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1.
Eur J Radiol ; 124: 108817, 2020 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-31931302

RESUMEN

PURPOSE: To clarify the utility of dual energy CT (DECT) virtual non-calcium (VNCa) imaging for investigating lumbar intervertebral disc degeneration. METHOD: Fifty-three patients who underwent both DECT and MR imaging were retrospectively reviewed. Midsagittal T2-weighted imaging findings of all discs were classified based on modified Pfirrmann grade (mPG). Quantitative evaluation of VNCa maps was achieved by setting volumes of interest on each disc. We compared VNCa CT values with mPG using Spearman's rank correlation and one-way ANOVA. VNCa imaging findings of each disc were classified by two neuroradiologists into one of three categories based on the attenuation of nucleus pulposus (NP) compared to that of annulus fibrosus (AF) or muscle. The relationship between the visual categories for each rater and mPGs was analyzed by chi-square test. Statistical significance was established at P < 0.05. RESULTS: Among the included 171 lumbar discs, significant positive correlation was found between VNCa CT values for NP and mPGs (R2 = 0.574, P < 0.05), whereas no significant correlation was found between those for AF and mPGs (R2= -0.015, P = 0.846). Mean VNCa CT values for NP were significantly different among each mPG (P < 0.05 for each), except between grades 3 and 4 (P = 0.111). Mean VNCa CT values for AF were not significantly different among each mPG (P = 0.160-1.000). Statistically significant difference was observed among the visual categories for VNCa maps and mPGs in each rater (P < 0.05 for both). CONCLUSIONS: VNCa imaging acquired by a single DECT scan and post-processing has potential as an imaging biomarker of lumbar intervertebral disc degeneration.

2.
Jpn J Radiol ; 2019 Oct 31.
Artículo en Inglés | MEDLINE | ID: mdl-31673998

RESUMEN

PURPOSE: The aim of this study was to develop an interactive deep learning-assisted identification of the hyperdense middle cerebral artery (MCA) sign (HMCAS) on non-contrast computed tomography (CT) among patients with acute ischemic stroke. MATERIALS AND METHODS: 35 HMCAS-positive and 39 HMCAS-negative samples extracted by 50-pixel-diameter circular regions of interest were obtained as training and validation datasets according to the consensus decisions of two experienced neuroradiologists. Data augmentation was performed to increase the number of training samples. A deep convolutional neural network (DCNN) (Xception) was used to classify input images as HMCAS-positive or -negative. Leave-one-case-out cross-validation was achieved to estimate sensitivity, specificity, and accuracy of the deep learning-based training model for identifying HMCAS. RESULTS: In terms of diagnostic performance, DCNN for HMCAS offered 82.9% sensitivity, 89.7% specificity, and 86.5% accuracy in leave-one-case-out cross-validation. Area under the receiver operating characteristic curve for HMCAS was 0.947 (95% confidence interval 0.895-0.998; P < 0.05). CONCLUSION: The deep learning method appears potentially beneficial for identifying HMCAS on non-contrast CT in patients with acute ischemic stroke.

3.
Graefes Arch Clin Exp Ophthalmol ; 257(9): 1879-1887, 2019 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-31236669

RESUMEN

PURPOSE: To evaluate the new method to quantitate the running pattern of the vessels in Haller's layer in en face optical coherence tomographic (OCT) images using the new algorithm. METHODS: A retrospective and cross-sectional study. The en face image of top 25% slab of Haller's layer was analyzed. The vascular area in these images was calculated after binarization. Then, the vessels were thinned, and the total length of the vessels and the mean vessel diameter were calculated. Based on the angle of vessel running, "natural oblique vessel" was defined. The ratio of the natural oblique vessel to the whole vessels was defined as the "symmetry index". To examine the reproducibility of the software, the images obtained on two different examination dates of the same subject (25 eyes of 25 healthy subjects) were analyzed. Also, to compare the symmetry index and subjective evaluations, 180 eyes and 180 healthy subjects were analyzed. The subjective evaluations classified the images into 3 groups, the Symmetrical, Semi-symmetrical, and Asymmetrical types. Symmetry index was compared in each group. RESULTS: The inter-measurement correlation coefficient (ICC) of the vessel area, vessel length, and vessel diameter were 0.955, 0.934, and 0.954, respectively. The ICC of the symmetry index was 0.926. The symmetry index of the Symmetrical type was 60.4 ± 7.2%, that of the Semi-symmetry type was 56.2 ± 4.6%, and that of the Asymmetry type was 52.6 ± 5.2%. CONCLUSIONS: The present algorithm can analyze vessels in Haller's layer of the en face images of choroid in an objective manner with good repeatability.


