Neuroimaging clinics of North America
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Neuroimaging Clin. N. Am. · May 2024
ReviewAdvances in Intraoperative Imaging for Vascular Neurosurgery.
Cerebrovascular surgery has many intraoperative imaging modalities available. Modern technologies include intraoperative digital subtraction angiogram, indocyanine green (ICG) angiography, relative fluorescent measurement with ICG, and ultrasound. Each of these can be used effectively in the treatment of open aneurysm and arteriovenous malformation surgeries, in addition to arteriovenous fistula surgery, and cerebral bypass surgery.
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Neuroimaging Clin. N. Am. · May 2024
ReviewMetabolic Imaging of Acute Ischemic Stroke (PET, 1Hydrogen Spectroscopy, 17Oxygen Imaging, 23Sodium MRI, pH Imaging).
Acute stroke imaging plays a vital and time-sensitive role in therapeutic decision-making. Current clinical workflows widely use computed tomography (CT) and magnetic resonance (MR) techniques including CT and MR perfusion to estimate the volume of ischemic penumbra at risk for infarction without acute intervention. The use of imaging techniques aimed toward evaluating the metabolic derangements underlying a developing infarct may provide additional information for differentiating the penumbra from benign oligemia and infarct core. The authors review several modalities of metabolic imaging including PET, hydrogen and oxygen spectroscopy, sodium MRI, and pH-weighted MRI.
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Ultrasound evaluation of the brain is performed through acoustic windows. Transcranial Doppler has long been used to monitor patients with subarachnoid hemorrhage for cerebral vasospasm. ⋯ Transcranial ultrasound may also be used to assess the risk of delayed cerebral ischemia, screen patients for the presence of elevated intracranial pressure, confirm the diagnosis of brain death, measure midline shift, and detect ventriculomegaly. Transcranial ultrasound should be integrated with other point-of-care ultrasound techniques as an essential skill for the neurointensivist.
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Neuroimaging Clin. N. Am. · May 2024
ReviewDual-Energy Computed Tomography in the Evaluation and Management of Subarachnoid Hemorrhage, Intracranial Hemorrhage, and Acute Ischemic Stroke.
Dual-energy computed tomography (DECT) has emerged as a valuable imaging modality in the diagnosis and management of various cerebrovascular pathologies, including subarachnoid hemorrhage, intracranial hemorrhage, and acute ischemic stroke. This article reviews the principles of DECT and its applications in the evaluation and management of these conditions. The authors discuss the advantages of DECT over conventional computed tomography, as well as its limitations, and provide an overview of current research and future directions in the field.
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Neuroimaging Clin. N. Am. · May 2024
ReviewVessel Wall Characterization Using Quantitative MR Imaging.
MR imaging's exceptional capabilities in vascular imaging stem from its ability to visualize and quantify vessel wall features, such as plaque burden, composition, and biomechanical properties. The application of advanced MR imaging techniques, including two-dimensional and three-dimensional black-blood MR imaging, T1 and T2 relaxometry, diffusion-weighted imaging, and dynamic contrast-enhanced MR imaging, wall shear stress, and arterial stiffness, empowers clinicians and researchers to explore the intricacies of vascular diseases. This array of techniques provides comprehensive insights into the development and progression of vascular pathologies, facilitating earlier diagnosis, targeted treatment, and improved patient outcomes in the management of vascular health.