A Practical Review of Functional MRI Anatomy of the Language and Motor Systems.

Functional MR imaging is being performed with increasing frequency in the typical neuroradiology practice; however, many readers of these studies have only a limited knowledge of the functional anatomy of the brain. This text will delineate the locations, anatomic boundaries, and functions of the cortical regions of the brain most commonly encountered in clinical practice-specifically, the regions involved in movement and language.

Current approaches to imaging of the sellar region and pituitary.

Recent advances in MR imaging have enabled the radiologist to view the pituitary gland in its normal and diseased states to a greater extent than ever before. The techniques for obtaining quality images of the sellar region and the normal appearance of the pituitary gland are discussed. This article also discusses the imaging of several pituitary disease processes, with emphasis on pitutiary adenomas and recent advances in diagnosis and follow-up. Current controversies also are addressed.

Reconstructive myofascial skull-base flaps: normal appearance on CT and MR imaging studies.

On imaging studies, the tendon and fractured coronoid process are clues to the presence of a temporalis myofascial flap. A large, bulky muscle and subcutaneous fat are characteristic of a free flap with microvascular anastomosis. The enhancing, thin, curvilinear pericranial flap bridges an osseous defect of the anterior skull base. Familiarity with these features is essential to avoid misdiagnosis of normal flap as tumor and to identify tumor recurrence.

Acute cholangitis: CT evaluation.

The CT findings of 23 patients with proven acute ascending cholangitis were retrospectively evaluated. Computed tomography confirmed the clinical diagnosis and detected the site and etiology of the obstructive process in the majority of patients. Biliary dilatation consistent with the clinical suspicion of acute cholangitis was present in 18 patients (78%), the level of the obstruction was detected in 15 patients, and the etiology of the obstructive process was visualized in 14 cases. Five patients presented with air in the biliary tree and three patients had liver abscesses. There was no good correlation established between jaundice, biliary infection, and the presence or degree of biliary dilatation. Biliary obstruction and acute cholangitis can develop before biliary dilatation is detected. In addition, CT showed limitations in establishing the etiology of the obstructive process, particularly in failing to detect 7 of 17 cases of cholesterol biliary stones.

Median cleft face syndrome: MR and CT data from 11 children.

Examination (including CT and magnetic resonance studies) of 11 unrelated children with median cleft face syndrome revealed 6 (55%) with dense calcification of the falx and 5 (45%) with interhemispheric lipoma. Of the 11 children, 3 exhibited Sedano facies type A, 4 exhibited Sedano facies type B, and 4 exhibited Sedano facies type D. Type A patients had no calcification or lipoma. Two of three type A patients were products of separate twin gestations, the only twins in the series. Type B patients had frequent falx calcification (three of four) and interhemispheric lipoma (two of four). Two of the four type B patients had concurrent Goldenhar syndrome, the only such patients in the series. Type D patients also had frequent falx calcification (three of four) and interhemispheric lipoma (three of four). Patients with median cleft face syndrome and Sedano facies type B or D should be examined radiologically for concurrent intracranial pathology.

Cerebellar pleomorphic xanthoastrocytoma in a patient with neurofibromatosis type 1.

We describe a case of cerebellar pleomorphic xanthoastrocytoma (PXA) occurring in a patient with neurofibromatosis type 1 (NF1). The histomorphology of this uncommon glial (astrocytic) neoplasm is discussed. The occurrence of this tumor within the posterior fossa is extremely rare. To our knowledge, this is the first reported case of a cerebellar PXA in a patient with NF1.