Asunto(s)
Algoritmos , Coroides/irrigación sanguínea , Imagen Tridimensional , Aprendizaje Automático , Vasos Retinianos/diagnóstico por imagen , Tomografía de Coherencia Óptica/métodos , Adulto , Estudios Transversales , Femenino , Humanos , Masculino , Reproducibilidad de los Resultados , Estudios Retrospectivos
4.
Invest Ophthalmol Vis Sci ; 60(7): 2614-2622, 2019 06 03.
Artículo en Inglés | MEDLINE | ID: mdl-31219537

RESUMEN

Purpose: To compare the submacular to the perimacular choroidal structure in images obtained by wide-field optical coherence tomography (OCT). Methods: Thirty eyes of 30 healthy volunteers (15 men) were studied. Twelve wide-field radial circumferential scans were recorded with enhanced depth imaging OCT from the macular and perimacular zones. The sizes of the luminal and stromal areas of the choroid were determined. The two zones were subdivided into the superior, inferior, nasal, and temporal sectors. The total choroidal area, the luminal and stromal areas, and the luminal ratio of each sector were compared. Results: All of the choroidal structural parameters analyzed in the present study were largest in the superior sector followed by the temporal, inferior, and nasal sectors. The coefficients of variation were larger in the perimacular zone than in the macular zone: The luminal ratio in the macular zone varied by 1.2%, and that in perimacular zone varied by 4.2%. Conclusions: The variations in the ratios of the luminal areas of the choroid in the wide-field OCT images are slight in the macular zone but considerable in the perimacular zone.


Asunto(s)
Coroides/anatomía & histología , Coroides/diagnóstico por imagen , Tomografía de Coherencia Óptica/métodos , Adulto , Estudios Transversales , Femenino , Voluntarios Sanos , Humanos , Presión Intraocular/fisiología , Masculino , Persona de Mediana Edad , Tonometría Ocular
7.
Jpn J Ophthalmol ; 63(1): 82-89, 2019 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-30357532

RESUMEN

PURPOSE: To determine the capabilities of the "Kago-Eye2" software to semi-automatically segment the choroid in the optical coherence tomographic (OCT) images. STUDY DESIGN: A cross-sectional, prospective study of 44 healthy volunteers. METHODS: The Kago-eye2 software was developed to detect the border between Choriocapillaris and Sattler's layer (C-S) and between Sattler's layer and Haller's layer (S-H). The intra- and inter-grader agreements were determined for the segmentations made with semi-automated and manual analysis using the Kago-Eye2 software. The inter-method agreements were determined for two independent graders. RESULTS: Forty-four right eyes of 44 heathy volunteers (22 men) with a mean age of 35.0 ± 8.8 years were studied. The intra-grader agreement of the C-S border was 0.97 for grader 1 and 0.892 for grader 2 for the manual segmentation, and 0.908 for grader 1 and 0.842 for grader 2 for the Kago-Eye2 segmentation. For the S-H border, the intra-grader agreement was 0.96 for grader 1 and 0.981 for grader 2 for manual segmentation and 0.855 for grader 1 and 0.839 for grader 2 with the Kago-Eye2. For the C-S and S-H border, the inter-grader agreement was 0.548 and 0.902 for manual segmentation and 0.947 and 0.833 for the Kago-Eye2. The inter-method agreement was 0.565 for the C-S border and 0.759 for the S-H border. CONCLUSION: The Kago-Eye2 software can segment the layers of the subfoveal choroid with good reproducibility and repeatability. We conclude that the Kago-Eye2 software can be used for semi-automatic segmentation of the choroidal layers.


