Primary brain lymphoma and glioblastoma: evaluation of DCE T1 and DSC T2 MRI perfusion findings.

BACKGROUND: The accurate differentiation of primary central nervous system lymphoma (PCNSL) from glioblastoma multiforme (GBM) is clinically crucial due to the different treatment strategies between them. PURPOSE: To define magnetic resonance imaging (MRI) perfusion findings in PCNSL to make a safe distinction from GBM with dynamic contrast-enhanced (DCE) T1 and DSC T2 MRI perfusion findings. MATERIAL AND METHODS: This retrospective analysis included 19 patients with histopathologically diagnosed PCNSL and 21 individuals with GBM. DCE T1 vascular permeability perfusion values including K-trans, Ve, Kep, IAUGC, and DSC T2 perfusion values including cerebral blood volume (CBV) and cerebral blood flow (CBF) in axial sections from the pathological lesion and contralateral normal brain parenchyma were measured quantitatively using region of interest analysis. RESULTS: The study observed no statistically significant difference between patients with PCNSL (T/B cell) and GBM in the median values of DCE T1 perfusion ratios (P > 0.05). Nevertheless, the DSC T2 perfusion ratios showed a substantial distinction between the two groups. In contrast to patients with PCNSL (1.185 vs. 1.224, respectively), those with GBM had higher median levels of r-CBV and r-CBF (2.898 vs. 2.467, respectively; P 0.01). A cutoff value of ≤1.473 for r-CBV (Lesion/N) and ≤1.6005 for r-CBF (Lesion/N) was found to estimate the positivity of PCNSL. CONCLUSION: DSC T2 MRI perfusion values showed lower r-CBV and r-CBF values in PCNSL patients compared to GBM patients. According to the findings, r-CBV and r-CBF are the most accurate MRI perfusion parameters for distinguishing between PCSNL and GBM.

Conventional and Diffusion-Weighted MR Imaging Findings of Parotid Gland Tumors.

OBJECTIVE: To investigate diffusion-weighted magnetic resonance imaging (MRI) findings of parotid gland lesions in addition to conventional MRI findings and demographic data. METHODS: A retrospective evaluation was made of the demographic data, histopathologic data, preoperative conventional and diffusion-weighted MRI of 74 patients who underwent parotidectomy. The patients were categorized according to the histopathology (pleomorphic adenoma [PA], Warthin's Tumor [WT] and malignant Tumor [MT]). RESULTS: Histologically, 30 patients had PA, 27 patients had WT, and the remaining 17 patients had MT. The mean age of the PA, WT and MT groups were 44±21 (20-72), 55±10 (41-71) and 62±20 (21-76) years, respectively. The WT (81%) and MT (70%) groups were male dominant, while the PA group showed female dominance (55%). The PA group showed statistically significant difference in terms of age (p<0.05) and gender (p=0.009) compared to the other two groups. The median apparent diffusion coefficient (ADC) values for the PA, WT and MT groups were 1.99±0.94 (1.10-2.41) × 10-3 mm2/s, 0.92±0.35 (0.21-1.79) × 10-3 mm2/s and 1.20±0.34 (0.78-1.47) × 10-3 mm2/s, respectively. PA was differentiated from the other two groups (p=0.001). The sensitivity and specificity for distinguishing PAs from WT was 97% and 85%, respectively, when the ADC cutoff value was 1.25; and for distinguishing PAs from MT was 77% and 83%, respectively, when the ADC cutoff value was 1.35. CONCLUSION: ADC measurements are useful for the differentiation of PA from both WT and MT; and can be used as a complementary tool to predict the histopathology in the preoperative planning of parotid tumors.

Magnetic Resonance Imaging of the Eustachian Tube and the Paratubal Structures in Patients with Unilateral Acquired Cholesteatoma.

