ABSTRACT
OBJECTIVE: Neuroimaging plays a major role in the early diagnosis of Alzheimer's disease (AD). Recent advances in voxelwise statistical analysis after anatomic standardization of images have made this early diagnosis easier and more objective than visual inspection. We present comparative observations of NEUROSTAT, statistical parametric mapping (SPM) 99, and SPM2 in the early diagnosis of AD using brain perfusion single-photon emission computed tomography (SPECT) and magnetic resonance imaging (MRI). METHODS: We performed voxel-by-voxel statistical group analysis for brain perfusion SPECT and gray matter images segmented from MRI between 61 patients with very early AD and 82 age-matched healthy volunteers. Anatomic standardization was performed using NEUROSTAT, SPM99, and SPM2 using both original and common templates. RESULTS: The location of significant reduction of regional cerebral blood flow (rCBF) for SPECT and gray matter concentration for MRI were identical among these three methods irrespective of the templates used. When using the original template, the significance of peak rCBF reduction in the posterior cingulate gyri was higher in SPM99 and SPM2 than that in NEUROSTAT. On the other hand, when using the common template, the significance of peak rCBF reduction in the posterior cingulate gyri was higher in NEUROSTAT and SPM2 than that in SPM99. NEUROSTAT showed almost the equal significance of peak rCBF reduction between the used templates. Almost the equal significance of reduction in gray matter concentration was observed in the parahippocampal gyri among the three methods. CONCLUSIONS: NEUROSTAT, SPM99, and SPM2 showed identical location of significant reductions in rCBF and gray matter concentration in very early AD patients. Used templates for anatomic standardization are relevant to the results of voxelwise statistical analysis in SPM, less prominently in SPM2 than in SPM99, whereas irrelevant in NEUROSTAT.
Subject(s)
Algorithms , Alzheimer Disease/diagnosis , Brain/diagnostic imaging , Brain/pathology , Image Interpretation, Computer-Assisted/methods , Magnetic Resonance Imaging/methods , Tomography, Emission-Computed, Single-Photon/methods , Aged , Aged, 80 and over , Data Interpretation, Statistical , Humans , Image Enhancement/methods , Imaging, Three-Dimensional/methods , Middle Aged , Reproducibility of Results , Retrospective Studies , Sensitivity and SpecificityABSTRACT
A 68-year-old female consulted our hospital, complaining of a large mass on the left side of the neck. Computed tomography and magnetic resonance imaging revealed the characteristic internal architecture of the mass, in which a small cyst was located within a cystic mass, showing a "cyst-within-cyst" appearance. A final diagnosis of second branchial cleft cyst was made pathologically. A "cyst-within-cyst" appearance is not usually seen in a second branchial cleft cyst. This appearance may be attributed to several fine-needle aspiration biopsies for diagnostic purposes.
Subject(s)
Cysts/congenital , Cysts/diagnosis , Neck/abnormalities , Neck/pathology , Aged , Female , Humans , Magnetic Resonance Imaging , Neck/diagnostic imaging , Tomography, X-Ray ComputedSubject(s)
Adenocarcinoma, Mucinous/diagnosis , Adenocarcinoma, Papillary/diagnosis , Carcinoma, Pancreatic Ductal/diagnosis , Granuloma/diagnosis , Pancreatic Neoplasms/diagnosis , Pancreatitis/diagnosis , Xanthomatosis/diagnosis , Adenocarcinoma, Mucinous/complications , Adenocarcinoma, Papillary/complications , Aged , Aged, 80 and over , Carcinoma, Pancreatic Ductal/complications , Contrast Media , Gadolinium DTPA , Granuloma/complications , Humans , Iopamidol , Magnetic Resonance Imaging , Male , Pancreatic Neoplasms/complications , Pancreatitis/complications , Tomography, X-Ray Computed , Xanthomatosis/complicationsABSTRACT
Granular cell tumor (GCT) is an uncommon benign tumor, which is thought to originate from a Schwann cell. GCT may involve any part of the body, but in our knowledge, there has been only one previous report of GCT, which arose in the intradural extramedullary space of the spine. We report a case of GCT, which occurred in the intradural extramedullary space.
Subject(s)
Granular Cell Tumor/diagnosis , Magnetic Resonance Imaging , Spinal Cord Neoplasms/diagnosis , Granular Cell Tumor/pathology , Humans , Lumbar Vertebrae , Male , Middle Aged , Phosphopyruvate Hydratase/analysis , S100 Proteins/analysis , Spinal Cord Neoplasms/pathologyABSTRACT
We reported a 68-year-old man of dural arteriovenous fistula at the cranio-cervical junction with dysesthesia ascending from his both toes. He recognized dysesthesia at his both toes 10 months previously. Thereafter dysesthesia ascended to his girdle which was stronger as far as his girdle and gait disturbance developed. Somatosensory evoked potential (SEP) revealed delayed central conduction time. Cervical MRI showed a swelling of the spinal cord and intramedullary hyperintense lesion from the C2 to C7 level on the T2-weighted image. Moreover flow void behind the mudulla oblongata on the T2-weighted MRI was outstanding. Angiogram through right ascending pharyngeal artery revealed enlarged and tortuous anterior and posterior spinal veins at the early arterial phase. We diagnosed as dural arteriovenous fistula (AVF) and conducted intraarterial embolization. After treatment, the swelling and hyperintense lesion of the cervical spinal cord improved on MRI, and flow void behind medulla oblongata was extinguished. Gait disturbance also improved. We think that the valves of veins in the spinal cord are responsible for the tendency of higher venous pressure in outer circumference, which results in the symptom dominating in the lower extremities. We recommend that dural AVF at the cranio-cervical junction should be considered as a differential diagnosis in case with the similar clinical course to our case.
