Gadolinium-Enhancing Lesions Lead to Decreases in White Matter Tract Fractional Anisotropy in Multiple Sclerosis.

Purpose: Although MRI identification of new lesions forms the basis for monitoring disease progression in multiple sclerosis patients, how lesion activity relates to longitudinal white matter changes in the brain is unknown. We hypothesized that patients with gadolinium-enhancing lesions would show greater longitudinal decline in fractional anisotropy in major tracts compared to those with stable disease.

Methods: Thirty patients with relapsing-remitting multiple sclerosis were included in this study-13 had enhancing lesions at baseline and 17 did not.

Surveillance after resection of vestibular schwannoma: measurement techniques and predictors of growth.

Objectives: To compare different methods of measuring tumor growth after resection of vestibular schwannoma and to identify predictors of growth.

Study Design: Retrospective case review.

Setting: Tertiary referral center, inpatient surgery with ambulatory follow-up.

Neuroimaging of cerebrovascular disease in the aging brain.

Cerebrovascular disease remains a significant public health burden with its greatest impact on the elderly population. Advances in neuroimaging techniques allow detailed and sophisticated evaluation of many manifestations of cerebrovascular disease in the brain parenchyma as well as in the intracranial and extracranial vasculature. These tools continue to contribute to our understanding of the multifactorial processes that occur in the age-dependent development of cerebrovascular disease.

Comparison of CT perfusion and digital subtraction angiography in the evaluation of delayed cerebral ischemia.

Rationale And Objectives: Delayed cerebral ischemia (DCI) is a devastating condition that occurs secondary to aneurysmal subarachnoid hemorrhage (A-SAH). The purpose is to compare computed tomography perfusion (CTP) and digital subtraction angiography (DSA) for determining DCI in A-SAH.

Materials And Methods: A retrospective study of A-SAH patients admitted at our institution between December 2004 and December 2008 was performed.

Developing a new reference standard: is validation necessary?

Rationale And Objectives: A gold standard is often an imperfect diagnostic test, falling short of achieving 100% accuracy in clinical practice. Using an imperfect gold standard without fully comprehending its limitations and biases can lead to erroneous classification of patients with and without disease. This will ultimately affect treatment decisions and patient outcomes.