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	<title>CT &#8211; AJNR Blog</title>
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	<link>https://www.ajnrblog.org</link>
	<description>The Official Blog of the American Journal of Neuroradiology</description>
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		<title>Brain CT Essentials</title>
		<link>https://www.ajnrblog.org/2021/01/08/brain-ct-essentials/</link>
		
		<dc:creator><![CDATA[bookreviews]]></dc:creator>
		<pubDate>Fri, 08 Jan 2021 22:24:21 +0000</pubDate>
				<category><![CDATA[Book Reviews]]></category>
		<category><![CDATA[Full Reviews]]></category>
		<category><![CDATA[Brain]]></category>
		<category><![CDATA[CT]]></category>
		<guid isPermaLink="false">http://www.ajnrblog.org/?p=19179</guid>

					<description><![CDATA[Mamourian A. Brain CT essentials. https://www.medmastery.com As part of the Medmastery catalog of online medical tutorials, Dr. Mamourian has developed excellent lectures on brain CT essentials, which require approximately 3 hours of viewing time and can be split into small]]></description>
										<content:encoded><![CDATA[<p><strong>Mamourian A. Brain CT essentials. <a href="https://www.medmastery.com/course/brain-ct-essentials">https://www.medmastery.com</a></strong></p>
<p>As part of the Medmastery catalog of online medical tutorials, Dr. Mamourian has developed excellent lectures on brain CT essentials, which require approximately 3 hours of viewing time and can be split into small segments of viewing time as desired. The material can be reviewed and replayed.</p>
<p>In this educational tool, there are 8 chapters, each of which contains multiple sections and all of which are narrated by Dr. Mamourian in a clear, unrushed manner.</p>
<p>This video presentation covers basic anatomy/concepts in brain CT: trauma, stroke imaging, non-traumatic hemorrhage, brain tumor imaging, seizures/epilepsy, metabolic/infectious/demyelination, and skull abnormalities. Within each of these 8 categories there are a number of segments (from 3 to 6, depending on the subject matter, and each takes an average of 4 minutes to view). Overall, there are 36 segments. At the end of each category, there is a quiz with 5 questions, which covers the key points of the prior lecture. After each question, the registrants can click on the explanation given by Dr. Mamourian for the correct answer; this is particularly helpful for any question for which an incorrect answer was given. At the conclusion of the video the registrants may apply for Category 1 CME credits and a certificate is then mailed to them.</p>
<p>Without going into each of these categories and chapters in detail, the reader of this review should be aware of the exceptional value of this educational tool. The images selected are of high quality and the MRI correlates are commonly shown, along with DSA images as needed for completeness. Embedded in each lecture are well-constructed drawings, which help the viewer better appreciate the material being presented. What the person who views this material will come away with is an understanding of the features of major intracranial diseases, the potential pitfalls in imaging interpretation, a sense of the important clinical correlates, and what additional studies should be performed. To list all the key findings and concepts contained in the video would make this review unwieldy and unnecessarily long, but the reader of this review can rest assured that all the basic (and in some cases more advanced) CT imaging is included.</p>
<p>There is no doubt that online educational material such as this will become the dominant teaching modality as we move to the future. This video should be required viewing by all junior residents before they start either their neuroradiology or ER rotations. As the more senior residents prepare for Part 1 of their ABR exam, this tool should be made available to them for review. Also, these video lectures should be viewed by residents starting their neurology residencies.</p>
<p>The brain CT essentials course as obtained online through Medmastery is highly recommended. Dr. Mamourian is to be congratulated for a masterful job in developing this educational tool.</p>
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			</item>
		<item>
		<title>Percutaneous CT-Guided Core Needle Biopsies of Head and Neck Masses: Technique, Histopathologic Yield, and Safety at a Single Academic Institution</title>
		<link>https://www.ajnrblog.org/2020/12/12/percutaneous-ct-guided-core-needle-biopsies-of-head-and-neck-masses-technique-histopathologic-yield-and-safety-at-a-single-academic-institution/</link>
		
		<dc:creator><![CDATA[jross]]></dc:creator>
		<pubDate>Sat, 12 Dec 2020 18:49:25 +0000</pubDate>
				<category><![CDATA[Editor's Choices]]></category>
		<category><![CDATA[Head and Neck]]></category>
		<category><![CDATA[core needle biopsy]]></category>
		<category><![CDATA[CT]]></category>
		<category><![CDATA[head and neck masses]]></category>
		<guid isPermaLink="false">http://www.ajnrblog.org/?p=19096</guid>

