Neuroimaging clinics of North America
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Cerebrovascular reactivity (CVR) reflects the change in cerebral blood flow in response to vasodilatory stimuli enabling assessment of the health of the cerebral vasculature. Recent advances in the quantitative delivery of CO2 stimuli with computer-controlled sequential gas delivery have enabled mapping of the speed and magnitude of response to flow stimuli. These CVR advances when applied to patients with acute concussion have unexpectedly shown faster speed and greater magnitude of responses unseen in other diseases that typically show the opposite effects. The strength of the CVR alterations have diagnostic potential in single subjects with AUC values in the 0.90-0.94 range.
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Neck masses are frequent in the pediatric population and are usually divided into congenital, inflammatory, and neoplastic. Many of these lesions are cystic and are often benign. Solid masses and vascular lesions are relatively less common, and the imaging appearances can be similar. This article reviews the clinical presentation and imaging patterns of pediatric solid and vascular neck masses.
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Congenital cystic masses are commonly encountered when imaging a patient presenting with a neck mass. Congenital cysts are present at birth; however, these cysts may not present until later in life with some growing slowly and others rapidly increasing in size due to hemorrhage of infection. A neonatal presentation is rare but when present may allow a narrower differential diagnosis. Imaging plays a significant role in defining a lesion as cystic, assessing location, and directing the next step in evaluation and or intervention.
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There is a wide variety of disease entities in children, which can present with cervical adenopathy. The spectrum of pathology and imaging appearance differs in many cases from that seen in adults. This review aims to compare the strengths and limitations of the various imaging modalities available to image pediatric patients presenting with cervical adenopathy, provide guidance on when to image, and highlight the imaging appearance of both common and uncommon disorders affecting the cervical nodes in children to aid the radiologist in their clinical practice.
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A variety of congenital and acquired disorders result in pediatric conductive hearing loss. Malformations of the external auditory canal are invariably associated with malformations of the middle ear space and ossicles. ⋯ Syndromes associated with external and middle ear malformations are frequently associated with abnormal development of first and second pharyngeal arch derivatives. Chronic inflammatory disorders include cholesteatoma, cholesterol granuloma, and tympanosclerosis.