Proton MR spectroscopic features of the cisternal segment of the trigeminal nerve in patients with trigeminal neuralgia: A pilot study.

PURPOSE: To investigate normal quantitative proton magnetic resonance spectroscopy (MRS) features of the cisternal segment of the trigeminal nerve and evaluate possible metabolite concentration differences in the affected and unaffected nerves of trigeminal neuralgia patients. MATERIAL AND METHODS: A total of 33 consecutive patients who underwent a MR study of the internal auditory canal/posterior fossa and dedicated trigeminal nerve multivoxel MRS were enrolled. Measurements of N-acetyl aspartate (NAA), creatine (Cr), choline (Cho), myoinositol (mI), glutamate-glutamine (Glx) concentrations, and ratios of NAA-to-Cr, Cho-to-Cr, and Cho-to-NAA were automatically calculated by the dedicated software. Vascular conflicts were also recorded. RESULTS: The mean Cr concentration was significantly higher on the affected sides in all parts of the nerve (p < 0.05), while the mean NAA concentration was significantly higher in only the distal portion (p = 0.04). Mean mI concentration was significantly higher in the middle and distal parts (p < 0.05). NAA-to-Cr ratio was significantly higher in the proximal and middle parts (p < 0.05), while Cho-to-Cr ratio was significantly higher only in the middle portion (p = 0.028). Finally, the Cho-to-NAA ratio was significantly higher only in the distal portion (p = 0.04). Vascular conflicts were observed in 24 patients (72.7%), and in 20 of them (60.6%) the conflict was on the same side as the neuralgia symptoms. CONCLUSION: Although the detected statistical relationships were variable in the spectroscopic measurements, metabolite concentrations and ratios were successfully exhibited in all patients. Features of a normal trigeminal nerve were able to determine by MRS. All calculated metabolite concentrations were higher in the affected nerves; however, only some of them were statistically significant. No statistically significant relationships were found between the MRS measurements and nerves with and without vascular compression.

Is there a relationship between oxygen saturation and MRI-induced anxiety? A prospective study.

PURPOSE: To prospectively examine the possible relationship between oxygen saturation changes and anxiety during MRI examinations. MATERIAL AND METHODS: One hundred and fifty randomly-selected patients referred to our department for MRI examination were included. Participants were asked to complete the Spielberger State and Trait Anxiety Inventory (STAI) to monitor subjective evaluation of anxiety. Both state (STAIs) and trait (STAIt) anxiety levels were recorded as pre-MRI scores. Following the inventory, oxygen saturation levels were measured before, during and immediately after an MRI scan. The patients completed the STAI again immediately following the procedure, and the post-MRI scores were recorded. The scan duration and examined body part were also noted. RESULTS: Ninty-one patients (60.7%) were female and 59 (39.3%) were male. Mean age was 43.68 ± 15.59 years. One hundred and thirty-one of them were head-first examinations, while 19 of them were foot-first, in reference to position on the table. Statistically significant relationships were found between pre- and mid-MRI oxygen saturation levels and mid- and post-MRI oxygen saturation levels. Additionally, mid-MRI saturation levels were significantly lower compared to pre- and post-MRI saturation levels (p = .001 for both measurements). The mean pre-MRI STAIs score was 35.6 ± 10.14, while the mean post-MRI score was 36.45 ± 9.92. The mean pre-MRI STAIt score was 44.01 ± 7.76, and post-MRI score was 44.39 ± 7.75 in the study group. There was no statistically significant relationship between pre- and post-MRI STAI scores. No significant correlation was found between oxygen saturation levels and STAI scores. CONCLUSION: To investigate a possible relationship between oxygen saturation changes during MRI examinations and MRI-induced anxiety, we designed a prospective study. We detected statistically significant lower oxygen saturation levels during the examination compared to pre- and post-MRI levels. However, no statistically significant relationship was found between the oxygen saturation decrease and pre- and post-MRI STAI scores.