					<description><![CDATA[Editor&#8217;s Choice This is a retrospective review of head and neck biopsies performed from January 2013 through December 2019. Clinical diagnosis and indication, patient demographics, mass location and size, biopsy needle type, technical approach, dose-length product, sedation details, complications, diagnostic]]></description>
										<content:encoded><![CDATA[<div class="editor-comment">
<h1>Editor&#8217;s Choice</h1>
<p>This is a retrospective review of head and neck biopsies performed from January 2013 through December 2019. Clinical diagnosis and indication, patient demographics, mass location and size, biopsy needle type, technical approach, dose-length product, sedation details, complications, diagnostic histopathologic yield, and the use of iodinated contrast were recorded for each case. Twenty-seven CT-guided head and neck core needle biopsies were performed in 26 patients. The diagnostic sample rate was 100% (27/27). A concordant histopathologic diagnosis was obtained in 93% (25/27) of cases. There was a single complication of core needle biopsy, a small asymptomatic superficial hematoma.</p>
<p class="signature"><img decoding="async" src="http://www.ajnrblog.org/wp-content/uploads/ross-signature.png" alt="" /></p>
<p><span id="more-19096"></span></p>
</div>
<h2 class="signature">Abstract</h2>
<div id="sec-1" class="subsection">
<h3 id="p-3">BACKGROUND AND PURPOSE</h3>
<figure id="attachment_19098" aria-describedby="caption-attachment-19098" style="width: 300px" class="wp-caption alignright"><a href="http://www.ajnrblog.org/wp-content/uploads/F1.large3_.jpg"><img decoding="async" class="wp-image-19098 size-medium" src="http://www.ajnrblog.org/wp-content/uploads/F1.large3_-300x147.jpg" alt="Figure 1 from Hillen et al" width="300" height="147" srcset="https://www.ajnrblog.org/wp-content/uploads/F1.large3_-300x147.jpg 300w, https://www.ajnrblog.org/wp-content/uploads/F1.large3_-150x74.jpg 150w, https://www.ajnrblog.org/wp-content/uploads/F1.large3_-630x309.jpg 630w, https://www.ajnrblog.org/wp-content/uploads/F1.large3_.jpg 1800w" sizes="(max-width: 300px) 100vw, 300px" /></a><figcaption id="caption-attachment-19098" class="wp-caption-text">CT-guided neck biopsies can be performed using multiple different approaches depending on the location of the lesion. In almost all approaches, there are critical neural and vascular structures adjacent to the needle tract. <em>A</em>, CT angiogram of the neck flipped vertically to depict prone positioning for a posterior-approach neck biopsy. Neck biopsies in the <em>shaded region</em> would commonly be performed using a posterior approach. In the <em>shaded region</em>, there are no critical neurovascular structures. <em>B</em>, CT angiogram soft-tissue-windowed image of the neck with the patient in a supine position for the paramaxillary approach (<em>white arrow</em>). The needle course is between the maxillary sinus and the mandible adjacent to the facial artery (<em>dashed arrow</em>) through the buccal space. This approach can be used for lesions in the buccal, masticator, parapharyngeal, retropharyngeal, and carotid sheath spaces. The critical structures to avoid include the facial artery (<em>dashed arrow</em>) and the internal carotid artery (<em>black arrow</em>). <em>C</em>, CT angiogram of the neck with the patient in a supine position for anterior-approach biopsies, which can be either medial (<em>black dashed arrow</em>) or lateral (<em>dashed white arrow</em>) to the carotid and jugular vasculature (<em>white oval</em>). These approaches can be used for lesions in the infrahyoid neck and lower cervical vertebrae. The critical structures to avoid include the carotid artery, jugular vein, and vagus nerve (<em>white oval</em>); the trachea (<em>white T</em>); the esophagus (<em>white E</em>); and the thyroid gland (<em>white asterisk</em>). CT angiograms of the neck with the patient in a decubitus position: This positioning will be used for the retromandibular (<em>D</em>), submastoid (<em>E</em>), and subzygomatic (<em>F</em>) approaches denoted by <em>white arrows</em>. Note that the needle will sometimes pass through a portion of the parotid gland for the retromandibular approach (<em>white asterisk</em>). Critical structures to avoid include the carotid (<em>gray arrows</em>) and vertebral arteries (<em>dashed white arrows</em>) with the retromandibular and submastoid approaches and the retromandibular vein in the retromandibular approach because of its proximity to the facial nerve. These approaches can be used for lesions in the deep parotid, parapharyngeal, pharyngeal, and retropharyngeal spaces.</figcaption></figure>
<p>CT-guided head and neck biopsies can be challenging due to the anatomy and adjacent critical structures but can often obviate the need for open biopsy. A few studies and review articles have described approaches to biopsy in the head and neck. This retrospective study evaluated technical considerations, histopathologic yield, and safety in CT-guided head and neck core needle biopsies.</p>
<div id="sec-2" class="subsection">
<h3 id="p-4">MATERIALS AND METHODS</h3>
<p>A retrospective review of head and neck biopsies performed from January 2013 through December 2019 was conducted. Clinical diagnosis and indication, patient demographics, mass location and size, biopsy needle type, technical approach, dose-length product, sedation details, complications, diagnostic histopathologic yield, and the use of iodinated contrast were recorded for each case.</p>
</div>
<div id="sec-3" class="subsection">
<h3 id="p-5">RESULTS</h3>
<p>A total of 27 CT-guided head and neck core needle biopsies were performed in 26 patients. The diagnostic sample rate was 100% (27/27). A concordant histopathologic diagnosis was obtained in 93% (25/27) of cases. There was a single complication of core needle biopsy, a small asymptomatic superficial hematoma.</p>
</div>
<div id="sec-4" class="subsection">
<h3 id="p-6">CONCLUSIONS</h3>
<p>Percutaneous CT-guided biopsy of deep masses in the head and neck is safe and effective with careful biopsy planning and has a high diagnostic yield that can obviate the need for open biopsy.</p>
</div>
</div>
<p><strong>Read this article: <a href="https://bit.ly/3oJLKLB">https://bit.ly/3oJLKLB</a></strong></p>
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			</item>
		<item>
		<title>Evaluation of Lower-Dose Spiral Head CT for Detection of Intracranial Findings Causing Neurologic Deficits</title>
		<link>https://www.ajnrblog.org/2019/11/24/evaluation-of-lower-dose-spiral-head-ct-for-detection-of-intracranial-findings-causing-neurologic-deficits/</link>
		
		<dc:creator><![CDATA[jross]]></dc:creator>
		<pubDate>Sun, 24 Nov 2019 18:00:30 +0000</pubDate>
				<category><![CDATA[Fellows' Journal Club]]></category>
		<category><![CDATA[Patient Safety]]></category>
		<category><![CDATA[CT]]></category>
		<category><![CDATA[dose level]]></category>
		<guid isPermaLink="false">http://www.ajnrblog.org/?p=18139</guid>

