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1.
Introduction
In the current study, we aimed to compare the diagnostic efficacies of phase-contrast magnetic resonance imaging (PC-MRI) and three-dimensional constructive interference in steady-state (3D-CISS) sequence over detection of aqueductal stenosis (AS) on the basis of contrast-enhanced magnetic resonance cisternography (MRC). 相似文献2.
CSF flow studies of intracranial cysts and cyst-like lesions achieved using reversed fast imaging with steady-state precession MR sequences 总被引:8,自引:0,他引:8
Hoffmann KT Hosten N Meyer BU Röricht S Sprung C Oellinger J Gutberlet M Felix R 《AJNR. American journal of neuroradiology》2000,21(3):493-502
BACKGROUND AND PURPOSE: Differentiating between intracranial cysts or cyst-like structures and communicating or noncommunicating cysts is often not possible with cranial CT or nonfunctional MR imaging. We evaluated a retrospective ECG-gated fast imaging with steady-state precession (PSIF) MR sequence with optional cine mode to differentiate cystic masses from enlarged CSF spaces and to determine the accuracy of detecting communication between cysts and neighboring CSF spaces. METHODS: Fourteen patients with intracranial cystic masses underwent CSF flow studies with an ungated and a retrospective ECG-gated cine-mode PSIF sequence in addition to spin-echo imaging. Findings were evaluated retrospectively by using a five-point rating scale and without knowledge of clinical or other imaging findings. Results were compared with intraoperative findings or with results of intrathecal contrast studies. RESULTS: Eighteen arachnoid cysts and one enlarged cisterna magna were diagnosed. Improved differentiation between cysts and enlarged CSF spaces was obtained with cine-mode PSIF imaging in six lesions (six patients). Increased diagnostic certainty as to communication between cysts and CSF spaces was obtained in 18 cysts (13 patients). Diagnoses were verified by membranectomy in five lesions, by CT cisternography in five lesions, and indirectly by shunting in one cystic lesion. In one case, MR diagnosis was not confirmed by CT cisternography. CONCLUSION: Cine-mode MR imaging with a retrospective ECG-gated flow-sensitive PSIF sequence contributed to the certainty of communication between arachnoid cysts and neighboring CSF spaces with an accuracy of 90%, using surgical findings or intrathecal contrast studies as reference. Differentiation between intracranial cysts and enlargement of CSF spaces and other cystic masses was improved in 25% of cases. 相似文献
3.
Summary Motion of the cerebrospinal fluid (CSF) in and around the brain and spinal cord was examined in healthy subjects and in a number of patients with abnormalities of the CSF circulation. The pulsatile motion of the CSF was determined by spin echo phase (velocity) imaging, sometimes in combination with gradient echo phase contrast cine. Differences in flow patterns across CSF spaces were observed: flow reversal in the cerebellomedullary cistern and lumbar area relative to cervical CSF, and in the posterior versus the anterior subarachnoid space in the spinal canal. Flow communication was demonstrated in known communicating cysts or cavities. Differences in flow were also noted across spinal narrowing or block, and across the walls of a variety of cystic lesions in the brain and spinal cord. MR phase imaging of CSF flow provides pathophysiological information of potential clinical importance for the assessment of diseases affecting the CSF circulation. 相似文献
4.
