis resulting in SCC were 14.8 and 13.9 mm in males and females, respectively. The prevalence of NCC was considerably lower among asymptomatic healthy volunteers; the cervical canal diameter in subjects with SCC or ISI was significantly smaller than in asymptomatic subjects; NCC is a risk factor for SCC.

Functional diagnostics of the cervical spine by using computer tomography

International Nuclear Information System (INIS)

Dvorak, J.; Hayek, J.; Grob, D.

1988-01-01

35 healthy adults and 137 patients after cervical spine injury were examined by functional CT. The range of axial rotation at the level occiput/atlas, atlas/axis and the segment below were measured in all subjects. A rotation occiput/atlas of more than 7 0 , and C1/C2 more than 54 0 could refer to segmental hypermobility, a rotation at the segment C1/C2 less than 29 0 to hypomobility. According to the postulated normal values based upon a 98% confidence level, out of 137 patients examined after cervical spine injury and with therapy-resistant neck pain, 45 showed signs of segmental hypermobility of the upper cervical spine, 17 showed hyper- or hypomobility at different levels, 10 patients presented segmental hypomobility at C1/C2 level alone. In all patients, according to the clinical assessment, functional pathology was suspected in the upper cervical spine. Surgical correction of rotatory instability should be considered as a possible therapeutic procedure after successful diagnostic stabilisation of the cervical spine by minerva cast. (orig.)

Functional diagnostics of the cervical spine by using computer tomography

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Dvorak, J; Hayek, J; Grob, D; Penning, L; Panjabi, M M; Zehnder, R

1988-04-01

35 healthy adults and 137 patients after cervical spine injury were examined by functional CT. The range of axial rotation at the level occiput/atlas, atlas/axis and the segment below were measured in all subjects. A rotation occiput/atlas of more than 7/sup 0/, and C1/C2 more than 54/sup 0/ could refer to segmental hypermobility, a rotation at the segment C1/C2 less than 29/sup 0/ to hypomobility. According to the postulated normal values based upon a 98% confidence level, out of 137 patients examined after cervical spine injury and with therapy-resistant neck pain, 45 showed signs of segmental hypermobility of the upper cervical spine, 17 showed hyper- or hypomobility at different levels, 10 patients presented segmental hypomobility at C1/C2 level alone. In all patients, according to the clinical assessment, functional pathology was suspected in the upper cervical spine. Surgical correction of rotatory instability should be considered as a possible therapeutic procedure after successful diagnostic stabilisation of the cervical spine by minerva cast.

Magnetic resonance imaging provides evidence of glymphatic drainage from human brain to cervical lymph nodes.

Science.gov (United States)

Eide, Per Kristian; Vatnehol, Svein Are Sirirud; Emblem, Kyrre Eeg; Ringstad, Geir

2018-05-08

Pre-clinical research in rodents provides evidence that the central nervous system (CNS) has functional lymphatic vessels. In-vivo observations in humans, however, are not demonstrated. We here show data on CNS lymphatic drainage to cervical lymph nodes in-vivo by magnetic resonance imaging (MRI) enhanced with an intrathecal contrast agent as a cerebrospinal fluid (CSF) tracer. Standardized MRI of the intracranial compartment and the neck were acquired before and up to 24-48 hours following intrathecal contrast agent administration in 19 individuals. Contrast enhancement was radiologically confirmed by signal changes in CSF nearby inferior frontal gyrus, brain parenchyma of inferior frontal gyrus, parahippocampal gyrus, thalamus and pons, and parenchyma of cervical lymph node, and with sagittal sinus and neck muscle serving as reference tissue for cranial and neck MRI acquisitions, respectively. Time series of changes in signal intensity shows that contrast enhancement within CSF precedes glymphatic enhancement and peaks at 4-6 hours following intrathecal injection. Cervical lymph node enhancement coincides in time with peak glymphatic enhancement, with peak after 24 hours. Our findings provide in-vivo evidence of CSF tracer drainage to cervical lymph nodes in humans. The time course of lymph node enhancement coincided with brain glymphatic enhancement rather than with CSF enhancement.

Acupuncture and Spontaneous Regression of a Radiculopathic Cervical Herniated Disc

Directory of Open Access Journals (Sweden)

Kim Sung-Ha

2012-06-01

Full Text Available The spontaneous regression of herniated cervical discs is not a well-established phenomenon. However, we encountered a case of a spontaneous regression of a severe radiculopathic herniated cervical disc that was treated with acupuncture, pharmacopuncture, and herb medicine. The symptoms were improved within 12 months of treatment. Magnetic resonance imaging (MRI conducted at that time revealed marked regression of the herniated disc. This case provides an additional example of spontaneous regression of a herniated cervical disc documented by MRI following non-surgical treatment.

Multi-parametric spinal cord MRI as potential progression marker in amyotrophic lateral sclerosis.

Science.gov (United States)

El Mendili, Mohamed-Mounir; Cohen-Adad, Julien; Pelegrini-Issac, Mélanie; Rossignol, Serge; Morizot-Koutlidis, Régine; Marchand-Pauvert, Véronique; Iglesias, Caroline; Sangari, Sina; Katz, Rose; Lehericy, Stéphane; Benali, Habib; Pradat, Pierre-François

2014-01-01

To evaluate multimodal MRI of the spinal cord in predicting disease progression and one-year clinical status in amyotrophic lateral sclerosis (ALS) patients. After a first MRI (MRI1), 29 ALS patients were clinically followed during 12 months; 14/29 patients underwent a second MRI (MRI2) at 11±3 months. Cross-sectional area (CSA) that has been shown to be a marker of lower motor neuron degeneration was measured in cervical and upper thoracic spinal cord from T2-weighted images. Fractional anisotropy (FA), axial/radial/mean diffusivities (λ⊥, λ//, MD) and magnetization transfer ratio (MTR) were measured within the lateral corticospinal tract in the cervical region. Imaging metrics were compared with clinical scales: Revised ALS Functional Rating Scale (ALSFRS-R) and manual muscle testing (MMT) score. At MRI1, CSA correlated significantly (Pleg ALFSRS-R scores. One year after MRI1, CSA predicted (Pleg ALSFRS-R subscore. From MRI1 to MRI2, significant changes (PDTI metrics predicted ALS disease progression. Cord atrophy was a better biomarker of disease progression than diffusion and MTR. Our study suggests that multimodal MRI could provide surrogate markers of ALS that may help monitoring the effect of disease-modifying drugs.

Traumatic cervical root injury: Diagnostic value of MR imaging

International Nuclear Information System (INIS)

Lee, Seon Kyu; Chang, Kee Hyun; Han, Moon Hee; Kim, Ho Chul; Kim, Jea Seung; Cha, Sang Hoon

1993-01-01

Although superior soft tissue contrast and direct multiplanar imaging capability of MRI are well recognized, myelography has been the imaging modality of choice in evaluation cervical root injury. We assessed the role of MRI and compared its diagnostic accuracy with myelography in the evaluation of cervical root injury. MR imagings of cervical root injury in ten patients (55 roots) were retrospectively reviewed. In 26 explored roots (6 patients). MR findings were compared with myelography and surgical results. In 29 roots (8 patients), which were confirmed by myelography or exploration, the MR findings were focal extradural CSF collections (pseudomeningocele) in 21/29 (72.4%, 8 patients), thickening of extradural roots in 4/29 (13.6%, 5 patients), and thickening of dura in 12/29 (41.4%, 6 patients) roots. T2-weighted axial image was superior to T1-weighted and protein-density- weighted images for delineation root avulsion. The sensitivity and specificity of MRI were 72.7% and 93.3% respectively, while those of myelography were 83% and 90%. Overall diagnostic accuracy of MRI and myelography were comparable (84.6% vs 87.5%). In conclusion, myelography is still considered as the modality of choice in the preoperative evaluation of the cervical root avulsion because of its higher sensitivity. MRI, however, may obviate the myelography with some technical refinements

MRI in Optic Neuritis: Structure, Function, Interactions

DEFF Research Database (Denmark)

Fuglø, Dan

2011-01-01

resonance imaging (MRI), and the visual evoked potential (VEP) continues to show a delayed P100 indicating persistent demyelination. The explanation for this apparent discrepancy between structure and function could be due to either a redundancy in the visual pathways so that some degree of signal loss...... will have very few or no clinical symptoms, or it could be due to compensatory mechanisms in the visual pathway or the visual cortex. In order to understand the pathophysiology and recovery processes in ON it is essential to have sensitive methods to asses both structure and function. These methods...... are low. Functional MRI (fMRI) is a non-invasive technique that can measure brain activity with a high spatial resolution. Recently, technical and methodological advancements have made it feasible to record VEPs and fMRI simultaneously and the relationship between averaged VEPs and averaged fMRI signals...

Brain activation studies with PET and functional MRI

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Yonekura, Yoshiharu [Fukui Medical Univ., Matsuoka (Japan). Biomedical Imaging Research Center; Sadato, Norihiro [Okazaki National Research Inst., Aichi (Japan). National Inst. for Physiological Sciences

2002-01-01

Application of PET and functional MRI in brain activation studies is reviewed. 3D-PET images obtained repeatedly after intravenous injection of about 370 MBq of H{sub 2}{sup 15}O can detect a faint blood flow change in the brain. Functional MRI can also detect the blood flow change in the brain due to blood oxygen level-dependent effect. Echo-planar imaging is popular in MRI with 1.5 or 3 T. Images are analyzed by statistical parametric mapping with correction of cerebral regions, anatomical normalization and statistics. PET data give the blood flow change by the H{sub 2}{sup 15}O incorporation into the brain and MRI data, by the scarce tissue oxygen consumption despite the change. Actual images during the cognition task-performance and of frequent artifacts are given. PET is suitable for studies of brain functions like sensibility and emotion and functional MRI, like cortex functions and clinical practices in identification of functional regions prior to surgery and evaluation of functional recovery of damaged brain. (K.H.)

Brain activation studies with PET and functional MRI

International Nuclear Information System (INIS)

Yonekura, Yoshiharu; Sadato, Norihiro

2002-01-01

Application of PET and functional MRI in brain activation studies is reviewed. 3D-PET images obtained repeatedly after intravenous injection of about 370 MBq of H 2 15 O can detect a faint blood flow change in the brain. Functional MRI can also detect the blood flow change in the brain due to blood oxygen level-dependent effect. Echo-planar imaging is popular in MRI with 1.5 or 3 T. Images are analyzed by statistical parametric mapping with correction of cerebral regions, anatomical normalization and statistics. PET data give the blood flow change by the H 2 15 O incorporation into the brain and MRI data, by the scarce tissue oxygen consumption despite the change. Actual images during the cognition task-performance and of frequent artifacts are given. PET is suitable for studies of brain functions like sensibility and emotion and functional MRI, like cortex functions and clinical practices in identification of functional regions prior to surgery and evaluation of functional recovery of damaged brain. (K.H.)

Adaptive Analysis of Functional MRI Data

International Nuclear Information System (INIS)

Friman, Ola

2003-01-01

Functional Magnetic Resonance Imaging (fMRI) is a recently developed neuro-imaging technique with capacity to map neural activity with high spatial precision. To locate active brain areas, the method utilizes local blood oxygenation changes which are reflected as small intensity changes in a special type of MR images. The ability to non-invasively map brain functions provides new opportunities to unravel the mysteries and advance the understanding of the human brain, as well as to perform pre-surgical examinations in order to optimize surgical interventions. This dissertation introduces new approaches for the analysis of fMRI data. The detection of active brain areas is a challenging problem due to high noise levels and artifacts present in the data. A fundamental tool in the developed methods is Canonical Correlation Analysis (CCA). CCA is used in two novel ways. First as a method with the ability to fully exploit the spatio-temporal nature of fMRI data for detecting active brain areas. Established analysis approaches mainly focus on the temporal dimension of the data and they are for this reason commonly referred to as being mass-univariate. The new CCA detection method encompasses and generalizes the traditional mass-univariate methods and can in this terminology be viewed as a mass-multivariate approach. The concept of spatial basis functions is introduced as a spatial counterpart of the temporal basis functions already in use in fMRI analysis. The spatial basis functions implicitly perform an adaptive spatial filtering of the fMRI images, which significantly improves detection performance. It is also shown how prior information can be incorporated into the analysis by imposing constraints on the temporal and spatial models and a constrained version of CCA is devised to this end. A general Principal Component Analysis technique for generating and constraining temporal and spatial subspace models is proposed to be used in combination with the constrained CCA

The prevalence of cervical myelopathy among subjects with narrow cervical spinal canal in a population-based magnetic resonance imaging study: the Wakayama Spine Study.

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Nagata, Keiji; Yoshimura, Noriko; Hashizume, Hiroshi; Muraki, Shigeyuki; Ishimoto, Yuyu; Yamada, Hiroshi; Takiguchi, Noboru; Nakagawa, Yukihiro; Minamide, Akihito; Oka, Hiroyuki; Kawaguchi, Hiroshi; Nakamura, Kozo; Akune, Toru; Yoshida, Munehito

2014-12-01

A narrow cervical spinal canal (CSC) is a well-known risk factor for cervical myelopathy (CM). However, no epidemiologic data of the CSC based on a population-based cohort are available. The purpose of the study was to investigate the age-related differences in CSC diameters on plain radiographs and to examine the associated magnetic resonance imaging (MRI) abnormalities including cervical cord compression and increased signal intensity (ISI) as well as the clinical CM with the narrow CSC. This was a cross-sectional study. Data were obtained from the baseline survey of the Wakayama Spine Study that was performed from 2008 to 2010 in a western part of Japan. Finally, a total of 959 subjects (319 men and 640 women; mean age, 66.4 years) were included. The outcome measures included in the study were the CSC diameter at C5 level on plain radiographs, cervical cord compression and ISI on sagittal T2-weighted MRI, and physical signs related to CM (eg, the Hoffmann reflex, hyperreflexia of the patellar tendon, the Babinski reflex, sensory and motor function, and bowel/bladder symptoms). The age-related differences of CSC diameters in men and women were investigated by descriptive statistics. The prevalence of MRI abnormalities and clinical CM was compared among the groups divided by the CSC diameter (less than 13, 13-15, and 15 mm or more). In addition, a logistic regression analysis was performed to determine the association of the CSC diameter with cervical cord compression/clinical CM after overall adjustment for age, sex, and body mass index. The CSC diameter was narrower with increasing age in both men and women. The prevalence of cervical cord compression, ISI, and the clinical CM was significantly higher in the narrower CSC group. The prevalence of cervical cord compression, ISI, and CM among subjects with CSC diameter less than 13 mm was 38.0%, 5.4%, and 10.1%, respectively. In the logistic model, the CSC diameter was a significant predictive factor for the

Imaging tools to study pharmacology: functional MRI on small rodents

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Elisabeth eJonckers; Disha eShah; Julie eHamaide; Marleen eVerhoye; Annemie eVan Der Linden

2015-01-01

Functional Magnetic Resonance Imaging (fMRI) is an excellent tool to study the effect of pharmacological modulations on brain function in a non-invasive and longitudinal manner. We introduce several blood oxygenation level dependent (BOLD) fMRI techniques, including resting state (rsfMRI), stimulus-evoked (st-fMRI), and pharmacological MRI (phMRI). Respectively, these techniques permit the assessment of functional connectivity during rest as well as brain activation triggered by sensory stimu...

Venous hypertensive myelopathy associated with cervical spondylosis.

Science.gov (United States)

Okada, Seiji; Chang, Charles; Chang, Geraldine; Yue, James J

2016-11-01

Venous hypertensive myelopathy (VHM) results from spinal vascular malformations of arteriovenous shunting that increases spinal venous pressure, leading to congestive edema and neurologic dysfunction. There has been no report of VHM associated with cervical spondylotic myelopathy (CSM). The aim of this study was to report an extremely rare case of VHM likely due to CSM. This study is a case report and review of the literature. The patient was a 51-year-old man with CSM exhibiting relatively rapid neurologic deterioration with an abnormal expansion of a centromedullary hyperintense lesion on T2-weighted magnetic resonance imaging (MRI) in the absence of traumatic injury. Neurologic examination and radiologic imaging were taken by various means. The patient developed a cervical radiculopathy, followed by gait disturbance and motor weakness. The MRI of the cervical spine demonstrated spinal canal stenosis due to disc bulging and flavum hypertrophy at the C5/C6 and C6/C7 levels as well as hyperintense area over the C5-C7 levels on T2-weighted images. Although decompression surgery was planned, an acute inflammatory process such as transverse myelitis or demyelinating disease other than cord compression was also considered, and the patient received intravenous steroids. His walking improved for several days. However, his symptoms then became significantly worse, and he had difficulty walking. Subsequent MRI demonstrated marked progression of the T2 hyperintense lesion over the C4-T1 vertebral levels. Flow voids were also noted on the dorsal surface of the upper cervical cord on T2-weighted MRI. His lab work, medical history, and the local enhancement on contrast-enhanced MRI indicated low probability of spinal inflammatory diseases. Therefore, the decision was made to perform anterior cervical discectomy and fusion surgery on two levels. Following surgery, his symptoms improved promptly. Our case indicates that VHM could be caused by spondylotic cord compression in the

Imaging tools to study pharmacology: functional MRI on small rodents

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Elisabeth eJonckers

2015-10-01

Full Text Available Functional Magnetic Resonance Imaging (fMRI is an excellent tool to study the effect of pharmacological modulations on brain function in a non-invasive and longitudinal manner. We introduce several blood oxygenation level dependent (BOLD fMRI techniques, including resting state (rsfMRI, stimulus-evoked (st-fMRI, and pharmacological MRI (phMRI. Respectively, these techniques permit the assessment of functional connectivity during rest as well as brain activation triggered by sensory stimulation and/or a pharmacological challenge. The first part of this review describes the physiological basis of BOLD fMRI and the hemodynamic response on which the MRI contrast is based. Specific emphasis goes to possible effects of anaesthesia and the animal’s physiological conditions on neural activity and the hemodynamic response. The second part of this review describes applications of the aforementioned techniques in pharmacologically-induced, as well as in traumatic and transgenic disease models and illustrates how multiple fMRI methods can be applied successfully to evaluate different aspects of a specific disorder. For example, fMRI techniques can be used to pinpoint the neural substrate of a disease beyond previously defined hypothesis-driven regions-of-interest (ROIs. In addition, fMRI techniques allow one to dissect how specific modifications (e.g. treatment, lesion etc. modulate the functioning of specific brain areas (st-fMRI, phMRI and how functional connectivity (rsfMRI between several brain regions is affected, both in acute and extended time frames. Furthermore, fMRI techniques can be used to assess/explore the efficacy of novel treatments in depth, both in fundamental research as well as in preclinical settings. In conclusion, by describing several exemplary studies, we aim to highlight the advantages of functional MRI in exploring the acute and long-term effects of pharmacological substances and/or pathology on brain functioning along with

Cervical facet dislocation adjacent to the fused motion segment

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Kunio Yokoyama

2016-01-01

Full Text Available This study reports on a case that forces re-examination of merits and demerits of anterior cervical fusion. A 79-year-old male was brought to the emergency room (ER of our hospital after he fell and struck the occipital region of his head following excessive alcohol consumption. Four years prior, he had undergone anterior cervical discectomy and fusion of C5/6 and a magnetic resonance imaging (MRI performed 3 years after this surgery indicated that he was suffering from degeneration of C6/7 intervertebral discs. After arriving at the ER, he presented motor impairment at level C7 and lower of manual muscle testing grade 1 as well as moderate loss of physical sensation from the trunk and peripheries of both upper limbs to the peripheries of both lower limbs (Frankel B. Cervical computed tomography (CT indicated anterior dislocation of C6/7, and MRI indicated severe spinal cord edema. We performed manipulative reduction of C6/7 with the patient under general anesthesia. Next, we performed laminectomy on C5-T1 and posterior fusion on C6/7. Postoperative CT indicated that cervical alignment had improved, and MRI indicated that the spinal cord edema observed prior to surgery had been mitigated. Three months after surgery, motor function and sensory impairment of the lower limbs had improved, and the patient was ambulatory upon discharge from the hospital (Frankel D. In the present case, although C5 and 6 were rigidly fused, degeneration of the C6/7 intervertebral disc occurred and stability was compromised. As a result, even slight trauma placed a severe dynamic burden on the facet joint of C6/7, which led to dislocation.

Functional connectivity of motor cortical network in patients with brachial plexus avulsion injury after contralateral cervical nerve transfer: a resting-state fMRI study

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Yu, Aihong; Cheng, Xiaoguang; Liang, Wei; Bai, Rongjie [The 4th Medical College of Peking University, Department of Radiology, Beijing Jishuitan Hospital, Xicheng Qu, Beijing (China); Wang, Shufeng; Xue, Yunhao; Li, Wenjun [The 4th Medical College of Peking University, Department of Hand Surgery, Beijing Jishuitan Hospital, Beijing (China)

2017-03-15

The purpose of this study is to assess the functional connectivity of the motor cortical network in patients with brachial plexus avulsion injury (BPAI) after contralateral C7 nerve transfer, using resting-state functional magnetic resonance imaging (RS-fMRI). Twelve patients with total brachial plexus root avulsion underwent RS-fMRI after contralateral C7 nerve transfer. Seventeen healthy volunteers were also included in this fMRI study as controls. The hand motor seed regions were defined as region of interests in the bilateral hemispheres. The seed-based functional connectivity was calculated in all the subjects. Differences in functional connectivity of the motor cortical network between patients and healthy controls were compared. The inter-hemispheric functional connectivity of the M1 areas was increased in patients with BPAI compared with the controls. The inter-hemispheric functional connectivity between the supplementary motor areas was reduced bilaterally. The resting-state inter-hemispheric functional connectivity of the bilateral M1 areas is altered in patients after contralateral C7 nerve transfer, suggesting a functional reorganization of cerebral cortex. (orig.)

Functional connectivity of motor cortical network in patients with brachial plexus avulsion injury after contralateral cervical nerve transfer: a resting-state fMRI study

International Nuclear Information System (INIS)

Yu, Aihong; Cheng, Xiaoguang; Liang, Wei; Bai, Rongjie; Wang, Shufeng; Xue, Yunhao; Li, Wenjun

2017-01-01

The purpose of this study is to assess the functional connectivity of the motor cortical network in patients with brachial plexus avulsion injury (BPAI) after contralateral C7 nerve transfer, using resting-state functional magnetic resonance imaging (RS-fMRI). Twelve patients with total brachial plexus root avulsion underwent RS-fMRI after contralateral C7 nerve transfer. Seventeen healthy volunteers were also included in this fMRI study as controls. The hand motor seed regions were defined as region of interests in the bilateral hemispheres. The seed-based functional connectivity was calculated in all the subjects. Differences in functional connectivity of the motor cortical network between patients and healthy controls were compared. The inter-hemispheric functional connectivity of the M1 areas was increased in patients with BPAI compared with the controls. The inter-hemispheric functional connectivity between the supplementary motor areas was reduced bilaterally. The resting-state inter-hemispheric functional connectivity of the bilateral M1 areas is altered in patients after contralateral C7 nerve transfer, suggesting a functional reorganization of cerebral cortex. (orig.)

The influence of changes in cervical lordosis on bulging disk and spinal stenosis: functional MR imaging

International Nuclear Information System (INIS)

Lee, Young Joon; Eun, Choong Ki

2001-01-01

To assess the effect of lordotic curve change of the cervical spine on disk bulging and spinal stenosis by means of functional cervical MR imaging at the flexion and extension position. Using a 1.5T imager, kinematic MR examinations of 25 patients with degenerative spondylosis (average age, 41 years) were performed at the neutral, flexed and extended position of the cervical spine. Sagittal T2-weighted turbo spin-echo images were obtained during each of the three phases. Lordotic angle, bulging thickness of the disk, AP diameter of the spinal canal, and distance between the disk and spinal cord were measured on the workstation at each disk level. After qualitative independent observation of disk bulging, one of four grades(0, normal; 1, mild; 2, moderate; 3, marked) was assigned at each phase, and after further comparative observation, one of five scores (-2, prominent decrease; -1, mild decrease; 0, no change; 1, notable increase; 2 prominent increase) was also assigned. In addition, bulging thickness of the disk was measured and compared at the neutral, flexed, and extended positions. Average angles of the cervical spine were 160.5±5.9 deg (neutral position, lordotic angle); 185.4±8.5 deg (flexion, kyphotic angle); and 143.7±6.7 deg (extension, lordotic angle). Average grades of disk bulging were 0.55 at the neutral position. 0.16 at flexion, and 0.7 at extension. Comparative observation showed that average scores of disk bulging were -0.39 at flexion and 0.31 at extension. The bulging thickness of the disk decreased by 24.2% at flexion and increased by 30.3% at extension, while the diameter of the spinal canal increased by 4.5% at flexion and decreased by 3.6% at extension. The distance from the posterior margin of the disk to the anterior margin of the spinal cord decreased at both flexion(6.6%) and extension(19.1%). Functional MRI showed that compared with the neutral position, disk bulging and spinal stenosis are less prominent at flexion and accentuated

The influence of changes in cervical lordosis on bulging disk and spinal stenosis: functional MR imaging

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Lee, Young Joon; Eun, Choong Ki [Pusan Paik Hospital, Inje Univ. College of Medicine, Pusan (Korea, Republic of)

2001-05-01

To assess the effect of lordotic curve change of the cervical spine on disk bulging and spinal stenosis by means of functional cervical MR imaging at the flexion and extension position. Using a 1.5T imager, kinematic MR examinations of 25 patients with degenerative spondylosis (average age, 41 years) were performed at the neutral, flexed and extended position of the cervical spine. Sagittal T2-weighted turbo spin-echo images were obtained during each of the three phases. Lordotic angle, bulging thickness of the disk, AP diameter of the spinal canal, and distance between the disk and spinal cord were measured on the workstation at each disk level. After qualitative independent observation of disk bulging, one of four grades(0, normal; 1, mild; 2, moderate; 3, marked) was assigned at each phase, and after further comparative observation, one of five scores (-2, prominent decrease; -1, mild decrease; 0, no change; 1, notable increase; 2 prominent increase) was also assigned. In addition, bulging thickness of the disk was measured and compared at the neutral, flexed, and extended positions. Average angles of the cervical spine were 160.5{+-}5.9 deg (neutral position, lordotic angle); 185.4{+-}8.5 deg (flexion, kyphotic angle); and 143.7{+-}6.7 deg (extension, lordotic angle). Average grades of disk bulging were 0.55 at the neutral position. 0.16 at flexion, and 0.7 at extension. Comparative observation showed that average scores of disk bulging were -0.39 at flexion and 0.31 at extension. The bulging thickness of the disk decreased by 24.2% at flexion and increased by 30.3% at extension, while the diameter of the spinal canal increased by 4.5% at flexion and decreased by 3.6% at extension. The distance from the posterior margin of the disk to the anterior margin of the spinal cord decreased at both flexion(6.6%) and extension(19.1%). Functional MRI showed that compared with the neutral position, disk bulging and spinal stenosis are less prominent at flexion and

Histological, magnetic resonance imaging, and discographic findings on cervical disc degeneration in cadaver spines. A comparative study

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Maruyama, Yuichiro [Juntendo Univ., Tokyo (Japan). School of Medicine

1995-11-01

A total of 210 cervical intervertebral discs were taken at autopsy from 36 cadavers, and underwent both magnetic resonance imaging (MRI) and discography to compare their diagnostic efficacies for investigating degenerative changes in the cervical spine. The age of the subjects had ranged from 43 to 92 years with an average of 68.1 years. Following the autopsy, MRI and discography were performed on the excised cervical spinal column, and the specimen was then prepared for histological examination. The findings were compared with those of the lumbar spine that had previously been reported by Yasuma et al. on 1238 lumbar discs from 197 cadavers ranging in age from 11 to 92 years. The results were as follows: Low intensity in the T2-weighted MRI was well correlated with histological degeneration in the cervical disc. The rate of appearance of the posterior protrusion of the cervical disc on the MRI was in accordance with the degree of histological disc degeneration, but it did not always correspond with histological posterior protrusion. There was a remarkably high incidence for false-positive posterior protrusion on the MRI, which should be kept in mind on reading the MRI. In the comparison of the MRI with the discography, a certain positive correlation was found as for disc degeneration, but not in complete accordance. There was a considerable difference in the patterns of degeneration and in posterior protrusion of the discs between the cervical spine and the lumbar spine. The posterior protrusion in the cervical disc was more likely related to horizontal fissure and hyalinization of the posterior annulus, while posterior protrusion in the lumbar disc was often related to reversed orientation of the bundles and myxomatous degeneration of the posterior annulus. This difference was attributed to the difference in the mechanical properties of the cervical and lumbar spines. (author).

Histological, magnetic resonance imaging, and discographic findings on cervical disc degeneration in cadaver spines. A comparative study

International Nuclear Information System (INIS)

Maruyama, Yuichiro

1995-01-01

A total of 210 cervical intervertebral discs were taken at autopsy from 36 cadavers, and underwent both magnetic resonance imaging (MRI) and discography to compare their diagnostic efficacies for investigating degenerative changes in the cervical spine. The age of the subjects had ranged from 43 to 92 years with an average of 68.1 years. Following the autopsy, MRI and discography were performed on the excised cervical spinal column, and the specimen was then prepared for histological examination. The findings were compared with those of the lumbar spine that had previously been reported by Yasuma et al. on 1238 lumbar discs from 197 cadavers ranging in age from 11 to 92 years. The results were as follows: Low intensity in the T2-weighted MRI was well correlated with histological degeneration in the cervical disc. The rate of appearance of the posterior protrusion of the cervical disc on the MRI was in accordance with the degree of histological disc degeneration, but it did not always correspond with histological posterior protrusion. There was a remarkably high incidence for false-positive posterior protrusion on the MRI, which should be kept in mind on reading the MRI. In the comparison of the MRI with the discography, a certain positive correlation was found as for disc degeneration, but not in complete accordance. There was a considerable difference in the patterns of degeneration and in posterior protrusion of the discs between the cervical spine and the lumbar spine. The posterior protrusion in the cervical disc was more likely related to horizontal fissure and hyalinization of the posterior annulus, while posterior protrusion in the lumbar disc was often related to reversed orientation of the bundles and myxomatous degeneration of the posterior annulus. This difference was attributed to the difference in the mechanical properties of the cervical and lumbar spines. (author)

The relationship between central motor conduction time and spinal cord compression in patients with cervical spondylotic myelopathy.

Science.gov (United States)

Rikita, T; Tanaka, N; Nakanishi, K; Kamei, N; Sumiyoshi, N; Kotaka, S; Adachi, N; Ochi, M

2017-04-01

Retrospective study. Few studies have reported a relationship between central motor conduction time (CMCT), which evaluates corticospinal function, and degree of spinal cord compression in patients with myelopathy. Thus, there is no consensus on predicting the degree of prolonged CMCT on the basis of the degree of spinal cord compression. If a correlation exists between CMCT and spinal cord compression, then spinal cord compression may be a useful noninvasive clinical indicator of corticospinal function. Therefore, this study evaluated the relationship between CMCT and cervical spinal cord compression measured by magnetic resonance imaging (MRI) in patients with cervical spondylotic myelopathy (CSM). Hiroshima University Hospital in Japan. We studied 33 patients undergoing laminoplasty. Patients exhibited significant cervical spinal cord compression on both MRI and intraoperative electrophysiological examination. We assessed transcranial magnetic stimulation measurement of CMCT; spinal cord compression parameters such as area, lateral diameter, anteroposterior diameter and flattening of the spinal cord at the lesion site and C2/3 levels on MRI; and pre- versus postoperative Japanese Orthopaedic Association (JOA) scores. Correlations between CMCT and flattening as well as anteroposterior diameter of the spinal cord at the lesion level were observed. Strong correlations between CMCT and the ratio of the flattening and anteroposterior diameter parameters at the lesion level to that at the C2/3 level were also observed. Measurement of spinal cord compression may be useful for the evaluation of corticospinal function as a proxy for CMCT in patients with CSM.

Striatocapsular infarction: MRI and MR angiography

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Croisille, P. (Dept. of Neuroradiology, Hopital Neurologique et Neurochirurgical Pierre Wertheimer, Lyon (France)); Turjman, F. (Dept. of Neuroradiology, Hopital Neurologique et Neurochirurgical Pierre Wertheimer, Lyon (France)); Croisile, B. (Dept. of Neurology, Hopital Neurologique et Neurochirurgical Pierre Wertheimer, Lyon (France)); Tournut, P. (Dept. of Neuroradiology, Hopital Neurologique et Neurochirurgical Pierre Wertheimer, Lyon (France)); Laharotte, J.C. (Dept. of Neuroradiology, Hopital Neurologique et Neurochirurgical Pierre Wertheimer, Lyon (France)); Aimard, G. (Dept. of Neurology, Hopital Neurologique et Neurochirurgical Pierre Wertheimer, Lyon (France)); Trillet, M. (Dept. of Neurology, Hopital Neurologique et Neurochirurgical Pierre Wertheimer, Lyon (France)); Duquesnel, J. (Dept. of Neuroradiology, Hopital Neurologique et Neurochirurgical Pierre Wertheimer, Lyon (France)); Froment, J.C. (Dept. of Neuroradiology, Hopital Neurologique et Neurochirurgical Pierre

1994-08-01

We present a case of left striatocapsular infarction manifest clinically as a transient right hemiparesis. MRI showed a left striatocapsular infarct. Striatocapsular infarction, unlike lacunar infarction, is often associated with occlusive disease of the carotid artery. In order to screen the carotid vessels, cervical MR angiography (MRA) was performed during the same examination, demonstrating a left internal carotid artery occlusion, confirmed by contrast arteriography. MRA, a noninvasive modality, can be a useful adjunct to MRI, when diagnostic information concerning the cervical carotid artery is needed. (orig.)

Facet joint injuries in acute cervical spine trauma : evaluation with CT and MRI

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Ha, Jeon Ju; Kim, Dong Hyun; Lee, Jeong Hwa; Lee, Keon; Kwon, Hyeok Po; Kwon, Jung Hyeok; Yun, Seong Mun [Dongkang General Hospital, Seoul (Korea, Republic of)

1999-05-01

To evaluate injury patterns of facet joints and associated soft tissue injuries in patients with acute traumatic cervical facet joint injuries. From among patients with cervical spine trauma, 27 with facet joint injuries, as seen on CT and MRI, were chosen for this study. CT scans were analyzed with regard to the location of facet joint injury, the presence or absence of facet dislocation or fracture, and other associated fractures. MR images were analyzed with regard to ligament injury, intervertebral disc injury, intervertebral disc herniation, and spinal cord injury. The most common location of facet joint injury was C6-7 level(n=10), followed by C5-6(n=8). Among these 27 patients with facet joint injuries, 12(44%) had bilateral injuries and 15(56%) unilateral injuries. Facet fractures were present in 17 cases(63%) and the fracture of inferior facet was more frequent than superior. Patterns of fracture were vertical, transverse, or comminuted, but vertical fracture was the most common. Various degrees of dislocation were observed in patients with facet fractures. Fractures other than facet included pillar(n=11), lamina(n=6), transverse process(n=14), body(n=13), and spinous process(n=3). On MR images, anterior longitudinal ligament injury was found in 8 patients(30%), posterior longitudinal ligament injury in 4(15%), and interspinous ligament injury in 20(74%). Twelve patients(44%) had spinal cord injuries including edema(n=8) and hemorrhage(n=4). Among patients with disc abnormalities, 11(41%) had intervertebral disc injuries, and traumatic disc herniations were found in nine. Traumatic cervical facet joint injuries were manifested as various patterns and frequently associated with other fractures or soft tissue injuries. Analysis of CT and MR findings of these injury patterns helped formulate a therapeutic plan and determine of prognosis.

Intra-rater reliability of cervical sensory motor function and cervical reconstruction test in healthy subjects

Directory of Open Access Journals (Sweden)

Hatamvand S

2016-07-01

Full Text Available Impairment of cervicocephalic and head joint position sense has an important role in the recurrent and chronic of cervicocephalic pain. The various tools are suggested for evaluating the cervicocephalic joint position sense. Although reconstruction of cervical angle is a clinical criterion for measuring the cervicocephalic proprioception, the reliability of this method has not been completely accepted. The purpose of this study was to evaluate intra-rater reliability of cervical sensory motor function and cervical reconstruction test in healthy subjects. twenty four healthy subjects (25.70±6.08 y through simple non-probability sampling participated in this single-group repeatedmeasures reliability study. Participants were asked to relocate the neck, as accurately as possible, after full active cervical flexion, extension and rotation to the left and right sides. Five trials were performed for each movement. Laser pointer was used in head of patient. The distance between zero spot and joint position which patient had been reconstructed, was measured by centimeter. Intra-class correlation Coefficient (ICCs and Pearson's correlation coefficient test was used to determine intra-rater reliability of variables. The results showed that intra-class correlation Coefficient (ICCs values with 95% confidence interval (CI and the standard error of the measurement (SEM were good to excellent agreement for a single investigator between measurement occasions. Intra-class correlation Coefficient (ICCs values were obtained for flexion movement (ICCs:0.75, good, extension movement (ICCs:0.81, very good, right rotation (ICCs:0.64, good and left rotation (ICCs:0.64, good. The cervicocephalic relocation test to neutral head position by laser pointer is a reliable method to measure cervical sensory motor function. Therefore, it can be used for evaluating cervicocephalic proprioception of patient with cervicocephalic pain.

