TY - JOUR. T1 - Signal polarity restoration in a 3D inversion recovery sequence used with delayed gadolinium-enhanced magnetic resonance imaging of cartilage (dGEMRIC). AU - Szumowski, Jerzy. AU - Durkan, Michael G.. AU - Foss, Erik W.. AU - Brown, Dawson S.. AU - Schwarz, Erwin. AU - Crawford, Dennis C.. PY - 2012/11/1. Y1 - 2012/11/1. N2 - Purpose: To develop an image reconstruction algorithm that restores the signal polarity in a three-dimensional inversion-recovery (3D-IR) sequence used in delayed gadolinium-enhanced MRI of cartilage (dGEMRIC). This approach effectively doubles the dynamic range of data used for T1 curve fitting. Materials and Methods: We applied this reconstruction algorithm to a 3D-IR TFE sequence used for T1 mapping, validated the technique in a phantom study, and performed T1-map calculations in postosteochondral allograft transplant (OAT) patients. In addition, we performed a signal simulation study to assess the algorithms capability to reduce the number of inversion ...
Differential diagnosis of ovarian cystadenofibromas should include stromal ovarian tumors with fibrous component, struma ovarri, ovarian metastases and endometriomas. Ovarian tumors with fibrous parts, including fibroma, fibrothecoma and Brenner tumor often present with a predominantly solid component of low signal intensity on T2-weighted images [7, 11, 12]. Struma ovarri has been described as multilocular ovarian mass, with variable signal intensity of the cystic parts and coexistence of hypointense areas on T2-weighted images, due to the presence of viscous colloid material [15, 16]. Ovarian metastases with a rich fibrous component, usually originating from the gastrointestinal tract often have areas of low signal intensity on T2-weighted images and display strong enhancement after contrast material administration [17 ...
Prostate cancer (PCa) patients receive androgen-deprivation therapy (ADT) to reduce tumor burden. However, complete eradication of PCa is unusual, and recurrent disease is evident within approximately 2 years in high-risk patients. Clinical evidence suggests that combining ADT with radiotherapy improves local control and disease-free survival in these patients compared with radiotherapy alone. We investigated whether vascularization of androgen-sensitive PCa xenografts changed after ADT and whether such therapy affected radiation response. CWR22 xenografts received combinations of ADT by castration (CWR22-cas) and 15 Gy of single-dose irradiation. At a shortest tumor diameter of 8 mm, vascularization was visualized by dynamic contrast-enhanced magnetic resonance imaging before radiation and 1 and 9 days after radiation. Voxel-wise quantitative modeling of contrast enhancement curves extracted the hemodynamic parameter Ktrans, reflecting a combination of permeability, density, and blood flow. ...
Examples of coronal cUS and axial MR images performed during the first week after birth in infants presenting with neonatal seizures. (A) HIE: hyperechogenicity in both thalami on cUS and low signal intensity on the ADC map in thalami, optic radiation and splenium of the corpus callosum (D); (B) PAIS of main branch of the left-middle cerebral artery: wedge-shaped hyperechogenicity with a linear demarcation line in the left hemisphere on cUS and low signal intensity on the ADC map in territory of the left-middle cerebral artery, as well as optic radiation and splenium of the corpus callosum (E); (C) haemorrhage in the right temporal lobe recognised on cUS as a round area of hyperechogenicity and on T2WI as an area of low signal intensity surrounded by high signal intensity due to oedema (F).. ...
White matter hyperintensities (WMH) of presumed vascular origin, as seen on T2-weighted fluid attenuated inversion recovery magnetic resonance imaging, are known to increase with age and are elevated in Alzheimers disease (AD). The cognitive implications of these common markers are not well understood. Previous research has primarily focused on global measures of WMH burden and broad localizations that contain multiple white matter tracts. The aims of this study were to determine the pattern of WMH accumulation with age, risk for AD, and the relationship with cognitive function utilizing a voxel-wise analysis capable of identifying specific white matter regions. A total of 349 participants underwent T1-weighted and high-resolution T2-weighted fluid attenuated inversion recovery magnetic resonance imaging and neuropsychological testing. Increasing age and lower cognitive speed and flexibility (a component of executive function), were both significantly associated with regional WMH throughout the ...
By EDWARD F. JACKSON, PhD. One key advantage of MR is the wide range of intrinsic tissue properties that can be assessed by the appropriate choice of parameters defining the associated measurement technique.. In neuroimaging applications, for example, routine MR imaging provides a qualitative means of assessing the breakdown of the blood brain barrier as reflected by the extent of gadolinium contrast agent extravasation (T1-weighted sequences), the extent of vasogenic edema (T2-weighted and T2-weighted fluid attenuated inversion recovery sequences), the presence of blood products such as hemosiderin, methemoglobin (T1-weighted and T2* susceptibility-weighted images), and the ability to assess brain atrophy and regional white/gray matter abnormalities (using proton density-weighted and/or magnetization prepared gradient-echo sequences).. Neurovascular anatomy can be evaluated with or without the injection of exogenous contrast agents (using time-of-flight and/or phase-contrast MR angiography ...
We hypothesized that pediatric patients with type 1 diabetes have cardiac magnetic resonance (CMR) detectable differences in thoracic aortic wall properties and hemodynamics leading to significant local differences in indices of wall shear stress, when compared with age-matched control subjects without diabetes. Pediatric patients with type 1 diabetes were recruited from Childrens Hospital of Wisconsin and compared with controls. All underwent morning CMR scanning, 4-limb blood pressure, brachial artery reactivity testing, and venipuncture. Patient-specific computational fluid dynamics modeling with fluid-structure interaction, based on CMR data, determined regional time-averaged wall shear stress (TAWSS) and oscillatory shear index (OSI). Twenty type 1 diabetic subjects, median age 15.8 years (11.6-18.4) and 8 controls 15.4 years (10.3-18.2) were similar except for higher glucose, hemoglobin A1c, and triglycerides for type 1 diabetic subjects. Lower flow-mediated dilation was seen for those with type
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A) Diffusion tensor imaging (DTI) demonstrates a clear U-fibre density reduction in the left frontal area, illustrated by high signal in the colour scale. (B) Three-dimensional reconstructed brain surface created by coregistration of preoperative MRI and post-implantation CT shows placement of intracranial depth electrodes on the left hemisphere. Electrode 1 represents the innermost contact; A1-A12: left superior frontal gyrus (frontobasal, anterior); B1-B8: left superior frontal gyrus (frontobasal); C1-C10: left superior frontal gyrus (medial); D1-D8: left superior frontal gyrus (posterior); E1-E12: left middle frontal gyrus (anterior); F1-F8: left middle frontal gyrus (posterior); G1-G8: left inferior frontal gyrus; H1-H8: left anterior insula; J1-J6: left posterior insula; K1-K8: left anterior temporal lobe; L1-11: right superior frontal gyrus (frontobasal); and M1-12: right middle frontal gyrus. (C) Results of extraoperative electrical stimulation mapping (monopolar stimulation was performed ...
Background: The monoclonal antibody, C595, against breast cancer cell line was conjugated with cyclic anhydride gadolinium-diethylenetriaminepenta-acetic acid (Gd-cDTPAa) to produce Gd-DTPA-C595 and used as specific breast cancer cell line (MCF-7) contrast agents in magnetic resonance imaging (MRI). Methods: After incubation of breast cancer cell line (MCF-7), with different contrast agents ...
