Teleradiology: experiences with magnetic resonance imaging using this new technology.

Teleradiology, a term encompassing electronic transmission of images for interpretation, is becoming an important part of telemedicine. Telemedicine is an exciting new electronic means of distributing specific medical knowledge by computer network. Teleradiology allows healthcare providers in locations that previously might not have had this service to access the use of radiology specialists and subspecialists. The combination of more efficiency in interpretation and the availability of high-quality imaging equipment to rural areas will be even more important in the future. The current concepts of teleradiology are discussed, as well as the findings of the authors' investigation of accuracy and agreement of interpretations of magnetic resonance imaging examinations.

Basimeningeal/spinal axis primitive neuroectodermal tumor without intraaxial lesion: radiological features.

Over a 12-year period, the authors encountered 2 patients with spinal axis/basimeningeal primitive neuroectodermal tumor (PNET) involving the spinal axis extramedullary, intradural compartment and the basimeninges. In neither patient was an intraaxial focus demonstrated. A 48-year-old woman had computed tomography (CT) findings of hydrocephalus and later abnormal basimeningeal enhancement. Cervical myelography revealed a low cervical intradural block. A 10-year-old boy was evaluated initially with non-contrast-enhanced CT of the brain, which revealed hydrocephalus. Contrast-enhanced CT revealed abnormal basimeningeal enhancement implicating cisternal obstruction. Subsequent magnetic resonance examination of the entire spine with and without gadolinium enhancement revealed diffuse abnormal enhancement of the spinal axis intradural, extramedullary compartment. While intraaxial PNETs are well recognized, the patients described here represent a distinctly unusual pattern of intradural spinal meningeal and basimeningeal infiltration by PNET in the absence of a demonstrable intraaxial lesion.

Epidural mass related to calvarial aneurysmal bone cyst: computed tomographic and magnetic resonance demonstration.

The computed tomographic and magnetic resonance appearance of a calvarial aneurysmal bone cyst is described. Both forms of imaging demonstrate an epidural mass in the right occiput. The fluid-fluid levels in the mass on the T2-weighted images are characteristic of, though not specific for, aneurysmal bone cyst.

Brain metastases from primary lung malignant fibrous histiocytoma: a case report.

Primary malignant fibrous histiocytomas are rare. The authors report on a 56-year-old man who presented with neurological symptoms due to cerebral metastasis of a primary malignant fibrous histiocytoma of the lung.

Desmoplastic infantile ganglioglioma: CT and MRI features.

We present three cases of desmoplastic infantile ganglioglioma in patients admitted to our institution in the past 8 years. CT and MR findings are discussed. Typically, these lesions are located in the frontal and parietal lobes, appearing as cystic tumors with a solid cortical component within the cerebrum, which enhances intensely, and moderate surrounding edema.

Posttraumatic cutaneous meningioma of the face.

We present the CT and MR features of a posttraumatic cutaneous meningioma of the face. We postulate that the patient's trauma and associated skull fracture resulted in a trapping of extracranial meningeal tissue, which many years later gave rise to a secondary facial meningioma.

Anterior communicating artery aneurysm rupture: an unusual cause of acute subdural hemorrhage.

A case of acute subdural hemorrhage caused by rupture of an anterior communicating artery aneurysm is presented. The patient is a young man who presented with an acute onset of neurologic symptoms; computed tomography revealed subdural hemorrhage in the absence of associated subarachnoid or intraparenchymal bleeding.

Kallmann syndrome: MR findings.

PURPOSE: To evaluate patients with known hypogonadotropic hypogonadism, some with known anosmia, for defective rhinocephalon development that resulted in olfactory tract abnormalities, an affliction known as Kallmann syndrome. METHODS: Six patients who clinically had hypogonadotropic hypogonadism were examined by MR. Thin coronal images of the interior frontal region were used to determine presence or absence of olfactory tract and to evaluate the olfactory sulci. RESULTS: Olfactory tracts were not seen in three of the six cases; two of which had hypoplastic olfactory sulci. CONCLUSIONS: T1-weighted MR examination of the inferior frontal region in the coronal plane can help determine whether a patient with hypogonadotropic hypogonadism, with or without clinically evident anosmia, is afflicted with Kallmann syndrome.

Magnetic resonance angiography.

OBJECTIVE: To outline the physical principles of magnetic resonance angiography (MRA), major current MRA techniques, clinical indications and some of the limitations of MRA. The rapidly changing nature of MRA techniques is stressed. DATA SOURCES AND DATA EXTRACTION: The MRA literature for the last eight years is reviewed with particular attention to the changing clinical role of MRA. Details of specific MRA techniques are omitted for simplicity and because of their lack of direct relevance to the clinicians requesting MRA examinations. Data concerning the clinical role of MRA techniques are extracted from the literature and combined with our own clinical experience. DATA SYNTHESIS: While stressing the rapidly changing nature of this new investigational technique, we find that MRA has a number of current roles in patient management. CONCLUSIONS: MRA is currently a useful investigation and will in all likelihood become more useful in the future as the technique improves further and becomes more available.

Gd-DTPA enhanced MRI of cervical anterior epidural venous plexus.

Seventy selected cases were reviewed retrospectively to assess the normal Gd-DTPA enhanced MR appearance of the cervical anterior epidural venous plexus. This structure can enhance quite markedly and has a somewhat variable appearance on MR imaging but we believe that it can be differentiated from pathological enhancement in the area if attention is paid to its normal anatomical characteristics.

Schizencephaly: case report of familial incidence.

Two half-siblings with schizencephaly are presented. They have the same mother who had a normal cerebral imaging study. Only one other kindred was found in which 2 siblings had this cerebral lesion. In the present patients, autosomal inheritance from the mother is possible, but other explanations should include familial, as well as genetic, factors. Family counseling should stress the sporadic nature of this entity but a recurrence in the same sibship is possible. Details of the clinical and magnetic resonance imaging studies are presented.

Cerebellar T-cell lymphoma: an unusual primary intracranial neoplasm.

Primary T-cell lymphoma within the central nervous system is extremely rare. Imaging characteristics appear indistinguishable from the more common B-cell lymphoma. A case of such a primary tumor is discussed and the MRI and CT findings presented.

Magnetic resonance imaging of acute symptomatic Schmorl's node formation.

The intraspongious herniation of intervertebral disk material into the endplate of a vertebral body was first described by Schmorl in 1927. Any process which weakens the cartilaginous endplate or the subchondral cancellous bone may predispose to the development of Schmorl's nodes. These include Scheuermann's disease, infection, metabolic disorders, neoplastic disorders, and degenerative disease. In the young individual, however, trauma may precipitate an acute focal and symptomatic endplate herniation by the well-hydrated and delineated nucleus pulposus. Magnetic resonance imaging (MRI) is the most sensitive imaging method for the detection of intervertebral disk disease and, thus, has facilitated the diagnosis of traumatic Schmorl's nodes. MRI was very helpful in diagnosing an acute, traumatic, symptomatic Schmorl's node when plain film radiographs and nuclear medicine bone scan were unremarkable.