Superior Cervical Sympathetic Ganglion: Normal Imaging Appearance on 3T-MRI

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Lee, Joo Yeon; Lee, Jeong Hyun [Department of Radiology and Research Institute of Radiology, University of Ulsan College of Medicine, Asan Medical Center, Seoul 05505 (Korea, Republic of); Song, Joon Seon; Song, Min Jeong [Department of Pathology, University of Ulsan College of Medicine, Asan Medical Center, Seoul 05505 (Korea, Republic of); Hwang, Seung-Jun [Department of Anatomy and Cell Biology, University of Ulsan College of Medicine, Asan Medical Center, Seoul 05505 (Korea, Republic of); Yoon, Ra Gyoung [Department of Radiology, Catholic Kwandong University International St. Mary' s Hospital, Catholic Kwandong University College of Medicine, Incheon 22711 (Korea, Republic of); Jang, Seung Won; Park, Ji Eun [Department of Radiology and Research Institute of Radiology, University of Ulsan College of Medicine, Asan Medical Center, Seoul 05505 (Korea, Republic of); Heo, Young Jin [Department of Radiology, Busan Paik Hospital, Inje University College of Medicine, Busan 47392 (Korea, Republic of); Choi, Young Jun; Baek, Jung Hwan [Department of Radiology and Research Institute of Radiology, University of Ulsan College of Medicine, Asan Medical Center, Seoul 05505 (Korea, Republic of)

2016-11-01

To identify superior cervical sympathetic ganglion (SCSG) and describe their characteristic MR appearance using 3T-MRI. In this prospective study, we recruited 53 consecutive patients without history of head and neck irradiation. Using anatomic location based on literature review, both sides of the neck were evaluated to identify SCSGs in consensus. SCSGs were divided into definite (medial to internal carotid artery [ICA] and lateral to longus capitis muscle [LCM]) and probable SCSGs based on relative location to ICA and LCM. Two readers evaluated signal characteristics including intraganglionic hypointensity of all SCSGs and relative location of probable SCSGs. Interrater and intrarater agreements were quantified using unweighted kappa. Ninety-one neck sites in 53 patients were evaluated after exclusion of 15 neck sites with pathology. Definite SCSGs were identified at 66 (73%) sites, and probable SCSGs were found in 25 (27%). Probable SCSGs were located anterior to LCM in 16 (18%), lateral to ICA in 6 (7%), and posterior to ICA in 3 (3%). Intraganglionic hypointensity was identified in 82 (90%) on contrast-enhanced fat-suppressed T1-weighted images. There was no statistical difference in the relative location between definite and probable SCSGs of the right and left sides with intragnalionic hypointensity on difference pulse sequences. Interrater and intrarater agreements on the location and intraganglionic hypointensity were excellent (κ-value, 0.749–1.000). 3T-MRI identified definite SCSGs at 73% of neck sites and varied location of the remaining SCSGs. Intraganglionic hypointensity was a characteristic feature of SCSGs.

Superior cervical sympathetic ganglion: Normal imaging appearance on 3T-MRI

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Lee, Joo Yeon; Lee, Jeong Hyun; Song, Joon Seon [Dept. of Radiology, and Research Institute of Radiology, University of Ulsan College of Medicine, Asan Medical Center, Seoul (Korea, Republic of); and others

2016-09-15

To identify superior cervical sympathetic ganglion (SCSG) and describe their characteristic MR appearance using 3T-MRI. In this prospective study, we recruited 53 consecutive patients without history of head and neck irradiation. Using anatomic location based on literature review, both sides of the neck were evaluated to identify SCSGs in consensus. SCSGs were divided into definite (medial to internal carotid artery [ICA] and lateral to longus capitis muscle [LCM]) and probable SCSGs based on relative location to ICA and LCM. Two readers evaluated signal characteristics including intraganglionic hypointensity of all SCSGs and relative location of probable SCSGs. Interrater and intrarater agreements were quantified using unweighted kappa. Ninety-one neck sites in 53 patients were evaluated after exclusion of 15 neck sites with pathology. Definite SCSGs were identified at 66 (73%) sites, and probable SCSGs were found in 25 (27%). Probable SCSGs were located anterior to LCM in 16 (18%), lateral to ICA in 6 (7%), and posterior to ICA in 3 (3%). Intraganglionic hypointensity was identified in 82 (90%) on contrast-enhanced fat-suppressed T1-weighted images. There was no statistical difference in the relative location between definite and probable SCSGs of the right and left sides with intragnalionic hypointensity on difference pulse sequences. Interrater and intrarater agreements on the location and intraganglionic hypointensity were excellent (κ-value, 0.749–1.000). 3T-MRI identified definite SCSGs at 73% of neck sites and varied location of the remaining SCSGs. Intraganglionic hypointensity was a characteristic feature of SCSGs.

MRI of the cervical spine with 3D gradient echo sequence at 3 T: initial experience

International Nuclear Information System (INIS)

Xiao, L.; Siu, C.W.J.; Yeung, K.; Leung, A.; Yuen, M.K.; Wong, Y.C.

2015-01-01

Aim: The aim of this study was to compare three-dimensional (3D) high resolution T2*-weighted gradient echo (3D FFE) magnetic resonance (MR) sequence with conventional 2D T2-weighted turbo spin echo (TSE) MR sequence for imaging of the cervical spine, especially to assess the detectability of the internal anatomy of the cervical spinal cord, i.e. to distinguish the grey and white matter. Methods: Fifteen volunteers were examined at 3.0T MR unit. Signal-to-noise (SNR), contrast-to-noise (CNR) and image homogeneity were evaluated. In the visual analysis, the visibility of anatomical structures of the cervical spine and artifacts were assessed. The nonparametric method of paired sample t-test was adopted to evaluate the differences between the sequences. Results: The 3D FFE sequence provided better results for CNR, cerebrospinal fluid (CSF) versus white matter, grey matter, disk and bone. Moreover, it yielded good results for the CNR grey matter versus white matter. The butterfly-shaped “H” is clearly displayed in the 3D FFE sequence. The statistical analysis revealed the statistically significant difference between the 2D TSE and 3D FFE sequences for the contrast of CSF versus spinal cord (both grey matter and white matter). Conclusion: The 3D FFE sequence in MR imaging of the cervical spinal cord is superior in delineation of spinal cord anatomical structures compared to 2D TSE sequence. -- Highlights: •We investigate the potential of 3D FFE sequence to distinguish the grey-white of the cervical spinal cord at 3T MRI system. •We optimized The 3D FFE sequence was optimized to increase the grey-white contrast. •Utilizing medium TE for T2W and the shortest TR for reduction of susceptibility related artifacts and motion artefacts. •This technique may increase the confidence in the diagnosis of disease with the improved delineation of cord anatomy

Are upright lateral cervical radiographs in the obtunded trauma patient useful? A retrospective study

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Bolles Gene

2007-02-01

Full Text Available Abstract Background The best method for radiographic "clearance" of the cervical spine in obtunded patients prior to removal of cervical immobilization devices remains debated. Dynamic radiographs or MRI are thought to demonstrate unstable injuries, but can be expensive and cumbersome to obtain. An upright lateral cervical radiograph (ULCR was performed in selected patients to investigate whether this study could provide this same information, to enable removal of cervical immobilization devices in the multiple trauma patient. Methods We retrospectively reviewed our experience with ULCR in 683 blunt trauma victims who presented over a 3-year period, with either a Glasgow Coma Score Results ULCR was performed in 163 patients. Seven patients had studies interpreted to be abnormal, of which six were also abnormal, by either CT or MRI. The seventh patient's only abnormality was soft tissue swelling; MRI was otherwise normal. Six patients had ULCR interpreted as normal, but had abnormalities on either CT or MRI. None of the missed injuries required surgical stabilization, although one had a vertebral artery injury demonstrated on subsequent angiography. ULCR had an apparent sensitivity of 45.5% and specificity of 71.4%. Conclusion ULCR are inferior to both CT and MRI in the detection of cervical injury in patients with normal plain radiographs. We therefore cannot recommend the use of ULCR in the obtunded trauma patient.

MRI to assess renal structure and function.

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Artunc, Ferruh; Rossi, Cristina; Boss, Andreas

2011-11-01

In addition to excellent anatomical depiction, MRI techniques have expanded to study functional aspects of renal physiology, such as renal perfusion, glomerular filtration rate (GFR) or tissue oxygenation. This review will focus on current developments with an emphasis on clinical applicability. The method of GFR determination is largely heterogeneous and still has weaknesses. However, the technique of employing liver disappearance curves has been shown to be accurate in healthy persons and patients with chronic kidney disease. In potential kidney donors, complete evaluation of kidney anatomy and function can be accomplished in a single-stop investigation. Techniques without contrast media can be utilized to measure renal tissue oxygenation (blood oxygen level-dependent MRI) or perfusion (arterial spin labeling) and could aid in the diagnosis and treatment of ischemic renal diseases, such as renal artery stenosis. Diffusion imaging techniques may provide information on spatially restricted water diffusion and tumor cellularity. Functional MRI opens new horizons in studying renal physiology and pathophysiology in vivo. Although extensively utilized in research, labor-intensive postprocessing and lack of standardization currently limit the clinical applicability of functional MRI. Further studies are necessary to evaluate the clinical value of functional magnetic resonance techniques for early discovery and characterization of kidney disease.

Function-specific and Enhanced Brain Structural Connectivity Mapping via Joint Modeling of Diffusion and Functional MRI.

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Chu, Shu-Hsien; Parhi, Keshab K; Lenglet, Christophe

2018-03-16

A joint structural-functional brain network model is presented, which enables the discovery of function-specific brain circuits, and recovers structural connections that are under-estimated by diffusion MRI (dMRI). Incorporating information from functional MRI (fMRI) into diffusion MRI to estimate brain circuits is a challenging task. Usually, seed regions for tractography are selected from fMRI activation maps to extract the white matter pathways of interest. The proposed method jointly analyzes whole brain dMRI and fMRI data, allowing the estimation of complete function-specific structural networks instead of interactively investigating the connectivity of individual cortical/sub-cortical areas. Additionally, tractography techniques are prone to limitations, which can result in erroneous pathways. The proposed framework explicitly models the interactions between structural and functional connectivity measures thereby improving anatomical circuit estimation. Results on Human Connectome Project (HCP) data demonstrate the benefits of the approach by successfully identifying function-specific anatomical circuits, such as the language and resting-state networks. In contrast to correlation-based or independent component analysis (ICA) functional connectivity mapping, detailed anatomical connectivity patterns are revealed for each functional module. Results on a phantom (Fibercup) also indicate improvements in structural connectivity mapping by rejecting false-positive connections with insufficient support from fMRI, and enhancing under-estimated connectivity with strong functional correlation.

The emerging role of multidetector row CT angiography in the diagnosis of cervical arterial dissection: preliminary study

International Nuclear Information System (INIS)

Elijovich, Lucas; Kazmi, Khuram; Gauvrit, Jean Y.; Law, Meng

2006-01-01

Cervical artery dissection is an important cause of ischemic stroke, particularly in young patients. The diagnosis can be made with invasive catheter angiography or non-invasive imaging, either with MRI in conjunction with MR angiography (MRA) or CT angiography (CTA). Both modalities have been shown to have a high specificity and sensitivity. New developments such as multi-slice CTA (MSCTA) are emerging as an alternative methods for imaging the cervical and intracranial arteries. However, the contribution of modern MSCTA to carotid artery dissection has not been reported. We present a retrospective series of seven patients in whom both MSCTA and cervical axial T1 MRI and MRA were performed in the acute to subacute setting of internal carotid artery dissection. Carotid artery dissection was identified in all seven patients by MSCTA. The combination of MRI and MRA identified dissection in five of the seven patients. Additionally, a pseudoaneurysm was identified by MSCTA that was missed by MRI and MRA. Our findings confirm that MSCTA is a complementary technique in comparison to cervical axial T1 MRI and cervical MRA for diagnosing carotid artery dissection, and at times may provide additional information that can impact patient management. (orig.)

Extraction of temporal information in functional MRI

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Singh, M.; Sungkarat, W.; Jeong, Jeong-Won; Zhou, Yongxia

2002-10-01

The temporal resolution of functional MRI (fMRI) is limited by the shape of the haemodynamic response function (hrf) and the vascular architecture underlying the activated regions. Typically, the temporal resolution of fMRI is on the order of 1 s. We have developed a new data processing approach to extract temporal information on a pixel-by-pixel basis at the level of 100 ms from fMRI data. Instead of correlating or fitting the time-course of each pixel to a single reference function, which is the common practice in fMRI, we correlate each pixel's time-course to a series of reference functions that are shifted with respect to each other by 100 ms. The reference function yielding the highest correlation coefficient for a pixel is then used as a time marker for that pixel. A Monte Carlo simulation and experimental study of this approach were performed to estimate the temporal resolution as a function of signal-to-noise ratio (SNR) in the time-course of a pixel. Assuming a known and stationary hrf, the simulation and experimental studies suggest a lower limit in the temporal resolution of approximately 100 ms at an SNR of 3. The multireference function approach was also applied to extract timing information from an event-related motor movement study where the subjects flexed a finger on cue. The event was repeated 19 times with the event's presentation staggered to yield an approximately 100-ms temporal sampling of the haemodynamic response over the entire presentation cycle. The timing differences among different regions of the brain activated by the motor task were clearly visualized and quantified by this method. The results suggest that it is possible to achieve a temporal resolution of /spl sim/200 ms in practice with this approach.

Multidetector Computed Tomography of Cervical Spine Fractures in Ankylosing Spondylitis

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Koivikko, M.P.; Kiuru, M.J.; Koskinen, S.K. [Helsinki Univ. Central Hospital, Toeoeloe Trauma Center (Finland). Dept. of Radiology

2004-11-01

Purpose: To analyze multidetector computed tomography (MDCT) cervical spine findings in trauma patients with advanced ankylosing spondylitis (AS). Material and Methods: Using PACS, 2282 cervical spine MDCT examinations requested by emergency room physicians were found during a period of 3 years. Of these patients, 18 (16 M, aged 41-87, mean 57 years) had advanced AS. Primary imaging included radiography in 12 and MRI in 11 patients. Results: MDCT detected one facet joint subluxation and 31 fractures in 17 patients: 14 transverse fractures, 8 spinous process fractures, 2 Jefferson's fractures, 1 type I and 2 type II odontoid process fractures, and 1 each: atlanto-occipital joint fracture and C2 laminar fracture plus isolated transverse process and facet joint fractures. Radiographs detected 48% and MRI 60% of the fractures. MRI detected all transverse and odontoid fractures, demonstrating spinal cord abnormalities in 72%. Conclusion: MDCT is superior to plain radiographs or MRI, showing significantly more injuries and yielding more information on fracture morphology. MRI is valuable, however, in evaluating the spinal cord and soft-tissue injuries. Fractures in advanced AS often show an abnormal orientation and are frequently associated with spinal cord injuries. In these patients, for any suspected cervical spine injuries, MDCT is therefore the imaging modality of choice.

Characterizing Tumor Heterogeneity With Functional Imaging and Quantifying High-Risk Tumor Volume for Early Prediction of Treatment Outcome: Cervical Cancer as a Model

International Nuclear Information System (INIS)

Mayr, Nina A.; Huang Zhibin; Wang, Jian Z.; Lo, Simon S.; Fan, Joline M.; Grecula, John C.; Sammet, Steffen; Sammet, Christina L.; Jia Guang; Zhang Jun; Knopp, Michael V.; Yuh, William T.C.

2012-01-01

Purpose: Treatment response in cancer has been monitored by measuring anatomic tumor volume (ATV) at various times without considering the inherent functional tumor heterogeneity known to critically influence ultimate treatment outcome: primary tumor control and survival. This study applied dynamic contrast-enhanced (DCE) functional MRI to characterize tumors' heterogeneous subregions with low DCE values, at risk for treatment failure, and to quantify the functional risk volume (FRV) for personalized early prediction of treatment outcome. Methods and Materials: DCE-MRI was performed in 102 stage IB 2 –IVA cervical cancer patients to assess tumor perfusion heterogeneity before and during radiation/chemotherapy. FRV represents the total volume of tumor voxels with critically low DCE signal intensity ( 20, >13, and >5 cm 3 , respectively, significantly predicted unfavorable 6-year primary tumor control (p = 0.003, 7.3 × 10 −8 , 2.0 × 10 −8 ) and disease-specific survival (p = 1.9 × 10 −4 , 2.1 × 10 −6 , 2.5 × 10 −7 , respectively). The FRVs were superior to the ATVs as early predictors of outcome, and the differentiating power of FRVs increased during treatment. Discussion: Our preliminary results suggest that functional tumor heterogeneity can be characterized by DCE-MRI to quantify FRV for predicting ultimate long-term treatment outcome. FRV is a novel functional imaging heterogeneity parameter, superior to ATV, and can be clinically translated for personalized early outcome prediction before or as early as 2–5 weeks into treatment.

Neuro-pharmacological functional MRI of epilepsy

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Kiriyama, Hideki; Makabe, Tetsuo; Tomita, Susumu; Omoto, Takashi; Asari, Shoji [Okayama Univ. (Japan). School of Medicine; Aihara, Hiroshi; Kinugasa, Kazushi; Nishimoto, Akira; Ito, Takahiko

2000-03-01

We studied patients with epilepsy by neuro-pharmacological functional MRI technique using diazepam. Five normal volunteers and 7 patients with epilepsy were investigated. MRI was performed by a 1.5 T unit (SIGNA Horizon, GE) using the following parameters: TR/TE 5000 msec/80 msec, FA 90 deg, FOV 200 mm, matrix 128 x 128, slice thickness 7 mm. We performed MRI scanning over 5 minutes (2 minutes before and 3 minutes after injection of diazepam) for each 1 session; we scanned 3 sessions for each patient at intervals of 5 minutes. The diazepam was injected rapidly from the antecubital vein. The dose of diazepam was 0.05 mg/kg/injection (total dose was 0.15 mg/kg). The data were analyzed statistically using t-test. Signal change after administration of diazepam was less than 1 to 2% in healthy volunteers. By contrast, in patient with epilepsy, the signal change was almost 3%, which was significantly greater than that of the normal area (p=0.01). The neuro-pharmacological functional MRI technique using diazepam might be a useful method to identify epileptic foci. (author)

Neuro-pharmacological functional MRI of epilepsy

International Nuclear Information System (INIS)

Kiriyama, Hideki; Makabe, Tetsuo; Tomita, Susumu; Omoto, Takashi; Asari, Shoji; Aihara, Hiroshi; Kinugasa, Kazushi; Nishimoto, Akira; Ito, Takahiko

2000-01-01

We studied patients with epilepsy by neuro-pharmacological functional MRI technique using diazepam. Five normal volunteers and 7 patients with epilepsy were investigated. MRI was performed by a 1.5 T unit (SIGNA Horizon, GE) using the following parameters: TR/TE 5000 msec/80 msec, FA 90 deg, FOV 200 mm, matrix 128 x 128, slice thickness 7 mm. We performed MRI scanning over 5 minutes (2 minutes before and 3 minutes after injection of diazepam) for each 1 session; we scanned 3 sessions for each patient at intervals of 5 minutes. The diazepam was injected rapidly from the antecubital vein. The dose of diazepam was 0.05 mg/kg/injection (total dose was 0.15 mg/kg). The data were analyzed statistically using t-test. Signal change after administration of diazepam was less than 1 to 2% in healthy volunteers. By contrast, in patient with epilepsy, the signal change was almost 3%, which was significantly greater than that of the normal area (p=0.01). The neuro-pharmacological functional MRI technique using diazepam might be a useful method to identify epileptic foci. (author)

Magnetic resonance imaging of cervical carcinoma using an endorectal surface coil

International Nuclear Information System (INIS)

Brocker, Kerstin A.; Alt, Céline D.; Gebauer, Gerhard; Sohn, Christof; Hallscheidt, Peter

2014-01-01

Introduction: The objective of this trial is to investigate the diagnostic value of magnetic resonance imaging (MRI) with an endorectal surface coil for precise local staging of patients with histologically proven cervical cancer by comparing the radiological, clinical, and histological results. Materials and methods: Women with cervical cancer were recruited for this trial between February 2007, and September 2010. All the patients were clinically staged according to the FIGO classification and underwent radiological staging by MRI that employed an endorectal surface coil. The staging results after surgery were compared to histopathology in all the operable patients. Results: A total of 74 consecutive patients were included in the trial. Forty-four (59.5%) patients underwent primary surgery, whereas 30 (40.5%) patients were inoperable according to FIGO and underwent primary radiochemotherapy. The mean age of the patients was 50.6 years. In 11 out of the 44 patients concordant staging results were obtained by all three staging modalities. Thirty-two of the 44 patients were concordantly staged by FIGO and histopathological examination, while only 16 were concordantly staged by eMRI and histopathological examination. eMRI overstaged tumors in 14 cases and understaged them in 7 cases. Conclusions: eMRI is applicable in patients with cervical cancer, yet of no benefit than staging with FIGO or standard pelvic MRI. The most precise preoperative staging procedure still appears to be the clinical examination

Sporadic lower motor neuron disease with a snake eyes appearance on the cervical anterior horns by MRI.

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Sasaki, Shoichi

2015-09-01

Lower motor neuron disease (LMND) is the term generally used to describe diseases in which only lower motor neuron signs are detected. A snake eyes appearance on magnetic resonance imaging (MRI) is associated with a wide spectrum of neurological conditions including LMND. The author reports on three unique LMND patients with upper limb muscle weakness and atrophy who show a snake eyes appearance by MRI. The patients were aged 18, 40 and 52 years, respectively, at the onset of the disease and had a longstanding clinical course (more than 10 years for two patients and 8 years for one patient). They were followed up for more than 6 years. Clinical manifestations were characterized by (1) longstanding slow progression or delayed spontaneous arrest of asymmetric lower motor neuron signs localized exclusively in the upper extremities with unilateral predominance and distal or proximal preponderance; (2) the absence of upper motor neuron signs, bulbar signs, sensory disturbances and respiratory involvement; (3) a snake eyes appearance on the anterior horns of the cervical cord over more than 3 vertebrae by axial T2-weighted MRI and a longitudinal linear-shaped T2-signal hyperintensity by sagittal MRI; (4) neurogenic change with fasciculation and denervation potentials (fibrillation and a positive sharp wave) confined to the affected muscles by needle electromyogram; and (5) normal cerebrospinal fluid and a normal creatine kinase level. These cases did not fall into any existing category of LMND, such as progressive muscular atrophy, flail arm syndrome or Hirayama disease. These patients should be classified as sporadic LMND with snake eyes on MRI with a relatively benign prognosis. Copyright © 2015 Elsevier B.V. All rights reserved.

Functional cervical myelography with iohexol

International Nuclear Information System (INIS)

Nakstad, P.; Aaserud, O.; Nyberg-Hansen, R.; Ganes, T.

1985-01-01

Thirty patients underwent functional cervical myelography, i.e. radiographs in the lateral view were obtained in extension as well as in flexion of the neck. Sagittal tomography was performed in both positions. Narrowing of the subarachnoid space and increased sagittal diameter of the spinal cord due to shortening were demonstrated in the lateral view in extension. In flexion a widening of the subarachnoid space was seen in almost all. In some cases with advanced narrowing or spinal block in extension, such widening in flexion resulted in better diagnostic images by providing passage of the contrast medium caudally. Although iohexol (Omnipaque, Nyegaard and Co., Oslo) was regularly forced into the posterior cranial fossa by the movements, the frequency of side effects was approximately the same as in our former trials with iohexol in conventional cervical myelography. EEG changes occurred in two patients (7%). A sitting position for 3-4 min after the examination followed by an elevated head end of the bed was probably important for preventing side effects from the contrast medium. Specific questioning revealed twice as many subjective side effects as reported after general questions alone. (orig.)

MRI assessment of cervical cancer for adaptive radiotherapy

International Nuclear Information System (INIS)

Dimopoulos, Johannes C.A.; Schirl, Gertrude; Baldinger, Anja; Poetter, Richard; Helbich, Thomas H.

2009-01-01

Purpose: To assess the importance of the information obtained from MRI for adaptive cervix cancer radiotherapy. Patients and methods: 49 patients with cervix cancer, treated by external-beam radiotherapy (EBRT) and MRI-assisted high-dose-rate brachytherapy ± concomitant cisplatin, underwent MRI at diagnosis and at the time of brachytherapy fractions. 190 MRI examinations were performed. Pretreatment scans were correlated with clinical examination (CE) findings. Measurements in 3-D of the tumor extension and also of the distance from the tumor to the pelvic side wall were performed using both MRI and CE. The tumor volume regression induced initially by EBRT and the subsequent regression after each brachytherapy fraction were assessed. Results: MRI and CE showed 92% agreement in overall parametrial staging and 73% agreement in terms of vaginal involvement. There was, however, disagreement in parametrial side (right/left) classification in 25% of the parametria examined. These were patients with unilateral displacement of the cervix and contralateral invasion of the parametrium. The mean tumor volume on the pretreatment MRI scan (GTVD) was 61 cm 3 . At the time of the four brachytherapy fractions the mean was 16 cm 3 , 10 cm 3 , 9 cm 3 , and 8 cm 3 , defined as the GTVBT plus the gray zones in the parametria. Conclusion: CE and MRI findings agree well in terms of overall staging. The clinical assessment of side-specific parametrial invasion improved when having access to the additional knowledge obtained from MRI. The greatest decrease in tumor volume occurs during EBRT, whereas tumor regression between the first and subsequent brachytherapy fractions is minor. (orig.)

Functional MR imaging of the cervical spine in patients with rheumatoid arthritis

International Nuclear Information System (INIS)

Allmann, K.H.; Uhl, M.; Uhrmeister, P.; Neumann, K.; Langer, M.; Kempis, J. von

1998-01-01

Purpose: To evaluate functional MR imaging in patients with rheumatoid arthritis (RA) involving the cervical spine. Material and Methods: We used a device that allows MR examination to be made of the cervical spine in infinitely variable degrees of flexion and extension. Dynamic functional MR imaging was performed on 25 patients with RA. Results: Functional MR imaging was able to show the degree of vertebral instability of the occipito-atlantal or atlanto-axial level as well as the subaxial level. By performing functional MR imaging, we were able to demonstrate the extent of synovial tissue around the dens, and the impingement and displacement of the spinal cord during flexion and extension. The basilar impression, the cord impingement into the foramen magnum, the cord compression, the slipping of vertebrae, and the angulation of the cord were all much more evident in functional than in static MR imaging. Conclusion: Functional MR imaging provided additional information in patients with RA, and is valuable in patients who have a normal MR study in the neutral position and yet have signs of a neurological deficit. Functional MR imaging is important in the planning of stabilizing operations of the cervical spine. (orig.)

Functional MRI in children: clinical and research applications

International Nuclear Information System (INIS)

Leach, James L.; Holland, Scott K.

2010-01-01

Functional MRI has become a critical research tool for evaluating brain function and developmental trajectories in children. Its clinical use in children is becoming more common. This presentation will review the basic underlying physiologic and technical aspects of fMRI, review research applications that have direct clinical relevance, and outline the current clinical uses of this technology. (orig.)

Modeling Dynamic Contrast-Enhanced MRI Data with a Constrained Local AIF

DEFF Research Database (Denmark)

Duan, Chong; Kallehauge, Jesper F.; Pérez-Torres, Carlos J

2018-01-01

PURPOSE: This study aims to develop a constrained local arterial input function (cL-AIF) to improve quantitative analysis of dynamic contrast-enhanced (DCE)-magnetic resonance imaging (MRI) data by accounting for the contrast-agent bolus amplitude error in the voxel-specific AIF. PROCEDURES....... RESULTS: When the data model included the cL-AIF, tracer kinetic parameters were correctly estimated from in silico data under contrast-to-noise conditions typical of clinical DCE-MRI experiments. Considering the clinical cervical cancer data, Bayesian model selection was performed for all tumor voxels...

Imaging of the cervical articular pillar

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Yeomans, E. [Orange Base Hospital, Orange, NSW (Australia)

1998-12-01

The cervical articular pillar, due to the complex anatomical structure of the cervical spine, is not well demonstrated in routine plain radiographic views. Dedicated views have been devised to demonstrate the pillar, yet their performance has abated considerably since the inception of Computed Tomography (CT) in the 1970`s. It is the consideration that CT does not image the articular pillar with a 10 per cent accuracy that poses the question: Is there still a need for plain radiography of the cervical articular pillar? This paper studies the anatomy, plain radiography, and incidence of injury to the cervical articular pillar. It discusses (with reference to current and historic literature) the efficacy of current imaging protocols in depicting this injury. It deals with plain radiography, CT, complex tomography, and Magnetic Resonance Imaging (MRI) of the cervical spine to conclude there may still be a position in current imaging protocols for plain radiography of the cervical articular pillar. Copyright (1998) Australian Institute of Radiography 43 refs., 5 figs.

X-Ray Exam: Cervical Spine

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... Staying Safe Videos for Educators Search English Español X-Ray Exam: Cervical Spine KidsHealth / For Parents / X-Ray ... MRI): Lumbar Spine Broken Bones Getting an X-ray (Video) X-Ray (Video) View more Partner Message About Us ...

Value of 18F-FDG PET/MRI for the outcome of CT-guided facet block therapy in cervical facet syndrome: initial results

International Nuclear Information System (INIS)

Sawixki, Lino M.; Schaarscjmidt, Benedikt M.; Heusch, Philipp; Buchbender, Christian; Antoch, Gerald; Rosenbaum-Krumme, Sandra; Bockisch, Andreas; Umutlu, Lale; Eicker, Sven O.; Floeth, Frank W.

2017-01-01

The aim of this study was to evaluate the ability of 18 F-fluorodeoxyglucose positron emission tomography/magnetic resonance imaging ( 18 F-FDG PET/MRI) to detect PET-positive cervical facet arthropathy and identify patients who benefit from facet block therapy. Ten patients with cervical facet syndrome (mean age: 65 ± 12 years) underwent 18 F-FDG PET/MRI of the neck. Focal 18 F-FDG uptake in PET-positive facet joints served as target for computed tomography (CT)-guided facet blocks. In PET-negative patients, the target joint for facet block therapy was selected by current clinical standards considering the level of maximum facet arthrosis and pain. Neck pain was measured on visual analogue scale (VAS) before and after therapy. Bone marrow signal intensity (SI) ratio on turbo inversion recovery magnitude (TIRM) images and maximum standard uptake values (SUVmax) was calculated for each facet joint. Pearson's correlation coefficient (r) was calculated between bone marrow SI ratios on TIRM and SUVmax. 18 F-FDG PET/MRI detected PET-positive facet arthropathy in six patients. Patients with PET-positive facet arthropathy had significantly less pain compared with the pretreatment pain 3 h (P = 0.002), 4 weeks (P = 0.002) and 3 months (P = 0.026) after facet block therapy. Pain did not change significantly in patients with PET-negative facet arthropathy. TIRM SI ratio was higher in PET-positive facet arthropathy than in PET-negative facet arthropathy (P < 0.001). Correlation was strong between bone marrow SI ratio on TIRM images and SUVmax (r = 0.7; P < 0.001).

Role of imagining diagnostics in assessing the involvement of the cervical spine in patients with rheumatoid arthritis

International Nuclear Information System (INIS)

Cyrylowski, L.; Walecka, A.; Koryzma, A.; Brzosko, M.; Brzosko, I.; Prajs, K.

2005-01-01

Rheumatoid arthritis (RA) is a polyarthritis caused by inflammatory overgrowth of synnovium known as pannus. Small joints of hands and feet are most frequently involved, followed by cervical spine, particularly the craniocervical junction. The cervical spine involvement may be a cause of a range of neurological complications. Imaging diagnostics of the spine in RA patients include radiograms, CT and MRI. Their purposes is to evaluate type, extension and advancing of the changes. The following lesions can be found in the cervical spine at least in 30% of RA patients with disease duration more than 10 years: subaxial subluxations, apophyseal joint erosions, odontoid erosions, apophyseal joint sclerosis, intervertebral space narrowing, and osteophytosis.These lesions can be easily detected with radiographic examinations whereas the presence of the pannus can be found only with MRI or contrast enhanced CT. The most dangerous complication of RA in the cervical spine is atlantoaxial subluxation. It can be well demonstrated with MRI.Even it is frequently asymptomatic, there is always the possibility of neurological symptoms from compression of the spinal cord by the odontoid process. Therefore, MRI of the cervical spine should be considered in all RA patients. (author)

Analysis of the Functional Independence Measure Value of Cervical Spine Injury Patients with Conservative Management

Directory of Open Access Journals (Sweden)

M. Zafrullah Arifin

2012-06-01

Full Text Available Analysis of the Functional Independence Measure Value of Cervical Spine Injury Patients with Conservative Management. Cervical spine injury is one of the most common spinal cord injuries in trauma patients. From 100,000 spinal cord injury cases reported in the United States of America (2008, sixty seven percent involve cervical spine injury. American Spinal Cord Injury Association (ASIA impairment score is used as an initial assessment but not enough attention prognostic outcome of these patients was paid to. The objective of this study is to analyze the value of functional independence measure (FIM cervical spine injury patients with conservative management and its correlation with age, sex, type of trauma, onset of trauma, cervical abnormalities, type of cervical spine lesion and ASIA impairment score. A prospective cohort study was performed to all patients with cervical spine injury treated inNeurosurgery Department of Dr. Hasan Sadikin Hospital Bandung that fullfiled the inclusion criteria. The subjects were classified based on age, sex, single/multiple trauma, acute /chronic, cervical abnormalities, complete/incomplete lesion and ASIA impairment score. The FIM examination was performed in Outpatient clinic of Neurosurgery. T-test and chi-square test was done to analyze the data. There were 17 cervical spine injury patients treated in Neurosurgery Department of Dr. Hasan Sadikin Hospital during April 2009–April 2010. The average FIM value of cervical spine injury in those patients is 4+ 1.63 by cohort prospective study. There were no correlation between FIM value with age, sex, type of trauma, onset of trauma and cervical abnormalities. Significant correlations were found between FIM value with type of cervical spine lesion and ASIA impairment score in cervical spine patients. Type of cervical spine lesion and ASIA impairment score have significant correlation with FIM value of patients in 6 months after cervical injury.