OBJECTIVES: This study aimed to compare the Eustachian tube (ET) and the paratubal structures between the two sides in subjects with unilateral acquired cholesteatoma and a healthy contralateral ear to determine if there are anatomical differences. MATERIALS AND METHODS: Of the 217 patients with cholesteatoma evaluated, 36 patients with unilateral cholesteatoma were included in the study. All of the patients had a healthy contralateral ear with no history of surgery. Nine different paratubal parameters were measured through contrast-enhanced magnetic resonance imaging (MRI). The measurements of the ear with cholesteatoma were compared with those of the healthy ear. RESULTS: The bimucosal thickness of the ET lumen, the mucosal thickness of the pharyngeal orifice, the lengths and diameters of the tensor veli palatini muscle and the levator veli palatini muscle, the diameter of the pharyngeal orifice of the ET, the diameter of the lateral pharyngeal recess mucosal thickness, and the diameter between the posterior border of the inferior nasal concha and the pharyngeal orifice of the ET were measured in MRI scans. No statistically significant difference was observed between the healthy ear and the ear with cholesteatoma for any of the parameters measured (p>0.05). CONCLUSION: We did not observe any anatomical differences in the measurements of the ET and the paratubal structures on MRI scans. Although ET dysfunction is considered to be the leading etiologic factor in acquired cholesteatoma, the ET and the paratubal structures may not exhibit an anatomic difference between the ear with cholesteatoma and the healthy contralateral ear.

Intravoxel incoherent motion parameters in the evaluation of chronic hepatitis B virus-induced hepatic injury: fibrosis and capillarity changes.

OBJECTIVE: To evaluate the diagnostic efficacy of intravoxel incoherent motion (IVIM) parameters in hepatitis B virus (HBV)-induced hepatic fibrosis using different calculation methods and to investigate histopathologic origins. MATERIALS AND METHODS: Liver biopsies from 37 prospectively recruited chronic hepatitis B patients were obtained. Twelve b-value (0-1000 s/mm2) diffusion-weighted imaging (DWI) was performed with a 1.5 T scanner and was followed by blinded percutaneous liver biopsy. All biopsy specimens were evaluated with Ishak staging, and the microvascular density (MVD) was calculated. Patients were classified as having no/mild (F0-1), moderate (F2-3), or marked (F4-5) fibrosis. Pseudodiffusion (D*), the perfusion fraction (f), and the apparent diffusion coefficient (ADC) were calculated using all b-values, while true diffusion (D) was calculated using all b-values [D0-1000] and b-values greater than 200 s/mm2 [D200-1000]. Three concentric regions of interest (ROIs) (5, 10, and 20 mm) centered on the biopsy site were used. RESULTS: D* was correlated with the MVD (p = 0.015, Pearson's r = 0.415), but f was not (p = 0.119). D0-1000 was inversely correlated with Ishak stage (p = 0.000, Spearman's rs = - 0.685) and was significantly decreased in all the fibrosis groups; however, only the no/mild and marked fibrosis groups had significantly different D200-1000 values. A pairwise comparison of receiver operating characteristic (ROC) curves of D0-1000 and D200-1000 showed significant differences (p = 0.039). D* was the best at discriminating early fibrosis (AUC = 0.861), while the ADC best discriminated advanced fibrosis (AUC = 0.964). CONCLUSION: D* was correlated with the MVD and is a powerful parameter to discriminate early hepatic fibrosis. D significantly decreased with advanced fibrosis stage when using b-values less than 200 s/mm2 in calculations.

