Neuroradiology 0028-3940

Bergström, M.; Muhr, C.; Ericson, K.; Lundqvist, H.; Lilja, A.; Eriksson, L.; Blomquist, G.; Långström, B.; Johnström, P.

doi: 10.1007/BF00451757pmid: 3497360

234 29 29 3 3 M. Bergström C. Muhr K. Ericson H. Lundqvist A. Lilja L. Eriksson G. Blomquist B. Långström P. Johnström Department of Radiation Physics Karolinska Hospital Stockholm Department of Neuroradiology Karolinska Hospital Stockholm Department of Clinical Neurophysiology Karolinska Hospital Stockholm Department of Karolinska Pharmacy Karolinska Hospital Stockholm Department of Neurology Gustaf Werner Institute Uppsala Sweden Department of Diagnostic Radiology Gustaf Werner Institute Uppsala Sweden Department of Physical Biology Gustaf Werner Institute Uppsala Sweden Department of Organic Chemistry Uppsala University Uppsala Sweden Department of Neurology University Hospital S-75185 Uppsala Sweden Summary Four patients with radiologically normal pituitary gland were examined with positron emission tomography after the administration of (methyl- 11 C)-L-methionine. On a following day the examination was repeated with (methyl- 11 c)-D-methionine. The accumulation rate of L-methionine in the pituitary was measured, giving a value that was about twice that of normal brain tissue. The accumulation rate of D-methionine in the pituitary was almost a factor of 10 lower than that of L-methionine. In the normal brain tissue that ratio was 2.3. The study clearly indicates that the methionine uptake in the pituitary is stereospecific. 11 C-D-methionine is freely distributed in the tissue without entrapment, whereas 11 C-L-methionine is irreversibly bound. It is concluded that PET with 11 C-L-methionine can be used to study amino acid utilization in the pituitary.

Miller, D.; Ormerod, I.; Gibson, A.; Boulay, E.; Rudge, P.; McDonald, W.

doi: 10.1007/BF00451758pmid: 2886954

234 29 29 3 3 D. H. Miller I. E. C. Ormerod A. Gibson E. P. G. H. du Boulay P. Rudge W. I. McDonald Institute of Neurology Queen Square London Northwick Park Hospital Harrow Middlesex England Summary We performed MR (magnetic resonance) brain imaging on 24 patients with a systemic vasculitis. MRI proved to be a sensitive method for detecting brain lesions (clinically silent or manifest) in these patients. The most frequent abnormalities were periventricular lesions seen in 12 cases. Such changes are not specific for vascular disease, and are often seen in multiple sclerosis. However, additional changes were commonly seen which suggested the correct diagnosis.

Zimmerman, R.; Gill, F.; Goldberg, H.; Bilaniuk, L.; Hackney, D.; Johnson, M.; Grossman, R.; Hecht-Leavitt, C.

doi: 10.1007/BF00451759pmid: 3614618

234 29 29 3 3 R. A. Zimmerman F. Gill H. I. Goldberg L. T. Bilaniuk D. B. Hackney M. Johnson R. I. Grossman C. Hecht-Leavitt Department of Radiology Hospital of the University of Pennsylvania Philadelphia USA Division of Hematology The Children's Hospital of Philadelphia Philadelphia USA the Department of Pediatrics, School of Medicine The University of Pennsylvania Philadelphia USA Summary Eleven patients with sickle cell disease and neurological symptoms underwent MRI examination. Cerebral infarcts of two types were found, those in the vascular distribution of the middle cerebral artery and those in the deep white matter. In the patient whose hydration and whose oxygenation of erythrocytes has been treated, MRI offers diagnostic advantages over arteriography and CT.

