Editor’s Choices
Association between Carotid Artery Plaque Type and Cerebral Microbleeds • L. Saba, R. Montisci, E. Raz, R. Sanfilippo, J.S. Suri, and M. Piga
This article explores the relationship between brain microbleeds and the type of plaque occurring in the carotid arteries of these patients. The authors assessed the plaques using CT and brain MRI with blood-sensitive gradient-echo sequences (they did not use SWI). Thirty percent of patients showed microbleeds; one-half were symptomatic. A statistically significant association between cerebral microbleeds and fatty carotid plaques was found.
Efficacy and Safety of Flow Diversion for Paraclinoid Aneurysms: A Matched-Pair Analysis Compared with Standard Endovascular Approaches • G. Lanzino, E. Crobeddu, H.J. Cloft, R. Hanel, and D.F. Kallmes
These seasoned investigators sought to evaluate the efficacy and safety of flow-diverting devices for the treatment of complex paraclinoid aneurysms in 21 patients and compared their results with historical matched controls treated at their institution. Aneurysm size, location, risk factors, and comorbidities were equal for both groups. In the hands of these authors, flow diverters achieved a higher rate of aneurysm obliteration when compared with other treatments and did not show an increased rate of complications.
Characterizing Hypervascular and Hypovascular Metastases and Normal Bone Marrow of the Spine Using Dynamic Contrast-Enhanced MR Imaging • N.R. Khadem, S. Karimi, K.K. Peck, Y. Yamada, E. Lis, J. Lyo, M. Bilsky, H.A. Vargas, and A.I. Holodny
In this study the feasibility of using dynamic postcontrast imaging to separate hypo- and hypervascular spine metastases was assessed. Using a T1 postcontrast sequence with temporal resolution of 6 seconds, the authors imaged spine lesions in 26 patients and from the data collected calculated 3 dynamic parameters. Hypervascular lesions showed steeper and higher wash-in slopes and higher peak enhancement. Conversely, conventional pre- and postcontrast images were unable to differentiate lesions.
Fellows’ Journal Club
A Comparison of Radiation Exposure between Diagnostic CTA and DSA Examinations of Cerebral and Cervicocerebral Vessels • A.-L. Manninen, J.-M. Isokangas, A. Karttunen, T. Siniluoto, and M.T. Nieminen
This article compares radiation exposure from CTA and DSA used to evaluate the extra- and intracranial circulations. Experiments were performed on a phantom using a 64-section CT scanner and biplane DSA. The authors concluded that the effective dose for CTA assessment of cerebral vessels was approximately one-fifth the dose compared with DSA. In the imaging of cervicocerebral vessels, the effective dose for CTA was approximately one-third higher compared with DSA.
Retinoblastoma: Value of Dynamic Contrast-Enhanced MR Imaging and Correlation with Tumor Angiogenesis • F. Rodjan, P. de Graaf, P. van der Valk, A.C. Moll, J.P.A. Kuijer, D.L. Knol, J.A. Castelijns, and P.J.W. Pouwels
Fifteen patients with retinoblastoma were assessed with dynamic contrast-enhanced MRI over a period of 8 minutes; late contrast enhancement was also studied. The authors found that during the early phase of the perfusion studies the time curve correlated with microvessel density whereas late enhancement correlated with tumor necrosis. Thus, dynamic contrast-enhanced MRI may be used to assess angiogenesis and necrosis and may be used to monitor treatment.
MR Imaging of IgG4-Related Disease in the Head and Neck and Brain • K. Toyoda, H. Oba, K. Kutomi, S. Furui, A. Oohara, H. Mori, K. Sakurai, K. Tsuchiya, S. Kan, and Y. Numaguchi
Autoimmune pancreatitis, sclerosing cholangitis and sialoadenitis, retroperitoneal and mediastinal fibrosis, and insterstitial pneumonia are all IgG-4 related disorders. This short article discusses the head and neck manifestations of this disease: orbital pseudotumor and lacrimal gland, cranial nerve, and pituitary involvement. Intracranially, the dura may be also affected. All of these lesions were contrast-enhancing and T2 dark, findings to be kept in mind so that one can suggest their etiology.