The Relationship between Corpus Callosum Morphometric Measurements and Age/Gender Characteristics: A Comprehensive MR Imaging Study.

OBJECTIVE: The objective of the study was to examine a possible relationship between morphometric corpus callosum (CC) measurements, age, and gender characteristics using MR images. MATERIALS AND METHODS: The medical data and MR examinations of 436 consecutive subjects were retrospectively reviewed. The CC thickness from five different sites, and additionally splenium length, height, and total length of the CC, and the splenium index (SI) were measured with a mid-sagittal T1-weighted sequence. Those measurements were compared with age and gender characteristics. RESULTS: A weak but statistically significant negative correlation was found between age and thicknesses of genu and all body portions of CC (P = ≤0.001 for all, r = -0.32 for genu, r = -0.317 for B1, r = -0.328 for B2, r = -0.328 for B2, and r = -0.194 for B3 and B4). There was a weak but statistically significant positive correlation between age and the lengths of CC and splenium (P ≤ 0.022 for both, r = 0.112 for CC length and r = 0.11 for splenium length). The second part of the body (B2) was thicker in females (P = 0.014). On the other hand, the CC and splenium lengths were greater in males compared to females (P = 0.029 for both). CONCLUSION: We designed a comprehensive MRI study to investigate a possible relationship between normal morphometric CC measurements in 436 healthy subjects. We preferred splenium length and SI as the main splenium measurements instead of direct splenium thickness, due to discrepancies regarding splenium measurement methods in the medical literature. There was a wide spectrum of results, and we compared those results with existing medical literature.

Posterior Reversible Encephalopathy Syndrome in a Normotensive Child after Allogeneic Hematopoietic Stem Cell Transplantation.

Posterior reversible encephalopathy syndrome (PRES) is an uncommon clinicoradiological syndrome that is characterized by acute neurological symptoms such as headache, convulsion, visual disturbance, and altered consciousness. The characteristic magnetic resonance (MR) finding is vasogenic edema, predominantly in the subcortical areas of the posterior parietal and occipital lobes on T2-weighted and fluid-attenuated inversion recovery (FLAIR) sequences. Herein, we described a rare case of PRES induced by cyclosporine (CsA) after an allogeneic hematopoietic stem cell transplantation (HSCT) from a sibling donor.

Magnetic Resonance Imaging Findings in Childhood Period Nasopharynx Cancer.

BACKGROUND: Nasopharyngeal carcinoma is a rarely seen tumor in childhood. It is mostly detected late as the clinical features are similar to other childhood tumors which affect the nasopharynx and adenoidal hypertrophy. Therefore, the radiological features of childhood tumors of the nasopharynx must be well known. The aim of this study was to investigate the contribution of MR imaging features of childhood nasopharynx cancer. MATERIAL/METHODS: The study included 10 nasopharyngeal carcinoma patients under the age of 18 years who presented at hospital between February 2008 and March 2014 and who had tissue diagnosis and MRI of the nasopharynx region. The MRI scans were evaluated by two radiologists. Loco-regional spread, asymmetry, signal intensity of the tumors, and lymph nodes were evaluated. RESULTS: In all the patients there was a mass which narrowed the nasopharynx. In all cases, unilateral mastoid opacification was observed. In 9 cases (90%), parapharyngeal extension was found. In 8 cases (80%), the mass showed an extension into the nasal cavity or oropharynx. In 5 cases (50%), there was an involvement of the skull base. In 3 patients (30%), an extension to the masticator space and pterygopalatine fossa was found. There were enlarged cervical lymph nodes bilaterally in 10 cases (100%). In 4 cases (40%), a lateral retropharyngeal lymph node was detected. CONCLUSIONS: Childhood nasopharyngeal cancers are often diagnosed at an advanced stage. MR imaging can be helpful in diagnosis and differential diagnosis of childhood nasopharynx cancer from other diseases of the nasopharynx.