Table of Contents
Perspectives
Review Articles
Practice Perspectives
Adult Brain
- Hyperintense Vessels on FLAIR: Hemodynamic Correlates and Response to Thrombolysis
The authors evaluated 62 consecutive patients with ischemic stroke with proven vessel occlusion with MRI before and within 24 hours of treatment and defined a hypoperfusion intensity ratio (volume with severe/mild hypoperfusion [time-to-maximum ≥ 8 seconds / time-to-maximum ≥ 2 seconds]). Patients with extensive hyperintense vessels on FLAIR (>4 sections) had higher NIHSS scores, larger baseline lesion volumes, higher rates of perfusion-diffusion mismatch, and more severe hypoperfusion intensity ratio.
- Improving Multiple Sclerosis Plaque Detection Using a Semiautomated Assistive Approach
The authors evaluated and validated a semiautomated software platform to facilitate detection of new lesions and improved MS lesions. Two neuroradiologists retrospectively assessed 161 MR imaging comparison study pairs acquired between 2009 and 2011. More comparison study pairs with new lesions and improved lesions were recorded by using the software compared with original radiology reports.
Functional
- Challenges in Identifying the Foot Motor Region in Patients with Brain Tumor on Routine MRI: Advantages of fMRI
Thirty-five attending-level raters evaluated 14 brain tumors involving the frontoparietal convexity. Raters identified the location of the foot motor homunculus and determined whether the tumor involved the foot motor area and/or motor cortex by using anatomic MR imaging. Seventy-seven percent of the time raters correctly identified whether the tumor was in the foot motor cortex. Raters with fMRI experience were significantly better than raters without experience at foot motor fMRI centroid predictions.
Interventional
- Woven EndoBridge Intrasaccular Flow Disrupter for the Treatment of Ruptured and Unruptured Wide-Neck Cerebral Aneurysms: Report of 55 Cases
This is a retrospective study of all ruptured and unruptured aneurysms that were treated with a WEB device (WEB Dual-Layer, Single-Layer, and Single-Layer Sphere) between April 2012 and August 2014 at 2 centers. Fifty-five aneurysms in 52 patients, including 14 ruptured aneurysms, underwent treatment with the WEB device. A favorable angiographic result at 3 months was achieved in 66% of cases, whereas the percentage of good anatomic results increased from 40% in 2012 to 75% in 2014.
Head & Neck
- Acute Invasive Fungal Rhinosinusitis: A Comprehensive Update of CT Findings and Design of an Effective Diagnostic Imaging Model
Two blinded neuroradiologists retrospectively graded 23 prespecified imaging abnormalities in the craniofacial region on CT examinations from 42 patients with pathology-proven acute invasive fungal rhinosinusitis and 42 control patients. A 7-variable model (periantral fat, bone dehiscence, orbital invasion, septal ulceration, pterygopalatine fossa, nasolacrimal duct, and lacrimal sac) was synthesized on the basis of multivariate analysis. The presence of abnormality involving a single variable in the model had an 87% positive predictive value, 95% negative predictive value, 95% sensitivity, and 86% specificity.
Pediatrics
- Radiation Necrosis in Pediatric Patients with Brain Tumors Treated with Proton Radiotherapy
The authors performed a retrospective study on 60 consecutive pediatric patients with primary brain tumors treated with proton radiation therapy. Thirty-one percent of patients developed radiation necrosis with a median time to development of 5 months. They conclude that patients with pediatric brain tumors treated with proton radiation therapy demonstrate a high incidence of radiation necrosis and a short time to development of necrosis. Multiple small areas of necrosis are frequently identified on imaging.
