| 1. |
- Abul-Kasim, Kasim, et al.
(författare)
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Perfusion weighted MR imaging may differentiate primary CNS-lymphoma from other homogeneously enhancing brain tumors.
- 2008
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Ingår i: The Neuroradiology Journal. - 1971-4009. ; 21:5, s. 637-644
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Tidskriftsartikel (refereegranskat)abstract
- Primary central nervous system lymphoma (PCNSL), glioblastoma multiforme (GBM) and metastases may be difficult to differentiate based on conventional imaging alone. The aim of this study was to investigate the value of perfusion weighted imaging (PWI) in differentiating homogeneously enhancing PCNSL from homogeneously enhancing GBM and metastases. Seven consecutive patients presenting with homogeneously enhancing intraaxial tumors on MRI were retrospectively analyzed. All seven patients (three immunocompetent patients with PCNSL, three with GBM, and one with cerebral metastases) were examined with identical MR-sequences including PWI. The relative regional Cerebral Blood Volume (rrCBV) and the rrCBV ratio (rrCBVratio) were calculated. In lymphomas rrCBVratio was 0.93 ± 0.42 (mean ± SD) compared with 7.93 ± 1.44 in GBM and metastases. All lymphomas had rrCBVratio < 1.43 while all GBM and metastases had rrCBVratio > 1.43 (Fischer exact test; p < 0.001). PWI may be a valuable method in differentiating homogenously enhancing PCNSL from GBM and metastases.
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| 2. |
- Abul-Kasim, Kasim, et al.
(författare)
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Vertebral Hemangiomas : Prevalence, New Classification and Natural History. Magnetic Resonance Imaging-Based Retrospective Longitudinal Study
- 2023
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Ingår i: Neuroradiology Journal. - : SAGE Publications. - 1971-4009 .- 2385-1996. ; 36:1, s. 23-30
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Tidskriftsartikel (refereegranskat)abstract
- Background and purpose: To determine the prevalence of vertebral hemangiomas (VHs), establish a new classification of VHs based on their MRI-signal pattern, and study their natural history. Methods: MRI of 1000 consecutive patients who underwent at least two MRI with an interval of at least 3 years. Growth rate and change of MRI-signal pattern during the follow-up period were the parameters included in studying the natural history of VHs. Results: The prevalence of VHs was 41%. VHs were classified as type I–IV with fat-rich VHs (type I), constituted 79% of all VHs. VHs were more common among females 43% versus males 39%, p =.22. The most affected vertebra was L1. Occurrence rates for cervical (1%), thoracic (7%), and lumbar spine (10%) differed significantly (p <.001). The prevalence of VHs increased with age regardless of gender or spinal part involved (p <.001). Only 26% of VHs changed their size and 4% changed their signal during the average follow-up of 7 years. All VHs were slowly growing lesions (average expected growth of <3 mm/10 years). No significant difference between growth rate of VHs type I (0.25 mm/year) and other types of VHs. None of the VHs that were initially reported as “metastases cannot be rule out” showed alarming change in signal or size. Conclusions: VH can be classified into four types based on their MRI-signal pattern. Regardless of their type, VHs are slowly growing lesions. The presence of typical morphological pattern should enable radiologists to confidently differentiate them from vertebral metastases.
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| 3. |
- Bashir, A, et al.
