Journal of neuroimaging : official journal of the American Society of Neuroimaging
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Variations in the venous drainage of the central nervous system can have imaging and clinical findings that mimic pathology, presenting a challenge for neuroimagers and clinicians. Patients with these variants may undergo unnecessary testing, and patients with pathology may receive delayed diagnoses because of overlap with benign findings. Consequently, the accurate identification of venous variations on cross-sectional imaging and angiography and their potential causes are critical for differentiating benign imaging variants from potential pathologic processes requiring further evaluation. ⋯ In addition, some supposedly benign variations, such as the developmental venous anomaly, can be complicated by pathology. The objective of this review article is to provide a descriptive and pictorial review of common anatomic and physiologic variations in the venous drainage system of the brain, spine, and orbits that can mimic pathology. Neuroimaging findings of related pathologies and differences in clinical presentations will also be discussed to assist in the approach to differential diagnosis.
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The cingulate island sign (CIS) on 18 F-fluorodeoxyglucose positron emission tomography (FDG-PET); ie, the relative preservation of mid-posterior cingulate cortex metabolism, is a supportive biomarker in the diagnostic criteria for dementia with Lewy bodies (DLB). However, limited information is currently available on the diagnostic value of the CIS on FDG-PET or 123 I-iodoamphetamine single-photon emission computed tomography (IMP-SPECT) for differentiating between mild cognitive impairment (MCI) due to Alzheimer's disease (AD) (MCI-AD) and MCI due to DLB (MCI-DLB). ⋯ The FDG-PET and IMP-SPECT derived CIS ratios are both useful for differentiating between AD and DLB. The FDG-PET derived CIS ratio is more valuable than the IMP-SPECT derived CIS ratio for differential diagnosis in patients with MCI. A larger study is needed to confirm these results.
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Myelin water imaging (MWI) is a magnetic resonance imaging technique that quantifies myelin in-vivo. Although MWI has been extensively applied to study myelin-related diseases in groups, clinical use in individual patients is challenging mainly due to population heterogeneity. The purpose of this study was twofold: (1) create a normative brain myelin water atlas depicting the population mean and regional variability of myelin content; and (2) apply the myelin atlas to assess the degree of demyelination in individuals with multiple sclerosis (MS). ⋯ The myelin water atlas can be used as a reference (URL: https://sourceforge.net/projects/myelin-water-atlas/) to demonstrate areas of demyelination in individual MS participants. Future studies will expand the atlas age range, account for education, and other variables that may affect myelination.
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To identify the differences in overall occurrence, location, and disease burden of white matter hyperintensities (WMH) in patients with sporadic hemiplegic migraine (SHM) and patients with migraine headaches. ⋯ The WMH occurrence in patients with SHM is significantly more in the parietal lobe when compared to those with migraine headaches. WMH burden was also higher in patients with SHM, and larger white matter lesions occurred more frequently in these patients with SHM (compared to ordinary migraineurs).
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Pediatric-onset multiple sclerosis (POMS) is associated with focal inflammatory lesions and the loss of cortical and deep gray matter. Optic neuritis (ON) and white matter (WM) lesions in the visual pathway can directly contribute to visual cortical mantle thinning. We determine the relative contributions of MS insult on anterior and posterior visual pathway integrity. ⋯ POMS negatively impacts the integrity of the anterior visual pathway, but it is the loss of WM integrity that drives anterograde loss of the cortical mantle. Preserved visual acuity and foveal sparing imply some degree of functional and structural resilience.