Finite element models have become more sophisticated in both detail and their ability to predict human responses to various loading conditions. More
TY - JOUR. T1 - Functional brain mapping by blood oxygenation level-dependent contrast magnetic resonance imaging. A comparison of signal characteristics with a biophysical model. AU - Ogawa, S.. AU - Menon, R. S.. AU - Tank, D. W.. AU - Kim, S. G.. AU - Merkle, H.. AU - Ellermann, J. M.. AU - Ugurbil, K.. PY - 1993. Y1 - 1993. N2 - It recently has been demonstrated that magnetic resonance imaging can be used to map changes in brain hemodynamics produced by human mental operations. One method under development relies on blood oxygenation level-dependent (BOLD) contrast: a change in the signal strength of brain water protons produced by the paramagnetic effects of venous blood deoxyhemoglobin. Here we discuss the basic quantitative features of the observed BOLD-based signal changes, including the signal amplitude and its magnetic field dependence and dynamic effects such as a pronounced oscillatory pattern that is induced in the signal from primary visual cortex during photic stimulation ...
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BACKGROUND:Diabetes is a major risk factor for cardiovascular disease. In particular, type 1 diabetes compromises the cardiac function of individuals at a relatively early age due to the protracted course of abnormal glucose homeostasis. The functional abnormalities of diabetic myocardium have been attributed to the pathological changes of diabetic cardiomyopathy.METHODS:In this study, we used high field magnetic resonance imaging (MRI) to evaluate the left ventricular functional characteristics of streptozotocin treated diabetic Sprague-Dawley rats (8 weeks disease duration) in comparison with age/sex matched controls.RESULTS:Our analyses of EKG gated cardiac MRI scans of the left ventricle showed a 28% decrease in the end-diastolic volume and 10% increase in the end-systolic volume of diabetic hearts compared to controls. Mean stroke volume and ejection fraction in diabetic rats were decreased (48% and 28%, respectively) compared to controls. Further, dV/dt changes were suggestive of phase ...
Magnetic resonance images (MRI) of the brain revealed an intrasellar and suprasellar cystic mass with well defined smooth borders, which displaced the optic chiasm superiorly. The lesion displayed high signal intensity on T1 weighted images (Images 1a and 1b, sagittal and axial, respectively) and showed peripheral enhancement with Gadolinium administration (Image 1c). The lesion also showed high signal intensity on T2 weighted images (Image 1d). A previous brain MRI from 1991 did not reveal sellar or suprasellar lesions. PATHOLOGICAL FINDINGS. FINAL DIAGNOSIS. ...
TY - JOUR. T1 - Diffusion and perfusion MRI findings of the signal-intensity abnormalities of brain associated with developmental venous anomaly. AU - Jung, H. N.. AU - Kim, Sung Tae. AU - Cha, J.. AU - Kim, H. J.. AU - Byun, H. S.. AU - Jeon, P.. AU - Kim, K. H.. AU - Kim, B. J.. AU - Kim, H. J.. PY - 2014/8. Y1 - 2014/8. N2 - BACKGROUND AND PURPOSE: Developmental venous anomalies are the most common intracranial vascular malformation. Increased signal-intensity on T2-FLAIR images in the areas drained by developmental venous anomalies are encountered occasionally on brain imaging studies. We evaluated diffusion and perfusion MR imaging findings of the abnormally high signal intensity associated with developmental venous anomalies to describe their pathophysiologic nature. MATERIALS AND METHODS: We retrospectively reviewed imaging findings of 34 subjects with signal-intensity abnormalities associated with developmental venous anomalies. All subjects underwent brain MR imaging with contrast and ...
BACKGROUND:Maintaining the quality of magnetic resonance images acquired with the current implantable coil technology is challenging in longitudinal studies. To overcome this challenge, the principle of inductive overcoupling is introduced as a method to tune and match a dual coil system. This system consists of an imaging coil built with fixed electrical elements and a matching coil equipped with tuning and matching capabilities. Overcoupling here refers to the condition beyond which the peak of the current in the imaging coil splits.METHODS:The combined coils are coupled inductively to operate like a transformer. Each coil circuit is electrically represented by equivalent lumped-elements. A theoretical analysis is given to identify the frequency response characteristics of the currents in each coil. The predictions from this analysis are translated into experiments and applied to locally image rat spinal cord at 9.4 T using an implantable coil as the imaging coil and an external volume coil ...
OBJECTIVES: Our goal was to validate myocardium at risk on T2-weighted short tau inversion recovery (T2-STIR) cardiac magnetic resonance (CMR) over time, compared with that seen with perfusion single-photon emission computed tomography (SPECT) in patients with ST-segment elevation myocardial infarction, and to assess the amount of salvaged myocardium after 1 week. BACKGROUND: To assess reperfusion therapy, it is necessary to determine how much myocardium is salvaged by measuring the final infarct size in relation to the initial myocardium at risk of the left ventricle (LV). METHODS: Sixteen patients with first-time ST-segment elevation myocardial infarction received (99m)Tc tetrofosmin before primary percutaneous coronary intervention. SPECT was performed within 4 h and T2-STIR CMR within 1 day, 1 week, 6 weeks, and 6 months. At 1 week, patients were injected with a gadolinium-based contrast agent for quantification of infarct size. RESULTS: Myocardium at risk at occlusion on SPECT was 33 +/- ...
Lactating rats must continuously maintain a critical balance between caring for pups and aggressively responding to nest threats. We tested the neural response of lactating females to the presentation of their own pups and novel intruder males using blood oxygen level-dependent functional magnetic resonance imaging at 7 T. Dams were presented with a single sequence of a control stimulus, pups or a male intruder in one imaging session (n = 7-9). To further determine the selectivity of neural processing, dams were imaged for their response to a male intruder in both the absence and presence of their pups (n = 6). Several maternal cortical and limbic brain regions were significantly activated by intruder presentation but not by pups or a control stimulus. These included the nucleus accumbens, periaqueductal gray, anterior cingulate, anterior thalamus, basal nucleus of the amygdala, temporal cortex, prelimbic/orbital area and insula. The nucleus accumbens, periaqueductal gray, temporal cortex and
TY - JOUR. T1 - Resting-state functional connectivity magnetic resonance imaging and outcome after acute stroke. AU - Puig, Josep. AU - Blasco, Gerard. AU - Alberich-Bayarri, Angel. AU - Schlaug, Gottfried. AU - Deco, Gustavo. AU - Biarnes, Carles. AU - Navas-Martí, Marian. AU - Rivero, Mireia. AU - Gich, Jordi. AU - Figueras, Jaume. AU - Torres, Cristina. AU - Daunis-I-Estadella, Pepus. AU - Oramas-Requejo, Celia L.. AU - Serena, Joaquín. AU - Stinear, Cathy M.. AU - Kuceyeski, Amy. AU - Soriano-Mas, Carles. AU - Thomalla, Götz. AU - Essig, Marco. AU - Figley, Chase R.. AU - Menon, Bijoy. AU - Demchuk, Andrew. AU - Nael, Kambiz. AU - Wintermark, Max. AU - Liebeskind, David S.. AU - Pedraza, Salvador. PY - 2018/1/1. Y1 - 2018/1/1. N2 - © 2018 American Heart Association, Inc. Background and Purpose: Physiological effects of stroke are best assessed over entire brain networks rather than just focally at the site of structural damage. Resting-state functional magnetic resonance imaging can map ...
In animal models of Parkinsons disease (PD), 1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine (MPTP) is one of the most widely used agents that damages the nigrostriatal dopaminergic pathway. However, brain structural changes in response to MPTP remain unclear. This study aimed to investigate in vivo longitudinal changes in gray matter (GM) volume and white matter (WM) microstructure in primate models administered with MPTP. In six cynomolgus monkeys, high-resolution magnetic resonance imaging (MRI) and diffusion tensor imaging (DTI) scans were acquired 7 times over 32 weeks, and assessments of motor symptoms were conducted over 15 months, before and after the MPTP injection ...
