Association between Developmental Venous Anomalies and Cavernous Angiomas: a Retrospective MR Study.

Developmental venous anomalies (DVA) are large veins usually arranged in a cluster around a collector vein draining directly into the superficial and deep venous systems. Since the introduction of magnetic resonance imaging DVA have been disclosed more frequently. Many studies suggested and then confirmed the association between cavernous angioma and developmental venous anomaly, described for the first time by Roberson in 1974. The aim of our study was a retrospective assessment of the case series at our institution, namely to determine the frequency of the association between developmental venous anomaly and cavernous and analyse the relation between the two lesions.

Three-Year Retrospective Study of Complications Arising during Interventional Procedures.

SUMMARY: This retrospective study aimed to assess the percentage of complications arising in our daily practice of interventional procedures, comparing our findings with those of leading international reference centers and accepted guidelines for endovascular treatment. During the threeyear period considered (2000-2002), we performed 246 interventional procedures, divided into seven different pathological conditions: aneurysms, brain AVMs dural and carotid cavernous fistulae, spine-spinal cord tumours, headneck tumours, carotid stenosis and thrombolysis. Aneurysmal disease accounted for 45% of all endovascular procedures. In conclusion, four periprocedural complications arose in the course of 246 procedures resulting in one death and three cases of permanent neurological deficit (2%).

Analysis of ethereal extracts of wines and other alcoholic beverages by high-performance liquid chromatography with microbore columns.

The ethereal extracts of wines, beer and vermouth were analysed by high-performance liquid chromatography. The following three characteristic peaks were first identified using GC-MS and then quantitatively determined: 5-hydroxy-methyl-2-furaldehyde, 2-(4-hydroxyphenyl)ethanol and 3-(2-hydroxyethyl)indole.

Magnetic resonance imaging.

All of the data published in the literature show that MR is more sensitive than CT in diagnosing cerebral ischemic lesions. This greater sensitivity is due to its ability to detect even the minimal changes in tissue water content which occur in the early phases of the infarct. The literature concerning the use of MR in lacunar lesions is extremely limited but agrees with the general data regarding ischemia. However, there is some doubt that the thickness of the strata of CT and the interval between the strata of MR could have an influence on their ability to detect very small lesions. Modifications in the sensitivity of MR in detecting ischemic lesions are now well known: during the acute phase, the T2 images are more sensitive, while in the subacute and chronic phase both T1 and T2 have the same diagnostic capability.

The role of MR and CT in evaluating clival chordomas and chondrosarcomas.

Sixteen chordomas and nine chondrosarcomas of the clivus were evaluated with CT and MR either before (22 cases) or after (three cases) treatment with proton beam irradiation. The ability of these imaging techniques to provide information necessary to direct patient treatment was studied. The tumor was detected and its gross margins were identified by both techniques in all instances. No reliable diagnostic features allowing differentiation between these two tumors were encountered. MR generally was superior in defining the exact position of the brainstem and optic chiasm relative to the tumor, and it frequently provided superior information about tumor extension into the nasopharynx and cavernous sinus. CT was always better than MR in demonstrating tumoral calcification and in defining the exact anatomy of bone destruction. MR was generally superior to CT in demonstrating the position of the cavernous internal carotid artery relative to the tumor and often provided superior visualization of the vertebral and basilar arteries. In cases in which bone-induced artifact obscured the interface between the neural axis and tumor in the CT image, or in which the tumor had suprasellar extension and was likely to compress the optic chiasm and tracts, MR was of great value in planning irradiation therapy. The high occurrence of clinically asymptomatic signal intensity alterations in the MR studies of previously treated patients appears to limit the differential diagnostic value of this information. Given its greater availability and lower cost, CT appears to be the technique of choice for routine follow-up of previously treated patients.

MR of vascular encasement in parasellar masses: comparison with angiography and CT.

