ABSTRACT
One hundred sixteen magnetic resonance (MR) imaging studies from 105 pediatric patients with a variety of cerebral abnormalities were reviewed to determine the diagnostic efficacy of MR in the pediatric population. All subjects tolerated the MR procedure well, although sedation was necessary for younger children. Compared with CT, MR proved to be advantageous in detection and characterization of the pathology in 23 of 105 patients, especially when the abnormality was located along the base of the brain and midline, or when it involved primarily the white matter. Intracranial calcification was the one abnormality not detected with MR although dense calcifications could be seen as areas of low signal intensity. Some characteristics of various pathological entities were compared in an attempt to differentiate among abnormalities in the same anatomical location: craniopharyngioma from optic chiasm and hypothalamic glioma, cystic glioma from arachnoid cyst, and chronic subdural hematoma from subdural hygroma. The lack of ionizing radiation in MR is of particular interest in pediatric neuroradiology since radiation is of special concern in the young age group.
Subject(s)
Brain Diseases/diagnosis , Brain Neoplasms/diagnosis , Magnetic Resonance Spectroscopy , Adolescent , Agenesis of Corpus Callosum , Calcinosis/diagnosis , Cerebellar Neoplasms/diagnosis , Cerebral Infarction/diagnosis , Child , Child, Preschool , Craniopharyngioma/diagnosis , Ependymoma/diagnosis , Female , Ganglioneuroma/diagnosis , Hemangioma/diagnosis , Hematoma, Subdural/diagnosis , Humans , Infant , Infant, Newborn , Leukoencephalopathy, Progressive Multifocal/diagnosis , Male , Medulloblastoma/diagnosis , Pituitary Neoplasms/diagnosisABSTRACT
Fifty-four patients with abnormalities primarily involving the base of the skull were evaluated by magnetic resonance (MR) imaging. The results were compared with information obtained by other radiologic studies, primarily X-ray CT. On MR imaging, better anatomic definition of soft tissues in the deep compartments of the nasopharynx was achieved through the high level of tissue contrast discrimination and lack of bone artifacts. The parapharyngeal fat plane, separating pterygoid from pharyngeal musculatures, was consistently demonstrated. However, the inability of MR to image compact bone proved to be a major drawback where bony detail was required. In general, MR imaging demonstrated 100% sensitivity to abnormalities involving the posterior compartment (clivus and craniovertebral junction) and was least valuable in the evaluation of the anterior compartment (orbits, cribiform plate, and sinuses.
Subject(s)
Magnetic Resonance Spectroscopy , Skull/pathology , Adolescent , Arnold-Chiari Malformation/diagnostic imaging , Evaluation Studies as Topic , Female , Head and Neck Neoplasms/diagnostic imaging , Humans , Infections/diagnostic imaging , Magnetic Resonance Spectroscopy/methods , Nasopharynx/diagnostic imaging , Paranasal Sinuses/diagnostic imaging , Skull/diagnostic imaging , Skull/injuries , Tomography, X-Ray ComputedABSTRACT
Magnetic resonance (MR) images of the brainstem region from 100 normal or asymptomatic individuals were reviewed in addition to those of 17 patients with intra-axial brainstem lesions and 15 patients with extra-axial masses around the brainstem. MR was able to demonstrate consistently the normal anatomy of the brainstem and adjacent cisterns, though the distinction between gray and white matter was seldom possible with the present technology. Masses in and around the brainstem were all accurately identified on MR and its sensitivity was superior to that of x-ray computed tomography (CT). These study results show that despite its technical limitations, MR is presently the examination of choice for the evaluation of brainstem abnormalities and eventually it will undoubtedly replace metrizamide CT cisternography.
Subject(s)
Brain Stem/anatomy & histology , Brain Stem/pathology , Magnetic Resonance Spectroscopy , Adolescent , Adult , Aged , Brain/pathology , Brain Diseases/diagnosis , Brain Neoplasms/diagnosis , Child , Child, Preschool , Female , Humans , Male , Middle AgedABSTRACT
The usefulness of nuclear magnetic resonance (NMR) images in the evaluation of spinal disorders below the craniocervical junction was studied. Six normal subjects and 41 patients with various spinal abnormalities were examined. NMR proved capable of demonstrating important normal and pathologic anatomic structures; it was useful in the evaluation of syringohydromyelia and cystic spinal cord tumors, and the bright signal intensity of lipoma was quite impressive. In the evaluation of herniated disk, NMR images offered a new perspective by visualizing abnormal degradation of the signal intensity of the nucleus pulposus itself. NMR images were least valuable in the evaluation of spondylosis and spinal stenosis. Although NMR imaging of the spine is still in a very early developmental stage, the absence of both ionizing radiation and risks associated with contrast material makes it especially attractive as a new diagnostic method. This limited experience with currently available equipment suggests that, with technical refinement, the efficacy of NMR of the spine will increase.
