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Assessment of Cerebrovascular Reserve in the Setting of Moyamoya Disease Using Arterial Spin-Labeling and Acetazolamide Challenge 应用动脉自旋标记和乙酰唑胺激发法评估烟雾病患者的脑血管储备
Neurographics Pub Date : 2022-10-01 DOI: 10.3174/ng.2100070
E. McConnell, M. Tivarus, H.Z. Wang
{"title":"Assessment of Cerebrovascular Reserve in the Setting of Moyamoya Disease Using Arterial Spin-Labeling and Acetazolamide Challenge","authors":"E. McConnell, M. Tivarus, H.Z. Wang","doi":"10.3174/ng.2100070","DOIUrl":"https://doi.org/10.3174/ng.2100070","url":null,"abstract":"Arterial spin-labeling is a safe, noninvasive, contrast-free MR imaging technique that can be used to assess CBF. In this review, we will briefly discuss the advantages and disadvantages of arterial spin-labeling juxtaposed to previously established modalities of cerebral perfusion\u0000 imaging, summarize the materials and methods required for arterial spin-labeling, and provide clinical case examples in which application of arterial spin-labeling combined with an acetazolamide challenge was used safely to improve patient outcomes in the setting of Moyamoya disease. Arterial\u0000 spin-labeling takes advantage of the directionality of arterial blood flow by labeling the patient's own endogenous water within the neck via radiofrequency pulse and imaging of the downstream brain after an appropriate delay. This tool allows repeatable intra- and intersession estimation\u0000 of CBF to better assess postinterventional outcomes in patients with cerebrovascular dysfunction. One specific example of the utility of arterial spin-labeling is its application in patients with Moyamoya disease by selection and stratification of those most likely to benefit from surgical\u0000 intervention. The combination of arterial spin-labeling with acetazolamide challenge is an effective way to assess cerebrovascular reserve in Moyamoya disease and is easily adaptable on a clinical 3T MR imaging scanner using a commercially available arterial spin-labeling pulse sequence to\u0000 generate augmentation and steal maps. The entire study can be completed in only 20 minutes in a routine clinical setting.Learning Objective: To describe the implementation and interpretation of arterial spin-labeling combined with an acetazolamide challenge","PeriodicalId":36193,"journal":{"name":"Neurographics","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41793460","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Meningioma or Mimic: Look Twice and Save a Life 脑膜瘤还是脑膜瘤:再看一遍，挽救一条生命
Neurographics Pub Date : 2022-10-01 DOI: 10.3174/ng.2100061
P.R. Damalcheruvu, M. Mian, S. Sharma, S. Patro, S. Vattoth, S. Viswamitra, R. Ramakrishnaiah, M. Kumar, R. V. Van Hemert
{"title":"Meningioma or Mimic: Look Twice and Save a Life","authors":"P.R. Damalcheruvu, M. Mian, S. Sharma, S. Patro, S. Vattoth, S. Viswamitra, R. Ramakrishnaiah, M. Kumar, R. V. Van Hemert","doi":"10.3174/ng.2100061","DOIUrl":"https://doi.org/10.3174/ng.2100061","url":null,"abstract":"Meningiomas are the most common brain tumors in adults and are often incidentally detected on imaging studies. Most often diagnostic confidence is high on the basis of imaging findings. Meningiomas may demonstrate atypical features such as cysts, hemorrhage, or metaplastic changes that\u0000 can be misleading. Several other neoplastic and granulomatous inflammatory conditions may mimic meningiomas. Differentiating these lesions from meningiomas is important because treatment strategies and prognoses differ. We will review and discuss the typical and atypical imaging features of\u0000 meningiomas and how to differentiate meningioma from its mimics.Learning Objectives: After reading the review and completing the accompanying CME questions, the reader will be able to do the following: describe the typical and less common imaging findings of meningiomas, diagnose meningiomas\u0000 presenting in uncommon locations, and differentiate meningiomas from mimics.","PeriodicalId":36193,"journal":{"name":"Neurographics","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46901643","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
3D Cinematic Volume-Rendering Technique of Traumatic Spine Injuries: A Powerful Tool for Radiology Education 创伤性脊柱损伤的三维电影体绘制技术:放射学教育的有力工具