A new method of detecting structured changes in trabecular bone, such as those associated with osteoporosis, was evaluated on magnetic resonance images of the wrist. The method was based on gray-scale morphological granulometries which classify image texture by iteratively filtering an image and measuring the rate of change of structural diminution in a filtered-image sequence. A classification scheme capable of distinguishing structural changes in trabecular bone starting from normal trabeculae through sclerotic, cystic, and grossly porotic bone is presented. Results of the application of this technique to the evaluation of high resolution magnetic resonance images of the wrist are presented ...
The prevalence of PML has increased greatly over the last 15 years, concomitantly with the rise of AIDS (1). Since the introduction of HAART, reports have indicated that AIDS-associated PML may show clinical and neuroradiologic improvement with longer survival (2-10). However, in our series of four consecutive AIDS patients with PML treated with HAART, two were short-term survivors and two were long-term survivors.. On MR images, PML typically appears as multifocal, scalloping lesions located in the white matter. The lesions are hypointense on T1-weighted images and show high signal intensity on T2-weighted images (11). Increased hypointensity on T1-weighted images has been observed on follow-up MR studies, and has been suggested to be indicative of an aggressive form of the disease (12, 13). This feature has also been described in pathologic series (14). It was suggested recently that such imaging findings as increased atrophy, confluence of lesions, and increased hypointensity on follow-up ...
PURPOSE: To prospectively compare the black-blood ( BB black blood ) imaging efficiency of a delay alternating with nutation for tailored excitation ( DANTE delay alternating with nutation for tailored excitation ) preparation module with conventional double inversion-recovery ( DIR double inversion recovery ) and motion-sensitive driven equilibrium ( MSDE motion-sensitive driven equilibrium ) preparation modules and to introduce a new three-dimensional ( 3D three-dimensional ) T1-weighted magnetic resonance (MR) imaging sequence. MATERIALS AND METHODS: Carotid artery wall imaging was performed in 10 healthy volunteers and 15 patients in accordance with an institutional review board-approved protocol. Two-dimensional ( 2D two-dimensional ) turbo spin-echo ( TSE turbo spin echo ) and 3D three-dimensional fast low-angle shot ( FLASH fast low-angle shot ) sequences served as readout modules. DANTE delay alternating with nutation for tailored excitation -prepared T1-, T2-, and proton density-weighted 2D two
Background and Purpose- Relative signal intensity of acute ischemic stroke lesions in fluid-attenuated inversion recovery (fluid-attenuated inversion recovery relative signal intensity [FLAIR-rSI]) magnetic resonance imaging is associated with time elapsed since stroke onset with higher intensities signifying longer time intervals. In the randomized controlled WAKE-UP trial (Efficacy and Safety of MRI-Based Thrombolysis in Wake-Up Stroke Trial), intravenous alteplase was effective in patients with unknown onset stroke selected by visual assessment of diffusion weighted imaging fluid-attenuated inversion recovery mismatch, that is, in those with no marked fluid-attenuated inversion recovery hyperintensity in the region of the acute diffusion weighted imaging lesion. In this post hoc analysis, we investigated whether quantitatively measured FLAIR-rSI modifies treatment effect of intravenous alteplase. Methods- FLAIR-rSI of stroke lesions was measured relative to signal intensity in a mirrored ...
Results A 73 year old male with rheumatic heart disease presented with blood pressure dependent dizziness, dysarthria, and right sided weakness. Workup revealed basilar occlusion above the left AICA with minimal leptomeningeal flow to the superior basilar segment, posterior cerebral and superior cerebellar arteries. The patient improved with, and thus was maintained on, IV vasopressor medications but could not be weaned from these medications after 8 days. High resolution MRI of the basilar segment was obtained. Endovascular revascularisation with mechanical thrombectomy (stent retriever) followed by stenting of the basilar artery was performed. The patient was neurologically stable after recanalisation despite return of blood pressure to baseline. Pathological evaluation of the removed thrombus was obtained.. ...
Neurosurgery may be the only option for the 15%-30% of people suffering from epilepsy who are refractory to drug therapy. Due to excellent soft tissue contrast...
STUDY DESIGN Postoperative back muscle injury was evaluated in rats by magnetic resonance imaging and histologic analyses. OBJECTIVE To compare the magnetic resonance imaging manifestation of back muscle injury with the histologic findings in rats and to subsequently clarify the histopathologic appearance of the high intensity regions on T2-weighted images in human postoperative back muscles. SUMMARY OF BACKGROUND DATA In a previous study, it was found that the signal intensity on T2-weighted images of the postoperative back muscles was increased in patients who had postsurgical lumbar muscle impairment, especially in those with a prolonged surgery duration. However, the specific histopathologic changes that cause the high signal intensity on T2-weighted images remain unclear. METHODS Rats were divided into three groups: sham operation group, 1-hour retraction group, and 2-hour retraction group. Magnetic resonance imaging and histology of the multifidus muscles were examined before surgery and at
A 33-year-old woman underwent buttock liposuction and fat injection to the breast at a cosmetic clinic 2 years previously. After the operation, she became aware of indurations and disfiguration of both breasts and visited our facility. Asymmetry of the breasts and huge indurations were palpable (Fig. 18). On preoperative blood examination, high levels of antinuclear antibodies were detected. On mammography, huge masses were detected in the subcutaneous tissue (Fig. 19). Chest computed tomography revealed multiple low-density areas encapsulated with high-density areas in the subdermis in both breasts. Magnetic resonance imaging indicated multiple injected fat with high-iso signal intensity on T1-weighted images and low signal intensity on T2-weighted images (Fig. 20). Surgery to remove the subcutaneous masses was performed. Our routine examination for foreign bodies using nuclear magnetic resonance detected a small amount of silicone contamination. This suggests that the high levels of ...
To clarify whether amnesia after treatment of anterior communicating aneurysm (ACoA)is related to infarcts caused by occlusion or damage of the perforating artery of the ACoA, we used 3.0-T 3D high resolution MR imaging to identify and localize infarcts in patients with amnesia following treatment of ACoA aneurysm ...
TY - JOUR. T1 - Automated method for accurate abdominal fat quantification on water-saturated magnetic resonance images. AU - Peng, Qi. AU - McColl, Roderick W.. AU - Ding, Yao. AU - Wang, Jihong. AU - Chia, Jonathan M.. AU - Weatherall, Paul T.. PY - 2007/9. Y1 - 2007/9. N2 - Purpose: To introduce and evaluate the performance of an automated fat quantification method for water-saturated magnetic resonance images. Materials and Methods: A fat distribution model is proposed for fat quantification on water saturated magnetic resonance images. Fat from both full- and partial-volume voxels are accounted for in this model based on image intensity histogram analysis. An automated threshold method is therefore proposed to accurately quantify total fat. This method is compared to a traditional full-volume-fat-only method in phantom and human studies. In the phantom study, fat quantification was performed on MR images obtained from a human abdomen oil phantom and was compared with the true oil volumes. ...
Recent Advances in MRI-based Diagnosis and Treatment of Back Pain. Recent advances suggest that axial-loaded MRI is preferable to recumbent MRI in obese patients suffering from back pain. It may enhance the diagnostic benefit of lumbar spine MRI in such individuals with possible spinal canal stenosis.[14]. Screening with a rapid lumbar spine (LS) MRI protocol using a single 3D-T2 fat-saturation sequence in patients with acute back pain admitted to the emergency department revealed fractures, cord signal abnormalities, and severe spinal canal stenosis in addition to detecting cord compression more rapidly and effectively than conventional LS MRI.[15]. The coronal short tau inversion recovery (STIR)-weighted magnetic resonance (MR) sequence, incorporated in lumbar spine MRI allowed the detection of extraspinal degenerative conditions contributing to lower back pain: sacroiliac joint defects, sacroiliitis, degeneration of the coxofemoral joint, renal and adrenal masses, genitourinary infarcts, ...