Comparison of {sup 18}F-FDG PET/MRI and MRI for pre-therapeutic tumor staging of patients with primary cancer of the uterine cervix

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Sarabhai, Theresia; Wetter, Axel; Forsting, Michael; Umutlu, Lale; Grueneisen, Johannes [University Hospital Essen, University of Duisburg-Essen, Department of Diagnostic and Interventional Radiology and Neuroradiology, Essen (Germany); Schaarschmidt, Benedikt M.; Kirchner, Julian [University Dusseldorf, Department of Diagnostic and Interventional Radiology, Medical Faculty, Dusseldorf (Germany); Aktas, Bahriye [University Hospital Essen, University of Duisburg-Essen, Department of Obstetrics and Gynecology, Essen (Germany); Ruhlmann, Verena; Herrmann, Ken [University Hospital Essen, University of Duisburg-Essen, Department of Nuclear Medicine, Essen (Germany)

2018-01-15

The aim of the present study was to assess and compare the diagnostic performance of integrated PET/MRI and MRI alone for local tumor evaluation and whole-body tumor staging of primary cervical cancers. In addition, the corresponding impact on further patient management of the two imaging modalities was assessed. A total of 53 consecutive patients with histopathological verification of a primary cervical cancer were prospectively enrolled for a whole-body 18F-FDG PET/MRI examination. Two experienced physicians analyzed the MRI data, in consensus, followed by a second reading session of the PET/MRI datasets. The readers were asked to perform a dedicated TNM staging in accordance with the 7th edition of the AJCC staging manual. Subsequently, the results of MRI and PET/MRI were discussed in a simulated interdisciplinary tumor board and therapeutic decisions based on both imaging modalities were recorded. Results from histopathology and cross-sectional imaging follow-up served as the reference standard. PET/MRI allowed for a correct determination of the T stage in 45/53 (85%) cases, while MRI alone enabled a correct identification of the tumor stage in 46/53 (87%) cases. In 24 of the 53 patients, lymph node metastases were present. For the detection of nodal-positive patients, sensitivity, specificity and accuracy of PET/MRI were 83%, 90% and 87%, respectively. The respective values for MRI alone were 71%, 83% and 77%. In addition, PET/MRI showed higher values for the detection of distant metastases than MRI alone (sensitivity: 87% vs. 67%, specificity: 92% vs. 90%, diagnostic accuracy: 91% vs. 83%). Among the patients with discrepant staging results in the two imaging modalities, PET/MRI enabled correct treatment recommendations for a higher number (n = 9) of patients than MRI alone (n = 3). The present results demonstrate the successful application of integrated PET/MRI imaging for whole-body tumor staging of cervical cancer patients, enabling improved treatment

Functional imaging of the kidneys with fast MRI techniques

International Nuclear Information System (INIS)

Prasad, Pottumarthi V.; Priatna, Agus

1999-01-01

Availability of faster and stronger gradient systems have given rise to a multitude of fast MRI data acquisition strategies which have tremendously increased the scope of MRI applications. These have led to the realization of long desired comprehensive approaches to evaluate anatomy and function using a single modality. In this work, we describe some of our own experiences with functional evaluation of the kidneys using MRI. Examples that suggest the feasibility of comprehensive approaches for evaluation of renal disease are also provided. We also introduce BOLD renal MRI, a method that may allow basic understanding of human renal physiology and pathophysiology in a way that has not been previously possible

Validity of soft-tissue thickness of calf measured using MRI for assessing unilateral lower extremity lymphoedema secondary to cervical and endometrial cancer treatments

International Nuclear Information System (INIS)

Lu, Qing; Li, Yulai; Chen, Tian-Wu; Yao, Yuan; Zhao, Zizhou; Li, Yang; Xu, Jianrong; Jiang, Zhaohua; Hu, Jiani

2014-01-01

Aim: To determine whether soft-tissue thickness of the calf measured using MRI could be valid for assessing unilateral lower extremity lymphoedema (LEL) secondary to cervical and endometrial cancer treatments. Materials and methods: Seventy women with unilateral LEL and 25 without LEL after cervical or endometrial cancer treatments underwent MRI examinations of their calves. Total thickness of soft-tissue (TT), muscle thickness (MT), and subcutaneous tissue thickness (STT) of the calf, and the difference between the affected and contralateral unaffected calf regarding TT (DTT), MT (DMT), and STT (DSTT) were obtained using fat-suppressed T2-weighted imaging in the middle of the calves. The volume of the calf and difference in volume (DV) between calves were obtained by the method of water displacement. Statistical analysis was performed to determine the validity of MRI measurements by volume measurements in staging LEL. Results: There was a close correlation between volume and TT for the affected (r = 0.927) or unaffected calves (r = 0.896). STT of the affected calf, and DTT or DSTT of the calves were closely correlated with volume of the affected calf or DV of the calves (all p < 0.05). Multivariate analysis showed significant differences in TT, STT, volume of the affected calf, DTT, DSTT, and DV between stages except in volume of the affected calf or in DV between stage 0 and 1. For staging LEL, DSTT showed the best discrimination ability among all the parameters. Conclusions: Soft-tissue thickness of the calf measured at MRI could be valid for quantitatively staging unilateral LEL, and DSTT of the calves could be the best classifying factor. - Highlights: • The soft tissue thickness of calves on MRI could quantitatively assess secondary LEL. • Calf soft tissue thickness indicated concurrent or construct validity of calf volume. • The difference of subcutaneous tissue thickness of calves could be used to stage LEL

Effect of Cervical Interlaminar Epidural Steroid Injection: Analysis According to the Neck Pain Patterns and MRI Findings

Science.gov (United States)

Choi, Ji Won; Lim, Hyung Woo; Lee, Jin Young; Lee, Won Il; Lee, Eun Kyung; Chang, Choo Hoon; Yang, Jae Young

2016-01-01

Background It is widely accepted that cervical interlaminar steroid injection (CIESI) is more effective in treating radicular pain than axial neck pain, but without direct comparison. And the differences of effect after CIESI according to MRI findings are inconsistent. In this retrospective study, we evaluated the therapeutic response of CIESI according to pain sites, durations, MRI findings, and other predictive factors altogether, unlike previous studies, which evaluated them separately. Methods The medical records of 128 patients who received fluoroscopy guided CIESI were analyzed. We evaluated the therapeutic response (more than a 50% reduction on the visual analog scale [VAS] by their second visit) after CIESI by (1) pain site; neck pain without radicular pain/radicular pain with or without neck pain, (2) pain duration; acute/chronic (more than 6 month), and (3) findings of MRI; herniated intervertebral disc (HIVD)/spinal stenosis, respectively and altogether. Results Eighty-eight patients (68%) responded to CIESI, and there were no significant differences in demographic data, initial VAS score, or laboratory findings. And there were no significant differences in the response rate relating to pain site, pain duration, or MRI findings, respectively. In additional analysis, acute radicular pain with HIVD patients showed significantly better response than chronic neck pain with spinal stenosis (P = 0.04). Conclusions We cannot find any sole predictive factor of therapeutic response to the CIESI. But the patients having acute radicular pain with HIVD showed the best response, and those having other chronic neck pain showed the worst response to CIESI. PMID:27103964

Pre-treatment MRI minimum apparent diffusion coefficient value is a potential prognostic imaging biomarker in cervical cancer patients treated with definitive chemoradiation

International Nuclear Information System (INIS)

Marconi, Daniel Grossi; Fregnani, Jose Humberto Tavares Guerreiro; Rossini, Rodrigo Ribeiro; Netto, Ana Karina Borges Junqueira; Lucchesi, Fabiano Rubião; Tsunoda, Audrey Tieko; Kamrava, Mitchell

2016-01-01

Diffusion Weighted (DW) Magnetic Resonance Imaging (MRI) has been studed in several cancers including cervical cancer. This study was designed to investigate the association of DW-MRI parameters with baseline clinical features and clinical outcomes (local regional control (LRC), disease free survival (DFS) and disease specific survival (DSS)) in cervical cancer patients treated with definitive chemoradiation. This was a retrospective study approved by an institutional review board that included 66 women with cervical cancer treated with definitive chemoradiation who underwent pre-treatment MRI at our institution between 2012 and 2013. A region of interest (ROI) was manually drawn by one of three radiologists with experience in pelvic imaging on a single axial CT slice encompassing the widest diameter of the cervical tumor while excluding areas of necrosis. The following apparent diffusion coefficient (ADC) values (×10 −3 mm 2 /s) were extracted for each ROI: Minimum - ADC min , Maximum - ADC max , Mean - ADC mean , and Standard Deviation of the ADC - ADC dev . Receiver operating characteristic (ROC) curves were built to choose the most accurate cut off value for each ADC value. Correlation between imaging metrics and baseline clinical features were evaluated using the Mann Whitney test. Confirmatory multi-variate Cox modeling was used to test associations with LRC (adjusted by gross tumor volume – GTV), DFS and DSS (both adjusted by FIGO stage). Kaplan Meyer curves were built for DFS and DSS. A p-value < 0.05 was considered significant. Women median age was 52 years (range 23–90). 67 % had FIGO stage I-II disease while 33 % had FIGO stage III-IV disease. Eighty-two percent had squamous cell cancer. Eighty-eight percent received concurrent cisplatin chemotherapy with radiation. Median EQD2 of external beam and brachytherapy was 82.2 Gy (range 74–84). Women with disease staged III-IV (FIGO) had significantly higher mean ADC max values compared with those

Functional Proton MRI in Emphysematous Rats.

Science.gov (United States)

Bianchi, Andrea; Tibiletti, Marta; Kjørstad, Åsmund; Birk, Gerald; Schad, Lothar R; Stierstorfer, Birgit; Stiller, Detlef; Rasche, Volker

2015-12-01

To demonstrate the feasibility of proton magnetic resonance imaging (MRI) ventilation-related maps in rodents for the evaluation of lung function in the presence of pancreatic porcine elastase (PPE)-induced emphysema. Twelve rats were equally divided into 3 groups: group 1 (no administration of PPE); group 2 (PPE selectively only in the left lung); and group 3 (PPE administered in both lungs). Magnetic resonance imaging (MRI) and computed tomographic (CT) data were acquired at baseline, at 2 weeks and 4 weeks after administration, after which the animals were euthanized. The MRI protocol comprised a golden angle 2-dimensional ultrashort echo time MRI sequence [echo time, 0.343 millisecond (ms); repetition time, 120 ms; 12 slides with thickness, 1 mm; acquisition time, 30 minutes], from which inspiration and expiration images were reconstructed after the extraction of a self-gating signal. Inspiration images were registered to images at expiration, and expansion maps were created by calculating the specific difference in signal intensity. The lungs were segmented, and the mean specific expansion (MSE) calculated as an established surrogate for fractional ventilation. Computed tomographic data provided lung density (peak of the Hounsfield unit histogram, HU_P), whereas histology provided the mean linear intercept for each lung. Two weeks after administration, the control group had a mean MSE in both lungs corresponding to 96% of the baseline. Group 2 had 85% of the baseline, and group 3 had 57%. Considering the PPE-treated lungs alone, a significant reduction in MSE of 27% at 2 weeks and 40% at 4 weeks was found with respect to nontreated lungs. Significant correlations between HU_P and MSE were found at all time points (baseline: r = 0.606, P = 0.0017; 2 weeks: r = 0.837, P ≤ 0.0001; 4 weeks: r = 0.765, P Mean linear intercept values significantly correlated both with MRI MSE (r = -0.770, P The calculated ventilation-related maps showed a reduction of function in

Mandarin functional MRI Language paradigms

OpenAIRE

Ci, He; van Graan, Andre; Gonz?lvez, Gloria; Thompson, Pamela; Hill, Andrea; Duncan, John S.

2016-01-01

Abstract Objective The objective of this study was to implement convenient, fast, and accurate Mandarin task paradigms for functional MRI, and to locate the Chinese language functional areas in frontal and temporal lobes. Materials and Methods Nineteen healthy Chinese volunteers participated in this study, which utilized a block design with four language tasks: auditory naming (AN), picture naming (PN), verbal fluency?character (VFC), and verbal fluency?letter (VFL). All functional images wer...

Functional MRI experiments : acquisition, analysis and interpretation of data

NARCIS (Netherlands)

Ramsey, NF; Hoogduin, H; Jansma, JM

2002-01-01

Functional MRI is widely used to address basic and clinical neuroscience questions. In the key domains of fMRI experiments, i.e. acquisition, processing and analysis, and interpretation of data, developments are ongoing. The main issues are sensitivity for changes in fMRI signal that are associated

Structural and functional MRI in children with renal disease. First experience

Energy Technology Data Exchange (ETDEWEB)

Joergensen, Bettina; Froekiaer, Joergen [Aarhus Univ. Hospital (Denmark). Inst. of Clinical Medicine; Karstoft, Kristian; Pedersen, Michael [Aarhus Univ. Hospital (Denmark). Inst. of Clinical Medicine; Aarhus Univ. Hospital (Denmark). MR Research Centre; Joergensen, Troels Munch [Aarhus Univ. Hospital (Denmark). Dept. of Urology; Rittig, Soeren [Aarhus Univ. Hospital (Denmark). Dept. of Paediatrics

2010-07-01

This MRI study demonstrates our first clinical experiences with structural and functional evaluation in children with renal dysfunction, and communicates our experience with quantitative measurements of renal function compared to reference values found employing radionucleotides. We included renal impaired children who were recruited for clinical radioisotopic GFR measurements (n=8). MRI was performed 2 hours after Cr-EDTA measurements and was conducted using a protocol involving both anatomical/structural sequences and a dynamic contrast-enhanced sequence. Data obtained with the dynamic MRI sequence were processed using the graphical Patlak approach to obtain estimates of GFR. We were able to characterize the intrarenal configuration (cortex, medulla, pelvicalyceal arrangement) in all cases. Functional analyses of dynamic contrast-enhanced MRI revealed an overall underestimation of GFR measured by MRI compared to Cr-EDTPA measures (range: -2% to -43%). We advocate the use of MRI as a single-modality approach in the structural and functional evaluation of impaired kidneys in children, and concurrently, we presented a clinically available strategy for estimations of renal cortical volume and single kidney function. However, the use of MRI contrast agents have recently become controversial in renal patients due to the risk of NSF. (orig.)

Development of functional MRI in gastric cancer

International Nuclear Information System (INIS)

Zhang Lei; Shao Guoliang

2013-01-01

Gastric cancer is one of the most common malignant tumors in digestive tract functional MRI can represent the functional changes of the tumor. DWI not only provides a new way to diagnosis the gastric cancer, but also reflect the pathology changes of the tumor, which has great value to predict the therapeutic effect and prognosis of the tumor. MRS is the only method to test the chemical composition of tissues in live without injury, which has great value in the early diagnosis of gastric tumor and in the research of tumor mechanism. This review is mainly focused on the status and development of functional MRI in gastric cancer. (authors)

Multi-parametric spinal cord MRI as potential progression marker in amyotrophic lateral sclerosis.

Directory of Open Access Journals (Sweden)

Mohamed-Mounir El Mendili

Full Text Available OBJECTIVE: To evaluate multimodal MRI of the spinal cord in predicting disease progression and one-year clinical status in amyotrophic lateral sclerosis (ALS patients. MATERIALS AND METHODS: After a first MRI (MRI1, 29 ALS patients were clinically followed during 12 months; 14/29 patients underwent a second MRI (MRI2 at 11±3 months. Cross-sectional area (CSA that has been shown to be a marker of lower motor neuron degeneration was measured in cervical and upper thoracic spinal cord from T2-weighted images. Fractional anisotropy (FA, axial/radial/mean diffusivities (λ⊥, λ//, MD and magnetization transfer ratio (MTR were measured within the lateral corticospinal tract in the cervical region. Imaging metrics were compared with clinical scales: Revised ALS Functional Rating Scale (ALSFRS-R and manual muscle testing (MMT score. RESULTS: At MRI1, CSA correlated significantly (P<0.05 with MMT and arm ALSFRS-R scores. FA correlated significantly with leg ALFSRS-R scores. One year after MRI1, CSA predicted (P<0.01 arm ALSFSR-R subscore and FA predicted (P<0.01 leg ALSFRS-R subscore. From MRI1 to MRI2, significant changes (P<0.01 were detected for CSA and MTR. CSA rate of change (i.e. atrophy highly correlated (P<0.01 with arm ALSFRS-R and arm MMT subscores rate of change. CONCLUSION: Atrophy and DTI metrics predicted ALS disease progression. Cord atrophy was a better biomarker of disease progression than diffusion and MTR. Our study suggests that multimodal MRI could provide surrogate markers of ALS that may help monitoring the effect of disease-modifying drugs.

Diagnostic radiology for functional analysis of the cervical vertebral column

International Nuclear Information System (INIS)

Kamieth, H.

1986-01-01

The book is averaged in 17 chapters. The first three, introductory chapters dealing with the significance of radiology for the functional diagnosis of the cervical spine are followed by three chapters discussing the movements of the atlantoaxial joints, the statics of the cervical spine, and the sagittal flexural movements in the C2-C7 segments. Subsequent chapters discuss the radiodiagnostical method according to Arlen, the innervation of the cervical spine segments of movement, disturbances of movement including restriction of movement, degenerative processes of the invertebral disks, and hypermobile disturbance of movement. The final chapters deal with compensational and dissociation phenomena, subluxations, defective or compulsive positions, etc., the causes of each, and with the clinical relevance of spondylochondrosis and arthrosis, and with the pain. With 171 figs [de

MicroRNA-373 functions as an oncogene and targets YOD1 gene in cervical cancer

International Nuclear Information System (INIS)

Wang, Luo-Qiao; Zhang, Yue; Yan, Huan; Liu, Kai-Jiang; Zhang, Shu

2015-01-01

miR-373 was reported to be elevated in several tumors; however, the role of miR-373 in cervical cancer has not been investigated. In this study we aimed to investigate the role of miR-373 in tumorigenicity of cervical cancer cells in vivo and in vitro. The expression of miR-373 was investigated using real-time reverse transcription-polymerase chain reaction assay in 45 cervical specimens and cervical cancer cell lines. The role of miR-373 in tumorigenicity of cervical cancer cells was assessed by cell proliferation, colony formation in vitro as well as tumor growth assays in vivo with the overexpression of miR-373 or gene silencing. The functional target gene of miR-373 in cervical cancer cells was identified using integrated bioinformatics analysis, gene expression arrays, and luciferase assay. We founded that the expression of miR-373 is upregulated in human cervical cancer tissues and cervical carcinoma cell lines when compared to the corresponding noncancerous tissues. Ectopic overexpression of miR-373 in human cervical cancer cells promoted cell growth in vitro and tumorigenicity in vivo, whereas silencing the expression of miR-373 decreased the rate of cell growth. YOD1 was identified as a direct and functional target of miR-373 in cervical cancer cells. Expression levels of miR-373 were inversely correlated with YOD1 levels in human cervical cancer tissues. RNAi-mediated knockdown of YOD1 phenocopied the proliferation-promoting effect of miR-373. Moreover, overexpression of YOD1 abrogated miR-373-induced proliferation of cervical cancer cells. These results demonstrate that miR-373 increases proliferation by directly targeting YOD1, a new potential therapeutic target in cervical cancer. - Highlights: • The expression of miR-373 is upregulated in human cervical cancer tissues. • miR-373 effects as oncogenic miRNA in cervical cancer in vitro and in vivo. • miR-373 increases proliferation of cervical cancer cells by directly targeting YOD1

Significance of magnetic resonance imaging in the diagnosis of vertebral artery injury associated with blunt cervical spine trauma

International Nuclear Information System (INIS)

Yokota, Hiroyuki; Atsumi, Takahiro; Araki, Takashi; Fuse, Akira; Sato, Hidetaka; Kawai, Makoto; Yamamoto, Yasuhiro

2007-01-01

Vertebral artery injury associated with non-penetrating cervical trauma is rare. We report 11 cases of vertebral artery injury diagnosed with magnetic resonance imaging (MRI) after blunt trauma to the cervical spine and discuss about the importance of MRI in the diagnosis of this injury. Seven cases were caused by motor vehicle accidents, three by diving accidents, and one by static compression of the neck. All of the patients had documented cervical spine fractures and dislocations. In three patients, the diagnosis of complete occlusion of the vertebral artery was made on the basis of MRI and digital subtraction angiography (DSA). In the other patients, mural injuries of the vertebral artery were demonstrated with DSA. These 11 patients presented with acute, nonspecific changes in neurological status. Two had infarctions of the cerebellum and brainstem. None were treated with anticoagulants. All of them survived and were discharged to other hospitals for physical and occupational therapy. Although DSA remains the gold standard for diagnosing vertebral artery injuries, MRI is a newer modality for assessing cervical cord injury, and it may be useful for evaluating the presence of vertebral injury after blunt cervical spine trauma. (author)

Acute traumatic central cord syndrome: MRI-pathological correlations

International Nuclear Information System (INIS)

Quencer, R.M.; Bunge, R.P.; Egnor, M.; Green, B.A.; Puckett, W.; Naidich, T.P.; Post, M.J.D.; Norenberg, M.

1992-01-01

The acute traumatic central cord syndrome (ATCCS) is commonly stated to result from an injury which affects primarily the center of the spinal cord and is frequently hemorrhagic. To test the validity of this widely disseminated hypothesis, the magnetic resonance images [MRI] of 11 consecutive cases of ATCCS caused by closed injury to the spine were analyzed and correlated with the gross pathological and histological features of 3 cervical spinal cords obtained at post mortem from patients with ATCCS, including 2 of patients studied by MRI. In this study, the MRI and pathological observations indicate that ATCCS is predominantly a white matter injury and that intramedullary hemorrhage is not a necessary feature of the syndrome; indeed, it is probably an uncommon event in ATCCS. We suggest that the most common mechanism of injury in ATCCS may be direct compression of the cervical spinal cord by buckling of the ligamenta flava into an already narrowed cervical spinal canal; this would explain the predominance of axonal injury in the white matter of the lateral columns. (orig./GDG)

Acute traumatic central cord syndrome: MRI-pathological correlations

Energy Technology Data Exchange (ETDEWEB)

Quencer, R.M. (Dept. of Radiology, Univ. of Miami MRI Center, FL (United States) Miami Project to Cure Paralysis, FL (United States)); Bunge, R.P.; Egnor, M.; Green, B.A. (Miami Project to Cure Paralysis, FL (United States) Dept. of Neurological Surgery, Univ. of Miami School of Medicine, FL (United States)); Puckett, W. (Miami Project to Cure Paralysis, FL (United States)); Naidich, T.P. (Dept. of Radiology, Univ. of Miami MRI Center, FL (United States) Miami Project to Cure Paralysis, FL (United States) Baptist Hospital of Greater Miami, FL (United States)); Post, M.J.D. (Dept. of Radiology, Univ. of Miami MRI Center, FL (United States)); Norenberg, M. (Dept. of Neuropathology, Univ. of Miami School of Medicine, FL (United States))

1992-04-01

The acute traumatic central cord syndrome (ATCCS) is commonly stated to result from an injury which affects primarily the center of the spinal cord and is frequently hemorrhagic. To test the validity of this widely disseminated hypothesis, the magnetic resonance images [MRI] of 11 consecutive cases of ATCCS caused by closed injury to the spine were analyzed and correlated with the gross pathological and histological features of 3 cervical spinal cords obtained at post mortem from patients with ATCCS, including 2 of patients studied by MRI. In this study, the MRI and pathological observations indicate that ATCCS is predominantly a white matter injury and that intramedullary hemorrhage is not a necessary feature of the syndrome; indeed, it is probably an uncommon event in ATCCS. We suggest that the most common mechanism of injury in ATCCS may be direct compression of the cervical spinal cord by buckling of the ligamenta flava into an already narrowed cervical spinal canal; this would explain the predominance of axonal injury in the white matter of the lateral columns. (orig./GDG).

Functional MRI in pre-surgical planning: case study and cautionary ...

African Journals Online (AJOL)

Background. Since its inception almost 20 years ago, functional magnetic resonance imaging (fMRI) has greatly advanced our knowledge of human brain function. Although the clinical applications of fMRI are still limited, there have recently been encouraging advances for its use in pre-operative functional cortical mapping ...

A case of subacute combined degeneration: MRI findings

International Nuclear Information System (INIS)

Yamada, K.; Shrier, D.A.; Tanaka, H.; Numaguchi, Y.

1998-01-01

The specific spinal cord lesion caused by vitamin B12 deficiency is known as subacute combined degeneration (SCD). Neuropathological studies of SCD show lesions mainly in the posterior and lateral columns, involving the cortico-spinal and spino-cerebellar tracts. We report a case of SCD in a 19-year-old man who presented with 4 weeks history of gradually progressing tingling in both hands. MRI of the cervical spine demonstrated symmetrical areas of T2 signal abnormality involving the dorsal columns of the cervical cord from the C2 through C5 levels associated with spinal cord expansion. He was treated with vitamin B12 supplements and experienced gradual improvement in his clinical symptoms. Repeat MRI of the cervical spine after 2 months revealed slight decrease in the area of abnormal signal. (orig.)

Does cervical kyphosis relate to symptoms following whiplash injury?

DEFF Research Database (Denmark)

Johansson, Mats Peter; Baann Liane, Martin Skogheim; Bendix, Tom

2011-01-01

The mechanisms for developing long-lasting neck pain after whiplash injuries are still largely unrevealed. In the present study it was investigated whether a kyphotic deformity of the cervical spine, as opposed to a straight or a lordotic spine, was associated with the symptoms at baseline...... appearance of the cervical spine in supine MRI. In relation to symptoms it was seen that a kyphotic deformity was associated with reporting the highest intensities of headache at baseline, but not with an increased risk of long-lasting neck pain or headache. In conclusion, a kyphotic deformity...... is not significantly associated with chronic whiplash associated pain. Moreover, it is a clear clinical implication that pain should not be ascribed to a straight spine on MRI. We suggest that future trials on cervical posture focus upon the presence of kyphotic deformity rather than just on the absence of lordosis....

The usefulness of dynamic MR imaging for the evaluation of cervical cancer

International Nuclear Information System (INIS)

Yoon, Jeong Hee; Park, Yeong Mi

2004-01-01

We wished to evaluate the diagnostic usefulness of dynamic MRI in assessing tumor visualization and the parametrial invasion of cervical cancer, and we also wished to determine the most adequate enhancing time by comparing the T2-weighted image (T2WI) and enhanced T1-weighted image (Gd-T1WI). Fifty-three women with histopathologically proven cervical cancer underwent a preoperative MRI. Using a 1.5 T magnet, the fast spin echo axial T2WI without fat saturation was taken; after contrast administration, 20, 40, 60, 90, 120 sec-dynamic MRIs were taken using fast SPGR and spin echo axial Gd-T1WI. Tumor conspicuity and parametrial invasion in each pulse sequence and the most adequate enhancing time for the evaluation of the tumor on dynamic MRI were evaluated prospectively by three radiologists working at three separate sessions. The results were then correlated with the histopathologic findings. The conspicuity of tumor on dynamic MRI (99.4%) and T2WI (95.6%) were better than on Gd-T1WI (89.3%). In the assessment of parametrial invasion of the tumor, the diagnostic accuracy of dynamic MRI, Gd-T1WI and T2WI was 79.9%, 78% and 76.1%, respectively; the highest values were for the dynamic MRI, but there was no statistically significant difference among three pulse sequences. The most adequate enhancing time on dynamic MRI was between 90 seconds and 120 seconds. Dynamic MRI is useful for the assessment of tumor visualization of cervical cancer, and the most appropriate scan time on dynamic MRI is between 90 seconds and 120 seconds. For the determination of parametrial invasion, the dynamic MRI revealed a higher diagnostic accuracy than that of T2WI or Gd-T1WI, but the differences were statistically insignificant

Cerebral activity mapped by functional MRI

International Nuclear Information System (INIS)

Bruening, R.; Danek, A.; Wu, R.H.; Berchtenbreiter, C.; Reiser, M.

1997-01-01

Functional magnetic resonance imaging (fMRI) is a method to noninvasively measure the changes in cerebral activation during sensitive, cognitive or motor activity. fMRI detects activity by subtraction of states of activity and rest. During activity the signal is increased presumably due to a decrease of deoxyhemoglobin in the capillary and venous structures. Using a full field visual stimulation by flashlight goggles, a signal increase of 3% was detected in the primary visual cortex (V1). Different sequences and postprocessing algorythms will be discussed. Data from the primary cortical areas suggest a high reproducability of the experiments. Successfull experiments highly depend on cooperation of subjects. Despite success in experiments fMRI still has to be established for clinical purposes. (orig.) [de

Validating excised rodent lungs for functional hyperpolarized xenon-129 MRI.

Directory of Open Access Journals (Sweden)

David M L Lilburn

Full Text Available Ex vivo rodent lung models are explored for physiological measurements of respiratory function with hyperpolarized (hp (129Xe MRI. It is shown that excised lung models allow for simplification of the technical challenges involved and provide valuable physiological insights that are not feasible using in vivo MRI protocols. A custom designed breathing apparatus enables MR images of gas distribution on increasing ventilation volumes of actively inhaled hp (129Xe. Straightforward hp (129Xe MRI protocols provide residual lung volume (RV data and permit for spatially resolved tracking of small hp (129Xe probe volumes during the inhalation cycle. Hp (129Xe MRI of lung function in the excised organ demonstrates the persistence of post mortem airway responsiveness to intravenous methacholine challenges. The presented methodology enables physiology of lung function in health and disease without additional regulatory approval requirements and reduces the technical and logistical challenges with hp gas MRI experiments. The post mortem lung functional data can augment histological measurements and should be of interest for drug development studies.

Functional imaging of the kidneys with fast MRI techniques

International Nuclear Information System (INIS)

Prasad, P.V.; Priatna, A.

1999-01-01

Availability of faster and stronger gradient systems have given rise to a multitude of fast MRI data acquisition strategies which have tremendously increased the scope of MRI applications. These have led to the realization of long desired comprehensive approaches to evaluate anatomy and function using a single modality. In this work, we describe some of our own experiences with functional evaluation of the kidneys using MRI. Examples that suggest the feasibility of comprehensive approaches for evaluation of renal disease are also provided. We also introduce BOLD renal MRI, a method that may allow basic understanding of human renal physiology and pathophysiology in a way that has not been previously possible. (Copyright (c) 1999 Elsevier Science B.V., Amsterdam. All rights reserved.)

Functional imaging of the kidneys with fast MRI techniques

Energy Technology Data Exchange (ETDEWEB)

Prasad, P.V.; Priatna, A. [AN-234, MRI Research, Department of Radiology, Beth Israel Deaconess Medical Center and Harvard Medical School, 330 Brookline Ave., Boston, MA (United States)

1999-02-01

Availability of faster and stronger gradient systems have given rise to a multitude of fast MRI data acquisition strategies which have tremendously increased the scope of MRI applications. These have led to the realization of long desired comprehensive approaches to evaluate anatomy and function using a single modality. In this work, we describe some of our own experiences with functional evaluation of the kidneys using MRI. Examples that suggest the feasibility of comprehensive approaches for evaluation of renal disease are also provided. We also introduce BOLD renal MRI, a method that may allow basic understanding of human renal physiology and pathophysiology in a way that has not been previously possible. (Copyright (c) 1999 Elsevier Science B.V., Amsterdam. All rights reserved.)

Efficacy of transvaginal contrast-enhanced MRI in the early staging of cervical carcinoma

International Nuclear Information System (INIS)

Akata, Deniz; Kerimoglu, Ulku; Hazirolan, Tuncay; Karcaaltincaba, Musturay; Oezmen, Mustafa N.; Akhan, Okan; Koese, Faruk

2005-01-01

The objective of this study was to evaluate the efficacy of transvaginal contrast for local staging of cervical carcinoma. Fifty patients diagnosed with cervical carcinoma prospectively underwent magnetic resonance (MR) imaging before and after vaginal opacification (VO) with a mixture of 25 ml saline and 25 ml barium. T2-weighted (T2W) TSE images in axial and sagittal planes were compared before and after vaginal opacification. Dynamic T1W images in sagittal and fat-suppressed T1W images in transverse planes were also evaluated after intravenous contrast administration. Involvement of vaginal wall, lumen, and fornices; parametrium; rectum; and bladder were noted. Changes in local tumor staging and in treatment planning were also assessed after vaginal opacification. MR results were later compared with surgical pathological findings. Twenty-eight patients who went through surgical staging were included in the study. VO did not change any of the MR interpretations in 14 patients (50%). Correct staging was achieved with T2W TSE images with and without VO (in sagittal and transverse planes) in 78.5% and 50% of the patients, respectively. VO correctly lowered staging in seven and increased it in three patients compared with sagittal standard T2W images. Treatment planning was also changed in four (14%) of these patients. When overall accuracy of MR staging to indicate the appropriate treatment was evaluated, patients would have received the proper treatment in 90% and 79% of the cases when only T2W sagittal images with and without VO were evaluated, respectively. Dynamic gradient-echo images in sagittal planes and postcontrast T1W images in transverse planes evaluated with T2W series after VO, accomplished correct staging in 23 (82%) of the patients. MRI staging in early cervical cancer may be difficult and overestimated, especially if the tumor is slightly extended into the proximal vagina. Use of vaginal contrast medium is an easy, well-tolerated, and effective

Sensory Loss Mimicking Cauda Equina Syndrome due to Cervical Spinal Lesion in a Patient with Clinically Isolated Syndrome

OpenAIRE

Vinceti, Giulia; Zini, Andrea; Nichelli, Paolo; Mandrioli, Jessica

2012-01-01

We describe the case of a 39-year-old woman with signs and symptoms suggesting cauda equina syndrome. Lumbosacral magnetic resonance imaging (MRI) demonstrated no lesion at this level, while cervical MRI showed a T2-hyperintense lesion in the middle-right anterolateral region of the cervical spinal cord, which may explain the symptoms by involving the anterior spinothalamic tract. We suggest that in cases with cauda equina syndrome presentation and normal lumbosacral MRI, a cervicodorsal lesi...

Chronological observation in early radiation myelopathy of the cervical spinal cord; Gadolinium-enhanced MRI findings in two cases

Energy Technology Data Exchange (ETDEWEB)

Hirota, Saeko; Yoshida, Shoji; Soejima, Toshinori (Hyogo Medical Center for Adults, Akashi (Japan)) (and others)

Gd-enhanced MR images of two patients with clinically and histopathologically diagnosed chronic progressive radiation myelitis (CPRM) were observed chronologically. One of them had had nasopharyngeal cancer and received radiotherapy at a dose of 100 Gy to the C1-2 level of the spinal cord. She developed CPRM 25 months after the termination of radiotherapy. The other had had malignant lymphoma originating from the tonsil and received chemoradiotherapy. The dose delivered to her cervical spinal cord was 40 Gy, and she developed CPRM 30 months later. Gd-enhanced MRI in the early phase revealed a small crescent-shaped nidus with or without a very small central nonenhanced area in both cases. Enhancement was not great. At that time, patients noticed only the inability to perceive pain and temperature or paresthesia in the opposite side. In a few months, MRI revealed a much more strongly enhanced and larger nidus with enlargement of a central nonenhanced area accompanied by long segmental cord enlargement. The patients' neurological symptoms had also progressed, with hemiparesis developing, for example. (author).

Diffusion Weighted Imaging of the Uterus: Regional ADC Variation with Oral Contraceptive Usage and Comparison with Cervical Cancer

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Messiou, Christina; Morgan, Veronica A.; Silva, Sonali S. de; Souza, Nandita M. de (Cancer Research UK Clinical Magnetic Resonance Research Group, Institute of Cancer Research and Royal Marsden NHS Foundation Trust, Surrey (United Kingdom)); Ind, Thomas E. (Dept. of Gynaecology and Obstetrics, St George' s Hospital NHS Trust, London (United Kingdom))

2009-07-15

Background: There is growing interest in diffusion weighted magnetic resonance imaging (MRI) of cervical carcinoma but normal uterine appearances and effects of the oral contraceptive pill (OCP) have not been described. Purpose: To establish apparent diffusion coefficient (ADC) values for normal regions of uterus, determine the effect of the OCP on these values, and compare them with ADCs from cervical cancer. Material and Methods: Twenty-seven premenopausal women (19 taking the OCP) with cervical intraepithelial neoplasia (CIN) were studied with T2W and diffusion weighted MRI (DW-MRI). Regions of interest were drawn on ADC maps by visual matching with T2W images on different zones of the uterus and values compared between women not taking and taking the OCp.A further group of 25 women with clinically obvious tumors of the cervix were also studied with T2W and DW-MRI and ADC values of tumor were compared with ADC values of cervical epithelium and stroma. Results: The ADC values of adjacent zones of the uterus and cervix were significantly different from one another (P<0.001). The junctional zone was seen as a band of restricted diffusion between endometrium and outer myometrium. The ADC value of the junctional zone of the uterus was significantly greater (P<0.001) in patients taking the OCP than those patients not taking the OCp.There was no significant affect of the OCP on the ADC values of other uterine zones. Conclusion: The zonal anatomy of the uterus is well demonstrated by DW-MRI with hormonal effects secondary to the OCP affecting junctional zone alone. ADC of cervical tumor is significantly different to cervical epithelium and stroma indicating a role in cervical cancer detection and local staging

Diffusion Weighted Imaging of the Uterus: Regional ADC Variation with Oral Contraceptive Usage and Comparison with Cervical Cancer

International Nuclear Information System (INIS)

Messiou, Christina; Morgan, Veronica A.; Silva, Sonali S. de; Souza, Nandita M. de; Ind, Thomas E.

2009-01-01

Background: There is growing interest in diffusion weighted magnetic resonance imaging (MRI) of cervical carcinoma but normal uterine appearances and effects of the oral contraceptive pill (OCP) have not been described. Purpose: To establish apparent diffusion coefficient (ADC) values for normal regions of uterus, determine the effect of the OCP on these values, and compare them with ADCs from cervical cancer. Material and Methods: Twenty-seven premenopausal women (19 taking the OCP) with cervical intraepithelial neoplasia (CIN) were studied with T2W and diffusion weighted MRI (DW-MRI). Regions of interest were drawn on ADC maps by visual matching with T2W images on different zones of the uterus and values compared between women not taking and taking the OCp.A further group of 25 women with clinically obvious tumors of the cervix were also studied with T2W and DW-MRI and ADC values of tumor were compared with ADC values of cervical epithelium and stroma. Results: The ADC values of adjacent zones of the uterus and cervix were significantly different from one another (P<0.001). The junctional zone was seen as a band of restricted diffusion between endometrium and outer myometrium. The ADC value of the junctional zone of the uterus was significantly greater (P<0.001) in patients taking the OCP than those patients not taking the OCp.There was no significant affect of the OCP on the ADC values of other uterine zones. Conclusion: The zonal anatomy of the uterus is well demonstrated by DW-MRI with hormonal effects secondary to the OCP affecting junctional zone alone. ADC of cervical tumor is significantly different to cervical epithelium and stroma indicating a role in cervical cancer detection and local staging

Joint brain connectivity estimation from diffusion and functional MRI data

Science.gov (United States)

Chu, Shu-Hsien; Lenglet, Christophe; Parhi, Keshab K.

2015-03-01

Estimating brain wiring patterns is critical to better understand the brain organization and function. Anatomical brain connectivity models axonal pathways, while the functional brain connectivity characterizes the statistical dependencies and correlation between the activities of various brain regions. The synchronization of brain activity can be inferred through the variation of blood-oxygen-level dependent (BOLD) signal from functional MRI (fMRI) and the neural connections can be estimated using tractography from diffusion MRI (dMRI). Functional connections between brain regions are supported by anatomical connections, and the synchronization of brain activities arises through sharing of information in the form of electro-chemical signals on axon pathways. Jointly modeling fMRI and dMRI data may improve the accuracy in constructing anatomical connectivity as well as functional connectivity. Such an approach may lead to novel multimodal biomarkers potentially able to better capture functional and anatomical connectivity variations. We present a novel brain network model which jointly models the dMRI and fMRI data to improve the anatomical connectivity estimation and extract the anatomical subnetworks associated with specific functional modes by constraining the anatomical connections as structural supports to the functional connections. The key idea is similar to a multi-commodity flow optimization problem that minimizes the cost or maximizes the efficiency for flow configuration and simultaneously fulfills the supply-demand constraint for each commodity. In the proposed network, the nodes represent the grey matter (GM) regions providing brain functionality, and the links represent white matter (WM) fiber bundles connecting those regions and delivering information. The commodities can be thought of as the information corresponding to brain activity patterns as obtained for instance by independent component analysis (ICA) of fMRI data. The concept of information

tuberculosis of the cervical spine mimicking a paraplegic tumour in ...

African Journals Online (AJOL)

2011-05-05

May 5, 2011 ... Magnetic Resonence Imaging. (MRI)and x-rays revealed an infiltrative lesion of C6-C7 vertebrae. Our main diffential ... response to result in caseation and abscess formation. INTRODUCTION. Tuberculosis (TB) of the ... MRI cervical spine coronal view (T2 weighted image). Notice the absence of significant ...

