Pearls and Pitfalls of T1-Weighted Neuroimaging: A Primer for the Clinical Radiologist.

All T1-weighted images are built upon one of two fundamental pulse sequences, spin-echo and gradient echo, each of which has distinct signal characteristics and clinical applications. Moreover, within each broadly defined category of T1-weighting, acquisition parameters can be modified to affect image quality, contrast, and scan duration; each tailored sequence has unique advantages, drawbacks, clinical indications, and potential artifacts. In this review, we describe key features that distinguish different types of T1-weighted sequences and discuss the utility of each sequence for specific clinical settings, including neuro-oncology, vasculopathy, and pediatric neuroradiology.

Intracranial meningioma: A review of recent and emerging data on the utility of preoperative imaging for management.

Meningiomas are the most common neoplasms of the central nervous system, accounting for approximately 40% of all brain tumors. Surgical resection represents the mainstay of management for symptomatic lesions. Preoperative planning is largely informed by neuroimaging, which allows for evaluation of anatomy, degree of parenchymal invasion, and extent of peritumoral edema.

CT predictors of sub-centimeter occult lymph node metastases in oral cavity squamous cell carcinoma: A case-control study.

Background: For patients with oral cavity squamous cell carcinoma (OCSCC) without evidence of nodal metastasis (cN0) on pre-operative evaluation, there are no clear guidelines who should undergo elective neck dissection (END) versus clinical surveillance.

Objective: To identify CT imaging characteristics of sub-centimeter lymph nodes that would help predict the likelihood of nodal metastases on pathology.

Methods: Retrospective review of cN0 OCSCC patients at a tertiary academic medical center was performed.

Imaging Cancer in Neuroradiology.

Neuroimaging plays a pivotal role in the diagnosis, management, and prognostication of brain tumors. Recently, the World Health Organization published the fifth edition of the WHO Classification of Tumors of the Central Nervous System (CNS5), which places greater emphasis on tumor genetics and molecular markers to complement the existing histological and immunohistochemical approaches. Recent advances in computational power allowed modern neuro-oncological imaging to move from a strictly morphology-based discipline to advanced neuroimaging techniques with quantifiable tissue characteristics such as tumor cellularity, microstructural organization, hemodynamic, functional, and metabolic features, providing more precise tumor diagnosis and management.

Skull base infections, their complications, and management.

Objective: Our review aims to summarize the current literature on skull base infections (SBIs) and retrospectively analyze any such cases encountered at our institution.

Design: A literature search was conducted using online databases PubMed, MEDLINE, and ResearchGate with the terms "skull base osteomyelitis," "temporal bone osteomyelitis," "skull base infections," "necrotizing otitis media," and "SBO". References from the resulting manuscripts were reviewed for relevant articles.

Diagnostic Errors in Cerebrovascular Pathology: Retrospective Analysis of a Neuroradiology Database at a Large Tertiary Academic Medical Center.

Background And Purpose: Diagnostic errors affect 2%-8% of neuroradiology studies, resulting in significant potential morbidity and mortality. This retrospective analysis of a large database at a single tertiary academic institution focuses on diagnostic misses in cerebrovascular pathology and suggests error-reduction strategies.

Materials And Methods: CT and MR imaging reports from a consecutive database spanning 2015-2020 were searched for errors of attending physicians in cerebrovascular pathology.

Analysis of perceptual errors in skull-base pathology.

Purpose: Medical errors result in significant mortality and morbidity. The purpose of this study is to analyze skull-base errors at a single tertiary institution, identify common anatomic sites of errors, and offer strategies to reduce errors in this region.

Methods: A Neuroradiology Quality Assurance Database of radiologic errors was searched for attending physician computer tomography and magnetic resonance imaging errors in skull-base pathology from 2014 to 2020.

Pre-styloid parapharyngeal space masses-Tumor margins as a predictor of benign versus malignant histology on pre-operative CT or MRI.

Purpose: Evaluate the frequency of benign versus malignant masses within the prestyloid parapharyngeal space (PPS) and determine if tumor margins on preoperative cross-sectional imaging can predict malignancy status.

Materials And Methods: The electronic health record at UC Davis Medical Center was searched for PPS masses surgically resected between 2015 and 2021. Cases located centrally within the prestyloid PPS with confirmed histologic diagnosis were included and separated into either benign or malignant groups.

Autoimmune disease of head and neck, imaging, and clinical review.

Autoimmune disease of the head and neck (H&N) could be primary or secondary to systemic diseases, medications, or malignancies. Immune-mediated diseases of the H&N are not common in daily practice of radiologists; the diagnosis is frequently delayed because of the non-specific initial presentation and lack of familiarity with some of the specific imaging and clinical features. In this review, we aim to provide a practical diagnostic approach based on the specific radiological findings for each disease.

Neuroradiology diagnostic errors at a tertiary academic centre: effect of participation in tumour boards and physician experience.

Aim: To quantify and correlate the diagnostic error rates in radiological interpretation with the experience of the attending neuroradiologist at a tertiary academic medical centre.

Materials And Methods: The institution's Neuroradiology Quality Assurance Database of diagnostic errors was searched for misses from 2014-2020. Attendance at Head and Neck (H&N), Brain, and Paediatric Neuroradiology (PN) tumour boards (TB) as the presenting radiologist was recorded.

Sellar, suprasellar, and parasellar masses: Imaging features and neurosurgical approaches.

The sellar, suprasellar, and parasellar space contain a vast array of pathologies, including neoplastic, congenital, vascular, inflammatory, and infectious etiologies. Symptoms, if present, include a combination of headache, eye pain, ophthalmoplegia, visual field deficits, cranial neuropathy, and endocrine manifestations. A special focus is paid to key features on CT and MRI that can help in differentiating different pathologies.

