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1.
AJNR Am J Neuroradiol ; 43(6): 823-828, 2022 06.
Article in English | MEDLINE | ID: mdl-35589140

ABSTRACT

BACKGROUND AND PURPOSE: There have been growing concerns around potential risks related to sports-related concussion and contact sport exposure to repetitive head impacts in young athletes. Here we investigate WM microstructural differences between collegiate football players with and without sports-related concussion. MATERIALS AND METHODS: The study included 78 collegiate athletes (24 football players with sports-related concussion, 26 football players with repetitive head impacts, and 28 non-contact-sport control athletes), available through the Federal Interagency Traumatic Brain Injury Research registry. Diffusion metrics of diffusion tensor/kurtosis imaging and WM tract integrity were calculated. Tract-Based Spatial Statistics and post hoc ROI analyses were performed to test group differences. RESULTS: Significantly increased axial kurtosis in those with sports-related concussion compared with controls was observed diffusely across the whole-brain WM, and some focal areas demonstrated significantly higher mean kurtosis and extra-axonal axial diffusivity in sports-related concussion. The extent of significantly different WM regions decreased across time points and remained present primarily in the corpus callosum. Similar differences in axial kurtosis were found between the repetitive head impact and control groups. Other significant differences were seen at unrestricted return-to-play with lower radial kurtosis and intra-axonal diffusivity in those with sports-related concussion compared with the controls, mainly restricted to the posterior callosum. CONCLUSIONS: This study highlights the fact that there are differences in diffusion microstructure measures that are present not only between football players with sports-related injuries and controls, but that there are also measurable differences between football players with repetitive head impacts and controls. This work reinforces previous work showing that the corpus callosum is specifically implicated in sports-related concussion and also suggests this to be true for repetitive head impacts.


Subject(s)
Athletic Injuries , Brain Concussion , Football , White Matter , Athletic Injuries/diagnostic imaging , Brain/diagnostic imaging , Brain Concussion/diagnostic imaging , Diffusion Magnetic Resonance Imaging/methods , Diffusion Tensor Imaging/methods , Football/injuries , Humans , White Matter/diagnostic imaging , White Matter/injuries
2.
AJNR Am J Neuroradiol ; 43(1): 24-32, 2022 01.
Article in English | MEDLINE | ID: mdl-34857514

ABSTRACT

BACKGROUND AND PURPOSE: Quantitative volumetric segmentation of gliomas has important implications for diagnosis, treatment, and prognosis. We present a deep-learning model that accommodates automated preoperative and postoperative glioma segmentation with a pipeline for clinical implementation. Developed and engineered in concert, the work seeks to accelerate clinical realization of such tools. MATERIALS AND METHODS: A deep learning model, autoencoder regularization-cascaded anisotropic, was developed, trained, and tested fusing key elements of autoencoder regularization with a cascaded anisotropic convolutional neural network. We constructed a dataset consisting of 437 cases with 40 cases reserved as a held-out test and the remainder split 80:20 for training and validation. We performed data augmentation and hyperparameter optimization and used a mean Dice score to evaluate against baseline models. To facilitate clinical adoption, we developed the model with an end-to-end pipeline including routing, preprocessing, and end-user interaction. RESULTS: The autoencoder regularization-cascaded anisotropic model achieved median and mean Dice scores of 0.88/0.83 (SD, 0.09), 0.89/0.84 (SD, 0.08), and 0.81/0.72 (SD, 0.1) for whole-tumor, tumor core/resection cavity, and enhancing tumor subregions, respectively, including both preoperative and postoperative follow-up cases. The overall total processing time per case was ∼10 minutes, including data routing (∼1 minute), preprocessing (∼6 minute), segmentation (∼1-2 minute), and postprocessing (∼1 minute). Implementation challenges were discussed. CONCLUSIONS: We show the feasibility and advantages of building a coordinated model with a clinical pipeline for the rapid and accurate deep learning segmentation of both preoperative and postoperative gliomas. The ability of the model to accommodate cases of postoperative glioma is clinically important for follow-up. An end-to-end approach, such as used here, may lead us toward successful clinical translation of tools for quantitative volume measures for glioma.