Is the version angle of the glenoid different in bone and cartilage? An MRI study

Background/aim: To determine whether or not there is a difference between the version of the bone and cartilage surfaces of the glenoid. Axial magnetic resonance imaging (MRI) slices were examined in order to evaluate the measurements taken based on both the cartilage and bone joint surfaces. Materials and methods: A retrospective evaluation was made of the MRI scans of 182 patients. All of the reviewers independently measured the glenoid version angles of all of the patients from 1­182. The process was then repeated, with each reviewer taking second measurements of the angles from 1­182. Pearson correlation coefficient analysis was applied to evaluate the interaction and relationships between the measurements taken from the bone and cartilage. The intra- and interobserver interclass correlation coefficients (ICCs) were assessed. Analysis of variance was applied to determine any interobserver significant differences. Results: The mean glenoid version was determined as ­3.58 ± 4.08° in the bone-based measurements and ­5.81 ± 4.30° in the cartilage-based measurements. The cartilage- and bone-based measurements were found to have inter- and intraobserver reliability. A statistically significant difference was observed between the mean cartilage-based version and the mean bone-based version. Changes in the cartilage- and bone-based measurements were correlated; however, this change was not linear. Conclusion: The cartilage-based version showed a significant difference from the bone- based version. Therefore, in the preoperative planning and evaluation of glenoid-based pathologies, it would be more appropriate to evaluate both the bone and cartilage surface on MRI.

Is It an Overlooked Injury? Magnetic Resonance Imaging Examination of Occult Talus Lesions Concomitant to Tibial Shaft Fracture.

Long-term studies have shown that 10% to 20% of patients continue to experience ankle pain years after tibial fracture, which causes poor functional results and dissatisfaction. The aim of this study was to show that there could be a talus injury in patients with a tibial shaft fracture and to reveal occult talus lesions with magnetic resonance imaging (MRI) examination. Fifty-two patients with a tibial shaft fracture, with closed epiphyses, not extending to the joint and with no problems in the application of MRI examination were included. All patients underwent intramedullary tibial nailing. Patients with a lesion detected on MRI were planned to be examined by MRI again at mean of 12 months later. Ankle function of the patients were evaluated with the American Orthopaedic Foot and Ankle Society, Freiburg, and Weber scoring systems at 3, 6, and 12 months postoperatively. At the first MRI, 22 (42.3%) patients with tibial shaft fracture were found to have talus lesions: 7 (13.5%) had osteochondritis dissecans, 12 (23.1%) had edema, and 3 (5.8%) had cysts. A second MRI was planned for patients with edema and osteochondritis dissecans at a mean of 12 months. Finally, at 12 months, MRI examinations revealed osteochondritis dissecans and edema in 9 (17.3%) and 8 (15.4%) patients, respectively. In the evaluations of the patients according to the ankle scoring systems, the scores of the patients with pathology determined in the talus were significantly worse statistically than those of patients with no pathology determined at 3, 6, and 12 months postoperatively. Atalus lesion accompanied the tibial shaft fracture at a rate of 37%. The talus injuries were seen especially with an indirect mechanism of trauma, in distal third fractures, in spiral fractures, and when the tibial fracture was accompanied by a lateral malleolar fracture. In the presence of findings indicating talus injury in cases of tibial shaft fracture, the talus should be evaluated with ankle MRI.

Intraoperative rotation control in closed intramedullary nailing in tibia diaphyseal fractures: a prospective, randomised study.

The intraoperative determination of rotation in closed intramedullar nailing of tibial fractures is difficult. In this study, a more reliable method was used and it was a more practical means of checking rotation intra-operatively for tibia diaphysis fractures. 42 patients who presented with a unilateral tibia diaphyseal fracture. were randomly divided into two groups. In Group 1, the Intraoperative Rotation Control Method (IRCM) was used and compared with Group 2 as the control group. The Delta Rotation obtained from the MRI measurements were recorded and the Mean Delta Rotation (MDR) was obtained for each group separately. Malrotation was determined at a statistically significantly lower rate in Group 1. The MDR was statistically significantly lower in Group 1. This method does not require exposure to radiation like other radiological methods. Thus, the method used can be considered to be effective in the prevention of malrotation.

Association Between Measures of Vertebral Endplate Morphology and Lumbar Intervertebral Disc Degeneration.