Asunto(s)
Coroides/diagnóstico por imagen , Imagen Tridimensional/métodos , Programas Informáticos , Tomografía de Coherencia Óptica/métodos , Adulto , Estudios Transversales , Femenino , Fóvea Central , Voluntarios Sanos , Humanos , Masculino , Persona de Mediana Edad , Estudios Prospectivos , Curva ROC , Reproducibilidad de los Resultados
8.
Jpn J Ophthalmol ; 62(6): 643-651, 2018 Nov.
Artículo en Inglés | MEDLINE | ID: mdl-30293226

RESUMEN

PURPOSE: To develop an automated method to segment the choroidal layers of en face optical coherent tomography (OCT) images by machine learning. STUDY DESIGN: A cross-sectional, prospective study of 276 eyes of 181 healthy subjects. METHODS: OCT en face images of the choroid were obtained every 2.6 µm from the retinal pigment epithelium (RPE) to the chorioscleral border. The images at the start of the choriocapillaris, start of Sattler's layer, and start of Haller's layer were identified, and the image numbers from the RPE line were taken as the teacher data. Forty-one feature quantities of each image were extracted. A support vector machine (SVM) model was created from each feature value of the training data, and a coefficient of determination was calculated for each layer of the choroid by a fivefold cross validation. Next, the same evaluation was performed after creating a SVM model with selected effective feature quantities. RESULTS: The mean coefficient of determination using all features was 0.9853 ± 0.0012. Nine effective feature quantities (relative choroid thickness, mean/kurtosis/variance of brightness, FFT_ skewness, k0_vessel width, k1/k2/k4_vessel area) were selected, and the mean of the coefficient of determinations with these quantities In this model was 0.9865 ± 0.0001. The number of errors in the image number at the start of each layer was 1.01 ± 0.79 for the choriocapillaris, 1.13 ± 1.12 for Sattler's layer, and 3.77 ± 2.90 for Haller's layer. CONCLUSION: Automated stratification of the choroid in en face images can be done with high accuracy through machine learning.


Asunto(s)
Coroides/anatomía & histología , Imagen Tridimensional , Aprendizaje Automático , Tomografía de Coherencia Óptica/métodos , Adulto , Anciano , Anciano de 80 o más Años , Estudios Transversales , Femenino , Voluntarios Sanos , Humanos , Masculino , Persona de Mediana Edad , Estudios Prospectivos , Reproducibilidad de los Resultados , Epitelio Pigmentado de la Retina/citología , Adulto Joven
9.
Yonago Acta Med ; 61(3): 145-155, 2018 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-30275744

RESUMEN

An accurate diagnosis of Parkinson's disease (PD) is a prerequisite for therapeutic management. In spite of recent advances in the diagnosis of parkinsonian disorders, PD is misdiagnosed in between 6 and 25% of patients, even in specialized movement disorder centers. Although the gold standard for the diagnosis of PD is a neuropathological assessment, neuroimaging has been playing an important role in the differential diagnosis of PD and is used for clinical diagnostic criteria. In clinical practice, differential diagnoses of PD include atypical parkinsonian syndromes such as dementia with Lewy bodies, multiple system atrophy, progressive supranuclear palsy, corticobasal degeneration, caused by a striatal dopamine deficiency following nigrostrial degeneration. PD may also be mimicked by syndromes not associated with a striatal dopamine deficiency such as essential tremor, drug-induced parkinsonism, and vascular parkinsonism. Moreover, difficulties are associated with the clinical differentiation of patients with parkinsonism from those with Alzheimer's disease. In this review, we summarize the typical imaging findings of PD and its related diseases described above using morphological imaging modalities (conventional MR imaging and neuromelanin MR imaging) and functional imaging modalities (99mTc-ethyl cysteinate dimer perfusion single photon emission computed tomography, 123I-metaiodobenzylguanidine myocardial scintigraphy, and 123I-FP-CIT dopamine transporter single photon emission computed tomography) that are clinically available in most hospitals. We also attempt to provide a diagnostic approach for the differential diagnosis of PD and its related diseases in clinical practice.

10.
Sci Rep ; 8(1): 10143, 2018 07 04.
Artículo en Inglés | MEDLINE | ID: mdl-29973663

RESUMEN

This study was conducted to investigate the size and shape of the foveal avascular zone (FAZ) determined by optical coherence tomography angiography (OCTA) and the relationship of the size and shape to the clinical findings in normal subjects. This was a cross-sectional study with seventy eyes of 70 volunteers. The size of the superficial FAZs were assessed by its area, length of perimeter, and Feret's diameter, and the shape by the circularity, axial ratio, roundness, and solidity. The correlations between each parameter and the clinical findings were statistically determined. The coefficients of variation (CV) of the parameters of FAZ size were higher than that of the parameters of FAZ shape. The refractive error and axial length were significantly correlated with area-related factors. The central macular thickness (CMT) was significantly correlated with all parameters. Although the CMT was a critical factor that was significantly correlated with the size and shape characteristics of the FAZ, the shape might be a better factor for characterizing the FAZ than the size because of the low CV of shape-related factors and the characteristics are less affected by the other ocular factors.


