WorldWideScience

Sample records for recovery flair mri

  1. A case of Marchiafava-Bignami disease: MRI findings on spin-echo and fluid attenuated inversion recovery (FLAIR) images

    International Nuclear Information System (INIS)

    Yamamoto, Takashi; Ashikaga, Ryuichiro; Araki, Yutaka; Nishimura, Yasumasa

    2000-01-01

    Marchiafava-Bignami disease (MBD) was diagnosed in a 56-year-old man. Spin-echo (SE) magnetic resonance imaging (MRI) at the acute phase showed normal signal areas in the central layer of the corpus callosum (CC), although the intensity of these areas revealed abnormal hyperintensity on fluid attenuated inversion recovery (FLAIR). On follow-up SE MRI at the late phase, the central layer of the CC showed fluid-like intensity. On FLAIR MRI, the lesions of the CC turned into hypointense cores surrounded by hyperintense rims indicating central necrosis and peripheral demyelination. Degenerative changes of the CC in MBD were clearly demonstrated by FLAIR MRI

  2. Efficacy of the fluid attenuated inversion recovery (FLAIR) sequence of MRI as a preoperative diagnosis of hippocampal sclerosis

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    Morioka, Takato; Nishio, Shunji; Mihara, Futoshi; Muraishi, Mitsuteru; Hisada, Kei; Hasuo, Kanehiro; Fukui, Masashi

    1998-01-01

    A newly advanced MRI pulse sequence, the FLAIR (fluid attenuated inversion recovery) imaging, in which a long TE spin echo sequence is used with suppression of the CSF with an inversion pulse, displays the CSF space as a no-signal intensity area. There have been only a few reports on the FLAIR pulse sequence of temporal lobe epilepsy (TLE) as yet. We examined 9 cases of intractable TLE by FLAIR images and analyzed the advantages and disadvantages of the FLAIR pulse sequence for decision making on temporal lobectomy. All patients underwent anterior temporal lobectomy with hippocampectomy, and the diagnoses were confirmed histologically after surgery. Abnormally high T2 signals (HT2S) were more conspicuous with the FLAIR sequence than with any of the conventional sequences. Tilted axial plane, orientated along to the long axis of the hippocampal body, clearly demonstrated hippocampal atrophy (HA). Selection of a FLAIR sequence into the routine MR examination of patients with TLE is recommended. (author)

  3. Clinical value of periventricular low-intensity areas detected by fluid attenuated inversion recovery (FLAIR). Relationships between perinatal vital parameter and neonatal MRI

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    Kadowaki, Sachiko; Iwata, Osuke; Tamura, Masanori [Nagano Children' s Hospital, Toyoshina (Japan)] (and others)

    2002-01-01

    A follow-up study was performed to assess the correlation among the incidence of periventricular low intensities (PVLI) on MRI (magnetic resonance imaging) FLAIR (fluid attenuated inversion recovery) imaging, clinical evidence of perinatal insults that may cause white matter damage, and the outcome of the infants. We evaluated periventricular white matter lesions of 329 neonates whose MRI were obtained before two months corrected age. The detective rate of periventricular abnormalities on FLAIR imaging was significantly higher than that of T1-T2 weighted imaging. The most typical lesion detected on FLAIR imaging was periventricular low intensities (PVLI), frequently observed in the neonates with a history of preterm labour, very low birth weight, birth asphyxia and severe respiratory failure. Although we could not characterize the risk factors of PVLI, the incidence of PVLI had a strong correlation with the scores of motor and developmental tests at 12 and 36-months corrected age. In conclusion, FLAIR imaging, detecting the border zone damage of white matter, would be a strong tool to pick out neonates at high risk of neurological disturbances from those without clinical evidence of neurological insults in the neonatal period. (author)

  4. Voxel based morphometry of FLAIR MRI in children with intractable focal epilepsy: Implications for surgical intervention

    International Nuclear Information System (INIS)

    Riney, Catherine J.; Chong, William K.; Clark, Chris A.; Cross, J. Helen

    2012-01-01

    Purpose: Magnetic resonance imaging (MRI), in particular fluid-attenuated inversion-recovery (FLAIR), has transformed the delineation of structural brain pathology associated with focal epilepsy. However, to date there is no literature on voxel based morphometry (VBM) of FLAIR in children with epilepsy. The aim of this study was to explore the role of visual and VBM assessment of FLAIR in pre-operative investigation of children with intractable focal epilepsy. Methods: Children with intractable epilepsy due to focal cortical dysplasia (FCD) and children with intractable cryptogenic focal epilepsy (CFE) were investigated. FLAIR and T1-weighted MRI were acquired on a 1.5T MRI scanner (Siemens, Erlangen, Germany). VBM was performed using SPM5 (Wellcome Institute of Cognitive Neuroscience, London). Results: Eight children with FCD (M = 5, age 7.9–17.3 years) and 14 children with CFE (M = 8, 7.8–16.8 years) were enrolled. VBM of FLAIR detected 7/8 (88%) of FCD whilst VBM of T1-weighted MRI detected only 3/8 (38%) FCD. VBM of FLAIR detected abnormality in 4/14 children with CFE, in 2/14 (14%) the abnormality was concordant with other data on the epileptogenic zone and with visible abnormality on repeat visual inspection of MR data. VBM of T1-weighed MRI detected abnormality in 2/14 children with CFE, none of which correlated with visible abnormality. Discussion: This study highlights the important role that FLAIR imaging has in the pre-operative assessment of children with intractable epilepsy. VBM of FLAIR may provide important information allowing selection of children with intractable CFE who are likely to benefit from further neuroradiological or neurophysiological evaluation.

  5. Contrast-enhanced FLAIR in the early diagnosis of infectious meningitis

    International Nuclear Information System (INIS)

    Splendiani, Alesssandra; Puglielli, Edoardo; Amicis, Rosanna De; Masciocchi, Carlo; Gallucci, Massimo; Necozione, Stefano

    2005-01-01

    We investigated the accuracy of MRI in the early diagnosis of infectious meningitis with emphasis on the value of gadolinium-enhanced fluid-attenuated inversion recovery (FLAIR) sequence. Twenty-seven patients with clinical suspicion of infectious meningitis were included. MRI was performed within 3 h of clinical evaluation. For all patients, T1-weighted spin-echo, dual-echo T2-weighted fast-spin-echo and FLAIR sequences were performed, followed by gadolinium-enhanced T1-weighted spin-echo and FLAIR sequences. Final diagnosis was based on the clinical findings and the analysis of cerebrospinal fluid, obtained by lumbar puncture after the MRI. Infectious meningitis was confirmed in 12 patients. In all of these patients of the plain studies, FLAIR was positive in only four patients. MRI gadolinium-enhanced FLAIR showed abnormal meningeal enhancement in all 12 patients, while gadolinium-enhanced T1-weighted spin-echo was positive only in six cases. There were no false-positive or false-negative results. It is concluded that MRI could have an important role in the early screening for infectious meningitis, provided a gadolinium-enhanced FLAIR sequence is used. (orig.)

  6. Contrast-enhanced FLAIR in the early diagnosis of infectious meningitis

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    Splendiani, Alesssandra; Puglielli, Edoardo; Amicis, Rosanna De; Masciocchi, Carlo; Gallucci, Massimo [University of L' Aquila, Department of Radiology, L' Aquila (Italy); Necozione, Stefano [University of L' Aquila, Department of Statistic, L' Aquila (Italy)

    2005-08-01

    We investigated the accuracy of MRI in the early diagnosis of infectious meningitis with emphasis on the value of gadolinium-enhanced fluid-attenuated inversion recovery (FLAIR) sequence. Twenty-seven patients with clinical suspicion of infectious meningitis were included. MRI was performed within 3 h of clinical evaluation. For all patients, T1-weighted spin-echo, dual-echo T2-weighted fast-spin-echo and FLAIR sequences were performed, followed by gadolinium-enhanced T1-weighted spin-echo and FLAIR sequences. Final diagnosis was based on the clinical findings and the analysis of cerebrospinal fluid, obtained by lumbar puncture after the MRI. Infectious meningitis was confirmed in 12 patients. In all of these patients of the plain studies, FLAIR was positive in only four patients. MRI gadolinium-enhanced FLAIR showed abnormal meningeal enhancement in all 12 patients, while gadolinium-enhanced T1-weighted spin-echo was positive only in six cases. There were no false-positive or false-negative results. It is concluded that MRI could have an important role in the early screening for infectious meningitis, provided a gadolinium-enhanced FLAIR sequence is used. (orig.)

  7. MRI in neuro-Behcet's syndrome: comparison of conventional spin-echo and FLAIR pulse sequences

    International Nuclear Information System (INIS)

    Jaeger, H.R.; Albrecht, T.; Curati-Alasonatti, W.L.; Williams, E.J.; Haskard, D.O.

    1999-01-01

    We compared the sensitivity of a fluid-attenuated inversion-recovery (FLAIR) sequence with that of a conventional dual-echo spin-echo (SE) sequence to brain lesions in 20 patients with Behcet's syndrome. They underwent 25 MRI examinations. The images were independently analysed for the number, type and anatomical location of lesions shown. There were 18 abnormal studies (13 initial and 5 follow-up). The FLAIR sequence detected significantly more lesions than the SE TE 80 (P < 0.05) and SE TE 20 (P < 0.01) sequences. It was particularly useful for demonstrating lesions in the juxtacortical white matter, which accounted for over half the lesions detected on the FLAIR images. Of patients presenting with nonspecific symptoms such as headache, seven had normal and five had abnormal studies. All patients presenting with focal neurological signs had abnormal imaging. We found supratentorial and, in particular, juxtacortical lesions to be more frequent than previously described. (orig.)

  8. Arterial hyperintensity on BLADE fluid-attenuated inversion recovery images (FLAIR) in hyperacute territorial infarction: comparison with conventional FLAIR

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    Kwag, Eujean; Lim, Soo Mee; Park, Ji Eun; Chae, In Hye [Ewha Womans University School of Medicine, Department of Radiology, Mokdong Hospital, Seoul (Korea, Republic of)

    2014-09-15

    To evaluate the utility of BLADE fluid-attenuated inversion recovery images (FLAIR) magnetic resonance (MR) imaging compared to conventional FLAIR for the detection of arterial hyperintensity (AH) in hyperacute territorial infarction. We retrospectively analysed MR images of patients with hyperacute (<6 h) territorial infarction over a 9-month study period. Special attention was paid to the presence or absence of AH in the frontal, parietal and temporal lobes and the number of AHs in the sylvian fissure. We also evaluated the presence of three kinds of artefacts on BLADE FLAIR and conventional FLAIR images. AH was seen in 41 (91 %) patients with conventional FLAIR and 45 (100 %) patients with BLADE FLAIR images. More instances of AH were detected in the frontal, parietal and temporal lobes and within the sylvian fissure using BLADE FLAIR. Motion artefacts, pulsation artefacts from the sigmoid sinus and incomplete cerebrospinal fluid (CSF) nulling that reduced image quality were observed more frequently on conventional FLAIR images than on BLADE FLAIR images. BLADE FLAIR sequences are more sensitive than conventional FLAIR for the detection of AH in hyperacute territorial infarctions and provide better image quality by reducing artefacts. They may be used in place of conventional FLAIR for patients with hyperacute stroke. (orig.)

  9. FLAIR imaging for differential diagnosis of new cerebral microbleeds

    International Nuclear Information System (INIS)

    Watanabe, Akira

    2009-01-01

    It may be difficult to determine the time of appearance of cerebral microbleeds (MBs) in T2*-weighted MR imaging (MRI), because most MBs take more than several years to become absorbed. The presence of MBs is closely related to intracerebral hemorrhage, and it is important to detect new MBs in order to prevent intracerebral hemorrhage. We evaluated 108 patients on maintenance hemodialysis with MRI at least twice from May 2003 to May 2008. Seventy-two new MBs were detected and 59 MBs disappeared. Initial fluid-attenuated inversion recovery (FLAIR) imaging revealed 3 MBs with surrounding hyperintensity (SH), but follow-up FLAIR imaging demonstrated disappearance of the SH in all cases. Five of the 72 new MBs had SH, but follow-up FLAIR imaging demonstrated disappearance of the SH in all cases. In one case, SH with the enlarged MB disappeared in follow-up FLAIR images. In conclusion, we considered SH of new MBs to be vasogenic edema accompanying new intracerebral hemorrhage. It was useful to compare T2*-weighted MRI with FLAIR imaging to determine the differential diagnosis of new MBs. (author)

  10. Clinical-Radiological Parameters Improve the Prediction of the Thrombolysis Time Window by Both MRI Signal Intensities and DWI-FLAIR Mismatch.

    Science.gov (United States)

    Madai, Vince Istvan; Wood, Carla N; Galinovic, Ivana; Grittner, Ulrike; Piper, Sophie K; Revankar, Gajanan S; Martin, Steve Z; Zaro-Weber, Olivier; Moeller-Hartmann, Walter; von Samson-Himmelstjerna, Federico C; Heiss, Wolf-Dieter; Ebinger, Martin; Fiebach, Jochen B; Sobesky, Jan

    2016-01-01

    With regard to acute stroke, patients with unknown time from stroke onset are not eligible for thrombolysis. Quantitative diffusion weighted imaging (DWI) and fluid attenuated inversion recovery (FLAIR) MRI relative signal intensity (rSI) biomarkers have been introduced to predict eligibility for thrombolysis, but have shown heterogeneous results in the past. In the present work, we investigated whether the inclusion of easily obtainable clinical-radiological parameters would improve the prediction of the thrombolysis time window by rSIs and compared their performance to the visual DWI-FLAIR mismatch. In a retrospective study, patients from 2 centers with proven stroke with onset value/mean value of the unaffected hemisphere). Additionally, the visual DWI-FLAIR mismatch was evaluated. Prediction of the thrombolysis time window was evaluated by the area-under-the-curve (AUC) derived from receiver operating characteristic (ROC) curve analysis. Factors such as the association of age, National Institutes of Health Stroke Scale, MRI field strength, lesion size, vessel occlusion and Wahlund-Score with rSI were investigated and the models were adjusted and stratified accordingly. In 82 patients, the unadjusted rSI measures DWI-mean and -SD showed the highest AUCs (AUC 0.86-0.87). Adjustment for clinical-radiological covariates significantly improved the performance of FLAIR-mean (0.91) and DWI-SD (0.91). The best prediction results based on the AUC were found for the final stratified and adjusted models of DWI-SD (0.94) and FLAIR-mean (0.96) and a multivariable DWI-FLAIR model (0.95). The adjusted visual DWI-FLAIR mismatch did not perform in a significantly worse manner (0.89). ADC-rSIs showed fair performance in all models. Quantitative DWI and FLAIR MRI biomarkers as well as the visual DWI-FLAIR mismatch provide excellent prediction of eligibility for thrombolysis in acute stroke, when easily obtainable clinical-radiological parameters are included in the prediction

  11. Detecting subarachnoid hemorrhage: Comparison of combined FLAIR/SWI versus CT

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    Verma, Rajeev Kumar, E-mail: rajeev.verma@insel.ch [University Institute of Diagnostic and Interventional Neuroradiology, Support Center for Advanced Neuroimaging, University of Bern, Inselspital, Freiburgstrasse 4, 3010 Bern (Switzerland); Kottke, Raimund, E-mail: raimund.kottke@insel.ch [University Institute of Diagnostic and Interventional Neuroradiology, Support Center for Advanced Neuroimaging, University of Bern, Inselspital, Freiburgstrasse 4, 3010 Bern (Switzerland); Andereggen, Lukas, E-mail: lukas.andereggen@insel.ch [Department of Neurosurgery, University of Bern, Inselspital, Freiburgstrasse 4, 3010 Bern (Switzerland); Weisstanner, Christian, E-mail: christian.weisstanner@insel.ch [University Institute of Diagnostic and Interventional Neuroradiology, Support Center for Advanced Neuroimaging, University of Bern, Inselspital, Freiburgstrasse 4, 3010 Bern (Switzerland); Zubler, Christoph, E-mail: christoph.zubler@insel.ch [University Institute of Diagnostic and Interventional Neuroradiology, Support Center for Advanced Neuroimaging, University of Bern, Inselspital, Freiburgstrasse 4, 3010 Bern (Switzerland); Gralla, Jan, E-mail: jan.gralla@insel.ch [University Institute of Diagnostic and Interventional Neuroradiology, Support Center for Advanced Neuroimaging, University of Bern, Inselspital, Freiburgstrasse 4, 3010 Bern (Switzerland); Kiefer, Claus, E-mail: claus.kiefer@insel.ch [University Institute of Diagnostic and Interventional Neuroradiology, Support Center for Advanced Neuroimaging, University of Bern, Inselspital, Freiburgstrasse 4, 3010 Bern (Switzerland); Slotboom, Johannes, E-mail: johannes.slotboom@insel.ch [University Institute of Diagnostic and Interventional Neuroradiology, Support Center for Advanced Neuroimaging, University of Bern, Inselspital, Freiburgstrasse 4, 3010 Bern (Switzerland); and others

    2013-09-15

    Objectives: Aim of this study was to compare the utility of susceptibility weighted imaging (SWI) with the established diagnostic techniques CT and fluid attenuated inversion recovery (FLAIR) in their detecting capacity of subarachnoid hemorrhage (SAH), and further to compare the combined SWI/FLAIR MRI data with CT to evaluate whether MRI is more accurate than CT. Methods: Twenty-five patients with acute SAH underwent CT and MRI within 6 days after symptom onset. Underlying pathology for SAH was head trauma (n = 9), ruptured aneurysm (n = 6), ruptured arteriovenous malformation (n = 2), and spontaneous bleeding (n = 8). SWI, FLAIR, and CT data were analyzed. The anatomical distribution of SAH was subdivided into 8 subarachnoid regions with three peripheral cisterns (frontal-parietal, temporal-occipital, sylvian), two central cisterns and spaces (interhemispheric, intraventricular), and the perimesencephalic, posterior fossa, superior cerebellar cisterns. Results: SAH was detected in a total of 146 subarachnoid regions. CT identified 110 (75.3%), FLAIR 127 (87%), and SWI 129 (88.4%) involved regions. Combined FLAIR and SWI identified all 146 detectable regions (100%). FLAIR was sensitive for frontal-parietal, temporal-occipital and Sylvian cistern SAH, while SWI was particularly sensitive for interhemispheric and intraventricular hemorrhage. Conclusions: By combining SWI and FLAIR, MRI yields a distinctly higher detection rate for SAH than CT alone, particularly due to their complementary detection characteristics in different anatomical regions. Detection strength of SWI is high in central areas, whereas FLAIR shows a better detection rate in peripheral areas.

  12. Improved differentiation between MS and vascular brain lesions using FLAIR* at 7 Tesla

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    Kilsdonk, Iris D.; Wattjes, Mike P.; Lopez-Soriano, Alexandra; Jong, Marcus C. de; Graaf, Wolter L. de; Conijn, Mandy M.A.; Barkhof, Frederik [VU University Medical Center, Department of Radiology, De Boelelaan 1118, HZ, Amsterdam (Netherlands); Kuijer, Joost P.A. [VU University Medical Center, Department of Physics and Medical Technology, Amsterdam (Netherlands); Polman, Chris H. [VU University Medical Center, Department of Neurology, Amsterdam (Netherlands); Luijten, Peter R. [University Medical Center, Department of Radiology, Utrecht (Netherlands); Geurts, Jeroen J.G. [VU University, Department of Anatomy and Neurosciences, Amsterdam (Netherlands); Geerlings, Mirjam I. [University Medical Center, Julius Center for Health Sciences and Primary Care, Utrecht (Netherlands)

    2014-04-15

    To investigate whether a new magnetic resonance image (MRI) technique called T2*-weighted fluid attenuation inversion recovery (FLAIR*) can differentiate between multiple sclerosis (MS) and vascular brain lesions, at 7 Tesla (T). We examined 16 MS patients and 16 age-matched patients with (risk factors for) vascular disease. 3D-FLAIR and T2*-weighted images were combined into FLAIR* images. Lesion type and intensity, perivascular orientation and presence of a hypointense rim were analysed. In total, 433 cerebral lesions were detected in MS patients versus 86 lesions in vascular patients. Lesions in MS patients were significantly more often orientated in a perivascular manner: 74 % vs. 47 % (P < 0.001). Ten MS lesions (2.3 %) were surrounded by a hypointense rim on FLAIR*, and 24 MS lesions (5.5 %) were hypointense on T2*. No lesions in vascular patients showed any rim or hypointensity. Specificity of differentiating MS from vascular lesions on 7-T FLAIR* increased when the presence of a central vessel was taken into account (from 63 % to 88 %), most obviously for deep white matter lesions (from 69 % to 94 %). High sensitivity remained (81 %). 7-T FLAIR* improves differentiation between MS and vascular lesions based on lesion location, perivascular orientation and presence of hypointense (rims around) lesions. circle A new MRI technique T2*-weighted fluid attenuation inversion recovery (FLAIR*) was investigated. circle FLAIR* at 7-T MRI combines FLAIR and T2* images into a single image. circle FLAIR* at 7 T does not require enhancement with contrast agents. (orig.)

  13. 3D-Flair sequence at 3T in cochlear otosclerosis

    International Nuclear Information System (INIS)

    Lombardo, Francesco; De Cori, Sara; Aghakhanyan, Gayane; Montanaro, Domenico; De Marchi, Daniele; Frijia, Francesca; Canapicchi, Raffaello; Fortunato, Susanna; Forli, Francesca; Berrettini, Stefano; Chiappino, Dante

    2016-01-01

    To assess the capability of three-dimensional fluid-attenuated inversion recovery (3D-FLAIR) sequences in detecting signal alterations of the endolabyrinthine fluid in patients with otosclerosis. 3D-FLAIR before and after (-/+) gadolinium (Gd) administration was added to the standard MR protocol and acquired in 13 patients with a clinical/audiological diagnosis of severe/profound hearing loss in otosclerosis who were candidates for cochlear implantation and in 11 control subjects using 3-T magnetic resonance imaging (MRI) equipment. The MRI signal of the fluid-filled cochlea was assessed both visually and calculating the signal intensity ratio (SIR = signal intensity cochlea/brainstem). We revealed no endocochlear signal abnormalities on T1-weighted -/+ Gd images for either group, while on 3D-FLAIR we found bilateral hyperintensity with enhancement after Gd administration in eight patients and bilateral hyperintensity without enhancement in one patient. No endocochlear signal abnormalities were detected in other patients or the control group. Using 3-T MRI equipment, the 3D-FLAIR -/+ Gd sequence is able to detect the blood-labyrinth barrier (BLB) breakdown responsible for alterations of the endolabyrinthine fluid in patients with cochlear otosclerosis. We believe that 3D-FLAIR +/- Gd is an excellent imaging modality to assess the intra-cochlear damage in otosclerosis patients. (orig.)

  14. 3D-Flair sequence at 3T in cochlear otosclerosis

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    Lombardo, Francesco; De Cori, Sara; Aghakhanyan, Gayane; Montanaro, Domenico; De Marchi, Daniele; Frijia, Francesca; Canapicchi, Raffaello [Fondazione CNR Regione Toscana ' ' G. Monasterio' ' , Neuroradiology Unit, Pisa (Italy); Fortunato, Susanna; Forli, Francesca; Berrettini, Stefano [University of Pisa, ENT Audiology Phoniatry Unit, Department of Neuroscience, Pisa (Italy); Chiappino, Dante [Fondazione CNR Regione Toscana ' ' G. Monasterio' ' , Department of Radiology, Massa (Italy)

    2016-10-15

    To assess the capability of three-dimensional fluid-attenuated inversion recovery (3D-FLAIR) sequences in detecting signal alterations of the endolabyrinthine fluid in patients with otosclerosis. 3D-FLAIR before and after (-/+) gadolinium (Gd) administration was added to the standard MR protocol and acquired in 13 patients with a clinical/audiological diagnosis of severe/profound hearing loss in otosclerosis who were candidates for cochlear implantation and in 11 control subjects using 3-T magnetic resonance imaging (MRI) equipment. The MRI signal of the fluid-filled cochlea was assessed both visually and calculating the signal intensity ratio (SIR = signal intensity cochlea/brainstem). We revealed no endocochlear signal abnormalities on T1-weighted -/+ Gd images for either group, while on 3D-FLAIR we found bilateral hyperintensity with enhancement after Gd administration in eight patients and bilateral hyperintensity without enhancement in one patient. No endocochlear signal abnormalities were detected in other patients or the control group. Using 3-T MRI equipment, the 3D-FLAIR -/+ Gd sequence is able to detect the blood-labyrinth barrier (BLB) breakdown responsible for alterations of the endolabyrinthine fluid in patients with cochlear otosclerosis. We believe that 3D-FLAIR +/- Gd is an excellent imaging modality to assess the intra-cochlear damage in otosclerosis patients. (orig.)

  15. MRI in seven cases of tacrolimus (FK-506) encephalopathy: utility of FLAIR and diffusion-weighted imaging

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    Furukawa, M. [Dept. of Radiology, Yamaguchi University School of Medicine, Ube (Japan); Dept. of Radiology, Hokkaido University School of Medicine, Sapporo (Japan); Terae, S.; Chu, B.C.; Kaneko, K.; Kamada, H.; Miyasaka, K. [Dept. of Radiology, Hokkaido University School of Medicine, Sapporo (Japan)

    2001-08-01

    We assessed the utility of fluid-attenuated inversion-recovery (FLAIR) and diffusion-weighted (DWI) images in investigation of tacrolimus (FK-506) encephalopathy, and to see whether we could predict its cause from clinical and imaging data. In seven patients with presumed FK-506 toxicity the areas involved on MRI were similar to those in cyclosporin A (CsA) toxicity. The abnormal signal was most evident on FLAIR in all cases. In three of four patients who underwent DWI, no diffusion abnormalities were detected; in the remaining patient, increased diffusion was seen in the deep white matter bilaterally on the apparent diffusion coefficient map, consistent with the findings on T2-weighted spin-echo and FLAIR images. Five of the six patients for whom we had clinical data showed sudden changes in electrolyte or fluid equilibrium due to diarrhoea, a polyuria or oliguria one day before or on the day of onset of the central nervous system disturbances. We speculate that FK-506 encephalopathy is triggered by the disturbance of the electrolyte and/or fluid equilibrium, given a certain serum level of FK-506. (orig.)

  16. MRI in seven cases of tacrolimus (FK-506) encephalopathy: utility of FLAIR and diffusion-weighted imaging

    International Nuclear Information System (INIS)

    Furukawa, M.; Terae, S.; Chu, B.C.; Kaneko, K.; Kamada, H.; Miyasaka, K.

    2001-01-01

    We assessed the utility of fluid-attenuated inversion-recovery (FLAIR) and diffusion-weighted (DWI) images in investigation of tacrolimus (FK-506) encephalopathy, and to see whether we could predict its cause from clinical and imaging data. In seven patients with presumed FK-506 toxicity the areas involved on MRI were similar to those in cyclosporin A (CsA) toxicity. The abnormal signal was most evident on FLAIR in all cases. In three of four patients who underwent DWI, no diffusion abnormalities were detected; in the remaining patient, increased diffusion was seen in the deep white matter bilaterally on the apparent diffusion coefficient map, consistent with the findings on T2-weighted spin-echo and FLAIR images. Five of the six patients for whom we had clinical data showed sudden changes in electrolyte or fluid equilibrium due to diarrhoea, a polyuria or oliguria one day before or on the day of onset of the central nervous system disturbances. We speculate that FK-506 encephalopathy is triggered by the disturbance of the electrolyte and/or fluid equilibrium, given a certain serum level of FK-506. (orig.)

  17. Regional Fluid-Attenuated Inversion Recovery (FLAIR at 7 Tesla correlates with Amyloid beta in Hippocampus and Brainstem of cognitively normal elderly subjects.

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    Simon J Schreiner

    2014-09-01

    Full Text Available Background: Accumulation of amyloid beta (Aβ may occur during healthy aging and is a risk factor for Alzheimer Disease (AD. While individual Aβ-accumulation can be measured non-invasively using Pittsburgh compound-B positron-emission-tomography (PiB-PET, Fluid-Attenuated Inversion Recovery (FLAIR is a Magnetic Resonance Imaging (MRI sequence, capable of indicating heterogeneous age-related brain pathologies associated with tissue-edema. In the current study cognitively normal elderly subjects were investigated for regional correlation of PiB- and FLAIR- intensity. Methods: 14 healthy elderly subjects without known history of cognitive impairment received 11C-PiB-PET for estimation of regional Aβ-load. In addition, whole brain T1-MPRAGE and FLAIR-MRI sequences were acquired at high field strength of 7 Tesla (7T. Volume-normalized intensities of brain regions were assessed by applying an automated subcortical segmentation algorithm for spatial definition of brain structures. Statistical dependence between FLAIR- and PiB-PET intensities was tested using Spearman's rank correlation coefficient (rho, followed by Holm-Bonferroni correction for multiple testing. Results: Neuropsychological testing revealed normal cognitive performance levels in all participants. Mean regional PiB-PET and FLAIR intensities were normally distributed and independent. Significant correlation between volume-normalized PiB-PET signals and FLAIR intensities resulted for Hippocampus (right:rho=0.86; left:rho=0.84, Brainstem (rho=0.85 and left Basal Ganglia vessel region (rho=0.82. Conclusions: Our finding of a significant relationship between PiB- and FLAIR-intensity mainly observable in the Hippocampus and Brainstem, indicates regional Aβ associated tissue-edema in cognitively normal elderly subjects. Further studies including clinical populations are necessary to clarify the relevance of our findings for estimating individual risk for age-related neurodegenerative

  18. Regional Fluid-Attenuated Inversion Recovery (FLAIR) at 7 Tesla correlates with amyloid beta in hippocampus and brainstem of cognitively normal elderly subjects

    Science.gov (United States)

    Schreiner, Simon J.; Liu, Xinyang; Gietl, Anton F.; Wyss, Michael; Steininger, Stefanie C.; Gruber, Esmeralda; Treyer, Valerie; Meier, Irene B.; Kälin, Andrea M.; Leh, Sandra E.; Buck, Alfred; Nitsch, Roger M.; Pruessmann, Klaas P.; Hock, Christoph; Unschuld, Paul G.

    2014-01-01

    Background: Accumulation of amyloid beta (Aβ) may occur during healthy aging and is a risk factor for Alzheimer Disease (AD). While individual Aβ-accumulation can be measured non-invasively using Pittsburgh Compund-B positron emission tomography (PiB-PET), Fluid-attenuated inversion recovery (FLAIR) is a Magnetic Resonance Imaging (MRI) sequence, capable of indicating heterogeneous age-related brain pathologies associated with tissue-edema. In the current study cognitively normal elderly subjects were investigated for regional correlation of PiB- and FLAIR intensity. Methods: Fourteen healthy elderly subjects without known history of cognitive impairment received 11C-PiB-PET for estimation of regional Aβ-load. In addition, whole brain T1-MPRAGE and FLAIR-MRI sequences were acquired at high field strength of 7 Tesla (7T). Volume-normalized intensities of brain regions were assessed by applying an automated subcortical segmentation algorithm for spatial definition of brain structures. Statistical dependence between FLAIR- and PiB-PET intensities was tested using Spearman's rank correlation coefficient (rho), followed by Holm–Bonferroni correction for multiple testing. Results: Neuropsychological testing revealed normal cognitive performance levels in all participants. Mean regional PiB-PET and FLAIR intensities were normally distributed and independent. Significant correlation between volume-normalized PiB-PET signals and FLAIR intensities resulted for Hippocampus (right: rho = 0.86; left: rho = 0.84), Brainstem (rho = 0.85) and left Basal Ganglia vessel region (rho = 0.82). Conclusions: Our finding of a significant relationship between PiB- and FLAIR intensity mainly observable in the Hippocampus and Brainstem, indicates regional Aβ associated tissue-edema in cognitively normal elderly subjects. Further studies including clinical populations are necessary to clarify the relevance of our findings for estimating individual risk for age-related neurodegenerative

  19. MRI in differentiation between recurrent disk herniation and postoperative scar. Value of FLAIR sequences

    International Nuclear Information System (INIS)

    Capiel, Carlos A. h; Bouzas, Carlos A.; Porto, Viviana G.

    2000-01-01

    The differential diagnosis between epidural fibrosis and recurrent or residual disk herniation in symptomatic patients who have been operated is often difficult. The MRI with Spin Echo T1 sequences before and after i.v. gadolinium plays and important role in the differentiation of these two entities. The signal characteristics in T1 and T2 sequences are not reliable to distinguish between herniated disk and scar. In order to evaluate the use of the FLAIR technique in the differentiation between herniated disk and epidural fibrosis we used MRI to study 37 symptomatic patients who had been operated of lumbar disk herniation, with FSE-T2 sequences in axial and sagittal planes, FLAIR in axial sections and SE-T1 in sagittal and axial sections before and after i.v. gadolinium. This sequence was used as gold standard for the final diagnosis. We conclude that the FLAIR technique is a reliable alternative in the differential diagnosis between epidural fibrosis and herniated disk, providing a positive correlation to the SE-T1-weighted images with i.v. gadolinium in 100% of the patients. (author)

  20. Evaluation of Possible Prognostic Factors of Fulminant Acute Disseminated Encephalomyelitis (ADEM) on Magnetic Resonance Imaging with Fluid-Attenuated Inversion Recovery (FLAIR) and Diffusion-Weighted Imaging

    Energy Technology Data Exchange (ETDEWEB)

    Donmez, F.Y.; Aslan, H.; Coskun, M. (Dept. of Radiology, Faculty of Medicine, Baskent Univ., Ankara (Turkey))

    2009-04-15

    Background: Acute disseminated encephalomyelitis (ADEM) may be a rapidly progressive disease with different clinical outcomes. Purpose: To investigate the radiological findings of fulminant ADEM on diffusion-weighted imaging (DWI) and fluid-attenuated inversion recovery (FLAIR) images, and to correlate these findings with clinical outcome. Material and Methods: Initial and follow-up magnetic resonance imaging (MRI) scans in eight patients were retrospectively evaluated for distribution of lesions on FLAIR images and presence of hemorrhage or contrast enhancement. DWI of the patients was evaluated as to cytotoxic versus vasogenic edema. The clinical records were analyzed, and MRI results and clinical outcome were correlated. Results: Four of the eight patients died, three had full recovery, and one had residual cortical blindness. The distribution of the hyperintense lesions on FLAIR sequence was as follows: frontal (37.5%), parietal (50%), temporal (37.5%), occipital (62.5%), basal ganglia (50%), pons (37.5%), mesencephalon (37.5%), and cerebellum (50%). Three of the patients who died had brainstem involvement. Two patients had a cytotoxic edema, one of whom died, and the other developed cortical blindness. Six patients had vasogenic edema: three of these patients had a rapid progression to coma and died; three of them recovered. Conclusion: DWI is not always helpful for evaluating the evolution or predicting the outcome of ADEM. However, extension of the lesions, particularly brainstem involvement, may have an influence on the prognosis.

  1. FLAIR images of subarachnoid hemorrhage

    Energy Technology Data Exchange (ETDEWEB)

    Mikami, Takeshi; Saito, Koji; Okuyama, Tohru; Sakamoto, Yasuo; Takahashi, Akira; Shibata, Kazunori [Kushiro Neurosurgical Hospital, Hokkaido (Japan)

    1996-12-01

    We studied MR fluid attenuated inversion recovery (FLAIR) pulse sequences in 37 cases with subarachnoid hemorrhage caused by aneurysmal rupture. FLAIR sequence suppressed the CSF signal and produced very heavy T{sub 2} weighted images. Subarachnoid hemorrhage was able to be demonstrated as high signal intensity on FLAIR sequences in all patients clear visualization of acute subarachnoid hemorrhage was able to be obtained by MR FLAIR sequences in not only Fisher`s group 3 or 4, but also Fisher`s group 2. Moreover it was suited for the detection of intraaxial hematoma, Sylvian hematoma, subdural hematoma and subarachnoid hemorrhage in the posterior fossa and interhemispheric fissure. Especially, it was useful for detecting intraventricular hemorrhage. Therefore, if patients suffering from subarachnoid hemorrhage present slight headache or atypical symptoms, sometimes it may be more suitable to perform MRI FLAIR pulse sequences first. Aneurysms were found in 21 cases (56.8%). When the aneurysmal size is more than 7 mm, the rate of detection becomes 100%. Aneurysms present various MR appearances because of flow characteristics. Aneurysms were demonstrated as low signal intensity except in 3 cases. In one out of 3 cases, aneurysms were revealed as high signal intensity and in the other two cases, it was revealed as mixed signal intensity. According to the previous studies, rapid flow was demonstrated as low signal intensity by vascular flow void, and delayed flow was demonstrated as high or mixed signal intensity by flow related enhancement and even echo rephasing. MR clearly delineates the size, the lumen, the flow, and the extraaxial location of aneurysms. (K.H.)

  2. Usefulness of fluid attenuated inversion recovery(FLAIR) image in mesial temporal sclerosis : comparison with turbo spin-echo T2-weighted image

    Energy Technology Data Exchange (ETDEWEB)

    Son, Seok Hyun; Chang, Seung Kuk; Eun, Choong Ki [Pusan Paik Hospital, Inje Univ. College of Medicine, Kimhae (Korea, Republic of)

    1999-12-01

    To determine the usefulness of fluid attenuated inversion recovery(FLAIR) imaging for the in detection of high signal intensity of hippocampus or amygdala in mesial temporal sclerosis (MTS), compared with that of turbo spin-echo T2-weighted imaging. Two neuroradiologists independently analyzed randomly mixed MR images of 20 lesions of 17 patients in whom MTS had been diagnosed, and ten normal controls. All subjects underwent both who performed both FLAIR and turbo spin-echo T2-weighted imaging, in a blind fashion. In order to determine hippocampal morphology, oblique coronal images perpendicular to the long axis of the hippocampus were obtained. The detection rate of high signal intensity in hippocampus or amygdala, the radiologists' preferred imaging sequence, and intersubject consistency of detection were evaluated. Signal intensity in hippocampus or amygdala was considered high if substantially higher than signal intensity in the cortex of adjacent temporo-parietal lobe. In all normal controls, FLAIR and spin-echo T2-weighted images showed normal signal intensity in hippocampus or amygdala. In MTS, the mean detection rate of high signal intensity in hippocampus or amygdala, as seen on FLAIR images was 93%, compared with 43% on spin-echo T2-weighted images. In all cases in which signal intensity on FLAIR images was normal, signal intensity on spin-echo T2-weighted images was also normal. The radiologists preferred the contrast properties of FLAIR to those of spin-echo T2-weighted images. In the diagnosis of MTS using MRI, FLAIR images are more useful for the detection of high signal intensity of hippocampus or amygdala than are spin-echo T2-weighted images. In the diagnosis of MTS, FLAIR imaging is therefore a suitable alternative to spin-echo T2-weighted imaging.

  3. Usefulness of fluid attenuated inversion recovery(FLAIR) image in mesial temporal sclerosis : comparison with turbo spin-echo T2-weighted image

    International Nuclear Information System (INIS)

    Son, Seok Hyun; Chang, Seung Kuk; Eun, Choong Ki

    1999-01-01

    To determine the usefulness of fluid attenuated inversion recovery(FLAIR) imaging for the in detection of high signal intensity of hippocampus or amygdala in mesial temporal sclerosis (MTS), compared with that of turbo spin-echo T2-weighted imaging. Two neuroradiologists independently analyzed randomly mixed MR images of 20 lesions of 17 patients in whom MTS had been diagnosed, and ten normal controls. All subjects underwent both who performed both FLAIR and turbo spin-echo T2-weighted imaging, in a blind fashion. In order to determine hippocampal morphology, oblique coronal images perpendicular to the long axis of the hippocampus were obtained. The detection rate of high signal intensity in hippocampus or amygdala, the radiologists' preferred imaging sequence, and intersubject consistency of detection were evaluated. Signal intensity in hippocampus or amygdala was considered high if substantially higher than signal intensity in the cortex of adjacent temporo-parietal lobe. In all normal controls, FLAIR and spin-echo T2-weighted images showed normal signal intensity in hippocampus or amygdala. In MTS, the mean detection rate of high signal intensity in hippocampus or amygdala, as seen on FLAIR images was 93%, compared with 43% on spin-echo T2-weighted images. In all cases in which signal intensity on FLAIR images was normal, signal intensity on spin-echo T2-weighted images was also normal. The radiologists preferred the contrast properties of FLAIR to those of spin-echo T2-weighted images. In the diagnosis of MTS using MRI, FLAIR images are more useful for the detection of high signal intensity of hippocampus or amygdala than are spin-echo T2-weighted images. In the diagnosis of MTS, FLAIR imaging is therefore a suitable alternative to spin-echo T2-weighted imaging

  4. MRI based thrombolysis for FLAIR-negative stroke patients within 4.5-6h after symptom onset.

    Science.gov (United States)

    Wei, Xiao-Er; Zhou, Jia; Li, Wen-Bin; Zhao, Yu-Wu; Li, Ming-Hua; Li, Yue-Hua

    2017-01-15

    To investigate the feasibility of DWI-FLAIR mismatch in identifying patients who might benefit from thrombolytic therapy within 4.5-6h, we analyzed the data of 105 ischemic stroke patients with known time of symptom onset who underwent MRI within 6h of stroke and thrombolysis between December 2006 and December 2013. They were divided into three groups: symptom onset within 4.5h (n=66); 4.5-6h and FLAIR images negative (n=9); and 4.5-6h and FLAIR images positive (n=30). Outcome of thrombolysis was assessed for each group by recanalization rate, National Institutes of Health Stroke Scale (NIHSS) and modified Rankin Scale (mRS) scores. The results showed that mismatch between positive DWI and negative FLAIR images identified patients within 4.5h of symptom onset with sensitivity, specificity, positive predictive value and negative predictive value of 40.9%, 76.9%, and 75% and 43.5%. Recanalization rate, NIHSS score and mRS score were all better in both the 0-4.5h and 4.5-6h FLAIR-negative groups than in the 4.5-6h FLAIR-positive group (psymptom onset, patients with negative FLAIR images may benefit from thrombolysis therapy. Copyright © 2016 Elsevier B.V. All rights reserved.

  5. Improve Image Quality of Transversal Relaxation Time PROPELLER and FLAIR on Magnetic Resonance Imaging

    Science.gov (United States)

    Rauf, N.; Alam, D. Y.; Jamaluddin, M.; Samad, B. A.

    2018-03-01

    The Magnetic Resonance Imaging (MRI) is a medical imaging technique that uses the interaction between the magnetic field and the nuclear spins. MRI can be used to show disparity of pathology by transversal relaxation time (T2) weighted images. Some techniques for producing T2-weighted images are Periodically Rotated Overlapping Parallel Lines with Enhanced Reconstruction (PROPELLER) and Fluid Attenuated Inversion Recovery (FLAIR). A comparison of T2 PROPELLER and T2 FLAIR parameters in MRI image has been conducted. And improve Image Quality the image by using RadiAnt DICOM Viewer and ENVI software with method of image segmentation and Region of Interest (ROI). Brain images were randomly selected. The result of research showed that Time Repetition (TR) and Time Echo (TE) values in all types of images were not influenced by age. T2 FLAIR images had longer TR value (9000 ms), meanwhile T2 PROPELLER images had longer TE value (100.75 - 102.1 ms). Furthermore, areas with low and medium signal intensity appeared clearer by using T2 PROPELLER images (average coefficients of variation for low and medium signal intensity were 0.0431 and 0.0705, respectively). As for areas with high signal intensity appeared clearer by using T2 FLAIR images (average coefficient of variation was 0.0637).

  6. Perbedaan Intensitas Penyengatan Meningeal Hasil MRI antara Sekuens T2 FLAIR Post Contrast dan T1WI Post Contrast Gadolinium-DTPA dalam Mendeteksi Penyangatan Meningeal pada Kasus Meningitis Tuberkulosis

    Directory of Open Access Journals (Sweden)

    Arie Hendarin

    2017-09-01

    Full Text Available Diagnosis meningitis TB terutama pada kasus possible dan probable sulit ditegakkan. Pemeriksaan MRI kepala dengan kontras Gadolinium-DTPA adalah modalitas radiologi yang paling sensitif untuk membantu mendiagnosis penyakit ini. Penyangatan meningeal di daerah basal merupakan gambaran MRI yang paling banyak ditemukan pada meningitis TB. Tujuan penelitian ini adalah mengetahui perbedaan peningkatan intensitas sinyal meningen sekuens T2-FLAIR dengan T1WI pada pasien meningitis tuberkulosis menggunakan pemeriksaan MRI kepala dengan kontras Gadolinium-DTPA di RSUP Dr. Hasan Sadikin Bandung pada bulan Januari 2015–Juni 2016. Subjek penelitian sebanyak 21 orang dengan meningitis TB dilakukan pemeriksaan MRI kepala dengan kontras Gadolinium-DTPA. Analisis statistik komparatif dilakukan untuk menguji perbedaan peningkatan intensitas sinyal meningen sekuens T2-FLAIR post contrast dengan T1WI post contrast. Hasil penelitian menujukkan rerata peningkatan intensitas sinyal meningen sekuen T2-FLAIR (∆T2-FLAIR sebesar 360,59±182,19 aμ sedangkan T1WI (∆T1WI sebesar 126,47±72,57 aμ. Hasil uji statistik menggunakan uji T pada derajat kepercayaan 95% menunjukkan perbedaan yang bermakna ∆T2-FLAIR dengan ∆T1WI pada nilai p=0,000. Sebagai simpulan didapatkan peningkatan intensitas sinyal meningen sekuens T2-FLAIR post contrast lebih besar daripada T1WI post contrast pada kasus meningitis TB.  [MKB. 2017;49(3:172–78] Kata kunci: Meningitis tuberkulosis, MRI sekuens T1WI dan T2-FLAIR, penyangatan meningeal Difference between Gadolinium-DTPA Enhanced T2 FLAIR Sequence and T1WI Sequence MRI in Detecting Meningeal Enhancement in Tuberculous Meningitis The diagnosis of TB meningitis, especially in possible and probable cases, is difficult. Contrast-enhanced MRI of the head with Gadolinium-DTPA is the most sensitive imaging modality that supports diagnosis of this disease. The most common presentation of TB meningitis in MRI is basal meningeal enhancement

  7. MRI of acute cerebral infarction: a comparison of FLAIR and T2-weighted fast spin-echo imaging

    International Nuclear Information System (INIS)

    Noguchi, K.; Ogawa, T.; Inugami, A.; Fujita, H.; Hatazawa, J.; Shimosegawa, E.; Okudera, T.; Uemura, K.; Seto, H.

    1997-01-01

    Fluid-attenuated inversion-recovery (FLAIR) sequences have been reported to provide high sensitivity to a wide range of central nervous system diseases. To our knowledge, however, FLAIR sequences have not been used to study patients with acute cerebral infarcts. We evaluated the usefulness of FLAIR sequences in this context. FLAIR sequences were acquired on a 0.5 T superconducting unit within 8 h of the onset in 19 patients (aged 26-80 years) with a total of 23 ischaemic lesions. The images were reviewed retrospectively by three neuroradiologists, and the FLAIR images were compared with T2-weighted fast spin-echo images. All but one of the ischaemic lesions involving grey matter was clearly demonstrated on FLAIR images as increased signal intensity in cortical or central grey matter. FLAIR images were particularly useful for detecting the hyperacute cortical infarcts within 3 h of onset, which were not readily detected on the spin-echo images. In 9 of 11 patients with complete proximal occlusion, the distal portion of the cerebral artery was visible as an area of high signal intensity on FLAIR images. (orig.). With 4 figs., 1 tab

  8. Hyperintense Acute Reperfusion Marker on FLAIR in a Patient with Transient Ischemic Attack

    Directory of Open Access Journals (Sweden)

    Alex Förster

    2016-01-01

    Full Text Available The hyperintense acute reperfusion marker (HARM has initially been described in acute ischemic stroke. The phenomenon is caused by blood-brain barrier disruption following acute reperfusion and consecutive delayed gadolinium enhancement in the subarachnoid space on fluid attenuated inversion recovery (FLAIR images. Here we report the case of an 80-year-old man who presented with transient paresis and sensory loss in the right arm. Initial routine stroke MRI including diffusion- and perfusion-weighted imaging demonstrated no acute pathology. Follow-up MRI after three hours demonstrated subarachnoid gadolinium enhancement in the left middle cerebral artery territory consistent with HARM that completely resolved on follow-up MRI three days later. This case illustrates that even in transient ischemic attack patients disturbances of the blood-brain barrier may be present which significantly exceed the extent of acute ischemic lesions on diffusion-weighted imaging. Inclusion of FLAIR images with delayed acquisition after intravenous contrast agent application in MRI stroke protocols might facilitate the diagnosis of a recent acute ischemic stroke.

  9. FLAIR vascular hyperintensities predict early ischemic recurrence in TIA.

    Science.gov (United States)

    Nam, Ki-Woong; Kim, Chi Kyung; Kim, Tae Jung; Oh, Kyungmi; Han, Moon-Ku; Ko, Sang-Bae; Yoon, Byung-Woo

    2018-02-27

    To evaluate the relationship between fluid-attenuated inversion recovery (FLAIR) vascular hyperintensity (FVH) and early ischemic lesion recurrence (follow-up diffusion-weighted imaging [FU-DWI] [+]) in patients with lesion-negative TIA. We recruited consecutive patients with lesion-negative TIA within 24 hours of symptom onset, who underwent follow-up MRI during the acute period. FVH was defined as a focal or serpentine high signal intensity on FLAIR images. Other potential confounders were adjusted to evaluate the relationship between FVH and FU-DWI (+). Furthermore, to compare clinical outcomes between the FU-DWI (+) and FU-DWI (-) groups, we assessed 1-year recurrent ischemic stroke or TIA. Among 392 patients with lesion-negative TIA, 82 patients had FU-DWI (+) on the follow-up MRI. In the multivariate analysis, FVH remained an independent predictor of FU-DWI (+) (adjusted odds ratio [aOR] = 4.77, 95% confidence interval [CI] 2.45-9.29, p TIA. As FU-DWI (+) frequently occurs during the acute period and has a subsequent worse outcome after discharge, additional radiologic or clinical markers for it are necessary. © 2018 American Academy of Neurology.

  10. Comparison of 3D cube FLAIR with 2D FLAIR for multiple sclerosis imaging at 3 tesla

    Energy Technology Data Exchange (ETDEWEB)

    Patzig, M.; Brueckmann, H.; Fesl, G. [Muenchen Univ. (Germany). Dept. of Neuroradiology; Burke, M. [GE Healthcare, Solingen (Germany)

    2014-05-15

    Purpose: Three-dimensional (3 D) MRI sequences allow improved spatial resolution with good signal and contrast properties as well as multiplanar reconstruction. We sought to compare Cube, a 3 D FLAIR sequence, to a standard 2 D FLAIR sequence in multiple sclerosis (MS) imaging. Materials and Methods: Examinations were performed in the clinical routine on a 3.0 Tesla scanner. 12 patients with definite MS were included. Lesions with MS-typical properties on the images of Cube FLAIR and 2 D FLAIR sequences were counted and allocated to different brain regions. Signal-to-noise ratios (SNR) and contrast-to-noise ratios (CNR) were calculated. Results: With 384 the overall number of lesions found with Cube FLAIR was significantly higher than with 2 D FLAIR (N = 221). The difference was mostly accounted for by supratentorial lesions (N = 372 vs. N = 216) while the infratentorial lesion counts were low in both sequences. SNRs and CNRs were significantly higher in CUBE FLAIR with the exception of the CNR of lesion to gray matter, which was not significantly different. Conclusion: Cube FLAIR showed a higher sensitivity for MS lesions compared to a 2 D FLAIR sequence. 3 D FLAIR might replace 2 D FLAIR sequences in MS imaging in the future. (orig.)

  11. Patient-specific 3D FLAIR for enhanced visualization of brain white matter lesions in multiple sclerosis.

    Science.gov (United States)

    Gabr, Refaat E; Pednekar, Amol S; Govindarajan, Koushik A; Sun, Xiaojun; Riascos, Roy F; Ramírez, María G; Hasan, Khader M; Lincoln, John A; Nelson, Flavia; Wolinsky, Jerry S; Narayana, Ponnada A

    2017-08-01

    To improve the conspicuity of white matter lesions (WMLs) in multiple sclerosis (MS) using patient-specific optimization of single-slab 3D fluid-attenuated inversion recovery (FLAIR) magnetic resonance imaging (MRI). Sixteen MS patients were enrolled in a prospective 3.0T MRI study. FLAIR inversion time and echo time were automatically optimized for each patient during the same scan session based on measurements of the relative proton density and relaxation times of the brain tissues. The optimization criterion was to maximize the contrast between gray matter (GM) and white matter (WM), while suppressing cerebrospinal fluid. This criterion also helps increase the contrast between WMLs and WM. The performance of the patient-specific 3D FLAIR protocol relative to the fixed-parameter protocol was assessed both qualitatively and quantitatively. Patient-specific optimization achieved a statistically significant 41% increase in the GM-WM contrast ratio (P < 0.05) and 32% increase in the WML-WM contrast ratio (P < 0.01) compared with fixed-parameter FLAIR. The increase in WML-WM contrast ratio correlated strongly with echo time (P < 10 -11 ). Two experienced neuroradiologists indicated substantially higher lesion conspicuity on the patient-specific FLAIR images over conventional FLAIR in 3-4 cases (intrarater correlation coefficient ICC = 0.72). In no case was the image quality of patient-specific FLAIR considered inferior to conventional FLAIR by any of the raters (ICC = 0.32). Changes in proton density and relaxation times render fixed-parameter FLAIR suboptimal in terms of lesion contrast. Patient-specific optimization of 3D FLAIR increases lesion conspicuity without scan time penalty, and has potential to enhance the detection of subtle and small lesions in MS. 1 Technical Efficacy: Stage 1 J. MAGN. RESON. IMAGING 2017;46:557-564. © 2016 International Society for Magnetic Resonance in Medicine.

  12. FLAIR images of mild head trauma with transient amnesia

    Energy Technology Data Exchange (ETDEWEB)

    Wakamoto, Hirooki; Miyazaki, Hiromichi; Inaba, Makoto; Ishiyama, Naomi [Hiratsuka City Hospital, Kanagawa (Japan); Kawase, Takeshi

    1998-11-01

    A newly advanced MRI pulse sequence, the FLAIR (fluid-attenuated inversion recovery) imaging, in which a long TE spin echo sequence is used with suppression of the CSF with an inversion pulse, displays the CSF space as a no signal intensity area. We examined 45 cases of mild head trauma with posttraumatic amnesia by FLAIR images and could detect some findings which could not be detected by CT scan and conventional MR images. These findings could be detected in many patients with long posttraumatic amnesia (over 2 hours), but they could not be detected in patients with short posttraumatic amnesia (within 30 mins). These findings existed surrounding lateral ventricles and we classified them into 3 types: type 1 is anterior horn of lateral ventricle, type 2 is the base of frontal lobe, and type 3 is cerebral deep white matter. Some of them were examined again by FLAIR images a month later, and these findings had disappeared. We suspect that these lesions were brain edema or mild contusion without hemorrhage. (author)

  13. FLAIR images of mild head trauma with transient amnesia

    International Nuclear Information System (INIS)

    Wakamoto, Hirooki; Miyazaki, Hiromichi; Inaba, Makoto; Ishiyama, Naomi; Kawase, Takeshi

    1998-01-01

    A newly advanced MRI pulse sequence, the FLAIR (fluid-attenuated inversion recovery) imaging, in which a long TE spin echo sequence is used with suppression of the CSF with an inversion pulse, displays the CSF space as a no signal intensity area. We examined 45 cases of mild head trauma with posttraumatic amnesia by FLAIR images and could detect some findings which could not be detected by CT scan and conventional MR images. These findings could be detected in many patients with long posttraumatic amnesia (over 2 hours), but they could not be detected in patients with short posttraumatic amnesia (within 30 mins). These findings existed surrounding lateral ventricles and we classified them into 3 types: type 1 is anterior horn of lateral ventricle, type 2 is the base of frontal lobe, and type 3 is cerebral deep white matter. Some of them were examined again by FLAIR images a month later, and these findings had disappeared. We suspect that these lesions were brain edema or mild contusion without hemorrhage. (author)

  14. Bilateral mesial temporal sclerosis: MRI with high-resolution fast spin-echo and fluid-attenuated inversion-recovery sequences

    Energy Technology Data Exchange (ETDEWEB)

    Oppenheim, C.; Dormont, D.; Lehericy, S.; Marsault, C. [Dept. of Neuroradiology, Groupe Hospitalier Pite-Salpetriere, Paris (France); Hasboun, D. [Dept. of Neuroradiology, Groupe Hospitalier Pite-Salpetriere, Paris (France)]|[Dept. of Neurology, Paris VI Univ. (France); Bazin, B.; Samson, S.; Baulac, M. [Dept. of Neurology, Paris VI Univ. (France)

    1999-07-01

    We report a retrospective analysis of MRI in 206 patients with intractable seizures and describe the findings in bilateral mesial temporal sclerosis (MTS) on fast spin-echo (FSE) and fast fluid-attenuated inversion-recovery (fFLAIR) sequences. Criteria for MTS were atrophy, signal change and loss of the digitations of the head of the hippocampus. In patients with bilateral MRI signs of MTS, correlation with clinical electro, volumetric MRI data and neuropsychological tests, when available, was performed. Bilateral MTS was observed in seven patients. Bilateral loss of the digitations and signal change of fFLAIR was seen in all seven. In three, bilateral atrophy was obvious. In two patients, mild bilateral atrophy was observed and in two others, the hippocampi were: asymmetrical, with obvious atrophy on only one side. Volumetric data confirmed bilateral symmetrical atrophy in five patients, and volumes were at the lowest of the normal range in other two. The EEG showed temporal abnormalities in all patients, unilateral in five and bilateral in two. All patients had memory impairment and neuropsychological data confirmed visual and verbal memory deficits; two patients failed the Wada test on both sides. High-resolution T2-weighted FSE and fFLAIR sequences allow diagnosis of bilateral MTS, which has important therapeutic and prognostic implications. (orig.)

  15. Bilateral mesial temporal sclerosis: MRI with high-resolution fast spin-echo and fluid-attenuated inversion-recovery sequences

    International Nuclear Information System (INIS)

    Oppenheim, C.; Dormont, D.; Lehericy, S.; Marsault, C.; Hasboun, D.; Bazin, B.; Samson, S.; Baulac, M.

    1999-01-01

    We report a retrospective analysis of MRI in 206 patients with intractable seizures and describe the findings in bilateral mesial temporal sclerosis (MTS) on fast spin-echo (FSE) and fast fluid-attenuated inversion-recovery (fFLAIR) sequences. Criteria for MTS were atrophy, signal change and loss of the digitations of the head of the hippocampus. In patients with bilateral MRI signs of MTS, correlation with clinical electro, volumetric MRI data and neuropsychological tests, when available, was performed. Bilateral MTS was observed in seven patients. Bilateral loss of the digitations and signal change of fFLAIR was seen in all seven. In three, bilateral atrophy was obvious. In two patients, mild bilateral atrophy was observed and in two others, the hippocampi were: asymmetrical, with obvious atrophy on only one side. Volumetric data confirmed bilateral symmetrical atrophy in five patients, and volumes were at the lowest of the normal range in other two. The EEG showed temporal abnormalities in all patients, unilateral in five and bilateral in two. All patients had memory impairment and neuropsychological data confirmed visual and verbal memory deficits; two patients failed the Wada test on both sides. High-resolution T2-weighted FSE and fFLAIR sequences allow diagnosis of bilateral MTS, which has important therapeutic and prognostic implications. (orig.)

  16. FLAIR lesion segmentation: Application in patients with brain tumors and acute ischemic stroke

    International Nuclear Information System (INIS)

    Artzi, Moran; Aizenstein, Orna; Jonas-Kimchi, Tali; Myers, Vicki; Hallevi, Hen; Ben Bashat, Dafna

    2013-01-01

    Background: Lesion size in fluid attenuation inversion recovery (FLAIR) images is an important clinical parameter for patient assessment and follow-up. Although manual delineation of lesion areas considered as ground truth, it is time-consuming, highly user-dependent and difficult to perform in areas of indistinct borders. In this study, an automatic methodology for FLAIR lesion segmentation is proposed, and its application in patients with brain tumors undergoing therapy; and in patients following stroke is demonstrated. Materials and methods: FLAIR lesion segmentation was performed in 57 magnetic resonance imaging (MRI) data sets obtained from 44 patients: 28 patients with primary brain tumors; 5 patients with recurrent-progressive glioblastoma (rGB) who were scanned longitudinally during anti-angiogenic therapy (18 MRI scans); and 11 patients following ischemic stroke. Results: FLAIR lesion segmentation was obtained in all patients. When compared to manual delineation, a high visual similarity was observed, with an absolute relative volume difference of 16.80% and 20.96% and a volumetric overlap error of 24.87% and 27.50% obtained for two raters: accepted values for automatic methods. Quantitative measurements of the segmented lesion volumes were in line with qualitative radiological assessment in four patients who received anti-anogiogenic drugs. In stroke patients the proposed methodology enabled identification of the ischemic lesion and differentiation from other FLAIR hyperintense areas, such as pre-existing disease. Conclusion: This study proposed a replicable methodology for FLAIR lesion detection and quantification and for discrimination between lesion of interest and pre-existing disease. Results from this study show the wide clinical applications of this methodology in research and clinical practice

  17. FLAIR lesion segmentation: Application in patients with brain tumors and acute ischemic stroke

    Energy Technology Data Exchange (ETDEWEB)

    Artzi, Moran, E-mail: artzimy@gmail.com [The Functional Brain Center, The Wohl Institute for Advanced Imaging, Tel Aviv Sourasky Medical Center, Tel Aviv (Israel); Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv (Israel); Aizenstein, Orna, E-mail: ornaaize@gmail.com [The Functional Brain Center, The Wohl Institute for Advanced Imaging, Tel Aviv Sourasky Medical Center, Tel Aviv (Israel); Jonas-Kimchi, Tali, E-mail: talijk@tlvmc.gov.il [Radiology Department, Tel Aviv Sourasky Medical Center, Tel Aviv (Israel); Myers, Vicki, E-mail: vicki_myers@hotmail.com [The Functional Brain Center, The Wohl Institute for Advanced Imaging, Tel Aviv Sourasky Medical Center, Tel Aviv (Israel); Hallevi, Hen, E-mail: hen.hallevi@gmail.com [Neurology Department, Tel Aviv Sourasky Medical Center, Tel Aviv (Israel); Ben Bashat, Dafna, E-mail: dafnab@tlvmc.gov.il [The Functional Brain Center, The Wohl Institute for Advanced Imaging, Tel Aviv Sourasky Medical Center, Tel Aviv (Israel); Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv (Israel)

    2013-09-15

    Background: Lesion size in fluid attenuation inversion recovery (FLAIR) images is an important clinical parameter for patient assessment and follow-up. Although manual delineation of lesion areas considered as ground truth, it is time-consuming, highly user-dependent and difficult to perform in areas of indistinct borders. In this study, an automatic methodology for FLAIR lesion segmentation is proposed, and its application in patients with brain tumors undergoing therapy; and in patients following stroke is demonstrated. Materials and methods: FLAIR lesion segmentation was performed in 57 magnetic resonance imaging (MRI) data sets obtained from 44 patients: 28 patients with primary brain tumors; 5 patients with recurrent-progressive glioblastoma (rGB) who were scanned longitudinally during anti-angiogenic therapy (18 MRI scans); and 11 patients following ischemic stroke. Results: FLAIR lesion segmentation was obtained in all patients. When compared to manual delineation, a high visual similarity was observed, with an absolute relative volume difference of 16.80% and 20.96% and a volumetric overlap error of 24.87% and 27.50% obtained for two raters: accepted values for automatic methods. Quantitative measurements of the segmented lesion volumes were in line with qualitative radiological assessment in four patients who received anti-anogiogenic drugs. In stroke patients the proposed methodology enabled identification of the ischemic lesion and differentiation from other FLAIR hyperintense areas, such as pre-existing disease. Conclusion: This study proposed a replicable methodology for FLAIR lesion detection and quantification and for discrimination between lesion of interest and pre-existing disease. Results from this study show the wide clinical applications of this methodology in research and clinical practice.

  18. Clinical usefulness of fluid-attenuated inversion recovery (FLAIR) sequences in intracranial lesions focusing on emergent cases

    Energy Technology Data Exchange (ETDEWEB)

    Kuramochi, Masashi; Niitsu, Mamoru; Itai, Yuji [Tsukuba Univ., Ibaraki (Japan). Inst. of Clinical Medicine; Wada, Mitsuyoshi

    1997-06-01

    Fluid-Attenuated Inversion Recovery (FLAIR) Pulse Sequences with inversion times of 1700 ms and echo times of 110 ms were used to demonstrate the brain of cerebrovascular disease (CVD) and brain trauma. The long inversion times and long echo times nulls the signal from cerebrospinal fluid and produces heavy T{sub 2} weighting images. We compared FLAIR Pulse Sequences with T{sub 2} weighted image Pulse Sequences for signal intensities of CVD and trauma. FLAIR Pulse Sequences is useful to detect at the periphery of the cerebral hemispheres, but infratentorial small infarctions often cannot be detected for its iso-intensity and slight intensity changes. In all patient of traumatic-subarachnoid hemorrhage (t-SAH) can be definitely detected high signal intensity of the cerebral hemispheres. (author)

  19. Usefulness of combined fat- and fluid-suppressed SPIR-FLAIR images in optic neurits : Comparison with fat-suppressed SPIR or STIR images

    International Nuclear Information System (INIS)

    Kim, Hye Yeon; Son, Seok Hyun; Eun, Choong Ki; Han, Sang Suk

    2001-01-01

    To compare the usefulness of combined fat- and fluid-suppressed selective partial inversion recovery-fluid attenuated inversion recovery(SPIR-FLAIR) images in the detection of high signal intensity of the optic nerve in optic neuritis with that of fat-suppressed selective partial inversion recovery(SPIR) or short inversion time inversion recovery(STIR) images. Two radiologists independently analyzed randomly mixed MR images of 16 lesions in 14 patients (M:F=7:7; mean age, 40 years) in whom optic neuritis had been clinically diagnosed. All subjects underwent both SPIR-FLAIR and fat-suppressed SPIR or STIR imaging, in a blind fashion. In order to evaluate the optic nerve, coronal images perpendicular to its long axis were obtained. The detection rate of high signal intensity of the optic nerve, the radiologists preferred imaging sequences, and intersubject consistency of detection were evaluated. 'High signal intensity' was defined as the subjective visual evaluation of increased signal intensity compared with that of the contralateral optic nerve or that of white matter. The mean detection rate of high signal intensity of the optic nerve was 90% for combined fat- and fluid-suppressed SPIR-FLAIR images, and 59% for fat-suppressed SPIR or STIR images. In all cases in which the signal intensity observed on SPIR-FLAIR images was normal, that on fat-suppressed SPIR or STIR images was also normal. The radiologists preferred the contrast properties of SPIR-FLAIR to those of fat-suppressed SPIR or STIR images. In the diagnosis of optic neuritis using MRI, combined fat- and fluid-suppressed SPIR-FLAIR images were more useful for the detection of high signal intensity of the optic nerve than fat-suppressed SPIR or STIR images. For the evaluation of optic neuritis, combined fat- and fluid-suppressed SPIR-FLAIR imaging is superior to fat-suppressed SPIR or STIR imaging

  20. FLAIR imaging in the follow-up of low-grade gliomas: time to dispense with the dual-echo?

    Energy Technology Data Exchange (ETDEWEB)

    Bynevelt, M.; Britton, J.; Seymour, H.; MacSweeney, E.; Sandhu, K. [Atkinson Morley' s Hospital, London (United Kingdom). Dept. of Neuroradiology; Thomas, N. [Dept. of Neurosurgery, Atkinson Morley' s Hospital, London (United Kingdom)

    2001-02-01

    Fluid-attenuated inversion-recovery (FLAIR) imaging has established its utility in neuroimaging. We propose this imaging sequence as a replacement for proton density (PD) and T2-weighted spin-echo sequences in the follow-up of low-grade glioma. 26 MRI examinations of 18 patients with such tumours were reviewed by three neuroradiologists and a neurosurgeon. FLAIR was found to be superior for appreciation of the lesion (91 % of studies) and for demonstration of its margin (92 %). FLAIR was also better at showing different tumour components, particularly in regions difficult to demonstrate in some planes, such as the vertex in axial imaging. The sequence also defines the postoperative cavity, shows the least amount of susceptibility effect associated with surgical clips, and demonstrates local spread (to white matter tracts, subependymal and capsular) more distinctly. We conclude that FLAIR can replace PD and T2-weighted spin-echo imaging in radiological follow-up of low-grade glioma. (orig.)

  1. Role of three-dimensional fluid-attenuated inversion recovery (3D FLAIR) and proton density magnetic resonance imaging for the detection and evaluation of lesion extent of focal cortical dysplasia in patients with refractory epilepsy

    International Nuclear Information System (INIS)

    Saini, Jitender; Kesavadas, Chandrasekharan; Thomas, Bejoy; Singh, Atampreet; Rathore, Chathurbhuj; Radhakrishnan, Ashalatha; Radhakrishnan, Kurupath; Bahuleyan, Biji

    2010-01-01

    Background: Focal cortical dysplasia (FCD) is often associated with epilepsy. Identification of FCD can be difficult due to subtle magnetic resonance imaging (MRI) changes. Though fluid-attenuated inversion recovery (FLAIR) sequence detects the majority of these lesions, smaller lesions may go unnoticed while larger lesions may be poorly delineated. Purpose: To determine the ability of a specialized epilepsy protocol in visualizing and delineating the extent of FCD. Material and Methods: We compared the imaging findings in nine patients with cortical malformation who underwent routine epilepsy MR imaging as well as a specialized epilepsy protocol. All imaging was done on a 1.5T MR unit. The specialized epilepsy protocol included 3D FLAIR in the sagittal plane as well as proton density (PD) and high-resolution T2-weighted (T2W) images in the transverse plane. Results: In all nine patients, the specialized protocol identified lesion anatomy better. In three patients in whom routine MRI was normal, the specialized epilepsy protocol including 3D FLAIR helped in identifying the lesions. One of these patients underwent surgery, and histo-pathology revealed a cortical dysplasia. In one patient, lesion characterization was improved, while in the remaining patients the extent of the FCD was more clearly demonstrated in the 3D FLAIR and PD images. Statistical analysis of images for cortical thickness, cortical signal intensity, adjacent white matter abnormalities, and gray-white matter junction showed significant statistical difference in the ability of 3D FLAIR to assess these aspects over conventional images. PD images were also found superior to the routine epilepsy protocol in assessment of cortical signal, adjacent white matter, and gray-white matter junction. Conclusion: Specialized MRI sequences and techniques should be performed whenever there is a high suspicion of cortical dysplasia, especially when they remain occult on conventional MR protocols. These techniques

  2. Diagnosis of acute subarachnoid hemorrhage at 1.5 Tesla using proton-density weighted FSE and FLAIR sequences

    International Nuclear Information System (INIS)

    Wiesmann, M.; Mayer, T.E.; Brueckmann, H.; Medele, R.

    1999-01-01

    Purpose: To evaluate MR imaging at 1.5 Tesla in patients suffering from acute subarachnoid hemorrhage (SAH) using proton-density weighted (PDW) fast spin echo (FSE) and fluid attenuated inversion recovery (FLAIR) sequences. Methods: 19 patients suffering from acute SAH as diagnosed by CT were studied 6 h to 3 days after hemorrhage. 10 patients without SAH were studied as a control group. The presence of subarachnoid blood as well as possible artifacts was recorded. Results: In all 19 patients subarachnoid hemorrhage was detected on both FLAIR and PDW images (100%). On the FLAIR images, the cerebral ventricles were partially obscured by flow artifacts in 7 of 19 patients, the basal cisterns in 6 of 19 patients. In 4 of these 13 regions blood was diagnosed on both PDW and CT images, while in the other 9 regions both PDW and CT were unremarkable. Conclusion: The sensitivity of MRI at 1.5 Tesla in the diagnosis of subarachnoid hemorrhage is comparable to CT. The combination of FLAIR and PDW FSE sequences helps to avoid false-positive results caused by flow artifacts. (orig.) [de

  3. Comparison between FLAIR images and T2-weighted fast spin-echo images of cerebral territory and lacunar infarction

    International Nuclear Information System (INIS)

    Paeng, Mi Hye; Choi, Hye-Young; Lim, Soo Mee; Lee, Jung Sik

    2003-01-01

    To assess the significance of fluid-attenuated inversion recovery (FLAIR) magnetic resonance (MR) imaging in the diagnosis of intracranial infarctions and to find out differential points between central lacunar infarctions and perivascular spaces. We consecutively selected 25 cases of territorial infarction in 20 patients, 37 cases of central infarction in 40 patients, and 30 patients with perivascular space. Signal intensity and lesion conspicuity were analyzed and compared between FLAIR and FSE T2-weighted images, and differences in signal intensity between central infarction and perivascular spaces were determined. Lesion conspicuity for FLAIR was better than for T2-weighted images in 12 and 15, worse in 4 and 24, and similar in 9 and 16 of territorial and central infarctions, respectively. In nine cases of territorial and one case of central infarction, there was associated hemorrhage. At FLAIR imaging, perivascular spaces showed a fine round low signal without a peripheral high signal rim in 17 patients but no demonstrable signals in 15. Differential diagnosis of perivascular spaces and central infarction was thus not difficult. FLAIR MRI was useful in the diagnosis of infarctions and in differentiating between central small lacular infarctions and perivascular spaces

  4. FLAIR images of brain diseases

    International Nuclear Information System (INIS)

    Segawa, Fuminori; Kinoshita, Masao; Kishibayashi, Jun; Kamada, Kazuhiko; Sunohara, Nobuhiko.

    1994-01-01

    The present study was designed to assess the usefulness of fluid-attenuated inversion recovery (FLAIR) images in diagnosing brain diseases. The subjects were 20 patients with multiple cerebral infarction, multiple sclerosis, temporal epilepsy, or brain trauma, and 20 other healthy adults. FLAIR images, with a long repetitive time of 6000 msec and a long inversion time of 1400-1600 msec, showed low signal intensity in the cerebrospinal fluid in the lateral ventricles and the cerebral sulci, and high signal intensity in brain tissues. Signal intensity on FLAIR images correlated well with T2 relaxation times under 100 msec. For multiple sclerosis and cerebral infarction, cystic lesions, which were shown on T2-weighted images with long relaxation times over 100 msec, appeared as low-signal areas; and the lesions surrounding the cystic lesions appeared as high-signal areas. For temporal lobe epilepsy, the hippocampus was visualized as a high-signal area. Hippocampal lesions were demonstrated better with FLAIR images than with conventional T2-weighted and proton-density images. In a patient with cerebral trauma, FLAIR images revealed the lobulated structure with the residual cortex shown as a high signal area. The lesions surrounding the cystic change were imaged as high signal areas. These structural changes were demonstrated better with FLAIR images than with conventional T2-weighted sequences. FLAIR images were useful in detecting white matter lesions surrounding the lateral ventricles and cortical and subcortical lesions near the brain surface, which were unclear on conventional T2-weighted and proton-density images. (N.K.)

  5. Computer aided detection of tumor and edema in brain FLAIR magnetic resonance image using ANN

    Science.gov (United States)

    Pradhan, Nandita; Sinha, A. K.

    2008-03-01

    This paper presents an efficient region based segmentation technique for detecting pathological tissues (Tumor & Edema) of brain using fluid attenuated inversion recovery (FLAIR) magnetic resonance (MR) images. This work segments FLAIR brain images for normal and pathological tissues based on statistical features and wavelet transform coefficients using k-means algorithm. The image is divided into small blocks of 4×4 pixels. The k-means algorithm is used to cluster the image based on the feature vectors of blocks forming different classes representing different regions in the whole image. With the knowledge of the feature vectors of different segmented regions, supervised technique is used to train Artificial Neural Network using fuzzy back propagation algorithm (FBPA). Segmentation for detecting healthy tissues and tumors has been reported by several researchers by using conventional MRI sequences like T1, T2 and PD weighted sequences. This work successfully presents segmentation of healthy and pathological tissues (both Tumors and Edema) using FLAIR images. At the end pseudo coloring of segmented and classified regions are done for better human visualization.

  6. Leptomeningeal high signal intensity (ivy sign) on fluid-attenuated inversion-recovery (FLAIR) MR images in moyamoya disease

    Energy Technology Data Exchange (ETDEWEB)

    Fujiwara, Hirokazu [Department of Diagnostic Radiology, School of Medicine, Keio University, Tokyo 1608582 (Japan)]. E-mail: hirokazu_fujiwara@ybb.ne.jp; Momoshima, Suketaka [Department of Diagnostic Radiology, School of Medicine, Keio University, Tokyo 1608582 (Japan); Kuribayashi, Sachio [Department of Diagnostic Radiology, School of Medicine, Keio University, Tokyo 1608582 (Japan)

    2005-08-01

    Purpose: There are a few reports on leptomeningeal high signal intensity (LMHI: ivy sign) on fluid-attenuated inversion-recovery (FLAIR) images in moyamoya disease, but the feature of this finding has not been completely understood. The purpose of this study was to characterize LMHI on FLAIR images in moyamoya disease and to assess usefulness of this finding in the diagnosis of moyamoya disease in conventional MR imaging. Material and methods: MR imaging of 28 patients with moyamoya disease was retrospectively reviewed. The grade of LMHI on FLAIR images was classified as 'absent,' 'minimal,' 'moderate' and 'marked.' Fifty-four hemispheres of 28 patients (2 patients had unilateral disease) were assessed for the frequency of visualization and distribution of LMHI. The correlations between LMHI on FLAIR images, moyamoya vessels on T1- and T2-weighted images and MR angiography findings were also analyzed. Results: Moderate and marked LMHI was seen in 31 out of 54 hemispheres (57%). LMHI was seen more prominently in the frontal and parietal lobes than in the temporal and occipital lobes. Although there was a tendency for LMHI on FLAIR images to be prominent in groups with moderate and marked moyamoya vessels on T1- and T2-weighted images, there was no significant correlation. More prominent LMHI was observed in the hemispheres in which cortical branches of the middle cerebral arteries were poorly visualized on MR angiography. Conclusion: Leptomeningeal high signal intensity (ivy sign) on FLAIR images is predominantly seen in the frontal and parietal lobes. Because this sign can be seen in patients with unremarkable moyamoya vessels, LMHI is a useful sign in conventional MR imaging for the diagnosis of moyamoya disease.

  7. Can a 15-sec FLAIR replace conventional FLAIR sequence in stroke MR protocols?

    Science.gov (United States)

    Benzakoun, J; Maïer, B; Calvet, D; Edjlali, M; Turc, G; Lion, S; Legrand, L; Ben Hassen, W; Naggara, O; Meder, J F; Mas, J L; Oppenheim, C

    2017-06-01

    Triage imaging facilitates the timely recognition of acute stroke with prognostic implications. Improvement in MR acquisition speed is needed given the extreme time constraints before treatment. We compared an ultrafast Echo-Planar FLAIR sequence (EPI-FLAIR) and a conventional FLAIR sequence (cFLAIR) for their diagnostic performances and ability to estimate the age of infarction. Between June and August 2014, 125 consecutive patients (age 69±18 years, 48% men) admitted for a suspicion of acute (≤48-hrs) stroke were explored by both FLAIR sequences at 1.5-Tesla. EPI-FLAIR (15-sec) and cFLAIR (2-min and 15-sec) were compared by two readers, blinded to clinical data. EPI-FLAIR was less prone to kinetic artefacts than cFLAIR (2-3% vs. 23-49% depending on the reader, P0.9). Amongst 8 hemorrhages, one subarachnoid hemorrhage presenting as a sudden deficit was missed on EPI-FLAIR sequence. Amongst 60 infarctions, cFLAIR and EPI-FLAIR were concordant in 50 (83%), while signal changes were visible on cFLAIR only in the remaining 10 (17%) cases. Amongst the 43 patients with known onset time (n=17 within 4.5hrs), FLAIR-DWI mismatch identified<4.5-hrs infarction with the same sensitivity (65%) using cFLAIR and EPI-FLAIR, but the positive predictive value (PPV) was higher for cFLAIR than for EPI-FLAIR (73% vs. 50%, P=0.008). EPI-FLAIR allows a drastic reduction of acquisition time devoted to FLAIR sequence and minimizes motion artifacts. Compared with cFLAIR, it is however associated with increased risk of undiagnosed stroke mimics and lower PPV for identifying<4.5-hrs infarctions. Copyright © 2017 Elsevier Masson SAS. All rights reserved.

  8. Clinical utility of MR FLAIR imaging for head injuries

    Energy Technology Data Exchange (ETDEWEB)

    Ashikaga, Ryuichiro [Kinki Univ., Osaka-Sayama, Osaka (Japan). School of Medicine

    1996-12-01

    To study the utility of fluid attenuated inversion recovery (FLAIR) MR images in the evaluation of traumatic head injury, 56 patients with traumatic head injuries were examined with long TR/TE spin-echo (SE) sequences and FLAIR sequences. In 40 of them, long TR/short TE images were added to those sequences. Careful readings of MR images were done by two well-trained neuroradiologists. The chi-square test was used for statistical evaluation of our results. The relative sensitivities of FLAIR images were significantly better than those of long TR/TE, long TR/short TE images for the detection of diffuse axonal injury (p<0.01), cortical contusion (p<0.01), and subdural hematoma (p<0.01 for long TR/TE, p<0.05 for long TR/short TE). The number of cases of epidural hematoma and brainstem injury was too small for statistical significance to be determined. In 9 patients with corpus callosum injuries. FLAIR images demonstrated the lesions as abnormally high signal intensity in the septum pellucidum and fornix. Only sagittal FLAIR images could definitely discriminate the traumatic lesions of the fornix from the surrounding CSF. In addition, FLAIR images could easily discriminate DAI of the corpus callosum from CSF of the cavum velli interpositi. MR FLAIR images were found to be useful for detecting traumatic head injuries. (author)

  9. Fast FLAIR MR images of intracranial hemorrhage

    International Nuclear Information System (INIS)

    Chun, Eun Ju; Choi, Hye Young; Cho, Young A; Kim, Wha Young

    1998-01-01

    The purpose of this study is to evaluate the signal characteristics of intracranial hemorrhage, as seen on fluid attenuated inversion recovery (FLAIR) MR imaging according to various stages, and to compare FLAIR imaging with spin-echo T1- and T2-weighted MR imaging. We retrospectively evaluated fast FLAIR images along with spin-echo T1- and T2 weighted MR images of 32 lesions in 25 patients (12 males and 14 females, aged 3 - 84 yrs) with intracranial hemorrhagic lesions. For imaging, 1.5 T unit was used, and the nature of the lesions was found to be as follows : intracranial hemorrhage (n=15); tumor (n=9); infarction (n=4); arteriovenous malformation (n=3); and arachnoid cyst with hemorrhage (n=1). On the basis of spin-echo MR imaging, lesions were classified as acute, early subacute, late subacute, early chronic, or late chronic stage. The signal characteristics of intracranial hemorrhage were analysed in accordance with each staging, as seen on MR FLAIR imaging, and compared to the staging seen on spin-echo T1- and T-2 weighted MR imaging. The signal intensity of intracranial hemorrhage, as seen on FLAIR imaging, was not characteristic; it was similar to that of T2WI during the acute and subacute stages, and similiar to that of T1WI during the chronic stage. When used together with spin-echo T1- and T2-weighted MR imaging, however, FLAIR imaging may be useful for the classification of chronic intracranial hemorrhage as either early or late stage. (author). 20 refs., 2 tabs., 6 figs

  10. Pre- and postcontrast FLAIR MR imaging in the diagnosis of intracranial meningeal pathology

    International Nuclear Information System (INIS)

    Tsuchiya, Kazuhiro; Katase, Shichiro; Yoshino, Ayako; Hachiya, Junichi

    2000-01-01

    Few reports address the use of fluid-attenuated inversion-recovery (FLAIR) images of the brain in the diagnosis of extraaxial lesions. Our purpose was to assess the value of FLAIR images, including postcontrast ones, in the diagnosis of intracranial meningeal diseases. We reviewed precontrast (n=24) and postcontrast (n=20) FLAIR images obtained from 25 patients with infectious meningitis (n=13), carcinomatous meningitis or dissemination of primary brain tumor (n=7), dural metastasis (n=3), and others (n=2) in comparison with fast spin-echo T2-weighted and postcontrast T1-weighted images. In lesion detectability, precontrast FLAIR images were significantly superior to fast spin-echo T2-weighted images but inferior to postcontrast T1-weighted images. There was no significant difference between postcontrast T1-weighted and FLAIR images. Precontrast FLAIR images can substitute for conventional fast spin-echo T2-weighted images. Postcontrast FLAIR images have diagnostic potential equivalent to conventional postcontrast T1-weighted images. (author)

  11. Detection of optic nerve atrophy following a single episode of unilateral optic neuritis by MRI using a fat-saturated short-echo fast FLAIR sequence

    International Nuclear Information System (INIS)

    Hickman, S.J.; Brex, P.A.; Silver, N.C.; Barker, G.J.; Miller, D.H.; Brierley, C.M.H.; Compston, D.A.S.; Scolding, N.J.; Moseley, I.F.; Plant, G.T.

    2001-01-01

    We describe an MRI technique for quantifying optic nerve atrophy resulting from a single episode of unilateral optic neuritis. We imaged 17 patients, with a median time since onset of optic neuritis of 21 months (range 3-81 months), using a coronal-oblique fat-saturated short-echo fast fluid-attenuated inversion-recovery (sTE fFLAIR) sequence. The mean cross-sectional area of the intraorbital portion of the optic nerves was calculated by a blinded observer from five consecutive 3 mm slices from the orbital apex forwards using a semiautomated contouring technique and compared with data from 16 controls. The mean optic nerve area was 11.2mm 2 in the affected eye of the patients, 12.9mm 2 in the contralateral eye (P = 0.006 compared to the affected eye) and 12.8mm 2 in controls (P = 0.03 compared to the affected eyes). There was a significant negative correlation between disease duration and the size of the affected optic nerve (r = -0.59, P = 0.012). The measurement coefficient of variation was 4.8 %. The sTE fFLAIR sequence enables measurement of optic nerve area with sufficient reproducibility to show optic nerve atrophy following a single episode of unilateral optic neuritis. The correlation of increasing optic nerve atrophy with disease duration would be consistent with ongoing axonal loss in a persistently demyelinated lesion, or Wallerian degeneration following axonal damage during the acute inflammatory phase. (orig.)

  12. Contrast-enhanced flair imaging in the evaluation of infectious leptomeningeal diseases

    International Nuclear Information System (INIS)

    Parmar, Hemant; Sitoh, Y.-Y.; Anand, Pooja; Chua, Violet; Hui, Francis

    2006-01-01

    Purpose: The purpose of our study was to compare contrast-enhanced fluid-attenuated inversion recovery (FLAIR) images with contrast-enhanced T1 weighted images for infectious leptomeningitis. Materials and methods: We studied twenty-four patients with a clinical suspicion of infectious meningitis with unenhanced FLAIR, contrast-enhanced T1 weighted and contrast-enhanced FLAIR MR sequences. Twelve patients had cytologic and biochemical diagnosis of meningitis on cerebrospinal fluid (CSF) examination obtained 48 h before or after the MR study. Sequences were considered positive if abnormal signal was seen in the subarachnoid space (cistern or sulci) or along pial surface. Results: Twenty-seven examinations in 24 patients were performed. Of the 12 patients (thirteen studies) in whom cytology was positive, unenhanced FLAIR images were positive in six cases (sensitivity 46%), contrast-enhanced FLAIR images were positive in 11 (sensitivity 85%), and contrast-enhanced T1 weighted MR images were positive in 11 patients (sensitivity 85%). Of the 12 patients (14 studies) in whom cerebrospinal fluid study was negative, unenhanced FLAIR images were negative in 13, contrast-enhanced FLAIR images were negative in 11, and contrast-enhanced T1 weighted MR images were negative in eight. Thus, the specificity of unenhanced FLAIR, contrast-enhanced FLAIR and contrast-enhanced T1 weighted images was 93, 79 and 57%, respectively. Conclusion: Our results suggest that post-contrast FLAIR images have similar sensitivity but a higher specificity compared to contrast-enhanced T1 weighted images for detection of leptomeningeal enhancement. It can be a useful adjunct to post-contrast T1 weighted images in evaluation of infectious leptomeningitis

  13. Contrast-enhanced flair imaging in the evaluation of infectious leptomeningeal diseases

    Energy Technology Data Exchange (ETDEWEB)

    Parmar, Hemant [Department of Neuroradiology, National Neuroscience Institute, 11 Jalan Tan Tock Seng, Singapore 308433 (Singapore) and Department of Diagnostic Imaging, Hospital for Sick Children, Toronto (Canada)]. E-mail: parurad@hotmail.com; Sitoh, Y.-Y. [Department of Neuroradiology, National Neuroscience Institute, 11 Jalan Tan Tock Seng, Singapore 308433 (Singapore); Anand, Pooja [Department of Neurology, National Neuroscience Institute, 11 Jalan Tan Tock Seng (Singapore); Chua, Violet [Department of Neuroradiology, National Neuroscience Institute, 11 Jalan Tan Tock Seng, Singapore 308433 (Singapore); Hui, Francis [Department of Neuroradiology, National Neuroscience Institute, 11 Jalan Tan Tock Seng, Singapore 308433 (Singapore)

    2006-04-15

    Purpose: The purpose of our study was to compare contrast-enhanced fluid-attenuated inversion recovery (FLAIR) images with contrast-enhanced T1 weighted images for infectious leptomeningitis. Materials and methods: We studied twenty-four patients with a clinical suspicion of infectious meningitis with unenhanced FLAIR, contrast-enhanced T1 weighted and contrast-enhanced FLAIR MR sequences. Twelve patients had cytologic and biochemical diagnosis of meningitis on cerebrospinal fluid (CSF) examination obtained 48 h before or after the MR study. Sequences were considered positive if abnormal signal was seen in the subarachnoid space (cistern or sulci) or along pial surface. Results: Twenty-seven examinations in 24 patients were performed. Of the 12 patients (thirteen studies) in whom cytology was positive, unenhanced FLAIR images were positive in six cases (sensitivity 46%), contrast-enhanced FLAIR images were positive in 11 (sensitivity 85%), and contrast-enhanced T1 weighted MR images were positive in 11 patients (sensitivity 85%). Of the 12 patients (14 studies) in whom cerebrospinal fluid study was negative, unenhanced FLAIR images were negative in 13, contrast-enhanced FLAIR images were negative in 11, and contrast-enhanced T1 weighted MR images were negative in eight. Thus, the specificity of unenhanced FLAIR, contrast-enhanced FLAIR and contrast-enhanced T1 weighted images was 93, 79 and 57%, respectively. Conclusion: Our results suggest that post-contrast FLAIR images have similar sensitivity but a higher specificity compared to contrast-enhanced T1 weighted images for detection of leptomeningeal enhancement. It can be a useful adjunct to post-contrast T1 weighted images in evaluation of infectious leptomeningitis.

  14. FLAIR* to visualize veins in white matter lesions: A new tool for the diagnosis of multiple sclerosis?

    International Nuclear Information System (INIS)

    Campion, T.; Turner, B.P.; Schmierer, K.; Smith, R.J.P.; Altmann, D.R.; Brito, G.C.; Evanson, J.; George, I.C.; Sati, P.; Reich, D.S.; Miquel, M.E.

    2017-01-01

    To explore the potential of a post-processing technique combining FLAIR and T_2* (FLAIR*) to distinguish between lesions caused by multiple sclerosis (MS) from cerebral small vessel disease (SVD) in a clinical setting. FLAIR and T_2* head datasets acquired at 3T of 25 people with relapsing MS (pwRMS) and ten with pwSVD were used. After post-processing, FLAIR* maps were used to determine the proportion of white matter lesions (WML) showing the 'vein in lesion' sign (VIL), a characteristic histopathological feature of MS plaques. Sensitivity and specificity of MS diagnosis were examined on the basis of >45% VIL"+ and >60% VIL"+ WML, and compared with current dissemination in space (DIS) MRI criteria. All pwRMS had >45% VIL"+ WML (range 58-100%) whilst in pwSVD the proportion of VIL"+ WML was significantly lower (0-64%; mean 32±20%). Sensitivity based on >45% VIL"+ was 100% and specificity 80% whilst with >60% VIL"+ as the criterion, sensitivity was 96% and specificity 90%. DIS criteria had 96% sensitivity and 40% specificity. FLAIR* enables VIL"+ WML detection in a clinical setting, facilitating differentiation of MS from SVD based on brain MRI. (orig.)

  15. Relationship between fluid-attenuated inversion-recovery (FLAIR) signal intensity and inflammatory mediator's levels in the hippocampus of patients with temporal lobe epilepsy and mesial temporal sclerosis.

    Science.gov (United States)

    Varella, Pedro Paulo Vasconcellos; Santiago, Joselita Ferreira Carvalho; Carrete, Henrique; Higa, Elisa Mieko Suemitsu; Yacubian, Elza Márcia Targas; Centeno, Ricardo Silva; Caboclo, Luís Otávio Sales Ferreira; Castro Neto, Eduardo Ferreira de; Canzian, Mauro; Amado, Débora; Cavalheiro, Esper Abrão; Naffah-Mazzacoratti, Maria da Graça

    2011-02-01

    We investigated a relationship between the FLAIR signal found in mesial temporal sclerosis (MTS) and inflammation. Twenty nine patients were selected through clinical and MRI analysis and submitted to cortico-amygdalo-hippocampectomy to seizure control. Glutamate, TNFα, IL1, nitric oxide (NO) levels and immunostaining against IL1β and CD45 was performed. Control tissues (n=10) were obtained after autopsy of patients without neurological disorders. The glutamate was decreased in the temporal lobe epilepsy (TLE) -MTS group (p<0.001), suggesting increased release of this neurotransmitter. The IL1β and TNFα were increased in the hippocampus (p<0.05) demonstrating an active inflammatory process. A positive linear correlation between FLAIR signal and NO and IL1β levels and a negative linear correlation between FLAIR signal and glutamate concentration was found. Lymphocytes infiltrates were present in hippocampi of TLE patients. These data showed an association between hippocampal signal alteration and increased inflammatory markers in TLE-MTS.

  16. Relationship between fluid-attenuated inversion-recovery (FLAIR signal intensity and inflammatory mediator's levels in the hippocampus of patients with temporal lobe epilepsy and mesial temporal sclerosis

    Directory of Open Access Journals (Sweden)

    Pedro Paulo Vasconcellos Varella

    2011-02-01

    Full Text Available We investigated a relationship between the FLAIR signal found in mesial temporal sclerosis (MTS and inflammation. Twenty nine patients were selected through clinical and MRI analysis and submitted to cortico-amygdalo-hippocampectomy to seizure control. Glutamate, TNFα, IL1, nitric oxide (NO levels and immunostaining against IL1β and CD45 was performed. Control tissues (n=10 were obtained after autopsy of patients without neurological disorders. The glutamate was decreased in the temporal lobe epilepsy (TLE -MTS group (p<0.001, suggesting increased release of this neurotransmitter. The IL1β and TNFα were increased in the hippocampus (p<0.05 demonstrating an active inflammatory process. A positive linear correlation between FLAIR signal and NO and IL1β levels and a negative linear correlation between FLAIR signal and glutamate concentration was found. Lymphocytes infiltrates were present in hippocampi of TLE patients. These data showed an association between hippocampal signal alteration and increased inflammatory markers in TLE-MTS.

  17. Difficulty of MRI based identification of lesion age by acute infra-tentorial ischemic stroke.

    Directory of Open Access Journals (Sweden)

    Florian Grosse-Dresselhaus

    Full Text Available Systemic thrombolysis in acute ischemic stroke is restricted to the 4.5 h time window. Many patients are excluded from this treatment because symptom onset is unknown. Magnetic resonance imaging (MRI studies have shown that stroke patients presenting with acute supra-tentorial diffusion-weighted imaging (DWI lesions that do not have matching lesions on fluid attenuated inversion recovery (FLAIR are likely to be within a 4.5 hour time window. This study examines the DWI-FLAIR mismatch in infra-tentorial stroke.This was a retrospectively conducted substudy of the "1000+" study; a prospective, single-center observational study (http://clinicaltrials.gov; NCT00715533. Fifty-six patients with infra-tentorial stroke confirmed by MRI and known symptom onset who underwent the scan within 24 h after symptom onset were analysed. Two neurologists blinded to clinical information separately rated the DWI lesion visibility on FLAIR. Lesion volume, relative signal intensities of DWI and relative apparent diffusion coefficient values were determined.Regarding baseline characteristics our study population had a median age of 66 years, a median time from symptom onset to MRI of 616.5 minutes, a median NIHSS of 3 and a median DWI lesion volume of 0.26 ml. A negative FLAIR allocated patients to a time window under 4.5 h correctly with a sensitivity of 55% and a specificity of 61%, a positive predictive value of 44% and a negative predictive value of 71%. FLAIR positivity decreased with age (p = 0.018, and showed no significant correlation to lesion volume (p = 0.145.In our study the DWI-FLAIR-Mismatch does not help to reliably identify patients within 4.5 h of symptom onset in acute ischemic infra-tentorial stroke. Thus therapeutical decisions based on the DWI-FLAIR mismatch estimation of time from onset cannot be recommended in patients with infra-tentorial stroke.