Radiologic Findings of Cervical Varix Developed in Late Pregnancy: Case Report

International Nuclear Information System (INIS)

Park, Young Chan; Kim, Ho Kyun

2006-01-01

Cervical varix is a rare cause of obstetric hemorrhage which needs accurate diagnosis and prompt management because the lesion may be associated with preterm delivery and maternal complications. Our patient was diagnosed with cervical varix and vaginal bleeding at 32 weeks' gestation, using trans vaginal ultrasound and MRI. Persistent vaginal bleeding and preterm labor led to an emergency cesarean section at 33 weeks' gestation. After delivery, cervical varix was spontaneously resolved in the follow-up trans vaginal ultrasound and CT. We report various radiologic features of cervical varix combined with vaginal bleeding in late pregnancy

“Awake” intraoperative functional MRI (ai-fMRI) for mapping the eloquent cortex: Is it possible in awake craniotomy?☆

Science.gov (United States)

Lu, Jun-Feng; Zhang, Han; Wu, Jin-Song; Yao, Cheng-Jun; Zhuang, Dong-Xiao; Qiu, Tian-Ming; Jia, Wen-Bin; Mao, Ying; Zhou, Liang-Fu

2012-01-01

As a promising noninvasive imaging technique, functional MRI (fMRI) has been extensively adopted as a functional localization procedure for surgical planning. However, the information provided by preoperative fMRI (pre-fMRI) is hampered by the brain deformation that is secondary to surgical procedures. Therefore, intraoperative fMRI (i-fMRI) becomes a potential alternative that can compensate for brain shifts by updating the functional localization information during craniotomy. However, previous i-fMRI studies required that patients be under general anesthesia, preventing the wider application of such a technique as the patients cannot perform tasks unless they are awake. In this study, we propose a new technique that combines awake surgery and i-fMRI, named “awake” i-fMRI (ai-fMRI). We introduced ai-fMRI to the real-time localization of sensorimotor areas during awake craniotomy in seven patients. The results showed that ai-fMRI could successfully detect activations in the bilateral primary sensorimotor areas and supplementary motor areas for all patients, indicating the feasibility of this technique in eloquent area localization. The reliability of ai-fMRI was further validated using intraoperative stimulation mapping (ISM) in two of the seven patients. Comparisons between the pre-fMRI-derived localization result and the ai-fMRI derived result showed that the former was subject to a heavy brain shift and led to incorrect localization, while the latter solved that problem. Additionally, the approaches for the acquisition and processing of the ai-fMRI data were fully illustrated and described. Some practical issues on employing ai-fMRI in awake craniotomy were systemically discussed, and guidelines were provided. PMID:24179766

Normal pancreatic exocrine function does not exclude MRI/MRCP chronic pancreatitis findings.

Science.gov (United States)

Alkaade, Samer; Cem Balci, Numan; Momtahen, Amir Javad; Burton, Frank

2008-09-01

Abnormal pancreatic function tests have been reported to precede the imaging findings of chronic pancreatitis. Magnetic resonance imaging (MRI) with magnetic resonance cholangiopancreatography (MRCP) is increasingly accepted as the primary imaging modality for the detection of structural changes of early mild chronic pancreatitis. The aim of this study was to evaluate MRI/MRCP findings in patients with symptoms consistent with chronic pancreatitis who have normal Secretin Endoscopic Pancreatic Function test. A retrospective study of 32 patients referred for evaluation of chronic abdominal pain consistent with chronic pancreatitis and reported normal standard abdominal imaging (ultrasound, computed tomography, or MRI). All patients underwent Secretin Endoscopic Pancreatic Function testing and pancreatic MRI/MRCP at our institution. We reviewed the MRI/MRCP images in patients who had normal Secretin Endoscopic Pancreatic Function testing. MRI/MRCP images were assessed for pancreatic duct morphology, gland size, parenchymal signal and morphology, and arterial contrast enhancement. Of the 32 patients, 23 had normal Secretin Endoscopic Pancreatic Function testing, and 8 of them had mild to marked spectrum of abnormal MRI/MRCP findings that were predominantly focal. Frequencies of the findings were as follows: pancreatic duct stricture (n=3), pancreatic duct dilatation (n=3), side branch ectasia (n=4), atrophy (n=5), decreased arterial enhancement (n=5), decreased parenchymal signal (n=1), and cavity formation (n=1). The remaining15 patients had normal pancreatic structure on MRI/MRCP. Normal pancreatic function testing cannot exclude abnormal MRI/MRCP especially focal findings of chronic pancreatitis. Further studies needed to verify significance of these findings and establish MRI/MRCP imaging criteria for the diagnosis of chronic pancreatitis.

Application of functional MRI in breast diseases

International Nuclear Information System (INIS)

Feng Yun; Liu Shiyuan; Wang Chenguang; Tao Xiaofeng; Wang Jinlin; Wang Jian

2007-01-01

Objective: To investigate the value of functional MRI in the diagnosis and differential diagnosis of breast diseases. Methods: Sixty-five patients with 68 lesions were enrolled in this study. Conventional T 1 WI and T 2 WI scan, dynamic contrast enhanced MRI, diffusion weighted imaging and 1 H single voxel MR spectroscopy were performed consequently. All lesions were verified by pathology, including 4 cases of breast adenosis, 22 fibroadenomas, 2 chronic inflammations, 3 cysts, 33 infitrating ductal carcinomas, 1 intraductal carcinoma and 3 cystosarcoma phyllodes tumors. Morphological features, maximum enhancement ratio, time-intensity curve, apparent diffusion coefficient and Choline peak were analyzed. Results: The detection rates of T 1 WI and T 2 WI were 14.7% (n=10) and 51.5% (n=35). The sensitivity, specificity, accuracy of dynamic contrast enhanced MRI for the malignant tumor were 94. 6%, 71.4% and 76.5% respectively. Retrospective study showed that diffusion weighted imaging, with the b value from 800 s/mm 2 to 1000 s/mm 2 , could be used to differentiate various types of breast lesions. 1 H signal voxel spectroscopy had a sensitivity of 51.4%, specificity of 82.6%, and accuracy of 67.6% for the malignent. The sensitivity, specificity and accuracy could reach 97.3%, 90.0% and 92.6% respectively by combining conventional scan, dynamic contrast enhanced MRI and MR spectroscopy. Conclusion: Functional MRI, with high sensitivity, specificity and accuracy, can be used widely in the diagnosis of malignant breast lesions. (authors)

Human brain functional MRI and DTI visualization with virtual reality.

Science.gov (United States)

Chen, Bin; Moreland, John; Zhang, Jingyu

2011-12-01

Magnetic resonance diffusion tensor imaging (DTI) and functional MRI (fMRI) are two active research areas in neuroimaging. DTI is sensitive to the anisotropic diffusion of water exerted by its macromolecular environment and has been shown useful in characterizing structures of ordered tissues such as the brain white matter, myocardium, and cartilage. The diffusion tensor provides two new types of information of water diffusion: the magnitude and the spatial orientation of water diffusivity inside the tissue. This information has been used for white matter fiber tracking to review physical neuronal pathways inside the brain. Functional MRI measures brain activations using the hemodynamic response. The statistically derived activation map corresponds to human brain functional activities caused by neuronal activities. The combination of these two methods provides a new way to understand human brain from the anatomical neuronal fiber connectivity to functional activities between different brain regions. In this study, virtual reality (VR) based MR DTI and fMRI visualization with high resolution anatomical image segmentation and registration, ROI definition and neuronal white matter fiber tractography visualization and fMRI activation map integration is proposed. Rationale and methods for producing and distributing stereoscopic videos are also discussed.

Functional MRI for planning in neurosurgery

International Nuclear Information System (INIS)

Erb, M.; Saur, R.

2007-01-01

Beside structural images from CT and MR, functional data about localization of brain activations with different tasks becomes more and more important for presurgical planning. With this method, it's possible to depict mainly primary sensory and motoric areas, but also higher functions like speech and memory. To judge this information adequately, one has to be aware of the variability of activation pattern dependent on chosen threshold. Especially, the absence of such activation at a given location does not necessary mean that this area has no function. The reliability of a measurement strongly depends on efficiency of experimental design and cooperation of the patient. Therefore, short and easy tasks which can be performed in a block design should be preferred. Information about localization of functions determined by fMRI can mainly be used for presurgical planning. Intraoperative usage in the navigation system is problematic due to the brain shift. Therefore, intraoperative imaging together with dynamic adaptation using nonlinear deformation algorithms may improve the value of fMRI in the future. (orig.)

[The implications of cervical spine degenerative and traumatic diseases in the pathogenesis of cervical vertigo and hearing loss].

Science.gov (United States)

Cobzeanu, M D; Rusu, Daniela; Moraru, R; Boboc, Andreea; Hănţăscu, I; Imbrea, Alice; Stratulat, S; Gheorghe, Liliana; Indrei, Anca

2009-01-01

Cervical spine together with vestibular system,visual system and proprioceptive afferents plays an important role in mentaining balance. Spine damage causes distortions in transmitting informations to the brain,favoring vertigo. The authors point out the occurrence of positional vertigo on 23 patients (20 patients with cervical spondylosis and 3 patients with cervical spine injury) due to blood flow disturbance through vertebral artery. The mechano-receptors located in intervertebral disks and cervical spine muscles are activated by column movement. Changes of blood flow in the vertebral and basilar arteries are showed up by cervical X-Rays, intracranial Doppler ultrasound or angio-MRI, an audiogram marking out the degree of hearing loss or tinnitus occurence. ENT complex treatment outcomes are analyzed and balneo-physio-therapy performed in order to improve vertigo and hearing loss. Stress beside muscle overload and cervical spine injures causes alteration in the ear blood-flow circulation that leads to hearing loss, vertigo and tinnitus. It emphasies the need for collaboration between balneologist and ENT specialist in solving balance and hearing disorders with cervicogenic cause.

Exploring connectivity with large-scale Granger causality on resting-state functional MRI.

Science.gov (United States)

DSouza, Adora M; Abidin, Anas Z; Leistritz, Lutz; Wismüller, Axel

2017-08-01

Large-scale Granger causality (lsGC) is a recently developed, resting-state functional MRI (fMRI) connectivity analysis approach that estimates multivariate voxel-resolution connectivity. Unlike most commonly used multivariate approaches, which establish coarse-resolution connectivity by aggregating voxel time-series avoiding an underdetermined problem, lsGC estimates voxel-resolution, fine-grained connectivity by incorporating an embedded dimension reduction. We investigate application of lsGC on realistic fMRI simulations, modeling smoothing of neuronal activity by the hemodynamic response function and repetition time (TR), and empirical resting-state fMRI data. Subsequently, functional subnetworks are extracted from lsGC connectivity measures for both datasets and validated quantitatively. We also provide guidelines to select lsGC free parameters. Results indicate that lsGC reliably recovers underlying network structure with area under receiver operator characteristic curve (AUC) of 0.93 at TR=1.5s for a 10-min session of fMRI simulations. Furthermore, subnetworks of closely interacting modules are recovered from the aforementioned lsGC networks. Results on empirical resting-state fMRI data demonstrate recovery of visual and motor cortex in close agreement with spatial maps obtained from (i) visuo-motor fMRI stimulation task-sequence (Accuracy=0.76) and (ii) independent component analysis (ICA) of resting-state fMRI (Accuracy=0.86). Compared with conventional Granger causality approach (AUC=0.75), lsGC produces better network recovery on fMRI simulations. Furthermore, it cannot recover functional subnetworks from empirical fMRI data, since quantifying voxel-resolution connectivity is not possible as consequence of encountering an underdetermined problem. Functional network recovery from fMRI data suggests that lsGC gives useful insight into connectivity patterns from resting-state fMRI at a multivariate voxel-resolution. Copyright © 2017 Elsevier B.V. All

SU-E-T-661: Quantitative MRI Assessment of a Novel Direction-Modulated Brachytherapy Tandem Applicator for Cervical Cancer

Energy Technology Data Exchange (ETDEWEB)

Soliman, A; Elzibak, A; Fatemi, A; Safigholi, H; Leung, E; Ravi, A; Song, W [Sunnybrook Research Institute, Sunnybrook Health Sciences Centre, Toronto, Ontario (Canada); Han, D [Sunnybrook Research Institute, Sunnybrook Health Sciences Centre, Toronto, Ontario (Canada); University of California, San Diego, La Jolla, CA (United States)

2015-06-15

Purpose: To quantitatively evaluate the MR image quality of a novel direction modulated brachytherapy (DMBT) tandem applicator for cervical cancer, using the clinical MRI scanning protocol for image guided brachytherapy. Methods: The tungsten alloy-based applicator was placed in a water phantom and clinical imaging protocol was performed. Axial images were acquired using 2D turbo-spin echo (TSE) T2-weighted sequence on a 1.5T GE 450w MR scanner and an 8-channel body coil. As multi-channel receiver coil was used, inhomogeneities in the B1 receive field must be considered before performing the quantification process. Therefore the applicator was removed from the phantom and the whole imaging session was performed again for the water phantom with the same parameters. Images from the two scans were then subtracted, resulting in a difference image that only shows the applicator with its surrounding magnetic susceptibility dipole artifact. Line profiles were drawn and plotted on the difference image at various angles and locations along the tandem. Full width at half maximum (FWHM) was measured at all the line profiles to quantify the extent of the artifact. Additionally, the extent of the artifact along the diameter of the tandem was measured at various angles and locations. Results: After removing the background inhomogeneities of the receiver coil, FWHM of the tandem measured 5.75 ± 0.35 mm (the physical tandem diameter is 5.4 mm). The average extent of the artifacts along the diameter of the tandem measured is 2.14 ± 0.56 mm. In contrast to CT imaging of the same applicator (not shown here), the tandem can be easily identified without additional correction algorithms. Conclusion: This work demonstrated that the novel DMBT tandem applicator has minimal susceptibility artifact in T2-weighted images employed in clinical practice for MRI-guided brachytherapy of cervical cancer.

Acute quadriplegia following closed traction reduction of a cervical facet dislocation in the setting of ossification of the posterior longitudinal ligament: case report.

Science.gov (United States)

Wimberley, David W; Vaccaro, Alexander R; Goyal, Nitin; Harrop, James S; Anderson, D Greg; Albert, Todd J; Hilibrand, Alan S

2005-08-01

. Following an immediate anterior decompression and a posterior stabilization procedure, the patient regained full motor and sensory function. This case report highlights the advantages and shows some safety concerns regarding immediate, closed traction reduction of cervical facet dislocation with real-time neural monitoring in an awake, alert, oriented, and appropriately select patient before MRI studies in the setting of preexisting central stenosis from OPLL.

Brain functional BOLD perturbation modelling for forward fMRI and inverse mapping

Science.gov (United States)

Robinson, Jennifer; Calhoun, Vince

2018-01-01

Purpose To computationally separate dynamic brain functional BOLD responses from static background in a brain functional activity for forward fMRI signal analysis and inverse mapping. Methods A brain functional activity is represented in terms of magnetic source by a perturbation model: χ = χ0 +δχ, with δχ for BOLD magnetic perturbations and χ0 for background. A brain fMRI experiment produces a timeseries of complex-valued images (T2* images), whereby we extract the BOLD phase signals (denoted by δP) by a complex division. By solving an inverse problem, we reconstruct the BOLD δχ dataset from the δP dataset, and the brain χ distribution from a (unwrapped) T2* phase image. Given a 4D dataset of task BOLD fMRI, we implement brain functional mapping by temporal correlation analysis. Results Through a high-field (7T) and high-resolution (0.5mm in plane) task fMRI experiment, we demonstrated in detail the BOLD perturbation model for fMRI phase signal separation (P + δP) and reconstructing intrinsic brain magnetic source (χ and δχ). We also provided to a low-field (3T) and low-resolution (2mm) task fMRI experiment in support of single-subject fMRI study. Our experiments show that the δχ-depicted functional map reveals bidirectional BOLD χ perturbations during the task performance. Conclusions The BOLD perturbation model allows us to separate fMRI phase signal (by complex division) and to perform inverse mapping for pure BOLD δχ reconstruction for intrinsic functional χ mapping. The full brain χ reconstruction (from unwrapped fMRI phase) provides a new brain tissue image that allows to scrutinize the brain tissue idiosyncrasy for the pure BOLD δχ response through an automatic function/structure co-localization. PMID:29351339

Brain functional BOLD perturbation modelling for forward fMRI and inverse mapping.

Science.gov (United States)

Chen, Zikuan; Robinson, Jennifer; Calhoun, Vince

2018-01-01

To computationally separate dynamic brain functional BOLD responses from static background in a brain functional activity for forward fMRI signal analysis and inverse mapping. A brain functional activity is represented in terms of magnetic source by a perturbation model: χ = χ0 +δχ, with δχ for BOLD magnetic perturbations and χ0 for background. A brain fMRI experiment produces a timeseries of complex-valued images (T2* images), whereby we extract the BOLD phase signals (denoted by δP) by a complex division. By solving an inverse problem, we reconstruct the BOLD δχ dataset from the δP dataset, and the brain χ distribution from a (unwrapped) T2* phase image. Given a 4D dataset of task BOLD fMRI, we implement brain functional mapping by temporal correlation analysis. Through a high-field (7T) and high-resolution (0.5mm in plane) task fMRI experiment, we demonstrated in detail the BOLD perturbation model for fMRI phase signal separation (P + δP) and reconstructing intrinsic brain magnetic source (χ and δχ). We also provided to a low-field (3T) and low-resolution (2mm) task fMRI experiment in support of single-subject fMRI study. Our experiments show that the δχ-depicted functional map reveals bidirectional BOLD χ perturbations during the task performance. The BOLD perturbation model allows us to separate fMRI phase signal (by complex division) and to perform inverse mapping for pure BOLD δχ reconstruction for intrinsic functional χ mapping. The full brain χ reconstruction (from unwrapped fMRI phase) provides a new brain tissue image that allows to scrutinize the brain tissue idiosyncrasy for the pure BOLD δχ response through an automatic function/structure co-localization.

Value of diffusion-weighted imaging in predicting parametrial invasion in stage IA2-IIA cervical cancer

International Nuclear Information System (INIS)

Park, Jung Jae; Kim, Chan Kyo; Park, Sung Yoon; Park, Byung Kwan; Kim, Bohyun

2014-01-01

To investigate the value of diffusion-weighted imaging (DWI) in evaluating parametrial invasion (PMI) in stage IA2-IIA cervical cancer. A total of 117 patients with stage IA2-IIA cervical cancer who underwent preoperative MRI and radical hysterectomy were included in this study. Preoperative clinical variables and MRI variables were analysed and compared between the groups with and without pathologically proven PMI. All variables except age were significantly different between patients with and without pathologic PMI (P < 0.05). All variables except squamous cell carcinoma (SCC) antigen were also significantly correlated with pathologic PMI on univariate analysis (P < 0.05). Multivariate analysis indicated that PMI on MRI (P < 0.001) and tumour apparent diffusion coefficient (ADC) (P = 0.029) were independent predictors of pathologic PMI. Area under the curve of PMI on MRI increased significantly from 0.793 to 0.872 when combined with tumour ADC (P = 0.002). When PMI on MRI was further stratified by tumour ADC, the false negative rate was 2.0 % (1/49). In stage IA2-IIA cervical cancer, tumour ADC and PMI on MRI seem to be independent predictors of pathologic PMI. Combining the two predictors improved the diagnostic performance of identifying patients at low risk of pathologic PMI. (orig.)

Effects of Field-Map Distortion Correction on Resting State Functional Connectivity MRI

Directory of Open Access Journals (Sweden)

Hiroki Togo

2017-12-01

Full Text Available Magnetic field inhomogeneities cause geometric distortions of echo planar images used for functional magnetic resonance imaging (fMRI. To reduce this problem, distortion correction (DC with field map is widely used for both task and resting-state fMRI (rs-fMRI. Although DC with field map has been reported to improve the quality of task fMRI, little is known about its effects on rs-fMRI. Here, we tested the influence of field-map DC on rs-fMRI results using two rs-fMRI datasets derived from 40 healthy subjects: one with DC (DC+ and the other without correction (DC−. Independent component analysis followed by the dual regression approach was used for evaluation of resting-state functional connectivity networks (RSN. We also obtained the ratio of low-frequency to high-frequency signal power (0.01–0.1 Hz and above 0.1 Hz, respectively; LFHF ratio to assess the quality of rs-fMRI signals. For comparison of RSN between DC+ and DC− datasets, the default mode network showed more robust functional connectivity in the DC+ dataset than the DC− dataset. Basal ganglia RSN showed some decreases in functional connectivity primarily in white matter, indicating imperfect registration/normalization without DC. Supplementary seed-based and simulation analyses supported the utility of DC. Furthermore, we found a higher LFHF ratio after field map correction in the anterior cingulate cortex, posterior cingulate cortex, ventral striatum, and cerebellum. In conclusion, field map DC improved detection of functional connectivity derived from low-frequency rs-fMRI signals. We encourage researchers to include a DC step in the preprocessing pipeline of rs-fMRI analysis.

Diagnosis of Chiari III malformation by second trimester fetal MRI with postnatal MRI and CT correlation

International Nuclear Information System (INIS)

Smith, Alice B.; Glenn, Orit A.; Gupta, Nalin; Otto, Carl

2007-01-01

We report a case of Chiari III malformation diagnosed by fetal MRI. Ultrasound (US) performed at a gestational age of 18 weeks demonstrated a posterior skull base cyst. Repeat US at 19 weeks demonstrated neural tissue in the cyst, consistent with an encephalocele. MR imaging at 23 weeks confirmed the presence of an occipital encephalocele, demonstrated additional bony defect in the upper cervical spine, and identified abnormal morphology and position of the brainstem consistent with the diagnosis of Chiari III. Postnatal MRI and CT confirmed the fetal MRI findings and demonstrate the utility of fetal MRI in the early evaluation of songraphically detected posterior fossa abnormalities. (orig.)

Diagnosis of Chiari III malformation by second trimester fetal MRI with postnatal MRI and CT correlation

Energy Technology Data Exchange (ETDEWEB)

Smith, Alice B.; Glenn, Orit A. [University of California, San Francisco, Department of Radiology, San Francisco, CA (United States); Gupta, Nalin [University of California, San Francisco, Department of Neurosurgery, San Francisco, CA (United States); Otto, Carl [California Pacific Medical Center, Department of Perinatology, San Francisco, CA (United States)

2007-10-15

We report a case of Chiari III malformation diagnosed by fetal MRI. Ultrasound (US) performed at a gestational age of 18 weeks demonstrated a posterior skull base cyst. Repeat US at 19 weeks demonstrated neural tissue in the cyst, consistent with an encephalocele. MR imaging at 23 weeks confirmed the presence of an occipital encephalocele, demonstrated additional bony defect in the upper cervical spine, and identified abnormal morphology and position of the brainstem consistent with the diagnosis of Chiari III. Postnatal MRI and CT confirmed the fetal MRI findings and demonstrate the utility of fetal MRI in the early evaluation of songraphically detected posterior fossa abnormalities. (orig.)

Reevaluation of the Pavlov ratio in patients with cervical myelopathy.

Science.gov (United States)

Suk, Kyung-Soo; Kim, Ki-Tack; Lee, Jung-Hee; Lee, Sang-Hun; Kim, Jin-Soo; Kim, Jin-Young

2009-03-01

This study was designed to reevaluate the effectiveness of the Pavlov ratio in patients with cervical myelopathy. We studied 107 patients who underwent open door laminoplasty for the treatment of cervical myelopathy between the C3 to C7 levels. We determined the Pavlov ratio on preoperative and postoperative cervical spine lateral radiographs, the vertebral body-to-canal ratio on sagittal reconstruction CT scans, and the vertebral body-to-cerebrospinal fluid (CSF) column ratio on T2-weighted sagittal MR images from C3 to C6. The severity of myelopathy was determined using the JOA score on both preoperative and postoperative images. The recovery rate was also calculated. The Pavlov ratio in plain radiographs from patients with myelopathy was compared with the ratio of the vertebral body to the spinal canal on CT and MRI. The average Pavlov ratio between C3 and C6 ranged from 0.71 to 0.76. On CT scan, the average vertebral body-to-canal ratio between C3 and C6 ranged from 0.62 to 0.66. On MRI, the vertebral body-to-CSF column ratio between C3 and C6 ranged between 0.53 and 0.57. A positive correlation was noted between the Pavlov ratio and the vertebral body-to-canal ratio on sagittal-reconstruction CT (correlation coefficient = 0.497-0.627, p = 0.000) and between the Pavlov ratio and the vertebral body-to-CSF column ratio on MRI (correlation coefficient = 0.511-0.649, p = 0.000). We demonstrated a good correlation between the Pavlov ratio and both the vertebral body-to-canal ratio on CT and the vertebral body-to-CSF column ratio on MRI. Therefore, the Pavlov ratio can be relied upon to predict narrowing of the cervical spinal canal in the sagittal plane.

Radiologic Findings of Cervical Varix Developed in Late Pregnancy: Case Report

Energy Technology Data Exchange (ETDEWEB)

Park, Young Chan; Kim, Ho Kyun [Catholic University of Daegu College of Medicine, Daegu (Korea, Republic of)

2006-12-15

Cervical varix is a rare cause of obstetric hemorrhage which needs accurate diagnosis and prompt management because the lesion may be associated with preterm delivery and maternal complications. Our patient was diagnosed with cervical varix and vaginal bleeding at 32 weeks' gestation, using trans vaginal ultrasound and MRI. Persistent vaginal bleeding and preterm labor led to an emergency cesarean section at 33 weeks' gestation. After delivery, cervical varix was spontaneously resolved in the follow-up trans vaginal ultrasound and CT. We report various radiologic features of cervical varix combined with vaginal bleeding in late pregnancy

Methodological principles for optimising functional MRI experiments

International Nuclear Information System (INIS)

Wuestenberg, T.; Giesel, F.L.; Strasburger, H.

2005-01-01

Functional magnetic resonance imaging (fMRI) is one of the most common methods for localising neuronal activity in the brain. Even though the sensitivity of fMRI is comparatively low, the optimisation of certain experimental parameters allows obtaining reliable results. In this article, approaches for optimising the experimental design, imaging parameters and analytic strategies will be discussed. Clinical neuroscientists and interested physicians will receive practical rules of thumb for improving the efficiency of brain imaging experiments. (orig.) [de

Bayesian Inference for Functional Dynamics Exploring in fMRI Data

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Xuan Guo

2016-01-01

Full Text Available This paper aims to review state-of-the-art Bayesian-inference-based methods applied to functional magnetic resonance imaging (fMRI data. Particularly, we focus on one specific long-standing challenge in the computational modeling of fMRI datasets: how to effectively explore typical functional interactions from fMRI time series and the corresponding boundaries of temporal segments. Bayesian inference is a method of statistical inference which has been shown to be a powerful tool to encode dependence relationships among the variables with uncertainty. Here we provide an introduction to a group of Bayesian-inference-based methods for fMRI data analysis, which were designed to detect magnitude or functional connectivity change points and to infer their functional interaction patterns based on corresponding temporal boundaries. We also provide a comparison of three popular Bayesian models, that is, Bayesian Magnitude Change Point Model (BMCPM, Bayesian Connectivity Change Point Model (BCCPM, and Dynamic Bayesian Variable Partition Model (DBVPM, and give a summary of their applications. We envision that more delicate Bayesian inference models will be emerging and play increasingly important roles in modeling brain functions in the years to come.

Research progress of BOLD-functional MRI of hepatic encephalopathy

International Nuclear Information System (INIS)

Ni Ling; Zhang Longjiang; Lu Guangming

2013-01-01

Hepatic encephalopathy (HE), characterized by a wide spectrum of clinical manifestations, ranging from behavior abnormality, conscious disorder and even coma, is a consequence of liver dysfunction in both acute and chronic hepatic diseases. Minimal hepatic encephalopathy (MHE) refers to a subgroup of cirrhotic patients without clinical overt hepatic encephalopathy symptoms hut with abnormalities in neuro -cognitive functions. HE/MHE can have a far-reaching impact on quality of life and prognosis. The exact neuropathology mechanism was still unclear. Recently, functional MRI (fMRI) has been increasingly applied for investigating the neuro-pathophysiological mechanism of HE. This paper will review the fMRI research applied on uncovering the neuropathology mechanism of HE. (authors)

Early stage cervical cancer, radical hysterectomy and sexual function: a longitudinal study

DEFF Research Database (Denmark)

Jensen, Pernille Tine

Background: Limited knowledge exists regarding the impact of treatment on the sexual function of early stage cervical cancer patients. We investigated the longitudinal course of self-reported sexual function after radical hysterectomy (RH) alone. Methods: 173 patients with lymph node-negative early...... stage cervical cancer who had undergone RH and pelvic lymphadenectomy alone were assessed prospectively using a validated self-assessment questionnaire 5 weeks and 3, 6, 12, 18, and 24 months after RH. Results were compared with an age-matched control group from the general population. At 12 months post......-surgery, the patients completed an extended version of the questionnaire with additional items assessing the patient’s perception of changes in sexual function compared with before the cancer diagnosis. Results: Compared with control women, patients experienced severe orgasmic problems and uncomfortable sexual...

Functional MRI (fMRI) on lesions in and around the motor and the eloquent cortices

International Nuclear Information System (INIS)

Hara, Yoshie; Nakamura, Mitsugu; Tamura, Shogo; Tamaki, Norihiko; Kitamura, Junji

1999-01-01

From the view point of neurosurgeons, to aim the preoperative localized diagnosis on the motor and the eloquent cortices and postoperative preservation of neurological functions, fMRI was carried for patients with lesions in and around the motor and the eloquent cortices. Even in cases of mechanical oppression or brain edema, the motor and the eloquent cortices are localized on cerebral gyri. In perioperative period, identification and preserving the motor and the eloquent cortices are important for keeping brain function. Twenty six preoperative cases and 3 normal healthy subjects were observed. Exercise enhanced fMRI was performed on 3 normal healthy subjects, fMRI with motor stimulation in 24 cases and fMRI with speech stimulation in 4 cases. The signal intensity increased in all cases responsing to both stimulations. But the signal intensity in 8 cases decreased in some regions by motor stimulation and 1 case by speech stimulation. The decrease of signal intensity in this study seems to be a clinically important finding and it will be required to examine the significance in future. (K.H.)

The relationship between electrodiagnosis using spinal cord evoked potential after spinal cord stimulation and MRI evaluation for cervical myelopathy

International Nuclear Information System (INIS)

Kato, Tsuyoshi; Shiba, Keiichiro; Ueta, Takayoshi; Ohta, Hideki; Mori, Eiji; Kaji, Kozo; Yuge, Itaru; Kawano, Osamu

2006-01-01

We studied the correlation between the site of high intensity spinal cord signals on preoperative sagittal T2 MRIs (T2-high signal) and that of intrdaperative electrophysiological abnormalities for 200 cervical myelopathy cases. We recorded the Sp(E)-SCEPs during posterior cervical laminoplasty operations. In the cases with a T2-high signal at single levels, conduction abnormality matched the site of T2-high signal in 50%, and no conduction abnormalities were detected in 44%. In the cases with a T2-high signal at two levels, conduction abnormality matched the site of T2-high signal in only 11%, and no conduction abnormalities were disclosed in 59%. In the cases with a T2-high signal at three or more levels, conduction abnormalities matched the site of T2-high signal in 8% and no conduction abnormalities were disclosed in 72%. Our study showed a higher correspondence between the MRI finding and conduction abnormalities in the cases with T2-high signal at single levels, although our Sp(E)-SCEP study could not disclose conduction abnormalities in nearly half the cases. False negative findings of Sp(E)-SCEPs may result from the simplified recording technique. (author)

Spinal cord edema with contrast enhancement mimicking intramedullary tumor in patient with cervical myelopathy: A case report and a brief literature review.

Science.gov (United States)

Gkasdaris, Grigorios; Chourmouzi, Danai; Karagiannidis, Apostolos; Kapetanakis, Stylianos

2017-01-01

Cervical myelopathy (CM) is a clinical diagnosis that may be associated with hyperintense areas on T2-weighted magnetic resonance imaging (MRI) scan. The use of contrast enhancement in such areas to differentiate between neoplastic and degenerative disease has rarely been described. We present a 41-year-old female with a 5-month course of progressive CM. The cervical MRI revealed spinal cord swelling, stenosis, and a hyperintense signal at the C5-C6 and C5-C7 levels. Both the neurologic and radiologic examinations were consistent with an intramedullary cervical cord tumor. To decompress the spinal canal, an anterior cervical discectomy and fusion was performed from C5 to C7 level. This resulted in immediate and significant improvement of the myelopathy. Postoperatively, over 1.5 years, the hyperintense, enhancing intramedullary lesion gradually regressed on multiple postoperative MRI scans. Spinal cord edema is occasionally seen on MR studies of the cervical spine in patients with degenerative CM. Contrast-enhanced MR studies may help differentiate hyperintense cord signals due to edema vs. atypical intramedullary tumors. Routine successive postoperative MRI evaluations are crucial to confirm the diagnosis of degenerative vs. neoplastic disease.

Characterizing Tumor Heterogeneity With Functional Imaging and Quantifying High-Risk Tumor Volume for Early Prediction of Treatment Outcome: Cervical Cancer as a Model

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Mayr, Nina A., E-mail: Nina.Mayr@osumc.edu [Department of Radiation Oncology, Ohio State University, Columbus, OH (United States); Huang Zhibin [Department of Radiation Oncology and Department of Physics, East Carolina University, Greenville, NC (United States); Wang, Jian Z. [Department of Radiation Oncology, Ohio State University, Columbus, OH (United States); Lo, Simon S. [Department of Radiation Oncology, Case Western Reserve University, Cleveland, OH (United States); Fan, Joline M. [Department of Molecular Biology, Stanford University, Stanford, CA (United States); Grecula, John C. [Department of Radiation Oncology, Ohio State University, Columbus, OH (United States); Sammet, Steffen [Department of Radiology, University of Chicago, Chicago, IL (United States); Department of Radiology, Ohio State University, Columbus, OH (United States); Sammet, Christina L. [Department of Radiology, University of Chicago, Chicago, IL (United States); Jia Guang; Zhang Jun; Knopp, Michael V.; Yuh, William T.C. [Department of Radiology, Ohio State University, Columbus, OH (United States)

2012-07-01

Purpose: Treatment response in cancer has been monitored by measuring anatomic tumor volume (ATV) at various times without considering the inherent functional tumor heterogeneity known to critically influence ultimate treatment outcome: primary tumor control and survival. This study applied dynamic contrast-enhanced (DCE) functional MRI to characterize tumors' heterogeneous subregions with low DCE values, at risk for treatment failure, and to quantify the functional risk volume (FRV) for personalized early prediction of treatment outcome. Methods and Materials: DCE-MRI was performed in 102 stage IB{sub 2}-IVA cervical cancer patients to assess tumor perfusion heterogeneity before and during radiation/chemotherapy. FRV represents the total volume of tumor voxels with critically low DCE signal intensity (<2.1 compared with precontrast image, determined by previous receiver operator characteristic analysis). FRVs were correlated with treatment outcome (follow-up: 0.2-9.4, mean 6.8 years) and compared with ATVs (Mann-Whitney, Kaplan-Meier, and multivariate analyses). Results: Before and during therapy at 2-2.5 and 4-5 weeks of RT, FRVs >20, >13, and >5 cm{sup 3}, respectively, significantly predicted unfavorable 6-year primary tumor control (p = 0.003, 7.3 Multiplication-Sign 10{sup -8}, 2.0 Multiplication-Sign 10{sup -8}) and disease-specific survival (p = 1.9 Multiplication-Sign 10{sup -4}, 2.1 Multiplication-Sign 10{sup -6}, 2.5 Multiplication-Sign 10{sup -7}, respectively). The FRVs were superior to the ATVs as early predictors of outcome, and the differentiating power of FRVs increased during treatment. Discussion: Our preliminary results suggest that functional tumor heterogeneity can be characterized by DCE-MRI to quantify FRV for predicting ultimate long-term treatment outcome. FRV is a novel functional imaging heterogeneity parameter, superior to ATV, and can be clinically translated for personalized early outcome prediction before or as early as 2

Combination of functional MRI with SAS and MRA

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Sumida, Masayuki; Takeshita, Shinichirou; Kutsuna, Munenori; Akimitsu, Tomohide; Arita, Kazunori; Kurisu, Kaoru [Hiroshima Univ. (Japan). School of Medicine

1999-02-01

For presurgical diagnosis of brain surface, combination of functional MRI (fMRI) with the MR angiography was examined. This method could visualize brain bay, convolution and vein as index of surface. Five normal adults (male, mean age: 28-year-old) and 7 patients with brain tumor on the main locus to surface (male: 4, female: 3, mean age: 52.3-year-old) were studied. fMRI was performed by SPGR method (TR 70, TE 40, flip angle 60, one slice, thickness 10 mm, FOV 20 cm, matrix 128 x 128). The brain surface was visualized by SAS (surface anatomy scanning). SAS was performed by FSE method (TR 6000, TE 200, echo train 16, thickness 20 mm, slice 3, NEX 2). Cortical veins near superior sagittal sinus were visualized by MRA with 2D-TOF method (TR 50, TE 20, flip angle 60, thickness 2 mm, slice 28, NEX 1). These images were superimposed and functional image of peripheral sensorimotor region was evaluated anatomically. In normal adults, high signal was visualized at another side of near sensorimotor region at 8 of 10 sides. All high signal area of fMRI agreed with cortical vein near sensorimotor region that was visualized by MRA. In patients with brain tumor, signal was visualized at another side of sensorimotor region of tumor without 2 cases with palsy. In another side of tumor, signal of fMRI was visualized in 5 of 7 cases. The tumor was visualized as opposite low signal field in SAS. Locational relation between tumor and brain surface and brain function was visualized distinctly by combination of MRA, SAS and MRA. This method could become useful for presurgical diagnosis. (K.H.)