PURPOSE: The aim of this study was to evaluate the association between vertebral endplate morphology and the degree of lumbar intervertebral disc degeneration via magnetic resonance imaging (MRI). METHODS: In total, 150 patients who met the inclusion criteria and were 20-60 years of age were retrospectively evaluated. Patients were evaluated for the presence of intervertebral disc degeneration or herniation, and the degree of degeneration was assessed at all lumbar levels. Vertebral endplate morphology was evaluated based on the endplate sagittal diameter, endplate sagittal concave angle (ECA), and endplate sagittal concave depth (ECD) on sagittal MRI. The association between intervertebral disc degeneration or herniation and endplate morphological measurements was analysed. RESULTS: In MRI, superior endplates (ie, inferior endplates of the superior vertebra) were concave and inferior endplates (ie, superior endplates of the inferior vertebra) were flat at all disc levels. A decrease in ECD and an increase in ECA were detected at all lumbar levels as disc degeneration increased (P < .05). At the L4-L5 and L5-S1 levels, a decrease in ECD and an increase in ECA were detected in the group with herniated lumbar discs (P < .05). There was no association between lumbar disc degeneration or herniation and endplate sagittal diameter at lumbar intervertebral levels (P > .05). At all levels, ECD of women was significantly lesser than that of men and ECA of women was significantly greater than that of men (P < .05). CONCLUSIONS: There is an association between vertebral endplate morphology and lumbar intervertebral disc degeneration. Vertebral endplates at the degenerated disc level become flat; the severity of this flattening is correlated with the degree of disc degeneration.

Functional evaluation of secondary renal amyloidosis with diffusion-weighted MR imaging.

OBJECTIVES: This study evaluated whether diffusion-weighted magnetic resonance imaging (DW-MRI) can be used to diagnose secondary renal amyloidosis looking specifically at the diagnostic efficacy of two apparent diffusion coefficient (ADC) measurement methods as they were used with DW-MRI. METHODS: The study included 24 amyloid nephropathy (AN) patients, 20 chronic kidney disease (CKD) patients, and 20 healthy volunteers (HV). ADC values were measured using two different methods: 1) the method of the region of interest indicators (ROIs) and 2) the method of drawing whole renal parenchyma (WP). The correlation between the two methods was evaluated. RESULTS: ROIs could differentiate AN-CKD (p = 0.007). ROIs and WP could differentiate AN-HV (p < 0.05). However, none of the methods could differentiate CKD-HV (p > 0.05). The sensitivity and specificity of the ROIs method in differentiating AN from CKD patients for 1.8 × 10(-3) cutoff ADC values were 79% and 60% and for AN-HV patients 79% and 70%. ADC values of AN patients with GFR > 60 mL/min were lower than that of HV (p < 0.01). CONCLUSION: DW-MRI is a useful and non-invasive diagnostic tool in diagnosing secondary renal amyloidosis and differentiating renal amyloidosis from other CKDs. ROIs had the highest sensitivity and specificity for assessing the involvement of renal amyloidosis. MRI diagnosis of AN may obviate a renal biopsy for diagnosis.

Diffusion-Weighted Mri of Postmenopausal Women with Vaginal Bleeding and Endometrial Thickening: Differentiation of Benign and Malignant Lesions.