The relationship between tumor mass and vascular involvement as seen on MR imaging was examined in 11 patients with masses in the parasellar region, and the findings were correlated with CT and angiography. In six cases, MR was superior to CT and angiography in depicting the relationship of the tumor to adjacent blood vessels. In these cases, MR demonstrated tumor surrounding the blood vessel without changing the diameter of its lumen. Angiography did not reveal encasement in these cases. In four cases, both MR and angiography showed signs of vascular encasement with narrowing of the vessel's lumen. In two cases, MR was equivocal while angiography revealed vascular encasement in one case and was negative for encasement in the other. CT was less sensitive than MR in defining vascular encasement since there is usually little contrast between an enhancing tumor and the major blood vessels. Coronal scanning appeared to be the best plane of imaging and correlated well with the anteroposterior angiogram. We propose that MR is the method of choice for evaluating arterial encasement by tumors and may obviate the need for angiography in those cases in which MR is positive for a basal lesion.

Low sensitivity of clinical MR imaging to small changes in the concentration of nonparamagnetic protein.

This study attempts to determine the magnitude of change in the concentration of a nonparamagnetic protein (human serum albumin) required to effect a detectable change in signal intensity on a clinical imaging unit. For a range of protein concentrations from 0-6100 mg/dl the concentration could not be predicted by inspecting the images. Measurement of displayed signal intensity failed to distinguish concentrations of 0.09-3700 mg/dl, while 6100 mg/dl gave slightly higher intensity signals. Although this low sensitivity represents expected behavior for low concentrations, the failure to differentiate the higher concentrations implies limitations imposed by clinical imaging techniques. Our results suggest that additional factors, such as paramagnetic material and motion as well as differences in protein concentration, may be involved in the MR signal intensities observed in pathologic CSF and cystic CNS collections.

Magnetic resonance imaging determination of gliomatosis cerebri.

Gliomatosis cerebri is a rare condition characterized by diffuse overgrowth of large portions of the brain and spinal cord by glial cells in varying stages of differentiation. The tumor process is primarily an infiltrative, rather than a destructive one. Hence, pre-operative diagnosis by traditional imaging studies, including computed tomography (CT), has been difficult. Magnetic resonance imaging (MRI), with its unique sensitivity for cerebral pathology, is an ideal modality for demonstrating this lesion. We present three cases of gliomatosis cerebri in which high-field MRI clearly delineates the extent of the pathologic process.

Intracranial meningiomas: high-field MR imaging.

Twenty-five newly diagnosed intracranial meningiomas were evaluated with magnetic resonance (MR) imaging at 1.5 T, and findings were correlated with those of computed tomography (CT), angiography, and tumor histology. Meningiomas were generally hypointense on T1-weighted images and hyperintense on T2-weighted images relative to cerebral white matter. In comparison with the cortex, they were hypointense or isointense on T1-weighted images and isointense or hyperintense on T2-weighted images. A heterogeneous texture produced by tumor vascularity, calcifications, cystic foci, or an intrinsic speckled or mottled pattern was observed in all but the smallest lesions. An interface between meningioma and brain was uniformly present and consisted of a cerebro-spinal fluid cleft, vascular rim, or dural margin. Large meningiomas were associated with arcuate displacement and compression of adjacent gyri. MR imaging was superior to CT in defining extracerebral tumor location, tumor vascularity, arterial encasement, and venous sinus invasion. No correlation was found between the appearance on MR images and the pathologic classification.

High field magnetic resonance evaluation of acoustic neurinomas.

Eight acoustic neurinomas were studied with magnetic resonance imaging (MRI) at 1.5 tesla utilizing spin-echo T1 and T2 weighted images (WI). T1 WI identified the tumors best and provided more exacting anatomic relationships particularly for small lesions than did T2 WI. Intracanalicular tumors are well defined. All tumors were hypointense on T1 WI but were usually heterogeneous and had variable intensity on T2 WI. Several lesions became obscured on T2 WI because of isointensity with the adjacent cerebellum or CSF. High signal to noise ratio at 1.5 tesla permits thin section imaging (3 mm) at relatively short imaging times. T1 MRI was considerably superior to CT for the detection and anatomic definition of acoustic neurinomas.