Asunto(s)
Angiografía/métodos , Fóvea Central/diagnóstico por imagen , Tomografía de Coherencia Óptica/métodos , Adulto , Angiografía/normas , Femenino , Fóvea Central/irrigación sanguínea , Humanos , Masculino , Persona de Mediana Edad , Vasos Retinianos/diagnóstico por imagen , Tomografía de Coherencia Óptica/normas
11.
Acta Radiol ; 59(11): 1372-1379, 2018 Nov.
Artículo en Inglés | MEDLINE | ID: mdl-29471670

RESUMEN

Background Detecting recurrence of glioma on magnetic resonance imaging (MRI) is getting more and more important, especially after administration of new anti-tumor agent. However, it is still hard to identify. Purpose To examine the utility of intravoxel incoherent motion (IVIM) MRI and arterial spin labeling-cerebral blood flow (ASL-CBF) for recurrent glioma after initiation of bevacizumab (BEV) treatment. Material and Methods Thirteen patients (7 men, 6 women; age range = 41-82 years) with glioma (high grade, n = 11; low grade, n = 2) were enrolled in the study. IVIM parameters including apparent diffusion coefficient (ADC), true diffusion coefficient (D), and perfusion fraction (f) were obtained with 14 different b-values. We identified tumor progression during BEV therapy by MRI monitoring consisting of diffusion-weighted imaging (DWI), fluid-attenuated inversion recovery (FLAIR) imaging, and contrast-enhanced T1-weighted (CE-T1W) imaging by measuring tumor area. We also measured each parameter of IVIM and ASL-CBF, and calculated relative ADC (rADC), relative D (rD), relative f (rf), and relative CBF (rCBF) by obtaining the ratio between each area and the contralateral cerebral white matter. We calculated the rate of change (Δ) by subtracting values from those from the preceding MRI study, and obtained Spearman's rank correlation coefficient (rs). Results Tumor progression was identified in nine patients (high grade, n = 7; low grade, n = 2). Negative correlations were identified between ΔrD and ΔDWI area (rs = -0.583), and between ΔrD and ΔCE-T1W imaging area (rs = -0.605). Conclusion Tumor progression after BEV treatment can be identified by decreasing rD.


Asunto(s)
Antineoplásicos Inmunológicos/uso terapéutico , Bevacizumab/uso terapéutico , Neoplasias Encefálicas/diagnóstico por imagen , Glioma/diagnóstico por imagen , Imagen por Resonancia Magnética/métodos , Recurrencia Local de Neoplasia/diagnóstico por imagen , Adulto , Anciano , Anciano de 80 o más Años , Neoplasias Encefálicas/tratamiento farmacológico , Medios de Contraste , Femenino , Glioma/tratamiento farmacológico , Humanos , Aumento de la Imagen/métodos , Masculino , Persona de Mediana Edad , Marcadores de Spin
12.
Neuroradiology ; 60(4): 391-401, 2018 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-29450601

RESUMEN

PURPOSE: Imaging findings of pilocytic astrocytoma (PA) vary widely, sometimes resembling those of high-grade glioma (HGG). This study aimed to identify the imaging parameters that can be used to differentiate PA from HGG. METHODS: Altogether, 60 patients with PAs and 138 patients with HGGs were included in the study. Tumor properties and the presence of hydrocephalus, peritumoral edema, and dissemination were evaluated. We also measured the maximum relative cerebral blood flow (rCBFmax) and volume (rCBVmax) and determined the minimum apparent diffusion coefficient (ADCmin) in the tumor's solid components. The relative T1 (rT1), T2 (rT2), and contrast-enhanced T1 (rCE-T1) intensity values were evaluated. Parameters were compared between PAs and HGGs using the Mann-Whitney U test. Receiver operating characteristic (ROC) curve analysis was also used to evaluate these imaging parameters. A value of P < .05 was considered to indicate significance. RESULTS: Intratumoral hemorrhage and calcification were observed in 10.0% and 21.7% of PAs, respectively. The rCBFmax and rCBVmax values were significantly lower in PAs (0.50 ± 0.35, 1.82 ± 1.21) than those in HGGs (2.98 ± 1.80, 9.54 ± 6.88) (P < .0001, P = .0002, respectively). The ADCmin values were significantly higher in PAs (1.36 ± 0.56 × 10-3 mm2/s) than those in HGGs (0.86 ± 0.37 × 10-3 mm2/s) (P < .0001). ROC analysis showed that the best diagnostic performance was achieved with rCBFmax. CONCLUSION: The rCBFmax, rCBVmax, and ADCmin can differentiate PAs from HGGs.