Subject(s)
Deep Learning , Glioma , Glioma/diagnostic imaging , Glioma/surgery , Humans , Image Processing, Computer-Assisted , Magnetic Resonance Imaging , Neural Networks, Computer , Postoperative Period
3.
AJNR Am J Neuroradiol ; 42(8): 1437-1443, 2021 08.
Article in English | MEDLINE | ID: mdl-33985946

ABSTRACT

BACKGROUND AND PURPOSE: Diffusion MR imaging sequences essential for clinical neuroradiology imaging protocols may be accelerated with simultaneous multislice acquisitions. We tested whether simultaneous multislice-accelerated diffusion data were clinically equivalent to standard acquisitions. MATERIALS AND METHODS: In this retrospective study, clinical diffusion sequences obtained before and after implementation of 2-slice simultaneous multislice acceleration and an altered diffusion gradient sampling scheme using the same 3T MRI scanner and 20-channel coil (n = 25 per group) were independently and blindly evaluated by 2 neuroradiologists for perceived quality, artifacts, and overall diagnostic utility. Diffusion tractography was performed in 13 patients both with and without 2-slice simultaneous multislice acceleration (b = 0, 1000, 2000 s/mm2; 60 directions). The corticospinal tract and arcuate fasciculus ipsilateral to the lesion were generated using the same ROIs and then blindly assessed by a neurosurgeon for anatomic fidelity, perceived quality, and impact on surgical management. Tract volumes were compared for spatial overlap. RESULTS: Two-slice simultaneous multislice diffusion reduced acquisition times from 141 to 45 seconds for routine diffusion and from 7.5 to 5.9 minutes for diffusion tractography using 3T MR imaging. The simultaneous multislice-accelerated diffusion sequence was rated equivalent for diagnostic utility despite reductions to perceived image quality. Simultaneous multislice-accelerated diffusion tractography was rated clinically equivalent. Dice similarity coefficients between routine and simultaneous multislice-generated corticospinal tract and arcuate fasciculus tract volumes were 0.78 (SD, 0.03) and 0.71 (SD, 0.05), respectively. CONCLUSIONS: Two-slice simultaneous multislice diffusion appeared clinically equivalent for standard acquisitions and diffusion tractography. Simultaneous multislice makes it feasible to acquire higher angular and q-space-resolution diffusion acquisitions required for translating advanced diffusion models into clinical practice.


Subject(s)
Diffusion Magnetic Resonance Imaging , Diffusion Tensor Imaging , Artifacts , Humans , Magnetic Resonance Imaging , Retrospective Studies
4.
AJNR Am J Neuroradiol ; 42(5): 824-830, 2021 05.
Article in English | MEDLINE | ID: mdl-33632738

ABSTRACT

BACKGROUND AND PURPOSE: Studies associate repeat gadolinium-based contrast agent administration with T1 shortening in the dentate nucleus and globus pallidus, indicating CNS gadolinium deposition, most strongly with linear agents but also reportedly with macrocyclics. Renal impairment effects on long-term CNS gadolinium deposition remain underexplored. We investigated the relationship between signal intensity changes and renal function in patients who received ≥10 administrations of the macrocyclic agent gadobutrol. MATERIALS AND METHODS: Patients who underwent ≥10 brain MR imaging examinations with administration of intravenous gadobutrol between February 1, 2014, and January 1, 2018, were included in this retrospective study. Dentate nucleus-to-pons and globus pallidus-to-thalamus signal intensity ratios were calculated, and correlations were calculated between the estimated glomerular filtration rate (minimum and mean) and the percentage change in signal intensity ratios from the first to last scan. Partial correlations were calculated to control for potential confounders. RESULTS: One hundred thirty-one patients (73 women; mean age at last scan, 55.9 years) showed a mean percentage change of the dentate nucleus-to-pons of 0.31%, a mean percentage change of the globus pallidus-to-thalamus of 0.15%, a mean minimum estimated glomerular filtration rate of 69.65 (range, 10.16-132.26), and a mean average estimated glomerular filtration rate at 89.48 (range, 38.24-145.93). No significant association was found between the estimated glomerular filtration rate and percentage change of the dentate nucleus-to-pons (minimum estimated glomerular filtration rate, r = -0.09, P = .28; average estimated glomerular filtration rate, r = -0.09, P = .30,) or percentage change of the globus pallidus-to-thalamus (r = 0.07, P = .43; r = 0.07, P = .40). When we controlled for age, sex, number of scans, and total dose, there were no significant associations between the estimated glomerular filtration rate and the percentage change of the dentate nucleus-to-pons (r = 0.16, P = .07; r = 0.15, P = .08) or percentage change of the globus pallidus-to-thalamus (r = -0.14, P = .12; r = -0.15, P = .09). CONCLUSIONS: In patients receiving an average of 12 intravenous gadobutrol administrations, no correlation was found between renal function and signal intensity ratio changes, even in those with mild or moderate renal impairment.