Omar A. Hassanien Khalid A. Abo-Dewan Omar M. Mahrous Shiref E. El Kheshin 《The Egyptian Journal of Radiology and Nuclear Medicine》2018,49(3):701-710
Purpose
The aim is to assess the usefulness of cine phase-contrast MRI for evaluation of patency of endoscopic third ventriculostomy operation and correlation with clinical state postoperatively.Material & methods
Prospective study performed upon 20 patients who underwent ETV operation, concerned on obstructive hydrocephalus (age range, 4–63 years; 11 male & 9 Female). Cine PC-MRI CSF flowmetry technique was applied for qualitative and quantitative assessment of CSF flow dynamics through ETV stoma to assess its patency.Results
The patency of ETV stoma was evaluated according to overall flow amplitude (OFA) as it was the most effective variable to predict the response to surgery, we found that when OFA value is ≥75?μL, the sensitivity and specificity of our technique to determine patient improvement were 71.4% and 76.9%, respectively.According to OFA, we classified the state of ETV stoma into three subcategories: patent stoma with adequate flow; OFA value ≥75?μL (10 patients), patent stoma with low flow; OFA value from 25 up to <75?μL (4 patients) and obstructed stoma with impaired flow; OFA value <25?μL (6 patients).Conclusion
Cine phase-contrast MR imaging is an effective and reliable method for evaluation and follow up of the ETV patients postoperatively. 相似文献5.
Elke Hattingen Richard DuMesnil Ulrich Pilatus Andreas Raabe Timo Kahles Jürgen Beck 《European radiology》2009,19(7):1799-1808
In contrast-enhanced (CE) MR myelography, hyperintense signal outside the intrathecal space in T1-weighted sequences with
spectral presaturation inversion recovery (SPIR) is usually considered to be due to CSF leakage. We retrospectively investigated
a hyperintense signal at the apex of the lung appearing in this sequence in patients with SIH (n = 5), CSF rhinorrhoea (n = 2), lumbar spine surgery (n = 1) and in control subjects (n = 6). Intrathecal application of contrast agent was performed in all patients before MR examination, but not in the control
group. The reproducible signal increase was investigated with other fat suppression techniques and MR spectroscopy. All patients
and controls showed strongly hyperintense signal at the apex of the lungs imitating CSF leakage into paraspinal tissue. This
signal increase was identified as an artefact, caused by spectroscopically proven shift and broadening of water and lipid
resonances (1–2 ppm) in this anatomical region. Only patients with SIH showed additional focal enhancement along the spinal
nerve roots and/or in the spinal epidural space. In conclusion CE MR myelography with spectral selective fat suppression shows
a reproducible cervicothoracic artefact, imitating CSF leakage. Selective water excitation technique as well as periradicular
and epidural contrast collections may be helpful to discriminate between real pathological findings and artefacts. 相似文献
6.
Han KT Choi DS Ryoo JW Cho JM Jeon KN Bae KS You JJ Chung SH Koh EH Park KJ 《Neuroradiology》2007,49(10):813-818
Introduction Pyogenic intraventricular empyema (PIE) is a potentially fatal CNS infection. However, it is sometimes difficult to diagnose
PIE on the basis of clinical and conventional MRI findings. Diffusion-weighted imaging (DWI) has been accepted as a useful
MR sequence for the diagnosis of various intracranial infections. The purpose of this study was to determine the DWI characteristics
of PIE and the role of DWI in the diagnosis of PIE.
Methods Eight patients with PIE underwent MRI including DWI. We assessed the presence and signal characteristics of PIE. In seven
patients, the signal intensities of the PIE and cerebrospinal fluid (CSF) were measured and the contrast-to-noise ratio (CNR)
percentage was calculated. ADC values of the PIE, CSF, and white matter were also determined.
Results PIE was detected in all patients by DWI, in five (63%) by FLAIR imaging, and in two (25%) by T1- and T2-weighted imaging.
The CNR percentages of the PIEs in relation to the CSF were highest for DWI, followed by FLAIR, T1-, and T2-weighted imaging.
There were statistically significant differences between the images of each sequence. In all patients, PIE showed hyperintensities
on DWI and hypointensities to the CSF and hypo- or isointensities to the white matter on ADC maps. The ADC values (mean±SD)
of the PIE, CSF, and white matter were 0.60±0.27, 2.81±0.04, and 0.79±0.08 (×10−3 mm2/s). There was a statistically significant difference between PIE and the CSF.
