Neuroimaging clinics of North America
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Fine-needle aspiration (FNA) and core needle biopsy are the primary diagnostic modalities for assessing mass lesions. Any superficial or deep-seated lesion occurring anywhere in the body, including bone and soft tissue, can undergo this procedure to pathologically characterize it. The outcomes of FNA, performed either alone or in combination with core biopsy, are best when performed and interpreted by skilled individuals. The roles of interventional radiologists and cytologists are pivotal in ensuring adequacy of the specimen and leading the clinical team in making the diagnosis and avoiding repeat diagnostic procedures or a more invasive open surgical biopsy.
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The vertebral column is the most common site of osseous metastasis, and percutaneous minimally invasive thermal ablation is becoming an important contributor to multidisciplinary treatment algorithms. Continuously evolving minimally invasive image-guided percutaneous spine thermal ablation procedures have proven safe and effective in management of selected patients with spinal metastases to achieve pain palliation and/or local tumor control. This article details the armamentarium available and the most recent advances in minimally invasive, percutaneous image-guided thermal ablation for management of spinal metastases.
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This article reviews image-guided approaches for the treatment of common spine pain generators. The following treatment targets are discussed: epidural space (interlaminar and transforaminal approaches), facet joint, sacroiliac joint, and synovial cysts.
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Spinal MR imaging is excellent for identifying details of spinal anatomy, including intraspinal contents, neural foramina, joints, ligaments, intervertebral discs, and bone marrow. Cortical bony structures of the spine are better imaged using CT. ⋯ Motion- and flow-related artifacts may occur during imaging and should not be mistaken for lesions. With advancements in MR imaging hardware and software, spinal MR imaging can expand its role in the delineation of normal and abnormal spinal anatomy.
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Neuroimaging Clin. N. Am. · Nov 2019
ReviewSpontaneous Intracranial Hypotension: Pathogenesis, Diagnosis, and Treatment.
Spontaneous intracranial hypotension (SIH) is a clinical syndrome that is increasingly recognized as an important and treatable secondary cause of headaches. Insight into the condition has evolved significantly over the past decade, resulting in a greater understanding of the underlying pathophysiology, development of new diagnostic imaging tools, and a broadening array of targeted treatment options. This article reviews the clinical presentation and pathogenesis of SIH, discusses the important role of imaging in diagnosis, and describes how imaging guides treatment.