Subject(s)
Intracranial Hypertension/diagnosis , Acetazolamide/therapeutic use , Adult , Contrast Media , Diagnosis, Differential , Female , Gadolinium , Humans , Image Enhancement/methods , Intracranial Hypertension/cerebrospinal fluid , Intracranial Hypertension/therapy , Magnetic Resonance Imaging/methods , Spinal Puncture/methods , Young AdultABSTRACT
Middle ear opacification on imaging studies performed in a non-traumatic setting mostly reflects chronic inflammatory/infectious disease. In some of these patients an underlying cholesteatoma will be found. High-resolution computed tomography examinations and magnetic resonance imaging are often used in the work-out of the disease. High-resolution computed tomography of the opacified middle ear serves to describe the status of the ossicular chain, and its suspensory apparatus, as well as the status of the tympanic and mastoid wall. When ossicular erosions are visualized, the probability of a present cholesteatoma is about 90%. Whereas high-resolution computed tomography is not able to differentiate cholesteatoma from other types of opacification, magnetic resonance imaging is. The combined use of delayed post-Gd T1-weighted images and non-EPI based DWI seems to be the actual best option on this matter.
Subject(s)
Cholesteatoma, Middle Ear/diagnosis , Ear, Middle/pathology , Contrast Media , Humans , Magnetic Resonance Imaging/methods , Mastoid/pathology , Otitis Media/diagnosis , Temporal Bone/pathology , Tomography, X-Ray Computed/methodsABSTRACT
The trigeminal nerve is the largest cranial nerve with both a sensory and motor function. MRI is an excellent technique to evaluate the trigeminal nerve. We report the MRI findings and illustrate the normal and diseased trigeminal nerve at Meckel's cave, the cavernous sinus, the skull base foramina, the pterygopalatine fossa and the peripheral branches.
Subject(s)
Magnetic Resonance Imaging , Trigeminal Ganglion/anatomy & histology , Trigeminal Nerve Diseases/diagnosis , Trigeminal Nerve/anatomy & histology , Bone Diseases/diagnosis , Cavernous Sinus/anatomy & histology , Contrast Media , Cranial Nerve Neoplasms/diagnosis , Head and Neck Neoplasms/diagnosis , Humans , Image Enhancement/methods , Magnetic Resonance Imaging/methods , Mandibular Nerve/anatomy & histology , Maxillary Nerve/anatomy & histology , Neoplasm Metastasis , Neurilemmoma/diagnosis , Ophthalmic Nerve/anatomy & histology , Pons/anatomy & histology , Skull/pathology , Skull Neoplasms/diagnosis , Subarachnoid Space/anatomy & histology , Trigeminal Ganglion/pathology , Trigeminal Nerve/pathologyABSTRACT
Devic's neuromyelitis optica is an uncommon but severe monophasic or relapsing demyelinating disease. Current evidence supports the concept that it is a distinct disorder from multiple sclerosis, with some specific imaging characteristics. The aim of this paper is to report the clinical and imaging features of this rare entity and to discuss its differential diagnosis.
Subject(s)
Diagnostic Imaging , Neuromyelitis Optica/diagnosis , Antibodies/blood , Brain/pathology , Diagnosis, Differential , Humans , Immunoglobulin G/blood , Magnetic Resonance Imaging , Multiple Sclerosis/diagnosis , Myelitis/physiopathology , Neuromyelitis Optica/cerebrospinal fluid , Neuromyelitis Optica/physiopathology , Optic Neuritis/physiopathology , Spinal Cord/pathology , Spinal Cord Diseases/diagnosisABSTRACT
Arachnoid granulations are rarely seen on high-resolution CT (HRCT) at the posterior temporal bone wall, where they appear as erosions, without bone spicules and often with a lobulated surface. Differential diagnosis includes endolymphatic sac tumor, paraganglioma, chordoma, and chondromatous and metastatic tumors. MR imaging can confirm the diagnosis because arachnoid granulations behave like CSF without gadolinium enhancement. This report aims to illustrate the appearance and differentiation of temporal bone arachnoid granulations on HRCT and MR imaging.
Subject(s)
Arachnoid/diagnostic imaging , Temporal Bone/diagnostic imaging , Tomography, X-Ray Computed , Aged, 80 and over , Arachnoid/anatomy & histology , Diagnosis, Differential , Endolymphatic Sac/diagnostic imaging , Female , Humans , Magnetic Resonance Imaging , Middle Aged , Temporal Bone/anatomy & histologyABSTRACT
Several authors have demonstrated the good tolerance of hepatic intra-arterial 131I-Lipiodol therapy and report survival rates of 21-25% after 1 year in inoperable patients. This study explored the possibility that more selective hepatic arterial instillation could be a strategy for increasing tumoural uptake and response of 131I-Lipiodol. Between June 1999 and September 2001 we selected 24 patients: 14 received a selective instillation of 131I-Lipiodol to the proper hepatic artery (SEL group); and 10 received a hyperselective instillation in the right or left hepatic artery (HYP-SEL group). The individual 131I-Lipiodol activity as a per cent of the injected activity per millilitre of tumour (%IA/ml tumour) was correlated with the selectivity of instillation in 28 tumours and with tumour response in 24 tumours. Differences in tumour response or tumour uptake between the SEL and HYP-SEL groups were not significant. In general, we observed a %IA/ml tumour of 0.05-2.6% for the uptake of 131I-Lipiodol. The uptake was significantly higher in responsive disease than in stable or progressive disease (P=0.002). A large tumour volume was invariably related to low uptake of 131I-Lipiodol and progressive disease (P=0.008). In conclusion, our study does not support the general use of hyper-selective or super-selective intra-arterial administration of 131I-Lipiodol. This result may be extrapolated to similar types of intra-arterial, loco-regional hepatic radionuclide therapy.