Conclusion PIE shows a bright intensity on DWI, and DWI is a sensitive MR sequence for the diagnosis of PIE. 相似文献
7.
evaluation of communication between intracranial arachnoid cysts and cisterns with phase-contrast cine MR imaging 总被引:4,自引:0,他引:4
Yildiz H Erdogan C Yalcin R Yazici Z Hakyemez B Parlak M Tuncel E 《AJNR. American journal of neuroradiology》2005,26(1):145-151
BACKGROUND AND PURPOSE: The demonstration of communication between arachnoid cysts (ACs) and the adjacent subarachnoid space is a prerequisite for their proper management. CT cisternography (CTC) is the conventional method for functional evaluation of ACs. The sensitivity of MR imaging to CSF flow has been demonstrated, but reports of the clinical usefulness of MR CSF flow techniques in this application are limited. The purpose of our study was to prospectively evaluate the accuracy of MR CSF flow study as an alternative to CTC in this setting. METHODS: MR CSF flow study with retrospective ECG-gated 2D, fast low-angle shot, phase-contrast (PC), cine gradient-echo sequence was performed in 39 patients with an intracranial AC. Results were compared with intraoperative and CTC findings. RESULTS: PC cine MR imaging results were compatible with operative or CTC findings in 36 (92.3%) of 39 patients. Twenty-four cysts were noncommunicating, and 15 were communicating. Three cysts were evaluated as being noncommunicating on PC cine MR imaging (false-negative) but demonstrated contrast enhancement on CTC. No false-positive diagnoses occurred. All cysts regarded as being communicating on PC cine MR imaging were also found to be communicating on both confirmation methods. CONCLUSION: MR CSF flow imaging with a PC cine sequence can be incorporated in the imaging work-up of ACs. This is a reliable alternative to invasive CTC for the functional evaluation of ACs. 相似文献
8.
Li Y Li J Segal S Wegiel J De Santi S Zhan J de Leon MJ 《AJNR. American journal of neuroradiology》2006,27(4):912-918
BACKGROUND AND PURPOSE: Perihippocampal fissures (PHFs) and hippocampal sulcus residual cavities (HSCs) are common findings in the MR imaging examination of the hippocampus in aging and Alzheimer disease (AD); however, little is known about how to distinguish them or their relative clinical relevance. We hypothesized that prominence of the HSC, unlike PHF, is not significantly influenced by the hippocampal atrophy related to aging or AD. METHODS: We studied and evaluated these hippocampal CSF spaces on MR imaging scans from 130 normal control (NC) subjects (20-90 years of age) and 27 AD patients. RESULTS: HSC is poorly correlated with age and is not related to the magnitude of hippocampal atrophy. There is no significant difference of HSCs between AD and age-matched NCs, but in the extremely high HSCs group (top 20%), 91% of cases are NC. PHFs, on the other hand, are strongly correlated with age and are valuable in the diagnosis of AD. Location and communication with ambient cistern is the key to distinguish HSC from PHF. CONCLUSION: Identifying hippocampal atrophy (enlarged PHF) may be particularly challenging in the presence of HSC. Distinguishing among the CSF spaces in hippocampus may help in the radiologic evaluation of hippocampal atrophy. Patients with extremely high HSCs (>8.4) can be excluded from AD risk with 93% specificity. 相似文献
9.
Shinji Naganawa Hiroko Satake Shingo Iwano Michihiko Sone Tsutomu Nakashima 《Radiation Medicine》2008,26(10):597-602
Purpose Intratympanic injection of gadolinium diethylenetriaminepentaacetic acid (Gd-DTPA) has been reported as a procedure to visualize
endolymphatic hydrops of Meniere’s disease. We frequently noted that cerebrospinal fluid (CSF) in the internal auditory canal
(IAC) was also enhanced after this procedure. The purpose of this study was to evaluate how frequently this occurs and to
investigate the specific features of patients who lack this communication.
Materials and methods A total of 25 patients with clinically suspected endolymphatic hydrops underwent the procedure. After 24 h, three-dimensional
fluid-attenuated inversion recovery (3D-FLAIR) and 3D constructive interference in steady state (3D-CISS) were performed.