  18. FLAIR* to visualize veins in white matter lesions: A new tool for the diagnosis of multiple sclerosis?

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    Campion, T.; Turner, B.P.; Schmierer, K. [Queen Mary University of London, Blizard Institute (Neuroscience), London (United Kingdom); Barts Health NHS Trust, Emergency Care and Acute Medicine Clinical Academic Group Neuroscience, The Royal London Hospital, London (United Kingdom); Smith, R.J.P. [Queen Mary University of London, Blizard Institute (Neuroscience), London (United Kingdom); Gloucestershire Hospitals NHS Trust, Cheltenham (United Kingdom); Altmann, D.R. [London School of Hygiene and Tropical Medicine, Department of Medical Statistics, London (United Kingdom); Brito, G.C. [Queen Mary University of London, Blizard Institute (Neuroscience), London (United Kingdom); Evanson, J. [Barts Health NHS Trust, Emergency Care and Acute Medicine Clinical Academic Group Neuroscience, The Royal London Hospital, London (United Kingdom); George, I.C. [NIH, Translational Neuroradiology Section, National Institute of Neurological Disorders and Stroke, Bethesda, MD (United States); Yale School of Medicine, Department of Neurology, New Haven, CT (United States); Sati, P.; Reich, D.S. [NIH, Translational Neuroradiology Section, National Institute of Neurological Disorders and Stroke, Bethesda, MD (United States); Miquel, M.E. [Barts Health NHS Trust, Emergency Care and Acute Medicine Clinical Academic Group Neuroscience, The Royal London Hospital, London (United Kingdom); Queen Mary University of London, William Harvey Research Institute (Cardiovascular Biomedical Research Unit), London (United Kingdom)

    2017-10-15

    To explore the potential of a post-processing technique combining FLAIR and T{sub 2}* (FLAIR*) to distinguish between lesions caused by multiple sclerosis (MS) from cerebral small vessel disease (SVD) in a clinical setting. FLAIR and T{sub 2}* head datasets acquired at 3T of 25 people with relapsing MS (pwRMS) and ten with pwSVD were used. After post-processing, FLAIR* maps were used to determine the proportion of white matter lesions (WML) showing the 'vein in lesion' sign (VIL), a characteristic histopathological feature of MS plaques. Sensitivity and specificity of MS diagnosis were examined on the basis of >45% VIL{sup +} and >60% VIL{sup +} WML, and compared with current dissemination in space (DIS) MRI criteria. All pwRMS had >45% VIL{sup +} WML (range 58-100%) whilst in pwSVD the proportion of VIL{sup +} WML was significantly lower (0-64%; mean 32±20%). Sensitivity based on >45% VIL{sup +} was 100% and specificity 80% whilst with >60% VIL{sup +} as the criterion, sensitivity was 96% and specificity 90%. DIS criteria had 96% sensitivity and 40% specificity. FLAIR* enables VIL{sup +} WML detection in a clinical setting, facilitating differentiation of MS from SVD based on brain MRI. (orig.)

  19. Utility of coronal contrast-enhanced fat-suppressed FLAIR in the evaluation of optic neuropathy and atrophy.

    Science.gov (United States)

    Boegel, Kevin H; Tyan, Andrew E; Iyer, Veena R; Rykken, Jeffrey B; McKinney, Alexander M

    2017-01-01

    Evaluating chronic sequelae of optic neuritis, such as optic neuropathy with or without optic nerve atrophy, can be challenging on whole brain MRI. This study evaluated the utility of dedicated coronal contrast-enhanced fat-suppressed FLAIR (CE-FS-FLAIR) MR imaging to detect optic neuropathy and optic nerve atrophy. Over 4.5 years, a 3 mm coronal CE-FS-FLAIR sequence at 1.5T was added to the routine brain MRIs of 124 consecutive patients, 102 of whom had suspected or known demyelinating disease. Retrospective record reviews confirmed that 28 of these 102 had documented onset of optic neuritis >4 weeks prior to the brain MRI. These 28 were compared to the other 22 ("controls") of the 124 patients who lacked a history of demyelinating disease or visual symptoms. Using coronal CE-FS-FLAIR, two neuroradiologists separately graded each optic nerve (n = 50 patients, 100 total nerves) as either negative, equivocal, or positive for optic neuropathy or atrophy. The scoring was later repeated. The mean time from acute optic neuritis onset to MRI was 4.1 ± 4.6 years (range 34 days-17.4 years). Per individual nerve grading, the range of sensitivity, specificity, and accuracy of coronal CE-FS-FLAIR in detecting optic neuropathy was 71.4-77.1%, 93.8-95.4%, and 85.5-89.0%, respectively, with strong interobserver (k = 0.667 - 0.678, p optic atrophy, interobserver agreement was moderate (k = 0.437 - 0.484, p optic neuropathy years after the onset of acute optic neuritis, but is less useful in detecting optic nerve atrophy.

  20. Paediatric PNET: pre-surgical MRI features

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    Chawla, A. [Department of Neuroradiology, National Neuroscience Institute (Singapore); Emmanuel, J.V. [Department of Neuroradiology, National Neuroscience Institute (Singapore); Seow, W.T. [Department of Neurosurgery, National Neuroscience Institute (Singapore); Lou, J. [Pediatric Medicine, KK Women' s and Children' s Hospital (Singapore); Teo, H.E. [Department of Diagnostic Imaging, KK Women' s and Children' s Hospital (Singapore); Lim, C.C.T. [Department of Neuroradiology, National Neuroscience Institute (Singapore) and Diagnostic Radiology, Yong Loo Lin Medical School, National University of Singapore (Singapore)]. E-mail: tchoyoson_lim@nni.com.sg

    2007-01-15

    Aim: To describe the preoperative magnetic resonance imaging (MRI) characteristics of primitive neuroectodermal tumours (PNETs), in particular the diffusion-weighted imaging (DWI), MR spectroscopy (MRS) features and cerebrospinal fluid (CSF) tumour dissemination. Material and methods: Twelve patients with PNETs were reviewed: nine with medulloblastoma and three with supratentorial PNETs (SPNETs). The MRI examination included contrast-enhanced intracranial and spinal MRI, and in some patients, gradient recalled echo, fluid-attenuated inversion recovery (FLAIR), DWI, and MRS. Results: All PNETs were either hypointense or isointense on T1-weighted images. Ten of the 12 tumours were either isointense or hypointense on T2-weighted images, and 11 were isointense on FLAIR images. Patients with SPNETs had large, vascular and haemorrhagic tumours. On DWI, all PNETs were hyperintense and had restricted apparent diffusion coefficient. MRS (two patients with medulloblastoma and one with a SPNET), showed elevated choline, decreased N-acetyl aspartate, and a small taurine peak in all three patients. Intraspinal tumour dissemination, visible as uniform or nodular enhancement coating the conus medullaris, was detected in six of 12 patients, two of whom also had intracranial dissemination. Conclusion: PNETs have a characteristic imaging appearance on FLAIR, DWI and MRS, which may help in differentiating these highly cellular neoplasms from other tumours. There is CSF tumour dissemination in a high proportion of patients, and spinal imaging is important for disease staging and to formulate treatment protocols.

  1. Paediatric PNET: pre-surgical MRI features

    International Nuclear Information System (INIS)

    Chawla, A.; Emmanuel, J.V.; Seow, W.T.; Lou, J.; Teo, H.E.; Lim, C.C.T.

    2007-01-01

    Aim: To describe the preoperative magnetic resonance imaging (MRI) characteristics of primitive neuroectodermal tumours (PNETs), in particular the diffusion-weighted imaging (DWI), MR spectroscopy (MRS) features and cerebrospinal fluid (CSF) tumour dissemination. Material and methods: Twelve patients with PNETs were reviewed: nine with medulloblastoma and three with supratentorial PNETs (SPNETs). The MRI examination included contrast-enhanced intracranial and spinal MRI, and in some patients, gradient recalled echo, fluid-attenuated inversion recovery (FLAIR), DWI, and MRS. Results: All PNETs were either hypointense or isointense on T1-weighted images. Ten of the 12 tumours were either isointense or hypointense on T2-weighted images, and 11 were isointense on FLAIR images. Patients with SPNETs had large, vascular and haemorrhagic tumours. On DWI, all PNETs were hyperintense and had restricted apparent diffusion coefficient. MRS (two patients with medulloblastoma and one with a SPNET), showed elevated choline, decreased N-acetyl aspartate, and a small taurine peak in all three patients. Intraspinal tumour dissemination, visible as uniform or nodular enhancement coating the conus medullaris, was detected in six of 12 patients, two of whom also had intracranial dissemination. Conclusion: PNETs have a characteristic imaging appearance on FLAIR, DWI and MRS, which may help in differentiating these highly cellular neoplasms from other tumours. There is CSF tumour dissemination in a high proportion of patients, and spinal imaging is important for disease staging and to formulate treatment protocols

  2. New multispectral MRI data fusion technique for white matter lesion segmentation: method and comparison with thresholding in FLAIR images

    International Nuclear Information System (INIS)

    Del C Valdes Hernandez, Maria; Ferguson, Karen J.; Chappell, Francesca M.; Wardlaw, Joanna M.

    2010-01-01

    Brain tissue segmentation by conventional threshold-based techniques may have limited accuracy and repeatability in older subjects. We present a new multispectral magnetic resonance (MR) image analysis approach for segmenting normal and abnormal brain tissue, including white matter lesions (WMLs). We modulated two 1.5T MR sequences in the red/green colour space and calculated the tissue volumes using minimum variance quantisation. We tested it on 14 subjects, mean age 73.3 ± 10 years, representing the full range of WMLs and atrophy. We compared the results of WML segmentation with those using FLAIR-derived thresholds, examined the effect of sampling location, WML amount and field inhomogeneities, and tested observer reliability and accuracy. FLAIR-derived thresholds were significantly affected by the location used to derive the threshold (P = 0.0004) and by WML volume (P = 0.0003), and had higher intra-rater variability than the multispectral technique (mean difference ± SD: 759 ± 733 versus 69 ± 326 voxels respectively). The multispectral technique misclassified 16 times fewer WMLs. Initial testing suggests that the multispectral technique is highly reproducible and accurate with the potential to be applied to routinely collected clinical MRI data. (orig.)

  3. Uso da sequência FLAIR-EPI na análise da esclerose mesial temporal EPI-FLAIR sequence in the evaluation of mesial temporal sclerosis

    Directory of Open Access Journals (Sweden)

    Marcos Alberto da Costa Machado Júnior

    2001-06-01

    Full Text Available O objetivo deste estudo é analisar as alterações morfológicas e de intensidade de sinal das regiões hipocampais em pacientes, com epilepsia temporal fármaco-resistente. Para tal, estudamos 8 pacientes com esclerose mesial temporal, utilizando aparelhagem de RM de 1,5T, com sequências Spin Eco - SE, Fast Spin Eco - FSE, Fluid Atenuation Inversion Recovery, com Eco Planar Imaging - FLAIR-EPI. Observamos a superioridade da sequência FLAIR na detecção do aumento da intensidade de sinal da região hipocampal, particularmente com cortes coronais, em relação às sequências SE e FSE, com a vantagem de ser uma técnica de rápida execução. A sequência STIR evidenciou adelgaçamento da cortical do hipocampo, na metade dos casos que apresentavam alteração de sinal.The purpose of this study is to evaluate morpholologycal and signal intensity changes in the hippocampus in patients with medically intractable temporal lobe epilepsy. We studied 8 patients with mesial temporal sclerosis using a 1.5 -T MR and the following sequences Spin Eco- SE, Fast Spin Echo- FSE, Fluid Atenuation Inversion Recovery Echo Planar Imaging - FLAIR-EPI. We noticed a sensitive increase signal intensity on FLAIR- EPI sequences, particularly, in coronal images, than on SE and FSE sequences. The STIR sequence showed a cortical hippocampus atrophy in half of the cases, in whom signal abnormalities were present.

  4. FLAIR MR sequence in the diagnosis and follow-up of low-grade astrocytomas

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    Stošić-Opinćal Tatjana

    2005-01-01

    Full Text Available Aim. To evaluate the sensitivity of fluid-attenuated inversion recovery (FLAIR sequence in the diagnosis and follow-up of the patients with low-grade astrocytomas compared with T2-weighted (T2W sequence. Methods. Twenty-four patients with biopsy- confirmed low-grade astrocytoma (age range, 15-66 years underwent T1- weighted (T1W, T2W and FLAIR imaging with a superconducting unit 1.0 T. FLAIR images were qualitatively evaluated by comparison with T2W images by the three experienced neuroradiologists. To evaluate the diagnostic value of FLAIR, the neuroradiologists individually assessed the possibilities of the detection of lesions, as well as the possibilities of the differentiation of tumor from the surrounding edema on FLAIR vs. T2W images. Every examiner ranked FLAIR sequence vs. T2W in three degrees: worse, equal and better. Results. The comparison of FLAIR with T2W spin-echo (SE images with regard to the detection of the lesions showed that 82.8% of FLAIR studies were superior, 17.2% were of similar diagnostic value, and none was inferior to the T2W images. The comparison of images with regard to the differentiation of tumor boundaries vs. surrounding edema showed that 92.5% of FLAIR studies were superior, 7.5% were of similar diagnostic value, and none was inferior to the T2W images. Conclusion. Our results were similar to the previous studies' results concerning the advantages of FLAIR sequence in the diagnosis of low grade astrocytomas over T2W sequence. FLAIR was better at showing different tumor components, and at distinguishing CSF from the cystic component, and the postoperative cavity, compared with T2W images. Our conclusion was that FLAIR could be routinely used in the evaluation and follow-up of low-grade astrocytomas.

  5. 7T MRI in focal epilepsy with unrevealing conventional field strength imaging.

    Science.gov (United States)

    De Ciantis, Alessio; Barba, Carmen; Tassi, Laura; Cosottini, Mirco; Tosetti, Michela; Costagli, Mauro; Bramerio, Manuela; Bartolini, Emanuele; Biagi, Laura; Cossu, Massimo; Pelliccia, Veronica; Symms, Mark R; Guerrini, Renzo

    2016-03-01

    To assess the diagnostic yield of 7T magnetic resonance imaging (MRI) in detecting and characterizing structural lesions in patients with intractable focal epilepsy and unrevealing conventional (1.5 or 3T) MRI. We conducted an observational clinical imaging study on 21 patients (17 adults and 4 children) with intractable focal epilepsy, exhibiting clinical and electroencephalographic features consistent with a single seizure-onset zone (SOZ) and unrevealing conventional MRI. Patients were enrolled at two tertiary epilepsy surgery centers and imaged at 7T, including whole brain (three-dimensional [3D] T1 -weighted [T1W] fast-spoiled gradient echo (FSPGR), 3D susceptibility-weighted angiography [SWAN], 3D fluid-attenuated inversion recovery [FLAIR]) and targeted imaging (2D T2*-weighted dual-echo gradient-recalled echo [GRE] and 2D gray-white matter tissue border enhancement [TBE] fast spin echo inversion recovery [FSE-IR]). MRI studies at 1.5 or 3T deemed unrevealing at the referral center were reviewed by three experts in epilepsy imaging. Reviewers were provided information regarding the suspected localization of the SOZ. The same team subsequently reviewed 7T images. Agreement in imaging interpretation was reached through consensus-based discussions based on visual identification of structural abnormalities and their likely correlation with clinical and electrographic data. 7T MRI revealed structural lesions in 6 (29%) of 21 patients. The diagnostic gain in detection was obtained using GRE and FLAIR images. Four of the six patients with abnormal 7T underwent epilepsy surgery. Histopathology revealed focal cortical dysplasia (FCD) in all. In the remaining 15 patients (71%), 7T MRI remained unrevealing; 4 of the patients underwent epilepsy surgery and histopathologic evaluation revealed gliosis. 7T MRI improves detection of epileptogenic FCD that is not visible at conventional field strengths. A dedicated protocol including whole brain FLAIR and GRE images at 7T

  6. MRI findings of Wernicke encephalopathy revisited due to hunger strike

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    Unlu, Ercument [Department of Radiology, Trakya University School of Medicine, Mimar Sinan m, Muammer Aksoy c, Yorulmaz apt, No 50, D-1 22030 Edirne (Turkey)]. E-mail: drercument@yahoo.com; Cakir, Bilge [Department of Radiology, Trakya University School of Medicine, Mimar Sinan m, Muammer Aksoy c, Yorulmaz apt, No 50, D-1 22030 Edirne (Turkey); Asil, Talip [Department of Neurology, Trakya University School of Medicine, Edirne (Turkey)

    2006-01-15

    Background and Purpose: The purpose of this study was to determine the characteristic magnetic resonance imaging (MRI) findings among a group of patients who presented with Wernicke encephalopathy (WE) due to the neurological complications of a long-term hunger strike (HS). Methods: MRI studies also including the fluid-attenuated inversion recovery (FLAIR) sequence and diffusion-weighted imaging (DWI) of six male patients with WE aged from 25 to 38 years (mean age 31 years) were evaluated. Results: In all subjects, T2-weighted sequences, FLAIR and DWI revealed a signal hyperintensity within the posteromedial thalami and surrounding the third ventricle. In particular, on coronal images, the hyperintense areas around the third ventricle showed a suggestive 'double wing' configuration. We observed an increased signal on proton-density and T2-weighted images in the mamillary bodies of three patients. Four patients demonstrated additional hyperintensities within the periaqueductal region and/or the tectal plate. At least one lesion area in five of six patients demonstrated contrast enhancement. Conclusion: The consistent imaging findings of our study suggest that MRI is a reliable means of diagnosing WE. Acute WE is sometimes underdiagnosed, yet early diagnosis and treatment of WE is crucial in order to avoid persistent brain damage. MRI, including postcontrast T1-weighted imaging, DWI beneath standardized T2-weighted imaging, and FLAIR sequences may prove to be a valuable adjunct to clinical diagnosis and to provide additional information in acute and/or subacute WE.

  7. MRI findings of Wernicke encephalopathy revisited due to hunger strike

    International Nuclear Information System (INIS)

    Unlu, Ercument; Cakir, Bilge; Asil, Talip

    2006-01-01

    Background and Purpose: The purpose of this study was to determine the characteristic magnetic resonance imaging (MRI) findings among a group of patients who presented with Wernicke encephalopathy (WE) due to the neurological complications of a long-term hunger strike (HS). Methods: MRI studies also including the fluid-attenuated inversion recovery (FLAIR) sequence and diffusion-weighted imaging (DWI) of six male patients with WE aged from 25 to 38 years (mean age 31 years) were evaluated. Results: In all subjects, T2-weighted sequences, FLAIR and DWI revealed a signal hyperintensity within the posteromedial thalami and surrounding the third ventricle. In particular, on coronal images, the hyperintense areas around the third ventricle showed a suggestive 'double wing' configuration. We observed an increased signal on proton-density and T2-weighted images in the mamillary bodies of three patients. Four patients demonstrated additional hyperintensities within the periaqueductal region and/or the tectal plate. At least one lesion area in five of six patients demonstrated contrast enhancement. Conclusion: The consistent imaging findings of our study suggest that MRI is a reliable means of diagnosing WE. Acute WE is sometimes underdiagnosed, yet early diagnosis and treatment of WE is crucial in order to avoid persistent brain damage. MRI, including postcontrast T1-weighted imaging, DWI beneath standardized T2-weighted imaging, and FLAIR sequences may prove to be a valuable adjunct to clinical diagnosis and to provide additional information in acute and/or subacute WE

  8. Revisiting the relationship of three-dimensional fluid attenuation inversion recovery imaging and hearing outcomes in adults with idiopathic unilateral sudden sensorineural hearing loss

    Energy Technology Data Exchange (ETDEWEB)

    Liao, Wen-Huei [School of Medicine, National Yang Ming University, Taipei, 11221, Taiwan (China); Department of Otolaryngology, Taipei Veterans General Hospital, Taipei, 11217, Taiwan (China); Wu, Hsiu-Mei [School of Medicine, National Yang Ming University, Taipei, 11221, Taiwan (China); Department of Radiology, Taipei Veterans General Hospital, Taipei, 11217, Taiwan (China); Wu, Hung-Yi [Department of Radiology, Taipei Veterans General Hospital, Taipei, 11217, Taiwan (China); Tu, Tzong-Yang; Shiao, An-Suey [School of Medicine, National Yang Ming University, Taipei, 11221, Taiwan (China); Department of Otolaryngology, Taipei Veterans General Hospital, Taipei, 11217, Taiwan (China); Castillo, Mauricio [Department of Radiology, University of North Carolina, Chapel Hill, NC, 27599-7510 (United States); Hung, Sheng-Che, E-mail: hsz829@gmail.com [School of Medicine, National Yang Ming University, Taipei, 11221, Taiwan (China); Department of Radiology, Taipei Veterans General Hospital, Taipei, 11217, Taiwan (China); Department of Biomedical Imaging and Radiological Sciences, National Yang Ming University, Taipei, 11221, Taiwan (China)

    2016-12-15

    Background and purpose: Three-dimensional fluid attenuation inversion recovery (3D FLAIR) may demonstrate high signal in the inner ears of patients with idiopathic sudden sensorineural hearing loss (ISSNHL), but the correlations of this finding with outcomes are still controversial. Here we compared 4 3D MRI sequences with the outcomes of patients with ISSNHL. Materials and methods: 77 adult patients with ISSNHL underwent MRI with pre contrast FLAIR, fast imaging employing steady-state acquisition images (FIESTA-C), post contrast T1WI and post contrast FLAIR. The extent and degree of high signal in both cochleas were evaluated in all patients, and asymmetry ratios between the affected ears and the normal ones were calculated. The relationships among MRI findings, including extent and asymmetry of abnormal cochlear high signals, degree of FLAIR enhancement, and clinical information, including age, vestibular symptoms, baseline hearing loss, and final hearing outcomes were analyzed. Results: 54 patients (28 men; age, 52.1 ± 15.5 years) were included in our study. Asymmetric cochlear signal intensities were more frequently observed in pre contrast and post contrast FLAIR (79.6% and 68.5%) than in FIESTA-C (61.1%) and T1WI (51.9%) (p < 0.001). Age, baseline hearing loss, extent of high signal and asymmetry ratios of pre contrast and post contrast FLAIR were all correlated with final hearing outcomes. In multivariate analysis, age and the extent of high signals were the most significant predictors of final hearing outcomes. Conclusion: 3D FLAIR provides a higher sensitivity in detecting the asymmetric cochlear signal abnormality. The more asymmetric FLAIR signals and presence of high signals beyond cochlea indicated a poorer prognosis.

  9. Comparison of T2 and FLAIR imaging for target delineation in high grade gliomas

    International Nuclear Information System (INIS)

    Stall, Bronwyn; Zach, Leor; Ning, Holly; Ondos, John; Arora, Barbara; Shankavaram, Uma; Miller, Robert W; Citrin, Deborah; Camphausen, Kevin

    2010-01-01

    FLAIR and T2 weighted MRIs are used based on institutional preference to delineate high grade gliomas and surrounding edema for radiation treatment planning. Although these sequences have inherent physical differences there is limited data on the clinical and dosimetric impact of using either or both sequences. 40 patients with high grade gliomas consecutively treated between 2002 and 2008 of which 32 had pretreatment MRIs with T1, T2 and FLAIR available for review were selected for this study. These MRIs were fused with the treatment planning CT. Normal structures, clinical tumor volume (CTV) and planning tumor volume (PTV) were then defined on the T2 and FLAIR sequences. A Venn diagram analysis was performed for each pair of tumor volumes as well as a fractional component analysis to assess the contribution of each sequence to the union volume. For each patient the tumor volumes were compared in terms of total volume in cubic centimeters as well as anatomic location using a discordance index. The overlap of the tumor volumes with critical structures was calculated as a measure of predicted toxicity. For patients with MRI documented failures, the tumor volumes obtained using the different sequences were compared with the recurrent gross tumor volume (rGTV). The FLAIR CTVs and PTVs were significantly larger than the T2 CTVs and PTVs (p < 0.0001 and p = 0.0001 respectively). Based on the discordance index, the abnormality identified using the different sequences also differed in location. Fractional component analysis showed that the intersection of the tumor volumes as defined on both T2 and FLAIR defined the majority of the union volume contributing 63.6% to the CTV union and 82.1% to the PTV union. T2 alone uniquely identified 12.9% and 5.2% of the CTV and PTV unions respectively while FLAIR alone uniquely identified 25.7% and 12% of the CTV and PTV unions respectively. There was no difference in predicted toxicity to normal structures using T2 or FLAIR. At the

  10. Comparison of T2 and FLAIR imaging for target delineation in high grade gliomas

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    Miller Robert W

    2010-01-01

    Full Text Available Abstract Background FLAIR and T2 weighted MRIs are used based on institutional preference to delineate high grade gliomas and surrounding edema for radiation treatment planning. Although these sequences have inherent physical differences there is limited data on the clinical and dosimetric impact of using either or both sequences. Methods 40 patients with high grade gliomas consecutively treated between 2002 and 2008 of which 32 had pretreatment MRIs with T1, T2 and FLAIR available for review were selected for this study. These MRIs were fused with the treatment planning CT. Normal structures, clinical tumor volume (CTV and planning tumor volume (PTV were then defined on the T2 and FLAIR sequences. A Venn diagram analysis was performed for each pair of tumor volumes as well as a fractional component analysis to assess the contribution of each sequence to the union volume. For each patient the tumor volumes were compared in terms of total volume in cubic centimeters as well as anatomic location using a discordance index. The overlap of the tumor volumes with critical structures was calculated as a measure of predicted toxicity. For patients with MRI documented failures, the tumor volumes obtained using the different sequences were compared with the recurrent gross tumor volume (rGTV. Results The FLAIR CTVs and PTVs were significantly larger than the T2 CTVs and PTVs (p Conclusions Although both T2 and FLAIR MRI sequences are used to define high grade glial neoplasm and surrounding edema, our results show that the volumes generated using these techniques are different and not interchangeable. These differences have bearing on the use of intensity modulated radiation therapy (IMRT and highly conformal treatment as well as on future clinical trials where the bias of using one technique over the other may influence the study outcome.

  11. Conventional and Diffusion-Weighted MRI in the Evaluation of Methanol Poisoning. A case report

    International Nuclear Information System (INIS)

    Server, A.; Nakstad, P.Hj.; Dullerud, R.; Haakonsen, M.; Hovda, K.E.; Jacobsen, D.

    2003-01-01

    Cerebral lesions were studied in 2 methanol-poisoned patients using conventional magnetic resonance imaging (MRI). In 1 patient, diffusion-weighted MRI (DWI) was also performed. In this patient, conventional MRI showed symmetrical, bilateral increased signal in the lentiform nuclei, involving predominantly putamina, but also extending into the corona radiata, centrum semiovale and subcortical white matter. DWI showed decreased diffusion, which most probably reflects cytotoxic edema. In the other patient, fluid attenuated-inversion recovery (FLAIR) and T2-weighted images showed hyperintensity in the putamina, characteristic of post-necrotic changes

  12. Diagnostic value of the fast-FLAIR sequence in MR imaging of intracranial tumors

    International Nuclear Information System (INIS)

    Husstedt, H.W.; Sickert, M.; Koestler, H.; Haubitz, B.; Becker, H.

    2000-01-01

    The aim of this study was to quantify imaging characteristics of fast fluid-attenuated inversion recovery (FLAIR) sequence in brain tumors compared with T1-postcontrast- and T2-sequences. Fast-FLAIR-, T2 fast spin echo (FSE)-, and T1 SE postcontrast images of 74 patients with intracranial neoplasms were analyzed. Four neuroradiologists rated signal intensity and inhomogeneity of the tumor, rendering of cystic parts, demarcation of the tumor vs brain, of the tumor vs edema and of brain vs edema, as well as the presence of motion and of other artifacts. Data analysis was performed for histologically proven astrocytomas, glioblastomas, and meningiomas, for tumors with poor contrast enhancement, and for all patients pooled. Only for tumors with poor contrast enhancement (n = 12) did fast FLAIR provide additional information about the lesion. In these cases, signal intensity, demarcation of the tumor vs brain, and differentiation of the tumor vs edema were best using fast FLAIR. In all cases, rendering of the tumor's inner structure was poor. For all other tumor types, fast FLAIR did not give clinically relevant information, the only exception being a better demarcation of the edema from brain tissue. Artifacts rarely interfered with evaluation of fast-FLAIR images. Thus, fast FLAIR cannot replace T2-weighted series. It provides additional information only in tumors with poor contrast enhancement. It is helpful for defining the exact extent of the edema of any tumor but gives little information about their inner structure. (orig.)

  13. Diagnostic value of the fast-FLAIR sequence in MR imaging of intracranial tumors.

    Science.gov (United States)

    Husstedt, H W; Sickert, M; Köstler, H; Haubitz, B; Becker, H

    2000-01-01

    The aim of this study was to quantify imaging characteristics of fast fluid-attenuated inversion recovery (FLAIR) sequence in brain tumors compared with T1-postcontrast- and T2-sequences. Fast-FLAIR-, T2 fast spin echo (FSE)-, and T1 SE postcontrast images of 74 patients with intracranial neoplasms were analyzed. Four neuroradiologists rated signal intensity and inhomogeneity of the tumor, rendering of cystic parts, demarcation of the tumor vs brain, of the tumor vs edema and of brain vs edema, as well as the presence of motion and of other artifacts. Data analysis was performed for histologically proven astrocytomas, glioblastomas, and meningiomas, for tumors with poor contrast enhancement, and for all patients pooled. Only for tumors with poor contrast enhancement (n = 12) did fast FLAIR provide additional information about the lesion. In these cases, signal intensity, demarcation of the tumor vs brain, and differentiation of the tumor vs edema were best using fast FLAIR. In all cases, rendering of the tumor's inner structure was poor. For all other tumor types, fast FLAIR did not give clinically relevant information, the only exception being a better demarcation of the edema from brain tissue. Artifacts rarely interfered with evaluation of fast-FLAIR images. Thus, fast FLAIR cannot replace T2-weighted series. It provides additional information only in tumors with poor contrast enhancement. It is helpful for defining the exact extent of the edema of any tumor but gives little information about their inner structure.

  14. Utility of coronal contrast-enhanced fat-suppressed FLAIR in the evaluation of optic neuropathy and atrophy

    Directory of Open Access Journals (Sweden)

    Kevin H. Boegel

    Full Text Available Background and purpose: Evaluating chronic sequelae of optic neuritis, such as optic neuropathy with or without optic nerve atrophy, can be challenging on whole brain MRI. This study evaluated the utility of dedicated coronal contrast-enhanced fat-suppressed FLAIR (CE-FS-FLAIR MR imaging to detect optic neuropathy and optic nerve atrophy. Materials and methods: Over 4.5 years, a 3 mm coronal CE-FS-FLAIR sequence at 1.5T was added to the routine brain MRIs of 124 consecutive patients, 102 of whom had suspected or known demyelinating disease. Retrospective record reviews confirmed that 28 of these 102 had documented onset of optic neuritis >4 weeks prior to the brain MRI. These 28 were compared to the other 22 (“controls” of the 124 patients who lacked a history of demyelinating disease or visual symptoms. Using coronal CE-FS-FLAIR, two neuroradiologists separately graded each optic nerve (n = 50 patients, 100 total nerves as either negative, equivocal, or positive for optic neuropathy or atrophy. The scoring was later repeated. Results: The mean time from acute optic neuritis onset to MRI was 4.1 ± 4.6 years (range 34 days-17.4 years. Per individual nerve grading, the range of sensitivity, specificity, and accuracy of coronal CE-FS-FLAIR in detecting optic neuropathy was 71.4–77.1%, 93.8–95.4%, and 85.5–89.0%, respectively, with strong interobserver (k = 0.667 − 0.678, p < 0.0001, and intraobserver (k = 0.706 − 0.763, p < 0.0001 agreement. For optic atrophy, interobserver agreement was moderate (k = 0.437 − 0.484, p < 0.0001, while intraobserver agreement was moderate-strong (k = 0.491 − 0.596, p < 0.0001. Conclusion: Coronal CE-FS-FLAIR is quite specific in detecting optic neuropathy years after the onset of acute optic neuritis, but is less useful in detecting optic nerve atrophy. Keywords: Optic

  15. Usefulness of low-field FlAIR sequence in MR imaging of intracranial tumors

    International Nuclear Information System (INIS)

    Sokolowska, D.; Sasiadek, M.; Zimny, A.

    2004-01-01

    Plain MR study is often insufficient for visualization of all important details of intracranial tumors, hence there are attempts to use supplementary MR techniques. One of them is FLAIR (fluid attenuated inversion recovery) sequence which previously was available only in high-field MR units, but recently has been introduced also in less expensive low-field units. FLAIR is already widely used in the diagnostics of ischemic and demyelinating lesions, while there are few papers concerning its application in intracranial tumors, none of them regarding low-field MR units.The aim of our study was detailed evaluation of low-field FLAIR in the diagnostics of intracranial tumors. The material consisted of 76 patients with intracranial tumors, who were examined with low-field open MR unit (0.23 Tesla). In all patients, standard T2-weighted and T1-weighted (before and after contrast enhancement) sequences, as well as FLAIR sequence, were performed. The following symptoms were compared in the aforementioned sequences: tumor-edema, edema-brain and tumor-brain borders, visualization of tumour structure, vessels in the tumor area and precise tumor localization. A superiority of FLAIR in assessment of all symptoms has been confirmed, at least in part of the patient group. It concerned particularly the evaluation of brain-edema and edema-brain borders which were better visible with FLAIR than with all other sequences in 29 and 30 patients, respectively. In the assessment of the remaining symptoms (tumor-brain border, tumor structure, visualization of vessels, tumor localization) FLAIR was superior to other sequences in smaller number of patients (13,11,11 and 12, respectively). Totally, in 48 out of 76 patients (63.2%) FLAIR allowed better assessment of at least one of the analyzed symptoms. Low-field MR FLAIR enriches diagnostic information in majority of patients with intracranial tumors, therefore it should be included routinely in the diagnostic algorithm in this group of

  16. FLAIR-HASTE sequence in differential diagnosis of focal hepatic lesions

    International Nuclear Information System (INIS)

    Kim, Yong Jae; Kim, Tae Kyoung; Bae, In Young; Kim, Pyo Nyun; Ha, Hyun Kwon; Kim, Ah Young; Lee, Moon Gyu

    2001-01-01

    To assess the feasibility of using the FLAIR (fluid-attenuated inversion recovery)-HASTE (half-fourier acquisition single-shot turbo spin-echo) sequence for the differential diagnosis of focal hepatic lesions. During a 12-month period, 80 patients with 127 focal hepatic lesions [hemangiomas (n=60), hepatocellular carcinomas (HCC) (n=27), cysts (n=25), and metastases (n=15) underwent MR imaging using a 1.5-T scanner. Verification of the diagnosis was based on the findings of pathology (n=11), of angiography and clinical investigation (n=17), or of dynamic contrast-enhanced MR imaging (n=99). MR sequences included T2-weighted HASTE (TE, 134 ms ; echo space, 4.4 ms), FLAIR-HASTE (TE, 64 ms ; echo space, 4.4 ms ; inversion time, 2000 ms ; number of slices, 5-9 ; acquisition time, 13-20 s), and dynamic gadolinium-enhanced T1-weighted FLASH (TR, 131 ms ; TE, 4 ms). FLAIR-HASTE imaging was of any focal lesions seen on T2-weighted HASTE images was performed in the liver area, and their signal intensity was classified in one of five ways : very high (higher than the spleen), moderately high (similar to the spleen), slightly high (higher than the liver and lower than the spleen), intermediate (similar to the liver), or low (lower than the liver). The signal intensity of the 25 cysts, as determined by FLAIR-HASTE, was low in 21 cases (84%), intermediate in three (12%), and very high in one (4%), which was diagnosed as a complicated cyst in which ultrasound revealed internal septa. At FLAIR-HASTE, all 60 hemangiomas showed either very high (n=50, 83%) or moderately high (n=10, 17%) signal intensity, while that of 42 hepatic malignant tumors was very high in 14 cases (33%), moderately high in 8 (19%), slightly high in 18 (43%), intermediate in one (2.5%), and low in one (2.5%). FLAIR-HASTE showed that the signal intensity of the majority of hepatic cysts was low, while that of most hemangiomas and solid liver tumors was high. For the differential diagnosis of cystic and

  17. Fast FLAIR MR imaging finidngs of cerebral infarction : comparison with T2-weighted spin echo imaging

    International Nuclear Information System (INIS)

    Kong, Keun Young; Choi, Woo Suk; Kim, Eui Jong

    1997-01-01

    To evaluate the utility of FLAIR(Fluid Attenuated Inversion Recovery) MR imaging in cerebral infarction by comparing its results with those of T2-weighted spin-echo imaging. We retrospectively evaluated fast FLAIR images and conventional spin echo images of 82 patients (47 men and 20 women ; median age 60.9 years) with cerebral infarction. MR imaging used a 1.5T MR unit with conventional T2(TR 3900, TE 90) and fast FLAIR sequence (TR 8000, TE 105, TI 2400). We analysed the size of the main lesion and number of lesions, and discrimination between old and new lesions and between small infarction and perivascular space. When T2-weighted and FLAIR imaging were compared, the latter showed that the main lesion was larger in 38 cases (46%), similar in 38 (46%), and smaller in six (7%). The number of lesions was greater in 23 cases(28%), similar in 52 (63%), and fewer in seven (9%). FLAIR images discriminated between old and new lesions in 31 cases ; perivascular space and small infarotion were differentiated in eight cases, and CSF inflowing artifact was observed in 66 (80%). In the diagnosis of cerebral infaretion, fast FLAIR provides images that are equal or superior to T2-weighted images. The fast FLAIR sequence may therefore be used as a part of routine MR brain study in the diagnosis of cerebral infarction

  18. Comparison of post-contrast 3D-T1-MPRAGE, 3D-T1-SPACE and 3D-T2-FLAIR MR images in evaluation of meningeal abnormalities at 3-T MRI.

    Science.gov (United States)

    Jeevanandham, Balaji; Kalyanpur, Tejas; Gupta, Prashant; Cherian, Mathew

    2017-06-01

    This study was to assess the usefulness of newer three-dimensional (3D)-T 1 sampling perfection with application optimized contrast using different flip-angle evolutions (SPACE) and 3D-T 2 fluid-attenuated inversion recovery (FLAIR) sequences in evaluation of meningeal abnormalities. 78 patients who presented with high suspicion of meningeal abnormalities were evaluated using post-contrast 3D-T 2 -FLAIR, 3D-T 1 magnetization-prepared rapid gradient-echo (MPRAGE) and 3D-T 1 -SPACE sequences. The images were evaluated independently by two radiologists for cortical gyral, sulcal space, basal cisterns and dural enhancement. The diagnoses were confirmed by further investigations including histopathology. Post-contrast 3D-T 1 -SPACE and 3D-T 2 -FLAIR images yielded significantly more information than MPRAGE images (p evaluation of meningeal abnormalities and when used in combination have the maximum sensitivity for leptomeningeal abnormalities. The negative-predictive value is nearly 100%, where no leptomeningeal abnormality was detected on these sequences. Advances in knowledge: Post-contrast 3D-T 1 -SPACE and 3D-T 2 -FLAIR images are more useful than 3D-T 1 -MPRAGE images in evaluation of meningeal abnormalities.

  19. CT and MRI findings of cyclosporine-related encephalopathy and hypertensive encephalopathy

    International Nuclear Information System (INIS)

    Yamamoto, Akira; Hayakawa, Katsumi; Houjyou, Makoto

    2002-01-01

    We present the MRI and CT findings of one child with cyclosporine-related encephalopathy, and one child with hypertensive encephalopathy following cyclosporine-related encephalopathy. The imaging findings were shown well on T2-weighted and fluid-attenuated inversion recovery (FLAIR) MR images. Cyclosporine-related encephalopathy was distributed predominantly in the posterior white matter. Hypertensive encephalopathy showed similar changes of CT attenuation, but with wider distribution. These two disorders seem to have the same pathogenesis. (orig.)

  20. Detection of lesions in multiple sclerosis by 2D FLAIR and single-slab 3D FLAIR sequences at 3.0 T: initial results

    International Nuclear Information System (INIS)

    Bink, Andrea; Gaa, Jochen; Lanfermann, Heinrich; Zanella, Friedhelm E.; Schmitt, Melanie; Mugler, John P.

    2006-01-01

    The aim of this study was to compare conventional 2D FLAIR and single-slab 3D FLAIR sequences in the detection of lesions in patients with multiple sclerosis. Eight patients with MS were examined at 3.0 T by using a 2D FLAIR sequence and a single-slab 3D FLAIR sequence. A comparison of lesion detectability was performed for the following regions: periventricular, nonperiventricular/juxtacortical and infratentorial. The contrast-to-noise ratios (CNRs) between lesions and brain tissue and CSF were calculated for each sequence. A total of 424 lesions were found using the 2D FLAIR sequence, while with the 3D FLAIR sequence 719 lesions were found. With the 2D FLAIR sequence, 41% fewer lesions were detected than with the 3D FLAIR sequence. Further, 40% fewer supratentorial and 62.5% fewer infratentorial lesions were found with the 2D FLAIR sequence. In images acquired with the 3D FLAIR sequence, the lesions had significantly higher CNRs than in images acquired with the 2D FLAIR sequence. These are the first results using a single-slab 3D FLAIR sequence at 3.0 T for detection of lesions in patients with MS. With the 3D FLAIR sequence significantly higher CNRs were achieved and significantly more lesions in patients with MS were detected. (orig.)

  1. The effect of magnetisation transfer contrast on cerebrospinal fluid on motion artefacts on fluid-attenuated inversion-recovery images

    International Nuclear Information System (INIS)

    Aprile, I.; Principi, M.; Ottaviano, P.; Scapeccia, M.

    2003-01-01

    We assessed possible advantages of the use of fluid-attenuated inversion-recovery (FLAIR) sequences with magnetisation-transfer contrast (MTC) over conventional FLAIR images. We carried out cranial MRI at 1 tesla on 50 patients with both sequences. In nine patients with multiple sclerosis (MS) we performed a quantitative comparison of the two sequences, looking at the contrast-to-noise ratio between lesions and normal white matter and counting the number of lesions shown using each method. A qualitative comparison on all patients consisted of the analysis of the appearance of the normal parenchyma, of any lesions, and of artefacts, with particular reference to cerebrospinal fluid (CSF) motion artefacts. The quantitative analysis showed no meaningful difference between the two sequences. The cerebral parenchyma and lesions appeared substantially the same with both techniques. With FLAIR MTC there was a clear, and consistent reduction in CSF motion artefacts. FLAIR MTC sequences can usefully be used in place of the conventional sequence at 1 tesla. (orig.)

  2. Evaluation of prospective motion correction of high-resolution 3D-T2-FLAIR acquisitions in epilepsy patients.

    Science.gov (United States)

    Vos, Sjoerd B; Micallef, Caroline; Barkhof, Frederik; Hill, Andrea; Winston, Gavin P; Ourselin, Sebastien; Duncan, John S

    2018-03-02

    T2-FLAIR is the single most sensitive MRI contrast to detect lesions underlying focal epilepsies but 3D sequences used to obtain isotropic high-resolution images are susceptible to motion artefacts. Prospective motion correction (PMC) - demonstrated to improve 3D-T1 image quality in a pediatric population - was applied to high-resolution 3D-T2-FLAIR scans in adult epilepsy patients to evaluate its clinical benefit. Coronal 3D-T2-FLAIR scans were acquired with a 1mm isotropic resolution on a 3T MRI scanner. Two expert neuroradiologists reviewed 40 scans without PMC and 40 with navigator-based PMC. Visual assessment addressed six criteria of image quality (resolution, SNR, WM-GM contrast, intensity homogeneity, lesion conspicuity, diagnostic confidence) on a seven-point Likert scale (from non-diagnostic to outstanding). SNR was also objectively quantified within the white matter. PMC scans had near-identical scores on the criteria of image quality to non-PMC scans, with the notable exception that intensity homogeneity was generally worse. Using PMC, the percentage of scans with bad image quality was substantially lower than without PMC (3.25% vs. 12.5%) on the other five criteria. Quantitative SNR estimates revealed that PMC and non-PMC had no significant difference in SNR (P=0.07). Application of prospective motion correction to 3D-T2-FLAIR sequences decreased the percentage of low-quality scans, reducing the number of scans that need to be repeated to obtain clinically useful data. Copyright © 2018 The Authors. Published by Elsevier Masson SAS.. All rights reserved.

  3. Serum levels of brain-derived neurotrophicfactor correlate with the number of T2 MRI lesions in multiple sclerosis

    Directory of Open Access Journals (Sweden)

    E.R. Comini-Frota

    2012-01-01

    Full Text Available The objective of the present study was to determine if there is a relationship between serum levels of brain-derived neurotrophic factor (BDNF and the number of T2/fluid-attenuated inversion recovery (T2/FLAIR lesions in multiple sclerosis (MS. The use of magnetic resonance imaging (MRI has revolutionized the study of MS. However, MRI has limitations and the use of other biomarkers such as BDNF may be useful for the clinical assessment and the study of the disease. Serum was obtained from 28 MS patients, 18-50 years old (median 38, 21 women, 0.5-10 years (median 5 of disease duration, EDSS 1-4 (median 1.5 and 28 healthy controls, 19-49 years old (median 33, 19 women. BDNF levels were measured by ELISA. T1, T2/FLAIR and gadolinium-enhanced lesions were measured by a trained radiologist. BDNF was reduced in MS patients (median [range] pg/mL; 1160 [352.6-2640] compared to healthy controls (1640 [632.4-4268]; P = 0.03, Mann-Whitney test and was negatively correlated (Spearman correlation test, r = -0.41; P = 0.02 with T2/FLAIR (11-81 lesions, median 42. We found that serum BDNF levels were inversely correlated with the number of T2/FLAIR lesions in patients with MS. BDNF may be a promising biomarker of MS.

  4. MRI of cortical dysplasia - correlation with pathological findings

    Energy Technology Data Exchange (ETDEWEB)

    Usui, N.; Kajita, Y.; Yoshida, J. [Dept. of Neurosurgery, Nagoya Univ. School of Medicine (Japan); Matsuda, K.; Mihara, T.; Tottori, T.; Ohtsubo, T.; Baba, K.; Matsuyama, N.; Inoue, Y.; Yagi, K. [National Epilepsy Centre, Shizuoka Higashi Hospital (Japan)

    2001-10-01

    Cortical dysplasia (CD) is the most epileptogenic structural lesion associated with epilepsy and patients with intractable seizures caused by this condition are good surgical candidates. MRI plays an important role in detecting the abnormalities of CD. We clarified the MRI characteristics of CD by comparing imaging and histological findings in 20 patients with intractable seizures who underwent surgical resection. There were 12 males and eight females, mean age at operation was 15 years. MRI was performed at 1.5 tesla; T1-weighted, T2- and proton density-weighted spin-echo and fluid-attenuated inversion-recovery (FLAIR) images were obtained. The lesions were in the frontal lobe in nine cases, temporal in two, occipital in another two, insular in one and multilobar in six. Blurring of the grey/white matter junction was seen in all patients, and T2 prolongation in white matter and/or at the grey/white matter junction in 19. Abnormal signal intensity was more frequent in the white matter or at the grey/white matter junction than in the grey matter. FLAIR images made this abnormal high signal easier to appreciate, and we thought them very useful in this context. In areas of T2 prolongation, we saw dysplastic neurones and/or balloon cells, dysmyelination, and ectopic neuronal clustering histologically; glial proliferation played an important role in prolonging T2. (orig.)

  5. Serum levels of brain-derived neurotrophic factor correlate with the number of T2 MRI lesions in multiple sclerosis

    International Nuclear Information System (INIS)

    Comini-Frota, E.R.; Rodrigues, D.H.; Miranda, E.C.; Brum, D.G.; Kaimen-Maciel, D.R.; Donadi, E.A.; Teixeira, A.L.

    2011-01-01

    The objective of the present study was to determine if there is a relationship between serum levels of brain-derived neurotrophic factor (BDNF) and the number of T2/fluid-attenuated inversion recovery (T2/FLAIR) lesions in multiple sclerosis (MS). The use of magnetic resonance imaging (MRI) has revolutionized the study of MS. However, MRI has limitations and the use of other biomarkers such as BDNF may be useful for the clinical assessment and the study of the disease. Serum was obtained from 28 MS patients, 18-50 years old (median 38), 21 women, 0.5-10 years (median 5) of disease duration, EDSS 1-4 (median 1.5) and 28 healthy controls, 19-49 years old (median 33), 19 women. BDNF levels were measured by ELISA. T1, T2/FLAIR and gadolinium-enhanced lesions were measured by a trained radiologist. BDNF was reduced in MS patients (median [range] pg/mL; 1160 [352.6-2640]) compared to healthy controls (1640 [632.4-4268]; P = 0.03, Mann-Whitney test) and was negatively correlated (Spearman correlation test, r = -0.41; P = 0.02) with T2/FLAIR (11-81 lesions, median 42). We found that serum BDNF levels were inversely correlated with the number of T2/FLAIR lesions in patients with MS. BDNF may be a promising biomarker of MS

  6. Serum levels of brain-derived neurotrophic factor correlate with the number of T2 MRI lesions in multiple sclerosis

    Energy Technology Data Exchange (ETDEWEB)

    Comini-Frota, E.R. [Unidade de Neurologia, Hospital Universitário, Universidade Federal de Minas Gerais, Belo Horizonte, MG (Brazil); Rodrigues, D.H. [Laboratório de Imunofarmacologia, Instituto de Ciências Biológicas, Universidade Federal de Minas Gerais, Belo Horizonte, MG (Brazil); Miranda, E.C. [Ecoar Diagnostic Center, Belo Horizonte, MG (Brazil); Brum, D.G. [Hospital das Clínicas,Faculdade de Medicina de Ribeirão Preto,Universidade de São Paulo, Ribeirão Preto, SP (Brazil); Kaimen-Maciel, D.R. [Unidade de Neurologia, Hospital Universitário, Universidade Estadual de Londrina, Londrina, PR (Brazil); Donadi, E.A. [Hospital das Clínicas,Faculdade de Medicina de Ribeirão Preto,Universidade de São Paulo, Ribeirão Preto, SP (Brazil); Teixeira, A.L. [Unidade de Neurologia, Hospital Universitário, Universidade Federal de Minas Gerais, Belo Horizonte, MG (Brazil); Laboratório de Imunofarmacologia, Instituto de Ciências Biológicas, Universidade Federal de Minas Gerais, Belo Horizonte, MG (Brazil)

    2011-11-23

    The objective of the present study was to determine if there is a relationship between serum levels of brain-derived neurotrophic factor (BDNF) and the number of T2/fluid-attenuated inversion recovery (T2/FLAIR) lesions in multiple sclerosis (MS). The use of magnetic resonance imaging (MRI) has revolutionized the study of MS. However, MRI has limitations and the use of other biomarkers such as BDNF may be useful for the clinical assessment and the study of the disease. Serum was obtained from 28 MS patients, 18-50 years old (median 38), 21 women, 0.5-10 years (median 5) of disease duration, EDSS 1-4 (median 1.5) and 28 healthy controls, 19-49 years old (median 33), 19 women. BDNF levels were measured by ELISA. T1, T2/FLAIR and gadolinium-enhanced lesions were measured by a trained radiologist. BDNF was reduced in MS patients (median [range] pg/mL; 1160 [352.6-2640]) compared to healthy controls (1640 [632.4-4268]; P = 0.03, Mann-Whitney test) and was negatively correlated (Spearman correlation test, r = -0.41; P = 0.02) with T2/FLAIR (11-81 lesions, median 42). We found that serum BDNF levels were inversely correlated with the number of T2/FLAIR lesions in patients with MS. BDNF may be a promising biomarker of MS.

  7. Detection of aneurysmal subarachnoid hemorrhage 3 months after initial bleeding: evaluation of T2* and FLAIR MR sequences at 3 T in comparison with initial non-enhanced CT as a gold standard.

    Science.gov (United States)

    Mulé, Sébastien; Soize, Sébastien; Benaissa, Azzedine; Portefaix, Christophe; Pierot, Laurent

    2016-08-01

    To investigate the ability of T2* and fluid-attenuated inversion recovery (FLAIR) MR sequences to detect hemosiderin deposition 3 months after aneurysmal subarachnoid hemorrhage (SAH) in comparison with early non-enhanced CT (NECT) as a gold standard. From September 2008 through May 2013, patients with aneurysmal SAH were included if a NECT less than 24 h after the onset of symptoms showed a SAH, and MRI, including T2* and FLAIR sequences, was performed 3 months later. All aneurysms were treated endovascularly. NECT and MR sequences were blindly analyzed for the presence of SAH (NECT) or hemosiderin deposition (MRI). When positive, details of the spatial distribution of SAH or hemosiderin deposits were noted. Sensitivities were calculated for each patient. Sensitivities, specificities, and positive predictive values (PPVs) were calculated for each location. Forty-nine patients (mean age 52.9 years) were included. Bleeding-related patterns were identified in 43 patients (87.8%) on T2* and 10 patients (20.4%) on FLAIR. T2* was highly predictive of the location of the initial hemorrhage, especially in the Sylvian cisterns (PPVs 95% and 100%) and the anterior interhemispheric fissure (PPV 90%). The T2* sequence can detect and localize a previous SAH a few months after aneurysmal bleeding. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

  8. Quantification of traumatic meningeal injury using dynamic contrast enhanced (DCE) fluid-attenuated inversion recovery (FLAIR) imaging

    Science.gov (United States)

    Castro, Marcelo A.; Williford, Joshua P.; Cota, Martin R.; MacLaren, Judy M.; Dardzinski, Bernard J.; Latour, Lawrence L.; Pham, Dzung L.; Butman, John A.

    2016-03-01

    Traumatic meningeal injury is a novel imaging marker of traumatic brain injury, which appears as enhancement of the dura on post-contrast T2-weighted FLAIR images, and is likely associated with inflammation of the meninges. Dynamic Contrast Enhanced MRI provides a better discrimination of abnormally perfused regions. A method to properly identify those regions is presented. Images of seventeen patients scanned within 96 hours of head injury with positive traumatic meningeal injury were normalized and aligned. The difference between the pre- and last post-contrast acquisitions was segmented and voxels in the higher class were spatially clustered. Spatial and morphological descriptors were used to identify the regions of enhancement: a) centroid; b) distance to the brain mask from external voxels; c) distance from internal voxels; d) size; e) shape. The method properly identified thirteen regions among all patients. The method failed in one case due to the presence of a large brain lesion that altered the mask boundaries. Most false detections were correctly rejected resulting in a sensitivity and specificity of 92.9% and 93.6%, respectively.

  9. Decreased hyperintense vessels on FLAIR images after endovascular recanalization of symptomatic internal carotid artery occlusion

    International Nuclear Information System (INIS)

    Liu Wenhua; Yin Qin; Yao Lingling; Zhu Shuanggen; Xu Gelin; Zhang Renliang; Ke Kaifu; Liu Xinfeng

    2012-01-01

    Background and purpose: Hyperintense vessels (HV) on fluid-attenuated inversion recovery (FLAIR) images were assumed to be explained by slow antegrade or retrograde leptomeningeal collateral flow related to extracranial or intracranial artery steno-occlusion. The aim of this study was to investigate the effect of recanalization after endovascular therapy of symptomatic internal carotid artery (ICA) occlusion on the presence of HV. Methods: Eleven patients with symptomatic ICA occlusion were retrospectively enrolled. Changes in the HV on FLAIR images were examined in affected hemisphere of each patient after successful treatment with endovascular recanalization (angioplasty, n = 3; stent-assisted angioplasty, n = 8). The relationship between postoperative changes in the HV and Thrombolysis In Cerebral Ischemia (TICI) scale (I-III) was assessed. Results: After operation, HV of the 11 affected hemispheres were showed to be decreased (n = 3) or disappeared (n = 8) in treated side. The median interval between pre- and postoperative MRI examinations was 97.0 h (range, from 69. to 48.7 h). Of the 8 patients with disappeared HV, 7 achieved high TICI grade flow (III) and 1 had relatively low TICI grade flow (IIc) in treated side. However, all the 3 patients with decreased HV were found to be relatively low TICI grade flow (IIc). Conclusion: Our data indicate that endovascular recanalization of ICA occlusion was effective for decreasing HV. Postoperative decrease in HV can be considered as a marker for hemodynamic improvement.

  10. MRI findings in 6 cases of children by inadvertent ingestion of diphenoxylate-atropine

    Energy Technology Data Exchange (ETDEWEB)

    Xiao Lianxiang [Shandong University School of Medicine, Shandong Medical Imaging Research Institute , No. 44 West Wenhua Road, Jinan 250012 (China); Lin Xiangtao, E-mail: yishui1982@126.com [Shandong University School of Medicine, Shandong Medical Imaging Research Institute, No. 44 West Wenhua Road, Jinan 250012 (China); Cao Jinfeng [Shandong University School of Medicine, Shandong Medical Imaging Research Institute , No. 44 West Wenhua Road, Jinan 250012 (China); Wang Xueyu [Division of Pediatrics, Shandong Provincial Hospital, Shandong University, No. 324 Jingwu Road, Jinan 250021 (China); Wu Lebin [Shandong Medical Imaging Research Institute, No. 324 Jingwu Road, Jinan 250021 (China)

    2011-09-15

    Purpose: Compound diphenoxylate (diphenoxylate-atropine) poisoning can cause toxic encephalopathy in children, and magnetic resonance imaging (MRI) of the brain in this condition has not been reported. This study is to analyze brain MRI findings and to investigate the relations between MRI features and possible pathophysiological changes in children. Methods: Six children accidentally swallowed compound diphenoxylate, 4 males, 2 females, aged 20-46 months, average 33 months. Quantity of ingested diphenoxylate-atropine was from 6 to 30 tablets, each tablet contains diphenoxylate 2.5 mg and atropine 0.025 mg. These patients were referred to our hospital within 24 h after diphenoxylate-atropine ingestion, and underwent brain MRI scan within 24-72 h after emergency treatment. The characteristics of conventional MRI were analyzed. Results: These pediatric patients had various symptoms of opioid intoxication and atropine toxicity. Brain MRI showed abnormal low signal intensity on T1-weighted images (T1WI) and abnormal high signal intensity on T2-weighted images (T2WI) and fluid-attenuated inversion recovery (FLAIR) imaging in bilateral in all cases; abnormal high signal intensity on T1WI, T2WI and FLAIR in 4 cases. Encephalomalacia was observed in 3 cases during follow-up. Conclusion: In the early stage of compound diphenoxylate poisoning in children, multiple extensive edema-necrosis and hemorrhagic-necrosis focus were observed in basic nucleus, pallium and cerebellum, these resulted in the corresponding brain dysfunction with encephalomalacia. MRI scan in the early stage in this condition may provide evidences of brain impairment, and is beneficial for the early diagnosis, treatment and prognosis assessment.

  11. MRI findings in 6 cases of children by inadvertent ingestion of diphenoxylate-atropine

    International Nuclear Information System (INIS)

    Xiao Lianxiang; Lin Xiangtao; Cao Jinfeng; Wang Xueyu; Wu Lebin

    2011-01-01

    Purpose: Compound diphenoxylate (diphenoxylate-atropine) poisoning can cause toxic encephalopathy in children, and magnetic resonance imaging (MRI) of the brain in this condition has not been reported. This study is to analyze brain MRI findings and to investigate the relations between MRI features and possible pathophysiological changes in children. Methods: Six children accidentally swallowed compound diphenoxylate, 4 males, 2 females, aged 20-46 months, average 33 months. Quantity of ingested diphenoxylate-atropine was from 6 to 30 tablets, each tablet contains diphenoxylate 2.5 mg and atropine 0.025 mg. These patients were referred to our hospital within 24 h after diphenoxylate-atropine ingestion, and underwent brain MRI scan within 24-72 h after emergency treatment. The characteristics of conventional MRI were analyzed. Results: These pediatric patients had various symptoms of opioid intoxication and atropine toxicity. Brain MRI showed abnormal low signal intensity on T1-weighted images (T1WI) and abnormal high signal intensity on T2-weighted images (T2WI) and fluid-attenuated inversion recovery (FLAIR) imaging in bilateral in all cases; abnormal high signal intensity on T1WI, T2WI and FLAIR in 4 cases. Encephalomalacia was observed in 3 cases during follow-up. Conclusion: In the early stage of compound diphenoxylate poisoning in children, multiple extensive edema-necrosis and hemorrhagic-necrosis focus were observed in basic nucleus, pallium and cerebellum, these resulted in the corresponding brain dysfunction with encephalomalacia. MRI scan in the early stage in this condition may provide evidences of brain impairment, and is beneficial for the early diagnosis, treatment and prognosis assessment.

  12. Influence of fluid-attenuated inversion-recovery on stroke apparent diffusion coefficient measurements and its clinical application

    Energy Technology Data Exchange (ETDEWEB)

    Ni Jianming [Medical Imaging Department, Wuxi Second Hospital Affiliated Nanjing Medical University, 68 Zhong Shan Road, Wuxi, Jiangsu Province 214002 (China); Radiology Department, Huashan Hospital, Shanghai Medical College, Fudan University, 12 Urumqi Middle Road, Shanghai 200040 (China); Nuclear Medicine Department, Renji Hospital, Medical School of Jiaotong University, Dongfang Road 1630, Shanghai 200127 (China); Mogensen, Monique A. [Department of Radiology, Division of Neuroradiology, University of Southern California, Los Angeles, CA (United States); Chen Zengai [Radiology Department, Huashan Hospital, Shanghai Medical College, Fudan University, 12 Urumqi Middle Road, Shanghai 200040 (China); Nuclear Medicine Department, Renji Hospital, Medical School of Jiaotong University, Dongfang Road 1630, Shanghai 200127 (China); Shuang Chen; Shen Tianzhen [Radiology Department, Huashan Hospital, Shanghai Medical College, Fudan University, 12 Urumqi Middle Road, Shanghai 200040 (China); Huang Gang, E-mail: huang2802@163.co [Nuclear Medicine Department, Renji Hospital, Medical School of Jiaotong University, Dongfang Road 1630, Shanghai 200127 (China)

    2010-08-15

    Background and purpose: The application of a fluid-attenuated inversion-recovery pulse with a conventional diffusion-weighted MRI sequence (FLAIR DWI) decreases the partial volume effects from cerebrospinal fluid on apparent diffusion coefficient (ADC) measurements. For this reason, FLAIR DWI may be more useful in the evaluation of ischemic stroke, but few studies have looked at the effect of FLAIR on ADC measurements in this setting. This study quantitatively compares FLAIR DWI and conventional DWI in ischemic stroke of varying ages to assess the potential advantages of this technique. Methods: We respectively analyzed 139 DWI studies in patients with ischemic stroke with and without FLAIR at varying time points ranging from hyperacute to chronic. ADC values were measured in each lesion, as well as in the contralateral normal side. Comparisons were made between the ADC values obtained from the DWI sequences with and without FLAIR for both the lesion and the normal contralateral side. Results: The ADC measurements within the ischemic lesion were very similar on FLAIR DWI and conventional DWI for lesions less than 14 days old (p > 0.05), but were significantly decreased on FLAIR DWI for lesions between 15 and 30 days old and in lesions >31 days old (chronic stage) (p < 0.01). The contralateral ADC values were all significantly decreased on the FLAIR DWI sequence compared with conventional DWI (p < 0.01). Conclusions: The application of an inversion pulse does not significantly affect the ADC values for early stage ischemic stroke (less than 14 days from symptom onset), but results in a more accurate relative ADC measurement by reducing the cerebrospinal fluid partial volume effects of the normal contralateral side. In addition, combined with the conventional DWI, FLAIR DWI may be helpful in determining the age of ischemic lesions.

  13. Flair MR imaging in the Detection of subarachnoid hemorrhage : comparison with CT and T1-weighted MR imaging

    Energy Technology Data Exchange (ETDEWEB)

    Min, Soo Hyun; Kim, Soo Youn; Lee, Ghi Jai; Shim, Jae Chan; Oh, Tae Kyung; Kim, Ho Kyun [College of Medicine, Jnje University, Seoul (Korea, Republic of)

    2000-03-01

    To compare the findings of fluid-attenuated inversion recovery (FLAIR) MR imaging in the detection of subarachnoid hemorrhage (SAH), with those of precontrast CT and T1-weighted MR imaging. In 13 patients (14 cases) with SAH, FLAIR MR images were retrospectively analyzed and compared with CT (10 patients, 11 cases) and T1-weighted MR images (9 cases). SAH was confirmed on the basis of high density along the subarachnoid space, as seen on precontrast CT, or lumbar puncture. MR imaging was performed on a 1.0T unit. FLAIR MR and CT images were obtained during the acute stage(less than 3 days after ictus) in 10 and 9 cases, respectively, during the subacute stage (4-14 days after ictus) in two cases and one, respectively, and during the chronic stage (more than 15 days after ictus) in two cases and one, respectively. CT was performed before FLAIR MR imaging, and the interval between CT and FLAIR ranged from 24 hours (6 cases) to 2-3 (2 cases) or 4-7 days (3 cases). In each study, the conspicuity of visualization of SAH was graded as excellent, good, fair, or negative at five locations (sylvian fissure, cortical sulci, anterior basal cistern, posterior basal cistern, and perimesencephalic cistern). In all cases, subarachnoid hemorrhages were demonstrated as high signal intensity areas on FLAIR images. The detection rates for SAH on CT and T1-weighted MR images were 100% (11/11) and 89% (8/9), respectively. FLAIR was superior to T1-weighted imaging in the detection of SAH at all sites except the anterior basal cistern (p less than 0.05) and superior to CT in the detection of SAH at the cortical sulci (p less than 0.05). On FLAIR MR images, subarachnoid hemorrhages at all stages are demonstrated as high signal intensity areas; the FLAIR MR sequence is thus considered useful in the detection of SAH. In particular FLAIR is more sensitive than CT for the detection of SAH in the cortical sulci. (author)

  14. MRI findings in 6 cases of children by inadvertent ingestion of diphenoxylate-atropine.

    Science.gov (United States)

    Xiao, Lianxiang; Lin, Xiangtao; Cao, Jinfeng; Wang, Xueyu; Wu, Lebin

    2011-09-01

    Compound diphenoxylate (diphenoxylate-atropine) poisoning can cause toxic encephalopathy in children, and magnetic resonance imaging (MRI) of the brain in this condition has not been reported. This study is to analyze brain MRI findings and to investigate the relations between MRI features and possible pathophysiological changes in children. Six children accidentally swallowed compound diphenoxylate, 4 males, 2 females, aged 20-46 months, average 33 months. Quantity of ingested diphenoxylate-atropine was from 6 to 30 tablets, each tablet contains diphenoxylate 2.5mg and atropine 0.025 mg. These patients were referred to our hospital within 24h after diphenoxylate-atropine ingestion, and underwent brain MRI scan within 24-72 h after emergency treatment. The characteristics of conventional MRI were analyzed. These pediatric patients had various symptoms of opioid intoxication and atropine toxicity. Brain MRI showed abnormal low signal intensity on T1-weighted images (T1WI) and abnormal high signal intensity on T2-weighted images (T2WI) and fluid-attenuated inversion recovery (FLAIR) imaging in bilateral in all cases; abnormal high signal intensity on T1WI, T2WI and FLAIR in 4 cases. Encephalomalacia was observed in 3 cases during follow-up. In the early stage of compound diphenoxylate poisoning in children, multiple extensive edema-necrosis and hemorrhagic-necrosis focus were observed in basic nucleus, pallium and cerebellum, these resulted in the corresponding brain dysfunction with encephalomalacia. MRI scan in the early stage in this condition may provide evidences of brain impairment, and is beneficial for the early diagnosis, treatment and prognosis assessment. Crown Copyright © 2010. Published by Elsevier Ireland Ltd. All rights reserved.

  15. FLAIR imaging for multiple sclerosis: a comparative MR study at 1.5 and 3.0 Tesla

    International Nuclear Information System (INIS)

    Bachmann, Rainald; Reilmann, Ralf; Schwindt, Wolfram; Kugel, Harald; Heindel, Walter; Kraemer, Stefan

    2006-01-01

    The purpose of this study was (1) to identify the optimal TE for FLAIR-imaging at 3.0 T assessing three different echo times qualitatively and quantitatively and (2) to evaluate the diagnostic efficacy of high-field 3.0-T FLAIR imaging in comparison to conventional 1.5-T MRI in patients with multiple sclerosis (MS). Twenty-two patients with clinically definite MS underwent axial FLAIR imaging at 1.5 and 3.0 T. In 15 of these patients further FLAIR images with a TE of 100, 120 and 140 ms were acquired at 3.0 T. Imaging protocols were modified for 3.0 T using the increased SNR to acquire more and thinner slices while maintaining a comparable scan time. FLAIR images of either different TEs or different field strengths were ranked for each patient qualitatively by two observers. Signal intensity measurements were obtained in the gray and white matter, CSF and representative white matter lesions (WML). At 3.0 T, a TE of 100 and 120 ms proved superior in all qualitative categories when compared to 140 ms. In the quantitative assessment CNR of WML was highest for 120 ms (CNR: 19.8), intermediate for 100 ms (17.2) and lowest for 140 ms (15.3) (P<0.003). For lesion conspicuity and overall image quality, 3.0 T was judged superior to 1.5 T, whereas no difference was found for gray-white differentiation and image noise. With regard to artifacts, 3.0 T was inferior to 1.5 T. The CNR for WML was slightly lower at 3.0 T, but the difference was not significant (22.6 vs. 28.0, P=ns). (orig.)

  16. Endolympathic hydrops in patients with vestibular schwannoma: visualization by non-contrast-enhanced 3D FLAIR

    Energy Technology Data Exchange (ETDEWEB)

    Naganawa, Shinji; Kawai, Hisashi [Nagoya University Graduate School of Medicine, Department of Radiology, Nagoya (Japan); Sone, Michihiko; Nakashima, Tsutomu [Nagoya University Graduate School of Medicine, Department of Otorhinolaryngology, Nagoya (Japan); Ikeda, Mitsuru [Nagoya University School of Health Sciences, Department of Radiological Technology, Nagoya (Japan)

    2011-12-15

    Signal intensity of ipsilateral labyrinthine lymph fluid has been reported to increase in most cases with vestibular schwannoma (VS) on 3D fluid attenuated inversion recovery (FLAIR). The purpose of this study was twofold, (1) to evaluate if endolymphatic space can be recognized in the patients with VS on non-contrast-enhanced 3D-FLAIR images and (2) to know if the vertigo in the patients with VS correlates to vestibular endolymphatic hydrops. From the introduction of 32-channel head coil at 3 T in May 2008 to June 2010, 15 cases with unilateral VS were identified in the radiology report database. The two cases without a significant signal increase on 3D FLAIR were excluded. Resting 13 cases were retrospectively analyzed in regard to the recognition of endolymphatic hydrops in the cochlea and vestibule and to the correlation between the patients' symptoms and endolymphatic hydrops. In all cases, vestibular endolymphatic space can be recognized on non-contrast-enhanced 3D FLAIR. Cochlear endolymphatic space can be identified only in one case with significant hydrops. Vestibular hydrops was identified in four cases. Among these four cases, three had vertigo, and one had no vertigo. In those nine cases without hydrops, two had vertigo, and seven did not have vertigo. No significant correlation between vertigo and vestibular hydrops was found. Vestibular endolymphatic space can be recognized on non-contrast-enhanced 3D FLAIR. In some patients with VS, vestibular hydrops is seen; however, endolymphatic hydrops in the vestibule might not be the only responsible cause of vertigo in the patients with VS. (orig.)

  17. Endolympathic hydrops in patients with vestibular schwannoma: visualization by non-contrast-enhanced 3D FLAIR

    International Nuclear Information System (INIS)

    Naganawa, Shinji; Kawai, Hisashi; Sone, Michihiko; Nakashima, Tsutomu; Ikeda, Mitsuru

    2011-01-01

    Signal intensity of ipsilateral labyrinthine lymph fluid has been reported to increase in most cases with vestibular schwannoma (VS) on 3D fluid attenuated inversion recovery (FLAIR). The purpose of this study was twofold, (1) to evaluate if endolymphatic space can be recognized in the patients with VS on non-contrast-enhanced 3D-FLAIR images and (2) to know if the vertigo in the patients with VS correlates to vestibular endolymphatic hydrops. From the introduction of 32-channel head coil at 3 T in May 2008 to June 2010, 15 cases with unilateral VS were identified in the radiology report database. The two cases without a significant signal increase on 3D FLAIR were excluded. Resting 13 cases were retrospectively analyzed in regard to the recognition of endolymphatic hydrops in the cochlea and vestibule and to the correlation between the patients' symptoms and endolymphatic hydrops. In all cases, vestibular endolymphatic space can be recognized on non-contrast-enhanced 3D FLAIR. Cochlear endolymphatic space can be identified only in one case with significant hydrops. Vestibular hydrops was identified in four cases. Among these four cases, three had vertigo, and one had no vertigo. In those nine cases without hydrops, two had vertigo, and seven did not have vertigo. No significant correlation between vertigo and vestibular hydrops was found. Vestibular endolymphatic space can be recognized on non-contrast-enhanced 3D FLAIR. In some patients with VS, vestibular hydrops is seen; however, endolymphatic hydrops in the vestibule might not be the only responsible cause of vertigo in the patients with VS. (orig.)

  18. Differentiation between vasogenic-edema versus tumor-infiltrative area in patients with glioblastoma during bevacizumab therapy: A longitudinal MRI study

    Energy Technology Data Exchange (ETDEWEB)

    Artzi, Moran, E-mail: artzimy@gmail.com [Functional Brain Center, Tel Aviv Sourasky Medical Center, Tel Aviv (Israel); Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv (Israel); Bokstein, Felix, E-mail: felixb@tlvmc.gov.il [Neuro-Oncology Service, Tel Aviv Sourasky Medical Center, Tel Aviv (Israel); Blumenthal, Deborah T., E-mail: deborahblumenthal@gmail.com [Neuro-Oncology Service, Tel Aviv Sourasky Medical Center, Tel Aviv (Israel); Aizenstein, Orna, E-mail: Ornaaizenstein@gmail.com [Functional Brain Center, Tel Aviv Sourasky Medical Center, Tel Aviv (Israel); Liberman, Gilad, E-mail: giladliberman@gmail.com [Functional Brain Center, Tel Aviv Sourasky Medical Center, Tel Aviv (Israel); Gonda Multidisciplinary Brain Research Center, Bar Ilan University, Ramat Gan (Israel); Corn, Benjamin W., E-mail: bencorn@tlvmc.gov.il [Functional Brain Center, Tel Aviv Sourasky Medical Center, Tel Aviv (Israel); Institute of Radiotherapy, Tel Aviv Sourasky Medical Center, Tel Aviv (Israel); Ben Bashat, Dafna, E-mail: dafnab@tlvmc.gov.il [Functional Brain Center, Tel Aviv Sourasky Medical Center, Tel Aviv (Israel); Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv (Israel); Sagol School of Neuroscience, Tel Aviv University, Tel Aviv (Israel)

    2014-07-15

    Background: Treatment with bevacizumab is associated with substantial radiologic response in patients with glioblastoma (GB). However, following this initial response, changes in T{sub 2}-weighted MRI signal may develop, suggesting an infiltrative pattern of tumor progression. The aim of this study was to differentiate between vasogenic-edema versus tumor-infiltrative area in GB patients. Methods and materials: Fourteen patients with GB were longitudinally scanned, before and during intravenous bevacizumab therapy (5/10 mg/kg every 2-weeks). A total of 40 MR scans including conventional, diffusion, dynamic susceptibility contrast, dynamic contrast enhancement imaging, and MR-spectroscopy (MRS) were analyzed. Classification of non-enhancing fluid-attenuation-inversion-recovery (FLAIR) area was performed based on mean diffusivity, cerebral blood volume and flow maps, and further characterized using multiple MRI parameters. Results: The non-enhancing FLAIR lesion area was classified into: vasogenic-edema, characterized by reduced perfusion and increased FLAIR values; or tumor-infiltrative area, characterized by increased perfusion. Tumor-infiltrative area demonstrated a higher malignant pattern on MRS compared to areas of vasogenic-edema. Substantial reductions of the enhanced T{sub 1}-weighted (58 ± 10%) and hyperintense FLAIR (53 ± 9%) lesion volumes were detected mainly during the first weeks of therapy, with a shift to an infiltrative pattern of tumor progression thereafter, as detected by an increase in tumor-infiltrative area in the majority of patients, which correlated with progression-free survival (week 8: r = −0.86, p = 0.003, week 16: r = −0.99, p = 0.001). Conclusion: Characterization of non-enhancing hyperintense FLAIR lesion area in GB patients can provide an MR-based biomarker, indicating a shift to an infiltrative progression pattern, and may improve therapy response assessment in patients following bevacizumab therapy.

  19. MR imaging at 0.5 Tesla with FLAIR sequence in the diagnosis of acute subarachnoid hemorrhage

    International Nuclear Information System (INIS)

    Kopsa, W.; Leitner, H.; Tscholakoff, D.; Perneczky, G.

    1998-01-01

    Purpose: Evaluation of MR imaging in patients with acute subarachnoid hemorrhage (SAH) at 0.5 Tesla using the FLAIR (Fluid Attenuated Inversion Recovery) sequenze. Additionally, the value of MR angiographie (MRA) in the diagnosis of intracranial aneurysms was assessed. Materials and Methods: 19 patients with suspected acute SAH were included in this study. MR imaging was performed using an axial FLAIR sequence and axial T 1 , T 2 and PD weighted sequences. In 16 patients an additional MRA (3D-TOF) was performed. 10 patients without SAH were examined as a control group. At the end of the study the 29 MR examinations were randomised and the images were read by two experienced radiologists; subsequently a consensus interpretation was made. Results: In 16 patients an acute SAH was verified with the FLAIR sequence, in 13 cases the origin of hemorrhage was found during surgery. In the consensus interpretation of the MR images all cases were diagnosed properly. 12 of the 16 MRA studies were of diagnostic quality, but only 6 cases were interpreted correctly. Conclusion: The FLAIR sequence at 0.5 Tesla proved effective in the diagnosis of acute SAH. MRA at 0.5 Tesla failed in the detection of intracranial aneurysms. (orig.) [de

  20. Postmortem verification of MS cortical lesion detection with 3D DIR

    NARCIS (Netherlands)

    Seewann, A.M.; Kooi, E.J.; Roosendaal, S.D.; Pouwels, P.J.W.; Wattjes, M.P.; van der Valk, P.; Barkhof, F.; Polman, C.H.; Geurts, J.J.G.

    2012-01-01

    Objective: To assess the sensitivity and specificity of 3D double inversion recovery (DIR) MRI for detecting multiple sclerosis (MS) cortical lesions (CLs) using a direct postmortem MRI to histopathology comparison. Methods: Single-slab 3D DIR and 3D fluid-attenuated inversion recovery (FLAIR)

  1. Diagnostic value of three-dimensional fluid-attenuated inversion recovery MR imaging after intratympanic administration of contrast media in Meniere's disease

    International Nuclear Information System (INIS)

    Shi Honglu; Zhang Daogong; Wang Guangbin; Fan Zhaomin; Bai Xue; Guo Lijun; Man Xiaoni

    2012-01-01

    Objective: After intratympanic gadolinium administration through the tympanic membrane, three-dimensional fluid-attenuated inversion recovery magnetic resonance imaging (3D-FLAIR MRI) was performed to evaluate endolymphatic visualization and its diagnostic value in Meniere's disease. Methods: Twenty-four hours after intratympanic gadolinium administration through the tympanic membrane, 19 patients with unilateral Meniere's disease diagnosed clinically underwent 3D-FLAIR and 3D-Balance-FFE imaging at 3.0 T MR scanner. The enhanced imaging of perilymphatic space in bilateral cochlea, vestibular and (or) canal were observed. Scala tympani and scala vestibule of bilateral cochlear basal turn were scored respectively. The enhanced range of bilateral vestibule and the signal intensity ratio (SIR) between the vestibule and the brain stem were measured. Wilcoxon tests and paired t tests were used. Results: The gadolinium appeared in almost all parts of the perilymph in cochlea,vestibular and (or) canal, so the endolymphatic space was clearly visualized on 3D-FLAIR imaging. The score of scala vestibuli between the affected side (3 cases scored 2, 9 cases scored 1, 7 cases scored 0) and the healthy side (15 cases scored 2, 2 cases scored 1, 2 cases scored 0) were significantly different (U=3.090, P<0.05). The area of enhanced vestibular were (5.77 ± 2.33) mm 2 and (8.11 ± 3.32) mm 2 for the affected side and the healthy side, which were significantly different (U=3.090, P<0.05 and t=2.638, P<0.05). Conclusions: According to 3D-Balance-FFE MRI and the enhancement of perilymphatic space, 3D-FLAIR MRI with intratympanic gadolinium injection through the tympanic membrane can be used to show the border between the perilymph and the endolymph and confirm endolymphatic hydrops, thus providing radiographic evidence for the diagnosis of Meniere's disease. (authors)

  2. Incidental pineal cysts in children who undergo 3-T MRI

    International Nuclear Information System (INIS)

    Whitehead, Matthew T.; Oh, Christopher C.; Choudhri, Asim F.

    2013-01-01

    Pineal cysts, both simple and complex, are commonly encountered in children. More cysts are being detected with MR technology; however, nearly all pineal cysts are benign and require no follow-up. To discover the prevalence of pineal cysts in children at our institution who have undergone high-resolution 3-T MRI. We retrospectively reviewed 100 consecutive 3-T brain MRIs in children ages 1 month to 17 years (mean 6.8 ± 5.1 years). We evaluated 3-D volumetric T1-W imaging, axial T2-W imaging, axial T2-W FLAIR (fluid attenuated inversion recovery) and coronal STIR (short tau inversion recovery) sequences. Pineal parenchymal and cyst volumes were measured in three planes. Cysts were analyzed for the presence and degree of complexity. Pineal cysts were present in 57% of children, with a mean maximum linear dimension of 4.2 mm (range 1.5-16 mm). Of these cysts, 24.6% showed thin septations or fluid levels reflecting complexity. None of the cysts demonstrated complete T2/FLAIR signal suppression. No cyst wall thickening or nodularity was present. There was no significant difference between the ages of children with and without cysts. Cysts were more commonly encountered in girls than boys (67% vs. 52%; P = 0.043). There was a slight trend toward increasing pineal gland volume with age. Pineal cysts are often present in children and can be incidentally detected by 3-T MRI. Characteristic-appearing pineal cysts in children are benign, incidental findings, for which follow-up is not required if there are no referable symptoms or excessive size. (orig.)

  3. Maturation of the limbic system revealed by MR FLAIR imaging

    Energy Technology Data Exchange (ETDEWEB)

    Schneider, Jacques F.; Vergesslich, Klara [University Children' s Hospital UKBB, Department of Paediatric Radiology, Basel (Switzerland)

    2007-04-15

    Cortical signal intensity (SI) of the limbic system in adults is known to be higher than in neocortical structures, but time-related changes in SI during childhood have not been described. To detect maturation-related SI changes within the limbic system using a fluid-attenuated inversion recovery (FLAIR) MR sequence. Twenty children (10 boys, 10 girls; age 3.5-18 years, mean 11.2 years) with no neurological abnormality and normal MR imaging examination were retrospectively selected. On two coronal FLAIR slices, ten regions of interest (ROI) with a constant area of 10 mm{sup 2} were manually placed in the archeocortex (hippocampus), periarcheocortex (parahippocampal gyrus, subcallosal area, cingulate gyrus) and in the neocortex at the level of the superior frontal gyrus on both sides. Significant SI gradients were observed with a higher intensity in the archeocortex, intermediate intensity in the periarcheocortex and low intensity in the neocortex. Significant higher SI values in hippocampal and parahippocampal structures were detected in children up to 10 years of age. These differences mainly reflected differences in cortical structure and myelination state. Archeocortical structures especially showed significant age-related intensity progression suggesting ongoing organization and/or myelination until early adolescence. (orig.)

  4. Maturation of the limbic system revealed by MR FLAIR imaging

    International Nuclear Information System (INIS)

    Schneider, Jacques F.; Vergesslich, Klara

    2007-01-01

    Cortical signal intensity (SI) of the limbic system in adults is known to be higher than in neocortical structures, but time-related changes in SI during childhood have not been described. To detect maturation-related SI changes within the limbic system using a fluid-attenuated inversion recovery (FLAIR) MR sequence. Twenty children (10 boys, 10 girls; age 3.5-18 years, mean 11.2 years) with no neurological abnormality and normal MR imaging examination were retrospectively selected. On two coronal FLAIR slices, ten regions of interest (ROI) with a constant area of 10 mm 2 were manually placed in the archeocortex (hippocampus), periarcheocortex (parahippocampal gyrus, subcallosal area, cingulate gyrus) and in the neocortex at the level of the superior frontal gyrus on both sides. Significant SI gradients were observed with a higher intensity in the archeocortex, intermediate intensity in the periarcheocortex and low intensity in the neocortex. Significant higher SI values in hippocampal and parahippocampal structures were detected in children up to 10 years of age. These differences mainly reflected differences in cortical structure and myelination state. Archeocortical structures especially showed significant age-related intensity progression suggesting ongoing organization and/or myelination until early adolescence. (orig.)

  5. Creutzfeldt-Jakob disease: the value of MRI

    International Nuclear Information System (INIS)

    Urbach, H.; Tschampa, H.J.; Keller, E.; Schild, H.H.; Paus, S.

    2001-01-01

    To define the role of MRI in the diagnosis of Creutzfeldt-Jakob disease (CJD). Methods: 14 patients with suspected CJD were studied within 3 years. MRI findings were correlated with WHO established diagnostic criteria (clinical findings, EEG, CSF with 14-3-3 protein assay). Results: 12 patients had CJD. One patient each suffered from Hashimoto's encephalitis and ALS dementia complex, respectively. Nine of 12 CJD patients had increased signal intensity of the striatum (n = 8), pulvinar thalami (n = 5) and/or cerebellar and cerebral cortex (n = 3), respectively. Signal intensity was most pronounced on FLAIR sequences; six patients were studied with diffusion-weighted MRI and showed impaired diffusion in these areas. Both patients without CJD did not show the abovementioned signal changes (sensitivity 75%, specificity and positive predictive value 100%, respectively). Conclusion: If patients with suspected CJD are studied with FLAIR and diffusion-weighted sequences, this disorder can reliably be proven or ruled out. Typical MRI findings narrow down the differential diagnosis and should be included in the WHO diagnostic criteria. (orig.) [de

  6. Iron accumulation in deep cortical layers accounts for MRI signal abnormalities in ALS: correlating 7 tesla MRI and pathology.

    Directory of Open Access Journals (Sweden)

    Justin Y Kwan

    Full Text Available Amyotrophic lateral sclerosis (ALS is a progressive neurodegenerative disorder characterized by cortical and spinal motor neuron dysfunction. Routine magnetic resonance imaging (MRI studies have previously shown hypointense signal in the motor cortex on T(2-weighted images in some ALS patients, however, the cause of this finding is unknown. To investigate the utility of this MR signal change as a marker of cortical motor neuron degeneration, signal abnormalities on 3T and 7T MR images of the brain were compared, and pathology was obtained in two ALS patients to determine the origin of the motor cortex hypointensity. Nineteen patients with clinically probable or definite ALS by El Escorial criteria and 19 healthy controls underwent 3T MRI. A 7T MRI scan was carried out on five ALS patients who had motor cortex hypointensity on the 3T FLAIR sequence and on three healthy controls. Postmortem 7T MRI of the brain was performed in one ALS patient and histological studies of the brains and spinal cords were obtained post-mortem in two patients. The motor cortex hypointensity on 3T FLAIR images was present in greater frequency in ALS patients. Increased hypointensity correlated with greater severity of upper motor neuron impairment. Analysis of 7T T(2(*-weighted gradient echo imaging localized the signal alteration to the deeper layers of the motor cortex in both ALS patients. Pathological studies showed increased iron accumulation in microglial cells in areas corresponding to the location of the signal changes on the 3T and 7T MRI of the motor cortex. These findings indicate that the motor cortex hypointensity on 3T MRI FLAIR images in ALS is due to increased iron accumulation by microglia.

  7. Ivy signs on FLAIR images before and after STA-MCA anastomosis in patients with Moyamoya disease

    Energy Technology Data Exchange (ETDEWEB)

    Ideguchi, Reiko; Enokizono, Mikako; Uetani, Masataka (Dept. of Radiological Sciences, Nagasaki Univ. Graduate School of Biomedical Sciences, Nagasaki (Japan)), e-mail: qqtt37gd9@forest.ocn.ne.jp; Morikawa, Minoru (Dept. of Radiology, Nagasaki Univ. School of Medicine, Nagasaki (Japan)); Ogawa, Yoji (Dept. of Radiology, Hanwa Daini Senboku Hospital, Osaka (Japan)); Nagata, Izumi (Dept. of Neurosurgery, Nagasaki Univ. School of Medicine, Nagasaki (Japan))

    2011-04-15

    Background: Leptomeningeal high signal intensity (ivy sign) on fluid-attenuated inversion-recovery (FLAIR) MR imaging is one of the features of Moyamoya disease. However, the correlation between ivy sign and cerebral perfusion status has not been fully evaluated. Purpose: To characterize ivy sign on FLAIR images in Moyamoya disease and compare this finding with hemodynamic alterations on perfusion single-photon emission CT (SPECT) obtained before and after bypass surgery. Material and Methods: Sixteen patients with angiographically confirmed Moyamoya disease who underwent superficial temporal artery-middle cerebral artery (STA-MCA) anastomosis were included in the study. The presence of ivy sign on FLAIR images was classified as 'negative', 'minimal' and 'positive'. We evaluated the relationship between ivy sign and findings of SPECT, including cerebral vascular reserve (CVR) before and after surgery. Results: Minimal or positive ivy sign was seen in 13 (81%) of 16 patients, and 21 (66%) of 32 hemispheres. CVR in the areas with positive or minimal ivy sign was lower than that in the areas with negative ivy sign. After STA-MCA anastomosis, ivy sign disappeared or decreased in all 21 hemispheres demonstrating ivy sign. SPECT demonstrated apparent hemodynamic improvement in areas demonstrating disappearance or decrease of ivy sign. Conclusion: Ivy sign on FLAIR image is seen in areas with decreased cerebral perfusion. The sign is useful for non-invasive assessment of cerebral hemodynamic status before and after surgery

  8. Cognitive Function and 3-Tesla Magnetic Resonance Imaging Tractography of White Matter Hyperintensities in Elderly Persons

    OpenAIRE

    Reginold, William; Luedke, Angela C.; Tam, Angela; Itorralba, Justine; Fernandez-Ruiz, Juan; Reginold, Jennifer; Islam, Omar; Garcia, Angeles

    2015-01-01

    Background/Aims: This study used 3-Tesla magnetic resonance imaging (MRI) tractography to determine if there was an association between tracts crossing white matter hyperintensities (WMH) and cognitive function in elderly persons. Methods: Brain T2-weighted fluid-attenuated inversion recovery (FLAIR) and diffusion tensor MRI scans were acquired in participants above the age of 60 years. Twenty-six persons had WMH identified on T2 FLAIR scans. They completed a battery of neuropsychological tes...

  9. MRI manifestation of Wilson's disease accompanied with central pontine myelinolysis

    International Nuclear Information System (INIS)

    Zhang Jingsong; Huan Yi; Chang Yingjuan; Chang Yingjuan; Ge Yali; Zhang Guangyun; Han Yuedong; Zhao Haitao; Yang Chunmin; Yang Yan

    2004-01-01

    Objective: To discuss MRI manifestation of Wilson's disease accompanied with central pontine myelinolysis (CPM), and to especially detect the value of diffusion-weighted MRI (DWI) in this disease. Methods: Two cases of Wilson's disease accompanied with CPM were performed with sequent MR examination including T 1 WI, T 2 WI, FLAIR, DWI, and contrast-enhanced MRI (CE MRI) by a 1.5 T magnetic resonance system (Philips gyroscan master). Results: Symmetric long T 1 and T 2 signals were found in central pontine region, lenticular nucleus, caudate nucleus, and thalamus. CEMRI showed no apparent enhanced lesions. DWI showed obviously high signal intensities in central pontine region with apparent diffusion coefficient values fluctuated between (100-300) x 10 -6 mm 2 /s while FLAIR images just showed slightly high signal in the same area, which suggested that cytotoxic edema did in fact exist in CPM. Meanwhile, DWI also showed high signals in bilateral lenticular nucleus with apparent diffusion coefficient values fluctuated between (300-600) x 10 -6 mm 2 /s, however, FLAIR images showed heterogeneous high signals and one case presented low DWI signals in bilateral head of caudate nucleus, all these signs might be explained by mixed-changes of cytotoxic edema and vasogenic edema in long period of Wilson's disease. Conclusion: Wilson's disease and CPM have characteristic MRI manifestation and DWI may be a very useful way to confirm a correct diagnosis. (authors)

  10. Comparison of endoscopic endonasal and bifrontal craniotomy approaches for olfactory groove meningiomas: A matched pair analysis of outcomes and frontal lobe changes on MRI.

    Science.gov (United States)

    de Almeida, John R; Carvalho, Felipe; Vaz Guimaraes Filho, Francisco; Kiehl, Tim-Rasmus; Koutourousiou, Maria; Su, Shirley; Vescan, Allan D; Witterick, Ian J; Zadeh, Gelareh; Wang, Eric W; Fernandez-Miranda, Juan C; Gardner, Paul A; Gentili, Fred; Snyderman, Carl H

    2015-11-01

    We compare the outcomes and postoperative MRI changes of endoscopic endonasal (EEA) and bifrontal craniotomy (BFC) approaches for olfactory groove meningiomas (OGM). All patients who underwent either BFC or EEA for OGM were eligible. Matched pairs were created by matching tumor volumes of an EEA patient with a BFC patient, and matching the timing of the postoperative scans. The tumor dimensions, peritumoral edema, resectability issues, and frontal lobe changes were recorded based on preoperative and postoperative MRI. Postoperative fluid-attenuated inversion recovery (FLAIR) hyperintensity and residual cystic cavity (porencephalic cave) volume were compared using univariable and multivariable analyses. From a total of 70 patients (46 EEA, 24 BFC), 10 matched pairs (20 patients) were created. Three patients (30%) in the EEA group and two (20%) in the BFC had postoperative cerebrospinal fluid leaks (p=0.61). Gross total resections were achieved in seven (70%) of the EEA group and nine (90%) of the BFC group (p=0.26), and one patient from each group developed a recurrence. On postoperative MRI, there was no significant difference in FLAIR signal volumes between EEA and BFC approaches (6.9 versus 13.3 cm(3); p=0.17) or in porencephalic cave volumes (1.7 versus 5.0 cm(3); p=0.11) in univariable analysis. However, in a multivariable analysis, EEA was associated with less postoperative FLAIR change (p=0.02) after adjusting for the volume of preoperative edema. This study provides preliminary evidence that EEA is associated with quantifiable improvements in postoperative frontal lobe imaging. Copyright © 2015 Elsevier Ltd. All rights reserved.

  11. Low-energy antiprotons physics and the FLAIR facility

    International Nuclear Information System (INIS)

    Widmann, E

    2015-01-01

    FLAIR, the Facility for low-energy antiproton and ion research has been proposed in 2004 as an extension of the planned FAIR facility at Darmstadt, Germany. FLAIR was not included into the modularized start version of FAIR, but the recent installation of the CRYRING storage ring at GSI Darmstadt has opened new perspectives for physics with low-energy antiprotons at FAIR. (paper)

  12. CT and MRI findings of Creutzfeldt-Jakob disease in the early stage. The usefulness of diffusion-weighted images

    International Nuclear Information System (INIS)

    Ukisu, Ryutaro; Kushihashi, Tamio; Gokan, Takehiko

    2001-01-01

    To detect subtle CT and MRI features of Creutzfeldt-Jacob disease (CJD) in the early stage is important to prevent a human-to-human transmission. This study included 10 patients of CJD who underwent CT and/or MRI in its early stage. CT, T1- and T2-weighted MRI, DWI, and FLAIR images were obtained in 10, 6, 4, and 2 patients respectively. On DWI, abnormal hyperintensities were observed in both cerebral cortex, and in basal ganglia in all patients. On FLAIR images, abnormal hyperintensies were observed in one patient. Detection of abnormal intensities may be possible in the early stage of CJD using MRI, particularly with DWI. (author)

  13. CT and MRI findings of Creutzfeldt-Jakob disease in the early stage. The usefulness of diffusion-weighted images

    Energy Technology Data Exchange (ETDEWEB)

    Ukisu, Ryutaro; Kushihashi, Tamio; Gokan, Takehiko [Showa Univ., Tokyo (Japan). School of Medicine] [and others

    2001-02-01

    To detect subtle CT and MRI features of Creutzfeldt-Jacob disease (CJD) in the early stage is important to prevent a human-to-human transmission. This study included 10 patients of CJD who underwent CT and/or MRI in its early stage. CT, T1- and T2-weighted MRI, DWI, and FLAIR images were obtained in 10, 6, 4, and 2 patients respectively. On DWI, abnormal hyperintensities were observed in both cerebral cortex, and in basal ganglia in all patients. On FLAIR images, abnormal hyperintensies were observed in one patient. Detection of abnormal intensities may be possible in the early stage of CJD using MRI, particularly with DWI. (author)

  14. Anterior temporal lobe white matter abnormal signal (ATLAS) as an indicator of seizure focus laterality in temporal lobe epilepsy: comparison of double inversion recovery, FLAIR and T2W MR imaging

    Energy Technology Data Exchange (ETDEWEB)

    Morimoto, Emiko; Kanagaki, Mitsunori; Okada, Tomohisa; Yamamoto, Akira; Togashi, Kaori [Kyoto University Graduate School of Medicine, Department of Diagnostic Imaging and Nuclear Medicine, Kyoto (Japan); Mori, Nobuyuki [Tenri Hospital, Department of Radiology, Tenri, Nara (Japan); Matsumoto, Riki; Ikeda, Akio; Takahashi, Ryosuke [Kyoto University Graduate School of Medicine, Department of Neurology, Kyoto (Japan); Mikuni, Nobuhiro [Sapporo Medical University, Department of Neurosurgery, Sapporo, Hokkaido (Japan); Kunieda, Takeharu; Miyamoto, Susumu [Kyoto University Graduate School of Medicine, Department of Neurosurgery, Kyoto (Japan); Paul, Dominik [Siemens AG Healthcare Sector, Erlangen (Germany)

    2013-01-15

    To investigate the diagnostic capability of anterior temporal lobe white matter abnormal signal (ATLAS) for determining seizure focus laterality in temporal lobe epilepsy (TLE) by comparing different MR sequences. This prospective study was approved by the institutional review board and written informed consent was obtained. Three 3D sequences (double inversion recovery (DIR), fluid-attenuated inversion recovery (FLAIR) and T2-weighted imaging (T2WI)) and two 2D sequences (FLAIR and T2WI) were acquired at 3 T. Signal changes in the anterior temporal white matter of 21 normal volunteers were evaluated. ATLAS laterality was evaluated in 21 TLE patients. Agreement of independent evaluations by two neuroradiologists was assessed using {kappa} statistics. Differences in concordance between ATLAS laterality and clinically defined seizure focus laterality were analysed using McNemar's test with multiple comparisons. Pre-amygdala high signals (PAHS) were detected in all volunteers only on 3D-DIR. Inter-evaluator agreement was moderate to almost perfect for each sequence. Correct diagnosis of seizure laterality was significantly more frequent on 3D-DIR than on any other sequences (P {<=} 0.031 for each evaluator). The most sensitive sequence for detecting ATLAS laterality was 3D-DIR. ATLAS laterality on 3D-DIR can be a good indicator for determining seizure focus localization in TLE. (orig.)

