Biopsy-proven case of childhood primary angiitis of the central nervous system presenting with bilateral panuveitis and anisocoria.

Childhood primary angiitis of the central nervous system (cPACNS) is a rare and poorly understood immune-mediated vasculitis that preferentially affects blood vessels of the central nervous system (CNS). It must be distinguished from other disorders to initiate prompt treatment and improve the patient's prognosis. The presentation of cPACNS is highly variable, making a clinical diagnosis challenging. However, MRI may be helpful in showing typical findings including perivascular space inflammation and enhancement. Identification of these imaging features allows the radiologist to specifically suggest this rare diagnosis. The purpose of this manuscript is to present a biopsy-confirmed case of cPACNS in a 9-year-old girl who presented uniquely with panuveitis and anisocoria, and emphasize the MRI features that should prompt the radiologist to suggest this rare diagnosis.

Enhancement in a brain glioma model: a comparison of half-dose gadobenate dimeglumine versus full-dose gadopentetate dimeglumine at 1.5 and 3 T.

PURPOSE: To examine dose reduction comparing enhancement with full-dose gadopentetate dimeglumine (0.1 mmol/kg) to half-dose gadobenate dimeglumine in a rat brain glioma model. MATERIALS AND METHODS: Intra-axial parenchymal brain tumors were implanted in 17 experimental animals. The 13 surviving animals were imaged at 1.5 or 3 T. Either gadopentetate dimeglumine or gadobenate dimeglumine was injected in random order on consecutive days. Tumor signal-to-noise ratio (SNR), contrast-to-noise ratio (CNR), and contrast enhancement (CE) for each agent were obtained with region of interest analyses and compared. Lesions were confirmed histopathologically. RESULTS: Statistically significantly lower SNR, CNR, and CE parameters were found at both 1.5 and 3 T with half-dose gadobenate dimeglumine relative to full-dose gadopentetate dimeglumine (P < 0.05). SNR on average at 3 T was 70.0 ± 14.4 for gadopentetate dimeglumine and 57.0 0 ± 4.8 for gadobenate dimeglumine (P < 0.02). CONCLUSION: Improved r1 relaxivity with gadobenate dimeglumine does not produce adequate half-dose contrast-enhancement relative to full-dose gadopentetate dimeglumine.

Technical considerations in MR angiography: an image-based guide.

As the complexity of the magnetic resonance angiography (MRA) techniques grows, it becomes more difficult for the practicing radiologist to appreciate the physical principles underlying these studies. Nevertheless, such an understanding is requisite for improving clinical image quality. As radiologists are most accustomed to dealing with medical images in everyday practice, it seems natural that an image-based approach to teaching MRA physics, rather than complex mathematical equations or pulse sequence diagrams, would be preferable. This article adopts such an approach. Simple ways to improve MRA image quality are emphasized along with new technologies and their physical basis. The ultimate goal of the article is to facilitate the practicing radiologist becoming more aware of the variety of MR techniques available, being more confident in modifying sequence parameters to improve image quality and reduce contrast dose, and understanding the basis behind newer MRA techniques.

Current classification and terminology of pediatric vascular anomalies.

OBJECTIVE: The purpose of this article is to review new terminology to diagnose, classify, and refer patients with vascular anomalies for additional imaging, intervention, and treatment. CONCLUSION: In recent decades, much has been learned regarding the histopathology, cause, and treatment of vascular anomalies. As information has been gleaned, a new classification system has emerged that divides vascular anomalies into neoplasms and malformations. Its utility is based on accurate initial diagnosis that correlates consistently with clinical presentation, disease course, and treatment.

Spectrum of radiological manifestations of paediatric cat-scratch disease.

Cat-scratch disease (CSD) is usually a self-limiting condition that may mimic more serious disorders due to its variable clinical and imaging presentations. Many cases are diagnosed throughout the United States annually, with the majority occurring in children and adolescents who have had contact with a cat, usually in the form of a scratch or bite. This manuscript will discuss the spectrum of radiologic manifestations of CSD emphasising key imaging findings of lymphadenopathy, hepatosplenic lesions, osteomyelitis, discitis, encephalitis, neuroretinitis and cranial neuritis.

Eponyms in cardiothoracic radiology: Part I. Neoplasms.

Eponyms serve the purpose of honoring individuals who have made important observations and discoveries. As with other fields of medicine, eponyms are frequently encountered in radiology, particularly in chest radiology. However, inappropriate use of an eponym may lead to potentially dangerous miscommunication. Moreover, an eponym may honor the incorrect person or a person who falls into disrepute. Despite their limitations, eponyms are still widespread in medical literature. Furthermore, in some circumstances, more than one individual may have contributed to the description or discovery of a particular anatomical structure or disease, whereas in others, an eponym may have been incorrectly applied initially and propagated for years in medical literature. Nevertheless, radiologic eponyms are a means of honoring those who have made lasting contributions to the field of radiology, and familiarity with these eponyms is critical for proper reporting and accurate communication. In addition, the acquisition of some historical knowledge about those whose names are associated with various structures or pathologic conditions conveys a sense of humanity in the field of medicine. In this article, the first of a multipart series, the authors discuss a number of chest radiology eponyms as they relate to neoplasms, including relevant clinical and imaging features, as well biographic information of the respective eponym׳s namesake.