The presence of contrast enhancement in the CSF space of the fundus of the IAC was evaluated.
Results The contrast ratio between CSF of the IAC fundus and cerebellar white matter on the injected side was 1.49 ± 0.65, and that
of the noninjected side was 0.32 ± 0.16 (P < 0.01). Enhancement of the CSF space in the IAC fundus was seen in all but two subjects: one had enlarged endolymphatic
duct and sac syndrome (EEDS), and the other had cochlear nerve agenesis. In these two patients, the cochlear modiolus seemed
to be normal.
Conclusion Intratympanic Gd-DTPA administration can reveal permeability of the modiolus and might facilitate evaluation of functional
abnormalities of the modiolus not detected by conventional imaging tests. 相似文献
10.
This study was designed to assess the feasibility of intrathecal gadolinium-enhanced magnetic resonance cisternography (MRC) for the evaluation of the presence or absence of communication of cranial arachnoid cysts with the cerebrospinal fluid (CSF) pathways of the central nervous system (CNS). This prospective study included 20 patients (12 males and 8 females) with a mean age of 37 years, who had, as a group, 22 intracranial arachnoid cysts identified on prior CT and/or MR examinations. Routine pre-contrast cranial MR imaging was followed by the intrathecal administration of 0.5 cc gadopentetate dimeglumine (GD) (Magnevist, Schering, Germany). Immediate and delayed (24 h) MR cisternography was then carried out. Eleven of 22 arachnoid cysts showed immediate CSF communication by the demonstration GD-contrast enhancement of the cyst fluid on the immediate post-injection scan. Contrast enhancement of the cyst was observed only on delayed MRC in six patients. MR imaging in five patients demonstrated no contrast enhancement of the arachnoid cysts on either immediate or delayed imaging. Six patients had mild transient post-procedure headache that was relieved by oral analgesics within 24 h. No serious immediate or chronic adverse effects or complications relating to the intrathecal contrast administration were observed. This study showed the relative safety, feasibility and reliability of low-dose intrathecal GD MR imaging in the demonstration of the communication or non-communication of intracranial arachnoid cysts with the CSF pathways of the CNS. In the future, this may have bearing on the selection for surgery of patients with intracranial arachnoid cysts presenting with clinical signs and symptoms potentially related to the location and mass effect of the cyst.This study was presented at RSNA 2000 相似文献
11.
Value of MR cholangiography in the evaluation of postoperative biliary complications following orthotopic liver transplantation 总被引:4,自引:0,他引:4
Meersschaut V Mortelé KJ Troisi R Van Vlierberghe H De Vos M Defreyne L de Hemptinne B Kunnen M 《European radiology》2000,10(10):1576-1581
The aim of this study was to describe the spectrum of abnormal biliary findings as seen with magnetic resonance cholangiography
(MRC) in symptomatic patients after orthotopic liver transplantation (OLT). In our study we included 12 consecutive patients
post-OLT who presented with clinical and/or biochemical suspicion of biliary complications. In all patients MRC was performed
on a 1.0-T whole-body magnet and breathhold half-Fourier acquired single-shot turbo spin echo and rapid acquisition with relaxation
enhancement sequences were used. Diagnostic confirmation was obtained with percutaneous transhepatic cholangiography (PTC;
n = 3 patients), endoscopic retrograde cholangiography (ERC; n = 3 patients), or clinical follow-up. A vast array of biliary abnormalities were detected in 11 of 12 patients: high-grade,
obstructive, anastomotic stricture was the most common unique abnormality. Findings consistent with bile duct necrosis, the
second most common abnormality, were accompanied by arterial abnormalities in 2 of 5 patients on subsequent MR- and digital
subtraction angiography. Compared with the findings obtained with direct cholangiography (n = 5 patients), MRC was highly accurate for the detection and characterization of postoperative biliary complications. Compared
with the final diagnosis, which was based on PTC-ERC findings and/or all available clinical data, MRC imaging alone was able
to provide a specific diagnosis in 9 of 12 patients. Magnetic resonance cholangiography is an accurate, time-saving, and non-invasive
imaging modality in the evaluation of post-OLT patients in whom suspicion of biliary complications exists. Although the precise
value of MRA in this patient group requires larger dedicated studies, single session “all-in-one” MR evaluation of both biliary
and arterial system in our series proved to be a substantial benefit in obtaining an accurate and complete diagnosis.