Neurographics Pub Date : 2022-10-01 DOI: 10.3174/ng.2100069
M. Breen, O. Jawhar, E. Lustrin, M. Young
{"title":"3D Cinematic Volume-Rendering Technique of Traumatic Spine Injuries: A Powerful Tool for Radiology Education","authors":"M. Breen, O. Jawhar, E. Lustrin, M. Young","doi":"10.3174/ng.2100069","DOIUrl":"https://doi.org/10.3174/ng.2100069","url":null,"abstract":"Spine trauma represents a common indication for imaging in the emergency department. Multidetector CT imaging, with its advantage of multiplanar reconstructions and fast image acquisition, is the technique of choice in the initial assessment of a patient with polytrauma. While many\u0000 simple spinal fractures are adequately evaluated on 2D multiplanar reconstruction images, more complex, potentially displaced fracture patterns can be more fully highlighted on 3D reconstructions. Compared with conventional volume-rendering techniques, cinematic rendering uses a complex illumination\u0000 model to create a more photorealistic representation of the fracture patterns, images that are certain to excite both trainees and clinicians. This review demonstrates the educational value and clinical utility of 3D cinematic rendering images in understanding complex spinal column injuries.Learning\u0000 Objective: To demonstrate the methodology, clinical applicability, and educational utility behind 3D photorealistic cinematic rendering images of spine injuries, with emphasis on the “tension bands” biomechanical concept","PeriodicalId":36193,"journal":{"name":"Neurographics","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47213769","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Deciphering the Clinical Trials of Immunotherapy in Glioblastoma: What a Neuroradiologist Needs to Know 解读胶质母细胞瘤免疫治疗的临床试验:神经放射学家需要知道的
Neurographics Pub Date : 2022-10-01 DOI: 10.3174/ng.2100055
F. N. Varzaneh, S. Merkaj, G. C. Petersen, R.C. Bahar, L. Jekel, A. Pala, A. Malhotra, J. Ivanidze, M. Aboian
{"title":"Deciphering the Clinical Trials of Immunotherapy in Glioblastoma: What a Neuroradiologist Needs to Know","authors":"F. N. Varzaneh, S. Merkaj, G. C. Petersen, R.C. Bahar, L. Jekel, A. Pala, A. Malhotra, J. Ivanidze, M. Aboian","doi":"10.3174/ng.2100055","DOIUrl":"https://doi.org/10.3174/ng.2100055","url":null,"abstract":"Glioblastoma is the most common malignant adult primary intracranial neoplasm. Although a multidisciplinary approach combining surgical resection followed by radiation therapy and chemotherapy is currently applied to the target glioblastoma, prognosis and survival outcomes are poor.\u0000 Consequently, a range of immunotherapeutic approaches is being actively investigated to address the need for more efficacious glioblastoma treatments. Given the rapid growth of immunotherapy in the treatment of glioblastoma, neuroradiologists need to be familiar with the basic concepts and\u0000 mechanisms of immunotherapy, along with the current state and future directions in this field. In the present study, we review different types of immunotherapies, including immune checkpoint inhibitors and glioblastoma vaccines, as well as their application to the treatment of glioblastoma.\u0000 Moreover, we review clinical trials of immunotherapy in glioblastoma, discuss reasons for trial failure, and summarize future directions for research.Learning Objective: To describe the different types of immunotherapies and their application to the treatment of glioblastoma and explain\u0000 the results of associated clinical trials along with reasons for trial failure and future directions","PeriodicalId":36193,"journal":{"name":"Neurographics","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46737974","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Agenesis of the ICA with a Contralateral Cavernous-Supraclinoid Anastomotic Vessel ICA与对侧海绵窦上吻合血管的发育不全
Neurographics Pub Date : 2022-10-01 DOI: 10.3174/ng.2100029
J. Lowenthal, I. W. Kane, G. Gupta, I. Keller, S. Roychowdhury