Functional MRI language mapping in pre-surgical epilepsy patients ...

African Journals Online (AJOL)

Background. Functional magnetic resonance imaging (fMRI) is commonly applied to study the neural substrates of language in clinical research and for neurosurgical planning. fMRI language mapping is used to assess language lateralisation, or determine hemispheric dominance, and to localise regions of the brain ...

Clinical significance of intraluminal contrast enhancement in patients with spontaneous cervical artery dissection. A black-blood MRI study

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Coppenrath, Eva; Lenz, Olga; Sommer, Nora; Treitl, Karla; Reiser, Maximilian [Munich Univ. (Germany). Inst. of Clinical Radiology; Lummel, Nina [Univ. Hospital Klinikum rechts der Isar Munich, Munich (Germany). Inst. of Neuroradiology and Interventional Neuroradiology; Linn, Jennifer [Univ. Hospital Dresden (Germany). Inst. of Neuroradiology; Bamberg, Fabian [Tuebingen Univ. (Germany). Diagnostical and Interventional Radiology; Pfefferkorn, Thomas [Munich Univ. (Germany). Interdisciplinary Stroke Center Munich; Saam, Tobias [Radiology Center Rosenheim (Germany)

2017-07-15

Recent studies have suggested that intraluminal thrombi show contrast enhancement on carotid black-blood T1w MRI. The aim of this study was to evaluate the significance of intraluminal contrast enhancement (iCE) regarding symptom status in patients with spontaneous cervical artery dissection (sCAD). 33 consecutive patients (19 men) with sCAD received a brain MRI (DIFF, T2w, T2{sup *}w, FLAIR) and a multi-sequence 3T-MRI with fat-saturated high-resolution black-blood T1w-sequences pre- and post-contrast, contrast-enhanced MR angiography and TOF images of carotid and vertebral arteries. Presence/absence of iCE, vessel occlusion and vessel wall hematoma (hyperintense in T1w pre-contrast) were analysed by two radiologists in consensus decision. 44 of 132 analysed vessels had a vessel wall hematoma, consistent with sCAD. In 17 of 44 dissected vessels an acute ischemic stroke was found. 16 of 17 (94.1 %) vessels ipsilateral to ischemic stroke demonstrated iCE, compared to 9 of 44 (20.4 %) dissected vessels without stroke (P< 0.001). The presence/absence of iCE resulted in a sensitivity, specificity, positive and negative predictive value and accuracy for ischemic stroke of 0.94, 0.67, 0.64, 0.95, and 0.77, respectively, and an odds ratio of 32.0. iCE, which is suggestive of intraluminal thrombus formation, is strongly correlated with ischemic symptoms in patients with sCAD.

Clinical significance of intraluminal contrast enhancement in patients with spontaneous cervical artery dissection. A black-blood MRI study

International Nuclear Information System (INIS)

Coppenrath, Eva; Lenz, Olga; Sommer, Nora; Treitl, Karla; Reiser, Maximilian

2017-01-01

Recent studies have suggested that intraluminal thrombi show contrast enhancement on carotid black-blood T1w MRI. The aim of this study was to evaluate the significance of intraluminal contrast enhancement (iCE) regarding symptom status in patients with spontaneous cervical artery dissection (sCAD). 33 consecutive patients (19 men) with sCAD received a brain MRI (DIFF, T2w, T2"*w, FLAIR) and a multi-sequence 3T-MRI with fat-saturated high-resolution black-blood T1w-sequences pre- and post-contrast, contrast-enhanced MR angiography and TOF images of carotid and vertebral arteries. Presence/absence of iCE, vessel occlusion and vessel wall hematoma (hyperintense in T1w pre-contrast) were analysed by two radiologists in consensus decision. 44 of 132 analysed vessels had a vessel wall hematoma, consistent with sCAD. In 17 of 44 dissected vessels an acute ischemic stroke was found. 16 of 17 (94.1 %) vessels ipsilateral to ischemic stroke demonstrated iCE, compared to 9 of 44 (20.4 %) dissected vessels without stroke (P< 0.001). The presence/absence of iCE resulted in a sensitivity, specificity, positive and negative predictive value and accuracy for ischemic stroke of 0.94, 0.67, 0.64, 0.95, and 0.77, respectively, and an odds ratio of 32.0. iCE, which is suggestive of intraluminal thrombus formation, is strongly correlated with ischemic symptoms in patients with sCAD.

The effect of balance training on cervical sensorimotor function and neck pain.

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Beinert, Konstantin; Taube, Wolfgang

2013-01-01

The authors' aim was to evaluate the effect of balance training on cervical joint position sense in people with subclinical neck pain. Thirty-four participants were randomly assigned to balance training or to stay active. Sensorimotor function was determined before and after 5 weeks of training by assessing the ability to reproduce the neutral head position and a predefined rotated head position. After balance training, the intervention group showed improved joint repositioning accuracy and decreased pain whereas no effects were observed in the control group. A weak correlation was identified between reduced neck pain intensity and improved joint repositioning. The present data demonstrate that balance training can effectively improve cervical sensorimotor function and decrease neck pain intensity.

Factors for vertebral artery injury accompanied by cervical trauma

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Murata, Masaaki; Shingu, Hikosuke; Kimura, Isao; Nasu, Yoshiro; Shiotani, Akihide [San-in Rosai Hospital, Yonago, Tottori (Japan). Spine and Low Back Pain Center

2001-09-01

Injury of the vertebral artery with cerebellar and brain stem infarction is a complication of cervical vertebral trauma. However, the pathogenesis and etiological factors remain to be clarified. In this study, we investigated patients with cervical vertebral and cord injury. This study included 51 patients with cervical vertebral and cord injury who were treated in our department. In these patients, plain X-ray, CT, MRI, and MRA findings were examined. The incidence of vertebral arterial injury was 33.3% (17 of 51 patients with cervical vertebral trauma). In 11 of the 17 patients, dislocation fracture was noted, comprising a markedly high percentage (64.7%). Particularly, vertebral arterial injury was commonly observed in patients with a large dislocation distance and severe paralysis. Cerebellar and brain stem infarction related to vertebral arterial injury was observed in 5 of the 17 patients (29.4%). No infarction developed in patients 50 years old or younger. Infarction was detected in relatively elderly patients. Vertebral arterial injury and cerebellar/brain stem infarction related to cervical vertebral trauma were frequently observed in patients with high energy injury. However, these disorders commonly occurred in elderly patients. Therefore, age-related factors such as arteriosclerosis may also be closely involved. In the acute stage, the state of the vertebral artery should be evaluated by MRA and MRI. Among patients with vertebral arterial injury, caution is needed during follow-up those with risk factors such as high energy injury and advanced age. (author)

Factors for vertebral artery injury accompanied by cervical trauma

International Nuclear Information System (INIS)

Murata, Masaaki; Shingu, Hikosuke; Kimura, Isao; Nasu, Yoshiro; Shiotani, Akihide

2001-01-01

Injury of the vertebral artery with cerebellar and brain stem infarction is a complication of cervical vertebral trauma. However, the pathogenesis and etiological factors remain to be clarified. In this study, we investigated patients with cervical vertebral and cord injury. This study included 51 patients with cervical vertebral and cord injury who were treated in our department. In these patients, plain X-ray, CT, MRI, and MRA findings were examined. The incidence of vertebral arterial injury was 33.3% (17 of 51 patients with cervical vertebral trauma). In 11 of the 17 patients, dislocation fracture was noted, comprising a markedly high percentage (64.7%). Particularly, vertebral arterial injury was commonly observed in patients with a large dislocation distance and severe paralysis. Cerebellar and brain stem infarction related to vertebral arterial injury was observed in 5 of the 17 patients (29.4%). No infarction developed in patients 50 years old or younger. Infarction was detected in relatively elderly patients. Vertebral arterial injury and cerebellar/brain stem infarction related to cervical vertebral trauma were frequently observed in patients with high energy injury. However, these disorders commonly occurred in elderly patients. Therefore, age-related factors such as arteriosclerosis may also be closely involved. In the acute stage, the state of the vertebral artery should be evaluated by MRA and MRI. Among patients with vertebral arterial injury, caution is needed during follow-up those with risk factors such as high energy injury and advanced age. (author)

Promoter hypermethylation of KLF4 inactivates its tumor suppressor function in cervical carcinogenesis.

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Wen-Ting Yang

Full Text Available OBJECTIVE: The KLF4 gene has been shown to be inactivated in cervical carcinogenesis as a tumor suppressor. However, the mechanism of KLF4 silencing in cervical carcinomas has not yet been identified. DNA methylation plays a key role in stable suppression of gene expression. METHODS: The methylation status of the KLF4 promoter CpG islands was analyzed by bisulfite sequencing (BSQ in tissues of normal cervix and cervical cancer. KLF4 gene expression was detected by RT-PCR, immunohistochemistry and western blot. KLF4 promoter methylation in cervical cancer cell line was determined by BSQ and methylation-specific polymerase chain reaction (MS-PCR. Cell proliferation ability was detected by cell growth curve and MTT assay. RESULTS: The methylated allele was found in 41.90% of 24 cervical cancer tissues but only in 11.11% of 11 normal cervix tissues (P<0.005. KLF4 mRNA levels were significantly reduced in cervical cancer tissues compared with normal cervix tissues (P<0.01 and KLF4 mRNA expression showed a significant negative correlation with the promoter hypermethylation (r = -0.486, P = 0.003. Cervical cancer cell lines also showed a significant negative correlation between KLF4 expression and hypermethylation. After treatment with the demethylating agent 5-Azacytidine (5-Aza, the expression of KLF4 in the cervical cancer cell lines at both mRNA and protein levels was drastically increased, the cell proliferation ability was inhibited and the chemosensitivity for cisplatin was significantly increased. CONCLUSION: KLF4 gene is inactivated by methylation-induced silencing mechanisms in a large subset of cervical carcinomas and KLF4 promoter hypermethylation inactivates the gene's function as a tumor suppressor in cervical carcinogenesis.

MRI of the brain and craniocervical junction in Morquio's disease

International Nuclear Information System (INIS)

Hughes, D.G.; Chadderton, R.D.; Cowie, R.A.; Wraith, J.E.; Jenkins, J.P.R.

1997-01-01

We reviewed MRI of the brain and cervical spine in 11 patients with Morquio's disease. No abnormality was seen in the brain. The odontoid peg was abnormal in all patients, with varying degrees of cord compression due to an anterior soft tissue mass and indentation by the posterior arch of the atlas. The degree of cord compression was more marked than suggested by the symptoms and signs. We recommend MRI of the cervical spine in children with Morquio's disease before the development of neurological symptoms, to optimise the timing and type of surgical intervention. (orig.). With 5 figs., 2 tabs

Use of muscle functional magnetic resonance imaging to compare cervical flexor activity between patients with whiplash-associated disorders and people who are healthy.

Science.gov (United States)

Cagnie, Barbara; Dolphens, Mieke; Peeters, Ian; Achten, Eric; Cambier, Dirk; Danneels, Lieven

2010-08-01

Chronic whiplash-associated disorders (WAD) have been shown to be associated with motor dysfunction. Increased electromyographic (EMG) activity in neck and shoulder girdle muscles has been demonstrated during different tasks in participants with persistent WAD. Muscle functional magnetic resonance imaging (mfMRI) is an innovative technique to evaluate muscle activity and differential recruitment of deep and superficial muscles following exercise. The purpose of this study was to compare the recruitment pattern of deep and superficial neck flexors between patients with WAD and controls using mfMRI. A cross-sectional design was used. The study was conducted in a physical and rehabilitation medicine department. The participants were 19 controls who were healthy (10 men, 9 women; mean [+/-SD] age=22.2+/-0.6 years) and 16 patients with WAD (5 men, 11 women; mean [+/-SD] age=32.9+/-12.7 years). The T2 values were calculated for the longus colli (Lco), longus capitis (Lca), and sternocleidomastoid (SCM) muscles at rest and following cranio-cervical flexion (CCF). In the overall statistical model for T2 shift, there was a significant main effect for muscle (F=3.906, P=.033) but not for group (F=2.855, P=.101). The muscle x group interaction effect was significant (F=3.618, P=.041). Although not significant, there was a strong trend for lesser Lco (P=.061) and Lca (P=.060) activity for the WAD group compared with the control group. Although the SCM showed higher T2 shifts, this difference was not significant (P=.291). Although mfMRI is an innovative and useful technique for the evaluation of deep cervical muscles, consideration is required, as this method encompasses a postexercise evaluation and is limited to resistance types of exercises. Muscle functional magnetic resonance imaging demonstrated a difference in muscle recruitment between the Lco, Lca, and SCM during CCF in the control group, but failed to demonstrate a changed activity pattern in the WAD group compared

Survey of cervical cancer survivors regarding quality of life and sexual function

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Wenjuan Zhou

2016-01-01

Conclusion: The QOL and sexual function of cervical cancer survivors were lower than the general population. Treatment-related complications and sexual dysfunction significantly affected patients' QOL. Having health insurance was associated with better QOL. Sexual function was adversely affected by radiotherapy and radical hysterectomy.

Elongated Styloid Process and Cervical Spondylosis

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Zeliha Unlu MD

2008-01-01

Full Text Available Background Dysphagia, is a significant sign of many different lesions in upper digestive system especially in proximal esophagus. Tumors, gastroesophageal reflux, achalasia and extrinsic compressions are the most common causes that may lead to dysphagia in geriatric population. Cervical osteophyte induced dysphagia, is one of the uncommon reasons of dysphagia, therefore other causes of dysphagia must be excluded to establish the exact diagnosis. Eagle syndrome is one of the considerable reason which may lead to misdiagnosis in patients with cervical osteophytes. In this case report, we represent four patients who had dysphagia due to anteriorly located cervical osteophytes and evaluate the patients with special reference to Eagle syndrome. Material and methods After a detailed anamnesis and ENT examination, cervical plain radiographs in four projections and Towne radiographs were obtained for every patient. After that, magnetic resonance imaging (MRI of cervical spine and barium swallowing studies were performed to evaluate the presence of esophageal compression. Results Eagle syndrome was excluded due to absence of other symptoms and physical signs, eventhough unilateral or bilateral elongation of styloid processes was found in all of the patients. Conclusion Cervical osteophytes induced dysphagia is a rare clinical entity, diagnosis should be done by a careful examination, intensive radiologic evaluation. Moreover, all the other causes like Eagle syndrome should be excluded during the diagnosis of cervical osteophyte induced dysphagia.

Restoration of Upper Limb Function in an Individual with Cervical Spondylotic Myelopathy using Functional Electrical Stimulation Therapy: A Case Study.

Science.gov (United States)

Popovic, Milos R; Zivanovic, Vera; Valiante, Taufik A

2016-01-01

Non-traumatic spinal cord pathology is responsible for 25-52% of all spinal cord lesions. Studies have revealed that spinal stenosis accounts for 16-21% of spinal cord injury (SCI) admissions. Impaired grips as well as slow unskilled hand and finger movements are the most common complaints in patients with spinal cord disorders, such as myelopathy secondary to cervical spondylosis. In the past, our team carried out couple of successful clinical trials, including two randomized control trials, showing that functional electrical stimulation therapy (FEST) can restore voluntary reaching and/or grasping function, in people with stroke and traumatic SCI. Motivated by this success, we decided to examine changes in the upper limb function following FEST in a patient who suffered loss of hand function due to myelopathy secondary to cervical spondylosis. The participant was a 61-year-old male who had C3-C7 posterior laminectomy and instrumented fusion for cervical myelopathy. The participant presented with progressive right hand weakness that resulted in his inability to voluntarily open and close the hand and to manipulate objects unilaterally with his right hand. The participant was enrolled in the study ~22 months following initial surgical intervention. Participant was assessed using Toronto Rehabilitation Institute's Hand Function Test (TRI-HFT), Action Research Arm Test (ARAT), Functional Independence Measure (FIM), and Spinal Cord Independence Measure (SCIM). The pre-post differences in scores on all measures clearly demonstrated improvement in voluntary hand function following 15 1-h FEST sessions. The changes observed were meaningful and have resulted in substantial improvement in performance of activities of daily living. These results provide preliminary evidence that FEST has a potential to improve upper limb function in patients with non-traumatic SCI, such as myelopathy secondary to cervical spondylosis.

Cervical chordoma with vertebral artery encasement mimicking neurofibroma: MRI findings

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Mortele, B.; Lemmerling, M.; Mortele, K.; Verstraete, K.; Defreyne, L.; Kunnen, M. [Department of Radiology, University Hospital, Gent (Belgium); Vandekerckhove, T. [Department of Neurosurgery, University Hospital, Gent (Belgium)

2000-06-01

A case of cervical chordoma in a 36-year-old white man with hypoesthesia in the neck and right shoulder, neck pain, and restricted neck mobility is presented. Plain radiographs of the cervical spine showed radiolucency of the body of C2 on the right side and enlargement of the right intervertebral foramen at C2-C3 level. Tumor encasement of the vertebral artery was demonstrated by MR imaging and confirmed by conventional arteriography. This proved to be particularly important for preoperative assessment. (orig.)

Cervical chordoma with vertebral artery encasement mimicking neurofibroma: MRI findings

International Nuclear Information System (INIS)

Mortele, B.; Lemmerling, M.; Mortele, K.; Verstraete, K.; Defreyne, L.; Kunnen, M.; Vandekerckhove, T.

2000-01-01

A case of cervical chordoma in a 36-year-old white man with hypoesthesia in the neck and right shoulder, neck pain, and restricted neck mobility is presented. Plain radiographs of the cervical spine showed radiolucency of the body of C2 on the right side and enlargement of the right intervertebral foramen at C2-C3 level. Tumor encasement of the vertebral artery was demonstrated by MR imaging and confirmed by conventional arteriography. This proved to be particularly important for preoperative assessment. (orig.)

Graph-based network analysis of resting-state functional MRI

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Jinhui Wang

2010-06-01

Full Text Available In the past decade, resting-state functional MRI (R-fMRI measures of brain activity have attracted considerable attention. Based on changes in the blood oxygen level-dependent signal, R-fMRI offers a novel way to assess the brain’s spontaneous or intrinsic (i.e., task-free activity with both high spatial and temporal resolutions. The properties of both the intra- and inter-regional connectivity of resting-state brain activity have been well documented, promoting our understanding of the brain as a complex network. Specifically, the topological organization of brain networks has been recently studied with graph theory. In this review, we will summarize the recent advances in graph-based brain network analyses of R-fMRI signals, both in typical and atypical populations. Application of these approaches to R-fMRI data has demonstrated non-trivial topological properties of functional networks in the human brain. Among these is the knowledge that the brain’s intrinsic activity is organized as a small-world, highly efficient network, with significant modularity and highly connected hub regions. These network properties have also been found to change throughout normal development, aging and in various pathological conditions. The literature reviewed here suggests that graph-based network analyses are capable of uncovering system-level changes associated with different processes in the resting brain, which could provide novel insights into the understanding of the underlying physiological mechanisms of brain function. We also highlight several potential research topics in the future.

Graph-based network analysis of resting-state functional MRI.

Science.gov (United States)

Wang, Jinhui; Zuo, Xinian; He, Yong

2010-01-01

In the past decade, resting-state functional MRI (R-fMRI) measures of brain activity have attracted considerable attention. Based on changes in the blood oxygen level-dependent signal, R-fMRI offers a novel way to assess the brain's spontaneous or intrinsic (i.e., task-free) activity with both high spatial and temporal resolutions. The properties of both the intra- and inter-regional connectivity of resting-state brain activity have been well documented, promoting our understanding of the brain as a complex network. Specifically, the topological organization of brain networks has been recently studied with graph theory. In this review, we will summarize the recent advances in graph-based brain network analyses of R-fMRI signals, both in typical and atypical populations. Application of these approaches to R-fMRI data has demonstrated non-trivial topological properties of functional networks in the human brain. Among these is the knowledge that the brain's intrinsic activity is organized as a small-world, highly efficient network, with significant modularity and highly connected hub regions. These network properties have also been found to change throughout normal development, aging, and in various pathological conditions. The literature reviewed here suggests that graph-based network analyses are capable of uncovering system-level changes associated with different processes in the resting brain, which could provide novel insights into the understanding of the underlying physiological mechanisms of brain function. We also highlight several potential research topics in the future.

The Value of Diffusion-Weighted Imaging in Combination With Conventional Magnetic Resonance Imaging for Improving Tumor Detection for Early Cervical Carcinoma Treated With Fertility-Sparing Surgery.

Science.gov (United States)

Li, Xiulei; Wang, Ling; Li, Yong; Song, Peiji

2017-10-01

This study aimed to investigate the value of diffusion-weighted imaging (DWI) in combination with conventional magnetic resonance imaging (MRI) for improving tumor detection in young patients treated with fertility-sparing surgery because of early cervical carcinoma. Fifty-four patients with stage Ia or Ib1 cervical carcinoma were enrolled into this study. Magnetic resonance examinations were performed for these patients using conventional MRI (including T1-weighted imaging, T2-weighted imaging, and dynamic contrast-enhanced MRI) and DWI. The apparent diffusion coefficient (ADC) values of cervical carcinoma were analyzed quantitatively and compared with that of adjacent epithelium. Sensitivity, positive predictive value, and accuracy of 2 sets of MRI sequences were calculated on the basis of histologic results, and the diagnostic ability of conventional MRI/DWI combinations was compared with that of conventional MRI. The mean ADC value from cervical carcinoma (mean, 786 × 10 mm/s ± 100) was significantly lower than that from adjacent epithelium (mean, 1352 × 10 mm/s ± 147) (P = 0.01). When the threshold ADC value set as 1010 × 10 mm/s, the sensitivity and specificity for differentiating cervical carcinoma from nontumor epithelium were 78.2% and 67.2%, respectively. The sensitivity and accuracy of conventional MRI for tumor detection were 76.0% and 70.4%, whereas the sensitivity and accuracy of conventional MRI/DWI combinations were 91.7% and 90.7%, respectively. Conventional MRI/DWI combinations revealed a positive predictive value of 97.8% and only 4 false-negative findings. The addition of DWI to conventional MRI considerably improves the sensitivity and accuracy of tumor detection in young patients treated with fertility-sparing surgery, which supports the inclusion quantitative analysis of ADC value in routine MRI protocol before fertility-sparing surgery.

Clinical application of functional MRI for chronic epilepsy

International Nuclear Information System (INIS)

Woermann, F.G.; Labudda, K.

2010-01-01

Functional magnetic resonance imaging (fMRI) is frequently used in the presurgical diagnostic procedure of epilepsy patients, in particular for lateralization of speech and memory and for localization of the primary motor cortex to delineate the epileptogenic lesion from eloquent brain areas. fMRI is one of the non-invasive procedures in the presurgical diagnostic process, together with medical history, seizure semiology, neurological examination, interictal and ictal EEG, structural MRI, video EEG monitoring and neuropsychology. This diagnostic sequence leads either to the decision for or against elective epilepsy surgery or to the decision to proceed with invasive diagnostic techniques (Wada test, intra-operative or extra-operative cortical stimulation). It is difficult to evaluate the contribution of the fMRI test in isolation to the validity of the entire diagnostic sequence. Complications such as memory loss and aphasia in temporal lobe resections or paresis after frontal lobe resections are rare and rarely of disastrous extent. This further complicates the evaluation of the clinical relevance of fMRI as a predictive tool. In this article studies which investigated the concordance between fMRI and other diagnostic gold standards will be presented as well as the association between presurgical fMRI and postsurgical morbidity. (orig.) [de

HIV Infection Is Associated with Impaired Striatal Function during Inhibition with Normal Cortical Functioning on Functional MRI

NARCIS (Netherlands)

du Plessis, Stéfan; Vink, Matthijs; Joska, John A; Koutsilieri, Eleni; Bagadia, Asif; Stein, Dan J; Emsley, Robin

2015-01-01

The aim of the present study was to investigate the effect of HIV infection on cortical and subcortical regions of the frontal-striatal system involved in the inhibition of voluntary movement. Functional MRI (fMRI) studies suggest that human immunodeficiency virus (HIV) infection is associated with

Methodological Improvements in Combining TMS and Functional MRI

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Moisa, Marius

2011-01-01

Since 1997, when Bohning and colleagues demonstrated for the first time the feasibility of interleaving transcranial magnetic stimulation (TMS) with blood oxygenation level dependency functional magnetic resonance imaging (BOLD fMRI), this combination became a very promising techniques to study brain connectivity. However, the implementation of a reliable setup for interleaved TMS/fMRI is still technically challenging. In this thesis, I intended to further explore and develop methodological i...

Functional alterations of V1 cortex in patients with primary open angle glaucoma using functional MRI retinotopic mapping

International Nuclear Information System (INIS)

Shi Linping; Cai Ping; Li Changying; Li Xueqin; Xie Bing; Li Sha; Liu Ting; Chen Xing; Shi Yanshu; Wang Jian

2011-01-01

Objective: To evaluate the functional changes of visual cortex (V1) in patients with primary open angle glaucoma (POAG) by fMRI retinotopic mapping technology. Methods: Fifteen POAG patients and 15 healthy volunteers underwent stimulations with fMRI retinotopic mapping stimulus and contrast-reversing checkerboard patterns stimulus on a Siemens Trio 3.0 T MRI whole-body scanner for functional data collection. Comparisons of V1 fMRI responses between the glaucomatous eyes and the healthy eyes of the patients were carried out using paired samples t-test, while independent samples t-test was used to compare V1 fMRI responses and activations between the healthy eyes of patients and the age-, gender- and side- matched eyes of normal people. Differences of V1 cortical functions and visual functions were analyzed by linear correlation analysis when the glaucomatous and the healthy eyes were simulated individually., Results: (1) V1 fMRI responses of the individually stimulated glaucomatous eyes [(1.24±0.72)%] were weaker than those of the healthy eyes [(2.18±0.93)%] (t=4.757, P 0.05). (2) Differences of V1 cortical functions were negatively correlated with those of visual functions in the individually stimulated glaucomatous and healthy eyes (r=-0.887, P< 0.01). (3) The activated area indexes of V1 cortexes in the healthy eyes from patients (0.72±0.12) were lower than those in the matched eyes of normal people (0.85±0.09) (t=-3.801, P<0.01) . Conclusion: Cortical function impairment was in accordance with visual function impairment in glaucoma. Located and quantified measurement with fMRI retinotopic mapping was a useful method for clinical follow-up and evaluation of functional alteration of glaucomatous visual cortex, and a potentially useful means of studying trans-synaptic degeneration of visual pathways of in vivo glaucoma. (authors)

Functional MRI in human motor control studies and clinical applications

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Toma, Keiichiro

2002-01-01

Functional magnetic resonance imaging (fMRI) has been a useful tool for the noninvasive mapping of brain function associated with various motor and cognitive tasks. Because fMRI is based on the blood oxygenation level dependent (BOLD) effect, it does not directly record neural activity. With the fMRI technique, distinguishing BOLD signals creased by cortical projection neurons from those created by intracortical neurons appears to be difficult. Two major experimental designs are used in fMRI studies: block designs and event-related designs. Block-designed fMRI presupposes the steady state of regional cerebral blood flow and has been applied to examinations of brain activation caused by tasks requiring sustained or repetitive movements. By contrast, the more recently developed event-related fMRI with time resolution of a few seconds allows the mapping of brain activation associated with a single movement according to the transient aspects of the hemodynamic response. Increasing evidence suggests that multiple motor areas are engaged in a networked manner to execute various motor acts. In order to understand functional brain maps, it is important that one understands sequential and parallel organizations of anatomical connections between multiple motor areas. In fMRI studies of complex motor tasks, elementary parameters such as movement length, force, velocity, acceleration and frequency should be controlled, because inconsistency in those parameters may alter the extent and intensity of motor cortical activation, confounding interpretation of the findings obtained. In addition to initiation of movements, termination of movements plays an important role in the successful achievement of complex movements. Brain areas exclusively related to the termination of movements have been, for the first time, uncovered with an event-related fMRI technique. We propose the application of fMRI to the elucidation of the pathophysiology of movement disorders, particularly dystonia

Functional MRI in human motor control studies and clinical applications

Energy Technology Data Exchange (ETDEWEB)

Toma, Keiichiro [Kyoto Univ. (Japan). Graduate School of Medicine; Nakai, Toshiharu [Inst. of Biomedical Research and Innovation, Kobe (Japan)

2002-07-01

Functional magnetic resonance imaging (fMRI) has been a useful tool for the noninvasive mapping of brain function associated with various motor and cognitive tasks. Because fMRI is based on the blood oxygenation level dependent (BOLD) effect, it does not directly record neural activity. With the fMRI technique, distinguishing BOLD signals creased by cortical projection neurons from those created by intracortical neurons appears to be difficult. Two major experimental designs are used in fMRI studies: block designs and event-related designs. Block-designed fMRI presupposes the steady state of regional cerebral blood flow and has been applied to examinations of brain activation caused by tasks requiring sustained or repetitive movements. By contrast, the more recently developed event-related fMRI with time resolution of a few seconds allows the mapping of brain activation associated with a single movement according to the transient aspects of the hemodynamic response. Increasing evidence suggests that multiple motor areas are engaged in a networked manner to execute various motor acts. In order to understand functional brain maps, it is important that one understands sequential and parallel organizations of anatomical connections between multiple motor areas. In fMRI studies of complex motor tasks, elementary parameters such as movement length, force, velocity, acceleration and frequency should be controlled, because inconsistency in those parameters may alter the extent and intensity of motor cortical activation, confounding interpretation of the findings obtained. In addition to initiation of movements, termination of movements plays an important role in the successful achievement of complex movements. Brain areas exclusively related to the termination of movements have been, for the first time, uncovered with an event-related fMRI technique. We propose the application of fMRI to the elucidation of the pathophysiology of movement disorders, particularly dystonia

Lateral Pectoral Nerve Injury Mimicking Cervical Radiculopathy.

Science.gov (United States)

Aktas, Ilknur; Palamar, Deniz; Akgun, Kenan

2015-07-01

The lateral pectoral nerve (LPN) is commonly injured along with the brachial plexus, but its isolated lesions are rare. Here, we present a case of an isolated LPN lesion confused with cervical radiculopathy. A 41-year-old man was admitted to our clinic because of weakness in his right arm. Previous magnetic resonance imaging (MRI) examination revealed right posterolateral protrusion at the C6-7 level. At the initial assessment, atrophy of the right pectoralis major muscle was evident, and mild weakness of the right shoulder adductor, internal rotator, and flexor muscles was observed. Therefore, electrodiagnostic evaluation was performed, and a diagnosis of isolated LPN injury was made. Nerve injury was thought to have been caused by weightlifting exercises and traction injury. Lateral pectoral nerve injury can mimic cervical radiculopathy, and MRI examination alone may lead to misdiagnosis. Repeated physical examinations during the evaluation and treatment phase will identify the muscle atrophy that occurs 1 or more months after the injury.

Cortical language activation in aphasia: a functional MRI study

International Nuclear Information System (INIS)

Xu Xiaojun; Zhang Minming; Shang Desheng; Wang Qidong; Luo Benyan

2004-01-01

Objective: To investigate the differences of the underlying neural basis of language processing between normal subjects and aphasics, and to study the feasibility for functional magnetic resonance imaging (fMRI) in examining the cortical language activation in clinical aphasics. Methods: fMRI was used to map language network in 6 normal subjects and 3 patients with aphasia who were in the stage of recovery from acute stroke. The participants performed word generation task during fMRI scanning, which measured the signal changes associated with regional neural activity induced by the task. These signal changes were processed to statistically generate the activation map that represented the language area. Results: In normal subjects, a distributed language network was activated. Activations were present in the frontal, temporal, parietal and occipital regions in normal group. In the patient group, however, no activation was showed in the left inferior frontal gyrus whether or not the patient had lesion in the left frontal lobe. Two patients showed activations in some right hemisphere regions where no activation appeared in normal subjects. Conclusion: The remote effect of focal lesion and functional redistribution or reorganization was found in aphasic patients. fMRI was useful in evaluating the language function in aphasic patients. (authors)

Magnetic resonance imaging of acute trauma of the cervical spine: spectrum of findings

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Forster, B.B.; Koopmans, R.A. [British Columbia Univ., Vancouver, BC (Canada). Faculty of Medicine

1995-06-01

The magnetic resonance imaging (MRI) spectrum of acute injury to the cervical spine was illustrated in this pictorial essay. The appearance of the traumatized cord was discussed, including intramedullary hemorrhage, and the causes of spinal cord compression, such as disk herniation, epidural hematoma, fracture, dislocation and underlying spinal stenosis. The ability of MRI to directly reveal the severity of cord injury and simultaneously indicate the cause of cord compression proved particularly useful in the management of incomplete injury, for which surgical intervention may prevent further deterioration. The protocol for MRI of cervical spinal trauma included sagittal T1-weighted and T2-weighted conventional spin-echo sequences. In addition, transverse T2-weighted gradient-echo images were obtained. MRI`s ability to directly reveal the extent of cord injury was said to be a powerful tool in the management of incomplete injuries where further deterioration could be prevented by timely surgical intervention. 7 refs., 12 figs.

Measurement and imaging of brain function using MRI, MEG, and TMS

International Nuclear Information System (INIS)

Iramina, Keiji

2008-01-01

This paper reviews functional imaging techniques in neuroscience such as magnetic resonance imaging (MRI) functional MRI (fMRI), magnetoencephalogray (MEG), and transcranial magnetic stimulation (TMS). fMRI and MEG allow the neuronal activity of the brain to be measured non-invasively. MEG detects an electrical activity as neuronal activity, while, fMRI detects a hemodynamic response as neuronal activity. TMS is the application of a brief magnetic pulse or a train of pulses to the skull, which results in the induction of a local electric current in the underlying surface of the brain, thereby producing a localized axonal depolarization. As a non-invasive and effective method to make reversible lesions in the human brain, TMS has a long and successful history. All of these techniques have major potential for applications in the neuroscience and medicine. (author)

Functional MRI: Genesis, State of the art and the Sequel

International Nuclear Information System (INIS)

Bharath, Rose Dawn

2014-01-01

The last 25 years have seen functional magnetic resonance imaging (fMRI) grow from an interesting experimental imaging technique in the hands of some to a primary investigation of choice in the localization and lateralization of brain function prior to surgery. Developments in the field of computational neurosciences have transformed fMRI analysis from classical subtractive type analysis to dynamic casual modeling, and now to graph theory analysis. This has widened the scope of fMRI, and is therefore finding applications in understanding neural correlates of diseases like autism and Alzheimer's disease, prognostication of diseases like traumatic brain injury, and has the potential to direct therapy. It is unfortunately true that this widened ambit has not received the clinical attention it deserves, probably because fMRI is susceptible to artifacts from skull base and blood products and has reduced sensitivity in patients with vascular malformations, or because a change in medical practice usually lags behind the technological and scientific developments that make it possible. This review focuses on the developmental chronology of fMRI image analysis in the last 25 years with highlights on major milestones like developments in the field of paradigms, analysis methods, resting state fMRI, and functional connectivity. To make the statistical images of brain at work more colorful, the article starts with genesis of fMRI and ends with the hope of a promising bright future. Many inputs for this article are obtained from a series of 103 review articles edited by Bandettini et al., compiling personal experiences of pioneers in this field. Interested readers are encouraged to refer to these for a more complete overview.

Hemiparesis Caused by Cervical Spontaneous Spinal Epidural Hematoma: A Report of 3 Cases

Directory of Open Access Journals (Sweden)

Kinya Nakanishi

2011-01-01

Full Text Available We report three cases of spontaneous spinal epidural hematoma (SSEH with hemiparesis. The first patient was a 73-year-old woman who presented with left hemiparesis, neck pain, and left shoulder pain. A cervical MRI scan revealed a left posterolateral epidural hematoma at the C3–C6 level. The condition of the patient improved after laminectomy and evacuation of the epidural hematoma. The second patient was a 62-year-old man who presented with right hemiparesis and neck pain. A cervical MRI scan revealed a right posterolateral dominant epidural hematoma at the C6-T1 level. The condition of the patient improved after laminectomy and evacuation of the epidural hematoma. The third patient was a 60-year-old woman who presented with left hemiparesis and neck pain. A cervical MRI scan revealed a left posterolateral epidural hematoma at the C2–C4 level. The condition of the patient improved with conservative treatment. The classical clinical presentation of SSEH is acute onset of severe irradiating back pain followed by progression to paralysis, whereas SSEH with hemiparesis is less common. Our cases suggest that acute cervical spinal epidural hematoma should be considered as a differential diagnosis in patients presenting with clinical symptoms of sudden neck pain and radicular pain with progression to hemiparesis.