					<description><![CDATA[Fellows&#8217; Journal Club Projection data from 83 patients undergoing unenhanced spiral head CT for suspected neurologic deficits were collected. A routine dose was obtained using 250 effective mAs and iterative reconstruction. Lower-dose configurations were reconstructed (25-effective mAs iterative reconstruction, 50-effective]]></description>
										<content:encoded><![CDATA[<div class="editor-comment">
<h1>Fellows&#8217; Journal Club</h1>
<p>Projection data from 83 patients undergoing unenhanced spiral head CT for suspected neurologic deficits were collected. A routine dose was obtained using 250 effective mAs and iterative reconstruction. Lower-dose configurations were reconstructed (25-effective mAs iterative reconstruction, 50-effective mAs filtered back-projection and iterative reconstruction, 100-effective mAs filtered back-projection and iterative reconstruction, 200-effective mAs filtered back-projection). Three neuroradiologists circled findings, indicating diagnosis, confidence, and image quality. The routine-dose jackknife alternative free-response receiver operating characteristic figure of merit was 0.87. Noninferiority was shown for 100-effective mAs iterative reconstruction and 200-effective mAs filtered back-projection, but not for100-effective mAs filtered back-projection. The authors conclude that substantial opportunity exists for dose reduction using spiral nonenhanced head CT and that the dose level might potentially be reduced to 40% of routine dose levels or a volume CT dose index of approximately 15mGy if slight decreases in performance are acceptable. The beneficial effect of iterative reconstrution was most pronounced at this 15-mGy dose level.</p>
<p class="signature"><img decoding="async" src="http://www.ajnrblog.org/wp-content/uploads/ross-signature.png" alt=""></p>
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</div>
<h2 class="signature">Abstract</h2>
<div id="sec-1" class="subsection">
<figure id="attachment_18140" aria-describedby="caption-attachment-18140" style="width: 300px" class="wp-caption alignright"><a href="http://www.ajnrblog.org/wp-content/uploads/F3.large-1-4.jpg"><img decoding="async" class="wp-image-18140 size-medium" src="http://www.ajnrblog.org/wp-content/uploads/F3.large-1-4-300x123.jpg" alt="Figure 3 from Fletcher et al" width="300" height="123" srcset="https://www.ajnrblog.org/wp-content/uploads/F3.large-1-4-300x123.jpg 300w, https://www.ajnrblog.org/wp-content/uploads/F3.large-1-4-150x62.jpg 150w, https://www.ajnrblog.org/wp-content/uploads/F3.large-1-4-630x259.jpg 630w, https://www.ajnrblog.org/wp-content/uploads/F3.large-1-4.jpg 1800w" sizes="(max-width: 300px) 100vw, 300px" /></a><figcaption id="caption-attachment-18140" class="wp-caption-text">Acute left lentiform nucleus infarct (<em>circle</em> indicates reference neuroradiologist markings at routine dose) with corresponding lower-dose FBP CT images along with reader results. The imaging finding on this CT examination evolved with time, with corresponding clinical confirmation of corresponding neurologic deficit by a staff neurologist, and the final diagnosis was recorded as acute left striatal infarct.</figcaption></figure>
<h3 id="p-3">BACKGROUND AND PURPOSE</h3>
<p>Despite the frequent use of unenhanced head CT for the detection of acute neurologic deficit, the radiation dose for this exam varies widely. Our aim was to evaluate the performance of lower-dose head CT for detection of intracranial findings resulting in acute neurologic deficit.</p>
<div id="sec-2" class="subsection">
<h3 id="p-4">MATERIALS AND METHODS</h3>
<p>Projection data from 83 patients undergoing unenhanced spiral head CT for suspected neurologic deficits were collected. Cases positive for infarction, intra-axial hemorrhage, mass, or extra-axial hemorrhage required confirmation by histopathology, surgery, progression of findings, or corresponding neurologic deficit; cases negative for these target diagnoses required negative assessments by two neuroradiologists and a clinical neurologist. A routine dose head CT was obtained using 250 effective mAs and iterative reconstruction. Lower-dose configurations were reconstructed (25-effective mAs iterative reconstruction, 50-effective mAs filtered back-projection and iterative reconstruction, 100-effective mAs filtered back-projection and iterative reconstruction, 200-effective mAs filtered back-projection). Three neuroradiologists circled findings, indicating diagnosis, confidence (0–100), and image quality. The difference between the jackknife alternative free-response receiver operating characteristic figure of merit at routine and lower-dose configurations was estimated. A lower 95% CI estimate of the difference greater than −0.10 indicated noninferiority.</p>
</div>
<div id="sec-3" class="subsection">
<h3 id="p-5">RESULTS</h3>
<p>Forty-two of 83 patients had 70 intracranial findings (29 infarcts, 25 masses, 10 extra- and 6 intra-axial hemorrhages) at routine head CT (CT dose index = 38.3 mGy). The routine-dose jackknife alternative free-response receiver operating characteristic figure of merit was 0.87 (95% CI, 0.81–0.93). Noninferiority was shown for 100-effective mAs iterative reconstruction (figure of merit difference, −0.04; 95% CI, −0.08 to 0.004) and 200-effective mAs filtered back-projection (−0.02; 95% CI, −0.06 to 0.02) but not for 100-effective mAs filtered back-projection (−0.06; 95% CI, −0.10 to −0.02) or lower-dose levels. Image quality was better at higher-dose levels and with iterative reconstruction (<em>P</em>&nbsp;&lt; .05).</p>
</div>
<div id="sec-4" class="subsection">
<h3 id="p-6">CONCLUSIONS</h3>
<p>Observer performance for dose levels using 100–200 eff mAs was noninferior to that observed at 250 effective mAs with iterative reconstruction, with iterative reconstruction preserving noninferiority at a mean CT dose index of 15.2 mGy.</p>
<p><strong data-rich-text-format-boundary="true">Read this article:&nbsp;<a href="http://bit.ly/2D9Vx84">http://bit.ly/2D9Vx84</a></strong></p>
</div>
</div>
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			</item>
		<item>
		<title>Cavitary Plaques in Otospongiosis: CT Findings and Clinical Implications</title>
		<link>https://www.ajnrblog.org/2018/07/01/13875/</link>
		
		<dc:creator><![CDATA[jross]]></dc:creator>
		<pubDate>Sun, 01 Jul 2018 19:30:41 +0000</pubDate>
				<category><![CDATA[Fellows' Journal Club]]></category>
		<category><![CDATA[Head and Neck]]></category>
		<category><![CDATA[cavitary plaques]]></category>
		<category><![CDATA[CT]]></category>
		<category><![CDATA[otospongiosis]]></category>
		<guid isPermaLink="false">http://www.ajnrblog.org/?p=13875</guid>

