- Blood-Brain Barrier Disruption after Cardiac Surgery
To shed light on brain complications occurring after heart surgery, the authors assessed BBB disruption and DWI findings in half of their patients by imaging at 24 hours after surgery and 24–48 hours later. Additionally, postcontrast T1 images were obtained postoperatively at 2–4 days in the other half of the patients. Almost half the patients undergoing cardiac surgery had evidence of BBB abnormalities and three-quarters showed acute lesions on DWI after surgery. BBB disruption is more prevalent in the first 24 hours after surgery. These findings suggest that MR can be used as an imaging biomarker to assess therapies that may protect the BBB in patients undergoing heart surgery.
- Cervical Spine MR Imaging Findings of Patients with Hirayama Disease in North America: A Multisite Study
The authors sought to determine if Hirayama disease in North America has the same imaging findings as it does in Asia. They assessed imaging studies in 21 patients and looked for loss of attachment of posterior dura, lower cord atrophy and high T2 signal, loss of cervical lordosis, and anterior dural shift in flexion. These 4 findings were able to discriminate patients from healthy controls. MR imaging findings in white North American patients with Hirayama disease include loss of attachment on neutral images and forward displacement of the dura with flexion. Findings are often present on neutral MR images and, in the appropriate clinical scenario, should prompt flexion MR imaging to evaluate anterior dural shift.
- Diffusion Tensor Imaging Correlates with the Clinical Assessment of Disease Severity in Cervical Spondylotic Myelopathy and Predicts Outcome following Surgery
The relationship between DTI findings and clinical severity of cervical myelopathy due to spondylosis was studied in 30 patients. Low fractional anisotropy correlated with initial clinical assessments and patients with high FA showed better outcome. T2 signal intensity was associated with functional status but did not predict outcome whereas degree of stenosis lacked correlation with all clinical parameters. Thus, DTI may be a useful diagnostic tool for assessing disease severity in these patients and its predictive value regarding postoperative outcome may improve surgical decision making.
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