[Multiple sclerosis and new imaging methods]. / Sclerosis multiplex a niektoré nové zobrazovacie metódy.

UNLABELLED: BACKGROUND OF PROBLEM: The recognition of the power of MRI and CT to show the involvement of the central nervous system in multiple sclerosis, as well as in other neuropathological phenomena, stimulate considerably their use in the assessment of diagnosis. Much experience gained during the development and clinical application of imaging on the basis of magnetic resonance (MRI) justify the use of this method also in verification of the diagnosis of multiple sclerosis. The development and clinical application of specific pulse sequences and unconventional techniques as e.g. "magnetisation transfer imaging", and other new methods with greater resolution are used in applied research. Routine clinical examinations of the brain and spinal cord are performed especially by use of "dual echo spin images". Flair sequences are not always more significantly sensitive, however, they can provide surprisingly remarkable facts. SUBJECTIVES: The aim of this study is to support the firm or tentative clinical diagnosis of multiple sclerosis. METHODS AND MATERIAL: 131 patients with multiple sclerosis were hospitalized at our clinic and examined by use of computerised tomography (CT) and magnetic resonance (MRI). The results of these examinations confirmed firmly the diagnosis of multiple sclerosis in 98 patients. The tentative diagnosis assessed in 33 patients was not supported by MRI. The findings gained by brain examination were evaluated according to the conditions assessed by Fazekasz and American Multiple Sclerosis Association. Examinations were performed by Signa Contour 0.5 Tesla magnetic resonance on transverse planes, and on sagital planes in T1 VO and T2 VO. RESULTS: During the initial period (1995-1996), CT examination of the brain was performed in 16 patients with firm diagnosis of multiple sclerosis, out of whom only 24% had the pathological periventricular finding within the white matter. Therefore, a majority of patients were subdued to MRI. In these patients, the characteristic finding of hyperintensive lesions were found within T2 VO. They were situated within periventricular white matter as well as in cerebellum, and in 24 patients they were located within the cervical part of the spinal cord. The patients forming the latter group had severe neurologic findings, and ranged 4-9 of the Kurtzke scale. MRI enabled to assess the diagnosis of multiple sclerosis in all patients. Out of the group of 33 patients, only 2 were subdued to CT of the brain. Their findings did not yield any changes in shape of brain tissue structures. MRI findings in these patients did not verify the diagnosis of multiple sclerosis sufficiently. The neurological findings were not pronounced, achieving the 1-3 degree of Kurtzke scale. CONCLUSION: Current techniques of CNS imaging, either by use of computerised tomography of MRI do not enable the assessment of the firm diagnosis of multiple sclerosis to full extent. MRI is capable only of supporting it. (Ref. 7.)

[Imaging methods in the diagnosis of acute cerebrovascular stroke]. / Príspevok zobrazovacích metód k diagnóze náhlej cievnej mozgovej príhody.

The authors emphasize the possibilities of some new imaging methods in the diagnosis of acute cerebrovascular attacks, i.e. methods used under local conditions: differentiation of intracranial haemorrhage in case of a haematoma in the area of a ruptured aneurysm, blood in the subarachnoidal space in subarachnoid haemorrhage. To differentiate a tumour decompensated by the vascular route. It is known that imaging by computed tomography. Imaging on the basis of magnetic resonance in the diagnosis of acute, subacute and chronic infarction has some specific features. It was revealed that also magnetic resonance angiography can be an asset, in particular when major vessels are affected. Classical intervention angiography still is useful in acute cerebrovascular attacks as well as in the diagnosis of cerebral death.

[The spinal canal, dural sac and spinal cord on cervical myelograms. Possibilities of quantification using a computer]. / Spinálny kanál, durálny vak a miecha na cervikálnych myelogramoch. Moznosti kvantifikácie pomocou pocítaca.

The objective of the presented work was to investigate anatomical structures of the cervial spine and their interrelations on cervical myelograms in a neutral position and in retroflexion. Cervical myelograms were made in 34 patients from a lateral approach between the first and second vertebra. In a neutral position and in retroflexion the relations of the dural sac and spinal canal were investigated in 26 subjects with a normal antero-posterior diameter of the spinal canal and in eight patients with congenital stenosis of the spinal canal. Quantification by means of a computer revealed that in retroflexion the antero-posterior diameters of the dural sac diminishes significantly in subjects with a normal antero-posterior diameter of the spinal canal as well as in subjects with congenital stenosis of the spinal canal. Moreover, the authors provided evidence that the area of the dural sac diminishes significantly in retroflexion, as compared with the neutral position in subjects with a normal spinal canal as well as in subjects with congenital stenosis of the spinal canal.

[Specific aspects of mobility and changes in the shape of the dural sac in functional lumbosacral myelography]. / Niektoré specifiká pohyblivosti a zmien tvaru durálneho vaku pri funkcnej lumbosakrálnej myelografii.

The purpose of the work was an analysis of lateral myelograms of the lumbosacral spine in the neutral position, in anteflexion and retroflexion from the aspect of the mobility of the dural sac and its relationship to the spinal canal. The group comprised 50 patients with clinically obvious discopathies and other vertebrogenic syndromes. The areas of the dural sac were measured planimetrically and evaluated by means of a computer. It was revealed: 1. The Soinal canal and dural sac are not static variables but dynamic ones. By movements of the lumbosacral spine the size of the dural sac changes and so does its shape. These phenomena can be evaluated not only qualitatively but also quantitatively. 2. The anteroposterior diameter of the dural sac on the myelograms in anteflexion and in retroflexion changes significantly, as compared with the neutral position, it increases during anteflexion and diminishes during retroflexion. 3. The area of the dural sac increases during anteflexion and diminishes in retroflexion, as compared with the neutral position. 4. Changes in the shape of the dorsal portion of the dural sac revealed in the segment of the discopathy are considered to be due to hypertrophy of the yellow ligaments.

[An unusual CT image of an ischemic focus]. / Neobvyklý CT obraz ischemického loziska.

In a 39-year-old man with focal cerebral ischaemia an uncommon CT picture of an ischaemic focus is described. The first CT examination was made two weeks after the development of the disease. After administration of the contrast substance an increased density along the fronte-parietal gyrification was detected. The finding was not typical for an ischaemic lesion. Two weeks after the first CT examination the examination was repeated. After administration of the contrast substance only at some sites the original increased density along the gyrification was found.

[Venous angiomas of the brain. Retrospective study of angiograms and clinical material]. / Venózne angiómy mozgu. Retrospektívna stúdia angiogramov a klinického materiálu.

The aim of the investigation was to reveal the existence of venous angiomas of the brain by serioangiography in selected neurological diseases and to test the possible connection between the angiographic finding of a VA and neurological symptomatology. The material was formed by 386 serioangiograms in patients with subarachnoid haemorrhage, intracerebral haemorrhage, focal epilepsy and unilateral headache. It was revealed that from the total number of mentioned diagnoses there were 18 venous angiomas, i.e. 4.66%. Intracerebral haemorrhage and unilateral headache were most frequent (7.3% and 9%). No difference was found between the right and left hemisphere and between different brain areas. Cerebral angiography remains an important method in the diagnosis of venous angiomas of the brain, provided a satisfactory programme and high quality material are used. Examination by computed tomography without a contrast is of little diagnostic value, the use of contrast in computer tomography can improve the diagnosis.