Table of Contents
Perspectives
Review Article
- Carotid Near-Occlusion: A Comprehensive Review, Part 2—Prognosis and Treatment, Pathophysiology, Confusions, and Areas for Improvement
Carotid near-occlusion is distal luminal collapse of the internal carotid artery beyond a tight stenosis. Part 2 of this systematic review focuses on prognosis and treatment and pathophysiology. Areas of confusion regarding terminology, diagnosis, and prognosis are also covered.
Patient Safety
- MR Angiographic–Guided Percutaneous Sclerotherapy for Venous Vascular Malformations: A Radiation Dose-Reduction Strategy
This case series of 5 patients describes the authors' approach to using dynamic MRA with direct puncture of venous malformations to define the angioarchitecture and draining veins in these lesions. MultiHance in a 1:100 dilution with normal saline solution was used for the contrast administration. Precontrast images were used as a mask and were digitally subtracted from the postcontrast images (13- and 51-second acquisitions, respectively). The authors conclude that they have developed a method to completely eliminate digital subtraction angiography x-ray radiation exposure during treatment of venous vascular malformations.
Health Care Reform Vignette
General Contents
- Multimodal Imaging in Malignant Brain Tumors: Enhancing the Preoperative Risk Evaluation for Motor Deficits with a Combined Hybrid MRI-PET and Navigated Transcranial Magnetic Stimulation Approach
Patients with malignant brain tumors involving the central region underwent a hybrid O-(2-[18F]fluoroethyl)-L-tyrosine–PET-MR imaging and motor mapping by neuronavigated transcranial magnetic stimulation. The spatial relationship between functional tissue and lesion volumes as depicted by structural and metabolic imaging was analyzed. Tumor infiltration of the M1 region or the corticospinal tract as depicted by FET-PET is highly indicative of motor impairment, better than contrast-enhanced T1WI alone, and is of predictive value for operative-risk evaluation.
- Flow-Diverter Stents for the Treatment of Saccular Middle Cerebral Artery Bifurcation Aneurysms
Fourteen patients with 15 saccular, nondissecting MCA bifurcation aneurysms were treated with flow-diverter stents and were retrospectively analyzed. Procedure-related morbidity and mortality at last follow-up were 21% and 0%, respectively. Complete occlusion was achieved in 62%. The authors conclude that compared with other therapeutic options, flow-diverter stents do not appear to be suitable for the treatment of saccular MCA bifurcation aneurysms.
Commentary
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- Usefulness of Pseudocontinuous Arterial Spin-Labeling for the Assessment of Patients with Head and Neck Squamous Cell Carcinoma by Measuring Tumor Blood Flow in the Pretreatment and Early Treatment Period
Forty-one patients with head and neck squamous cell carcinoma were evaluated by using pseudocontinuous ASL. Quantitative tumor blood flow was calculated at the pretreatment and the early treatment periods. Pretreatment tumor blood flow in patients in the treatment failure group was significantly lower than that in patients in the local control group. The use of the percentage change of tumor blood flow combined with the percentage change of tumor volume had high diagnostic accuracy for predicting local control.
- Treatment of 213 Patients with Symptomatic Tarlov Cysts by CT-Guided Percutaneous Injection of Fibrin Sealant
This cohort study assesses outcomes in patients who underwent CT-guided aspiration and injection of sacral Tarlov cysts at Johns Hopkins Hospital from 2003–2013. A total of 289 cysts were treated in 213 consecutive patients, with 83% followed for 3–6 years. One year postprocedure, excellent results were obtained in 104 patients (54.2% of patients followed), and good or satisfactory results were obtained in 53 patients (27.6%).