Orbital magnetic resonance imaging (MRI) scans show rhabdomyosarcoma in left ethmoid sinus with low signal intensity on T1-weighted image (A,B) and moderate enh
On MRI a subchondral fracture is best seen on T1-weighted images as linear subcortical low signal intensity. It may not be well seen on T2-weighted images unless there is trabecular impaction, which causes a low signal intensity line on both T1 and T2-weighted images. The double line sign on T2-weighted images is considered diagnostic of osteonecrosis. The inner increased signal intensity line represents vascularized granulation tissue and the outer low signal intensity line is due to sclerotic appositional new bone.6 The double line sign can be visible in epiphyseal or metadiaphyseal lesions and has no predictive value in and of itself for eventual outcome in cases of pre-existing osteonecrosis, which can either resolve, stabilize, or progress to cortical collapse. However, the development of the double line sign in follow up imaging of a previously uncomplicated subchondral fracture may herald the progression to irreversible damage. It is only in the relatively more recent literature of ...
Coronary heart disease (CHD) has been associated with impaired cognition, but the mechanisms underlying these changes remain unclear. We designed this study to determine whether adults with CHD show regional brain losses of grey matter volume relative to controls. We used statistical parametric mapping (SPM5) to determine regional changes in grey matter volume of T 1-weighted magnetic resonance images of 11 adults with prior history of myocardial infarction relative to seven healthy controls. All analyses were adjusted for total grey and white matter volume, age, sex and handedness. CHD participants showed a loss of grey matter volume in the left medial frontal lobe (including the cingulate), precentral and postcentral cortex, right temporal lobe and left middle temporal gyrus, and left precuneus and posterior cingulate. CHD is associated with loss of grey matter in various brain regions, including some that play a significant role in cognitive function and behaviour. The underlying causes of ...
Purpose To refine methods that assess structural brain abnormalities and calculate intracranial volumes in fetuses with congenital heart diseases (CHD) using in utero MR (iuMR) imaging. Our secondary objective was to assess the prevalence of brain abnormalities in this high-risk cohort and compare the brain volumes with normative values. Methods We performed iuMR on 16 pregnant women carrying a fetus with CHD and gestational age ≥ 28-week gestation and no brain abnormality on ultrasonography. All cases had fetal echocardiography by a pediatric cardiologist. Structural brain abnormalities on iuMR were recorded. Intracranial volumes were made from 3D FIESTA acquisitions following manual segmentation and the use of 3D Slicer software and were compared with normal fetuses. Z scores were calculated, and regression analyses were performed to look for differences between the normal and CHD fetuses. Results Successful 2D and 3D volume imaging was obtained in all 16 cases within a 30-min scan. Despite ...
The dorsolateral prefrontal cortex (DLPFC) is a brain region that has figured prominently in studies of schizophrenia and working memory, yet the exact neuroanatomical localization of this brain region remains to be defined. DLPFC primarily involves the superior frontal gyrus and middle frontal gyrus (MFG). The latter, however is not a single neuroanatomical entity but instead is comprised of rostral (anterior, middle, and posterior) and caudal regions. In this study we used structural MRI to develop a method for parcellating MFG into its component parts. We focused on this region of DLPFC because it includes BA46, a region involved in working memory. We evaluated volume differences in MFG in 20 patients with chronic schizophrenia and 20 healthy controls. Mid-rostral MFG (MR-MFG) was delineated within the rostral MFG using anterior and posterior neuroanatomical landmarks derived from cytoarchitectonic definitions of BA46. Gray matter volumes of MR-MFG were then compared between groups, and a ...
Objective To ascertain whether high-field magnetic resonance imaging (MRI) allows accurate estimation of the weight of various fetal organs at postmortem before 20 weeks gestation. Methods From 23 fetuses at 920 weeks, following termination of pregnancy or in-utero fetal death (IUFD), 207 assorted fetal organs were evaluated by high-field MRI at 9.4 T prior to conventional autopsy. Fetal organ density was calculated by correlating volume and weight at autopsy using linear regression analysis, and this was used to estimate fetal organ weight by MRI. The relative error in MRI estimation of organ weight was calculated as follows: (,MRI weight - autopsy weight,/autopsy weight) x 100 (%). Multiple regression analysis was used to investigate the effect on the relative error of MRI organ weight estimates of gestational age at TOP or delivery following IUFD, autopsy weight, fetal organ examined, IUFD and fetal maceration. Results Of the 207 organs evaluated, 133 (64%) were examined for fetal organ ...
MRI signal abnormalities in the disc have been described predominantly as low signal intensity on T2 weighted images. Loss of disc height and disc
TY - JOUR. T1 - Default mode network alterations in individuals with high-trait-anxiety: An EEG functional connectivity study. AU - Della Marca, Giacomo. AU - Imperatori, Claudio. AU - Farina, Benedetto. AU - Adenzato, Mauro. AU - Valenti, Enrico Maria. AU - Murgia, Cristina. AU - Brunetti, Riccardo. AU - Fontana, Elena. AU - Ardito, Rita B.. PY - 2019. Y1 - 2019. N2 - Background: Although several researches investigated Default Mode Network (DMN) alterations in individuals with anxiety disorders, up to now no studies have investigated DMN functional connectivity in non-clinical individuals with high-trait-anxiety using quantitative electroencephalography (EEG). Here, the main aim was to extend previous findings investigating the association between trait anxiety and DMN EEG functional connectivity. Methods: Twenty-three individuals with high-trait-anxiety and twenty-four controls were enrolled. EEG was recorded during 5 min of resting state (RS). EEG analyses were conducted by means of the ...
PubMed journal article: Magnetic resonance T2 image signal intensity ratio and clinical manifestation predict prognosis after surgical intervention for cervical spondylotic myelopathy. Download Prime PubMed App to iPhone, iPad, or Android
Background: Magnetic Resonance Imaging (MRI) of the carotid artery can detect features of atherosclerotic plaque that may be associated with an increased stroke risk. This study tested the ability of MRI at 3 Tesla to identify features of acutely symptomatic carotid plaques and their association with downstream brain injury.. Methods: 41 patients presenting acutely with TIA or minor stroke and 40 asymptomatic controls underwent dark-blood T1, T2 and proton density-weighted turbo spin echo MRI of the carotid arteries, followed by diffusion-weighted (DWI) and FLAIR imaging of the brain on 2 separate occasions. Plaques were graded (MRI modified American Heart Association system) and related to the extent of MRI-determined brain injury.. Results: AHA type VI (ruptured) plaque was seen in 22 / 41 (54 %) in the symptomatic group vs. 8 / 40 (20 %) in the asymptomatic group (P , 0.05), and was due to intra-plaque haemorrhage (34% vs. 18%, P = 0.08; figure A), luminal thrombus (7% vs. 0%, P = 0.24; ...