					<description><![CDATA[Fellows&#8217; Journal Club Cross-sectional CT images and clinical records of 47 patients (89 temporal bones) were evaluated for the presence, location, and imaging features of cavitary and noncavitaryotospongiotic plaques, as well as clinical symptoms and complications in those who underwent]]></description>
										<content:encoded><![CDATA[<div class="editor-comment">
<h1>Fellows&#8217; Journal Club</h1>
<p>Cross-sectional CT images and clinical records of 47 patients (89 temporal bones) were evaluated for the presence, location, and imaging features of cavitary and noncavitaryotospongiotic plaques, as well as clinical symptoms and complications in those who underwent cochlear implantation. Noncavitaryotospongiotic plaques were present in 86 (97%) temporal bones and cavitary plaques in 30 (35%). Cavitary plaques predominated with increasing age, mostly involving the anteroinferior wall of the internal auditory canal, and their presence was not associated with a higher grade of otospongiosis by imaging or with a specific type of hearing loss. The authors conclude that cavitary plaques occurred in one-third of patients with otospongiosis.</p>
<p class="signature"><img decoding="async" src="http://www.ajnrblog.org/wp-content/uploads/ross-signature.png" alt="" /></p>
<p><span id="more-13875"></span></p>
</div>
<h2 class="signature">Abstract</h2>
<div id="sec-1" class="subsection">
<figure id="attachment_13876" aria-describedby="caption-attachment-13876" style="width: 300px" class="wp-caption alignright"><a href="http://www.ajnrblog.org/wp-content/uploads/F2.large-39.jpg"><img decoding="async" class="size-medium wp-image-13876" src="http://www.ajnrblog.org/wp-content/uploads/F2.large-39-300x86.jpg" alt="Figure 2 from paper" width="300" height="86" srcset="https://www.ajnrblog.org/wp-content/uploads/F2.large-39-300x86.jpg 300w, https://www.ajnrblog.org/wp-content/uploads/F2.large-39-150x43.jpg 150w, https://www.ajnrblog.org/wp-content/uploads/F2.large-39-630x180.jpg 630w, https://www.ajnrblog.org/wp-content/uploads/F2.large-39.jpg 1800w" sizes="(max-width: 300px) 100vw, 300px" /></a><figcaption id="caption-attachment-13876" class="wp-caption-text">Axial (<em>A</em>) and coronal (<em>B</em>) CT images show the presence of a cavitary plaque (<em>arrows</em>) involving the anterior and inferior walls of the IAC next to the basal turn of the cochlea. Additionally, there is an otospongiotic plaque (<em>arrowhead</em>) at the fissula ante fenestram. Coronal CISS MR image (<em>C</em>) demonstrates a clear communication between the cavity and CSF of the IAC.</figcaption></figure>
<h3 id="p-3">BACKGROUND AND PURPOSE</h3>
<p>Cavitary plaques have been reported as a manifestation of otospongiosis. They have been related to third window manifestations, complications during cochlear implantation, and sensorineural hearing loss. However, their etiology and clinical implications are not entirely understood. Our purpose was to determine the prevalence, imaging findings, and clinical implications of cavitary plaques in otospongiosis.</p>
<div id="sec-2" class="subsection">
<h3 id="p-4">MATERIALS AND METHODS</h3>
<p>We identified patients with otospongiosis at a tertiary care academic medical center from January 2012 to April 2017. Cross-sectional CT images and clinical records of 47 patients (89 temporal bones) were evaluated for the presence, location, and imaging features of cavitary and noncavitary otospongiotic plaques, as well as clinical symptoms and complications in those who underwent cochlear implantation.</p>
</div>
<div id="sec-3" class="subsection">
<h3 id="p-5">RESULTS</h3>
<p>Noncavitary otospongiotic plaques were present in 86 (97%) temporal bones and cavitary plaques in 30 (35%). Cavitary plaques predominated with increasing age (mean age, 59 years; <em>P</em> = .058), mostly involving the anteroinferior wall of the internal auditory canal (<em>P</em> = .003), and their presence was not associated with a higher grade of otospongiosis by imaging (<em>P</em> = .664) or with a specific type of hearing loss (<em>P</em> = .365). No patients with cavitary plaques had third window manifestations, and those with a history of cochlear implantation (<em>n</em> = 6) did not have complications during the procedure.</p>
</div>
<div id="sec-4" class="subsection">
<h3 id="p-6">CONCLUSIONS</h3>
<p>Cavitary plaques occurred in one-third of patients with otospongiosis. Typically, they occurred in the anteroinferior wall of the internal auditory canal. There was no correlation with the degree of otospongiosis, type of hearing loss, or surgical complications. Cavitary plaques tended to present in older patients.</p>
</div>
<p><strong>Read this article: <a href="http://bit.ly/2Mv2wvG">http://bit.ly/2Mv2wvG</a></strong></p>
</div>
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		<item>
		<title>Value of Quantitative Collateral Scoring on CT Angiography in Patients with Acute Ischemic Stroke</title>
		<link>https://www.ajnrblog.org/2018/06/17/13869/</link>
		
		<dc:creator><![CDATA[jross]]></dc:creator>
		<pubDate>Sun, 17 Jun 2018 19:30:05 +0000</pubDate>
				<category><![CDATA[Fellows' Journal Club]]></category>
		<category><![CDATA[Interventional]]></category>
		<category><![CDATA[acute ischemic stroke]]></category>
		<category><![CDATA[CT]]></category>
		<category><![CDATA[CT angiography]]></category>
		<guid isPermaLink="false">http://www.ajnrblog.org/?p=13869</guid>

					<description><![CDATA[Fellows&#8217; Journal Club From the MR CLEAN data base, all baseline thin-slice CTA images of patients with acute ischemic stroke with intracranial large-vessel occlusion were retrospectively collected. The quantitative collateral score was calculated as the ratio of the vascular appearance]]></description>
										<content:encoded><![CDATA[<div class="editor-comment">
<h1>Fellows&#8217; Journal Club</h1>
<p>From the MR CLEAN data base, all baseline thin-slice CTA images of patients with acute ischemic stroke with intracranial large-vessel occlusion were retrospectively collected. The quantitative collateral score was calculated as the ratio of the vascular appearance of both hemispheres and was compared with the visual collateral score. Primary outcomes were 90-day mRS score and follow-up infarct volume. A total of 442 patients were included. The quantitative collateral score strongly correlated with the visual collateral score and was an independent predictor of mRS and follow-up infarct volume per 10% increase. The quantitative collateral score showed areas under the curve of 0.71 and 0.69 for predicting functional independence (mRS 0-2) and follow-up infarct volume of greater than 90 mL, respectively. The authors conclude that automated quantitative collateral scoring in patients with acute ischemic stroke is a reliable and user-independent measure of the collateral capacity on baseline CTA and has the potential to augment the triage of patients with acute stroke for endovascular therapy.</p>
<p class="signature"><img decoding="async" src="http://www.ajnrblog.org/wp-content/uploads/ross-signature.png" alt="" /></p>
<p><span id="more-13869"></span></p>
</div>
<h2 class="signature">Abstract</h2>
<div id="sec-1" class="subsection">
<figure id="attachment_13870" aria-describedby="caption-attachment-13870" style="width: 234px" class="wp-caption alignright"><a href="http://www.ajnrblog.org/wp-content/uploads/F1.large-37.jpg"><img loading="lazy" decoding="async" class="size-medium wp-image-13870" src="http://www.ajnrblog.org/wp-content/uploads/F1.large-37-234x300.jpg" alt="Figure 1 from paper" width="234" height="300" srcset="https://www.ajnrblog.org/wp-content/uploads/F1.large-37-234x300.jpg 234w, https://www.ajnrblog.org/wp-content/uploads/F1.large-37-117x150.jpg 117w, https://www.ajnrblog.org/wp-content/uploads/F1.large-37-469x600.jpg 469w, https://www.ajnrblog.org/wp-content/uploads/F1.large-37.jpg 1000w" sizes="auto, (max-width: 234px) 100vw, 234px" /></a><figcaption id="caption-attachment-13870" class="wp-caption-text">An example of quantitative collateral capacity scoring. <em>A</em>, An axial plane of a baseline CTA image acquired in the peak venous phase with a right-sided M1 segment occlusion of the MCA territory. <em>B</em>, Segmentation results of automated quantitative collateral assessment of the ipsilateral (<em>red</em>) and contralateral (<em>blue</em>) hemispheres. The quantitative collateral score was 46%. <em>C</em>, 3D representation of the segmented vasculature.</figcaption></figure>
<h3 id="p-3">BACKGROUND AND PURPOSE</h3>
<p>Many studies have emphasized the relevance of collateral flow in patients presenting with acute ischemic stroke. Our aim was to evaluate the relationship of the quantitative collateral score on baseline CTA with the outcome of patients with acute ischemic stroke and test whether the timing of the CTA acquisition influences this relationship.</p>
<div id="sec-2" class="subsection">
<h3 id="p-4">MATERIALS AND METHODS</h3>
<p>From the Multicenter Randomized Clinical Trial of Endovascular Treatment of Acute Ischemic Stroke in the Netherlands (MR CLEAN) data base, all baseline thin-slice CTA images of patients with acute ischemic stroke with intracranial large-vessel occlusion were retrospectively collected. The quantitative collateral score was calculated as the ratio of the vascular appearance of both hemispheres and was compared with the visual collateral score. Primary outcomes were 90-day mRS score and follow-up infarct volume. The relation with outcome and the association with treatment effect were estimated. The influence of the CTA acquisition phase on the relation of collateral scores with outcome was determined.</p>
</div>
<div id="sec-3" class="subsection">
<h3 id="p-5">RESULTS</h3>
<p>A total of 442 patients were included. The quantitative collateral score strongly correlated with the visual collateral score (ρ = 0.75) and was an independent predictor of mRS (adjusted odds ratio = 0.81; 95% CI, .77–.86) and follow-up infarct volume (exponent β = 0.88; <em>P</em> &lt; .001) per 10% increase. The quantitative collateral score showed areas under the curve of 0.71 and 0.69 for predicting functional independence (mRS 0–2) and follow-up infarct volume of &gt;90 mL, respectively. We found significant interaction of the quantitative collateral score with the endovascular therapy effect in unadjusted analysis on the full ordinal mRS scale (<em>P</em> = .048) and on functional independence (<em>P</em> = .049). Modification of the quantitative collateral score by acquisition phase on outcome was significant (mRS: <em>P</em> = .004; follow-up infarct volume: <em>P</em> &lt; .001) in adjusted analysis.</p>
</div>
<div id="sec-4" class="subsection">
<h3 id="p-6">CONCLUSIONS</h3>
<p>Automated quantitative collateral scoring in patients with acute ischemic stroke is a reliable and user-independent measure of the collateral capacity on baseline CTA and has the potential to augment the triage of patients with acute stroke for endovascular therapy.</p>
</div>
<p><strong>Read this article: <a href="http://bit.ly/2JIZbv9">http://bit.ly/2JIZbv9</a></strong></p>
</div>
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		<title>Accuracy of CT Angiography for Differentiating Pseudo-Occlusion from True Occlusion or High-Grade Stenosis of the Extracranial ICA in Acute Ischemic Stroke: A Retrospective MR CLEAN Substudy</title>
		<link>https://www.ajnrblog.org/2018/05/27/accessaccuracy-ct-angiography-differentiating-pseudo-occlusion-true-occlusion-high-grade-stenosis-extracranial-ica-acute-ischemic-stroke-retrospective-mr-clean-sub/</link>
		