Evaluation of magnetic resonance imaging in the diagnosis of extension in uterine cervical cancer cases

International Nuclear Information System (INIS)

Goto, Masaki; Okamura, Shinsuke; Ueki, Minoru; Sugimoto, Osamu

1990-01-01

To prove the usefulness of magnetic resonance imaging (MRI) in determining the invasion of uterine cervical cancer with imaging planes, we evaluated 44 patients with histologically proved cervical cancer. MRI was performed with a Signa 1.5 T (General Electric), and a T 2 -weighted image was used. In coronal planes, the accuracy was 75.0% for parametrial invasion. It was impossible to diagnose in 77.8%, 92.1% and 63.2% the invasion of the uterine body, bladder, and rectum, respectively. In axial planes, the accuracy was 76.3%, 92.1% and 78.9% for the invasion of parametrium, bladder and rectum, respectively. It was impossible to diagnose in 72.2% the invasion of the uterine body. In sagittal planes, the accuracy was 80.6%, 97.4% and 89.7% for invasion of the uterine body, bladder and rectum, respectively. In all 39 cases it was impossible to diagnose parametrial invasion. In five cases, MRI failed to detect the tumor in any of the three planes, but in three cases it was able to detect the tumor in at least one of the three. We conclude as follows: MRI is a useful method in determining the invasion of cervical cancer. Coronal planes are recommended for the determination of parametrial invasion, axial planes for the parametrium, bladder and rectum, and sagittal planes for the uterine body, bladder and rectum. All three planes are needed to determine cervical cancer. (author)

Comparison of left ventricular function assessment between echocardiography and MRI in Duchenne muscular dystrophy

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Buddhe, Sujatha; Lewin, Mark; Olson, Aaron; Soriano, Brian D. [University of Washington School of Medicine and Seattle Children' s Hospital, Division of Cardiology, Department of Pediatrics, Seattle, WA (United States); Ferguson, Mark [University of Washington School of Medicine and Seattle Children' s Hospital, Department of Radiology, Seattle, WA (United States)

2016-09-15

Cardiomyopathy in Duchenne muscular dystrophy (DMD) is associated with death in approximately 40% of patients. Echocardiography is routinely used to assess left ventricular (LV) function; however, it has limitations in these patients. We compared echocardiographic measures of cardiac function assessment to cardiac MRI. We included children and young adults with DMD who had MRI performed between January 2010 and July 2015. We measured echocardiographic and MRI parameters of function assessment, including strain. Presence of late gadolinium enhancement (LGE) was assessed by MRI. Subjects were divided into two groups based on MRI left ventricular ejection fraction (LVEF): group I, LVEF ≥55% and group II, LVEF <55%. We included 41 studies in 33 subjects, with 25 in group I and 16 in group II. Mean age of subjects was 13.6 ± 2.8 years and mean duration between echocardiogram and MRI was 7.6 ± 4.1 months. Only 8 of 16 (50%) patients in group II had diminished function on echocardiogram. Echocardiographic images were suboptimal in 16 subjects (39%). Overall, echocardiographic parameters had weak correlation with MRI-derived ejection fraction percentage. MRI-derived myocardial strain assessment has better correlation with MRI ejection fraction as compared to echocardiography-derived strain parameters. Echocardiography-based ventricular functional assessment has weak correlation with MRI parameters in children and young adults with Duchenne muscular dystrophy. While this correlation improves in the subset of subjects with adequate echocardiographic image quality, it remains modest and potentially suboptimal for clinical management. Accordingly, we conclude that MRI should be performed routinely and early in children with DMD, not only for LGE imaging but also for functional assessment. (orig.)

Comparison of left ventricular function assessment between echocardiography and MRI in Duchenne muscular dystrophy

International Nuclear Information System (INIS)

Buddhe, Sujatha; Lewin, Mark; Olson, Aaron; Soriano, Brian D.; Ferguson, Mark

2016-01-01

Cardiomyopathy in Duchenne muscular dystrophy (DMD) is associated with death in approximately 40% of patients. Echocardiography is routinely used to assess left ventricular (LV) function; however, it has limitations in these patients. We compared echocardiographic measures of cardiac function assessment to cardiac MRI. We included children and young adults with DMD who had MRI performed between January 2010 and July 2015. We measured echocardiographic and MRI parameters of function assessment, including strain. Presence of late gadolinium enhancement (LGE) was assessed by MRI. Subjects were divided into two groups based on MRI left ventricular ejection fraction (LVEF): group I, LVEF ≥55% and group II, LVEF <55%. We included 41 studies in 33 subjects, with 25 in group I and 16 in group II. Mean age of subjects was 13.6 ± 2.8 years and mean duration between echocardiogram and MRI was 7.6 ± 4.1 months. Only 8 of 16 (50%) patients in group II had diminished function on echocardiogram. Echocardiographic images were suboptimal in 16 subjects (39%). Overall, echocardiographic parameters had weak correlation with MRI-derived ejection fraction percentage. MRI-derived myocardial strain assessment has better correlation with MRI ejection fraction as compared to echocardiography-derived strain parameters. Echocardiography-based ventricular functional assessment has weak correlation with MRI parameters in children and young adults with Duchenne muscular dystrophy. While this correlation improves in the subset of subjects with adequate echocardiographic image quality, it remains modest and potentially suboptimal for clinical management. Accordingly, we conclude that MRI should be performed routinely and early in children with DMD, not only for LGE imaging but also for functional assessment. (orig.)

Mechanism and patterns of cervical spine fractures-dislocations in vertebral artery injury

Directory of Open Access Journals (Sweden)

Pankaj Gupta

2012-01-01

Full Text Available Purpose: To identify the fracture patterns and mechanism of injury, based on subaxial cervical spine injury classification system (SLIC, on non-contrast computed tomography (NCCT of cervical spine predictive of vertebral artery injury (VAI. Patients and Methods: We retrospectively analyzed cervical spine magnetic resonance imaging (MRI of 320 patients who were admitted with cervical spine injury in our level I regional trauma center over a period of two years (April 2010 to April 2012. Diagnosis of VAI was based on hyperintensity replacing the flow void on a T2-weighted axial image. NCCT images of the selected 43 patients with MRI diagnosis of VAI were then assessed for the pattern of injury. The cervical spinal injuries were classified into those involving the C1 and C2 and subaxial spine. For the latter, SLIC was used. Results: A total of 47 VAI were analyzed in 43 patients. Only one patient with VAI on MRI had no detectable abnormality on NCCT. C1 and C2 injuries were found in one and six patients respectively. In subaxial injuries, the most common mechanism of injury was distraction (37.5% with facet dislocation with or without fracture representing the most common pattern of injury (55%. C5 was the single most common affected vertebral level. Extension to foramen transversarium was present in 20 (42.5% cases. Conclusion: CT represents a robust screening tool for patients with VAI. VAI should be suspected in patients with facet dislocation with or without fractures, foramina transversarium fractures and C1-C3 fractures, especially type III odontoid fractures and distraction mechanism of injury.

Functional MRI in the Investigation of Blast-Related Traumatic Brain Injury

Science.gov (United States)

Graner, John; Oakes, Terrence R.; French, Louis M.; Riedy, Gerard

2012-01-01

This review focuses on the application of functional magnetic resonance imaging (fMRI) to the investigation of blast-related traumatic brain injury (bTBI). Relatively little is known about the exact mechanisms of neurophysiological injury and pathological and functional sequelae of bTBI. Furthermore, in mild bTBI, standard anatomical imaging techniques (MRI and computed tomography) generally fail to show focal lesions and most of the symptoms present as subjective clinical functional deficits. Therefore, an objective test of brain functionality has great potential to aid in patient diagnosis and provide a sensitive measurement to monitor disease progression and treatment. The goal of this review is to highlight the relevant body of blast-related TBI literature and present suggestions and considerations in the development of fMRI studies for the investigation of bTBI. The review begins with a summary of recent bTBI publications followed by discussions of various elements of blast-related injury. Brief reviews of some fMRI techniques that focus on mental processes commonly disrupted by bTBI, including working memory, selective attention, and emotional processing, are presented in addition to a short review of resting state fMRI. Potential strengths and weaknesses of these approaches as regards bTBI are discussed. Finally, this review presents considerations that must be made when designing fMRI studies for bTBI populations, given the heterogeneous nature of bTBI and its high rate of comorbidity with other physical and psychological injuries. PMID:23460082

Boosting the SNR by adding a receive-only endorectal monopole to an external antenna array for high-resolution, T2 -weighted imaging of early-stage cervical cancer with 7-T MRI

NARCIS (Netherlands)

van Kalleveen, I.M.L.; Hoogendam, J.P.; Raaijmakers, A.J.E.; Visser, F.; Arteaga de Castro, C.S.; Verheijen, R.H.M.; Luijten, P.R.; Zweemer, R.P.; Veldhuis, W.B.; Klomp, D.W.J.

The aim of this study was to investigate the signal-to-noise ratio (SNR) gain in early-stage cervical cancer at ultrahigh-field MRI (e.g. 7 T) using a combination of multiple external antennas and a single endorectal antenna. In particular, we used an endorectal monopole antenna to increase the SNR

Diffusion tensor imaging of the cervical spinal cord in healthy adult population: normative values and measurement reproducibility at 3T MRI.

Science.gov (United States)

Brander, Antti; Koskinen, Eerika; Luoto, Teemu M; Hakulinen, Ullamari; Helminen, Mika; Savilahti, Sirpa; Ryymin, Pertti; Dastidar, Prasun; Ohman, Juha

2014-05-01

Compared to diffusion tensor imaging (DTI) of the brain, there is a paucity of reports addressing the applicability of DTI in the evaluation of the spinal cord. Most normative data of cervical spinal cord DTI consist of relatively small and arbitrarily collected populations. Comprehensive normative data are necessary for clinical decision-making. To establish normal values for cervical spinal cord DTI metrics with region of interest (ROI)- and fiber tractography (FT)-based measurements and to assess the reproducibility of both measurement methods. Forty healthy adults underwent cervical spinal cord 3T MRI. Sagittal and axial conventional T2 sequences and DTI in the axial plane were performed. Whole cord fractional anisotropy (FA) and apparent diffusion coefficient (ADC) values were determined at different cervical levels from C2 to C7 using the ROI method. DTI metrics (FA, axial, and radial diffusivities based on eigenvalues λ1, λ2, and λ3, and ADC) of the lateral and posterior funicles were measured at C3 level. FA and ADC of the whole cord and the lateral and posterior funicles were also measured using quantitative tractography. Intra- and inter-observer variation of the measurement methods were assessed. Whole cord FA values decreased and ADC values increased in the rostral to caudal direction from C2 to C7. Between the individual white matter funicles no statistically significant difference for FA or ADC values was found. Both axial diffusivity and radial diffusivity of both lateral funicles differed significantly from those of the posterior funicle. Neither gender nor age correlated with any of the DTI metrics. Intra-observer variation of the measurements for whole cord FA and ADC showed almost perfect agreement with both ROI and tractography-based measurements. There was more variation in measurements of individual columns. Inter-observer agreement varied from moderate to strong for whole cord FA and ADC. Both ROI- and FT-based measurements are applicable

[Cervical myelopathy from an aspect of a neurological surgeon].

Science.gov (United States)

Koyama, T

1994-12-01

More than 65 per cent of intramedurally tumors and intradural extramedurally tumors were located in cervical region. They enact a cause of cervical myelopathy. A special attention should be paid to solitaly intramedurally vascular malformations, when the patients show an acute progressive myelopathy. In very rare cases of syringomyelia, intramedurally tumors such as hemangioblastoma or ependymoma could be found, so that enhanced MRI or angiography should be done if necessary. In cases of a herniated disc, cervical spondylosis and OPLL, the distance between articulo-pillar line and spinolaminal line must be measured. If the distance of both lines is near or the same, that means narrow cervical canal. In rare cases the form of the vertebral body is round. This is a rare cause of a type of narrow canal.

PROMIS Physical Function Correlation With NDI and mJOA in the Surgical Cervical Myelopathy Patient Population.

Science.gov (United States)

Owen, Robert J; Zebala, Lukas P; Peters, Colleen; McAnany, Steven

2018-04-15

Retrospective review. To determine the correlation of Patient-Reported Outcomes Measurement Information System (PROMIS) physical function with Neck Disability Index (NDI) and Modified Japanese Orthopedic Association (mJOA) scores in the surgical cervical myelopathy patient population. Outcome measures such as NDI and mJOA are essential for analyzing treatments for cervical myelopathy. Administrative burdens impose limits on completion of these measures. The PROMIS group developed an outcome measure to improve reporting of patient symptoms and function and to reduce administrative burden. Despite early success, NDI and mJOA have not been compared with PROMIS in patients with cervical myelopathy. This study determines the correlation of NDI and mJOA with PROMIS in surgical patients with cervical myelopathy. A total of 60 patients with cervical myelopathy undergoing surgery were included. PROMIS, NDI, and mJOA were collected preoperatively, and in the first 6 months postoperatively. Correlations between NDI, mJOA, and PROMIS were quantified using Pearson correlation coefficients. Students t tests were used to test significance. All 60 (100%) of patients completed preoperative questionnaires. Fifty-five (92%) of patients completed initial follow-up questionnaires within the first 6 months. PROMIS physical function and NDI demonstrated a strong negative correlation at baseline and in initial follow-up (R = -0.69, -0.76). PROMIS and mJOA demonstrated a strong positive correlation at baseline and in initial follow-up (R = 0.61, 0.72). PROMIS physical function has a strong negative correlation with NDI and a strong positive correlation with mJOA at baseline and in the early postoperative course in patients undergoing surgery for cervical myelopathy. Surgeons may factor these outcomes into the delivery and interpretation of patient-reported outcome measures in this population. Use of PROMIS may improve completion of outcome measures in the office and reduce

The power of using functional fMRI on small rodents to study brain pharmacology and disease

OpenAIRE

Jonckers, Elisabeth; Shah, Disha; Hamaide, Julie; Verhoye, Marleen; Van der Linden, Annemie

2015-01-01

Abstract: Functional magnetic resonance imaging (fMRI) is an excellent tool to study the effect of pharmacological modulations on brain function in a non-invasive and longitudinal manner. We introduce several blood oxygenation level dependent (BOLD) fMRI techniques, including resting state (rsfMRI), stimulus-evoked (st-fMRI), and pharmacological MRI (phMRI). Respectively, these techniques permit the assessment of functional connectivity during rest as well as brain activation triggered by sen...

Parameterized hemodynamic response function data of healthy individuals obtained from resting-state functional MRI in a 7T MRI scanner

Directory of Open Access Journals (Sweden)

D. Rangaprakash

2018-04-01

Full Text Available Functional magnetic resonance imaging (fMRI, being an indirect measure of brain activity, is mathematically defined as a convolution of the unmeasured latent neural signal and the hemodynamic response function (HRF. The HRF is known to vary across the brain and across individuals, and it is modulated by neural as well as non-neural factors. Three parameters characterize the shape of the HRF, which is obtained by performing deconvolution on resting-state fMRI data: response height, time-to-peak and full-width at half-max. The data provided here, obtained from 47 healthy adults, contains these three HRF parameters at every voxel in the brain, as well as HRF parameters from the default-mode network (DMN. In addition, we have provided functional connectivity (FC data from the same DMN regions, obtained for two cases: data with deconvolution (HRF variability minimized and data with no deconvolution (HRF variability corrupted. This would enable researchers to compare regional changes in HRF with corresponding FC differences, to assess the impact of HRF variability on FC. Importantly, the data was obtained in a 7T MRI scanner. While most fMRI studies are conducted at lower field strengths, like 3T, ours is the first study to report HRF data obtained at 7T. FMRI data at ultra-high fields contains larger contributions from small vessels, consequently HRF variability is lower for small vessels at higher field strengths. This implies that findings made from this data would be more conservative than from data acquired at lower fields, such as 3T. Results obtained with this data and further interpretations are available in our recent research study (Rangaprakash et al., in press [1]. This is a valuable dataset for studying HRF variability in conjunction with FC, and for developing the HRF profile in healthy individuals, which would have direct implications for fMRI data analysis, especially resting-state connectivity modeling. This is the first public HRF

Motor function deficits in schizophrenia: an fMRI and VBM study

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Singh, Sadhana; Modi, Shilpi; Kumar, Pawan; Singh, Namita; Khushu, Subash [Institute of Nuclear Medicine and Allied Sciences (INMAS), NMR Research Center, Delhi (India); Goyal, Satnam; Bhatia, Triptish; Deshpande, Smita N. [RML Hospital, PGIMER, New Delhi (India)

2014-05-15

To investigate whether the motor functional alterations in schizophrenia (SZ) are also associated with structural changes in the related brain areas using functional magnetic resonance imaging (fMRI) and voxel-based morphometry (VBM). A sample of 14 right-handed SZ patients and 14 right-handed healthy control subjects matched for age, sex, and education were examined with structural high-resolution T1-weighted MRI; fMRI images were obtained during right index finger-tapping task in the same session. fMRI results showed reduced functional activation in the motor areas (contralateral precentral and postcentral gyrus) and ipsilateral cerebellum in SZ subjects as compared to healthy controls (n = 14). VBM analysis also revealed reduced grey matter in motor areas and white matter reduction in cerebellum of SZ subjects as compared to controls. The present study provides an evidence for a possible association between structural alterations in the motor cortex and disturbed functional activation in the motor areas in persons affected with SZ during a simple finger-tapping task. (orig.)

Motor function deficits in schizophrenia: an fMRI and VBM study

International Nuclear Information System (INIS)

Singh, Sadhana; Modi, Shilpi; Kumar, Pawan; Singh, Namita; Khushu, Subash; Goyal, Satnam; Bhatia, Triptish; Deshpande, Smita N.

2014-01-01

To investigate whether the motor functional alterations in schizophrenia (SZ) are also associated with structural changes in the related brain areas using functional magnetic resonance imaging (fMRI) and voxel-based morphometry (VBM). A sample of 14 right-handed SZ patients and 14 right-handed healthy control subjects matched for age, sex, and education were examined with structural high-resolution T1-weighted MRI; fMRI images were obtained during right index finger-tapping task in the same session. fMRI results showed reduced functional activation in the motor areas (contralateral precentral and postcentral gyrus) and ipsilateral cerebellum in SZ subjects as compared to healthy controls (n = 14). VBM analysis also revealed reduced grey matter in motor areas and white matter reduction in cerebellum of SZ subjects as compared to controls. The present study provides an evidence for a possible association between structural alterations in the motor cortex and disturbed functional activation in the motor areas in persons affected with SZ during a simple finger-tapping task. (orig.)

Muscle MRI and functional outcome measures in Becker muscular dystrophy.

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Barp, Andrea; Bello, Luca; Caumo, Luca; Campadello, Paola; Semplicini, Claudio; Lazzarotto, Annalisa; Sorarù, Gianni; Calore, Chiara; Rampado, Alessandro; Motta, Raffaella; Stramare, Roberto; Pegoraro, Elena

2017-11-22

Becker muscular dystrophy (BMD) is a neuromuscular disorder allelic to Duchenne muscular dystrophy (DMD), caused by in-frame mutations in the dystrophin gene, and characterized by a clinical progression that is both milder and more heterogeneous than DMD. Muscle magnetic resonance imaging (MRI) has been proposed as biomarker of disease progression in dystrophinopathies. Correlation with clinically meaningful outcome measures such as North Star Ambulatory Assessment (NSAA) and 6 minute walk test (6MWT) is paramount for biomarker qualification. In this study, 51 molecularly confirmed BMD patients (aged 7-69 years) underwent muscle MRI and were evaluated with functional measures (NSAA and 6MWT) at the time of the MRI, and subsequently after one year. We confirmed a pattern of fatty substitution involving mainly the hip extensors and most thigh muscles. Severity of muscle fatty substitution was significantly correlated with specific DMD mutations: in particular, patients with an isolated deletion of exon 48, or deletions bordering exon 51, showed milder involvement. Fat infiltration scores correlated with baseline functional measures, and predicted changes after 1 year. We conclude that in BMD, skeletal muscle MRI not only strongly correlates with motor function, but also helps in predicting functional deterioration within a 12-month time frame.

Evaluation of pulmonary arterial morphology and function in cyanotic congenital heart disease by MRI and cine MRI

International Nuclear Information System (INIS)

Hashimoto, Ikuo; Tsubata, Shinichi; Miyazaki, Ayumi; Ichida, Fukiko; Okada, Toshio; Murakami, Arata; Futatsuya, Ryuusuke; Nakajima, Kenshuu; Nakajima, Akio

1993-01-01

Pulmonary arterial anatomy was evaluated by magnetic resonance imaging (MRI), angiography and two-dimensional echocardiography in 20 patients with cyanotic heart disease associated with decreased pulmonary blood flow. Excellent correlation between MRI and angiographic estimates of pulmonary artery diameter was obtained (main pulmonary artery, r=0.87; right pulmonary artery, r=0.96; left pulmonary artery, r=0.95). However, echocardiography could not describe peripheral pulmonary arteries obviously, especially left pulmonary artery. In the assessment of peripheral pulmonary stenosis or obstruction, cine MRI was superior to echocardiography. We conclude that MRI and cine MRI will play an important role in the serial evaluation of pulmonary arterial morphology and function in patients with cyanotic congenital heart disease before and after surgical repair. (author)

Evaluation of pulmonary arterial morphology and function in cyanotic congenital heart disease by MRI and cine MRI

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Hashimoto, Ikuo; Tsubata, Shinichi; Miyazaki, Ayumi; Ichida, Fukiko; Okada, Toshio; Murakami, Arata; Futatsuya, Ryuusuke; Nakajima, Kenshuu; Nakajima, Akio [Toyama Medical and Pharmaceutical Univ. (Japan)

1993-01-01

Pulmonary arterial anatomy was evaluated by magnetic resonance imaging (MRI), angiography and two-dimensional echocardiography in 20 patients with cyanotic heart disease associated with decreased pulmonary blood flow. Excellent correlation between MRI and angiographic estimates of pulmonary artery diameter was obtained (main pulmonary artery, r=0.87; right pulmonary artery, r=0.96; left pulmonary artery, r=0.95). However, echocardiography could not describe peripheral pulmonary arteries obviously, especially left pulmonary artery. In the assessment of peripheral pulmonary stenosis or obstruction, cine MRI was superior to echocardiography. We conclude that MRI and cine MRI will play an important role in the serial evaluation of pulmonary arterial morphology and function in patients with cyanotic congenital heart disease before and after surgical repair. (author).

Myelopathy hand in cervical radiculopathy

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Hosono, Noboru; Mukai, Yoshihiro; Takenaka, Shota; Fuji, Takeshi; Sakaura, Hironobu; Miwa, Toshitada; Makino, Takahiro

2010-01-01

The so-called 'myelopathy hand', or characteristic finger paralysis, often recognized in cervical compression myelopathy, has been considered a unique manifestation of cervical myelopathy. We used our original grip and release test, a 15-second test in which finger motion is captured with a digital camera, to investigate whether cervical radiculopathy has the same characteristics as myelopathy hand. Thirty patients with pure radiculopathy, id est (i.e.), who had radiating arm pain and evidence of corresponding nerve root impingement on X-ray images or MRI scans, but did not have spinal cord compression, served as the subjects. In contrast to other radiculopathies, C7 radiculopathy was manifested by a significant reduction in the number of finger motion cycles on the affected side in comparison with the unaffected side, the same as in myelopathy hand. Uncoordinated finger motion was significantly more frequent on the affected side in C6 radiculopathy than on the unaffected side. These findings contradict the conventional notion that myelopathy hand is a unique manifestation of cervical myelopathy, but some radiculopathies manifested the same kinds of finger paralysis observed in myelopathy hand. (author)

Significance of T2 Hyperintensity on Magnetic Resonance Imaging After Cervical Cord Injury and Return to Play in Professional Athletes.

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Tempel, Zachary J; Bost, Jeffrey W; Norwig, John A; Maroon, Joseph C

2015-07-01

Cervical cord magnetic resonance imaging (MRI) T2 hyperintensity is used as evidence of cord trauma in the evaluation and management of athletes in contact sports. The long-term pathophysiologic and prognostic value of this finding is poorly understood, especially in return to play (RTP). To examine the significance of T2 hyperintensity in the cervical spinal cord of professional athletes. Retrospective review of MRI T2 hyperintensity findings between 2007 and 2014 in 5 professional athletes. Pertinent examination and demographics, including mechanism of injury, surgical intervention, radiographs, MRI studies, long-term outcomes, and RTP recommendations were collected. Four National Football League players and 1 professional wrestler had prior traumatic neurapraxia that at the time of initial consultation had resolved. MRIs showed congenitally small cervical canal (1) and multilevel spondylosis/stenosis/disc herniation (4) along with focal cord T2 hyperintensity (5). The signal abnormalities were at C3/C4 (3), C4 mid-vertebral body (1), and C5/C6 (1). Four athletes had single-level anterior cervical discectomy and fusion, and 1 was nonoperative. Serial MRI imaging at 3 months after surgery showed hyperintensity partially resolved (4) and unchanged (1), and at 9-months 3 of the 5 completely resolved. Based on the author's RTP criteria, 4 of 5 were released to return to their sport. Clearance for RTP preceded complete resolution of MRI T2 hyperintensity in 3 of 4 athletes. The 2 athletes that have returned to profession sport have not had any additional episodes of neurapraxia or any cervical spine-related complications. MRI T2 hyperintensity in contact sport athletes who are symptom-free with normal examination and no evidence of spinal instability may not be a contraindication to RTP. Additional observations are needed to confirm this observation.

Morphological changes in the cervical muscles of women with chronic whiplash can be modified with exercise-A pilot study.

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O'leary, Shaun; Jull, Gwendolen; Van Wyk, Luke; Pedler, Ashley; Elliott, James

2015-11-01

In this preliminary study we determined whether MRI markers of cervical muscle degeneration [elevated muscle fatty infiltration (MFI), cross-sectional area (CSA), and reduced relative muscle CSA (rmCSA)] could be modified with exercise in patients with chronic whiplash. Five women with chronic whiplash undertook 10 weeks of neck exercise. MRI measures of the cervical multifidus (posterior) and longus capitus/colli (anterior) muscles, neck muscle strength, and self-reported neck disability were recorded at baseline and at completion of the exercise program. Overall significant increases in CSA and rmCSA were observed for both muscles, but significant reductions in MFI were only evident in the cervical multifidus muscle. These changes coincided with increased muscle strength and reduced neck disability. MRI markers of muscle morphology in individuals with chronic whiplash appear to be modifiable with exercise. © 2015 Wiley Periodicals, Inc.

Diagnostic radiology for functional analysis of the cervical vertebral column. Roentgenfunktionsdiagnostik der Halswirbelsaeule

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Kamieth, H

1986-01-01

The book is averaged in 17 chapters. The first three, introductory chapters dealing with the significance of radiology for the functional diagnosis of the cervical spine are followed by three chapters discussing the movements of the atlantoaxial joints, the statics of the cervical spine, and the sagittal flexural movements in the C2-C7 segments. Subsequent chapters discuss the radiodiagnostical method according to Arlen, the innervation of the cervical spine segments of movement, disturbances of movement including restriction of movement, degenerative processes of the invertebral disks, and hypermobile disturbance of movement. The final chapters deal with compensational and dissociation phenomena, subluxations, defective or compulsive positions, etc., the causes of each, and with the clinical relevance of spondylochondrosis and arthrosis, and with the pain. With 171 figs..

Methodology for functional MRI of simulated driving.

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Kan, Karen; Schweizer, Tom A; Tam, Fred; Graham, Simon J

2013-01-01

The developed world faces major socioeconomic and medical challenges associated with motor vehicle accidents caused by risky driving. Functional magnetic resonance imaging (fMRI) of individuals using virtual reality driving simulators may provide an important research tool to assess driving safety, based on brain activity and behavior. A fMRI-compatible driving simulator was developed and evaluated in the context of straight driving, turning, and stopping in 16 young healthy adults. Robust maps of brain activity were obtained, including activation of the primary motor cortex, cerebellum, visual cortex, and parietal lobe, with limited head motion (driving is a feasible undertaking.

Spondilitis Tuberkulosa Cervical

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Roni Eka Saputra

2015-05-01

Full Text Available Abstrak Spondilitis tuberkulosa servikalis adalah penyakit yang cukup jarang dijumpai, hanya berkisar 2-3% dariseluruh kasus spondilitis tuberkulosa. Gambaran klinis sangat bervariasi, mulai dari gejala ringan dan tidak spesifikhingga komplikasi neurologis yang berat. Seorang wanita berusia 29 tahun datang dengan keluhan lemah keempatanggota gerak yang semakin memberat dalam 10 hari terakhir yang didahului oleh nyeri leher yang menjalar ke bahudan lengan sejak 6 bulan sebelumnya. Nyeri awalnya dirasakan sebagai keterbatasan gerakan leher saat menolehkesamping kiri dan kanan serta menundukkan kepala. Nyeri dirasakan semakin berat dengan pergerakan danberkurang jika istirahat. Pasien mengalami penurunan berat badan sejak 2 bulan terakhir. Tidak dijumpai riwayat batukatau nyeri dada. Pemeriksaan neurologis menunjukkan kelemahan  pada keempat ekstremitas. Hasil laboratoriumditemukan peningkatan Laju Endap Darah (LED. Rontgen foto toraks dalam batas normal. Roentgen foto cervicalmenunjukkan destruksi setinggi C5. MRI cervical menunjukkan destruksi pada korpus C5-6 dengan penyempitan padadiscus intervertebrae C5-6 disertai dengan  massa/abses paravertebral dengan penekanan ke posterior. MRI Thorakaltampak destruksi corpus verebre T4,5 dengan diskus intervertebralis yang menyempit. Sugestif suatu spondilitistuberkulosa. Pasien dilakukan tindakan pembedahan anterior corpectomi melalui microscopic surgery dengan graftdari iliac sinistra, serta insersi anterior plate 1 level. Hasil pemeriksaan patologi anatomi menunjukkan spodilitis TBCkaseosa. Pada spondilitis vertebre T4,5 dilakukan laminectomi, debridement costotrasversektomi, dan stabilisasidengan pedicle screw T2, T3, dan T5. Pasien diterapi dengan obat antituberkulosis. Keadaan pasien saat ini, pasiensudah bisa beraktifitas normal dengan motorik dan sensorik baik. Spondilitis tuberkulosa merupakan bentuktuberkulosa tulang yang paling sering dijumpai. Spondilitis tuberkulosa cervical berkisar 2

Posterior longitudinal ligament status in cervical spine bilateral facet dislocations

International Nuclear Information System (INIS)

Carrino, John A.; Manton, Geoffrey L.; Morrison, William B.; Flanders, Adam E.; Vaccaro, Alex R.; Schweitzer, Mark E.

2006-01-01

It is generally accepted that cervical spine bilateral facet dislocation results in complete disruption of the posterior longitudinal ligament. The goal of this study was to evaluate the integrity of numerous spine-stabilizing structures by MRI, and to determine if any associations between injury patterns exist with respect to the posterior longitudinal ligament status. Retrospective case series. A retrospective review was performed of 30 cervical spine injury subjects with bilateral facet dislocation. Assessment of 1.5T MRI images was carried out for: intervertebral disc disruption, facet fracture, and ligamentous disruption. Statistical analyses were performed to evaluate for associations between various injury patterns and posterior longitudinal ligament status. The frequency of MRI abnormalities was: anterior longitudinal ligament disruption (26.7%), disc herniation or disruption (90%), posterior longitudinal ligament disruption (40%), facet fracture (63.3%) and disruption of the posterior column ligament complex (97%). There were no significant associations between injury to the posterior longitudinal ligament and other structures. Compared to surgical reports, MRI was accurate for determining the status for 24 of 26 ligaments (three of three anterior longitudinal ligament, seven of nine posterior longitudinal ligament, and 14 of 14 posterior column ligament complex) but generated false negatives in two instances (in both MRI showed an intact posterior longitudinal ligament that was torn at surgery). (orig.)

[A case of the myelitis due to Toxocara canis infection complicated with cervical spondylosis].

Science.gov (United States)

Mitsuhashi, Yutaka; Naitou, Kentarou; Yamauchi, Shigeru; Naruse, Hirotsune; Matsuoka, Yoshimi; Nakamura-Uchiyama, Fukumi; Hiromatsu, Kenji

2006-11-01

A 59-year-old male had suffered from numbness of the hands for 7 months. With a diagnosis of cervical spondylosis, he had been treated conservatively at a nearby clinic. After he fell off his bicycle, the numbness intensified and limb weakness developed. Cervical MRI revealed spinal cord compression at the C4/5 and C5/6 levels due to cervical spondylosis with prominent edema in the spinal cord spreading from the C4 to C6 level. The edema was very serious. Therefore, we suspected that the traumatic spinal injury underlying the cervical spondylosis was complicated by another disease. Cervical spinal angiography revealed no apparent vascular disorder. Contrast enhanced MRI showed a small enhanced area in the spinal cord at the C5 level. Because of the rapid progression of gait disturbance, expansive laminoplasty was performed without further examination. Although remarkable amelioration of the symptoms was seen just after the surgery, the symptoms worsened again about 1 month later. The patient's clinical history was reconsidered, revealing that he likes raw bovine liver. Serological examination, because of suspicion of parasitic infection showed elevated titers of anti-Toxocara canis antibody in the serum and cerebrospinal fluid. Administration of albendazole improved the clinical symptoms, and normalized the serological and MRI findings. Myelitis due to T canis infection is a rare disease. For an early and accurate diagnosis, it is important to be fully aware of this disease and to include detailed information on food preferences and pet-keeping in the process of compiling a clinical history.

Cognitive function and MRI findings in very low birth weight infants

International Nuclear Information System (INIS)

Imamura, Atsuko; Takagishi, Yuka; Takada, Satoru; Uetani, Yoshiyuki; Nakamura, Toru; Nakamura, Hajime; Inagaki, Yuko.

1996-01-01

Twenty-two very low birth weight infants at preschool ages of 5-6 years were studied to clarify the correlation between cognitive function and MRI findings. Cognitive function was evaluated by the Wechsler Intelligence Scale for Children-Revised (WISC-R) and the Frostig developmental test of visual perception. Ventricular enlargement, assessed by the bioccipital index (B.I.) measured on MRI, was correlated to cognitive disorders. Children with periventricular high intensity areas (T 2 -weighted images) extending from the posterior periventricular region to the parietal lobe tend to highly suffer from cerebral palsy and visuoperceptual impairment. These results indicate that the disorders of cognitive function in very low birth weight infants were caused by a damage of association fibers in periventricular areas which was detectable by MRI. (author)

Loss of cervical lordosis: What is the prognosis?

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Laura Lippa

2017-01-01

Full Text Available Neck pain is a diffuse problem with a high incidence and often leads to the more or less appropriate prescription of imaging studies of the cervical spine. In general, this is represented by a magnetic resonance imaging (MRI scan. Frequently such studies reveal no other significant findings apart from a loss of cervical lordosis either under the form of a simple straightening of the spine or even an inversion of the normal curvature into a kyphosis. Faced with this entity, the clinician is put in front of a series of questions: to which extent such a finding plays a role in the patient's symptoms? If it does what is the role of conservative or even invasive treatment? What are the implications for surgery either for decompressive procedures or corrective procedures? To shed some light on these questions, the authors present a narrative review of the most relevant literature on the topic. Papers examined span from the initial epidemiologic reports out of the pre-MRI and computerized tomography era up to the most recent discussions on cervical sagittal alignment and its implications both for the surgical and nonsurgical patient. In this process, it becomes increasingly clear that we are still far from making any definite statements.

Function and structure of the deep cervical extensor muscles in patients with neck pain.

Science.gov (United States)

Schomacher, Jochen; Falla, Deborah

2013-10-01

The deep cervical extensors are anatomically able to control segmental movements of the cervical spine in concert with the deep cervical flexors. Several investigations have confirmed changes in cervical flexor muscle control in patients with neck pain and as a result, effective evidence-based therapeutic exercises have been developed to address such dysfunctions. However, knowledge on how the deep extensor muscles behave in patients with neck pain disorders is scare. Structural changes such as higher concentration of fat within the muscle, variable cross-sectional area and higher proportions of type II fibres have been observed in the deep cervical extensors of patients with neck pain compared to healthy controls. These findings suggest that the behaviour of the deep extensors may be altered in patients with neck pain. Consistent with this hypothesis, a recent series of studies confirm that patients display reduced activation of the deep cervical extensors as well as less defined activation patterns. This article provides an overview of the various different structural and functional changes in the deep neck extensor muscles documented in patients with neck pain. Relevant recommendations for the management of muscle dysfunction in patients with neck pain are presented. Copyright © 2013 Elsevier Ltd. All rights reserved.

The usefulness of transvaginal ultrasonography and MRI in endometrial carcinoma

International Nuclear Information System (INIS)

Yoshihara, Eisuke

1992-01-01

Between October 1988 and March 1991, 29 patients with endometrial carcinoma had both transvaginal ultrasonography (TVUS) and magnetic resonance imaging (MRI) performed following hysterectomy at the Department of Gynecology and Obstetrics, Okayama University Medical School. The findings were compared with the pathological findings to determine the usefulness of each method. The sensitivity of detecting myometrial invasion was 100% by TVUS and 96% by MRI. The accuracy was 86% by each method. The depth of myometrial invasion was classified into 3 degrees [no myometrial invasion, superficial invasion (≤1/2), deep invasion (>1/2)]. The correct diagnostic rate was 86% by TVUS and MRI. The minimum width and the minimum/maximum width ratio of the intact myometrium obtained by each method in the pathological deep invasion group were significantly lower than those obtained in the other two groups (p<0.01). The sensitivity, the accuracy and the specificity for detecting cervical invasion were 89%, 93% and 95% by both methods. There was no difference between TVUS and MRI for diagnosing myometrial and cervical invasion of endometrial carcinoma. (author)

Cervical cancer. Application of MR imaging in brachytherapy

International Nuclear Information System (INIS)

Ebe, Kazuyu; Matsunaga, Naofumi

1996-01-01

For the purpose of application of MRI in arrangement of brachytherapy of cervical cancer, a method was proposed to see the radiation doses in surrounding tissues by superimposing the dose distribution pattern of the radiation source on the MR image. The applicator for the source was filled with water to get its T2-weighted image and was inserted in the patients. The MRI apparatus was Siemens Magnetom Vision (1.5T) with phased array coil. T2-weighted sagittal and coronary images were taken by turbospin echo and HASTE methods. The section thickness was 5 mm. The dose distribution pattern was superimposed on the frontal and lateral images by Siemens Mevaplan to see the doses in surrounding tissues. In 4 patients, it was possible to estimate the radiation dose in the posterior wall of bladder, anterior wall of rectum and urinary duct. The method is promising for arranging brachytherapy of cervical cancer. (K.H.)

