Journal of neuroimaging : official journal of the American Society of Neuroimaging
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Cerebral toxoplasmosis is a frequent complication in immunosuppressed patients such as AIDS (acquired immunodeficiency syndrome). Frequently, lesions are located deep in the brain which are inaccessible for biopsy making rapid diagnosis dependent on accurate interpretation of neuroimaging findings. The commonest cranial CT findings reported in toxoplasmosis are ring enhancing hypodense lesions in basal ganglia or cortical gray matter. ⋯ Six patients had hemorrhage at the time of initial clinical presentation and one developed hemorrhage following 2 weeks of antitoxoplasma treatment. We conclude that hemorrhagic lesions are frequently found on cranial MRI scans in cerebral toxoplasmosis. AIDS patients presenting with hemorrhagic cerebral lesions should be considered for a trial of presumptive antitoxoplasma treatment.
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Despite denial as a disease entity, carotidynia had shown relatively concordant imaging finding as an inflammatory process surrounding the carotid bifurcation area. We report serial computed tomography (CT) images of a case with carotidynia that showed the layered thickening of the carotid wall with self-limiting disease course.
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Conventional brain MRI lesion measures have unreliable associations with clinical progression in multiple sclerosis (MS). Gray matter imaging may improve clinical-MRI correlations. ⋯ Gray matter T2-hypointensity, suggestive of excessive iron deposition is associated with worsening disability in patients with MS. Gray matter MRI assessment may be able to capture neurodegenerative aspects of the disease, with more clinical relevance than derived from conventional MRI measures. J Neuroimaging 2009;19:3-8.
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Comparative Study
Comparative reliability of total intracranial volume estimation methods and the influence of atrophy in a longitudinal semantic dementia cohort.
Total intracranial volume (TIV) as a measure of premorbid brain size is often used to correct volumes of interest for interindividual differences in magnetic resonance imaging (MRI) studies. We directly compared the reliability of different TIV estimation methods to address whether such methods are influenced by brain atrophy in the neurodegenerative disease, semantic dementia. ⋯ The mid-cranial sampling of PD images achieved the best combination of precision, reliability, and user-friendliness. SPM5 is an attractive alternative if the highest level of precision is not required.
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Ischemic stroke is mainly caused by embolism. Vascular emboli can be solid or gaseous and can be non-invasively registered by transcranial Doppler ultrasound as microembolic signals (MESs). The existing methods are limited as they do not distinguish between cases in which a single embolus is present and those in which multiple emboli -- perhaps a mix of those gaseous and solid in nature -- are present. In a previous in vitro study, we have developed a wavelet-based algorithm to detect multiple emboli. We proceed with this technique to investigate whether it could prove useful in patients. ⋯ Multiple emboli were detected and quantified in patients using continuous wavelet transform. These were difficult to observe using conventional analysis techniques.