Neuroimaging clinics of North America
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Jugular foramen, albeit complex, is essentially a bony conduit transmitting nerves and vessels from the posterior cranial fossa to the nasopharyngeal carotid space. In addition to its intrinsic pathologic conditions, a variety of lesions can arise from the contiguous surrounding structures and invade the foramen. A thorough understanding of the anatomy of this region is fundamental for diagnostic evaluation and assessment of its disease extent. Vascular variants and imaging artifacts are potential pitfalls, which should be recognized and avoided.
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This article reviews the embryology, anatomy, congenital anomaly, acquired disorders, degenerative diseases, neoplasms, and inflammatory and infectious disorders in the craniovertebral junction. The imaging characteristics and differential diagnoses of these lesions are provided. This review also focuses on the complimentary roles of different imaging modalities.
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Neuroimaging Clin. N. Am. · Feb 2009
ReviewProton magnetic resonance spectroscopy in multiple sclerosis.
Proton magnetic resonance spectroscopy ((1)H-MRS) provides tissue metabolic information in vivo. This article reviews the role of MRS-determined metabolic alterations in lesions, normal-appearing white matter, gray matter, and spinal cord in advancing our knowledge of pathologic changes in multiple sclerosis (MS). In addition, the role of MRS in objectively evaluating therapeutic efficacy is reviewed. This potential metabolic information makes MRS a unique tool to follow MS disease evolution, understand its pathogenesis, evaluate the disease severity, establish a prognosis, and objectively evaluate the efficacy of therapeutic interventions.
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Neuroimaging Clin. N. Am. · Feb 2009
ReviewSpinal-cord MRI in multiple sclerosis: conventional and nonconventional MR techniques.
Multiple sclerosis is a diffuse disease of the central nervous system, and MRI of the spinal cord is highly recommended in the clinical evaluation of patients suspected of having multiple sclerosis. Within the new diagnostic criteria, spinal cord MRI increases sensitivity and possibly specificity for MS, but further work is needed to investigate other criteria that may give greater weight to the presence of cord lesions in patients with clinically isolated syndromes or suspected relapsing-remitting multiple sclerosis. Techniques should be further studied and validated in studies comparing these techniques with clinical status and histopathology, however.
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Neuroimaging Clin. N. Am. · Nov 2008
ReviewBrain atrophy assessment in multiple sclerosis: importance and limitations.
The use of MR imaging-derived methods to provide sensitive and reproducible assessments of brain volume (eg, to estimate atrophy) has increased the interest in this measure as a reliable indicator of disease progression in many neurologic disorders, including multiple sclerosis (MS). After an overview of the most commonly used methods for assessing brain atrophy state and changes in MS, this article discusses the clinical relevance of the most recent developments and reflects on its interpretation in a complex disease such as MS. Some caveats of these measurements are considered and possible future approaches discussed for improving the potential of this measure in assessing and monitoring pathologic evolution and treatment efficacy in this disease.