DOI: 10.14704/nq.2021.19.1.NQ21001. Diagnostic Accuracy and Correlation between Double Inversion Recovery (DIR), FLAIR and T2W Imaging Sequences with EDSS in Detection of Lesions at different Anatomical Regions in MS Patients. Abdullah Dhaifallah Almutairi, Hasyma Abu Hassan, Subapriya Suppiah, Othman I Alomair, Abdulrahim Almotairy, Ali M. Muslim, Abdullah Almanaa and Rozi Mahmud. Abstract. The aim of our study is to evaluate the diagnostic accuracy of double inversion recovery (DIR) in detection of multiple sclerosis (MS) lesions as well as the correlation between the expanded disability status scale (EDSS) and lesion load measurement detected by DIR, fluid attenuated inversion recovery (FLAIR) and T2 weighted imaging (T2WI) in order to reveal the essential role of DIR sequence in assessing clinical inability as a practicable experiment. A total of 97 patients were assessed on a 3T Siemens Skyra MRI scanner using DIR, FLAIR, and T2W_TSE sequences. EDSS was used to assess the physical ...
Few tasks are simpler to perform than a breath hold; however, the neural basis underlying this voluntary inhibitory behaviour, which must suppress spontaneous respiratory motor output, is unknown. Here, using blood oxygen level-dependent functional magnetic resonance imaging (BOLD fMRI), we investig …
Lesions of the menisci on MRI are divided into four grades. Normal meniscus has uniformly low signal intensity on T2-weighted images (T2W). Grade I and II lesions can be a normal appearance of ageing in older patients.
Assessment of acute spinal inflammation in patients with ankylosing spondylitis by magnetic resonance imaging: a comparison between contrast enhanced T1 and short tau inversion recovery (STIR) ...
TY - JOUR. T1 - Sugar-based biopolymers as novel imaging agents for molecular magnetic resonance imaging. AU - Han, Zheng. AU - Liu, Guanshu. PY - 2019/7/1. Y1 - 2019/7/1. N2 - Sugar-based biopolymers have been recognized as attractive materials to develop macromolecule- and nanoparticle-based cancer imaging and therapy. However, traditional biopolymer-based imaging approaches rely on the use of synthetic or isotopic labeling, and because of it, clinical translation often is hindered. Recently, a novel magnetic resonance imaging (MRI) technology, chemical exchange saturation transfer (CEST), has emerged, which allows the exploitation of sugar-based biopolymers as MRI agents by their hydroxyl protons-rich nature. In the study, we reviewed recent studies on the topic of CEST MRI detection of sugar-based biopolymers. The CEST MRI property of each biopolymer was briefly introduced, followed by the pre-clinical and clinical applications. The findings of these preliminary studies imply the enormous ...
TY - JOUR. T1 - Gadolinium-enhanced fat-suppressed T1-weighted imaging of the head and neck. T2 - Comparison of gradient and conventional SE sequences. AU - Hirsch, Joshua A.. AU - Loevner, Laurie A.. AU - Yousem, David M.. AU - Siegelman, Evan S.. AU - Keiper, Mark D.. AU - Marquis, Robert P.. AU - Grossman, Robert I.. PY - 1998. Y1 - 1998. N2 - Purpose: The purpose of this study was to compare contrast-enhanced GRE and conventional SE (CSE) fat-suppressed T1-weighted techniques in the evaluation of head and neck lesions. A hybrid, opposed phase, frequency- selective, fat-suppressed fast multiplanar spoiled GRE (FMPSPGR) sequence was compared with a fat-suppressed CSE sequence. Method: Thirty-two patients with head and neck pathology were evaluated With both fat-suppressed CSE and FMPSPGR sequences. Regions of interest obtained by two viewers in consensus were used to establish contrast-to-noise (CNR) and signal-to-noise ratios for both sequences. Three neuroradiologists also independently ...
Gd3L is a trinuclear Gd3R complex of intermediate size, designed for contrast agent applications in high field magnetic resonance imaging (H12L is based on a trimethylbenzene core bearing three methylene-diethylenetriamine-N,N,N00,N00-tetraacetate moieties). Thanks to its appropriate size, the presence of two inner sphere water molecules and a fast water exchange, Gd3L has remarkable proton relaxivities at high magnetic field (r1¼10.2 vs 3.0mM S1 sS1 for GdDOTA at 9.4 T, 37-C, in H2O). Here we report an in vivo MRI feasibility study, complemented with dynamic g scintigraphic imaging and biodistribution experiments using the 153Sm-enriched analog. MRI experiments were performed at 9.4 T in mice with Gd3L and the commercial contrast agent gadolinium(III)-1,4,7,10-tetraazacyclododecane-1,4,7,10-tetraacetate (GdDOTA). Gd3L was well tolerated by the animals at the dose of 8mmol Gd kgS1 body weight. Dynamic contrast enhanced (DCE) images showed considerably higher signal enhancement in the kidney medulla and
TY - JOUR. T1 - High payload Gd(III) encapsulated in hollow silica nanospheres for high resolution magnetic resonance imaging. AU - Lin, Wan Ing. AU - Lin, Chien Yuan. AU - Lin, Yu Shen. AU - Wu, Si Han. AU - Huang, Yu Ru. AU - Hung, Yann. AU - Chang, Chen. AU - Mou, Chung Yuan. PY - 2013/2/7. Y1 - 2013/2/7. N2 - For clear MR imaging of blood vessels, a long blood circulation time of effective T1 contrast agents is necessary. Nanoparticulate MR contrast agents are much more effective owing to their enhanced relaxivity, a result of reduced tumbling rates, and large payloads of active magnetic species. PEGylated yolk-shell silica nanospheres containing high payloads of Gd(iii) with cross-linking ligands are synthesized and evaluated as a blood-pool magnetic resonance contrast agent. The hydrophilic PEG coating and the microporous silica shell allow water exchange while keeping the multi-nuclear Gd species from leaching out. These Gd(iii)-containing yolk-shell silica nanoparticles with PEGylated ...
Alexander disease is a rare disorder resulting from a glial fibrillary acidic protein gene mutation which causes progressive degeneration of white matter. With the usual poor prognosis, there are few case reports with long-term follow-up. We report the five-year clinical course of Alexander disease in one case using serial magnetic resonance imaging. A 12-month-old Japanese male was referred to the pediatrics department in our hospital because of developmental retardation. Alexander disease was diagnosed by gene examination of the mutation of a glial fibrillary acidic protein. Magnetic resonance imaging findings showed abnormalities in white matter, deep gray matter, and medulla oblongata. Serial magnetic resonance imaging examinations until the age of five were performed and changes in magnetic resonance imaging findings were compared to the progression in clinical symptoms. Alexander disease is a very rare disease with a variety of clinical phenotypes. Therefore serial magnetic resonance imaging
TY - JOUR. T1 - High-resolution three-dimensional magnetic resonance angiography and three-dimensional spoiled gradient-recalled imaging in the evaluation of neurovascular compression in patients with trigeminal neuralgia. T2 - A double-blind pilot study. AU - Anderson, Valerie C.. AU - Berryhill, Phillip C.. AU - Sandquist, Michael A.. AU - Ciaverella, David P.. AU - Nesbit, Gary M.. AU - Burchiel, Kim J.. PY - 2006/4/1. Y1 - 2006/4/1. N2 - OBJECTIVE: To assess the value of high-resolution three-dimensional (3D) time-of-flight (TOF) magnetic resonance (MR) angiography and gadolinium (Gad)-enhanced 3D spoiled gradient-recalled imaging in the visualization of neurovascular compression in patients with trigeminal neuralgia. METHODS: Forty-eight patients with unilateral trigeminal neuralgia underwent high-resolution 3D TOF MR angiography. After administration of a contrast agent, a 3D spoiled gradient-recalled sequence (3D Gad) was run. Images were reviewed by a radiologist blinded to clinical ...