Subject(s)
Central Nervous System/metabolism , Contrast Media/adverse effects , Gadolinium/metabolism , Kidney/metabolism , Organometallic Compounds/adverse effects , Adolescent , Adult , Aged , Aged, 80 and over , Cerebellar Nuclei/metabolism , Child , Child, Preschool , Contrast Media/pharmacokinetics , Female , Glomerular Filtration Rate , Humans , Kidney Diseases/metabolism , Kidney Function Tests , Magnetic Resonance Imaging/adverse effects , Magnetic Resonance Imaging/methods , Male , Middle Aged , Organometallic Compounds/pharmacokinetics , Pons/metabolism , Retrospective Studies , Young Adult
5.
AJNR Am J Neuroradiol ; 41(8): E52-E59, 2020 08.
Article in English | MEDLINE | ID: mdl-32732276

ABSTRACT

Fueled by new techniques, computational tools, and broader availability of imaging data, artificial intelligence has the potential to transform the practice of neuroradiology. The recent exponential increase in publications related to artificial intelligence and the central focus on artificial intelligence at recent professional and scientific radiology meetings underscores the importance. There is growing momentum behind leveraging artificial intelligence techniques to improve workflow and diagnosis and treatment and to enhance the value of quantitative imaging techniques. This article explores the reasons why neuroradiologists should care about the investments in new artificial intelligence applications, highlights current activities and the roles neuroradiologists are playing, and renders a few predictions regarding the near future of artificial intelligence in neuroradiology.


Subject(s)
Artificial Intelligence/trends , Neurology/methods , Neurology/trends , Radiology/methods , Radiology/trends , Humans
6.
AJNR Am J Neuroradiol ; 41(9): 1629-1631, 2020 09.
Article in English | MEDLINE | ID: mdl-32675340

ABSTRACT

The thalamus consists of several functionally distinct nuclei, some of which serve as targets for functional neurosurgery. Visualization of such nuclei is a major challenge due to their low signal contrast on conventional imaging. We introduce MR susceptibility imaging with a short TE, leveraging susceptibility differences among thalamic nuclei, to automatically delineate 15 thalamic subregions. The technique has the potential to enable direct targeting of thalamic nuclei for functional neurosurgical guidance.


Subject(s)
Magnetic Resonance Imaging/methods , Thalamic Nuclei/anatomy & histology , Adult , Aged , Female , Humans , Male , Middle Aged , Young Adult
7.
AJNR Am J Neuroradiol ; 40(9): 1438-1444, 2019 09.
Article in English | MEDLINE | ID: mdl-31371359

ABSTRACT

BACKGROUND AND PURPOSE: Working memory impairment is one of the most troubling and persistent symptoms after mild traumatic brain injury (MTBI). Here we investigate how working memory deficits relate to detectable WM microstructural injuries to discover robust biomarkers that allow early identification of patients with MTBI at the highest risk of working memory impairment. MATERIALS AND METHODS: Multi-shell diffusion MR imaging was performed on a 3T scanner with 5 b-values. Diffusion metrics of fractional anisotropy, diffusivity and kurtosis (mean, radial, axial), and WM tract integrity were calculated. Auditory-verbal working memory was assessed using the Wechsler Adult Intelligence Scale, 4th ed, subtests: 1) Digit Span including Forward, Backward, and Sequencing; and 2) Letter-Number Sequencing. We studied 19 patients with MTBI within 4 weeks of injury and 20 healthy controls. Tract-Based Spatial Statistics and ROI analyses were performed to reveal possible correlations between diffusion metrics and working memory performance, with age and sex as covariates. RESULTS: ROI analysis found a significant positive correlation between axial kurtosis and Digit Span Backward in MTBI (Pearson r = 0.69, corrected P = .04), mainly present in the right superior longitudinal fasciculus, which was not observed in healthy controls. Patients with MTBI also appeared to lose the normal associations typically seen in fractional anisotropy and axonal water fraction with Letter-Number Sequencing. Tract-Based Spatial Statistics results also support our findings. CONCLUSIONS: Differences between patients with MTBI and healthy controls with regard to the relationship between microstructure measures and working memory performance may relate to known axonal perturbations occurring after injury.


