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doi: 10.1007/BF00344344pmid: 2674767
234 31 31 3 3 D. Uhlenbrock S. Sehlen Radiological Department, St. Vincenz-Hospital Paderborn Teaching Hospital of the University of Münster Paderborn Federal Republic of Germany Summary The aim of the study was to define reliable criteria for the differentiation of MR imaging between patients with MS and with “vascular” white matter lesions/SAE. We examined 35 patients with proven MS according to the Poser criteria and 35 patients with other white matter lesions and/or SAE. The result is that with MR a differentiation can be achieved provided that T1-weighted spin-echo sequences are included and the different pattern of distribution is considered. MS plaques are predominantly located in the subependymal region, vascular white matter lesions are mainly located in the water-shed of the superficial middle cerebral branches and the deep perforating long medullary vessels in the centrum semiovale. Infratentorial lesions are more often seen in MS. Confluence at the lateral ventricles is frequently accompanied by confluent abnormalities around the third ventricle, Sylvian aqueduct, and fourth ventricle, which is uncommon in SAE. In MS many lesions visible on T2-weighted images have a cellular or intracellular composition that renders them visible also on T1-weighted ones as regions with low signal intensity and more or less distinct boundary. “Vascular” white matter lesions and SAE mainly represent demyelination and can there-fore be seen on T2-weighted images, but corresponding low signal intensity lesions on T1-weighted images are uncommon. In some exceptions there are such lesions with low signal representing lacunar infarcts or widened Virchow-Robin-spaces.
doi: 10.1007/BF00344345pmid: 2779770
234 31 31 3 3 D. Enzmann J. B. Rubin Department of Diagnostic Radiology and Nuclear Medicine Stanford University School of Medicine California USA Summary A prospective study of 16 patients was performed to compare quantitatively a contiguous single slice 2DFT version with a 3DFT version of a short TR, variable flip angle, gradient echo (GRASS) pulse sequence. The 3DFT GRASS scans had higher signal-to-noise ratios (SNR) of cord and CSF compared to the single slice 2DFT GRASS scans. The 3DFT GRASS scans, however, had lower CSF-cord and CSF-disc contrast than the single slice 2DFT version. The 3DFT GRASS sequence demonstrated comparable contrast only on the end slices of an imaging volume suggesting influence of an entry phenomenon. The lower CSF-cord and CSF-disc contrast of the 3DFT GRASS technique diminished its usefulness in the diagnosis of cervical disc disease compared to the single slice 2DFT GRASS technique. Two different slice thicknesses (3 mm and 5 mm) were investigated with the 2DFT GRASS technique and found to be comparable although the 3 mm scans had sharper disc and dural margins because of less partial volume artifact.
Hulcelle, P.; Dooms, G.; Mathurin, P.; Cornelis, G.
doi: 10.1007/BF00344346pmid: 2779771
234 31 31 3 3 P. J. Hulcelle G. C. Dooms P. Mathurin G. Cornelis Service de Radiologie Université Catholique de Louvain, Cliniques Universitaires Saint-Luc Brussels Belgium Summary In three patients with clinically unsuspected diagnosis, MRI has afforded a positive and conspicuous demonstration of dural sinus thrombosis, allowing specific treatment and followed by improvement in the patients' condition. Even in retrospect, CT examinations were nondiagnostic. Presenting symptoms were usual and nonspecific. CT and radionuclide scanning have proved valuable when performed on a clinically oriented basis. Angiography cannot be carried out without clear indications. MRI offers advantages in being a non-invasive technique without ionising radiation, allowing direct visualization and accurate delineation of the thrombus. MRI is definitely the method of choice to assess clinically suspected cerebral venous occlusion. As MR diagnosis relies on a routine examination protocol, we believe that it will detect other unsuspected cases of dural sinus thrombosis.
Kushnir, U.; Shalev, J.; Bronstein, M.; Bider, D.; Lipitz, S.; Nebel, L.; Mashiaeh, S.; Ben-Rafael, Z.
doi: 10.1007/BF00344347pmid: 2674768
234 31 31 3 3 U. Kushnir J. Shalev M. Bronstein D. Bider S. Lipitz L. Nebel S. Mashiaeh Z. Ben-Rafael Department of Obstetrics and Gynaecology Chaim Sheba Medical Center, affiliated to Sackler Faculty of Medicine, Tel-Aviv University Tel-Aviv Israel Department of Embryology Chaim Sheba Medical Center, affiliated to Sackler Faculty of Medicine, Tel-Aviv University Tel-Aviv Israel Department of Obstetrics and Gynaecology Rambam Hospital Haifa Israel Summary The normal values and ranges of fetal intracranial structures were studied by high resolution transvaginal ultrasonic scan at 12, 13 and at 14 weeks' gestation. The data including measurements of crown rump length (CRL), bi-parietal diameter (BPD), head circumference (HC), hemispheric width (HW), lateral ventricle width (LVW), LVW/HW ratio, thalamus and cerebellum may be useful in determining deviations from the normal and also in expanding the range of prenatal diagnoses of fetal structural abnormalities in early pregnancy.