TY - JOUR. T1 - The influence of the amplitude of low-frequency fluctuations on resting-state functional connectivity. AU - Di, Xin. AU - Kim, Eun H.. AU - Huang, Chu Chung. AU - Tsai, Shih Jen. AU - Lin, Ching Po. AU - Biswal, Bharat B.. PY - 2013/3/18. Y1 - 2013/3/18. N2 - Studies of brain functional connectivity have provided a better understanding of organization and integration of large-scale brain networks. Functional connectivity using resting-state functional magnetic resonance imaging (fMRI) is typically based upon the correlations of the low-frequency fluctuation of fMRI signals. Reproducible spatial maps in the brain have also been observed using the amplitude of low-frequency fluctuations (ALFF) in resting-state. However, little is known about the influence of the ALFF on the functional connectivity measures. In the present study, we analyzed resting-state fMRI data on 79 healthy old individuals. Spatial independent component analysis (ICA) and regions of interest (ROIs) based ...
COSTA, Flávia Martins et al. Proton magnetic resonance spectroscopy and perfusion magnetic resonance imaging in the evaluation of musculoskeletal tumors. Radiol Bras [online]. 2009, vol.42, n.4, pp.215-223. ISSN 1678-7099. https://doi.org/10.1590/S0100-39842009000400006.. OBJECTIVE: To assess the role of proton magnetic resonance spectroscopy and dynamic contrast-enhanced magnetic resonance imaging in the differentiation between malignant and benign musculoskeletal tumors. MATERIALS AND METHODS: Fifty-five patients with musculoskeletal tumors (27 malignant and 28 benign) were studied. The examinations were performed in a 1.5 T magnetic resonance scanner with standard protocol, and single voxel proton magnetic resonance spectroscopy with 135 msec echo time. The dynamic contrast study was performed using T1-weighted gradient-echo sequence after intravenous gadolinium injection. Timesignal intensity curves and slope values were calculated. The statistical analysis was performed with the Levenes ...
BACKGROUND AND PURPOSE: White matter hyperintensities (WMH) on MRI are a quantitative marker for sporadic cerebral small vessel disease and are highly heritable. To date, large-scale genetic studies have identified only a single locus influencing WMH burden. This might in part relate to biological heterogeneity of sporadic WMH. The current study searched for genetic modifiers of WMH volume in cerebral autosomal-dominant arteriopathy with subcortical infarcts and leukoencephalopathy (CADASIL), a monogenic small vessel disease.. METHODS: We performed a genome-wide association study to identify quantitative trait loci for WMH volume by combining data from 517 CADASIL patients collected through 7 centers across Europe. WMH volumes were centrally analyzed and quantified on fluid attenuated inversion recovery images. Genotyping was performed using the Affymetrix 6.0 platform. Individuals were assigned to 2 distinct genetic clusters (cluster 1 and cluster 2) based on their genetic background.. RESULTS: ...
Primary angiitis of the central nervous system is a rare disease of unclear etiology. There is no single test diagnostic of primary angiitis of the central nervous system. We report an unusual pattern on brain magnetic resonance imaging that might be specific for primary angiitis of the central nervous system. A 47-year-old Caucasian man developed progressive bilateral hand tremor, difficulty walking, cognitive slowing and headache. A physical examination showed bilateral hand tremor with dysmetria, hyperreflexia and abnormal gait. Magnetic resonance imaging of his brain showed bilateral, symmetrical, increased intensity on T2-weighted images concurrent with linear contrast enhancement in a radial distribution throughout his white matter, sparing subcortical regions in his centrum semiovale, corona radiata, basal ganglia and brainstem. Magnetic resonance spectroscopy demonstrated elevated choline and decreased N-acetyl aspartate. Except for elevated protein and lymphocytic pleocytosis, examination of
White matter hyperintensities were associated with an increased risk of dementia in the general population, but not in studies on high risk populations (mainly with mild cognitive impairment or a history of stroke). When subtypes of dementia were assessed, the three studies that investigated the relation of white matter hyperintensities with incident vascular dementia found a significant association, both in the general population and in patients with mild cognitive impairment.31 33 41 Conversely, although the meta-analysis testing the relation of white matter hyperintensities with incident Alzheimers disease yielded an overall significant association, this association was driven by the large population based study,31 whereas the two smaller studies on patients with mild cognitive impairment did not identify any association.41 49 Finally, our systematic review suggests that, in most studies looking at the association of white matter hyperintensities with decline in cognitive performance, white ...
Differential diagnosis must be done from other cyst-like lesions of that region. PACs arise from the adjacent Meckels cave, and secondary erode into the petrous apex [4], whereas lesions such as cholesteatoma, cholesterol granuloma, mucocele, apical petrositis and petrous apex effusion, arise from the petrous apex and expand it from within [3, 4]. Furthermore, epidermoid cysts have high signal intensity on fluid-attenuation inversion-recovery sequence, whereas the signal of arachnoid cysts is suppressed. Diffusion weighted imaging (DWI) also allows differentiation of epidermoid and arachnoid cysts i.e. epidermoid cysts yield high signal on DWI due to their restricted diffusion while arachnoid cysts, like CSF, show very low signal intensity. In addition, lesions that have high signal intensity on T2W sequences such as paraganglioma, chondroma, chordoma and apex petrositis show contrast enhancement [2 ...
Background/Aims: The high incidence of cardiovascular disease (CVD) in patients with autoimmune rheumatic diseases (ARDs) is the main driver towards increased mortality in this patient group. Cardiovascular magnetic resonance (CMR) can non-invasively and robustly detect CVD in ARD patients at an early stage of development. The review summarises the diagnostic information provided by CMR in ARD patients. Summary : CMR uses a strong magnetic field combined with radio-frequency pulses (pulse sequences) to generate images. Firstly, balanced steady-state free precession(bSSFP) can be used for evaluating cardiac anatomy, mass, wall motion, atrial/ventricular function. Secondly, T2-weighted imaging (T2-W) can be used for oedema detection, which appears as a high signal intensity area on STIR (short tau inversion recovery) images. T2 mapping is a newer T2-W technique that can provide more optimal identification of myocardial oedema. Lastly, late gadolinium enhanced (LGE) T1-W images, taken 15 min. after
TY - JOUR. T1 - White Matter Hyperintensity Volume and Cerebral Perfusion in Older Individuals with Hypertension Using Arterial Spin-Labeling. AU - van Dalen, J. W.. AU - Mutsaerts, H. J. M. M.. AU - Nederveen, A. J.. AU - Vrenken, H.. AU - Steenwijk, M. D.. AU - Caan, M. W. A.. AU - Majoie, C. B. L. M.. AU - van Gool, W. A.. AU - Richard, E.. PY - 2016/10. Y1 - 2016/10. U2 - 10.3174/ajnr.A4828. DO - 10.3174/ajnr.A4828. M3 - Article. C2 - 27282862. VL - 37. SP - 1824. EP - 1830. JO - American Journal of Neuroradiology. JF - American Journal of Neuroradiology. SN - 0195-6108. IS - 10. ER - ...
TY - JOUR. T1 - Small (,2-cm) upper-tract urothelial carcinoma. T2 - Evaluation with gadolinium-enhanced three-dimensional spoiled gradient-recalled echo MR urography. AU - Takahashi, Naoki. AU - Kawashima, Akira. AU - Glockner, James F.. AU - Hartman, Robert P.. AU - Leibovich, Bradley C.. AU - Brau, Anja C.S.. AU - Beatty, Philip J.. AU - King, Bernard F.. PY - 2008/5/1. Y1 - 2008/5/1. N2 - Purpose: To retrospectively evaluate the detection of small (,2-cm) urothelial tumors by using gadolinium-enhanced three-dimensional (3D) spoiled gradient-recalled echo (GRE) magnetic resonance (MR) urography. Materials and Methods: This HIPAA-compliant study received institutional review board approval. All patients included had previously consented to the use of their medical records for research purposes. Eleven of 110 patients (10 men, one woman; mean age, 73.5 years) who underwent MR urography were ultimately identified to have 23 upper-tract urothelial carcinomas smaller than 2 cm or carcinoma in ...
