Table of Contents
Perspectives
Review Article
Patient Safety
- Cerebral CTA with Low Tube Voltage and Low Contrast Material Volume for Detection of Intracranial Aneurysms
A cohort of 204 patients were randomly divided into 2 groups. Patients in group A (n = 102) underwent 80-kVp CTA with 30 mL of contrast agent, while patients in group B (n = 102) underwent conventional CTA (120 kVp, 60 mL of contrast agent). With DSA as a reference standard, diagnostic accuracy on a per-aneurysm basis was 89.9% for group A and 93.9% for group B. The authors conclude that in detecting intracranial aneurysms, 80-kVp/30-mL contrast CTA provides the same diagnostic accuracy as conventional CTA with substantial radiation dose and contrast agent reduction.
General Contents
- Magnetic Susceptibility from Quantitative Susceptibility Mapping Can Differentiate New Enhancing from Nonenhancing Multiple Sclerosis Lesions without Gadolinium Injection
In 54 patients, new T2-weighted lesions were evaluated for enhancement on conventional T1-weighted imaging with gadolinium, and their susceptibility values were measured on quantitative susceptibility mapping. Eighty-six of 133 new lesions that were gadolinium-enhancing had relative susceptibility values significantly lower than those of nonenhancing lesions. Using susceptibility values to discriminate enhancing from nonenhancing lesions showed a sensitivity of 88.4% and specificity of 91.5%, with a cutoff value of 11.2 parts per billion for QSM.
- High-Convexity Tightness Predicts the Shunt Response in Idiopathic Normal Pressure Hydrocephalus
Sixty patients with idiopathic normal pressure hydrocephalus underwent presurgical brain MR imaging and clinical evaluation before and 1 year after shunt surgery. The authors assessed the MR imaging features including Evans index, high-convexity tightness, Sylvian fissure dilation, callosal angle, focal enlargement of the cortical sulci, bumps in the lateral ventricular roof, and deep white matter and periventricular hyperintensities. Multiple linear regression analyses demonstrated that presurgical high-convexity tightness alone predicted the improvement of the clinical symptoms 1 year after surgery.
- Flow Diversion for Ophthalmic Artery Aneurysms
This is a retrospective review of 48 patients with 50 carotid-ophthalmic aneurysms in which 44 patients with 46 aneurysms were treated with flow diversion from June 2009 to June 2015. There were no permanent adverse visual outcomes. There was 1 death due to late intraparenchymal hemorrhage (2.2%). Six-month angiography showed complete occlusion in 24 of 37 patients (64.9%), and 3-year angiography results showed occlusion in 24 of 25 patients (96%).
- Ocular Signs Caused by Dural Arteriovenous Fistula without Involvement of the Cavernous Sinus: A Case Series with Review of the Literature
Ocular signs are unusual in the presentation of cranial dural arteriovenous fistulas in locations other than the cavernous sinus. Between 2000–2015, 13 patients met the inclusion criteria for this retrospective analysis. The most common signs were chemosis (61.5%), loss of visual acuity (38.5%), exophthalmia (38.5%), and ocular hypertension (7.7%). Dural arteriovenous fistulas presenting with ocular signs were classified into 4 types due to their pathologic mechanism (local venous reflux into the superior ophthalmic vein, massive venous engorgement of the cerebrum responsible for intracranial hypertension, compression of an oculomotor nerve by a venous dilation, or intraorbital fistula with drainage into the superior ophthalmic vein).
- Imaging Appearance of SMARCB1 (INI1)-Deficient Sinonasal Carcinoma: A Newly Described Sinonasal Malignancy
SMARCB1 (INI1) is a tumor-suppressor gene that has been implicated in a growing number of malignancies involving multiple anatomic sites, including the kidneys, soft tissues, and the CNS (See OMIM *601607). The authors describe a case series of 17 patients collected from 6 different centers to give a comprehensive description of the appearance of these tumors on CT, MR, and PET/CT studies. SMARCB1 (INI1)-deficient sinonasal carcinoma should be included in the differential diagnosis of a central sinonasal mass demonstrating aggressive imaging features, particularly when there is associated calcification.