Subject(s)
Brain Concussion/diagnostic imaging , Brain Concussion/psychology , Brain/diagnostic imaging , Memory, Short-Term , Adolescent , Adult , Aged , Axons/metabolism , Biomarkers , Body Water/metabolism , Diffusion Magnetic Resonance Imaging , Educational Status , Female , Humans , Male , Middle Aged , Nerve Net/diagnostic imaging , Neuropsychological Tests , Prospective Studies , Wechsler Scales , White Matter/diagnostic imaging , Young Adult
8.
AJNR Am J Neuroradiol ; 40(4): 601-608, 2019 04.
Article in English | MEDLINE | ID: mdl-30923084

ABSTRACT

BACKGROUND AND PURPOSE: The effects of multiple head impacts, even without detectable primary injury, on subsequent behavioral impairment and structural abnormality is yet well explored. Our aim was to uncover the dynamic changes and long-term effects of single and repetitive head injury without focal contusion on tissue microstructure and macrostructure. MATERIALS AND METHODS: We introduced a repetitive closed-head injury rodent model (n = 70) without parenchymal lesions. We performed a longitudinal MR imaging study during a 50-day study period (T2-weighted imaging, susceptibility-weighted imaging, and diffusion tensor imaging) as well as sequential behavioral assessment. Immunohistochemical staining for astrogliosis was examined in a subgroup of animals. Paired and independent t tests were used to evaluate the outcome change after injury and the cumulative effects of impact load, respectively. RESULTS: There was no gross morphologic evidence for head injury such as skull fracture, contusion, or hemorrhage on micro-CT and MR imaging. A significant decrease of white matter fractional anisotropy from day 21 on and an increase of gray matter fractional anisotropy from day 35 on were observed. Smaller mean cortical volume in the double-injury group was shown at day 50 compared with sham and single injury (P < .05). Behavioral deficits (P < .05) in neurologic outcome, balance, and locomotor activity were also aggravated after double injury. Histologic analysis showed astrogliosis 24 hours after injury, which persisted throughout the study period. CONCLUSIONS: There are measurable and dynamic changes in microstructure, cortical volume, behavior, and histopathology after both single and double injury, with more severe effects seen after double injury. This work bridges cross-sectional evidence from human subject and pathologic studies using animal models with a multi-time point, longitudinal research paradigm.


Subject(s)
Brain Concussion/complications , Brain Concussion/pathology , Gait Disorders, Neurologic/etiology , Sensation Disorders/etiology , Animals , Cross-Sectional Studies , Diffusion Tensor Imaging/methods , Disease Models, Animal , Gray Matter/pathology , Head Injuries, Closed/complications , Head Injuries, Closed/pathology , Longitudinal Studies , Male , Rats , Rats, Sprague-Dawley , White Matter/pathology
9.
AJNR Am J Neuroradiol ; 39(12): 2200-2204, 2018 12.
Article in English | MEDLINE | ID: mdl-30498019