Asunto(s)
Astrocitoma/diagnóstico por imagen , Astrocitoma/patología , Neoplasias Encefálicas/diagnóstico por imagen , Neoplasias Encefálicas/patología , Glioma/diagnóstico por imagen , Glioma/patología , Imagen por Resonancia Magnética/métodos , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Niño , Preescolar , Diagnóstico Diferencial , Imagen de Difusión por Resonancia Magnética , Femenino , Humanos , Lactante , Japón , Masculino , Persona de Mediana Edad , Clasificación del Tumor , Estudios Retrospectivos
15.
Acta Radiol ; 59(5): 593-598, 2018 May.
Artículo en Inglés | MEDLINE | ID: mdl-28743197

RESUMEN

Background Both neuromelanin-sensitive magnetic resonance imaging (NmMRI) and 123I-FP-CIT single photon emission computed tomography (SPECT) (DaTSCAN) assist the diagnosis of Parkinson's disease (PD). However, there have been few studies investigating a correlation between them. Purpose To correlate the utility of NmMRI and DaTSCAN and to evaluate the relationship between both imaging findings and the Unified PD rating scale part III (UPDRS III) score for the diagnosis and management of PD. Material and Methods Seventeen patients with PD who underwent both NmMRI and DaTSCAN were included. We measured the volume of the neuromelanin-positive substantia nigra pars compacta (SNc volume) on NmMRI and measured the specific binding ratio (SBR) on DaTSCAN. The asymmetry index (AI) of the SNc volume and SBR were also calculated. We evaluated the relationship between the UPDRS III score and the SNc volume and SBR, respectively. Results The SNc volume showed a significant correlation with the SBR. The AIs of them also showed a significant correlation. Both the mean of the bilateral SBR and the mean of the bilateral SNc volume showed significant negative correlations with the UPDRS III score. However, the correlation between the SBR and the UPDRS III score was stronger than that between the SNc volume and the UPDRS III score. Conclusion Both NmMRI and DaTSCAN are helpful for PD diagnosis. However, we conclude that DaTSCAN is more suitable for the evaluation of the clinical motor severity and would be more useful for the management of PD patients than NmMRI.


Asunto(s)
Imagen por Resonancia Magnética/métodos , Enfermedad de Parkinson/diagnóstico por imagen , Tomografía Computarizada de Emisión de Fotón Único/métodos , Adulto , Anciano , Anciano de 80 o más Años , Femenino , Humanos , Interpretación de Imagen Asistida por Computador , Masculino , Melaninas , Persona de Mediana Edad , Estudios Retrospectivos , Sustancia Negra/patología , Tropanos
16.
Brain Dev ; 40(2): 116-125, 2018 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-28838686

RESUMEN

AIM: To determine the use of high b value diffusion-weighted imaging (DWI) in the diagnosis and assessment of acute febrile encephalopathy/encephalitis in childhood. SUBJECTS AND METHODS: We enrolled 22 children, for whom we examined DWI with b=1000s/mm2, DWI with b=3000s/mm2, and apparent diffusion coefficient (ADC) map with b=1000 during the acute phase of febrile encephalopathy/encephalitis. Clinical diagnoses included acute encephalopathy with biphasic seizures and late reduced diffusion (AESD; n=6), clinically mild encephalopathy/encephalitis with a reversible splenial lesion (MERS; n=6), and herpes simplex virus encephalitis (HSE; n=3), unclassified acute encephalopathy/acute encephalitis (n=2); acute encephalitis with refractory, repetitive partial seizures (AERRPS; n=1); other encephalopathy (n=1); infarction (n=1); head injury (n=1); or mitochondrial myopathy, encephalopathy, lactic acidosis, and stroke-like episodes (n=1). The diagnostic quality of brain lesions was compared between b=1000 and b=3000 DWI images by visual inspection. In addition, we attempted a quantitative assessment using apparent diffusion coefficient (ADC) value and an index of signal intensity (SI) ratio, defined as the mean SI at the affected lesion divided by the mean SI at the pons. RESULTS: High intensity lesions were either visible only on b=3000 DWI (n=5; 2 AESD, 1 MERS, 1 HSE, and 1 unclassifiable encephalopathy) or more effectively identified on b=3000 DWI than on b=1000 DWI (n=17). The outcome of the former five subjects was favorable, without motor or intellectual sequelae. The mean SI ratio of b=3000 was significantly greater than that of b=1000 in AESD and MERS subgroups as well as in all 22 subjects. Mean ADC values were lower in the AESD and MERS than that in the HSE subgroups. CONCLUSION: We concluded that b=3000 DWI was superior to b=1000 DWI in detecting abnormal lesions in acute encephalopathy/encephalitis during childhood.


