Early postoperative MRI and detection of residual adenoma after transsphenoidal pituitary surgery.

Objective: Current practice guidelines recommend delayed (≥ 3 months after operation) postoperative MRI after transsphenoidal surgery for pituitary adenomas, although this practice defers obtaining important information, such as the presence of a residual adenoma, that might influence patient management during the perioperative period. In this study, the authors compared detection of residual adenomas by means of early postoperative (EPO) MRI (< 48 hours postsurgery) with both surgeon intraoperative assessment and late postoperative (LPO) MRI at 3 months.

Methods: Adult patients who underwent microscopic transsphenoidal surgery for pituitary adenomas with MRI preoperatively, < 48 hours after the operation, 3 months postoperatively, and yearly for 4 years were included.

Significance of degree of neurovascular compression in surgery for trigeminal neuralgia.

Objective: The aim of this study was to identify preoperative imaging predictors of surgical success in patients with classic trigeminal neuralgia (cTN) undergoing microvascular decompression (MVD) via retrospective multivariate regression analysis.

Methods: All included patients met criteria for cTN and underwent preoperative MRI prior to MVD. MR images were blindly graded regarding the presence and severity (i.

Contrast-Induced Acute Kidney Injury: Pathophysiology, Manifestations, Prevention, and Management.

Contrast-induced acute kidney injury is a phenomenon that has been extensively studied throughout the years. There is a large volume of literature documenting this risk, and most radiology departments and radiologists use this information when making decisions regarding contrast administration. A review of the current information on the topic of contrast-induced acute kidney injury is necessary to ensure that the risks of intravenous contrast are properly weighed against the benefits of a contrast-enhanced computed tomography scan.

PET/CT for Head and Neck Squamous Cell Carcinoma: Should We Routinely Include the Head and Abdomen?

Objective: The purpose of our study was to determine the diagnostic and therapeutic yield of the head and abdomen portions of PET/CT scans of patients with head and neck squamous cell cancer (HNSCC) to determine whether these areas should be routinely included with PET/CT of the neck and chest.

Materials And Methods: Patients with pathologically proven HNSCC who underwent full-body PET/CT were evaluated for metastases to the head, chest, and abdomen. Medical records were reviewed to determine whether the head and abdominal findings changed the clinical management, beyond the findings in the neck and chest.

Reproducibility and Bias in Healthy Brain Segmentation: Comparison of Two Popular Neuroimaging Platforms.

We evaluated and compared the performance of two popular neuroimaging processing platforms: Statistical Parametric Mapping (SPM) and FMRIB Software Library (FSL). We focused on comparing brain segmentations using Kirby21, a magnetic resonance imaging (MRI) replication study with 21 subjects and two scans per subject conducted only a few hours apart. We tested within- and between-platform segmentation reliability both at the whole brain and in 10 regions of interest (ROIs).

White Matter Injuries in Mild Traumatic Brain Injury and Posttraumatic Migraines: Diffusion Entropy Analysis.

Purpose To determine the performance of Shannon entropy (SE) as a diagnostic tool in patients with mild traumatic brain injury (mTBI) with posttraumatic migraines (PTMs) and those without PTMs on the basis of analysis of fractional anisotropy (FA) maps. Materials and Methods The institutional review board approved this retrospective study, with waiver of informed consent. FA maps were obtained and neurocognitive testing was performed in 74 patients with mTBI (57 with PTM, 17 without PTM).

Evaluation of White Matter Injury Patterns Underlying Neuropsychiatric Symptoms after Mild Traumatic Brain Injury.

Purpose: To determine if a central axonal injury underlies neuropsychiatric symptoms after mild traumatic brain injury (mTBI) by using tract-based spatial statistics analysis of diffusion-tensor images.

Materials And Methods: The institutional review board approved this study, with waiver of informed consent. Diffusion-tensor imaging and serial neurocognitive testing with the Immediate Post-Concussion Assessment and Cognitive Testing evaluation were performed in 45 patients with mTBI (38 with irritability, 32 with depression, and 18 with anxiety).