Johnson, G.; Miller, D.; MacManus, D.; Tofts, P.; Barnes, D.; Boulay, E.; McDonald, W.

doi: 10.1007/BF00451760pmid: 3614619

234 29 29 3 3 G. Johnson D. H. Miller D. MacManus P. S. Tofts D. Barnes E. P. G. H. du Boulay W. I. McDonald Institute of Neurology Queen Square London UK National Hospitals for Nervous Dieseases Queen Square London UK Summary Orbital fat surrounding the optic nerve causes considerable difficulties in NMR imaging due to its high image intensity and the chemical shift artefact. We have investigated the ability of inversion recovery seqeunces with short inversion times (STIR sequences) to suppress fat signals in imaging the optic nerve. We have also compared the contrast attainable with STIR sequences with that obtainable from other sequences. Measurements were made on 4 normal controls and 5 patients with multiple sclerosis (MS) to obtain typical values of relaxation times and proton densities for orbital fat, cerebral white matter and MS lesions. The fat T 1 measurements were used to predict an appropriate inversion time for the STIR sequence and estimate how much residual fat signal might be expected as a result of natural variations in fat T 1 . STIR sequences can be used to suppress the signal from orbital fat with little residual signal. Measurements from white matter and MS lesions were used to predict the contrast between normal and pathological tissues that is attainable with STIR sequences. STIR contrast compares favourably with that obtainable from other sequences.

Zimmerman, R.; Bilaniuk, L.; Hackney, D.; Goldberg, H.; Grossman, R.

doi: 10.1007/BF00451761pmid: 3614620

234 29 29 3 3 R. A. Zimmerman L. T. Bilaniuk D. B. Hackney H. I. Goldberg R. I. Grossman Department of Radiology Hospital of the University of Pennsylvania Philadelphia PA USA Summary In seven patients with temporal bone fractures examined by both CT and MRI, thin section CT proved superior to MRI in demonstrating the full extent of the fractures and the status of the ossicular chain. MR studies were able to demonstrate fractures, when these fractures contained blood or CSF, and the presence of ossicular dislocation in one case where the middle ear was completely filled with CSF or blood. Admixture of air in the middle ear gave a false impression of ossicular dislocation, while air in the fracture obscured portions of it. MR proved superior to CT in the evaluation of intracranial contents by showing 5 additional subdural hematomas, 2 epidural hematomas and 2 hemorrhagic contusions.

Kadoya, S.; Nakamura, T.; Kobayashi, S.; Yamamoto, I.

doi: 10.1007/BF00451762pmid: 3614621

234 29 29 3 3 S. Kadoya T. Nakamura S. Kobayashi I. Yamamoto Department of Neurosurgery and Radiology Kanazawa Medical University 920-02 Uchinada Japan Summary Magnetic resonance imaging of acute spinal cord injury is described. The traumatized cord segment was clearly shown as a hyperintensity in a T2-weighted image whereas it appeared as an isointensity in a moderately T1-weighted image. This different sensitivity may result from parenchymal hemorrhagic tissue and edematous changes due to direct trauma. Hyperintense tissue was also seen in the retro-pharyngeal and-tracheal spaces.

Nakstad, P.

doi: 10.1007/BF00451763pmid: 3614622

234 29 29 3 3 P. Nakstad Department of Radiology, Section of Neuroradiology, Rikshospitalet, The National Hospital University of Oslo Oslo Norway Summary One hundred cervical myelographies in patients without degenerative changes on plain radiographs were evaluated. Pathologic changes were seen in 75 patients, most of them with congenital spinal canal stenosis and dural sac stenosis. Normal values for sagittal diameter of the dural sac from C2 to C6 were established. It was found that a quotient <0.9 between the sagittal diameter of the spinal canal and the midsagittal diameter of the vertebral body indicated congenital stenosis. It is concluded that plain radiographs of the cervical spine are unreliable in predicting the diagnostic value of cervical myelography.

