The human cerebral cortex on MRI: value of the coronal plane.

The evaluation of different cortical areas of the cerebral cortex has been analyzed using MRI of 50 normal subjects without any neurological symptoms. This analysis has been made with different spin echo and gradient echo in T1 or T2 in three different planes: horizontal, sagittal and coronal. The most accurate plane to define important cortical areas such as Broca area, Wernicke area, temporal cortex at the level of the superior temporal sulcus, angular gyrus, supra marginal gyrus, hippocampal and parahippocampal cortices as well as that of the parieto or temporo-occipital areas is the coronal plane. Evidently it must be correlated with the other orthogonal planes. To be compared with the main Atlas of Neuroanatomy these sections must be perpendicular or parallel to the plane passing through the anterior and posterior commissures. MRI of patients with neurological disorders must have, as a routine, a series of MR sections performed in the coronal plane, as well as in horizontal and sagittal ones. The coronal plane is certainly the most precise to evaluate these areas involved in language, memory, visuo spatial or behavioral functions. It must be always compared with the rest of the neuroradiological examination and correlated with the clinical neurological signs.

[Magnetic resonance studies in Alzheimer's dementia. What routine scanning shows]. / L'exploration en IRM des démences de type Alzheimer. Que peut-on voir sur un examen de routine?

Magnetic resonance images of the brain acquired in relationship to the commissural plane have been analyzed in twenty cases classified as Probable Alzheimer's disease (Pr. AD). These examinations have been compared to normal aged matched subjects. All examinations have been made in strict correlation with the planes defined by Talairach and Tournoux (1988). The analysis of brain cortical damage was made by evaluating the sulci of the brain mainly on coronal sections correlated with simultaneous image review of the same area on the two other orthogonal planes. In Pr. AD, an asymmetric atrophic pattern was found mainly on the following areas: amygdaloid nucleus, para hippocampal gyrus, hippocampus, areas 22 and 21, temporal pole, insula, dorso frontal cortex, angular gyrus, superior parietal lobule. The primary motor and visual areas were normal in all cases.

Research and teaching access to a large clinical picture archiving and communication system.

PURPOSE: To identify practical issues surrounding delivering digital images from picture archiving and communication systems (PACS) for research and teaching purposes. The complexity of Digital Imaging and Communications in Medicine (DICOM) access methods, security, patient confidentiality, PACS database integrity, portability, and scalability are discussed. A software prototype designed to resolve these issues is described. SYSTEM ARCHITECTURE: A six-component, three-tier, client server software application program supporting DICOM query/retrieve services was developed in the JAWA language. This software was interfaced to a large GE (Mt Prospect, IL) Medical Systems clinical PACS at Northwestern Memorial Hospital (NMH). CONCLUSION: Images can be delivered from a clinical PACS for research and teaching purposes. Concerns for security, patient confidentiality, integrity of the PACS database, and management of the transactions can be addressed. The described software is one such solution for achieving this goal.