PURPOSE: To investigate the feasibility of diffusion-weighted magnetic resonance imaging (DWI) with apparent diffusion coefficient (ADC) values in differentiating endometrial cancer from benign endometrial lesions in postmenopausal patients with vaginal bleeding and endometrial thickening and to predict the depth of myometrial invasion in endometrial cancer. MATERIALS AND METHODS: Postmenopausal patients with vaginal bleeding and endometrial thickening were enrolled in this prospective study. T2-weighted, pre- and postcontrast T1-weighted and diffusion-weighted images were obtained. The ADC values of all the patients with endometrial pathologies were recorded. The staging accuracies of DWI and postcontrast T1-weighted images in the assessment of myometrial invasion were evaluated in histopathologically proven endometrial cancer patients. RESULTS: Fifty-two patients (mean age: 57 ± 10, range: 41-79) were enrolled in the study. Thirty-eight of the lesions were benign (27 as hyperplasia and endometritis; 11 as polyps). Fourteen of the 52 endometrial lesions were pathologically proven as cancers and underwent hysterectomy, and all the specimens were reported as endometrioid adenocarcinomas. The mean ADC value (10-3 mm2/second) of cancer (0.88 ± 0.10) was significantly lower than that of benign lesions (1.78 ± 0.27, p = 0,001). There was no significant difference between ADC values of endometrial tissue in patients with FIGO stage 1A (0.87 ± 0.11, n = 9) and FIGO stage 1B (0.91 ± 0.07, n = 5). The staging accuracy was 92.9 per cent (13/14) for DWI and 85.7 per cent (12/14) for postcontrast T1-weighted images. CONCLUSION: ADC values allow benign endometrial lesions to be differentiated from endometrial cancer in postmenopausal patients but do not correlate with the depth of myometrial invasion and histological tumor grading.

Giant cemento-ossifying fibroma of the maxilla.

INTRODUCTION: Fibro-osseous lesions of the skull and facial bones are benign tumors, but they can be mistaken for malignant tumors due to their clinically aggressive behavior. Cemento-ossifying fibroma (COF) is a benign fibro-osseous lesion characterized by slow growth and fibrous and calcified tissue content. COFs are locally destructive lesions causing deformities in the bones. The recurrence risk is high if they are not completely removed. CASE REPORT: In this case report we describe a giant COF mimicking chondrosarcoma in the oral cavity of a 55-year-old woman causing significant facial deformity and feeding problems. CONCLUSIONS: Giant COF occurs rarely in the jaws and given that this lesion has similar imaging and clinical features to several other tumors, the diagnosis is always a challenge for clinicians, radiologists and pathologists.

Elevated neutrophil-to-lymphocyte ratio in Bell's palsy and its correlation with facial nerve enhancement on MRI.

OBJECTIVE: The aim of this study was to investigate the role of inflammation and atherothrombosis in Bell's palsy (BP) by using neutrophil-to-lymphocyte ratio (NLR) and mean platelet volume (MPV), respectively, and to study their relations with the facial nerve enhancement on temporal gadolinium-enhanced magnetic resonance imaging (TGd-MRI). STUDY DESIGN: Case control study. SETTING: Tertiary health institution. SUBJECTS AND METHODS: This study was performed on 65 patients who were diagnosed with BP and a control group of 35 healthy individuals. The BP patients were also divided into 2 groups, those with facial nerve enhancement on TGd-MRI and those without enhancement. The NLR and MPV of each group were compared. RESULTS: The NLRs of the BP patients were significantly higher than control group (P = .001). The NLRs of patients with facial nerve enhancement on TGd-MRI were significantly higher than patients without enhancement (P = .001). There was a positive and significant correlation between NLR and House-Brackmann (HB) grade of the patients (r = 0.641; P < .05). MPV did not show any significant correlation with any of the parameters studied (P > .05). CONCLUSION: NLR can be used as a new and important marker in BP since it is high in BP patients and significantly correlated with HB grade and facial nerve enhancement on TGd-MR. On the other hand, MPV does not have such correlations. These results offer evidence to support an inflammatory theory rather than microvascular response theory in the etiopatogenesis of BP.

Aneurysmal bone cyst of the calcaneus.

Aneurysmal bone cysts (ABCs) are benign, non-neoplastic, expansile, vascular, locally destructive lesions. The lesion may arise de novo (65%) or secondarily (35%) in pre-existing benign or malignant lesions (giant cell tumor, osteoblastoma, chondroblastoma, angioma, and others). The calcaneus is a rare localization for ABC, comprising only 1.6% of the cases. In this paper, we present a case of a female patient with a 3-month history of heel pain that got worse and was accompanied by swelling and difficulty in walking. The magnetic resonance images of the postero-lateral calcaneus showed a contrast-enhanced cystic lesion located in the medullary cavity; exophytic portion of the tumor extended into the soft tissue causing distinctive cortical thinning. Heterogeneous hyperintense septae formations and blood level components were also detected. After correlation with pathology results, the lesion was diagnosed as an ABC. Since an ABC of the calcaneus is a rarely seen phenomenon, we present the radiologic findings in this case and a review of the literature.

