More articles from Adult Brain
- Optimal Diagnostic Indices for Idiopathic Normal Pressure Hydrocephalus Based on the 3D Quantitative Volumetric Analysis for the Cerebral Ventricle and Subarachnoid Space
Patients with suspected idiopathic normal pressure hydrocephalus (NPH) on the basis of the ventriculomegaly and a triad of symptoms underwent the CSF tap test. CSF volumes were extracted from a T2-weighted 3D spin-echo SPACE sequence on 3T MR imaging and were quantified semiautomatically. Twenty-four patients with tap-positive idiopathic NPH, 25 patients without response to the tap test, and 23 age-matched controls were included. The CSF volume of the parietal convexity had the highest area under the ROC curve in the discrimination of the tap-test response (0.768), followed by the z-Evans Index (0.758), and the upper-to-lower subarachnoid space ratio index (0.723). CSF volume of the parietal convexity of less than 38 mL, upper-to-lower subarachnoid space ratio of less than 0.33, and a z-Evans Index of greater than 0.42 are the newly proposed useful indices for idiopathic NPH diagnosis.
- Brain Magnetic Susceptibility Changes in Patients with Natalizumab-Associated Progressive Multifocal Leukoencephalopathy
These authors retrospectively evaluated 12 patients with natalizumab–progressive multifocal leukoencephalopathy (PML), 5 with PML from other causes, and 55 patients with MS without progressive PML for comparison. They observed T2* or SWI signal abnormalities at the chronic stage in all patients with PML, but in patients without PML no areas of low SWI signal intensity were detected. PML—related to natalizumab or not—induces brain susceptibility changes within U-fibers or deep gray matter that are visible on T2* or SWI and potentially explained by iron deposition.
- Risk Factors for Hemorrhagic Complications following Pipeline Embolization Device Treatment of Intracranial Aneurysms: Results from the International Retrospective Study of the Pipeline Embolization Device
In this study of 793 patients with 906 aneurysms, 20 (2.5%) had intraparenchymal hemorrhage. Nine patients with intraparenchymal hemorrhage (45.0%) died, 10 (50.0%) had major neurologic morbidity, and 1 (5.0%) had minor neurologic morbidity. Variables associated with higher odds of intraparenchymal hemorrhage included treatment of ruptured aneurysms and the use of 3 or more Pipeline Embolization Devices. The Shuttle sheath was not associated with intraparenchymal hemorrhage.
- Diagnostic Accuracy of PET, SPECT, and Arterial Spin-Labeling in Differentiating Tumor Recurrence from Necrosis in Cerebral Metastasis after Stereotactic Radiosurgery
The authors retrospectively reviewed patients treated between 2007–2010 and identified 14 patients with cerebral metastasis who had clinical or radiographic progression following stereotactic radiosurgery and were imaged with arterial spin-labeling (ASL), FDG-PET, and thallium SPECT before stereotactic biopsy. FDG-PET and ASL were equally sensitive in detecting tumor progression (83%). The specificity of ASL was superior to that of the other modalities (100%, 75%, and 50%, respectively). A combination of modalities did not augment the sensitivity, specificity, positive predictive value, or negative predictive value of ASL.