		<dc:creator><![CDATA[jross]]></dc:creator>
		<pubDate>Sun, 27 May 2018 19:30:37 +0000</pubDate>
				<category><![CDATA[Fellows' Journal Club]]></category>
		<category><![CDATA[Interventional]]></category>
		<category><![CDATA[angiography]]></category>
		<category><![CDATA[CT]]></category>
		<category><![CDATA[stroke]]></category>
		<guid isPermaLink="false">http://www.ajnrblog.org/?p=13807</guid>

					<description><![CDATA[Fellows&#8217; Journal Club All patients from the Multicenter Randomized Clinical Trial of Endovascular Treatment for Acute Ischemic Stroke in the Netherlands (MR CLEAN) with an apparent ICA occlusion on CTA and available DSA images were included. Two independent observers classified]]></description>
										<content:encoded><![CDATA[<div class="editor-comment">
<h1>Fellows&#8217; Journal Club</h1>
<p>All patients from the Multicenter Randomized Clinical Trial of Endovascular Treatment for Acute Ischemic Stroke in the Netherlands (MR CLEAN) with an apparent ICA occlusion on CTA and available DSA images were included. Two independent observers classified CTA images as atherosclerotic cause (occlusion/high-grade stenosis), dissection, or suspected pseudo-occlusion. Pseudo-occlusion was suspected if CTA showed a gradual contrast decline located above the level of the carotid bulb, especially in the presence of an occludedintracranial ICA bifurcation (T-occlusion). In 108 of 476 patients (23%), CTA showed an apparent extracranial carotid occlusion. DSA was available in 46 of these cases, showing an atherosclerotic cause in 13 (28%), dissection in 16 (35%), and pseudo-occlusion in 17 (37%). The sensitivity for detecting pseudo-occlusion on CTA was 82% for both observers. The authors conclude that on CTA, extracranial ICA pseudo-occlusions can be differentiated from true carotid occlusions.</p>
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</div>
<h2 class="signature">Abstract</h2>
<div id="sec-1" class="subsection">
<figure id="attachment_13812" aria-describedby="caption-attachment-13812" style="width: 300px" class="wp-caption alignright"><a href="http://www.ajnrblog.org/wp-content/uploads/Fig-3-2.jpg"><img loading="lazy" decoding="async" class="size-medium wp-image-13812" src="http://www.ajnrblog.org/wp-content/uploads/Fig-3-2-300x300.jpg" alt="Figure 3 from paper" width="300" height="300" srcset="https://www.ajnrblog.org/wp-content/uploads/Fig-3-2-300x300.jpg 300w, https://www.ajnrblog.org/wp-content/uploads/Fig-3-2-150x150.jpg 150w, https://www.ajnrblog.org/wp-content/uploads/Fig-3-2-600x600.jpg 600w, https://www.ajnrblog.org/wp-content/uploads/Fig-3-2-230x230.jpg 230w, https://www.ajnrblog.org/wp-content/uploads/Fig-3-2-330x330.jpg 330w, https://www.ajnrblog.org/wp-content/uploads/Fig-3-2-120x120.jpg 120w, https://www.ajnrblog.org/wp-content/uploads/Fig-3-2.jpg 1800w" sizes="auto, (max-width: 300px) 100vw, 300px" /></a><figcaption id="caption-attachment-13812" class="wp-caption-text">Examples of suspected dissection or pseudo-occlusion on CTA with a noncorresponding cause of apparent occlusion found on DSA. <em>A</em>, Dissection of the right ICA in a 65-year-old woman. CTA shows a blurred contrast cutoff above the level of the carotid bulb, suggesting pseudo-occlusion, without T-occlusion present. <em>B</em>, DSA of the patient in <em>A</em> shows major vessel wall irregularities and the impossibility of passing the occlusion with a catheter (<em>C</em>), indicating the presence of a dissection rather than pseudo-occlusion. <em>D</em>, Pseudo-occlusion of the left ICA in a 63-year-old man. CTA shows a sharp, diagonal contrast cutoff above the level of the carotid bifurcation, suggesting dissection, with T-occlusion present. <em>E</em>, DSA of patient in <em>D</em> shows a blurred contrast cutoff slowly moving upward and finally a patent ICA with intracranial carotid T-occlusion present (<em>F</em>), indicating pseudo-occlusion.</figcaption></figure>
<h3 id="p-3">BACKGROUND AND PURPOSE</h3>
<p>The absence of opacification on CTA in the extracranial ICA in acute ischemic stroke may be caused by atherosclerotic occlusion, dissection, or pseudo-occlusion. The latter is explained by sluggish or stagnant flow in a patent artery caused by a distal intracranial occlusion. This study aimed to explore the accuracy of CTA for differentiating pseudo-occlusion from true occlusion of the extracranial ICA.</p>
<div id="sec-2" class="subsection">
<h3 id="p-4">MATERIALS AND METHODS</h3>
<p>All patients from the Multicenter Randomized Clinical Trial of Endovascular Treatment for Acute Ischemic Stroke in the Netherlands (MR CLEAN) with an apparent ICA occlusion on CTA and available DSA images were included. Two independent observers classified CTA images as atherosclerotic cause (occlusion/high-grade stenosis), dissection, or suspected pseudo-occlusion. Pseudo-occlusion was suspected if CTA showed a gradual contrast decline located above the level of the carotid bulb, especially in the presence of an occluded intracranial ICA bifurcation (T-occlusion). DSA images, classified into the same 3 categories, were used as the criterion standard.</p>
</div>
<div id="sec-3" class="subsection">
<h3 id="p-5">RESULTS</h3>
<p>In 108 of 476 patients (23%), CTA showed an apparent extracranial carotid occlusion. DSA was available in 46 of these, showing an atherosclerotic cause in 13 (28%), dissection in 16 (35%), and pseudo-occlusion in 17 (37%). The sensitivity for detecting pseudo-occlusion on CTA was 82% (95% CI, 57–96) for both observers; specificity was 76% (95% CI, 56–90) and 86% (95% CI, 68–96) for observers 1 and 2, respectively. The κ value for interobserver agreement was .77, indicating substantial agreement. T-occlusions were more frequent in pseudo- than true occlusions (82% versus 21%, <em>P</em> &lt; .001).</p>
</div>
<div id="sec-4" class="subsection">
<h3 id="p-6">CONCLUSIONS</h3>
<p>On CTA, extracranial ICA pseudo-occlusions can be differentiated from true carotid occlusions.</p>
</div>
<p><strong>Read this article: <a href="http://bit.ly/2wLrZ03">http://bit.ly/2wLrZ03</a></strong></p>
</div>
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		<title>Neuroimaging Clinics of North America: Dual Energy CT: Applications in Head and Neck and Neurologic Imaging</title>
		<link>https://www.ajnrblog.org/2018/04/11/neuroimaging-clinics-north-america-dual-energy-ct-applications-head-neck-neurologic-imaging/</link>
		
