Acta radiologica
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The concentration of N-acetylaspartate (NAA) in hippocampus, as measured with magnetic resonance spectroscopy (MRS), and the ratio of NAA/(choline (Cho) + creatine (Cr)) are valuable tools in the lateralization of temporal lobe epilepsy (TLE). MRS of hippocampus is also increasingly used to study certain psychiatric and degenerative diseases. However, the reliability of such measurements of hippocampus has been questioned. ⋯ Metabolite concentrations in the mesial temporal lobe obtained with MRS imaging represent the mean value of hippocampus and a considerable amount of adjacent tissue. To assess the hippocampus alone, an actual voxel well below 1 cm(3) and a sub-centimeter slice thickness are required.
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Arterial input functions may differ between brain regions due to delay and dispersion effects in the vascular supply network. Unless corrected for, these differences may degrade quantitative estimations of cerebral blood flow in dynamic susceptibility contrast magnetic resonance perfusion imaging (DSC-MRI). ⋯ Given knowledge of neurovascular anatomy, the current blind approach seemingly produced reasonable estimates of voxel-specific arterial input functions. In addition to potentially reducing quantification errors in DSC-MRI, these user-independent voxel-specific arterial input functions could be useful for visualizing abnormal blood supply patterns in patients.
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Concern has been raised regarding the mounting collective radiation doses from computed tomography (CT), increasing the risk of radiation-induced cancers in exposed populations. ⋯ By reducing X-ray tube potential from 120 to 100 kVp, while keeping all other scanning parameters unchanged, the radiation dose to the patient may be almost halved without deterioration of diagnostic quality, which may be of particular benefit in young individuals.
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Digital subtraction angiography (DSA) is still regarded as the gold standard for detecting residual flow in treated aneurysms. Recent reports have also shown excellent results from magnetic resonance angiography (MRA) imaging. This is an important observation, since DSA is associated with a risk of medical complications, is time consuming, and is more expensive. ⋯ The present study shows that 1.5T TOF-MRA is a feasible primary follow-up modality after coiling of intracranial aneurysms. Given our data, we now suggest that, in every patient with a coiled intracranial aneurysm, the first follow-up, 3 months after coiling, should be an MRA study. Only when this MRA is inconclusive (e.g., because of coil artifacts), or in the case of suspicion of recanalization, should DSA be performed additionally.
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Two patients with compression fractures from metastases who had pain with radicular symptoms mainly in upright position that resolved when not upright and were treated with vertebroplasty were retrospectively analyzed. Both patients had symptom relief at treated levels until death. These cases show that patients with radicular signs and symptoms from compression fractures secondary to metastases or myeloma, worse in upright position and relieved when recumbent, may benefit from vertebroplasty.