Received: 2 December 1999; Revised: 24 February 2000; Accepted: 24 February 2000 相似文献
12.
Ljumanovic R Langendijk JA Hoekstra OS Knol DL Leemans CR Castelijns JA 《European radiology》2008,18(10):2231-2240
The purpose was to determine if pre-radiotherapy (RT) and/or post-radiotherapy magnetic resonance (MR) imaging can predict
response in patients with laryngeal carcinoma treated with RT. Pre- and post-RT MR examinations of 80 patients were retrospectively
reviewed and associated with regard to local control. Pre-RT MR imaging parameters such as tumor involvement of specific laryngeal
anatomic subsites including laryngeal cartilages and post-RT changes, i.e., complete resolution of the tumor or focal mass/asymmetric
obliteration of laryngeal tissue and signal pattern on T2-weighted images, were evaluated. Local control was defined as absence
of a recurrence at the primary site for 2 years. Local control rates based on pretreatment MR findings were 73% for low pre-RT
risk-profile and 29% for high pre-RT risk-profile patients (p = 0.0001). Based on posttreatment MR findings, local control
rates were 100% score 1, 64% score 2, and 4% score 3 (p < 0.0001). Using post-RT T2-weighted images, significant association
was found between differences in signal pattern and local control: 77% hypointense, 54% isointense and 15% hyperintense lesions
(p < 0.001). Differences between means of delay of post-MRI examination were significantly associated with regard to local
control (p = 0.003); recurrent tumors followed 5 months after RT were more easily detectable on MRI than recurrent tumors
within 4 months after RT. Sensitivity, specificity, accuracy, negative and positive predictive values of post-RT score 3 were
96%, 76%, 83%, 98% and 66%. Pre- and post-RT MRI evaluation of the larynx can identify patients at high risk for developing
local failure. 相似文献
13.
Jan Fritz Eva K. Galeczko Nina Schwenzer Michael Fenchel Claus D. Claussen John A. Carrino Marius S. Horger 《European radiology》2009,19(9):2217-2224
We retrospectively assessed the longitudinal changes of rheumatoid arthritis under rituximab therapy by use of quantitative
and dynamic contrast-enhanced 3-T magnetic resonance (MR) imaging of the metacarpophalangeal joints of 10 patients at baseline
and 26 weeks (n = 10). Additional studies were available at 12 weeks (n = 9) and at 52 weeks (n = 5). Clinical activity was assessed by use of the 28-joint disease activity score (DAS28). MR imaging was used to assess
volumes of synovial enhancement, osseous enhancement, and erosions and early rapid enhancement. DAS28 and serum C-reactive
protein trended down over time and were significantly lower at 26 weeks. Volume of synovial enhancement and early rapid enhancement
showed a significant minimum at 26 weeks and increased thereafter. The erythrocyte sedimentation rate paralleled these two
trends. Osseous enhancement did not significantly change over time. Erosions showed a significant progression. Trends of DAS28
and erosions were significantly different (P = 0.0075). In conclusion, our preliminary results suggest that rituximab is associated with a decrease of the inflammatory
activity of synovitis with a minimum at 26 weeks and increasing activity thereafter suggesting recurrence. Our results further
suggest subclinical progression of erosions with an inverse relationship to decreasing disease activity scores. Further studies
are needed to confirm these results. 相似文献
14.