  15. Anterior temporal lobe white matter abnormal signal (ATLAS) as an indicator of seizure focus laterality in temporal lobe epilepsy: comparison of double inversion recovery, FLAIR and T2W MR imaging

    International Nuclear Information System (INIS)

    Morimoto, Emiko; Kanagaki, Mitsunori; Okada, Tomohisa; Yamamoto, Akira; Togashi, Kaori; Mori, Nobuyuki; Matsumoto, Riki; Ikeda, Akio; Takahashi, Ryosuke; Mikuni, Nobuhiro; Kunieda, Takeharu; Miyamoto, Susumu; Paul, Dominik

    2013-01-01

    To investigate the diagnostic capability of anterior temporal lobe white matter abnormal signal (ATLAS) for determining seizure focus laterality in temporal lobe epilepsy (TLE) by comparing different MR sequences. This prospective study was approved by the institutional review board and written informed consent was obtained. Three 3D sequences (double inversion recovery (DIR), fluid-attenuated inversion recovery (FLAIR) and T2-weighted imaging (T2WI)) and two 2D sequences (FLAIR and T2WI) were acquired at 3 T. Signal changes in the anterior temporal white matter of 21 normal volunteers were evaluated. ATLAS laterality was evaluated in 21 TLE patients. Agreement of independent evaluations by two neuroradiologists was assessed using κ statistics. Differences in concordance between ATLAS laterality and clinically defined seizure focus laterality were analysed using McNemar's test with multiple comparisons. Pre-amygdala high signals (PAHS) were detected in all volunteers only on 3D-DIR. Inter-evaluator agreement was moderate to almost perfect for each sequence. Correct diagnosis of seizure laterality was significantly more frequent on 3D-DIR than on any other sequences (P ≤ 0.031 for each evaluator). The most sensitive sequence for detecting ATLAS laterality was 3D-DIR. ATLAS laterality on 3D-DIR can be a good indicator for determining seizure focus localization in TLE. (orig.)

  16. Age, gender, and interracial variability of normal lacrimal gland volume using MRI.

    Science.gov (United States)

    Bukhari, Amal A; Basheer, Naushad A; Joharjy, Heba I

    2014-01-01

    Aimed to evaluate normal volume of the lacrimal gland in patients of different age groups and race. All MRI studies of the brain that were done between June 2012 and April 2013 were examined. Lacrimal glands were identified using fat-saturated fluid-attenuated inversion recovery (FLAIR) images, and the volumes were calculated using TeraRecon iNtuition viewer. Volumes for the right and left lacrimal glands were recorded for persons of different age groups and race, and the results were compared with those of a randomly selected group of patients who had undergone the same calculation method using CT of the brain, orbit, or paranasal sinuses. The authors included 998 lacrimal glands of 499 patients. The mean volumes for the right and left lacrimal glands were 0.770 and 0.684 cm, respectively. Lacrimal glands were larger in women; the largest volumes were observed during the second decade of life. Mean volumes also varied with race: 0.840 cm in Asians, 0.790 cm in Africans, 0.760 cm in Indians, and 0.710 cm in Middle Easterners. The consultant neuroradiologist and the intern showed excellent agreement for measurements of lacrimal gland volume. No significant difference was observed between lacrimal gland measurements method on MRI and CT. Lacrimal gland volume varies according to age, gender, race, and laterality. Measurements with MRI using fat-saturated FLAIR images and TeraRecon iNtuition viewer software are reliable, accurate, and can be used by junior staff with less radiation exposure to patients.

  17. Study of the fast inversion recovery pulse sequence. With reference to fast fluid attenuated inversion recovery and fast short TI inversion recovery pulse sequence

    International Nuclear Information System (INIS)

    Tsuchihashi, Toshio; Maki, Toshio; Suzuki, Takeshi

    1997-01-01

    The fast inversion recovery (fast IR) pulse sequence was evaluated. We compared the fast fluid attenuated inversion recovery (fast FLAIR) pulse sequence in which inversion time (TI) was established as equal to the water null point for the purpose of the water-suppressed T 2 -weighted image, with the fast short TI inversion recovery (fast STIR) pulse sequence in which TI was established as equal to the fat null point for purpose of fat suppression. In the fast FLAIR pulse sequence, the water null point was increased by making TR longer. In the FLAIR pulse sequence, the longitudinal magnetization contrast is determined by TI. If TI is increased, T 2 -weighted contrast improves in the same way as increasing TR for the SE pulse sequence. Therefore, images should be taken with long TR and long TI, which are longer than TR and longer than the water null point. On the other hand, the fat null point is not affected by TR in the fast STIR pulse sequence. However, effective TE was affected by variation of the null point. This increased in proportion to the increase in effective TE. Our evaluation indicated that the fast STIR pulse sequence can control the extensive signals from fat in a short time. (author)

  18. Application of variable threshold intensity to segmentation for white matter hyperintensities in fluid attenuated inversion recovery magnetic resonance images

    International Nuclear Information System (INIS)

    Yoo, Byung Il; Han, Ji Won; Oh, San Yeo Wool; Kim, Tae Hui; Lee, Jung Jae; Lee, Eun Young; MacFall, James R.; Payne, Martha E.; Kim, Jae Hyoung; Kim, Ki Woong

    2014-01-01

    White matter hyperintensities (WMHs) are regions of abnormally high intensity on T2-weighted or fluid-attenuated inversion recovery (FLAIR) magnetic resonance imaging (MRI). Accurate and reproducible automatic segmentation of WMHs is important since WMHs are often seen in the elderly and are associated with various geriatric and psychiatric disorders. We developed a fully automated monospectral segmentation method for WMHs using FLAIR MRIs. Through this method, we introduce an optimal threshold intensity (I O ) for segmenting WMHs, which varies with WMHs volume (V WMH ), and we establish the I O -V WMH relationship. Our method showed accurate validations in volumetric and spatial agreements of automatically segmented WMHs compared with manually segmented WMHs for 32 confirmatory images. Bland-Altman values of volumetric agreement were 0.96 ± 8.311 ml (bias and 95 % confidence interval), and the similarity index of spatial agreement was 0.762 ± 0.127 (mean ± standard deviation). Furthermore, similar validation accuracies were obtained in the images acquired from different scanners. The proposed segmentation method uses only FLAIR MRIs, has the potential to be accurate with images obtained from different scanners, and can be implemented with a fully automated procedure. In our study, validation results were obtained with FLAIR MRIs from only two scanner types. The design of the method may allow its use in large multicenter studies with correct efficiency. (orig.)

  19. Application of variable threshold intensity to segmentation for white matter hyperintensities in fluid attenuated inversion recovery magnetic resonance images

    Energy Technology Data Exchange (ETDEWEB)

    Yoo, Byung Il; Han, Ji Won; Oh, San Yeo Wool; Kim, Tae Hui [Seoul National University Bundang Hospital, Department of Neuropsychiatry, Seongnam, Gyeonggi-do (Korea, Republic of); Lee, Jung Jae; Lee, Eun Young [Kyungbook National University Chilgok Hospital, Department of Psychiatry, Buk-gu, Daegu (Korea, Republic of); MacFall, James R. [Duke University Medical Center, Neuropsychiatric Imaging Research Laboratory, Durham, NC (United States); Duke University Medical Center, Department of Radiology, Durham, NC (United States); Payne, Martha E. [Duke University Medical Center, Neuropsychiatric Imaging Research Laboratory, Durham, NC (United States); Duke University Medical Center, Department of Psychiatry and Behavioral Sciences, Durham, NC (United States); Kim, Jae Hyoung [Seoul National University Bundang Hospital, Department of Radiology, Seongnam, Gyeonggi-do (Korea, Republic of); Seoul National University College of Medicine, Department of Radiology, Jongno-gu, Seoul (Korea, Republic of); Kim, Ki Woong [Seoul National University Bundang Hospital, Department of Neuropsychiatry, Seongnam, Gyeonggi-do (Korea, Republic of); Seoul National University College of Medicine, Department of Psychiatry, Jongno-gu, Seoul (Korea, Republic of); Seoul National University College of Natural Sciences, Department of Brain and Cognitive Science, Gwanak-gu, Seoul (Korea, Republic of)

    2014-04-15

    White matter hyperintensities (WMHs) are regions of abnormally high intensity on T2-weighted or fluid-attenuated inversion recovery (FLAIR) magnetic resonance imaging (MRI). Accurate and reproducible automatic segmentation of WMHs is important since WMHs are often seen in the elderly and are associated with various geriatric and psychiatric disorders. We developed a fully automated monospectral segmentation method for WMHs using FLAIR MRIs. Through this method, we introduce an optimal threshold intensity (I{sub O}) for segmenting WMHs, which varies with WMHs volume (V{sub WMH}), and we establish the I{sub O} -V{sub WMH} relationship. Our method showed accurate validations in volumetric and spatial agreements of automatically segmented WMHs compared with manually segmented WMHs for 32 confirmatory images. Bland-Altman values of volumetric agreement were 0.96 ± 8.311 ml (bias and 95 % confidence interval), and the similarity index of spatial agreement was 0.762 ± 0.127 (mean ± standard deviation). Furthermore, similar validation accuracies were obtained in the images acquired from different scanners. The proposed segmentation method uses only FLAIR MRIs, has the potential to be accurate with images obtained from different scanners, and can be implemented with a fully automated procedure. In our study, validation results were obtained with FLAIR MRIs from only two scanner types. The design of the method may allow its use in large multicenter studies with correct efficiency. (orig.)

  20. Utilizing 18F-fluoroethyltyrosine (FET) positron emission tomography (PET) to define suspected nonenhancing tumor for radiation therapy planning of glioblastoma.

    Science.gov (United States)

    Hayes, Aimee R; Jayamanne, Dasantha; Hsiao, Edward; Schembri, Geoffrey P; Bailey, Dale L; Roach, Paul J; Khasraw, Mustafa; Newey, Allison; Wheeler, Helen R; Back, Michael

    2018-01-31

    The authors sought to evaluate the impact of 18F-fluoroethyltyrosine (FET) positron emission tomography (PET) on radiation therapy planning for patients diagnosed with glioblastoma (GBM) and the presence of suspected nonenhancing tumors compared with standard magnetic resonance imaging (MRI). Patients with GBM and contrast-enhanced MRI scans showing regions suspicious of nonenhancing tumor underwent postoperative FET-PET before commencing radiation therapy. Two clinical target volumes (CTVs) were created using pre- and postoperative MRI: MRI fluid-attenuated inversion recovery (FLAIR) sequences (CTV FLAIR ) and MRI contrast sequences with an expansion on the surgical cavity (CTV Sx ). FET-PET was used to create biological tumor volumes (BTVs) by encompassing FET-avid regions, forming BTV FLAIR and BTV Sx . Volumetric analyses were conducted between CTVs and respective BTVs using Wilcoxon signed-rank tests. The volume increase with addition of FET was analyzed with respect to BTV FLAIR and BTV Sx . Presence of focal gadolinium contrast enhancement within previously nonenhancing tumor or within the FET-avid region was noted on MRI scans at 1 and 3 months after radiation therapy. Twenty-six patients were identified retrospectively from our database, of whom 24 had demonstrable FET uptake. The median CTV FLAIR , CTV Sx , BTV FLAIR , and BTV Sx were 57.1 mL (range, 1.1-217.4), 83.6 mL (range, 27.2-275.8), 62.8 mL (range, 1.1-307.3), and 94.7 mL (range, 27.2-285.5), respectively. When FET-PET was used, there was a mean increase in volume of 26.8% from CTV FLAIR to BTV FLAIR and 20.6% from CTV Sx to BTV Sx . A statistically significant difference was noted on Wilcoxon signed-rank test when assessing volumetric change between CTV FLAIR and BTV FLAIR (P Wilcoxon signed-rank tests. FET-PET may help improve delineation of GBM in cases with a suspected nonenhancing component and reduce the risk of potential geographical miss. Copyright © 2018 American Society for Radiation

  1. MRI assessment of relapsed glioblastoma during treatment with bevacizumab: Volumetric measurement of enhanced and FLAIR lesions for evaluation of response and progression—A pilot study

    International Nuclear Information System (INIS)

    Pichler, Josef; Pachinger, Corinna; Pelz, Manuela; Kleiser, Raimund

    2013-01-01

    Purpose: To develop a magnetic resonance imaging (MRI) metric that is useful for therapy monitoring in patients with relapsed glioblastoma (GBM) during treatment with the antiangiogenic monoclonal antibody bevacizumab (Bev). We evaluated the feasibility of tumour volume measurement with our software tool in clinical routine and tried to establish reproducible and quantitative parameters for surveillance of patients on treatment with antiangiogenic drugs. Materials and methods: In this retrospective institutional pilot study, 18 patients (11 men, 7 women; mean age 53.5) with recurrent GBM received bevacizumab and irinotecan every two weeks as second line therapy. Follow up scans were assessed every two to four months. Data were collected on a 1.5 T MR System (Siemens, Symphony) with the standard head coil using our standardized tumour protocol. Volumetric measurement was performed with a commercial available software stroketool in FLAIR and T1-c imaging with following procedure: Pre-processing involved cutting noise and electing a Gaussian of 3 × 3 to smooth images, selecting a ROI (region of interest) in healthy brain area of the contra lateral side with quantifying the intensity value, adding 20% to this value to define the threshold level. Only values above this threshold are left corresponding to the tumour lesion. For the volumetric measurement the detected tumour area was circuited in all slices and finally summing up all values and multiplied by slice thickness to get the whole volume. Results: With McDonalds criteria progression was indicated in 14 out of 18 patients. In contrast, volumetric measurement showed an increase of contrast enhancement of >25%, defined as threshold for progression, in 11 patients (78%) and in 12 patients (85%) in FLAIR volume, respectively. 6 patients revealed that volumes in MRI increased earlier than the last scan, which was primarily defined as the date of progression with McDonald criteria, changing PFS after re-evaluation of

  2. MRI assessment of relapsed glioblastoma during treatment with bevacizumab: volumetric measurement of enhanced and FLAIR lesions for evaluation of response and progression--a pilot study.

    Science.gov (United States)

    Pichler, Josef; Pachinger, Corinna; Pelz, Manuela; Kleiser, Raimund

    2013-05-01

    To develop a magnetic resonance imaging (MRI) metric that is useful for therapy monitoring in patients with relapsed glioblastoma (GBM) during treatment with the antiangiogenic monoclonal antibody bevacizumab (Bev). We evaluated the feasibility of tumour volume measurement with our software tool in clinical routine and tried to establish reproducible and quantitative parameters for surveillance of patients on treatment with antiangiogenic drugs. In this retrospective institutional pilot study, 18 patients (11 men, 7 women; mean age 53.5) with recurrent GBM received bevacizumab and irinotecan every two weeks as second line therapy. Follow up scans were assessed every two to four months. Data were collected on a 1.5 T MR System (Siemens, Symphony) with the standard head coil using our standardized tumour protocol. Volumetric measurement was performed with a commercial available software stroketool in FLAIR and T1-c imaging with following procedure: Pre-processing involved cutting noise and electing a Gaussian of 3 × 3 to smooth images, selecting a ROI (region of interest) in healthy brain area of the contra lateral side with quantifying the intensity value, adding 20% to this value to define the threshold level. Only values above this threshold are left corresponding to the tumour lesion. For the volumetric measurement the detected tumour area was circuited in all slices and finally summing up all values and multiplied by slice thickness to get the whole volume. With McDonalds criteria progression was indicated in 14 out of 18 patients. In contrast, volumetric measurement showed an increase of contrast enhancement of >25%, defined as threshold for progression, in 11 patients (78%) and in 12 patients (85%) in FLAIR volume, respectively. 6 patients revealed that volumes in MRI increased earlier than the last scan, which was primarily defined as the date of progression with McDonald criteria, changing PFS after re-evaluation of the tumour volumes from 6.8 to 5.6 months

  3. MRI assessment of relapsed glioblastoma during treatment with bevacizumab: Volumetric measurement of enhanced and FLAIR lesions for evaluation of response and progression—A pilot study

    Energy Technology Data Exchange (ETDEWEB)

    Pichler, Josef, E-mail: josef.pichler@gespag.at [Wagner Jauregg Weg 15, 4020 Linz, Landesnervenklinik Linz (Austria); Pachinger, Corinna, E-mail: pachingercorinna@gmx.at [Wagner Jauregg Weg 15, 4020 Linz, Landesnervenklinik Linz (Austria); Pelz, Manuela, E-mail: mauela.pelz@gespag.at [Wagner Jauregg Weg 15, 4020 Linz, Landesnervenklinik Linz (Austria); Kleiser, Raimund, E-mail: raimund.kleiser@gespag.at [Wagner Jauregg Weg 15, 4020 Linz, Landesnervenklinik Linz (Austria)

    2013-05-15

    Purpose: To develop a magnetic resonance imaging (MRI) metric that is useful for therapy monitoring in patients with relapsed glioblastoma (GBM) during treatment with the antiangiogenic monoclonal antibody bevacizumab (Bev). We evaluated the feasibility of tumour volume measurement with our software tool in clinical routine and tried to establish reproducible and quantitative parameters for surveillance of patients on treatment with antiangiogenic drugs. Materials and methods: In this retrospective institutional pilot study, 18 patients (11 men, 7 women; mean age 53.5) with recurrent GBM received bevacizumab and irinotecan every two weeks as second line therapy. Follow up scans were assessed every two to four months. Data were collected on a 1.5 T MR System (Siemens, Symphony) with the standard head coil using our standardized tumour protocol. Volumetric measurement was performed with a commercial available software stroketool in FLAIR and T1-c imaging with following procedure: Pre-processing involved cutting noise and electing a Gaussian of 3 × 3 to smooth images, selecting a ROI (region of interest) in healthy brain area of the contra lateral side with quantifying the intensity value, adding 20% to this value to define the threshold level. Only values above this threshold are left corresponding to the tumour lesion. For the volumetric measurement the detected tumour area was circuited in all slices and finally summing up all values and multiplied by slice thickness to get the whole volume. Results: With McDonalds criteria progression was indicated in 14 out of 18 patients. In contrast, volumetric measurement showed an increase of contrast enhancement of >25%, defined as threshold for progression, in 11 patients (78%) and in 12 patients (85%) in FLAIR volume, respectively. 6 patients revealed that volumes in MRI increased earlier than the last scan, which was primarily defined as the date of progression with McDonald criteria, changing PFS after re-evaluation of

  4. Adherence to MRI protocol consensus guidelines in multiple sclerosis: an Australian multi-centre study

    International Nuclear Information System (INIS)

    Curley, Michael; Josey, Lawrence; Lucas, Robyn; Dear, Keith; Taylor, Bruce V.; Coulthard, Alan; Ausimmune Investigator Group

    2012-01-01

    Multiple sclerosis (MS) is a debilitating disease that causes significant morbidity within a young demographic. Diagnostic guidelines for MS have evolved, and imaging has played an increasingly important role in diagnosis over the last two decades. For imaging to contribute to diagnosis in a meaningful way, it must be reproducible. Consensus guidelines for MRI in MS exist to define correct sequence type and imaging technique, but it is not clear to what extent they are followed. This study reviewed MRI studies performed on Australian individuals presenting with a first clinical diagnosis of central nervous system demyelination (FCD) for adherence to published guidelines and discussed practical implementation of MS guidelines in light of recent updates. The Ausimmune study was a prospective case control study of Australian participants presenting with FCD from 2003 to 2006. Baseline cranial and spinal cord MRI studies of 226 case participants from four separate Australian regions were reviewed. MRI sequences were classified according to anatomical location, slice plane, tissue weighting and use of gadolinium-containing contrast media. Results were compared with the 2003 Consortium of Multiple Sclerosis Centres MRI protocol for the diagnosis of MS. The composition of core cranial MRI sequences performed varied across the 226 scans. Of the studies, 91% included sagittal fluid attenuated inversion recovery (FLAIR) sequences. Cranial axial T2-weighted, axial FLAIR and axial proton density-weighted sequences were performed in 88%, 60% and 16% (respectively) of scans. Only 25% of the studies included a T1-weighted contrast-enhanced sequence. Concordance with the guidelines in all sequences was very low (2). Only a small number of MRI investigations performed included all of the sequences stipulated by consensus guidelines. This is likely due to poor awareness in the imaging community of the guidelines and the rationale behind certain sequences. Radiologists with a sub

  5. Magnetic Resonance Imaging in Breath-Hold Divers with Cerebral Decompression Sickness

    Directory of Open Access Journals (Sweden)

    Ryu Matsuo

    2014-01-01

    Full Text Available The mechanism of cerebral decompression sickness (DCS is still unclear. We report 2 cases of breath-hold divers with cerebral DCS in whom magnetic resonance imaging (MRI demonstrated distinctive characteristics. One case presented right hemiparesthesia, diplopia, and gait disturbance after breath-hold diving into the sea at a depth of 20 m. Brain MRI with fluid-attenuated inversion recovery (FLAIR sequence revealed multiple hyperintense lesions in the right frontal lobe, bilateral thalamus, pons, and right cerebellar hemisphere. The second case presented visual and gait disturbance after repetitive breath-hold diving into the sea. FLAIR imaging showed hyperintense areas in the bilateral occipito-parietal lobes. In both cases, diffusion-weighted imaging and apparent diffusion coefficient mapping revealed hyperintense areas in the lesions identified by FLAIR. Moreover, follow-up MRI showed attenuation of the FLAIR signal abnormalities. These findings are suggestive of transient hyperpermeability in the microvasculature as a possible cause of cerebral DCS.

  6. Edge Contrast of the FLAIR Hyperintense Region Predicts Survival in Patients with High-Grade Gliomas following Treatment with Bevacizumab.

    Science.gov (United States)

    Bahrami, N; Piccioni, D; Karunamuni, R; Chang, Y-H; White, N; Delfanti, R; Seibert, T M; Hattangadi-Gluth, J A; Dale, A; Farid, N; McDonald, C R

    2018-04-05

    Treatment with bevacizumab is standard of care for recurrent high-grade gliomas; however, monitoring response to treatment following bevacizumab remains a challenge. The purpose of this study was to determine whether quantifying the sharpness of the fluid-attenuated inversion recovery hyperintense border using a measure derived from texture analysis-edge contrast-improves the evaluation of response to bevacizumab in patients with high-grade gliomas. MRIs were evaluated in 33 patients with high-grade gliomas before and after the initiation of bevacizumab. Volumes of interest within the FLAIR hyperintense region were segmented. Edge contrast magnitude for each VOI was extracted using gradients of the 3D FLAIR images. Cox proportional hazards models were generated to determine the relationship between edge contrast and progression-free survival/overall survival using age and the extent of surgical resection as covariates. After bevacizumab, lower edge contrast of the FLAIR hyperintense region was associated with poorer progression-free survival ( P = .009) and overall survival ( P = .022) among patients with high-grade gliomas. Kaplan-Meier curves revealed that edge contrast cutoff significantly stratified patients for both progression-free survival (log-rank χ 2 = 8.3, P = .003) and overall survival (log-rank χ 2 = 5.5, P = .019). Texture analysis using edge contrast of the FLAIR hyperintense region may be an important predictive indicator in patients with high-grade gliomas following treatment with bevacizumab. Specifically, low FLAIR edge contrast may partially reflect areas of early tumor infiltration. This study adds to a growing body of literature proposing that quantifying features may be important for determining outcomes in patients with high-grade gliomas. © 2018 by American Journal of Neuroradiology.

  7. All that glitters is not gold: Increased Signal in the Subarachnoid Space on Fluid-Attenuated Inversion Recovery Imaging after gadolinium injection

    Directory of Open Access Journals (Sweden)

    Juliana Avila Duarte

    2016-08-01

    Full Text Available A 61-year-old woman arrived at the emergency department of the Hospital Nossa Senhora das Graças, Canoas, southern Brazil, with suspected ischemic stroke. After clinical and laboratory examination, the clinical diagnosis of ischemic stroke was made, without fulfilling criteria for thrombolysis. The patient had no history of renal failure. Three days later, she performed a magnetic resonance imaging (MRI examination that confirmed the suspected diagnosis. This examination was performed without sedation or supplemental oxygen. Brain MRI was performed after gadolinium injection, using fluid-attenuated inversion recovery (FLAIR imaging, T1-weighted image, diffusion-weighted imaging, and T2-weighted image sequences that revealed signs of subacute watershed stroke in the left cerebral hemisphere (Figures 1, 2 and 3. There was a hyperintense cerebrospinal fluid (CSF in the subarachnoid space (SAS on FLAIR imaging, a finding that has been reported in many  pathologic conditions1 such as superior sagittal thrombosis, subarachnoid hemorrhage², meningitis,  meningeal carcinomatosis,  next to tumors, status epilepticus and stroke.3-7 It has also been reported in otherwise healthy patients undergoing anesthesia with supplemental oxygen.8 The exact mechanism by which CSF diffuses into the SAS in patients with or without renal insufficiency is not completely explained. Some authores have suggested that in patients with renal failure, the gadolinium may shift across an osmotic gradient at the circumventricular organs in the setting of proctracted elevation of plasma concentrations.9 We believe that the cause of this imaging phenomenon of hyperintense signal of the CSF in the SAS which has already been noted in patients with compromised cerebral perfusion, including cases of acute ischemic stroke, was due to the recent stroke.10-11 Keywords: Flair hyperintensity, MRI, stroke, Gadolinium

  8. Increased signal intensity of the cochlea on pre- and post-contrast enhanced 3D-FLAIR in patients with vestibular schwannoma

    Energy Technology Data Exchange (ETDEWEB)

    Yamazaki, Masahiro; Naganawa, Shinji; Kawai, Hisashi; Nihashi, Takashi [Nagoya University, Department of Radiology, Graduate School of Medicine, Nagoya (Japan); Fukatsu, Hiroshi [Aichi Medical University Hospital, Department of Medical Informatics, Nagakute (Japan); Nakashima, Tsutomu [Nagoya University, Department of Otorhinolaryngology, Graduate School of Medicine, Nagoya (Japan)

    2009-12-15

    In the vestibular schwannoma patients, the pathophysiologic mechanism of inner ear involvement is still unclear. We investigated the status of the cochleae in patients with vestibular schwannoma by evaluating the signal intensity of cochlear fluid on pre- and post-contrast enhanced thin section three-dimensional fluid-attenuated inversion recovery (3D-FLAIR). Twenty-eight patients were retrospectively analyzed. Post-contrast images were obtained in 18 patients, and 20 patients had the records of their pure-tone audiometry. Regions of interest of both cochleae (C) and of the medulla oblongata (M) were determined on 3D-FLAIR images by referring to 3D heavily T2-weighted images on a workstation. The signal intensity ratio between C and M on the 3D-FLAIR images (CM ratio) was then evaluated. In addition, correlation between the CM ratio and the hearing level was also evaluated. The CM ratio of the affected side was significantly higher than that of the unaffected side (p < 0.001). In the affected side, post-contrast signal elevation was observed (p < 0.005). In 13 patients (26 cochleae) who underwent both gadolinium injection and the pure-tone audiometry, the post-contrast CM ratio correlated with hearing level (p < 0.05). The results of the present study suggest that alteration of cochlear fluid composition and increased permeability of the blood-labyrinthine barrier exist in the affected side in patients with vestibular schwannoma. Furthermore, although weak, positive correlation between post-contrast cochlear signal intensity on 3D-FLAIR and hearing level warrants further study to clarify the relationship between 3D-FLAIR findings and prognosis of hearing preservation surgery. (orig.)

  9. Increased signal intensity of the cochlea on pre- and post-contrast enhanced 3D-FLAIR in patients with vestibular schwannoma

    International Nuclear Information System (INIS)

    Yamazaki, Masahiro; Naganawa, Shinji; Kawai, Hisashi; Nihashi, Takashi; Fukatsu, Hiroshi; Nakashima, Tsutomu

    2009-01-01

    In the vestibular schwannoma patients, the pathophysiologic mechanism of inner ear involvement is still unclear. We investigated the status of the cochleae in patients with vestibular schwannoma by evaluating the signal intensity of cochlear fluid on pre- and post-contrast enhanced thin section three-dimensional fluid-attenuated inversion recovery (3D-FLAIR). Twenty-eight patients were retrospectively analyzed. Post-contrast images were obtained in 18 patients, and 20 patients had the records of their pure-tone audiometry. Regions of interest of both cochleae (C) and of the medulla oblongata (M) were determined on 3D-FLAIR images by referring to 3D heavily T2-weighted images on a workstation. The signal intensity ratio between C and M on the 3D-FLAIR images (CM ratio) was then evaluated. In addition, correlation between the CM ratio and the hearing level was also evaluated. The CM ratio of the affected side was significantly higher than that of the unaffected side (p < 0.001). In the affected side, post-contrast signal elevation was observed (p < 0.005). In 13 patients (26 cochleae) who underwent both gadolinium injection and the pure-tone audiometry, the post-contrast CM ratio correlated with hearing level (p < 0.05). The results of the present study suggest that alteration of cochlear fluid composition and increased permeability of the blood-labyrinthine barrier exist in the affected side in patients with vestibular schwannoma. Furthermore, although weak, positive correlation between post-contrast cochlear signal intensity on 3D-FLAIR and hearing level warrants further study to clarify the relationship between 3D-FLAIR findings and prognosis of hearing preservation surgery. (orig.)

  10. DWI-ASPECTS (Diffusion-Weighted Imaging-Alberta Stroke Program Early Computed Tomography Scores) and DWI-FLAIR (Diffusion-Weighted Imaging-Fluid Attenuated Inversion Recovery) Mismatch in Thrombectomy Candidates: An Intrarater and Interrater Agreement Study.

    Science.gov (United States)

    Fahed, Robert; Lecler, Augustin; Sabben, Candice; Khoury, Naim; Ducroux, Célina; Chalumeau, Vanessa; Botta, Daniele; Kalsoum, Erwah; Boisseau, William; Duron, Loïc; Cabral, Dominique; Koskas, Patricia; Benaïssa, Azzedine; Koulakian, Hasmik; Obadia, Michael; Maïer, Benjamin; Weisenburger-Lile, David; Lapergue, Bertrand; Wang, Adrien; Redjem, Hocine; Ciccio, Gabriele; Smajda, Stanislas; Desilles, Jean-Philippe; Mazighi, Mikaël; Ben Maacha, Malek; Akkari, Inès; Zuber, Kevin; Blanc, Raphaël; Raymond, Jean; Piotin, Michel

    2018-01-01

    We aimed to study the intrarater and interrater agreement of clinicians attributing DWI-ASPECTS (Diffusion-Weighted Imaging-Alberta Stroke Program Early Computed Tomography Scores) and DWI-FLAIR (Diffusion-Weighted Imaging-Fluid Attenuated Inversion Recovery) mismatch in patients with acute ischemic stroke referred for mechanical thrombectomy. Eighteen raters independently scored anonymized magnetic resonance imaging scans of 30 participants from a multicentre thrombectomy trial, in 2 different reading sessions. Agreement was measured using Fleiss κ and Cohen κ statistics. Interrater agreement for DWI-ASPECTS was slight (κ=0.17 [0.14-0.21]). Four raters (22.2%) had a substantial (or higher) intrarater agreement. Dichotomization of the DWI-ASPECTS (0-5 versus 6-10 or 0-6 versus 7-10) increased the interrater agreement to a substantial level (κ=0.62 [0.48-0.75] and 0.68 [0.55-0.79], respectively) and more raters reached a substantial (or higher) intrarater agreement (17/18 raters [94.4%]). Interrater agreement for DWI-FLAIR mismatch was moderate (κ=0.43 [0.33-0.57]); 11 raters (61.1%) reached a substantial (or higher) intrarater agreement. Agreement between clinicians assessing DWI-ASPECTS and DWI-FLAIR mismatch may not be sufficient to make repeatable clinical decisions in mechanical thrombectomy. The dichotomization of the DWI-ASPECTS (0-5 versus 0-6 or 0-6 versus 7-10) improved interrater and intrarater agreement, however, its relevance for patients selection for mechanical thrombectomy needs to be validated in a randomized trial. © 2017 American Heart Association, Inc.

  11. Evaluation of multimodal segmentation based on 3D T1-, T2- and FLAIR-weighted images - the difficulty of choosing.

    Science.gov (United States)

    Lindig, Tobias; Kotikalapudi, Raviteja; Schweikardt, Daniel; Martin, Pascal; Bender, Friedemann; Klose, Uwe; Ernemann, Ulrike; Focke, Niels K; Bender, Benjamin

    2018-04-15

    Voxel-based morphometry is still mainly based on T1-weighted MRI scans. Misclassification of vessels and dura mater as gray matter has been previously reported. Goal of the present work was to evaluate the effect of multimodal segmentation methods available in SPM12, and their influence on identification of age related atrophy and lesion detection in epilepsy patients. 3D T1-, T2- and FLAIR-images of 77 healthy adults (mean age 35.8 years, 19-66 years, 45 females), 7 patients with malformation of cortical development (MCD) (mean age 28.1 years,19-40 years, 3 females), and 5 patients with left hippocampal sclerosis (LHS) (mean age 49.0 years, 25-67 years, 3 females) from a 3T scanner were evaluated. Segmentation based on T1-only, T1+T2, T1+FLAIR, T2+FLAIR, and T1+T2+FLAIR were compared in the healthy subjects. Clinical VBM results based on the different segmentation approaches for MCD and for LHS were compared. T1-only segmentation overestimated total intracranial volume by about 80ml compared to the other segmentation methods. This was due to misclassification of dura mater and vessels as GM and CSF. Significant differences were found for several anatomical regions: the occipital lobe, the basal ganglia/thalamus, the pre- and postcentral gyrus, the cerebellum, and the brainstem. None of the segmentation methods yielded completely satisfying results for the basal ganglia/thalamus and the brainstem. The best correlation with age could be found for the multimodal T1+T2+FLAIR segmentation. Highest T-scores for identification of LHS were found for T1+T2 segmentation, while highest T-scores for MCD were dependent on lesion and anatomical location. Multimodal segmentation is superior to T1-only segmentation and reduces the misclassification of dura mater and vessels as GM and CSF. Depending on the anatomical region and the pathology of interest (atrophy, lesion detection, etc.), different combinations of T1, T2 and FLAIR yield optimal results. Copyright © 2017 Elsevier

  12. MRI in diagnosis of tuberculous meningitis%结核性脑膜炎磁共振的诊断应用

    Institute of Scientific and Technical Information of China (English)

    袁杭; 王安龙; 林上奇; 邱小伟; 朱卫平; 吴莲慧

    2013-01-01

    OBJECTIVE To evaluate the value of magnetic resonance liquid attenuated inversion recovery(FLAIRtechnology and GDPA enhanced MRI in diagnosis of tuberculous meningitis so as to guide the clinical treatment.METHODS A total of 90 cases of tuberculous meningitis patients underwent the conventional TSE sequence T1WI/ T2WI,FLAIR sequence and enhanced MRI examination,then display capabilities of tuberculous meningitis of the three imaging methods were compared.RESULTS Of totally 90 cases of patients receiving the examinations,the MRI enhancement discovered the meningeal disease in 83 cases;the FLAIR sequence found meningeal abnormal in 72 cases;the TSE sequence T2WI found meningeal abnormalities in 61 cases,the difference between the three examination methods was statistically significant.Compared with the display rate of the tuberculous meningitis between each pair,the display rates of the simple tuberculous meningitis was 45.6% by the MRI enhancement,37.8% by FLAIR sequence,33.3% by T1WI/T2WI; the display rate of the merged intracranial tuberculous tumor was 33.3% by the MRI enhancement,28.9% by FLAIR sequence,22.2% by T1WI/T2WI; the display rate of the complications was 13.3% by the MRI enhancement,13.3% by FLAIR sequence,10.0% by T1WI/ T2WI; the chi-square test indicated that the difference in the display of the simple tuberculous meningitis or the merged intracranial tuberculous tumor between the three examination methods was statistically significant(P< 0.05)and that the difference in the display rate of the complication was not statistically significant.CONCLUSION The enhanced MRI has a characteristic performance of tuberculous meningitis,the enhanced MRI combined with FLAIR sequence can significantly improve the display rate of tuberculous meningitis so as to provide a reliable basis for the clinical diagnosis of tuberculous meningitis.%目的 评价磁共振液体衰减反转恢复(FLAIR

  13. Lateralization of temporal lobe epilepsy using a novel uncertainty analysis of MR diffusion in hippocampus, cingulum, and fornix, and hippocampal volume and FLAIR intensity.

    Science.gov (United States)

    Nazem-Zadeh, Mohammad-Reza; Schwalb, Jason M; Elisevich, Kost V; Bagher-Ebadian, Hassan; Hamidian, Hajar; Akhondi-Asl, Ali-Reza; Jafari-Khouzani, Kourosh; Soltanian-Zadeh, Hamid

    2014-07-15

    To analyze the utility of a quantitative uncertainty analysis approach for evaluation and comparison of various MRI findings for the lateralization of epileptogenicity in mesial temporal lobe epilepsy (mTLE), including novel diffusion-based analyses. We estimated the hemispheric variation uncertainty (HVU) of hippocampal T1 volumetry and FLAIR (Fluid Attenuated Inversion Recovery) intensity. Using diffusion tensor images of 23 nonepileptic subjects, we estimated the HVU levels of mean diffusivity (MD) in the hippocampus, and fractional anisotropy (FA) in the posteroinferior cingulum and crus of fornix. Imaging from a retrospective cohort of 20 TLE patients who had undergone surgical resection with Engel class I outcomes was analyzed to determine whether asymmetry of preoperative volumetrics, FLAIR intensities, and MD values in hippocampi, as well as FA values in posteroinferior cingula and fornix crura correctly predicted laterality of seizure onset. Ten of the cohort had pathologically proven mesial temporal sclerosis (MTS). Seven of these patients had undergone extraoperative electrocorticography (ECoG) for lateralization or to rule out extra-temporal foci. HVU was estimated to be 3.1×10(-5) for hippocampal MD, 0.027 for FA in posteroinferior cingulum, 0.018 for FA in crus of fornix, 0.069 for hippocampal normalized volume, and 0.099 for hippocampal normalized FLAIR intensity. Using HVU analysis, a higher hippocampal MD value, lower FA within the posteroinferior cingulum and crus of fornix, shrinkage in hippocampal volume, and higher hippocampal FLAIR intensity were observed beyond uncertainty on the side ipsilateral to seizure onset for 10, 10, 9, 9, and 10 out of 10 pathology-proven MTS patients, respectively. Considering all 20 TLE patients, these numbers were 18, 15, 14, 13, and 16, respectively. However, consolidating the lateralization results of HVU analysis on these quantities by majority voting has detected the epileptogenic side for 19 out of 20 cases

  14. Implications of post-gadolinium MRI results in 13 cases with posterior reversible encephalopathy syndrome

    International Nuclear Information System (INIS)

    Ugurel, Mehmet Sahin; Hayakawa, Minako

    2005-01-01

    Background: There is a relative lack of definitive information about the contrast-enhancement characteristics of lesions in posterior reversible encephalopathy syndrome (PRES). Objective: Evaluation of contrast-enhanced MRI findings in PRES with a special emphasis on pathophysiology of post-gadolinium behavior of these lesions. Materials and methods: Contrast-enhanced 1.5 T MRI findings and relevant clinical data of the patients were retrospectively reviewed on 13 cases (six males, seven females; age range: 22-78; mean age 47). Although fluid attenuated inversion recovery (FLAIR) and diffusion-weighted MR images were considered for identification of the entity, primarily post-contrast T1-weighted MR images were searched for traces of enhancement in the lesions. Results: No definitely enhancing lesion was identified in the MR images obtained in 6-48 h after onset of symptoms (mostly headaches, seizures and cortical visual field deficits) in this series. Severity of disease indicated by small hemorrhages, confluence of lesions or progression to cytotoxic edema did not seem to alter this result. Typical lesion characteristics were consistent with vasogenic edema on FLAIR and diffusion MR images. Acute elevation of blood pressure on chronic hypertensive background was responsible in four, eclampsia in three, uremia with blood pressure fluctuations in three, and cyclosporine-toxicity in three cases. Conclusion: Although occasional enhancing brain lesions have been reported in the literature on PRES, contrast-enhancement of lesions may be a factor of scan timing and underlying etiology. Prospective studies with larger series on PRES are required for better evaluation of contrast-enhancement in MRI with respect to scan timing, which in turn may help understand its pathophysiology better

  15. Merosin-deficient congenital muscular dystrophy (CMD): a study of 25 Brazilian patients using MRI

    International Nuclear Information System (INIS)

    Leite, Claudia C.; Lucato, Leandro T.; Martin, Maria G.M.; Ferreira, Lucio G.; Resende, Maria B.D.; Carvalho, Mary S.; Marie, Suely K.N.; Reed, Umbertina C.; Jinkins, J.Randy

    2005-01-01

    Merosin-deficient congenital muscular dystrophy (CMD) is characterized clinically by hypotonia and muscular weakness and, on imaging studies, by white matter (WM) abnormality. To evaluate MRI findings in Brazilian patients with merosin-deficient CMD. Twenty-five patients were evaluated using MRI. Three patients presented with partial merosin deficiency and 22 with total merosin deficiency. Follow-up examinations were done in 7 cases. T1- and T2-weighted images were performed in all examinations, and fluid-attenuated inversion recovery (FLAIR) was performed in 15. Enhanced images were done in 11 cases. The WM involvement was classified according to location and severity. From 1991 to 2004, 32 MRI examinations were performed. Severe involvement was found in 23 patients in the frontal and temporal lobes, in 18 patients in the parietal lobes, and in 7 patients in the occipital lobes. The brain stem (n=5), cerebellum (n=6), internal capsules (n=1), and external capsules (n=5) were also affected. One patient had occipital pachygyria, and one had cerebellar vermian hypoplasia. No gadolinium enhancement was noted. Follow-up MRI showed no interval change (n=4), progression (n=1), or improvement of the findings (n=2). (orig.)

  16. Bayesian segmentation of brainstem structures in MRI

    DEFF Research Database (Denmark)

    Iglesias, Juan Eugenio; Van Leemput, Koen; Bhatt, Priyanka

    2015-01-01

    the brainstem structures in novel scans. Thanks to the generative nature of the scheme, the segmentation method is robust to changes in MRI contrast or acquisition hardware. Using cross validation, we show that the algorithm can segment the structures in previously unseen T1 and FLAIR scans with great accuracy...

  17. Fast fluid-attenuated inversion-recovery imaging: first experience with a 3D version in epilepsy

    International Nuclear Information System (INIS)

    Wieshmann, U.C.; Symms, M.R.; Bartlett, P.A.; Shorvon, S.D.; Barker, G.J.; Stevens, J.M.

    1998-01-01

    We developed a 3D version of fast fluid-attenuated inversion-recovery imaging (FLAIR) which provides images with a slice thickness of 1.5 mm. We present our initial experience with 3D fast FLAIR in patients with epilepsy. We compared 3D fast FLAIR (slice thickness 1.5 mm), 2D fast FLAIR (slice thickness 5 mm) and a 3D spoiled GRASS (IRSPGR) sequence (slice thickness 1.5 mm) in 10 patients with lesional epilepsy (head injury 1, hippocampal sclerosis 2, low-grade glioma 2, dysembryoplastic neuroepithelial tumour 2, polymicrogyria 1, perinatal infarct 1 and presumed thrombosed aneurysm 1). Both 2D and 3D fast FLAIR sequences yielded higher conspicuity for lesions than the T1-weighted IRSPGR sequence, except in the patient with polymicrogyria. The extent of the lesion, in particular that of low-grade tumours, was best assessed on 3D fast FLAIR images. 3D fast FLAIR may be a useful additional tool especially for imaging low-grade tumours. (orig.)

  18. Fluid-Attenuated Inversion Recovery Hypointensity of the Pulvinar Nucleus of Patients with Alzheimer Disease: Its Possible Association with Iron Accumulation as Evidenced by the T2 Map

    International Nuclear Information System (INIS)

    Moon, Won Jin; Roh, Hong Gee; Choi, Jin Woo; Kim, Hee Jin; Han, Seol Heui

    2012-01-01

    We hypothesized that prominent pulvinar hypointensity in brain MRI represents the disease process due to iron accumulation in Alzheimer disease (AD). We aimed to determine whether or not the pulvinar signal intensity (SI) on the fluid-attenuated inversion recovery (FLAIR) sequences at 3.0T MRI differs between AD patients and normal subjects, and also whether the pulvinar SI is correlated with the T2 map, an imaging marker for tissue iron, and a cognitive scale. Twenty one consecutive patients with AD and 21 age-matched control subjects were prospectively included in this study. The pulvinar SI was assessed on the FLAIR image. We measured the relative SI ratio of the pulvinar to the corpus callosum. The T2 values were calculated from the T2 relaxometry map. The differences between the two groups were analyzed, by using a Student t test. The correlation between the measurements was assessed by the Pearson's correlation test. As compared to the normal white matter, the FLAIR signal intensity of the pulvinar nucleus was significantly more hypointense in the AD patients than in the control subjects (p < 0.01). The pulvinar T2 was shorter in the AD patients than in the control subjects (51.5 ± 4.95 ms vs. 56.5 ± 5.49 ms, respectively, p = 0.003). The pulvinar SI ratio was strongly correlated with the pulvinar T2 (r = 0.745, p < 0.001). When controlling for age, only the pulvinar-to-CC SI ratio was positively correlated with that of the Mini-Mental State Examination (MMSE) score (r = 0.303, p < 0.050). Conversely, the pulvinar T2 was not correlated with the MMSE score (r = 0.277, p = 0.080). The FLAIR hypointensity of the pulvinar nucleus represents an abnormal iron accumulation in AD and may be used as an adjunctive finding for evaluating AD.

  19. Contrast-enhanced fast fluid-attenuated inversion recovery MR imaging in patients with brain tumors

    International Nuclear Information System (INIS)

    Kim, Chan Kyo; Na, Dong Gyu; Ryoo, Wook Jae; Byun Hong Sik; Yoon, Hye Kyung; Kim, Jong hyun

    2000-01-01

    To assess the feasibility of contrast-enhanced fast fluid-attenuated inversion recovery (fast FLAIR) MR imaging in patients with brain tumors. This study involved 31 patients with pathologically proven brain tumors and nine with clinically diagnosed metastases. In all patients, T2-weighted, fast FLAIR, images were visual contrast-enhanced T1-weighted MR images were obtained. Contrast-enhanced fast FLAIR images were visually compared with other MR sequences in terms of tumor conspicuity. In order to distinguish tumor and surrounding edema, contrast-enhanced fast FLAIR images were compared with fast FLAIR and T2-weighted images. The tumor-to- white matter contrast-to-noise ratios (CNRs), as demonstrated by T2-weighted, fast FLAIR, contrast-enhanced fast FLAIR and contrast-enhanced T1-weighted imaging, were quantitatively assessed and compared. For the visual assessment of tumor conspicuity, contrast-enhanced fast FLAIR image imaging superior to fast FLAIR in 60% of cases (24/40), and superior to T2-weighted in 70% (28/40). Contrast-enhanced fast FLAIR imaging was inferior to contrast-enhanced T1-weighted in 58% of cases (23/40). For distinguishing between tumor and surrounding edema, contrast-enhanced fast FLAIR imaging was superior to fast FLAIR or T2-weighted in 22 of 27 tumors with peritumoral edema (81%). Quantitatively, CNR was the highest on contrast-enhanced fast FLAIR image and the lowest on fast FLAIR. For the detection of leptomeningeal metastases, contrast-enhanced fast FLAIR was partially superior to contrast-enhanced T1-weighted imaging in two of three high-grade gliomas. Although contrast-enhanced fast FLAIR imaging should not be seen as a replacement for conventional modalities, it provides additional informaton for assessment of the extent of glial cell tumors and leptomeningeal metastases in patients with brain tumors. (author)

  20. Mobius syndrome: MRI features

    International Nuclear Information System (INIS)

    Markarian, Maria F.; Villarroel, Gonzalo M.; Nagel, Jorge R.

    2003-01-01

    Purpose: Mobius Syndrome or congenital facial diplegia is associated with paralysis of the lateral gaze movements. This syndrome may include other cranial nerve palsies and be associated to musculoskeletal anomalies. Our objective is to show the MRI findings in Mobius Syndrome. Material and methods: MRI study was performed in 3 patients with clinic diagnosis of Mobius Syndrome. RMI (1.5T); exams included axial FSE (T1 and T2), FLAIR, SE/EPI, GRE/20, sagittal FSE T2 , coronal T1, diffusion, angio MRI and Spectroscopy sequences. Results: The common features of this syndrome found in MRI were: depression or straightening of the floor of the fourth ventricle, brainstem anteroposterior diameter diminution, morphologic alteration of the pons and medulla oblongata and of the hypoglossal nuclei as well as severe micrognathia. Conclusion: The morphologic alterations of Mobius Syndrome can be clearly identified by MRI; this method has proved to be a useful diagnostic examination. (author)

  1. MRI findings in eastern equine encephalitis: the "parenthesis" sign.

    Science.gov (United States)

    Nickerson, Joshua P; Kannabiran, Suma; Burbank, Heather N

    2016-01-01

    Two patients with eastern equine encephalitis (EEE) presented to a tertiary referral center. Both subjects' brain magnetic resonance imaging showed T2/FLAIR (fluid-attenuated inversion recovery) hyperintensities including linear areas of hyperintensity in the external and internal capsules with sparing of the lentiform nuclei. Single case reports of imaging findings in EEE exist with nonspecific patterns of abnormality. We propose that this "( ) parentheses sign" on T2 or FLAIR imaging may distinguish EEE from other processes. Copyright © 2015 Elsevier Inc. All rights reserved.

  2. MRI diagnosis of supratentorial and intraspinal primitive neuroectodermal tumors

    International Nuclear Information System (INIS)

    Liu Meili; Cui Shimin; Han Tong; Li Tao; Liu Li; Lei Jing; Qing Jingxi; Yan Xiaoling; Kong Fanming

    2004-01-01

    Objective: To analyze the MRI features of supratentorial and intraspinal primitive neuroectodermal tumors (PNET) and improve the diagnostic accuracy. Methods: MRI manifestations of 9 PNET diagnosed via operation and pathological examination were analyzed. There were 6 men and 3 women, and the mean age was 32.6 years. In all 9 cases, conventional plain MR scans were performed, including spin echo (SE), fast spin echo (FSE), and fluid attenuated inversion recovery (FLAIR) sequences. Diffusion weighted images (DWIs) and postcontrast MR images were obtained in 2 and 4 cases, respectively. Results: The 8 cases with supratentorial lesions included fronto-temporal lesion in 2 cases, occipital lesion in 2 cases, fronto-parietal lobe, parietal lobe, frontal lobe lesion in each 1 case, and posterior part of third ventricle in 1 case, and the lesion located in the thoracic spinal canal in 1 case. All the lesions were quite large in volume, and the largest one was 6.0 cm x 6.9 cm x 4.9 cm. Except for the round-like lesion in the posterior part of third ventricle, the other 7 supratentorial lesions were irregular in shape, well demarked, and often with solid consistency and slight peritumoral edema. The lesions demonstrated long T 1 and long or slightly long T 2 signal intensity in 4 cases, mixed signal intensity on T 1 WI, T 2 WI, and FLAIR images in 4 cases. Small cystic degeneration could be seen in 2 cases, hemorrhage in 4 cases, and flow void vessels in 3 cases. 3 cases demonstrated irregular ring-like enhancement and ependymal dissemination. The lesion in the thoracic canal demonstrated as a slightly enhanced soft tissue mass with adjacent bony destruction and muscle infiltration. Conclusion: MR findings of PNET are rather characteristic, but the final diagnosis relies on pathology

  3. Influence of crosstalk on the fast fluid attenuated inversion recovery pulse sequence

    International Nuclear Information System (INIS)

    Urata, Tohru; Nonoshita, Koji; Miyazaki, Takayuki; Arima, Akira

    2000-01-01

    The influence of crosstalk on the fast fluid attenuated inversion recovery (fast FLAIR) pulse sequence was studied. On multislice fast FLAIR images, the water null point was shortened in comparison with that on single slice images owing to the crosstalk received from adjacent slices. That influence became greater with decreases in the slice gap and increases in the number of slices. The timing of crosstalk in each slice varied according to excitation order. The process of recovery of longitudinal magnetization changed according to differences in timing; thus, it was possible that the water null point changed in each slice. In brain images with thinner slice gaps, the signal intensity of CSF is increased by the effect of crosstalk. In order to eliminate changes in the water null point caused by crosstalk on fast FLAIR, the multislice sequence requires a sequence with interleaving based on the premise that slice gaps are set for more than 100% of slice thickness. (author)

  4. Influence of crosstalk on the fast fluid attenuated inversion recovery pulse sequence

    Energy Technology Data Exchange (ETDEWEB)

    Urata, Tohru; Nonoshita, Koji; Miyazaki, Takayuki; Arima, Akira [Funabashi Municipal Medical Center, Chiba (Japan)

    2000-04-01

    The influence of crosstalk on the fast fluid attenuated inversion recovery (fast FLAIR) pulse sequence was studied. On multislice fast FLAIR images, the water null point was shortened in comparison with that on single slice images owing to the crosstalk received from adjacent slices. That influence became greater with decreases in the slice gap and increases in the number of slices. The timing of crosstalk in each slice varied according to excitation order. The process of recovery of longitudinal magnetization changed according to differences in timing; thus, it was possible that the water null point changed in each slice. In brain images with thinner slice gaps, the signal intensity of CSF is increased by the effect of crosstalk. In order to eliminate changes in the water null point caused by crosstalk on fast FLAIR, the multislice sequence requires a sequence with interleaving based on the premise that slice gaps are set for more than 100% of slice thickness. (author)

  5. Lesion segmentation from multimodal MRI using random forest following ischemic stroke.

    Science.gov (United States)

    Mitra, Jhimli; Bourgeat, Pierrick; Fripp, Jurgen; Ghose, Soumya; Rose, Stephen; Salvado, Olivier; Connelly, Alan; Campbell, Bruce; Palmer, Susan; Sharma, Gagan; Christensen, Soren; Carey, Leeanne

    2014-09-01

    Understanding structure-function relationships in the brain after stroke is reliant not only on the accurate anatomical delineation of the focal ischemic lesion, but also on previous infarcts, remote changes and the presence of white matter hyperintensities. The robust definition of primary stroke boundaries and secondary brain lesions will have significant impact on investigation of brain-behavior relationships and lesion volume correlations with clinical measures after stroke. Here we present an automated approach to identify chronic ischemic infarcts in addition to other white matter pathologies, that may be used to aid the development of post-stroke management strategies. Our approach uses Bayesian-Markov Random Field (MRF) classification to segment probable lesion volumes present on fluid attenuated inversion recovery (FLAIR) MRI. Thereafter, a random forest classification of the information from multimodal (T1-weighted, T2-weighted, FLAIR, and apparent diffusion coefficient (ADC)) MRI images and other context-aware features (within the probable lesion areas) was used to extract areas with high likelihood of being classified as lesions. The final segmentation of the lesion was obtained by thresholding the random forest probabilistic maps. The accuracy of the automated lesion delineation method was assessed in a total of 36 patients (24 male, 12 female, mean age: 64.57±14.23yrs) at 3months after stroke onset and compared with manually segmented lesion volumes by an expert. Accuracy assessment of the automated lesion identification method was performed using the commonly used evaluation metrics. The mean sensitivity of segmentation was measured to be 0.53±0.13 with a mean positive predictive value of 0.75±0.18. The mean lesion volume difference was observed to be 32.32%±21.643% with a high Pearson's correlation of r=0.76 (p<0.0001). The lesion overlap accuracy was measured in terms of Dice similarity coefficient with a mean of 0.60±0.12, while the contour

  6. Temporal pole signal abnormality on MR imaging in temporal lobe epilepsy with hippocampal sclerosis: a fluid-attenuated inversion-recovery study; Anormalidade de sinal na imagem por RM do polo temporal na epilepsia do lobo temporal com esclerose hipocampal: um estudo pela sequencia inversao recuperacao com supressao da agua livre (FLAIR)

    Energy Technology Data Exchange (ETDEWEB)

    Carrete Junior, Henrique; Abdala, Nitamar; Szjenfeld, Jacob; Nogueira, Roberto Gomes [Universidade Federal de Sao Paulo (UNIFESP-EPM), Sao Paulo, SP (Brazil). Dept. de Diagnostico por Imagem; Lin, Katia; Caboclo, Luis Otavio; Centeno, Ricardo Silva; Sakamoto, Americo Ceiki; Yacubian, Elza Marcia Targas [Universidade Federal de Sao Paulo (UNIFESP-EPM), Sao Paulo, SP (Brazil). Dept. de Neurologia e Neurocirurgia

    2007-09-15

    Objective: To determine the frequency and regional involvement of temporal pole signal abnormality (TPA) in patients with hippocampal sclerosis (HS) using fluid-attenuated inversion-recovery (FLAIR) MR imaging, and to correlate this feature with history. Method: Coronal FLAIR images of the temporal pole were assessed in 120 patients with HS and in 30 normal subjects, to evaluate gray-white matter demarcation. Results: Ninety (75%) of 120 patients had associated TPA. The HS side made difference regarding the presence of TPA, with a left side prevalence (p=0.04, {chi}{sup 2} test). The anteromedial zone of temporal pole was affected in 27 (30%) out of 90 patients. In 63 (70%) patients the lateral zone were also affected. Patients with TPA were younger at seizure onset (p=0.018), but without association with duration of epilepsy. Conclusion: Our FLAIR study show temporal pole signal abnormality in 3/4 of patients with HS, mainly seen on the anteromedial region, with a larger prevalence when the left hippocampus was involved. (author)

  7. Straight sinus thrombosis during neurosurgical operation.

    Science.gov (United States)

    Kawano, Hiroto; Nitta, Naoki; Nozaki, Kazuhiko

    2016-01-01

    Perioperative straight sinus thrombosis is extremely rare. A 59-year-old female was admitted to our department because of incidentally found small anterior cerebral artery (A1) aneurysm with microbleeding. After clipping the cerebral aneurysm, she had delayed emergence from anesthesia, total aphasia, and right hemiparesis. Fluid-attenuated inversion recovery (FLAIR) magnetic resonance imaging (MRI) of the head showed hyperintensity in the bilateral caudate nuclei, putamina, and thalami, and computed tomography of the head showed a hyperdense straight sinus, suggesting straight sinus thrombosis. Her neurologic symptoms improved gradually, and she achieved a full clinical recovery, with radiological evidence of recanalization of the straight sinus at follow-up. The possibility of straight sinus thrombosis should be considered in postoperative patients with unexplained postoperative deficits when MRI demonstrates hyperintensity in the bilateral basal ganglia and thalami on FLAIR signal images.

  8. Dynamic oxygen-enhanced MRI of cerebrospinal fluid.

    Directory of Open Access Journals (Sweden)

    Taha M Mehemed

    Full Text Available Oxygen causes an increase in the longitudinal relaxation rate of tissues through its T1-shortening effect owing to its paramagnetic properties. Due to such effects, MRI has been used to study oxygen-related signal intensity changes in various body parts including cerebrospinal fluid (CSF space. Oxygen enhancement of CSF has been mainly studied using MRI sequences with relatively longer time resolution such as FLAIR, and T1 value calculation. In this study, fifteen healthy volunteers were scanned using fast advanced spin echo MRI sequence with and without inversion recovery pulse in order to dynamically track oxygen enhancement of CSF. We also focused on the differences of oxygen enhancement at sulcal and ventricular CSF. Our results revealed that CSF signal after administration of oxygen shows rapid signal increase in both sulcal CSF and ventricular CSF on both sequences, with statistically significant predominant increase in sulcal CSF compared with ventricular CSF. CSF is traditionally thought to mainly form from the choroid plexus in the ventricles and is absorbed at the arachnoid villi, however, it is also believed that cerebral arterioles contribute to the production and absorption of CSF, and controversy remains in terms of the precise mechanism. Our results demonstrated rapid oxygen enhancement in sulcal CSF, which may suggest inhaled oxygen may diffuse into sulcal CSF space rapidly probably due to the abundance of pial arterioles on the brain sulci.

  9. Signal alteration of the cochlear perilymph on 3 different sequences after intratympanic Gd-DTPA administration at 3 tesla. Comparison of 3D-FLAIR, 3D-T1-weighted imaging, and 3D-CISS

    International Nuclear Information System (INIS)

    Yamazaki, Masahiro; Naganawa, Shinji; Kawai, Hisashi; Nihashi, Takashi; Nakashima, Tsutomu

    2010-01-01

    Three-dimensional fluid-attenuated inversion recovery (3D-FLAIR) imaging after intratympanic gadolinium injection is useful for pathophysiologic and morphologic analysis of the inner ear. However, statistical analysis of differences in inner ear signal intensity among 3D-FLAIR and other sequences has not been reported. We evaluated the signal intensity of cochlear fluid on each of 3D-FLAIR, 3D-T 1 -weighted imaging (T 1 WI), and 3D-constructive interference in the steady state (CISS) to clarify the differences in contrast effect among these 3 sequences using intratympanic gadolinium injection. Twenty-one patients underwent 3D-FLAIR, 3D-T 1 WI, and 3D-CISS imaging at 3 tesla 24 hours after intratympanic injection of gadolinium. We determined regions of interest of the cochleae (C) and medulla oblongata (M) on each image, evaluated the signal intensity ratio between C and M (CM ratio), and determined the ratio of cochlear signal intensity of the injected side to that of the non-injected side (contrast value). The CM ratio of the injected side (3.00±1.31, range, 0.53 to 4.88, on 3D-FLAIR; 0.83±0.30, range, 0.36 to 1.58 on 3D-T 1 WI) was significantly higher than that of the non-injected side (0.52±0.14, range, 0.30 to 0.76 on 3D-FLAIR; 0.49±0.11, range, 0.30 to 0.71 on 3D-T 1 WI) on 3D-FLAIR and 3D-T 1 WI (P 1 WI (1.73±0.60 range, 0.98 to 3.09) (P<0.001). The 3D-FLAIR sequence is the most sensitive for observing alteration in inner ear fluid signal after intratympanic gadolinium injection. Our results warrant use of 3D-FLAIR as a sensitive imaging technique to clarify the pathological and morphological mechanisms of disorders of the inner ear. (author)

  10. Creutzfeldt-Jakob disease: the value of MRI; Creutzfeldt-Jakob-Krankheit: Stellenwert der MRT

    Energy Technology Data Exchange (ETDEWEB)

    Urbach, H.; Tschampa, H.J.; Keller, E.; Schild, H.H. [Radiologische Klinik, Neuroradiologie, Rheinische Friedrich-Wilhelms-Univ. Bonn (Germany); Paus, S. [Neurologische Klinik, Rheinische Friedrich-Wilhelms-Univ. Bonn (Germany)

    2001-06-01

    To define the role of MRI in the diagnosis of Creutzfeldt-Jakob disease (CJD). Methods: 14 patients with suspected CJD were studied within 3 years. MRI findings were correlated with WHO established diagnostic criteria (clinical findings, EEG, CSF with 14-3-3 protein assay). Results: 12 patients had CJD. One patient each suffered from Hashimoto's encephalitis and ALS dementia complex, respectively. Nine of 12 CJD patients had increased signal intensity of the striatum (n = 8), pulvinar thalami (n = 5) and/or cerebellar and cerebral cortex (n = 3), respectively. Signal intensity was most pronounced on FLAIR sequences; six patients were studied with diffusion-weighted MRI and showed impaired diffusion in these areas. Both patients without CJD did not show the abovementioned signal changes (sensitivity 75%, specificity and positive predictive value 100%, respectively). Conclusion: If patients with suspected CJD are studied with FLAIR and diffusion-weighted sequences, this disorder can reliably be proven or ruled out. Typical MRI findings narrow down the differential diagnosis and should be included in the WHO diagnostic criteria. (orig.) [German] Bestimmung des Stellenwerts der MRT in der Diagnostik der Creutzfeldt-Jakob-Krankheit (CJK). Methoden: Analyse der MRTs von 14 innerhalb von drei Jahren mit Verdacht auf CJK zugewiesenen Patienten. Korrelation der MRTs mit den entsprechend den WHO-Diagnosekriterien etablierten Untersuchungsverfahren (Klinik, EEG, Liquor mit 14-3-3 Protein-Nachweis). Ergebnisse: 12 Patienten hatten eine CJK, jeweils ein Patient hatte eine Hashimoto-Enzephalitis bzw. einen ALS-Demenz-Komplex. Bei 9 der 12 CJK-Patienten fanden sich beidseits Signalerhoehungen des Striatum (n = 8), des Pulvinar thalami (n = 5) und/oder des Kleinhirn- bzw. Grosshirnkortex (n = 3). Die Signalerhoehungen waren am deutlichsten auf FLAIR-Aufnahmen erkennbar; 6 mit diffusionsgewichteter MRT untersuchte Patienten wiesen eine eingeschraenkte Diffusion dieser Areale

  11. MRI assessment of whole-brain structural changes in aging.

    Science.gov (United States)

    Guo, Hui; Siu, William; D'Arcy, Ryan Cn; Black, Sandra E; Grajauskas, Lukas A; Singh, Sonia; Zhang, Yunting; Rockwood, Kenneth; Song, Xiaowei

    2017-01-01

    One of the central features of brain aging is the accumulation of multiple age-related structural changes, which occur heterogeneously in individuals and can have immediate or potential clinical consequences. Each of these deficits can coexist and interact, producing both independent and additive impacts on brain health. Many of the changes can be visualized using MRI. To collectively assess whole-brain structural changes, the MRI-based Brain Atrophy and Lesion Index (BALI) has been developed. In this study, we validate this whole-brain health assessment approach using several clinical MRI examinations. Data came from three independent studies: the Alzheimer's Disease Neuroimaging Initiative Phase II (n=950; women =47.9%; age =72.7±7.4 years); the National Alzheimer's Coordinating Center (n=722; women =55.1%; age =72.7±9.9 years); and the Tianjin Medical University General Hospital Research database on older adults (n=170; women =60.0%; age =62.9±9.3 years). The 3.0-Tesla MRI scans were evaluated using the BALI rating scheme on the basis of T1-weighted (T1WI), T2-weighted (T2WI), T2-weighted fluid-attenuated inversion recovery (T2-FLAIR), and T2*-weighted gradient-recalled echo (T2*GRE) images. Atrophy and lesion changes were commonly seen in each MRI test. The BALI scores based on different sequences were highly correlated (Spearman r 2 >0.69; P age ( r 2 >0.29; P 26.48, P aging and dementia-related decline of structural brain health. Inclusion of additional MRI tests increased lesion differentiation. Further research is to integrate MRI tests for a clinical tool to aid the diagnosis and intervention of brain aging.

  12. Diagnosis and temporal evolution of signs of intracranial hypotension on MRI of the brain

    Energy Technology Data Exchange (ETDEWEB)

    Forghani, R. [McGill University Health Center, Department of Radiology, Montreal, Que (Canada); Massachusetts General Hospital, Division of Neuroradiology, Boston, MA (United States); Farb, R.I. [University of Toronto, Department of Medical Imaging, Division of Neuroradiology, Toronto Western Hospital, Toronto, Ontario (Canada)

    2008-12-15

    A comprehensive evaluation of cranial magnetic resonance imagings (MRIs) of 23 patients with intracranial hypotension (IH) was performed, and the evolution of the abnormalities on follow-up MRIs was correlated with the clinical outcome. The MRI report database at the University Health Network in Toronto was searched, and 23 cases of IH were identified between 2001 and 2007. A retrospective review of the MRIs of the brain and the electronic patient chart was performed. A control group of 40 subjects was also selected to complement the analysis of the pituitary gland. A positive venous distention sign (VDS) was observed in 23 out of 23 patients and was the first sign to disappear on early follow-up scans following successful treatment. Pachymeningeal enhancement was seen in 23 out of 23 patients, and pachymeningeal thickening was detectable on unenhanced fluid attenuation inversion recovery (FLAIR) sequences in 17 out of 23 patients (74%). An increase in pituitary size in IH was also demonstrated based on the measured pituitary height and was qualitatively detectable in 12 out of 21 (57%) patients as the protrusion of the pituitary gland above the sella turica (two postpartum patients were excluded from this analysis). Overall, there was good correlation between the imaging findings and clinical outcome following treatment. Accurate diagnosis and follow-up of IH should be possible is some patients on unenhanced MRI of the brain by combining the signs on FLAIR and sagittal T1W images, enabling timely diagnosis in unsuspected cases and avoiding unnecessary administration of gadolinium compounds. In addition, VDS might be useful for early assessment of response to treatment. (orig.)

  13. The diagnosis of a fully flexed neck position MRI diagnosis in juvenile muscular atrophy of the distal upper extremity

    International Nuclear Information System (INIS)

    Liu Huaijun; Li Caiying; He Dan; Chi Chen; Cui Caixia; Huang Boyuan; Wang Guoshi; Zhu Qingfeng

    2006-01-01

    Objective: To investigate the value of the diagnosis of MRI during neck flexion in juvenile muscular atrophy of the distal upper extremity. Methods: Five young male patients (mean age 21 years old) with clinical and electrophysiological alterations were performed MR examination with routine neck position and a fully flexed neck position. Eight age-match young men were examined as control subjects. SE T 1 WI, T 2 WI, Fluid-attenuated inversion recovery (FLAIR) sequences were scanned. Results: A distinctive finding in the disorder was forward displacement of the cervical dural sac, compressive flattening of the lower cervical cord during neck flexion and flow void in the posterior epidural space. The forward displacement was significantly greater in patients than in age-matched control subjects. Conclusion: Flexed neck position MRI is helpful to find radiological abnormalities of the lower cervical dural sac and spinal cord, which were combined with clinical disorder to diagnose juvenile muscular atrophy of the distal upper extremity. (authors)

  14. Fast fluid-attenuated inversion-recovery MR image in the intracranial tumors: comparison with fast spin-echo image

    International Nuclear Information System (INIS)

    Choi, Hye Young; Kwang, Hyoen Joo; Baek, Seoung Yeon; Lee, Sun Wha

    1997-01-01

    To evaluate the significance of fluid-attenuated inversion recovery(FLAIR) magnetic resonance(MR) images for the diagnosis of intracranial tumors. MR imaging was used to study 15 patients with various intracranial tumors and were compared the findings according to fast spin echo and fast FLAIR images. In 12 of 15 patients, tumor signal intensities on FLAIR images were consistent with those shown on T2-weighted(T2W) images. In seven of eight patients who had cystic or necrotic components within the mass, FLAIR images showed isosignal intensity and in the other patient, high signal intensity was seen. There was variation in the signal intensity from cerebrospinal fluid(CSF). In 12 of 13 patients in whom edema was associated with tumor, FLAIR images were clearer than T2W images as their signal intensity was brighter. In eight patients, however, FLAIR and T2W images provided a similar definition of the margin between edema and tumor. In six patients with intratumoral hemorrhage except the chronic cystic stage. We concluded that in the diagnosis of intracranial tumors, FLAIR images can supplement conventional spin-echo images

  15. Is the type and extent of hippocampal sclerosis measurable on high-resolution MRI?

    Energy Technology Data Exchange (ETDEWEB)

    Urbach, H; Schwarzwald, R [Medical Center University of Freiburg, Dept. of Neuroradiology, Freiburg (Germany); Huppertz, H.J. [Swiss Epilepsy Center, Zurich (Switzerland); Becker, A.J. [Medical Center University of Bonn, Department of Neuropathology, Bonn (Germany); Wagner, J. [Medical Center University of Bonn, Department of Epileptology, Bonn (Germany); Bahri, M. Delsous; Tschampa, H.J. [Medical Center University of Bonn, Department of Radiology/Neuroradiology, Bonn (Germany)

    2014-09-15

    The purpose of this study is to relate hippocampal volume and FLAIR signal intensity to Wyler grading of hippocampal sclerosis (HS). Of 100 consecutive patients with temporal lobe epilepsy and HS as histopathological diagnosis, 32 had high-resolution 3 Tesla MRI and anatomically well-preserved hippocampi following amygdalo-hippocampectomy. Hippocampal volume on 3D T1-weighted gradient echo and signal intensity on coronal FLAIR sequences were determined using FreeSurfer and SPM tools and related to Wyler grading. Seizure outcome was determined after 1 year. Histopathology showed four Wyler II, 19 Wyler III, and 9 Wyler IV HS. Hippocampal volumes were 3.08 ml for Wyler II (Wyler II/contralateral side: p > 0.05), 2.19 ml for Wyler III (p < 0.01), 2.62 ml for Wyler IV (p = 0.01), and 3.08 ml for the contralateral side. Normalized FLAIR signals were 1,354 (p = 0.0004), 1,408 (p < 0.0001), 1,371 (p < 0.04), and 1,296, respectively. Wyler II hippocampi were visually normal. Two of four (50 %) Wyler II, 16/19 (84 %) Wyler III, and 6/9 (66 %) Wyler IV patients achieved Engel I outcome. Combined volumetry and quantitative FLAIR signal analysis clearly identifies Wyler III and IV HS. Quantitative FLAIR signal analysis may be helpful to identify Wyler II HS. (orig.)

  16. MRI or not to MRI! Should brain MRI be a routine investigation in children with autistic spectrum disorders?

    Science.gov (United States)

    Zeglam, Adel M; Al-Ogab, Marwa F; Al-Shaftery, Thouraya

    2015-09-01

    To evaluate the routine usage of Magnetic Resonance Imaging (MRI) of brain and estimate the prevalence of brain abnormalities in children presenting to the Neurodevelopment Clinic of Al-Khadra Hospital (NDC-KH), Tripoli, Libya with autistic spectrum disorders (ASD). The records of all children with ASD presented to NDC-KH over 4-year period (from January 2009 to December 2012) were reviewed. All MRIs were acquired with a 1.5-T Philips (3-D T1, T2, FLAIR coronal and axial sequences). MRIs were reported to be normal, abnormal or no significant abnormalities by a consultant neuroradiologist. One thousand and seventy-five children were included in the study. Seven hundred and eighty-two children (72.7 %) had an MRI brain of whom 555 (71 %) were boys. 26 children (24 males and 2 females) (3.3 %) demonstrated MRI abnormalities (8 leukodystrophic changes, 4 periventricular leukomalacia, 3 brain atrophy, 2 tuberous sclerosis, 2 vascular changes, 1 pineoblastoma, 1 cerebellar angioma, 1 cerebellar hypoplasia, 3 agenesis of corpus callosum, 1 neuro-epithelial cyst). An unexpectedly high rate of MRI abnormalities was found in the first large series of clinical MRI investigations in children with autism. These results could contribute to further research into the pathogenesis of autistic spectrum disorder.

  17. Cyclosporine-related reversible posterior leukoencephalopathy: MRI

    International Nuclear Information System (INIS)

    Jarosz, J.M.; Howlett, D.C.; Cox, T.C.S.; Bingham, J.B.

    1997-01-01

    Three patients aged 48, 11 and 40 years, two of whom were recent recipients of renal transplants and one of a bone marrow transplant, developed seizures, with cortical blindness in two cases. All were immunosuppressed with cyclosporine and were hypertensive at the onset of symptoms. MRI showed predominantly posterior signal changes in all three cases. The abnormalities were more conspicuous on fast FLAIR images than on conventional T2-weighted spin-echo images. (orig.). With 4 figs

  18. Differential diagnosis of neurodegenerative diseases using structural MRI data

    DEFF Research Database (Denmark)

    Koikkalainen, Juha; Rhodius-Meester, Hanneke; Tolonen, Antti

    2016-01-01

    individuals was used for evaluation. The cross-validated classification accuracy was 70.6% and balanced accuracy was 69.1% for the five disease groups using only automatically determined MRI features. Vascular dementia patients could be detected with high sensitivity (96%) using features from FLAIR images....... Controls (sensitivity 82%) and Alzheimer's disease patients (sensitivity 74%) could be accurately classified using T1-based features, whereas the most difficult group was the dementia with Lewy bodies (sensitivity 32%). These results were notable better than the classification accuracies obtained...... characteristics from T1 images, and vascular characteristics from FLAIR images. Classification was performed using a multi-class classifier based on Disease State Index methodology. The classifier provided continuous probability indices for each disease to support clinical decision making. A dataset of 504...

  19. Contributions of an adiabatic initial inversion pulse and K-space Re-ordered by inversion-time at each slice position (KRISP) to control of CSF artifacts and visualization of the brain in FLAIR magnetic resonance imaging

    International Nuclear Information System (INIS)

    Curati, Walter L.; Oatridge, Angela; Herlihy, Amy H.; Hajnal, Joseph V.; Puri, Basant K.; Bydder, Graeme M.

    2001-01-01

    AIM: The aim of this study was to compare the performance of three fluid attenuated inversion recovery (FLAIR) pulse sequences for control of cerebrospinal fluid (CSF) and blood flow artifacts in imaging of the brain. The first of these sequences had an initial sinc inversion pulse which was followed by conventional k-space mapping. The second had an initial sinc inversion pulse followed by k-space re-ordered by inversion time at each slice position (KRISP) and the third had an adiabatic initial inversion pulse followed by KRISP. MATERIALS AND METHODS: Ten patients with established disease were studied with all three pulse sequences. Seven were also studied with the adiabatic KRISP sequence after contrast enhancement. Their images were evaluated for patient motion artifact, CSF and blood flow artifact as well as conspicuity of the cortex, meninges, ventricular system, brainstem and cerebellum. The conspicuity of lesions and the degree of enhancement were also evaluated. RESULTS: Both the sinc and adiabatic KRISP FLAIR sequences showed better control of CSF and blood flow artifacts than the conventional FLAIR sequence. In addition the adiabatic KRISP FLAIR sequence showed better control of CSF artifact at the inferior aspect of the posterior fossa. The lesion conspicuity was similar for each of the FLAIR sequences as was the degree of contrast enhancement to that shown with a T 1 weighted spin echo sequence. CONCLUSION: The KRISP FLAIR sequence controls high signal artifacts from CSF flow and blood flow and the adiabatic pulse controls high signal artifacts due to inadequate inversion of the CSF magnetization at the periphery of the head transmitter coil. The KRISP FLAIR sequence also improves cortical and meningeal definition as a result of an edge enhancement effect. The effects are synergistic and can be usefully combined in a single pulse sequence. Curati, W.L. et al. (2001)

  20. FLAIR vascular hyperintensities and dynamic 4D angiograms for the estimation of collateral blood flow in posterior circulation occlusion

    International Nuclear Information System (INIS)

    Foerster, Alex; Wenz, Holger; Kerl, Hans Ulrich; Al-Zghloul, Mansour; Habich, Sonia; Groden, Christoph

    2014-01-01

    The objectives of this paper are to assess collateral blood flow in posterior circulation occlusion by MRI-based approaches (fluid-attenuated inversion recovery (FLAIR) vascular hyperintensities (FVHs), collateralization on dynamic 4D angiograms) and investigate its relation to ischemic lesion size and growth. In 28 patients with posterior cerebral artery (PCA) and 10 patients with basilar artery (BA) occlusion, MRI findings were analyzed, with emphasis on distal FVH and collateralization on dynamic 4D angiograms. In PCA occlusion, distal FVH was observed in 18/29 (62.1 %), in BA occlusion, in 8/10 (80 %) cases. Collateralization on dynamic 4D angiograms was graded 1 in 8 (27.6 %) patients, 2 in 1 (3.4 %) patient, 3 in 12 (41.4 %) patients, and 4 in 8 (27.6 %) patients with PCA occlusion and 0 in 1 (10 %) patient, 2 in 3 (30 %) patients, 3 in 1 (10 %) patient, and 4 in 5 (50 %) patients with BA occlusion. FVH grade showed neither correlation with initial or follow-up diffusion-weighted image (DWI) lesion size nor DWI-perfusion-weighted imaging (PWI) mismatch ratio. Collateralization on dynamic 4D angiograms correlated inversely with initial DWI lesion size and moderately with the DWI-(PWI) mismatch ratio. The combination of distal FVH and collateralization grade on dynamic 4D angiograms correlated inversely with initial as well as follow-up DWI lesion size and highly with the DWI-PWI mismatch ratio. In posterior circulation occlusion, FVH is a frequent finding, but its prognostic value is limited. Dynamic 4D angiograms are advantageous to examine and graduate collateral blood flow. The combination of both parameters results in an improved characterization of collateral blood flow and might have prognostic relevance. (orig.)

  1. Hyperintense vessels on FLAIR: A useful non-invasive method for assessing intracerebral collaterals

    International Nuclear Information System (INIS)

    Liu Wenhua; Xu Gelin; Yue Xuanye; Wang Xiaoliang; Ma Minmin; Zhang Renliang; Wang Handong; Zhou Changsheng; Liu Xinfeng

    2011-01-01

    Objective: This study was aimed to evaluate relationship between hyperintense vessels (HV) on fluid-attenuated inversion recovery (FLAIR) and artery steno-occlusion related intracerebral collaterals. Materials and methods: A total of 233 patients with 260 atherosclerotic lesions in the M1 segment of the middle cerebral artery (MCA) were examined with FLAIR and digital subtraction angiography (DSA). HV were graded as 0, 1, 2 and 3 by its distributions in the MCA territory. Grade 0 indicated no HV; Grade 1 indicated the HV limited in Sylvian fissure; Grade 2 indicated the HV limited in Sylvian fissure and the temporal-occipital junction; Grade 3 indicated the HV extended to frontal-parietal lobes. Collateral blood flows were classified by DSA results. The relationship between HV grades and patterns of collateral flows was analyzed. Results: HV were observed in 76 out of 260 hemispheres. For patients with Grade 1 HV, most of their collateral flows (80.8%) were antegrade; for patients with Grade 2, the retrograde leptomeningeal flows were commonly manifested as anterior cerebral artery to MCA (75%); for patients with Grade 3 HV, most of the retrograde leptomeningeal flows were manifested as posterior cerebral artery to MCA (81.8%). As the grade HV increased, the frequency of retrograde leptomeningeal collateral from ACA to MCA decreased (100% to 75% and to 18.2%), and increased (0% to 25% and to 81.8%) for the retrograde leptomeningeal collateral via PCA to MCA (P < 0.001). Conclusions: The HV could assess non-invasively intracerebral collaterals in patients with steno-occlusive lesions of M1 segment of MCA.

  2. Functional MRI activation of somatosensory and motor cortices in a hand-grafted patient with early clinical sensorimotor recovery

    International Nuclear Information System (INIS)

    Neugroschl, C.; Denolin, V.; Schuind, F.; Holder, C. van; David, P.; Baleriaux, D.; Metens, T.

    2005-01-01

    The aim of this study was to investigate somatosensory and motor cortical activity with functional MRI (fMRI) in a hand-grafted patient with early clinical recovery. The patient had motor fMRI examinations before transplantation, and motor and passive tactile stimulations after surgery. His normal hand and a normal group were studied for comparison. A patient with complete brachial plexus palsy was studied to assess the lack of a fMRI signal in somatosensory areas in the case of total axonal disconnection. Stimulating the grafted hand revealed significant activation in the contralateral somatosensory cortical areas in all fMRI examinations. The activation was seen as early as 10 days after surgery; this effect cannot be explained by the known physiological mechanisms of nerve regeneration. Although an imagination effect cannot be excluded, the objective clinical recovery of sensory function led us to formulate the hypothesis that a connection to the somatosensory cortex was rapidly established. Additional cases and fundamental studies are needed to assess this hypothesis, but several observations were compatible with this explanation. Before surgery, imaginary motion of the amputated hand produced less intense responses than executed movements of the intact hand, whereas the normal activation pattern for right-handed subjects was found after surgery, in agreement with the good clinical motor recovery. (orig.)

  3. Advanced MRI assessment to predict benefit of anti-programmed cell death 1 protein immunotherapy response in patients with recurrent glioblastoma

    Energy Technology Data Exchange (ETDEWEB)

    Qin, Lei [Dana-Farber Cancer Institute, Department of Imaging, Boston, MA (United States); Harvard Medical School, Department of Radiology, Boston, MA (United States); Li, Xiang; Qu, Jinrong [Affiliated Cancer Hospital of Zhengzhou University, Department of Radiology, Zhengzhou, Henan (China); Brigham and Women' s Hospital, Department of Radiology, Boston, MA (United States); Stroiney, Amanda [Dana-Farber Cancer Institute, Department of Imaging, Boston, MA (United States); Northeastern University, Department of Behavioral Neuroscience, College of Sciences, Boston, MA (United States); Helgager, Jeffrey [Brigham and Women' s Hospital, Department of Pathology, Boston, MA (United States); Reardon, David A. [Dana-Farber Cancer Institute, CenterforNeuro-Oncology, Boston, MA (United States); Department of Medicine, Boston, MA (United States); Young, Geoffrey S. [Harvard Medical School, Department of Radiology, Boston, MA (United States); Brigham and Women' s Hospital, Department of Radiology, Boston, MA (United States)

    2017-02-15

    We describe the imaging findings encountered in GBM patients receiving immune checkpoint blockade and assess the potential of quantitative MRI biomarkers to differentiate patients who derive therapeutic benefit from those who do not. A retrospective analysis was performed on longitudinal MRIs obtained on recurrent GBM patients enrolled on clinical trials. Among 10 patients with analyzable data, bidirectional diameters were measured on contrast enhanced T1 (pGd-T1WI) and volumes of interest (VOI) representing measurable abnormality suggestive of tumor were selected on pGdT1WI (pGdT1 VOI), FLAIR-T2WI (FLAIR VOI), and ADC maps. Intermediate ADC (IADC) VOI represented voxels within the FLAIR VOI having ADC in the range of highly cellular tumor (0.7-1.1 x 10{sup -3} mm{sup 2}/s) (IADC VOI). Therapeutic benefit was determined by tissue pathology and survival on trial. IADC VOI, pGdT1 VOI, FLAIR VOI, and RANO assessment results were correlated with patient benefit. Five patients were deemed to have received therapeutic benefit and the other five patients did not. The average time on trial for the benefit group was 194 days, as compared to 81 days for the no benefit group. IADC VOI correlated well with the presence or absence of clinical benefit in 10 patients. Furthermore, pGd VOI, FLAIR VOI, and RANO assessment correlated less well with response. MRI reveals an initial increase in volumes of abnormal tissue with contrast enhancement, edema, and intermediate ADC suggesting hypercellularity within the first 0-6 months of immunotherapy. Subsequent stabilization and improvement in IADC VOI appear to better predict ultimate therapeutic benefit from these agents than conventional imaging. (orig.)

  4. Hippocampal malrotation: MRI findings

    International Nuclear Information System (INIS)

    Yanez, Paulina; Martinez, Adriana; Romero, Carlos; Lopez, Miriam; Zaffaroni, Alejandra; Lopez, Adriana

    2001-01-01

    Purpose: To demonstrate the common features of hippocampus malrotation in patients with epilepsy by volumetric and high-resolution MRI. Material and methods: MRI study was performed in 5 patients (2 females and 3 males) ages ranged between 6-41 years (average: 25 years), all of them with epilepsy diagnosis. MRI was performed with a 1.5 T (GE Signa). The epilepsy protocol include sagittal T1, axial T1 and T2, coronal FLAIR, coronal T2 (high-resolution) and volumetric 3D SPGR IR 1.5 mm thick sequences. Results: The common features found in all patients were: a) Incomplete inversion and round configuration of the hippocampus; b) Unilateral affectation; c) Variable affectation of the hippocampus; d) Normal signal intensity; e) Modification of the inner structure of the hippocampus; f) Abnormal angularity of the collateral sulcus; g) Abnormal position and size of the fornix; h) Normal size of the temporal lobe; and i) Enlargement of the temporal horn with particular configuration. Conclusion: Hippocampus malrotation is a malformation that should be included in the differential diagnosis of the epilepsy patients. MRI provides accurate information for the diagnosis. (author)

  5. Rabies, encephalomyelitis: MRI findings

    International Nuclear Information System (INIS)

    Peloso, Raul; Gonzalez, Roberto

    2002-01-01

    The authors present a 14 year old patient who started with walking and swallowing difficulty; followed by fever, abdominal and lower back pain. Mechanical breathing difficulties required a respiratory mechanic assistance. The diagnosis of Guillain-Barre syndrome was thought at first. Since the patient have had previous contact with a bat two months before the symptoms began, this suggested rabies as the main diagnosis, which was later confirmed by hair-bulb, cornea, oral mucosa and salival immunofluorescence. The brain and spinal cord MRI showed focal lesions in T2 and FLAIR sequences, compatible with encephalomyelitis. (author)

  6. Ultra-low energy storage ring at FLAIR

    International Nuclear Information System (INIS)

    Welsch, Carsten P.; Papash, A. I.; Gorda, O.; Harasimowicz, J.; Karamyshev, O.; Karamysheva, G.; Newton, D.; Panniello, M.; Putignano, M.; Siggel-King, M. R. F.; Smirnov, A.

    2012-01-01

    The Ultra-low energy electrostatic Storage Ring (USR) at the future Facility for Low-energy Antiproton and Ion Research (FLAIR) will provide cooled beams of antiprotons in the energy range between 300 keV down to 20 keV and possibly less. The USR has been completely redesigned over the past three years. The ring structure is based on a “split achromat” lattice that allows in-ring experiments with internal gas jet target. Beam parameters might be adjusted in a wide range: from very short pulses in the nanosecond regime to a Coasting beam. In addition, a combined fast and slow extraction scheme was developed that allows for providing external experiments with cooled beams of different time structure. Detailed investigations of the USR, including studies into the ring’s long term beam dynamics, life time, equilibrium momentum spread and equilibrium lateral spread during collisions with an internal target were carried out. New tools and beam handling techniques for diagnostics of ultra-low energy ions at beam intensities less than 10 6 were developed by the QUASAR Group. In this paper, progress on the USR project will be presented with an emphasis on the expected beam parameters available to the experiments at FLAIR.

  7. A multimodal MRI approach to identify and characterize microstructural brain changes in neuropsychiatric systemic lupus erythematosus.

    Science.gov (United States)

    Ercan, Ece; Ingo, Carson; Tritanon, Oranan; Magro-Checa, Cesar; Smith, Alex; Smith, Seth; Huizinga, Tom; van Buchem, Mark A; Ronen, Itamar

    2015-01-01

    Systemic lupus erythematosus (SLE) is an autoimmune disease with multi-organ involvement and results in neurological and psychiatric (NP) symptoms in up to 40% of the patients. To date, the diagnosis of neuropsychiatric systemic lupus erythematosus (NPSLE) poses a challenge due to the lack of neuroradiological gold standards. In this study, we aimed to better localize and characterize normal appearing white matter (NAWM) changes in NPSLE by combining data from two quantitative MRI techniques, diffusion tensor imaging (DTI) and magnetization transfer imaging (MTI). 9 active NPSLE patients (37 ± 13 years, all females), 9 SLE patients without NP symptoms (44 ± 11 years, all females), and 14 healthy controls (HC) (40 ± 9 years, all females) were included in the study. MTI, DTI and fluid attenuated inversion recovery (FLAIR) images were collected from all subjects on a 3 T MRI scanner. Magnetization transfer ratio (MTR), mean diffusivity (MD), fractional anisotropy (FA), radial diffusivity (RD), axial diffusivity (AD) maps and white matter lesion maps based on the FLAIR images were created for each subject. MTR and DTI data were then co-analyzed using tract-based spatial statistics and a cumulative lesion map to exclude lesions. Significantly lower MTR and FA and significantly higher AD, RD and MD were found in NPSLE compared to HC in NAWM regions. The differences in DTI measures and in MTR, however, were only moderately co-localized. Additionally, significant differences in DTI measures, but not in MTR, were found between NPSLE and SLE patients, suggesting that the underlying microstructural changes detected by MD are linked to the onset of NPSLE. The co-analysis of the anatomical distribution of MTI and DTI measures can potentially improve the diagnosis of NPSLE and contribute to the understanding of the underlying microstructural damage.

  8. MRI Findings in 77 Children with Non-Syndromic Autistic Disorder

    Science.gov (United States)

    Boddaert, Nathalie; Zilbovicius, Mônica; Philipe, Anne; Robel, Laurence; Bourgeois, Marie; Barthélemy, Catherine; Seidenwurm, David; Meresse, Isabelle; Laurier, Laurence; Desguerre, Isabelle; Bahi-Buisson, Nadia; Brunelle, Francis; Munnich, Arnold; Samson, Yves; Mouren, Marie-Christine; Chabane, Nadia

    2009-01-01

    Background The clinical relevance of MR scanning in children with autism is still an open question and must be considered in light of the evolution of this technology. MRI was judged to be of insufficient value to be included in the standard clinical evaluation of autism according to the guidelines of the American Academy of Neurology and Child Neurology Society in 2000 [1]. However, this statement was based on results obtained from small samples of patients and, more importantly, included mostly insufficient MRI sequences. Our main objective was to evaluate the prevalence of brain abnormalities in a large group of children with a non-syndromic autistic disorder (AD) using T1, T2 and FLAIR MRI sequences. Methodology MRI inspection of 77 children and adolescents with non-syndromic AD (mean age 7.4±3.6) was performed. All met the DSM-IV and ADI –R criteria for autism. Based on recommended clinical and biological screenings, we excluded patients with infectious, metabolic or genetic diseases, seizures or any other neurological symptoms. Identical MRI inspections of 77 children (mean age 7.0±4.2) without AD, developmental or neurological disorders were also performed. All MRIs were acquired with a 1.5-T Signa GE (3-D T1-FSPGR, T2, FLAIR coronal and axial sequences). Two neuroradiologists independently inspected cortical and sub-cortical regions. MRIs were reported to be normal, abnormal or uninterpretable. Principal Findings MRIs were judged as uninterpretable in 10% (8/77) of the cases. In 48% of the children (33/69 patients), abnormalities were reported. Three predominant abnormalities were observed, including white matter signal abnormalities (19/69), major dilated Virchow–Robin spaces (12/69) and temporal lobe abnormalities (20/69). In all, 52% of the MRIs were interpreted as normal (36/69 patients). Conclusions An unexpectedly high rate of MRI abnormalities was found in the first large series of clinical MRI investigations in non-syndromic autism. These

  9. Preliminary study on the mechanism of reading recovery in a pure alexia by using functional MRI

    International Nuclear Information System (INIS)

    Ma Lin; Li Dejun; Weng Xuchu; Tang Yiyuan; Zhang Wutian; Sun Weijian; Feng Shiwen

    2004-01-01

    Objective: To observe the changes of the brain function during reading recovery by using functional MRI (fMRI), and to provide the experimental data in elucidating the mechanism on the recovery of reading and language function. Methods: fMRI was performed in a native Chinese patient with pure alexia on the 45 th and 130 th day after the onset, respectively. Three kinds of Chinese characters were presented during the scan and the patient was asked to make the judgement weather he could recognize the characters or not. The brain activation maps were acquired after postprocessing, and the activated location and volume were compared between the first and second experiments. Results: In both experiments, Broca area, Wernicke area, and the right extrastriate were significantly activated, while the left extrastriate around the lesion was markedly activated only in the second experiment, and the volume of activation in the right extrastriate in the second experiment was about 3 times as large as that in the first experiment. Conclusion: The left extrastriate cortex is one of the key areas responsible for reading function in the brain. The recovery of reading function can be compensated in contralateral corresponding cortical area, or it can be the result of reorganization in ipsilateral peri-lesion cortex. Both mechanisms may simultaneously play important roles in reading recovery

  10. Ivy Sign on Fluid-Attenuated Inversion Recovery Images in Moyamoya Disease: Correlation with Clinical Severity and Old Brain Lesions

    OpenAIRE

    Seo, Kwon-Duk; Suh, Sang Hyun; Kim, Yong Bae; Kim, Ji Hwa; Ahn, Sung Jun; Kim, Dong-Seok; Lee, Kyung-Yul

    2015-01-01

    Purpose Leptomeningeal collateral, in moyamoya disease (MMD), appears as an ivy sign on fluid-attenuated inversion-recovery (FLAIR) images. There has been little investigation into the relationship between presentation of ivy signs and old brain lesions. We aimed to evaluate clinical significance of ivy signs and whether they correlate with old brain lesions and the severity of clinical symptoms in patients with MMD. Materials and Methods FLAIR images of 83 patients were reviewed. Each cerebr...

  11. Investigation of the Correlation Between Neurocognitive Function with Advanced Magnetic Resonance Imaging (MRI), Electroencephalography (EEG) in Patients with Traumatic Brain Injury Exposure: Neurocognitive function and advanced MRI and EEG

    Science.gov (United States)

    2011-01-01

    child (MVA007), pneumonia (MVA017), urinary infection (MVA018), appendix (MVA026), a leg fracture (MVA008), and tonsils and fractures (MVA019). The...Toronto CR 2011-015 59 Glossary ..... DTI – diffusion tensor imaging EEG – electroencephalography FLAIR – fluid-attenuated inversion recovery

  12. MRI texture heterogeneity in the optic nerve predicts visual recovery after acute optic neuritis

    Directory of Open Access Journals (Sweden)

    Yunyan Zhang

    2014-01-01

    Conclusions: Tissue heterogeneity may be a potential measure of functional outcome in ON patients and advanced analysis of the texture in standard MRI could provide insights into mechanisms of injury and recovery in patients with similar disorders.

