Retrospective study using MRI to measure depths of acupuncture points in neck and shoulder region.

Objectives: There are safety issues associated with acupuncture treatment. Previous studies regarding needling depth of acupuncture points revealed inconsistent results due to vague depth definition, acupuncture point localisation and measuring tools. The objective of this study is to find and compare the differences of the mean depths of 11 acupuncture points in the neck and shoulder region between subjects, with variables including gender and body mass index (BMI).

Hematoma shape, hematoma size, Glasgow coma scale score and ICH score: which predicts the 30-day mortality better for intracerebral hematoma?

Purpose: To investigate the performance of hematoma shape, hematoma size, Glasgow coma scale (GCS) score, and intracerebral hematoma (ICH) score in predicting the 30-day mortality for ICH patients. To examine the influence of the estimation error of hematoma size on the prediction of 30-day mortality.

Materials And Methods: This retrospective study, approved by a local institutional review board with written informed consent waived, recruited 106 patients diagnosed as ICH by non-enhanced computed tomography study.

Intrasinus thrombolysis by mechanical and urokinase for severe cerebral venous sinus thrombosis : a case report.

Purpose: Cerebral venous and sinus thrombosis (CVST) is a rare stroke disorder, which requires prompt recognition and appropriate intervention to prevent a devastating outcome. Intrasinus thrombolysis is an alternative and effective method to anticoagulant therapy for the treatment of CVST, but is rarely used in Taiwan.

Case Report: A 46-year-old man presented with a one-week history of intractable headache and progressive weakness of his right lower limb.

Comparison of the 2010 and 2005 versions of the McDonald MRI criteria for dissemination-in-time in Taiwanese patients with classic multiple sclerosis.

In 2010, the International Panel on the Diagnosis of Multiple Sclerosis revised the 2005 version of the McDonald criteria. The revisions to MRI dissemination-in-time criteria include adoption of a new criterion by demonstration of simultaneous asymptomatic gadolinium-enhancing and nonenhancing lesions on baseline MRI scans. The purpose of this study was to demonstrate the diagnostic validity of the modified MRI dissemination-in-time criteria.

Acute bilateral hearing loss as a "worsening sign" in a patient with critical basilar artery stenosis.

We report a patient who presented with an acute-onset transient vertigo and unsteady gait with bilateral hearing loss. Brain MRI revealed a critical basilar artery (BA) stenosis at the lower pons and infarction in various areas on both sides in the territories of the posterior inferior cerebellar arteries (PICA). Further, we could not visualize the right anterior inferior cerebellar artery (AICA).

Delayed parkinsonism after CO intoxication: evaluation of the substantia nigra with inversion-recovery MR imaging.

Purpose: To quantitatively investigate signal alterations of the substantia nigra in patients with delayed parkinsonism following CO intoxication, as seen on gray matter (GM)-suppressed inversion-recovery (IR) magnetic resonance (MR) images.

Materials And Methods: This prospective study was approved by the local institutional review board, and written informed consent was obtained from all subjects. Thirteen patients with delayed onset of CO-induced parkinsonism (nine men and four women; mean age, 40.

Local intra-arterial thrombolysis with urokinase for acute ischemic stroke before and after the approval of intravenous tissue plasminogen activator treatment in Taiwan.

Background: Local intra-arterial thrombolysis (LIT) has been previously suggested as an effective therapy for acute ischemic stroke. In this study, we describe our experience of using LIT for the treatment of Taiwanese patients with ischemic stroke at different vascular locations, before and after Alteplase was approved as a first-line treatment in Taiwan. The criteria required for the initiation of LIT have become more stringent after the approval of Alteplase (AA).

Modifications to the McDonald MRI dissemination in space criteria for use in Asians with classic multiple sclerosis: the Taiwanese experience.

Background: The McDonald MRI dissemination in space criteria have been found to be less sensitive when applied to Asians with classic multiple sclerosis. The Asian neurological community thus proposed modifications to the criteria with reduction of minimal number of T2 lesions from nine to four, and removal of restriction on spinal cord lesion length and morphology for use in Asians.

