AJNR. American journal of neuroradiology
-
AJNR Am J Neuroradiol · Dec 2011
ReviewPseudoprogression and pseudoresponse: imaging challenges in the assessment of posttreatment glioma.
The current standard of care for newly diagnosed cases of high-grade glioma is surgical resection followed by RT with concurrent chemotherapy. The most widely used criteria for assessing treatment response are based on a 2D measurement of the enhancing area on MR imaging known as the Macdonald Criteria. Recently, nontumoral increases (pseudoprogression) and decreases (pseudoresponse) in enhancement have been found, and these can confuse outcome evaluation. Here we review pseudoprogression and pseudoresponse and describe how better understanding of these phenomena can aid interpretation.
-
AJNR Am J Neuroradiol · Dec 2011
Using quantitative CT perfusion for evaluation of delayed cerebral ischemia following aneurysmal subarachnoid hemorrhage.
DCI is a serious complication following aneurysmal SAH leading to permanent neurologic deficits, infarction, and death. Our aim was to prospectively evaluate the diagnostic accuracy of CTP and to determine a quantitative threshold for DCI in aneurysmal SAH. ⋯ CBF and MTT have the highest overall diagnostic accuracy. Threshold values of 35 mL/100 g/min for CBF and 5.5-second MTT are suggested for DCI on the basis of the patient population utility method. Absolute threshold values may not be generalizable due to differences in scanner equipment and postprocessing methods.
-
AJNR Am J Neuroradiol · Dec 2011
Multiparametric MR imaging of sinonasal diseases: time-signal intensity curve- and apparent diffusion coefficient-based differentiation between benign and malignant lesions.
The sinonasal region is a platform for a broad spectrum of benign and malignant diseases, and image-based differentiation between benign and malignant diseases in this area is often difficult. Here, we evaluated multiparametric MR imaging with combined use of TICs and ADCs for the differentiation between benign and malignant sinonasal tumors and tumorlike diseases. ⋯ Multiparametric MR imaging by using TICs and ADCs may help differentiate benign and malignant sinonasal diseases.
-
Clopidogrel is an inhibitor of platelet aggregation, indicated for the prevention of ischemic stroke and in-stent thrombosis. However, it has a number of drawbacks, including an increased risk of hemorrhage; a clinical effect that is slow in onset and irreversible; a genetically determined variability in its clinical potency; and interactions with other commonly administered drugs.