ABSTRACT

BACKGROUND AND PURPOSE: Mild traumatic brain injury is a leading cause of death and disability worldwide with 42 million cases reported annually, increasing the need to understand the underlying pathophysiology because this could help guide the development of targeted therapy. White matter, particularly the corpus callosum, is susceptible to injury. Animal models suggest stretch-induced mechanoporation of the axonal membrane resulting in ionic shifts and altered sodium ion distribution. The purpose of this study was to compare the distribution of total sodium concentration in the corpus callosum between patients with mild traumatic brain injury and controls using sodium (23Na) MR imaging. MATERIALS AND METHODS: Eleven patients with a history of mild traumatic brain injury and 10 age- and sex-matched controls underwent sodium (23Na) MR imaging using a 3T scanner. Total sodium concentration was measured in the genu, body, and splenium of the corpus callosum with 5-mm ROIs; total sodium concentration of the genu-to-splenium ratio was calculated and compared between patients and controls. RESULTS: Higher total sodium concentration in the genu (49.28 versus 43.29 mmol/L, P = .01) and lower total sodium concentration in the splenium (which was not statistically significant; 38.35 versus 44.06 mmol/L, P = .08) was seen in patients with mild traumatic brain injury compared with controls. The ratio of genu total sodium concentration to splenium total sodium concentration was also higher in patients with mild traumatic brain injury (1.3 versus 1.01, P = .001). CONCLUSIONS: Complex differences are seen in callosal total sodium concentration in symptomatic patients with mild traumatic brain injury, supporting the notion of ionic dysfunction in the pathogenesis of mild traumatic brain injury. The total sodium concentration appears to be altered beyond the immediate postinjury phase, and further work is needed to understand the relationship to persistent symptoms and outcome.


Subject(s)
Brain Concussion/metabolism , Corpus Callosum/chemistry , Sodium/analysis , Adult , Aged , Female , Humans , Magnetic Resonance Imaging/methods , Male , Middle Aged , Pilot Projects , Young Adult
10.
AJNR Am J Neuroradiol ; 39(7): 1222-1225, 2018 07.
Article in English | MEDLINE | ID: mdl-29794235

ABSTRACT

BACKGROUND AND PURPOSE: Cerebral microhemorrhages are a known marker of mild traumatic brain injury. Blast-related mild traumatic brain injury relates to a propagating pressure wave, and there is evidence that the mechanism of injury in blast-related mild traumatic brain injury may be different from that in blunt head trauma. Two recent reports in mixed cohorts of blunt and blast-related traumatic brain injury in military personnel suggest that the prevalence of cerebral microhemorrhages is lower than in civilian head injury. In this study, we aimed to characterize the prevalence of cerebral microhemorrhages in military service members specifically with chronic blast-related mild traumatic brain injury. MATERIALS AND METHODS: Participants were prospectively recruited and underwent 3T MR imaging. Susceptibility-weighted images were assessed by 2 neuroradiologists independently for the presence of cerebral microhemorrhages. RESULTS: Our cohort included 146 veterans (132 men) who experienced remote blast-related mild traumatic brain injury (mean, 9.4 years; median, 9 years after injury). Twenty-one (14.4%) reported loss of consciousness for <30 minutes. Seventy-seven subjects (52.7%) had 1 episode of blast-related mild traumatic brain injury; 41 (28.1%) had 2 episodes; and 28 (19.2%) had >2 episodes. No cerebral microhemorrhages were identified in any subject, as opposed to the frequency of SWI-detectable cerebral microhemorrhages following blunt-related mild traumatic brain injury in the civilian population, which has been reported to be as high as 28% in the acute and subacute stages. CONCLUSIONS: Our results may reflect differences in pathophysiology and the mechanism of injury between blast- and blunt-related mild traumatic brain injury. Additionally, the chronicity of injury may play a role in the detection of cerebral microhemorrhages.


Subject(s)
Blast Injuries/complications , Brain Concussion/etiology , Cerebral Hemorrhage/epidemiology , Cerebral Hemorrhage/etiology , Adult , Aged , Blast Injuries/diagnostic imaging , Brain Concussion/diagnostic imaging , Cerebral Hemorrhage/diagnostic imaging , Cohort Studies , Female , Humans , Magnetic Resonance Imaging/methods , Male , Middle Aged , Military Personnel , Prevalence , Young Adult
11.
AJNR Am J Neuroradiol ; 38(4): 726-728, 2017 Apr.
Article in English | MEDLINE | ID: mdl-28034997

ABSTRACT

The effect of T1 signal on FSL voxel-based morphometry modulated GM density and FreeSurfer cortical thickness is explored. The techniques rely on different analyses, but both are commonly used to detect spatial changes in GM. Standard pipelines show FSL voxel-based morphometry is sensitive to T1 signal alterations within a physiologic range, and results can appear discordant between FSL voxel-based morphometry and FreeSurfer cortical thickness. Care should be taken in extrapolating results to the effect on brain volume.