Asunto(s)
Encefalopatía Aguda Febril/diagnóstico por imagen , Encéfalo/diagnóstico por imagen , Imagen de Difusión por Resonancia Magnética , Encefalopatía Aguda Febril/terapia , Niño , Preescolar , Imagen de Difusión por Resonancia Magnética/métodos , Femenino , Humanos , Lactante , Recién Nacido , Masculino
17.
World Neurosurg ; 109: 230-232, 2018 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-29017984

RESUMEN

BACKGROUND: Cavernous malformations in the pineal region are rare and difficult to anticipate from preoperative evaluation in patients with pineal apoplexy. We herein report the first case of a pineal cavernous malformation with superficial siderosis. Radiological findings were helpful in identifying the presence of the cavernous malformation. CASE DESCRIPTION: A 47-year-old female presented with a 4-month history of progressive headache, nausea, and dizziness. She complained of double vision and exhibited upward gaze palsy and papilledema on fundoscopy. Radiological examination revealed subacute hemorrhage in the pineal region and enlarged lateral ventricles. Furthermore, T2-star-weighted gradient-echo magnetic resonance imaging demonstrated a linear hypointensity along the pial surface of the cerebral cortex, brainstem, and cerebellum, indicating hemosiderin deposition consistent with superficial siderosis. Suspecting the presence of a cavernous malformation based on the radiological findings of superficial siderosis, we performed total mass resection. The postoperative course was uneventful and her preoperative symptoms resolved completely. CONCLUSION: Radiological findings of superficial siderosis on T2-star-weighted gradient-echo imaging are useful to making a diagnosis of cavernous malformation in cases of pineal apoplexy. They are also important for making the treatment decision to perform total mass resection, which is the best curative method for pineal cavernous malformations.


Asunto(s)
Hemangioma Cavernoso del Sistema Nervioso Central/complicaciones , Glándula Pineal/diagnóstico por imagen , Pinealoma/complicaciones , Siderosis/complicaciones , Femenino , Cefalea/diagnóstico por imagen , Cefalea/etiología , Hemangioma Cavernoso del Sistema Nervioso Central/diagnóstico por imagen , Humanos , Imagen por Resonancia Magnética , Persona de Mediana Edad , Náusea/diagnóstico por imagen , Náusea/etiología , Papiledema/diagnóstico por imagen , Papiledema/etiología , Pinealoma/diagnóstico por imagen , Siderosis/diagnóstico por imagen
18.
Otol Neurotol ; 38(10): 1523-1527, 2017 12.
Artículo en Inglés | MEDLINE | ID: mdl-29135869

