AJNR. American journal of neuroradiology
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AJNR Am J Neuroradiol · Mar 2008
Comparative StudyWhite matter abnormalities in mild traumatic brain injury: a diffusion tensor imaging study.
Traumatic axonal injury is a primary brain abnormality in head trauma and is characterized by reduction of fractional anisotropy (FA) on diffusion tensor imaging (DTI). Our hypothesis was that patients with mild traumatic brain injury (TBI) have widespread brain white matter regions of reduced FA involving a variety of fiber bundles and show fiber disruption on fiber tracking in a minority of these regions. ⋯ Patients with mild TBI have multiple regions with reduced FA in various white matter locations and involving various fiber bundles. A minority of these fiber bundles show discontinuity on fiber tracking.
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AJNR Am J Neuroradiol · Mar 2008
Comparative StudyCSF leaks: correlation of high-resolution CT and multiplanar reformations with intraoperative endoscopic findings.
Skull base defects can result in CSF leaks, with meningitis as a potential complication. Surgeons are now routinely repairing these leaks via a nasal endoscopic approach. Accurate preoperative imaging is essential for surgical planning. A variety of imaging regimens have been employed, including axial and direct coronal CT, CT cisternography with iodinated contrast, radionuclide cisternography, and MR imaging. Now that multidetector helical CT is available, the purpose of this study was to determine how well coronal and sagittal multiplanar reformatted (MPR) images generated from a high-resolution axial dataset correlate with intraoperative findings in a group of patients with clinically proved CSF leaks. ⋯ Axial images, and coronal, sagittal, and oblique MPR images generated from high-resolution axial CT performed well preoperatively, localizing the skull base defect responsible for the CSF leak. However, active manipulation of the axial dataset at a workstation is crucial in identifying and correctly describing these lesions. When submillimeter collimation is available, measurement of the osseous defects are accurate most of the time.
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AJNR Am J Neuroradiol · Mar 2008
Contrast extravasation on CT predicts mortality in primary intracerebral hemorrhage.
Recent studies of intracerebral hemorrhage (ICH) treatments have highlighted the need to identify reliable predictors of hematoma expansion. The goal of this study was to determine whether contrast extravasation on multisection CT angiography (CTA) and/or contrast-enhanced CT (CECT) of the brain is associated with hematoma expansion and increased mortality in patients with primary ICH. ⋯ Active contrast extravasation on CT in patients with primary ICH independently predicts mortality and hematoma growth.
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AJNR Am J Neuroradiol · Mar 2008
A T1 hyperintense perilesional signal aids in the differentiation of a cavernous angioma from other hemorrhagic masses.
A cavernous angioma is a developmental vascular malformation with a high risk of hemorrhage. The purpose of this work was to retrospectively determine whether an MR sign of T1 hyperintense perilesional signal intensity is useful for the differentiation of cavernous angioma from other hemorrhagic cerebral masses. ⋯ When the MR sign of T1 hyperintense perilesional signal intensity is present, there is a high probability of cavernous angioma being present in the brain, and this MR sign may be helpful for differentiating cavernous angioma from hemorrhagic tumors and intracerebral hemorrhages.
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AJNR Am J Neuroradiol · Feb 2008
Randomized Controlled Trial Multicenter StudyHydroCoil Endovascular Aneurysm Occlusion and Packing Study (HELPS trial): procedural safety and operator-assessed efficacy results.
Coated coils have been in clinical use for several years without robust evidence to determine their safety/efficacy. The HydroCoil Endovascular Aneurysm Occlusion and Packing Study (HELPS) addresses this deficiency for the HydroCoil embolic system. This article reports periprocedural safety/operator-assessed angiographic results from HELPS. ⋯ These HELPS results reinforce coiling as an effective treatment for aneurysms, with an excellent technical success rate. Hydrogel coils can be used in a wide spectrum of aneurysms with a risk profile equivalent to that of bare platinum.