Davis, S.; Tress, B.; Hopper, J.; Kaye, A.; Rossiter, S.

doi: 10.1007/BF00451764pmid: 3614623

234 29 29 3 3 S. M. Davis B. M. Tress J. L. Hopper A. H. Kaye S. C. Rossiter Department of Medicine, Royal Melbourne Hospital University of Melbourne Melbourne Australia Department of Radiology, Royal Melbourne Hospital University of Melbourne Melbourne Australia Department of Neurology, Royal Melbourne Hospital University of Melbourne Melbourne Australia Neurosurgery Unit, Royal Melbourne Hospital University of Melbourne Melbourne Australia Summary Dynamic cerebral CT scanning (DCT) was used to quantitatively analyse the haemodynamic effects of extracranial and intracranial arterial occlusive lesions in 17 patients with TIA's or minor cerebral infarcts. Using DCT and gamma variate curve fitting, mean transit times were determined for the terminal internal carotid arteries, middle cerebral arteries and middle cerebral-supplied Sylvian cortex at the level of the Circle of Willis. Six patients were studied sequentially, four before and after transcranial bypass surgery. No arterial or tissue delays were found in patients without haemodynamic arterial lesions or cortical infarcts. Seven of nine patients with haemodynamic, extracranial carotid lesions showed ipsilateral delays in arterial or tissue transit times. Tissue delays usually correlated with CT or clinical evidence of infarction. Improved haemodynamics in patients re-studied correlated with the effects of surgery or clinical recovery. DCT has several important limitations but has the potential to provide additional haemodynamic information about the cerebral circulation in selected patients with cerebral arterial occlusive disease.

Schubiger, O.; Valavanis, A.; Wichmann, W.

doi: 10.1007/BF00451765pmid: 3614624

234 29 29 3 3 O. Schubiger A. Valavanis W. Wichmann Department of Radiology, Section of Neuroradiology Kantonspital Aarau Aarau Switzerland Department of Neuroradiology University Hospital Zurich Switzerland Klinik im Park Seestrasse 220 CH-8002 Zurich Switzerland Summary In four cases of giant intracranial aneurysm, CT demonstrated a hyperdense open-, or closed-ring structure at the periphery of the aneurysm. Surgery in two of the cases demonstrated that this peripheral hyperdensity represents fresh clot inside the wall of the thrombosed mass. An analogy is established between giant intracranial aneurysms, chronic subdural hematomas and growing encapsulated intracerebral hematomas. The common feature of the three entities is slow growth by recurrent hemorrhages into the lesion. It is proven that growth of chronic subdural hematomas and of growing encapsulated hematomas is related to recurrent hemorrhage from capillaries sprouting within the membrane of the lesion. The highly vascularized membranous wall of a giant intracranial aneurysm seems to behave like the membrane of a chronic subdural hematoma. It is suggested that the giant intracranial aneurysm grows by recurrent hemorrhage into its wall and behaves like growing encapsulated hematomas.

Berg, J.; Overtoom, T.; Ludwig, J.; Bijlsma, J.; Tulleken, C.; Willemse, J.

doi: 10.1007/BF00451766pmid: 3302757

234 29 29 3 3 J. W. M. ter Berg T. M. D. Overtoom J. W. Ludwig J. B. Bijlsma C. A. F. Tulleken J. Willemse Department of Child Neurology University Hospital Utrecht The Netherlands Department of Radiology St. Antonius Hospital Nieuwegein The Netherlands Clinical Genetics Center University of Utrecht The Netherlands Department of Neurosurgery University Hospital Utrecht The Netherlands Department of Neurology Regional Hospital Almelo Almelo The Netherlands Summary The authors discuss the detection of intracranial aneurysms (IA) by means of intravenous digital angiography (ivDSA) in (a)symptomatic first degree relatives of families in which two or more individuals have IA. ivDSA is an almost noninvasive and low-risk diagnostic procedure. Screening, by means of ivDSA, of two affected families is described. In family I which includes 7 members with proven IA, ivDSA has been carried out in 36 asymptomatic individuals: in one, a 6x15 mm aneurysm was found at the left posterior communicating artery (PCoA). In family II, including one member with a proven IA and another with a subarachnoid hemorrhage, ivDSA has been carried out in 4 members: one aneurysm with a diameter of 6 mm was found at the left PCoA. Conventional cerebral angiography (CCA) confirmed both IA's. Neurosurgical treatment followed. The advantages and disadvantages of ivDSA vs. CCA as elective screening procedure in such cases are discussed. Screening of asymptomatic first degree relatives of cases with familial IA by means of ivDSA is strongly advocated.