Dee Malkerneker Reuven Brenner William H. Martin Uchechukwu K. A. Sampson Irene D. Feurer Marvin W. Kronenberg Dominique Delbeke 《Journal of nuclear cardiology》2007,14(3):314-323
Background The purpose of this study was to compare stress supine single photon emission computed tomography (SPECT) imaging with attenuation
correction (AC) via computed tomography-based attenuation maps with stress prone SPECT imaging with regard to the rate of
equivocal interpretation of rest/stress myocardial perfusion imaging.
Methods and Results Interpretations for 324 consecutive patients referred for rest/stress myocardial perfusion imaging were performed by use of
the following sets of poststress SPECT images: supine with no AC (NC), supine NC/AC, supine NC/prone, and all images. The
number of equivocal studies decreased with additional imaging: supine NC, 40%; supine NC/prone, 18%; supine NC/AC, 11%; and
all images, 8%. The supine NC/AC sets of images reduced the number of defects to a greater extent than the supine NC/prone
images for all patients (P=.01), men (P=.002), and women (P=.425). For the inferior (but not the anterior) wall, the percent decrease in defects with supine NC/AC images was lower as
compared with supine NC/prone images.
Conclusion Interpretation with all images resulted in the fewest equivocal studies. The supine NC/AC images reduced the number of equivocal
studies to a greater extent than the supine NC/prone images. AC and prone imaging were more helpful in men than women and
were more helpful to resolve inferior than anterior wall defects. Adding prone imaging to supine imaging without and with
AC does not significantly alter the number of equivocal interpretations. 相似文献
15.
Pranav K Vyas Thomas L Vesy Orhan Konez David P Ciavellara Keidang Hua Godfrey Gaisie 《Journal of magnetic resonance imaging : JMRI》2002,15(1):75-81
PURPOSE: To evaluate the utility of magnetic resonance cholangiography (MRC) in estimation of gallbladder ejection fraction (GBEF) and to comparing this value to the conventional method, hepatobiliary scintigraphy (HBS). MATERIALS AND METHODS: Twenty-one healthy volunteers were imaged on sequential weeks to determine GBEF using MRC and HBS. GBEF was calculated by HBS after infusion of 20 ng/kg of sincalide following injection of 111 Mbq of Tc 99(m) mebrofenin. For estimation by MRC, imaging of the gallbladder was performed before and after slow infusion of sincalide every 5 minutes, for a total of 60 minutes. Gallbladder imaging was performed using a heavily T2-weighted 2D fast spin echo (FSE) sequence. Data was analyzed using a variance component analysis technique. RESULTS: Mean GBEF by HBS was 65.7%, with an SD of +/-27.3%. Mean GBEF by MRC was 62.7%, with an SD of +/- 20.4%. If minimum normal GBEF is set at 35%, two of the cases showed discordance, with HBS calculating an abnormally low average GBEF compared to MRC. Additionally, two cases showed abnormally low GBEF for both modalities. The coefficient of correlation between HBS and MRC was 0.72. Inter- and intraobserver variance is acceptable within the two modalities with <1.1% variation. CONCLUSION: GBEF can be calculated with MRC, yielding similar values when a group of volunteers are considered. Further study with symptomatic patients is needed to determine the validity of this technique for clinical diagnosis. 相似文献
16.
Yoshinori Shigematsu Yukunori Korogi Toshinori Hirai Tomoko Okuda Takeshi Sugahara Luxia Liang Yulin Ge Mutsumasa Takahashi 《Journal of magnetic resonance imaging : JMRI》1998,8(2):289-296
Recent advances in three-dimensional (3D) data acquisition and postprocessing technologies have been playing a important role in widening the potential applications of 3D display. The authors described new applications of a virtual endoscopic algorithm for 3D display of high resolution MR images: (a) intracranial intravascular virtual MR endoscopy using the 3D fast imaging with steady state precession (FISP) sequence, and (b) virtual MR endoscopy of the cerebrospinal fluid (CSF) spaces using the constructive interference in steady state (CISS) three-dimensional Fourier transform (3DFT) sequence. The virtual endoscopic images were displayed with use of a commercially available perspective volume-rendering algorithm. Our initial experience showed that virtual MR endoscopy can be performed to observe the intracranial arteries and CSF spaces from the viewpoints within themselves. Although the clinical use of the intracranial virtual MR endoscopy has not been established yet, the images obtained are very attractive and further investigations in this field will be expected. 相似文献
17.