Assessment of rates of acute adverse reactions to gadobenate dimeglumine: review of more than 130,000 administrations in 7.5 years.

Objective: The purpose of this study was to determine the incidence of adverse events associated with gadobenate dimeglumine over 7.5 years in a major hospital system consisting of both academic and community hospitals.

Subjects And Methods: As part of a regular and continuous prospective quality assurance project, MRI technologists contemporaneously recorded all gadolinium-based contrast administrations and any associated adverse reactions, including type of reaction and treatment rendered, between August 1, 2005, and March 14, 2013.

A multi-disciplinary model of risk factors for fatal outcome in posterior reversible encephalopathy syndrome.

Purpose: To evaluate the relative impact of clinical data, imaging findings, and CSF laboratory values on clinical outcome in patients with posterior reversible encephalopathy syndrome (PRES).

Methods: 47 patients with PRES who underwent a lumbar puncture were retrospectively evaluated. Fatal outcome was defined as death directly ascribed to PRES toxicity.

Neurodegenerative changes after mild traumatic brain injury.

A link between mild traumatic brain injury (mTBI) and neurodegenerative diseases, specifically Alzheimer's disease and chronic traumatic encephalopathy (CTE), has long been suspected. Shared clinical symptomology - most notably the prominent role of central auditory dysfunction and sleep-wake disturbances in both disease states - and similar findings on postmortem pathological examination has further reinforced suspected commonality between these seemingly disparate entities. However, conventional imaging techniques, including computed tomography and anatomic magnetic resonance, are unable to detect the symptomatic injuries in mTBI patients and therefore detection of neurodegenerative changes in vivo has previously not been reported.

Value of prominent flow voids without cord edema in the detection of spinal arteriovenous fistulae.

Purpose: To determine the prevalence of spinal dural arteriovenous fistulae (SDAVF) in patients presenting with prominent vascular flow voids on imaging without other imaging findings suggestive of SDAVF.

Methods: We retrospectively identified patients from January 1, 2005 to March 1, 2012 who underwent spinal angiography for suspected SDAVF with prominent vascular flow voids on prior imaging. We excluded patients with other major spinal pathology or other imaging findings of SDAVF including cord hyperintensity, enhancement, or expansion.

Sex differences in white matter abnormalities after mild traumatic brain injury: localization and correlation with outcome.

Purpose: To evaluate sex differences in diffusion-tensor imaging (DTI) white matter abnormalities after mild traumatic brain injury (mTBI) using tract-based spatial statistics (TBSS) and to compare associated clinical outcomes.

Materials And Methods: The institutional review board approved this study, with waiver of informed consent. DTI in 69 patients with mTBI (47 male and 22 female patients) and 21 control subjects (10 male and 11 female subjects) with normal conventional magnetic resonance (MR) images were retrospectively reviewed.

Detection of central white matter injury underlying vestibulopathy after mild traumatic brain injury.

Purpose: To determine if central axonal injury underlies vestibulopathy and ocular convergence insufficiency after mild traumatic brain injury (TBI) by using tract-based spatial statistics (TBSS) analysis of diffusion-tensor imaging (DTI).

Materials And Methods: The institutional review board approved this study, and the requirement to obtain informed consent was waived. Diffusion-tensor images were retrospectively reviewed in 30 patients with mild TBI and vestibular symptoms and 25 patients with mild TBI and ocular convergence insufficiency.

Angioglioma misdiagnosed as encephalomalacia on magnetic resonance imaging for over a decade.

We report a case of intractable seizures secondary to an angioglioma that was misdiagnosed as post-traumatic encephalomalacia for over a decade, with a discussion of the radiological findings and a review of the literature.

Evaluation of tentorial length and angle in sleep-wake disturbances after mild traumatic brain injury.

Objective: The purpose of this study was to determine if there is an association between tentorial length and angle and sleep-wake disturbances in patients with mild traumatic brain injury (TBI).

Materials And Methods: MRI examinations of the brain of 34 consecutive patients with mild TBI with sleep-wake disturbance and 30 patients with mild TBI without sleep-wake disturbance were retrospectively reviewed. The length of the tentorium on a sagittal T1-weighted image (tentorial length) and the angle formed between the tentorium and a line through the foramen magnum (tentorial angle) were measured.

