RESUMO
PURPOSE: This study was undertaken to assess the value of a chemical (spectral) fat-saturation (fat-sat) pulse added to a T1-weighted spin-echo sequence after intravenous administration of paramagnetic contrast agent in detecting enhancing lesions in multiple sclerosis. MATERIALS AND METHODS: Twenty patients with relapsing-remitting multiple sclerosis underwent a brain 1.0-Tesla magnetic resonance (MR) scan with T1-weighted spin-echo sequences (24 contiguous para-axial slices with a thickness of 5 mm, pixel size 0.96 mm(2), number of excitations 2, flip angle 90 degrees ) 5 min after intravenous injection of 0.1 mmol/kg of gadodiamide with and without fat-sat, acquired with randomised order of priority. Two readers counted by consensus the number of enhancing lesions and assigned a conspicuity score (low conspicuity=1; high conspicuity=2) to each enhancing lesion during a randomised reading without any visual comparison between the two corresponding images (with and without fat-sat) of the same patient. McNemar and Wilcoxon matched-pair signed-rank tests were used. RESULTS: Seventy-two enhancing lesions without fat-sat and 94 with fat-sat were detected; 22 lesions were visible only with fat-sat, whereas no lesion was detected only without fat-sat (p<0.0001). The conspicuity score was 1.17+/-0.38 (mean+/-standard deviation) and 1.57+/-0.44, respectively (p<0.0001). CONCLUSIONS: A fat-sat pulse added to a T1-weighted spin-echo sequence increases significantly the number and conspicuity of contrast-enhancing lesions in patients with relapsing-remitting multiple sclerosis.
Assuntos
Encéfalo/patologia , Imageamento por Ressonância Magnética/métodos , Esclerose Múltipla Recidivante-Remitente/patologia , Adulto , Meios de Contraste/administração & dosagem , Feminino , Gadolínio DTPA/administração & dosagem , Humanos , Masculino , Sensibilidade e Especificidade , Estatísticas não ParamétricasRESUMO
The goals of the treatment of paranasal sinuses mucocele are the relief of the symptoms due to compression and the prevention of recurrence. Because of the benignity of the pathology, it is mandatory to choose the approach that minimizes the surgical trauma. When an anterior clinoid mucocele is found, the conventional approaches are the trans-nasoethmoidal, the subtemporal or the pterional ones: we think that as a really mini-invasive approach, the transnasal endoscopy may be proposed. Anterior clinoid localization may be reached by a trans-sphenoidal way and treated by endoscopic microsurgery with a very low morbility. This paper deals with a case of anterior clinoid mucocele treated by this way with good anatomic and functional results and stresses the importance of the pre-operative imaging (CT/MR) allowing one to make a sure diagnosis and to choose the cases suitable for this surgical approach.
Assuntos
Endoscopia/métodos , Mucocele/cirurgia , Doenças dos Seios Paranasais/cirurgia , Seio Esfenoidal , Adulto , Feminino , Humanos , Imageamento por Ressonância Magnética , Mucocele/diagnóstico , Nariz , Doenças dos Seios Paranasais/diagnósticoRESUMO
An unusual case is reported in which a nail was driven into the head with suicidal intention. Neuroradiological examination, surgical treatment and results are discussed.
Assuntos
Corpos Estranhos/cirurgia , Lobo Parietal/lesões , Ferimentos Perfurantes/cirurgia , Seguimentos , Humanos , Masculino , Pessoa de Meia-Idade , Tomografia Computadorizada por Raios XRESUMO
In a consecutive series of 600 patients scanned by CT for various spinal diseases, those with low back and sciatic pain without disc herniation were selected for study. The causes proved to be joint facet degeneration (32 cases), stenosis of the neural foramina (13 cases), stenosis of the spinal canal (13 cases), lateral recess stenosis (6 cases) and spondylolisthesis (6 cases). The predominance of joint facet pathology as the underlying cause of low back and sciatic pain in the absence of disc herniation is confirmed. CT scanning of the soft tissues as well as of the skeletal structures is crucial to the aetiological diagnosis of the condition under study and hence to the proper planning of treatment.
Assuntos
Dor nas Costas/diagnóstico por imagem , Vértebras Lombares , Ciática/diagnóstico por imagem , Dor nas Costas/etiologia , Humanos , Artropatias/diagnóstico por imagem , Ciática/etiologia , Doenças da Coluna Vertebral/complicações , Doenças da Coluna Vertebral/diagnóstico por imagem , Estenose Espinal/diagnóstico por imagem , Espondilolistese/diagnóstico por imagem , Tomografia Computadorizada por Raios XRESUMO
16 patients with hypophyseal adenoma undergoing degenerative changes, namely necrotic-cystic changes, bleeding and calcification, were subjected to CT and the resulting density values studied. The cases were verified at operation and at histological examination. Evaluation of these features, despite the limitations of the method, proved to be very useful in differential diagnosis and in the planning of treatment.
Assuntos
Adenoma/diagnóstico por imagem , Neoplasias Hipofisárias/diagnóstico por imagem , Adenoma/complicações , Adenoma/patologia , Diagnóstico Diferencial , Hemorragia/etiologia , Humanos , Necrose , Neoplasias Hipofisárias/complicações , Neoplasias Hipofisárias/patologia , Tomografia Computadorizada por Raios XRESUMO
Vascular changes in the cerebral arterioles (150 - 500 mu) were demonstrated by means of magnification serial cerebral angiography (focal spot 0.15 mm) in a consecutive series of 25 hypertensive patients of advanced age suffering from cerebrovascular disease. The changes identified were: (a) arteriosclerotic lesions, (b) arteriolar occlusion, and (c) miliary aneurysms. The enhancement of vascular details obtained is essential to arrive at exact diagnosis and accurate clinical management.