Guillaume Bierry François Jehl Nelly Boehm Philippe Robert Jean-Louis Dietemann Stéphane Kremer 《European radiology》2009,19(7):1604-1611
The purpose of this study was to prospectively evaluate USPIO-enhanced MR imaging for the differentiation of vertebral infectious
osteomyelitis and sterile inflammation. Vertebral osteomyelitis and sterile vertebral inflammation were induced in two groups
of six rabbits each. MRI examinations were performed including unenhanced and gadolinium-enhanced fat-saturated SE T1w sequences.
Once endplate enhancement was observed on the T1 gadolinium-enhanced MR sequence, a second MRI examination (SE T1w sequence)
was performed 24 h after USPIO administration (45 μmol Fe/kg). MR imaging was correlated with histopathological findings (macrophage
immunostaining and Perls Prussian blue staining). On gadolinium-enhanced T1 sequences, a significant SNR increase in vertebral
endplates was present in both groups without significant difference between the two groups (P = 0.26). On USPIO-enhanced T1 sequences, a significant SNR increase was only observed in the infection group (P = 0.03) with a significant difference in SNR between the infection and the sterile-inflammation groups (P = 0.002). Infected areas presented replacement of bone marrow by an intense macrophage infiltration, some being iron-loaded.
Sterile inflammation showed a replacement of bone marrow by inflammatory tissue with only rare macrophages without any Perls
blue staining. USPIO-enhanced MR imaging can distinguish infectious osteomyelitis from sterile vertebral inflammation due
to different macrophage distributions in the two lesions. 相似文献
18.
Sönke Arlt Stefanie Brassen Holger Jahn Florian Wilke Martin Eichenlaub Ivayla Apostolova Fabian Wenzel Frank Thiele Stewart Young Ralph Buchert 《European journal of nuclear medicine and molecular imaging》2009,36(7):1090-1100
Purpose Brain imaging of FDG uptake and cerebrospinal fluid (CSF) concentration of amyloid-beta 1–42 (Aβ1-42) or tau proteins are promising biomarkers in the diagnosis of Alzheimer’s disease (AD). There is still uncertainty regarding
any association between decreased FDG uptake and alterations in CSF markers.
Methods The relationship between FDG uptake, CSF Aβ1-42 and total tau (T-tau), as well as the Mini-Mental State Examination (MMSE) score was investigated in 34 subjects with probable
AD using step-wise linear regression. FDG uptake was scaled to the pons.
Results Scaled FDG uptake was significantly reduced in the probable AD subjects compared to 17 controls bilaterally in the precuneus/posterior
cingulate area, angular gyrus/inferior parietal cortex, inferior temporal/midtemporal cortex, midfrontal cortex, and left
caudate. Voxel-based single-subject analysis of the probable AD subjects at p < 0.001 (uncorrected) revealed a total volume of significant hypometabolism ranging from 0 to 452 ml (median 70 ml). The
total hypometabolic volume was negatively correlated with the MMSE score, but it was not correlated with the CSF measures.
VOI-based step-wise linear regression revealed that scaled FDG uptake in the precuneus/posterior cingulate was negatively
correlated with CSF Aβ1-42. Scaled FDG uptake in the caudate was positively correlated with CSF T-tau.
Conclusion The extent and local severity of the reduction in FDG uptake in probable AD subjects are associated with cognitive impairment.
In addition, there appears to be a relationship between local FDG uptake and CSF biomarkers which differs between different
brain regions. 相似文献
19.