{"title":"Agenesis of the ICA with a Contralateral Cavernous-Supraclinoid Anastomotic Vessel","authors":"J. Lowenthal, I. W. Kane, G. Gupta, I. Keller, S. Roychowdhury","doi":"10.3174/ng.2100029","DOIUrl":"https://doi.org/10.3174/ng.2100029","url":null,"abstract":"Congenital agenesis of an ICA is exceptionally rare. Survival requires remodeling of the intracranial vasculature, with several classic vascular patterns and anastomoses having been recognized in the literature. We present a patient with ICA agenesis who exhibited a distinctive anastomotic\u0000 vessel extending from the contralateral cavernous carotid artery directly to the supraclinoid ICA on the affected side, a finding only documented in a handful of patients with this already rare condition.","PeriodicalId":36193,"journal":{"name":"Neurographics","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44774836","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Pictorial Review of Cavernous Sinus Hemangiomas (Venous Malformations) 海绵窦血管瘤（静脉畸形）图片回顾
Neurographics Pub Date : 2022-10-01 DOI: 10.3174/ng.2100063
M. Nasralla, J. Cain, S. Mathur
{"title":"Pictorial Review of Cavernous Sinus Hemangiomas (Venous Malformations)","authors":"M. Nasralla, J. Cain, S. Mathur","doi":"10.3174/ng.2100063","DOIUrl":"https://doi.org/10.3174/ng.2100063","url":null,"abstract":"Cavernous venous malformations of the cavernous sinus are rare, benign tumors that account for 2%‐3% of all cavernous sinus lesions. An accurate pretreatment diagnosis is important due to the highly vascular nature of these lesions and the risk of major intraoperative hemorrhage.\u0000 A shifting preference toward radiosurgery as a primary treatment, increasingly without a pretreatment biopsy, further underscores the need for an accurate imaging diagnosis. The aim of this pictorial review is to illustrate the imaging findings of cavernous sinus venous malformations on CT\u0000 and MR imaging, the use of red blood cell scintigraphy as an adjunct imaging technique, relevant differential diagnoses, and management.Learning Objective: To describe the main imaging features of cavernous sinus venous malformations using CT, MR imaging, and red blood cell scintigraphy\u0000 to differentiate them from other common lesions of the cavernous sinus","PeriodicalId":36193,"journal":{"name":"Neurographics","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49266691","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Leukocoria in Children: Findings on CT and MRI of the Principal Causes 儿童白斑:主要病因的CT和MRI表现
Neurographics Pub Date : 2022-10-01 DOI: 10.3174/ng.2100035
N. Sanchez, P. Kranz, D. Constenla
{"title":"Leukocoria in Children: Findings on CT and MRI of the Principal Causes","authors":"N. Sanchez, P. Kranz, D. Constenla","doi":"10.3174/ng.2100035","DOIUrl":"https://doi.org/10.3174/ng.2100035","url":null,"abstract":"Leukocoria is the result of an alteration in the normal red reflex of the ocular fundus, secondary to an obstruction of the normal passage of light to the fundus of the eye that produces a white light reflex. There are many ocular pathologies that can present as leukocoria, among which\u0000 retinoblastoma is the most frequent. Other causes include cataracts, Coats disease, persistent fetal vasculature, coloboma, retinopathy of prematurity, vitreous hemorrhage, astrocytic hamartoma, and ocular toxocariasis. Although in many situations the diagnosis of these pathologies is clinical\u0000 or possible with the use of ocular sonography, in certain circumstances, CT or MR imaging may play a very important role in the differential diagnosis. In this review article, we propose that findings such as ocular size, the presence of calcifications, intravenous contrast enhancement, MR\u0000 imaging signal intensity, CT density, and other pathology-specific findings, along with some clinical data, will guide us to the cause of leukocoria. Knowledge of the most prevalent ages of presentation of these pathologies assists with establishing the final diagnosis.Learning Objectives:\u0000 To understand why leukocoria occurs, to list the major causes of leukocoria in children, and to recognize the imaging findings of the most frequent causes of leukocoria and apply them in the differential diagnosis","PeriodicalId":36193,"journal":{"name":"Neurographics","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47135743","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Radiologic Findings of Dorsal Root Entry Zone Lesioning 背根进入区病变的影像学表现
Neurographics Pub Date : 2022-07-01 DOI: 10.3174/ng.2100019
M. Al-Hameed, N. Mills, K. M. Zaki-Metias, R. Kaakaji, K. A. Shah