Subject(s)
Brain/diagnostic imaging , Image Processing, Computer-Assisted/methods , Magnetic Resonance Imaging/methods , Neuroimaging/methods , Humans
12.
AJNR Am J Neuroradiol ; 37(11): 1996-2000, 2016 Nov.
Article in English | MEDLINE | ID: mdl-27418467

ABSTRACT

BACKGROUND AND PURPOSE: Obtaining high-resolution brain MR imaging in patients with a previously implanted deep brain stimulator has been challenging and avoided by many centers due to safety concerns relating to implantable devices. We present our experience with a practical clinical protocol at 1.5T by using 2 magnet systems capable of achieving presurgical quality imaging in patients undergoing bilateral, staged deep brain stimulator insertion. MATERIALS AND METHODS: Protocol optimization was performed to minimize the specific absorption rate while providing image quality necessary for adequate surgical planning of the second electrode placement. We reviewed MR imaging studies performed with a minimal specific absorption rate protocol in patients with a deep brain stimulator in place at our institution between February 1, 2012, and August 1, 2015. Images were reviewed by a neuroradiologist and a functional neurosurgeon. Image quality was qualitatively graded, and the presence of artifacts was noted. RESULTS: Twenty-nine patients (22 with Parkinson disease, 6 with dystonia, 1 with essential tremor) were imaged with at least 1 neuromodulation implant in situ. All patients were imaged under general anesthesia. There were 25 subthalamic and 4 globus pallidus implants. Nineteen patients were preoperative for the second stage of bilateral deep brain stimulator placement; 10 patients had bilateral electrodes in situ and were being imaged for other neurologic indications, including lead positioning. No adverse events occurred during or after imaging. Mild device-related local susceptibility artifacts were present in all studies, but they were not judged to affect overall image quality. Minimal aliasing artifacts were seen in 7, and moderate motion, in 4 cases on T1WI only. All preoperative studies were adequate for guidance of a second deep brain stimulator placement. CONCLUSIONS: An optimized MR imaging protocol that minimizes the specific absorption rate can be used to safely obtain high-quality images in patients with previously implanted deep brain stimulators, and these images are adequate for surgical guidance.

13.
AJNR Am J Neuroradiol ; 36(3): E12-23, 2015 Mar.
Article in English | MEDLINE | ID: mdl-25655872

ABSTRACT

The past decade has seen impressive advances in the types of neuroimaging information that can be acquired in patients with traumatic brain injury. However, despite this increase in information, understanding of the contribution of this information to prognostic accuracy and treatment pathways for patients is limited. Available techniques often allow us to infer the presence of microscopic changes indicative of alterations in physiology and function in brain tissue. However, because histologic confirmation is typically lacking, conclusions reached by using these techniques remain solely inferential in almost all cases. Hence, a need exists for validation of these techniques by using data from large population samples that are obtained in a uniform manner, analyzed according to well-accepted procedures, and correlated with closely monitored clinical outcomes. At present, many of these approaches remain confined to population-based research rather than diagnosis at an individual level, particularly with regard to traumatic brain injury that is mild or moderate in degree. A need and a priority exist for patient-centered tools that will allow advanced neuroimaging tools to be brought into clinical settings. One barrier to developing these tools is a lack of an age-, sex-, and comorbidities-stratified, sequence-specific, reference imaging data base that could provide a clear understanding of normal variations across populations. Such a data base would provide researchers and clinicians with the information necessary to develop computational tools for the patient-based interpretation of advanced neuroimaging studies in the clinical setting. The recent "Joint ASNR-ACR HII-ASFNR TBI Workshop: Bringing Advanced Neuroimaging for Traumatic Brain Injury into the Clinic" on May 23, 2014, in Montreal, Quebec, Canada, brought together neuroradiologists, neurologists, psychiatrists, neuropsychologists, neuroimaging scientists, members of the National Institute of Neurologic Disorders and Stroke, industry representatives, and other traumatic brain injury stakeholders to attempt to reach consensus on issues related to and develop consensus recommendations in terms of creating both a well-characterized normative data base of comprehensive imaging and ancillary data to serve as a reference for tools that will allow interpretation of advanced neuroimaging tests at an individual level of a patient with traumatic brain injury. The workshop involved discussions concerning the following: 1) designation of the policies and infrastructure needed for a normative data base, 2) principles for characterizing normal control subjects, and 3) standardizing research neuroimaging protocols for traumatic brain injury. The present article summarizes these recommendations and examines practical steps to achieve them.