Jacques AE Sahdev A Sandrasagara M Goldstein R Berney D Rockall AG Chew S Reznek RH 《European radiology》2008,18(12):2885-2892
The purpose of this study was to describe the range of appearances of adrenal phaeochromocytomas on T2-weighted MRI, correlate
appearances with histopathology, and quantify the incidence of the previously described hyperintense appearance. The appearance
and MR characteristics of 44 phaeochromocytomas were reviewed retrospectively. T2-weighted appearances were grouped: (1) ‘classical’,
homogeneous, high signal intensity, isointense to CSF; (2) homogeneous, isointense or minimally hyperintense to spleen, hypointense
to CSF; (3) heterogeneous, marbled appearance; (4) heterogeneous, multiple high signal intensity pockets. All 44 adrenal phaeochromocytomas
were well circumscribed, 1.2–15 cm in maximum diameter, with no visual or quantitative signal loss on chemical shift imaging.
On T2-weighted MRI 5/44 (11%) had group 1 appearance; 15/44 (34%) group 2, 7/44 (16%) group 3; and 17/44 (39%) group 4. Homogeneous
group 1 and 2 lesions were smaller (mean 4.5 cm) than heterogeneous group 3 and 4 lesions (mean 6.3 cm). Increasing MRI heterogeneity
correlated pathologically with increasing amounts of haemorrhage, necrosis and fibrosis. No MRI features were predictive of
malignancy. Non-functioning phaeochromocytomas were larger than functioning lesions. No size difference was seen between syndrome
and sporadic lesions. In this large series we report a wide range of appearances of adrenal phaeochromocytomas on T2-weighted
MRI. The previously described classical hyperintense phaeochromocytoma is relatively uncommon. 相似文献
20.
Staging of Klatskin tumours (hilar cholangiocarcinomas): comparison of MR cholangiography, MR imaging, and endoscopic retrograde cholangiography 总被引:2,自引:2,他引:0
Vogl TJ Schwarz WO Heller M Herzog C Zangos S Hintze RE Neuhaus P Hammerstingl RM 《European radiology》2006,16(10):2317-2325
The aim of the study was to compare prospectively magnetic resonance cholangiography (MRC) and magnetic resonance imaging (MRI) with endoscopic retrograde cholangiography (ERC) in the diagnosis and staging of Klatskin tumours of the biliary tree (hilar cholangiocarcinomas). Forty-six patients with suspected Klatskin tumours of the biliary tract underwent MRI and heavily T2-weighted, non-breathhold, respiratory-triggered fast spin-echo MRC. Forty-two patients underwent ERC within 24 h; in four patients, ERC was not feasible, and percutaneous trans-hepatic cholangiography (PTC) was carried out instead. Two independent investigators evaluated imaging results for the presence of tumour, bile duct dilatation, and stenosis. Clinical and histopathological correlation revealed Klatskin tumours in 33 patients. MRI revealed a slightly hyperintense signal of infiltrated bile ducts in T2-weighted fast spin-echo sequences. The malignant lesion was regularly visualized as a hypointense area in T1-weighted gradient-echo sequences with substantial contrast enhancement along the involved bile duct walls. MRC revealed the location and extension of the tumour in 31 of 33 cases correctly (sensitivity 94%, specificity 100%, diagnostic accuracy 95%). In 27 of 31 cases, ERC enabled accurate staging and diagnosis of Klatskin tumours with a sensitivity of 87%. ERC and PTC combined yielded a sensitivity of 84% and a specificity of 97%. Tumours were grouped according to the Bismuth classification, with MRC allowing correct identification of type I tumour in seven patients, type II tumour in four patients, type III tumour in 12 patients, and type IV tumour in ten patients. MRC provided superior visualization of completely obstructed peripheral systems. MRC in combination with MRI is a reliable non-invasive diagnostic method for the pre-therapeutic staging of Klatskin tumours. 相似文献