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
Identification of the normal jugular foramen and lower cranial nerve anatomy: contrast-enhanced 3D fast imaging employing steady-state acquisition MR imaging.
Conventional imaging protocols are unable to visualize the intraforaminal/canalicular segments of the lower cranial nerves (IX-XII). On the basis of previous successful demonstration of individual cranial nerves within the cavernous sinus by constructive interference in steady-state MR imaging, we describe the use of contrast-enhanced 3D fast imaging employing steady-state acquisition MR imaging to demonstrate normal in vivo intraforaminal and canalicular segments of cranial nerves IX-XII in 10 patients by using a standardized imaging protocol.
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AJNR Am J Neuroradiol · Feb 2008
Comparative StudyComparison of three different methods for measurement of cervical cord atrophy in multiple sclerosis.
Evidence is mounting that spinal cord atrophy significantly correlates with disability in patients with multiple sclerosis (MS). The purpose of this work was to validate 3 different measures for the measurement of cervical cord atrophy on high-resolution MR imaging in patients with MS and in normal control subjects (NCs). We also wanted to evaluate the relationship between cervical cord atrophy and clinical disability in the presence of other conventional and nonconventional brain MR imaging metrics by using a unique additive variance regression model. ⋯ 3D CCAV measurement showed the largest differences between NCs and MS patients and between different disease subtypes. Cervical cord atrophy measurement provides valuable additional information related to disability that is not obtainable from brain MR imaging metrics.