  13. MRI diagnosis of intracranial tuberculosis (73 cases report)

    International Nuclear Information System (INIS)

    Zeng Qingyong; Li Xin; He Zhihui; Cheng Chuanhu; Deng Kaijun; Deng Ming

    2008-01-01

    Objective: To assess the MRI features, classification and diagnostic value for intracranial tuberculosis. Methods MRI findings of 73 patients suffering from intracranial tuberculosis proved by pathology or clinic were analyzed respectively. Among the total 73 patients, 39 cases were tuberculosis meningitis, 12 cases simple intracranial tuberculoma, while 22 cases were tuberculoma combining with meningitis. Results: The MRI features of tuberculous meningitis are cerebral infarction, hydrocephalus, abnormal meningeal and cerebral cistern enhancement. 12 cases mature tuberculoma demon- strated typical features with high or low density on T 2 WI images and ring contrast enhancement; 22 cases non-mature tuberculoma showed focal nodular contrast enhancement with evident cerebral edema. FLAIR is more sensitive to find out focus than T 2 WI. Small lesions could be showed definitively by contrast-enhanced scan. Conclusion: MRI possess typical features in the diagnosis of intracranial tuberculosis. It plays an important role in evaluating location, range, classification of intracranial tuberculosis, and is helpful to clinical treatment. (authors)

  14. Statistical approach of measurement of signal to noise ratio in according to change pulse sequence on brain MRI meningioma and cyst images

    International Nuclear Information System (INIS)

    Lee, Eul Kyu; Choi, Kwan Woo; Jeong, Hoi Woun; Jang, Seo Goo; Kim, Ki Won; Son, Soon Yong; Min, Jung Whan; Son, Jin Hyun

    2016-01-01

    The purpose of this study was to needed basis of measure MRI CAD development for signal to noise ratio (SNR) by pulse sequence analysis from region of interest (ROI) in brain magnetic resonance imaging (MRI) contrast. We examined images of brain MRI contrast enhancement of 117 patients, from January 2005 to December 2015 in a University-affiliated hospital, Seoul, Korea. Diagnosed as one of two brain diseases such as meningioma and cysts SNR for each patient's image of brain MRI were calculated by using Image J. Differences of SNR among two brain diseases were tested by SPSS Statistics21 ANOVA test for there was statistical significance (p < 0.05). We have analysis socio-demographical variables, SNR according to sequence disease, 95% confidence according to SNR of sequence and difference in a mean of SNR. Meningioma results, with the quality of distributions in the order of T1CE, T2 and T1, FLAIR. Cysts results, with the quality of distributions in the order of T2 and T1, T1CE and FLAIR. SNR of MRI sequences of the brain would be useful to classify disease. Therefore, this study will contribute to evaluate brain diseases, and be a fundamental to enhancing the accuracy of CAD development

  15. Statistical approach of measurement of signal to noise ratio in according to change pulse sequence on brain MRI meningioma and cyst images

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Eul Kyu [Inje Paik University Hospital Jeo-dong, Seoul (Korea, Republic of); Choi, Kwan Woo [Asan Medical Center, Seoul (Korea, Republic of); Jeong, Hoi Woun [The Baekseok Culture University, Cheonan (Korea, Republic of); Jang, Seo Goo [The Soonchunhyang University, Asan (Korea, Republic of); Kim, Ki Won [Kyung Hee University Hospital at Gang-dong, Seoul (Korea, Republic of); Son, Soon Yong [The Wonkwang Health Science University, Iksan (Korea, Republic of); Min, Jung Whan; Son, Jin Hyun [The Shingu University, Sungnam (Korea, Republic of)

    2016-09-15

    The purpose of this study was to needed basis of measure MRI CAD development for signal to noise ratio (SNR) by pulse sequence analysis from region of interest (ROI) in brain magnetic resonance imaging (MRI) contrast. We examined images of brain MRI contrast enhancement of 117 patients, from January 2005 to December 2015 in a University-affiliated hospital, Seoul, Korea. Diagnosed as one of two brain diseases such as meningioma and cysts SNR for each patient's image of brain MRI were calculated by using Image J. Differences of SNR among two brain diseases were tested by SPSS Statistics21 ANOVA test for there was statistical significance (p < 0.05). We have analysis socio-demographical variables, SNR according to sequence disease, 95% confidence according to SNR of sequence and difference in a mean of SNR. Meningioma results, with the quality of distributions in the order of T1CE, T2 and T1, FLAIR. Cysts results, with the quality of distributions in the order of T2 and T1, T1CE and FLAIR. SNR of MRI sequences of the brain would be useful to classify disease. Therefore, this study will contribute to evaluate brain diseases, and be a fundamental to enhancing the accuracy of CAD development.

  16. MR textural analysis on T2 FLAIR images for the prediction of true oligodendroglioma by the 2016 WHO genetic classification.

    Science.gov (United States)

    Rui, Wenting; Ren, Yan; Wang, Yin; Gao, Xinyi; Xu, Xiao; Yao, Zhenwei

    2017-11-15

    The genetic status of 1p/19q is important for differentiating oligodendroglioma, isocitrate-dehydrogenase (IDH)-mutant, and 1p/19q-codeleted from diffuse astrocytoma, IDH-mutant according to the 2016 World Health Organization (WHO) criteria. To assess the value of magnetic resonance textural analysis (MRTA) on T 2 fluid-attenuated inversion recovery (FLAIR) images for making a genetically integrated diagnosis of true oligodendroglioma by WHO guidelines. Retrospective case control. In all, there were 54 patients with a histopathological diagnosis of diffuse glioma (grade II). All were tested for IDH and 1p/19q. 3.0T, including T 2 FLAIR sequence, axial T 1 -weighted, and T 2 -weighted sequence. MRTA on a representative tumor region of interest (ROI) was made on preoperative T 2 FLAIR images around the area that had the largest diameter of solid tumor using Omni Kinetics software. Differences between IDH-mutant and 1p/19q-codeleted and IDH-mutant and 1p/19q-intact gliomas were analyzed by the Mann-Whitney rank sum test. Receiver operating characteristic curves (ROC) were created to assess MRTA diagnostic performance. Sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) were calculated with a cutoff value according to the Youden Index. Comparisons demonstrated significant differences in kurtosis (P = 0.007), energy (0.008), entropy (0.008), mean deviation (MD) (features comprising entropy (area under the curve [AUC] = 0.718, sensitivity = 97.1%) and energy (0.719, 94.1%) had the highest sensitivity but lower specificity (both 45%). Second-order features such as HGLRE (AUC = 0.750, sensitivity = 73.5%, specificity = 80.0%) and sum average (0.751, 70.6%, 80.0%) had relatively higher specificity, and all had AUC >0.7. MD had the highest diagnostic performance, with AUC = 0.878, sensitivity = 94.1%, specificity = 75.0%, PPV = 86.5%, and NPV = 88.2%. MRTA on T 2 FLAIR images may be

  17. Ex-vivo diffusion MRI reveals microstructural alterations in stress-sensitive brain regions: A chronic mild stress recovery study

    DEFF Research Database (Denmark)

    Khan, Ahmad Raza; Hansen, Brian; Wiborg, Ove

    Depression is a leading cause of disability worldwide and causes significant microstructural alterations in stress-sensitive brain regions. However, the potential recovery of these microstructural alterations has not previously been investigated, which we, therefore, set out to do using diffusion...... MRI (d-MRI) in the chronic mild stress (CMS) rat model of depression. This study reveals significant microstructural alterations after 8 weeks of recovery, in the opposite direction to change induced by stress in the acute phase of the experiment. Such findings may be useful in the prognosis...... of depression or for monitoring treatment response....

  18. Abnormal hyperintensity within the subarachnoid space evaluated by fluid-attenuated inversion-recovery MR imaging: a spectrum of central nervous system diseases

    International Nuclear Information System (INIS)

    Maeda, M.; Sakuma, H.; Takeda, K.; Yagishita, A.; Yamamoto, T.

    2003-01-01

    A variety of central nervous system (CNS) diseases are associated with abnormal hyperintensity within the subarachnoid space (SAS) by fluid-attenuated inversion-recovery (FLAIR) MR imaging. Careful attention to the SAS can provide additional useful information that may not be available with conventional MR sequences. The purpose of this article is to provide a pictorial essay about CNS diseases and FLAIR images with abnormal hyperintensity within the SAS. We present several CNS diseases including subarachnoid hemorrhage, meningitis, leptomeningeal metastases, acute infarction, and severe arterial occlusive diseases such as moya-moya disease. We also review miscellaneous diseases or normal conditions that may exhibit cerebrospinal fluid hyperintensity on FLAIR images. Although the detection of abnormal hyperintensity suggests the underlying CNS diseases and narrows differential diagnoses, FLAIR imaging sometimes presents artifactual hyperintensity within the SAS that can cause the misinterpretation of normal SAS as pathologic conditions; therefore, radiologists should be familiar with such artifactual conditions as well as pathologic conditions shown as hyperintensity by FLAIR images. This knowledge is helpful in establishing the correct diagnosis. (orig.)

  19. Arterial spin-labeling MR imaging in moyamoya disease compared with clinical assessments and other MR imaging finings

    Energy Technology Data Exchange (ETDEWEB)

    Noguchi, Tomoyuki, E-mail: tnogucci@radiol.med.kyushu-u.ac.jp [Department of Radiology, Faculty of Medicine, Saga University, 5-1-1, Nabeshima, Saga 849-8501 (Japan); Kawashima, Masatou [Department of Neurosurgery, Faculty of Medicine, Saga University, 5-1-1, Nabeshima, Saga 849-8501 (Japan); Nishihara, Masashi; Hirai, Tetsuyoshi [Department of Radiology, Faculty of Medicine, Saga University, 5-1-1, Nabeshima, Saga 849-8501 (Japan); Matsushima, Toshio [Department of Neurosurgery, Faculty of Medicine, Saga University, 5-1-1, Nabeshima, Saga 849-8501 (Japan); Irie, Hiroyuki [Department of Radiology, Faculty of Medicine, Saga University, 5-1-1, Nabeshima, Saga 849-8501 (Japan)

    2013-12-01

    Purpose: Our purpose was to identify the causal factors for the perfusion distribution obtained with ASL-MRI by comparing ASL-MRI with clinical information and other MRI findings in moyamoya disease. Methods: Seventy-one patients with moyamoya disease underwent ASL-MRI and other MRI, including fluid-attenuated inversion recovery imaging (FLAIR) and three-dimensional time-of-flight magnetic resonance angiography (MRA) on 3.0-Tesla MRI system. Cerebral blood flow (CBF) values (ASL values) for the cerebral hemispheres (142 sides) were measured on CBF maps generated by ASL-MRI. Relationships between the ASL values and the following 9 factors were assessed: sex, family history, revascularization surgery, age at MR exam, age at onset, the steno-occlusive severity on MRA (MRA score), degree of basal collaterals, degree of leptomeningeal high signal intensity seen on FLAIR, and size of ischemic or hemorrhagic cerebrovascular accident lesion (CVA score). Results: Patients with a family history had significantly higher ASL values than those without such a history. There were significant negative correlations between ASL values and age at MR exam, MRA score, and CVA score. Conclusions: ASL-MRI may have cause-and-effect or mutual associations with family history, current patient age, size of CVA lesion, and intracranial arterial steno-occlusive severity in Moyamoya disease.

  20. Arterial spin-labeling MR imaging in moyamoya disease compared with clinical assessments and other MR imaging finings

    International Nuclear Information System (INIS)

    Noguchi, Tomoyuki; Kawashima, Masatou; Nishihara, Masashi; Hirai, Tetsuyoshi; Matsushima, Toshio; Irie, Hiroyuki

    2013-01-01

    Purpose: Our purpose was to identify the causal factors for the perfusion distribution obtained with ASL-MRI by comparing ASL-MRI with clinical information and other MRI findings in moyamoya disease. Methods: Seventy-one patients with moyamoya disease underwent ASL-MRI and other MRI, including fluid-attenuated inversion recovery imaging (FLAIR) and three-dimensional time-of-flight magnetic resonance angiography (MRA) on 3.0-Tesla MRI system. Cerebral blood flow (CBF) values (ASL values) for the cerebral hemispheres (142 sides) were measured on CBF maps generated by ASL-MRI. Relationships between the ASL values and the following 9 factors were assessed: sex, family history, revascularization surgery, age at MR exam, age at onset, the steno-occlusive severity on MRA (MRA score), degree of basal collaterals, degree of leptomeningeal high signal intensity seen on FLAIR, and size of ischemic or hemorrhagic cerebrovascular accident lesion (CVA score). Results: Patients with a family history had significantly higher ASL values than those without such a history. There were significant negative correlations between ASL values and age at MR exam, MRA score, and CVA score. Conclusions: ASL-MRI may have cause-and-effect or mutual associations with family history, current patient age, size of CVA lesion, and intracranial arterial steno-occlusive severity in Moyamoya disease

  1. A comparison of lesion detection and conspicuity on T2-weighted images (T2 FFE), FLAIR and diffusion-weighted images in patients with traumatic brain injury

    International Nuclear Information System (INIS)

    Kwon, Eun Yong; Lee, Myeong sub; Kim, Myung Soon; Hong, In Soo; Kim, Young Ju; Whang, Gum

    2001-01-01

    To compare the lesion detectability and conspicuity in traumatic brain injury on T-2 FFE, FLAIR and diffusion weighted imaging (DWI) sequences. Thirty-three patients who underwent MR brain imaging after traumatic brain injury were reviewed. T-2 FFE, FLAIR and diffusion-weighted MR sequences were obtained and were compared in terms of the detectability and conspicuity of intra- and extra-axial lesions which showed abnormal signal intensities. Among 33 patients, a total of 108 lesions were found, T-2 FFE sequences detected 88(81%) of these, FLAIR sequences 91%(84%), and diffusion-weighted sequences 57(52%). In the case of petechial hemorrhagic lesions, 16 were detected by T-2 FFE imaging but only one by FLAIR and one by DWI. Sixteen extra-axial lesions (73%) were detected by T-2 FFE, 21 (95%) by FLAIR, and 11(50%) by DWI. Lesion conspicuity on FLAIR images was judged superior to that on T-2 FFE and diffusion-weighted images in 42 lesions (75%). Eleven extra-axial Lesions (92%) were more conspicuous on FLAIR than on T-2 FFE and DWI. For detecting traumatic brain lesions and determining their conspicuity, FLAIR imaging was more useful than T-2 FFE and diffusion weighting , while T-2 FFE imaging was more sensitive for the detecion of petechial hemorrhage. Although diffusion-weighted imaging was generally inferior to both FLAIR and T-2 FFE in terms of lesion detection and conspicuity, for some lesions it was superior. The results suggest that images obtained at each pulse sequence can be used as complementary imaging sequences, and that in traumatic brain injury, the acquisition of FLAIR, T-2 FFE and diffusion-weighted images is useful

  2. Creutzfeldt jakob disease

    International Nuclear Information System (INIS)

    Haider, E.; Raja, S.; Wali, W.; Tariq, M.

    2013-01-01

    A case of 50 years of age, male with sporadic Creutzfeldt Jakob Disease (sCJD) is reported. Patient had dementia, behavioural abnormalities, unsteady gait and myoclonic jerks. Magnetic resonance imaging (MRI) brain T2 weighted and Fluid Attenuated Inverse Recovery (FLAIR) images showed abnormally increased signal intensity in caudate nucleus and putamen. Scalp electroencephalogram (EEG) revealed periodic synchronous biphasic sharp wave complexes. On the basis of history, clinical findings, typical MRI brain and EEG changes, diagnosis of sporadic CJD was made. (author)

  3. Posterior reversible encephalopathy syndrome: diagnosis with CT and MRI

    International Nuclear Information System (INIS)

    Wang Guangbin; Zhao Bin; Yang Zhenzhen; Shi Hao; Chiu, L.C.; Shan Ruiqin

    2006-01-01

    Objective: To evaluate the role of CT and MRI in the diagnosis of posterior reversible encephalopathy syndrome (PRES). Methods: Eight women with PRES (6 pregnant women, 1 case after chemotherapy, and 1 patient with hypertension)were enrolled in our study. All of them had MR imaging (T 1 WI, T 2 WI, FLAIR, DWI), and five cases underwent post-contrast T 1 WI and three dimensional contrast enhanced MR angiography (3D CEMRA). Two cases also had CT scan. Results: MRV in all 8 patients showed no evidence of stenosis, dilation, or thrombosis in cranial veins and sinuses. MRI demonstrated multiple lesions located in bilateral parieto-occipital lobes (8 cases), bilateral basal ganglia (2 cases), and bilateral frontal lobes (4 cases). The lesions were prominent within white matter, some of them involved gray matter (3 cases). Lesions appeared as hyperintense signals on FLAIR and T 2 -weighted images, isointense or mildly hypointense signals on T 1 -weighted images, normal or decreased intensity on DWI, and isointensity or hyperintensity on apparent diffusion coefficient (ADC) maps. Post-contrast T 1 WI showed mild reversible enhancement and 3D CEMRA displayed numerous reversible 'grape-like' enhancements in terminal arterial branches along the middle cerebral artery (MCA), anterior cerebral artery (ACA) and posterior cerebral artery (PCA). Follow-up scan showed decreased abnormal signals. Conclusion: Lesions of PRES are usually located in parieto-occipital lobes, especially in white matter, but they can also be seen in frontal lobes and basal ganglia bilaterally. Post-contrast T 1 WI and 3D enhanced MRA can provide useful information in the manifestation of reversible enhancement. MRI has advantages to display lesion in PRES. (authors)

  4. Sensitivity of different MRI sequences in the early detection of melanoma brain metastases

    Science.gov (United States)

    Breckwoldt, Michael O.; Schwarz, Daniel; Radbruch, Alexander; Enk, Alexander; Bendszus, Martin; Hassel, Jessica; Schlemmer, Heinz-Peter

    2018-01-01

    Background After the emergence of new MRI techniques such as susceptibility- and diffusion-weighted imaging (SWI and DWI) and because of specific imaging characteristics of melanoma brain metastases (MBM), it is unclear which MRI sequences are most beneficial for detection of MBM. This study was performed to investigate the sensitivity of six clinical MRI sequences in the early detection of MBM. Methods Medical records of all melanoma patients referred to our center between November 2005 and December 2016 were reviewed for presence of MBM. Analysis encompassed six MRI sequences at the time of initial diagnosis of first or new MBM, including non-enhanced T1-weighted (T1w), contrast-enhanced T1w (ceT1w), T2-weighted (T2w), T2w-FLAIR, susceptibility-weighted (SWI) and diffusion-weighted (DWI) MRI. Each lesion was rated with respect to its conspicuity (score from 0—not detectable to 3—clearly visible). Results Of 1210 patients, 217 with MBM were included in the analysis and up to 5 lesions per patient were evaluated. A total of 720 metastases were assessed and all six sequences were available for 425 MBM. Sensitivity (conspicuity ≥2) was 99.7% for ceT1w, 77.0% for FLAIR, 64.7% for SWI, 61.0% for T2w, 56.7% for T1w, and 48.4% for DWI. Thirty-one (7.3%) of 425 lesions were only detectable by ceT1w but no other sequence. Conclusions Contrast-enhanced T1-weighting is more sensitive than all other sequences for detection of MBM. Disruption of the blood-brain-barrier is consistently an earlier sign in MBM than perifocal edema, signal loss on SWI or diffusion restriction. PMID:29596475

  5. An Observational Study to Assess Brain MRI Change and Disease Progression in Multiple Sclerosis Clinical Practice-The MS-MRIUS Study.

    Science.gov (United States)

    Zivadinov, Robert; Khan, Nasreen; Medin, Jennie; Christoffersen, Pia; Price, Jennifer; Korn, Jonathan R; Bonzani, Ian; Dwyer, Michael G; Bergsland, Niels; Carl, Ellen; Silva, Diego; Weinstock-Guttman, Bianca

    2017-05-01

    To describe methodology, interim baseline, and longitudinal magnetic resonance imaging (MRI) acquisition parameter characteristics of the multiple sclerosis clinical outcome and MRI in the United States (MS-MRIUS). The MS-MRIUS is an ongoing longitudinal and retrospective study of MS patients on fingolimod. Clinical and brain MRI image scan data were collected from 600 patients across 33 MS centers in the United States. MRI brain outcomes included change in whole-brain volume, lateral ventricle volume, T2- and T1-lesion volumes, and new/enlarging T2 and gadolinium-enhancing lesions. Interim baseline and longitudinal MRI acquisition parameters results are presented for 252 patients. Mean age was 44 years and 81% were female. Forty percent of scans had 3-dimensional (3D) T1 sequence in the preindex period, increasing to 50% in the postindex period. Use of 2-dimensional (2D) T1 sequence decreased over time from 85% in the preindex period to 65% in the postindex. About 95% of the scans with FLAIR and 2D T1-WI were considered acceptable or good quality compared to 99-100% with 3D T1-WI. There were notable changes in MRI hardware, software, and coil (39.5% in preindex to index and 50% in index to postindex). MRI sequence parameters (orientation, thickness, or protocol) differed for 36%, 29%, and 20% of index/postindex scans for FLAIR, 2D T1-WI, and 3D T1-WI, respectively. The MS-MRIUS study linked the clinical and brain MRI outcomes into an integrated database to create a cohort of fingolimod patients in real-world practice. Variability was observed in MRI acquisition protocols overtime. © 2016 The Authors. Journal of Neuroimaging published by Wiley Periodicals, Inc. on behalf of American Society of Neuroimaging.

  6. Fast spine echo and fast fluid attenuated inversion recovery sequences in multiple sclerosis

    International Nuclear Information System (INIS)

    Paolillo, Andrea; Giugni, Elisabetta; Bozzao, Alessandro; Bastianello, Stefano

    1997-01-01

    Fast spin echo (FSE) and fast fluid attenuated inversion recovery (fast-FLAIR) sequences, were compared with conventional spin echo (CSE) in quantitating multiple sclerosis (MS) lesion burden. For each sequence, the total number and volume of MS lesions were calculated in 38 remitting multiple sclerosis patients using a semiautomated lesion detection program. Conventional spin echo, fast spin echo, and fast fluid attenuated inversion recovery image were reported on randomly and at different times by two expert observers. Interobserver differences, the time needed to quantitative multiple sclerosis lesions and lesion signal intensity (contrast-to-noise ratio and overall contrast) were considered. The lesions were classified by site into infratentorial, white matter and cortical/subcortical. A total of 2970 lesions with a volume of 961.7 cm 3 was calculated on conventional spin echo images. Fast spin echo images depicted fewer (16.6%; p < .005) and smaller (24.9%; p < .0001) lesions and the differences were statistically significant. Despite an overall nonsignificant reduction for fast-FLAIR images (-5% and 4.8% for lesion number and volume, respectively), significantly lower values (lesion number: p < 0.1; volume: p < .04)were observed for infratentorial lesions, while significantly higher values were seen for cortical/subcortical lesions (lesion number: p < .01; volume: p < .02). A higher lesion/white matter contrast (p < .002), a significant time saving for lesion burden quantitation (p < .05) and very low interobserver variability were found in favor of fast-FLAIR. Our data suggest that, despite the limitations regarding infratentorial lesions, fast-FLAIR sequences are indicated in R studies because of their good identification of cortical/subcortical lesions, almost complete interobserver agreement, higher contrast-to-noise ratio and limited time needed for semiautomated quantitation

  7. Retrospective review of previous minor leak before major subarachnoid hemorrhage diagnosed by MRI as a predictor of occurrence of symptomatic delayed cerebral ischemia.

    Science.gov (United States)

    Oda, Shinri; Shimoda, Masami; Hirayama, Akihiro; Imai, Masaaki; Komatsu, Fuminari; Shigematsu, Hideaki; Nishiyama, Jun; Hotta, Kazuko; Matsumae, Mitsunori

    2018-02-01

    OBJECTIVE This study attempted to determine whether a previous minor leak correlated with the occurrence of symptomatic delayed cerebral ischemia (sDCI). METHODS The authors retrospectively evaluated sDCI-related clinical features and findings from MRI, including T1-weighted imaging (T1WI)-FLAIR mismatch at the time of admission, in 151 patients admitted with subarachnoid hemorrhage (SAH) within 48 hours of ictus. RESULTS The overall incidence of sDCI was 23% (35 of 151 patients). In all subjects, multivariate analysis revealed that World Federation of Neurosurgical Societies Grades II-V, age 70 years or older, presence of rebleeding after admission, a previous minor leak before the major SAH attack as diagnosed by T1WI-FLAIR mismatch, acute infarction on diffusion-weighted imaging, and CT SAH score were significantly associated with occurrence of sDCI. In patients with no previous minor leak before major SAH as diagnosed by T1WI-FLAIR mismatch, the incidence of sDCI was only 7% (7 of 97 patients). CONCLUSIONS A previous minor leak before major SAH as diagnosed by T1WI-FLAIR mismatch represents an important sDCI-related factor. When the analysis was restricted to patients with true acute SAH without a previous minor leak diagnosed by T1WI-FLAIR mismatch, the incidence of sDCI was extremely low.

  8. Diffusion-weighted imaging in the diagnosis of enterovirus 71 encephalitis

    International Nuclear Information System (INIS)

    Lian, Zhou-yang; Huang, Biao; Liang, Chang-hong; He, Shaoru; Guo, Yuxiong

    2012-01-01

    Background. In the early phase of viral encephalitis, conventional MRI may appear normal. Diffusion-weighted imaging (DWI) is a sensitive tool for detecting early changes in cellular function in the central nervous system. Purpose. To investigate the usefulness of DWI in the diagnosis of enterovirus 71 (EV71) encephalitis, and to determine whether DWI is superior to conventional MR sequences. Material and Methods. MRI scans in 26 patients were retrospectively evaluated for distribution of lesions on T1-weighted images (T1WI), T2-weighted images (T2WI), fluid-attenuated inversion recovery (FLAIR), and DWI. Contrast-to-noise ratios (CNRs) were calculated for all regions on each sequence and differences in the four MRI sequences were assessed using CNRs. Apparent diffusion coefficient (ADC) values were measured for all regions to look for true restriction of diffusion. Results. Fifteen out of 26 cases showed positive findings on MR imaging. The brain stem was involved in 11 patients, cortex and subcortical white matter in four patients. DWI was more sensitive in detecting the abnormalities (89.7%) compared to T2WI (48.7%), FLAIR (41.0%), and T1WI (35.9%), and the positive ratio of DWI was significantly higher compared to other sequences. Furthermore, no significant difference was found between T2WI and FLAIR (P 0.649). The corresponding mean CNRs were 8.73 ± 2.57, 83.59 ± 29.28, 24.22 ± 6.22, and 132.27 ± 78.32 on T1WI, T2WI, FLAIR, and DWI, respectively. The absolute values of CNRs of lesions on DWI were significantly greater than those on other sequences. Conclusion. DWI appears to be more sensitive in detecting EV71 encephalitis than conventional MRI sequences. This capability may improve the accuracy in diagnosing EV71 encephalitis, especially at the early stage

  9. Diffusion-weighted imaging in the diagnosis of enterovirus 71 encephalitis

    Energy Technology Data Exchange (ETDEWEB)

    Lian, Zhou-yang; Huang, Biao; Liang, Chang-hong (Department of Radiology, Guangdong General Hospital, Guangdong Academy of Medical Sciences, Guangzhou, Guangdong (China)), Email: cjr.huangbiao@vip.163.com; He, Shaoru; Guo, Yuxiong (Department of Pediatrics, Guangdong General Hospital, Guangdong Academy of Medical Sciences, Guangzhou, Guangdong (China))

    2012-03-15

    Background. In the early phase of viral encephalitis, conventional MRI may appear normal. Diffusion-weighted imaging (DWI) is a sensitive tool for detecting early changes in cellular function in the central nervous system. Purpose. To investigate the usefulness of DWI in the diagnosis of enterovirus 71 (EV71) encephalitis, and to determine whether DWI is superior to conventional MR sequences. Material and Methods. MRI scans in 26 patients were retrospectively evaluated for distribution of lesions on T1-weighted images (T1WI), T2-weighted images (T2WI), fluid-attenuated inversion recovery (FLAIR), and DWI. Contrast-to-noise ratios (CNRs) were calculated for all regions on each sequence and differences in the four MRI sequences were assessed using CNRs. Apparent diffusion coefficient (ADC) values were measured for all regions to look for true restriction of diffusion. Results. Fifteen out of 26 cases showed positive findings on MR imaging. The brain stem was involved in 11 patients, cortex and subcortical white matter in four patients. DWI was more sensitive in detecting the abnormalities (89.7%) compared to T2WI (48.7%), FLAIR (41.0%), and T1WI (35.9%), and the positive ratio of DWI was significantly higher compared to other sequences. Furthermore, no significant difference was found between T2WI and FLAIR (P 0.649). The corresponding mean CNRs were 8.73 +- 2.57, 83.59 +- 29.28, 24.22 +- 6.22, and 132.27 +- 78.32 on T1WI, T2WI, FLAIR, and DWI, respectively. The absolute values of CNRs of lesions on DWI were significantly greater than those on other sequences. Conclusion. DWI appears to be more sensitive in detecting EV71 encephalitis than conventional MRI sequences. This capability may improve the accuracy in diagnosing EV71 encephalitis, especially at the early stage

  10. Age-related findings on MRI in neurofibromatosis type 1

    Energy Technology Data Exchange (ETDEWEB)

    Gill, Deepak S. [Children' s Hospital at Westmead, The T. Y. Nelson Department of Neurology, Sydney, NSW (Australia); Hyman, Shelley L. [Children' s Hospital at Westmead, Neurogenetics Research Unit, Sydney (Australia); Steinberg, Adam [Children' s Hospital at Westmead, Department of Radiology, Sydney (Australia); North, Kathryn N. [Children' s Hospital at Westmead, The T. Y. Nelson Department of Neurology, Sydney, NSW (Australia); Children' s Hospital at Westmead, Neurogenetics Research Unit, Sydney (Australia)

    2006-10-15

    T2 hyperintensities (T2H) on MRI are the most common CNS lesions in individuals with neurofibromatosis type 1 (NF1). The aim was to determine the frequency, signal characteristics and localization of T2H at different ages. In addition, we examined the sensitivity of different MR imaging sequences in detecting these lesions. We studied prospectively a cohort of children, adolescents and young adults with NF1 using T2-volume (T2-V) and conventional MRI sequences. Lesions were designated as either discrete or diffuse, and the region of signal abnormality was recorded. A total of 103 patients were studied (age range 8.0-25.4 years, mean 13.9 years). The frequency, size, and intensity of T2H decreased with age in the basal ganglia (BG) and the cerebellum/brainstem (CB/BS). The majority of thalamic and CB/BS lesions were diffuse. Of the total cohort, 80% had diffuse bilateral hippocampal hyperintensities and 18.4% had hemispheric lesions best demonstrated on FLAIR; there was no significant difference in the frequency or signal intensity of hemispheric lesions with age. Lesions in the cerebral hemispheres and hippocampus imaged by MR do not change in prevalence over time, suggesting a different pathological basis from the lesions in the in BG and CB/BS that resolve with age. FLAIR and T2-V sequences are more sensitive in detecting lesions than standard T2-weighted sequences. (orig.)

  11. Age-related findings on MRI in neurofibromatosis type 1

    International Nuclear Information System (INIS)

    Gill, Deepak S.; Hyman, Shelley L.; Steinberg, Adam; North, Kathryn N.

    2006-01-01

    T2 hyperintensities (T2H) on MRI are the most common CNS lesions in individuals with neurofibromatosis type 1 (NF1). The aim was to determine the frequency, signal characteristics and localization of T2H at different ages. In addition, we examined the sensitivity of different MR imaging sequences in detecting these lesions. We studied prospectively a cohort of children, adolescents and young adults with NF1 using T2-volume (T2-V) and conventional MRI sequences. Lesions were designated as either discrete or diffuse, and the region of signal abnormality was recorded. A total of 103 patients were studied (age range 8.0-25.4 years, mean 13.9 years). The frequency, size, and intensity of T2H decreased with age in the basal ganglia (BG) and the cerebellum/brainstem (CB/BS). The majority of thalamic and CB/BS lesions were diffuse. Of the total cohort, 80% had diffuse bilateral hippocampal hyperintensities and 18.4% had hemispheric lesions best demonstrated on FLAIR; there was no significant difference in the frequency or signal intensity of hemispheric lesions with age. Lesions in the cerebral hemispheres and hippocampus imaged by MR do not change in prevalence over time, suggesting a different pathological basis from the lesions in the in BG and CB/BS that resolve with age. FLAIR and T2-V sequences are more sensitive in detecting lesions than standard T2-weighted sequences. (orig.)

  12. T1-weighted fluid-attenuated inversion recovery and T1-weighted fast spin-echo contrast-enhanced imaging: a comparison in 20 patients with brain lesions

    International Nuclear Information System (INIS)

    Al-Saeed, O.; Athyal, R. P.; Ismail, M.; Rudwan, M.; Khafajee, S.

    2009-01-01

    Full text: Tl-weighted fluid-attenuated inversion recovery (FLAIR) sequence is a relatively new pulse sequence for intracranial MR imaging. This study was performed to compare the image quality of Tl-weighted FLAIR with the Tl-weighted FSE sequence. Twenty patients with brain lesions underwent Tl-weighted fast spin-echo (FSE) and Tl-weighted FLAIR during the same imaging session. Four quantitative and three qualitative criteria were used to compare the two sequences after contrast. Two of four quantitative criteria pertained to lesion characteristics: lesion to white matter (WM) contrast-to-noise ratio (CNR) and lesion to cerebrospinal fluid (CSF) CNR, and two related to signals from normal tissue: grey matter to WM CNR and WM to CSF CNR. The three qualitative criteria were conspicuousness of the lesion, the presence of image artefacts and the overall image contrast. Both Tl-weighted FSE and FLAIR images were effective in demonstrating lesions. Image contrast was superior in Tl-weighted FLAIR images with significantly improved grey matter-WM CNRs and CSF-WM CNRs. The overall image contrast was judged to be superior on Tl-weighted FLAIR images compared with Tl-weighted FSE images by all neuroradiologists. Two of three reviewers considered that the FLAIR images had slightly increased imaging artefacts that, however, did not interfere with image interpretation. Tl-weighted FLAIR imaging provides improved lesion-to-background and grey to WM contrast-to-noise ratios. Superior conspicuity of lesions and overall image contrast is obtained in comparable acquisition times. These indicate an important role for Tl-weighted FLAIR in intracranial imaging and highlight its advantage over the more widely practiced Tl-weighted FSE sequence

  13. CT and MRI characteristica of tumours of the temporal bone and the cerebello-pontine angle

    International Nuclear Information System (INIS)

    Imhof, H.; Henk, C.B.; Dirisamer, A.; Czerny, C.; Gstoettner, W.

    2003-01-01

    Tumours lesions of the temporal bone and of the cerebello-pontine angle are rare.This tumours can be separated into benign and malignant lesions. In this paper the CT and MRI characteristica of tumours of the temporal bone and the cerebello-pontane angle will be demonstrated. High resolution CT (HRCT) as usually performed in the axial plane are using a high resolution bone window level setting, coronal planes are the reconstructed from the axial data set or will be obtained directly. With the MRI FLAIR sequence in the axial plane the whole brain will be scanned either to depict or exclude a tumour invasion into the brain. After this,T2-weighted fast spin echo sequences or fatsuppressed inversion recovery sequences in high resolution technique in the axial plane will be obtained from the temporal bone and axial T1-weighted spinecho sequences before and after the intravenous application of contrast material will be obtained of this region. Finally T1-weighted spinecho sequences in high resolution technique with fatsuppression after the intravenous application of contrast material will be performed in the coronal plane. HRCT and MRI are both used to depict the most exact tumorous borders. HRCT excellently depicts the osseous changes for example exostosis of the external auditory canal, while also with HRCT osseous changes maybe characterized into more benign or malignant types. MRI has a very high soft tissue contrast and may therefore either characterize vascular space-occupying lesions for example glomus jugulare tumours or may differentiate between more benign or malignant lesions. In conclusion HRCT and MRI of the temporal bone are excellent methods to depict and mostly characterize tumour lesions and can help to differentiate between benign and malignant lesion. These imaging methods shall be used complementary and may have a great impact for the therapeutic planning. (orig.) [de

  14. Detection of brain metastasis. Comparison of Turbo-FLAIR imaging, T2-weighted imaging and double-dose gadolinium-enhanced MR imaging

    International Nuclear Information System (INIS)

    Okubo, Toshiyuki; Hayashi, Naoto; Shirouzu, Ichiro; Abe, Osamu; Ohtomo, Kuni; Sasaki, Yasuhito; Aoki, Shigeki; Wada, Akihiko

    1998-01-01

    The purpose of this study was to compare Turbo-FLAIR imaging, T 2 -weighted imaging, and double-dose gadolinium-enhanced MR imaging in the detection of brain metastasis. Using the three sequences, 20 consecutive patients with brain metastases were prospectively studied with a 1.5-Tesla system. Three independent, blinded readers assessed the images for the presence, size, number, and location of metastatic lesions. In the detection of large lesions (>0.5 cm), Turbo-FLAIR imaging (38/48, 79%) was not significantly different from gadolinium-enhanced imaging (42/48, 88%) (p=0.273). T 2 -weighted imaging (31/48, 65%), however, was inferior to gadolinium-enhanced imaging (p<0.05). There was no difference between Turbo-FLAIR imaging and gadolinium-enhanced imaging in the accuracy of detecting solitary brain metastasis (4/4, 100%). In conclusion, Turbo-FLAIR imaging is a useful, noninvasive screening modality for brain metastasis. Its use may lead to cost savings in the diagnosis of brain metastases and may impact positively the cost-effectiveness of treatment. (author)

  15. A Comparison of Supervised Machine Learning Algorithms and Feature Vectors for MS Lesion Segmentation Using Multimodal Structural MRI

    Science.gov (United States)

    Sweeney, Elizabeth M.; Vogelstein, Joshua T.; Cuzzocreo, Jennifer L.; Calabresi, Peter A.; Reich, Daniel S.; Crainiceanu, Ciprian M.; Shinohara, Russell T.

    2014-01-01

    Machine learning is a popular method for mining and analyzing large collections of medical data. We focus on a particular problem from medical research, supervised multiple sclerosis (MS) lesion segmentation in structural magnetic resonance imaging (MRI). We examine the extent to which the choice of machine learning or classification algorithm and feature extraction function impacts the performance of lesion segmentation methods. As quantitative measures derived from structural MRI are important clinical tools for research into the pathophysiology and natural history of MS, the development of automated lesion segmentation methods is an active research field. Yet, little is known about what drives performance of these methods. We evaluate the performance of automated MS lesion segmentation methods, which consist of a supervised classification algorithm composed with a feature extraction function. These feature extraction functions act on the observed T1-weighted (T1-w), T2-weighted (T2-w) and fluid-attenuated inversion recovery (FLAIR) MRI voxel intensities. Each MRI study has a manual lesion segmentation that we use to train and validate the supervised classification algorithms. Our main finding is that the differences in predictive performance are due more to differences in the feature vectors, rather than the machine learning or classification algorithms. Features that incorporate information from neighboring voxels in the brain were found to increase performance substantially. For lesion segmentation, we conclude that it is better to use simple, interpretable, and fast algorithms, such as logistic regression, linear discriminant analysis, and quadratic discriminant analysis, and to develop the features to improve performance. PMID:24781953

  16. Temporal pole signal abnormality on MR imaging in temporal lobe epilepsy with hippocampal sclerosis: a fluid-attenuated inversion-recovery study Anormalidade de sinal na imagem por RM do pólo temporal na epilepsia do lobo temporal com esclerose hipocampal: um estudo pela seqüência inversão recuperação com supressão da água livre (FLAIR

    Directory of Open Access Journals (Sweden)

    Henrique Carrete Junior

    2007-09-01

    Full Text Available OBJECTIVE: To determine the frequency and regional involvement of temporal pole signal abnormality (TPA in patients with hippocampal sclerosis (HS using fluid-attenuated inversion-recovery (FLAIR MR imaging, and to correlate this feature with history. METHOD: Coronal FLAIR images of the temporal pole were assessed in 120 patients with HS and in 30 normal subjects, to evaluate gray-white matter demarcation. RESULTS: Ninety (75% of 120 patients had associated TPA. The HS side made difference regarding the presence of TPA, with a left side prevalence (p=0.04, chi2 test. The anteromedial zone of temporal pole was affected in 27 (30% out of 90 patients. In 63 (70% patients the lateral zone were also affected. Patients with TPA were younger at seizure onset (p=0.018, but without association with duration of epilepsy. CONCLUSION: Our FLAIR study show temporal pole signal abnormality in 3/4 of patients with HS, mainly seen on the anteromedial region, with a larger prevalence when the left hippocampus was involved.OBJETIVO: Determinar a freqüência e o envolvimento regional da anormalidade de sinal do pólo temporal (APT em pacientes com esclerose hipocampal (EH utilizando seqüência inversão recuperação com supressão da água (FLAIR por RM, e correlacioná-la com a história. MÉTODO: Foram analisadas as imagens coronais FLAIR dos pólos temporais de 120 pacientes com EH e de 30 indivíduos normais, para avaliar a demarcação entre substâncias branca e cinzenta. RESULTADOS: Noventa (75% dos 120 pacientes tinham APT associada. Houve prevalência do lado esquerdo (p=0.04, chi2 teste na relação entre APT e o lado da EH. A zona ântero-medial estava acometida em 27 (30% destes pacientes. Em 63 (70% pacientes também a zona lateral estava acometida. Pacientes com APT apresentaram início da epilepsia quando mais jovens (p=0.018, porém sem associação com a sua duração. CONCLUSÃO: A seqüência FLAIR mostra haver ATP em 3/4 dos pacientes com EH

  17. Automated detection of Lupus white matter lesions in MRI

    Directory of Open Access Journals (Sweden)

    Eloy Roura Perez

    2016-08-01

    Full Text Available Brain magnetic resonance imaging provides detailed information which can be used to detect and segment white matter lesions (WML. In this work we propose an approach to automatically segment WML in Lupus patients by using T1w and fluid-attenuated inversion recovery (FLAIR images. Lupus WML appear as small focal abnormal tissue observed as hyperintensities in the FLAIR images. The quantification of these WML is a key factor for the stratification of lupus patients and therefore both lesion detection and segmentation play an important role. In our approach, the T1w image is first used to classify the three main tissues of the brain, white matter (WM, gray matter (GM and cerebrospinal fluid (CSF, while the FLAIR image is then used to detect focal WML as outliers of its GM intensity distribution. A set of post-processing steps based on lesion size, tissue neighborhood, and location are used to refine the lesion candidates. The proposal is evaluated on 20 patients, presenting qualitative and quantitative results in terms of precision and sensitivity of lesion detection (True Positive Rate (62% and Positive Prediction Value (80% respectively as well as segmentation accuracy (Dice Similarity Coefficient (72%. Obtained results illustrate the validity of the approach to automatically detect and segment lupus lesions. Besides, our approach is publicly available as a SPM8/12 toolbox extension with a simple parameter configuration.

  18. SU-G-IeP1-07: Inaccuracy of Lesion Blood Flow Quantification Related to the Proton Density Reference Image in Arterial Spin Labeling MRI of Brain Tumors

    International Nuclear Information System (INIS)

    Jen, M; Johnson, J; Hou, P; Liu, H

    2016-01-01

    Purpose: Cerebral blood flow quantification in arterial spin labeling (ASL) MRI requires an estimate of the equilibrium magnetization of blood, which is often obtained by a set of proton density (PD) reference image. Normally, a constant blood-brain partition coefficient is assumed across the brain. However, this assumption may not be valid for brain lesions. This study aimed to evaluate the impact of lesion-related PD variations on ASL quantification in patients with brain tumors. Methods: MR images for posttreatment evaluation of 42 patients with brain tumors were retrospectively analyzed. These images were acquired on a 3T MRI scanner, including T2-weighted FLAIR, 3D pseudo-continuous ASL and post-contrast T1-weighted images. Anatomical images were coregistered with ASL images using the SPM software. Regions of interest (ROIs) of the enhancing and FLAIR lesions were manually drawn on the coregistered images. ROIs of the contralateral normal appearing tissues were also determined, with the consideration of approximating coil sensitivity patterns in lesion ROIs. Relative lesion blood flow (lesion/contralateral tissue) was calculated from both the CBF map (dependent on the PD) and the ΔM map for comparison. Results: The signal intensities in both enhancing and FLAIR lesions were significantly different than contralateral tissues on the PD reference image (p<0.001). The percent signal difference ranged from −15.9 to 19.2%, with a mean of 5.4% for the enhancing lesion, and from −2.8 to 22.9% with a mean of 10.1% for the FLAIR lesion. The high/low lesion-related PD signal resulted in inversely proportional under-/over-estimation of blood flow in both enhancing and FLAIR lesions. Conclusion: Significant signal differences were found between lesions and contralateral tissues in the PD reference image, which introduced errors in blood flow quantification in ASL. The error can be up to 20% in individual patients with an average of 5- 10% for the group of patients

  19. SU-G-IeP1-07: Inaccuracy of Lesion Blood Flow Quantification Related to the Proton Density Reference Image in Arterial Spin Labeling MRI of Brain Tumors

    Energy Technology Data Exchange (ETDEWEB)

    Jen, M; Johnson, J; Hou, P; Liu, H [UT MD Anderson Cancer Center, Houston, TX (United States)

    2016-06-15

    Purpose: Cerebral blood flow quantification in arterial spin labeling (ASL) MRI requires an estimate of the equilibrium magnetization of blood, which is often obtained by a set of proton density (PD) reference image. Normally, a constant blood-brain partition coefficient is assumed across the brain. However, this assumption may not be valid for brain lesions. This study aimed to evaluate the impact of lesion-related PD variations on ASL quantification in patients with brain tumors. Methods: MR images for posttreatment evaluation of 42 patients with brain tumors were retrospectively analyzed. These images were acquired on a 3T MRI scanner, including T2-weighted FLAIR, 3D pseudo-continuous ASL and post-contrast T1-weighted images. Anatomical images were coregistered with ASL images using the SPM software. Regions of interest (ROIs) of the enhancing and FLAIR lesions were manually drawn on the coregistered images. ROIs of the contralateral normal appearing tissues were also determined, with the consideration of approximating coil sensitivity patterns in lesion ROIs. Relative lesion blood flow (lesion/contralateral tissue) was calculated from both the CBF map (dependent on the PD) and the ΔM map for comparison. Results: The signal intensities in both enhancing and FLAIR lesions were significantly different than contralateral tissues on the PD reference image (p<0.001). The percent signal difference ranged from −15.9 to 19.2%, with a mean of 5.4% for the enhancing lesion, and from −2.8 to 22.9% with a mean of 10.1% for the FLAIR lesion. The high/low lesion-related PD signal resulted in inversely proportional under-/over-estimation of blood flow in both enhancing and FLAIR lesions. Conclusion: Significant signal differences were found between lesions and contralateral tissues in the PD reference image, which introduced errors in blood flow quantification in ASL. The error can be up to 20% in individual patients with an average of 5- 10% for the group of patients

  20. Neuroradiological study of cerebral microlesions (2). Changes in elderly

    International Nuclear Information System (INIS)

    Qu, Hong; Nishimaru, Katsuya; Utsunomiya, Hidetsuna; Une, Hiroshi

    2003-01-01

    Some of the cerebral microlesions less than 3 mm in diameter observed on magnetic resonance imaging (MRI) are considered to represent pathological processes. The present study investigated changes due to aging in microlesions according to anatomical regions and phenotypes. A total of 390 cases without localized lesions other than lacune less than 15 mm in diameter were studied. Microlesion type on MRI was categorized into hypo-, iso-, and hyper-intensities on T1-weighted (T1WI), T2-weighted (T2WI), and proton-weighted or fluid-attenuated inversion recovery (proton/FLAIR) images. Correlations between unidentified bright objects (UBO) in white matter and vascular risk factors were analyzed using logistic regression analysis. Microlesions of the upper basal ganglia showing low intensity on T1WI, high intensity on T2WI and iso intensity on proton/FLAIR, and showing low intensity on T1WI, high intensity on T2WI and low intensity on proton/FLAIR increased with age, whereas those showing low intensity on T1WI, iso intensity on T2WI, and low intensity on proton/FLAIR of the upper basal ganglia decreased. In subcortical white matter, microlesions of the first two types: and those showing iso intensity on T1WI, high intensity on T2WI and iso intensity on proton/FLAIR decreased with age. Conversely, UBO increased with age, and significantly correlated with hypertension. Although microlesions in the upper basal ganglia increase with age, those in the subcortical white matter decrease with age. These observations suggest pathological changes surrounding small arteries with aging in the brain. (author)

  1. A prospective comparison study of fast T1 weighted fluid attenuation inversion recovery and T1 weighted turbo spin echo sequence at 3 T in degenerative disease of the cervical spine.

    Science.gov (United States)

    Ganesan, K; Bydder, G M

    2014-09-01

    This study compared T1 fluid attenuation inversion recovery (FLAIR) and T1 turbo spin echo (TSE) sequences for evaluation of cervical spine degenerative disease at 3 T. 72 patients (44 males and 28 females; mean age of 39 years; age range, 27-75 years) with suspected cervical spine degenerative disease were prospectively evaluated. Sagittal images of the spine were obtained using T1 FLAIR and T1 TSE sequences. Two experienced neuroradiologists compared the sequences qualitatively and quantitatively. On qualitative evaluation, cerebrospinal fluid (CSF) nulling and contrast at cord-CSF, disc-CSF and disc-cord interfaces were significantly higher on fast T1 FLAIR images than on T1 TSE images (p degenerative disease, owing to higher cord-CSF, disc-cord and disc-CSF contrast. However, intrinsic cord contrast is low on T1 FLAIR images. T1 FLAIR is more promising and sensitive than T1 TSE for evaluation of degenerative spondyloarthropathy and may provide a foundation for development of MR protocols for early detection of degenerative and neoplastic diseases.

  2. Non-arteritic anterior ischaemic optic neuropathy: evaluation of the brain and optic pathway by conventional MRI and magnetisation transfer imaging

    Energy Technology Data Exchange (ETDEWEB)

    Argyropoulou, Maria I.; Zikou, Anastasia K.; Tzovara, Ioanna; Margariti, Persefoni [University of Ioannina, Department of Radiology, Medical School, Ioannina (Greece); Nikas, Alexios; Asproudis, Ioannis [University of Ioannina, Ophthalmologic Clinic, Medical School, Ioannina (Greece); Blekas, Kostandinos; Galatsanos, Nikolaos [University of Ioannina, Department of Informatics, Ioannina (Greece)

    2007-07-15

    The purpose of the study was to examine the brain and the visual pathway of patients with non-arteritic anterior ischaemic optic neuropathy (NAION) by using conventional MRI (cMRI) and volumetric magnetisation transfer imaging (MTI). Thirty NAION patients, aged 67.5 {+-} 8.14 years, and 28 age- and gender-matched controls were studied. MTI was used to measure the magnetisation transfer ratio (MTR) of the chiasm and for MTR histograms of the brain. The presence of areas of white matter hyperintensity (WMH) was evaluated on fluid-attenuated inversion recovery (FLAIR) images. Area of the optic nerves (ONs) and volume of the chiasm were assessed, as were coronal short-tau inversion recovery (STIR) and MTI images, respectively. More areas of WMH were observed in patients (total 419; mean 14.4; SD 19) than in controls (total 127; mean 4.7; SD 5.7), P < 0.001. Area (in square millimetres) of the affected ONs, volume(in cubic millimetres) and MTR (in percent) of the chiasm (10.7 {+-} 4.6), (75.8 {+-} 20.2), (56.4 {+-} 6.5), respectively, were lower in patients than in controls (13.6 {+-} 4.3), (158.2 {+-} 75.3) (62.1 {+-} 6.2), respectively, P < 0.05. Mean MTR of brain histograms was lower in patients (53.0 {+-} 8.0) than in controls (58.0 {+-} 5.6), P < 0.05. NAION is characterised by decreased ON and chiasmatic size. The low MTR of the chiasm and brain associated with increased areas of WMH may be suggestive of demyelination and axonal damage due to generalised cerebral vascular disease. (orig.)

  3. MRI for transformation of preserved organs and their pathologies into digital formats for medical education and creation of a virtual pathology museum. A pilot study

    International Nuclear Information System (INIS)

    Venkatesh, S.K.; Wang, G.; Seet, J.E.; Teo, L.L.S.; Chong, V.F.H.

    2013-01-01

    Aim: To evaluate the feasibility of magnetic resonance imaging (MRI) for the transformation of preserved organs and their disease entities into digital formats for medical education and creation of a virtual museum. Materials and methods: MRI of selected 114 pathology specimen jars representing different organs and their diseases was performed using a 3 T MRI machine with two or more MRI sequences including three-dimensional (3D) T1-weighted (T1W), 3D-T2W, 3D-FLAIR (fluid attenuated inversion recovery), fat–water separation (DIXON), and gradient-recalled echo (GRE) sequences. Qualitative assessment of MRI for depiction of disease and internal anatomy was performed. Volume rendering was performed on commercially available workstations. The digital images, 3D models, and photographs of specimens were archived into a workstation serving as a virtual pathology museum. Results: MRI was successfully performed on all specimens. The 3D-T1W and 3D-T2W sequences demonstrated the best contrast between normal and pathological tissues. The digital material is a useful aid for understanding disease by giving insights into internal structural changes not apparent on visual inspection alone. Volume rendering produced vivid 3D models with better contrast between normal tissue and diseased tissue compared to real specimens or their photographs in some cases. The digital library provides good illustration material for radiological–pathological correlation by enhancing pathological anatomy and information on nature and signal characteristics of tissues. In some specimens, the MRI appearance may be different from corresponding organ and disease in vivo due to dead tissue and changes induced by prolonged contact with preservative fluid. Conclusions: MRI of pathology specimens is feasible and provides excellent images for education and creating a virtual pathology museum that can serve as permanent record of digital material for self-directed learning, improving teaching aids, and

  4. Three-dimensional fluid-attenuated inversion recovery sequence for visualisation of subthalamic nucleus for deep brain stimulation in Parkinson's disease

    Energy Technology Data Exchange (ETDEWEB)

    Heo, Young Jin [University of Ulsan College of Medicine, Asan Medical Center, Department of Radiology, Research Institute of Radiology, Seoul (Korea, Republic of); Inje University, Department of Radiology, Busan Paik Hospital, Busan (Korea, Republic of); Kim, Sang Joon; Kim, Ho Sung; Choi, Choong Gon; Jung, Seung Chai [University of Ulsan College of Medicine, Asan Medical Center, Department of Radiology, Research Institute of Radiology, Seoul (Korea, Republic of); Lee, Jung Kyo [University of Ulsan College of Medicine, Asan Medical Center, Department of Neurosurgery, Seoul (Korea, Republic of); Lee, Chong Sik; Chung, Sun J. [University of Ulsan College of Medicine, Asan Medical Center, Department of Neurology, Seoul (Korea, Republic of); Cho, So Hyun [Department of Radiology, Busan (Korea, Republic of); Lee, Gyoung Ro [Philips HealthCare Korea, Seoul (Korea, Republic of)

    2015-09-15

    Deep brain stimulation (DBS) of the subthalamic nucleus (STN) is an accepted treatment for advanced Parkinson's disease (PD). However, targeting the STN is difficult due to its relatively small size and variable location. The purpose of this study was to assess which of the following sequences obtained with the 3.0 T MR system can accurately delineate the STN: coronal 3D fluid-attenuated inversion recovery (FLAIR), 2D T2*-weighted fast-field echo (T2*-FFE) and 2D T2-weighted turbo spin-echo (TSE) sequences. We included 20 consecutive patients with PD who underwent 3.0 T MR for DBS targeting. 3D FLAIR, 2D T2*-FFE and T2-TSE images were obtained for all study patients. Image quality and demarcation of the STN were analysed using 4-point scales, and contrast ratio (CR) of the STN and normal white matter was calculated. The Friedman test was used to compare the three sequences. In qualitative analysis, the 2D T2*-FFE image showed more artefacts than 3D FLAIR or 2D T2-TSE, but the difference did not reach statistical significance. 3D FLAIR images showed significantly superior demarcation of the STN compared with 2D T2*-FFE and T2-TSE images (P < 0.001, respectively). The CR of 3D FLAIR was significantly higher than that of 2D T2*-FFE or T2-TSE images in multiple comparison correction (P < 0.001), but there was no significant difference in the CR between 2D T2*-FFE and T2-TSE images. Coronal 3D FLAIR images showed the most accurate demarcation of the STN for DBS targeting among coronal 3D FLAIR, 2D T2*-FFE and T2-TSE images. (orig.)

  5. Three-dimensional fluid-attenuated inversion recovery sequence for visualisation of subthalamic nucleus for deep brain stimulation in Parkinson's disease

    International Nuclear Information System (INIS)

    Heo, Young Jin; Kim, Sang Joon; Kim, Ho Sung; Choi, Choong Gon; Jung, Seung Chai; Lee, Jung Kyo; Lee, Chong Sik; Chung, Sun J.; Cho, So Hyun; Lee, Gyoung Ro

    2015-01-01

    Deep brain stimulation (DBS) of the subthalamic nucleus (STN) is an accepted treatment for advanced Parkinson's disease (PD). However, targeting the STN is difficult due to its relatively small size and variable location. The purpose of this study was to assess which of the following sequences obtained with the 3.0 T MR system can accurately delineate the STN: coronal 3D fluid-attenuated inversion recovery (FLAIR), 2D T2*-weighted fast-field echo (T2*-FFE) and 2D T2-weighted turbo spin-echo (TSE) sequences. We included 20 consecutive patients with PD who underwent 3.0 T MR for DBS targeting. 3D FLAIR, 2D T2*-FFE and T2-TSE images were obtained for all study patients. Image quality and demarcation of the STN were analysed using 4-point scales, and contrast ratio (CR) of the STN and normal white matter was calculated. The Friedman test was used to compare the three sequences. In qualitative analysis, the 2D T2*-FFE image showed more artefacts than 3D FLAIR or 2D T2-TSE, but the difference did not reach statistical significance. 3D FLAIR images showed significantly superior demarcation of the STN compared with 2D T2*-FFE and T2-TSE images (P < 0.001, respectively). The CR of 3D FLAIR was significantly higher than that of 2D T2*-FFE or T2-TSE images in multiple comparison correction (P < 0.001), but there was no significant difference in the CR between 2D T2*-FFE and T2-TSE images. Coronal 3D FLAIR images showed the most accurate demarcation of the STN for DBS targeting among coronal 3D FLAIR, 2D T2*-FFE and T2-TSE images. (orig.)

  6. Tissue Border Enhancement by inversion recovery MRI at 7.0 Tesla

    International Nuclear Information System (INIS)

    Costagli, Mauro; Tiberi, Gianluigi; Kelley, Douglas A.C.; Symms, Mark R.; Biagi, Laura; Tosetti, Michela; Stara, Riccardo; Cosottini, Mirco; Maggioni, Eleonora; Barba, Carmen; Guerrini, Renzo

    2014-01-01

    This contribution presents a magnetic resonance imaging (MRI) acquisition technique named Tissue Border Enhancement (TBE), whose purpose is to produce images with enhanced visualization of borders between two tissues of interest without any post-processing. The technique is based on an inversion recovery sequence that employs an appropriate inversion time to produce images where the interface between two tissues of interest is hypo-intense; therefore, tissue borders are clearly represented by dark lines. This effect is achieved by setting imaging parameters such that two neighboring tissues of interest have magnetization with equal magnitude but opposite sign; therefore, the voxels containing a mixture of each tissue (that is, the tissue interface) possess minimal net signal. The technique was implemented on a 7.0 T MRI system. This approach can assist the definition of tissue borders, such as that between cortical gray matter and white matter; therefore, it could facilitate segmentation procedures, which are often challenging on ultra-high-field systems due to inhomogeneous radiofrequency distribution. TBE allows delineating the contours of structural abnormalities, and its capabilities were demonstrated with patients with focal cortical dysplasia, gray matter heterotopia, and polymicrogyria. This technique provides a new type of image contrast and has several possible applications in basic neuroscience, neurogenetic research, and clinical practice, as it could improve the detection power of MRI in the characterization of cortical malformations, enhance the contour of small anatomical structures of interest, and facilitate cortical segmentation. (orig.)

  7. Tissue Border Enhancement by inversion recovery MRI at 7.0 Tesla

    Energy Technology Data Exchange (ETDEWEB)

    Costagli, Mauro; Tiberi, Gianluigi [Imago7 Foundation, Pisa (Italy); IRCCS Stella Maris, Pisa (Italy); Kelley, Douglas A.C. [GE Healthcare Technologies, San Francisco, CA (United States); Symms, Mark R. [GE Applied Science Laboratory, Pisa (Italy); Biagi, Laura; Tosetti, Michela [IRCCS Stella Maris, Pisa (Italy); Stara, Riccardo; Cosottini, Mirco [Imago7 Foundation, Pisa (Italy); University of Pisa, Pisa (Italy); Maggioni, Eleonora [IRCCS Scientific Institute E. Medea, Bosisio Parini, Lecco (Italy); Politecnico di Milano, Milan (Italy); Barba, Carmen [Children' s Hospital A. Meyer - University of Florence, Neuroscience Department, Florence (Italy); Guerrini, Renzo [IRCCS Stella Maris, Pisa (Italy); Children' s Hospital A. Meyer - University of Florence, Neuroscience Department, Florence (Italy)

    2014-07-15

    This contribution presents a magnetic resonance imaging (MRI) acquisition technique named Tissue Border Enhancement (TBE), whose purpose is to produce images with enhanced visualization of borders between two tissues of interest without any post-processing. The technique is based on an inversion recovery sequence that employs an appropriate inversion time to produce images where the interface between two tissues of interest is hypo-intense; therefore, tissue borders are clearly represented by dark lines. This effect is achieved by setting imaging parameters such that two neighboring tissues of interest have magnetization with equal magnitude but opposite sign; therefore, the voxels containing a mixture of each tissue (that is, the tissue interface) possess minimal net signal. The technique was implemented on a 7.0 T MRI system. This approach can assist the definition of tissue borders, such as that between cortical gray matter and white matter; therefore, it could facilitate segmentation procedures, which are often challenging on ultra-high-field systems due to inhomogeneous radiofrequency distribution. TBE allows delineating the contours of structural abnormalities, and its capabilities were demonstrated with patients with focal cortical dysplasia, gray matter heterotopia, and polymicrogyria. This technique provides a new type of image contrast and has several possible applications in basic neuroscience, neurogenetic research, and clinical practice, as it could improve the detection power of MRI in the characterization of cortical malformations, enhance the contour of small anatomical structures of interest, and facilitate cortical segmentation. (orig.)

  8. Case report of a young stroke patient showing interim normalization of the MRI diffusion-weighted imaging lesion

    International Nuclear Information System (INIS)

    Ostwaldt, Ann-Christin; Usnich, Tatiana; Nolte, Christian H.; Villringer, Kersten; Fiebach, Jochen B.

    2015-01-01

    In acute ischemic stroke, diffusion weighted imaging (DWI) shows hyperintensities and is considered to indicate irreversibly damaged tissue. We present the case of a young stroke patient with unusual variability in the development of signal intensities within the same vessel territory. A 35-year-old patient presented with symptoms of global aphasia and hypesthesia of the left hand. MRI demonstrated a scattered lesion in the MCA territory. After rtPA therapy the patient received further MRI examination, three times on day 1, and once on day 2, 3, 5 and 43. The posterior part of the lesion showed the usual pattern with increasing DWI hyperintensity and decreased ADC, as well as delayed FLAIR positivity. However, the anterior part of the lesion, which was clearly visible in the first examination completely normalized on the first day and only reappeared on day 2. This was accompanied by a normalization of the ADC as well as an even further delayed FLAIR positivity. We showed that interim normalization of DWI and ADC in the acute phase can not only be found in rodent models of stroke, but also in humans. We propose that DWI lesion development might be more variable during the first 24 h after stroke than previously assumed

  9. Diffusion- and perfusion-weighted MRI in a patient with a prolonged reversible ischaemic neurological deficit

    International Nuclear Information System (INIS)

    Neumann-Haefelin, T.; Wittsack, H.J.; Wenserski, F.; Li, T.Q.; Moseley, M.E.; Siebler, M.; Freund, H.J.

    2000-01-01

    We report acute and follow-up diffusion- and perfusion-weighted MRI (DWI, PWI) findings in a patient with a prolonged reversible ischaemic neurological deficit. PWI 12 h after the patient was last seen to be without symptoms revealed a large perfusion deficit in the left posterior MCA territory with a relatively inconspicuous and much smaller abnormality on DWI. Follow-up showed resolution of abnormalities on both DWI and PWI, and conventional MRI was normal, apart from a very slight abnormality, visible only on FLAIR images, at the centre of the initially DWI-positive region. These findings demonstrate the utility of PWI when be used in combination with DWI to investigate the pathophysiology of transient ischemic syndromes. (orig.)

  10. Temporal pole signal abnormality on MR imaging in temporal lobe epilepsy with hippocampal sclerosis: a fluid-attenuated inversion-recovery study.

    Science.gov (United States)

    Carrete, Henrique; Abdala, Nitamar; Lin, Kátia; Caboclo, Luís Otávio; Centeno, Ricardo Silva; Sakamoto, Américo Ceiki; Szjenfeld, Jacob; Nogueira, Roberto Gomes; Yacubian, Elza Márcia Targas

    2007-09-01

    To determine the frequency and regional involvement of temporal pole signal abnormality (TPA) in patients with hippocampal sclerosis (HS) using fluid-attenuated inversion-recovery (FLAIR) MR imaging, and to correlate this feature with history. Coronal FLAIR images of the temporal pole were assessed in 120 patients with HS and in 30 normal subjects, to evaluate gray-white matter demarcation. Ninety (75%) of 120 patients had associated TPA. The HS side made difference regarding the presence of TPA, with a left side prevalence (p=0.04, chi2 test). The anteromedial zone of temporal pole was affected in 27 (30%) out of 90 patients. In 63 (70%) patients the lateral zone were also affected. Patients with TPA were younger at seizure onset (p=0.018), but without association with duration of epilepsy. Our FLAIR study show temporal pole signal abnormality in 3/4 of patients with HS, mainly seen on the anteromedial region, with a larger prevalence when the left hippocampus was involved.

  11. Temporal pole signal abnormality on MR imaging in temporal lobe epilepsy with hippocampal sclerosis: a fluid-attenuated inversion-recovery study

    International Nuclear Information System (INIS)

    Carrete Junior, Henrique; Abdala, Nitamar; Szjenfeld, Jacob; Nogueira, Roberto Gomes; Lin, Katia; Caboclo, Luis Otavio; Centeno, Ricardo Silva; Sakamoto, Americo Ceiki; Yacubian, Elza Marcia Targas

    2007-01-01

    Objective: To determine the frequency and regional involvement of temporal pole signal abnormality (TPA) in patients with hippocampal sclerosis (HS) using fluid-attenuated inversion-recovery (FLAIR) MR imaging, and to correlate this feature with history. Method: Coronal FLAIR images of the temporal pole were assessed in 120 patients with HS and in 30 normal subjects, to evaluate gray-white matter demarcation. Results: Ninety (75%) of 120 patients had associated TPA. The HS side made difference regarding the presence of TPA, with a left side prevalence (p=0.04, χ 2 test). The anteromedial zone of temporal pole was affected in 27 (30%) out of 90 patients. In 63 (70%) patients the lateral zone were also affected. Patients with TPA were younger at seizure onset (p=0.018), but without association with duration of epilepsy. Conclusion: Our FLAIR study show temporal pole signal abnormality in 3/4 of patients with HS, mainly seen on the anteromedial region, with a larger prevalence when the left hippocampus was involved. (author)

  12. Flair: A powerful but user friendly graphical interface for FLUKA

    International Nuclear Information System (INIS)

    Vlachoudis, V.

    2009-01-01

    FLAIR is an advanced user graphical interface for FLUKA, to enable the user to start and control FLUKA jobs completely from a GUI environment without the need for command-line interactions. It is written entirely with python and Tkinter allowing easier portability across various operating systems and great programming flexibility with focus to be used as an Application Programming Interface (API) for FLUKA. FLAIR is an integrated development environment (IDE) for FLUKA, it does not only provide means for the post processing of the output but a big emphasis has been set on the creation and checking of error free input files. It contains a fully featured editor for editing the input files in a human readable way with syntax highlighting, without hiding the inner functionality of FLUKA from the users. It provides also means for building the executable, debugging the geometry, running the code, monitoring the status of one or many runs, inspection of the output files, post processing of the binary files (data merging) and interface to plotting utilities like gnuplot and PovRay for high quality plots or photo-realistic images. The program includes also a database of selected properties of all known nuclides and their known isotopic composition as well a reference database of ∼ 300 predefined materials together with their Sterheimer parameters. (authors)

  13. Seven-Tesla Magnetization Transfer Imaging to Detect Multiple Sclerosis White Matter Lesions.

    Science.gov (United States)

    Chou, I-Jun; Lim, Su-Yin; Tanasescu, Radu; Al-Radaideh, Ali; Mougin, Olivier E; Tench, Christopher R; Whitehouse, William P; Gowland, Penny A; Constantinescu, Cris S

    2018-03-01

    Fluid-attenuated inversion recovery (FLAIR) imaging at 3 Tesla (T) field strength is the most sensitive modality for detecting white matter lesions in multiple sclerosis. While 7T FLAIR is effective in detecting cortical lesions, it has not been fully optimized for visualization of white matter lesions and thus has not been used for delineating lesions in quantitative magnetic resonance imaging (MRI) studies of the normal appearing white matter in multiple sclerosis. Therefore, we aimed to evaluate the sensitivity of 7T magnetization-transfer-weighted (MT w ) images in the detection of white matter lesions compared with 3T-FLAIR. Fifteen patients with clinically isolated syndrome, 6 with multiple sclerosis, and 10 healthy participants were scanned with 7T 3-dimensional (D) MT w and 3T-2D-FLAIR sequences on the same day. White matter lesions visible on either sequence were delineated. Of 662 lesions identified on 3T-2D-FLAIR images, 652 were detected on 7T-3D-MT w images (sensitivity, 98%; 95% confidence interval, 97% to 99%). The Spearman correlation coefficient between lesion loads estimated by the two sequences was .910. The intrarater and interrater reliability for 7T-3D-MT w images was good with an intraclass correlation coefficient (ICC) of 98.4% and 81.8%, which is similar to that for 3T-2D-FLAIR images (ICC 96.1% and 96.7%). Seven-Tesla MT w sequences detected most of the white matter lesions identified by FLAIR at 3T. This suggests that 7T-MT w imaging is a robust alternative for detecting demyelinating lesions in addition to 3T-FLAIR. Future studies need to compare the roles of optimized 7T-FLAIR and of 7T-MT w imaging. © 2017 The Authors. Journal of Neuroimaging published by Wiley Periodicals, Inc. on behalf of American Society of Neuroimaging.

  14. Magnetic resonance imaging in 120 patients with intractable partial seizures: a preoperative assessment

    Energy Technology Data Exchange (ETDEWEB)

    Lefkopoulos, A.; Haritanti, A.; Papadopoulou, E.; Karanikolas, D.; Fotiadis, N.; Dimitriadis, A.S. [AHEPA University Hospital, Department of Radiology, Thessaloniki (Greece)

    2005-05-01

    The aim of this study was to describe magnetic resonance imaging (MRI) findings in patients with medically intractable epilepsy and to compare different magnetic resonance (MR) sequences in order to establish a dedicated and shorter scan time imaging protocol of choice. One hundred and twenty patients with seizures that were refractory to medical treatment were assessed by MRI with spin-echo (SE) T1, fast spin-echo (FSE) T2, fluid-attenuated inversion recovery (FLAIR), inversion recovery (IR) and contrast-enhanced T1 SE sequences. Pathological scans were acquired in 78 patients. Hippocampal sclerosis was detected in 30 patients (25%), cerebral, tumoral, mass lesions in 12 patients (10%), vascular malformations in nine patients (7.5%), cortical infarcts in eight patients (6.7%), cerebral infections in four patients (4.2%) and developmental disorders in 15 patients (12.5%). The most common location of the lesions was the temporal lobe (60%). Coronal, thin (slice thickness 4-5 mm) images have proven to be the most useful in the assessment of the hippocampus. FLAIR and IR are particularly useful in the detection of lesions abutting cerebrospinal fluid (CSF) spaces and developmental disorders, respectively, while T1 SE sequences before and after the intravenous administration of gadolinium offer great facility in identifying space-occupying lesions and infections. MRI is the most important diagnostic tool for the assessment of epileptogenic foci, thus playing the primary role in indicating the type of treatment to be applied. (orig.)

  15. Magnetic resonance imaging in 120 patients with intractable partial seizures: a preoperative assessment

    International Nuclear Information System (INIS)

    Lefkopoulos, A.; Haritanti, A.; Papadopoulou, E.; Karanikolas, D.; Fotiadis, N.; Dimitriadis, A.S.

    2005-01-01

    The aim of this study was to describe magnetic resonance imaging (MRI) findings in patients with medically intractable epilepsy and to compare different magnetic resonance (MR) sequences in order to establish a dedicated and shorter scan time imaging protocol of choice. One hundred and twenty patients with seizures that were refractory to medical treatment were assessed by MRI with spin-echo (SE) T1, fast spin-echo (FSE) T2, fluid-attenuated inversion recovery (FLAIR), inversion recovery (IR) and contrast-enhanced T1 SE sequences. Pathological scans were acquired in 78 patients. Hippocampal sclerosis was detected in 30 patients (25%), cerebral, tumoral, mass lesions in 12 patients (10%), vascular malformations in nine patients (7.5%), cortical infarcts in eight patients (6.7%), cerebral infections in four patients (4.2%) and developmental disorders in 15 patients (12.5%). The most common location of the lesions was the temporal lobe (60%). Coronal, thin (slice thickness 4-5 mm) images have proven to be the most useful in the assessment of the hippocampus. FLAIR and IR are particularly useful in the detection of lesions abutting cerebrospinal fluid (CSF) spaces and developmental disorders, respectively, while T1 SE sequences before and after the intravenous administration of gadolinium offer great facility in identifying space-occupying lesions and infections. MRI is the most important diagnostic tool for the assessment of epileptogenic foci, thus playing the primary role in indicating the type of treatment to be applied. (orig.)

  16. MRI findings and diagnosis of brain echinococcus

    International Nuclear Information System (INIS)

    Miriguli Shayiti; Jia Wenxiao

    2010-01-01

    Objective: To study the characteristic findings of brain echinococcosis on MRI. Methods: The MRI findings of 18 patients with pathologically confirmed brain echinococcosis were retrospectively reviewed. Results: Among the patients, there were 9 cases of cystic echinococcosis and 9 cases of alveolar echinococcosis. In cystic echinococcosis, MRI revealed homogeneously hypointensity on T 1 WI and hyperintensity on T 2 WI, while it showed low signal intensity inside the cysts on FLAIR and DWI. In 6 cases of cystic echinococcosis, no edema was detected surrounding the lesions, while edema resulting from cyst rupture was found in 3 cases. The cystic walls were visible in 6 cases, obscure in 3 cases. The ruptured hydatid cysts in 3 cases showed slight ring enhancement. Alveolar echinococcosis appeared as multiple lesions with isointensity on T 1 WI and hypointensity on T 2 WI, surrounded by vasogenic edema. The 'charcoal-like' hypointensity and innumerous hyperintense bubbles of 1-10 mm in diameter inside the lesions on T 2 -weighted MR images were characteristic for lesions of alveolar echinococcosis. The lesions revealed hypointensity on DWI and showed irregular ring enhancement after injection of Gd-DTPA. Perfusion-weighted MR imaging revealed low relative cerebral blood volume. Conclusion: MRI can demonstrate lesions of brain echinococcosis accurately due to its advantages of multiorientation and multiparameter. It is clinically valuable. (authors)

  17. Image quality at synthetic brain magnetic resonance imaging in children

    Energy Technology Data Exchange (ETDEWEB)

    Lee, So Mi; Cho, Seung Hyun; Kim, Won Hwa; Kim, Hye Jung [Kyungpook National University Hospital, Department of Radiology, Daegu (Korea, Republic of); Choi, Young Hun; Cheon, Jung-Eun; Kim, In-One [Seoul National University College of Medicine, Department of Radiology and Institute of Radiation Medicine, Seoul (Korea, Republic of); Cho, Hyun-Hae [Ewha Womans University Mokdong Hospital, Department of Radiology, Seoul (Korea, Republic of); You, Sun-Kyoung [Chungnam National University Hospital, Department of Radiology, Daejeon (Korea, Republic of); Park, Sook-Hyun [Kyungpook National University Hospital, Department of Pediatrics, Daegu (Korea, Republic of); Hwang, Moon Jung [GE Healthcare, MR Applications and Workflow, Seoul (Korea, Republic of)

    2017-11-15

    The clinical application of the multi-echo, multi-delay technique of synthetic magnetic resonance imaging (MRI) generates multiple sequences in a single acquisition but has mainly been used in adults. To evaluate the image quality of synthetic brain MR in children compared with that of conventional images. Twenty-nine children (median age: 6 years, range: 0-16 years) underwent synthetic and conventional imaging. Synthetic (T2-weighted, T1-weighted and fluid-attenuated inversion recovery [FLAIR]) images with settings matching those of the conventional images were generated. The overall image quality, gray/white matter differentiation, lesion conspicuity and image degradations were rated on a 5-point scale. The relative contrasts were assessed quantitatively and acquisition times for the two imaging techniques were compared. Synthetic images were inferior due to more pronounced image degradations; however, there were no significant differences for T1- and T2-weighted images in children <2 years old. The quality of T1- and T2-weighted images were within the diagnostically acceptable range. FLAIR images showed greatly reduced quality. Gray/white matter differentiation was comparable or better in synthetic T1- and T2-weighted images, but poorer in FLAIR images. There was no effect on lesion conspicuity. Synthetic images had equal or greater relative contrast. Acquisition time was approximately two-thirds of that for conventional sequences. Synthetic T1- and T2-weighted images were diagnostically acceptable, but synthetic FLAIR images were not. Lesion conspicuity and gray/white matter differentiation were comparable to conventional MRI. (orig.)

  18. Characterization and optimization of the visualization performance of continuous flow overhauser DNP hyperpolarized water MRI: Inversion recovery approach.

    Science.gov (United States)

    Terekhov, Maxim; Krummenacker, Jan; Denysenkov, Vasyl; Gerz, Kathrin; Prisner, Thomas; Schreiber, Laura Maria

    2016-03-01

    Overhauser dynamic nuclear polarization (DNP) allows the production of liquid hyperpolarized substrate inside the MRI magnet bore as well as its administration in continuous flow mode to acquire MR images with enhanced signal-to-noise ratio. We implemented inversion recovery preparation in order to improve contrast-to-noise ratio and to quantify the overall imaging performance of Overhauser DNP-enhanced MRI. The negative enhancement created by DNP in combination with inversion recovery (IR) preparation allows canceling selectively the signal originated from Boltzmann magnetization and visualizing only hyperpolarized fluid. The theoretical model describing gain of MR image intensity produced by steady-state continuous flow DNP hyperpolarized magnetization was established and proved experimentally. A precise quantification of signal originated purely from DNP hyperpolarization was achieved. A temperature effect on longitudinal relaxation had to be taken into account to fit experimental results with numerical prediction. Using properly adjusted IR preparation, the complete zeroing of thermal background magnetization was achieved, providing an essential increase of contrast-to-noise ratio of DNP-hyperpolarized water images. To quantify and optimize the steady-state conditions for MRI with continuous flow DNP, an approach similar to that incorporating transient-state thermal magnetization equilibrium in spoiled fast field echo imaging sequences can be used. © 2015 Wiley Periodicals, Inc.

  19. Rationality, Intuition and Flair in Entrepreneur’s Configuration - an Epistemological Approach

    OpenAIRE

    Zoltan Raluca; Vancea Romulus

    2011-01-01

    The present paper proposes an overview of the evolution of the concept of entrepreneur in an epistemological approach. After a brief history of the concept, there are some basic economic and managerial guidelines in entrepreneur’s configuration; these guidelines are found in the work of experts in management, respectively, leading economists. Rationality, flair and intuition of the entrepreneur are then analyzed in terms of existing trends in the economy, acknowledging the entrepreneurship an...

  20. Cortical reorganization associated lower extremity motor recovery as evidenced by functional MRI and diffusion tensor tractography in a stroke patient.

    Science.gov (United States)

    Jang, Sung Ho; You, Sung H; Kwon, Yong-Hyun; Hallett, Mark; Lee, Mi Young; Ahn, Sang Ho

    2005-01-01

    Recovery mechanisms supporting upper extremity motor recovery following stroke are well established, but cortical mechanism associated with lower extremity motor recovery is unknown. The aim of this study was to assess cortical reorganization associated with lower extremity motor recovery in a hemiparetic patient. Six control subjects and a 17 year-old woman with left intracerebral hemorrhage due to an arterio-venous malformation rupture were evaluated. The motor function of the paretic (left) hip and knee had recovered slowly to the extent of her being able to overcome gravity for 10 months after the onset of stroke. However, her paretic upper extremity showed no significant motor recovery. Blood oxygenation level dependent (BOLD) functional MRI at 1.5 Tesla was used to determine the acutual location of cortical activation in the predefined regions of interest. Concurrently, Diffusion Tensor Imaging (DTI) in combination with a novel 3D-fiber reconstruction algorithm was utilized to investigate the pattern of the corticospinal pathway connectivity between the areas of the motor stream. All subjects' body parts were secured in the scanner and performed a sequential knee flexion-extension with a predetermined angle of 0-60 degrees at 0.5 Hz. Controls showed anticipated activation in the contralateral sensorimotor cortex (SM1) and the descending corticospinal fibers stemming from motor cortex. In contrast to control normal subjects, the stroke patient showed fMRI activation only in the unaffected (right) primary SM1 during either paretic or nonparetic knee movements. DTT fiber tracing data showed that the corticospinal tract fibers were found only in the unaffected hemisphere but not in the affected hemisphere. Our results indicate that an ipsilateral motor pathway from the unaffected (right) motor cortex to the paretic (right) leg was present in this patient. This study raises the potential that the contralesional (ipsilateral) SM1 is involved in cortical

  1. MRI of the brain stem using fluid attenuated inversion recivery pulse sequences

    International Nuclear Information System (INIS)

    De Coene, B.; Hajnal, J.V.; Pennock, J.M.; Bydder, G.M.

    1993-01-01

    Heavily T2-weighted fluid-attenuated inversion recovery (FLAIR) sequences with inversion times of 2000-2500 ms and echo times of 130-200 ms were used to image the brain stem of a normal adult and five patients. These sequences produce high signal from many white matter tracts and display high lesion contrast. The corticospinal and parietopontine tracts, lateral and medial lemnisci, superior and inferior cerebellar peduncles, medial longitudinal fasciculi, thalamo-olivary tracts the cuneate and gracile fasiculi gave high signal and were directly visualised. The oculomotor and trigeminal nerves were demonstrated within the brain stem. Lesions not seen with conventional T2-weighted spin echo sequences were seen with high contrast in patients with infarction, multiple sclerosis, sarcoidosis, chunt obstruction and metastatic tumour. The anatomical detail and high lesion contrast given by the FLAIR pulse sequence appear likely to be of value in diagnosis of disease in the brain stem. (orig.)

  2. Non-arteritic anterior ischaemic optic neuropathy: evaluation of the brain and optic pathway by conventional MRI and magnetisation transfer imaging

    International Nuclear Information System (INIS)

    Argyropoulou, Maria I.; Zikou, Anastasia K.; Tzovara, Ioanna; Margariti, Persefoni; Nikas, Alexios; Asproudis, Ioannis; Blekas, Kostandinos; Galatsanos, Nikolaos

    2007-01-01

    The purpose of the study was to examine the brain and the visual pathway of patients with non-arteritic anterior ischaemic optic neuropathy (NAION) by using conventional MRI (cMRI) and volumetric magnetisation transfer imaging (MTI). Thirty NAION patients, aged 67.5 ± 8.14 years, and 28 age- and gender-matched controls were studied. MTI was used to measure the magnetisation transfer ratio (MTR) of the chiasm and for MTR histograms of the brain. The presence of areas of white matter hyperintensity (WMH) was evaluated on fluid-attenuated inversion recovery (FLAIR) images. Area of the optic nerves (ONs) and volume of the chiasm were assessed, as were coronal short-tau inversion recovery (STIR) and MTI images, respectively. More areas of WMH were observed in patients (total 419; mean 14.4; SD 19) than in controls (total 127; mean 4.7; SD 5.7), P < 0.001. Area (in square millimetres) of the affected ONs, volume(in cubic millimetres) and MTR (in percent) of the chiasm (10.7 ± 4.6), (75.8 ± 20.2), (56.4 ± 6.5), respectively, were lower in patients than in controls (13.6 ± 4.3), (158.2 ± 75.3) (62.1 ± 6.2), respectively, P < 0.05. Mean MTR of brain histograms was lower in patients (53.0 ± 8.0) than in controls (58.0 ± 5.6), P < 0.05. NAION is characterised by decreased ON and chiasmatic size. The low MTR of the chiasm and brain associated with increased areas of WMH may be suggestive of demyelination and axonal damage due to generalised cerebral vascular disease. (orig.)

  3. Qualitative and quantitative comparison of contrast-enhanced fluid-attenuated inversion recovery, magnetization transfer spin echo, and fat-saturation T1-weighted sequences in infectious meningitis

    Energy Technology Data Exchange (ETDEWEB)

    Azad, Rajiv; Tayal, Mohit; Azad, Sheenam; Sharma, Garima; Srivastava, Rajendra Kumar [SGRR Institute of Medical and Health Sciences, Patel Nagar, Dehradun (India)

    2017-11-15

    To compare the contrast-enhanced fluid-attenuated inversion recovery (CE-FLAIR), the CE T1-weighted (CE-T1W) sequence with fat suppression (FS) and magnetization transfer (MT) for early detection and characterization of infectious meningitis. Fifty patients and 10 control subjects were evaluated with the CE-FLAIR and the CE-T1W sequences with FS and MT. Qualitative assessment was done by two observers for presence and grading of abnormal leptomeningeal enhancement. Quantitative assessment included computation of net meningeal enhancement, using single pixel signal intensity software. A newly devised FLAIR based scoring system, based on certain imaging features including ventricular dilatation, ependymal enhancement, infarcts and subdural effusions was used to indicate the etiology. Data were analysed using the Student's t test, Cohen's Kappa coefficient, Pearson's correlation coefficient, the intraclass correlation coefficient, one way analysis of variance, and Fisher's exact test with Bonferroni correction as the post hoc test. The CE-FLAIR sequence demonstrated a better sensitivity (100%), diagnostic accuracy (95%), and a stronger correlation with the cerebrospinal fluid, total leukocyte count (r = 0.75), protein (r = 0.77), adenosine deaminase (r = 0.81) and blood glucose (r = -0.6) values compared to the CE-T1W sequences. Qualitative grades and quantitative meningeal enhancement on the CE-FLAIR sequence were also significantly greater than those on the other sequences. The FLAIR based scoring system yielded a diagnostic accuracy of 91.6% and a sensitivity of 96%. A strong inverse Pearson's correlation (r = -0.95) was found between the assigned score and patient's Glasgow Coma Scale at the time of admission. The CE-FLAIR sequence is better suited for evaluating infectious meningitis and could be included as a part of the routine MR imaging protocol.

  4. Qualitative and quantitative comparison of contrast-enhanced fluid-attenuated inversion recovery, magnetization transfer spin echo, and fat-saturation T1-weighted sequences in infectious meningitis

    International Nuclear Information System (INIS)

    Azad, Rajiv; Tayal, Mohit; Azad, Sheenam; Sharma, Garima; Srivastava, Rajendra Kumar

    2017-01-01

    To compare the contrast-enhanced fluid-attenuated inversion recovery (CE-FLAIR), the CE T1-weighted (CE-T1W) sequence with fat suppression (FS) and magnetization transfer (MT) for early detection and characterization of infectious meningitis. Fifty patients and 10 control subjects were evaluated with the CE-FLAIR and the CE-T1W sequences with FS and MT. Qualitative assessment was done by two observers for presence and grading of abnormal leptomeningeal enhancement. Quantitative assessment included computation of net meningeal enhancement, using single pixel signal intensity software. A newly devised FLAIR based scoring system, based on certain imaging features including ventricular dilatation, ependymal enhancement, infarcts and subdural effusions was used to indicate the etiology. Data were analysed using the Student's t test, Cohen's Kappa coefficient, Pearson's correlation coefficient, the intraclass correlation coefficient, one way analysis of variance, and Fisher's exact test with Bonferroni correction as the post hoc test. The CE-FLAIR sequence demonstrated a better sensitivity (100%), diagnostic accuracy (95%), and a stronger correlation with the cerebrospinal fluid, total leukocyte count (r = 0.75), protein (r = 0.77), adenosine deaminase (r = 0.81) and blood glucose (r = -0.6) values compared to the CE-T1W sequences. Qualitative grades and quantitative meningeal enhancement on the CE-FLAIR sequence were also significantly greater than those on the other sequences. The FLAIR based scoring system yielded a diagnostic accuracy of 91.6% and a sensitivity of 96%. A strong inverse Pearson's correlation (r = -0.95) was found between the assigned score and patient's Glasgow Coma Scale at the time of admission. The CE-FLAIR sequence is better suited for evaluating infectious meningitis and could be included as a part of the routine MR imaging protocol

  5. [A case of migraine presenting with thunderclap headache associated with posterior reversible encephalopathy syndrome].

    Science.gov (United States)

    Katoh, Hirotaka; Saito, Yu; Ohwan, Yoshiyuki; Kasai, Hideyo; Fujita, Kazuhisa; Kawamura, Mitsuru

    2014-10-01

    We report a 47-year-old woman who developed a thunderclap headache. Head axial, fluid-attenuated inversion recovery magnetic resonance imaging (FLAIR MRI) revealed high signal lesions in the left occipital and right parietal lobes. Apparent diffusion coefficient mapping showed a vasogenic edema pattern. Upon admission, the patient's blood pressure was normal and the neurological examination was unremarkable. As thunderclap headaches are associated with a repeated rise in blood pressure, we considered cerebral vasoconstriction and administered a calcium channel blocker. Thereafter, her headache with high blood pressure eased significantly and the high signal lesions on FLAIR MRI disappeared. We diagnosed the condition as posterior reversible encephalopathy syndrome (PRES). In addition, head magnetic resonance angiogram showed vasoconstriction of the right anterior cerebral artery, left middle cerebral artery, and bilateral posterior cerebral artery. Calcium channel blocker use was continued and vasoconstriction improved by day 70. In this case, the presenting symptom was thunderclap headache, which is a characteristic feature of reversible cerebral vasoconstriction syndrome (RCVS). Therefore, PRES may be caused by RCVS.

  6. Two cases of possible neuro-Sweet disease with meningoencephalitis as the initial manifestation

    Directory of Open Access Journals (Sweden)

    Go Makimoto

    2012-02-01

    Full Text Available We report 2 cases that were considered to be neuro-Sweet disease. They initially manifested with meningoencephalitis and no skin lesions, and rapidly improved with corticosteroid therapy. In both cases, patients complained of meningitic symptoms such as fever and headache, and HLA-B54 and -Cw1 turned out to be positive over the clinical course. Cerebrospinal fluid analysis showed increased levels of lymphocytes and protein. In case #1, fluid-attenuated inversion recovery (FLAIR, magnetic resonance imaging (MRI and diffusion-weighted images (DWI showed high-intensity signals in the right dorsal medulla oblongata, bilateral dorsal midbrain, and left thalamus. In case #2, FLAIR and DWI showed high-intensity signals in the bilateral cerebellar cortex and left caudate nucleus. Symptoms and MRI images were markedly improved in both cases after corticosteroid pulse therapy. According to published diagnostic criteria, these 2 cases were considered possible neuro-Sweet disease. These cases suggest that the combination of meningoencephalitis and HLA specificity is important to consider the possibility of neuro-Sweet disease, even without skin lesions.

  7. T1- Thresholds in Black Holes Increase Clinical-Radiological Correlation in Multiple Sclerosis Patients.

    Science.gov (United States)

    Thaler, Christian; Faizy, Tobias; Sedlacik, Jan; Holst, Brigitte; Stellmann, Jan-Patrick; Young, Kim Lea; Heesen, Christoph; Fiehler, Jens; Siemonsen, Susanne

    2015-01-01

    Magnetic Resonance Imaging (MRI) is an established tool in diagnosing and evaluating disease activity in Multiple Sclerosis (MS). While clinical-radiological correlations are limited in general, hypointense T1 lesions (also known as Black Holes (BH)) have shown some promising results. The definition of BHs is very heterogeneous and depends on subjective visual evaluation. We aimed to improve clinical-radiological correlations by defining BHs using T1 relaxation time (T1-RT) thresholds to achieve best possible correlation between BH lesion volume and clinical disability. 40 patients with mainly relapsing-remitting MS underwent MRI including 3-dimensional fluid attenuated inversion recovery (FLAIR), magnetization-prepared rapid gradient echo (MPRAGE) before and after Gadolinium (GD) injection and double inversion-contrast magnetization-prepared rapid gradient echo (MP2RAGE) sequences. BHs (BHvis) were marked by two raters on native T1-weighted (T1w)-MPRAGE, contrast-enhancing lesions (CE lesions) on T1w-MPRAGE after GD and FLAIR lesions (total-FLAIR lesions) were detected separately. BHvis and total-FLAIR lesion maps were registered to MP2RAGE images, and the mean T1-RT were calculated for all lesion ROIs. Mean T1 values of the cortex (CTX) were calculated for each patient. Subsequently, Spearman rank correlations between clinical scores (Expanded Disability Status Scale and Multiple Sclerosis Functional Composite) and lesion volume were determined for different T1-RT thresholds. Significant differences in T1-RT were obtained between all different lesion types with highest T1 values in visually marked BHs (BHvis: 1453.3±213.4 ms, total-FLAIR lesions: 1394.33±187.38 ms, CTX: 1305.6±35.8 ms; p1500 ms (Expanded Disability Status Scale vs. lesion volume: rBHvis = 0.442 and rtotal-FLAIR = 0.497, p<0.05; Multiple Sclerosis Functional Composite vs. lesion volume: rBHvis = -0.53 and rtotal-FLAIR = -0.627, p<0.05). Clinical-radiological correlations in MS patients are

  8. Functional MRI of Language Processing and Recovery

    NARCIS (Netherlands)

    C. Méndez Orellana (Carolina)

    2015-01-01

    markdownabstract__Abstract__ My thesis describe the utility of implementing fMRI to investigate how the language system is reorganized in brain damaged patients. Specifically for aphasia research fMRI allows to show how specific language treatment methods have the potential to enhance language

  9. ROLE OF MRI IN WHITE MATTER DISEASES- CLINICO-RADIOLOGICAL CORRELATION

    Directory of Open Access Journals (Sweden)

    Ravindranath Reddy Kamireddy

    2017-11-01

    Full Text Available BACKGROUND The diagnostic process is difficult as there are many different white matter disorders (inherited and acquired. MRI has high diagnostic specificity to study the pattern of brain structures. MRI is more useful in demonstrating abnormalities of myelination. MATERIALS AND METHODS Our study developed a practical algorithm that relies mainly on the characteristics of brain MRI. Our study included clinicallysuspected patients with demyelination during a period of one year. RESULTS Our study included 25 clinically-suspected patients (out of total of 400 patients with demyelination during a period of one year (February 2016 to January 2017.  Multiple sclerosis accounted for the majority of cases (36.0% followed by acute disseminated encephalomyelitis (20%.  In multiple sclerosis, majority of the patients presented in the third decade of life with a definite female preponderance (M:F-1:2.  The most common symptom and site of involvement were visual impairment (73.3% and periventricular area (80%, respectively.  Other causes like PML, PVL, CPM, reversible posterior leucoencephalopathy, leukodystrophies and motor neuron disease comprised the remainder of the cases. CONCLUSION MRI due to its excellent grey white matter resolution is very sensitive in detecting subtle demyelination, the sensitivity being still further enhanced by FLAIR sequences. MRI in correlation with the clinical signs and symptoms is an ideal modality in early diagnosis of white matter diseases.

  10. Comparison of T1-weighted fast spin-echo and T1-weighted fluid-attenuated inversion recovery images of the lumbar spine at 3.0 Tesla

    International Nuclear Information System (INIS)

    Lavdas, Eleftherios; Vlychou, Marianna; Arikidis, Nikos; Kapsalaki, Eftychia; Roka, Violetta; Fezoulidis, Ioannis V.

    2010-01-01

    Background: T1-weighted fluid-attenuated inversion recovery (FLAIR) sequence has been reported to provide improved contrast between lesions and normal anatomical structures compared to T1-weighted fast spin-echo (FSE) imaging at 1.5T regarding imaging of the lumbar spine. Purpose: To compare T1-weighted FSE and fast T1-weighted FLAIR imaging in normal anatomic structures and degenerative and metastatic lesions of the lumbar spine at 3.0T. Material and Methods: Thirty-two consecutive patients (19 females, 13 males; mean age 44 years, range 30-67 years) with lesions of the lumbar spine were prospectively evaluated. Sagittal images of the lumbar spine were obtained using T1-weighted FSE and fast T1-weighted FLAIR sequences. Both qualitative and quantitative analyses measuring the signal-to-noise ratio (SNR), contrast-to-noise ratio (CNR), and relative contrast (ReCon) between degenerative and metastatic lesions and normal anatomic structures were conducted, comparing these sequences. Results: On quantitative evaluation, SNRs of cerebrospinal fluid (CSF), nerve root, and fat around the root of fast T1-weighted FLAIR imaging were significantly lower than those of T1-weighted FSE images (P<0.001). CNRs of normal spinal cord/CSF and disc herniation/ CSF for fast T1-weighted FLAIR images were significantly higher than those for T1-weighted FSE images (P<0.001). ReCon of normal spinal cord/CSF, disc herniation/CSF, and vertebral lesions/CSF for fast T1-weighted FLAIR images were significantly higher than those for T1-weighted FSE images (P<0.001). On qualitative evaluation, it was found that CSF nulling and contrast at the spinal cord (cauda equina)/CSF interface for T1-weighted FLAIR images were significantly superior compared to those for T1-weighted FSE images (P<0.001), and the disc/spinal cord (cauda equina) interface was better for T1-weighted FLAIR images (P<0.05). Conclusion: The T1-weighted FLAIR sequence may be considered as the preferred lumbar spine imaging

  11. Update on the MRI Core of the Alzheimer's Disease Neuroimaging Initiative

    Science.gov (United States)

    Jack, Clifford R; Bernstein, Matt A; Borowski, Bret J; Gunter, Jeffrey L; Fox, Nick C; Thompson, Paul M; Schuff, Norbert; Krueger, Gunnar; Killiany, Ronald J; DeCarli, Charles S; Dale, Anders M; Weiner, Michael W

    2010-01-01

    Functions of the ADNI MRI core fall into three categories: (1) those of the central MRI core lab at Mayo Clinic, Rochester, Minnesota, needed to generate high quality MRI data in all subjects at each time point; (2) those of the funded ADNI MRI core imaging analysis groups responsible for analyzing the MRI data, and (3) the joint function of the entire MRI core in designing and problem solving MR image acquisition, pre-processing and analyses methods. The primary objective of ADNI was and continues to be improving methods for clinical trials in Alzheimer's disease. Our approach to the present (“ADNI-GO”) and future (“ADNI-2”, if funded) MRI protocol will be to maintain MRI methodological consistency in previously enrolled “ADNI-1” subjects who are followed longitudinally in ADNI-GO and ADNI-2. We will modernize and expand the MRI protocol for all newly enrolled ADNI-GO and ADNI-2 subjects. All newly enrolled subjects will be scanned at 3T with a core set of three sequence types: 3D T1-weighted volume, FLAIR, and a long TE gradient echo volumetric acquisition for micro hemorrhage detection. In addition to this core ADNI-GO and ADNI-2 protocol, we will perform vendor specific pilot sub-studies of arterial spin labeling perfusion, resting state functional connectivity and diffusion tensor imaging. One each of these sequences will be added to the core protocol on systems from each MRI vendor. These experimental sub-studies are designed to demonstrate the feasibility of acquiring useful data in a multi-center (but single vendor) setting for these three emerging MRI applications. PMID:20451869

  12. Differentiation of sCJD and vCJD forms by automated analysis of basal ganglia intensity distribution in multisequence MRI of the brain--definition and evaluation of new MRI-based ratios.

