Table of Contents
Perspectives
Review Articles
Radiology-Pathology Correlation
General Contents
- Clinical and Neuroimaging Correlation in Patients with COVID-19
This was a retrospective study performed at a large academic hospital in the United States. A total of 641 patients presented to the authors' institution between March 3, 2020 and May 6, 2020, for treatment of coronavirus disease 2019, of whom, 150 underwent CT and/or MR imaging of the brain. CT and/or MR imaging examinations were evaluated for the presence of hemorrhage, infarction, and leukoencephalopathy. Of the 150 patients, 26 (17%) had abnormal CT and/or MR imaging findings, with hemorrhage in 11 of the patients (42%), infarction in 13 of the patients (50%), and leukoencephalopathy in 7 of the patients (27%). Significant associations were seen between abnormal CT/MR imaging findings and intensive care unit admission, intubation, and acute kidney injury.
- Imaging Features of Acute Encephalopathy in Patients with COVID-19: A Case Series
The authors present 5 cases that illustrate varying imaging presentations of acute encephalopathy in patients with coronavirus disease 2019. MR features include leukoencephalopathy, diffusion restriction that involves the GM and WM, microhemorrhages, and leptomeningitis.
- Presurgical Identification of Primary Central Nervous System Lymphoma with Normalized Time-Intensity Curve: A Pilot Study of a New Method to Analyze DSC-PWI
The aims of this study were to: 1) to design a new method of postprocessing time-intensity curves, which renders normalized curves, and 2) to test its feasibility and performance on the diagnosis of primary central nervous system lymphoma. Time-intensity curves of enhancing tumor and normal-appearing white matter were obtained for each case. Enhancing tumor time-intensity curves were normalized relative to normal-appearing white matter. The authors performed pair-wise comparisons for primary central nervous system lymphoma against the other tumor type. The best discriminatory time points of the curves were obtained through a stepwise selection. Logistic binary regression was applied to obtain prediction models. A total of 233 patients were included in the study with 47 primary central nervous system lymphomas, 48 glioblastomas, 39 anaplastic astrocytomas, 49 metastases, and 50 meningiomas. The classifiers satisfactorily performed all bilateral comparisons in the test subset. They conclude that the proposed method for DSC-PWI time-intensity curve normalization renders comparable curves beyond technical and patient variability. Normalized time-intensity curves performed satisfactorily for the presurgical identification of primary central nervous system lymphoma.
- Tentorial Venous Anatomy: Variation in the Healthy Population
The authors retrospectively reviewed tentorial venous anatomy of the head using CTA/CTV performed for routine care or research purposes in 238 patients. Tentorial vein development was related to the ring configuration of the tentorial sinuses. There were 3 configurations: Groups 1A and 1B had ring configuration, while group 2 did not. Group 1A had a medialized ring configuration, and group 1B had a lateralized ring configuration. Measurements of skull base development were predictive of these groups. The ring configuration of group 1 was related to the presence of a split confluens, which correlated with a decreased internal auditory canal-petroclival fissure angle. Configuration 1A was related to the degree of petrous apex pneumatization.
- Olfactory Bulb Signal Abnormality in Patients with COVID-19 Who Present with Neurologic Symptoms
This retrospective case-control study compared the olfactory bulb and olfactory tract signal intensity on thin-section T2WI and postcontrast 3D T2 FLAIR images in patients with COVID-19 and neurologic symptoms, and age-matched controls imaged for olfactory dysfunction. Olfactory bulb 3D T2-FLAIR signal intensity was greater in the patients with COVID-19 and neurologic symptoms compared with an age-matched control group with olfactory dysfunction, and this was qualitatively apparent in 4 of 12 patients with COVID-19. Analysis of these preliminary findings suggests that olfactory apparatus vulnerability to COVID-19 might be supported on conventional neuroimaging and may serve as a noninvasive biomarker of infection.
- Are Gadolinium-Enhanced MR Sequences Needed in Simultaneous 18F-FDG-PET/MRI for Tumor Delineation in Head and Neck Cancer?
Consecutive patients who underwent simultaneous head and neck 18F-FDG-PET/MR imaging staging or restaging followed by surgery were retrospectively included in this study. Local tumor invasion and lymph node extension were assessed by 2 rater groups in 45 head and neck anatomic regions using 18F-FDG-PET/MR imaging. Two reading sessions were performed, one without contrast-enhanced sequences (using only T1WI, T2WI, and PET images) and a second with additional T1-weighted postcontrast sequences. The k concordance coefficient between the reading sessions and sensitivity and specificity for each region were calculated. There was excellent agreement between the contrast-free and postgadolinium reading sessions in delineating precise tumor extension in the 45 anatomic regions studied. The diagnostic accuracy did not differ between contrast-free and postgadolinium reading sessions, being 0.97 for both groups and both reading sessions. The authors conclude that gadolinium-based contrast administration showed no added value for accurate characterization of head and neck primary tumor extension and could possibly be avoided in the PET/MR imaging head and neck workflow.
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