J Neuroradiology
-
3D angiography is a true technical revolution that allows improvement in the quality and safety of diagnostic and endovascular treatment procedures. 3D angiography images are obtained by reconstruction of a rotational angiography acquisition done on a C-arm (GE Medical Systems) spinning at 40 degrees per second. The carotid or vertebral selective injection of a total of 15 ml of non-ionic contrast media at 3 ml/sec over 5 seconds allows the selection of the "arterial phase". Four hundred sixty 3D angiographic studies were performed from December 1996 to September 1998 on 260 patients and have been analyzed in MIP (Maximum Intensity Projection) and SSD (Shaded Surface Display) views. ⋯ Also, in particular for complex cases, it brings additional elements complementing the results of standard 2D DSA and rotational angiograms. In the cervical vascular pathology, 3D angiography allows for a better assessment of the stenosis level and of dissection lesions. Our current research activities focus on the matching without stereotactic frame between 3D X-ray angiography and volumetric MR acquisition, which should allow us to improve the treatment of intracerebral arterio-venous malformations (AVMs).
-
Two cases of intracranial dural arterio-venous fistula (DAVF) with perimedullary venous drainage are reported. In both cases, MRI T2-weighted (T2W) images showed an hypersignal within the cervical cord with sparing of the thoracic cord. In one case perimedullary vessels were demonstrated on T1W images after gadolinium i.v. administration. ⋯ Hypersignal limited to the cervical cord at MRI on T2W images remain exceptionnal in case of intracranial DAVF with perimedullary venous drainage. When neurological symptoms are suggestive, post gadolinium T1W sequences should be conducted, followed by selective spinal angiogram. If normal venous drainage is not objectivated (e.g. opacification of radiculo-medullary veins on the late phase), cerebral angiogram should be done to rule out an intracranial DAVF.
-
Vertebral artery tortuosity causing neural foraminal widening is a well described abnormality that should not be confused with other causes of neural foraminal enlargement, particularly on conventional roentgenograms. We, hereby, describe CT features of another cervical osseous change due to the vertebral artery tortuosity, the so called "tubular shaped vertebral artery canal", which is embedded in the vertebral body instead of causing neural foramen enlargement. Catheter and MR angiographic studies have also been performed to confirm the vertebral artery tortuosity causing the osseous changes.
-
Editorial Biography Historical Article
[The skull and brain according to Leonardo: a survey on 4 pages by de Vinci and analogy of the onion. The scientific philosophy of the domino theory].
-
Comparative Study
[The contribution of "time-of-flight" MRI-angiography in the study of neurovascular interactions (hemifacial spasm and trigeminal neuralgia)].
The purpose of this study was to investigate capabilities of Magnetic Resonance Angiography (MRA) in delineating neurovascular compression which has emerged as the most frequent etiology in cases of Hemi-Facial Spasm and Trigeminal Neuralgia. MR investigations were carried out at 1.5 t unit (Magnetom Vision, Siemens). The examination consisted of 3D time-of-flight MRA (3d TOF) protocol, with a FISP sequence (Fast Imaging Steady Precession) and magnetization transfer. ⋯ In control group on 34 explanations only there are only 4 contacts between Vth nerve and SCA. MRA with a 3D-TOF FISP sequence allows recognition of neurovascular conflicts in case of hemifacial spasm and trigeminal neuralgia while MIP helps to characterize the implicated vessel. Sources images need to be carefully assessed in order to depict unsuspected pathology.