A rare cystic lesion of the neck: parathyroid cyst.

Parathyroid cysts are rarely observed neck masses. Their physical examination is not specific and preoperative diagnosis is usually difficult. Imaging findings and ultrasound-guided fine-needle aspiration with hormone analysis evaluation are important diagnostic criteria. A 48-year-old female patient admitted to our hospital with a symptom of swelling on the left side of the neck was diagnosed with parathyroid cyst by imaging methods (ultrasonography, MRI, parathyroid scintigraphy) and laboratory findings. Fine-needle aspiration biopsy was performed and because of relapse on the follow-up sclerotherapy was planned. Our aim in this study was to present the radiological findings of this case of parathyroid cyst.

Spinal inflammation by magnetic resonance imaging in patients with ankylosing spondylitis: association with disease activity and outcome parameters.

Magnetic resonance imaging (MRI) has major contribution in early diagnosis of ankylosing spondylitis (AS). As it is difficult to determine disease activity owing to the lack of close relation between laboratory tests, clinical findings and imaging, MRI has been used as an objective outcome measure. The aim of this study is to investigate the relation between spinal MRI findings with disease activity and other outcome measures. Fifty patients fulfilling modified New York criteria for AS were enrolled to the study. All the patients were evaluated with Bath AS Disease Activity Index (BASDAI), AS Disease Activity Score (ASDAS), Bath AS Functional Index (BASFI), Bath AS Metrology Index (BASMI), Bath AS Radiology Index (BASRI) and As Quality of Life. Erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP) were measured as laboratory parameters, and ASspiMR scores were determined by spinal MRI. The median total ASspiMR-a score was 5.2. Spinal inflammation was evaluated in spinal segments, and thoracic segments had the highest mean ASspiMR-a level (3.1 ± 5.94). Cervical and lumbar ASspiMR were correlated with only BASRI, and total ASspiMR score was correlated with BASRI, BASMI and CRP. Thoracic ASspiMR score was correlated with patient's and doctor's global assessments, BASFI, BASMI, BASRI, ASDAS A, ASDAS B, ASDAS C, ASDAS D, ESR and CRP (P < 0.05). According to our results, the thoracic spine was the most related region with disease activity parameters and clinical outcome measures, so we suggest thoracic spine MRI evaluation in order to determine the disease activity.

Congenital absence of the medial meniscus associated with lipoma arborescens.

Congenital abnormalities of the medial meniscus are extremely rare and have been reported commonly with other deformities. We report an isolated aplasia of the medial meniscus. A 37-year-old man presented with a slow-growing painless swelling, accompanied by intermittent effusion of his left knee. Magnetic resonance imaging demonstrated frond-like proliferations of fatty synovium. He was initially diagnosed with synovial chondromatosis, but later found to have lipoma arborescens. While an arthroscopic synovectomy was being performed, congenital absence of the medial meniscus was discovered as an incidental finding.

Evaluation of postoperative menisci with MR arthrography and routine conventional MRI.