(författare)
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Intra-arterial nimodipine for cerebral vasospasm after subarachnoid haemorrhage: Influence on clinical course and predictors of clinical outcome
- 2016
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Ingår i: The neuroradiology journal. - : SAGE Publications. - 1971-4009 .- 2385-1996. ; 29:1, s. 72-81
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Tidskriftsartikel (refereegranskat)abstract
- Intra-arterial nimodipine (IAN) has shown a promising effect on cerebral vasospasm (CV) after aneurysmal subarachnoid haemorrhage. At our institution, Rigshospitalet, IAN treatment has been used since 2009, but the short- and long-term clinical efficacy of IAN has not yet been assessed. The purpose was to evaluate the efficacy and clinical outcome of IAN treatment of symptomatic CV, and to assess the predictors of clinical outcome. Medical records of 25 patients undergoing a total of 41 IAN treatment sessions were retrospectively reviewed. Data on angiographic results, blood-flow velocities and the clinical condition before and after the IAN treatment were recorded. Predictors of the clinical outcome were assessed with a linear regression model. Positive angiographic response was achieved in 95.1% of 41 IAN treatment sessions. Flow-velocity measurements showed no relationship with angiographic responses of IAN. The immediate clinical improvement was observed in three patients (12%). Five patients (20%) had a favourable outcome at discharge and at three-month follow-up; 10 patients (40%) had a moderate to poor outcome; and the rest (40%) died. Increased number of affected vessels and number of procedures carried out per patient, and a trend toward an increased delay time from symptomatic CV to confirming angiographic CV and thus instituting IAN treatment predicted the poor clinical outcome. IAN treatment appears to be effective in reversing angiographic CV. However, it is not always effective in reversing clinical deterioration, as several other factors including treatment delay affect the clinical course.
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| 4. |
- Delgado, Anna Falk, et al.
(författare)
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Neuroimaging lesion assessment by pseudo-subtraction of overlaid semi-transparent volumes : A technical description and feasibility series
- 2021
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Ingår i: The Neuroradiology Journal. - : Sage Publications. - 1971-4009 .- 2385-1996. ; 34:2, s. 128-130
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Tidskriftsartikel (refereegranskat)abstract
- Assessing and reporting clinical images constitutes the mainstay of clinical neuroradiology. Continually increasing numbers of neuroradiology referrals and follow-up examinations call for reproducible, accurate, and rapid workflows. Readily available and easy to use, advanced workstation tools such as co-registration of volume series can be used to overlay volume series from two different time points as semi-transparent images, with an inverse color scale. By overlaying semi-transparent inverse color maps, stationary findings will be shaded out in grey, whereas progressing or regressing lesions will be highlighted as white or black in the resulting pseudo-subtraction map. Pseudosubtraction in longitudinal neuroradiology imaging might enhance workflow and imaging assessment.
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| 5. |
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| 6. |
- Samuelsson, Jennifer, et al.
(författare)
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Intra-arterial nimodipine for severe cerebral vasospasm after aneurysmal subarachnoid haemorrhage - neurological and radiological outcome.
- 2022
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Ingår i: The neuroradiology journal. - : SAGE Publications. - 2385-1996 .- 1971-4009. ; 35:2, s. 213-219
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Tidskriftsartikel (refereegranskat)abstract
- Cerebral vasospasm is a known complication to aneurysmal subarachnoid haemorrhage, which can lead to severe morbidity. Intra-arterial vasodilation therapy is widely used as a last resort treatment in patients with symptomatic refractory cerebral vasospasm but there is limited data about the outcome. The purpose of this study is to evaluate the neurological and radiological outcome in patients treated with intra-arterial nimodipine in relation to cerebral infarction, procedure-related complications and clinical outcome.Patients with refractory cerebral vasospasm treated with intra-arterial nimodipine during 2009-2020 at Sahlgrenska University Hospital were retrospectively reviewed. Neurological outcome (modified Rankin Scale) at 30 days and 6 months, development of cerebral infarction after intra-arterial nimodipine treatment and procedure-related complications were studied.Forty-eight patients were treated with intra-arterial nimodipine. A good outcome (modified Rankin Scale 0-2) was seen in 25% (n=12) of the patients after 30 days and in 47% (n=22) of the patients after six months. Infarction related to the vasospastic vessel after treatment with intra-arterial nimodipine was seen in 60% (n=29) of the patients. A total of 124 procedures with intra-arterial nimodipine were performed where complications were seen in 10 (21%) patients in 10 (8%) procedures. Four (8%) patients died within 30 days.A majority of patients developed an ischaemic cerebral infarction in spite of intra-arterial nimodipine treatment. However, a good clinical recovery was seen in almost half of the patients after 6 months. Minor complications occurred in one out of five patients.
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