J Neuroradiology
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Comparative Study
Treatment decision in ruptured intracranial aneurysms: comparison between multi-detector row CT angiography and digital subtraction angiography.
The aim of this study was to determine the accuracy of multi-detector row computed tomography angiography (CTA) for the triage of patients with acutely ruptured aneurysms, and to assess how therapeutic decisions based on this method compared with digital subtraction angiography (DSA). ⋯ Multi-detector row CTA provides accurate anatomic information for aneurysm location as well as sac and neck sizes; however, the technique appears to have a low sensitivity in detecting branches incorporated into the aneurysmal sac.
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Interest in the identification of cognitive decline in its earliest manifestations and the heterogeneity of clinically diagnosed Alzheimer's disease (AD) explain the growing number of neuroimaging studies of AD. Alzheimer-type lesions are associated with loss of neurons, and magnetic resonance imaging (MRI) can detect predominantly left atrophic changes in the entorhinal cortex, amygdala and anterior hippocampus several years before the onset of clinical symptoms. Cerebrovascular disease can mimic AD in the elderly whereas MR markers of subcortical vascular disease-leukoaraiosis, lacunar infarcts, microbleeds, ventricular enlargement, cortical and hippocampal atrophy-appear to be structural changes associated with vascular-related cognitive impairment. ⋯ Mesiotemporal atrophy on MRI predicts late-onset DAT, but the current rating scales or measurements of mesiotemporal atrophy do not differentiate anteromesial temporal atrophy that is highly suggestive of AD from predominantly hippocampal atrophy, suggestive of non-AD damage and, usually, vascular disease. The other, most common MRI predictors of late-onset DAT may be considered indirect markers of arterial senescence whereas brain atrophy is diffusely milder and MR markers of small-vessel disease more frequent in late-onset, compared with early-onset, DAT. Thus, MRI suggests an overestimation of AD pathology while underestimating 'arteriosclerotic brain degeneration' in the clinical picture of 'Alzheimer syndrome'.
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Controlled Clinical Trial
[Clinical findings, electroneuromyography and MRI in trauma of the brachial plexus].
Management of traumatic lesions of the brachial plexus mainly depends on whether the injury is pre- (nerve root avulsion) or postganglionic (trunks and cords). The aim of this study was to assess the diagnostic and prognostic value of MRI in such lesions, and to determine any correlations among radiological, clinical and electroneuromyographical (EMG) data from both the initial and follow-up studies. ⋯ MRI is the best technique to demonstrate nerve root avulsion. However, unlike EMG, MRI does not allow visualization of distal lesions of the brachial plexus. Differentiation between edema (reversible) and demyelination (irreversible) of trunk and cord lesions remains difficult, and requires EMG or late MRI.