RESUMO
Objectives: Contrast-enhanced FLAIR fat-suppressed (CE-FLAIR-FS) imaging can potentially increase the diagnostic accuracy of uveal diseases and ultimately provide better patient management. This study aimed to determine the diagnostic value of CE-FLAIR-FS imaging versus contrast-enhanced T1-weighted imaging (CE-T1WI) in the assessment of pediatric patients with uveitis. Material and methods: Twenty-one children with uveitis who underwent whole brain magnetic resonance imaging (MRI), including CE-FLAIR-FS and CE-T1WI, were retrospectively included in the study. We evaluated the presence of uveal tract contrast enhancement with thickening, vitreous humor signal abnormality, and accompanying brain abnormalities. The uveal enhancement intensity was assessed semiquantitatively as mild, moderate, and marked uveitis compared to CE-T1WI and CE-FLAIR-FS images. Results: Panuveitis (61.9%) was the most frequent anatomic location, and most of them were idiopathic (47.6%). Of the 42 eyes with clinical uveitis, enhancement of the uveal tract was observed on CE-FLAIR-FS images in 21 eyes (50%), while in 5 eyes (11.9%) on CE-T1WI. The sensitivity of CE-FLAIR-FS in panuveitis was detected to be quite high (80.8%). The number of affected eyes and enhancement degree were found to be higher on CE-FLAIR-FS (p < 0.001). In assessing the severity of uveitis, CE-FLAIR-FS grades were significantly higher and more sensitive than CE-T1WI (p < 0.001, Z: -4.347). Three patients had vitreous abnormal signals on CE-FLAIR-FS images, but none on CE-T1WI. Conclusion: CE-FLAIR-FS plays a significant role in the diagnosis of pediatric uveitis, identifying the involvement and severity of the uveal inflammation and guiding the appropriate management. It would be beneficial to add it as a standard sequence to the routine MRI protocol for uveal pathologies.
RESUMO
AIM: To provide a definition of arterial anomalies in the anterior communicating artery complex (ACoAC), determine their prevalence and investigate their relationship with aneurysms. MATERIAL AND METHODS: The three-dimensional time-of-flight magnetic resonance angiography images of 1,857 adult patients who presented to our hospital between January 2020 and September 2022 were evaluated retrospectively. The images of 1,537 cases were subsequently classified according to their ACoAC anatomical variants. The patients were further grouped as those with no pathology, those with ACoAC aneurysms and those with pathologies other than ACoAC, and the relationship between the ACoAC anatomical variants of each group was investigated using statistical methods. Rare variants such as trifurcations of the A2 segments, single A2 segments, fenestrations of the A1 segment and double AComAs were evaluated in separate groups. RESULTS: The results of the classification of the 1,537 cases revealed the classical anatomical variant in 39.2% of the cases without ACoAC pathologies and 53.3% of the cases with ACoAC aneurysms. There was no significant difference between the sexes in terms of variant distribution (p=0.09), and no significant relationship between the presence of ACoAC aneurysms and sex (p=0.5). CONCLUSION: ACoAC anatomical variants of the cerebral arterial system were detected in 60% of the cases. The most common anterior circulation (AC) vascular variants (VV) were A1 segment hypoplasia and aplasia. No clear relationship was found between intracranial aneurysms and anatomical variation.