Journal of neuroimaging : official journal of the American Society of Neuroimaging
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Review Case Reports
The Neuroimaging Spectrum of Septum Posticum Derangement and Associated Thoracic Myelopathy.
Arachnoid cysts and meningeal membranes are among the differential diagnostic considerations of extra-medullary causes of thoracic myelopathy. In this case series of 7 patients, we present compressive meningeal membranes mimicking dorsal arachnoid cyst. The propensity of the meningeal membranes for the dorsal aspect of upper thoracic spine may reflect derangements of the septum posticum. ⋯ Derangements of septum posticum may present a spectrum of findings that should be considered in the differential of thoracic myelopathy. Flattening of the posterior cord margin is a reliable imaging clue for a dorsal extra-medullary compressive lesion. Cord compression results from combination of adhesive membranes and turbulent CSF flow. The clinical course may be difficult to predict. Periodic imaging follow up can be helpful to confirm stability of findings in expectantly managed cases.
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Whether hemodynamic and/or embolic transcranial Doppler (TCD) features of internal carotid artery (ICA) stenosis contribute to the classification of stroke patterns on MRI. ⋯ Our findings suggest that TCD characteristics of the ICA stenosis contribute to better define stroke patterns on MRI in about one-third of the patients presenting with pure TT or BZ lesions.
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The lumbosacral plexus is a complex anatomic area that serves as the conduit of innervation and sensory information to and from the lower extremities. It is formed by the ventral rami of the lumbar and sacral spine which then combine into larger nerves serving the pelvis and lower extremities. It can be a source of severe disability and morbidity for patients when afflicted with pathology. ⋯ It can identify the cause for disability, indicate prognosis for improvement, and be a tool for delivery of interventions. Knowledge of proper MR protocols and imaging features is key for appropriate and timely diagnosis. Here we discuss the relevant anatomy of the lumbosacral plexus, appropriate imaging techniques for its evaluation, and discuss the variety of pathologies that may afflict it.
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Comparative Study
Dynamic Contrast-Enhanced Perfusion MRI and Diffusion-Weighted Imaging in Grading of Gliomas.
Accurate glioma grading is crucial for treatment planning and predicting prognosis. We performed a quantitative volumetric analysis to assess the diagnostic accuracy of histogram analysis of diffusion-weighted imaging (DWI) and dynamic contrast-enhanced (DCE) T1-weighted perfusion imaging in the preoperative evaluation of gliomas. ⋯ When derived from whole-tumor histogram analysis, DCE-MRI perfusion parameters performed better than ADC in noninvasively discriminating low- from high-grade gliomas.
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The Qureshi grading scheme is an effective classification system for evaluating the severity of acute arterial occlusion. However, this scheme is of limited utility because it is based on invasive angiography. In this study, we assessed whether a relationship between a noninvasive Qureshi score, based on magnetic resonance angiography (MRA) or computed tomography angiography (CTA), and 90-day functional outcome could be observed in patients with acute ischemic stroke. ⋯ The noninvasive Qureshi scheme using MRA or CTA provides meaningful information about long-term functional outcomes in patients with acute ischemic stroke.