Application of CT Angiography of Complex Cerebrovascular Lesions during Surgical Decision Making

Helical computed tomographic angiography (CTA) is a relatively new noninvasive volumetric imaging technique. Since early reports in the 1990s, CTA has rapidly improved image resolution and scan volume. Cerebral arteries can be imaged clearly, which is advantageous in the diagnosis of vascular diseases such as cerebral aneurysms, arteriovenous malformations, and cerebrovascular occlusive disease. Before attacking a cerebrovascular lesion near or in the skull base, precise preoperative knowledge of anatomic relationships between the bony and neurovascular structures is critical for obtaining successful outcomes. The sensitivity of CTA for the detection of cerebral aneurysms < or = 5 mm in diameter may be higher than that of digital subtraction angiography (DSA), with equal specificity and high interoperator reliability. With minor modification to the technique, paraclinoid vascular lesions can be depicted using CTA. We present our experience using CTA in addition to DSA to obtain important anatomic information about skull base vascular lesions that assisted in the clinical decision-making process.     

Spectrally weighted twisted projection imaging: Reducing T2 signal attenuation effects in fast three-dimensional sodium imaging

A scheme for the reduction of T₂ signal attenuation effects in three-dimensional twisted projection imaging is presented. By purposely reducing the sample density at the high spatial frequencies, a considerable reduction in readout time is achieved. The reduction in readout time leads to decreased T₂ signal attenuation which translates into improved signal-to-noise ratio (SNR). The SNR improvement is achieved without decreasing the image's resolution since the point spread function depends on the sample weighting as well as the T₂ attenuation. The results indicate that SNR improvements of up to 40% can be achieved using the proposed scheme.     

Diagnostic Features, Differential Diagnosis, and Treatment of Suhungual Osteochondroma

Abstract: Osteochondromas are among the most common cartilaginous neoplasms, but are rarely seen on the fingers and toes. We report a 10-year-old girl who had a dystrophic fingernail since Infancy that was identified as a subungual Osteochondroma radiologically and histopathologically. The clinical, radiographic, and histopathologic features, as well as the pertinent differential diagnoses and treatment options are discussed.     

Comorbidity of mental disorders with alcohol and other drug abuse. Results from the Epidemiologic Catchment Area (ECA) Study

The prevalence of comorbid alcohol, other drug, and mental disorders in the US total community and institutional population was determined from 20,291 persons interviewed in the National Institute of Mental Health Epidemiologic Catchment Area Program. Estimated US population lifetime prevalence rates were 22.5% for any non-substance abuse mental disorder, 13.5% for alcohol dependence-abuse, and 6.1% for other drug dependence-abuse. Among those with a mental disorder, the odds ratio of having some addictive disorder was 2.7, with a lifetime prevalence of about 29% (including an overlapping 22% with an alcohol and 15% with another drug disorder). For those with either an alcohol or other drug disorder, the odds of having the other addictive disorder were seven times greater than in the rest of the population. Among those with an alcohol disorder, 37% had a comorbid mental disorder. The highest mental-addictive disorder comorbidity rate was found for those with drug (other than alcohol) disorders, among whom more than half (53%) were found to have a mental disorder with an odds ratio of 4.5. Individuals treated in specialty mental health and addictive disorder clinical settings have significantly higher odds of having comorbid disorders. Among the institutional settings, comorbidity of addictive and severe mental disorders was highest in the prison population, most notably with antisocial personality, schizophrenia, and bipolar disorders.