OBJECTIVE: Our goal was to assess the value of MR imaging to patient care in the setting of angiographically negative subarachnoid hemorrhage and to evaluate the potential of MR imaging for revealing the mechanism for idiopathic perimesencephalic subarachnoid hemorrhage.. MATERIALS AND METHODS: We retrospectively reviewed 71 patients who presented with subarachnoid hemorrhage and in whom the results of a four-vessel cerebral arteriogram were negative, a CT scan showed no evidence of intraaxial hemorrhage, and MR imaging had been performed within 72 hr of presentation. MR imaging of the brain included sagittal spin-echo T1-weighted, turbo spin-echo proton density-weighted, T2-weighted, and axial T2-weighted gradient-echo sequences. MR imaging of the cervical spine, which was performed in 41 of the 71 patients, included sagittal spin-echo T1-weighted, turbo spin-echo proton density-weighted, T2-weighted, and axial T2-weighted gradient-echo sequences.. RESULTS: Perimesencephalic subarachnoid ...
TY - JOUR. T1 - Proton and multinuclear magnetic resonance spectroscopy in the human brain at ultra-high field strength. T2 - A review. AU - Henning, Anke. PY - 2018/3. Y1 - 2018/3. N2 - Magnetic Resonance Spectroscopy (MRS) allows for a non-invasive and non-ionizing determination of in vivo tissue concentrations and metabolic turn-over rates of more than 20 metabolites and compounds in the central nervous system of humans. The aim of this review is to give a comprehensive overview about the advantages, challenges and advances of ultra-high field MRS with regard to methodological development, discoveries and applications from its beginnings around 15 years ago up to the current state. The review is limited to human brain and spinal cord application at field strength of 7T and 9.4T and includes all relevant nuclei (1H, 31P, 13C).. AB - Magnetic Resonance Spectroscopy (MRS) allows for a non-invasive and non-ionizing determination of in vivo tissue concentrations and metabolic turn-over rates of ...
The ordered electrical stimulation of the ventricles is achieved by a specialized network of fibres known as the Purkinje system. The gross anatomy and basic functional role of the Purkinje system is well understood. However, very little is known about the detailed anatomy of the Purkinje system, its inter-individual variability and the implications of the variability in ventricular function, in part due to limitations in experimental techniques. In this study, we aim to provide new insight into the inter-individual variability of the free running Purkinje system anatomy and its impact on ventricular electrophysiological function. As a first step towards achieving this aim, high resolution magnetic resonance imaging (MRI) datasets of rat and the rabbit ventricles are obtained and analysed using a novel semi-automatic image processing algorithm for segmentation of the free-running Purkinje system. Segmented geometry from the MRI datasets is used to construct a computational model of the Purkinje system,
Dive into the research topics of Association of white matter hyperintensity volume with decreased cognitive functioning: The Framingham Heart Study. Together they form a unique fingerprint. ...
TY - JOUR. T1 - Exome chip analysis identifies low-frequency and rare variants in MRPL38 for white matter hyperintensities on brain magnetic resonance imaging. AU - neuroCHARGE Working Group. AU - Jian, Xueqiu. AU - Satizabal, Claudia L.. AU - Smith, Albert V.. AU - Wittfeld, Katharina. AU - Bis, Joshua C.. AU - Smith, Jennifer A.. AU - Hsu, Fang Chi. AU - Nho, Kwangsik. AU - Hofer, Edith. AU - Hagenaars, Saskia P.. AU - Nyquist, Paul A.. AU - Mishra, Aniket. AU - Adams, Hieab H.H.. AU - Li, Shuo. AU - Teumer, Alexander. AU - Zhao, Wei. AU - Freedman, Barry I.. AU - Saba, Yasaman. AU - Yanek, Lisa R.. AU - Chauhan, Ganesh. AU - Van Buchem, Mark A.. AU - Cushman, Mary. AU - Royle, Natalie A.. AU - Nick Bryan, R.. AU - Niessen, Wiro J.. AU - Windham, Beverly G.. AU - DeStefano, Anita L.. AU - Habes, Mohamad. AU - Heckbert, Susan R.. AU - Palmer, Nicholette D.. AU - Lewis, Cora E.. AU - Eiriksdottir, Gudny. AU - Maillard, Pauline. AU - Mathias, Rasika A.. AU - Homuth, Georg. AU - ...
An MRI scan is the best way to locate multiple sclerosis (MS) lesions (also called plaques) in the brain or spinal cord. An MRI scan is abnormal in more than 95% of people recently diagnosed with MS.footnote 1. But abnormal MRI results do not always mean that you have MS. Abnormalities show up on scans from many illnesses other than MS. An abnormal finding on an MRI scan alone is not enough to diagnose MS. Your doctor will confirm a diagnosis of MS based on your symptoms, your neurological exam, and the results from an MRI and other tests.. When abnormal MRI results occur along with a medical history, abnormal nervous system exam, and other test results that are typical of MS, it is very likely that you have MS.. If you have already been diagnosed with MS, MRI scans can sometimes distinguish new lesions from older ones and can help your doctor(s) follow the progress of the disease. Continuing to have periodic MRI scans if you have relapsing-remitting MS may help identify new lesions even when ...
Regarding diagnosis with AAM, the characteristic MRI findings of AAM include the following: On T1-weighted MRI, it has low signal intensity. That is, it is of the same signal intensity as the skeletal muscle. On T2-weighted MRI, it has high signal intensity. These appearances likely relate to the loose myxoid matrix and high water content of angiomyxoma [11]. The CT findings demonstrated that the tumor, later identified as AAM, had a well-defined margin and an attenuation less than that of a muscle [11]. On ultrasonography, AAM appears as a hypoechoic or cystic mass [12]. In our case, the liver mass showed high signal intensity on T2-weighted MRI, as an attenuated mass on CT, and as a hypoechoic cystic region on ultrasound (Fig. 1). In our case, CT and FDG-PET unable to detect any mass in other regions including the pelvi-perineal region. Therefore, the AAM was concluded as of liver origin.. Immunohistochemically, AAM has been found to be positive for vimentin, desmin, CD 34, ER, PgR, and ...
A 48 year old left handed man presented with a history of a burst, very brief electrical tingling in the left forearm, hand, and lower leg for almost 2 years. The symptom occurred only on flexion of the neck and abated even when the neck was kept flexed. No other neck movements caused this symptom. A year later, the patient noted mild dysaesthesia in the left arm and leg. A sagittal heavily T2 weighted fast spin echo MR image of the cervical spine showed a small ovoid area of T2 hyperintensity within the posterior cervical spinal cord at the cervical 3-4 level with minimal mass effect. Subtle low signal intensity about its rim suggested hemosiderin deposition (figure). A few weeks later, after raking his yard, the patient experienced acute neck pain. A day later, he noticed diminished coordination of the left arm and leg. A sagittal T2 weighted fast spin echo MRI of the cervical spine obtained a few days later showed an extensive intramedullary low signal intensity area in the midposterior ...