		<dc:creator><![CDATA[bookreviews]]></dc:creator>
		<pubDate>Wed, 11 Apr 2018 21:33:03 +0000</pubDate>
				<category><![CDATA[Book Reviews]]></category>
		<category><![CDATA[Full Reviews]]></category>
		<category><![CDATA[CT]]></category>
		<category><![CDATA[Head and Neck]]></category>
		<category><![CDATA[neuroimaging]]></category>
		<guid isPermaLink="false">http://www.ajnrblog.org/?p=13676</guid>

					<description><![CDATA[Forghani R, Kelly HR, eds. Mukherji SK, consulting ed. Neuroimaging Clinics of North America: Dual Energy CT: Applications in Head and Neck and Neurologic Imaging. Elsevier; 2017;27(3):371–546; $365.00 Dual energy CT (DECT) is probably the single most exciting innovation in CT]]></description>
										<content:encoded><![CDATA[<p><strong>Forghani R, Kelly HR, eds. Mukherji SK, consulting ed. <em>Neuroimaging Clinics of North America: Dual Energy CT: Applications in Head and Neck and Neurologic Imaging.</em> Elsevier; <strong>2017;27(3):371–546; $365.00</strong></strong></p>
<p><a href="http://www.ajnrblog.org/wp-content/uploads/Dual-Energy-CT-Applications-in-Head-and-Neck-and-Neurologic-Imaging-Mukherji.jpg"><img loading="lazy" decoding="async" class="alignright size-medium wp-image-13677" src="http://www.ajnrblog.org/wp-content/uploads/Dual-Energy-CT-Applications-in-Head-and-Neck-and-Neurologic-Imaging-Mukherji-200x300.jpg" alt="Cover of Mukherji" width="200" height="300" srcset="https://www.ajnrblog.org/wp-content/uploads/Dual-Energy-CT-Applications-in-Head-and-Neck-and-Neurologic-Imaging-Mukherji-200x300.jpg 200w, https://www.ajnrblog.org/wp-content/uploads/Dual-Energy-CT-Applications-in-Head-and-Neck-and-Neurologic-Imaging-Mukherji-100x150.jpg 100w, https://www.ajnrblog.org/wp-content/uploads/Dual-Energy-CT-Applications-in-Head-and-Neck-and-Neurologic-Imaging-Mukherji-399x600.jpg 399w, https://www.ajnrblog.org/wp-content/uploads/Dual-Energy-CT-Applications-in-Head-and-Neck-and-Neurologic-Imaging-Mukherji.jpg 511w" sizes="auto, (max-width: 200px) 100vw, 200px" /></a></p>
<p>Dual energy CT (DECT) is probably the single most exciting innovation in CT in the last decade. I have been passionate about this topic since 2006 when DECT was first introduced into clinical practice. There are many excellent publications covering this topic; however, this long-awaited issue of <em>Neuroimaging Clinics</em> is an excellent place to start.</p>
<p>The entire issue is dedicated to DECT and provides a rather comprehensive review of this topic. It is comprised of 13 articles contributed by 32 authors, many of whom are well-recognized neuroradiologists. In order to simplify this review, I chose to categorize the articles into 4 sections:</p>
<p><strong>DECT Physics</strong>: Two articles cover the fundamental principles of DECT. The authors make a genuine effort to simplify a very complicated topic. The articles are comprehensive and cover physical principles, CT scanner systems, and practical considerations for implementing DECT acquisition in clinical practice.</p>
<p><strong>DECT Applications</strong>: Nine articles deal with the practical clinical applications of DECT. One article discusses the evaluation of intracranial pathology, another the evaluation of spine pathology, and 6 articles thoroughly review the DECT evaluation of head and neck anatomy and pathology with specific emphasis on head and neck tumor imaging, including squamous cell carcinoma and cervical lymphadenopathy. Overall, the articles are well written, and each topic is methodically discussed. The authors include scenarios where DECT provides superfluous information and others where DECT is key in making a correct diagnosis. Generally, the image quality is excellent and most images and diagrams are of high resolution and vibrant in color.</p>
<p>A separate article in this “section” highlights the advantages of DECT in reducing artifacts and improving image quality in neuroimaging. This is an invaluable article validating the utility of DECT in many common clinical scenarios where conventional scanning can be degraded by metal artifacts.</p>
<p>My only criticism of this “section” is that it does not cover DECT application after cochlear implantation. This is a very exciting topic where DECT can provide invaluable information that is not possible with conventional scanning. This information, namely the exact electrode position, can have significant implications for management.</p>
<p><strong>DECT in Clinical Practice:</strong> This is a very important article for any radiologist or group considering incorporating DECT in their practice. The article objectively goes over advantages and hurdles for implementing this technique and suggests a practical workflow.</p>
<p><strong>DECT Tissue Characterization and Emerging Applications</strong>: The final article of this issue deals with advanced applications of DECT in tissue characterization and discusses exciting potential future applications of this scanning technique.</p>
<p>Overall, I really enjoyed reading this well-organized, well-illustrated book. In my opinion, it provides essential information that each and every neuroradiologist should be familiar with. It is a must read for neuroradiology fellows and faculty alike.</p>
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		<title>Improved Detection of Anterior Circulation Occlusions: The “Delayed Vessel Sign” on Multiphase CT Angiography</title>
		<link>https://www.ajnrblog.org/2017/11/05/13314/</link>
		