RESUMEN

OBJECTIVE: To investigate the usefulness of magnetic resonance imaging (MRI) including three-dimensional (3D) sequences in the differentiation between Bell's palsy (BP) and Ramsay Hunt syndrome (RHS). STUDY DESIGN: A prospective study. SETTING: Tertiary care center. PATIENTS: Twenty patients: 15 patients with BP and five patients with RHS. INTERVENTION: Diagnostic. MAIN OUTCOME MEASURE: Clinical diagnosis (BP or RHS). RESULTS: The presence of hyperintensity on 3D-fluid-attenuated inversion recovery sequence (3D-FLAIR) and enhancement on gadolinium-enhanced (CE)-3D-FLAIR and CE-3D-T1-weighted image (3D-T1WI) along the internal auditory canal (IAC) wall were significantly associated with RHS (p < 0.05). Hyperintensity in the inner ear was observed on pre- and postcontrast 3D-FLAIR, and enhancement of the cranial nerve (CN)-VIII was observed only on CE-3D-FLAIR. The presence of these findings also showed significant relationships with RHS (p < 0.05). Moreover, thickening of the CN-VII in the fundus of the IAC in 3D-constructive interference on steady state sequence (3D-CISS) also showed a significant association with RHS (p < 0.05). In contrast, the presence of hyperintensity of the CN-VII in the fundus of the IAC on 3D-FLAIR did not demonstrate a significant relationship (p = 0.95), and enhancement in this region was observed in all cases on CE-3D-FLAIR and gadolinium-enhanced-three-dimensional-T1-weighted gradient echo sequence (CE-3D-T1WI). CONCLUSIONS: 3D MRI sequences are useful for differentiating RHS from BP. In particular, the enhancement in the CN-VIII and/or along the IAC wall are valuable findings, and CE-3D-FLAIR is the most useful sequence to evaluate these findings. Thickening of the CN-VII on 3D-CISS is also an important finding.


Asunto(s)
Parálisis de Bell/patología , Parálisis Facial/patología , Herpes Zóster Ótico/patología , Imagen Tridimensional/métodos , Imagen por Resonancia Magnética/métodos , Adulto , Anciano , Anciano de 80 o más Años , Parálisis de Bell/diagnóstico por imagen , Nervios Craneales/diagnóstico por imagen , Nervios Craneales/patología , Parálisis Facial/diagnóstico por imagen , Femenino , Gadolinio/administración & dosificación , Herpes Zóster Ótico/diagnóstico por imagen , Humanos , Masculino , Persona de Mediana Edad , Estudios Prospectivos
20.
J Stroke Cerebrovasc Dis ; 26(7): 1457-1461, 2017 Jul.
Artículo en Inglés | MEDLINE | ID: mdl-28385516

RESUMEN

BACKGROUND: The congestion of spin-labeled blood at large-vessel occlusion can present as hyperintense signals on perfusion magnetic resonance imaging with 3-dimensional pseudo-continuous arterial spin labeling (proximal bright vessel sign). The purpose of this study was to clarify the difference between proximal bright vessel sign and susceptibility vessel sign in acute cardioembolic cerebral infarction. METHODS: Forty-two patients with cardioembolic cerebral infarction in the anterior circulation territory underwent magnetic resonance imaging including diffusion-weighted imaging, 3-dimensional pseudo-continuous arterial spin labeling perfusion magnetic resonance imaging, T2*-weighted imaging, and 3-dimensional time-of-flight magnetic resonance angiography using a 3-T magnetic resonance scanner. Visual assessments of proximal bright vessel sign and the susceptibility vessel sign were performed by consensus of 2 experienced neuroradiologists. The relationship between these signs and the occlusion site of magnetic resonance angiography was also investigated. RESULTS: Among 42 patients with cardioembolic cerebral infarction, 24 patients showed proximal bright vessel sign (57.1%) and 25 showed susceptibility vessel sign (59.5%). There were 19 cases of proximal bright vessel sign and susceptibility vessel sign-clear, 12 cases of proximal bright vessel sign and susceptibility vessel sign-unclear, and 11 mismatched cases. Four out of 6 patients with proximal bright vessel sign-unclear and susceptibility vessel sign-clear showed distal middle cerebral artery occlusion, and 2 out of 5 patients with proximal bright vessel sign-clear and susceptibility vessel sign-unclear showed no occlusion on magnetic resonance angiography. CONCLUSIONS: Proximal bright vessel sign is almost compatible with susceptibility vessel sign in patients with cardioembolic cerebral infarction.


Asunto(s)
Infarto Cerebral/diagnóstico por imagen , Imagen de Difusión por Resonancia Magnética/métodos , Embolia/complicaciones , Cardiopatías/complicaciones , Embolia Intracraneal/diagnóstico por imagen , Angiografía por Resonancia Magnética/métodos , Marcadores de Spin , Anciano , Anciano de 80 o más Años , Infarto Cerebral/etiología , Embolia/diagnóstico , Femenino , Cardiopatías/diagnóstico , Humanos , Interpretación de Imagen Asistida por Computador , Embolia Intracraneal/etiología , Masculino , Persona de Mediana Edad , Valor Predictivo de las Pruebas , Reproducibilidad de los Resultados , Estudios Retrospectivos
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