Objective: The study is to examine the accuracy of modified MRI dissemination in space criteria for prediction of conversion from clinically isolated syndrome to definite multiple sclerosis according to patients' baseline MRI.

Do aggressive imaging features correlate with advanced histopathological grade in meningiomas?

Atypical and malignant meningiomas are more likely to recur than benign meningiomas. We aimed to distinguish atypical and malignant meningiomas from benign meningiomas based on imaging findings. Between 2004 and 2007, a total of 75 patients with resected intracranial meningiomas were retrospectively reviewed.

Salivary glands: echo-planar versus PROPELLER Diffusion-weighted MR imaging for assessment of ADCs.

Purpose: To compare the image distortion and the quantification variation in parotid gland apparent diffusion coefficients (ADCs) on periodically rotated overlapping parallel lines with enhanced reconstruction (PROPELLER) versus echo-planar diffusion-weighted (DW) magnetic resonance (MR) images and to investigate the relationship between parotid gland ADC and parotid gland fat content.

Materials And Methods: This prospective study was approved by a local institutional review board. Written informed consent was obtained from all 33 enrolled healthy volunteers (15 men, 18 women; mean age, 36.

T2-enhanced tensor diffusion trace-weighted image in the detection of hyper-acute cerebral infarction: comparison with isotropic diffusion-weighted image.

Background And Purpose: Although isotropic diffusion-weighted imaging (isoDWI) is very sensitive to the detection of acute ischemic stroke, it may occasionally show diffusion negative result in hyper-acute stroke. We hypothesize that high diffusion contrast diffusion trace-weighted image with enhanced T2 may improve stroke lesion conspicuity.

Methods: Five hyper acute stroke patients (M:F=0:5, average age=61.

(99m)Tc-TRODAT-1 and (123)I-IBZM SPECT studies in a patient with extrapontine myelinolysis with parkinsonian features.

Osmotic demyelination syndrome can result from the rapid correction of hyponatremia, and is categorized by central pontine myelinolysis and extrapontine myelinolysis (EPM). Magnetic resonance imaging (MRI) is currently the most useful modality for visualizing EPM lesions. However, MRI is unable to delineate the severity of involvement in the nigrostriatal dopaminergic pathway.

Volume-dependent overestimation of spontaneous intracerebral hematoma volume by the ABC/2 formula.

Background: Although the ABC/2 formula has been widely used to estimate the volume of intracerebral hematoma (ICH), the formula tends to overestimate hematoma volume. The volume-related imprecision of the ABC/2 formula has not been documented quantitatively.

Purpose: To investigate the volume-dependent overestimation of the ABC/2 formula by comparing it with computer-assisted volumetric analysis (CAVA).

A thrombophilic patient with a dural arteriovenous fistula presenting sensory aphasia and complicated with an acute pulmonary embolism.

Background: Neuropsychiatric symptoms as the initial presentation of dural arteriovenous fistula (DAVF) are unusual. Anticoagulation therapy may be warranted for prevention of further thromboembolism if an underlying thrombophilia condition is diagnosed.

Case Report: We present a 70-year-old woman with sensory aphasia, who was diagnosed with a DAVF, Cognard type II a + b, by cerebral angiography.

Perfusion characteristics of late radiation injury of parotid glands: quantitative evaluation with dynamic contrast-enhanced MRI.

We aimed to quantitatively investigate the alteration of parotid perfusion after irradiation using dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) based on a two-compartment tracer kinetic model. This study enrolled 19 patients (53.2 +/- 14.

Detection of suspicious malignant cervical lymph nodes of unknown origin: diagnostic accuracy of ultrasound-guided fine-needle aspiration biopsy with nodal size and central necrosis correlate.

Objective: To assess the role of ultrasound-guided fine-needle aspiration biopsy (US-guided FNAB) in the diagnostic workup of suspicious malignant cervical lymph nodes in patients with palpable neck masses and without known primary cancer. The diagnostic accuracy of imaging morphologic criteria, including sizes and central necrosis for assessing suspicious malignant nodes, were also examined.