OBJECTIVE: The diagnosis of a recurrent tear can be more difficult in the postoperative meniscus. The purpose of our study was to determine the accuracy of conventional magnetic resonance imaging (MRI) and MRI with intraarticular contrast material [magnetic resonance (MR) arthrography] for detecting recurrent meniscal tears after surgery. MATERIALS AND METHODS: Seventy-two patients who had arthroscopic surgery for meniscal tear and still got complaints were selected prospectively for MR arthrography and conventional MRI. Routine knee protocols with appropriate surface coil were used on 0.5 T MRI system. A 1:100 gadolinium-saline solution 30-40 ml was injected intraarticulary for MR arthrography. Of 72 patients, 45 had repeated arthroscopy for comparison of the results. The morphology of the meniscus as seen on MR images was characterized according to meniscal repair an the degree of meniscal resection into three groups. (1) less than 25% of the meniscal resection, (2) more than 25% meniscal resection, (3) meniscal repair. With routine conventional MR images, we grouped patients according to the signal intensity of menisci as Grade 1, Grade 2, Grade 3, and tear. RESULTS: The prevalence of recurrent meniscal tears in our study group was [68% (37/72 tears)]. In the diagnosis of recurrent meniscal tear, conventional MRI and MR arthrography had sensitivities of 54.0% and 94.5%, respectively; specificities of 75.0% and 87.5%, respectively; and accuracy of 57.7% and 93.4%, respectively. The accuracy of the conventional MRI studies was significantly less than that of the MR arthrography group (P<.05). CONCLUSION: Our study results indicate high overall accuracy for MR arthrography in the diagnosis of recurrent or residual meniscal tears. When meniscal resection is minimal, the right diagnosis could be obtained with conventional MRI. MR arthrography is necessary for patients with meniscal resection of more than 25% and who do not have sufficient joint effusion.

Dural sinus thrombosis following head injury: report of two cases and review of the literature.

Dural sinus thrombosis (DST) usually involves the sagittal, transverse and sigmoid sinuses and is more common in women due to pregnancy, puerperium and oral contraceptive use. Other etiologies include coagulopathies, infection and head injury. We have present two DST cases following head injury. The first case was a 35-year-old man hospitalized because of one-week history of headache and repeated vomiting after a mild head injury. Thrombosis of the superior sagittal sinus, right transverse and sigmoid sinuses and right jugular vein was determined on angiography. The second case was a 25- year-old man operated on for epidural hematoma at the posterior fossa. Meningitis developed and an abducens palsy was determined. Magnetic resonance imaging demonstrated thrombosis of the right transverse and sigmoid sinus. Low molecular weight heparin was administrated for three months. Both cases had good recovery, but one had recanalisation of the thrombosis. Intracranial hematomas, depressed skull fracture or skull fracture that cross the sinus can obstruct the blood flow in the sinus. Moreover, closed head injury may cause to DST. Because of undefinitive pathophysiology, a consensus was not obtained on overall strategy concerning conservative, radiosurgical, or surgical therapy yet.

Comparison of FSE T2W and 3D FIESTA sequences in the evaluation of posterior fossa cranial nerves with MR cisternography.

PURPOSE: The aim of this study was to compare 3D fast imaging with steady state acquisition (3D FIESTA) to fast spin echo T2-weighted (FSE T2W) MRI sequences in the imaging of cisternal parts of cranial nerves V-XII. MATERIALS AND METHODS: We retrospectively evaluated the temporal MRI sequences of 50 patients (F:M ratio, 27:23; mean age, 44.5 +/- 15.9 years) who were admitted to our hospital with vertigo, tinnitus, and hearing loss. In all, we evaluated 800 nerves. Two radiologists, working independently, divided the imaging findings into 3 groups: 0 (not visualized), 1 (partially visualized), and 2 (completely visualized). RESULTS: The rate of visualization of these cranial nerves with FSE T2W and 3D FIESTA sequences, respectively, (partially and completely visualized) were as follows: nerve V (100% and 100%); nerve VI (43% and 98%); nerve VII (100% and 100%); nerve VIII (100% and 100%); nerve IX-XI complex (67% and 100%); nerve XII (2% and 91%). CONCLUSION: 3D FIESTA sequences are superior to FSE T2W sequences in the imaging of cisternal parts of the posterior fossa nerves. 3D FIESTA sequences may be used for obtaining high-resolution MR cisternography images.