    Science.gov (United States)

    Linguraru, Marius George; Ayache, Nicholas; Bardinet, Eric; Ballester, Miguel Angel González; Galanaud, Damien; Haïk, Stéphane; Faucheux, Baptiste; Hauw, Jean-Jacques; Cozzone, Patrick; Dormont, Didier; Brandel, Jean-Philippe

    2006-08-01

    We present a method for the analysis of basal ganglia (including the thalamus) for accurate detection of human spongiform encephalopathy in multisequence magnetic resonance imaging (MRI) of the brain. One common feature of most forms of prion protein diseases is the appearance of hyperintensities in the deep grey matter area of the brain in T2-weighted magnetic resonance (MR) images. We employ T1, T2, and Flair-T2 MR sequences for the detection of intensity deviations in the internal nuclei. First, the MR data are registered to a probabilistic atlas and normalized in intensity. Then smoothing is applied with edge enhancement. The segmentation of hyperintensities is performed using a model of the human visual system. For more accurate results, a priori anatomical data from a segmented atlas are employed to refine the registration and remove false positives. The results are robust over the patient data and in accordance with the clinical ground truth. Our method further allows the quantification of intensity distributions in basal ganglia. The caudate nuclei are highlighted as main areas of diagnosis of sporadic Creutzfeldt-Jakob Disease (sCJD), in agreement with the histological data. The algorithm permitted the classification of the intensities of abnormal signals in sCJD patient FLAIR images with a higher hypersignal in caudate nuclei (10/10) and putamen (6/10) than in thalami. Defining normalized MRI measures of the intensity relations between the internal grey nuclei of patients, we robustly differentiate sCJD and variant CJD (vCJD) patients, in an attempt to create an automatic classification tool of human spongiform encephalopathies.

  13. Spectrum of findings on magnetic resonance imaging of the brain in patients with neurological manifestations of dengue fever

    Directory of Open Access Journals (Sweden)

    Tejeshwar Singh Jugpal

    Full Text Available Abstract Objective: To describe the spectrum of magnetic resonance imaging (MRI findings in patients with neurological manifestations of dengue. Materials and Methods: We included nine patients with dengue fever (three females and six males; age range, 9–30 years, all of whom presented with neurological manifestations. The MRI examinations, performed in 1.5 T or 3 T scanners, included T1-weighted, T2-weighted, and fluid-attenuated inversion recovery (FLAIR sequences. Diffusion-weighted imaging with apparent diffusion coefficient mapping was also employed. Fast low-angle shot and susceptibility-weighted gradient-recalled echo sequences, as well as contrast-enhanced T1-weighted scans, were also obtained in order to assess parenchymal enhancement. MRI scans were analyzed for lesion distribution and imaging features. Results: All patients showed areas of altered signal intensity that appeared as hyperintensity on T2-weighted and FLAIR sequences. The most commonly affected site was the basal ganglia-thalamus complex. Other affected sites were the cerebellum, cerebral cortex, white matter, and brainstem. In all cases, we observed patchy areas of restricted diffusion and focal areas of hemorrhage. Conclusion: Dengue encephalitis commonly affects the basal ganglia, thalamus, cerebellum, cerebral cortex, and white matter. Therefore, MRI should be an indispensable part of the evaluation of patients with neurological complications of dengue fever.

  14. 3T MRI diagnosis of cerebral micro-bleed from hypertension

    International Nuclear Information System (INIS)

    Xu Jinfa; Bu Chunqing; Xie Guohua; Bai Min; Li Shuhua; Chen Jun; Di Yujin

    2011-01-01

    Objective: To explore the efficacy of 3T MRI for demonstrating hypertensive cerebral micro-bleed (CMB). Methods: 78 hypertensive patients (age range: 32-60 years) with (58) or without (20) lacunar infarction underwent susceptibility weighted imaging (SWI). The SWI was compared with T 1 WI, T 2 WI, and T 2 WI-FLAIR sequences. Results: The incidence of CMB was 41.38% (24/58) and 15.0% (3/20) in the patient groups with and without lacunar infarct respectively. The overall incidence of CMB was 34.61% (27/78). Of all pulse sequences, the SWI displayed CMB more clearly as round or oval punctuate areas of signal loss with diameter of 2 to 5 mm and no surrounding edema. CMB was located mainly in the cortex, subcortex, basal ganglia, thalamus, cerebellum and brainstem. Conclusion: The finding of CMB on MRI suggests severe microvascular disease with secondary hemorrhage. It has significant impact on treatment options and prognosis in patients with cerebral infarction. (authors)

  15. MRI for transformation of preserved organs and their pathologies into digital formats for medical education and creation of a virtual pathology museum. A pilot study.

    Science.gov (United States)

    Venkatesh, S K; Wang, G; Seet, J E; Teo, L L S; Chong, V F H

    2013-03-01

    To evaluate the feasibility of magnetic resonance imaging (MRI) for the transformation of preserved organs and their disease entities into digital formats for medical education and creation of a virtual museum. MRI of selected 114 pathology specimen jars representing different organs and their diseases was performed using a 3 T MRI machine with two or more MRI sequences including three-dimensional (3D) T1-weighted (T1W), 3D-T2W, 3D-FLAIR (fluid attenuated inversion recovery), fat-water separation (DIXON), and gradient-recalled echo (GRE) sequences. Qualitative assessment of MRI for depiction of disease and internal anatomy was performed. Volume rendering was performed on commercially available workstations. The digital images, 3D models, and photographs of specimens were archived into a workstation serving as a virtual pathology museum. MRI was successfully performed on all specimens. The 3D-T1W and 3D-T2W sequences demonstrated the best contrast between normal and pathological tissues. The digital material is a useful aid for understanding disease by giving insights into internal structural changes not apparent on visual inspection alone. Volume rendering produced vivid 3D models with better contrast between normal tissue and diseased tissue compared to real specimens or their photographs in some cases. The digital library provides good illustration material for radiological-pathological correlation by enhancing pathological anatomy and information on nature and signal characteristics of tissues. In some specimens, the MRI appearance may be different from corresponding organ and disease in vivo due to dead tissue and changes induced by prolonged contact with preservative fluid. MRI of pathology specimens is feasible and provides excellent images for education and creating a virtual pathology museum that can serve as permanent record of digital material for self-directed learning, improving teaching aids, and radiological-pathological correlation. Copyright © 2012

  16. Hyperintense acute reperfusion marker is associated with higher contrast agent dosage in acute ischaemic stroke

    Energy Technology Data Exchange (ETDEWEB)

    Ostwaldt, Ann-Christin; Schaefer, Tabea; Villringer, Kersten; Fiebach, Jochen B. [Charite Universitaetsmedizin Berlin, Academic Neuroradiology, Center for Stroke Research Berlin (CSB), Berlin (Germany); Rozanski, Michal; Ebinger, Martin [Charite Universitaetsmedizin Berlin, Academic Neuroradiology, Center for Stroke Research Berlin (CSB), Berlin (Germany); Charite Universitaetsmedizin, Department of Neurology, Berlin (Germany); Jungehuelsing, Gerhard J. [Stiftung des Buergerlichen Rechts, Juedisches Krankenhaus Berlin, Berlin (Germany)

    2015-11-15

    The hyperintense acute reperfusion marker (HARM) on fluid-attenuated inversion recovery (FLAIR) images is associated with blood-brain barrier (BBB) permeability changes. The aim of this study was to examine the influence of contrast agent dosage on HARM incidence in acute ischaemic stroke patients. We prospectively included 529 acute ischaemic stroke patients (204 females, median age 71 years). Patients underwent a first stroke-MRI within 24 hours from symptom onset and had a follow-up on day 2. The contrast agent Gadobutrol was administered to the patients for perfusion imaging or MR angiography. The total dosage was calculated as ml/kg body weight and ranged between 0.04 and 0.31 mmol/kg on the first examination. The incidence of HARM was evaluated on day 2 FLAIR images. HARM was detected in 97 patients (18.3 %). HARM incidence increased significantly with increasing dosages of Gadobutrol. Also, HARM positive patients were significantly older. HARM was not an independent predictor of worse clinical outcome, and we did not find an association with increase risk of haemorrhagic transformation. A higher dosage of Gadobutrol in acute stroke patients on initial MRI is associated with increased HARM incidence on follow-up. MRI studies on BBB should therefore standardize contrast agent dosages. (orig.)

  17. Cortical restricted diffusion as the predominant MRI finding in sporadic Creutzfeldt-Jakob disease

    Energy Technology Data Exchange (ETDEWEB)

    Talbott, Sabrina D.; Sattenberg, Ronald J.; Heidenreich, Jens O. (Dept. of Radiology, Univ. of Louisville, Louisville (United States)), e-mail: sdtalb02@gwise.louisville.edu; Plato, Brian M (Dept. of Neurology, Univ. of Louisville, Louisville (United States)); Parker, John (Dept. of Pathology and Laboratory Medicine, Univ. of Louisville, Louisville (United States))

    2011-04-15

    Creutzfeldt-Jakob disease is a rare and fatal neurodegenerative disorder with MR findings predominantly limited to the grey matter of the cortex and the basal ganglia. Sporadic Creutzfeldt-Jakob disease can produce a spectrum of MR imaging findings of the brain, most notably on DWI and FLAIR sequences. Involvement of the basal ganglia and neocortex is the most common finding, but isolated involvement of the cortex can also be seen. We describe the clinical history and MRI findings of three patients with sporadic Creutzfeldt-Jakob disease confirmed by brain biopsy or autopsy and review the literature of imaging manifestations of this disease

  18. Cortical restricted diffusion as the predominant MRI finding in sporadic Creutzfeldt-Jakob disease

    International Nuclear Information System (INIS)

    Talbott, Sabrina D.; Sattenberg, Ronald J.; Heidenreich, Jens O.; Plato, Brian M; Parker, John

    2011-01-01

    Creutzfeldt-Jakob disease is a rare and fatal neurodegenerative disorder with MR findings predominantly limited to the grey matter of the cortex and the basal ganglia. Sporadic Creutzfeldt-Jakob disease can produce a spectrum of MR imaging findings of the brain, most notably on DWI and FLAIR sequences. Involvement of the basal ganglia and neocortex is the most common finding, but isolated involvement of the cortex can also be seen. We describe the clinical history and MRI findings of three patients with sporadic Creutzfeldt-Jakob disease confirmed by brain biopsy or autopsy and review the literature of imaging manifestations of this disease

  19. MRI sequences in head and neck radiology. State of the art

    Energy Technology Data Exchange (ETDEWEB)

    Widmann, Gerlig; Henninger, Benjamin; Kremser, Christian; Jaschke, Werner [Medical Univ. of Innsbruck (Austria). Dept. of Radiology

    2017-05-15

    Magnetic resonance imaging (MRI) has become an essential imaging modality for the evaluation of head and neck pathologies. However, the diagnostic power of MRI is strongly related to the appropriate selection and interpretation of imaging protocols and sequences. The aim of this article is to review state-of-the-art sequences for the clinical routine in head and neck MRI and to describe the evidence for which medical question these sequences and techniques are useful. Literature review of state-of-the-art sequences in head and neck MRI. Basic sequences (T1w, T2w, T1wC+) and fat suppression techniques (TIRM/STIR, Dixon, Spectral Fat sat) are important tools in the diagnostic workup of inflammation, congenital lesions and tumors including staging. Additional sequences (SSFP (CISS, FIESTA), SPACE, VISTA, 3D-FLAIR) are used for pathologies of the cranial nerves, labyrinth and evaluation of endolymphatic hydrops in Meniere's disease. Vessel and perfusion sequences (3D-TOF, TWIST/TRICKS angiography, DCE) are used in vascular contact syndromes, vascular malformations and analysis of microvascular parameters of tissue perfusion. Diffusion-weighted imaging (EPI-DWI, non-EPI-DWI, RESOLVE) is helpful in cholesteatoma imaging, estimation of malignancy, and evaluation of treatment response and posttreatment recurrence in head and neck cancer. Understanding of MRI sequences and close collaboration with referring physicians improves the diagnostic confidence of MRI in the daily routine and drives further research in this fascinating image modality.

  20. MRI sequences in head and neck radiology. State of the art

    International Nuclear Information System (INIS)

    Widmann, Gerlig; Henninger, Benjamin; Kremser, Christian; Jaschke, Werner

    2017-01-01

    Magnetic resonance imaging (MRI) has become an essential imaging modality for the evaluation of head and neck pathologies. However, the diagnostic power of MRI is strongly related to the appropriate selection and interpretation of imaging protocols and sequences. The aim of this article is to review state-of-the-art sequences for the clinical routine in head and neck MRI and to describe the evidence for which medical question these sequences and techniques are useful. Literature review of state-of-the-art sequences in head and neck MRI. Basic sequences (T1w, T2w, T1wC+) and fat suppression techniques (TIRM/STIR, Dixon, Spectral Fat sat) are important tools in the diagnostic workup of inflammation, congenital lesions and tumors including staging. Additional sequences (SSFP (CISS, FIESTA), SPACE, VISTA, 3D-FLAIR) are used for pathologies of the cranial nerves, labyrinth and evaluation of endolymphatic hydrops in Meniere's disease. Vessel and perfusion sequences (3D-TOF, TWIST/TRICKS angiography, DCE) are used in vascular contact syndromes, vascular malformations and analysis of microvascular parameters of tissue perfusion. Diffusion-weighted imaging (EPI-DWI, non-EPI-DWI, RESOLVE) is helpful in cholesteatoma imaging, estimation of malignancy, and evaluation of treatment response and posttreatment recurrence in head and neck cancer. Understanding of MRI sequences and close collaboration with referring physicians improves the diagnostic confidence of MRI in the daily routine and drives further research in this fascinating image modality.

  1. Magnetic resonance imaging (MRI) of liver and brain in haematologic-organic patients with fever of unknown origin

    International Nuclear Information System (INIS)

    Heussel, C.P.; Kauczor, H.U.; Poguntke, M.; Schadmand-Fischer, S.; Mildenberger, P.; Thelen, M.; Heussel, G.

    1998-01-01

    To examine the advantage of liver and brain MRI in clinically anomalous haematological patients with fever of unknown origin. Material and Methods: Twenty liver MRI (T 2 -TSE, T 2 -HASTE, T 1 -FLASH±Gd dynamic) and 16 brain MRI (T 2 -TSE, FLAIR, T 1 -TSE±Gd) were performed searching for a focus of fever with a suspected organ system. Comparison with clinical follow-up. Results: suspected organ system. Comparison with clinical follow-up. Results: A focus was detected in 11/20 liver MRI. Candidiasis (n=3), mycobacteriosis (n=2), relapse of haematological disease (n=3), graft versus host disease (n=1), non-clarified (n=2). The remaining 9 cases with normal MRI were not suspicious of infectious hepatic disease during follo-wup. In brain MRI, 3/16 showed a focus (toxoplasmosis, aspergillosis, mastoiditis). Clinical indication for an infectious involvement of the brain was found in 4/16 cases 2--5 months after initially normal brain MRI. No suspicion of an infectious involvement of brain was present in the remaining 9/16 cases. Conclusion: In case of fever of unknown origin and suspicion of liver involvement, MRI of the liver should be performed due to data given in literature and its sensitivity of 100%. Because of the delayed detectability of cerebral manifestations, in cases of persisting suspicion even a previously normal MRI of the brain should be repeated. (orig.) [de

  2. Functional hemispherotomy in Rasmussen syndrome in the absence of classic MRI findings

    Directory of Open Access Journals (Sweden)

    Yasunori Nagahama

    2017-01-01

    Full Text Available A 7-year-old previously healthy girl presented with a left-sided focal seizure without impaired consciousness and subsequently developed epilepsia partialis continua. Initial MRI was normal, and the subsequent images only showed a focal T2/FLAIR hyperintense area without cortical atrophy. She was diagnosed with Rasmussen syndrome by pathology and promptly treated with functional hemispherotomy. Rasmussen syndrome is a rare progressive neurological disorder, the only definitive cure for which is hemispheric disconnection. The disease presents a management dilemma, especially early in disease course without characteristic neuroimaging features. A high index of suspicion, multidisciplinary approach, and clear timely communication with the family are critical.

  3. Degenerative disc disease of the lumbar spine: a prospective comparison of fast T1-weighted fluid-attenuated inversion recovery and T1-weighted turbo spin echo MR imaging

    International Nuclear Information System (INIS)

    Erdem, L. Oktay; Erdem, C. Zuhal; Acikgoz, Bektas; Gundogdu, Sadi

    2005-01-01

    Objective: To compare fast T1-weighted fluid-attenuated inversion recovery (FLAIR) and T1-weighted turbo spin-echo (TSE) imaging of the degenerative disc disease of the lumbar spine. Materials and methods: Thirty-five consecutive patients (19 females, 16 males; mean age 41 years, range 31-67 years) with suspected degenerative disc disease of the lumbar spine were prospectively evaluated. Sagittal images of the lumbar spine were obtained using T1-weighted TSE and fast T1-weighted FLAIR sequences. Two radiologists compared these sequences both qualitatively and quantitatively. Results: On qualitative evaluation, CSF nulling, contrast at the disc-CSF interface, the disc-spinal cord (cauda equina) interface, and the spinal cord (cauda equina)-CSF interface of fast T1-weighted FLAIR images were significantly higher than those for T1-weighted TSE images (P < 0.001). On quantitative evaluation of the first 15 patients, signal-to-noise ratios of cerebrospinal fluid of fast T1-weighted FLAIR imaging were significantly lower than those for T1-weighted TSE images (P < 0.05). Contrast-to-noise ratios of spinal cord/CSF and normal bone marrow/disc for fast T1-weighted FLAIR images were significantly higher than those for T1-weighted TSE images (P < 0.05). Conclusion: Results in our study have shown that fast T1-weighted FLAIR imaging may be a valuable imaging modality in the armamentarium of lumbar spinal T1-weighted MR imaging, because the former technique has definite superior advantages such as CSF nulling, conspicuousness of the normal anatomic structures and changes in the lumbar spinal discogenic disease and image contrast and also almost equally acquisition times

  4. Degenerative disc disease of the lumbar spine: a prospective comparison of fast T1-weighted fluid-attenuated inversion recovery and T1-weighted turbo spin echo MR imaging

    Energy Technology Data Exchange (ETDEWEB)

    Erdem, L. Oktay [Department of Radiology, Zonguldak Karaelmas University, School of Medicine, 6700 Kozlu, Zonguldak (Turkey)]. E-mail: sunarerdem@yahoo.com; Erdem, C. Zuhal [Department of Radiology, Zonguldak Karaelmas University, School of Medicine, 6700 Kozlu, Zonguldak (Turkey); Acikgoz, Bektas [Department of Neurosurgery, Zonguldak Karaelmas University, School of Medicine, Zonguldak (Turkey); Gundogdu, Sadi [Department of Radiology, Zonguldak Karaelmas University, School of Medicine, 6700 Kozlu, Zonguldak (Turkey)

    2005-08-01

    Objective: To compare fast T1-weighted fluid-attenuated inversion recovery (FLAIR) and T1-weighted turbo spin-echo (TSE) imaging of the degenerative disc disease of the lumbar spine. Materials and methods: Thirty-five consecutive patients (19 females, 16 males; mean age 41 years, range 31-67 years) with suspected degenerative disc disease of the lumbar spine were prospectively evaluated. Sagittal images of the lumbar spine were obtained using T1-weighted TSE and fast T1-weighted FLAIR sequences. Two radiologists compared these sequences both qualitatively and quantitatively. Results: On qualitative evaluation, CSF nulling, contrast at the disc-CSF interface, the disc-spinal cord (cauda equina) interface, and the spinal cord (cauda equina)-CSF interface of fast T1-weighted FLAIR images were significantly higher than those for T1-weighted TSE images (P < 0.001). On quantitative evaluation of the first 15 patients, signal-to-noise ratios of cerebrospinal fluid of fast T1-weighted FLAIR imaging were significantly lower than those for T1-weighted TSE images (P < 0.05). Contrast-to-noise ratios of spinal cord/CSF and normal bone marrow/disc for fast T1-weighted FLAIR images were significantly higher than those for T1-weighted TSE images (P < 0.05). Conclusion: Results in our study have shown that fast T1-weighted FLAIR imaging may be a valuable imaging modality in the armamentarium of lumbar spinal T1-weighted MR imaging, because the former technique has definite superior advantages such as CSF nulling, conspicuousness of the normal anatomic structures and changes in the lumbar spinal discogenic disease and image contrast and also almost equally acquisition times.

  5. Multimodal MEMPRAGE, FLAIR, and R2* Segmentation to Resolve Dura and Vessels from Cortical Gray Matter

    Directory of Open Access Journals (Sweden)

    Roberto Viviani

    2017-05-01

    Full Text Available While widely in use in automated segmentation approaches for the detection of group differences or of changes associated with continuous predictors in gray matter volume, T1-weighted images are known to represent dura and cortical vessels with signal intensities similar to those of gray matter. By considering multiple signal sources at once, multimodal segmentation approaches may be able to resolve these different tissue classes and address this potential confound. We explored here the simultaneous use of FLAIR and apparent transverse relaxation rates (a signal related to T2* relaxation maps and having similar contrast with T1-weighted images. Relative to T1-weighted images alone, multimodal segmentation had marked positive effects on 1. the separation of gray matter from dura, 2. the exclusion of vessels from the gray matter compartment, and 3. the contrast with extracerebral connective tissue. While obtainable together with the T1-weighted images without increasing scanning times, apparent transverse relaxation rates were less effective than added FLAIR images in providing the above mentioned advantages. FLAIR images also improved the detection of cortical matter in areas prone to susceptibility artifacts in standard MPRAGE T1-weighted images, while the addition of transverse relaxation maps exacerbated the effect of these artifacts on segmentation. Our results confirm that standard MPRAGE segmentation may overestimate gray matter volume by wrongly assigning vessels and dura to this compartment and show that multimodal approaches may greatly improve the specificity of cortical segmentation. Since multimodal segmentation is easily implemented, these benefits are immediately available to studies focusing on translational applications of structural imaging.

  6. Veins in plaques of multiple sclerosis patients - a longitudinal magnetic resonance imaging study at 7 Tesla

    Energy Technology Data Exchange (ETDEWEB)

    Dal-Bianco, Assunta; Auff, Eduard; Leutmezer, Fritz; Vass, Karl [Medical University of Vienna, Department of Neurology, Wien (Austria); Hametner, Simon [Medical University of Vienna, Center for Brain Research, Wien (Austria); Grabner, Guenther; Schernthaner, Melanie; Kronnerwetter, Claudia; Trattnig, Siegfried [Medical University of Vienna, Department of Radiology, Wien (Austria); Reitner, Andreas; Vass, Clemens; Kircher, Karl [Medical University of Vienna, Department of Ophthalmology, Wien (Austria)

    2015-10-15

    To monitor the venous volumes in plaques of patients with multiple sclerosis (MS) compared to an age-matched control group over a period of 3.5 years. Ten MS patients underwent an annual neurological examination and MRI. Susceptibility-weighted imaging (SWI) combined with fluid-attenuated inversion recovery (FLAIR) or FLAIR-like contrast at 7 Tesla (7 T) magnetic resonance imaging (MRI) was used for manual segmentation of veins in plaques, in the normal-appearing white matter (NAWM) and in location-matched white matter of 9 age-matched controls. Venous volume to tissue volume ratio was assessed for each time point in order to describe the dynamics of venous volumes in MS plaques over time. MS plaques, which were newly detected during the study period, showed significantly higher venous volumes compared to the preplaque area 1 year before plaque detection and the corresponding NAWM regions. Venous volumes in established MS plaques, which were present already in the first scans, were significantly higher compared to the NAWM and controls. Our data underpin a relation of veins and plaque development in MS and reflect increased apparent venous calibers due to increased venous diameters or increased oxygen consumption in early MS plaques. (orig.)

  7. Veins in plaques of multiple sclerosis patients - a longitudinal magnetic resonance imaging study at 7 Tesla

    International Nuclear Information System (INIS)

    Dal-Bianco, Assunta; Auff, Eduard; Leutmezer, Fritz; Vass, Karl; Hametner, Simon; Grabner, Guenther; Schernthaner, Melanie; Kronnerwetter, Claudia; Trattnig, Siegfried; Reitner, Andreas; Vass, Clemens; Kircher, Karl

    2015-01-01

    To monitor the venous volumes in plaques of patients with multiple sclerosis (MS) compared to an age-matched control group over a period of 3.5 years. Ten MS patients underwent an annual neurological examination and MRI. Susceptibility-weighted imaging (SWI) combined with fluid-attenuated inversion recovery (FLAIR) or FLAIR-like contrast at 7 Tesla (7 T) magnetic resonance imaging (MRI) was used for manual segmentation of veins in plaques, in the normal-appearing white matter (NAWM) and in location-matched white matter of 9 age-matched controls. Venous volume to tissue volume ratio was assessed for each time point in order to describe the dynamics of venous volumes in MS plaques over time. MS plaques, which were newly detected during the study period, showed significantly higher venous volumes compared to the preplaque area 1 year before plaque detection and the corresponding NAWM regions. Venous volumes in established MS plaques, which were present already in the first scans, were significantly higher compared to the NAWM and controls. Our data underpin a relation of veins and plaque development in MS and reflect increased apparent venous calibers due to increased venous diameters or increased oxygen consumption in early MS plaques. (orig.)

  8. Estimation of gadolinium-induced T1-shortening with measurement of simple signal intensity ratio between the cochlea and brain parenchyma on 3D-FLAIR. Correlation with T1 measurement by TI scout sequence

    International Nuclear Information System (INIS)

    Naganawa, Shinji; Ishihara, Shunichi; Iwano, Shingo; Kawai, Hisashi; Sone, Michihiko; Nakashima, Tsutomu

    2010-01-01

    The purpose of this study was to T 1 -shortening of labyrinthine fluid on 3-dimensional fluid-attenuated inversion recovery (3D-FLAIR) has been reported in many inner ear disorders. Although semi-quantitative assessment by simple signal intensity ratio between cochlear fluid and brain tissue has been tried, its feasibility using a multi-channel phased-array head coil with an inherently inhomogenous sensitivity distribution has not been fully evaluated. We evaluated the feasibility of measuring simple signal intensity ratio by correlating rapid T 1 measurements using an inversion time (TI) scout sequence. We evaluated 10 patients with Meniere's disease and 4 patients with sudden deafness. Nine of the patients with Meniere's disease received a unilateral intratympanic injection of gadolinium-diethylenetriamine pentaacetic acid (Gd-DTPA); the tenth patient received bilateral injections. The 4 patients with sudden deafness received a double-dose intravenous injection. Magnetic resonance (MR) images were obtained 24 hours after intratympanic injections and 4 hours after intravenous injections at 3 tesla using a 32-channel head coil. We measured the ratio (CM ratio) between the signal intensity of the perilymph in the cochlea (C) and that of the medulla oblongata (M) and correlated it with the null-point inversion time (TI null ) obtained with the TI scout sequence. The TI scout consisted of 85 images obtained with TI values between 132.5 and 3087.5 ms at increments of 37.5 ms. The correlation coefficient between TI null and the natural logarithm of the CM ratio was -0.88 (P<0.01). There was significant negative linear correlation. Measurement of the simple signal intensity ratio between the cochlea and the medulla can be used for semi-quantitative analysis of 3D-FLAIR. The results of this study may facilitate clinical research of inner-ear disease using 3D-FLAIR. (author)

  9. Real-time functional MR imaging (fMRI) for presurgical evaluation of paediatric epilepsy

    Energy Technology Data Exchange (ETDEWEB)

    Kesavadas, Chandrasekharan; Thomas, Bejoy; Kumar Gupta, Arun [Sree Chitra Tirunal Institute for Medical Sciences and Technology, Department of Imaging Sciences and Interventional Radiology, Trivandrum (India); Sujesh, Sreedharan [Sree Chitra Tirunal Institute for Medical Sciences and Technology, Biomedical Technology Wing, Trivandrum (India); Ashalata, Radhakrishnan; Radhakrishnan, Kurupath [Sree Chitra Tirunal Institute for Medical Sciences and Technology, Department of Neurology, Trivandrum (India); Abraham, Mathew [Sree Chitra Tirunal Institute for Medical Sciences and Technology, Department of Neurosurgery, Trivandrum (India)

    2007-10-15

    The role of fMRI in the presurgical evaluation of children with intractable epilepsy is being increasingly recognized. Real-time fMRI allows the clinician to visualize functional brain activation in real time. Since there is no off-line data analysis as in conventional fMRI, the overall time for the procedure is reduced, making it clinically feasible in a busy clinical sitting. (1) To study the accuracy of real-time fMRI in comparison to conventional fMRI with off-line processing; (2) to determine its effectiveness in mapping the eloquent cortex and language lateralization in comparison to invasive procedures such as intraoperative cortical stimulation and Wada testing; and (3) to evaluate the role of fMRI in presurgical decision making in children with epilepsy. A total of 23 patients (age range 6-18 years) underwent fMRI with sensorimotor, visual and language paradigms. Data processing was done in real time using in-line BOLD. The results of real-time fMRI matched those of off-line processing done using the well-accepted standard technique of statistical parametric mapping (SPM) in all the initial ten patients in whom the two techniques were compared. Coregistration of the fMRI data on a 3-D FLAIR sequence rather than a T1-weighted image gave better information regarding the relationship of the lesion to the area of activation. The results of intraoperative cortical stimulation and fMRI matched in six out of six patients, while the Wada test and fMRI had similar results in four out of five patients in whom these techniques were performed. In the majority of patients in this series the technique influenced patient management. Real-time fMRI is an easily performed and reliable technique in the presurgical workup of children with epilepsy. (orig.)

  10. Real-time functional MR imaging (fMRI) for presurgical evaluation of paediatric epilepsy

    International Nuclear Information System (INIS)

    Kesavadas, Chandrasekharan; Thomas, Bejoy; Kumar Gupta, Arun; Sujesh, Sreedharan; Ashalata, Radhakrishnan; Radhakrishnan, Kurupath; Abraham, Mathew

    2007-01-01

    The role of fMRI in the presurgical evaluation of children with intractable epilepsy is being increasingly recognized. Real-time fMRI allows the clinician to visualize functional brain activation in real time. Since there is no off-line data analysis as in conventional fMRI, the overall time for the procedure is reduced, making it clinically feasible in a busy clinical sitting. (1) To study the accuracy of real-time fMRI in comparison to conventional fMRI with off-line processing; (2) to determine its effectiveness in mapping the eloquent cortex and language lateralization in comparison to invasive procedures such as intraoperative cortical stimulation and Wada testing; and (3) to evaluate the role of fMRI in presurgical decision making in children with epilepsy. A total of 23 patients (age range 6-18 years) underwent fMRI with sensorimotor, visual and language paradigms. Data processing was done in real time using in-line BOLD. The results of real-time fMRI matched those of off-line processing done using the well-accepted standard technique of statistical parametric mapping (SPM) in all the initial ten patients in whom the two techniques were compared. Coregistration of the fMRI data on a 3-D FLAIR sequence rather than a T1-weighted image gave better information regarding the relationship of the lesion to the area of activation. The results of intraoperative cortical stimulation and fMRI matched in six out of six patients, while the Wada test and fMRI had similar results in four out of five patients in whom these techniques were performed. In the majority of patients in this series the technique influenced patient management. Real-time fMRI is an easily performed and reliable technique in the presurgical workup of children with epilepsy. (orig.)

  11. Effect of bevacizumab on radiation necrosis of the brain

    International Nuclear Information System (INIS)

    Gonzalez, Javier; Kumar, Ashok J.; Conrad, Charles A.; Levin, Victor A.

    2007-01-01

    Purpose: Because blocking vascular endothelial growth factor (VEGF) from reaching leaky capillaries is a logical strategy for the treatment of radiation necrosis, we reasoned that bevacizumab might be an effective treatment of radiation necrosis. Patients and Methods: Fifteen patients with malignant brain tumors were treated with bevacizumab or bevacizumab combination for their tumor on either a 5 mg/kg/2-week or 7.5 mg/kg/3-week schedule. Radiation necrosis was diagnosed in 8 of these patients on the basis of magnetic resonance imaging (MRI) and biopsy. MRI studies were obtained before treatment and at 6-week to 8-week intervals. Results: Of the 8 patients with radiation necrosis, posttreatment MRI performed an average of 8.1 weeks after the start of bevacizumab therapy showed a reduction in all 8 patients in both the MRI fluid-attenuated inversion-recovery (FLAIR) abnormalities and T1-weighted post-Gd-contrast abnormalities. The average area change in the T1-weighted post-Gd-contrast abnormalities was 48% (±22 SD), and the average change in the FLAIR images was 60% (±18 SD). The average reduction in daily dexamethasone requirements was 8.6 mg (±3.6). Conclusion: Bevacizumab, alone and in combination with other agents, can reduce radiation necrosis by decreasing capillary leakage and the associated brain edema. Our findings will need to be confirmed in a randomized trial to determine the optimal duration of treatment

  12. MRI Sequences in Head & Neck Radiology - State of the Art.

    Science.gov (United States)

    Widmann, Gerlig; Henninger, Benjamin; Kremser, Christian; Jaschke, Werner

    2017-05-01

    Background  Magnetic resonance imaging (MRI) has become an essential imaging modality for the evaluation of head & neck pathologies. However, the diagnostic power of MRI is strongly related to the appropriate selection and interpretation of imaging protocols and sequences. The aim of this article is to review state-of-the-art sequences for the clinical routine in head & neck MRI and to describe the evidence for which medical question these sequences and techniques are useful. Method  Literature review of state-of-the-art sequences in head & neck MRI. Results and Conclusion  Basic sequences (T1w, T2w, T1wC+) and fat suppression techniques (TIRM/STIR, Dixon, Spectral Fat sat) are important tools in the diagnostic workup of inflammation, congenital lesions and tumors including staging. Additional sequences (SSFP (CISS, FIESTA), SPACE, VISTA, 3D-FLAIR) are used for pathologies of the cranial nerves, labyrinth and evaluation of endolymphatic hydrops in Menière's disease. Vessel and perfusion sequences (3D-TOF, TWIST/TRICKS angiography, DCE) are used in vascular contact syndromes, vascular malformations and analysis of microvascular parameters of tissue perfusion. Diffusion-weighted imaging (EPI-DWI, non-EPI-DWI, RESOLVE) is helpful in cholesteatoma imaging, estimation of malignancy, and evaluation of treatment response and posttreatment recurrence in head & neck cancer. Understanding of MRI sequences and close collaboration with referring physicians improves the diagnostic confidence of MRI in the daily routine and drives further research in this fascinating image modality. Key Points:   · Understanding of MRI sequences is essential for the correct and reliable interpretation of MRI findings.. · MRI protocols have to be carefully selected based on relevant clinical information.. · Close collaboration with referring physicians improves the output obtained from the diagnostic possibilities of MRI.. Citation Format · Widmann G, Henninger B, Kremser C et

  13. Identifying MRI markers to evaluate early treatment-related changes post-laser ablation for cancer pain management

    Science.gov (United States)

    Tiwari, Pallavi; Danish, Shabbar; Madabhushi, Anant

    2014-03-01

    Laser interstitial thermal therapy (LITT) has recently emerged as a new treatment modality for cancer pain management that targets the cingulum (pain center in the brain), and has shown promise over radio-frequency (RF) based ablation which is reported to provide temporary relief. One of the major advantages enjoyed by LITT is its compatibility with magnetic resonance imaging (MRI), allowing for high resolution in vivo imaging to be used in LITT procedures. Since laser ablation for pain management is currently exploratory and is only performed at a few centers worldwide, its short-, and long-term effects on the cingulum are currently unknown. Traditionally treatment effects are evaluated by monitoring changes in volume of the ablation zone post-treatment. However, this is sub-optimal since it involves evaluating a single global parameter (volume) to detect changes pre-, and post-MRI. Additionally, the qualitative observations of LITT-related changes on multi-parametric MRI (MPMRI) do not specifically address differentiation between the appearance of treatment related changes (edema, necrosis) from recurrence of the disease (pain recurrence). In this work, we explore the utility of computer extracted texture descriptors on MP-MRI to capture early treatment related changes on a per-voxel basis by extracting quantitative relationships that may allow for an in-depth understanding of tissue response to LITT on MRI, subtle changes that may not be appreciable on original MR intensities. The second objective of this work is to investigate the efficacy of different MRI protocols in accurately capturing treatment related changes within and outside the ablation zone post-LITT. A retrospective cohort of studies comprising pre- and 24-hour post-LITT 3 Tesla T1-weighted (T1w), T2w, T2-GRE, and T2-FLAIR acquisitions was considered. Our scheme involved (1) inter-protocol as well as inter-acquisition affine registration of pre- and post-LITT MRI, (2) quantitation of MRI parameters

  14. Mapping Radiation Injury and Recovery in Bone Marrow Using 18F-FLT PET/CT and USPIO MRI in a Rat Model.

    Science.gov (United States)

    Rendon, David A; Kotedia, Khushali; Afshar, Solmaz F; Punia, Jyotinder N; Sabek, Omaima M; Shirkey, Beverly A; Zawaski, Janice A; Gaber, M Waleed

    2016-02-01

    We present and test the use of multimodality imaging as a topological tool to map the amount of the body exposed to ionizing radiation and the location of exposure, which are important indicators of survival and recovery. To achieve our goal, PET/CT imaging with 3'-deoxy-3'-(18)F-fluorothymidine ((18)F-FLT) was used to measure cellular proliferation in bone marrow (BM), whereas MRI using ultra-small superparamagnetic iron oxide (USPIO) particles provided noninvasive information on radiation-induced vascular damage. Animals were x-ray-irradiated at a dose of 7.5 Gy with 1 of 3 radiation schemes-whole-body irradiation, half-body shielding (HBS), or 1-leg shielding (1LS)-and imaged repeatedly. The spatial information from the CT scan was used to segment the region corresponding to BM from the PET scan using algorithms developed in-house, allowing for quantification of proliferating cells, and BM blood volume was estimated by measuring the changes in the T2 relaxation rates (ΔR2) collected from MR scans. (18)F-FLT PET/CT imaging differentiated irradiated from unirradiated BM regions. Two days after irradiation, proliferation of 1LS animals was significantly lower than sham (P = 0.0001, femurs; P < 0.0001, tibias) and returned to sham levels by day 10 (P = 0.6344, femurs; P = 0.3962, tibias). The degree of shielding affected proliferation recovery, showing an increase in the irradiated BM of the femurs, but not the tibias, of HBS animals when compared with 1LS (P = 0.0310, femurs; P = 0.5832, tibias). MRI of irradiated spines detected radiation-induced BM vascular damage, measured by the significant increase in ΔR2 2 d after whole-body irradiation (P = 0.0022) and HBS (P = 0.0003) with a decreasing trend of values, returning to levels close to baseline over 10 d. Our data were corroborated using γ-counting and histopathology. We demonstrated that (18)F-FLT PET/CT and USPIO MRI are valuable tools in mapping regional radiation exposure and the effects of radiation on

  15. MRI detection of hypointense brain lesions in patients with multiple sclerosis: T1 spin-echo vs. gradient-echo

    Energy Technology Data Exchange (ETDEWEB)

    Dupuy, Sheena L.; Tauhid, Shahamat; Kim, Gloria; Chu, Renxin; Tummala, Subhash [Departments of Neurology, Brigham and Women' s Hospital, Laboratory for Neuroimaging Research, Partners MS Center, Harvard Medical School, Boston, MA (United States); Hurwitz, Shelley [Departments of Medicine, Brigham and Women' s Hospital, Harvard Medical School, Boston, MA (United States); Bakshi, Rohit, E-mail: rbakshi@bwh.harvard.edu [Departments of Neurology, Brigham and Women' s Hospital, Laboratory for Neuroimaging Research, Partners MS Center, Harvard Medical School, Boston, MA (United States); Departments of Radiology, Brigham and Women' s Hospital, Harvard Medical School, Boston, MA (United States)

    2015-08-15

    Highlights: • Compared T1SE and T1GE in detecting hypointense brain lesions in MS patients. • T1GE detected a higher cerebral lesion volume and number than T1SE. • T1SE correlated significantly with disability, while T1GE did not. • Hypointense lesions on T1SE and T1GE are not interchangeable in patients with MS. - Abstract: Objective: Compare T1 spin-echo (T1SE) and T1 gradient-echo (T1GE) sequences in detecting hypointense brain lesions in multiple sclerosis (MS). Background: Chronic hypointense lesions on T1SE MRI scans are a surrogate of severe demyelination and axonal loss in MS. The role of T1GE images in the detection of such lesions has not been clarified. Design/methods: In 45 patients with MS [Expanded Disability Status Scale (EDSS) score (mean ± SD) 3.5 ± 2.0; 37 relapsing-remitting (RR); 8 secondary progressive (SP)], cerebral T1SE, T1GE, and T2-weighted fluid-attenuated inversion-recovery (FLAIR) images were acquired on a 1.5 T MRI scanner. Images were re-sampled to axial 5 mm slices before directly comparing lesion detectability using Jim (v.7, Xinapse Systems). Statistical methods included Wilcoxon signed rank tests to compare sequences and Spearman correlations to test associations. Results: Considering the entire cohort, T1GE detected a higher lesion volume (5.90 ± 6.21 vs. 4.17 ± 4.84 ml, p < 0.0001) and higher lesion number (27.82 ± 20.66 vs. 25.20 ± 20.43, p < 0.05) than T1SE. Lesion volume differences persisted when considering RR and SP patients separately (both p < 0.01). A higher lesion number by T1GE was seen only in the RR group (p < 0.05). When comparing correlations between lesion volume and overall neurologic disability (EDSS score), T1SE correlated with EDSS (Spearman r = 0.29, p < 0.05) while T1GE (r = 0.23, p = 0.13) and FLAIR (r = 0.24, p = 0.12) did not. Conclusion: Our data suggest that hypointense lesions on T1SE and T1GE are not interchangeable in patients with MS. Based on these results, we hypothesize that T1GE

  16. MRI detection of hypointense brain lesions in patients with multiple sclerosis: T1 spin-echo vs. gradient-echo

    International Nuclear Information System (INIS)

    Dupuy, Sheena L.; Tauhid, Shahamat; Kim, Gloria; Chu, Renxin; Tummala, Subhash; Hurwitz, Shelley; Bakshi, Rohit

    2015-01-01

    Highlights: • Compared T1SE and T1GE in detecting hypointense brain lesions in MS patients. • T1GE detected a higher cerebral lesion volume and number than T1SE. • T1SE correlated significantly with disability, while T1GE did not. • Hypointense lesions on T1SE and T1GE are not interchangeable in patients with MS. - Abstract: Objective: Compare T1 spin-echo (T1SE) and T1 gradient-echo (T1GE) sequences in detecting hypointense brain lesions in multiple sclerosis (MS). Background: Chronic hypointense lesions on T1SE MRI scans are a surrogate of severe demyelination and axonal loss in MS. The role of T1GE images in the detection of such lesions has not been clarified. Design/methods: In 45 patients with MS [Expanded Disability Status Scale (EDSS) score (mean ± SD) 3.5 ± 2.0; 37 relapsing-remitting (RR); 8 secondary progressive (SP)], cerebral T1SE, T1GE, and T2-weighted fluid-attenuated inversion-recovery (FLAIR) images were acquired on a 1.5 T MRI scanner. Images were re-sampled to axial 5 mm slices before directly comparing lesion detectability using Jim (v.7, Xinapse Systems). Statistical methods included Wilcoxon signed rank tests to compare sequences and Spearman correlations to test associations. Results: Considering the entire cohort, T1GE detected a higher lesion volume (5.90 ± 6.21 vs. 4.17 ± 4.84 ml, p < 0.0001) and higher lesion number (27.82 ± 20.66 vs. 25.20 ± 20.43, p < 0.05) than T1SE. Lesion volume differences persisted when considering RR and SP patients separately (both p < 0.01). A higher lesion number by T1GE was seen only in the RR group (p < 0.05). When comparing correlations between lesion volume and overall neurologic disability (EDSS score), T1SE correlated with EDSS (Spearman r = 0.29, p < 0.05) while T1GE (r = 0.23, p = 0.13) and FLAIR (r = 0.24, p = 0.12) did not. Conclusion: Our data suggest that hypointense lesions on T1SE and T1GE are not interchangeable in patients with MS. Based on these results, we hypothesize that T1GE

  17. Magnetic resonance characteristics and susceptibility weighted imaging of the brain in gadolinium encephalopathy.

    Science.gov (United States)

    Samardzic, Dejan; Thamburaj, Krishnamoorthy

    2015-01-01

    To report the brain imaging features on magnetic resonance imaging (MRI) in inadvertent intrathecal gadolinium administration. A 67-year-old female with gadolinium encephalopathy from inadvertent high dose intrathecal gadolinium administration during an epidural steroid injection was studied with multisequence 3T MRI. T1-weighted imaging shows pseudo-T2 appearance with diffusion of gadolinium into the brain parenchyma, olivary bodies, and membranous labyrinth. Nulling of cerebrospinal fluid (CSF) signal is absent on fluid attenuation recovery (FLAIR). Susceptibility-weighted imaging (SWI) demonstrates features similar to subarachnoid hemorrhage. CT may demonstrate a pseudo-cerebral edema pattern given the high attenuation characteristics of gadolinium. Intrathecal gadolinium demonstrates characteristic imaging features on MRI of the brain and may mimic subarachnoid hemorrhage on susceptibility-weighted imaging. Identifying high dose gadolinium within the CSF spaces on MRI is essential to avoid diagnostic and therapeutic errors. Copyright © 2013 by the American Society of Neuroimaging.

  18. Central nervous system infectious diseases mimicking multiple sclerosis: recognizing distinguishable features using MRI

    Directory of Open Access Journals (Sweden)

    Antonio Jose da Rocha

    2013-09-01

    Full Text Available The current diagnostic criteria for multiple sclerosis (MS confirm the relevant role of magnetic resonance imaging (MRI, supporting the possibility of characterizing the dissemination in space (DIS and the dissemination in time (DIT in a single scan. To maintain the specificity of these criteria, it is necessary to determine whether T2/FLAIR visible lesions and the gadolinium enhancement can be attributed to diseases that mimic MS. Several diseases are included in the MS differential diagnosis list, including diseases with exacerbation, remitting periods and numerous treatable infectious diseases, which can mimic the MRI features of MS. We discuss the most relevant imaging features in several infectious diseases that resemble MS and examine the primary spatial distributions of lesions and the gadolinium enhancement patterns related to MS. Recognizing imaging "red flags" can be useful for the proper diagnostic evaluation of suspected cases of MS, facilitating the correct differential diagnosis by assessing the combined clinical, laboratory and MR imaging information.

  19. Cerebrospinal Fluid Enhancement on Fluid Attenuated Inversion Recovery Images After Carotid Artery Stenting with Neuroprotective Balloon Occlusions: Hemodynamic Instability and Blood–Brain Barrier Disruption

    International Nuclear Information System (INIS)

    Ogami, Ryo; Nakahara, Toshinori; Hamasaki, Osamu; Araki, Hayato; Kurisu, Kaoru

    2011-01-01

    Purpose: A rare complication of carotid artery stenting (CAS), prolonged reversible neurological symptoms with delayed cerebrospinal fluid (CSF) space enhancement on fluid attenuated inversion recovery (FLAIR) images, is associated with blood–brain barrier (BBB) disruption. We prospectively identified patients who showed CSF space enhancement on FLAIR images. Methods: Nineteen patients—5 acute-phase and 14 scheduled—underwent 21 CAS procedures. Balloon catheters were navigated across stenoses, angioplasty was performed using a neuroprotective balloon, and stents were placed with after dilation under distal balloon protection. CSF space hyperintensity or obscuration on FLAIR after versus before CAS indicated CSF space enhancement. Correlations with clinical factors were examined. Results: CSF space was enhanced on FLAIR in 12 (57.1%) cases. Postprocedural CSF space enhancement was significantly related to age, stenosis rate, acute-stage procedure, and total occlusion time. All acute-stage CAS patients showed delayed enhancement. Only age was associated with delayed CSF space enhancement in scheduled CAS patients. Conclusions: Ischemic intolerance for severe carotid artery stenosis and temporary neuroprotective balloon occlusion, causing reperfusion injury, seem to be the main factors that underlie BBB disruption with delayed CSF space enhancement shortly after CAS, rather than sudden poststenting hemodynamic change. Our results suggest that factors related to hemodynamic instability or ischemic intolerance seem to be associated with post-CAS BBB vulnerability. Patients at risk for hemodynamic instability or with ischemic intolerance, which decrease BBB integrity, require careful management to prevent intracranial hemorrhagic and other post-CAS complications.

  20. MRI in head trauma

    International Nuclear Information System (INIS)

    Hong, Jin Kyo

    1986-01-01

    In the diagnosis of head injury, Magnetic Resonance Imaging (MRI), like CT, is an effective method of distinguishing between intracerebral and extracerebral lesions. In our experience of MRI, early hematomas are almost isointense by Saturation Recovery (SR) method, so these must be performed with Spin Echo (SE) method for better visualization of hematomas. Isodense subdural hematomas, which is a diagnostic dilemma on CT images, are clearly seen on MRI. Delayed hematomas or residual parenchymal lesions are better demonstrated on MRI than on CT. Direct cornal, sagittal images and multiplanar facility of MRI provides excellent visualization of the the location and shape of extracerebral collection of hematoma. For the screening of head traumas, SE method is a technique of choice because of its excellent sensitivity within limited time.

  1. MRI in head trauma

    Energy Technology Data Exchange (ETDEWEB)

    Hong, Jin Kyo [Shin Wha Hospital, Seoul (Korea, Republic of)

    1986-02-15

    In the diagnosis of head injury, Magnetic Resonance Imaging (MRI), like CT, is an effective method of distinguishing between intracerebral and extracerebral lesions. In our experience of MRI, early hematomas are almost isointense by Saturation Recovery (SR) method, so these must be performed with Spin Echo (SE) method for better visualization of hematomas. Isodense subdural hematomas, which is a diagnostic dilemma on CT images, are clearly seen on MRI. Delayed hematomas or residual parenchymal lesions are better demonstrated on MRI than on CT. Direct cornal, sagittal images and multiplanar facility of MRI provides excellent visualization of the the location and shape of extracerebral collection of hematoma. For the screening of head traumas, SE method is a technique of choice because of its excellent sensitivity within limited time.

  2. MRI in multiple sclerosis of the spinal cord: evaluation of fast short-tan inversion-recovery and spin-echo sequences

    International Nuclear Information System (INIS)

    Dietemann, J.L.; Thibaut-Menard, A.; Neugroschl, C.; Gillis, C.; Abu Eid, M.; Bogorin, A.; Warter, J.M.; Tranchant, C.

    2000-01-01

    We compared the sensitivity of T2-weighted spin-echo (FSE) and fast short-tau inversion-recovery (fSTIR) sequences in detection of multiple sclerosis of the spinal cord in 100 consecutive patients with clinically confirmed multiple sclerosis (MS); 86 patients underwent also brain MRI. In all, 310 focal lesions were detected on fSTIR and 212 on T2-weighted FSE, spinal cord lesions were seen better on fSTIR images, with a higher contrast between the lesion and the normal spinal cord. In 24 patients in whom cord plaques were shown with both sequences, the cranial study was normal or inconclusive. Assessment of spinal plaques can be particularly important when MRI of the brain is inconclusive, and in there situations fSTIR can be helpful. (orig.)

  3. Separate visualization of endolymphatic space, perilymphatic space and bone by a single pulse sequence; 3D-inversion recovery imaging utilizing real reconstruction after intratympanic Gd-DTPA administration at 3 tesla

    International Nuclear Information System (INIS)

    Naganawa, Shinji; Satake, Hiroko; Kawamura, Minako; Fukatsu, Hiroshi; Sone, Michihiko; Nakashima, Tsutomu

    2008-01-01

    Twenty-four hours after intratympanic administration of gadolinium contrast material (Gd), the Gd was distributed mainly in the perilymphatic space. Three-dimensional FLAIR can differentiate endolymphatic space from perilymphatic space, but not from surrounding bone. The purpose of this study was to evaluate whether 3D inversion-recovery turbo spin echo (3D-IR TSE) with real reconstruction could separate the signals of perilymphatic space (positive value), endolymphatic space (negative value) and bone (near zero) by setting the inversion time between the null point of Gd-containing perilymph fluid and that of the endolymph fluid without Gd. Thirteen patients with clinically suspected endolymphatic hydrops underwent intratympanic Gd injection and were scanned at 3 T. A 3D FLAIR and 3D-IR TSE with real reconstruction were obtained. In all patients, low signal of endolymphatic space in the labyrinth on 3D FLAIR was observed in the anatomically appropriate position, and it showed negative signal on 3D-IR TSE. The low signal area of surrounding bone on 3D FLAIR showed near zero signal on 3D-IR TSE. Gd-containing perilymphatic space showed high signal on 3D-IR TSE. In conclusion, by optimizing the inversion time, endolymphatic space, perilymphatic space and surrounding bone can be separately visualized on a single image using a 3D-IR TSE with real reconstruction. (orig.)

  4. Cerebral lesions in acute arterial hypertension: the characteristic MRI in hypertensive encephalopathy

    International Nuclear Information System (INIS)

    Schneider, J.P.; Krohmer, S.; Guenther, A.; Zimmer, C.

    2006-01-01

    Purpose: in the nine years since the posterior reversible (leuc) encephalopathy syndrome (PRES) was first described, a number of causes have been under discussion. These not only include arterial hypertension, i. e. hypertensive crises, but also various toxic substances, i. e. immunosuppressive or chemotherapeutic agents, that are responsible for the formation of the symptoms and characteristic MR tomographic brain findings. Materials and methods: initial and follow-up MRI examinations of 8 patients were analyzed. All patients had acute neurological symptoms (headaches, seizures, visual disorders and vigilance disturbances) together with a detectable hypertensive crisis. Results: MRI disclosed increased signal intensity in subcortical and some cortical lesions in all patient FLAIR sequences. These changes were particularly extensive in the posterior circulation (occipital, cerebellum and brain stem) although they were also detected in brain areas supplied by the carotid artery. However, a cytotoxic genesis of the changes was ruled out in each patient by means of a normal DWI. Furthermore, when the blood pressure was normalized, reversibility of the lesions as proof of the diagnosis was detectable. (orig.)

  5. Examination of the role of magnetic resonance imaging in multiple sclerosis: A problem-orientated approach

    Directory of Open Access Journals (Sweden)

    McFarland Henry

    2009-01-01

    Full Text Available Magnetic Resonance Imaging (MRI has brought in several benefits to the study of Multiple Sclerosis (MS. It provides accurate measurement of disease activity, facilitates precise diagnosis, and aid in the assessment of newer therapies. The imaging guidelines for MS are broadly divided in to approaches for imaging patients with suspected MS or clinically isolated syndromes (CIS or for monitoring patients with established MS. In this review, the technical aspects of MR imaging for MS are briefly discussed. The imaging process need to capture the twin aspects of acute MS viz. the autoimmune acute inflammatory process and the neurodegenerative process. Gadolinium enhanced MRI can identify acute inflammatory lesions precisely. The commonly applied MRI marker of disease progression is brain atrophy. Whole brain magnetization Transfer Ratio (MTR and Magnetic Resonance Spectroscopy (MRS are two other techniques use to monitor disease progression. A variety of imaging techniques such as Double Inversion Recovery (DIR, Spoiled Gradient Recalled (SPGR acquisition, and Fluid Attenuated Inversion Recovery (FLAIR have been utilized to study the cortical changes in MS. MRI is now extensively used in the Phase I, II and III clinical trials of new therapies. As the technical aspects of MRI advance rapidly, and higher field strengths become available, it is hoped that the impact of MRI on our understanding of MS will be even more profound in the next decade.

  6. Multimodal 18F-Fluciclovine PET/MRI and Ultrasound-Guided Neurosurgery of an Anaplastic Oligodendroglioma.

    Science.gov (United States)

    Karlberg, Anna; Berntsen, Erik Magnus; Johansen, Håkon; Myrthue, Mariane; Skjulsvik, Anne Jarstein; Reinertsen, Ingerid; Esmaeili, Morteza; Dai, Hong Yan; Xiao, Yiming; Rivaz, Hassan; Borghammer, Per; Solheim, Ole; Eikenes, Live

    2017-12-01

    Structural magnetic resonance imaging (MRI) and histopathologic tissue sampling are routinely performed as part of the diagnostic workup for patients with glioma. Because of the heterogeneous nature of gliomas, there is a risk of undergrading caused by histopathologic sampling errors. MRI has limitations in identifying tumor grade and type, detecting diffuse invasive growth, and separating recurrences from treatment induced changes. Positron emission tomography (PET) can provide quantitative information of cellular activity and metabolism, and may therefore complement MRI. In this report, we present the first patient with brain glioma examined with simultaneous PET/MRI using the amino acid tracer 18 F-fluciclovine ( 18 F-FACBC) for intraoperative image-guided surgery. A previously healthy 60-year old woman was admitted to the emergency care with speech difficulties and a mild left-sided hemiparesis. MRI revealed a tumor that was suggestive of glioma. Before surgery, the patient underwent a simultaneous PET/MRI examination. Fused PET/MRI, T1, FLAIR, and intraoperative three-dimensional ultrasound images were used to guide histopathologic tissue sampling and surgical resection. Navigated, image-guided histopathologic samples were compared with PET/MRI image data to assess the additional value of the PET acquisition. Histopathologic analysis showed anaplastic oligodendroglioma in the most malignant parts of the tumor, while several regions were World Health Organization (WHO) grade II. 18 F-Fluciclovine uptake was found in parts of the tumor where regional WHO grade, cell proliferation, and cell densities were highest. This finding suggests that PET/MRI with this tracer could be used to improve accuracy in histopathologic tissue sampling and grading, and possibly for guiding treatments targeting the most malignant part of extensive and eloquent gliomas. Copyright © 2017 The Author(s). Published by Elsevier Inc. All rights reserved.

  7. [The Role of Imaging in Central Nervous System Infections].

    Science.gov (United States)

    Yokota, Hajime; Tazoe, Jun; Yamada, Kei

    2015-07-01

    Many infections invade the central nervous system. Magnetic resonance imaging (MRI) is the main tool that is used to evaluate infectious lesions of the central nervous system. The useful sequences on MRI are dependent on the locations, such as intra-axial, extra-axial, and spinal cord. For intra-axial lesions, besides the fundamental sequences, including T1-weighted images, T2-weighted images, and fluid-attenuated inversion recovery (FLAIR) images, advanced sequences, such as diffusion-weighted imaging, diffusion tensor imaging, susceptibility-weighted imaging, and MR spectroscopy, can be applied. They are occasionally used as determinants for quick and correct diagnosis. For extra-axial lesions, understanding the differences among 2D-conventional T1-weighted images, 2D-fat-saturated T1-weighted images, 3D-Spin echo sequences, and 3D-Gradient echo sequence after the administration of gadolinium is required to avoid wrong interpretations. FLAIR plus gadolinium is a useful tool for revealing abnormal enhancement on the brain surface. For the spinal cord, the sequences are limited. Evaluating the distribution and time course of the spinal cord are essential for correct diagnoses. We summarize the role of imaging in central nervous system infections and show the pitfalls, key points, and latest information in them on clinical practices.

  8. Cognitive Function and 3-Tesla Magnetic Resonance Imaging Tractography of White Matter Hyperintensities in Elderly Persons.

    Science.gov (United States)

    Reginold, William; Luedke, Angela C; Tam, Angela; Itorralba, Justine; Fernandez-Ruiz, Juan; Reginold, Jennifer; Islam, Omar; Garcia, Angeles

    2015-01-01

    This study used 3-Tesla magnetic resonance imaging (MRI) tractography to determine if there was an association between tracts crossing white matter hyperintensities (WMH) and cognitive function in elderly persons. Brain T2-weighted fluid-attenuated inversion recovery (FLAIR) and diffusion tensor MRI scans were acquired in participants above the age of 60 years. Twenty-six persons had WMH identified on T2 FLAIR scans. They completed a battery of neuropsychological tests and were classified as normal controls (n = 15) or with Alzheimer's dementia (n = 11). Tractography was generated by the Fiber Assignment by Continuous Tracking method. All tracts that crossed WMH were segmented. The average fractional anisotropy and average mean diffusivity of these tracts were quantified. We studied the association between cognitive test scores with the average mean diffusivity and average fractional anisotropy of tracts while controlling for age, total WMH volume and diagnosis. An increased mean diffusivity of tracts crossing WMH was associated with worse performance on the Wechsler Memory Scale-III Longest Span Forward (p = 0.02). There was no association between the fractional anisotropy of tracts and performance on cognitive testing. The mean diffusivity of tracts crossing WMH measured by tractography is a novel correlate of performance on the Wechsler Memory Scale-III Longest Span Forward in elderly persons.

  9. Brain Magnetic Resonance Imaging Does Not Contribute to the Diagnosis of Chronic Neuroborreliosis

    Energy Technology Data Exchange (ETDEWEB)

    Aalto, A.; Sjoewall, J.; Davidsson, L.; Forsberg, P.; Smedby, Oe. [Div. of Radiology, Dept. of Medicine and Care, and Div. of Infectious Diseases, Dept. of Molecular and Clinical Medicine, Linkoeping Univ., Linkoeping (Sweden)

    2007-09-15

    Background: Borrelia infections, especially chronic neuroborreliosis (NB), may cause considerable diagnostic problems. This diagnosis is based on symptoms and findings in the cerebrospinal fluid but is not always conclusive. Purpose: To evaluate brain magnetic resonance imaging (MRI) in chronic NB, to compare the findings with healthy controls, and to correlate MRI findings with disease duration. Material and Methods: Sixteen well-characterized patients with chronic NB and 16 matched controls were examined in a 1.5T scanner with a standard head coil. T1- (with and without gadolinium), T2-, and diffusion-weighted imaging plus fluid-attenuated inversion recovery (FLAIR) imaging were used. Results: White matter lesions and lesions in the basal ganglia were seen in 12 patients and 10 controls (no significant difference). Subependymal lesions were detected in patients down to the age of 25 and in the controls down to the age of 43. The number of lesions was correlated to age both in patients ( = 0.83, P<0.01) and in controls ( = 0.61, P<0.05), but not to the duration of disease. Most lesions were detected with FLAIR, but many also with T2-weighted imaging. Conclusion: A number of MRI findings were detected in patients with chronic NB, although the findings were unspecific when compared with matched controls and did not correlate with disease duration. However, subependymal lesions may constitute a potential finding in chronic NB.

  10. Learning Foreign Languages with ClipFlair: Using Captioning and Revoicing Activities to Increase Students' Motivation and Engagement

    Science.gov (United States)

    Baños, Rocío; Sokoli, Stavroula

    2015-01-01

    The purpose of this paper is to present the rationale and outcomes of ClipFlair, a European-funded project aimed at countering the factors that discourage Foreign Language Learning (FLL) by providing a motivating, easily accessible online platform to learn a foreign language through revoicing (e.g. dubbing) and captioning (e.g. subtitling). This…

  11. Fluid-attenuated inversion recovery vascular hyperintensities in predicting cerebral hyperperfusion after intracranial arterial stenting

    Energy Technology Data Exchange (ETDEWEB)

    Wan, Chih-Cheng; Chen, David Yen-Ting; Tseng, Ying-Chi; Lee, Kun-Yu; Chiang, Chen-Hua; Chen, Chi-Jen [Taipei Medical University, Department of Radiology, Shuang-Ho Hospital, New Taipei City (China); Taipei Medical University, School of Medicine, College of Medicine, Taipei (China); Yan, Feng-Xian [Taipei Medical University, Department of Radiology, Shuang-Ho Hospital, New Taipei City (China)

    2017-08-15

    No reliable imaging sign predicting cerebral hyperperfusion after intracranial arterial stenting (IAS) had been described in the literature. This study evaluated the effect of fluid-attenuated inversion recovery vascular hyperintensities (FVHs), also called hyperintense vessel sign on T2-weighted fluid-attenuated inversion recovery (T2-FLAIR) MR images, in predicting significant increase in cerebral blood flow (CBF) defined by arterial spin labeling (ASL) after IAS. We reviewed ASL CBF images and T2-FLAIR MR images before (D0), 1 day after (D1), and 3 days after (D3) IAS of 16 patients. T1-weighted MR images were used as cerebral maps for calculating CBF. The changes in CBF values after IAS were calculated in and compared among stenting and nonstenting vascular territories. An increase more than 50% of CBF was considered as hyperperfusion. The effect of FVHs in predicting hyperperfusion was calculated. The D1 CBF value was significantly higher than the D0 CBF value in stenting vascular, contralateral anterior cerebral artery, contralateral middle cerebral artery, and contralateral posterior cerebral artery (PCA) territories (all P <.05). The D1 and D3 CBF values were significantly higher than the D0 CBF value in overall vascular (P <.001), overall nonstenting vascular (P <.001), and ipsilateral PCA (P <.05) territories. The rate of more than 50% increases in CBF was significantly higher in patients who exhibited asymmetric FVHs than in those who did not exhibit these findings. FVHs could be a critical predictor of a significant increase in CBF after IAS. (orig.)

  12. Fluid-attenuated inversion recovery vascular hyperintensities in predicting cerebral hyperperfusion after intracranial arterial stenting

    International Nuclear Information System (INIS)

    Wan, Chih-Cheng; Chen, David Yen-Ting; Tseng, Ying-Chi; Lee, Kun-Yu; Chiang, Chen-Hua; Chen, Chi-Jen; Yan, Feng-Xian

    2017-01-01

    No reliable imaging sign predicting cerebral hyperperfusion after intracranial arterial stenting (IAS) had been described in the literature. This study evaluated the effect of fluid-attenuated inversion recovery vascular hyperintensities (FVHs), also called hyperintense vessel sign on T2-weighted fluid-attenuated inversion recovery (T2-FLAIR) MR images, in predicting significant increase in cerebral blood flow (CBF) defined by arterial spin labeling (ASL) after IAS. We reviewed ASL CBF images and T2-FLAIR MR images before (D0), 1 day after (D1), and 3 days after (D3) IAS of 16 patients. T1-weighted MR images were used as cerebral maps for calculating CBF. The changes in CBF values after IAS were calculated in and compared among stenting and nonstenting vascular territories. An increase more than 50% of CBF was considered as hyperperfusion. The effect of FVHs in predicting hyperperfusion was calculated. The D1 CBF value was significantly higher than the D0 CBF value in stenting vascular, contralateral anterior cerebral artery, contralateral middle cerebral artery, and contralateral posterior cerebral artery (PCA) territories (all P <.05). The D1 and D3 CBF values were significantly higher than the D0 CBF value in overall vascular (P <.001), overall nonstenting vascular (P <.001), and ipsilateral PCA (P <.05) territories. The rate of more than 50% increases in CBF was significantly higher in patients who exhibited asymmetric FVHs than in those who did not exhibit these findings. FVHs could be a critical predictor of a significant increase in CBF after IAS. (orig.)

  13. Magnetic resonance imaging of the brain in phenylketonuria

    International Nuclear Information System (INIS)

    Izumi, Mina; Yamazaki, Hirotaka; Nakabayashi, Hiroki; Owada, Misao

    2006-01-01

    To investigate the correlation between the abnormalities of magnetic resonance imaging (MRI) of the brain and blood phenylalanine (Phe) levels in phenylketonuria (PKU) and hyperphenylalaninemia (HPA), we reviewed MRIs from 16 patients with early treated PKU and HPA. Their ages ranged from 4-24 years and were found by mass screening and treated from early infancy, and 5 patients with late detected PKU who were aged 24-33 years. The former patients had no remarkable neurological signs or symptoms. One patient of the latter had severe mental retardation and 3 patients had mild to border mental retardation. Axial T 1 -weighted and T 2 -weighted spin echo sequences, fluid attenuated inversion recovery MR sequences (FLAIR) through the brain were performed. The scans were graded according to the extent of increased signal intensity of white matter on T 2 -weighted and FLAIR sequences. To investigate the influence of plasma Phe levels, three approaches were used. Firstly an average of all yearly serial blood Phe concentration was calculated for each patient, then Phe was determined for a period of 6 months and 12 months prior to MRI, and also for their lifetime up to their age at the time this study began. These average blood Phe levels were classified into four categories: group A: Phe level below 5 mg/dl, group B: 5-8 mg/dl, group C: 9-12 mg/dl, group D: above 12 mg/dl. MRI findings were not significant in group A. Remarkable high signals of white matter were obtained in group C and D, except for one patient in group D whose MRI finding was normal. MRI findings correlated to long-term dietary control stronger than those of 6 months prior to MRI. The clinical significance of MRI abnormalities is still unclear, and further study is required to clarify the relationship of the MRI findings and clinical conditions. (author)

  14. Fully automated processing of fMRI data in SPM: from MRI scanner to PACS.

    Science.gov (United States)

    Maldjian, Joseph A; Baer, Aaron H; Kraft, Robert A; Laurienti, Paul J; Burdette, Jonathan H

    2009-01-01

    Here we describe the Wake Forest University Pipeline, a fully automated method for the processing of fMRI data using SPM. The method includes fully automated data transfer and archiving from the point of acquisition, real-time batch script generation, distributed grid processing, interface to SPM in MATLAB, error recovery and data provenance, DICOM conversion and PACS insertion. It has been used for automated processing of fMRI experiments, as well as for the clinical implementation of fMRI and spin-tag perfusion imaging. The pipeline requires no manual intervention, and can be extended to any studies requiring offline processing.

  15. MRI of the Chest

    Medline Plus

    Full Text Available ... used in tattoos may contain iron and could heat up during an MRI scan, but this is ... injection. If you do not require sedation, no recovery period is necessary. You may resume your usual ...

  16. A semi-automated measuring system of brain diffusion and perfusion magnetic resonance imaging abnormalities in patients with multiple sclerosis based on the integration of coregistration and tissue segmentation procedures

    International Nuclear Information System (INIS)

    Revenaz, Alfredo; Ruggeri, Massimiliano; Laganà, Marcella; Bergsland, Niels; Groppo, Elisabetta; Rovaris, Marco; Fainardi, Enrico

    2016-01-01

    Diffusion-weighted imaging (DWI) and perfusion-weighted imaging (PWI) abnormalities in patients with multiple sclerosis (MS) are currently measured by a complex combination of separate procedures. Therefore, the purpose of this study was to provide a reliable method for reducing analysis complexity and obtaining reproducible results. We implemented a semi-automated measuring system in which different well-known software components for magnetic resonance imaging (MRI) analysis are integrated to obtain reliable measurements of DWI and PWI disturbances in MS. We generated the Diffusion/Perfusion Project (DPP) Suite, in which a series of external software programs are managed and harmonically and hierarchically incorporated by in-house developed Matlab software to perform the following processes: 1) image pre-processing, including imaging data anonymization and conversion from DICOM to Nifti format; 2) co-registration of 2D and 3D non-enhanced and Gd-enhanced T1-weighted images in fluid-attenuated inversion recovery (FLAIR) space; 3) lesion segmentation and classification, in which FLAIR lesions are at first segmented and then categorized according to their presumed evolution; 4) co-registration of segmented FLAIR lesion in T1 space to obtain the FLAIR lesion mask in the T1 space; 5) normal appearing tissue segmentation, in which T1 lesion mask is used to segment basal ganglia/thalami, normal appearing grey matter (NAGM) and normal appearing white matter (NAWM); 6) DWI and PWI map generation; 7) co-registration of basal ganglia/thalami, NAGM, NAWM, DWI and PWI maps in previously segmented FLAIR space; 8) data analysis. All these steps are automatic, except for lesion segmentation and classification. We developed a promising method to limit misclassifications and user errors, providing clinical researchers with a practical and reproducible tool to measure DWI and PWI changes in MS

  17. The effect of hippocampal function, volume and connectivity on posterior cingulate cortex functioning during episodic memory fMRI in mild cognitive impairment

    International Nuclear Information System (INIS)

    Papma, Janne M.; Koudstaal, Peter J.; Swieten, John C. van; Smits, Marion; Lugt, Aad van der; Groot, Marius de; Vrooman, Henri A.; Mattace Raso, Francesco U.; Niessen, Wiro J.; Veen, Frederik M. van der; Prins, Niels D.

    2017-01-01

    Diminished function of the posterior cingulate cortex (PCC) is a typical finding in early Alzheimer's disease (AD). It is hypothesized that in early stage AD, PCC functioning relates to or reflects hippocampal dysfunction or atrophy. The aim of this study was to examine the relationship between hippocampus function, volume and structural connectivity, and PCC activation during an episodic memory task-related fMRI study in mild cognitive impairment (MCI). MCI patients (n = 27) underwent episodic memory task-related fMRI, 3D-T1w MRI, 2D T2-FLAIR MRI and diffusion tensor imaging. Stepwise linear regression analysis was performed to examine the relationship between PCC activation and hippocampal activation, hippocampal volume and diffusion measures within the cingulum along the hippocampus. We found a significant relationship between PCC and hippocampus activation during successful episodic memory encoding and correct recognition in MCI patients. We found no relationship between the PCC and structural hippocampal predictors. Our results indicate a relationship between PCC and hippocampus activation during episodic memory engagement in MCI. This may suggest that during episodic memory, functional network deterioration is the most important predictor of PCC functioning in MCI. (orig.)

  18. The effect of hippocampal function, volume and connectivity on posterior cingulate cortex functioning during episodic memory fMRI in mild cognitive impairment

    Energy Technology Data Exchange (ETDEWEB)

    Papma, Janne M.; Koudstaal, Peter J.; Swieten, John C. van [Erasmus MC - University Medical Center Rotterdam, Department of Neurology, Rotterdam (Netherlands); Smits, Marion; Lugt, Aad van der [Erasmus MC - University Medical Center Rotterdam, Department of Radiology, Rotterdam (Netherlands); Groot, Marius de; Vrooman, Henri A. [Erasmus MC - University Medical Center Rotterdam, Department of Radiology, Rotterdam (Netherlands); Erasmus MC - University Medical Center Rotterdam, Department of Medical Informatics, Rotterdam (Netherlands); Mattace Raso, Francesco U. [Erasmus MC - University Medical Center Rotterdam, Department of Geriatrics, Rotterdam (Netherlands); Niessen, Wiro J. [Erasmus MC - University Medical Center Rotterdam, Department of Radiology, Rotterdam (Netherlands); Erasmus MC - University Medical Center Rotterdam, Department of Medical Informatics, Rotterdam (Netherlands); Delft University of Technology, Faculty of Applied Sciences, Delft (Netherlands); Veen, Frederik M. van der [Erasmus University Rotterdam, Institute of Psychology, Rotterdam (Netherlands); Prins, Niels D. [VU University Medical Center, Alzheimer Center, Department of Neurology, Amsterdam (Netherlands)

    2017-09-15

    Diminished function of the posterior cingulate cortex (PCC) is a typical finding in early Alzheimer's disease (AD). It is hypothesized that in early stage AD, PCC functioning relates to or reflects hippocampal dysfunction or atrophy. The aim of this study was to examine the relationship between hippocampus function, volume and structural connectivity, and PCC activation during an episodic memory task-related fMRI study in mild cognitive impairment (MCI). MCI patients (n = 27) underwent episodic memory task-related fMRI, 3D-T1w MRI, 2D T2-FLAIR MRI and diffusion tensor imaging. Stepwise linear regression analysis was performed to examine the relationship between PCC activation and hippocampal activation, hippocampal volume and diffusion measures within the cingulum along the hippocampus. We found a significant relationship between PCC and hippocampus activation during successful episodic memory encoding and correct recognition in MCI patients. We found no relationship between the PCC and structural hippocampal predictors. Our results indicate a relationship between PCC and hippocampus activation during episodic memory engagement in MCI. This may suggest that during episodic memory, functional network deterioration is the most important predictor of PCC functioning in MCI. (orig.)

  19. Delayed contrast-enhanced MRI: use in myocardial viability assessment and other cardiac pathology

    International Nuclear Information System (INIS)

    Bogaert, J.; Dymarkowski, S.

    2005-01-01

    As in other organs, tissue characterization is important for many cardiac diseases. For example, in ischemic heart disease, differentiation between reversibly and irreversibly damaged myocardium in patients with a prior myocardial infarction is crucial in determining disease severity, functional recovery and patient outcome. With the recent advent of the single inversion-recovery contrast-enhanced magnetic resonance imaging (MRI) sequence (delayed contrast-enhanced MRI), contrast between normal and abnormal tissues could be significantly enhanced compared with the conventional cardiac MRI sequences, enabling even subtle abnormalities to be visualized. Together with other advances in cardiac MRI (e.g. functional imaging, coronary artery imaging), MRI has become one of the preferred non-invasive modalities to study cardiac diseases. In this paper an overview of the versatility of delayed contrast-enhanced MRI for investigating cardiac diseases is given. (orig.)

  20. Prediction of tumor-brain adhesion in intracranial meningiomas by MR imaging and DSA

    International Nuclear Information System (INIS)

    Takeguchi, Takashi; Miki, Hitoshi; Shimizu, Teruhiko; Kikuchi, Keiichi; Mochizuki, Teruhito; Ohue, Shiro; Ohnishi, Takanori

    2003-01-01

    The purpose of this study was to evaluate the usefulness of MRI (magnetic resonance imaging) and DSA (digital subtraction angiography) by using preoperative MRI and DSA findings in the examination of meningiomas before excision. In particular, we focused on their usefulness in predicting tumor-brain adhesion during surgery. The subjects were 36 patients with intracranial meningioma who underwent tumor excision at which time neurosurgeons examined the tumor-brain adhesion. Two neurosurgeons evaluated the degree of tumor-brain adhesion from operation records and videotapes recorded during surgery. Two neuroradiologists retrospectively evaluated the preoperative MRI findings including tumor diameter, signal intensity of the tumor parenchyma obtained with T 2 -weighted imaging (T 2 WI), characteristics of the tumor-brain interface, and degree of peritumoral brain edema. The vascular supply was also evaluated from the preoperative DSA findings. The relationship between these MRI and DSA findings and the degree of tumor-brain adhesion during surgery as classified by the neurosurgeons was statistically analyzed. The degree of peritumoral brain edema and the shapes and characteristics of the tumor-brain interface, including the findings of FLAIR (fluid-attenuated inversion recovery) imaging and vascular supply observed by DSA, were significantly correlated with tumor-brain adhesion. In particular, the shapes and characteristics of the tumor-brain interface as observed by T 1 -weighted imaging (T 1 WI), T2WI, and FLAIR, respectively, as well as the vascular supply observed by DSA, were closely correlated with the degree of tumor-brain adhesion encountered during surgery. According to these results, we developed a method of predicting tumor-brain adhesion that considers the shape of the tumor-brain interface revealed by MRI and the vascular supply revealed by DSA. We retrospectively examined the findings of MRI and DSA performed before excision of meningioma and clarified

  1. Assessment of motor recovery and MRI correlates in a porcine spinal cord injury model

    Directory of Open Access Journals (Sweden)

    Igor Šulla

    2014-01-01

    Full Text Available The study concentrated on behavioral and magnetic resonance imaging (MRI characteristics in a porcine spinal cord injury model. Six adult minipigs weighing 32–35 kg were narcotized by thiopental, intubated, and placed on a volume-cycled ventilator. Anaesthesia was maintained by 1.5% sevoflurane with oxygen. Following location of the 1st lumbar vertebra animals were fastened in an immobilization frame. The spinal cord, exposed through a laminectomy, was compressed by a 5 mm thick circular rod with a peak force of 0.8 kg at a velocity of 3 cm·s-1. The next day the minipigs were paraplegic but improved rapidly to paraparesis. On the 12th postoperative day they were euthanasied. Neural tissue changes were evaluated by post mortem MRI, which showed damage to the spinal cord white and/or gray matter in the epicentre of compression with longitudinal spreading over one segment cranially and caudally. Statistical analyses performed by Spearman’s rho test revealed positive correlations between damaged areas and the whole area of the spinal cord white/gray matter (P = 0.047; rs = 0.742 and (P = 0.002; rs = 0.943, respectively. The study confirmed the reliability and reproducibility of the utilised model of spinal cord trauma. The structural changes in the epicentre of injury did not impede the rapid but incomplete recovery of motor functions.

  2. Cognitive Function and 3-Tesla Magnetic Resonance Imaging Tractography of White Matter Hyperintensities in Elderly Persons

    Directory of Open Access Journals (Sweden)

    William Reginold

    2015-10-01

    Full Text Available Background/Aims: This study used 3-Tesla magnetic resonance imaging (MRI tractography to determine if there was an association between tracts crossing white matter hyperintensities (WMH and cognitive function in elderly persons. Methods: Brain T2-weighted fluid-attenuated inversion recovery (FLAIR and diffusion tensor MRI scans were acquired in participants above the age of 60 years. Twenty-six persons had WMH identified on T2 FLAIR scans. They completed a battery of neuropsychological tests and were classified as normal controls (n = 15 or with Alzheimer's dementia (n = 11. Tractography was generated by the Fiber Assignment by Continuous Tracking method. All tracts that crossed WMH were segmented. The average fractional anisotropy and average mean diffusivity of these tracts were quantified. We studied the association between cognitive test scores with the average mean diffusivity and average fractional anisotropy of tracts while controlling for age, total WMH volume and diagnosis. Results: An increased mean diffusivity of tracts crossing WMH was associated with worse performance on the Wechsler Memory Scale-III Longest Span Forward (p = 0.02. There was no association between the fractional anisotropy of tracts and performance on cognitive testing. Conclusion: The mean diffusivity of tracts crossing WMH measured by tractography is a novel correlate of performance on the Wechsler Memory Scale-III Longest Span Forward in elderly persons.

  3. 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

  4. Simple and complex dysembryoplastic neuroepithelial tumors (DNT) variants: clinical profile, MRI, and histopathology

    Energy Technology Data Exchange (ETDEWEB)

    Campos, Alexandre R.; Clusmann, Hans; Lehe, Marec von; Schramm, Johannes [University of Bonn Medical Center, Department of Neurosurgery, Bonn (Germany); Niehusmann, Pitt; Becker, Albert J. [University of Bonn Medical Center, Department of Neuropathology, Bonn (Germany); Urbach, Horst [University of Bonn Medical Center, Department of Radiology, Bonn (Germany)

    2009-07-15

    Dysembryoplastic neuroepithelial tumors (DNTs) are long-term epilepsy associated tumors subdivided into simple and complex variants. The purpose of this study was to relate different DNT components identified on magnetic resonance imaging (MRI) to histopathological features and to test the hypothesis that glial nodules as a histopathological feature of complex variants induce an occasional glioma misdiagnosis. Clinical, MRI, and histopathologic features of DNTs operated between 1988 and 2008 were reviewed. From a total of 61 DNTs, 48 simple and 13 complex variants were identified. Multiple or single pseudocysts in a cortical/subcortical location with small cysts sometimes separated from the tumor represented the glioneuronal element and were found in all DNTs. FLAIR hyperintense tissue was found between pseudocysts but - in neocortical DNTs - also circumscript in deeper tumor parts. Calcification and hemorrhages in this location occurred in four of 13 complex variants, and one of these patients was also the only one with tumor growth. Patients with complex variants had earlier seizure onset, and complex variants were more often located outside the temporal lobe. Although complex variants represented a higher diagnostic challenge, misdiagnoses also occurred in simple variants. One of five of DNTs showed contrast enhancement, which varied on follow-up studies with enhancing parts becoming nonenhancing and vice versa. The glioneuronal element is readily identifiable on MRI and should be considered to support the DNT diagnosis. Complex DNT variants have a different clinical profile and a more variable histopathological and MRI appearance; however, misdiagnoses occasionally also occur in simple variants. (orig.)

  5. Cerebral toxoplasmosis: case review and description of a new imaging sign

    International Nuclear Information System (INIS)

    Masamed, R.; Meleis, A.; Lee, E.W.; Hathout, G.M.

    2009-01-01

    Toxoplasmosis can have catastrophic consequences in immunocompromised patients if left untreated. Accurate diagnosis is difficult, as there is substantial overlap between the imaging findings and presenting clinical syndromes of cerebral toxoplasmosis and primary central nervous system lymphoma. This paper reviews the previously described and fairly well-known post-contrast computed tomography (CT) and T1-weighted (W) magnetic resonance imaging (MRI) target signs seen in toxoplasmosis. In addition, it offers a new imaging sign, the T2W/FLAIR (fluid attenuated inversion recovery) target sign, which is often seen in clinical practice but not well-published, as an aid to the diagnosis of cerebral toxoplasmosis.

  6. Cerebral toxoplasmosis: case review and description of a new imaging sign

    Energy Technology Data Exchange (ETDEWEB)

    Masamed, R. [Department of Radiological Sciences, UCLA Medical Center, Los Angeles, CA (United States)], E-mail: rmasamed@mednet.ucla.edu; Meleis, A. [Princeton University, New Jersey, CA (United States); Lee, E.W. [Department of Radiological Sciences, UCLA Medical Center, Los Angeles, CA (United States); Hathout, G.M. [Department of Radiological Sciences, UCLA Medical Center, Los Angeles, CA (United States); Department of Neuroradiology, Olive View UCLA Medical Center, Los Angeles, CA (United States); Department of Neuroradiology, West L.A. VA Medical Center, Los Angeles, CA (United States)

    2009-05-15

    Toxoplasmosis can have catastrophic consequences in immunocompromised patients if left untreated. Accurate diagnosis is difficult, as there is substantial overlap between the imaging findings and presenting clinical syndromes of cerebral toxoplasmosis and primary central nervous system lymphoma. This paper reviews the previously described and fairly well-known post-contrast computed tomography (CT) and T1-weighted (W) magnetic resonance imaging (MRI) target signs seen in toxoplasmosis. In addition, it offers a new imaging sign, the T2W/FLAIR (fluid attenuated inversion recovery) target sign, which is often seen in clinical practice but not well-published, as an aid to the diagnosis of cerebral toxoplasmosis.

  7. The usefulness of the ivy sign on fluid-attenuated intensity recovery images in improved brain hemodynamic changes after superficial temporal artery-middle cerebral artery anastomosis in adult patients with moyamoya disease.

    Science.gov (United States)

    Lee, Jung Keun; Yoon, Byul Hee; Chung, Seung Young; Park, Moon Sun; Kim, Seong Min; Lee, Do Sung

    2013-10-01

    MR perfusion and single photon emission computerized tomography (SPECT) are well known imaging studies to evaluate hemodynamic change between prior to and following superficial temporal artery (STA)-middle cerebral artery (MCA) anastomosis in moyamoya disease. But their side effects and invasiveness make discomfort to patients. We evaluated the ivy sign on MR fluid attenuated inversion recovery (FLAIR) images in adult patients with moyamoya disease and compared it with result of SPECT and MR perfusion images. We enrolled twelve patients (thirteen cases) who were diagnosed with moyamoya disease and underwent STA-MCA anastomosis at our medical institution during a period ranging from September of 2010 to December of 2012. The presence of the ivy sign on MR FLAIR images was classified as Negative (0), Minimal (1), and Positive (2). Regions were classified into four territories: the anterior cerebral artery (ACA), the anterior MCA, the posterior MCA and the posterior cerebral artery. Ivy signs on preoperative and postoperative MR FLAIR were improved (8 and 4 in the ACA regions, 13 and 4 in the anterior MCA regions and 19 and 9 in the posterior MCA regions). Like this result, the cerebrovascular reserve (CVR) on SPECT was significantly increased in the sum of CVR in same regions after STA-MCA anastomosis. After STA-MCA anastomosis, ivy signs were decreased in the cerebral hemisphere. As compared with conventional diagnostic modalities such as SPECT and MR perfusion images, the ivy sign on MR FLAIR is considered as a useful indicator in detecting brain hemodynamic changes between preoperatively and postoperatively in adult moyamoya patients.

  8. Accuracy of high-field intraoperative MRI in the detectability of residual tumor in glioma grade IV resections

    Energy Technology Data Exchange (ETDEWEB)

    Hesselmann, Volker; Mager, Ann-Kathrin [Asklepios-Klinik Nord, Hamburg (Germany). Radiology/Neurologie; Goetz, Claudia; Kremer, Paul [Asklepios-Klinik Nord, Hamburg (Germany). Dept. of Neurosurgery; Detsch, Oliver [Asklepios-Klinik Nord, Hamburg (Germany). Dept. of Anaesthesiology and Intensive Care Medicine; Theisgen, Hannah-Katharina [Universitaetsklinikum Schleswig-Holstein, Kiel (Germany). Dept. of Neurosurgery; Friese, Michael; Gottschalk, Joachim [Asklepios-Klinik Nord, Hamburg (Germany). Dept. of Pathology and Neuropathology; Schwindt, Wolfram [Univ. Hospital Muenster (Germany). Dept. of Clinical Radiology

    2017-06-15

    To assess the sensitivity/specificity of tumor detection by T1 contrast enhancement in intraoperative MRI (ioMRI) in comparison to histopathological assessment as the gold standard in patients receiving surgical resection of grade IV glioblastoma. 68 patients with a primary or a recurrent glioblastoma scheduled for surgery including fluorescence guidance and neuronavigation were included (mean age: 59 years, 26 female, 42 male patients). The ioMRI after the first resection included transverse FLAIR, DWI, T2-FFE and T1 - 3 d FFE ± GD-DPTA. The second resection was performed whenever residual contrast-enhancing tissue was detected on ioMRI. Resected tissue samples were histopathologically evaluated (gold standard). Additionally, we evaluated the early postoperative MRI scan acquired within 48 h post-OP for remaining enhancing tissue and compared them with the ioMRI scan. In 43 patients ioMRI indicated residual tumorous tissue, which could be confirmed in the histological specimens of the second resection. In 16 (4 with recurrent, 12 with primary glioblastoma) cases, ioMRI revealed truly negative results without residual tumor and follow-up MRI confirmed complete resection. In 7 cases (3 with recurrent, 4 with primary glioblastoma) ioMRI revealed a suspicious result without tumorous tissue in the histopathological workup. In 2 (1 for each group) patients, residual tumorous tissue was detected in spite of negative ioMRI. IoMRI had a sensitivity of 95 % (94 % recurrent and 96 % for primary glioblastoma) and a specificity of 69.5 % (57 % and 75 %, respectively). The positive predictive value was 86 % (84 % for recurrent and 87 % for primary glioblastoma), and the negative predictive value was 88 % (80 % and 92 %, respectively). ioMRI is effective for detecting remaining tumorous tissue after glioma resection. However, scars and leakage of contrast agent can be misleading and limit specificity. Intraoperative MRI (ioMRI) presents with a high sensitivity for residual

  9. Accuracy of high-field intraoperative MRI in the detectability of residual tumor in glioma grade IV resections

    International Nuclear Information System (INIS)

    Hesselmann, Volker; Mager, Ann-Kathrin; Goetz, Claudia; Kremer, Paul; Detsch, Oliver; Theisgen, Hannah-Katharina; Friese, Michael; Gottschalk, Joachim; Schwindt, Wolfram

    2017-01-01

    To assess the sensitivity/specificity of tumor detection by T1 contrast enhancement in intraoperative MRI (ioMRI) in comparison to histopathological assessment as the gold standard in patients receiving surgical resection of grade IV glioblastoma. 68 patients with a primary or a recurrent glioblastoma scheduled for surgery including fluorescence guidance and neuronavigation were included (mean age: 59 years, 26 female, 42 male patients). The ioMRI after the first resection included transverse FLAIR, DWI, T2-FFE and T1 - 3 d FFE ± GD-DPTA. The second resection was performed whenever residual contrast-enhancing tissue was detected on ioMRI. Resected tissue samples were histopathologically evaluated (gold standard). Additionally, we evaluated the early postoperative MRI scan acquired within 48 h post-OP for remaining enhancing tissue and compared them with the ioMRI scan. In 43 patients ioMRI indicated residual tumorous tissue, which could be confirmed in the histological specimens of the second resection. In 16 (4 with recurrent, 12 with primary glioblastoma) cases, ioMRI revealed truly negative results without residual tumor and follow-up MRI confirmed complete resection. In 7 cases (3 with recurrent, 4 with primary glioblastoma) ioMRI revealed a suspicious result without tumorous tissue in the histopathological workup. In 2 (1 for each group) patients, residual tumorous tissue was detected in spite of negative ioMRI. IoMRI had a sensitivity of 95 % (94 % recurrent and 96 % for primary glioblastoma) and a specificity of 69.5 % (57 % and 75 %, respectively). The positive predictive value was 86 % (84 % for recurrent and 87 % for primary glioblastoma), and the negative predictive value was 88 % (80 % and 92 %, respectively). ioMRI is effective for detecting remaining tumorous tissue after glioma resection. However, scars and leakage of contrast agent can be misleading and limit specificity. Intraoperative MRI (ioMRI) presents with a high sensitivity for residual

  10. Magnetic Resonance Imaging (MRI) -- Head

    Medline Plus

    Full Text Available ... used in tattoos may contain iron and could heat up during an MRI scan, but this is ... injection. If you do not require sedation, no recovery period is necessary. You may resume your usual ...

  11. Clinical experience with MRI in head trauma cases

    International Nuclear Information System (INIS)

    Yamagami, Tatsuhito; Goto, Yasunobu; Kinuta, Yuji; Tashiro, Yuzuru; Nishihara, Kiyoshi; Hashimoto, Kenji; Minamikawa, Jun; Kikuchi, Haruhiko; Imataka, Kiyoharu.

    1988-01-01

    The ability to identify lesions after head trauma using magnetic resonance imaging (MRI) was tested in 199 cases. A resistive-type MRI scanner operating at a field of 0.2 Tesla was utilized in inversion-recovery (IR) and saturation-recovery (SR) radiofrequency-pulse sequences. Of the total number of cases, 54 were examined within 4 days after injury. An intracranial hematoma was removed in 47 cases. The MRI findings were normal in the cases of cerebral concussion, even in the presence of skull fracture. High intensity areas were seen in the SR images in 12 cases which were normal on X-ray CT. Both acute and subacute non-hemorrhagic contusion sites were visible as low intensity areas on the T 1 -weighted images and as high intensity areas on the SR images. Acute hemorrhagic contusion sites were visible as isointense and low intensity areas in the T 1 -weighted images and as high intensity areas in the SR images. Subacute sites appeared as high intensity areas in the T 1 -weighted, SR, and T 2 -weighted images. Direct coronal and sagittal views were adequate for the recognition of the three-dimensional brain structure. MRI was useful in the identification of brain contusion, in postoperative follow-ups, and in the detection of complications in the chronic stage. In the follow-up of 48 brain contusion cases, 13 cases showed normalized MRI findings and 9 cases showed improved findings. The recovery of cerebral function in these cases was good. The lesions demonstrated by MRI were considered to be contusional hematoma, petechiae, brain edema, shear injury, and non-hemorrhagic contusion. When they persist, such lesions are thought to change into such conditions as scar, gliosis, porencephaly, and brain atrophy. (author)

  12. CT and MRI appearances of methotrexate leucoencephalopathy

    International Nuclear Information System (INIS)

    Wilks, M.J.; Tie, M.L.K.; Pozza, C.H.