Kuchiwaki, H.; Nagasaka, M.; Takada, S.; Ishiguri, H.; Kameyama, H.; Aoyama, Y.
doi: 10.1007/BF00344348pmid: 2789346
234 31 31 3 3 H. Kuchiwaki M. Nagasaka S. Takada H. Ishiguri H. Kameyama Y. Aoyama Department of Neurosurgery Nagoya University School of Medicine Nagoya Japan Clinical Laboratory of Nuclear Medicine Nagoya University Hospital Nagoya Japan Summary Radioisotope cisternography with statistical analysis was evaluated in 18 patients with suspected hydrocephalus shown by conventional CT, and 4 control patients. Regions of interest were located at cisterna magna, basal cistern, lateral cistern Sylvii, interhemispheric cistern, and lateral ventricle using three dimensional SPECT images. A value for the constant K was determined for each exponential radioactivity decay curve. On the basis of SPECT-derived K values our patients were grouped into hydrocephalus, nonhydrocephalus, and control patients. Twelve of 14 hydrocephalus patients were treated by shunt operation. Our less-invasive method showed reliable criteria for assessing the cerebrospinal fluid circulation.
Wilson, F.; Jaspan, T.; Holland, I.
doi: 10.1007/BF00344349pmid: 2779772
234 31 31 3 3 F. M. A. Wilson T. Jaspan I. M. Holland Neuroradiology Department University Hospital Nottingham England Neuradiology Division Department of Radiology University Hospital NG7 2UH Nottingham England Summary 254 consecutive cases of angiographically demonstrated intracranial cerebral aneurysms occuring over a three year period were reviewed with specific reference to aneurysm multiplicity, site, patient age and the presence of infundibular abnormalities. The overall incidence of multiple aneurysms was 44.9%. Female patients accounted for 66.5% of all aneurysm cases. The incidence of multiplicity was higher in women (51.5%) than men (31.7%) and overall was higher in patients over 40 years of age (52.8%) compared to those under this age (26.3%). Infundibula occured in 27.2% of all patients and 9.45% of all patients demonstrated infundibular dilatation of the origin of the posterior communicating artery.
Kazui, S.; Kuriyama, Y.; Naritomi, H.; Sawada, T.; Ogawa, M.; Maruyama, M.
doi: 10.1007/BF00344350pmid: 2779773
234 31 31 3 3 S. Kazui Y. Kuriyama H. Naritomi T. Sawada M. Ogawa M. Maruyama Cerebrovascular Division, Department of Internal Medicine National Cadiovascular Center Osaka Japan Summary In 80 patients with no stenotic lesions in the vertebrobasilar arterial system, a study was made of the relationship between the deviation of the basilar artery (BA) from the midline on computed tomography (CT) and the right-to-left vertebral arterial caliber difference on angiograms. In 66 patients (83%), the BA was visible on plain CT films, and 55 of them showed deviation of the BA to either side. In 44 of these patients (80%), the vertebral artery (VA) contralateral to the side of BA deviation had a larger caliber compared with the ipsilateral one on angiograms. In 6 patients whose unilateral VA terminated in the posterior inferior cerebellar artery (PICA) and showed an extremely small caliber compared to the contralateral one, the BA was always deviated to the side of the smaller VA. Our data suggest that the deviation of the BA on plain CT films may represent a good indicator for estimating the right-to-left VA caliber difference. At the time of vertebral angiography, injection of contrast medium should preferably be made from the larger VA in order to avoid laminar flow in the BA and to shorten the procedure. Prior estimation of the right-to-left VA caliber difference by CT may be of great benefit to the angiographic procedure.
Kingsley, D.; Butler, P.; Rowe, G.; Travis, R.; Wylie, I.
doi: 10.1007/BF00344351pmid: 2674769
234 31 31 3 3 D. P. E. Kingsley P. Butler G. M. Rowe R. C. Travis I. G. Wylie Lysholm Radiological Department National Hospital for Nervous Diseases London UK Department of Radiology General Hospital Hereford UK Department of Radiology Country Hospital Hereford UK Department of Radiology Middlemore Hospital Otahuhu Auckland NZ Department of Neuroradiology The London Hospital London UK Summary A four year study has been undertaken into the effects on the workload and cost implications of the introduction of digital subtraction angiography (DSA) in a large United Kingdom teaching hospital. The increase in workload has been entirely due to the ability to perform intravenous angiography. DSA is cheaper than conventional angiography if more than 210 cases are undertaken each year. This difference is accounted for by the reduced use of X-ray film. However, intravenous angiography is more expensive because of the use of large volumes of nonionic medium.
doi: 10.1007/BF00344352pmid: 2779774
234 31 31 3 3 P. H. Nakstad Department of Radiology, Section of Neuroradiology, Rikshospitalet, The National Hospital University of Oslo Norway Summary The purpose of this study was to evaluate possible vasoconstrictive or vasocilatator effects of the low osmolar non-ionic contrast medium iohexol (Omnipaque) on the calibre of cerebral arteries. The diameters of respectively 5 and 6 different locations of the vertebral and carotid arteries were recorded from angiograms of 3 successive injections. The material consisted of 18 patients. It could not be shown that Omnipaque induced vasoconstriction or vasodilatation when normal doses and adequate technique was applied. The difference in diameters found were not statistically significant and are probably due to natural pulsations and to the difficulties in performing exact measurements.
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