		<dc:creator><![CDATA[jross]]></dc:creator>
		<pubDate>Sun, 05 Nov 2017 18:30:39 +0000</pubDate>
				<category><![CDATA[Brain]]></category>
		<category><![CDATA[Fellows' Journal Club]]></category>
		<category><![CDATA[CT]]></category>
		<category><![CDATA[CT angiography]]></category>
		<category><![CDATA[Occlusions]]></category>
		<guid isPermaLink="false">http://www.ajnrblog.org/?p=13314</guid>

					<description><![CDATA[Fellows&#8217; Journal Club The authors evaluated 23 distal anterior circulation occlusions during a 2-year period. Ten M1-segment occlusions and 10 cases without a vessel occlusion were also included. There was significant improvement in the sensitivity of detection of distal anterior]]></description>
										<content:encoded><![CDATA[<div class="editor-comment">
<h1>Fellows&#8217; Journal Club</h1>
<p>The authors evaluated 23 distal anterior circulation occlusions during a 2-year period. Ten M1-segment occlusions and 10 cases without a vessel occlusion were also included. There was significant improvement in the sensitivity of detection of distal anterior circulation vessel occlusions, overall confidence, and time taken to interpret with multiphase CTA compared with single-phase CTA. The delayed vessel sign is a reliable indicator of anterior circulation vessel occlusion, particularly in cases involving distal branches.</p>
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<h2 class="signature">Abstract</h2>
<div id="sec-1" class="subsection">
<figure id="attachment_13315" aria-describedby="caption-attachment-13315" style="width: 300px" class="wp-caption alignright"><a href="http://www.ajnrblog.org/wp-content/uploads/F1.large-7.jpg"><img loading="lazy" decoding="async" class="size-medium wp-image-13315" src="http://www.ajnrblog.org/wp-content/uploads/F1.large-7-300x91.jpg" alt="Figure 1 from paper" width="300" height="91" srcset="https://www.ajnrblog.org/wp-content/uploads/F1.large-7-300x91.jpg 300w, https://www.ajnrblog.org/wp-content/uploads/F1.large-7-150x45.jpg 150w, https://www.ajnrblog.org/wp-content/uploads/F1.large-7-630x191.jpg 630w, https://www.ajnrblog.org/wp-content/uploads/F1.large-7.jpg 1800w" sizes="auto, (max-width: 300px) 100vw, 300px" /></a><figcaption id="caption-attachment-13315" class="wp-caption-text">Multiphase CTA and follow-up MR imaging of an 83-year-old woman presenting with acute right upper limb weakness and dysphasia. <em>A</em>, Axial MIP of the first phase demonstrates subtle paucity of vessels in the distribution of the left MCA compared with the right side. <em>B</em>, Axial MIP of the second phase demonstrates the delayed vessel sign (<em>long arrow</em>). There is delayed enhancement of the distal left MCA via pial collateral vessels (<em>short arrows</em>). This vessel is not seen on the first phase due to the presence of an M2 vessel occlusion. <em>C</em>, Axial MIP of the third phase also demonstrates the “delayed” left MCA vessel (long arrow). <em>D</em>, DWI <em>b</em>=1000 image 2 weeks postpresentation demonstrates a recent infarct (<em>arrow</em>) in the same left MCA territory.</figcaption></figure>
<h3 id="p-3">BACKGROUND AND PURPOSE</h3>
<p>Multiphase CTA, a technique to dynamically assess the vasculature in acute ischemic stroke, was primarily developed to evaluate collateral filling. We have observed that it is also useful in identifying distal anterior circulation occlusions due to delayed anterior circulation opacification on multiphase CTA, an observation we term the “delayed vessel sign.” We aimed to determine the usefulness of this sign by comparing multiphase CTA with single-phase CTA.</p>
<div id="sec-2" class="subsection">
<h3 id="p-4">MATERIALS AND METHODS</h3>
<p>All 23 distal anterior circulation occlusions during a 2-year period were included. Ten M1-segment occlusions and 10 cases without a vessel occlusion were also included. All patients had follow-up imaging confirming the diagnosis. Initially, the noncontrast CT and first phase of the multiphase CTA study for each patient were blindly evaluated (2 neuroradiologists, 2 radiology trainees) for an anterior circulation occlusion. Readers&#8217; confidence, speed, and sensitivity of detection were recorded. Readers were then educated on the “delayed vessel sign,” and each multiphase CTA study was re-examined for a vessel occlusion after at least 14 days.</p>
</div>
<div id="sec-3" class="subsection">
<h3 id="p-5">RESULTS</h3>
<p>There was significant improvement in the sensitivity of detection of distal anterior circulation vessel occlusions (P &lt; .001), overall confidence (P &lt; .001), and time taken to interpret (P &lt; .001) with multiphase CTA compared with single-phase CTA. Readers preferred MIP images compared with source images in &gt;90% of cases.</p>
</div>
<div id="sec-4" class="subsection">
<h3 id="p-6">CONCLUSIONS</h3>
<p>The delayed vessel sign is a reliable indicator of anterior circulation vessel occlusion, particularly in cases involving distal branches. Assessment of the later phases of multiphase CTA for the delayed vessel sign leads to a significant improvement in the speed and confidence of interpretation, compared with single-phase CTA.</p>
</div>
<p><strong>Read this article: <a href="http://bit.ly/2h5aqxw">http://bit.ly/2h5aqxw</a></strong></p>
</div>
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		<title>SPECT and SPECT/CT: A Clinical Guide</title>
		<link>https://www.ajnrblog.org/2017/08/28/spect-spect-ct-clinical-guide/</link>
		