Eponyms in cardiothoracic radiology--part II: vascular.

Eponyms serve the purpose of honoring individuals who have made important observations and discoveries. As with other fields of medicine, eponyms are frequently encountered in radiology, particularly in chest radiology. However, inappropriate use of an eponym may lead to potentially dangerous miscommunication. Moreover, an eponym may honor the incorrect person or a person who falls into disrepute. Despite their limitations, eponyms are still widespread in the medical literature. Furthermore, in some circumstances, more than one individual may have contributed to the description or discovery of a particular anatomical structure or disease, whereas in others, an eponym may have been incorrectly applied initially and propagated for years in the medical literature. Nevertheless, radiologic eponyms are a means of honoring those who have made lasting contributions to the field of radiology, and familiarity with these eponyms is critical for proper reporting and accurate communication. In addition, the acquisition of some historical knowledge about those whose names are associated with various structures or pathologic conditions conveys a sense of humanity in the science of medicine. In this second part of a multipart series, the authors discuss a number of chest radiology eponyms as they relate to the pulmonary vasculature, including relevant clinical and imaging features, as well biographic information of the respective eponym׳s namesake.

Eponyms in cardiothoracic radiology: part III--interstitium.

Eponyms serve the purpose of honoring individuals who have made important observations and discoveries. As with other fields of medicine, eponyms are frequently encountered in radiology, particularly in chest radiology. However, inappropriate use of an eponym may lead to potentially dangerous miscommunication. Moreover, an eponym may honor the incorrect person or a person who falls into disrepute. Despite their limitations, eponyms are still widespread in the medical literature. Furthermore, in some circumstances, more than one individual may have contributed to the description or discovery of a particular anatomical structure or disease, whereas in others, an eponym may have been incorrectly applied initially and propagated for years in the medical literature. Nevertheless, radiologic eponyms are a means of honoring those who have made lasting contributions to the field of radiology, and familiarity with these eponyms is critical for proper reporting and accurate communication. In addition, the acquisition of some historical knowledge about those whose names are associated with various structures or pathologic conditions conveys a sense of humanity in the science of medicine. In this third installment of this series, the authors discuss a number of chest radiology eponyms as they relate to the pulmonary interstitium, including relevant clinical and imaging features, as well biographical information of the respective eponym's namesake.

Use of a Trellis device for endovascular treatment of venous thrombosis involving a duplicated inferior vena cava.

Congenital anomalies of the inferior vena cava (IVC) are increasingly recognized with CT and venography techniques. Although many patients with IVC anomalies are asymptomatic, recent studies have suggested an association with venous thromboembolism. We report the case of a 62-year-old woman with extensive venous clot involving the infrarenal segment of a duplicated left IVC who underwent pharmacomechanical thrombectomy and tissue plasminogen activator catheter-directed thrombolysis with complete deep venous thrombosis resolution. To our knowledge this is the first reported case in the English literature of the use of a Trellis thrombectomy catheter in the setting of duplicated IVC.

Echo planar diffusion-weighted imaging: possibilities and considerations with 12- and 32-channel head coils.

Interest in clinical brain magnetic resonance imaging using 32-channel head coils for signal reception continues to increase. The present investigation assesses possibilities for improving diffusion-weighted image quality using a 32-channel in comparison to a conventional 12-channel coil. The utility of single-shot (ss) and an approach to readout-segmented (rs) echo planar imaging (EPI) are examined using both head coils. Substantial image quality improvements are found with rs-EPI. Imaging with a 32-channel head coil allows for implementation of greater parallel imaging acceleration factors or acquisition of scans at a higher resolution. Specifically, higher resolution imaging with rs-EPI can be achieved by increasing the number of readout segments without increasing echo-spacing or echo time to the degree necessary with ss-EPI - a factor resulting in increased susceptibility artifact and reduced signal-to-noise with the latter.

Rare combination of frontonasal and bilateral naso-orbital encephaloceles.

Encephaloceles, while a common entity affecting 1:4000 live births, typically occur in the occipital region. Encephaloceles involving the frontal region comprise only 15% of all cases. Naso-orbital encephaloceles are rarely seen. Our case profiles a child born at term with an atrial septal defect (ASD), micrognathia, cleft lip, and frontonasal as well as bilateral naso-orbital encephaloceles. At birth the encephaloceles were undetected. During the cleft palate pre-operative preparation, the bilateral naso-orbital encephaloceles were diagnosed as dacrocystoceles for which the child underwent surgical repair. Misdiagnosis and loss to follow up lead to delayed surgical treatment until the child was almost two years of age; the right eye was near complete closure due to the increasing size of the encephalocele. This case highlights the importance of meticulous radiologic interpretation of midline nasal masses, as a correct diagnosis impacts clinical management and directs surgical repair.