Paramagnetic Rim Lesions are Highly Specific for Multiple Sclerosis in Real-World Data.

Background: Paramagnetic rim lesions (PRL) are an emerging biomarker for multiple sclerosis (MS). In addition to associating with greater disease severity, PRL may be diagnostically supportive.

Objective: Our aim was to determine PRL specificity and sensitivity for discriminating MS from its diagnostic mimics using real-world clinical diagnostic and imaging data.

AI tools in Emergency Radiology reading room: a new era of Radiology.

Artificial intelligence tools in radiology practices have surged, with modules developed to target specific findings becoming increasingly prevalent and proving valuable in the daily emergency room radiology practice. The number of US Food and Drug Administration-cleared radiology-related algorithms has soared from just 10 in early 2017 to over 200 presently. This review will concentrate on the present utilization of AI tools in clinical ER radiology setting, including a brief discussion of the limitations of the technique.

Nontraumatic brain parenchymal hemorrhage: The usual suspects and more.

Brain parenchymal hemorrhage is a common neuroimaging finding in an emergency room. It is considered primary in the absence of an underlying lesion or coagulopathy. Secondary hemorrhages are caused by various structural causes and pathologies.

Paramagnetic Rim Lesions in Multiple Sclerosis: Comparison of Visualization at 1.5-T and 3-T MRI.

Multiple sclerosis (MS) is characterized by both acute and chronic intrathecal inflammation. A subset of MS lesions show paramagnetic rims on susceptibility-weighted MRI sequences, reflecting iron accumulation in microglia. These para-magnetic rim lesions have been proposed as a marker of compartmentalized smoldering disease.

Computed tomography angiography-derived area stenosis calculations overestimate degree of carotid stenosis compared with North American Symptomatic Carotid Endarterectomy Trial-derived diameter stenosis calculations.

Objective: The degree of carotid artery stenosis, calculated using catheter-based angiography and the North American Symptomatic Carotid Endarterectomy Trial (NASCET) method, has been shown to predict the stroke risk in several, large, randomized controlled trials. In the present era, patients have been increasingly evaluated using computed tomography (CT) angiography (CTA) before carotid artery revascularization, especially as the use of transcarotid artery revascularization has increased. Interpretation of CTA findings regarding the degree of carotid stenosis has not been standardized, with both NASCET methods and the area stenosis used.

MRI Findings of Injury to the Longus Colli Muscle in Patients With Neck Trauma.

Objective: The longus colli muscle (LCM) forms the bulk of the deep flexor muscles of the neck. To our knowledge, very little information on the effects of trauma on this muscle group has been published. We describe MRI findings related to injury of the LCM in patients with a history of neck trauma.

Skull fractures in pediatric patients on computerized tomogram: comparison between routing bone window images and 3D volume-rendered images.

Skull fracture is a common finding following head trauma. It has a prognostic significance and its presence points to severe trauma. Additionally, there is a greater possibility of detecting associated small underlying extra-axial hematomas and subtle injuries to the brain parenchyma.

Correlation of apparent diffusion coefficient with Ki-67 proliferation index in grading meningioma.

Objective: A noninvasive method to predict aggressiveness of high-grade meningiomas would be desirable because it would help anticipate tumor recurrence and improve tumor management and the treatment outcomes. The Ki-67 protein is a marker of tumor proliferation, and apparent diffusion coefficient (ADC) is related to tumor cellularity. Therefore, we sought to determine whether there is a statistically significant correlation between ADC and Ki-67 values in meningiomas and whether ADC values can differentiate various meningioma subtypes.

Sinus pericranii with a hair collar sign.

Sinus pericranii is a rare vascular malformation in which the extracranial veins are connected to the intracranial venous circulation. It typically appears as a soft mass with a blue hue on the scalp. We describe a patient with sinus pericranii and associated hair collar sign.

Flow artifact in the anterior communicating artery resembling aneurysm on the time of flight MR angiogram.

Background: Magnetic resonance angiogram (MRA) of the brain is a widely employed non-invasive test to diagnose aneurysms. However, its overall accuracy is less than digital subtraction angiography and is prone to give false-positive or false-negative results. False-negative results can be seen with hemorrhage, lipoma, dermoid, posterior lobe of the pituitary gland, and the flow artifacts.

Role of noncontrast head CT in the assessment of vascular abnormalities in the emergency room.

Noncontrast CT of the head is a widely used noninvasive investigation for a variety of acute and chronic neurological conditions. Since CT head without contrast is usually the first and often the only investigation in the emergency room for many neurological symptoms, it is imperative to detect subtle vascular changes, which in many patients can be life-saving. The vascular abnormalities may present with increased density and/or size of the vessels, filling defects, and be associated with parenchymal and bony changes.

Improved image quality and detection of small cerebral infarctions with diffusion-tensor trace imaging.

Objective: The purpose of this study was to test a hypothesis that routinely performed diffusion-tensor trace imaging is of sufficient image quality and sensitivity for infarct detection to safely and routinely replace standard diffusion-weighted imaging (DWI) in the clinical setting.

Materials And Methods: Both routine DWI and 15-direction diffusion-tensor imaging (DTI) with parallel acquisition technique were obtained on all brain MRI studies from a single 1.5-T MRI scanner at a tertiary care referral center over a 1-year period, permitting direct comparison of the two different diffusion studies on the same patients (2537 studies, 365 infarct-positive studies).

MR imaging of acute cervical spinal ligamentous and soft tissue trauma.

The increasing availability of magnetic resonance imaging (MRI) and the high sensitivity of MRI for soft tissue injury are resulting in the increased use of MRI for the evaluation of acute trauma. As cervical spine injury can have a devastating consequence, MRI is being more commonly used to evaluate cervical spine injury in the acute setting, necessitating emergent interpretation by the on-call radiologist. Unless one is formally trained in a trauma center, the MRI findings of soft tissue and ligamentous cervical spine injury may not be fully appreciated.