Comparison of simulated cone beam computed tomography to conventional helical computed tomography for imaging of rhinosinusitis.

Objectives/hypothesis: Cone beam computed tomography (CBCT) has emerged as a low radiation dose alternative to traditional computed tomography (CT) to evaluate the paranasal sinuses. The purpose of our study was to determine how often clinically important findings would be missed if CBCT was used routinely for sinus imaging.

Study Design: Retrospective review.

Incidental findings of CSF leakage in patients without spontaneous intracranial hypotension and development of post-dural puncture headache.

Objectives: To determine if nerve root sleeve diverticula or CSF leakage correlate with post-dural puncture headache (PDPH).

Methods: A total of 781 lumbar and 408 cervical post-myelogram CTs were reviewed using a total diverticulum and leakage (TDL) score: 1, nerve root sleeve diverticulum not beyond the lateral vertebral body; 2, diverticulum beyond the lateral vertebral body; 3, periradicular contrast; 4, epidural contrast medium collection. Two scores at each level (left, right) were added for a total score.

Evaluation of a limited three-slice head CT protocol for monitoring patients with ventriculoperitoneal shunts.

Objective: Patients with a ventriculoperitoneal shunt for the management of hydrocephalus often undergo multiple head CT examinations for assessment of shunt malfunction. The purpose of this study was to evaluate whether a limited three-slice CT protocol would consistently provide adequate information for the diagnosis of shunt malfunction with a decrease in effective dose.

Materials And Methods: The study group included 231 unenhanced head CT examinations performed on 128 patients with shunts for hydrocephalus.

Symptomatic white matter changes in mild traumatic brain injury resemble pathologic features of early Alzheimer dementia.

Purpose: To evaluate white matter integrity in patients with mild traumatic brain injury (TBI) who did not have morphologic abnormalities at conventional magnetic resonance (MR) imaging with diffusion-tensor imaging to determine any relationship between patterns of white matter injury and severity of postconcussion symptoms.

Materials And Methods: The institutional review board approved this study, with waiver of informed consent. Diffusion-tensor images from 64 consecutive patients with mild TBI obtained with conventional MR imaging were evaluated retrospectively.

Cervical spinal cord infarction after cervical spine decompressive surgery.

Objective: To report five patients who underwent cervical decompressive surgeries and developed persistent postoperative neurologic deficits compatible with spinal cord infarctions and evaluate causes for these rare complications.

Methods: The clinical courses and imaging studies of five patients were retrospectively analyzed. Imaging findings, types of surgeries, vascular compromise or risk factors, hypotensive episodes, intraoperative somatosensory evoked potentials, concomitant brain infarctions, and clinical degree and radiographic extent of spinal cord infarction were studied.

Spontaneous abdominal hemorrhage: causes, CT findings, and clinical implications.

Objective: The purpose of this article is to present the most common causes of spontaneous abdominal hemorrhage and to review the CT findings that are important in establishing the correct diagnosis and in guiding appropriate therapy.

Conclusion: Knowledge of the common CT manifestations of various causes of spontaneous abdominal hemorrhage allows their accurate diagnosis and has a direct impact on clinical decision making.

Platelet C4d is associated with acute ischemic stroke and stroke severity.

Background And Purpose: Platelets bearing complement C4d were recently reported to be 99% specific for a diagnosis of systemic lupus erythematosus (SLE) and associated with neuropsychiatric lupus. We compared the prevalence of platelet C4d and investigated the clinical associations of platelet C4d in patients with acute ischemic stroke.

Methods: We recruited 80 patients hospitalized for acute ischemic stroke.

Parathyroid imaging.

The most common indication for parathyroid imaging is hyperparathyroidism, which is caused by a solitary parathyroid adenoma in most patients. The primary function of parathyroid imaging is localization of the abnormal parathyroid gland, enabling the surgeon to pursue a minimally invasive resection. Ultrasound and (99m)Tc sestamibi scintigraphy are the mainstays for the preoperative localization of culprit lesions.