{"title":"Radiologic Findings of Dorsal Root Entry Zone Lesioning","authors":"M. Al-Hameed, N. Mills, K. M. Zaki-Metias, R. Kaakaji, K. A. Shah","doi":"10.3174/ng.2100019","DOIUrl":"https://doi.org/10.3174/ng.2100019","url":null,"abstract":"Dorsal root entry zone lesioning is an intervention that may be performed in patients with brachial plexus avulsion injuries to reduce neuropathic pain. There is little description in the literature of the expected postoperative imaging findings following dorsal root entry zone ablation.\u0000 We describe a case of a 36-year-old man who underwent MR imaging of the cervical spine 3 years following dorsal root entry zone lesioning. This article will also discuss the expected postoperative imaging findings following dorsal root entry zone lesioning as well as the imaging features of\u0000 common complications of the procedure.","PeriodicalId":36193,"journal":{"name":"Neurographics","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44321167","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Breaking the Rules: Nonclassic Appearances of Parathyroid Adenomas 打破规则：甲状旁腺腺瘤的非经典表现
Neurographics Pub Date : 2022-07-01 DOI: 10.3174/ng.2100052
S.S. Kumar, K. Mathew, M. Czaplicki, P. Manickam, W. Quiñones, N. Purdy, T. Ly, A. M. De Luca, K. Sargar, G. Mongelluzzo
{"title":"Breaking the Rules: Nonclassic Appearances of Parathyroid Adenomas","authors":"S.S. Kumar, K. Mathew, M. Czaplicki, P. Manickam, W. Quiñones, N. Purdy, T. Ly, A. M. De Luca, K. Sargar, G. Mongelluzzo","doi":"10.3174/ng.2100052","DOIUrl":"https://doi.org/10.3174/ng.2100052","url":null,"abstract":"At many institutions, 4D-CT has become the first-line technique for localizing candidate parathyroid adenomas before surgical resection. The appearance of the classic parathyroid adenoma on 4D-CT is well described in the literature, including enhancement pattern, morphology, and typical\u0000 locations. However, readers of 4D-CT are quick to learn that many parathyroid adenomas do not conform to this conventional appearance. We will review both the classic appearance of parathyroid adenoma on 4D-CT as well as variations in appearance and location that are important to know for\u0000 successful lesion localization. Familiarity with histologically proved adenomas that deviate from the classic appearance enables practicing neuroradiologists to more effectively identify potential candidate lesions, aiding the surgeon in rendering a cure.Learning Objective: To describe\u0000 the nonclassic appearance of parathyroid adenomas to improve preoperative identification of candidate lesions","PeriodicalId":36193,"journal":{"name":"Neurographics","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41778989","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Arterial Spin-Labeling Perfusion for Neuroradiologists: The Essentials 动脉自旋标记灌注神经放射学家:要领
Neurographics Pub Date : 2022-07-01 DOI: 10.3174/ng.2100043
T. Marini, D. Mistry, S. Jetty, H. Wang, E. Lin, J. Almast, N. Soni, S. Ellika
{"title":"Arterial Spin-Labeling Perfusion for Neuroradiologists: The Essentials","authors":"T. Marini, D. Mistry, S. Jetty, H. Wang, E. Lin, J. Almast, N. Soni, S. Ellika","doi":"10.3174/ng.2100043","DOIUrl":"https://doi.org/10.3174/ng.2100043","url":null,"abstract":"Arterial spin-labeling is an increasingly used advanced imaging technique that can assess perfusion without the administration of IV contrast. There is a myriad of clinical uses for arterial spin-labeling that are important to the practice of neuroradiology. In this pictorial review,\u0000 we provide an image-rich guide to the different clinical applications of arterial spin-labeling with a focus on the essential imaging findings. Covered areas include the applications of arterial spin-labeling in tumors, cerebrovascular disease, arteriovenous malformation, infection, and dementia.\u0000 A mastery of arterial spin-labeling provides an important tool in the neuroradiologist's arsenal to best assist the ordering clinician in arriving at the correct diagnostic interpretation.Learning Objective: To describe the various clinical applications of arterial spin-labeling and their\u0000 associated imaging findings","PeriodicalId":36193,"journal":{"name":"Neurographics","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42902914","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
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