A Simple Bone Cyst in Cervical Vertebrae of an Adolescent Patient

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Adriana Bruges Boude

2017-01-01

Full Text Available Introduction. Spinal simple bone cysts, also known as solitary cysts, are extremely unusual benign primary bone tumors with few cases reported in the literature. Case Presentation. Incidental Magnetic Resonance Imaging (MRI finding of a C2 Simple bone cyst in a 13-year-old female patient is reported. Complementary studies suggested the benign nature of the lesion. Patient underwent cervical curettage followed by tumor excision. A lateral submandibular approach to the upper cervical spine was used and careful bone resection was possible with a radiofrequency assisted burr and no instrumentation or fixation was required. The stability of the defect was ensured by filling it with bone allograft and by prescribing a postsurgical plastic cervical collar to maintain neck immobilization. Histological examination supported the diagnosis of simple bone cyst. At 6–12-month follow-up the patient presented no recurrence or symptomatology. Conclusions. Solitary bone cysts are infrequent entities in the cervical vertebrae and preservation of spine stability without instrumentation to avoid neurological complications is often challenging. In this case, the proximity of the cyst to the right vertebral artery and the risk of injury were high; however the surgical approach used was successful and no recurrence or instability was evidenced on postoperative MRI.

A novel passive paradigm for functional magnetic resonance imaging (fMRI) to localize brain functions

International Nuclear Information System (INIS)

Gasser, T.; Sandalcioglu, I.E.; Skwarek, V.; Gizewski, E.; Stolke, D.; Hans, V.

2003-01-01

The design of a shielded stimulation-device for electrical stimulation of peripheral nerves in the MRI-environment as passive fMRI-paradigm is content of this study. Especially the technical aspects and selection criteria of the stimulation-parameters are discussed. The clinical value for neurosurgical patients is outlined by supplying data from clinical studies, evaluating this novel paradigm. Thus neurosurgeons are supplied with superior information about functional anatomy, therefore being able to preserve functionally relevant brain-structures. (orig.) [de

Biochemical imaging of cervical intervertebral discs with glycosaminoglycan chemical exchange saturation transfer magnetic resonance imaging: feasibility and initial results

International Nuclear Information System (INIS)

Schleich, Christoph; Mueller-Lutz, Anja; Zimmermann, Lisa; Boos, Johannes; Wittsack, Hans-Joerg; Antoch, Gerald; Miese, Falk; Schmitt, Benjamin

2016-01-01

To evaluate glycosaminoglycan chemical exchange saturation transfer (gagCEST) imaging at 3T in the assessment of the GAG content of cervical IVDs in healthy volunteers. Forty-two cervical intervertebral discs of seven healthy volunteers (four females, three males; mean age: 21.4 ± 1.4 years; range: 19-24 years) were examined at a 3T MRI scanner in this prospective study. The MRI protocol comprised standard morphological, sagittal T2 weighted (T2w) images to assess the magnetic resonance imaging (MRI) based grading system for cervical intervertebral disc degeneration (IVD) and biochemical imaging with gagCEST to calculate a region-of-interest analysis of nucleus pulposus (NP) and annulus fibrosus (AF). GagCEST of cervical IVDs was technically successful at 3T with significant higher gagCEST values in NP compared to AF (1.17 % ± 1.03 % vs. 0.79 % ± 1.75 %; p = 0.005). We found topological differences of gagCEST values of the cervical spine with significant higher gagCEST effects in lower IVDs (r = 1; p = 0). We could demonstrate a significant, negative correlation between gagCEST values and cervical disc degeneration of NP (r = -0.360; p = 0.019). Non-degenerated IVDs had significantly higher gagCEST effects compared to degenerated IVDs in NP (1.76 % ± 0.92 % vs. 0.52 % ± 1.17 %; p < 0.001). Biochemical imaging of cervical IVDs is feasible at 3T. GagCEST analysis demonstrated a topological GAG distribution of the cervical spine. The depletion of GAG in the NP with increasing level of morphological degeneration can be assessed using gagCEST imaging. (orig.)

Pharmaco fMRI: Determining the functional anatomy of the effects of medication.

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Wandschneider, Britta; Koepp, Matthias J

2016-01-01

Functional MRI studies have helped to elucidate underlying mechanisms in complex neurological and neuropsychiatric disorders. Disease processes often involve complex large-scale network interactions, extending beyond the presumed main disease focus. Given both the complexity of the clinical phenotype and the underlying dysfunctional brain circuits, so called pharmaco-fMRI (ph-MRI) studies probe pharmacological effects on functional neuro-anatomy, and can help to determine early treatment response, mechanisms of drug efficacy and side effects, and potentially advance CNS drug development. In this review, we discuss recent ph-MRI research in three major neuropsychiatric and neurological disorders and associated network alterations, namely selective serotonin and noradrenergic reuptake inhibitors in affective disorders and emotional processing circuits; antiepileptic drugs in epilepsy and cognitive networks; and stimulants in attention-deficit/hyperactivity disorder and networks of attention control. We conclude that ph-MRI studies show consistent and reproducible changes on disease relevant networks, and prove sensitive to early pharmacological effects on functional anatomy associated with disease. Further CNS drug research and development would benefit greatly from improved disease phenotyping, or biomarkers, using advanced imaging techniques.

The Management of Unstable Cervical Spine Injuries

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Venu M. Nemani

2014-01-01

Full Text Available Injuries to the cervical spine can cause potentially devastating morbidity and even mortality. In this review we discuss the anatomy and biomechanics of the cervical spine. The evaluation and treatment of cervical spine injuries begins with the prompt immobilization of suspected injuries in the field. Once an assessment of the patient's neurological status is made, imaging studies are obtained, which can include X-rays, CT, and MRI. Careful scrutiny of the imaging studies for bony and/or ligamentous injury allows the physician to determine the mechanism of injury, which guides treatment. The ultimate treatment plan can consist of non-operative or operative management, and depends on patient specific factors (medical condition and neurological status, the mechanism of injury, and the resultant degree of instability. With prompt diagnosis and appropriate management, the morbidity of these injuries can be minimized.

Detection of focal epileptic activity using combined simultaneous electroencephalogram-functional MRI

International Nuclear Information System (INIS)

Zhang Zhiqiang; Lu Guangming; Tian Lei; Sun Kanjian; Tan Qifu; Zhu Jianguo; Nie Cong; Hao Shaowei; Jiang Li; Liu Yijun

2007-01-01

Objective: To observe the brain activation of interictal epiletiform discharges (IEDs) and to localize the epileptogenic foci of epilepsy. Methods: The electroencephalogram (EEG) and functional MRI data of 12 focal epileptic patients were acquired using a combination of EEG and functional MRI simultaneously. The IEDs onset time detected with EEG were set as the time parameters in an event- related paradigm of functional MRI analysis. The spatial and temporal characters of IEDs activation were analyzed in detail. In order to confirm the consistency of this method, all patients were scanned repeatedly and the results were correlated with clinical evaluation. Results: Of the 12 patients, valid data from EEG- fMRI were obtained from 10 patients in a total of 18 sessions. Compared with the structural foci, the epileptic foci localization results of eleven sessions were good, five sessions were fairly good, and two sessions were poor. The results obtained from six patients in two separate sessions were concordant, respectively. Moreover, thalamic activation was detected in ten sessions, cerebellar activation was detected in all sessions, and the deactivation was found in the default mode loci in nine sessions. Conclusion: The method of performing EEG and fMRI simultaneously can potentially be a useful tool in epilepsy research. (authors)

The stratification of severity of acute radiation proctopathy after radiotherapy for cervical carcinoma using diffusion-weighted MRI

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Li, Xiang Sheng, E-mail: lxsheng500@163.com [Department of Radiology, Air Force General Hospital of People' s Liberation Army, Beijing 100142 (China); Fang, Hong, E-mail: hongfang196808@sina.com [Department of Radiology, Air Force General Hospital of People' s Liberation Army, Beijing 100142 (China); Song, Yunlong, E-mail: yunlongsong010@sina.com [Department of Radiology, Air Force General Hospital of People' s Liberation Army, Beijing 100142 (China); Li, Dechang, E-mail: dechangli1972@sina.com [Department of Pathology, Air Force General Hospital of People' s Liberation Army, Beijing 100142 (China); Wang, Yingjie, E-mail: wangyj19710813@sina.com [Department of Radiotherapy, Air Force General Hospital of People' s Liberation Army, Beijing 100142 (China); Zhu, Hongxian, E-mail: hongxian0102@sina.cn [Department of Radiology, Air Force General Hospital of People' s Liberation Army, Beijing 100142 (China); Meng, Limin, E-mail: liminmeng1977@sina.com [Department of Radiology, Air Force General Hospital of People' s Liberation Army, Beijing 100142 (China); Wang, Ping, E-mail: pingwang1978@sina.com [Department of Radiology, Air Force General Hospital of People' s Liberation Army, Beijing 100142 (China); Wang, Dong, E-mail: dongwang1964@sina.com [Department of Radiology, Air Force General Hospital of People' s Liberation Army, Beijing 100142 (China); Fan, Hongxia, E-mail: fanhongxia1975@sina.com [Department of Radiology, Air Force General Hospital of People' s Liberation Army, Beijing 100142 (China)

2017-02-15

Objective: To determine whether diffusion-weighted imaging (DWI) can be used for quantitatively evaluating severity of acute radiation proctopathy after radiotherapy for cervical carcinoma. Materials and methods: One hundred and twenty-four patients with cervical carcinoma underwent MR examination including DWI before and after radiotherapy. Acute radiation proctopathy was classified into three groups (grade 0, grade I–II and grade III–IV) according to Toxicity Criteria of the Radiation Therapy Oncology Group (RTOG). The pretreatment ADC (ADC{sub pre}), ADC after treatment (ADC{sub post}) and ADC change (ΔADC) were compared among three groups. In addition, acute radiation proctopathy was classified into good-prognosis group and poor-prognosis group. ADC{sub pre}, ADC{sub post} and ΔADC were compared between two groups. For DWI parameter that had significant difference, discriminatory capability of the parameter was determined using receiver operating characteristics (ROC) analysis. Results: ADC{sub post} and ΔADC were higher in grade I–II group than in grade 0 group (p < 0.05), yielding a sensitivity of 79.3% and specificity of 69.4% for ADC{sub post}, and 85.1%, 72.3% for ΔADC for discrimination between two groups. ADC{sub post} and ΔADC were higher in grade III–IV group than in grade I–II group (p < 0.05), yielding a sensitivity of 80.3% and specificity of 72.5% for ADC{sub post}, and 84.1%, 74.5% for ΔADC for discrimination between two groups. ADC{sub post} and ΔADC were higher in poor-prognosis group than in good-prognosis group (p < 0.05), yielding a sensitivity of 79.5% and specificity of 73.4% for ADC{sub post}, and 87.2%, 78.3% for ΔADC for discrimination between two groups. Conclusion: Diffusion-weighted MRI can be used for quantitative stratification of severity of acute radiation proctopathy, which serves as an important basis for appropriate timely adjustment of radiotherapy for cervical carcinoma in order to maximally reduce the

Cognitive function and MRI findings in very low birth weight infants

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Imamura, Atsuko; Takagishi, Yuka; Takada, Satoru; Uetani, Yoshiyuki; Nakamura, Toru; Nakamura, Hajime [Kobe Univ. (Japan). School of Medicine; Inagaki, Yuko

1996-07-01

Twenty-two very low birth weight infants at preschool ages of 5-6 years were studied to clarify the correlation between cognitive function and MRI findings. Cognitive function was evaluated by the Wechsler Intelligence Scale for Children-Revised (WISC-R) and the Frostig developmental test of visual perception. Ventricular enlargement, assessed by the bioccipital index (B.I.) measured on MRI, was correlated to cognitive disorders. Children with periventricular high intensity areas (T{sub 2}-weighted images) extending from the posterior periventricular region to the parietal lobe tend to highly suffer from cerebral palsy and visuoperceptual impairment. These results indicate that the disorders of cognitive function in very low birth weight infants were caused by a damage of association fibers in periventricular areas which was detectable by MRI. (author)

Functional MRI in pre-surgical planning: Case study and cautionary notes

Directory of Open Access Journals (Sweden)

Bruce S Spottiswoode

2012-09-01

Full Text Available Background. Since its inception almost 20 years ago, functional magnetic resonance imaging (fMRI has greatly advanced our knowledge of human brain function. Although the clinical applications of fMRI are still limited, there have recently been encouraging advances for its use in pre-operative functional cortical mapping to identify potentially eloquent areas prior to neurosurgery. Objectives. We explore the potential use of this emerging technique by presenting a neurosurgical case study, as performed at the Cape Universities Brain Imaging Centre (CUBIC, Tygerberg, Cape Town. We conclude with a brief summary of the potential pitfalls of this technique, as well as cautionary guidelines based on our experience. Methods and results. A 22-year-old male patient from Tygerberg Hospital underwent the successful resection of an anaplastic astrocytoma after fMRI presurgical planning at our facility. The subject was able to leave the ward unassisted. Conclusion. If consideration is given to the many limitations of this emerging technique, fMRI can be useful in aiding the neurosurgeon in pre-operative planning of his surgical approach.

Clearance of the cervical spine in clinically unevaluable trauma patients.

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Halpern, Casey H; Milby, Andrew H; Guo, Wensheng; Schuster, James M; Gracias, Vicente H; Stein, Sherman C

2010-08-15

Meta-analytic costeffectiveness analysis. Our goal was to compare the results of different management strategies for trauma patients in whom the cervical spine was not clinically evaluable due to impaired consciousness, endotracheal intubation, or painful distracting injuries. We performed a structured literature review related to cervical spine trauma, radiographic clearance techniques (plain radiography, flexion/extension, CT, and MRI), and complications associated with semirigid collar use. Meta-analytic techniques were used to pool data from multiple sources to calculate pooled mean estimates of sensitivities and specificities of imaging techniques for cervical spinal clearance, rates of complications from various clearance strategies and from empirical use of semirigid collars. A decision analysis model was used to compare outcomes and costs among these strategies. Slightly more than 7.5% of patients who are clinically unevaluable have cervical spine injuries, and 42% of these injuries are associated with spinal instability. Sensitivity of plain radiography or fluoroscopy for spinal clearance was 57% (95% CI: 57%-60%). Sensitivities for CT and MRI alone were 83% (82%-84%) and 87% (84%-89%), respectively. Complications associated with collar use ranged from 1.3% (2 days) to 7.1% (10 days) but were usually minor and short-lived. Quadriplegia resulting from spinal instability missed by a clearance test had enormous impacts on longevity, quality of life, and costs. These impacts overshadowed the effects of prolonged collar application, even when the incidence of quadriplegia was extremely low. As currently used, neuroimaging studies for cervical spinal clearance in clinically unevaluable patients are not cost-effective compared with empirical immobilization in a semirigid collar.

Functional MRI studies of the neural mechanisms of human brain attentional networks

International Nuclear Information System (INIS)

Hao Jing; Li Kuncheng; Chen Qi; Wang Yan; Peng Xiaozhe; Zhou Xiaolin

2005-01-01

Objective: To identify the neural mechanisms of the anterior attention network (AAN) and posterior attention network (PAN) , investigate the possible interaction between them with event-related functional MRI(ER-fMRI). Methods: Eight right-handed healthy volunteers participated in the experiment designed with inhibition of return in visual orienting and Stroop color-word interference effect. The fMRI data were collected on Siemens 1.5 T Sonata MRI systems and analyzed by AFNI to generate the activation map. Results: The data sets from 6 of 8 subjects were used in the study. The functional localizations of the Stroop and IOR, which manifest the function of the AAN and PAN respectively, were consistent with previous imaging researches. On cued locations, left inferior parietal lobule (IPL), area MT/V5, right dorsolateral prefrontal cortex (DLPFC) and left anterior cingulated cortex (ACC) were significantly activated. On uncued locations, right superior parietal lobule (SPL) and bilateral area MT/V5 were significantly activated. Conclusion: The AAN exerts control over the PAN, while its function can be in turn modulated by the PAN. There are interaction between the AAN and PAN. In addition, it is also proved that ER-fMRI is a feasible method to revise preexisting cognitive model and theory. (authors)

Progressive shoulder-neck exercise on cervical muscle functions in middle-aged and senior patients with chronic neck pain.

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Lin, I-Hsien; Chang, Kwang-Hwa; Liou, Tsan-Hon; Tsou, Chih-Min; Huang, Yi-Ching

2018-02-01

Although neck pain is a common musculoskeletal disorder, there is no consensus on suitable exercise methods for middle-aged and senior patients with chronic neck pain. Therefore, this study investigated the effectiveness of a 6-week shoulder-neck exercise intervention program on cervical muscle function improvement in patients aged 45 years or older with chronic neck pain. The aim of the present study was to evaluate the effects of progressive shoulder-neck exercise on cervical muscle functions of middle-aged and senior patients with chronic neck pain. A randomized controlled single-blind trial. Rehabilitation department of a hospital. A total of 72 subjects aged ≥45 years with chronic neck pain were randomly allocated to either an experimental group (N.=36; age 57.3±8.74 years) or a control group (N.=36; age 58.15±8.17 years). The control group received only traditional physiotherapy, whereas the experimental group participated in a 6-week shoulder-neck exercise program consisting of cranio-cervical flexion and progressive resistance exercises in addition to receiving traditional physiotherapy. The muscle functions of subjects in both groups were tested before the experiment and also after the intervention program. The pretest and posttest measured the cranio-cervical flexion test (CCFT) and the superficial cervical muscle strength. After the intervention, the experimental group had a 56.48 point improvement in the performance index of the CCFT (Pcervical muscle functions. This study confirmed that the 6-week progressive shoulder-neck exercise program can effectively improve cervical muscle function in middle-aged and senior patients with chronic neck pain. Progressive shoulder-neck exercise might provide positive effect on deep and superficial neck muscle strength in patients with chronic neck pain. Therefore, this study may serve as a reference for the clinical rehabilitation of patients with chronic neck pain.

Pathogenesis of spinal cord involvement induced by lower cervical instability in rheumatoid spondylitis

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Taniguchi, Hironobu; Kuwabara, Shigeru; Fukuda, Kenji; Kuroki, Tatsuji; Tajima, Naoya (Miyazaki Medical Coll., Kiyotake (Japan))

1994-07-01

To examine prognostic factors in rheumatoid arthritis (RA), plain radiography findings and magnetic resonance imaging (MRI) findings were compared with histopathological findings in 129 RA patients who had local or neurologic symptoms due to the cervical spine. All patients underwent plain radiography, and subdislocation more than 2 mm towards the anterior and posterior directions on plain radiographs was defined as instability. In predicting induction of instability of the inferior cervical spine and risk for spinal compression, erosion of the vertebral rim, as seen on plain X-rays, and irregular findings of the end-plate of the vertebral body and Gd-enhanced nodules around the intervertebral disk, as seen on MRI, seemed to be important. (N.K.).

Molecular imaging in the management of cervical cancer

Directory of Open Access Journals (Sweden)

Chyong-Huey Lai

2012-08-01

Full Text Available Positron emission tomography (PET, magnetic resonance imaging (MRI, and integrated 18-fluorodeoxyglucose (18F-FDG PET/computed tomography are valuable techniques for assessing prognosis, treatment response after the completion of concurrent chemoradiation, suspicious or documented recurrence, unexplained post therapy elevations in tumor markers, and the response to salvage treatment when managing cervical cancer. However, PET plays a limited role in the primary staging of MRI-defined node-negative patients. Currently, 18F-FDG is still the only tracer approved for routine use, but several novel targeting PET compounds, high-Tesla MRI machines, diffusion-weighted imaging without contrast, and dynamic nuclear polarized-enhanced 13C-MR spectroscopic imaging may hold promising applications.

Functional connectivity analysis of the brain network using resting-state fMRI

International Nuclear Information System (INIS)

Hayashi, Toshihiro

2011-01-01

Spatial patterns of spontaneous fluctuations in blood oxygenation level-dependent (BOLD) signals reflect the underlying neural architecture. The study of the brain network based on these self-organized patterns is termed resting-state functional MRI (fMRI). This review article aims at briefly reviewing a basic concept of this technology and discussing its implications for neuropsychological studies. First, the technical aspects of resting-state fMRI, including signal sources, physiological artifacts, image acquisition, and analytical methods such as seed-based correlation analysis and independent component analysis, are explained, followed by a discussion on the major resting-state networks, including the default mode network. In addition, the structure-function correlation studied using diffuse tensor imaging and resting-state fMRI is briefly discussed. Second, I have discussed the reservations and potential pitfalls of 2 major imaging methods: voxel-based lesion-symptom mapping and task fMRI. Problems encountered with voxel-based lesion-symptom mapping can be overcome by using resting-state fMRI and evaluating undamaged brain networks in patients. Regarding task fMRI in patients, I have also emphasized the importance of evaluating the baseline brain activity because the amplitude of activation in BOLD fMRI is hard to interpret as the same baseline cannot be assumed for both patient and normal groups. (author)

Positional device for cinematographic MR of the cervical spine

International Nuclear Information System (INIS)

Muhle, C.; Melchert, U.H.; Brossmann, J.; Schroeder, C.; Wiskirchen, J.; Heller, M.

1995-01-01

A novel positioning device is explained and the experience obtained so far with its application in cinematic MRI of the cervical spine, allowing an extended range of movement from 60 degrees ante- to 40 degrees retroflexion. The tests were done with volounteers. (orig./MG) [de

Motor tic disorder and traumatic cervical myelopathy: a case report Trastorno de tic motor y mielopatía cervical traumática: relato de caso Transtorno de tique motor e mielopatia cervical traumática: relato de caso

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Ericson Sfredo

2011-01-01

Full Text Available The association between motor tics and cervical myelopathy is rare and not well understood. Only a few papers in the literature reported this disorder until the present date. This is a case report of a cervical myelopathy case secondary to a motor tic disorder. A 23-year-old male with a 10-year history of motor tic disorder, involving sudden forced extension of the head and cervical spine. Disturbed tactile sensation and kinetic posturing that progressed to the Lhermitte sign every time he made the movement were detected over the last six months. Magnetic resonance imaging (MRI showed hyperintense intramedullary lesion at C2-C3, degeneration at C3-C4, and no signs of spinal cord compression. On sagittal view, functional MRI with head extension showed anterior compression with protrusion of the intervertebral disc and posterior compression of the yellow ligaments causing spinal cord stenosis. Anterior discectomy and fixation of C3-C4 were performed. There were no complications. The patient showed improvement and the motor tics were controlled by haloperidol. The patient remains symptom-free after 2 years of follow-up. Uncontrolled motor tics can compromise spinal cord function. Functional MRI can reproduce the abnormal movements and clarify the physiopathology.La asociación entre tics motores y mielopatía cervical es rara y no es bien comprendida. Pocos estudios, que analizan este disturbio, han sido encontrados en la literatura hasta el momento. Este es el relato de un caso de mielopatía cervical secundaria a tics motores. Paciente masculino de 23 años con historial de trastorno de tic motor desde hace diez años, involucrando extensión forzada de la cabeza y columna cervical. En los últimos seis meses, se diagnosticaron deficiencias de sensaciones táctiles y postura cinética que progresaron hacia la señal de Lhermitte, cada vez que el paciente se movía. La Resonancia Magnética (RM reveló lesión intramedular hiperintensa al nivel de

Evaluation of various somatosensory stimulations for functional MRI

International Nuclear Information System (INIS)

Hara, Kazushi; Nakasato, Nobukazu; Mizoi, Kazuo; Yoshimoto, Takashi; Shimizu, Hiroaki.

1997-01-01

The aim of this functional magnetic resonance imaging (fMRI) study was to test detectability of activated area using various somatosensory stimulations. The following stimulations were performed in normal volunteers: regular or irregular electrical median nerve stimulation (n=5, each), tactile stimulation to the palm and fingers (n=8), pain stimulation to the index finger (n=5) or to the palm and fingers (n=5). fMRI was acquired with a spoiled gradient echo sequence at 1.5 T. Detectability of activated area was the highest when the pain stimulation was applied to the palm and fingers (80%). A successful rate for the tactile stimulation was 25%, and the other stimulations failed to demonstrate any activation. When successful, the highest signal activation on fMRI was seen on a sulcus, which presumably arose from a vein. The sulcus was defined as the central sulcus by somatosensory evoked field using a median nerve stimulation. Our study indicates that the pain stimulation to the palm and fingers may be a choice for the sensory fMRI. (author)

Ciguatera fish poisoning with elevated muscle enzymes and abnormal spinal MRI.

Science.gov (United States)

Wasay, Mohammad; Sarangzai, Amanullah; Siddiqi, Ather; Nizami, Qamaruddin

2008-03-01

We report three cases of ciguatera fish poisoning. One patient died secondary to respiratory failure. Two patients showed elevated muscle enzymes and one patients had an abnormal cervical spinal MRI. MRI findings have not been previously described. MRI findings explain the mechanism of the L'hermitte phenomenon (a common complaint) among these patients. Respiratory failure is rare in ciguatera fish poisoning. Our findings suggest this could be related to respiratory muscles involvement.

Functional MRI in schizophrenia. Diagnostics and therapy monitoring of cognitive deficits of schizophrenic patients by functional MRI

International Nuclear Information System (INIS)

Furtner, J.; Prayer, D.; Sachs, G.

2010-01-01

Cognitive impairments are core psychopathological components of the symptomatic of schizophrenic patients. These dysfunctions are generally related to attention, executive functions and memory. This report provides information on the importance of using functional magnetic resonance imaging (fMRI) for the diagnostics and therapy monitoring of the different subtypes of cognitive dysfunctions. Furthermore, it describes the typical differences in the activation of individual brain regions between schizophrenic patients and healthy control persons. This information should be helpful in identifying the deficit profile of each patient and create an individual therapy plan. (orig.) [de

Changes in use of cervical spine magnetic resonance imaging for pediatric patients with nonaccidental trauma.

Science.gov (United States)

Oh, Ahyuda; Sawvel, Michael; Heaner, David; Bhatia, Amina; Reisner, Andrew; Tubbs, R Shane; Chern, Joshua J

2017-09-01

OBJECTIVE Past studies have suggested correlations between abusive head trauma and concurrent cervical spine (c-spine) injury. Accordingly, c-spine MRI (cMRI) has been increasingly used in radiographic assessments. This study aimed to determine trends in cMRI use and treatment, and outcomes related to c-spine injury in children with nonaccidental trauma (NAT). METHODS A total of 503 patients with NAT who were treated between 2009 and 2014 at a single pediatric health care system were identified from a prospectively maintained database. Additional data on selected clinical events were retrospectively collected from electronic medical records. In 2012, a clinical pathway on cMRI usage for patients with NAT was implemented. The present study compared cMRI use and clinical outcomes between the prepathway (2009-2011) and postpathway (2012-2014) periods. RESULTS There were 249 patients in the prepathway and 254 in the postpathway groups. Incidences of cranial injury and Injury Severity Scores were not significantly different between the 2 groups. More patients underwent cMRI in the years after clinical pathway implementation than before (2.8% vs 33.1%, p spine injury in this population increased the use of cMRI and cervical collar immobilization over a 6-year period. However, severe c-spine injury remains rare, and increased use of cMRI might not affect outcomes markedly.

Sexual functioning of cervical cancer survivors : A review with a female perspective

NARCIS (Netherlands)

Lammerink, Ellen A. G.; de Bock, Geertruida H.; Pras, Elisabeth; Reyners, Anna K. L.; Mourits, Marian J. E.

Objective: Sex is an important, often deteriorated, dimension of quality of life after cancer treatment. We conducted a systematic review on sexual functioning of cervical cancer survivors. Methods: Studies between January 1988 and April 2010 were rated on their internal validity. Results were

Pharmaco fMRI: Determining the functional anatomy of the effects of medication

Directory of Open Access Journals (Sweden)

Britta Wandschneider

2016-01-01

Full Text Available Functional MRI studies have helped to elucidate underlying mechanisms in complex neurological and neuropsychiatric disorders. Disease processes often involve complex large-scale network interactions, extending beyond the presumed main disease focus. Given both the complexity of the clinical phenotype and the underlying dysfunctional brain circuits, so called pharmaco-fMRI (ph-MRI studies probe pharmacological effects on functional neuro-anatomy, and can help to determine early treatment response, mechanisms of drug efficacy and side effects, and potentially advance CNS drug development. In this review, we discuss recent ph-MRI research in three major neuropsychiatric and neurological disorders and associated network alterations, namely selective serotonin and noradrenergic reuptake inhibitors in affective disorders and emotional processing circuits; antiepileptic drugs in epilepsy and cognitive networks; and stimulants in attention-deficit/hyperactivity disorder and networks of attention control. We conclude that ph-MRI studies show consistent and reproducible changes on disease relevant networks, and prove sensitive to early pharmacological effects on functional anatomy associated with disease. Further CNS drug research and development would benefit greatly from improved disease phenotyping, or biomarkers, using advanced imaging techniques.

Essentials of clinical MRI; Essentials der klinischen MRT

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Attenberger, Ulrike I.; Schoenberg, Stefan O. (eds.) [Heidelberg Univ. Universitaetsmedizin Mannheim (Germany). Inst. fuer Klinische Radiologie und Nuklearmedizin; Runge, Val M. [Univ. of Texas Medical Branch (UTMB), Galveston, TX (United States). Dept. of Radiology; Morelli, John N. [Texas A and M Univ., Temple, TX (United States). Dept. of Radiology

2011-07-01

The text book on practical magnetic resonance imaging includes the following chapters: brain; cervical spine; thoracic spine; lumbar spine; head and neck; heart and thorax; mammary glands; abdomen and pelvis; musculoskeletal system; MRI contrast media; magnetic resonance angiography.

BOLDSync: a MATLAB-based toolbox for synchronized stimulus presentation in functional MRI.

Science.gov (United States)

Joshi, Jitesh; Saharan, Sumiti; Mandal, Pravat K

2014-02-15

Precise and synchronized presentation of paradigm stimuli in functional magnetic resonance imaging (fMRI) is central to obtaining accurate information about brain regions involved in a specific task. In this manuscript, we present a new MATLAB-based toolbox, BOLDSync, for synchronized stimulus presentation in fMRI. BOLDSync provides a user friendly platform for design and presentation of visual, audio, as well as multimodal audio-visual (AV) stimuli in functional imaging experiments. We present simulation experiments that demonstrate the millisecond synchronization accuracy of BOLDSync, and also illustrate the functionalities of BOLDSync through application to an AV fMRI study. BOLDSync gains an advantage over other available proprietary and open-source toolboxes by offering a user friendly and accessible interface that affords both precision in stimulus presentation and versatility across various types of stimulus designs and system setups. BOLDSync is a reliable, efficient, and versatile solution for synchronized stimulus presentation in fMRI study. Copyright © 2013 Elsevier B.V. All rights reserved.

Comparison of Cervical Kinematics, Pain, and Functional Disability Between Single- and Two-level Anterior Cervical Discectomy and Fusion.

Science.gov (United States)

Chien, Andy; Lai, Dar-Ming; Wang, Shwu-Fen; Hsu, Wei-Li; Cheng, Chih-Hsiu; Wang, Jaw-Lin

2016-08-01

A prospective, time series design. The purpose of this study is two-fold: firstly, to investigate the impact of altered cervical alignment and range of motion (ROM) on patients' self-reported outcomes after anterior cervical discectomy and fusion (ACDF), and secondly, to comparatively differentiate the influence of single- and two-level ACDF on the cervical ROM and adjacent segmental kinematics up to 12-month postoperatively. ACDF is one of the most commonly employed surgical interventions to treat degenerative disc disease. However, there are limited in vivo data on the impact of ACDF on the cervical kinematics and its association with patient-reported clinical outcomes. Sixty-two patients (36 males; 55.63 ± 11.6 yrs) undergoing either a single- or consecutive two-level ACDF were recruited. The clinical outcomes were assessed with the Pain Visual Analogue Scale (VAS) and the Neck Disability Index (NDI). Radiological results included cervical lordosis, global C2-C7 ROM, ROM of the Functional Spinal Unit (FSU), and its adjacent segments. The outcome measures were collected preoperatively and then at 3, 6, and 12-month postoperatively. A significant reduction of both VAS and NDI was found for both groups from the preoperative to 3-month period (P < 0.01). Pearson correlation revealed no significant correlation between global ROM with neither VAS (P = 0.667) nor NDI (P = 0.531). A significant reduction of global ROM was identified for the two-level ACDF group at 12 months (P = 0.017) but not for the single-level group. A significant interaction effect was identified for the upper adjacent segment ROM (P = 0.024) but not at the lower adjacent segment. Current study utilized dynamic radiographs to comparatively evaluate the biomechanical impact of single- and two-level ACDF. The results highlighted that the two-level group demonstrated a greater reduction of global ROM coupled with an increased upper adjacent segmental compensatory motions that

[Cervical cerclage].

Science.gov (United States)

Akladios, C Y; Sananes, N; Gaudineau, A; Boudier, E; Langer, B

2015-10-01

Cervical cerclage aims to strengthen not only the mechanical properties of the cervix, but also its immunological and anti-infectious functions. The demonstration of a strong interrelation between cervical insufficiency as well as decreased cervical length at endo-vaginal ultrasonography and infection has changed the indications cerclage. Actually we can distinguish three indications for cerclage: prophylactic, for obstetrical history; therapeutic, for shortened cervical length at ultrasonography in patients at risk and; emergency cerclage in case of threatening cervix at physical examination. The McDonald's technique is the most recommended. In case of failure, it is proposed to realize cerclage at a higher level on the cervix either by vaginal or abdominal route. Copyright © 2015 Elsevier Masson SAS. All rights reserved.

Exploring structure and function of sensory cortex with 7T MRI.

Science.gov (United States)

Schluppeck, Denis; Sanchez-Panchuelo, Rosa-Maria; Francis, Susan T

2018-01-01

In this paper, we present an overview of 7T magnetic resonance imaging (MRI) studies of the detailed function and anatomy of sensory areas of the human brain. We discuss the motivation for the studies, with particular emphasis on increasing the spatial resolution of functional MRI (fMRI) using reduced field-of-view (FOV) data acquisitions. MRI at ultra-high-field (UHF) - defined here as 7T and above - has several advantages over lower field strengths. The intrinsic signal-to-noise ratio (SNR) of images is higher at UHF, and coupled with the increased blood-oxygen-level-dependent (BOLD) signal change, this results in increased BOLD contrast-to-noise ratio (CNR), which can be exploited to improve spatial resolution or detect weaker signals. Additionally, the BOLD signal from the intra-vascular (IV) compartment is relatively diminished compared to lower field strengths. Together, these properties make 7T functional MRI an attractive proposition for high spatial specificity measures. But with the advantages come some challenges. For example, increased vulnerability to susceptibility-induced geometric distortions and signal loss in EPI acquisitions tend to be much larger. Some of these technical issues can be addressed with currently available tools and will be discussed. We highlight the key methodological considerations for high resolution functional and structural imaging at 7 T. We then present recent data using the high spatial resolution available at UHF in studies of the visual and somatosensory cortex to highlight promising developments in this area. Copyright © 2017 Elsevier Inc. All rights reserved.

Hidden Markov event sequence models: toward unsupervised functional MRI brain mapping.

Science.gov (United States)

Faisan, Sylvain; Thoraval, Laurent; Armspach, Jean-Paul; Foucher, Jack R; Metz-Lutz, Marie-Noëlle; Heitz, Fabrice

2005-01-01

Most methods used in functional MRI (fMRI) brain mapping require restrictive assumptions about the shape and timing of the fMRI signal in activated voxels. Consequently, fMRI data may be partially and misleadingly characterized, leading to suboptimal or invalid inference. To limit these assumptions and to capture the broad range of possible activation patterns, a novel statistical fMRI brain mapping method is proposed. It relies on hidden semi-Markov event sequence models (HSMESMs), a special class of hidden Markov models (HMMs) dedicated to the modeling and analysis of event-based random processes. Activation detection is formulated in terms of time coupling between (1) the observed sequence of hemodynamic response onset (HRO) events detected in the voxel's fMRI signal and (2) the "hidden" sequence of task-induced neural activation onset (NAO) events underlying the HROs. Both event sequences are modeled within a single HSMESM. The resulting brain activation model is trained to automatically detect neural activity embedded in the input fMRI data set under analysis. The data sets considered in this article are threefold: synthetic epoch-related, real epoch-related (auditory lexical processing task), and real event-related (oddball detection task) fMRI data sets. Synthetic data: Activation detection results demonstrate the superiority of the HSMESM mapping method with respect to a standard implementation of the statistical parametric mapping (SPM) approach. They are also very close, sometimes equivalent, to those obtained with an "ideal" implementation of SPM in which the activation patterns synthesized are reused for analysis. The HSMESM method appears clearly insensitive to timing variations of the hemodynamic response and exhibits low sensitivity to fluctuations of its shape (unsustained activation during task). Real epoch-related data: HSMESM activation detection results compete with those obtained with SPM, without requiring any prior definition of the expected

Staging cancer of the uterus: A national audit of MRI accuracy

International Nuclear Information System (INIS)

Duncan, K.A.; Drinkwater, K.J.; Frost, C.; Remedios, D.; Barter, S.

