Journal of neuroimaging : official journal of the American Society of Neuroimaging
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The events leading up to the development of new multiple sclerosis (MS) lesions on conventional imaging are unknown. The purpose of this study is to use diffusion tensor imaging (DTI) to investigate prelesional changes in MS to better understand the pathological changes that lead to lesion development. ⋯ A significant change in diffusion measures can be seen prior to gadolinium enhancement. Changes in TD drove changes in FA and MD, providing evidence for impaired myelin integrity prior to gadolinium enhancement. DTI may be a sensitive measure for early detection of inflammatory disease activity in MS.
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Spinal cord (SC) pathology is common in multiple sclerosis (MS), and measures of SC-atrophy are increasingly utilized. Normalization reduces biological variation of structural measurements unrelated to disease, but optimal parameters for SC volume (SCV)-normalization remain unclear. Using a variety of normalization factors and clinical measures, we assessed the effect of SCV normalization on detecting group differences and clarifying clinical-radiological correlations in MS. ⋯ SCV-normalization by length improves the ability to detect group differences, strengthens clinical-radiological correlations, and is particularly relevant in settings of subtle disease-related SC-atrophy in MS. SCV-normalization by length may enhance the clinical utility of measures of SC-atrophy.
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Quantitative signal targeting with alternating radiofrequency labeling of arterial regions (QUASAR) is a recent spin labeling technique that could improve the reliability of brain perfusion measurements. Although it is considered reliable for measuring gray matter as a whole, it has never been evaluated regionally. Here we assessed this regional reliability. ⋯ Thus, QUASAR reliability for regional perfusion is high within gray matter, but uncertain within white matter.
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Case Reports
Early experience with low contrast imaging (LCI) technology during neuroendovascular interventional procedures.
Early recognition of complications during intracranial neuroendovascular interventions is important for medical decision making and prompts administration of life-saving treatments. Low contrast imaging (LCI) provides computed tomographic (CT)-like images of anatomical brain structures, capable of detecting hydrocephalus and intracranial hemorrhage complications. We present our early experience with LCI using the Toshiba Infinix-i biplane angiographic suite during neurointerventional cases, including acute stroke interventions, aneurysm embolization, and subarachnoid hemorrhage management. ⋯ LCI is a promising tool in the arsenal of a neuroendovascular interventionist, especially when a complication is suspected during an intervention, potentially obviating the need for immediate transfer of the patient to a conventional CT scanner. Further studies comparing LCI with conventional noncontrast CT imaging are necessary.
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Vasospasm has been considered the most severe acute complication after subarachnoid hemorrhage (SAH). MRA is not considered ideal for detecting cerebral vasospasm because of background including the hemorrhage. The aim of this study is to evaluate the efficacy of Subtraction MRA (SMRA) by comparing it to that of conventional MRA (CMRA) for diagnosis of cerebral vasospasm. ⋯ Diagnosis of cerebral vasospasm is more accurate by SMRA than by CMRA. The advantages are its noninvasive nature and its ability to detect cerebral vasospasm.