    2002-01-01

    Methotrexate is a well recognised cause of diffuse symmetrical leucoencephalopathy. The widespread use of the drug in chemotherapeutic regimes necessitates awareness of this complication. A case report and a brief literature review is presented. A 20-year-old single woman presented to the Emergency Department with a 6-week history of general malaise, lower back pain and a petechial rash. From investigations including blood picture and bone marrow trephine, the diagnosis of acute lymphoblastic leukaemia (ALL) was made. Three cycles of induction chemotherapy were administered consisting of intravenous cytarabine and hydrocortisone and intrathecal methotrexate. Shortly after the third cycle of induction chemotherapy (6 weeks following diagnosis, 2 days following the last dose of intrathecal methotrexate) she presented with an acute neurological episode consisting of muteness and somnolence. Physical examination showed generalised flaccidity to all muscle groups and generalised loss of reflexes. There were no consistent cranial neuropathies and the patient was not neutropenic. Computed tomography of the brain showed extensive symmetric white matter hypodensity extending throughout the corona radiata and deep white matter tracts especially the external capsules. There was no abnormal enhancement with non-ionic contrast administration or evidence of grey matter involvement. Magnetic resonance imaging was subsequently performed, the fluid attenuated inversion recovery images (FLAIR) and T2-weighted image (T2WI) demonstrated marked white matter hyperintensity; the involvement was more extensive than demonstrated on the CT with additional involvement of the subcortical and cerebellar white matter, the basal ganglia and cortex of the mesial temporal and inferior frontal lobes. Gadolinium was not administered. A follow up study after 4 weeks of steroid and folinic acid therapy showed complete resolution of the white matter hyperintensity on the T2WI and FLAIR sequences

  13. MRI and MRV in differentiation of posterior reversible encephalopathy syndrome and venous occlusion in patients with eclampsia or pre-eclampsia

    International Nuclear Information System (INIS)

    Xia Shuang; Liu Qingxian; Qi Ji

    2009-01-01

    Objective: To evaluate the role of MRV and MRI in the diagnosis of posterior encephalopathy syndrome (PRES) and venous sinus occlusion in patients with eclampsia or pre-eclampsia. Methods: We respectively studied the clinical and imaging data of 27 pre-eclampsia or eclampsia patients who occurred epilepsy, headache, and vision deficient during pregnancy or post partum. All patients underwent MRI and MRV examinations. The imaging protocol included coronal, sagittal, and axial T 1 WI, T 2 WI, FLAIR, DWI, and MRV. Results: 14 patients showed evidence of venous occlusion. Among them, 3 occurred in cortical vein, 4 in superior sagittal sinus, 2 in transverse sinus, l in sigmoid sinus, 2 in deep vein system, 3 in jugular vein, and 2 with complete sinus occlusion. Brain edema distributed in the corresponding area of occlusive sinus and 2 cases combined with secondary hemorrhage. 13 patients suffered from hypertensive encephalopathy. All of the lesions involved arcuate fibre in the bilateral parietal lobe (10 cases), right parietal lobe (2 cases), bilateral occipital lobe (7 cases), bilateral frontal lobe (6 cases), right frontal lobe (3 cases), bilateral temporal lobe (4 cases), left temporo-occipital lobe (1 case), splenium of corpus callosum (1 case), bilateral basal ganglia (2 cases), right basal ganglia (1 case), left centrum semiovale (1 case), and bilateral cerebellar hemisphere (1 case). Both of the lesions of PRES and venous occlusion showed hyperintensity on FLAIR and T 2 WI images, isointensity on DWI and hyperintensity on ADC, indicating vasogenic edema. Decreased lesion extent or completely disappeared was identified in 12 patients on follow-up scans. Conclusion: Lesions of PRES are usually located in the parietal and occipital lobes, especially in white matter. The lesion of venous occlusion usually occurs in the area of corresponding occlusive sinus. The MRV has an important value in diagnosis of PRES and venous sinus occlusion. (authors)

  14. Recovery of Urinary Function after Radical Prostatectomy: Predictors of Urinary Function on Preoperative Prostate Magnetic Resonance Imaging

    Science.gov (United States)

    von Bodman, Christian; Matsushita, Kazuhito; Savage, Caroline; Matikainen, Mika P.; Eastham, James A.; Scardino, Peter T.; Rabbani, Farhang; Akin, Oguz; Sandhu, Jaspreet S.

    2016-01-01

    Purpose To determine if pelvic soft tissue and bony dimensions on endorectal MRI influence recovery of continence after radical prostatectomy (RP) and whether adding significant MRI variables to a statistical model improves prediction of continence recovery. Materials and Methods Between 2001 and 2004, 967 men undergoing RP had preoperative MRI. Soft tissue and bony dimensions were retrospectively measured by two raters blinded to clinical and pathological data. Patients who received neoadjuvant therapy, were preoperatively incontinent, or had missing followup for continence were excluded, leaving 600 patients eligible for analysis. No pad usage defined continent. Logistic regression was used to identify variables associated with continence recovery at 6 and 12 months. We evaluated whether predictive accuracy of a base model improved by adding independently significant MRI variables. Results Urethral length and urethral volume were both significantly associated with recovery of continence at 6 and 12 months. Larger inner and outer levator distances were significantly associated with a decreased probability of regaining continence at either 6 or 12 months; they did not reach statistical significance for the other time point. Addition of these four MRI variables to a base model including age, clinical stage, PSA and comorbidities marginally improved the discrimination (12 months AUC improved from 0.587 to 0.634). Conclusions Membranous urethral length, urethral volume and an anatomically close relation between the levator muscle and membranous urethra on preoperative MRI are independent predictors of continence recovery after RP. Addition of MRI variables to a base model improved the predictive accuracy for continence recovery but predictive accuracy remains low. PMID:22264458

  15. Human and nonhuman primate meninges harbor lymphatic vessels that can be visualized noninvasively by MRI.

    Science.gov (United States)

    Absinta, Martina; Ha, Seung-Kwon; Nair, Govind; Sati, Pascal; Luciano, Nicholas J; Palisoc, Maryknoll; Louveau, Antoine; Zaghloul, Kareem A; Pittaluga, Stefania; Kipnis, Jonathan; Reich, Daniel S

    2017-10-03

    Here, we report the existence of meningeal lymphatic vessels in human and nonhuman primates (common marmoset monkeys) and the feasibility of noninvasively imaging and mapping them in vivo with high-resolution, clinical MRI. On T2-FLAIR and T1-weighted black-blood imaging, lymphatic vessels enhance with gadobutrol, a gadolinium-based contrast agent with high propensity to extravasate across a permeable capillary endothelial barrier, but not with gadofosveset, a blood-pool contrast agent. The topography of these vessels, running alongside dural venous sinuses, recapitulates the meningeal lymphatic system of rodents. In primates, meningeal lymphatics display a typical panel of lymphatic endothelial markers by immunohistochemistry. This discovery holds promise for better understanding the normal physiology of lymphatic drainage from the central nervous system and potential aberrations in neurological diseases.

  16. Diffusion-weighted imaging in patients with progressive multifocal leukoencephalopathy

    Energy Technology Data Exchange (ETDEWEB)

    Cosottini, M. [University of Pisa, Department of Neuroscience, Pisa (Italy); Service of Neuroradiology AO, Pisa (Italy); Tavarelli, C.; De Cori, S.; Bartolozzi, C. [University of Pisa, Department of Radiology, Pisa (Italy); Del Bono, L.; Doria, G. [Unit of Infectious Diseases AO, Pisa (Italy); Giannelli, M. [Unit of Medical Physics, Pisa (Italy); Michelassi, M.C. [Service of Neuroradiology AO, Pisa (Italy); Murri, L. [University of Pisa, Department of Neuroscience, Pisa (Italy)

    2008-05-15

    Progressive multifocal leukoencephalopathy (PML) is a severe demyelinating disease of the central nervous system due to JC polyoma virus infection of oligodendrocytes. PML develops in patients with impaired T-cell function as occurs in HIV, malignancy or immunosuppressive drugs users. Until now no imaging methods have been reported to correlate with clinical status. Diffusion-weighted imaging (DWI) is a robust MRI tool in investigating white matter architecture and diseases. The aim of our work was to assess diffusion abnormalities in focal white matter lesions in patients with PML and to correlate the lesion load measured with conventional MRI and DWI to clinical variables. We evaluated eight patients with a biopsy or laboratory-supported diagnosis of PML. All patients underwent MRI including conventional sequences (fluid attenuated inversion recovery-FLAIR) and DWI. Mean diffusivity (MD) maps were used to quantify diffusion on white matter lesions. Global lesion load was calculated by manually tracing lesions on FLAIR images, while total, central core and peripheral lesion loads were calculated by manually tracing lesions on DWI images. Lesion load obtained with the conventional or DWI-based methods were correlated with clinical variables such as disease duration, disease severity and survival. White matter focal lesions are characterized by a central core with low signal on DWI images and high MD (1.853 x 10{sup -3} mm2/s), surrounded by a rim of high signal intensity on DWI and lower MD (1.1 x 10{sup -3} mm2/s). The MD value of normal-appearing white matter is higher although not statistically significant (0.783 x 10{sup -3} mm2/s) with respect to control subjects (0.750 x 10{sup -3} mm2/s). Inter-rater correlations of global lesion load between FLAIR (3.96%) and DWI (3.43%) was excellent (ICC =0.87). Global lesion load on FLAIR and DWI correlates with disease duration and severity (respectively, p = 0.037, p = 0.0272 with Karnofsky scale and p = 0.0338 with

  17. Optic nerve injury demonstrated by MRI with STIR sequences

    International Nuclear Information System (INIS)

    Takehara, S.; Tanaka, T.; Uemura, K.; Shinohara, Y.; Yamamoto, T.; Tokuyama, T.; Satoh, A.

    1994-01-01

    We studied nine patients with optic nerve injury associated with closed head trauma by magnetic resonance imaging (MRI) with short inversion time inversion recovery (STIR) sequences on 11 occasions from 4 days to 14 years after the injury: three studies were within 17 days and eight over 4 months to 14 years. MRI revealed abnormal high signal in 10 of the 11 injured nerves. MRI 4 days after the injury showed no abnormality. (orig.)

  18. Diffusion MRI and MR spectroscopy reveal microstructural and metabolic brain alterations in chronic mild stress exposed rats: A CMS recovery study.

    Science.gov (United States)

    Khan, Ahmad Raza; Hansen, Brian; Wiborg, Ove; Kroenke, Christopher D; Jespersen, Sune Nørhøj

    2018-02-15

    Chronic mild stress (CMS) induced depression elicits several debilitating symptoms and causes a significant economic burden on society. High variability in the symptomatology of depression poses substantial impediment to accurate diagnosis and therapy outcome. CMS exposure induces significant metabolic and microstructural alterations in the hippocampus (HP), prefrontal cortex (PFC), caudate-putamen (CP) and amygdala (AM), however, recovery from these maladaptive changes are limited and this may provide negative effects on the therapeutic treatment and management of depression. The present study utilized anhedonic rats from the unpredictable CMS model of depression to study metabolic recovery in the ventral hippocampus (vHP) and microstructural recovery in the HP, AM, CP, and PFC. The study employed 1 H MR spectroscopy ( 1 H MRS) and in-vivo diffusion MRI (d-MRI) at the age of week 18 (week 1 post CMS exposure) week 20 (week 3 post CMS) and week 25 (week 8 post CMS exposure) in the anhedonic group, and at the age of week 18 and week 22 in the control group. The d-MRI data have provided an array of diffusion tensor metrics (FA, MD, AD, and RD), and fast kurtosis metrics (MKT, W L and W T ). CMS exposure induced a significant metabolic alteration in vHP, and significant microstructural alterations were observed in the HP, AM, and PFC in comparison to the age match control and within the anhedonic group. A significantly high level of N-acetylaspartate (NAA) was observed in vHP at the age of week 18 in comparison to age match control and week 20 and week 25 of the anhedonic group. HP and AM showed significant microstructural alterations up to the age of week 22 in the anhedonic group. PFC showed significant microstructural alterations only at the age of week 18, however, most of the metrics showed significantly higher value at the age of week 20 in the anhedonic group. The significantly increased NAA concentration may indicate impaired catabolism due to astrogliosis or

  19. Hippocampal diffusion tensor imaging microstructural changes in vascular dementia

    DEFF Research Database (Denmark)

    Ostojic, Jelena; Kozic, Dusko; Pavlovic, Aleksandra

    2015-01-01

    To explore microstructural integrity of hippocampus in vascular dementia (VD) using DTI. Twenty-five individuals with VD, without magnetic resonance imaging (MRI) evidence of gray matter pathology, and 25 matched healthy control (HC) individuals underwent a 3T MRI protocol including T2, FLAIR, an...

  20. Detection of Subarachnoid Hemorrhage at Acute and Subacute/Chronic Stages: Comparison of Four Magnetic Resonance Imaging Pulse Sequences and Computed Tomography

    Directory of Open Access Journals (Sweden)

    Mei-Kang Yuan

    2005-03-01

    Conclusion: FLAIR and GE T2* MRI pulse sequences, and CT scans, are all statistically significant indicators of acute SAH. GE T2*-weighted images are statistically significant indicators of subacute-to-chronic SAH, whereas other MRI pulse sequences, and CT scans, are not.

  1. Partial volume effect in MRI

    International Nuclear Information System (INIS)

    Maeda, Munehiro; Yoshiya, Kazuhiko; Suzuki, Eiji

    1989-01-01

    According to the direction and the thickness of the imaging slice in tomography, the border between the tissues becomes unclear (partial volume effect). In the present MRI experiment, we examined border area between fat and water components using phantom in order to investigate the partial volume effect in MRI. In spin echo sequences, the intensity of the border area showed a linear relationship with composition of fat and water. Whereas, in inversion recovery and field echo sequences, we found the parameters to produce an extremely low intensity area at the border region between fat and water. This low intensity area was explained by cancellation of NMR signals from fat and water due to the difference in the direction of magnetic vectors. Clinically, partial volume effect can cause of mis-evaluation of walls, small nodules, tumor capsules and the tumor invasion in the use of inversion recovery and field echo sequences. (author)

  2. Magnetic resonance imaging in acute ischemic stroke

    Energy Technology Data Exchange (ETDEWEB)

    Ohta, Kouichi [Mito Red Cross Hospital (Japan)

    2000-01-01

    This paper summarizes current MRI technology used in the diagnosis of acute cerebral infarction and discusses tasks for further improvement of MRI technology. First, the principles and methods of MRI imaging are described in terms of 1) diffusion-weighted imaging (DWI) and ADC maps, 2) perfusion imaging, 3) the fluid-attenuated inversion recovery (FLAIR) method, and 4) MR angiography (MRA). Then, the actual use of MRI in the early phase of ischemic cerebrovascular disorders is discussed focusing on general MRI procedures, cases in which an ischemic lesion dose not yield a high signal with DWI in the acute phase, and chronological changes in DWI signal strength and ADC. Third, chronological changes in acute cerebrovascular disorder in an animal model of local cerebral ischemia are summarized in terms of expansion of reduced ADC areas and ischemic penumbras in the acute phase of cerebral ischemia. Finally, chronological changes in acute ischemic disorders in patients with cerebrovascular disorders are assessed by reviewing the development of reduced ADC and expansion of DWI lesions. Whether MRI can identify cerebral tissues that can be rescued by the reperfusion method by examining the mismatchs between perfusion images and DWI, relative CBV, and ADC is also discussed. (K.H.)

  3. Somatic mutations associated with MRI-derived volumetric features in glioblastoma

    Energy Technology Data Exchange (ETDEWEB)

    Gutman, David A.; Dunn, William D. [Emory University School of Medicine, Departments of Neurology, Atlanta, GA (United States); Emory University School of Medicine, Biomedical Informatics, Atlanta, GA (United States); Grossmann, Patrick; Alexander, Brian M. [Harvard Medical School, Department of Radiation Oncology, Dana-Farber Cancer Institute, Brigham and Women' s Hospital, Boston, MA (United States); Cooper, Lee A.D. [Emory University School of Medicine, Biomedical Informatics, Atlanta, GA (United States); Georgia Institute of Technology, Department of Biomedical Engineering, Atlanta, GA (United States); Holder, Chad A. [Emory University School of Medicine, Radiology and Imaging Sciences, Atlanta, GA (United States); Ligon, Keith L. [Brigham and Women' s Hospital, Harvard Medical School, Pathology, Dana-Farber Cancer Institute, Boston, MA (United States); Aerts, Hugo J.W.L. [Harvard Medical School, Department of Radiation Oncology, Dana-Farber Cancer Institute, Brigham and Women' s Hospital, Boston, MA (United States); Brigham and Women' s Hospital, Harvard Medical School, Radiology, Dana-Farber Cancer Institute, Boston, MA (United States)

    2015-12-15

    MR imaging can noninvasively visualize tumor phenotype characteristics at the macroscopic level. Here, we investigated whether somatic mutations are associated with and can be predicted by MRI-derived tumor imaging features of glioblastoma (GBM). Seventy-six GBM patients were identified from The Cancer Imaging Archive for whom preoperative T1-contrast (T1C) and T2-FLAIR MR images were available. For each tumor, a set of volumetric imaging features and their ratios were measured, including necrosis, contrast enhancing, and edema volumes. Imaging genomics analysis assessed the association of these features with mutation status of nine genes frequently altered in adult GBM. Finally, area under the curve (AUC) analysis was conducted to evaluate the predictive performance of imaging features for mutational status. Our results demonstrate that MR imaging features are strongly associated with mutation status. For example, TP53-mutated tumors had significantly smaller contrast enhancing and necrosis volumes (p = 0.012 and 0.017, respectively) and RB1-mutated tumors had significantly smaller edema volumes (p = 0.015) compared to wild-type tumors. MRI volumetric features were also found to significantly predict mutational status. For example, AUC analysis results indicated that TP53, RB1, NF1, EGFR, and PDGFRA mutations could each be significantly predicted by at least one imaging feature. MRI-derived volumetric features are significantly associated with and predictive of several cancer-relevant, drug-targetable DNA mutations in glioblastoma. These results may shed insight into unique growth characteristics of individual tumors at the macroscopic level resulting from molecular events as well as increase the use of noninvasive imaging in personalized medicine. (orig.)

  4. Somatic mutations associated with MRI-derived volumetric features in glioblastoma

    International Nuclear Information System (INIS)

    Gutman, David A.; Dunn, William D.; Grossmann, Patrick; Alexander, Brian M.; Cooper, Lee A.D.; Holder, Chad A.; Ligon, Keith L.; Aerts, Hugo J.W.L.

    2015-01-01

    MR imaging can noninvasively visualize tumor phenotype characteristics at the macroscopic level. Here, we investigated whether somatic mutations are associated with and can be predicted by MRI-derived tumor imaging features of glioblastoma (GBM). Seventy-six GBM patients were identified from The Cancer Imaging Archive for whom preoperative T1-contrast (T1C) and T2-FLAIR MR images were available. For each tumor, a set of volumetric imaging features and their ratios were measured, including necrosis, contrast enhancing, and edema volumes. Imaging genomics analysis assessed the association of these features with mutation status of nine genes frequently altered in adult GBM. Finally, area under the curve (AUC) analysis was conducted to evaluate the predictive performance of imaging features for mutational status. Our results demonstrate that MR imaging features are strongly associated with mutation status. For example, TP53-mutated tumors had significantly smaller contrast enhancing and necrosis volumes (p = 0.012 and 0.017, respectively) and RB1-mutated tumors had significantly smaller edema volumes (p = 0.015) compared to wild-type tumors. MRI volumetric features were also found to significantly predict mutational status. For example, AUC analysis results indicated that TP53, RB1, NF1, EGFR, and PDGFRA mutations could each be significantly predicted by at least one imaging feature. MRI-derived volumetric features are significantly associated with and predictive of several cancer-relevant, drug-targetable DNA mutations in glioblastoma. These results may shed insight into unique growth characteristics of individual tumors at the macroscopic level resulting from molecular events as well as increase the use of noninvasive imaging in personalized medicine. (orig.)

  5. The Optimization of Magnetic Resonance Imaging Pulse Sequences in Order to Better Detection of Multiple Sclerosis Plaques.

    Science.gov (United States)

    Farshidfar, Z; Faeghi, F; Haghighatkhah, H R; Abdolmohammadi, J

    2017-09-01

    Magnetic resonance imaging (MRI) is the most sensitive technique to detect multiple sclerosis (MS) plaques in central nervous system. In some cases, the patients who were suspected to MS, Whereas MRI images are normal, but whether patients don't have MS plaques or MRI images are not enough optimized enough in order to show MS plaques? The aim of the current study is evaluating the efficiency of different MRI sequences in order to better detection of MS plaques. In this cross-sectional study which was performed at Shohada-E Tajrish in Tehran - Iran hospital between October, 2011 to April, 2012, included 20 patients who suspected to MS disease were selected by the method of random sampling and underwent routine brain Pulse sequences (Axial T2w, Axial T1w, Coronal T2w, Sagittal T1w, Axial FLAIR) by Siemens, Avanto, 1.5 Tesla system. If any lesion which is suspected to the MS disease was observed, additional sequences such as: Sagittal FLAIR Fat Sat, Sagittal PDw-fat Sat, Sagittal PDw-water sat was also performed. This study was performed in about 52 lesions and the results in more than 19 lesions showed that, for the Subcortical and Infratentorial areas, PDWw sequence with fat suppression is the best choice, And in nearly 33 plaques located in Periventricular area, FLAIR Fat Sat was the most effective sequence than both PDw fat and water suppression pulse sequences. Although large plaques may visible in all images, but important problem in patients with suspected MS is screening the tiny MS plaques. This study showed that for revealing the MS plaques located in the Subcortical and Infratentorial areas, PDw-fat sat is the most effective sequence, and for MS plaques in the periventricular area, FLAIR fat Sat is the best choice.

  6. White Matter Lesion Assessment in Patients with Cognitive Impairment and Healthy Controls: Reliability Comparisons between Visual Rating, a Manual, and an Automatic Volumetrical MRI Method—The Gothenburg MCI Study

    Directory of Open Access Journals (Sweden)

    Erik Olsson

    2013-01-01

    Full Text Available Age-related white matter lesions (WML are a risk factor for stroke, cognitive decline, and dementia. Different requirements are imposed on methods for the assessment of WML in clinical settings and for research purposes, but reliability analysis is of major importance. In this study, WML assessment with three different methods was evaluated. In the Gothenburg mild cognitive impairment study, MRI scans from 152 participants were used to assess WML with the Fazekas visual rating scale on T2 images, a manual volumetric method on FLAIR images, and FreeSurfer volumetry on T1 images. Reliability was acceptable for all three methods. For low WML volumes (2/3 of the patients, reliability was overall lower and nonsignificant for the manual volumetric method. Unreliability in the assessment of patients with low WML with manual volumetry may mainly be due to intensity variation in the FLAIR sequence used; hence, intensity standardization and normalization methods must be used for more accurate assessments. The FreeSurfer segmentations resulted in smaller WML volumes than the volumes acquired with the manual method and showed deviations from visible hypointensities in the T1 images, which quite likely reduces validity.

  7. SU-F-J-93: Automated Segmentation of High-Resolution 3D WholeBrain Spectroscopic MRI for Glioblastoma Treatment Planning

    Energy Technology Data Exchange (ETDEWEB)

    Schreibmann, E; Shu, H [Department of Radiation Oncology, Winship Cancer Institute of Emory University, Atlanta, GA (United States); Cordova, J; Gurbani, S; Holder, C; Cooper, L; Shim, H [Department of Radiology and Imaging Sciences, Emory University, Atlanta, GA (United States)

    2016-06-15

    Purpose: We report on an automated segmentation algorithm for defining radiation therapy target volumes using spectroscopic MR images (sMRI) acquired at nominal voxel resolution of 100 microliters. Methods: Wholebrain sMRI combining 3D echo-planar spectroscopic imaging, generalized auto-calibrating partially-parallel acquisitions, and elliptical k-space encoding were conducted on 3T MRI scanner with 32-channel head coil array creating images. Metabolite maps generated include choline (Cho), creatine (Cr), and N-acetylaspartate (NAA), as well as Cho/NAA, Cho/Cr, and NAA/Cr ratio maps. Automated segmentation was achieved by concomitantly considering sMRI metabolite maps with standard contrast enhancing (CE) imaging in a pipeline that first uses the water signal for skull stripping. Subsequently, an initial blob of tumor region is identified by searching for regions of FLAIR abnormalities that also display reduced NAA activity using a mean ratio correlation and morphological filters. These regions are used as starting point for a geodesic level-set refinement that adapts the initial blob to the fine details specific to each metabolite. Results: Accuracy of the segmentation model was tested on a cohort of 12 patients that had sMRI datasets acquired pre, mid and post-treatment, providing a broad range of enhancement patterns. Compared to classical imaging, where heterogeneity in the tumor appearance and shape across posed a greater challenge to the algorithm, sMRI’s regions of abnormal activity were easily detected in the sMRI metabolite maps when combining the detail available in the standard imaging with the local enhancement produced by the metabolites. Results can be imported in the treatment planning, leading in general increase in the target volumes (GTV60) when using sMRI+CE MRI compared to the standard CE MRI alone. Conclusion: Integration of automated segmentation of sMRI metabolite maps into planning is feasible and will likely streamline acceptance of this

  8. Evaluation of a deep learning approach for the segmentation of brain tissues and white matter hyperintensities of presumed vascular origin in MRI.

    Science.gov (United States)

    Moeskops, Pim; de Bresser, Jeroen; Kuijf, Hugo J; Mendrik, Adriënne M; Biessels, Geert Jan; Pluim, Josien P W; Išgum, Ivana

    2018-01-01

    Automatic segmentation of brain tissues and white matter hyperintensities of presumed vascular origin (WMH) in MRI of older patients is widely described in the literature. Although brain abnormalities and motion artefacts are common in this age group, most segmentation methods are not evaluated in a setting that includes these items. In the present study, our tissue segmentation method for brain MRI was extended and evaluated for additional WMH segmentation. Furthermore, our method was evaluated in two large cohorts with a realistic variation in brain abnormalities and motion artefacts. The method uses a multi-scale convolutional neural network with a T 1 -weighted image, a T 2 -weighted fluid attenuated inversion recovery (FLAIR) image and a T 1 -weighted inversion recovery (IR) image as input. The method automatically segments white matter (WM), cortical grey matter (cGM), basal ganglia and thalami (BGT), cerebellum (CB), brain stem (BS), lateral ventricular cerebrospinal fluid (lvCSF), peripheral cerebrospinal fluid (pCSF), and WMH. Our method was evaluated quantitatively with images publicly available from the MRBrainS13 challenge ( n  = 20), quantitatively and qualitatively in relatively healthy older subjects ( n  = 96), and qualitatively in patients from a memory clinic ( n  = 110). The method can accurately segment WMH (Overall Dice coefficient in the MRBrainS13 data of 0.67) without compromising performance for tissue segmentations (Overall Dice coefficients in the MRBrainS13 data of 0.87 for WM, 0.85 for cGM, 0.82 for BGT, 0.93 for CB, 0.92 for BS, 0.93 for lvCSF, 0.76 for pCSF). Furthermore, the automatic WMH volumes showed a high correlation with manual WMH volumes (Spearman's ρ  = 0.83 for relatively healthy older subjects). In both cohorts, our method produced reliable segmentations (as determined by a human observer) in most images (relatively healthy/memory clinic: tissues 88%/77% reliable, WMH 85%/84% reliable) despite various degrees of

  9. The effect of hippocampal function, volume and connectivity on posterior cingulate cortex functioning during episodic memory fMRI in mild cognitive impairment.

    Science.gov (United States)

    Papma, Janne M; Smits, Marion; de Groot, Marius; Mattace Raso, Francesco U; van der Lugt, Aad; Vrooman, Henri A; Niessen, Wiro J; Koudstaal, Peter J; van Swieten, John C; van der Veen, Frederik M; Prins, Niels D

    2017-09-01

    Diminished function of the posterior cingulate cortex (PCC) is a typical finding in early Alzheimer's disease (AD). It is hypothesized that in early stage AD, PCC functioning relates to or reflects hippocampal dysfunction or atrophy. The aim of this study was to examine the relationship between hippocampus function, volume and structural connectivity, and PCC activation during an episodic memory task-related fMRI study in mild cognitive impairment (MCI). MCI patients (n = 27) underwent episodic memory task-related fMRI, 3D-T1w MRI, 2D T2-FLAIR MRI and diffusion tensor imaging. Stepwise linear regression analysis was performed to examine the relationship between PCC activation and hippocampal activation, hippocampal volume and diffusion measures within the cingulum along the hippocampus. We found a significant relationship between PCC and hippocampus activation during successful episodic memory encoding and correct recognition in MCI patients. We found no relationship between the PCC and structural hippocampal predictors. Our results indicate a relationship between PCC and hippocampus activation during episodic memory engagement in MCI. This may suggest that during episodic memory, functional network deterioration is the most important predictor of PCC functioning in MCI. • PCC functioning during episodic memory relates to hippocampal functioning in MCI. • PCC functioning during episodic memory does not relate to hippocampal structure in MCI. • Functional network changes are an important predictor of PCC functioning in MCI.

  10. 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...

  11. Magnetic resonance imaging (MRI) of liver and brain in haematologic-organic patients with fever of unknown origin; Magnetresonanztomographie (MRT) der Leber und des Gehirns bei haematologisch-onkologischen Patienten mit Fieber unbekannter Ursache

    Energy Technology Data Exchange (ETDEWEB)

    Heussel, C.P.; Kauczor, H.U.; Poguntke, M.; Schadmand-Fischer, S.; Mildenberger, P.; Thelen, M. [Mainz Univ. (Germany). Klinik und Poliklinik fuer Radiologie; Heussel, G. [Mainz Univ. (Germany). 3. Medizinische Klinik und Poliklinik

    1998-08-01

    To examine the advantage of liver and brain MRI in clinically anomalous haematological patients with fever of unknown origin. Material and Methods: Twenty liver MRI (T{sub 2}-TSE, T{sub 2}-HASTE, T{sub 1}-FLASH{+-}Gd dynamic) and 16 brain MRI (T{sub 2}-TSE, FLAIR, T{sub 1}-TSE{+-}Gd) were performed searching for a focus of fever with a suspected organ system. Comparison with clinical follow-up. Results: suspected organ system. Comparison with clinical follow-up. Results: A focus was detected in 11/20 liver MRI. Candidiasis (n=3), mycobacteriosis (n=2), relapse of haematological disease (n=3), graft versus host disease (n=1), non-clarified (n=2). The remaining 9 cases with normal MRI were not suspicious of infectious hepatic disease during follo-wup. In brain MRI, 3/16 showed a focus (toxoplasmosis, aspergillosis, mastoiditis). Clinical indication for an infectious involvement of the brain was found in 4/16 cases 2--5 months after initially normal brain MRI. No suspicion of an infectious involvement of brain was present in the remaining 9/16 cases. Conclusion: In case of fever of unknown origin and suspicion of liver involvement, MRI of the liver should be performed due to data given in literature and its sensitivity of 100%. Because of the delayed detectability of cerebral manifestations, in cases of persisting suspicion even a previously normal MRI of the brain should be repeated. (orig.) [Deutsch] Untersuchung des Nutzens der MRT der Leber und des Gehirns bei klinisch auffaelligen haematologischen Patienten mit Fieber unbekannter Ursache. Material und Methoden: Es wurden 20 MRT der Leber (T{sub 2}-TSE, T{sub 2}-HASTE, T{sub 1}-FLASH{+-}Gd dynamisch) und 16 MRT des Gehirns (T{sub 2}-TSE, FLAIR, T{sub 1}-TSE{+-}Gd) zur Fokussuche bei Infektionsverdacht und Organhinweisen durchgefuehrt. Es erfolgte der Abgleich mit dem weiteren klinischen Verlauf. Ergebnisse: 11/20 MRT-Untersuchungen der Leber zeigten einen Herdbefund: Candidiasis (n=3), Mykobakteriose (n=2

  12. Thrombotic stroke in the anesthetized monkey (Macaca mulatta): characterization by MRI - A pilot study

    International Nuclear Information System (INIS)

    Gauberti, Maxime; Gakuba, Clement; Orset, Cyrille; Obiang, Pauline; Guedin, Pierre; Balossier, Anne; Diependaele, Anne-Sophie; Young, Alan R.; Agin, Veronique; Chazalviel, Laurent; Vivien, Denis

    2012-01-01

    The lack of a relevant stroke model in large nonhuman primates hinders the development of innovative diagnostic/therapeutic approaches concerned with this cerebrovascular disease. Our objective was to develop a novel and clinically relevant model of embolic stroke in the anesthetized monkey that incorporates readily available clinical imaging techniques and that would allow the possibility of drug delivery including strategies of reperfusion. Thrombin was injected into the lumen of the middle cerebral artery (MCA) in 12 anesthetized (sevoflurane) male rhesus macaques (Macaca mulatta). Sequential MRI studies (including angiography, FLAIR, PWI, DWI, and gadolinium-enhanced T1W imaging) were performed in a 3 T clinical MRI. Physiological and biochemical parameters were monitored throughout the investigations. Once standardized, the surgical procedure induced transient occlusion of the middle cerebral artery in all operated animals. All animals studied showed spontaneous reperfusion, which occurred some time between 2 h and 7 days post-ictus. Eighty percent of the studied animals showed diffusion/perfusion mismatch. The ischemic lesions at 24 h spared both superficial and profound territories of the MCA. Some animals presented hemorrhagic transformation at 7 days post-ictus. In this study, we developed a pre-clinically relevant model of embolic stroke in the anesthetized nonhuman primate. (authors)

  13. Detection of white matter lesion regions in MRI using SLIC0 and convolutional neural network.

    Science.gov (United States)

    Diniz, Pedro Henrique Bandeira; Valente, Thales Levi Azevedo; Diniz, João Otávio Bandeira; Silva, Aristófanes Corrêa; Gattass, Marcelo; Ventura, Nina; Muniz, Bernardo Carvalho; Gasparetto, Emerson Leandro

    2018-04-19

    White matter lesions are non-static brain lesions that have a prevalence rate up to 98% in the elderly population. Because they may be associated with several brain diseases, it is important that they are detected as soon as possible. Magnetic Resonance Imaging (MRI) provides three-dimensional data with the possibility to detect and emphasize contrast differences in soft tissues, providing rich information about the human soft tissue anatomy. However, the amount of data provided for these images is far too much for manual analysis/interpretation, representing a difficult and time-consuming task for specialists. This work presents a computational methodology capable of detecting regions of white matter lesions of the brain in MRI of FLAIR modality. The techniques highlighted in this methodology are SLIC0 clustering for candidate segmentation and convolutional neural networks for candidate classification. The methodology proposed here consists of four steps: (1) images acquisition, (2) images preprocessing, (3) candidates segmentation and (4) candidates classification. The methodology was applied on 91 magnetic resonance images provided by DASA, and achieved an accuracy of 98.73%, specificity of 98.77% and sensitivity of 78.79% with 0.005 of false positives, without any false positives reduction technique, in detection of white matter lesion regions. It is demonstrated the feasibility of the analysis of brain MRI using SLIC0 and convolutional neural network techniques to achieve success in detection of white matter lesions regions. Copyright © 2018. Published by Elsevier B.V.

  14. Intramedullary disorders diagnosed by MRI. Clinical course in 23 cases

    International Nuclear Information System (INIS)

    Nagata, Kensei; Ohashi, Teruaki; Ishibashi, Kazumasa; Hirohashi, Akiyuki; Sato, Kimiaki

    1996-01-01

    We report the clinical course of 23 cases with intramedullary disorders diagnosed by MRI. Spinal vascular disease was the most common, and occurred in 11 cases, intramedullary tumor occurred in 6, and multiple sclerosis, myelitis, spinal edema each in 2. The characteristic MRI findings of the intramedullary disorders were spinal cord swelling on T1 weighted image and changes in the intensity on the T2 weighted image. Surgical treatment was performed in 5 of the 11 with spinal vascular disease and in 6 with an intra-medullary tumor. One patient with AV malformation underwent embolization of the spinal artery. The other 11 received conservative treatment. The period of follow-up ranged from 6 months to 9 years after onset. Complete recovery from symptoms was achieved in only 2 patients, some recovery was achieved in 8, no change in 10, and deterioration occurred in 3. In conclusion, it has become easy to diagnose intramedullary disorders by utilizing MRI. However, an accurate qualitative diagnosis is difficult except for spinal vascular disease. Complete recovery from the symptoms of intramedullary disorders remains difficult to achieve by available treatments. (author)

  15. Intramedullary disorders diagnosed by MRI. Clinical course in 23 cases

    Energy Technology Data Exchange (ETDEWEB)

    Nagata, Kensei; Ohashi, Teruaki; Ishibashi, Kazumasa; Hirohashi, Akiyuki; Sato, Kimiaki [Kurume Univ., Fukuoka (Japan). School of Medicine

    1996-09-01

    We report the clinical course of 23 cases with intramedullary disorders diagnosed by MRI. Spinal vascular disease was the most common, and occurred in 11 cases, intramedullary tumor occurred in 6, and multiple sclerosis, myelitis, spinal edema each in 2. The characteristic MRI findings of the intramedullary disorders were spinal cord swelling on T1 weighted image and changes in the intensity on the T2 weighted image. Surgical treatment was performed in 5 of the 11 with spinal vascular disease and in 6 with an intra-medullary tumor. One patient with AV malformation underwent embolization of the spinal artery. The other 11 received conservative treatment. The period of follow-up ranged from 6 months to 9 years after onset. Complete recovery from symptoms was achieved in only 2 patients, some recovery was achieved in 8, no change in 10, and deterioration occurred in 3. In conclusion, it has become easy to diagnose intramedullary disorders by utilizing MRI. However, an accurate qualitative diagnosis is difficult except for spinal vascular disease. Complete recovery from the symptoms of intramedullary disorders remains difficult to achieve by available treatments. (author)

  16. PET/MRI assessment of the infarcted mouse heart

    Energy Technology Data Exchange (ETDEWEB)

    Buonincontri, Guido, E-mail: gb396@cam.ac.uk [Wolfson Brain Imaging Centre, Department of Clinical Neurosciences, University of Cambridge, Cambridge (United Kingdom); Methner, Carmen; Krieg, Thomas [Department of Medicine, University of Cambridge, Cambridge (United Kingdom); Hawkes, Robert C.; Adrian Carpenter, T. [Wolfson Brain Imaging Centre, Department of Clinical Neurosciences, University of Cambridge, Cambridge (United Kingdom); Sawiak, Stephen J., E-mail: sjs80@cam.ac.uk [Wolfson Brain Imaging Centre, Department of Clinical Neurosciences, University of Cambridge, Cambridge (United Kingdom); Behavioural and Clinical Neuroscience Institute, University of Cambridge, Cambridge (United Kingdom)

    2014-01-11

    Heart failure originating from myocardial infarction (MI) is a leading cause of death worldwide. Mouse models of ischaemia and reperfusion injury (I/R) are used to study the effects of novel treatment strategies targeting MI, however staging disease and treatment efficacy is a challenge. Damage and recovery can be assessed on the cellular, tissue or whole-organ scale but these are rarely measured in concert. Here, for the first time, we present data showing measures of injury in infarcted mice using complementary techniques for multi-modal characterisation of the heart. We use in vivo magnetic resonance imaging (MRI) to assess heart function with cine-MRI, hindered perfusion with late gadolinium enhancement imaging and muscular function with displacement encoded with stimulated echoes (DENSE) MRI. These measures are followed by positron emission tomography (PET) with 18-F-fluorodeoxyglucose to assess cellular metabolism. We demonstrate a protocol combining each of these measures for the same animal in the same imaging session and compare how the different markers can be used to quantify cardiac recovery on different scales following injury.

  17. PET/MRI assessment of the infarcted mouse heart

    International Nuclear Information System (INIS)

    Buonincontri, Guido; Methner, Carmen; Krieg, Thomas; Hawkes, Robert C.; Adrian Carpenter, T.; Sawiak, Stephen J.

    2014-01-01

    Heart failure originating from myocardial infarction (MI) is a leading cause of death worldwide. Mouse models of ischaemia and reperfusion injury (I/R) are used to study the effects of novel treatment strategies targeting MI, however staging disease and treatment efficacy is a challenge. Damage and recovery can be assessed on the cellular, tissue or whole-organ scale but these are rarely measured in concert. Here, for the first time, we present data showing measures of injury in infarcted mice using complementary techniques for multi-modal characterisation of the heart. We use in vivo magnetic resonance imaging (MRI) to assess heart function with cine-MRI, hindered perfusion with late gadolinium enhancement imaging and muscular function with displacement encoded with stimulated echoes (DENSE) MRI. These measures are followed by positron emission tomography (PET) with 18-F-fluorodeoxyglucose to assess cellular metabolism. We demonstrate a protocol combining each of these measures for the same animal in the same imaging session and compare how the different markers can be used to quantify cardiac recovery on different scales following injury

  18. Clinical evaluation of MRI for lumbar spinal disease

    International Nuclear Information System (INIS)

    Moriwaka, Yosuke; Nakayama, Sachiko; Murai, Nobuko; Watanabe, Katsushi; Kawano, Keiichiro; Tajima, Naoya; Kihara, Yasushi; Okada, Akihiko; Fujimoto, Toshiro.

    1985-01-01

    Thirty-two patients were examined to determine the clinical usefulness of magnetic resonance imaging (MRI) of the lumbar spine. MRI using a resistive magnet at 0.1 Tesla was compared with computed tomography (CT) and myelography. A saturation recovery (SR) technique with repetition time (TR) of 500 msec was used in all cases. There were 19 cases with disk herniation, 5 with canal stenosis, 2 with spondylosis deformans and 6 with other suspected disease. MRI showed the protrusion of disk, displacement of epidural fat and degenerative change of disk more clearly than CT and myelography. Of the 12 herniated disks, 8 disks were clearly shown and one was not detected by MRI. In some cases, herniated disk could not be differentiated from disk bulging. With further technical advance, MRI is likely to become the initial procedure for evaluation of lumbar spinal disease. (author)

  19. A brainstem variant of reversible posterior leukoencephalopathy syndrome

    Energy Technology Data Exchange (ETDEWEB)

    Kitaguchi, H.; Tomimoto, H.; Terada, K. [Kyoto University, Department of Neurology, Graduate School of Medicine, Sakyo-ku, Kyoto (Japan); Miki, Y.; Yamamoto, A. [Kyoto University, Department of Nuclear Medicine and Diagnostic Imaging, Graduate School of Medicine, Sakyo-ku, Kyoto (Japan); Satoi, H.; Kanda, M. [Ijinkai Takeda General Hospital, Department of Neurology, Fushimi-ku, Kyoto (Japan); Fukuyama, H. [Kyoto University, Human Brain Research Center, Graduate School of Medicine, Sakyo-ku, Kyoto (Japan)

    2005-09-01

    Reversible posterior leukoencephalopathy syndrome (RPLS) is caused by various heterogeneous factors, the commonest being hypertension, followed by nonhypertensive causes such as eclampsia, renal diseases and immunosuppressive therapy. Patients with RPLS exhibit bilateral white and gray matter abnormalities in the posterior aspects of the cerebral hemispheres. However, this syndrome may affect the brainstem predominantly, and these cases are designated as hypertensive brainstem encephalopathy. We present here two patients with reversible brainstem encephalopathy: one with hypertension and the other without hypertension. These patients presented with swelling and diffuse hyperintensities of the brainstem in fluid-attenuated inversion-recovery (FLAIR) and T2-weighted MRI, but with relatively mild clinical symptoms. They recovered without major neurological deficits, but had residual lacunar lesions in the pons. Reversible brainstem encephalopathy with characteristic MRI features was found in both hypertensive and nonhypertensive patients. These patients were diagnosed with a brainstem variant of RPLS, which is potentially fully reversible after an adequate treatment, and therefore should be carefully differentiated from other brainstem disease conditions. (orig.)

  20. A brainstem variant of reversible posterior leukoencephalopathy syndrome

    International Nuclear Information System (INIS)

    Kitaguchi, H.; Tomimoto, H.; Terada, K.; Miki, Y.; Yamamoto, A.; Satoi, H.; Kanda, M.; Fukuyama, H.

    2005-01-01

    Reversible posterior leukoencephalopathy syndrome (RPLS) is caused by various heterogeneous factors, the commonest being hypertension, followed by nonhypertensive causes such as eclampsia, renal diseases and immunosuppressive therapy. Patients with RPLS exhibit bilateral white and gray matter abnormalities in the posterior aspects of the cerebral hemispheres. However, this syndrome may affect the brainstem predominantly, and these cases are designated as hypertensive brainstem encephalopathy. We present here two patients with reversible brainstem encephalopathy: one with hypertension and the other without hypertension. These patients presented with swelling and diffuse hyperintensities of the brainstem in fluid-attenuated inversion-recovery (FLAIR) and T2-weighted MRI, but with relatively mild clinical symptoms. They recovered without major neurological deficits, but had residual lacunar lesions in the pons. Reversible brainstem encephalopathy with characteristic MRI features was found in both hypertensive and nonhypertensive patients. These patients were diagnosed with a brainstem variant of RPLS, which is potentially fully reversible after an adequate treatment, and therefore should be carefully differentiated from other brainstem disease conditions. (orig.)

  1. MRI findings of spinal accessory neuropathy

    International Nuclear Information System (INIS)

    Li, A.E.; Greditzer, H.G.; Melisaratos, D.P.; Wolfe, S.W.; Feinberg, J.H.; Sneag, D.B.

    2016-01-01

    Aim: To characterise the magnetic resonance imaging (MRI) appearance of patients with spinal accessory nerve (SAN) denervation. Material and methods: Twelve patients who had SAN denervation on electromyography (EMG) were included. The sternocleidomastoid and trapezius muscles and the SAN were assessed using MRI. Results: Trapezius muscle atrophy was seen in 11 (92%), and of those patients, T2/short tau inversion recovery (STIR) signal hyperintensity was also demonstrated in seven (58%). All three patients with prior neck surgery had scarring around the SAN, and one of these patients demonstrated a neuroma, which was confirmed surgically. Conclusion: Features of SAN neuropathy on MRI include atrophy and T2/STIR signal hyperintensity of the trapezius, and in patients who have had posterior triangle neck surgery, scarring may be seen around the nerve. - Highlights: • Spinal accessory nerve injury is most commonly the result of neck surgery. • MRI findings include trapezius muscle atrophy and T2 signal hyperintensity. • In cases of suspected injury, the course of the spinal accessory nerve should be assessed on MRI.

  2. Parietal operculum and motor cortex activities predict motor recovery in moderate to severe stroke

    Directory of Open Access Journals (Sweden)

    Firdaus Fabrice Hannanu

    2017-01-01

    In subacute stroke, fMRI brain activity related to passive movement measured in a sensorimotor network defined by activity during voluntary movement predicted motor recovery better than baseline motor-FMS alone. Furthermore, fMRI sensorimotor network activity measures considered alone allowed excellent clinical recovery prediction and may provide reliable biomarkers for assessing new therapies in clinical trial contexts. Our findings suggest that neural reorganization related to motor recovery from moderate to severe stroke results from balanced changes in ipsilesional MI (BA4a and a set of phylogenetically more archaic sensorimotor regions in the ventral sensorimotor trend, in which OP1 and OP4 processes may complement the ipsilesional dorsal motor cortex in achieving compensatory sensorimotor recovery.

  3. Initial Incidence of White Matter Hyperintensities on MRI in Astronauts

    Science.gov (United States)

    Norcross, Jason; Sherman, Paul; McGuire, Steve; Kochunov, Peter

    2016-01-01

    Introduction: Previous literature has described the increase in white matter hyperintensity (WMH) burden associated with hypobaric exposure in the U-2 and altitude chamber operating personnel. Although astronauts have similar hypobaric exposure pressures to the U2 pilot population, astronauts have far fewer exposures and each exposure would be associated with a much lower level of decompression stress due to rigorous countermeasures to prevent decompression sickness. Therefore, we postulated that the WMH burden in the astronaut population would be less than in U2 pilots. Methods: Twenty-one post-flight de-identified astronaut MRIs (5 mm slice thickness FLAIR sequences) were evaluated for WMH count and volume. The only additional data provided was an age range of the astronauts (43-57) and if they had ever performed an EVA (13 yes, 8 no). Results: WMH count in these 21 astronaut MRI was 21.0 +/- 24.8 (mean+/- SD) and volume was 0.382 +/- 0.602 ml, which was significantly higher than previously published results for the U2 pilots. No significant differences between EVA and no EVA groups existed. Age range of astronaut population is not directly comparable to the U2 population. Discussion: With significantly less frequent (sometimes none) and less stressful hypobaric exposures, yet a much higher incidence of increased WMH, this indicates the possibility of additional mechanisms beyond hypobaric exposure. This increase unlikely to be attributable just to the differences in age between astronauts and U2 pilots. Forward work includes continuing review of post-flight MRI and evaluation of pre to post flight MRI changes if available. Data mining for potential WMH risk factors includes collection of age, sex, spaceflight experience, EVA hours, other hypobaric exposures, hyperoxic exposures, radiation, high performance aircraft experience and past medical history. Finally, neurocognitive and vision/eye results will be evaluated for any evidence of impairment linked to

  4. Diffusion tensor MRI: clinical applications

    International Nuclear Information System (INIS)

    Meli, Francisco; Romero, Carlos; Carpintiero, Silvina; Salvatico, Rosana; Lambre, Hector; Vila, Jose

    2005-01-01

    Purpose: To evaluate the usefulness of diffusion-tensor imaging (DTI) on different neurological diseases, and to know if this technique shows additional information than conventional Magnetic Resonance Imaging (MRI). Materials and method: Eight patients, with neurological diseases (five patients with brain tumors, one with multiple sclerosis (MS), one with variant Creutzfeldt-Jakob disease (vCJD) and the other with delayed CO intoxication were evaluated. A MR scanner of 1.5 T was used and conventional sequences and DTI with twenty-five directions were done. Quantitative maps were gotten, where the fractional anisotropy (FA) through regions of interest (ROIs) in specific anatomic area were quantified (i.e.: internal and external capsules, frontal and temporal bundles, corpus fibers). Results: In the patients with brain tumors, there was a decrease of FA on intra and peritumoral fibers. Some of them had a disruption in their pattern. In patients with MS and CO intoxication, partial interruption along white matter bundles was demonstrated. However, a 'mismatch' between the findings of FLAIR, Diffusion-weighted images (DWI) and DTI, in the case of CO intoxication, was seen. Conclusions: DTI gave more information compared to conventional sequences about ultrastructural brain tissue in almost all the diseases above mentioned. Therefore, there is a work in progress about DTI acquisition, to evaluate a new technique, called tractography. (author)

  5. fMRI and brain activation after sport concussion: a tale of two cases

    Directory of Open Access Journals (Sweden)

    Michael G Hutchison

    2014-04-01

    Full Text Available Sport-related concussions are now recognized as a major public health concern: The number of participants in sport and recreation is growing, possibly playing their games faster, and there is heightened public awareness of injuries to some high-profile athletes. However, many clinicians still rely on subjective symptom reports for the clinical determination of recovery. Relying on subjective symptom reports can be dangerous, as it has been shown that some concussed athletes may downplay their symptoms. The use of neuropsychological (NP testing tools has enabled clinicians to measure the effects and extent of impairment following concussion more precisely, providing more objective metrics for determining recovery after concussion. Nevertheless, there is a remaining concern that brain abnormalities may exist beyond the point at which individuals achieve recovery in self-reported symptoms and cognition measured by NP testing. Our understanding of brain recovery after concussion is important not only from a neuroscience perspective, but also from the perspective of clinical decision making for safe return-to-play (RTP. A number of advanced neuroimaging tools, including blood oxygen level dependent (BOLD functional magnetic resonance imaging (fMRI, have independently yielded early information on these abnormal brain functions. In the two cases presented in this article, we report contrasting brain activation patterns and recovery profiles using fMRI. Importantly, fMRI was conducted using adapted versions of the most sensitive computerized NP tests administered in current clinical practice to determine impairments and recovery after sport-related concussion. One of the cases is consistent with the concept of lagging brain recovery.

  6. Imaging-genomics reveals driving pathways of MRI derived volumetric tumor phenotype features in Glioblastoma

    International Nuclear Information System (INIS)

    Grossmann, Patrick; Gutman, David A.; Dunn, William D. Jr; Holder, Chad A.; Aerts, Hugo J. W. L.

    2016-01-01

    Glioblastoma (GBM) tumors exhibit strong phenotypic differences that can be quantified using magnetic resonance imaging (MRI), but the underlying biological drivers of these imaging phenotypes remain largely unknown. An Imaging-Genomics analysis was performed to reveal the mechanistic associations between MRI derived quantitative volumetric tumor phenotype features and molecular pathways. One hundred fourty one patients with presurgery MRI and survival data were included in our analysis. Volumetric features were defined, including the necrotic core (NE), contrast-enhancement (CE), abnormal tumor volume assessed by post-contrast T1w (tumor bulk or TB), tumor-associated edema based on T2-FLAIR (ED), and total tumor volume (TV), as well as ratios of these tumor components. Based on gene expression where available (n = 91), pathway associations were assessed using a preranked gene set enrichment analysis. These results were put into context of molecular subtypes in GBM and prognostication. Volumetric features were significantly associated with diverse sets of biological processes (FDR < 0.05). While NE and TB were enriched for immune response pathways and apoptosis, CE was associated with signal transduction and protein folding processes. ED was mainly enriched for homeostasis and cell cycling pathways. ED was also the strongest predictor of molecular GBM subtypes (AUC = 0.61). CE was the strongest predictor of overall survival (C-index = 0.6; Noether test, p = 4x10 −4 ). GBM volumetric features extracted from MRI are significantly enriched for information about the biological state of a tumor that impacts patient outcomes. Clinical decision-support systems could exploit this information to develop personalized treatment strategies on the basis of noninvasive imaging. The online version of this article (doi:10.1186/s12885-016-2659-5) contains supplementary material, which is available to authorized users

  7. Comparative study between MRI and echocardiography in noncompaction of ventricular myocardium

    International Nuclear Information System (INIS)

    Sun Ziyan; Xia Liming; Wang Chengyuan; Rao Jingjing; Shenyu Weihui

    2007-01-01

    Objective: To investigate the MRI and echocardiography manifestations of noncompaction of ventricular myocardium(NVM) and assess the role of MR1 in the diagnosis of NVM by comparing it with echocardiography. Methods: Fourteen cases of NVM diagnosed by echocardiography were examined with MRI, including scanning of black-blood sequences, double inversion recovery fast spin echo (DIBFSE) and triple inversion recovery fast spin echo (TIRFSE), and white blood sequence: fast imaging employ steady state acquisition (FIESTA). Scanning plane includes short axis view, four-chamber view and long axis view. Results: Both MRI and echocardiography displayed involvement of left ventricles in thirteen cases and involvement of double ventricles in one case. Apexes of heart and the intermedius are commonly affected. MRI showed 54 segments and echocardiography showed 53 segments affected, and there is no significant difference between the capability of MRI and echocardiography (P=1,000). The affected myocardium consisted of two layers: subendocardial noncompacted myocardium and epicardial compacted myocardium, and the ratio measurement of N/C by MRI was 3.37±0.89 and it was 3.19±0.82 by echocardiography. Noncompacted myocardium was characterized by prominent and excessive myocardial trabeculations and deep intratrabecular recesses, in which the blood flow was communicated with the ventricle. One case was complicated with ventricular aneurysm, and coronary arteriography was performed with unremarkable findings. One case underwent heart transplantation because of progressive heart failure, Gross findings demonstrated prominent muscular' trabeculations with deep intratrabecular recesses, which coincided well with MRI findings. Conclusion: The MRI manifestation of NVM is characteristic, and MRI with multiple series and planes is helpful in the diagnose of NVM. Compared with echocardiography, MRI could display the pathological cardiac muscle more clearly, because of its high soft

  8. MRI of endolymphatic hydrops in patients with Meniere's disease: a case-controlled study with a simplified classification based on saccular morphology

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    Attye, Arnaud; Krainik, Alexandre [Department of Neuroradiology and MRI, CS 10217-Grenoble Alpes University Hospital - SFR RMN Neurosciences, Grenoble Cedex 9 (France); Univ. Grenoble Alpes, IRMaGe, Grenoble (France); Eliezer, Michael [Rouen University Hospital, Department of Radiology, Rouen (France); Boudiaf, Naila [Department of Neuroradiology and MRI, CS 10217-Grenoble Alpes University Hospital - SFR RMN Neurosciences, Grenoble Cedex 9 (France); Tropres, Irene [IRMaGe, Inserm US 17, CNRS UMS 3552, Grenoble (France); Chechin, David [Philips Healthcare, Paris (France); Schmerber, Sebastien; Dumas, Georges [Grenoble Alpes University Hospital, Department of Otology, Grenoble (France)

    2017-08-15

    Endolymphatic hydrops (EH) can be studied in patients by MRI. With the semi-quantitative grading system, previous imaging studies showed discrepancies in the occurrence and grading of EH in patients with Meniere's disease (MD). Here, we compared the inversion of the saccule to utricle area ratio (SURI) with the semi-quantitative method of grading conventionally used to diagnose MD. Imaging was carried out on a 3-T MRI scanner. We performed 3D-FLAIR sequences 4 h after a single intravenous dose of contrast agent. Two radiologists independently studied the morphology of the inner ear structures in the healthy subjects and MD patients. Each subject was then graded on the basis of the EH semi-quantitative analysis and on saccular morphology using axial and sagittal reference slices in the vestibule plane. Thirty healthy subjects and 30 MD patients had MRI scans. Using the semi-quantitative method, we found no significant difference in the number of subjects with EH between the two groups. SURI was found in 15 out of 30 MD patients and in none of the 30 healthy subjects. In three MD patients the saccule was not visible. SURI is currently the most specific criterion for imaging diagnosis of MD. (orig.)

  9. Predictors of short-term outcome in patients with acute middle cerebral artery occlusion: unsuitability of fluid-attenuated inversion recovery vascular hyperintensity scores

    Directory of Open Access Journals (Sweden)

    Chan-chan Li

    2018-01-01

    Full Text Available Fluid-attenuated inversion recovery (FLAIR vascular hyperintensity (FVH is used to assess leptomeningeal collateral circulation, but clinical outcomes of patients with FVH can be very different. The aim of the present study was to assess a FVH score and explore its relationship with clinical outcomes. Patients with acute ischemic stroke due to middle cerebral artery M1 occlusion underwent magnetic resonance imaging and were followed up at 10 days (National Institutes of Health Stroke Scale and 90 days (modified Rankin Scale to determine short-term clinical outcomes. Effective collateral circulation indirectly improved recovery of neurological function and short-term clinical outcome by extending the size of the pial penumbra and reducing infarct lesions. FVH score showed no correlation with 90-day functional clinical outcome and was not sufficient as an independent predictor of short-term clinical outcome.

  10. Computational Diffusion MRI : MICCAI Workshop

    CERN Document Server

    Grussu, Francesco; Ning, Lipeng; Tax, Chantal; Veraart, Jelle

    2018-01-01

    This volume presents the latest developments in the highly active and rapidly growing field of diffusion MRI. The reader will find numerous contributions covering a broad range of topics, from the mathematical foundations of the diffusion process and signal generation, to new computational methods and estimation techniques for the in-vivo recovery of microstructural and connectivity features, as well as frontline applications in neuroscience research and clinical practice. These proceedings contain the papers presented at the 2017 MICCAI Workshop on Computational Diffusion MRI (CDMRI’17) held in Québec, Canada on September 10, 2017, sharing new perspectives on the most recent research challenges for those currently working in the field, but also offering a valuable starting point for anyone interested in learning computational techniques in diffusion MRI. This book includes rigorous mathematical derivations, a large number of rich, full-colour visualisations and clinically relevant results. As such, it wil...

  11. Presence of a central vein within white matter lesions on susceptibility weighted imaging: a specific finding for multiple sclerosis?

    International Nuclear Information System (INIS)

    Lummel, Nina; Boeckh-Behrens, Tobias; Brueckmann, Hartmut; Linn, Jennifer; Schoepf, Veronika; Burke, Michael

    2011-01-01

    Susceptibility weighted imaging depicts the perivenous extent of multiple sclerosis white matter lesions (MS-WML) in vivo by directly visualizing their centrally running vein. The aim of this study was to investigate the specificity of this finding for MS. Fifteen patients with MS and 15 patients with microangiopathic white matter lesions (mWML) underwent 3T MRI, including a fluid-attenuated inversion recovery sequence (FLAIR) and a susceptibility weighted angiography (SWAN). All WMLs were identified on FLAIR and assigned to one of the following localizations: supratentorial peripheral, supratentorial periventricular, or infratentorial. Subsequently, the presence of a central vein within these lesions was assessed on SWAN. A total of 711 MS-WMLs and 1,119 m-WMLs were identified on FLAIR, all of which could also be visualized on SWAN. A central vein was detectable in 80% of the MS-WMLs and in 78% of the m-WMLs (in 73% and 76% of the peripheral, in 92% and 94% of the periventricular, and in 71% and 75% of the infratentorial MS-WMLs and m-WMLs, respectively). With regard to the supratentorial peripheral lesions, significantly more m-WMLs showed a central vein compared to the MS-WMLs. For the other localizations, there was no significant difference between the groups with regard to the percentage of lesions with central vein. Our results indicate that the detection of a central vein within a WML should not be considered a specific finding for MS; it is also found in WMLs of other etiologies. (orig.)

  12. Presence of a central vein within white matter lesions on susceptibility weighted imaging: a specific finding for multiple sclerosis?

    Energy Technology Data Exchange (ETDEWEB)

    Lummel, Nina; Boeckh-Behrens, Tobias; Brueckmann, Hartmut; Linn, Jennifer [University of Munich, Department of Neuroradiology, Munich (Germany); Schoepf, Veronika [University of Munich, Department of Neuroradiology, Munich (Germany); Medical University of Vienna, MR Centre of Excellence, Vienna (Austria); Burke, Michael [GE Healthcare, Solingen (Germany)

    2011-05-15

    Susceptibility weighted imaging depicts the perivenous extent of multiple sclerosis white matter lesions (MS-WML) in vivo by directly visualizing their centrally running vein. The aim of this study was to investigate the specificity of this finding for MS. Fifteen patients with MS and 15 patients with microangiopathic white matter lesions (mWML) underwent 3T MRI, including a fluid-attenuated inversion recovery sequence (FLAIR) and a susceptibility weighted angiography (SWAN). All WMLs were identified on FLAIR and assigned to one of the following localizations: supratentorial peripheral, supratentorial periventricular, or infratentorial. Subsequently, the presence of a central vein within these lesions was assessed on SWAN. A total of 711 MS-WMLs and 1,119 m-WMLs were identified on FLAIR, all of which could also be visualized on SWAN. A central vein was detectable in 80% of the MS-WMLs and in 78% of the m-WMLs (in 73% and 76% of the peripheral, in 92% and 94% of the periventricular, and in 71% and 75% of the infratentorial MS-WMLs and m-WMLs, respectively). With regard to the supratentorial peripheral lesions, significantly more m-WMLs showed a central vein compared to the MS-WMLs. For the other localizations, there was no significant difference between the groups with regard to the percentage of lesions with central vein. Our results indicate that the detection of a central vein within a WML should not be considered a specific finding for MS; it is also found in WMLs of other etiologies. (orig.)

  13. Brain tumor segmentation in MRI by using the fuzzy connectedness method

    Science.gov (United States)

    Liu, Jian-Guo; Udupa, Jayaram K.; Hackney, David; Moonis, Gul

    2001-07-01

    The aim of this paper is the precise and accurate quantification of brain tumor via MRI. This is very useful in evaluating disease progression, response to therapy, and the need for changes in treatment plans. We use multiple MRI protocols including FLAIR, T1, and T1 with Gd enhancement to gather information about different aspects of the tumor and its vicinity- edema, active regions, and scar left over due to surgical intervention. We have adapted the fuzzy connectedness framework to segment tumor and to measure its volume. The method requires only limited user interaction in routine clinical MRI. The first step in the process is to apply an intensity normalization method to the images so that the same body region has the same tissue meaning independent of the scanner and patient. Subsequently, a fuzzy connectedness algorithm is utilized to segment the different aspects of the tumor. The system has been tested, for its precision, accuracy, and efficiency, utilizing 40 patient studies. The percent coefficient of variation (% CV) in volume due to operator subjectivity in specifying seeds for fuzzy connectedness segmentation is less than 1%. The mean operator and computer time taken per study is 3 minutes. The package is designed to run under operator supervision. Delineation has been found to agree with the operators' visual inspection most of the time except in some cases when the tumor is close to the boundary of the brain. In the latter case, the scalp is included in the delineation and an operator has to exclude this manually. The methodology is rapid, robust, consistent, yielding highly reproducible measurements, and is likely to become part of the routine evaluation of brain tumor patients in our health system.

  14. Prospective trial evaluating the sensitivity and specificity of 3,4-dihydroxy-6-[18F]-fluoro-L-phenylalanine (18F-DOPA) PET and MRI in patients with recurrent gliomas.

    Science.gov (United States)

    Youland, Ryan S; Pafundi, Deanna H; Brinkmann, Debra H; Lowe, Val J; Morris, Jonathan M; Kemp, Bradley J; Hunt, Christopher H; Giannini, Caterina; Parney, Ian F; Laack, Nadia N

    2018-05-01

    Treatment-related changes can be difficult to differentiate from progressive glioma using MRI with contrast (CE). The purpose of this study is to compare the sensitivity and specificity of 18F-DOPA-PET and MRI in patients with recurrent glioma. Thirteen patients with MRI findings suspicious for recurrent glioma were prospectively enrolled and underwent 18F-DOPA-PET and MRI for neurosurgical planning. Stereotactic biopsies were obtained from regions of concordant and discordant PET and MRI CE, all within regions of T2/FLAIR signal hyperintensity. The sensitivity and specificity of 18F-DOPA-PET and CE were calculated based on histopathologic analysis. Receiver operating characteristic curve analysis revealed optimal tumor to normal (T/N) and SUVmax thresholds. In the 37 specimens obtained, 51% exhibited MRI contrast enhancement (M+) and 78% demonstrated 18F-DOPA-PET avidity (P+). Imaging characteristics included M-P- in 16%, M-P+ in 32%, M+P+ in 46% and M+P- in 5%. Histopathologic review of biopsies revealed grade II components in 16%, grade III in 43%, grade IV in 30% and no tumor in 11%. MRI CE sensitivity for recurrent tumor was 52% and specificity was 50%. PET sensitivity for tumor was 82% and specificity was 50%. A T/N threshold > 2.0 altered sensitivity to 76% and specificity to 100% and SUVmax > 1.36 improved sensitivity and specificity to 94 and 75%, respectively. 18F-DOPA-PET can provide increased sensitivity and specificity compared with MRI CE for visualizing the spatial distribution of recurrent gliomas. Future studies will incorporate 18F-DOPA-PET into re-irradiation target volume delineation for RT planning.

  15. Magnetic resonance in the diagnostic imaging study of mesial temporal sclerosis; Diagnostico por imagen con resonancia magnetica de la esclerosis temporal mesial

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    Pastor, E.; Sanchez, J. C.; Rodriguez, I.; Altuzarra, A.; Machado, F. [Hospital Universitario Virgen de las Nieves. Granada (Spain); Aguilar, D. [Hospital Clinico Universitario San Cecilio. Granada (Spain)

    2001-07-01

    Mesial temporal sclerosis (MTS) consists of hippocampal atrophy and gliosis and is the most common cause of temporal lobe epilepsy. The objective of the authors was to establish a magnetic resonance imaging (MRI) protocol for its diagnosis. A prospective study was carried out in 72 patients with drug resistant complex partial seizures (42 women and 30 men ranging in age from 6 to 66 year: mean: 30 years). Using a 1.5-Tesla magnet, paracoronal sections were made in hippocampi for T1-weighted inversion-recovery images and volume measurements, fluid-attenuated inversion-recovery (FLAIR) and T2 relaxometry. A control group of 30 health volunteers was included in the study. MTS was considered to be indicated by the presence of atrophy and hyperintensity in hippocampi on T2-weighted images. There were no differences among the hippocampi of the healthy individuals. The confidence intervals (mean{+-} 1.96 SD) were 4169 mm''3-5911 mm''3 for volume of right side, 4097 mm''3-5940 mm''3 for volume of left side and 98-113 ms for T2 relaxation time. MTS was detected in 40 patients (55.5%): 23 cases involving the left side, 13 involving the right and 4 cases of bilateral asymmetric involvement. The 95% confidence intervals for the diagnostic validity of the results (sensitivity/specificity) were (88.8%-97.2%)/(87.6%-96.4%) for T1 volumetry, (88.8%-97.2%)(95.7%-100.3%) for FLAIR and (85.4%-96.6%)/(85.4%-96.6%) for T2 relaxometry. In 5 cases of MTS, astrophy of other extra hippocampal structures was also observed, and MTS was associated with an extra hippocampal lesion (dual pathology), especially neurona migration disorders, in 8 patients. Seventeen patients (23.5%) presented lesions without MTS (tumors, cortical dysplasias and heterotopias) and there was no MRI evidence of anomalies in 15 (21%). Twenty-five patients underwent surgical treatment: 20 with MTS (19 diagnosed according to MRI and one in whom there had been no abnormal findings

  16. Magnetic resonance in the diagnostic imaging study of mesial temporal sclerosis; Diagnostico por imagen con resonancia magnetica de la esclerosis temporal mesial

    Energy Technology Data Exchange (ETDEWEB)

    Pastor, E; Sanchez, J C; Rodriguez, I; Altuzarra, A; Machado, F [Hospital Universitario Virgen de las Nieves. Granada (Spain); Aguilar, D [Hospital Clinico Universitario San Cecilio. Granada (Spain)

    2001-07-01

    Mesial temporal sclerosis (MTS) consists of hippocampal atrophy and gliosis and is the most common cause of temporal lobe epilepsy. The objective of the authors was to establish a magnetic resonance imaging (MRI) protocol for its diagnosis. A prospective study was carried out in 72 patients with drug resistant complex partial seizures (42 women and 30 men ranging in age from 6 to 66 year: mean: 30 years). Using a 1.5-Tesla magnet, paracoronal sections were made in hippocampi for T1-weighted inversion-recovery images and volume measurements, fluid-attenuated inversion-recovery (FLAIR) and T2 relaxometry. A control group of 30 health volunteers was included in the study. MTS was considered to be indicated by the presence of atrophy and hyperintensity in hippocampi on T2-weighted images. There were no differences among the hippocampi of the healthy individuals. The confidence intervals (mean{+-} 1.96 SD) were 4169 mm''3-5911 mm''3 for volume of right side, 4097 mm''3-5940 mm''3 for volume of left side and 98-113 ms for T2 relaxation time. MTS was detected in 40 patients (55.5%): 23 cases involving the left side, 13 involving the right and 4 cases of bilateral asymmetric involvement. The 95% confidence intervals for the diagnostic validity of the results (sensitivity/specificity) were (88.8%-97.2%)/(87.6%-96.4%) for T1 volumetry, (88.8%-97.2%)(95.7%-100.3%) for FLAIR and (85.4%-96.6%)/(85.4%-96.6%) for T2 relaxometry. In 5 cases of MTS, astrophy of other extra hippocampal structures was also observed, and MTS was associated with an extra hippocampal lesion (dual pathology), especially neurona migration disorders, in 8 patients. Seventeen patients (23.5%) presented lesions without MTS (tumors, cortical dysplasias and heterotopias) and there was no MRI evidence of anomalies in 15 (21%). Twenty-five patients underwent surgical treatment: 20 with MTS (19 diagnosed according to MRI and one in whom there had been no abnormal findings), 4 with tumors and 1 with a ballooned

  17. Magnetic resonance in the diagnostic imaging study of mesial temporal sclerosis

    International Nuclear Information System (INIS)

    Pastor, E.; Sanchez, J. C.; Rodriguez, I.; Altuzarra, A.; Machado, F.; Aguilar, D.

    2001-01-01

    Mesial temporal sclerosis (MTS) consists of hippocampal atrophy and gliosis and is the most common cause of temporal lobe epilepsy. The objective of the authors was to establish a magnetic resonance imaging (MRI) protocol for its diagnosis. A prospective study was carried out in 72 patients with drug resistant complex partial seizures (42 women and 30 men ranging in age from 6 to 66 year: mean: 30 years). Using a 1.5-Tesla magnet, paracoronal sections were made in hippocampi for T1-weighted inversion-recovery images and volume measurements, fluid-attenuated inversion-recovery (FLAIR) and T2 relaxometry. A control group of 30 health volunteers was included in the study. MTS was considered to be indicated by the presence of atrophy and hyperintensity in hippocampi on T2-weighted images. There were no differences among the hippocampi of the healthy individuals. The confidence intervals (mean± 1.96 SD) were 4169 mm''3-5911 mm''3 for volume of right side, 4097 mm''3-5940 mm''3 for volume of left side and 98-113 ms for T2 relaxation time. MTS was detected in 40 patients (55.5%): 23 cases involving the left side, 13 involving the right and 4 cases of bilateral asymmetric involvement. The 95% confidence intervals for the diagnostic validity of the results (sensitivity/specificity) were (88.8%-97.2%)/(87.6%-96.4%) for T1 volumetry, (88.8%-97.2%)(95.7%-100.3%) for FLAIR and (85.4%-96.6%)/(85.4%-96.6%) for T2 relaxometry. In 5 cases of MTS, astrophy of other extra hippocampal structures was also observed, and MTS was associated with an extra hippocampal lesion (dual pathology), especially neurona migration disorders, in 8 patients. Seventeen patients (23.5%) presented lesions without MTS (tumors, cortical dysplasias and heterotopias) and there was no MRI evidence of anomalies in 15 (21%). Twenty-five patients underwent surgical treatment: 20 with MTS (19 diagnosed according to MRI and one in whom there had been no abnormal findings), 4 with tumors and 1 with a ballooned cell

  18. Multiparametric MRI changes persist beyond recovery in concussed adolescent hockey players

    Science.gov (United States)

    Manning, Kathryn Y.; Schranz, Amy; Bartha, Robert; Dekaban, Gregory A.; Barreira, Christy; Brown, Arthur; Fischer, Lisa; Asem, Kevin; Doherty, Timothy J.; Fraser, Douglas D.; Holmes, Jeff

    2017-01-01

    Objective: To determine whether multiparametric MRI data can provide insight into the acute and long-lasting neuronal sequelae after a concussion in adolescent athletes. Methods: Players were recruited from Bantam hockey leagues in which body checking is first introduced (male, age 11–14 years). Clinical measures, diffusion metrics, resting-state network and region-to-region functional connectivity patterns, and magnetic resonance spectroscopy absolute metabolite concentrations were analyzed from an independent, age-matched control group of hockey players (n = 26) and longitudinally in concussed athletes within 24 to 72 hours (n = 17) and 3 months (n = 14) after a diagnosed concussion. Results: There were diffusion abnormalities within multiple white matter tracts, functional hyperconnectivity, and decreases in choline 3 months after concussion. Tract-specific spatial statistics revealed a large region along the superior longitudinal fasciculus with the largest decreases in diffusivity measures, which significantly correlated with clinical deficits. This region also spatially intersected with probabilistic tracts connecting cortical regions where we found acute functional connectivity changes. Hyperconnectivity patterns at 3 months after concussion were present only in players with relatively less severe clinical outcomes, higher choline concentrations, and diffusivity indicative of relatively less axonal disruption. Conclusions: Changes persisted well after players' clinical scores had returned to normal and they had been cleared to return to play. Ongoing white matter maturation may make adolescent athletes particularly vulnerable to brain injury, and they may require extended recovery periods. The consequences of early brain injury for ongoing brain development and risk of more serious conditions such as second impact syndrome or neural degenerative processes need to be elucidated. PMID:29070666

  19. Can MR appearance performed a few days after injury predict the morphological recovery of the anterior cruciate ligament treated by early protective motion?

    International Nuclear Information System (INIS)

    Ihara, Hidetoshi; Kawano, Tsutomu

    2011-01-01

    The aim of this study was to determine whether early MRI after anterior cruciate ligament (ACL) injury can predict the morphological recovery of the torn ACL treated by early protective motion. Consecutive acute ruptures of the ACL in 35 patients (mean age; 27.2 years) who were allowed to be healed without surgery were evaluated by repeated MRI. MR images were compared for a few days after injury (initial MRI), approximately one month after treatment (second MRI), and at an average follow-up of 8.5 months (follow-up MRI). The average time from injury to the initial MRI was 7.3 days. The initial MR appearance of the torn ligament was classified into five types of visualized ligament contours. The emergence of restoration signs such as straight band and/or verticalization was examined in the second MRI. The follow-up MR appearance of the treated ACL was categorized into four grades depending on homogeneity, straight band, and size. Relationships between the initial MRI and the follow-up MRI, the restoration signs on the second MRI and the follow-up MRI were analyzed using the Spearman rank correlation coefficient. As a result, the contour of the initial MRI was found to correlate with morphological recovery on the follow-up MRI (r s =0.565, p<0.001). There was no correlation between the emergence of restoration signs on the second MRI and morphological recovery on the follow-up MRI. (author)

  20. Radiological assessment of Creutzfeldt-Jakob disease

    Energy Technology Data Exchange (ETDEWEB)

    Tschampa, Henriette J.; Urbach, Horst [University of Bonn, Department of Radiology, Bonn (Germany); Zerr, Inga [University of Goettingen, National Reference Center for TSE Surveillance at the Department of Neurology, Goettingen (Germany)

    2007-05-15

    Creutzfeldt-Jakob disease is a rare fatal neurodegenerative disorder, characterized by rapidly progressive dementia and neurological signs. There is a need for early and accurate clinical diagnosis in order to exclude any treatable disorder. Additionally, it is of public interest to differentiate the sporadic form of the disease from the variant CJD type (vCJD), which is probably transmitted from cattle infected with bovine spongiform encephalopathy (BSE). High signal in the striatum on T2-weighted, FLAIR and diffusion weighted (DW) MRI as well as cortical high signal in FLAIR and DW MRI are the classical findings in sCJD. The ''pulvinar sign'', defined as high signal in the pulvinar thalami that is brighter than potential additional high signal in the basal ganglia, is considered pathognomonic for vCJD. (orig.)

  1. Radiological assessment of Creutzfeldt-Jakob disease

    International Nuclear Information System (INIS)

    Tschampa, Henriette J.; Urbach, Horst; Zerr, Inga

    2007-01-01

    Creutzfeldt-Jakob disease is a rare fatal neurodegenerative disorder, characterized by rapidly progressive dementia and neurological signs. There is a need for early and accurate clinical diagnosis in order to exclude any treatable disorder. Additionally, it is of public interest to differentiate the sporadic form of the disease from the variant CJD type (vCJD), which is probably transmitted from cattle infected with bovine spongiform encephalopathy (BSE). High signal in the striatum on T2-weighted, FLAIR and diffusion weighted (DW) MRI as well as cortical high signal in FLAIR and DW MRI are the classical findings in sCJD. The ''pulvinar sign'', defined as high signal in the pulvinar thalami that is brighter than potential additional high signal in the basal ganglia, is considered pathognomonic for vCJD. (orig.)

  2. Restructuring Reward Mechanisms in Nicotine Addiction: A Pilot fMRI Study of Mindfulness-Oriented Recovery Enhancement for Cigarette Smokers

    Directory of Open Access Journals (Sweden)

    B. Froeliger

    2017-01-01

    Full Text Available The primary goal of this pilot feasibility study was to examine the effects of Mindfulness-Oriented Recovery Enhancement (MORE, a behavioral treatment grounded in dual-process models derived from cognitive science, on frontostriatal reward processes among cigarette smokers. Healthy adult (N=13; mean (SD age 49 ± 12.2 smokers provided informed consent to participate in a 10-week study testing MORE versus a comparison group (CG. All participants underwent two fMRI scans: pre-tx and after 8-weeks of MORE. Emotion regulation (ER, smoking cue reactivity (CR, and resting-state functional connectivity (rsFC were assessed at each fMRI visit; smoking and mood were assessed throughout. As compared to the CG, MORE significantly reduced smoking (d=2.06 and increased positive affect (d=2.02. MORE participants evidenced decreased CR-BOLD response in ventral striatum (VS; d=1.57 and ventral prefrontal cortex (vPFC; d=1.7 and increased positive ER-BOLD in VS (dVS=2.13 and vPFC (dvmPFC=2.66. Importantly, ER was correlated with smoking reduction (r’s = .68 to .91 and increased positive affect (r’s = .52 to .61. These findings provide preliminary evidence that MORE may facilitate the restructuring of reward processes and play a role in treating the pathophysiology of nicotine addiction.

  3. MRI of neuronal migration disorders

    International Nuclear Information System (INIS)

    Engelbrecht, V.

    1996-01-01

    Twenty-one MRI examinations of the brain were performed in 19 children with neuronal migration disorders. Multiplanar oriented spin-echo sequences were on a scanner with 1.5 T. In 8 children we performed an additional turbo-inversion recovery (TIR) sequence. Results of sonography or CT from five children were compared with MRI scans. Using the actual nomenclature, we found the following migration disorders: Lissencephaly (n=6), cobblestone lissencephaly with Walker-Warbung syndrome (WWS) (n=2), polymicrogyria and schizencephaly (n=2), focal heterotopia (n=5), diffuse heterotopie (n=2) and hemimegalencephaly (n=2). MRI was superior to CT and sonography in all children. Except for the two boys with WWS, the TIR sequence was the best to demonstrate the changes in migration disorder because of the high contrast between gray and white matter. We demonstrate the characteristic features of the different migration disorders and compare them with the existing literature. (orig.) [de

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

    Energy Technology Data Exchange (ETDEWEB)

    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.

  5. 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.

  6. Functional connectivity metrics during stroke recovery

    DEFF Research Database (Denmark)

    Yourganov, Grigori; Schmah, Tanya; Small, Steven L.

    2010-01-01

    We explore functional connectivity in nine subjects measured with 1 5T fMRI-BOLD in a longitudinal study of recovery from unilateral stroke affecting the motor area (Small et al, 2002) We found that several measures of complexity of covariance matrices show strong correlations with behavioral mea...

  7. About pathognomonic images: an infrequent case of acute encephalopathy

    Directory of Open Access Journals (Sweden)

    Alessandro Grasso

    2013-05-01

    Full Text Available BACKGROUND The occurrence of acute encephalopathy is a dramatic clinical dilemma when usual diagnostic techniques (blood tests, cerebral CT and cerebrospinal fluid analysis show no abnormalities. CLINICAL CASE We describe a case of a 73 years old man admitted in our Internal Medicine Unit for acute diarrhoea with vomiting and fever who developed a prolonged gastrointestinal dysmotility syndrome with poor nutritional intake. Although a parenteral support was provided, he developed acute encephalopathy followed by hypotension and lactic acidosis without evidence of renal and hepatic disease or glycemic alterations. Likewise, no cerebral CT and cerebrospinal fluid alterations were found. Conversely, cerebral MRI showed marked and diffuse DP-2 and FLAIR hyperintensity of the mesencephalic tectal plate, of the periaqueductal area, and of the periventricular region of the third ventricle including the median thalamic area. These MRI descriptions were considered pathognomonic of Wernicke encephalopathy. Thus, the immediate use of ev thiamine was followed by a prompt and complete recovery of neurological, hemodinamic and metabolic conditions. CONCLUSIONS Non-alcoholic Wernicke encephalopathy is a rare and dramatic clinical event with high mortality. In this context, brain MRI is the best diagnostic tool providing a typical picture.

  8. Value of diffusion-weighted MR imaging in the diagnosis of Creutzfeldt-Jakob disease

    International Nuclear Information System (INIS)

    Xu Quangang; Wu Weiping; Huang Dehui; Zhang Jiatang; Lang Senyang; Pu Chuanqiang

    2005-01-01

    Objective: To assess the diagnosis value of diffusion- weighted imaging (DWI) in Creutzfeldt-Jakob disease (CJD). Methods: 8 cases of sporadic CJD who underwent MRI were reported. 4 cases were definite, 3 cases were probable and 1 case was possible. The sensitivity of DWI and conventional MRI were compared. Results: T 1 WI and T 2 WI revealed no abnormal signals except nonspecific diffuse brain atrophy in 4 cases, whereas DWI detected hyperintense abnormalities in all cases. 2 cases showed linear lesions only in the cerebral cortex, and 6 cases showed lesions in both the cerebral cortex and the striatum. The lesions were symmetric in 5 cases, but were asymmetric in the other 3 cases. Although fluid- attenuated inversion recovery (FLAIR) imaging also showed cortical hyperintensity in 1 case, the high signal changes were more evident and extensive on DWI. Conclusions: The hyperintense changes in the cerebral cortices and/or striata on DWI are considered characteristic of CJD. DWI is more sensitive than conventional MRI in depicting lesions of CJD and may be an essential tool for the early diagnosis of this disease. (authors)

  9. Influence of low back pain and prognostic value of MRI in sciatica patients in relation to back pain.

    Science.gov (United States)

    el Barzouhi, Abdelilah; Vleggeert-Lankamp, Carmen L A M; Lycklama à Nijeholt, Geert J; Van der Kallen, Bas F; van den Hout, Wilbert B; Koes, Bart W; Peul, Wilco C

    2014-01-01

    Patients with sciatica frequently complain about associated back pain. It is not known whether there are prognostic relevant differences in Magnetic Resonance Imaging (MRI) findings between sciatica patients with and without disabling back pain. The study population contained patients with sciatica who underwent a baseline MRI to assess eligibility for a randomized trial designed to compare the efficacy of early surgery with prolonged conservative care for sciatica. Two neuroradiologists and one neurosurgeon independently evaluated all MR images. The MRI readers were blinded to symptom status. The MRI findings were compared between sciatica patients with and without disabling back pain. The presence of disabling back pain at baseline was correlated with perceived recovery at one year. Of 379 included sciatica patients, 158 (42%) had disabling back pain. Of the patients with both sciatica and disabling back pain 68% did reveal a herniated disc with nerve root compression on MRI, compared to 88% of patients with predominantly sciatica (Psciatica at baseline was negatively associated with perceived recovery at one year (Odds ratio [OR] 0.32, 95% Confidence Interval 0.18-0.56, PSciatica patients with disabling back pain in absence of nerve root compression on MRI at baseline reported less perceived recovery at one year compared to those with predominantly sciatica and nerve root compression on MRI (50% vs 91%, PSciatica patients with disabling low back pain reported an unfavorable outcome at one-year follow-up compared to those with predominantly sciatica. If additionally a clear herniated disc with nerve root compression on MRI was absent, the results were even worse.

  10. MRI and MRS and outcome in infants with hypoxic ischaemic cerebral injury

    International Nuclear Information System (INIS)

    Saddick, D.; Charlton, M.; Carse, E.; Barfield, C.; Coleman, L.; Goergen, S.

    2002-01-01

    Full text: To audit clinical outcome at 18 to 30 months in infants with hypoxic ischaemic encephalopathy (HIE) and who had MRI and proton MR spectroscopy (MRS) in infancy. 7 infants diagnosed with HIE at birth were examined prior to day 10 of life (mean = 4.5 days) with cranial MRI and MRS. MRS consisted of a single voxel placed over the basal ganglia and a STEAM (TE = 20ms) or PRESS (TE = 270ms) technique. A TE = 135 was used if a lactate doublet was identified at 1.3ppm. T1, T2, PD, FLAIR and diffusion weighted (DW) MR images were scored independently by two radiologists blinded to outcome. Metabolite peak areas were calculated for lactate, NAA, and creatine and a qualitative assessment of glutamine/ glutamate elevation was made. Of the 7 children, one died on day 6 and the others were invited to participate in neurodevelopmental assessment between 18 and 30 months of age. The MDI and PDI of the Bayley scales of infant development were used to assess intellectual and fine and gross motor development respectively and 3 children have attended the clinic thus far. A neurologist performed a standard neurological examination and graded the result on a six-point scale. The two children who had a very poor outcome on the MDI, PDI and/or neurological assessment and the infant died all had Lac: NAA greater than 1.0 or NAA: Cr less than 0.7 and extensive white matter injury. One child had normal MRS and MRI but has not yet presented for assessment at 18 months. The DW images were abnormal in only one child. The findings of marked lactate elevation and extensive white matter injury correlated with poor prognosis in our small group of patients. Diffusion weighted images were frequently normal. Copyright (2002) Blackwell Science Pty Ltd

  11. HR 3 tesla MRI for the diagnosis of endolymphatic hydrops and differential diagnosis of inner ear tumors. Demonstrated by two cases with similar symptoms

    International Nuclear Information System (INIS)

    Homann, G.; Fahrendorf, D.; Niederstadt, T.; Nagelmann, N.; Heindel, W.; Vieth, V.; Luetkenhoener, B.; Boeckenfeld, Y.; Basel, T.

    2014-01-01

    The synchronous appearance of different inner ear pathologies with a nearly equivalent clinical manifestation such as Meniere's disease and vestibular schwannoma is very rare but leads to a relevant dilemma concerning therapy options. MRI is the method of choice to detect intralabyrinthine tumors. Since endolymphatic hydrops is considered the morphological equivalent of Meniere's disease, magnetic resonance imaging including hT2w-FLAIR sequences 4 h after i.v. administration of gadolinium-based contrast agents (GBCA) allows the diagnosis and grading of endolymphatic hydrops in vivo synchronous to diagnosis and monitoring of ILT. To this day, only a few cases of intralabyrinthine schwannoma could be shown to appear simultaneously with endolymphatic hydrops by MRI, but to our knowledge the dedicated distinction of endolymphatic space has not been previously demonstrated. The aim of this work was not only to detect the coincidence of endolymphatic hydrops and vestibular schwannoma, but also to differentiate tumor tissue from endolymphatic space by 3 Tesla MRI. This enables therapy options that are originally indicated for Meniere's disease. The aim of this work was to describe the feasibility and usefulness of endolymphatic hydrops MRI on intralabyrinthal tumors in a special case of intravestibular schwannoma to demonstrate the high clinical relevance and impact in therapeutic decision-making for the synchronous appearance of endolymphatic hydrops and intralabyrinthine tumors. Therefore, we present a typical case of Meniere's disease in contrast to a patient with an intralabyrinthine schwannoma and Meniere's-like symptoms. (orig.)

  12. MRI diagnosis of posterior fossa tumors

    International Nuclear Information System (INIS)

    Yamashita, Yasuyuki; Takahashi, Mutsumasa; Sakamoto, Yuuji; Kojima, Ryutarou; Bussaka, Hiromasa; Korogi, Yukunori

    1988-01-01

    Magnetic resonance images (MRI) of 58 patients with posterior fossa tumors were compared with computed tomography (CT). Spin echo (SE) technique and inversion recovery (IR) technique were obtained using 0.22 tesla resistive magnetic resonance unit. MRI was superior to CT in detecting the lesions and showing internal archtecture, hemorrhage, edema of the tumor and displacement of the normal brain. CT was superior to MRI in demonstrating calcification. MRI and CT were comparable in detecting erosions of the skull base, while MRI was superior to CT in showing erosions of the clivus. Most tumors showed hypointensity on T1 weighted images and hyperintensity on T2 weighted images. Meningioma showed equal or almost equal intensity to cerebral gray matter on both SE images. The boundary of intra-axial tumors was unclear in many cases without contrast enhancement using Gd-DTPA, while most extra-axial tumors showed clear margin surrounded by a thin band (rim). In 81.8 % of acoustic neurinomas, signal void rims were demonstrated on both SE images, and they were considered to be vessels around the tumor. The rims of meningioma, on the other hand, were hypointense on T1 weighted images and hyperintense on T2 weighted images. They were considered to be cerebrospinal fluid or capsule around the tumor. It has been concluded that MRI is the most important technique for diagnosis of posterior fossa tumors. (author)

  13. Loss of neuronal integrity: a cause of hypometabolism in patients with traumatic brain injury without MRI abnormality in the chronic stage

    International Nuclear Information System (INIS)

    Shiga, Tohru; Matsuyama, Tetsuaki; Kageyama, Hiroyuki; Kohno, Tomoya; Tamaki, Nagara; Ikoma, Katsunori; Isoyama, Hirotaka; Katoh, Chietsugu; Kuge, Yuji; Terae, Satoshi

    2006-01-01

    Traumatic brain injury (TBI) causes brain dysfunction in many patients. However, some patients have severe brain dysfunction but display no abnormalities on magnetic resonance imaging (MRI). There have been some reports of hypometabolism even in such patients. The purpose of this study was to investigate the relationship between metabolic abnormality and loss of neuronal integrity in TBI patients with some symptoms but without MRI abnormalities. The study population comprised ten patients with TBI and ten normal volunteers. All of the patients were examined at least 1 year after the injury. 15 O-labelled gas PET and [ 11 C]flumazenil (FMZ) positron emission tomography (PET) were carried out. The cerebral metabolic rate of oxygen (CMRO 2 ) and binding potential (BP) images of FMZ were calculated. Axial T2WI, T2*WI and FLAIR images were obtained. Coronal images were added in some cases. All of the patients had normal MRI findings, and all showed areas with abnormally low CMRO 2 . Low uptake on BP images was observed in six patients (60%). No lesions that showed low uptake on BP images were without low CMRO 2 . On the other hand, there were 14 lesions with low CMRO 2 but without BP abnormalities. These results indicate that there are metabolic abnormalities in TBI patients with some symptoms after brain injury but without abnormalities on MRI. Some of the hypometabolic lesions showed low BP, indicating a loss of neuronal integrity. Thus, FMZ PET may have potential to distinguish hypometabolism caused by neuronal loss from that caused by other factors. (orig.)

  14. Combination of diffusion tensor and functional magnetic resonance imaging during recovery from the vegetative state

    Directory of Open Access Journals (Sweden)

    Fernández-Espejo Davinia

    2010-09-01

    Full Text Available Abstract Background The rate of recovery from the vegetative state (VS is low. Currently, little is known of the mechanisms and cerebral changes that accompany those relatively rare cases of good recovery. Here, we combined functional magnetic resonance imaging (fMRI and diffusion tensor imaging (DTI to study the evolution of one VS patient at one month post-ictus and again twelve months later when he had recovered consciousness. Methods fMRI was used to investigate cortical responses to passive language stimulation as well as task-induced deactivations related to the default-mode network. DTI was used to assess the integrity of the global white matter and the arcuate fasciculus. We also performed a neuropsychological assessment at the time of the second MRI examination in order to characterize the profile of cognitive deficits. Results fMRI analysis revealed anatomically appropriate activation to speech in both the first and the second scans but a reduced pattern of task-induced deactivations in the first scan. In the second scan, following the recovery of consciousness, this pattern became more similar to that classically described for the default-mode network. DTI analysis revealed relative preservation of the arcuate fasciculus and of the global normal-appearing white matter at both time points. The neuropsychological assessment revealed recovery of receptive linguistic functioning by 12-months post-ictus. Conclusions These results suggest that the combination of different structural and functional imaging modalities may provide a powerful means for assessing the mechanisms involved in the recovery from the VS.

  15. Degenerative cerebellar diseases and differential diagnoses; Degenerative Kleinhirnerkrankungen und Differenzialdiagnosen

    Energy Technology Data Exchange (ETDEWEB)

    Reith, W.; Roumia, S.; Dietrich, P. [Universitaetsklinikum des Saarlandes, Klinik fuer Diagnostische und Interventionelle Neuroradiologie, Homburg/Saar (Germany)

    2016-11-15

    Cerebellar syndromes result in distinct clinical symptoms, such as ataxia, dysarthria, dysmetria, intention tremor and eye movement disorders. In addition to the medical history and clinical examination, imaging is particularly important to differentiate other diseases, such as hydrocephalus and multi-infarct dementia from degenerative cerebellar diseases. Degenerative diseases with cerebellar involvement include Parkinson's disease, multiple system atrophy as well as other diseases including spinocerebellar ataxia. In addition to magnetic resonance imaging (MRI), nuclear medicine imaging investigations are also helpful for the differentiation. Axial fluid-attenuated inversion recovery (FLAIR) and T2-weighted sequences can sometimes show a signal increase in the pons as a sign of degeneration of pontine neurons and transverse fibers in the basilar part of the pons. The imaging is particularly necessary to exclude other diseases, such as normal pressure hydrocephalus (NPH), multi-infarct dementia and cerebellar lesions. (orig.) [German] Klinisch imponieren Kleinhirnsyndrome durch Ataxie, Dysarthrie, Dysmetrie, Intentionstremor und Augenbewegungsstoerungen. Neben der Anamnese und klinischen Untersuchung ist die Bildgebung v. a. wichtig um andere Erkrankungen wie Hydrozephalus und Multiinfarktdemenz von degenerativen Kleinhirnerkrankungen zu differenzieren. Zu den degenerativen Erkrankungen mit Kleinhirnbeteiligung gehoeren der Morbus Parkinson, die Multisystematrophie sowie weitere Erkrankungen einschliesslich der spinozerebellaeren Ataxien. Neben der MRT sind auch nuklearmedizinische Untersuchungen zur Differenzierung hilfreich. Axiale Fluid-attenuated-inversion-recovery(FLAIR)- und T2-gewichtete Sequenzen koennen mitunter eine Signalsteigerung im Pons als Ausdruck einer Degeneration der pontinen Neuronen und transversalen Bahnen im Brueckenfuss zeigen. Die Bildgebung ist aber v. a. notwendig, um andere Erkrankungen wie Normaldruckhydrozephalus

  16. Brain activation studies with PET and functional MRI

    Energy Technology Data Exchange (ETDEWEB)

    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.)

  17. 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.)

  18. Gadolinium contrast-enhanced MRI sequence does not have an incremental value in the assessment of sacroiliitis in patients with early inflammatory back pain by using MRI in combination with pelvic radiographs: a 2-year follow-up study

    NARCIS (Netherlands)

    van Onna, M.; van Tubergen, A.; van der Heijde, D.; Jurik, A. G.; Landewé, R.