2012-01-01

Aim: To report the results of a nationwide audit of the accuracy of magnetic resonance imaging (MRI) staging in uterine body cancer when staging myometrial invasion, cervical extension, and lymph node spread. Materials and methods: All UK radiology departments were invited to participate using a web-based tool for submitting anonymized data for a 12 month period. MRI staging was compared with histopathological staging using target accuracies of 85, 86, and 70% respectively. Results: Of the departments performing MRI staging of endometrial cancer, 37/87 departments contributed. Targets for MRI staging were achieved for two of the three standards nationally with diagnostic accuracy for depth of myometrial invasion, 82%; for cervical extension, 90%; and for pelvic nodal involvement, 94%; the latter two being well above the targets. However, only 13/37 (35%) of individual centres met the target for assessing depth of myometrial invasion, 31/36 (86%) for cervical extension and 31/34 (91%) for pelvic nodal involvement. Statistical analysis demonstrated no significant difference for the use of intravenous contrast medium, but did show some evidence of increasing accuracy in assessment of depth of myometrial invasion with increasing caseload. Conclusion: Overall performance in the UK was good, with only the target for assessment of depth of myometrial invasion not being met. Inter-departmental variation was seen. One factor that may improve performance in assessment of myometrial invasion is a higher caseload. No other clear factor to improve performance were identified.

Staging cancer of the uterus: A national audit of MRI accuracy

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Duncan, K.A., E-mail: k.duncan@nhs.net [Clinical Radiology Audit Committee, Royal College of Radiologists, London (United Kingdom); Drinkwater, K.J. [Clinical Radiology Audit Committee, Royal College of Radiologists, London (United Kingdom); Frost, C. [Department of Medical Statistics, London School of Hygiene and Tropical Medicine, Keppel Street, London (United Kingdom); Remedios, D.; Barter, S. [Clinical Radiology Audit Committee, Royal College of Radiologists, London (United Kingdom)

2012-06-15

Aim: To report the results of a nationwide audit of the accuracy of magnetic resonance imaging (MRI) staging in uterine body cancer when staging myometrial invasion, cervical extension, and lymph node spread. Materials and methods: All UK radiology departments were invited to participate using a web-based tool for submitting anonymized data for a 12 month period. MRI staging was compared with histopathological staging using target accuracies of 85, 86, and 70% respectively. Results: Of the departments performing MRI staging of endometrial cancer, 37/87 departments contributed. Targets for MRI staging were achieved for two of the three standards nationally with diagnostic accuracy for depth of myometrial invasion, 82%; for cervical extension, 90%; and for pelvic nodal involvement, 94%; the latter two being well above the targets. However, only 13/37 (35%) of individual centres met the target for assessing depth of myometrial invasion, 31/36 (86%) for cervical extension and 31/34 (91%) for pelvic nodal involvement. Statistical analysis demonstrated no significant difference for the use of intravenous contrast medium, but did show some evidence of increasing accuracy in assessment of depth of myometrial invasion with increasing caseload. Conclusion: Overall performance in the UK was good, with only the target for assessment of depth of myometrial invasion not being met. Inter-departmental variation was seen. One factor that may improve performance in assessment of myometrial invasion is a higher caseload. No other clear factor to improve performance were identified.

Impact of MRI in the management and staging of cancer of the uterine cervix

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Stenstedt, Kristina (Centre of Surgical Gastroenterology, Karolinska Univ. Hospital and Karolinska Inst., Stockholm (Sweden)); Hellstroem, Ann-Cathrin (Dept. of Gynecological Oncology, Radiumhemmet, Karolinska Univ. Hospital and Karolinska Inst., Stockholm (Sweden)); Fridsten, Susanne; Blomqvist, Lennart (Dept. of Diagnostic Radiology Karolinska Univ. Hospital and Karolinska Inst., Stockholm (Sweden))

2011-04-15

Background. Cervical carcinoma is the only gynecological tumor still being staged mainly by clinical examination and only a limited use of diagnostic radiology. Cross sectional imaging is increasingly used as an aid in the staging procedure. We wanted to assess the impact of magnetic resonance imaging (MRI) in addition to the clinical staging of patients with carcinoma of the uterine cervix. Material and methods. A retrospective single-centre analysis of 183 women referred to a tertiary referral centre for gynecological tumors (<= 65 years old) with cervical cancer diagnosed between January 1, 2003 and December 31, 2006 who have undergone an MRI investigation before start of treatment. Patient records were retrospectively reviewed and any change of the planned treatment after the MRI examination was noted. Results. In patients with cervical carcinoma FIGO stage Ia2-IIa treated surgically, the treatment plan was altered due to MRI results in 10/125 patients. In the smaller group of patients with clinically more advanced disease receiving radio-chemotherapy, the treatment plan was altered in 12/58 patients. Reasons for changing the treatment plan after MRI were findings indicating a higher (n = 8) or lower (n = 5) local tumor stage, findings of para aortic nodal disease (n = 4) or difficulty to clinically examine the patient due to obesity (n = 2). MRI was also an aid in deciding whether or not to offer fertility preserving treatment in three cases. Conclusion. The use of MRI affects treatment planning in patients with cancer of the uterine cervix. The impact is more obvious in more advanced stages of disease and in patients who are difficult to examine clinically due to, for example body constitution. The result of MRI is also an aid in deciding whether or not a fertility preserving operation is feasible

Impact of MRI in the management and staging of cancer of the uterine cervix

International Nuclear Information System (INIS)

Stenstedt, Kristina; Hellstroem, Ann-Cathrin; Fridsten, Susanne; Blomqvist, Lennart

2011-01-01

Background. Cervical carcinoma is the only gynecological tumor still being staged mainly by clinical examination and only a limited use of diagnostic radiology. Cross sectional imaging is increasingly used as an aid in the staging procedure. We wanted to assess the impact of magnetic resonance imaging (MRI) in addition to the clinical staging of patients with carcinoma of the uterine cervix. Material and methods. A retrospective single-centre analysis of 183 women referred to a tertiary referral centre for gynecological tumors (≤ 65 years old) with cervical cancer diagnosed between January 1, 2003 and December 31, 2006 who have undergone an MRI investigation before start of treatment. Patient records were retrospectively reviewed and any change of the planned treatment after the MRI examination was noted. Results. In patients with cervical carcinoma FIGO stage Ia2-IIa treated surgically, the treatment plan was altered due to MRI results in 10/125 patients. In the smaller group of patients with clinically more advanced disease receiving radio-chemotherapy, the treatment plan was altered in 12/58 patients. Reasons for changing the treatment plan after MRI were findings indicating a higher (n = 8) or lower (n = 5) local tumor stage, findings of para aortic nodal disease (n = 4) or difficulty to clinically examine the patient due to obesity (n = 2). MRI was also an aid in deciding whether or not to offer fertility preserving treatment in three cases. Conclusion. The use of MRI affects treatment planning in patients with cancer of the uterine cervix. The impact is more obvious in more advanced stages of disease and in patients who are difficult to examine clinically due to, for example body constitution. The result of MRI is also an aid in deciding whether or not a fertility preserving operation is feasible

Staging of Cervical Lymph Nodes in Oral Squamous Cell Carcinoma

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Norling, Rikke; Buron, Birgitte Marie Due; Therkildsen, Marianne Hamilton

2014-01-01

INTRODUCTION: Clinical staging of patients with oral squamous cell carcinoma (OSCC) is crucial for the choice of treatment. Computed tomography (CT) and/or magnetic resonance imaging (MRI) are typically recommended and used for staging of the cervical lymph nodes (LNs). Although ultrasonography (US...

Cervical sagittal balance parameters after single-level anterior cervical discectomy and fusion: Correlations with clinical and functional outcomes

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Ioannis Siasios

2018-01-01

Conclusions: Single-level ACDF significantly increases upper cervical lordosis (C1–C2 without significantly changing lower cervical lordosis (C2–C7. The C7 slope is a significant marker of overall cervical sagittal alignment (P < 0.05.

Adrenal phaeochromocytoma: correlation of MRI appearances with histology and function

International Nuclear Information System (INIS)

Jacques, Audrey E.T.; Sahdev, Anju; Sandrasagara, Madrika; Rockall, Andrea G.; Reznek, Rodney H.; Goldstein, Rick; Chew, Shern; Berney, Daniel

2008-01-01

The purpose of this study was to describe the range of appearances of adrenal phaeochromocytomas on T2-weighted MRI, correlate appearances with histopathology, and quantify the incidence of the previously described hyperintense appearance. The appearance and MR characteristics of 44 phaeochromocytomas were reviewed retrospectively. T2-weighted appearances were grouped: (1) 'classical', homogeneous, high signal intensity, isointense to CSF; (2) homogeneous, isointense or minimally hyperintense to spleen, hypointense to CSF; (3) heterogeneous, marbled appearance; (4) heterogeneous, multiple high signal intensity pockets. All 44 adrenal phaeochromocytomas were well circumscribed, 1.2-15 cm in maximum diameter, with no visual or quantitative signal loss on chemical shift imaging. On T2-weighted MRI 5/44 (11%) had group 1 appearance; 15/44 (34%) group 2, 7/44 (16%) group 3; and 17/44 (39%) group 4. Homogeneous group 1 and 2 lesions were smaller (mean 4.5 cm) than heterogeneous group 3 and 4 lesions (mean 6.3 cm). Increasing MRI heterogeneity correlated pathologically with increasing amounts of haemorrhage, necrosis and fibrosis. No MRI features were predictive of malignancy. Non-functioning phaeochromocytomas were larger than functioning lesions. No size difference was seen between syndrome and sporadic lesions. In this large series we report a wide range of appearances of adrenal phaeochromocytomas on T2-weighted MRI. The previously described classical hyperintense phaeochromocytoma is relatively uncommon. (orig.)

Preliminary clinical applications of DTI in human cervical spinal cord

International Nuclear Information System (INIS)

Song Ting; Mai Weiwen; Liang Biling; Shen Jun; Huang Suiqiao; Hu Chunhong

2007-01-01

Objective: To condcut preliminary study of the value of DTI(diffusion tensor imaging) in human cervical spinal cord. Methods: Twenty-one patients suffering from cervical spondylotic myelopathy and twenty volunteers without any clinical symptoms underwent routine MRI and DTI examination. DTI was performed in six non-collinear directions with single-shot fast spin echo echo, planar imaging sequence(b value = 400 s·mm -2 ). ADC(apparent diffusion coefficient) and FA(fractional anisotropy)values were measured by ROIs(regions of interest) in 4 different level segment spinal cord (C 2/3 , C 3/4 , C 4/5 , C 5/6 ) in normal volunteers, in lesions and normal segmental spinal cord in clinical cases respectively. DTI original images were automatically processed by using IDL (Version 5.6) soft- ware to produce color tensor images. SPSS11.0 software for windows was used for t-test and one-way ANOVA analysis. The difference was considered statistically significant if P 2/3 , C 3/4 , C 4/5 , C 5/6 , were analyzed and it was found that FA value between them had a significant difference by ANOVA, F=159.24, P 2/3 level. However, ADC value between 4 segments had no significant difference(F=2.191, P>0.05). (2)In patients of cervical spondylotic myelopathy, routine MRI T2WI showed abnormal signal in 9 cases, and showed no abnormal signal in 12 dases. In sixteen cases it was found that abnormal patchy green signal on colorized tensor maps appeared on the normal blue spinal cord. Also, in patients of cervical spondylotic myelopathy, there was significant difference in ADC and FA value between lesions and normal spinal cord (paired t test, for ADC, t=2.88, P 2/3 level segment spinal cord in normal volunteers (0.85 ± 0.03) is the highest among other segments. FA value decreases gradually along cervical spinal cord towards the caudal direction. However, the difference of ADC values amongst 4 segments is not significant. DTI colorized tensor maps can show more lesions than routine MRI

[Traumatic spinal complications of cervical arthrosis].

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Verstichel, P; Berthelot, J L; Randriananja, H; Crozier, S; Masson, C

1996-02-17

Cervical spondylotic myelopathy is usually a chronic and progressive disease. In a few cases, however, dramatic tetraplegia sometimes occurs after even minor injury. We report seven patients (6 males, 1 female, aged from 41 to 63), who suffered from acute myelopathy after an injury. In 5 cases, the injury revealed the cervical spondylotic myelopathy. A hyperextension of the cervical spine was found in 5 cases. The injury was severe in only one case, but there was no bony abnormalities, except arthrosis. The most common cause was a fall. In contrast, severe tetraplegia was found in 4 cases. Spontaneous, but incomplete, recuperation occurred in 4 patients. In all 7 cases, CT scan and MRI showed congenital cervical stenosis associated with cervical spondylosis. The level of disco-osteophytic changes was mainly in C4, C5, C6. On T2-weighted spin-echo image, an increased signal intensity was present in the cord of 3 patients, but was not correlated with the severity of the symptoms, nor with improvement. Surgical treatment was performed in 6 cases: 3 laminectomies, 3 anterior or antero-lateral approaches. Improvement after operative decompression was observed in all but one case, even when the motor or sensory deficit persists for more than one year. Motricity of the inferior limbs improved better than the other deficits, perhaps because of the location of non-reversible lesions in the spinal gray matter. The acute medullary syndrome of cervical spondylotic myelopathy is serious and can cause major handicaps. This complication justifies a preventive surgical attitude when medullar signs are moderate, and cervical imagery shows a spondylotic compression of the cord with congenital stenosis.

Quadriplegia secondary to cervical spondylotic myelopathy-a rare complication of head and neck surgery.

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Chen, Wei-Fan; Kang, Chung-Jan; Lee, Sai-Cheung; Tsao, Chung-Kan

2013-02-01

Free tissue reconstruction after ablation of head and neck malignancy often requires extensive cervical manipulation, which may exacerbate preexisting cervical spondylosis and result in progression to cervical myelopathy. We present a rare case of postoperative quadriplegia caused by cervical spondylotic myelopathy after head and neck reconstruction. A 63-year-old man without a history of cervical spondylosis underwent resection of a gingivo-buccal squamous cell carcinoma with immediate reconstruction with free fibula osteocutaneous flap. On postoperative day 4, the patient was found to have quadriplegia. MRI demonstrated severe cervical myelopathy. Decompressive laminectomy was performed. The patient underwent an extensive rehabilitation program but only realized moderate improvement. Cervical spondylotic myelopathy is a rare but disastrous complication of head and neck surgery. We hypothesize that it is potentially avoidable with heightened awareness of this disease entity, preoperative identification of patients at risk, and prophylactic interventions Copyright © 2011 Wiley Periodicals, Inc.

Should helical tomotherapy replace brachytherapy for cervical cancer? Case report.

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Hsieh, Chen-Hsi; Wei, Ming-Chow; Hsu, Yao-Peng; Chong, Ngot-Swan; Chen, Yu-Jen; Hsiao, Sheng-Mou; Hsieh, Yen-Ping; Wang, Li-Ying; Shueng, Pei-Wei

2010-11-23

Stereotactic body radiation therapy (SBRT) administered via a helical tomotherapy (HT) system is an effective modality for treating lung cancer and metastatic liver tumors. Whether SBRT delivered via HT is a feasible alternative to brachytherapy in treatment of locally advanced cervical cancer in patients with unusual anatomic configurations of the uterus has never been studied. A 46-year-old woman presented with an 8-month history of abnormal vaginal bleeding. Biopsy revealed squamous cell carcinoma of the cervix. Magnetic resonance imaging (MRI) showed a cervical tumor with direct invasion of the right parametrium, bilateral hydronephrosis, and multiple uterine myomas. International Federation of Gynecology and Obstetrics (FIGO) stage IIIB cervical cancer was diagnosed. Concurrent chemoradiation therapy (CCRT) followed by SBRT delivered via HT was administered instead of brachytherapy because of the presence of multiple uterine myomas with bleeding tendency. Total abdominal hysterectomy was performed after 6 weeks of treatment because of the presence of multiple uterine myomas. Neither pelvic MRI nor results of histopathologic examination at X-month follow-up showed evidence of tumor recurrence. Only grade 1 nausea and vomiting during treatment were noted. Lower gastrointestinal bleeding was noted at 14-month follow-up. No fistula formation and no evidence of haematological, gastrointestinal or genitourinary toxicities were noted on the most recent follow-up. CCRT followed by SBRT appears to be an effective and safe modality for treatment of cervical cancer. Larger-scale studies are warranted.

Should helical tomotherapy replace brachytherapy for cervical cancer? Case report

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Chen Yu-Jen

2010-11-01

Full Text Available Abstract Background Stereotactic body radiation therapy (SBRT administered via a helical tomotherapy (HT system is an effective modality for treating lung cancer and metastatic liver tumors. Whether SBRT delivered via HT is a feasible alternative to brachytherapy in treatment of locally advanced cervical cancer in patients with unusual anatomic configurations of the uterus has never been studied. Case Presentation A 46-year-old woman presented with an 8-month history of abnormal vaginal bleeding. Biopsy revealed squamous cell carcinoma of the cervix. Magnetic resonance imaging (MRI showed a cervical tumor with direct invasion of the right parametrium, bilateral hydronephrosis, and multiple uterine myomas. International Federation of Gynecology and Obstetrics (FIGO stage IIIB cervical cancer was diagnosed. Concurrent chemoradiation therapy (CCRT followed by SBRT delivered via HT was administered instead of brachytherapy because of the presence of multiple uterine myomas with bleeding tendency. Total abdominal hysterectomy was performed after 6 weeks of treatment because of the presence of multiple uterine myomas. Neither pelvic MRI nor results of histopathologic examination at X-month follow-up showed evidence of tumor recurrence. Only grade 1 nausea and vomiting during treatment were noted. Lower gastrointestinal bleeding was noted at 14-month follow-up. No fistula formation and no evidence of haematological, gastrointestinal or genitourinary toxicities were noted on the most recent follow-up. Conclusions CCRT followed by SBRT appears to be an effective and safe modality for treatment of cervical cancer. Larger-scale studies are warranted.

Should helical tomotherapy replace brachytherapy for cervical cancer? Case report

International Nuclear Information System (INIS)

Hsieh, Chen-Hsi; Wei, Ming-Chow; Hsu, Yao-Peng; Chong, Ngot-Swan; Chen, Yu-Jen; Hsiao, Sheng-Mou; Hsieh, Yen-Ping; Wang, Li-Ying; Shueng, Pei-Wei

2010-01-01

Stereotactic body radiation therapy (SBRT) administered via a helical tomotherapy (HT) system is an effective modality for treating lung cancer and metastatic liver tumors. Whether SBRT delivered via HT is a feasible alternative to brachytherapy in treatment of locally advanced cervical cancer in patients with unusual anatomic configurations of the uterus has never been studied. A 46-year-old woman presented with an 8-month history of abnormal vaginal bleeding. Biopsy revealed squamous cell carcinoma of the cervix. Magnetic resonance imaging (MRI) showed a cervical tumor with direct invasion of the right parametrium, bilateral hydronephrosis, and multiple uterine myomas. International Federation of Gynecology and Obstetrics (FIGO) stage IIIB cervical cancer was diagnosed. Concurrent chemoradiation therapy (CCRT) followed by SBRT delivered via HT was administered instead of brachytherapy because of the presence of multiple uterine myomas with bleeding tendency. Total abdominal hysterectomy was performed after 6 weeks of treatment because of the presence of multiple uterine myomas. Neither pelvic MRI nor results of histopathologic examination at X-month follow-up showed evidence of tumor recurrence. Only grade 1 nausea and vomiting during treatment were noted. Lower gastrointestinal bleeding was noted at 14-month follow-up. No fistula formation and no evidence of haematological, gastrointestinal or genitourinary toxicities were noted on the most recent follow-up. CCRT followed by SBRT appears to be an effective and safe modality for treatment of cervical cancer. Larger-scale studies are warranted

[Characteristics and treatment of traumatic cervical disc herniation].

Science.gov (United States)

Miao, Jing-Lei; Zhang, Chao-Yue; Peng, Zhi

2012-10-01

To explore clinical presentations and the operational opportunity of traumatic cervical disc herniation. From June 2002 to June 2009,40 patients with traumatic cervical disc herniation were treated. There were 24 males and 16 females, with an average age of 43.2 years old ranging from 30 to 56 years. There were 36 patients with single intervertebral disc herniation and 4 patients with double. The injury level of those patients were at C3,4 in 16 cases, C4,5 in 10 cases, C5,6 in 12 cases and C6,7 in 6 cases. Among them, 18 patients showed spinal cord signal changes by MRI, 5 patients suffered from nothing but neck and shoulder pain, 8 patients with nerve root stimulation; 10 patients with spinal cord compression, and 17 patients had both nerve root stimulation and spinal cord compression symptoms. Conservative treatment were applied to 13 patients with neck and shoulder pain and nerve root stimulation, 5 cases of which were transferred to operation in case of poor effects, and Odom criteria were used to assess operational effects. Twenty-seven patients with spinal cord compression accepted operation from 1 to 27days after their trauma, 16 of which were operated in 5 days (early operational group with an JOA score of 11.3 +/- 2.8), other 11 cases were operated from 5 to 27 days (delayed operational group with an JOA score of 11.4 +/- 2.9 ), then functional assessment of spinal cord were assessed according to JOA criteria. Three patients who were transferred from conservative treatment recovered excellently according to Odom criteria and the other 2 were good at final followed-up. JOA score of early operational group increased from (11.3 +/- 2.8) to (15.3 +/- 1.8) one week after operation (P traumatic cervical disc herniation and cervical spondylosis. Early operation is favorable to the recovery of neurological function in patients with spinal cord compression.

Are early MRI findings correlated with long-lasting symptoms following whiplash injury? A prospective trial with 1-year follow-up

DEFF Research Database (Denmark)

Kongsted, Alice; Sorensen, Joan; Andersen, Hans

2008-01-01

. Clinical follow-ups were performed after 3 and 12 months. Outcome parameters were neck pain, headache, neck disability and working ability. A total of 178 participants had a cervical MRI scan on average 13 days after the injury. Traumatic findings were observed in seven participants. Signs of disc......Neck pain is the cardinal symptom following whiplash injuries. The trauma mechanism could theoretically lead to both soft tissue and bone injury that could be visualised by means of MRI. From previous quite small trials it seems that MRI does not demonstrate significant tissue damage. Large...... prospectively followed cohorts are needed to identify possible clinically relevant MRI findings. The objective of this trial was to evaluate (1) the predictive value of cervical MRI after whiplash injuries and (2) the value of repeating MRI examinations after 3 months including sequences with flexion...

Superior cervical ganglion mimicking retropharyngeal adenopathy in head and neck cancer patients: MRI features with anatomic, histologic, and surgical correlation

Energy Technology Data Exchange (ETDEWEB)

Loke, S.C.; Karandikar, A.; Goh, J.P.N. [Tan Tock Seng Hospital, Department of Diagnostic Radiology, Singapore (Singapore); Ravanelli, M.; Farina, D.; Maroldi, R. [Department of Radiology, University of Brescia, Brescia (Italy); Ling, E.A. [National University of Singapore, Department of Anatomy, Yong Loo Lin School of Medicine, Singapore (Singapore); Tan, T.Y. [Changi General Hospital, Department of Radiology, Singapore (Singapore)

2016-01-15

To describe the unique MRI findings of superior cervical ganglia (SCG) that may help differentiate them from retropharyngeal lymph nodes (RPLNs). A retrospective review of post-treatment NPC patients from 1999 to 2012 identified three patients previously irradiated for NPC that were suspected of having recurrent nodal disease in retropharyngeal lymph nodes during surveillance MRI. Subsequent surgical exploration revealed enlarged SCG only; no retropharyngeal nodal disease was found. A cadaveric head specimen was also imaged with a 3T MRI before and after dissection. In addition, SCG were also harvested from three cadaveric specimens and subjected to histologic analysis. The SCG were found at the level of the C2 vertebral body, medial to the ICA. They were ovoid on axial images and fusiform and elongated with tapered margins in the coronal plane. T2-weighted (T2W) signal was hyperintense. No central elevated T1-weighted (T1W) signal was seen within the ganglia in non-fat-saturated sequences to suggest the presence of a fatty hilum. Enhancement after gadolinium was present. A central ''black dot'' was seen on axial T2W and post-contrast images in two of the three SCG demonstrated. Histology showed the central black line was comprised of venules and interlacing neurites within the central portion of the ganglion. The SCG can be mistaken for enlarged RPLNs in post-treatment NPC patients. However, there are features which can help differentiate them from RPLNs, preventing unnecessary therapy. These imaging findings have not been previously described. (orig.)

Incidental MRI Findings in Patients with Impaired Cognitive Function

International Nuclear Information System (INIS)

Hwang, Yoon Joon

2013-01-01

This study aims to evaluate the incidental findings on brain MRI of patients with cognitive function impairments. We analyzed magnetic resonance (MR) findings of 236 patients with decreased cognitive function. MR protocols include conventional T2 weighted axial images, fluid attenuated inversion recovery axial images, T1 weighted coronal 3-dimensional magnetization-prepared rapid acquisition of gradient echo and diffusion tensor images. We retrospectively evaluated the signal changes that suggest acute/subacute infarction and space occupying lesions which show mass effect. Incidental MR findings were seen in 16 patients. Nine patients (3.8%) showed increased signal intensity on trace map of diffusion tensor images suggesting acute/subacute infarctions. Space occupying lesions were detected in 7 patients, and 3 lesions (1.27%) had mass effect and edema and were considered clinically significant lesions that diminish cognitive functions. Several incidental MR findings were detected in patients with decreased cognitive function, and the incidence of aucte/subacute infarctions were higher. Proper evaluations of MRI in patients with impaired cognitive functions will be helpful in early detection and management of ischemic lesions and space occupying lesions.

Do clinical features and MRI suggest the same nerve root in acute cervical radiculopathy

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M. Conradie

2006-02-01

Full Text Available Different proposed pathophysiological mechanisms can result in variable clinical presentations of cervical radiculopathy (CR, often making it difficult to detect minor nerve root (NR conditions. This descriptive study determined (1 the level(s of  NR involvement suggested by the distribution patterns of clinical features and detected by magnetic resonance imaging (MRI and (2 the most common associations between the different variables in patients diagnosed with acute CR by a neurosurgeon. A physiotherapist blinded to the level(s of NR involvement performed a standardized interview on 21 subjects to determine the distribution patterns of pain and paraesthesia, and a neurological examination. The Fisher exact test was used to determine associations between the different variables. Only seven subjects presented clinically and radiologically with the same single-level NR involvement. Multiple- level presentations occurred which might be due to dermatomal overlapping, central sensitization or the possible involvement of two adjacent NR levels. Distribution patterns of motor weakness, pain and paraesthesia, and to a lesser extent sensory and reflex changes, have value in identifying the compressed NR level. For this sample the distri-bution patterns of radicular features identified C6 and C8 with more certainty than C7.

Does cervical kyphosis relate to symptoms following whiplash injury?

DEFF Research Database (Denmark)

Johansson, Mats Peter; Baann Liane, Martin Skogheim; Bendix, Tom

2011-01-01

is not significantly associated with chronic whiplash associated pain. Moreover, it is a clear clinical implication that pain should not be ascribed to a straight spine on MRI. We suggest that future trials on cervical posture focus upon the presence of kyphotic deformity rather than just on the absence of lordosis....

Cervical spine instability in the course of rheumatoid arthritis – imaging methods

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Małgorzata Mańczak

2017-08-01

Full Text Available Cervical spine is affected in more than a half of patients with rheumatoid arthritis (RA. Depending on the degree of damage to the individual joints and ligaments RA-related cervical spine instability takes the form of atlanto-axial subluxation, subaxial subluxation or cranial settling. In the advanced cases spinal stenosis can occur as well as spinal cord injuries with typical neurological symptoms. The identification of patients with cervical spine instability before the occurrence of neurological complications still constitutes a diagnostic challenge. The article presents the methods of cervical spine imaging with the use of plain radiographs, magnetic resonance imaging (MRI and computed tomography (CT. We discuss the advantages and disadvantages associated with each method and the possibility of its application in the diagnosis of cervical spine instability in RA. The knowledge of the above mentioned issues is indispensable to select an appropriate time for surgical intervention.

Quantitation of global and regional left ventricular function by MRI

NARCIS (Netherlands)

van der Geest, RJ; Reiber, JHC; Reiber, JHC; VanDerWall, EE

1998-01-01

Magnetic resonance imaging (MRI) provides several imaging strategies for assessing left ventricular function. As a three-dimensional imaging technique, all measurements can be performed without relying on geometrical assumptions. Global and regional function parameters can be derived from

Large-scale Granger causality analysis on resting-state functional MRI

Science.gov (United States)

D'Souza, Adora M.; Abidin, Anas Zainul; Leistritz, Lutz; Wismüller, Axel

2016-03-01

We demonstrate an approach to measure the information flow between each pair of time series in resting-state functional MRI (fMRI) data of the human brain and subsequently recover its underlying network structure. By integrating dimensionality reduction into predictive time series modeling, large-scale Granger Causality (lsGC) analysis method can reveal directed information flow suggestive of causal influence at an individual voxel level, unlike other multivariate approaches. This method quantifies the influence each voxel time series has on every other voxel time series in a multivariate sense and hence contains information about the underlying dynamics of the whole system, which can be used to reveal functionally connected networks within the brain. To identify such networks, we perform non-metric network clustering, such as accomplished by the Louvain method. We demonstrate the effectiveness of our approach to recover the motor and visual cortex from resting state human brain fMRI data and compare it with the network recovered from a visuomotor stimulation experiment, where the similarity is measured by the Dice Coefficient (DC). The best DC obtained was 0.59 implying a strong agreement between the two networks. In addition, we thoroughly study the effect of dimensionality reduction in lsGC analysis on network recovery. We conclude that our approach is capable of detecting causal influence between time series in a multivariate sense, which can be used to segment functionally connected networks in the resting-state fMRI.

Acquisition and analysis strategies in functional MRI at high fields

International Nuclear Information System (INIS)

Windischberger, C.

2001-08-01

Functional magnetic resonance imaging represents a non-invasive technique to examine neuronal activity in the brain. It applies radio waves to excite nuclear spins, using the emitted signal during relaxation for image generation. Signal modulations from local blood flow and oxygenation level changes caused by neuronal activity are the basis for calculating functional brain maps with high spatial resolution. The present work discusses concepts for improving the spatial and temporal resolution, as well as sophisticated analysis approaches. Besides an exhaustive description of image reconstruction algorithms, computational simulations on echo-shifting in echo-planar imaging are presented and effects on spatial resolution are quantified. The results demonstrate that echo-shifting causes only minimal resolution losses for high signal-to-noise data, but leads to severe resolution degradation (up to 30 %) in images with low signal-to-noise ratios. After an overview of the mechanisms that cause fMRI signal changes subsequent to neuronal activity, explorative analysis algorithms like Fuzzy Cluster Analysis, as well as parametric approaches are described and discussed. In the context of fMRI artifacts, effects of respiratory motion are examined. For the first time, well-defined breathing patterns are used to quantify the influences on fMRI signal intensity. Also, the variability of fMRI activation in a mental rotation paradigm are investigated, using single-trial analysis. Such, intra-subject activation consistency was determined successfully. Finally, in a second study on mental rotation explorative data analysis was applied to retrieve neuro-functional hypotheses. (author)

Evaluation of the kinesthetic sense and function of the hand in early period in operated cervical disc hernia.

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Kara, Býlge; Yildirim, Yücel; Karadýbak, Dýdem; Acar, Umýt

2006-06-01

A prospective study made into cervical disc hernias. To determine the kinesthetic sense and hand functions, which are important for the patients with cervical disc hernia to return to work life and daily activities that need skill. Neurosurgical department. Data Symptoms in cervical disc hernias and hand functions are affected depending on long-term pain. The evaluation of the hand is essential in assessing the patients' overall recovery and ability to return to daily activities and work life. Thirty-four patients with cervical disc hernia, who were operated on, were included in the study. Eight different test positions in the assessment of the hand's kinesthetic sense and hand function sort (HFS) in the evaluation of the hand function were applied. The disability levels of the patients were determined with The Neck Pain and Disability Scale, on the preoperative and postoperative discharge day and in the postoperative second month. Patients were divided into groups according to the side involved. In the evaluation of the kinesthetic test of the hand, only in the postoperative second month was a significant difference observed between the 1, 2, 3, and 4 test positions of the right side of the groups. On the other hand, no significant difference was found between the groups in the assessment of the hand function. In the measurement of hand functions and disability levels, strong and important correlations were determined. An early assessment of the hand's kinesthetic sense and function is instrumental in the patients' evaluation of recovery and resumption of work.

High frame rate retrospectively triggered Cine MRI for assessment of murine diastolic function.

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Coolen, Bram F; Abdurrachim, Desiree; Motaal, Abdallah G; Nicolay, Klaas; Prompers, Jeanine J; Strijkers, Gustav J

2013-03-01

To assess left ventricular (LV) diastolic function in mice with Cine MRI, a high frame rate (>60 frames per cardiac cycle) is required. For conventional electrocardiography-triggered Cine MRI, the frame rate is inversely proportional to the pulse repetition time (TR). However, TR cannot be lowered at will to increase the frame rate because of gradient hardware, spatial resolution, and signal-to-noise limitations. To overcome these limitations associated with electrocardiography-triggered Cine MRI, in this paper, we introduce a retrospectively triggered Cine MRI protocol capable of producing high-resolution high frame rate Cine MRI of the mouse heart for addressing left ventricular diastolic function. Simulations were performed to investigate the influence of MRI sequence parameters and the k-space filling trajectory in relation to the desired number of frames per cardiac cycle. An optimized protocol was applied in vivo and compared with electrocardiography-triggered Cine for which a high-frame rate could only be achieved by several interleaved acquisitions. Retrospective high frame rate Cine MRI proved superior to the interleaved electrocardiography-triggered protocols. High spatial-resolution Cine movies with frames rates up to 80 frames per cardiac cycle were obtained in 25 min. Analysis of left ventricular filling rate curves allowed accurate determination of early and late filling rates and revealed subtle impairments in left ventricular diastolic function of diabetic mice in comparison with nondiabetic mice. Copyright © 2012 Wiley Periodicals, Inc.

Comparison of post-surgical MRI presentation of the pituitary gland and its hormonal function.

Science.gov (United States)

Bladowska, Joanna; Sokolska, Violetta; Sozański, Tomasz; Bednarek-Tupikowska, Grażyna; Sąsiadek, Marek

2010-01-01

Post-surgical evaluation of the pituitary gland in MRI is difficult because of a change of anatomical conditions. It depends also on numerous other factors, including: size and expansion of a tumour before surgery, type of surgical access, quality and volume of filling material used and time of its resorption.The aim of the study was to compare MR image of the pituitary gland after surgery with clinical findings and to establish a correlation between MRI presentation of spared pituitary and its hormonal function. 124 patients after resection of pituitary adenomas - 409 MRI results in total - were studied. With a 1.5-T unit, T1-weighted sagittal and coronal, enhanced and unenhanced images were obtained. The pituitary gland seemed to be normal in MRI in 11 patients, 8 of them had completely regular pituitary function but in 3 of them we noticed a partial hypopituitarism. In 99 patients only a part of the pituitary gland was recognised, 53 of them had hypopituitarism but 46 of them were endocrinologically healthy. 14 patients seemed to have no persistent pituitary gland in MRI, in comparison to hormonal studies: there was panhypopituitarism in 6 and hypopituitarism in 8 cases. MRI presentation of post - surgical pituitary gland doesn't necessarily correlate with its hormonal function - there was a significant statistical difference. Some patients with partial pituitary seems normal hormonal function. In some cases the pituitary seem normal in MRI but these patients have hormonal disorders and need substitution therapy.

Functional MRI in Patients with Intracranial Lesions near Language Areas.

Science.gov (United States)

Hakyemez, B; Erdogan, C; Yildirim, N; Bora, I; Bekar, A; Parlak, M

2006-06-30

We aimed to depict Broca's area and Wernicke's area by word generation and sentence formation paradigms in patients with various intracranial lesions adjacent to language areas using functional MRI technique and to evaluate the ability of functional MRI to lateralize the hemispheric dominance for language. Twenty-three right-handed patients were included in this study. Lesions were classified as low-grade glioma (n=8), high-grade glioma (n=9), metastasis (n=1), meningioma (n=1), arteriovenous malformation (n=2) and mesial temporal sclerosis (n=2). We performed blood-oxygenated-level-dependant functional MRI using a 1.5-T unit. Word generation and sentence formation tasks were used to activate language areas. Language areas were defined as Brodmann 44, 45 (Broca's area) and Brodmann 22 area (Wernicke's area). Laterality index was used to show the dominant hemisphere. Two poorly cooperative patients showed no activation and were excluded from the study. Broca's area was localized in 21 patients (100 %). Wernicke's area, on the other hand, could only be localized in eight of the 21 patients (38 %).The left hemisphere was dominant in 86% of patients while atypical language lateralization (right or bilateral) was demonstrated in 14% of the patients. Bilateral activation areas were shown in 10% of those patients while right cerebral hemisphere was dominant in 4% of the patients. Word generation and sentence formation tasks are especially helpful in localizing Broca's area. Wernicke's area could also be demonstrated in some of the cases. Functional MRI can be used as an important and useful means of demonstrating language areas in patients with lesions adjacent to those areas and depicting the hemispheric dominance.

Comparative studies of brain activation with MEG and functional MRI