Journal of neuroimaging : official journal of the American Society of Neuroimaging
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Although transesophageal echocardiography (TEE) is the gold standard for right to left shunt detection, we observed that transcranial Doppler (TCD) was more sensitive and sought an explanation. ⋯ TEEs and TCDs are operator dependent and thus subject to false negatives. The lower yield and interoperator variability in TEE results appear to reflect the lack of performance protocols and engender concern about false negatives in community use. Consensus performance protocols and certification criteria for both modalities should have an impact on accuracy of shunt detection.
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Integration of functional connectivity analysis based on resting-state functional Magnetic Resonance Imaging (fMRI) and structural connectivity analysis based on Diffusion-Weighted Imaging (DWI) has shown great potential to improve understanding of the neural networks in the human brain. However, there are sensitivity and specificity-related interpretation issues that must be addressed. ⋯ This fMRI/DWI integration study suggests that functional connectivity analysis might be a more sensitive and robust approach in understanding the connectivity between cortical regions, and can be used to improve DWI-based structural connectivity analysis.
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Comparative Study
Evaluating of small intracranial aneurysms by 64-detector CT Angiography: a comparison with 3-dimensional rotation DSA or surgical findings.
The diagnostic performance of 64-detector computed tomographic angiography (CTA) for detection of small intracranial aneurysms (SIAs) was evaluated. ⋯ The diagnostic performance of 64-detector CTA did not improve much compared with 16-detector CTA for detecting SIAs, especially for very small aneurysms. VR-RDSA is still necessary for patients with a history of subarachnoid hemorrhage if the CTA findings are negative.
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Sinonasal organized hematoma (SOH) is an uncommon benign entity with locally aggressive behavior. The conventional approach is complete resection. ⋯ This case suggests that the possibility of an aneurysm should always be considered if a SOH is suspected, especially when it is huge and close to the ICA. Surgical resection may not be the first therapeutic choice unless the differential cause of a hidden aneurysm can be excluded.
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This study aimed to identify predictors of acute mortality after intracerebral hemorrhage (ICH), including voxel-wise analysis of hematoma location. ⋯ For patients with lobar ICH, acute mortality is related to both hematoma size and location, with findings potentially useful for therapeutic decision making. The current findings also underscore differences between the syndromes of acute deep and lobar ICH.