Methods: This is a retrospective study of 426 patients with palpable neck masses from an outpatient department evaluated with computed tomography, magnetic resonance imaging, or US.

Diffuse Cerebral Vasculopathy in a HIV-Positive Patient with Recurrent Strokes.

The causes of ischemic stroke in the young adult are diverse. Human immunodeficiency virus (HIV) infection-related vasculopathy is usually not included in the list of differential diagnoses. HIV-positive patients may present with acute neurologic dysfunction of different causes, among which cerebral infarction is an uncommon one.

Typical Meningioma with Atypical MR Imaging Features Masquerading Malignancy. A Case Report.

Meningiomas are the most common extraaxial tumors of intracranial neoplasms. They are usually benign with characteristic pathologic and imaging features. However, a histologically typical meningioma can have unusual or misleading imaging features that may not be suggestive of meningioma.

Brain injury after acute carbon monoxide poisoning: early and late complications.

Objective: The purposes of this article are to illustrate the variable CT and MRI features of carbon monoxide-induced brain injury and to discuss the underlying pathogenesis.

Conclusion: Carbon monoxide can produce different patterns of brain injury in the acute and delayed stages. CT and MRI are valuable in the delineation of disease extent and helpful for understanding the pathophysiologic mechanisms.

Diffusion-weighted magnetic resonance imaging of spontaneous venous infarction and cortical hemorrhage complicating dural arteriovenous fistula.

Dural arteriovenous fistula (DAVF) is an abnormal arteriovenous shunt that occurs in the dura matter within or near a dural sinus. The clinical manifestations vary. The authors report herein a rare case of type III DAVF presenting with coexisting intracranial hemorrhage (ICH) and venous infarction evidenced by computed tomography (CT) and diffusion-weighted magnetic resonance imaging.

Acute putaminal necrosis and white matter demyelination in a child with subnormal copper metabolism in Wilson disease: MR imaging and spectroscopic findings.

Wilson disease (WD) that manifests solely with acute and severe neurological damage in the absence of hepatic disease and Kayser-Fleischer ring of the cornea is rare and difficult to diagnose at the acute setting. This report describes unusual diffusion and proton spectroscopic magnetic resonance (MR) imaging findings in a 12-year-old boy with WD who presented with hemichorea and subnormal copper metabolism. The MR imaging findings of lactate accumulation, decrease of N-acerylaspartate/creatinine (NAA/Cr) ratio and markedly increased apparent diffusion coefficient (ADC) value of the asymmetrical edematous putaminal lesions in the early stage were suggestive of acute necrosis with anaerobic metabolism of glucose leading to poor clinical outcome at follow-up.

Hippocampal alterations in children with temporal lobe epilepsy with or without a history of febrile convulsions: evaluations with MR volumetry and proton MR spectroscopy.

Background And Purpose: The causal effect of early febrile convulsions (FC) on later-onset temporal lobe epilepsy (TLE) remains unclear. In this study, we sought to examine the hippocampal alterations in epileptic children with or without FC history by using MR spectroscopy and volumetry.

Methods: Fifty-five children ranging in age from 18 months to 15 years were enrolled in this study.

Parasellar solitary fibrous tumor of meninges: magnetic resonance imaging features with pathologic correlation.

Solitary fibrous tumor (SFT) is a benign mensenchymal neoplasm of spindle-cell origin. The authors report the case of a 50-year-old man with SFT arising from the meninges of the left parasellar region with cavernous sinus involvement. The tumor was demonstrated isointense on T1-weighted and heterogeneously hypointense on T2-weighted magnetic resonance imaging (MRI) with strong contrast enhancement.

Disappearing calvarium in Gorham disease: MR imaging characteristics with pathologic correlation.

Gorham disease is a rare condition characterized by intraosseous neoplastic proliferation of hemangiomatous tissue with progressive, massive osteolysis. We present a pathologically proved case of Gorham disease that involved the left parietal bone in a 23-year-old man. Imaging studies including conventional radiography of the skull, CT, MR imaging, and Technetium-99 m (Tc-99 m) scintigraphy demonstrated a large skull defect without associated soft tissue mass over the left parietal skull.