Subject(s)
Brain Injuries , Databases, Factual , Neuroimaging , Brain Injuries/pathology , Female , Humans , Male
14.
Phys Rev Lett ; 108(26): 262501, 2012 Jun 29.
Article in English | MEDLINE | ID: mdl-23004969

ABSTRACT

A high-resolution measurement of inelastic proton scattering off (90)Zr near 0° was performed at 295 MeV with a focus on a pronounced strength previously reported in the low-energy tail of giant dipole resonance. A forest of fine structure was observed in the excitation energy region 7-12 MeV. A multipole decomposition analysis of the angular distribution for the forest was carried out using the ECIS95 distorted-wave Born approximation code with the Hartree-Fock plus random-phase approximation model of E1 and M1 transition densities and inclusion of E1 Coulomb excitation. The analysis separated pygmy dipole and M1 resonances in the forest at E(PDR)=9.15±0.18 MeV with Γ(PDR)=2.91±0.64 MeV and at E(M1)=9.53±0.06 MeV with Γ(M1)=2.70±0.17 MeV in the Lorentzian function, respectively. The B(E1)↑ value for pygmy dipole resonance over 7-11 MeV is 0.75±0.08 e(2)fm(2), which corresponds to 2.1±0.2% of the Thomas-Reiche-Kuhn sum rule.

15.
AJNR Am J Neuroradiol ; 33(6): 1041-5, 2012 Jun.
Article in English | MEDLINE | ID: mdl-22282448

ABSTRACT

BACKGROUND AND PURPOSE: There is no standardized curriculum currently available at most institutions for establishing procedural competency in trainees performing cervicocerebral angiography. The purpose of this study was to evaluate a simple learning program to supplement the teaching of basic cervicocerebral angiography. MATERIALS AND METHODS: An 11-session interactive curriculum was implemented covering anatomic, clinical, and radiographic topics for the novice cervicocerebral angiographer. The target learner was the neuroradiology fellow. Data were gathered regarding fellow comfort level on topics relating to cervicocerebral angiography by using a 5-point Likert scale. Improvement in scores on knowledge-based questions after completion of the curriculum was calculated (McNemar test). Trainee-perceived utility of the program was also recorded by using a 5-point Likert scale. Focus sessions were held at the completion of the curriculum to gather feedback regarding the strengths and weaknesses of the program from participants. RESULTS: Ten subjects were enrolled in this pilot study for 3 years. Topics where participants reported a poor initial comfort level (4 or higher) included selection of injection rates and volumes and reformation of reverse-curve catheters. Trainees demonstrated a statistically significant change in the distribution of scores of 29.3% (49.4%-78.7% correct response rate, P < .0001). The average perceived utility was 1.5 (1 = most useful, 5 = least useful). CONCLUSIONS: This simple learning program was a useful adjunct to the training of fellows in diagnostic cervicocerebral angiography, resulting in quantitative improvements in knowledge.


Subject(s)
Catheterization, Peripheral , Cerebral Angiography , Educational Measurement , Internship and Residency/statistics & numerical data , Neuroradiography , Radiology/education , Adult , Curriculum , Female , Humans , Male , New York , Pilot Projects , Young Adult
16.
AJNR Am J Neuroradiol ; 32(4): 617-26, 2011 Apr.
Article in English | MEDLINE | ID: mdl-20595365