		<dc:creator><![CDATA[bookreviews]]></dc:creator>
		<pubDate>Mon, 28 Aug 2017 08:30:11 +0000</pubDate>
				<category><![CDATA[Book Reviews]]></category>
		<category><![CDATA[Books Briefly Noted]]></category>
		<category><![CDATA[CT]]></category>
		<category><![CDATA[SPECT]]></category>
		<category><![CDATA[thyroid]]></category>
		<guid isPermaLink="false">http://www.ajnrblog.org/?p=13124</guid>

					<description><![CDATA[Kim CK, Zukotynski KA. SPECT and SPECT/CT: A Clinical Guide. Thieme; 2017; 218 pp; 250 ill; $99.99 While this 218-page softcover book is written for those primarily involved in nuclear medicine or for those in a general radiology practice who maintain some]]></description>
										<content:encoded><![CDATA[<p><strong>Kim CK, Zukotynski KA. <em>SPECT and SPECT/CT: A Clinical Guide</em>. Thieme; 2017; 218 pp; 250 ill; $99.99</strong></p>
<p><a href="http://www.ajnrblog.org/wp-content/uploads/SPECT-AND-SPECT-CT-DR.-KATHERINE-ZUKOTYNSKI.jpg"><img loading="lazy" decoding="async" class="alignright size-medium wp-image-13125" src="http://www.ajnrblog.org/wp-content/uploads/SPECT-AND-SPECT-CT-DR.-KATHERINE-ZUKOTYNSKI-212x300.jpg" alt="Cover of Zukotynski" width="212" height="300" srcset="https://www.ajnrblog.org/wp-content/uploads/SPECT-AND-SPECT-CT-DR.-KATHERINE-ZUKOTYNSKI-212x300.jpg 212w, https://www.ajnrblog.org/wp-content/uploads/SPECT-AND-SPECT-CT-DR.-KATHERINE-ZUKOTYNSKI-106x150.jpg 106w, https://www.ajnrblog.org/wp-content/uploads/SPECT-AND-SPECT-CT-DR.-KATHERINE-ZUKOTYNSKI.jpg 350w" sizes="auto, (max-width: 212px) 100vw, 212px" /></a></p>
<p>While this 218-page softcover book is written for those primarily involved in nuclear medicine or for those in a general radiology practice who maintain some involvement in nuclear medicine, there are sections of the book that would be of interest to neuroradiologists. Two chapters encompassing 33 pages deal with SPECT and SPECT/CT in the neurosciences and in the thyroid/parathyroid glands. Throughout this volume, Drs. Kim and Zukotynski, along with 14 other contributing authors, have put together succinct and well-illustrated chapters. The format is similar across sections, with short descriptions of key diseases, radiopharmaceuticals used, images, and bibliographies.</p>
<p>In the chapter on SPECT in the neurosciences, a general overview is given in 7 pages. It would have been good to have had a normal SPECT shown in 2 planes in order to compare with the abnormals. Brain tumor imaging is only peripherally mentioned. The chapter on thyroid and parathyroid glands is more extensively dealt with (in 26 pages) and is a decent review of the benign and malignant lesions of both glands, along with some unusual variants.</p>
<p>Certainly this would not be a primary purchase for a neuroradiologist or for a neuroradiology sectional library. It would be a publication that could be borrowed from a colleague or from a department library, and the contents that pertain to neuroradiology could be quickly reviewed.</p>
<p>&nbsp;</p>
<p>&nbsp;</p>
<p>&nbsp;</p>
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		<title>Sectional Anatomy by MRI and CT</title>
		<link>https://www.ajnrblog.org/2016/05/06/11782/</link>
		
		<dc:creator><![CDATA[bookreviews]]></dc:creator>
		<pubDate>Fri, 06 May 2016 20:37:16 +0000</pubDate>
				<category><![CDATA[Book Reviews]]></category>
		<category><![CDATA[Books Briefly Noted]]></category>
		<category><![CDATA[CT]]></category>
		<category><![CDATA[MRI]]></category>
		<category><![CDATA[musculoskeletal radiology]]></category>
		<category><![CDATA[sectional anatomy]]></category>
		<guid isPermaLink="false">http://www.ajnrblog.org/?p=11782</guid>

					<description><![CDATA[Anderson MW, Fox MG, eds. Sectional Anatomy by MRI and CT. 4th ed. Elsevier; 2016; 624 pp; 1165 ill; $299.99 This 4th edition of Sectional Anatomy by MRI and CT, written by Drs. Anderson and Fox, is heavily weighted to the]]></description>
										<content:encoded><![CDATA[<p><strong>Anderson MW, Fox MG, eds. <em>Sectional Anatomy by MRI and CT</em>. 4th ed. Elsevier; 2016; 624 pp; 1165 ill; $299.99</strong></p>
<p><a href="http://www.ajnrblog.org/wp-content/uploads/anderson-sectional-anatomy-mri-ct-elsevier_cover.jpg"><img loading="lazy" decoding="async" class="alignright size-full wp-image-11783" src="http://www.ajnrblog.org/wp-content/uploads/anderson-sectional-anatomy-mri-ct-elsevier_cover.jpg" alt="anderson-sectional-anatomy-mri-ct-elsevier_cover" width="200" height="256" srcset="https://www.ajnrblog.org/wp-content/uploads/anderson-sectional-anatomy-mri-ct-elsevier_cover.jpg 200w, https://www.ajnrblog.org/wp-content/uploads/anderson-sectional-anatomy-mri-ct-elsevier_cover-117x150.jpg 117w" sizes="auto, (max-width: 200px) 100vw, 200px" /></a>This 4<sup>th</sup> edition of Sectional Anatomy by MRI and CT, written by Drs. Anderson and Fox, is heavily weighted to the musculoskeletal (MSK) system. If one includes the spine and back, MSK composes 85% of the book—no neuroanatomy (brain/head/neck) is included. It would be a satisfactory anatomy reference guide for someone who is in MSK radiology, but not for a neuroradiologist.</p>
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