    2014-01-01

    To evaluate the potential incremental value in detecting sacroiliitis of the T1 post-gadolinium diethylenetriaminepenta-acetic acid (Gd-DTPA) MRI sequence of the sacroiliac joints (SIJ) compared with the combination of short tau inversion recovery (STIR) MRI sequence and pelvic radiographs in

  19. Bone marrow MRI in patients with myelodysplastic syndromes

    International Nuclear Information System (INIS)

    Chen Zhao; Guo You; Wang Renfa; Zou Mingli; Liu Wenli; Xia Liming; Wang Chengyuan

    2004-01-01

    Objective: To observe the MR imaging of bone marrow in myelodysplastic syndromes (MDS) and acute myeloid leukemia (AML), and to reveal the rule of bone marrow infiltration and the role of MRI in diagnosing and predicting the prognosis of myelodysplastic syndromes. Methods: Thirty patients received MRI after the diagnosis based on clinic and FAB subtype study, including 16 with MDS and 14 with AML. MR image was obtained by T 1 -weighted spin echo and shot time inversion recovery in pelvis and femur. The examining results of morphology and blood routine were collected at the same time. 30 age-matched volunteers were selected as controls. Results: The MRI appearance was classified into their patterns based on scope of focus. MRI patterns from grade 1 to grade 3 was observed in patients with MDS. All patients with AML distributed in grade 2 to grade 3. The distribution of patterns had no significant difference between MDS and AML (P>0.05). The marrow ratio had significant difference among MDS, AML, and controls (P<0.05). The MRI grade was consistent with the clinic diagnostic indexes. Conclusion: MRI can provide a better understanding of the difference between MDS and AML. MRI can estimate the extent of disease in the marrow as a whole. MRI of bone marrow can provide imaging basis in diagnosis and predicting the prognosis for patients with MDS

  20. MRI findings of multiple sclerosis involving the brainstem

    International Nuclear Information System (INIS)

    Park, Jeong Hoon; Jeong, Hae Woong; Kim, Hyun Jin; Cho, Jae Kwoeng; Kim, Chang Soo

    2001-01-01

    To describe MRI findings of multiple sclerosis involving the brainstem. Among 35 cases of clinically definite multiple sclerosis, the authors retrospectively analysed 20 in which the brainstem was involved. MR images were analysed with regard to involvement sites in the brainstem or other locations, signal intensity, multiplicity, shape, enhancement pattern, and contiguity of brainstem lesions with cisternal or ventricular CSF space. The brainstem was the only site of involvement in five cases (25%), while simultaneous involvement of the brainstem and other sites was observed in 15 cases (75%). No case involved only the midbrain or medulla oblongata, and simultaneous involvement of the midbrain, pons and medulla oblongata was noted in 12 cases (60%). The most frequently involved region of the brainstem was the medulla oblongata (n=13; 90%), followed by the pons (n=17; 85%) and the midbrain (n=16; 80%). Compared with normal white matter, brainstem lesions showed low signal intensity on T1 weighted images, and high signal intensity on T2 weighted, proton density weighted, and FLAIR images. In 17 cases (85%), multiple intensity was observed, and the shape of lesions varied: oval, round, elliptical, patchy, crescentic, confluent or amorphous were seen on axial MR images, and in 14 cases (82%), coronal or sagittal scanning showed that lesions were long and tubular. Contiguity between brainstem lesions and cisternal or ventricular CSF space was seen in all cases (100%) involving midbrain (16/16) and medulla oblongata (18/18) and in 15 of 17 (88%) involving the pons. Contrast enhancement was apparent in 7 of 12 cases (58%). In the brainstem, MRI demonstrated partial or total contiguity between lesions and cisternal or ventricular CSF space, and coronal or sagittal images showed that lesions were long and tubuler

  1. Neuro-Behcet: about a clinical case

    International Nuclear Information System (INIS)

    Gonzalez, G.; Perez, R.; Satriano, R.; Rotondo, M.

    2007-01-01

    The case of a 7-year-old Uruguayan boy with recurrent episodes of fever, oral aphthas lesions and meningoencephalitis with elevated protein levels and lymphocytic pleocytosis is presented. Other diagnoses were excluded. MRI showed in acute stages CNS involvement in iso- or hipointense in T1- weighted images and hyperintense in T2-weighted or fluid- attenuated inversion recovery (FLAIR) images in mesodiencephalic junction, cerebellar peduncles, pons, corpus callosum, basal ganglia and internal capsule, and cerebral hemispheres. In the evolution skin lesions appeared, fulfilling the International Study Group Criteria for the Diagnosis of Behcet' Disease. Corticosteroids and immunosuppressant treatment was done.The main difficulty in children is having all the criteria for diagnosis; especially when recurrent genital ulceration and eye lesion rarely appear at this age. (author) [es

  2. Successful combination immunotherapy of anti-gamma aminobutyric acid (GABA)A receptor antibody-positive encephalitis with extensive multifocal brain lesions.

    Science.gov (United States)

    Fukami, Yuki; Okada, Hiroaki; Yoshida, Mari; Yamaguchi, Keiji

    2017-08-31

    A 78-year old woman who presented with akinetic mutism was admitted to our hospital. Brain MRI showed multifocal increased T 2 /FLAIR signal with extensive cortical-subcortical involvement. We suspected autoimmune encephalitis and the patient received methylprednisolone pulse. Her conscious level gradually recovered, but later relapsed again and presented with refractory status epilepticus. We treated her with intravenous immunoglobulin, plasma exchange and pulsed cyclophosphamide, with satisfactory response. A brain biopsy showed perivascular lymphocytic infiltrates and reactive gliosis. Anti-gamma aminobutyric acid (GABA) A receptor antibodies test came back to be positive after her recovery, and the diagnosis of anti-GABA A receptor antibody-positive encephalitis was made. This is a very rare case where brain biopsies were performed in a patient with anti-GABA A receptor antibody-positive encephalitis.

  3. MRI of sporadic Creutzfeldt-Jakob disease

    International Nuclear Information System (INIS)

    Kong, A.; Vliet, A. Van der.

    2008-01-01

    Full text: The key MRI findings in five cases of sporadic Creutzfeldt-Jakob disease (CJD) are illustrated with four 'definite' and one 'probable' according to World Health Organization criteria. Close attention to fluid-attenuation inversion recovery and diffusion-weighted imaging sequences are important for diagnosis, noting especially restricted diffusion in cortical and deep grey matter. Our study and those of others show predominant cortical, caudate and thalamic involvement. This pattern is highly sensitive and specific for the diagnosis. Fluid-attenuation inversion recovery and diffusion-weighted imaging signal abnormality becomes progressively more extensive and bilateral as disease progresses, but may become less pronounced in end-stage disease because of atrophy.

  4. Multi-contrast, isotropic, single-slab 3D MR imaging in multiple sclerosis

    NARCIS (Netherlands)

    Moraal, Bastiaan; Roosendaal, Stefan; Pouwels, Petra; Vrenken, Hugo; Schijndel, van Ronald; Meier, Dominik; Guttmann, Charles; Geurts, Jeroen; Barkhof, Frederik

    2008-01-01

    To describe signal and contrast properties of an isotropic, single-slab 3D dataset [double inversion- recovery (DIR), fluid-attenuated inversion recovery (FLAIR), T2, and T1-weighted magnetization prepared rapid acquisition gradient-echo (MPRAGE)] and to evaluate its performance in detecting

  5. MRI Diagnosis of Intracranial Hemorrhage : Experimental and Clinical Studies

    International Nuclear Information System (INIS)

    Alemany Ripoll, Montserrat

    2003-02-01

    The purpose of this work was to improve the diagnosis of intracranial hemorrhage with MRI, and add knowledge about the newer sequences increasing in use to depict intra parenchymal bleeds, especially T2*-w GE sequences. We also compared the effect of magnetic field strengths. The sequences and field strengths were tested in animals. Then, the most effective technique was applied to patients with hematomas of different ages and with hematoma residuals. Occurrence of residuals of earlier, clinically silent, haemorrhages in patients with acute spontaneous hematoma or with suspected ischemic stroke were compared. Experimental studies: The MR detectability of small experimental haematomas in the brain and of blood in the cerebrospinal fluid (CSF) spaces of 30 rabbits was evaluated. MRI examinations were performed at determined intervals using different pulse sequences at two field strengths. The last MR images were compared to the formalin fixed brain sections and, in 16 rabbits, also to the histological findings. T2*-weighted GE sequences revealed all the intra parenchymal haematomas at 1.5 T: they were strongly hypointense. Their sizes became smaller but the signal patterns remained unchanged during the follow-up. The haematoma sizes and shapes corresponded well to gross pathology at acute and subacute stages. At chronic stage, the signal changes were larger than iron deposits. Blood in the CSF spaces was best detected at 1.5T with T2*-weighted GE sequences during the first 2 days. The FLAIR sequence often revealed blood in CSF spaces but not in the brain. SE sequences were rather insensitive. Imaging at 0.5 T was less effective than at 1.5 T. Clinical studies: All MR examinations on patients were performed at 1.5T, including T1- and T2-w SE, FLAIR, T2*-w GE sequences, and, occasionally, diffusion-w sequences. Sixty-six intra parenchymal hematomas were examined in the first clinical study. The hematomas were of different sizes and the ages varied from 8 hours to 3

  6. Nodular fasciitis: MRI appearance and literature review

    International Nuclear Information System (INIS)

    Leung, L.Y.J.; Shu, S.J.; Chan, M.K.; Chan, C.H.S.; Chan, A.C.L.

    2002-01-01

    Objective: To describe the MRI features of nodular fasciitis and to review the clinical, MRI and histologic aspects of the tumor. Design and patients: Three patients with biopsy-proven nodular fasciitis were selected for a retrospective study. A literature review was also carried out. Results and conclusions: All the lesions appeared slightly hyperintense to skeletal muscle on T1-weighted images, and hyperintense on T2-weighted images with fat saturation [either frequency saturation or Short TI Inversion Recovery (STIR) sequences]. Two enhanced homogeneously after intravenous gadolinium, whereas the third showed heterogeneous enhancement with a nonenhancing area. Despite the difference in enhancing patterns, the histologic appearances of these lesions were similar. Our study shows that the MRI appearance of nodular fasciitis may not be related to the location of lesion. It is thought that the age of nodular fasciitis may reflect its gross morphology, and it is possible that the MRI and histologic appearances could correlate with the age of the lesion, but it would require a larger series to evaluate this concept. (orig.)

  7. [Anti-Ma2, anti-NMDA-receptor and anti-GluRε2 limbic encephalitis with testicular seminoma: short-term memory disturbance].

    Science.gov (United States)

    Kubota, Akihiro; Tajima, Takashi; Narukawa, Shinya; Yamazato, Masamizu; Fukaura, Hikoaki; Takahashi, Yukitoshi; Tanaka, Keiko; Shimizu, Jun; Nomura, Kyoichi

    2012-01-01

    A 36-year-old man presented with cognitive impairment and disturbance of short-term memory functions with character change. Cerebrospinal fluid analysis revealed no abnormalities; however, brain MRI revealed high-signal intensity from bilateral hippocampus lesions on fluid attenuated inversion recovery (FLAIR) images and T(2) weighted images. The 18F-fluorodeoxyglucose PET demonstrated high glucose uptake in the bilateral hippocampus lesions. He was diagnosed as limbic encephalitis, and was administered high-dose intravenous methylprednisolone and immune adsorption plasma therapy followed by intravenous immunoglobulin therapy. MRI abnormalities improved after treatment but recent memory disturbance remained. Ma2 antibody, NMDA-receptor antibody, and GluRε2 antibody were positive. Eleven months atter the onset of disease, the tumor was identified in left testicle by ultrasound and removed the tumor. The pathological findings were seminoma. We experienced a case of paraneoplastic limbic encephalitis associated with seminoma with short-term memory disturbance. The occurrence of paraneoplastic limbic encephalitis with antibodies against cell membrane (NMDA-receptor antibody and GluRε2 antibody) and intracellular (Ma2 antibody) is rare even in the literature.

  8. Acute hemorrhagic encephalitis: An unusual presentation of dengue viral infection

    International Nuclear Information System (INIS)

    Nadarajah, Jeyaseelan; Madhusudhan, Kumble Seetharama; Yadav, Ajay Kumar; Gupta, Arun Kumar; Vikram, Naval Kumar

    2015-01-01

    Dengue is a common viral infection worldwide with presentation varying from clinically silent infection to dengue fever, dengue hemorrhagic fever, and severe fulminant dengue shock syndrome. Neurological manifestation usually results from multisystem dysfunction secondary to vascular leak. Presentation as hemorrhagic encephalitis is very rare. Here we present the case of a 13-year-old female admitted with generalized tonic clonic seizures. Plain computed tomography (CT) scan of head revealed hypodensities in bilateral deep gray matter nuclei and right posterior parietal lobe without any hemorrhage. Cerebrospinal fluid (CSF) and serology were positive for IgM and IgG antibodies to dengue viral antigen. Contrast-enhanced magnetic resonance imaging (MRI) revealed multifocal T2 and fluid attenuated inversion recovery (FLAIR) hyperintensities in bilateral cerebral parenchyma including basal ganglia. No hemorrhage was seen. She was managed with steroids. As her clinical condition deteriorated, after being stable for 2 days, repeat MRI was done which revealed development of hemorrhage within the lesions, and diagnosis of acute hemorrhagic encephalitis of dengue viral etiology was made

  9. Magnetic Resonance Imaging of a Case of Central Neurocytoma

    OpenAIRE

    Dedushi, Kreshnike; Kabashi, Serbeze; Ugurel, Mehmet Sahin; Ramadani, Naser; Mucaj, Sefedin; Zeqiraj, Kamber

    2016-01-01

    Background: The purpose of this study is to investigate the MRI features of central neurocytoma. Case report: A 45 year old man with 3 months of worsening daily headaches. These headaches were diffuse, lasted for several hours, and mostly occurred in the morning. She was initially diagnosed and treated for migraines but later he had epileptic attack and diplopia and neurolog recomaded MRI. Methods: precontrast MRI; TSE/T2Wsequence in axial/coronal planes; 3D?Hi-resolution T1W sagittal; FLAIR/...

  10. Multi-contrast, isotropic, single-slab 3D MR imaging in multiple sclerosis

    NARCIS (Netherlands)

    Moraal, B.; Roosendaal, S.D.; Pouwels, P.J.W.; Vrenken, H.; van Schijndel, R.A.; Meier, D.S.; Guttmann, C.R.G.; Geurts, J.J.G.; Barkhof, F.

    2008-01-01

    To describe signal and contrast properties of an isotropic, single-slab 3D dataset [double inversion-recovery (DIR), fluid-attenuated inversion recovery (FLAIR), T2, and T1-weighted magnetization prepared rapid acquisition gradient-echo (MPRAGE)] and to evaluate its performance in detecting multiple

  11. MRI and neurological presentation of hypertrophic olivary degeneration

    Directory of Open Access Journals (Sweden)

    Abdelaziz Elnekiedy

    2016-09-01

    Conclusion: HOD is an infrequent neurological pathology, sequel to Guillain and Mollaret triangle affection that involves a wide range of symptomatology. It manifests as enlargement of the ION with high T2 and FLAIR signal without enhancement, restricted diffusion or blooming on T2∗ or SWI.

  12. Recovery from primary deep cerebral venous sinus thrombosis with recanalisation

    International Nuclear Information System (INIS)

    Nagatomo, Y.; Yanaka, K.; Kamezaki, T.; Kobayashi, E.; Matsumura, A.; Nose, T.

    1995-01-01

    A 50-year-old woman with idiopathic deep cerebral sinus and vein thrombosis (DCVT) had cerebellar disturbance prior to impaired consciousness. CT and MRI revealed haemorrhagic infarction in the cerebellum and signal changes suggesting infarction in the thalamus and basal ganglia bilaterally. The straight sinus and internal cerebral vein (ICV) were dense on CT. On angiography, the vein of Galen (VG) and straight sinus were not seen. Following clinical recovery, CT and MRI became normal, and angiography showed recanalization of the VG and ICV. The relationship between cerebellar infarction and DCVT, and signal changes on CT and MRI are discussed. (orig.). With 4 figs., 1 tab

  13. Employing visual analytics to aid the design of white matter hyperintensity classifiers

    NARCIS (Netherlands)

    Raidou, Renata Georgia; Kuijf, Hugo J.; Sepasian, Neda; Pezzotti, Nicola; Bouvy, Willem H.; Breeuwer, Marcel; Vilanova, Anna

    2016-01-01

    Accurate segmentation of brain white matter hyperintensities (WMHs) is important for prognosis and disease monitoring. To this end,classifiers are often trained – usually,using T1 and FLAIR weighted MR images. Incorporating additional features,derived from diffusion weighted MRI,could improve

  14. MRI of the shoulder

    Energy Technology Data Exchange (ETDEWEB)

    Vahlensieck, M.

    2000-02-01

    Shoulder imaging is one of the major applications in musculoskeletal MRI. In order to analyze the images it is important to keep informed about anatomical and pathological findings and publications. In this article MRI technique, anatomy and pathology is reviewed. Technical considerations about MR sequences and examination strategy are only shortly discussed with emphasis on turbo spin echo and short T1 inversion recovery imaging. Basic anatomy as well as recent findings, including macroscopic aspects of the supraspinatus fat pad, composition of the supraspinatus muscle belly, and variability of the glenohumeral ligaments or coracoid ligament, are presented. Basic pathological conditions are described in detail, e. g. instability particularly problems in differentiating the various subtypes of labral pathology. Rotator cuff diseases are elucidated with emphasis on some rarer entities such as subscapularis calcifying tendinitis, coracoid impingement, chronic bursitis producing the double-line sign, prominent coraco-acromial ligament and the impingement due to an inflamed os acromiale. (orig.)

  15. MRI of the shoulder

    International Nuclear Information System (INIS)

    Vahlensieck, M.

    2000-01-01

    Shoulder imaging is one of the major applications in musculoskeletal MRI. In order to analyze the images it is important to keep informed about anatomical and pathological findings and publications. In this article MRI technique, anatomy and pathology is reviewed. Technical considerations about MR sequences and examination strategy are only shortly discussed with emphasis on turbo spin echo and short T1 inversion recovery imaging. Basic anatomy as well as recent findings, including macroscopic aspects of the supraspinatus fat pad, composition of the supraspinatus muscle belly, and variability of the glenohumeral ligaments or coracoid ligament, are presented. Basic pathological conditions are described in detail, e. g. instability particularly problems in differentiating the various subtypes of labral pathology. Rotator cuff diseases are elucidated with emphasis on some rarer entities such as subscapularis calcifying tendinitis, coracoid impingement, chronic bursitis producing the double-line sign, prominent coraco-acromial ligament and the impingement due to an inflamed os acromiale. (orig.)

  16. MRI in Lyme disease of the spinal cord

    Energy Technology Data Exchange (ETDEWEB)

    Mantienne, C.; Catalaa, I.; Sevely, A.; Cognard, C.; Manelfe, C. [Dept. of Diagnostic and Therapeutic Neuroradiology, Hopital Purpan, Toulouse (France); Albucher, J.F. [Dept. of Neurology, Hopital Purpan, Toulouse (France)

    2001-06-01

    We report a case of Lyme myelitis in a 31-year-old man, presenting with a conus medullaris syndrome. MRI demonstrated contrast enhancement on the pial surface of the lower thoracic cord and conus medullaris. Elevated blood immunoglobulins and IgM antibodies against Borrelia burgdorferi in the cerebrospinal fluid (CSF) were found. Leptomeningitis may be the first stage of spinal infection in Lyme disease, preceding parenchymal infection leading to myelitis. Vasculitis is probably the major mechanism. MRI findings are nonspecific and the diagnosis is given by serum and CSF analyses. Early treatment with antibiotics and high doses steroids may result in complete recovery, as in this case. (orig.)

  17. MRI in Lyme disease of the spinal cord

    International Nuclear Information System (INIS)

    Mantienne, C.; Catalaa, I.; Sevely, A.; Cognard, C.; Manelfe, C.; Albucher, J.F.

    2001-01-01

    We report a case of Lyme myelitis in a 31-year-old man, presenting with a conus medullaris syndrome. MRI demonstrated contrast enhancement on the pial surface of the lower thoracic cord and conus medullaris. Elevated blood immunoglobulins and IgM antibodies against Borrelia burgdorferi in the cerebrospinal fluid (CSF) were found. Leptomeningitis may be the first stage of spinal infection in Lyme disease, preceding parenchymal infection leading to myelitis. Vasculitis is probably the major mechanism. MRI findings are nonspecific and the diagnosis is given by serum and CSF analyses. Early treatment with antibiotics and high doses steroids may result in complete recovery, as in this case. (orig.)

  18. [Contrastive analysis of artifacts produced by metal dental crowns in 3.0 T magnetic resonance imaging with six sequences].

    Science.gov (United States)

    Lan, Gao; Yunmin, Lian; Pu, Wang; Haili, Huai

    2016-06-01

    This study aimed to observe and evaluate six 3.0 T sequences of metallic artifacts produced by metal dental crowns. Dental crowns fabricated with four different materials (Co-Gr, Ni-Gr, Ti alloy and pure Ti) were evaluated. A mature crossbreed dog was used as the experimental animal, and crowns were fabricated for its upper right second premolar. Each crown was examined through head MRI (3.0 T) with six sequences, namely, T₁ weighted-imaging of spin echo (T₁W/SE), T₂ weighted-imaging of inversion recovery (T₂W/IR), T₂ star gradient echo (T₂*/GRE), T2 weighted-imaging of fast spin echo (T₂W/FSE), T₁ weighted-imaging of fluid attenuate inversion recovery (T₂W/FLAIR), and T₂ weighted-imaging of propeller (T₂W/PROP). The largest area and layers of artifacts were assessed and compared. The artifact in the T₂*/GRE sequence was significantly wider than those in the other sequences (P 0.05). T₂*/GRE exhibit the strongest influence on the artifact, whereas the five other sequences contribute equally to artifact generation.

  19. Limbic encephalitis associated with anti-voltage-gated potassium channel complex antibodies as a cause of adult-onset mesial temporal lobe epilepsy.

    Science.gov (United States)

    Toyota, Tomoko; Akamatsu, Naoki; Tsuji, Sadatoshi; Nishizawa, Shigeru

    2014-06-01

    Recently, some reports have indicated that limbic encephalitis associated with anti-voltage-gated potassium channel complex antibodies (VGKC-Ab) is a cause of adult-onset mesial temporal lobe epilepsy (MTLE). We report a 53-year-old woman who had her first epileptic seizure at the age of 50 years old. Examination by 3-Tesla brain MRI revealed left hippocampal high signal intensity and swelling on fluid-attenuated inversion recovery (FLAIR) and T2-weighted imaging at 2 months after her first seizure. The patient received intravenous methylprednisolone and carbamazepine 300 mg/day. One month later, MRI revealed improvement of her left hippocampal abnormalities. Thereafter, she had no seizures, however, three years after her first seizure, EEG revealed a seizure pattern in the left temporal region. Brain MRI revealed left hippocampal high signal intensity and brain fluorodeoxyglucose positron emission tomography revealed hypermetabolism. Her serum VGKC-Ab levels were 118 pM(normal VGKC-Ab levels decreased to 4.4 pM. Remission of the epileptic seizures was also observed. This MTLE in the middle age was considered as limbic encephalitis associated with anti- VGKC-Ab. In cases of unexplained adult-onset MTLE, limbic encephalitis associated with anti-VGKC-Ab, which responds well to immunotherapy, should be considered in the differential diagnosis.

  20. Conspicuity of diffuse axonal injury lesions on diffusion-weighted MR imaging

    International Nuclear Information System (INIS)

    Kinoshita, Toshibumi; Moritani, Toshio; Hiwatashi, Akio; Wang, Henry Z.; Shrier, David A.; Numaguchi, Yuji; Westesson, Per-Lennart A.

    2005-01-01

    Objective: (1) To detect diffuse axonal injury (DAI) lesions by diffusion-weighted imaging (DWI), as compared with fluid-attenuated inversion recovery (FLAIR) imaging and (2) to evaluate hemorrhagic DAI lesions by b 0 images obtained from DWI, as compared with gradient-echo (GRE) imaging. Methods: We reviewed MR images of 36 patients with a diagnosis of DAI. MR imaging was performed 20 h to 14 days (mean, 3.7 days) after traumatic brain injury. We evaluated: (1) conspicuity of lesions on DWI and FLAIR and (2) conspicuity of hemorrhage in DAI lesions on b 0 images and GRE imaging. Results: DWI clearly depicted high-signal DAI lesions. The sensitivity of DWI to lesional conspicuity in DAI lesions was almost equal to that of FLAIR. The sensitivity of b 0 images to identification of hemorrhagic DAI lesions was inferior to that of GRE. Conclusion: DWI is as useful as FLAIR in detecting DAI lesions. GRE imaging is still the superior tool for the evaluation of hemorrhagic DAI

  1. Myocardial viability: comparison of free-breathing navigator-echo-gated three-dimensional inversion-recovery gradient-echo MR and standard multiple breath-hold two-dimensional inversion-recovery gradient-echo MR

    International Nuclear Information System (INIS)

    Kim, Jin Hee; Seo, Joon Beom; Do, Kyung Hyun; Yang, Dong Hyun; Lee, Soo Hyun; Ko, Sung Min; Heo, Jeong Nam; Lim, Tae Hwan

    2004-01-01

    To compare a free-breathing, navigator-echo-gated, three-dimensional, inversion-recovery, gradient-echo, MR pulse sequence (3D-MRI) with standard, multiple breath-hold, two-dimensional, inversion-recovery, gradient-echo MR (2D-MRI) for the evaluation of delayed hyperenhancement of nonviable myocardium in patients with chronic ischemic heart disease. Ten patients with chronic ischemic heart disease were enrolled in this study. MRI was performed on a 1.5-T system. 3D-MRI was obtained in the short axis plane at 10 minutes after the administration of Gd-DTPA (0.2 mmol/kg, 4 cc/sec). Prospective gating of the acquisition based on the navigator echo was applied. 2D-MRI was performed immediately after finishing 3D-MRI. The area of total and hyperenhanced myocardium measured on both image sets was compared with paired Student t-test and Bland-Altman method. By using a 60-segment model, the transmural extent and segment width of the hyperenhanced area were recorded by 3-scale grading method. The agreement between the two sequences was evaluated with kappa statistics. We also evaluated the agreement of hyperenhancement among the three portions (apical, middle and basal portion) of the left ventricle with kappa statistics. The two sequences showed good agreement for the measured area of total and hyperenhanced myocardium on paired t-test (ρ = 0.11 and ρ = 0.34, respectively). No systematic bias was shown on Bland-Altman analysis. Good agreement was found for the segmental width (Κ = 0.674) and transmural extent (Κ = 0.615) of hyperenhancement on the segmented analysis. However, the agreement of the transmural extent of hyperenhancement in the apical segments was relatively poor compared with that in the middle or basal portions. This study showed good agreement between 3D-MRI and 2D-MRI in evaluation of non-viable myocardium. Therefore, 3D-MRI may be useful in the assessment of myocardial viability in patients with dyspnea and children because it allows free

  2. Comparison of brain perfusion SPECT and MRI findings in children with neuronal ceroid-lipofuscinosis and in their families

    International Nuclear Information System (INIS)

    Sayit, E.; Yorulmaz, I; Gumuser, F.G.; Dirik, E.; Bekis, R.; Kaya, G.; Durak, H.

    2002-01-01

    Neuronal ceroid-lipofuscinoses (NCL) are among the progressive encephalopathies of childhood that are inherited in an autosomal recessive manner. In this study we specifically aimed to investigate any white-matter changes in the carriers (parents) and the healthy siblings of individuals with neuronal ceroid lipofuscinosis disease and whether we may be able to predict the occurrence of any neurological symptoms in healthy children in the future thus enabling early management. Since the NCLs are genetically determined diseases, we investigated fifteen individuals in three families that had diseased children of the juvenile type, with brain perfusion SPECT and MRI. Brain perfusion SPECT was performed after administering 222-555 MBq (6-15 mCi) Tc-99m hexamethyl-propylene amine oxime (HMPAO) intravenously in a dimmed and quiet room. Imaging was performed at least one hour after injection, with a three headed gamma camera equipped with high resolution collimators. A Metz filter (FWHM: 11 mm) was used for processing. Cranial MRI was performed with an imager operating at 1.5 Tesla. Spin-echo T1- and T2-weighted and FLAIR slices were obtained for each individual. In all of the five diseased children we observed pathologic findings both on MRI and Tc-99m HMPAO SPECT. The findings on MRI were mainly features of cerebral and cerebellar atrophy and the observations on Tc-99m HMPAO SPECT were regional perfusion abnormalities. We observed some structural abnormalities on MRI in four of the parents and two of the four healthy siblings. We also noted perfusion abnormalities on Tc-99m HMPAO SPECT in two of the parents and two of the healthy siblings. Because the disease is inherited in an autosomal recessive manner, the parents and the healthy siblings were not supposed to exhibit any demonstrable brain lesions, but the brain perfusion SPECT and MRI examinations clearly revealed multiple lesions in some of the parents and healthy siblings. Detailed neurological examinations of these

  3. [Degenerative cerebellar diseases and differential diagnoses].

    Science.gov (United States)

    Reith, W; Roumia, S; Dietrich, P

    2016-11-01

    Cerebellar syndromes result in distinct clinical symptoms, such as ataxia, dysarthria, dysmetria, intention tremor and eye movement disorders. In addition to the medical history and clinical examination, imaging is particularly important to differentiate other diseases, such as hydrocephalus and multi-infarct dementia from degenerative cerebellar diseases. Degenerative diseases with cerebellar involvement include Parkinson's disease, multiple system atrophy as well as other diseases including spinocerebellar ataxia. In addition to magnetic resonance imaging (MRI), nuclear medicine imaging investigations are also helpful for the differentiation. Axial fluid-attenuated inversion recovery (FLAIR) and T2-weighted sequences can sometimes show a signal increase in the pons as a sign of degeneration of pontine neurons and transverse fibers in the basilar part of the pons. The imaging is particularly necessary to exclude other diseases, such as normal pressure hydrocephalus (NPH), multi-infarct dementia and cerebellar lesions.

  4. MR imaging of acute intermittent porphyria mimicking reversible posterior leukoencephalopathy syndrome

    International Nuclear Information System (INIS)

    Utz, N.; Kinkel, B.; Hedde, J.P.; Bewermeyer, H.

    2001-01-01

    Reversible posterior leukoencephalopathy syndrome (PLS) is characterized by headache, altered mental function, visual disturbances and seizures. Neuroimaging studies suggest a white-matter oedema, predominantly in the posterior parietal-temporal-occipital regions of the brain. We present the case of a 30-year-old woman who had suffered her first attack of acute intermittent porphyria (AIP). Following 1 week of abdominal pain she developed several generalized seizures, and hallucinations, and exhibited a progressive deterioration of the consciousness. T2-weighted images, especially fluid-attenuated inversion recovery (FLAIR) sequences showed bilateral lesions in the posterior frontal, parietal and occipital cortex and subcortical white matter. Following treatment with haematin and a high carbohydrate diet the patient's condition improved. Follow-up magnetic resonance imaging (MRI) revealed complete resolution of the lesions. To our knowledge, this is the first report concerning a completely reversible PLS in AIP. (orig.)

  5. Childhood acute disseminated encephalomyelitis: the role of brain and spinal cord MRI

    International Nuclear Information System (INIS)

    Khong, Pek-Lan; Cheng, Pui-Wai; Chan, Fu-Luk; Ho, Hok-Kung; Wong, Virginia C.N.; Goh, Winnie

    2002-01-01

    Background. It is recognised that the clinical and radiological spectrum of childhood acute disseminated encephalomyelitis (ADEM) is wide. Objective. To determine whether initial MRI features are predictive of clinical outcome and to determine the role of MRI in the management of ADEM. Materials and methods. The MRI scans of ten consecutive children (eight boys, two girls), clinically and radiologically diagnosed to have ADEM, were retrospectively reviewed. Follow-up MRI was available for eight patients. Results. Lesions ranged from small and punctate (<1 cm) to moderate sized and confluent (4-5 cm) to diffuse and extensive. Spinal cord lesions, seen in five of seven children, were contiguous or segmental. Seven children (70%) made good clinical recovery while three children (30%) remained severely handicapped. There was no correlation between the site, extent and pattern of involvement and clinical outcome. However, the evolution of MRI findings on follow-up correlated well with the subsequent clinical course and outcome. Conclusions. Although the extent and site of lesions on initial MRI scans are not predictive of clinical outcome, early MRI of the brain and spine is useful in aiding clinical diagnosis, and subsequent follow-up MRI is helpful in monitoring disease progression. (orig.)

  6. Importance of contrast-enhanced fluid-attenuated inversion reconvery magnetic resonance imaging in various intracranial pathologic conditions

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Eun Kyoung; Lee, Eun Ja; Kim, Sung Won; Lee, Yong Seok [Dept. of Radiology, Dongguk University Ilsan Hospital, Goyang(Korea, Republic of)

    2016-02-15

    Intracranial lesions may show contrast enhancement through various mechanisms that are closely associated with the disease process. The preferred magnetic resonance sequence in contrast imaging is T1-weighted imaging (T1WI) at most institutions. However, lesion enhancement is occasionally inconspicuous on T1WI. Although fluid-attenuated inversion recovery (FLAIR) sequences are commonly considered as T2-weighted imaging with dark cerebrospinal fluid, they also show mild T1-weighted contrast, which is responsible for the contrast enhancement. For several years, FLAIR imaging has been successfully incorporated as a routine sequence at our institution for contrast-enhanced (CE) brain imaging in detecting various intracranial diseases. In this pictorial essay, we describe and illustrate the diagnostic importance of CE-FLAIR imaging in various intracranial pathologic conditions.

  7. Comparision the value of detecting myocardial viability between low dose dobutamine stress MRI and echocardiography

    International Nuclear Information System (INIS)

    He Yi; Zhang Zhaoqi; Yu Wei; Miao Cuilian; Zhao Yike; Yan Zixu

    2006-01-01

    Objective: To Compare the diagnostic value between low dose dobutamine stress transthrotic echocardiography and low dose dobutamine stress MRI in detecting myocardial viability of chronic myocardial infarction. Methods: Rest and low dose dobutamine (5, 10 μg·kg -1 ·min -1 ) stress transthrotic echocardiography and cine-MRI were performed in 30 patients with chronic myocardial infarction. 24 patients underwent successful revascularization and 10 of them underwent another rest cine-MRI study to assess segmental myocardial functional recovery. Left ventricular were divided into 16 segments, the criteria of viability in different techniques is: MRI: dobutamine induced systolic wall thickening was ≥2 mm in akinetic or diskinetic segments at rest; Echocardiography: wall motion score reduced at least 1 after dobutamine stress in akinetic or' diskinetic segments at rest. Results: One hundren and eight segments showed wall motion abnormalities of 30 patients, 65 and 56 segments shows positive reaction, 43 and 52 segments shows negativereaction in MRI and echocardiography after dobutamine stress respectively. Kappa value of the two techniques is 0.75, concordance in both techniques is 88%. Twenty-four segments showed functional recovery, 14 segments remained dysfunction 3-6 months after revascularization, the sensitivity, specificity and accuracy of detecting myocardial viability in chronic myocardial infarction in MRI and echocardiography is 95.8% vs 79.2% (P>0.05), 85.7% vs 85.7% (P>0.05), 92.1% vs 81.6% (P>0.05) respectively. The sensitivity and accuracy of MRI is a little higher. Conclusion: The ability of detecting myocardial viability by both low dose dobutamine stress transthrotic echocardiography and low dose dobutamine stress MRI is similer, the sensitivity and accuracy of MRI is a little higher. (authors)

  8. Mutual Connectivity Analysis (MCA) Using Generalized Radial Basis Function Neural Networks for Nonlinear Functional Connectivity Network Recovery in Resting-State Functional MRI.

    Science.gov (United States)

    DSouza, Adora M; Abidin, Anas Zainul; Nagarajan, Mahesh B; Wismüller, Axel

    2016-03-29

    We investigate the applicability of a computational framework, called mutual connectivity analysis (MCA), for directed functional connectivity analysis in both synthetic and resting-state functional MRI data. This framework comprises of first evaluating non-linear cross-predictability between every pair of time series prior to recovering the underlying network structure using community detection algorithms. We obtain the non-linear cross-prediction score between time series using Generalized Radial Basis Functions (GRBF) neural networks. These cross-prediction scores characterize the underlying functionally connected networks within the resting brain, which can be extracted using non-metric clustering approaches, such as the Louvain method. We first test our approach on synthetic models with known directional influence and network structure. Our method is able to capture the directional relationships between time series (with an area under the ROC curve = 0.92 ± 0.037) as well as the underlying network structure (Rand index = 0.87 ± 0.063) with high accuracy. Furthermore, we test this method for network recovery on resting-state fMRI data, where results are compared to the motor cortex network recovered from a motor stimulation sequence, resulting in a strong agreement between the two (Dice coefficient = 0.45). We conclude that our MCA approach is effective in analyzing non-linear directed functional connectivity and in revealing underlying functional network structure in complex systems.

  9. Test-Retest Reliability of fMRI During Nonverbal Semantic Decisions in Moderate-Severe Nonfluent Aphasia Patients

    Directory of Open Access Journals (Sweden)

    Jacquie Kurland

    2004-01-01

    Full Text Available Cortical reorganization in poststroke aphasia is not well understood. Few studies have investigated neural mechanisms underlying language recovery in severe aphasia patients, who are typically viewed as having a poor prognosis for language recovery. Although test-retest reliability is routinely demonstrated during collection of language data in single-subject aphasia research, this is rarely examined in fMRI studies investigating the underlying neural mechanisms in aphasia recovery.

  10. A non-invasive method of quantifying pancreatic volume in mice using micro-MRI.

    Directory of Open Access Journals (Sweden)

    Jose L Paredes

    Full Text Available In experimental models of pancreatic growth and recovery, changes in pancreatic size are assessed by euthanizing a large cohort of animals at varying time points and measuring organ mass. However, to ascertain this information in clinical practice, patients with pancreatic disorders routinely undergo non-invasive cross-sectional imaging of the pancreas using magnetic resonance imaging (MRI or computed tomography (CT. The aim of the current study was to develop a thin-sliced, optimized sequence protocol using a high field MRI to accurately calculate pancreatic volumes in the most common experimental animal, the mouse. Using a 7 Telsa Bruker micro-MRI system, we performed abdominal imaging in whole-fixed mice in three standard planes: axial, sagittal, and coronal. The contour of the pancreas was traced using Vitrea software and then transformed into a 3-dimensional (3D reconstruction, from which volumetric measurements were calculated. Images were optimized using heart perfusion-fixation, T1 sequence analysis, and 0.2 to 0.4 mm thick slices. As proof of principle, increases in pancreatic volume among mice of different ages correlated tightly with increasing body weight. In summary, this is the first study to measure pancreatic volumes in mice, using a high field 7 Tesla micro-MRI and a thin-sliced, optimized sequence protocol. We anticipate that micro-MRI will improve the ability to non-invasively quantify changes in pancreatic size and will dramatically reduce the number of animals required to serially assess pancreatic growth and recovery.

  11. Experimental acute intracerebral hemorrhage: Value of MR sequences for a safe diagnosis at 1.5 and 0.5 T

    International Nuclear Information System (INIS)

    Kueker, W.; Thron, A.; Thiex, R.; Rohde, I.; Rohde, V.

    2000-01-01

    To determine the detectability of intracerebral hematomas with MR imaging at 1.5 T and 0.5 T with fluid attenuated inversion recovery turbo spin-echo (FLAIR) and gradient-echo sequences. Material and Methods: Twenty-seven intracerebral hematomas were created in 25 piglets by injection of venous blood into the brain through a burr hole. All were imaged with T2*-weighted gradient echo sequences (fast field echo, FFE), T2-weighted fluid attenuated inversion recovery turbo spin-echo sequences (FLAIR), T2-weighted turbo spin-echo (TSE) and T1-weighted spin-echo sequences. Follow-up was performed on the 2nd, 4th and 10th postoperative days. Ten animals were additionally investigated with similar sequences at 0.5 T. Histologic correlation was obtained in all cases. Results: T2* FFE sequences detected all acute intracerebral hematomas and demonstrated the size correctly at 1.5 T and 0.5 T. The conspicuity was better at 1.5 T. FLAIR sequences were unreliable in the hyperacute phase at 1.5 T. However, subarachnoid and intraventricular extension was best appreciated with FLAIR images. T2 TSE images were incapable of detecting para ventricular and subarachnoid hemorrhages, but clearly demonstrated intracerebral blood in other locations. T1-weighted images were insensitive to hemorrhage in the acute state but very useful in subacute and chronic hematomas. Conclusion: The safe and reliable diagnosis of intracerebral hemorrhage is probably possible with MR imaging at 1.5 T and 0.5 T even of hematomas less than 90 min old, but requires the application of at least FLAIR, T2* FFE and T1 sequences and is therefore time consuming

  12. Comparative analysis of MR sequences to detect structural brain lesions in tuberous sclerosis

    International Nuclear Information System (INIS)

    Pinto Gama, Hugo Pereira; Campos Meirelles, Rogerio Goncalves de; Mendonca do Rego, Jose Iram; Rocha, Antonio Jose da; Silva, Carlos Jorge da; Braga, Flavio Tulio; Martins Maia, Antonio Carlos; Lederman, Henrique Manoel

    2006-01-01

    Tuberous sclerosis (TS) is a neurocutaneous genetically inherited disease with variable penetrance characterized by dysplasias and hamartomas affecting multiple organs. MR is the imaging method of choice to demonstrate structural brain lesions in TS. To compare MR sequences and determine which is most useful for the demonstration of each type of brain lesion in TS patients. We reviewed MR scans of 18 TS patients for the presence of cortical tubers, white matter lesions (radial bands), subependymal nodules, and subependymal giant cell astrocytoma (SGCA) on the following sequences: (1) T1-weighted spin-echo (T1 SE) images before and after gadolinium (Gd) injection; (2) nonenhanced T1 SE sequence with an additional magnetization transfer contrast medium pulse on resonance (T1 SE/MTC); and (3) fluid-attenuated inversion recovery (FLAIR) sequence. Cortical tubers were found in significantly (P<0.05) larger numbers and more conspicuously in FLAIR and T1 SE/MTC sequences. The T1 SE/MTC sequence was far superior to other methods in detecting white matter lesions (P<0.01). There was no significant difference between the T1 SE/MTC and T1 SE (before and after Gd injection) sequences in the detection of subependymal nodules; FLAIR sequence showed less sensitivity than the others in identifying the nodules. T1 SE sequences after Gd injection demonstrated better the limits of the SGCA. We demonstrated the importance of appropriate MRI sequences for diagnosis of the most frequent brain lesions in TS. Our study reinforces the fact that each sequence has a particular application according to the type of TS lesion. Gd injection might be useful in detecting SGCA; however, the parameters of size and location are also important for a presumptive diagnosis of these tumors. (orig.)

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

    Energy Technology Data Exchange (ETDEWEB)

    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.)

  14. 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.)

  15. Neural correlates of longitudinal recovery of naming in stroke

    Directory of Open Access Journals (Sweden)

    Rajani Sebastian

    2015-05-01

    Our preliminary data suggests that recovery of naming is dynamic and may have different time courses in different individuals. Further, brain reorganization during language recovery may not proceed in three phases as proposed by Saur and colleagues. This finding is in line with the recent work from our lab, which examined recovery of language within the first two months after a stroke (Jarso et al., 2014. To further understand the processes involved in naming recovery, we are analyzing DTI and resting state fMRI data. It is hoped that the results from the multimodality imaging data will serve as the basis for targeted brain-based interventions for aphasia, which require an understanding of the anatomy of language networks, as well as the extent and timing of how these networks reorganize after injury.

  16. Cerebral fat embolism studied with MRI and SPECT

    Energy Technology Data Exchange (ETDEWEB)

    Erdem, E. (Dept. of Neurology, Hacettepe Univ. School of Medicine, Ankara (Turkey)); Namer, I.J. (Inst. of Biophysics, Faculty of Medicine, Louis Pasteur Univ., Strasbourg (France)); Saribas, O. (Dept. of Neurology, Hacettepe Univ. School of Medicine, Ankara (Turkey)); Aras, T. (Dept. of Nuclear Medicine, Hacettepe Univ. School of Medicine Ankara (Turkey)); Tan, E. (Dept. of Neurology, Hacettepe Univ. School of Medicine, Ankara (Turkey)); Bekdik, C. (Dept. of Nuclear Medicine, Hacettepe Univ. School of Medicine Ankara (Turkey)); Zileli, T. (Dept. of Neurology, Hacettepe Univ. School of Medicine, Ankara (Turkey))

    1993-03-01

    In a patient with fat embolism to the brain CT showed no abnormality. MRI performed after recovery from coma, when the patient had aphasia and quadriparesis, demonstrated multiple high signal abnormalities in the white matter on both T1- and T2-weighted images. HMPAO-SPECT showed left-sided hypoperfusion which resolved in parallel with clinical improvement 1 month later. (orig.)

  17. Spontaneous acute spinal subdural hematoma: spontaneous recovery from severe paraparesis--case report and review.

    Science.gov (United States)

    Payer, Michael; Agosti, Reto

    2010-11-01

    Spontaneous idiopathic acute spinal subdural hematomas are highly exceptional. Neurological symptoms are usually severe, and rapid diagnosis with MRI is mandatory. Surgical evacuation has frequently been used therapeutically; however, spontaneous recovery in mild cases has also been reported. We present a case of spontaneous recovery from severe paraparesis after spontaneous acute SSDH, and review the English-speaking literature.

  18. Prenatal diagnosis and perinatal management of congenital hydrocephalus using MRI

    International Nuclear Information System (INIS)

    Hamada, Hiromi; Koresawa, Mitsuhiko; Kubo, Takeshi

    1990-01-01

    We studied congenital hydrocephalus in 14 patients who were diagnosed prenatally. As a result, we obtained the following insights concerning the prenatal diagnosis by MRI (magnetic resonance imaging) and perinatal management of congenital hydrocephalus. Accurate diagnosis of congenital hydrocephalus was impossible prenatally by two-dimensional ultrasonography or computed tomography alone in some patients. MRI was useful for accurate prenatal diagnosis. Problem of MRI in prenatal diagnosis included deterioration of the image by fetal movements and safety concern over the fetus. The cause of hydrocephalus, complicated anomaly, cerebral cortical thickness, and gestational age must be considered in the perinatal management of congenital hydrocephalus. There appeared to be a chance of recovery to a certain extent from thinning of cerebral cortex by decompression in a patient in whom dilation of cerebral ventricles progressed rapidly. (author)

  19. Comparison of MR sequences in early cerebral infarction at 0.5 T

    International Nuclear Information System (INIS)

    Saatci, I.; Baskan, O.; Cekirge, H.S.; Besim, A.

    2000-01-01

    To compare the diagnostic values of fluid-attenuated inversion recovery (FLAIR) and gradient spin-echo (GRASE) with those of conventional spin-echo (SE) and fast SE T2-weighted sequences in the evaluation of acute cerebrovascular lesions at 0.5 T. Material and Methods: Twenty-two consecutive patients with the clinical diagnosis of acute cerebrovascular accident were examined by MR imaging within the first 48 h of ictus. MR examination included 5-mm axial conventional SE and turbo SE (TSE) T2-weighted, dual-echo GRASE and FLAIR sequences. The patients also had pre- and postcontrast T1-weighted axial images. Two examiners evaluated the images and scored the conspicuity of the acute lesions. Results: Regardless of location, FLAIR provided the best lesion conspicuity in the detection of acute infarcts, followed by the GRASE sequence. In the posterior fossa, TSE and SE demonstrated the lesions better than GRASE and FLAIR techniques. In the detection of hemorrhagic elements within the ischemic region, TSE demonstrated statistically significant superiority over other sequences. Conclusion: In the detection of acute ischemic lesions in locations other than the posterior fossa, FLAIR provided the best lesion conspicuity among four T2-weighted sequences, including SE, TSE, GRASE and FLAIR. However, for the posterior fossa examination, preference of SE or TSE T2-weighted sequences is suggested

  20. Comparison of MR sequences in early cerebral infarction at 0.5 T

    Energy Technology Data Exchange (ETDEWEB)

    Saatci, I.; Baskan, O.; Cekirge, H.S.; Besim, A. [Hacettepe Univ. Hospital, Ankara (Turkey). Radiology Dept.

    2000-11-01

    To compare the diagnostic values of fluid-attenuated inversion recovery (FLAIR) and gradient spin-echo (GRASE) with those of conventional spin-echo (SE) and fast SE T2-weighted sequences in the evaluation of acute cerebrovascular lesions at 0.5 T. Material and Methods: Twenty-two consecutive patients with the clinical diagnosis of acute cerebrovascular accident were examined by MR imaging within the first 48 h of ictus. MR examination included 5-mm axial conventional SE and turbo SE (TSE) T2-weighted, dual-echo GRASE and FLAIR sequences. The patients also had pre- and postcontrast T1-weighted axial images. Two examiners evaluated the images and scored the conspicuity of the acute lesions. Results: Regardless of location, FLAIR provided the best lesion conspicuity in the detection of acute infarcts, followed by the GRASE sequence. In the posterior fossa, TSE and SE demonstrated the lesions better than GRASE and FLAIR techniques. In the detection of hemorrhagic elements within the ischemic region, TSE demonstrated statistically significant superiority over other sequences. Conclusion: In the detection of acute ischemic lesions in locations other than the posterior fossa, FLAIR provided the best lesion conspicuity among four T2-weighted sequences, including SE, TSE, GRASE and FLAIR. However, for the posterior fossa examination, preference of SE or TSE T2-weighted sequences is suggested.

  1. Cerebellar Ataxia with Complete Clinical Recovery and Resolution of MRI Lesions Related to Central Pontine Myelinolysis: Case Report and Literature Review

    Directory of Open Access Journals (Sweden)

    Cristina Dolciotti

    2010-12-01

    Full Text Available There are several reports of central pontine myelinolysis (CPM in a setting of malnutrition, alcoholism, and chronic debilitating illness associated with electrolyte abnormalities, especially hyponatremia. The cause of myelinolysis is still under debate, and, although osmotic effects are thought to be responsible in most cases, alternative pathological factors should be considered [King et al.: Am J Med Sci 2010;339:561–567]. We report a case of CPM in a patient with recent chemotherapy for colon cancer without electrolyte unbalance and otherwise unexplained causes. Moreover, the present case is an example of the unusual clinical ataxic variant, followed by complete recovery without any specific treatment. The diagnosis was confirmed by MRI, which showed a characteristic hyperintense signal abnormality in the central part of the pons with an unaffected outer rim. One month later, we observed complete resolution of clinical and radiological symptoms.

  2. Effect of pubic bone marrow edema on recovery from endoscopic surgery for athletic pubalgia.

    Science.gov (United States)

    Kuikka, L; Hermunen, H; Paajanen, H

    2015-02-01

    Athletic pubalgia (sportsman's hernia) is often repaired by surgery. The presence of pubic bone marrow edema (BME) in magnetic resonance imaging (MRI) may effect on the outcome of surgery. Surgical treatment of 30 patients with athletic pubalgia was performed by placement of totally extraperitoneal endoscopic mesh behind the painful groin area. The presence of pre-operative BME was graded from 0 to 3 using MRI and correlated to post-operative pain scores and recovery to sports activity 2 years after operation. The operated athletes participated in our previous prospective randomized study. The athletes with (n = 21) or without (n = 9) pubic BME had similar patients' characteristics and pain scores before surgery. Periostic and intraosseous edema at symphysis pubis was related to increase of post-operative pain scores only at 3 months after surgery (P = 0.03) but not to long-term recovery. Two years after surgery, three athletes in the BME group and three in the normal MRI group needed occasionally pain medication for chronic groin pain, and 87% were playing at the same level as before surgery. This study indicates that the presence of pubic BME had no remarkable long-term effect on recovery from endoscopic surgical treatment of athletic pubalgia. © 2013 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  3. Diagnosis of fetal neural tube defects by MRI

    International Nuclear Information System (INIS)

    Dong Suzhen; Zhu Ming; Zhong Yumin; Zhang Hong; Pan Huihong

    2010-01-01

    Objective: To explore the diagnostic value of MRI on fetal neural tube defects. Methods: Ten pregnant women, aged from 25 to 35 years (average 28 years) and with gestation from 20-39 weeks (average 33 weeks) were studied with a 1.5 T superconductive MR unit within 24 to 48 hours after ultrasound (US) studies. The imaging protocol included fast-imaging employing steady-state acquisition, single-shot FSE and T 1 -weighted fast inversion recovery motion insensitive sequences in the axial, fromtal, and sagittal planes relative to the fetal brain, thorax, abdomen, and spines. Prenatal US and MRI findings were compared with postnatal MRI diagnoses (3 fetuses) or autopsy (7 fetuses). Results: Ten pregnant women (9 with a single fetus and 1 with twin fetuses) were examined. For all cases, the diagnoses established by MRI were correct when compared with postnatal diagnosis or autopsy. In 7 cases, US and MRI findings were in complete agreement with postnatal diagnoses. US missed the diagnosis in 1 cases and misdiagnosed in 2 cases. Ten neural tube defects in this study included anencephaly (1 case), exencephaly (1 case), meningoencephalocele associated with amniotic band sequence (1 case), meningocele (1 case), thoracic myelomeningocele (1 case), lumbar spinal bifida (1 case), sacroiliac myelomeningocele (2 cases), sacroiliac large cystic spinal meningocele (1 case), sacroiliac spinal bifida (1 case). Conclusions: Prenatal MRI is effective in the assessment of fetal neural tube defects. It can exactly discriminate herniated contents and locate the spinal lesion level. (authors)

  4. Cerebral atrophy in elderly with subjective memory complaints

    NARCIS (Netherlands)

    Palm, W.M.; Ferrarini, L.; van der Flier, W.M.; Westendorp, R.G.J.; Bollen, E.L.E.M.; Middelkoop, H.A.M.; Milles, J.R.; van der Grond, J.; van Buchem, M.A.

    2013-01-01

    Purpose To evaluate ventricular shape differences along the complete surface of the lateral and third ventricles of persons with subjective memory complaints (MC). Materials and Methods We included 28 controls and 21 persons with MC. FLAIR, T2, and PD-weighted brain MRI scans were acquired at 1.5

  5. Cerebellar Lesions of Uremic Encephalopathy on MRI in Hemodialyzed Diabetic Patient: A Case Report

    Energy Technology Data Exchange (ETDEWEB)

    Kil, Min Chul; Lee, Seung Young; Cha, Sang Hoon; Cho, Bum Sang; Kang, Min Ho [Dept. of Radiology, Chungbuk National Universty Hospital, Cheongju (Korea, Republic of)

    2012-01-15

    Uremic encephalopathy (UE) is a well-known complication of uremia, but its pathophysiology remains unknown. It is widely reported that in UE, the bilateral basal ganglia (BG) shows hyperintensities on T2/fluid attenuated inversion recovery magnetic resonance imaging (MRI), but cerebellar lesions are extremely rare, with to the best of our knowledge, only one case reported to date. We describe the findings from computed tomography and MRI for typical BG and cerebellar vermis lesions.

  6. Cerebellar Lesions of Uremic Encephalopathy on MRI in Hemodialyzed Diabetic Patient: A Case Report

    International Nuclear Information System (INIS)

    Kil, Min Chul; Lee, Seung Young; Cha, Sang Hoon; Cho, Bum Sang; Kang, Min Ho

    2012-01-01

    Uremic encephalopathy (UE) is a well-known complication of uremia, but its pathophysiology remains unknown. It is widely reported that in UE, the bilateral basal ganglia (BG) shows hyperintensities on T2/fluid attenuated inversion recovery magnetic resonance imaging (MRI), but cerebellar lesions are extremely rare, with to the best of our knowledge, only one case reported to date. We describe the findings from computed tomography and MRI for typical BG and cerebellar vermis lesions.

  7. Cranial x-ray CT and MRI in congenital muscular dystrophy

    International Nuclear Information System (INIS)

    Horikawa, Hirosei; Konishi, Toshihiko; Konagaya, Masaaki; Mano, Yukio; Takayanagi, Tetsuya

    1988-01-01

    The involvements of central nervous system in those cases of congenital muscular dystrophy (CMD), especially in Fukuyama type CMD, have been observed both radiologically and pathologically. The recent development of MRI made it easier to detect fine structural changes in brain matter than the X-ray CT. Then, we tried to evaluate the central nervous system abnormalities of six cases of CMD by both X-ray CT and MRI. In one case, X-ray CT revealed diffuse hypodensity of cerebral white matter, and MRI showed high intensity on long spin-echo image and low intensity on inversion-recovery image. In another case, X-ray CT showed no abnormal findings, but long spin-echo image revealed two high intensity spots in cerebral white matter. In other four cases, brain atrophy was demonstrated by X-ray CT and/or MRI, one case of these patients had bilateral congenital arachnoid cysts in the middle cranial fossa and hypogenesis of temporal lobes. Although we could not demonstrate polymicrogyria and agyria in all cases by MRI, white matter changes and structural changes were revealed more clearly than X-ray CT. The combination of X-ray CT and MRI seems to make a noteworthy contribution to estimate the central nervous system abnormalities in CMD. (author)

  8. Creutzfeldt-Jakob disease, Heidenhain variant: case report with MRI (DWI) findings

    International Nuclear Information System (INIS)

    Arruda, Walter Oleschko; Bordignon, Kelly C.; Milano, Jeronimo B.; Ramina, Ricardo

    2004-01-01

    Creutzfeldt-Jakob disease (CJD) is a pre senile dementia characterized by rapidly progressive mental deterioration, myoclonic jerking, and other less common neurological signs. Few accentuates cases have been described in Brazil. A 54-year-old white woman, was admitted in our service with a month history of progressive, bilateral cortical blindness. After admission, she developed right partial motor seizures (right facial, upper and lower limbs), she became progressively aphasic (mixed aphasia). Seizures were controlled with phenytoine, but she developed choreoathetotic movements on her right dimidium, with partial control after introduction of chlorpromazine 25 mg q/d. She could no longer stand up or walk due to severe ataxia. The first EEG (October, 2001) showed left hemisphere severe seizure activity (status epilepticus partial is). She was delivered home with enteral nutrition, phenytoine, chlorpromazine and mepacrine 100 mg q d. The following laboratory tests were negative or normal: blood series, platelets, ESR, kidney and liver function, copper, ceruloplasmin, Vedril, HIV, HTLV-1, lactate, and cerebral Dsa (performed in other service). A spinal tap with normal opening pressure was perform and CSFR examination was normal. CSFR 14-3-3 protein was positive, CSF specific neuronal enolase 7.5 ng/ml(normal). Genetic study of PRNP gene did not disclosed any known mutation. A MRI (October, 2001) showed areas of hyperintense signal (T 2 and FLAIR) without Gd-enhancement on T1, in the left temporal lobe and in both occipital lobes; basal ganglia have a normal appearance. DWI imaging showed bright areas at the same sites. An EEG (March, 2002) disclosed a periodical sharp triphasic waves pattern, suggestive of CJD. A second MRI (April, 2002) showed mild generalized atrophy, no ventricular dilatation, and the hyperintense sites disappeared. She remained clinically stable and under use of chlorpromazine and mepacrine until she died due to pulmonary complications on April

  9. Low-grade Glioma Surgery in Intraoperative Magnetic Resonance Imaging: Results of a Multicenter Retrospective Assessment of the German Study Group for Intraoperative Magnetic Resonance Imaging.

    Science.gov (United States)

    Coburger, Jan; Merkel, Andreas; Scherer, Moritz; Schwartz, Felix; Gessler, Florian; Roder, Constantin; Pala, Andrej; König, Ralph; Bullinger, Lars; Nagel, Gabriele; Jungk, Christine; Bisdas, Sotirios; Nabavi, Arya; Ganslandt, Oliver; Seifert, Volker; Tatagiba, Marcos; Senft, Christian; Mehdorn, Maximilian; Unterberg, Andreas W; Rössler, Karl; Wirtz, Christian Rainer

    2016-06-01

    The ideal treatment strategy for low-grade gliomas (LGGs) is a controversial topic. Additionally, only smaller single-center series dealing with the concept of intraoperative magnetic resonance imaging (iMRI) have been published. To investigate determinants for patient outcome and progression-free-survival (PFS) after iMRI-guided surgery for LGGs in a multicenter retrospective study initiated by the German Study Group for Intraoperative Magnetic Resonance Imaging. A retrospective consecutive assessment of patients treated for LGGs (World Health Organization grade II) with iMRI-guided resection at 6 neurosurgical centers was performed. Eloquent location, extent of resection, first-line adjuvant treatment, neurophysiological monitoring, awake brain surgery, intraoperative ultrasound, and field-strength of iMRI were analyzed, as well as progression-free survival (PFS), new permanent neurological deficits, and complications. Multivariate binary logistic and Cox regression models were calculated to evaluate determinants of PFS, gross total resection (GTR), and adjuvant treatment. A total of 288 patients met the inclusion criteria. On multivariate analysis, GTR significantly increased PFS (hazard ratio, 0.44; P surgery. Patients with accidentally left tumor remnants showed a similar prognosis compared with patients harboring only partially resectable tumors. Use of high-field iMRI was significantly associated with GTR. However, the field strength of iMRI did not affect PFS. EoR, extent of resectionFLAIR, fluid-attenuated inversion recoveryGTR, gross total resectionIDH1, isocitrate dehydrogenase 1iMRI, intraoperative magnetic resonance imagingLGG, low-grade gliomaMGMT, methylguanine-deoxyribonucleic acid methyltransferasenPND, new permanent neurological deficitOS, overall survivalPFS, progression-free survivalSTR, subtotal resectionWHO, World Health Organization.

  10. Quantitative chemical shift-encoded MRI is an accurate method to quantify hepatic steatosis.

    Science.gov (United States)

    Kühn, Jens-Peter; Hernando, Diego; Mensel, Birger; Krüger, Paul C; Ittermann, Till; Mayerle, Julia; Hosten, Norbert; Reeder, Scott B

    2014-06-01

    To compare the accuracy of liver fat quantification using a three-echo chemical shift-encoded magnetic resonance imaging (MRI) technique without and with correction for confounders with spectroscopy (MRS) as the reference standard. Fifty patients (23 women, mean age 56.6 ± 13.2 years) with fatty liver disease were enrolled. Patients underwent T2-corrected single-voxel MRS and a three-echo chemical shift-encoded gradient echo (GRE) sequence at 3.0T. MRI fat fraction (FF) was calculated without and with T2* and T1 correction and multispectral modeling of fat and compared with MRS-FF using linear regression. The spectroscopic range of liver fat was 0.11%-38.7%. Excellent correlation between MRS-FF and MRI-FF was observed when using T2* correction (R(2)  = 0.96). With use of T2* correction alone, the slope was significantly different from 1 (1.16 ± 0.03, P fat were addressed, the results showed equivalence between fat quantification using MRI and MRS (slope: 1.02 ± 0.03, P = 0.528; intercept: 0.26% ± 0.46%, P = 0.572). Complex three-echo chemical shift-encoded MRI is equivalent to MRS for quantifying liver fat, but only with correction for T2* decay and T1 recovery and use of spectral modeling of fat. This is necessary because T2* decay, T1 recovery, and multispectral complexity of fat are processes which may otherwise bias the measurements. Copyright © 2013 Wiley Periodicals, Inc.

  11. L'uso del doppiaggio e del sottotitolaggio nell'insegnamento della L2: Il caso della piattaforma ClipFlair

    Directory of Open Access Journals (Sweden)

    Lupe Romero

    2016-01-01

    Full Text Available Abstract – The purpose of this paper is to present the Clipflair project, a web platform for foreign language learning (FLL through revoicing and captioning of clips. Using audiovisual material in the language classroom is a common resource for teachers since it introduces variety, provides exposure to nonverbal cultural elements and, most importantly, presents linguistic and cultural aspects of communication in their context. However, teachers using this resource face the difficulty of finding active tasks that will engage learners and discourage passive viewing. ClipFlair proposes working with AV material productively while also motivating learners by getting them to revoice or caption a clip. Revoicing is a term used to refer to (rerecording voice onto a clip, as in dubbing, free commentary, audio description and karaoke singing. The term captioning refers to adding written text to a clip, such as standard subtitles, annotations and intertitles. Clips can be short video or audio files, including documentaries, film scenes, news pieces, animations and songs. ClipFlair develops materials that enable foreign language learners to practice all four standard CEFR skills: writing, speaking, listening and reading. Within the project’s scope, more than 350 ready-made activities, which involve captioning and/or revoicing of clips, has been created. These activities has been created for more than 16 languages including English, Spanish and Italian, but focus is placed on less widely taught languages, namely Estonian, Greek, Romanian and Polish, as well as minority languages, i.e. Basque, Catalan and Irish. Non-European languages, namely Arabic, Chinese, Japanese, Russian and Ukrainian are also included. The platform has three different areas: The Gallery offers the materials and the activities; the Studio area, offers a captioning and revoicing tools, in order to create or practice and learn languages by using the activities; the Social Network area

  12. MRI of meniscal bucket-handle tears

    Energy Technology Data Exchange (ETDEWEB)

    Magee, T.H.; Hinson, G.W. [Menorah Medical Center, Overland Park, KS (United States). Dept. of Radiology

    1998-09-01

    A meniscal bucket-handle tear is a tear with an attached fragment displaced from the meniscus of the knee joint. Low sensitivity of MRI for detection of bucket-handle tears (64% as compared with arthroscopy) has been reported previously. We report increased sensitivity for detecting bucket-handle tears with the use of coronal short tau inversion recovery (STIR) images. Results. By using four criteria for diagnosis of meniscal bucket-handle tears, our overall sensitivity compared with arthroscopy was 93% (28 of 30 meniscal bucket-handle tears seen at arthroscopy were detected by MRI). The meniscal fragment was well visualized in all 28 cases on coronal STIR images. The double posterior cruciate ligament sign was seen in 8 of 30 cases, the flipped meniscus was seen in 10 of 30 cases and a fragment in the intercondylar notch was seen in 18 of 30 cases. (orig.)

  13. Diagnostic precision of PET imaging and functional MRI in disorders of consciousness

    DEFF Research Database (Denmark)

    Stender, Johan; Gosseries, Olivia; Bruno, Marie-Aurélie

    2014-01-01

    a validation study of two neuroimaging-based diagnostic methods: PET imaging and functional MRI (fMRI). METHODS: For this clinical validation study, we included patients referred to the University Hospital of Liège, Belgium, between January, 2008, and June, 2012, who were diagnosed by our unit...... with unresponsive wakefulness syndrome, locked-in syndrome, or minimally conscious state with traumatic or non-traumatic causes. We did repeated standardised clinical assessments with the Coma Recovery Scale-Revised (CRS-R), cerebral (18)F-fluorodeoxyglucose (FDG) PET, and fMRI during mental activation tasks. We...... state (48=traumatic, 78=non-traumatic; 110=chronic, 16=subacute). (18)F-FDG PET had high sensitivity for identification of patients in a minimally conscious state (93%, 95% CI 85-98) and high congruence (85%, 77-90) with behavioural CRS-R scores. The active fMRI method was less sensitive at diagnosis...

  14. Visualization of white matter tracts using a non-diffusion weighted magnetic resonance imaging method: does intravenous gadolinium injection four hours prior to the examination affect the visualization of white matter tracts?

    Directory of Open Access Journals (Sweden)

    Masahiro Yamazaki

    Full Text Available OBJECTIVES: Visualization of white matter (WM-tracts such as the corticospinal tract (CST, medial lemniscus (ML, and superior cerebellar peduncle (SCP using delayed enhanced (DE-heavily T2-weighted three-dimensional fluid-attenuated inversion-recovery (hT2w-3D-FLAIR imaging has recently been reported. In that report, all patients were clinically suspected of having Ménière's disease, because DE-hT2w-3D-FLAIR imaging of the inner ear has been reported to separately visualize perilymph and endolymph fluid and can identify the presence of endolymphatic hydrops. Therefore, the previous report could not rule out the possible effect of delayed enhancement. From this perspective, the purpose of this study was to elucidate if the use of gadolinium affects the visualization of WM-tracts on hT2w-3D-FLAIR. MATERIALS AND METHODS: The records of nine patients with suspected Ménière's disease who underwent plain (P and DE-hT2w-3D-FLAIR by 3-Tesla were retrospectively analyzed. The regions of interest were set on the CST, ML, and SCP, and on contiguous brain parenchyma: The thalamus (Th, pontine parenchyma (PP, and cerebellar parenchyma (CP, respectively. The signal intensity ratio between each WM-tract and the relevant contiguous brain parenchyma was calculated for both P- and DE-hT2w-3D-FLAIR images, and statistically compared using paired t-tests. RESULTS: The CST/Th signal intensity ratio was 3.75±0.67 on P-hT2w-3D-FLAIR and 3.62±0.50 on DE-hT2w-3D-FLAIR (p = 0.24. The ML/PP signal intensity ratio was 2.19±0.59 on P-hT2w-3D-FLAIR and 2.08±0.53 on DE-hT2w-3D-FLAIR (p = 0.25. The SCP/CP signal intensity ratio was 4.08±0.91 on P-hT2w-3D-FLAIR and 4.04±0.96 on DE-hT2w-3D-FLAIR (p = 0.43. There were no significant differences in the signal intensity ratios between P- and DE-hT2w-3D-FLAIR images. CONCLUSIONS: The use of gadolinium is not necessary for visualization of WM-tracts using hT2w-3D-FLAIR, and P-hT2w-3D-FLAIR without gadolinium may

  15. Conspicuity of diffuse axonal injury lesions on diffusion-weighted MR imaging

    Energy Technology Data Exchange (ETDEWEB)

    Kinoshita, Toshibumi [Department of Radiology, Division of Neuroradiology, University of Rochester Medical Center, 601 Elmwood Avenue, Box 648, Rochester, NY 14642 (United States)]. E-mail: kino@grape.med.tottori-u.ac.jp; Moritani, Toshio [Department of Radiology, Division of Neuroradiology, University of Rochester Medical Center, 601 Elmwood Avenue, Box 648, Rochester, NY 14642 (United States); Hiwatashi, Akio [Department of Radiology, Division of Neuroradiology, University of Rochester Medical Center, 601 Elmwood Avenue, Box 648, Rochester, NY 14642 (United States); Wang, Henry Z. [Department of Radiology, Division of Neuroradiology, University of Rochester Medical Center, 601 Elmwood Avenue, Box 648, Rochester, NY 14642 (United States); Shrier, David A. [Department of Radiology, Division of Neuroradiology, University of Rochester Medical Center, 601 Elmwood Avenue, Box 648, Rochester, NY 14642 (United States); Numaguchi, Yuji [Department of Radiology, Division of Neuroradiology, University of Rochester Medical Center, 601 Elmwood Avenue, Box 648, Rochester, NY 14642 (United States); Westesson, Per-Lennart A. [Department of Radiology, Division of Neuroradiology, University of Rochester Medical Center, 601 Elmwood Avenue, Box 648, Rochester, NY 14642 (United States)

    2005-10-01

    Objective: (1) To detect diffuse axonal injury (DAI) lesions by diffusion-weighted imaging (DWI), as compared with fluid-attenuated inversion recovery (FLAIR) imaging and (2) to evaluate hemorrhagic DAI lesions by b{sub 0} images obtained from DWI, as compared with gradient-echo (GRE) imaging. Methods: We reviewed MR images of 36 patients with a diagnosis of DAI. MR imaging was performed 20 h to 14 days (mean, 3.7 days) after traumatic brain injury. We evaluated: (1) conspicuity of lesions on DWI and FLAIR and (2) conspicuity of hemorrhage in DAI lesions on b{sub 0} images and GRE imaging. Results: DWI clearly depicted high-signal DAI lesions. The sensitivity of DWI to lesional conspicuity in DAI lesions was almost equal to that of FLAIR. The sensitivity of b{sub 0} images to identification of hemorrhagic DAI lesions was inferior to that of GRE. Conclusion: DWI is as useful as FLAIR in detecting DAI lesions. GRE imaging is still the superior tool for the evaluation of hemorrhagic DAI.

  16. Prion diseases of the brain

    International Nuclear Information System (INIS)

    Lutz, Kira; Urbach, Horst

    2015-01-01

    The prion diseases of the brain, especially Creutzfeldt-Jakob disease, are rare fatal neurodegenerative disorders. A definitive CJD diagnosis is currently only possible by a brain biopsy or post mortem autopsy. The diagnosis of Creutzfeldt-Jakob disease is based on clinical signs, pathognomonic EEG, on typical MRI findings and the examination of the cerebrospinal fluid. Using the MRI the diagnosis Creutzfeldt-Jakob disease can be confirmed or excluded with high certainty. The MRI examination should contain diffusion-weighted and FLAIR imaging sequences. This review article provides an overview of the prion diseases of the brain with the corresponding imaging findings.

  17. Prion diseases of the brain; Prionenerkrankung des Gehirns

    Energy Technology Data Exchange (ETDEWEB)

    Lutz, Kira; Urbach, Horst [Universitaetsklinik Freiburg (Germany). Klinik fuer Neuroradiologie

    2015-09-15

    The prion diseases of the brain, especially Creutzfeldt-Jakob disease, are rare fatal neurodegenerative disorders. A definitive CJD diagnosis is currently only possible by a brain biopsy or post mortem autopsy. The diagnosis of Creutzfeldt-Jakob disease is based on clinical signs, pathognomonic EEG, on typical MRI findings and the examination of the cerebrospinal fluid. Using the MRI the diagnosis Creutzfeldt-Jakob disease can be confirmed or excluded with high certainty. The MRI examination should contain diffusion-weighted and FLAIR imaging sequences. This review article provides an overview of the prion diseases of the brain with the corresponding imaging findings.

  18. A rare case of toxic optic neuropathy secondary to consumption of neem oil

    Directory of Open Access Journals (Sweden)

    A R Suresha

    2014-01-01

    Full Text Available A 35-year-old female was referred to our hospital with bilateral loss of vision of two days duration. She gave history of consumption of about 150 ml of neem oil five days back.Examination revealed no perception of light in both eyes. Both pupils were dilated and sluggishly reacting to light. Her fundus examination showed bilateral hyperemic, edematous discs and also edema extending along the superior and inferior temporal vascular arcade. Magnetic resonance imaging (MRI scan showed bilateral putaminal regions with altered signal, hypointensities in T1-weighted images, hyperintensities on T2-weighted, images and hyperintense on Fluid Attenuation Inversion Recovery (FLAIR images suggestive of cytotoxic edema due to tissue hypoxia. Her vision improved to 20/200 in both eyes with treatment after two months. This is the first case report of such nature in the literature to the best of our knowledge.

  19. Degenerative cerebellar diseases and differential diagnoses

    International Nuclear Information System (INIS)

    Reith, W.; Roumia, S.; Dietrich, P.

    2016-01-01

    Cerebellar syndromes result in distinct clinical symptoms, such as ataxia, dysarthria, dysmetria, intention tremor and eye movement disorders. In addition to the medical history and clinical examination, imaging is particularly important to differentiate other diseases, such as hydrocephalus and multi-infarct dementia from degenerative cerebellar diseases. Degenerative diseases with cerebellar involvement include Parkinson's disease, multiple system atrophy as well as other diseases including spinocerebellar ataxia. In addition to magnetic resonance imaging (MRI), nuclear medicine imaging investigations are also helpful for the differentiation. Axial fluid-attenuated inversion recovery (FLAIR) and T2-weighted sequences can sometimes show a signal increase in the pons as a sign of degeneration of pontine neurons and transverse fibers in the basilar part of the pons. The imaging is particularly necessary to exclude other diseases, such as normal pressure hydrocephalus (NPH), multi-infarct dementia and cerebellar lesions. (orig.) [de

  20. Morphometric changes of whole brain in patients with alcohol addiction: a voxel-based morphometry study

    International Nuclear Information System (INIS)

    Li Jinfeng; Chen Zhiye; Ma Lin

    2011-01-01

    Objective: To evaluate morphometric changes of brain in patients with alcohol addiction by voxel-based morphometry. Methods: Fifteen patients with alcohol addiction and 15 health controls were recruited and underwent fluid attenuated inversion recovery (FLAIR) and 3D fast spoiled gradient echo (FSPGR) T 1 -weighted sequences on a 3.0 T MRI system. 3D FSPGR T 1 structure images were normalized, segmented and smoothed, and then underwent voxel-based morphometry. An ANCOVA was applied with age, body mass index (BMI), and education years as covariates because of exact sex match. A statistical threshold of P 0.05). Conclusions: Regional gray and white matter atrophy can be the initial changes in patients with alcohol addiction and the frontal region is a relative specific damaged brain region. VBM has a potential value for the detection of subtle brain atrophy in patients with alcohol addiction. (authors)

  1. Single-shot echo-planar MR sequences in the diagnosis of intracranial infectious diseases

    International Nuclear Information System (INIS)

    Tsuchiya, Kazuhiro; Katase, Shichiro; Yoshino, Ayako; Yamakami, Norio; Hachiya, Junichi

    1998-01-01

    The purpose of this study was to present our preliminary experience in the application of echo-planar-imaging (EPI) MR sequences for the diagnosis of intracranial infectious diseases and to assess the value of these sequences. We reviewed single-shot EPI MR images obtained at 1.5 T in 17 patients and compared these images with conventional or fast spin-echo (SE) or fluid attenuated inversion-recovery (FLAIR) images. The clinical diagnoses for the 17 patients were meningitis (2 patients), encephalitis or meningoencephalitis (7 patients), brain abscess (5 patients), epidural empyema (2 patients) and Creutzfeldt-Jakob disease (1 patient). We obtained EPI-T 2 -weighted (T 2 W) images in 8 patients, EPI-FLAIR images in 13 patients and EPI-diffusion-weighted (DW) images in 14 patients. Among the 8 patients for whom EPI-T 2 W imaging was performed, EPI-T 2 W imaging yielded superior results compared with SE-T 2 W imaging in 3 patients as a consequence of patient motion and equal results compared with SE-T 2 W imaging in 5 patients. Among the 13 patients for whom EPI-FLAIR imaging was performed, the EPI-FLAIR images were superior to conventional FLAIR images in 3 unstable patients. In the remaining 10 patients for whom EPI-FLAIR imaging was performed, EPI-FLAIR images were equivalent or inferior to conventional FLAIR images. In 6 patients with encephalitis or meningoencephalitis, the encephalitic lesions showed hyperintensity in EPI-DW images to a greater extent than in images obtained with the other techniques. In 3 patients, EPI-DW images also demonstrated hyperintensity for the contents of abscesses or areas of empyema that was not seen with the other imaging techniques. The value of EPI-T 2 W and EPI-FLAIR imaging is limited in uncooperative patients. EPI-DW imaging was found to be of value for the evaluation of several intracranial infectious diseases. (author)

  2. Single-shot echo-planar MR sequences in the diagnosis of intracranial infectious diseases

    Energy Technology Data Exchange (ETDEWEB)

    Tsuchiya, Kazuhiro; Katase, Shichiro; Yoshino, Ayako; Yamakami, Norio; Hachiya, Junichi [Kyorin Univ., Mitaka, Tokyo (Japan). School of Medicine

    1998-06-01

    The purpose of this study was to present our preliminary experience in the application of echo-planar-imaging (EPI) MR sequences for the diagnosis of intracranial infectious diseases and to assess the value of these sequences. We reviewed single-shot EPI MR images obtained at 1.5 T in 17 patients and compared these images with conventional or fast spin-echo (SE) or fluid attenuated inversion-recovery (FLAIR) images. The clinical diagnoses for the 17 patients were meningitis (2 patients), encephalitis or meningoencephalitis (7 patients), brain abscess (5 patients), epidural empyema (2 patients) and Creutzfeldt-Jakob disease (1 patient). We obtained EPI-T{sub 2}-weighted (T{sub 2}W) images in 8 patients, EPI-FLAIR images in 13 patients and EPI-diffusion-weighted (DW) images in 14 patients. Among the 8 patients for whom EPI-T{sub 2}W imaging was performed, EPI-T{sub 2}W imaging yielded superior results compared with SE-T{sub 2}W imaging in 3 patients as a consequence of patient motion and equal results compared with SE-T{sub 2}W imaging in 5 patients. Among the 13 patients for whom EPI-FLAIR imaging was performed, the EPI-FLAIR images were superior to conventional FLAIR images in 3 unstable patients. In the remaining 10 patients for whom EPI-FLAIR imaging was performed, EPI-FLAIR images were equivalent or inferior to conventional FLAIR images. In 6 patients with encephalitis or meningoencephalitis, the encephalitic lesions showed hyperintensity in EPI-DW images to a greater extent than in images obtained with the other techniques. In 3 patients, EPI-DW images also demonstrated hyperintensity for the contents of abscesses or areas of empyema that was not seen with the other imaging techniques. The value of EPI-T{sub 2}W and EPI-FLAIR imaging is limited in uncooperative patients. EPI-DW imaging was found to be of value for the evaluation of several intracranial infectious diseases. (author)

  3. Reduced artefacts and improved assessment of hyperintense brain lesions with BLADE MR imaging in patients with neurofibromatosis type 1

    Energy Technology Data Exchange (ETDEWEB)

    Kalle, Thekla von; Fabig-Moritz, Claudia; Mueller-Abt, Peter; Zieger, Michael; Winkler, Peter [Department of Paediatric Radiology, Stuttgart (Germany); Blank, Bernd [Haematology and Immunology, Department of Paediatric Oncology, Stuttgart (Germany); Wohlfarth, Katrin [Siemens Healthcare Sector, Erlangen (Germany)

    2009-11-15

    Assessment of small brain lesions in children is often compromised by pulsation, flow or movement artefacts. MRI with a rotating blade-like k-space covering (BLADE, PROPELLER) can compensate for these artefacts. We compared T2-weighted FLAIR images that were acquired with different k-space trajectories (conventional Cartesian and BLADE) to evaluate the impact of BLADE technique on the delineation of small or low-contrast brain lesions. The subject group comprised 26 children with neurofibromatosis type 1 (NF 1), who had been routinely scanned at 1.5 T for optic pathway gliomas with both techniques and who had the typical hyperintense brain lesions seen in NF 1. Four experienced radiologists retrospectively compared unlabelled 4-mm axial images with respect to the presence of artefacts, visibility of lesions, quality of contour and contrast. Both techniques were comparable in depicting hyperintense lesions as small as 2 mm independent of contrast and edge definition. Pulsation and movement artefacts were significantly less common with BLADE k-space trajectory. In 7 of 26 patients (27%), lesions and artefacts were rated as indistinguishable in conventional FLAIR, but not in BLADE FLAIR images. BLADE imaging significantly improved the depiction of lesions in T2-W FLAIR images due to artefact reduction especially in the posterior fossa. (orig.)

  4. Reduced artefacts and improved assessment of hyperintense brain lesions with BLADE MR imaging in patients with neurofibromatosis type 1

    International Nuclear Information System (INIS)

    Kalle, Thekla von; Fabig-Moritz, Claudia; Mueller-Abt, Peter; Zieger, Michael; Winkler, Peter; Blank, Bernd; Wohlfarth, Katrin

    2009-01-01

    Assessment of small brain lesions in children is often compromised by pulsation, flow or movement artefacts. MRI with a rotating blade-like k-space covering (BLADE, PROPELLER) can compensate for these artefacts. We compared T2-weighted FLAIR images that were acquired with different k-space trajectories (conventional Cartesian and BLADE) to evaluate the impact of BLADE technique on the delineation of small or low-contrast brain lesions. The subject group comprised 26 children with neurofibromatosis type 1 (NF 1), who had been routinely scanned at 1.5 T for optic pathway gliomas with both techniques and who had the typical hyperintense brain lesions seen in NF 1. Four experienced radiologists retrospectively compared unlabelled 4-mm axial images with respect to the presence of artefacts, visibility of lesions, quality of contour and contrast. Both techniques were comparable in depicting hyperintense lesions as small as 2 mm independent of contrast and edge definition. Pulsation and movement artefacts were significantly less common with BLADE k-space trajectory. In 7 of 26 patients (27%), lesions and artefacts were rated as indistinguishable in conventional FLAIR, but not in BLADE FLAIR images. BLADE imaging significantly improved the depiction of lesions in T2-W FLAIR images due to artefact reduction especially in the posterior fossa. (orig.)

  5. Recovery from optic neuritis: an ROI-based analysis of LGN and visual cortical areas

    DEFF Research Database (Denmark)

    Korsholm, Kirsten; Madsen, Kristoffer Hougaard; Frederiksen, Jette L

    2007-01-01

    in the ROIs and compared activation during monocular stimulation of the affected and unaffected eye. In the acute phase the activation of LGN during visual stimulation of the affected eye was significantly reduced (P difference in LGN activation between...... the affected and unaffected eye diminished during recovery, and after 180 days the difference was no longer significant (P = 0.59). The decreased difference during recovery was mainly due to an increase in the fMRI signal when stimulating the affected eye, but included a component of a decreasing fMRI signal...... from LGN when stimulating the unaffected eye. In LOC, V1 and V2 activation during visual stimulation of the affected eye in the acute phase was significantly reduced (P difference diminished with no significant differences left after 180...

  6. Ivy Sign on Fluid-Attenuated Inversion Recovery Images in Moyamoya Disease: Correlation with Clinical Severity and Old Brain Lesions.

    Science.gov (United States)

    Seo, Kwon-Duk; Suh, Sang Hyun; Kim, Yong Bae; Kim, Ji Hwa; Ahn, Sung Jun; Kim, Dong-Seok; Lee, Kyung-Yul

    2015-09-01

    Leptomeningeal collateral, in moyamoya disease (MMD), appears as an ivy sign on fluid-attenuated inversion-recovery (FLAIR) images. There has been little investigation into the relationship between presentation of ivy signs and old brain lesions. We aimed to evaluate clinical significance of ivy signs and whether they correlate with old brain lesions and the severity of clinical symptoms in patients with MMD. FLAIR images of 83 patients were reviewed. Each cerebral hemisphere was divided into 4 regions and each region was scored based on the prominence of the ivy sign. Total ivy score (TIS) was defined as the sum of the scores from the eight regions and dominant hemispheric ivy sign (DHI) was determined by comparing the ivy scores from each hemisphere. According to the degree of ischemic symptoms, patients were classified into four subgroups: 1) nonspecific symptoms without motor weakness, 2) single transient ischemic attack (TIA), 3) recurrent TIA, or 4) complete stroke. TIS was significantly different as follows: 4.86±2.55 in patients with nonspecific symptoms, 5.89±3.10 in patients with single TIA, 9.60±3.98 in patients with recurrent TIA and 8.37±3.39 in patients with complete stroke (p=0.003). TIS associated with old lesions was significantly higher than those not associated with old lesions (9.35±4.22 vs. 7.49±3.37, p=0.032). We found a significant correlation between DHI and motor symptoms (p=0.001). Because TIS has a strong tendency with severity of ischemic motor symptom and the presence of old lesions, the ivy sign may be useful in predicting severity of disease progression.

  7. Focal neuronal loss, reversible subcortical focal T2 hypointensity in seizures with a nonketotic hyperglycemic hyperosmolar state

    Energy Technology Data Exchange (ETDEWEB)

    Raghavendra, S.; Ashalatha, R.; Thomas, Sanjeev V. [Sree Chitra Tirunal Institute for Medical Sciences and Technology, Department of Neurology, Trivandrum, Kerala (India); Kesavadas, C. [Sree Chitra Tirunal Institute for Medical Sciences and Technology, Department of Imaging Sciences and Interventional Radiology, Trivandrum (India)

    2007-04-15

    Neuroimaging in seizures associated with nonketotic hyperglycemia (NKH) is considered normal. We report magnetic resonance imaging (MRI) abnormalities in four patients with NKH and seizures. We prospectively evaluated clinical and radiological abnormalities in four patients with NKH during the period March 2004 to December 2005. All patients presented with seizures, either simple or complex partial seizures or epilepsia partialis continua. Two of them had transient hemianopia. MRI showed subcortical T2 hypointensity in the occipital white matter and in or around the central sulcus (two patients each), T2 hyperintensity of the overlying cortex (two patients), focal overlying cortical enhancement (three patients) and bilateral striatal hyperintensity (one patient). Diffusion-weighted imaging (DWI) performed in three patients showed restricted diffusion. The ictal semiology and electroencephalographic (EEG) findings correlated with the MRI abnormalities. On clinical recovery, the subcortical T2 hypointensity and striatal hyperintensity reversed in all patients. The initial cortical change evolved to FLAIR hyperintensity suggestive of focal cortical gliosis. The radiological differential diagnosis considered initially included encephalitis, malignancy and hemorrhagic infarct rendering a diagnostic dilemma. We identified subcortical T2 hypointensity rather than hyperintensity as a characteristic feature of seizures associated with NKH. Only very few similar reports exist in literature. Reversible bilateral striatal T2 hyperintensity in NKH has not been reported to the best of our knowledge. (orig.)

  8. Focal neuronal loss, reversible subcortical focal T2 hypointensity in seizures with a nonketotic hyperglycemic hyperosmolar state

    International Nuclear Information System (INIS)

    Raghavendra, S.; Ashalatha, R.; Thomas, Sanjeev V.; Kesavadas, C.

    2007-01-01

    Neuroimaging in seizures associated with nonketotic hyperglycemia (NKH) is considered normal. We report magnetic resonance imaging (MRI) abnormalities in four patients with NKH and seizures. We prospectively evaluated clinical and radiological abnormalities in four patients with NKH during the period March 2004 to December 2005. All patients presented with seizures, either simple or complex partial seizures or epilepsia partialis continua. Two of them had transient hemianopia. MRI showed subcortical T2 hypointensity in the occipital white matter and in or around the central sulcus (two patients each), T2 hyperintensity of the overlying cortex (two patients), focal overlying cortical enhancement (three patients) and bilateral striatal hyperintensity (one patient). Diffusion-weighted imaging (DWI) performed in three patients showed restricted diffusion. The ictal semiology and electroencephalographic (EEG) findings correlated with the MRI abnormalities. On clinical recovery, the subcortical T2 hypointensity and striatal hyperintensity reversed in all patients. The initial cortical change evolved to FLAIR hyperintensity suggestive of focal cortical gliosis. The radiological differential diagnosis considered initially included encephalitis, malignancy and hemorrhagic infarct rendering a diagnostic dilemma. We identified subcortical T2 hypointensity rather than hyperintensity as a characteristic feature of seizures associated with NKH. Only very few similar reports exist in literature. Reversible bilateral striatal T2 hyperintensity in NKH has not been reported to the best of our knowledge. (orig.)

  9. Corpus callosum lesions after closed head injury in children: MRI, clinical features and outcome

    International Nuclear Information System (INIS)

    Mendelsohn, D.B.; Bruce, D.

    1992-01-01

    Thirty-four children who sustained moderate to severe closed head injury underwent magnetic resonance imaging (MRI). Eight (24%) had MRI evidence of corpus callosum injury, most commonly within the posterior body and splenium. In contradistinction to reports in adults, there was no definite relationship between callosal injury and lower initial Glasgow Coma Scale scores, nor was there a significantly higher incidence of primary brain-stem lesions, diffuse axonal shear injury or intraventricular hemorrhage. In none of these 8 children did the initial admission computed tomography show evidence of callosal injury. Callosal injuries on MRI are not necessarily a poor prognostic finding, the majority of the 8 children showing good functional recovery. (orig.)

  10. Supratentorial white matter blurring associated with voltage-gated potassium channel-complex limbic encephalitis

    Energy Technology Data Exchange (ETDEWEB)

    Urbach, H.; Mader, I. [University Medical Center Freiburg, Department of Neuroradiology, Freiburg (Germany); Rauer, S.; Baumgartner, A. [University Medical Center Freiburg, Department of Neurology, Freiburg (Germany); Paus, S. [University Medical Center, Department of Neurology, Bonn (Germany); Wagner, J. [University Medical Center, Department of Epileptology, Bonn (Germany); Malter, M.P. [University of Cologne, Department of Neurology, Cologne (Germany); Pruess, H. [Charite - Universitaetsmedizin Berlin, Department of Neurology, Berlin (Germany); Lewerenz, J.; Kassubek, J. [Ulm University, Department of Neurology, Ulm (Germany); Hegen, H.; Auer, M.; Deisenhammer, F. [University Innsbruck, Department of Neurology, Innsbruck (Austria); Ufer, F. [University Medical Center, Department of Neurology, Hamburg (Germany); Bien, C.G. [Epilepsy Centre Bethel, Bielefeld-Bethel (Germany)

    2015-12-15

    Limbic encephalitis (LE) associated with voltage-gated potassium channel-complex antibodies (VGKC-LE) is frequently non-paraneoplastic and associated with marked improvement following corticosteroid therapy. Mesial temporal lobe abnormalities are present in around 80 % of patients. If associated or preceded by faciobrachial dystonic seizures, basal ganglia signal changes may occur. In some patients, blurring of the supratentorial white matter on T2-weighted images (SWMB) may be seen. The purpose of this study was to evaluate the incidence of SWMB and whether it is specific for VGKC-LE. Two experienced neuroradiologists independently evaluated signal abnormalities on FLAIR MRI in 79 patients with LE while unaware on the antibody type. SWMB was independently assessed as present in 10 of 36 (28 %) compared to 2 (5 %) of 43 non-VGKC patients (p = 0.009). It was not related to the presence of LGI1 or CASPR2 proteins of VGKC antibodies. MRI showed increased temporomesial FLAIR signal in 22 (61 %) VGKC compared to 14 (33 %) non-VGKC patients (p = 0.013), and extratemporomesial structures were affected in one VGKC (3 %) compared to 11 (26 %) non-VGKC patients (p = 0.005). SWMB is a newly described MRI sign rather specific for VGKC-LE. (orig.)

  11. Supratentorial white matter blurring associated with voltage-gated potassium channel-complex limbic encephalitis

    International Nuclear Information System (INIS)

    Urbach, H.; Mader, I.; Rauer, S.; Baumgartner, A.; Paus, S.; Wagner, J.; Malter, M.P.; Pruess, H.; Lewerenz, J.; Kassubek, J.; Hegen, H.; Auer, M.; Deisenhammer, F.; Ufer, F.; Bien, C.G.

    2015-01-01

    Limbic encephalitis (LE) associated with voltage-gated potassium channel-complex antibodies (VGKC-LE) is frequently non-paraneoplastic and associated with marked improvement following corticosteroid therapy. Mesial temporal lobe abnormalities are present in around 80 % of patients. If associated or preceded by faciobrachial dystonic seizures, basal ganglia signal changes may occur. In some patients, blurring of the supratentorial white matter on T2-weighted images (SWMB) may be seen. The purpose of this study was to evaluate the incidence of SWMB and whether it is specific for VGKC-LE. Two experienced neuroradiologists independently evaluated signal abnormalities on FLAIR MRI in 79 patients with LE while unaware on the antibody type. SWMB was independently assessed as present in 10 of 36 (28 %) compared to 2 (5 %) of 43 non-VGKC patients (p = 0.009). It was not related to the presence of LGI1 or CASPR2 proteins of VGKC antibodies. MRI showed increased temporomesial FLAIR signal in 22 (61 %) VGKC compared to 14 (33 %) non-VGKC patients (p = 0.013), and extratemporomesial structures were affected in one VGKC (3 %) compared to 11 (26 %) non-VGKC patients (p = 0.005). SWMB is a newly described MRI sign rather specific for VGKC-LE. (orig.)

  12. Supratentorial white matter blurring associated with voltage-gated potassium channel-complex limbic encephalitis.

    Science.gov (United States)

    Urbach, H; Rauer, S; Mader, I; Paus, S; Wagner, J; Malter, M P; Prüss, H; Lewerenz, J; Kassubek, J; Hegen, H; Auer, M; Deisenhammer, F; Ufer, F; Bien, C G; Baumgartner, A

    2015-12-01

    Limbic encephalitis (LE) associated with voltage-gated potassium channel-complex antibodies (VGKC-LE) is frequently non-paraneoplastic and associated with marked improvement following corticosteroid therapy. Mesial temporal lobe abnormalities are present in around 80 % of patients. If associated or preceded by faciobrachial dystonic seizures, basal ganglia signal changes may occur. In some patients, blurring of the supratentorial white matter on T2-weighted images (SWMB) may be seen. The purpose of this study was to evaluate the incidence of SWMB and whether it is specific for VGKC-LE. Two experienced neuroradiologists independently evaluated signal abnormalities on FLAIR MRI in 79 patients with LE while unaware on the antibody type. SWMB was independently assessed as present in 10 of 36 (28 %) compared to 2 (5 %) of 43 non-VGKC patients (p = 0.009). It was not related to the presence of LGI1 or CASPR2 proteins of VGKC antibodies. MRI showed increased temporomesial FLAIR signal in 22 (61 %) VGKC compared to 14 (33 %) non-VGKC patients (p = 0.013), and extratemporomesial structures were affected in one VGKC (3 %) compared to 11 (26 %) non-VGKC patients (p = 0.005). SWMB is a newly described MRI sign rather specific for VGKC-LE.

  13. posterior reversible encephalopathy syndrome (PRES)

    African Journals Online (AJOL)

    brain edema area, an MRI image shows hypointense or isointense signals in T1WI and hyperintense signals in. T2WI and FLAIR sequence2,11. The combination of. DWI and ADC maps can separate vasogenic edema from cytotoxic edema, which is critical in the diagnosis of PRES11. The hypointensive or isointensive ...

  14. T1-weighted MRI for the detection of coronary artery plaque haemorrhage

    International Nuclear Information System (INIS)

    Oei, May Lin; Ozgun, Murat; Seifarth, Harald; Bunck, Alexander; Fischbach, Roman; Heindel, Walter; Maintz, David; Orwat, Stefan; Botnar, Rene

    2010-01-01

    Hyperintense areas in atherosclerotic plaques on pre-contrast T1-weighted MRI have been shown to correlate with intraplaque haemorrhage. We evaluated the presence of T1 hyperintensity in coronary artery plaques in coronary artery disease (CAD) patients and correlated results with multi-detector computed tomography (MDCT) findings. Fifteen patients with CAD were included. Plaques detected by MDCT were categorised based on their Hounsfield number. T1-weighted inversion recovery (IR) MRI prepared coronary MRI for the detection of plaque and steady-state free-precession coronary MR-angiography for anatomical correlation was performed. After registration of MDCT and MRI, regions of interest were defined on MDCT-visible plaques and in corresponding vessel segments acquired with MRI. MDCT density and MR signal measurement were performed in each plaque. Forty-three plaques were identified with MDCT. With IR-MRI 5/43 (12%) plaques were hyperintense, 2 of which were non-calcified and 3 mixed. Average signal-to-noise and contrast-to-noise ratios of hyperintense plaques were 15.7 and 9.1, compared with 5.6 and 1.2 for hypointense plaques. Hyperintense plaques exhibited a significantly lower CT density than hypointense plaques (63.6 vs. 140.8). There was no correlation of plaque signal intensity with degree of stenosis. T1-weighted IR-MRI may be useful for non-invasive detection and characterisation of intraplaque haemorrhage in coronary artery plaques. (orig.)