Common blind spots and interpretive errors of neck imaging.

Complex anatomy and a wide spectrum of diseases in the head and neck predispose interpretation of neck imaging to cognitive pitfalls and perceptual errors. Extra attention to common blind spots in the neck and familiarity with common interpretive challenges could aid radiologists in preventing these diagnostic errors.

Autoimmune diseases of the brain, imaging and clinical review.

There is an extensive spectrum of autoimmune entities that can involve the central nervous system, which has expanded with the emergence of new imaging modalities and several clinicopathologic entities. Clinical presentation is usually non-specific, and imaging has a critical role in the workup of these diseases. Immune-mediated diseases of the brain are not common in daily practice for radiologists and, except for a few of them such as multiple sclerosis, there is a vague understanding about differentiating them from each other based on the radiological findings.

Added value in stroke imaging: accuracy and utility of additional coronal diffusion-weighted imaging.

Aim: To evaluate the value of adding additional coronal diffusion-weighted imaging with the same section thickness as standard axial images to improve detection of small infarcts.

Materials And Methods: Axial and coronal diffusion-weighted images (4 or 5 mm section thickness, 1 mm gap) were studied retrospectively in two rounds of data collection. During the first round, two radiologists identified sub-centimetre infarcts on only axial images during one sitting, and only coronal images during a second sitting.

Analysis of misses in imaging of head and neck pathology by attending neuroradiologists at a single tertiary academic medical centre.

Aim: To analyse errors in head and neck (H&N) pathology made by attending neuroradiologists at a single tertiary-care centre.

Materials And Methods: A neuroradiology quality assurance (QA) database of radiological errors was searched for attending physician errors in H&N pathology from 2014-2020. Data were limited to computed tomography (CT) and magnetic resonance imaging (MRI) reports.

Multimodality oncologic evaluation of superficial neck and facial lymph nodes.

Involvement of lymph nodes in patients with head and neck cancers impacts treatment and prognosis. Head and neck lymph nodes are comprised of superficial and deep groups which are interconnected. The deep lymph nodes, predominantly centered along internal jugular veins, are very well-known to radiologists and clinicians.

Bilateral external auditory canal masses following repair of ruptured abdominal aortic aneurysm and open decompressive exploratory laparotomy for compartment syndrome: A rare case of spontaneous bilateral otorrhagia.

Very few cases of spontaneous otorrhagia (SO) following nonotolaryngologic surgery have ever been reported in surgical literature and none in radiographic. Of the surgical cases reported, SO occurred in the perioperative period following laparoscopic surgeries in the Trendelenburg position. We report the first case of spontaneous bilateral otorrhagia which presented as bilateral external auditory canal masses following endovascular surgery and open decompressive laparotomy in a 60-year-old male with a prior history of hypertension and smoking.

Can the Positional Release Technique Affect Central Sensitization in Patients With Chronic Tension-Type Headache? A Randomized Clinical Trial.

Objectives: To investigate whether the positional release technique (PRT) affects central sensitization in patients with chronic tension-type headache (TTH).

Design: Randomized controlled trial with concealed allocation, assessor blinding, and intention-to-treat analysis.

Setting: Two university neurology clinics.

An Imager's Guide to Perineural Tumor Spread in Head and Neck Cancers: Radiologic Footprints on F-FDG PET, with CT and MRI Correlates.

Perineural spread (PNS) refers to tumor growth along large nerves, a macroscopic analog of microscopic perineural invasion. This phenomenon most commonly occurs in the head and neck, but its incidence varies with histologic tumor subtype. PNS results from a complex molecular interplay between tumor cells, nerves, and connective stroma.

Clinical manifestations and imaging findings of thrombosis of developmental venous anomalies.

Aim: To determine clinical manifestations, imaging findings and outcome of patients with thrombosed developmental venous anomalies (DVAs).

Materials And Methods: The radiology database was searched retrospectively for thrombosed DVAs between 01/01/2000 to 07/01/2016. Demographic variables, associated risk factors, clinical manifestations, imaging findings, treatments, and follow-up were recorded.

Reduced Intercarotid Artery Distance in Syndromic and Isolated Brachycephaly.

Introduction: The morphology of the skull base can be altered in craniosynostoses. The objective of this study is to evaluate the reduced intercarotid artery distance in the lacerum segment in patients with syndromic and isolated brachycephaly.

Materials And Methods: The distances between the inner walls of the carotid canal at the lacerum segment were measured on high-resolution CT scans in children with Crouzon (25), Pfeiffer (21), Apert (26), Saethre-Chotzen (7) syndromes, isolated bicoronal synostosis (9), and compared to an age-matched control group (30).

Neuroimaging in Central Nervous System Lymphoma.

Primary central nervous system lymphoma (PCNSL) is a rare aggressive high-grade type of extranodal lymphoma. PCNSL can have a variable imaging appearance and can mimic other brain disorders such as encephalitis, demyelination, and stroke. In addition to PCNSL, the CNS can be secondarily involved by systemic lymphoma.

Evolution of Obstructive Sleep Apnea in Infants with Cleft Palate and Micrognathia.

Study Objectives: Children with craniofacial anomalies are a heterogeneous group at high risk for obstructive sleep apnea (OSA). However, the prevalence and structural predictors of OSA in this population are unknown. We hypothesized that infants with micrognathia would have more significant OSA than those with isolated cleft palate ± cleft lip (ICP), and those with ICP would have more significant OSA than controls.