Editor’s Choices

Can Quantitative Diffusion-Weighted MR Imaging Differentiate Benign and Malignant Cold Thyroid Nodules? Initial Results in 25 Patients • C. Schueller-Weidekamm, K. Kaserer, G. Schueller, C. Scheuba, H. Ringl, M. Weber, C. Czerny, and A.M. Herneth

Cold thyroid nodules are not uncommonly found in nuclear scans. Because they have up to a 20% rate of malignancy, most have to be biopsied or excised. In this article, the authors used quantitative diffusion-weighted imaging to further characterize cold nodules as benign or malignant. They found apparent diffusion coefficient values differed significantly between carcinoma, adenoma, and normal tissue and concluded DWI is helpful in separating carcinomas from adenomas. This article illustrates once more the utility of DWI in head and neck pathology.
 

Comparison of Eye Lens Dose on Neuroimaging Protocols between 16- and 64-Section Multidetector CT: Achieving the Lowest Possible Dose • J.S.P. Tan, K.-L. Tan, J.C.L. Lee, C.-M. Wan, J.-L. Leong, and L.-L. Chan

We are all aware of the need to reduce radiation exposure from CT scans, particularly with respect to the eyes. In this study, radiation dose exposure was assessed in 16- and 64-section CT scans obtained with nearly identical protocols. Surprisingly, the dose delivered was less using the 64-section scanner. This is probably due to improvement in automatic current modulation techniques.

 
MR Imaging Detection of Cerebral Microbleeds: Effect of Susceptibility-Weighted Imaging, Section Thickness, and Field Strength • R.N.K. Nandigam, A. Viswanathan, P. Delgado, M.E. Skehan, E.E. Smith, J. Rosand, S.M. Greenberg, and B.C. Dickerson

Until now, most of us have used gradient-echo images to detect microbleeds. Because GE offers low spatial resolution, susceptibility-weighted imaging has gained popularity for this purpose. In this study, the authors compared both techniques in patients with cerebral amyloid angiopathy. Because SWI is obtained with thinner sections at greater field strength, it outperformed GE, which identified only 33% of the microbleeds seen on SWI.

Fellow’s Journal Club

MR Imaging Features of Isolated Cortical Vein Thrombosis: Diagnosis and Follow-Up • M. Boukobza, I. Crassard, M.G. Bousser, and H. Chabriat

Many feel, like I do, that cortical vein thrombosis must be a fairly common event but diagnosing it is difficult. The authors of this article assessed different MR imaging sequences in 8 patients with isolated cortical vein thrombosis. They found that on gradient-echo sequences the thrombosed vein could be identified in all subjects. Six patients showed parenchymal changes in the vicinity of the affected vein. Hemorrhages (petechial or larger) were present in 5 patients.

Vertebroplasty for the Treatment of Traumatic Nonosteoporotic Compression Fractures • E.M. Knavel, K.R. Thielen, and D.F. Kallmes

Vertebroplasties are generally used for osteoporotic compression fractures and their benefit in that situation is well established. In this article, the authors used this procedure to treat nonosteoporotic vertebral compression fractures. From their data base they identified 15 such patients, and found that after the procedure these patients experienced improvement in mobility and decreased use of pain medications. Complications were few and asymptomatic.

MR Angiography Follow-Up 5 Years after Coiling: Frequency of New Aneurysms and Enlargement of Untreated Aneurysms • M.E. Sprengers, W.J. van Rooij, M. Sluzewski, G.J.E. Rinkel, B.K. Velthuis, G.A.P. de Kort, and C.B.L.M. Majoie

Although many articles have been published about how to follow previously coiled aneurysms, this deals with a different topic: using MR angiography to detect new aneurysms and enlargement of untreated ones in patients who have had a previously coiled aneurysm. The authors identified additional aneurysms in 20% of the 65 original patients. Only 1 aneurysm was considered to arise de novo and 1 grew slightly. The authors concluded MRA is helpful for this purpose.