Neuroimaging clinics of North America
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Neuroimaging Clin. N. Am. · Aug 2023
ReviewDynamic Contrast-Enhanced MR Perfusion: Role in Diagnosis and Treatment Follow-Up in Patients with Vertebral Body Tumors.
Recent therapeutic advances have led to increased survival times for patients with metastatic disease. Key to survival is early diagnosis and subsequent treatment as well as early detection of treatment failure allowing for therapy modifications. Conventional MR imaging techniques of the spine can be at times suboptimal for identifying viable tumor, as structural changes and imaging characteristics may not differ pretreatment and posttreatment. Advanced imaging techniques such as DCE-MRI can allow earlier and more accurate noninvasive assessment of viable disease by characterizing physiologic changes and tumor microvasculature.
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There are various mass-like lesions that can mimic true neoplasms in the spine, including inflammatory, infectious, vascular, congenital, and degenerative etiologies. While some lesions have distinctive imaging features that suggest a correct diagnosis, others have overlapping characteristics that do not allow their differentiation based solely on their imaging findings. For entities with nonspecific imaging features, knowledge of the clinical and laboratory information is critical to provide an accurate diagnosis.
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Neuroimaging Clin. N. Am. · Aug 2023
ReviewConventional and Advanced Imaging of Spinal Cord Tumors.
Spinal cord tumors are best identified by conventional MR imaging with contrast. Most intramedullary spinal cord tumors have characteristic MR imaging features that allow an accurate preoperative diagnosis. ⋯ Rare tumors such as primary CNS lymphoma and melanocytic tumors are also described. Advanced imaging techqniques of more common intramedullary tumors are also reviewed.
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Neuroimaging Clin. N. Am. · Aug 2023
ReviewThe Role of 3D Printing in Treatment Planning of Spine and Sacral Tumors.
Three-dimensional (3D) printing technology has proven to have many advantages in spine and sacrum surgery. 3D printing allows the manufacturing of life-size patient-specific anatomic and pathologic models to improve preoperative understanding of patient anatomy and pathology. Additionally, virtual surgical planning using medical computer-aided design software has enabled surgeons to create patient-specific surgical plans and simulate procedures in a virtual environment. This has resulted in reduced operative times, decreased complications, and improved patient outcomes. Combined with new surgical techniques, 3D-printed custom medical devices and instruments using titanium and biocompatible resins and polyamides have allowed innovative reconstructions.
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The pediatric spine undergoes complex stages of development and growth, resulting in highly age-dependent physiology and variable susceptibility to certain pathologies. Optimal radiologic evaluation requires image acquisition tailored to the clinical history and an interpretive approach that accounts for demographic variations. In this article, the author discusses the diagnostic approach to pediatric spine masses, beginning with a discussion of normal anatomy and variants, clinical evaluation, and imaging techniques and protocols. The author then covers the major etiologies, imaging appearances, and mimics of pediatric spine masses in the following categories: congenital malformations, genetic syndromes, intramedullary, intradural, epidural, bone, and paraspinal lesions.