ABSTRACT

Childhood central skull base masses are rare, often difficult to diagnose, and have overlapping imaging findings. In this review, we provide an overview of the epidemiology, clinical findings, and management of pediatric sphenoid bone and sphenoid sinus masses with an emphasis on imaging findings that may help to differentiate lesions. Radiologic-pathologic correlation is provided. Finally, an imaging-based algorithm is presented as a guide to help radiologists narrow their differential diagnoses. Some of the entities discussed are virtually unique to the pediatric population; others occur rarely in this age group but should be considered in the appropriate clinical setting. Entities included in the discussion are grouped into 2 categories: those that cause nonaggressive osseous remodeling and those that are more commonly associated with aggressive bone changes. Mucocele, aneurysmal bone cyst, giant cell lesions, meningioma, and fibrous dysplasia tend to remodel bone, while entities such as chordoma, craniopharyngioma, rhabdomyosarcoma, sinonasal carcinoma, and neuroblastoma may cause more aggressive local bone changes.


Subject(s)
Bone Diseases/diagnostic imaging , Bone Diseases/pathology , Skull Base Neoplasms/diagnostic imaging , Skull Base Neoplasms/pathology , Sphenoid Bone/diagnostic imaging , Sphenoid Bone/pathology , Child , Diagnosis, Differential , Humans , Radiography
17.
AJNR Am J Neuroradiol ; 31(9): 1552-63, 2010 Oct.
Article in English | MEDLINE | ID: mdl-20190208

ABSTRACT

CTP has a growing role in evaluating stroke. It can be performed immediately following NCCT and has advantages of accessibility and speed. Differentiation of salvageable ischemic penumbra from unsalvageable core infarct may help identify patients most likely to benefit from thrombectomy or thrombolysis. Still, CTP interpretation can be complex. We review normal and ischemic perfusion patterns followed by an illustrative series of technical/diagnostic challenges of CTP interpretation in the setting of acute stroke syndromes.


Subject(s)
Brain Ischemia/diagnostic imaging , Brain/diagnostic imaging , Diagnostic Errors/prevention & control , Perfusion Imaging/methods , Tomography, X-Ray Computed/methods , Humans
18.
Anaesthesia ; 64(11): 1254-7, 2009 Nov.
Article in English | MEDLINE | ID: mdl-19825064

ABSTRACT

Propofol is a commonly used anaesthetic agent and is rarely associated with seizure-like phenomena. This case report presents a young woman with seizure-like phenomena lasting more than 4 weeks after a single dose of propofol. The underlying pathophysiology of this condition is poorly understood but a psychological component is possible in this case.


Subject(s)
Anesthetics, Intravenous/adverse effects , Myoclonus/chemically induced , Postoperative Complications/chemically induced , Propofol/adverse effects , Adult , Female , Humans
19.
Phys Rev Lett ; 100(16): 162502, 2008 Apr 25.
Article in English | MEDLINE | ID: mdl-18518192

ABSTRACT

Photoneutron cross sections were measured for 91Zr, 92Zr, and 94Zr near the neutron separation energy with quasimonochromatic gamma rays. The data exhibit some extra components around the neutron threshold. A coherent analysis of the photoneutron data for 92Zr together with the neutron capture on 91Zr based on the microscopic Hartree-Fock-Bogoliubov plus quasiparticle random-phase approximation model for the E1 strength has revealed the presence of an M1 resonance at 9 MeV. The microscopic approach systematically shows the same M1 strength in the photoneutron cross section for 91Zr and 94Zr. The total M1 strength is about 75% larger than the strength predicted by the systematics, being qualitatively consistent with the giant M1 resonance observed in the inelastic proton scattering.

20.
Phys Rev Lett ; 96(19): 192501, 2006 May 19.
Article in English | MEDLINE | ID: mdl-16803099

ABSTRACT

Photoneutron cross sections for (181)Ta(y, n) (180)Ta(m) were determined from simultaneous measurements of total cross sections (sigma(tot) and ground-state cross sections (sigma(gs)) for (180)Ta in photodisintegration of with laser Compton-backscattered rays. Techniques of direct neutron counting and photoactivation were used for the measurement of sigma(tot) and sigma(gs), respectively. The partial cross sections for the isomeric state serves as a novel probe of the nuclear level density of (180)Ta. Implications for the p- and s-process nucleosynthesis of (180)Ta(m) are given.

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