Table of Contents
Perspectives
Review Articles
Level 1 EBM Expedited Publication
General Contents
- Diagnostic Performance of a 10-Minute Gadolinium-Enhanced Brain MRI Protocol Compared with the Standard Clinical Protocol for Detection of Intracranial Enhancing Lesions
A total of 53 patients underwent MR imaging consisting of 5 basic fast precontrast sequences plus standard and accelerated versions of the same postcontrast T1WI sequences. Two neuroradiologists assessed the image quality and the final diagnosis for each set of postcontrast sequences and compared their performances. The 10-minute brain MR imaging protocol with contrast was comparable in diagnostic performance with the standard protocol in an inpatient motion-prone population, with the additional benefits of reducing acquisition times and image artifacts.
- Relationship between Glioblastoma Heterogeneity and Survival Time: An MR Imaging Texture Analysis
A group of 133 patients with primary glioblastoma who underwent postcontrast T1-weighted imaging (acquired before treatment) and whose data were filed with the survival times were selected from the Cancer Genome Atlas. On the basis of overall survival, the patients were divided into 2 groups: long-term (≥12 months, n = 67) and short-term (<12 months, n = 66) survival. To measure heterogeneity, the authors extracted 3 types of textures, co-occurrence matrix, run-length matrix, and histogram, reflecting local, regional, and global spatial variations, respectively. Then the support vector machine classification was used to determine how different texture types perform in differentiating the 2 groups. The results suggest that local and regional heterogeneity may play an important role in the survival stratification of patients with glioblastoma.
- Amide Proton Transfer Imaging Allows Detection of Glioma Grades and Tumor Proliferation: Comparison with Ki-67 Expression and Proton MR Spectroscopy Imaging
Amide proton transfer–weighted imaging (APTWI) is a novel molecular MR imaging technique developed to detect and quantitatively visualize endogenous proteins and peptides. APTWI is usually reported in terms of asymmetry in the magnetization transfer ratio at 3.5 ppm. This study included 42 patients with low-grade (n = 28) or high-grade (n = 14) glioma, all of whom underwent conventional MR imaging, proton MR spectroscopy imaging, and amide proton transfer–weighted imaging on the same 3T scanner within 2 weeks before surgery. The asymmetric magnetization transfer ratio at 3.5 ppm values measured by different readers showed good concordance and were significantly higher in high-grade gliomas than in low-grade gliomas, with sensitivity and specificity values of 92.9% and 71.4%, respectively, at a cutoff value of 2.93%. The asymmetric magnetization transfer ratio at 3.5 ppm may serve as a potential biomarker not only for assessing proliferation, but also for predicting histopathologic grades in gliomas.
- Identification and Quantitative Assessment of Different Components of Intracranial Atherosclerotic Plaque by Ex Vivo 3T High-Resolution Multicontrast MRI
Fifty-three intracranial arterial specimens with atherosclerotic plaques from 20 cadavers were imaged by 3T MR with T1, T2, and proton-density–weighted FSE and STIR sequences. The signal characteristics and areas of fibrous cap, lipid core, calcification, fibrous tissue, and healthy vessel wall were recorded on MR images and compared with histology. The signal intensity of the lipid core was significantly lower than that of the fibrous cap on T2-weighted, proton-density, and STIR sequences and was comparable on T1-weighted sequences. Optimal contrast between the lipid core and fibrous cap was found on T2-weighted images. Ex vivo 3T MR imaging can accurately identify and quantitatively assess intracranial atherosclerotic plaque components, providing a direct reference for in vivo intracranial plaque imaging.
- Influence of Carotid Siphon Anatomy on Brain Aneurysm Presentation
Lateral view DSA images of 692 consecutive patients with intracranial aneurysms treated at the authors' institution were reviewed and had their angles measured. Data on the location, presentation, and size of the lesions were collected and evaluated by multivariate analysis in relation to the measured angles. Multivariate analysis showed an association between angles of >15.40° and rupture (P = .005), postsiphon location (P = .034), and aneurysm size of >1.001 mm (P = .015). These findings may be associated with the hemodynamic interactions of blood flow and the curvature of the carotid siphon.
- Analysis of 30 Spinal Angiograms Falsely Reported as Normal in 18 Patients with Subsequently Documented Spinal Vascular Malformations
Eighteen patients with 19 lesions underwent a total of 30 negative spinal angiograms. The lesions included 9 epidural arteriovenous fistulas, 8 dural arteriovenous fistulas, and 2 perimedullary arteriovenous fistulas. Seventeen patients underwent endovascular (11) or surgical (6) treatment, with a delay ranging between 1 week and 32 months; the Aminoff-Logue score improved in 76.5%. Causes of the inadequate results included: 1) lesion angiographically documented but not identified (55.6%); 2) region of interest not documented (29.6%); or 3) level investigated but injection technically inadequate (14.8%). All the angiograms falsely reported as normal were caused by correctible, operator-dependent factors.
