Journal of neuroimaging : official journal of the American Society of Neuroimaging
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Conventional MRI sequences in neuro-oncology are insufficient for glioma grading. However, newly developed diffusion-weighted imaging techniques have been shown to have a great potential for glioma grading. This study examined the diagnostic performance of diffusion tensor imaging (DTI), diffusion kurtosis imaging (DKI), neurite orientation dispersion and density imaging (NODDI), and their combinations in glioma grading. ⋯ DTI, DKI, and NODDI approaches can differentiate between HGG and LGG; however, kurtosis parameters perform better and adding NODDI parameters does not improve diagnostic performance. Using multishell b-value has not led to an increase in diagnostic performance.
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Observational Study
Evaluation of the transverse venous sinus with transcranial color-coded duplex.
Ultrasound-derived diagnosis of transverse venous sinus stenosis (TVSS) may have a promise given recent exploration of its role in pathophysiology of intracranial hypertension and availability of interventions like venous stenting. We investigated transverse venous sinus (TVS) insonation using transcranial color-coded duplex (TCCD) to establish normative values, inform on inherent physiological variability, and other measures to allow future studies on testing the construct validity of TCCD venous in diagnosing TVSS. ⋯ These results can inform future studies validating the normative values in a larger sample and help explore the role of TCCD venous in the diagnosis of venous sinus stenosis.
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Neurologists in both the inpatient and outpatient settings are increasingly using ultrasound to diagnose and manage common neurological diseases. Advantages include cost-effectiveness, the lack of exposure to ionizing radiation, and the ability to perform at the bedside to provide real-time data. There is a growing body of literature that supports using ultrasonography to improve diagnostic accuracy and aid in performing procedures. ⋯ This includes neuromuscular diseases such as motor neuron disorders, focal neuropathies, and muscular dystrophy as well as vascular conditions such as stroke and vasospasm in subarachnoid hemorrhage. We also address ultrasound's use in critically ill patients to aid in identifying increased intracranial pressure, hemodynamics, and arterial and/or venous catheterization. Finally, we address the importance of standardized ultrasound curricula in trainee education and make recommendations for the future directions of research and competency guidelines within our specialty.
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When head and neck infection is suspected, appropriate imaging contributes to treatment decisions and prognosis. While contrast-enhanced CT is the standard imaging modality for evaluating head and neck infections, MRI can better characterize the skull base, intracranial involvement, and osteomyelitis, implying that these are complementary techniques for a comprehensive assessment. Both CT and MRI are useful in the evaluation of abscesses and thrombophlebitis, while MRI is especially useful in the evaluation of intracranial inflammatory spread/abscess formation, differentiation of abscess from other conditions, evaluation of the presence and activity of inflammation and osteomyelitis, evaluation of mastoid extension in middle ear cholesteatoma, and evaluation of facial neuritis and labyrinthitis. ⋯ Dual-energy CT is helpful in reducing metal artifacts, evaluating deep neck abscess, and detecting salivary stones. Subtraction CT techniques are used to detect progressive bone-destructive changes and to reduce dental amalgam artifacts. This article provides a region-based approach to the imaging evaluation of head and neck infections, using both conventional and advanced imaging techniques.
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Stenting is an important treatment for preventing stroke. However, the effect of vertebrobasilar stenting (VBS) might be limited because of relatively high periprocedural risks. Silent brain infarcts (SBIs) are known as a predictor for future stroke. Because of anatomical differences, factors for SBIs might be different between carotid artery stenting (CAS) and VBS. We compared the characteristics of SBIs between VBS and CAS. ⋯ Compared to CAS, VBS was associated with longer procedure time, more residual stenosis, and more SBIs, especially outside the stent-inserted vascular territory. The risk of SBIs after CAS was associated with stent size and procedural difficulty. Only age was associated with SBIs in VBS. The pathomechanism of SBIs after VBS and CAS may be different.