  15. A study comparing MRI with clinical examinations on wrists with rheumatoid arthritis

    International Nuclear Information System (INIS)

    Wang Jun; Niu Jinliang; Xie Weina; Song Zhizhen; Zheng Jie; Ma Qiang

    2004-01-01

    Objective: To study the appearances of rheumatoid arthritis (RA) on MRI, and compare MRI with clinical examinations on wrists with RA. Methods: Fifty patients, fulfilled 1987 American Rheumatism Association (ARA) revised criteria, and 10 age-matched healthy controls entered the study. T 1 -weighted spin echo, short time inversion recovery (STIR) of both wrists, gadolinium contrast material-enhanced sequences of dominant wrists were performed in the coronal planes. MRl, plain wrist radiographs, clinical date, including swollen joint, patient global assessment (AIMS), and laboratory examinations including ESR, RF, APF, and AKA were obtained at the same time. Functional disability was assessed using the Health Assessment Questionnaire Disability Score. Results: In 50 patients, all had pannus on MRI of wrists, 38 patients had enhanced signal intensity for pannus, 21 patients had bone marrow edema, 37 patients had joint effusion, and 37 patients had bone erosions. There were significant difference in the ESR, HAQ, AIMS as well as swollen joint count between patients with bone marrow edema and patients without bone marrow edema (P 2 =5.06, P=0.025; χ 2 =5.59, P=0.018). Number of patients with MRI erosion of wrists was associated with the number of patients without MRI bone marrow edema of wrists (χ 2 =5.11, P=0.024). Conclusion: MRI can find the appearances of wrists with RA. Comparing MRI with clinical examinations on wrists with RA, authors can assess and evaluate the role of MRI on RA

  16. Sequential MRI, SPECT and PET in respiratory syncytial virus encephalitis

    International Nuclear Information System (INIS)

    Hirayama, K.; Sakazaki, Hiromi; Murakami, Seiko; Yonezawa, Sumiko; Fujimoto, Keiji; Seto, Toshiyuki; Tanaka, Katsuji; Hattori, Hideji; Matsuoka, Osamu; Murata, Ryosuke

    1999-01-01

    We report on a 3-year-old girl with respiratory syncytial virus (RSV) encephalitis manifested by disturbance of consciousness, conjugate eye deviation, anuria, truncal ataxia and intention tremor. T2-weighted magnetic resonance imaging (MRI) showed hyperintense areas in the cerebellar cortex. No lesion was detected in the cerebral cortex, pons or spinal cord. The hyperintense areas in the cerebellar cortex diminished with recovery from the clinical manifestations and had resolved 2 months after onset. The MRI lesions in the cerebellum were considered to be due to oedema. SPECT and positron emission tomography (PET), performed 3 months after onset, disclosed areas of hypoperfusion and hypometabolism at the same sites. One year after onset, MRI showed mild atrophy of the cerebellum. Hypoperfusion on SPECT and hypometabolism on PET remained. Neuroimaging showed that ataxia and tremor in this case were the result of cerebellitis. The patient has no neurological deficit except for mild truncal ataxia. This patient is a rare example of RSV encephalitis. (orig.)

  17. Craniocerebral trauma. Magnetic resonance imaging of diffuse axonal injury

    International Nuclear Information System (INIS)

    Mallouhi, A.

    2014-01-01

    Acceleration-deceleration rotational brain trauma is a common cause of disability or death in young adults and often leads to a focal destruction of axons. The resulting pathology, axonal shear injury is referred to as diffuse axonal injury (DAI). The DAI-associated lesions occur bilaterally, are widely dispersed and have been observed in the surface and deep white matter. They are found near to and far from the impact site. When DAI is clinically suspected, magnetic resonance imaging (MRI) is the method of choice for further clarification, especially in patients where cranial computed tomography (CT) is inconspicuous. To investigate the presence of DAI after traumatic brain injury (TBI), a multimodal MRI approach is applied including the common structural and also functional imaging sequences. For structural MRI, fluid-attenuated inversion recovery (FLAIR) weighted and susceptibility contrast imaging (SWI) are the sequences mainly used. The SWI technique is extremely sensitive to blood breakdown products, which appear as small signal voids at three locations, at the gray-white interface, in the corpus callosum and in the brain stem. Functional MRI comprises a group of constantly developing techniques that have great potential in optimal evaluation of the white matter in patients after craniocerebral trauma. These imaging techniques allow the visualization of changes associated with shear injuries, such as functional impairment of axons and decreased blood flow and abnormal metabolic activity of the brain parts affected. The multimodal MRI approach in patients with DAI results in a more detailed and differentiated representation of the underlying pathophysiological changes of the injured nerve tracts and helps to improve the diagnostic and prognostic accuracy of MRI. When DAI is suspected multimodal MRI should be performed as soon as possible after craniocerebral injury. (orig.) [de

  18. Changes in brain activation induced by visual stimulus during and after propofol conscious sedation: a functional MRI study.

    Science.gov (United States)

    Shinohe, Yutaka; Higuchi, Satomi; Sasaki, Makoto; Sato, Masahito; Noda, Mamoru; Joh, Shigeharu; Satoh, Kenichi

    2016-12-07

    Conscious sedation with propofol sometimes causes amnesia while keeping the patient awake. However, it remains unknown how propofol compromises the memory function. Therefore, we investigated the changes in brain activation induced by visual stimulation during and after conscious sedation with propofol using serial functional MRI. Healthy volunteers received a target-controlled infusion of propofol, and underwent functional MRI scans with a block-design paradigm of visual stimulus before, during, and after conscious sedation. Random-effect model analyses were performed using Statistical Parametric Mapping software. Among the areas showing significant activation in response to the visual stimulus, the visual cortex and fusiform gyrus were significantly suppressed in the sedation session and tended to recover in the early-recovery session of ∼20 min (Psedation and early-recovery sessions (Psedation with propofol may cause prolonged suppression of the activation of memory-related structures, such as the hippocampus, during the early-recovery period, which may lead to transient amnesia.

  19. Apparent diffusion coefficient histogram metrics correlate with survival in diffuse intrinsic pontine glioma: a report from the Pediatric Brain Tumor Consortium

    Science.gov (United States)

    Poussaint, Tina Young; Vajapeyam, Sridhar; Ricci, Kelsey I.; Panigrahy, Ashok; Kocak, Mehmet; Kun, Larry E.; Boyett, James M.; Pollack, Ian F.; Fouladi, Maryam

    2016-01-01

    Background Diffuse intrinsic pontine glioma (DIPG) is associated with poor survival regardless of therapy. We used volumetric apparent diffusion coefficient (ADC) histogram metrics to determine associations with progression-free survival (PFS) and overall survival (OS) at baseline and after radiation therapy (RT). Methods Baseline and post-RT quantitative ADC histograms were generated from fluid-attenuated inversion recovery (FLAIR) images and enhancement regions of interest. Metrics assessed included number of peaks (ie, unimodal or bimodal), mean and median ADC, standard deviation, mode, skewness, and kurtosis. Results Based on FLAIR images, the majority of tumors had unimodal peaks with significantly shorter average survival. Pre-RT FLAIR mean, mode, and median values were significantly associated with decreased risk of progression; higher pre-RT ADC values had longer PFS on average. Pre-RT FLAIR skewness and standard deviation were significantly associated with increased risk of progression; higher pre-RT FLAIR skewness and standard deviation had shorter PFS. Nonenhancing tumors at baseline showed higher ADC FLAIR mean values, lower kurtosis, and higher PFS. For enhancing tumors at baseline, bimodal enhancement histograms had much worse PFS and OS than unimodal cases and significantly lower mean peak values. Enhancement in tumors only after RT led to significantly shorter PFS and OS than in patients with baseline or no baseline enhancement. Conclusions ADC histogram metrics in DIPG demonstrate significant correlations between diffusion metrics and survival, with lower diffusion values (increased cellularity), increased skewness, and enhancement associated with shorter survival, requiring future investigations in large DIPG clinical trials. PMID:26487690

  20. 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)

  1. Leukoencephalopathy with brainstem and spinal cord involvement and lactate elevation (LBSL): Assessment of the involved white matter tracts by MRI

    Energy Technology Data Exchange (ETDEWEB)

    Kassem, Hassan [Department of Radiology, Benha University (Egypt); Wafaie, Ahmed, E-mail: a_wafaie@yahoo.com [Department of Radiology, Cairo University (Egypt); Abdelfattah, Sherif [Department of Radiology, Cairo University (Egypt); Farid, Tarek [Pediatric Department, Egyptian National Research Center (Egypt)

    2014-01-15

    Background and purpose: Leukoencephalopathy with brain stem and spinal cord involvement and lactate elevation (LBSL) is a recently identified autosomal recessive disorder with early onset of symptoms and slowly progressive pyramidal, cerebellar and dorsal column dysfunction. LBSL is characterized by distinct white matter abnormalities and selective involvement of brainstem and spinal cord tracts. The purpose of this study is to assess the imaging features of the involved white matter tracts in cases of LBSL by MRI. Patients and methods: We retrospectively reviewed the imaging features of the selectively involved white matter tracts in sixteen genetically proven cases of leukoencephalopathy with brainstem and spinal cord involvement and elevated brain lactate (LBSL). All patients presented with slowly progressive cerebellar sensory ataxia with spasticity and dorsal column dysfunction. MRI of the brain and spine using 1.5 T machine and proton magnetic resonance spectroscopy ({sup 1}H MRS) on the abnormal white matter were done to all patients. The MRI and MRS data sets were analyzed according to lesion location, extent, distribution and signal pattern as well as metabolite values and ratios in MRS. Laboratory examinations ruled out classic leukodystrophies. Results: In all cases, MRI showed high signal intensity in T2-weighted and FLAIR images within the cerebral subcortical, periventricular and deep white matter, posterior limbs of internal capsules, centrum semiovale, medulla oblongata, intraparenchymal trajectory of trigeminal nerves and deep cerebellar white matter. In the spine, the signal intensity of the dorsal column and lateral cortico-spinal tracts were altered in all patients. The subcortical U fibers, globi pallidi, thalami, midbrain and transverse pontine fibers were spared in all cases. In 11 cases (68.8%), the signal changes were inhomogeneous and confluent whereas in 5 patients (31.2%), the signal abnormalities were spotty. MRI also showed variable

  2. Leukoencephalopathy with brainstem and spinal cord involvement and lactate elevation (LBSL): Assessment of the involved white matter tracts by MRI

    International Nuclear Information System (INIS)

    Kassem, Hassan; Wafaie, Ahmed; Abdelfattah, Sherif; Farid, Tarek

    2014-01-01

    Background and purpose: Leukoencephalopathy with brain stem and spinal cord involvement and lactate elevation (LBSL) is a recently identified autosomal recessive disorder with early onset of symptoms and slowly progressive pyramidal, cerebellar and dorsal column dysfunction. LBSL is characterized by distinct white matter abnormalities and selective involvement of brainstem and spinal cord tracts. The purpose of this study is to assess the imaging features of the involved white matter tracts in cases of LBSL by MRI. Patients and methods: We retrospectively reviewed the imaging features of the selectively involved white matter tracts in sixteen genetically proven cases of leukoencephalopathy with brainstem and spinal cord involvement and elevated brain lactate (LBSL). All patients presented with slowly progressive cerebellar sensory ataxia with spasticity and dorsal column dysfunction. MRI of the brain and spine using 1.5 T machine and proton magnetic resonance spectroscopy ( 1 H MRS) on the abnormal white matter were done to all patients. The MRI and MRS data sets were analyzed according to lesion location, extent, distribution and signal pattern as well as metabolite values and ratios in MRS. Laboratory examinations ruled out classic leukodystrophies. Results: In all cases, MRI showed high signal intensity in T2-weighted and FLAIR images within the cerebral subcortical, periventricular and deep white matter, posterior limbs of internal capsules, centrum semiovale, medulla oblongata, intraparenchymal trajectory of trigeminal nerves and deep cerebellar white matter. In the spine, the signal intensity of the dorsal column and lateral cortico-spinal tracts were altered in all patients. The subcortical U fibers, globi pallidi, thalami, midbrain and transverse pontine fibers were spared in all cases. In 11 cases (68.8%), the signal changes were inhomogeneous and confluent whereas in 5 patients (31.2%), the signal abnormalities were spotty. MRI also showed variable signal

  3. Degeneration of pyramidal tract of MRI (magnetic resonance imaging)

    International Nuclear Information System (INIS)

    Yamagami, Tatsuhito; Harada, Noboru; Gotoh, Yasunobu; Imataka, Kiyoharu; Kinuta, Yuji; Okumura, Teizo; Niijima, Kyo; Taki, Waro; Kikuchi, Haruhiko.

    1988-01-01

    MRI (magnetic resonance imaging) examinaion was performed on cases of hemiplegia and hemiparesis. These included seven cases of intracerebral hemorrhage, four cases of subarachnoid hemorrhage, one case of cerebral infarct, and two cases of head trauma. The pyramidal tract in the brain stem was studied in five patients with complete hemiplegia and in nine with incomplete hemiparesis. The scanner of the MRI was a resistive type operating at a field of 0.2 Tesla. The inversion recovery (IR) and saturation recovery (SR) techniques were utilized. The pyramidal tract at the level of the midbrain and the pons was recognized as a low intensity area on the T 1 image (IR 1500/43) in the cases of complete hemiplegia. However, it was recognized as a high intensity area on the SR image (SR 1000/60) and the T 2 image (SR 2000/100). No abnormal signal intensity was found in the cases of incomplete hemiparesis. A low intensity area on the T 1 image and a high intensity area on the T 2 image were recognized in the ventral portion of the midbrain and the pons on the affected side. These findings indicate a degeneration of the pyramidal tract at the level of the brain stem in patients with complete hemiplegia. (author)

  4. Extra-ocular muscle MRI in genetically-defined mitochondrial disease

    International Nuclear Information System (INIS)

    Pitceathly, Robert D.S.; Morrow, Jasper M.; Hanna, Michael G.; Sinclair, Christopher D.J.; Yousry, Tarek A.; Thornton, John S.; Woodward, Cathy; Sweeney, Mary G.; Rahman, Shamima; Plant, Gordon T.; Ali, Nadeem; Bremner, Fion; Davagnanam, Indran

    2016-01-01

    Conventional and quantitative MRI was performed in patients with chronic progressive external ophthalmoplegia (CPEO), a common manifestation of mitochondrial disease, to characterise MRI findings in the extra-ocular muscles (EOMs) and investigate whether quantitative MRI provides clinically relevant measures of disease. Patients with CPEO due to single mitochondrial DNA deletions were compared with controls. Range of eye movement (ROEM) measurements, peri-orbital 3 T MRI T1-weighted (T1w) and short-tau-inversion-recovery (STIR) images, and T2 relaxation time maps were obtained. Blinded observers graded muscle atrophy and T1w/STIR hyperintensity. Cross-sectional areas and EOM mean T2s were recorded and correlated with clinical parameters. Nine patients and nine healthy controls were examined. Patients had reduced ROEM (patients 13.3 , controls 49.3 , p < 0.001), greater mean atrophy score and increased T1w hyperintensities. EOM mean cross-sectional area was 43 % of controls and mean T2s were prolonged (patients 75.6 ± 7.0 ms, controls 55.2 ± 4.1 ms, p < 0.001). ROEM correlated negatively with EOM T2 (rho = -0.89, p < 0.01), whilst cross-sectional area failed to correlate with any clinical measures. MRI demonstrates EOM atrophy, characteristic signal changes and prolonged T2 in CPEO. Correlation between elevated EOM T2 and ROEM impairment represents a potential measure of disease severity that warrants further evaluation. (orig.)

  5. Extra-ocular muscle MRI in genetically-defined mitochondrial disease

    Energy Technology Data Exchange (ETDEWEB)

    Pitceathly, Robert D.S.; Morrow, Jasper M.; Hanna, Michael G. [UCL Institute of Neurology and National Hospital for Neurology and Neurosurgery, MRC Centre for Neuromuscular Diseases, London (United Kingdom); Sinclair, Christopher D.J.; Yousry, Tarek A.; Thornton, John S. [UCL Institute of Neurology and National Hospital for Neurology and Neurosurgery, MRC Centre for Neuromuscular Diseases, London (United Kingdom); UCL Institute of Neurology, Neuroradiological Academic Unit, Department of Brain Repair and Rehabilitation, London (United Kingdom); Woodward, Cathy; Sweeney, Mary G. [National Hospital for Neurology and Neurosurgery, Neurogenetics Unit, London (United Kingdom); Rahman, Shamima [UCL Institute of Neurology and National Hospital for Neurology and Neurosurgery, MRC Centre for Neuromuscular Diseases, London (United Kingdom); UCL Institute of Child Health, Mitochondrial Research Group, Clinical and Molecular Genetics Unit, London (United Kingdom); Plant, Gordon T.; Ali, Nadeem [National Hospital for Neurology and Neurosurgery, Department of Neuro-ophthalmology, London (United Kingdom); Moorfields Eye Hospital, Department of Neuro-ophthalmology, London (United Kingdom); Bremner, Fion [National Hospital for Neurology and Neurosurgery, Department of Neuro-ophthalmology, London (United Kingdom); Davagnanam, Indran [National Hospital for Neurology and Neurosurgery, The Lysholm Department of Neuroradiology, London (United Kingdom)

    2016-01-15

    Conventional and quantitative MRI was performed in patients with chronic progressive external ophthalmoplegia (CPEO), a common manifestation of mitochondrial disease, to characterise MRI findings in the extra-ocular muscles (EOMs) and investigate whether quantitative MRI provides clinically relevant measures of disease. Patients with CPEO due to single mitochondrial DNA deletions were compared with controls. Range of eye movement (ROEM) measurements, peri-orbital 3 T MRI T1-weighted (T1w) and short-tau-inversion-recovery (STIR) images, and T2 relaxation time maps were obtained. Blinded observers graded muscle atrophy and T1w/STIR hyperintensity. Cross-sectional areas and EOM mean T2s were recorded and correlated with clinical parameters. Nine patients and nine healthy controls were examined. Patients had reduced ROEM (patients 13.3 , controls 49.3 , p < 0.001), greater mean atrophy score and increased T1w hyperintensities. EOM mean cross-sectional area was 43 % of controls and mean T2s were prolonged (patients 75.6 ± 7.0 ms, controls 55.2 ± 4.1 ms, p < 0.001). ROEM correlated negatively with EOM T2 (rho = -0.89, p < 0.01), whilst cross-sectional area failed to correlate with any clinical measures. MRI demonstrates EOM atrophy, characteristic signal changes and prolonged T2 in CPEO. Correlation between elevated EOM T2 and ROEM impairment represents a potential measure of disease severity that warrants further evaluation. (orig.)

  6. MRI for clinically suspected pediatric appendicitis: an implemented program

    Energy Technology Data Exchange (ETDEWEB)

    Moore, Michael M.; Gustas, Cristy N.; Choudhary, Arabinda K.; Methratta, Sosamma T.; Hulse, Michael A.; Eggli, Kathleen D.; Boal, Danielle K.B. [Penn State Milton S. Hershey Medical Center, Department of Radiology, Mail Code H066, 500 University Drive, P.O. Box 850, Hershey, PA (United States); Geeting, Glenn [Penn State Milton S. Hershey Medical Center, Department of Emergency Medicine, Hershey, PA (United States)

    2012-09-15

    Emergent MRI is now a viable alternative to CT for evaluating appendicitis while avoiding the detrimental effects of ionizing radiation. However, primary employment of MRI in the setting of clinically suspected pediatric appendicitis has remained significantly underutilized. To describe our institution's development and the results of a fully implemented clinical program using MRI as the primary imaging evaluation for children with suspected appendicitis. A four-sequence MRI protocol consisting of coronal and axial single-shot turbo spin-echo (SS-TSE) T2, coronal spectral adiabatic inversion recovery (SPAIR), and axial SS-TSE T2 with fat saturation was performed on 208 children, ages 3 to 17 years, with clinically suspected appendicitis. No intravenous or oral contrast material was administered. No sedation was administered. Data collection includes two separate areas: time parameter analysis and MRI diagnostic results. Diagnostic accuracy of MRI for pediatric appendicitis indicated a sensitivity of 97.6% (CI: 87.1-99.9%), specificity 97.0% (CI: 93.2-99.0%), positive predictive value 88.9% (CI: 76.0-96.3%), and negative predictive value 99.4% (CI: 96.6-99.9%). Time parameter analysis indicated clinical feasibility, with time requested to first sequence obtained mean of 78.7 +/- 52.5 min, median 65 min; first-to-last sequence time stamp mean 14.2 +/- 8.8 min, median 12 min; last sequence to report mean 57.4 +/- 35.2 min, median 46 min. Mean age was 11.2 +/- 3.6 years old. Girls represented 57% of patients. MRI is an effective and efficient method of imaging children with clinically suspected appendicitis. Using an expedited four-sequence protocol, sensitivity and specificity are comparable to CT while avoiding the detrimental effects of ionizing radiation. (orig.)

  7. MRI signal changes of the bone marrow in HIV-infected patients with lipodystrophy: correlation with clinical parameters

    International Nuclear Information System (INIS)

    Garcia, Ana I.; Tomas, Xavier; Pomes, Jaume; Amo, Montserrat del; Milinkovic, Ana; Perez, Inaki; Mallolas, Josep; Rios, Jose; Vidal-Sicart, Sergi

    2011-01-01

    To assess the prevalence, imaging appearance, and clinical significance, of bone marrow MR signal changes in a group of human immunodeficiency virus (HIV)-infected patients with lipodystrophy syndrome. Twenty-eight HIV-infected patients with lipodystrophy syndrome treated with highly active antiretroviral therapy, and 12 HIV-negative controls underwent MRI of the legs. Whole-body MRI, SPECT/CT, and a complete radiographic skeletal survey were obtained in subjects with signal changes in bone marrow. MRI and clinical evaluations were reviewed 6 months after baseline to determine changes after switching from thymidine analogs (TA) to tenofovir-DF (TDF). MRI results correlated with clinical parameters. We observed foci of a serous-like pattern (low signal and no enhancement on T1-weighted, high signal on T2-weighted images) in 4 out of 28 patients (14.3%) and an intermediate signal on T1-weighted images in 4 out of 28 patients (14.3%). Serous-like lesions were located in the lower limbs and scattered in the talus, calcaneus, femurs, and humeral bones; they showed slight uptake on SPECT bone scans and were normal on CT and radiographs. Patients with serous-like lesions had significantly lower peripheral and total fat at baseline than other groups (P < 0.05). No changes at 6 months were observed on MRI, and the serous-like lesion group showed good peripheral fat recovery after changing drug treatment. A serous-like MRI pattern is observed in the peripheral skeletons of HIV-infected patients with lipodystrophy, which correlates with peripheral lipoatrophy, and should not be misdiagnosed as malignant or infectious diseases. Although the MR lesions did not improve after switching the treatment, there was evidence of lipoatrophy recovery. (orig.)

  8. Tuberous sclerosis: diffusion MRI findings in the brain

    International Nuclear Information System (INIS)

    Sener, R.N.

    2002-01-01

    Diffusion MRI has mainly been used for detection of acute ischemia, and for distinction of cytotoxic and vasogenic edema. We applied diffusion MRI in patients with tuberous sclerosis in order to evaluate diffusion imaging characteristics of parenchymal changes. Five children with known tuberous sclerosis were included in this study. The MRI examinations were performed on a 1.5-T MR unit. Diffusion MRI was obtained using the echo-planar imaging sequence. Apparent diffusion coefficient (ADC) values from the abnormal brain parenchyma were calculated directly from automatically generated ADC maps. Seven normal children were available for comparison. In this control group the mean ADC value of the normal white matter was 0.84±0.12 x 10 -3 mm 2 /s. In tuberous sclerosis patients the mean ADC value of the white matter hamartomas (n=20) was apparently high (1.52±0.24 x 10 -3 mm 2 /s) compared with that of normal white matter. The ADC value of calcified hamartomas was ''zero''. The ADC value within a giant cell tumor was 0.89 x 10 -3 mm 2 /s, similar to that of normal cerebral white matter. The ADC maps were superior to b=1000 s/mm 2 (true diffusion) images with respect to lesion evaluation, and they provided mathematical information on tissue integrity. With respect to detection of the exact numbers and sizes of the parenchymal hamartomas fluid-attenuated inversion recovery images were superior to ADC maps. It is believed that diffusion MRI can be useful in evaluation of various parenchymal changes associated with tuberous sclerosis. Further studies on tuberous sclerosis, and on various brain lesions, would provide increasing data on this relatively new MRI sequence. (orig.)

  9. Usefulness of muscle denervation as an MRI sign of peripheral nerve pathology

    International Nuclear Information System (INIS)

    Lisle, D. A.; Johnstone, S. A.

    2007-01-01

    Full text: Peripheral nerve disorders may be classified into compressive or entrapment neuropathies and non-compressive neuropathies. Muscle denervation recognized on MRI may be a useful sign in the diagnosis of peripheral nerve disorders. Acute or subacute denervation results in prolonged T 2 relaxation time, producing increased signal in skeletal muscle on short tau inversion-recovery and fat-suppressed T 2 -weighted images. Chronic denervation produces fatty atrophy of skeletal muscles, resulting in increased muscle signal on T 1 -weighted images. This review will outline and illustrate the various ways that muscle denervation as seen on MRI may assist in the diagnosis and localization of peripheral nerve disorders

  10. 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)

  11. Transient Splenial Lesion of Corpus Callosum Associated with Antiepileptic Drug: Conventional and Diffusion-weighted Magnetic Resonance Images

    Energy Technology Data Exchange (ETDEWEB)

    Hakyemez, B.; Erdogan, C.; Yildirim, N.; Gokalp, G.; Parlak, M. [Uludag Univ. Medical School, Bursa (Turkey). Dept. of Radiology

    2005-11-01

    Transient focal lesions of splenium of corpus callosum can be seen as a component of many central nervous system diseases, including antiepileptic drug toxicity. The conventional magnetic resonance (MR) findings of the disease are characteristic and include ovoid lesions with high signal intensity at T2-weighted MRI. Limited information exists about the diffusion-weighted MRI characteristics of these lesions vanishing completely after a period of time. We examined the conventional, FLAIR, and diffusion-weighted MR images of a patient complaining of depressive mood and anxiety disorder after 1 year receiving antiepileptic medication.

  12. Unusual MRI findings in grey matter heteropia

    International Nuclear Information System (INIS)

    Soto Ares, G.; Hamon-Kerautret, M.; Leclerc, X.; Pruvo, J.P.; Houlette, C.; Godefroy, O.

    1998-01-01

    We report unusual MRI patterns in patients with grey matter heterotopia. Standard T1- and T2-weighted spin-echo and inversion-recovery sequences were used in 22 patients presenting with seizures or developmental delay. The images were reviewed for signal change surrounding white matter and for atypical size, morphology or topography. We found 10 cases of subependymal heterotopias 11 of focal subcortical heterotopia and of diffuse subcortical heterotopia. On clinical or MRI grounds, 8 cases were considered unusual: 2 of the subependymal type, 2 of focal subcortical heterotopia with white matter abnormalities, 2 of focal subcortical heterotopia with no clinicoradiological correlation 1 of extensive hemispheric subcortical heterotopia and 1 of diffuse subcortical heterotopia confined to the frontal lobe. The classical classification of heterotopia enables easy radiological diagnosis even in cases with unusual patterns. In some cases, heterogeneity and high signal in surrounding white matter can be found. Cortical dysplasia is the most frequent associated malformation. (orig.)

  13. An MRI rating scale for amyloid-related imaging abnormalities with edema or effusion

    NARCIS (Netherlands)

    Barkhof, F.; Daams, M.; Scheltens, P.; Brashear, H.R.; Arrighi, H.M.; Bechten, A.K.; Morris, K.; McGovern, M.; Wattjes, M.P.

    2013-01-01

    BACKGROUND AND PURPOSE: Immune therapy against amyloid-Appears to be a promising target in Alzheimer disease. However, a dose-related risk for ARIA on FLAIR images thought to represent parenchymal vasogenic edema or sulcal effusion (termed "ARIA-E"), has been observed in clinical trials. To assess

  14. Imaging network level language recovery after left PCA stroke.

    Science.gov (United States)

    Sebastian, Rajani; Long, Charltien; Purcell, Jeremy J; Faria, Andreia V; Lindquist, Martin; Jarso, Samson; Race, David; Davis, Cameron; Posner, Joseph; Wright, Amy; Hillis, Argye E

    2016-05-11

    The neural mechanisms that support aphasia recovery are not yet fully understood. Our goal was to evaluate longitudinal changes in naming recovery in participants with posterior cerebral artery (PCA) stroke using a case-by-case analysis. Using task based and resting state functional magnetic resonance imaging (fMRI) and detailed language testing, we longitudinally studied the recovery of the naming network in four participants with PCA stroke with naming deficits at the acute (0 week), sub acute (3-5 weeks), and chronic time point (5-7 months) post stroke. Behavioral and imaging analyses (task related and resting state functional connectivity) were carried out to elucidate longitudinal changes in naming recovery. Behavioral and imaging analysis revealed that an improvement in naming accuracy from the acute to the chronic stage was reflected by increased connectivity within and between left and right hemisphere "language" regions. One participant who had persistent moderate naming deficit showed weak and decreasing connectivity longitudinally within and between left and right hemisphere language regions. These findings emphasize a network view of aphasia recovery, and show that the degree of inter- and intra- hemispheric balance between the language-specific regions is necessary for optimal recovery of naming, at least in participants with PCA stroke.

  15. High-speed imaging at 3 tesla. A technical and clinical review with an emphasis on whole-brain 3D imaging

    International Nuclear Information System (INIS)

    Naganawa, Shinji; Kawai, Hisashi; Fukatsu, Hiroshi; Ishigaki, Takeo; Komada, Tomomi

    2005-01-01

    Improvements to the inherently high specific-absorption rate (SAR) of high-speed imaging at 3T are necessary in order to render this method clinically feasible. Various efforts have been undertaken to improve the associated hardware and software. In this review, we focus on whole-brain isotropic 3D imaging with a turbo spin-echo sequence with variable flip-angle echo trains (3D-TSE-VFL) and present its technical and clinical features. This sequence can be used to acquire images of various contrasts including T 2 -weighted, fat-suppressed T 2 -weighted, fluid-attenuated inversion recovery (FLAIR), fat-suppressed FLAIR, and STIR (short tau inversion recovery). Various aspects of 3D-TSE-VFL are discussed, including CSF (cerebrospinal fluid) and metal artifacts, STIR contrast, small-part visualization other than brain, and the possibility of serial subtraction. Some images from clinical cases are presented. (author)

  16. Craniocerebral trauma. Magnetic resonance imaging of diffuse axonal injury; Schaedel-Hirn-Trauma. MRT bei diffuser axonaler Verletzung

    Energy Technology Data Exchange (ETDEWEB)

    Mallouhi, A. [Medizinische Universitaet Wien, Allgemeines Krankenhaus, Abteilung fuer Neuro- und Muskuloskelettale Radiologie, Klinik fuer Radiologie und Nuklearmedizin, Wien (Austria)

    2014-09-15

    Acceleration-deceleration rotational brain trauma is a common cause of disability or death in young adults and often leads to a focal destruction of axons. The resulting pathology, axonal shear injury is referred to as diffuse axonal injury (DAI). The DAI-associated lesions occur bilaterally, are widely dispersed and have been observed in the surface and deep white matter. They are found near to and far from the impact site. When DAI is clinically suspected, magnetic resonance imaging (MRI) is the method of choice for further clarification, especially in patients where cranial computed tomography (CT) is inconspicuous. To investigate the presence of DAI after traumatic brain injury (TBI), a multimodal MRI approach is applied including the common structural and also functional imaging sequences. For structural MRI, fluid-attenuated inversion recovery (FLAIR) weighted and susceptibility contrast imaging (SWI) are the sequences mainly used. The SWI technique is extremely sensitive to blood breakdown products, which appear as small signal voids at three locations, at the gray-white interface, in the corpus callosum and in the brain stem. Functional MRI comprises a group of constantly developing techniques that have great potential in optimal evaluation of the white matter in patients after craniocerebral trauma. These imaging techniques allow the visualization of changes associated with shear injuries, such as functional impairment of axons and decreased blood flow and abnormal metabolic activity of the brain parts affected. The multimodal MRI approach in patients with DAI results in a more detailed and differentiated representation of the underlying pathophysiological changes of the injured nerve tracts and helps to improve the diagnostic and prognostic accuracy of MRI. When DAI is suspected multimodal MRI should be performed as soon as possible after craniocerebral injury. (orig.) [German] Das Rotationstrauma des Gehirns ist bei jungen Erwachsenen ein haeufiger Grund

  17. Methotrexate-induced acute toxic leukoencephalopathy

    Directory of Open Access Journals (Sweden)

    Parag R Salkade

    2012-01-01

    Full Text Available Acute lymphoblastic leukemia (ALL is one of the most common malignancies of childhood, which is treated with high doses of methotrexate (MTX, as it crosses the blood-brain barrier and can be administered intravenously and via intrathecal route to eradicate leukemic cells from central nervous system (CNS. Additionally, high doses of MTX not only prevent CNS recurrence but also hematologic relapses. Although, standard treatment protocol for ALL includes multimodality therapy, MTX is usually associated with neurotoxicity and affects periventricular deep white matter region. Methotrexate-induced ′acute toxic leukoencephalopathy′ has varying clinical manifestations ranging from acute neurological deficit to seizures or encephalopathy. Diffusion weighted magnetic resonance imaging (DW-MRI is widely available and routinely used in clinical practice to identify acute stroke and also to distinguish acute stroke from non-stroke like conditions. We report a local teenage Chinese girl who developed 2 discrete episodes of left upper and lower limb weakness with left facial nerve paresis after receiving the 2 nd and 3 rd cycle of high dose of intravenous and intrathecal methotrexate, without having cranial irradiation. After each episode of her neurological deficit, the DW-MRI scan showed focal restricted diffusion in right centrum semiovale. Her left sided focal neurological deficit and facial nerve paresis almost completely subsided on both these occasions within 3 days of symptom onset. Follow-up DW-MRI, after her neurological recovery, revealed almost complete resolution of previously noted restricted diffusion in right centrum semiovale, while the lesion was not evident on concurrent T2W (T2-weighted and FLAIR (Fluid-Attenuated Inversion recovery sequences, nor showed any post contrast enhancement on post gadolinium enhanced T1W (T1-weighted sequences. No residual neurological deficit or intellectual impairment was identified on clinical follow up

  18. Heart MRI

    Science.gov (United States)

    Magnetic resonance imaging - cardiac; Magnetic resonance imaging - heart; Nuclear magnetic resonance - cardiac; NMR - cardiac; MRI of the heart; Cardiomyopathy - MRI; Heart failure - MRI; Congenital heart disease - MRI

  19. Transient Global Amnesia with Reversible White Matter Lesions: A Variant of Posterior Reversible Encephalopathy Syndrome?

    Directory of Open Access Journals (Sweden)

    Tomoki Nakamizo

    2015-01-01

    Full Text Available Transient global amnesia (TGA is a self-limited disease characterized by isolated amnesia, which resolves within 24 h. In contrast, posterior reversible encephalopathy syndrome (PRES is a potentially life-threatening disease that usually presents with seizures, altered mental status, headache, and visual disturbances. It is characterized by reversible vasogenic edema that predominantly involves the parieto-occipital subcortical white matter as shown by neuroimaging studies. To date, there have been no reported cases of PRES with a clinical course resembling TGA. Here we report the case of a 58-year-old woman who presented with isolated amnesia and headache. On admission, her blood pressure was 187/100 mmHg. She had complete anterograde amnesia and slight retrograde amnesia without other neurological findings. After the treatment of her hypertension, the amnesia resolved within 24 h. Although the initial magnetic resonance image (MRI was almost normal, the fluid attenuation inversion recovery (FLAIR images of the MRI on the next day revealed several small foci of high intensity areas in the fronto-parieto-occipital subcortical white matter, presumed to be vasogenic edema in PRES. The lesions disappeared one month later. This case suggests that PRES can mimic the clinical course of TGA. PRES should be considered in the differential diagnosis for TGA.

  20. Development of a screening MRI for infants at risk for abusive head trauma

    Energy Technology Data Exchange (ETDEWEB)

    Flom, Lynda; Panigrahy, Ashok [Children' s Hospital of Pittsburgh of UPMC, Department of Radiology, Pittsburgh, PA (United States); Fromkin, Janet [University of Pittsburgh, Department of Pediatrics, Children' s Hospital of Pittsburgh of UPMC, Pittsburgh, PA (United States); Tyler-Kabara, Elizabeth [University of Pittsburgh, Department of Neurosurgery, Children' s Hospital of Pittsburgh of UPMC, McGowan Institute for Regenerative Medicine, Pittsburgh, PA (United States); Berger, Rachel P. [University of Pittsburgh, Department of Pediatrics, Children' s Hospital of Pittsburgh of UPMC, Pittsburgh, PA (United States); University of Pittsburgh, Safar Center for Resuscitation Research, Pittsburgh, PA (United States)

    2016-04-15

    Abusive head trauma (AHT) is an important cause of morbidity in infants. Identifying which well-appearing infants are at risk for AHT and need neuroimaging is challenging, and concern about radiation exposure limits the use of head CT. Availability of an MRI protocol that is highly sensitive for intracranial hemorrhage would allow for AHT screening of well-appearing infants without exposing them to radiation. To develop a screening MRI protocol to identify intracranial hemorrhage in well-appearing infants at risk for AHT. Infants enrolled in a parent study of well-appearing infants at increased risk for AHT were eligible for the current study if they underwent both head CT and conventional brain MRI. A derivation cohort of nine infants with AHT was used to identify sequences that provided the highest sensitivity for intracranial hemorrhage. A validation cohort of 78 infants including both controls with normal neuroimaging and cases with AHT was used to evaluate the accuracy of the selected sequences. Three pulse sequences - axial T2, axial gradient recalled echo (GRE) and coronal T1-W inversion recovery - were 100% sensitive for intracranial hemorrhage in the derivation cohort. The same sequences were 100% sensitive (25/25) and 83% specific (44/53) for intracranial hemorrhage in the validation cohort. A screening MRI protocol including axial T2, axial GRE and coronal T1-W inversion recovery sequences is highly sensitive for intracranial hemorrhage and may be useful as a screening tool to differentiate well-appearing infants at risk for AHT who should undergo head CT from those who can safely be discharged without head CT. Additional research is needed to evaluate the feasibility of this approach in clinical practice. (orig.)

  1. Muscle MRI STIR signal intensity and atrophy are correlated to focal lower limb neuropathy severity.

    Science.gov (United States)

    Deroide, N; Bousson, V; Mambre, L; Vicaut, E; Laredo, J D; Kubis, Nathalie

    2015-03-01

    The objective is to determine if muscle MRI is useful for assessing neuropathy severity. Clinical, MRI and electromyography (EMG) examinations were performed in 17 patients with focal lower limb neuropathies. MRI Short Tau Inversion Recovery (STIR) signal intensity, amyotrophy, and muscle fatty infiltration measured after T1-weighted image acquisition, EMG spontaneous activity (SA), and maximal voluntary contraction (MVC) were graded using semiquantitative scores and quantitative scores for STIR signal intensity and were correlated to the Medical Research Council (MRC) score for testing muscle strength. Within this population, subgroups were selected according to severity (mild versus severe), duration (subacute versus chronic), and topography (distal versus proximal) of the neuropathy. EMG SA and MVC MRI amyotrophy and quantitative scoring of muscle STIR intensity were correlated with the MRC score. Moreover, MRI amyotrophy was significantly increased in severe, chronic, and proximal neuropathies along with fatty infiltration in chronic lesions. Muscle MRI atrophy and quantitative evaluation of signal intensity were correlated to MRC score in our study. Semiquantitative evaluation of muscle STIR signal was sensitive enough for detection of topography of the nerve lesion but was not suitable to assess severity. Muscle MRI could support EMG in chronic and proximal neuropathy, which showed poor sensitivity in these patients.

  2. Muscle MRI STIR signal intensity and atrophy are correlated to focal lower limb neuropathy severity

    Energy Technology Data Exchange (ETDEWEB)

    Deroide, N.; Mambre, L.; Kubis, Nathalie [Service de Physiologie Clinique-Explorations Fonctionnelles, AP-HP, Hopital Lariboisiere, Paris (France); Universite Paris Diderot, Sorbonne Paris Cite France, Paris (France); Bousson, V.; Laredo, J.D. [Universite Paris Diderot, Sorbonne Paris Cite France, Paris (France); Radiologie Osteo-articulaire, AP-HP, Hopital Lariboisiere, Paris (France); Vicaut, E. [Universite Paris Diderot, Sorbonne Paris Cite France, Paris (France); URC, AP-HP, Hopital Lariboisiere, Paris (France)

    2014-09-26

    The objective is to determine if muscle MRI is useful for assessing neuropathy severity. Clinical, MRI and electromyography (EMG) examinations were performed in 17 patients with focal lower limb neuropathies. MRI Short Tau Inversion Recovery (STIR) signal intensity, amyotrophy, and muscle fatty infiltration measured after T1-weighted image acquisition, EMG spontaneous activity (SA), and maximal voluntary contraction (MVC) were graded using semiquantitative scores and quantitative scores for STIR signal intensity and were correlated to the Medical Research Council (MRC) score for testing muscle strength. Within this population, subgroups were selected according to severity (mild versus severe), duration (subacute versus chronic), and topography (distal versus proximal) of the neuropathy. EMG SA and MVC MRI amyotrophy and quantitative scoring of muscle STIR intensity were correlated with the MRC score. Moreover, MRI amyotrophy was significantly increased in severe, chronic, and proximal neuropathies along with fatty infiltration in chronic lesions. Muscle MRI atrophy and quantitative evaluation of signal intensity were correlated to MRC score in our study. Semiquantitative evaluation of muscle STIR signal was sensitive enough for detection of topography of the nerve lesion but was not suitable to assess severity. Muscle MRI could support EMG in chronic and proximal neuropathy, which showed poor sensitivity in these patients. (orig.)

  3. African Journal of Neurological Sciences 2012 - Vol. 31, No 1 http ...

    African Journals Online (AJOL)

    AJNS WEBMASTERS

    L'imagerie par résonance magnétique cérébrale révélait des hypersignaux ... acquisitions but in Africa the insufficiency of medical care limits this ... sur les séquences T2, Flair réalisées en coupes (axiales, sagittales, coronales) avec injection de gadolinium .... MRI brain scan in type IV 3-methylglutaconic aciduria.

  4. The reliability of magnetic resonance imaging in traumatic brain injury lesion detection

    NARCIS (Netherlands)

    Geurts, B.H.J.; Andriessen, T.M.J.C.; Goraj, B.M.; Vos, P.E.

    2012-01-01

    Objective: This study compares inter-rater-reliability, lesion detection and clinical relevance of T2-weighted imaging (T2WI), Fluid Attenuated Inversion Recovery (FLAIR), T2*-gradient recalled echo (T2*-GRE) and Susceptibility Weighted Imaging (SWI) in Traumatic Brain Injury (TBI). Methods: Three

  5. Comparison of neurite density measured by MRI and histology after TBI.

    Directory of Open Access Journals (Sweden)

    Shiyang Wang

    Full Text Available Functional recovery after brain injury in animals is improved by marrow stromal cells (MSC which stimulate neurite reorganization. However, MRI measurement of neurite density changes after injury has not been performed. In this study, we investigate the feasibility of MRI measurement of neurite density in an animal model of traumatic brain injury (TBI with and without MSC treatment.Fifteen male Wistar rats, were treated with saline (n = 6 or MSCs (n = 9 and were sacrificed at 6 weeks after controlled cortical impact (CCI. Healthy non-CCI rats (n = 5, were also employed. Ex-vivo MRI scans were performed two days after the rats were sacrificed. Multiple-shell hybrid diffusion imaging encoding scheme and spherical harmonic expansion of a two-compartment water diffusion displacement model were used to extract neurite related parameters. Bielshowski and Luxol Fast blue was used for staining axons and myelin, respectively. Modified Morris water maze and neurological severity score (mNSS test were performed for functional evaluation. The treatment effects, the correlations between neurite densities measured by MRI and histology, and the correlations between MRI and functional variables were calculated by repeated measures analysis of variance, the regression correlation analysis tests, and spearman correlation coefficients.Neurite densities exhibited a significant correlation (R(2>0.80, p<1E-20 between MRI and immuno-histochemistry measurements with 95% lower bound of the intra-correlation coefficient (ICC as 0.86. The conventional fractional anisotropy (FA correlated moderately with histological neurite density (R(2 = 0.59, P<1E-5 with 95% lower bound of ICC as 0.76. MRI data revealed increased neurite reorganization with MSC treatment compared with saline treatment, confirmed by histological data from the same animals. mNSS were significantly correlated with MRI neurite density in the hippocampus region.The present studies

  6. The diagnostic utility of resistive MRI for lumbar disc hernias

    International Nuclear Information System (INIS)

    Sakaida, Hiroshi; Hanakita, Junya; Suwa, Hideyuki; Nishihara, Kiyoshi; Nishi, Shogo; Ohta, Fumito; Iihara, Kouji

    1990-01-01

    The diagnostic utility of the 0.1 tesla resistive magnetic resonance imaging (MRI) system was studied for 78 lumbar disc hernias in surgically treated 70 patients. Myelographic appearance of the lumbar disc hernias fell into the following three categories: (1) medial type, compressing the thecal sac; (2) mediolateral type, compressing both the nerve root and thecal sac; and (3) lateral type, compressing the nerve root. MRI was performed in low-flip angle (LF) and saturation-recovery (SR) radiofrequency-pulse sequences for the midline and paramedian sagittal sections, respectively. A transverse section was found positive when the laterality of the disc hermia was obtained. A coronal section was found positive when high-intensity disc material compresisng the nerve root was recognized. Diagnostic capability of MRI was graded in three scores: Excellent- the optimal information was provided; Fair- some pieces of information was obtained, but not enough for diagnosis; Poor- the information was not helpful for diagnosis in deciding the operative procedure. Of 13 medial disc hernias, 84.6% was positive in the sagittal plane and 88.9% in the transverse plane. MRI was superior to myelography in 9 lesions. Of 38 mediolateral disc hernias, 84.2% were positive in the sagittal plane, 74.2% in the transverse plane, and 26.7% in the coronal plane. MRI was judged as excellent for 17 lesions, fair for 15 lesions, and poor for 6 lesions. Of 27 lateral disc hernias, 55.6% were positive in the sagittal plane, 50.0% in the transverse plane, and 30.0% in the coronal plane. MRI was judged as excellent for 4 lesions, fair for 11 lesions, and poor for 12 lesions. Resistive MRI system was of limited value in diagnosing surgical indication of lateral lumbar disc hernias, especially for small but painful lesions. (N.K.)

  7. Magnetic resonance imaging applied to motor neuron disease

    International Nuclear Information System (INIS)

    Markarian, Maria F.; Villarroal, Gonzalo M.; Giavitto, Enrique; Nagel, Jorge

    2005-01-01

    Objective: Differentiate Motor Neuron Disease by MRI. Material and Methods: 10 patients were studied, 7 patients had a diagnosis of definite ALS by the El Escorial criteria, 2 patients had lower motor neuron signs (LMN) and hyperreflexia and one patient had LMN signs without pain. MRI was performed: slices brain: Sagittal T1-weighted, sagittal and axial FSE T2, axial and coronal FLAIR, diffusion, singlevoxel spectroscopy in protuberances. Functional MRI with motor test; slices in cervical spine: Sagittal T1-weighted, sagittal and axial FSE T2, sagittal FSIR. Results: The 7 patients with definite ALS by El Escorial criteria and 2 patients with LMN signs and hyperreflexia: hyperintensity signal in FSE T2 and FLAIR extending from the motor cortex down to the corona radiate, posterior limb of internal capsules, cerebral peduncles and protuberance base; FSE T2: hypointensity sign in motor cortex; elevation in diffusivity and hyperintensity signal in ADC in posterior limb of internal capsule; reduction of NAA, high levels of Glutamine-Glutamate and of Colina. One of these 9 patients showed disc hernia in C4-5, and other patient in C3-C4, C4-C5 without cord lesion. The patient with LMN signs without pain showed normal brain and disc hernia C5-C6, hypertrophy yellow ligament, anterior-posterior diminution of medullar canal, hyperintensity signal in spine cord in the same level in sagittal FSIR. fMRI: increase signal in contralateral, ipsilateral motor area, and areas involved in initiation and planning movement. Conclusion: MRI allow differentiation between ALS and myelopathy cervical spondylitis and others motor neuron disease. (author) [es

  8. Magnetic Resonance Imaging of a Case of Central Neurocytoma.

    Science.gov (United States)

    Dedushi, Kreshnike; Kabashi, Serbeze; Ugurel, Mehmet Sahin; Ramadani, Naser; Mucaj, Sefedin; Zeqiraj, Kamber

    2016-12-01

    The purpose of this study is to investigate the MRI features of central neurocytoma. A 45 year old man with 3 months of worsening daily headaches. These headaches were diffuse, lasted for several hours, and mostly occurred in the morning. She was initially diagnosed and treated for migraines but later he had epileptic attack and diplopia and neurolog recomaded MRI. precontrast MRI; TSE/T2Wsequence in axial/coronal planes; 3D-Hi-resolution T1W sagittal; FLAIR/T2W axial; FLAIR/T2W and Flash/T2W oblique coronal plane (perpendicular to temporal lobes) GRE/T2W axial plane for detection of heme products. Post-contrast TSE/T1W sequence in axial, coronal and sagittal planes. Diffusion weighted and ADC mapping MRI images for EPI sequence in axial plane. A 23x12mm heterogeneous mass within aqueductus cerebri, with calcified and hemorrhagic foci and extending downwards till fourth ventricle. It's originating from the right paramedian posterior aqueductal wall (tectum), and also extending to and involving the tegmentum of mesencephalon at its right paramedian aspect. CSF flow obstruction secondary to described aqueductal mass, with resultant triventricular hydrocephalus). Marked transependymal CSF leak can be noted at periventricular white matter, secondary to severe hydrocephalus. After IV injection of contrast media, this mass shows mild-to-moderate heterogenous speckled enhancement. MRI is helpful in defining tumor extension, which is important in preoperative planning. Although IN is a relatively rare lesion, it should be considered in the differential diagnosis of intraventricular lesions in the presence of such typical MR findings. However, a definitive diagnosis requires immunochemical study and electron microscopy.

  9. Imaging resilience and recovery in alcohol dependence.

    Science.gov (United States)

    Charlet, Katrin; Rosenthal, Annika; Lohoff, Falk W; Heinz, Andreas; Beck, Anne

    2018-05-09

    Resilience and recovery are of increasing importance in the field of alcohol dependence (AD). This paper describes how imaging studies in man can be used to assess the neurobiological correlates of resilience and, if longitudinal, of disease trajectories, progression rates and markers for recovery to inform treatment and prevention options. Original articles on recovery and resilience in alcohol addiction and its neurobiological correlates were identified from 'PubMed' and have been analyzed and condensed within a systematic literature review. Findings deriving from (f)MRI and PET studies have identified links between increased resilience and less task-elicited neural activation within the basal ganglia, and benefits of heightened neural prefrontal cortex (PFC) engagement regarding resilience in a broader sense, namely resilience against relapse in early abstinence of AD. Furthermore, findings consistently propose at least partial recovery of brain glucose metabolism and executive and general cognitive functioning, as well as structural plasticity effects throughout the brain of alcohol-dependent patients during the course of short, medium and long-term abstinence, even when patients only lowered their alcohol consumption to a moderate level. Additionally, specific factors were found that appear to influence these observed brain recovery processes in AD, e.g. genotype-dependent neuronal (re)growth, gender-specific neural recovery effects, critical interfering effects of psychiatric comorbidities, additional smoking or marijuana influences, or adolescent alcohol abuse. Neuroimaging research has uncovered neurobiological markers that appear to be linked to resilience and improved recovery capacities that are furthermore influenced by various factors such as gender or genetics. Consequently, future system-oriented approaches may help to establish a broad neuroscience-based research framework for alcohol dependence. This article is protected by copyright. All rights

  10. MRI-validation of SEP monitoring for ischemic events during microsurgical clipping of intracranial aneurysms.

    Science.gov (United States)

    Krayenbühl, Niklaus; Sarnthein, Johannes; Oinas, Minna; Erdem, Eren; Krisht, Ali F

    2011-09-01

    During surgical clipping of intracranial aneurysms, reduction in SEP amplitude is thought to indicate cortical ischemia and subsequent neurological deficits. Since the sensitivity of SEP is questioned, we investigated SEP with respect to post-operative ischemia. In 36 patients with 51 intracranial aneurysms, clinical evaluation and diffusion-weighted MRI (DWI) was performed before and within 24h after surgery. During surgery, time of temporary occlusion was recorded. MRI images were reviewed for signs of ischemia. For 43 clip applications (84%), we observed neither pathologic SEP events nor ischemia in MRI. In two cases where reduction lasted >10 min after clip release, SEP events correlated with ischemia in the MRI. Only one of the ischemic patients was symptomatic and developed a transient hemiparesis. While pathologic SEP events correlated with visible ischemia in MRI only in two cases with late SEP recovery, ischemia in MRI may have been transient or may not have reached detection threshold in the other cases, in agreement with the absence of permanent neurological deficits. In complex aneurysm cases, where prolonged temporary occlusion is expected, SEP should be used to detect ischemia at a reversible stage to improve the safety of aneurysm clipping. Copyright © 2011 International Federation of Clinical Neurophysiology. Published by Elsevier Ireland Ltd. All rights reserved.

  11. Diffusion tensor magnetic resonance imaging driven growth modeling for radiotherapy target definition in glioblastoma.

    Science.gov (United States)

    Jensen, Morten B; Guldberg, Trine L; Harbøll, Anja; Lukacova, Slávka; Kallehauge, Jesper F

    2017-11-01

    The clinical target volume (CTV) in radiotherapy is routinely based on gadolinium contrast enhanced T1 weighted (T1w + Gd) and T2 weighted fluid attenuated inversion recovery (T2w FLAIR) magnetic resonance imaging (MRI) sequences which have been shown to over- or underestimate the microscopic tumor cell spread. Gliomas favor spread along the white matter fiber tracts. Tumor growth models incorporating the MRI diffusion tensors (DTI) allow to account more consistently for the glioma growth. The aim of the study was to investigate the potential of a DTI driven growth model to improve target definition in glioblastoma (GBM). Eleven GBM patients were scanned using T1w, T2w FLAIR, T1w + Gd and DTI. The brain was segmented into white matter, gray matter and cerebrospinal fluid. The Fisher-Kolmogorov growth model was used assuming uniform proliferation and a difference in white and gray matter diffusion of a ratio of 10. The tensor directionality was tested using an anisotropy weighting parameter set to zero (γ0) and twenty (γ20). The volumetric comparison was performed using Hausdorff distance, Dice similarity coefficient (DSC) and surface area. The median of the standard CTV (CTVstandard) was 180 cm 3 . The median surface area of CTVstandard was 211 cm 2 . The median surface area of respective CTV γ0 and CTV γ20 significantly increased to 338 and 376 cm 2 , respectively. The Hausdorff distance was greater than zero and significantly increased for both CTV γ0 and CTV γ20 with respective median of 18.7 and 25.2 mm. The DSC for both CTV γ0 and CTV γ20 were significantly below one with respective median of 0.74 and 0.72, which means that 74 and 72% of CTVstandard were included in CTV γ0 and CTV γ20, respectively. DTI driven growth models result in CTVs with a significantly increased surface area, a significantly increased Hausdorff distance and decreased overlap between the standard and model derived volume.

  12. Parahippocampal activation during successful recognition of words: a self-paced event-related fMRI study

    NARCIS (Netherlands)

    Daselaar, S. M.; Rombouts, S. A.; Veltman, D. J.; Raaijmakers, J. G.; Lazeron, R. H.; Jonker, C.

    2001-01-01

    In this study, we investigated retrieval from verbal episodic memory using a self-paced event-related fMRI paradigm, similar to the designs typically used in behavioral studies of memory function. We tested the hypothesis that the medial temporal lobe (MTL) is involved in the actual recovery of

  13. Studies on the reliability of high-field intra-operative MRI in brain glioma resection

    Directory of Open Access Journals (Sweden)

    Zhi-jun SONG

    2011-07-01

    Full Text Available Objective To evaluate the reliability of high-field intra-operative magnetic resonance imaging(iMRI in detecting the residual tumors during glioma resection.Method One hundred and thirty-one cases of brain glioma(69 males and 62 females,aged from 7 to 79 years with mean of 39.6 years hospitalized from Nov.2009 to Aug.2010 were involved in present study.All the patients were evaluated using magnetic resonance imaging(MRI before the operation.The tumors were resected under conventional navigation microscope,and the high-field iMRI was used for all the patients when the operators considered the tumor was satisfactorily resected,while the residual tumor was difficult to detect under the microscope,but resected after being revealed by high-field iMRI.Histopathological examination was performed.The patients without residual tumors recieved high-field MRI scan at day 4 or 5 after operation to evaluate the accuracy of high-field iMRI during operation.Results High quality intra-operative images were obtained by using high-field iMRI.Twenty-eight cases were excluded because their residual tumors were not resected due to their location too close to functional area.Combined with the results of intra-operative histopathological examination and post-operative MRI at the early recovery stage,the sensitivity of high-field iMRI in residual tumor diagnosis was 98.0%(49/50,the specificity was 94.3%(50/53,and the accuracy was 96.1%(99/103.Conclusion High-quality intra-operative imaging could be acquired by high-field iMRI,which maybe used as a safe and reliable method in detecting the residual tumors during glioma resection.

  14. Consensus recommendations for MS cortical lesion scoring using double inversion recovery MRI

    DEFF Research Database (Denmark)

    Geurts, J J G; Roosendaal, S D; Calabrese, M

    2011-01-01

    Different double inversion recovery (DIR) sequences are currently used in multiple sclerosis (MS) research centers to visualize cortical lesions, making it difficult to compare published data. This study aimed to formulate consensus recommendations for scoring cortical lesions in patients with MS...

  15. Magnetic Resonance Imaging Findings in Chronic Carbon Monoxide Intoxication

    Energy Technology Data Exchange (ETDEWEB)

    Durak, A. C.; Coskun, A.; Yikilmaz, A.; Erdogan, F.; Mavili, E.; Guven, M. [Hospital of Erciyes Univ., Kayseri (Turkey). Dept. of Radiology

    2005-05-01

    Purpose: To define the cranial magnetic resonance imaging (MRI) features of the chronic stage of carbon monoxide (CO) poisoning in patients with and without neuropsychiatric sequelae. Material and Methods: Eight patients who had neither symptoms nor neurological sequelae and eight patients with neuropsychiatric sequelae were included in the study. Patients aged between 9 to 57 (mean 32.2 years). All patients had been comatose at initial admittance and awoke after normobaric 100% oxygen therapy within 1-7 days. In this study, the patients were being examined with routine cranial MRI between 1 and 10 years (mean 3.4 years) after exposure to CO. Results: The most common finding was bilateral symmetric hyperintensity of the white matter, which was more significant in the centrum semiovale, with relative sparing of the temporal lobes and anterior parts of the frontal lobes on T2-weighted and FLAIR images in all patients. Cerebral cortical atrophy was seen in 10 patients; mild atrophy of cerebellar hemispheres in 8; and vermian atrophy in 11. Corpus callosum was atrophic in one patient. Bilateral globus pallidus lesions were seen in three patients. The lesions were hypointense on T1-weighted images and hyperintense on T2-weighted and FLAIR images. Conclusion: Patients with severe CO intoxication may develop persistent cerebral changes independently of their neuropsychiatric findings in the chronic stage. They may present with characteristic MRI findings as described here, even if asymptomatic. The history of CO exposure is therefore helpful for recognizing and interpreting the MRI findings of chronic stage CO intoxication.

  16. Analysis of spatial and temporal dynamics of xylem refilling in Acer rubrum L. using magnetic resonance imaging (MRI.

    Directory of Open Access Journals (Sweden)

    Maciej Andrzej Zwieniecki

    2013-07-01

    Full Text Available We report results of an analysis of embolism formation and subsequent refilling observed in stems of Acer rubrum L. using magnetic resonance imaging (MRI. MRI is one of the very few techniques that can provide direct non-destructive observations of the water content within opaque biological materials at a micrometer resolution. Thus, it has been used to determine temporal dynamics and water distributions within xylem tissue. In this study, we found good agreement between MRI measures of pixel brightness to assess xylem liquid water content and the percent loss in hydraulic conductivity (PLC in response to water stress (P50 values of 2.51 and 2.70 for MRI and PLC, respectively. These data provide strong support that pixel brightness is well correlated to PLC and can be used as a proxy of PLC even when single vessels cannot be resolved on the image. Pressure induced embolism in moderately stressed plants resulted in initial drop of pixel brightness. This drop was followed by brightness gain over 100 minutes following pressure application suggesting that plants can restore water content in stem after induced embolism. This recovery was limited only to current year wood ring; older wood did not show signs of recovery within the length of experiment (16 hours. In vivo MRI observations of the xylem of moderately stressed (~-0.5 MPa A. rubrum stems revealed evidence of a spontaneous embolism formation followed by rapid refilling (~30 minutes. Spontaneous (not induced embolism formation was observed only once, despite over 60 hours of continuous MRI observations made on several plants. Thus this observation provide evidence for presence of naturally occurring embolism-refilling cycle in A. rubrum, but it is impossible to infer any conclusions in relation to its frequency in nature.

  17. MRI evidence of structural changes in the sacroiliac joints of patients with non-radiographic axial spondyloarthritis even in the absence of MRI inflammation.

    Science.gov (United States)

    Maksymowych, Walter P; Wichuk, Stephanie; Dougados, Maxime; Jones, Heather; Szumski, Annette; Bukowski, Jack F; Marshall, Lisa; Lambert, Robert G

    2017-06-06

    Studies have shown that structural lesions may be present in patients with non-radiographic axial spondyloarthritis (nr-axSpA). However, the relevance of structural lesions in these patients is unclear, particularly without signs of inflammation on magnetic resonance imaging (MRI). We assessed the presence of structural lesions at baseline on MRI in the sacroiliac joints (SIJ) of patients with nr-axSpA with and without SIJ inflammation on MRI. Bone marrow edema (BME) was assessed on short tau inversion recovery (STIR) scans from 185 patients with nr-axSpA, by two independent readers at baseline using the Spondyloarthritis Research Consortium of Canada (SPARCC) score. Structural lesions were evaluated on T1 weighted spin echo scans, with readers blinded to STIR scans, using the SPARCC MRI SIJ structural score. Disease characteristics and structural lesions were compared in patients with SIJ BME (score ≥2) and without SIJ BME (score <2). Both SIJ BME and structural lesions scores were available for 183 patients; 128/183 (69.9%) patients had SIJ BME scores ≥2 and 55/183 (30.1%) had scores <2. Frequencies of MRI structural lesions in patients with vs without SIJ BME were: erosions (45.3% vs 10.9%, P < 0.001), backfill (20.3% vs 0%, P < 0.001), fat metaplasia (10.9% vs 1.8%, P = 0.04), and ankylosis (2.3% vs 1.8%, P = ns). Significantly more patients with both SIJ BME and structural lesions were male and/or HLA-B27 positive than patients with only SIJ BME. Mean (SD) spinal scores (23 discovertebral units) were significantly higher in patients with SIJ structural lesions than without: 6.5 (11.5) vs 3.3 (5.1), respectively, P = 0.01. In patients with nr-axSpA, SIJ structural lesions, particularly erosions, may be present on MRI when radiographs are normal or inconclusive, even in patients negative for MRI SIJ inflammation. They may reflect more severe disease with greater spinal inflammation. ClinicalTrials.gov, NCT01258738 . Registered on 9

  18. The effects of multiple anaesthetic episodes on equine recovery quality.

    Science.gov (United States)

    Platt, J P; Simon, B T; Coleman, M; Martinez, E A; Lepiz, M A; Watts, A E

    2018-01-01

    Although rare, 70% of equine fatalities during recovery from general anaesthesia (GA) are due to catastrophic fractures from poor recovery quality. To determine the effect of repeated GA recovery on GA recovery quality. Experimental blinded trial. Eight adult horses underwent six GA events on sevoflurane for distal limb MRI examination over a 14-week period. Prior to GA recovery, xylazine was administered. Randomly ordered video-recorded GA recoveries were scored by three blinded board certified veterinary anaesthesiologists, unaware of patient identity or GA event number, for nine parameters using a 100 mm visual analogue scale (VAS) where 0 = worst and 100 = best. The number of attempts to stand, duration of lateral and sternal recumbency, total recovery duration and physiologic parameters during each GA event were recorded. Repeated measures ANOVA were used to detect differences. Agreement between observer VAS scores was determined via inter-rater reliability using an intraclass correlation. With GA recovery experience, VAS scores for balance and coordination, knuckling, and overall quality of recovery were improved and the duration of lateral recumbency was increased. There were no differences in total recovery duration, number of attempts to stand, physiologic parameters other than heart rate during GA, or VAS scores for activity in lateral recumbency, move to sternal, move to stand, or strength. Each GA event was relatively short and there was no surgical stimulation. The same results may not occur if there was surgical stimulation and pain during each GA event. Recovery from GA improves with multiple anaesthetic episodes in horses. Clinicians can advise clients that horses are likely to have better GA recovery on repeated GA recovery due to improved balance and coordination and reduced knuckling. Additionally, there is no change in anaesthetic morbidity with six repeated GA events over a 14-week period. © 2017 EVJ Ltd.

  19. Accuracy of multiecho magnitude-based MRI (M-MRI) for estimation of hepatic proton density fat fraction (PDFF) in children.

    Science.gov (United States)

    Zand, Kevin A; Shah, Amol; Heba, Elhamy; Wolfson, Tanya; Hamilton, Gavin; Lam, Jessica; Chen, Joshua; Hooker, Jonathan C; Gamst, Anthony C; Middleton, Michael S; Schwimmer, Jeffrey B; Sirlin, Claude B

    2015-11-01

    To assess accuracy of magnitude-based magnetic resonance imaging (M-MRI) in children to estimate hepatic proton density fat fraction (PDFF) using two to six echoes, with magnetic resonance spectroscopy (MRS) -measured PDFF as a reference standard. This was an IRB-approved, HIPAA-compliant, single-center, cross-sectional, retrospective analysis of data collected prospectively between 2008 and 2013 in children with known or suspected nonalcoholic fatty liver disease (NAFLD). Two hundred eighty-six children (8-20 [mean 14.2 ± 2.5] years; 182 boys) underwent same-day MRS and M-MRI. Unenhanced two-dimensional axial spoiled gradient-recalled-echo images at six echo times were obtained at 3T after a single low-flip-angle (10°) excitation with ≥ 120-ms recovery time. Hepatic PDFF was estimated using the first two, three, four, five, and all six echoes. For each number of echoes, accuracy of M-MRI to estimate PDFF was assessed by linear regression with MRS-PDFF as reference standard. Accuracy metrics were regression intercept, slope, average bias, and R(2) . MRS-PDFF ranged from 0.2-40.4% (mean 13.1 ± 9.8%). Using three to six echoes, regression intercept, slope, and average bias were 0.46-0.96%, 0.99-1.01, and 0.57-0.89%, respectively. Using two echoes, these values were 2.98%, 0.97, and 2.72%, respectively. R(2) ranged 0.98-0.99 for all methods. Using three to six echoes, M-MRI has high accuracy for hepatic PDFF estimation in children. © 2015 Wiley Periodicals, Inc.

  20. MRI of the wrist and finger joints in inflammatory joint diseases at 1-year interval: MRI features to predict bone erosions

    International Nuclear Information System (INIS)

    Savnik, Anette; Malmskov, Hanne; Graff, Lykke B.; Danneskiold-Samsoee, Bente; Bliddal, Henning; Thomsen, Henrik S.; Nielsen, Henrik; Boesen, Jens

    2002-01-01

    The aim of this study was to assess the ability of MRI determined synovial volumes and bone marrow oedema to predict progressions in bone erosions after 1 year in patients with different types of inflammatory joint diseases. Eighty-four patients underwent MRI, laboratory and clinical examination at baseline and 1 year later. Magnetic resonance imaging of the wrist and finger joints was performed in 22 patients with rheumatoid arthritis less than 3 years (group 1) who fulfilled the American College of Rheumatology (ACR) criteria for rheumatoid arthritis, 18 patients with reactive arthritis or psoriatic arthritis (group 2), 22 patients with more than 3 years duration of rheumatoid arthritis, who fulfilled the ACR criteria for rheumatoid arthritis (group 3), and 20 patients with arthralgia (group 4). The volume of the synovial membrane was outlined manually before and after gadodiamide injection on the T1-weighted sequences in the finger joints. Bones with marrow oedema were summed up in the wrist and fingers on short-tau inversion recovery sequences. These MRI features was compared with the number of bone erosions 1 year later. The MR images were scored independently under masked conditions. The synovial volumes in the finger joints assessed on pre-contrast images was highly predictive of bone erosions 1 year later in patients with rheumatoid arthritis (groups 1 and 3). The strongest individual predictor of bone erosions at 1-year follow-up was bone marrow oedema, if present at the wrist at baseline. Bone erosions on baseline MRI were in few cases reversible at follow-up MRI. The total synovial volume in the finger joints, and the presence of bone oedema in the wrist bones, seems to be predictive for the number of bone erosions 1 year later and may be used in screening. The importance of very early bone changes on MRI and the importance of the reversibility of these findings remain to be clarified. (orig.)

  1. MRI of the spine in cobalamin deficiency: the value of examining both spinal cord and bone marrow

    Energy Technology Data Exchange (ETDEWEB)

    Duprez, T.P. [Dept. of Diagnostic Imaging, Cliniques Univ. Saint-Luc, Univ. Catholique de Louvain, Brussls (Belgium); Gille, M. [Clinique Sainte-Elisabeth, Brussels (Belgium). Dept. of Neurology; Vande Berg, B.C. [Dept. of Diagnostic Imaging, Cliniques Univ. Saint-Luc, Univ. Catholique de Louvain, Brussls (Belgium); Malghem, J. [Dept. of Diagnostic Imaging, Cliniques Univ. Saint-Luc, Univ. Catholique de Louvain, Brussls (Belgium); Grandin, C.B. [Dept. of Diagnostic Imaging, Cliniques Univ. Saint-Luc, Univ. Catholique de Louvain, Brussls (Belgium); Michel, P. [Dept. of Pathology, Brussels (Belgium); Ghariani, S. [Clinique Sainte-Elisabeth, Brussels (Belgium). Dept. of Neurology; Maldague, B.E. [Dept. of Diagnostic Imaging, Cliniques Univ. Saint-Luc, Univ. Catholique de Louvain, Brussls (Belgium)

    1996-08-01

    We observed a case of pernicious anaemia in which MRI of the spine demonstrated both intrinsic lesions of the spinal cord and abnormal signal in the bone marrow. The latter resolved with replacement therapy. Only partial recovery of the cord lesions was observed. (orig.)

  2. MRI of the spine in cobalamin deficiency: the value of examining both spinal cord and bone marrow

    International Nuclear Information System (INIS)

    Duprez, T.P.; Gille, M.; Malghem, J.; Grandin, C.B.; Michel, P.; Ghariani, S.

    1996-01-01

    We observed a case of pernicious anaemia in which MRI of the spine demonstrated both intrinsic lesions of the spinal cord and abnormal signal in the bone marrow. The latter resolved with replacement therapy. Only partial recovery of the cord lesions was observed. (orig.)

  3. Revised Recommendations of the Consortium of MS Centers Task Force for a Standardized MRI Protocol and Clinical Guidelines for the Diagnosis and Follow-Up of Multiple Sclerosis

    Science.gov (United States)

    Traboulsee, A.; Simon, J.H.; Stone, L.; Fisher, E.; Jones, D.E.; Malhotra, A.; Newsome, S.D.; Oh, J.; Reich, D.S.; Richert, N.; Rammohan, K.; Khan, O.; Radue, E.-W.; Ford, C.; Halper, J.; Li, D.

    2016-01-01

    SUMMARY An international group of neurologists and radiologists developed revised guidelines for standardized brain and spinal cord MR imaging for the diagnosis and follow-up of MS. A brain MR imaging with gadolinium is recommended for the diagnosis of MS. A spinal cord MR imaging is recommended if the brain MR imaging is nondiagnostic or if the presenting symptoms are at the level of the spinal cord. A follow-up brain MR imaging with gadolinium is recommended to demonstrate dissemination in time and ongoing clinically silent disease activity while on treatment, to evaluate unexpected clinical worsening, to re-assess the original diagnosis, and as a new baseline before starting or modifying therapy. A routine brain MR imaging should be considered every 6 months to 2 years for all patients with relapsing MS. The brain MR imaging protocol includes 3D T1-weighted, 3D T2-FLAIR, 3D T2-weighted, post-single-dose gadolinium-enhanced T1-weighted sequences, and a DWI sequence. The progressive multifocal leukoencephalopathy surveillance protocol includes FLAIR and DWI sequences only. The spinal cord MR imaging protocol includes sagittal T1-weighted and proton attenuation, STIR or phase-sensitive inversion recovery, axial T2- or T2*-weighted imaging through suspicious lesions, and, in some cases, postcontrast gadolinium-enhanced T1-weighted imaging. The clinical question being addressed should be provided in the requisition for the MR imaging. The radiology report should be descriptive, with results referenced to previous studies. MR imaging studies should be permanently retained and available. The current revision incorporates new clinical information and imaging techniques that have become more available. PMID:26564433

  4. Prognosis and MRI findings in patients with peripheral facial palsy

    International Nuclear Information System (INIS)

    Mineta, Masayuki; Saitoh, Yasuhiro; Yoshikawa, Daihei; Yamada, Tomonori; Aburano, Tamio; Matoba, Mitsuaki.

    1997-01-01

    We examined a series of 21 peripheral facial palsy patients attempted to ( 17 Bell's palsy, 4 Hunt syndrome) with Gd-DTPA-enhanced MRI and attempted to determine the relation between prognosis and MRI findings. We divided patients into two groups based on facial palsy scores of Japanese facial nerve research; a good group (G-Group) and a bad group (B-group). The G-group scored over 20 points on the 20th day after the first visit and the B-group under 20 points. G-group consisted of 9 Bell's palsy and 1 Hunt syndrome patients, and the B-group of 8 Bell's palsy and 3 Hunt syndrome patients. The averaged facial palsy score of both groups was analyzed every week during 4 weeks. Recovery from the palsy was better in the G-group than the B-group (P<0.05); the scores at the 4th week of the G- and B-groups were 32.6±15.2 and 7.8±7.4, respectively. The MRI findings of both groups were examined retrospectively. Nine of 10 G-group and nine of 11 B-group patients had abnormal contrast enhancement. The result of enhanced facial nerve segment was as follows: G-group, auditory canal 1, labyrinthine/geniculate 7, tympanic 7, mastoid 7: B-group, auditory canal 2, labyrinthine/geniculate 8, tympanic 8, mastoid 7. Our results indicate no relation between the prognosis and the MRI findings. Therefore, it is impossible to predict the prognosis of facial palsy from the results of Gd-DTPA-enhanced MRI. (author)

  5. Prognosis and MRI findings in patients with peripheral facial palsy

    Energy Technology Data Exchange (ETDEWEB)

    Mineta, Masayuki; Saitoh, Yasuhiro; Yoshikawa, Daihei; Yamada, Tomonori; Aburano, Tamio [Asahikawa Medical College, Hokkaido (Japan); Matoba, Mitsuaki

    1997-02-01

    We examined a series of 21 peripheral facial palsy patients attempted to ( 17 Bell`s palsy, 4 Hunt syndrome) with Gd-DTPA-enhanced MRI and attempted to determine the relation between prognosis and MRI findings. We divided patients into two groups based on facial palsy scores of Japanese facial nerve research; a good group (G-Group) and a bad group (B-group). The G-group scored over 20 points on the 20th day after the first visit and the B-group under 20 points. G-group consisted of 9 Bell`s palsy and 1 Hunt syndrome patients, and the B-group of 8 Bell`s palsy and 3 Hunt syndrome patients. The averaged facial palsy score of both groups was analyzed every week during 4 weeks. Recovery from the palsy was better in the G-group than the B-group (P<0.05); the scores at the 4th week of the G- and B-groups were 32.6{+-}15.2 and 7.8{+-}7.4, respectively. The MRI findings of both groups were examined retrospectively. Nine of 10 G-group and nine of 11 B-group patients had abnormal contrast enhancement. The result of enhanced facial nerve segment was as follows: G-group, auditory canal 1, labyrinthine/geniculate 7, tympanic 7, mastoid 7: B-group, auditory canal 2, labyrinthine/geniculate 8, tympanic 8, mastoid 7. Our results indicate no relation between the prognosis and the MRI findings. Therefore, it is impossible to predict the prognosis of facial palsy from the results of Gd-DTPA-enhanced MRI. (author)

  6. The natural history of partial rotator cuff tear evaluated by MRI. Can we predict the prognosis of partial rotator cuff tear by MRI?

    International Nuclear Information System (INIS)

    Matsuura, Koumei

    2010-01-01

    The cause and progress of the tear in the title are not fully understood and its treatment varies dependently on the injured site, depth, accompanied disease and symptom, and imaging profile. The author classified the tears in 4 types in MRI findings, followed their temporal progression and clinical symptom, and found that this classification in MRI finding was helpful to predict the prognosis, which is described in this paper. Subjects are 47 shoulders of 45 patients (M19/F26, av. age 71.0 y) who underwent conservative treatment of the disease during the time May, 2003-Oct. 2008, periodical MRI (2.7 times in av.) for 18.5 mo in av. and follow-up diagnosis until 24.9 mo in av. MRI is conducted with the machine 1.0 T Siemens harmonicdome to acquire the fast spin echo T1, T2 weighted images, and short inversion time inversion recovery (STIR) coronal, axial and sagittal ones. Tears in MRI are classified in Type 1 (abnormal signal type) (25 shoulders), Type 2 (abnormal signal and swelling type) (7 shoulders), Type 3 (cut off end type) (10 shoulders) and Type 4 (tapered end type) (5 shoulders). The partial rotator cuff tear is suggested to be originated from the denaturation of the cuff with a subsequent certain injury or loading to become Type 1 to 2 and to progress to Type 3 to 4 by continuous acrominal impingement. It is suggested that at the first diagnosis the Type 1 does not have so much serious symptom, but which tends to last long while the symptom is serious in Type 2 and 3: the prognosis in Type 4 is good. (K.T)

  7. Usefulness of MRI in the diagnosis of atlanto-axial dislocation

    Energy Technology Data Exchange (ETDEWEB)

    Nakamura, Ko; Fukui, Keiji; Sadamoto, Kazuhiko; Miki, Hitoshi; Niida, Akira; Sakaki, Saburo.

    1988-08-01

    We studied 14 cases of atlanto-axial dislocation (AAD) by means of a 0.5 Tesla superconductive magnetic resonance imaging (MRI) system using saturation recovery sequences (Tr: 500 msec, Te: 20 - 30 msec) with a 5 - 10 mm slice thickness, and directly evaluated the degree of the spinal-cord compression in flexion, neutral, and extension of the head on the midsagittal images. The patients ranged from 11 to 76 years of age, and 8 of the 14 were male. In all cases we could demonstrate the cord compression in various degrees by either the odontoid process or the posterior arch of the atlas. The spinal cords were compressed from ventral in flexion in 6 cases, from dorsal in flexion in 2 cases, from dorsal in extension in 2 cases, and from ventral in both flexion and extension in 2 cases each. In addition, syringomyelia could be revealed by MRI in combination with AAD in 2 cases. MRI is useful in revealing the direction and degree of spinal-cord compression in patients with AAD, and in evaluating combined diseases such as syringomyelia and Arnold-Chiari malformations.

  8. Magnetic resonance separation imaging using a divided inversion recovery technique (DIRT).

    Science.gov (United States)

    Goldfarb, James W

    2010-04-01

    The divided inversion recovery technique is an MRI separation method based on tissue T(1) relaxation differences. When tissue T(1) relaxation times are longer than the time between inversion pulses in a segmented inversion recovery pulse sequence, longitudinal magnetization does not pass through the null point. Prior to additional inversion pulses, longitudinal magnetization may have an opposite polarity. Spatial displacement of tissues in inversion recovery balanced steady-state free-precession imaging has been shown to be due to this magnetization phase change resulting from incomplete magnetization recovery. In this paper, it is shown how this phase change can be used to provide image separation. A pulse sequence parameter, the time between inversion pulses (T180), can be adjusted to provide water-fat or fluid separation. Example water-fat and fluid separation images of the head, heart, and abdomen are presented. The water-fat separation performance was investigated by comparing image intensities in short-axis divided inversion recovery technique images of the heart. Fat, blood, and fluid signal was suppressed to the background noise level. Additionally, the separation performance was not affected by main magnetic field inhomogeneities.

  9. MRI of lumbar trunk muscles in patients with Parkinson's disease and camptocormia.

    Science.gov (United States)

    Margraf, N G; Rohr, A; Granert, O; Hampel, J; Drews, A; Deuschl, G

    2015-07-01

    Camptocormia in Parkinson's disease (PD) is an axial postural disorder usually accompanied by histopathological changes in the paravertebral muscles of unknown etiology. The diagnostic potential of magnetic resonance imaging (MRI) of back muscles in camptocormia has not been systematically assessed. Our objective was to characterize pathological muscle changes with MRI and to develop radiological criteria for camptocormia. The criteria edema, swelling and fatty degeneration in 20 idiopathic PD patients with camptocormia were assessed using MRI (T1w and short tau inversion recovery (STIR) sequences) of the lumbar trunk muscles and compared with 20 group-matched PD patients without camptocormia. Edema and fatty degeneration of the paravertebral muscles were significantly more frequent in camptocormia. Edema correlated negatively and fatty degeneration positively with the duration of camptocormia and not PD. Swelling of the paravertebral muscles, edema and swelling of the quadratus lumborum muscle and rare edema of the psoas muscle were only found in camptocormia patients. In this case-control study the defined MRI criteria distinguish the group of PD patients with camptocormia versus those without. Our findings suggest dynamic changes in the MRI signals over time in the paravertebral muscles: edema and swelling are found initially, followed by fatty atrophic degeneration 2-3 years after the beginning of camptocormia. Muscle MRI qualifies as a tool for categorizing phases of camptocormia as acute or chronic, with potential consequences for therapeutic approaches. The involvement of muscles beyond an isolated impairment of the paravertebral muscles implies a more systemic view with a deregulation of lumbar trunk muscles.

  10. Magnetic Resonance Imaging of a Case of Central Neurocytoma

    Science.gov (United States)

    Dedushi, Kreshnike; Kabashi, Serbeze; Ugurel, Mehmet Sahin; Ramadani, Naser; Mucaj, Sefedin; Zeqiraj, Kamber

    2016-01-01

    Background: The purpose of this study is to investigate the MRI features of central neurocytoma. Case report: A 45 year old man with 3 months of worsening daily headaches. These headaches were diffuse, lasted for several hours, and mostly occurred in the morning. She was initially diagnosed and treated for migraines but later he had epileptic attack and diplopia and neurolog recomaded MRI. Methods: precontrast MRI; TSE/T2Wsequence in axial/coronal planes; 3D–Hi-resolution T1W sagittal; FLAIR/T2W axial; FLAIR/T2W and Flash/T2W oblique coronal plane (perpendicular to temporal lobes) GRE/T2W axial plane for detection of heme products. Post-contrast TSE/T1W sequence in axial, coronal and sagittal planes. Diffusion weighted and ADC mapping MRI images for EPI sequence in axial plane. Results: A 23x12mm heterogeneous mass within aqueductus cerebri, with calcified and hemorrhagic foci and extending downwards till fourth ventricle. It’s originating from the right paramedian posterior aqueductal wall (tectum), and also extending to and involving the tegmentum of mesencephalon at its right paramedian aspect. CSF flow obstruction secondary to described aqueductal mass, with resultant triventricular hydrocephalus). Marked transependymal CSF leak can be noted at periventricular white matter, secondary to severe hydrocephalus. After IV injection of contrast media, this mass shows mild-to-moderate heterogenous speckled enhancement. Conclusion: MRI is helpful in defining tumor extension, which is important in preoperative planning. Although IN is a relatively rare lesion, it should be considered in the differential diagnosis of intraventricular lesions in the presence of such typical MR findings. However, a definitive diagnosis requires immunochemical study and electron microscopy. PMID:28077908

  11. A Technique for Generating Volumetric Cine MRI (VC-MRI)

    Science.gov (United States)

    Harris, Wendy; Ren, Lei; Cai, Jing; Zhang, You; Chang, Zheng; Yin, Fang-Fang

    2016-01-01

    Purpose To develop a technique to generate on-board volumetric-cine MRI (VC-MRI) using patient prior images, motion modeling and on-board 2D-cine MRI. Methods One phase of a 4D-MRI acquired during patient simulation is used as patient prior images. 3 major respiratory deformation patterns of the patient are extracted from 4D-MRI based on principal-component-analysis. The on-board VC-MRI at any instant is considered as a deformation of the prior MRI. The deformation field is represented as a linear combination of the 3 major deformation patterns. The coefficients of the deformation patterns are solved by the data fidelity constraint using the acquired on-board single 2D-cine MRI. The method was evaluated using both XCAT simulation of lung cancer patients and MRI data from four real liver cancer patients. The accuracy of the estimated VC-MRI was quantitatively evaluated using Volume-Percent-Difference(VPD), Center-of-Mass-Shift(COMS), and target tracking errors. Effects of acquisition orientation, region-of-interest(ROI) selection, patient breathing pattern change and noise on the estimation accuracy were also evaluated. Results Image subtraction of ground-truth with estimated on-board VC-MRI shows fewer differences than image subtraction of ground-truth with prior image. Agreement between profiles in the estimated and ground-truth VC-MRI was achieved with less than 6% error for both XCAT and patient data. Among all XCAT scenarios, the VPD between ground-truth and estimated lesion volumes was on average 8.43±1.52% and the COMS was on average 0.93±0.58mm across all time-steps for estimation based on the ROI region in the sagittal cine images. Matching to ROI in the sagittal view achieved better accuracy when there was substantial breathing pattern change. The technique was robust against noise levels up to SNR=20. For patient data, average tracking errors were less than 2 mm in all directions for all patients. Conclusions Preliminary studies demonstrated the

  12. MRI Primer

    International Nuclear Information System (INIS)

    Oldendorf, W.; Oldendorf, W. Jr.

    1991-01-01

    Designed for studies, radiologists, and clinicians at all levels of training, this book provides a basic introduction to the principles, physics, and instrumentation of magnetic resonance imaging. The fundamental concepts that are essential for the optimal clinical use of MRI are thoroughly explained in easily accessible terms. To facilitate the reader's comprehension, the material is presented nonmathematically, using no equations and a minimum of symbols and abbreviations. MRI Primer presents a clear account of the phenomenon of nuclear magnetic resonance and the use of gradient magnetic fields to create clinically useful images of cross-sectional slices. Close attention is given to the magnetization vector as a means of expressing nuclear behavior, the role of T 1 and T 2 weighing in imaging, the use of contrast agents, and the pulse sequences most often used in clinical practice, as well as to the relative capabilities and limitations of MRI and CT. The basic hardware components of an MRI scanner are described in detail. Sample MRI scans illustrate how MRI characterizes tissue. An appendix provides a brief introduction to quantum processes in MRI

  13. A method for assessing the physical recovery of Antarctic desert pavements following human-induced disturbances: a case study in the Ross Sea region of Antarctica.

    Science.gov (United States)

    O'Neill, Tanya A; Balks, Megan R; López-Martínez, Jerónimo; McWhirter, Judi L

    2012-12-15

    With increasing visitor numbers an understanding of the impacts of human activities in Antarctic terrestrial environments has become important. The objective of this study was to develop a means for assessing recovery of the ground surface desert pavement following physical disturbance. A set of 11 criteria were identified to assess desert pavement recovery. Assessed criteria were: embeddedness of surface clasts; impressions of removed clasts; degree of clast surface weathering; % overturned clasts; salt on underside of clasts; development of salt coatings; armouring per m(2); colour contrast; evidence of subsidence/melt out; accumulation of salt on cut surfaces; and evidence of patterned ground development. Recovery criteria were assigned a severity/extent rating on a scale from zero to four, zero being highly disturbed, and four being undisturbed. A relative % recovery for each criteria was calculated for each site by comparison with a nearby undisturbed control area, and an overall Mean Recovery Index (MRI) was assigned to each pavement surface. To test the method, 54 sites in the Ross Sea region of Antarctica were investigated including areas disturbed by: bulldozer scraping for road-fill, contouring for infrastructure, geotechnical investigations, and experimental treading trial sites. Disturbances had occurred at timescales ranging from one week to 50 years prior to assessment. The extent of desert pavement recovery at the sites investigated in this study was higher than anticipated. Fifty of the 54 sites investigated were in an intermediate, or higher, stage of desert pavement recovery, 30 sites were in an advanced stage of recovery, and four sites were indistinguishable from adjacent control sites (MRI = 100%). It was found that active surfaces, such as the gravel beach deposits at the Greenpeace World Park Base site at Cape Evans, the aeolian sand deposits at Bull Pass, and the alluvial fan deposits of the Loop Moraine field campsite, recovered relatively

  14. Functional brain activation differences in stuttering identified with a rapid fMRI sequence

    Science.gov (United States)

    Kraft, Shelly Jo; Choo, Ai Leen; Sharma, Harish; Ambrose, Nicoline G.

    2011-01-01

    The purpose of this study was to investigate whether brain activity related to the presence of stuttering can be identified with rapid functional MRI (fMRI) sequences that involved overt and covert speech processing tasks. The long-term goal is to develop sensitive fMRI approaches with developmentally appropriate tasks to identify deviant speech motor and auditory brain activity in children who stutter closer to the age at which recovery from stuttering is documented. Rapid sequences may be preferred for individuals or populations who do not tolerate long scanning sessions. In this report, we document the application of a picture naming and phoneme monitoring task in three minute fMRI sequences with adults who stutter (AWS). If relevant brain differences are found in AWS with these approaches that conform to previous reports, then these approaches can be extended to younger populations. Pairwise contrasts of brain BOLD activity between AWS and normally fluent adults indicated the AWS showed higher BOLD activity in the right inferior frontal gyrus (IFG), right temporal lobe and sensorimotor cortices during picture naming and and higher activity in the right IFG during phoneme monitoring. The right lateralized pattern of BOLD activity together with higher activity in sensorimotor cortices is consistent with previous reports, which indicates rapid fMRI sequences can be considered for investigating stuttering in younger participants. PMID:22133409

  15. In vivo longitudinal MRI and behavioral studies in experimental spinal cord injury.

    Science.gov (United States)

    Sundberg, Laura M; Herrera, Juan J; Narayana, Ponnada A

    2010-10-01

    Comprehensive in vivo longitudinal studies that include multi-modal magnetic resonance imaging (MRI) and a battery of behavioral assays to assess functional outcome were performed at multiple time points up to 56 days post-traumatic spinal cord injury (SCI) in rodents. The MRI studies included high-resolution structural imaging for lesion volumetry, and diffusion tensor imaging (DTI) for probing the white matter integrity. The behavioral assays included open-field locomotion, grid walking, inclined plane, computerized activity box performance, and von Frey filament tests. Additionally, end-point histology was assessed for correlation with both the MRI and behavioral data. The temporal patterns of the lesions were documented on structural MRI. DTI studies showed significant changes in white matter that is proximal to the injury epicenter and persisted to day 56. White matter in regions up to 1 cm away from the injury epicenter that appeared normal on conventional MRI also exhibited changes that were indicative of tissue damage, suggesting that DTI is a more sensitive measure of the evolving injury. Correlations between DTI and histology after SCI could not be firmly established, suggesting that injury causes complex pathological changes in multiple tissue components that affect the DTI measures. Histological evidence confirmed a significant decrease in myelin and oligodendrocyte presence 56 days post-SCI. Multiple assays to evaluate aspects of functional recovery correlated with histology and DTI measures, suggesting that damage to specific white matter tracts can be assessed and tracked longitudinally after SCI.

  16. 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.

  17. Clinicopathological and neuroradiological study of extraventricular neurocytoma

    International Nuclear Information System (INIS)

    Dai Yueli; Xu Yikai; Chen Wanqi; Li Weiyue; Xiao Xiang; Yan Chenggong; Wu Yuankui; Zhao Liang; Liang Wen

    2013-01-01

    Objective: To analyze clinicopathologic features, imaging findings, and differential diagnosis of extraventricular neurocytomas (EVN) after the literature were comprehensively reviewed. Methods: Nine cases with pathologically proved EVN were analyzed retrospectively. Plain and post-contrast MRI were performed in all 9 patients, of which 6 patients underwent a liquid attenuation inversion recovery (FLAIR) sequence scanning. Plain and enhanced CT were performed in 2 cases. Meanwhile, Clinical manifestations and imaging features of the reported EVN cases in literature were reviewed comprehensively by searching Ovid Medline, PubMed, Embase and China biological literature database. Results: Among the 9 patients, 5 were male and 4 were female with age range from 2 to 59 years. The lesions located in cerebral hemispheres in 3 cases, in midbrain in 3 cases and in the pineal gland, vermis and sellar region in 1 case respectively. Two cases with CT data appeared iso-dense or slightly hyperdense. On MRI, all 9 lesions presented hypointense or isointense on T 1 WI, hyperintense on T 2 WI and mild to marked heterogeneous enhancement except one with no enhancement. Six cases showed hyperintense on FLAIR sequence. Other images signs included bleeding in 3 patients, completely solid components in 2 cases, completely cystic in I case, cystic change in 6 cases and calcification in 2 cases. Seven tumors showed clear border. Peritumoral edema was found in 5 cases with mild in 3 cases, moderate and severe edema in 1 case respectively. Four cases showed no edema. In the reported 142 cases with EVN, 78 cases were male and 63 were female, with an median age of 31 years (one of the patients did not provide the information of gendler and age). The tumor in 86 eases were located in cerebral hemispheres, of which 38 cases were in frontal lobe, 23 cases in spinal cords, and 12 cases outside the central nervous system. CT scans appeared low density, iso-dense or slightly hyperdense. MRI scans

  18. MRI and PET/CT of patients with bone metastases from breast carcinoma

    International Nuclear Information System (INIS)

    Grankvist, J.; Fisker, R.; Iyer, V.; Fründ, E.T.; Simonsen, C.; Christensen, T.; Stenbygaard, L.; Ewertz, M.; Larsson, E.-M.

    2012-01-01

    3.0 Tesla magnetic resonance imaging (MRI) with diffusion-weighted imaging (DWI) was compared with combined 18F-fluorodeoxyglucose positron emission tomography and computed tomography (PET/CT) in patients with suspected bone metastases from breast cancer. A prospective clinical study was performed in 13 female breast cancer patients (mean age 61years; range 45–85 years). The spine was imaged in the sagittal plane with T1-weighted (T1), short tau inversion recovery (STIR), and T2-weighted fat-saturated (T2) sequences. The pelvis was imaged similarly in the coronal plane. Axial DWI was performed from the skull base to the mid-thigh. MRI and PET/CT were performed in all patients at a maximum interval of 10 working days and at least 14 days after chemotherapy. MRI was reviewed by two radiologists, and their consensus on potential metastases in 27 predefined locations was recorded. The predefined locations were the vertebral bodies (24), the left (1) and right (1) pelvic bones, and the sacral bone (1). The PET/CT was reviewed by a radiologists and a nuclear medicine physician. MRI detected 59 of the 60 active metastases found with our gold standard modality PET/CT. T1 had the highest sensitivity (98%) but rather low specificity (77%), but with the addition of STIR and DWI, the specificity increased to 95%. The additional metastases detected with MRI most likely represented postherapeutic residual scars without active tumour. In conclusion, 3.0 Tesla MRI with T1, STIR, and DWI is useful for the clinical evaluation of bone metastases from breast cancer and compares well to PET/CT.

  19. Leptomeningeal Contrast Enhancement Is Associated with Disability Progression and Grey Matter Atrophy in Multiple Sclerosis

    Directory of Open Access Journals (Sweden)

    Gleb Makshakov

    2017-01-01

    Full Text Available Leptomeningeal contrast enhancement (LMCE on magnetic resonance imaging (MRI is a newly recognized possible biomarker in multiple sclerosis (MS, associated with MS progression and cortical atrophy. In this study, we aimed to assess the prevalence of LMCE foci and their impact on neurodegeneration and disability. Materials. 54 patients with MS were included in the study. LMCE were detected with a 3 Tesla scanner on postcontrast fluid-attenuated inversion-recovery (FLAIR sequence. Expanded Disability Status Scale (EDSS score, number of relapses during 5 years from MS onset, and number of contrast-enhancing lesions on T1 weighted MRI were counted. Results. LMCE was detected in 41% (22/54 of patients. LMCE-positive patients had longer disease duration (p=0,0098 and higher EDSS score (p=0,039, but not a higher relapse rate (p=0,091. No association of LMCE with higher frequency of contrast-enhancing lesions on T1-weighted images was detected (p=0,3842. Analysis of covariates, adjusted for age, sex, and disease duration, revealed a significant effect of LMCE on the cortex volume (p=0.043, F=2.529, the total grey matter volume (p=0.043, F=2.54, and total ventricular volume (p=0.039, F=2.605. Conclusions. LMCE was shown to be an independent and significant biomarker of grey matter atrophy and disability in MS.

  20. A case of recurrent delayed radiation myelopathy with 5-year remission interval

    International Nuclear Information System (INIS)

    Tsukagoshi, Setsuki; Ikeda, Masaki; Tano, Shinobu; Obayashi, Kai; Fujita, Yukio; Okamoto, Koichi

    2010-01-01

    We report a 47-year-old woman with relapsed delayed radiation myelopathy (DRM), occurring 5 years and 10 years after radiation therapy for nasopharyngeal carcinoma at 37 years old. Sensations of pain and temperature had been disturbed in the right leg since 42 years old. MRI showed Gadolinium-enhanced lesion as a ring-like-enhancement of the spinal cord at C1-2 on T 1 -weighted image (T 1 WI), with high signal area and swelling of the spinal cord at the upper C1 to C6 areas on T 2 -weighted image. We diagnosed her as having DRM after considering the differential diagnosis, e.g., multiple sclerosis, spinal tumor and other neurological diseases. Her sensory symptoms quickly improved following therapy with prednisolone and warfarin. Although she remained healthy for a few years, dysesthesia of the neck on the right side appeared 5 years later after the first clinical occurrence. At this time, MRI demonstrated Gadolinium-enhanced lesion as a ring-like enhancement of the spinal cord at C2 on T 1 WI, but the area also differed from that of previous lesion; a high signal area and swelling of the spinal cord was also seen on fluid attenuated inversion recovery (FLAIR) image of the medulla and upper C1 to C6. For recurrence of DRM, we administered prednisolone and warfarin. Thereafter, the patient recovered and the spinal cord lesion on MRI decreased markedly. The clinical course demonstrated that administration of prednisolone and warfarin might be effective for relapsed DRM. (author)