METHODS: Proton density and T2 weighted images were obtained on a 1.0 Tesla MRI scanner in patients with dementia with Lewy bodies (consensus criteria; n=27, mean age=75.9 years), Alzheimers disease (NINCDS/ADRDA; n=28, mean age=77.4 years), vascular dementia (NINDS/AIREN; n=25, mean age=76.8 years), and normal controls (n=26, mean age=76.2 years). Cognitive function, depressive symptoms, and psychotic features were assessed using a standardised protocol. Periventricular hyperintensities (PVHs), white matter hyperintensities (WMHs) and basal ganglia hyperintensities (BGHs) were visually rated blind to diagnosis using a semiquantitative scale ...
The aim of this study is to describe the association of bone marrow lesions (BMLs) present on two different MRI sequences with clinical outcomes, cartilage defect progression, cartilage volume loss over 2.7 years, and total knee replacement (TKR) over 13.3 years. 394 participants (50-80 years) were assessed at baseline and 2.7 years. BML presence at baseline was scored on T1-weighted fat-suppressed 3D gradient-recalled acquisition (T1) and T2-weighted fat-suppressed 2D fast spin-echo (T2) sequences. Knee pain, function, and stiffness were assessed using WOMAC. Cartilage volume and defects were assessed using validated methods. Incident TKR was determined by data linkage. BMLs were mostly present on both MRI sequences (86%). BMLs present on T2, T1, and both sequences were associated with greater knee pain and functional limitation (odds ratio = 1.49 to 1.70; all p p p p p , 0.05). BMLs present on T2, T1, and both sequences were strongly associated with incident TKR. BMLs can be assessed on either ...
TY - JOUR. T1 - Preoperative Magnetic Resonance and Intraoperative Ultrasound Fusion Imaging for Real-Time Neuronavigation in Brain Tumor Surgery. AU - Prada, F.. AU - Del Bene, M.. AU - Mattei, L.. AU - Lodigiani, L.. AU - Debeni, S.. AU - Kolev, V.. AU - Vetrano, I.. AU - Solbiati, L.. AU - Sakas, G.. AU - Dimeco, F.. PY - 2015/4/1. Y1 - 2015/4/1. N2 - Purpose: Brain shift and tissue deformation during surgery for intracranial lesions are the main actual limitations of neuro-navigation (NN), which currently relies mainly on preoperative imaging. Ultrasound (US), being a real-time imaging modality, is becoming progressively more widespread during neurosurgical procedures, but most neurosurgeons, trained on axial computed tomography (CT) and magnetic resonance imaging (MRI) slices, lack specific US training and have difficulties recognizing anatomic structures with the same confidence as in preoperative imaging. Therefore real-time intraoperative fusion imaging (FI) between preoperative imaging ...
A thin line of cortical low signal intensity (motor dark line or hypointense rim) of the precentral gyrus on T2WI or FLAIR images has been advocated to be a marker of UMN compromise in ALS, particularly in advanced disease20,27. However, this T2 shortening effect results from excessive iron deposition, fibrillary gliosis, and/or macrophage infiltration, and such a change is neither sensitive nor specific to the pathology of UMN degeneration in ALS and can be found in healthy people, as well as in those with other degenerative diseases10,28-30.. Precentral gyrus subcortical hyperintensity on T2WI or FLAIR images has been reported as an important finding that represents CST abnormalities in UMN degeneration20,27,29. This hyperintensity is probably due to ALS-related degenerative changes and contributes to the diagnosis of ALS in some studies, although with a low sensitivity20,28,31. Central sulcus enlargement and CST hyperintensity on FLAIR images have demonstrated low sensitivity and ...
A core symptom of anxiety disorders is the tendency to interpret ambiguous information as threatening. Using electroencephalography and blood oxygenation level dependent magnetic resonance imaging (BOLD-MRI), several studies have begun to elucidate brain processes involved in fear-related perceptual biases, but thus far mainly found evidence for general hypervigilance in high fearful individuals. Recently, multi-voxel pattern analysis (MVPA) has become popular for decoding cognitive states from distributed patterns of neural activation. Here, we used this technique to assess whether biased fear generalization, characteristic of clinical fear, is already present during the initial perception and categorization of a stimulus, or emerges during the subsequent interpretation of a stimulus. Individuals with low spider fear (n = 20) and high spider fear (n = 18) underwent functional MRI scanning while viewing series of schematic flowers morphing to spiders. In line with previous studies, individuals ...
Diabetes mellitus is associated with an increase in proliferative lesions in the small cerebral vessels.1 Functionally, the blood-retinal barrier is closely related to the blood-brain barrier (BBB)2 and cortical capillaries in experimental models of diabetes exhibit similar microangiopathy to that found in the human retina in diabetes.3, 4. A principal neuroradiological feature that may be associated with cerebral microvascular disease is white matter hyperintensities or leukoaraiosis, a mixed condition of uncertain aetiology manifested on CT scans as hypodensity in the cerebral white matter, and as hyperintensities on T2, proton density or fluid attenuated inversion recovery (FLAIR) MR imaging.5 Recent longitudinal studies have highlighted diabetes as a risk factor for dementia, doubling the risk of senile dementia of the Alzheimer type.6 Several studies have established a correlation between the presence and extent of white matter hyperintensities and cognitive impairment, ranging from ...
Poor response inhibition has been implicated in the development of alcohol dependence, yet little is known about how neural pathways underlying cognitive control are affected in this disorder. Moreover, endogenous opioid levels may impact the functionality of inhibitory control pathways. This study investigated the relationship between alcohol dependence severity and functional connectivity of fronto-striatal networks during response inhibition in an alcohol-dependent sample. A secondary aim of this study was to test the moderating effect of a functional polymorphism (A118G) of the μ-opioid receptor (OPRM1) gene. Twenty individuals with alcohol dependence (six females; 90% Caucasian; mean age = 29.4) who were prospectively genotyped on the OPRM1 gene underwent blood oxygen level-dependent functional magnetic resonance imaging while performing a Stop-Signal Task. The relationship between alcohol dependence severity and functional connectivity within fronto-striatal networks important for ...
A method for determining a pore characteristic of a substance includes the following steps: subjecting the substance to a substantially uniform static magnetic field; applying a magnetic pulse sequence to the substance, the pulse sequence being selected to produce nuclear magnetic resonance signals that are responsive to internal magnetic field inhomogeneities in the pore structure of the substance, and detecting, as measurement signals, nuclear magnetic resonance signals from the substance; applying a reference magnetic pulse sequence to the substance, the reference pulse sequence being selected to produce nuclear magnetic resonance signals that are substantially unresponsive to internal magnetic field inhomogeneities in the pore structure of the substance, and detecting, as reference measurement signals, nuclear magnetic resonance signals from the substance; and determining a pore characteristic of the substance from the measurement signals and the reference measurement signals.
The diagnosis of discospondylitis is based mainly on diagnostic imaging and laboratory results. Herein, we describe the magnetic resonance imaging (MRI) findings in 13 dogs with confirmed discospondylitis. In total there were 17 sites of discospondylitis. Eleven (81.1%) of the dogs had spinal pain for ,3 weeks and a variable degree of neurologic signs. Two dogs had spinal pain and ataxia for 4 days. Radiographs were available in nine of the dogs. In MR images there was always involvement of two adjacent vertebral endplates and the associated disk. The involved endplates and adjacent marrow were T1-hypointense with hyperintensity in short tau inversion recovery (STIR) images in all dogs, and all dogs also had contrast enhancement of endplates and paravertebral tissues. The intervertebral disks were hyperintense in T2W and STIR images and characterized by contrast enhancement in 15 sites (88.2%). Endplate erosion was present in 15 sites (88.2%) and was associated with T2-hypointense bone marrow ...
PURPOSE: As Quantitative Susceptibility Mapping (QSM) is maturing, more clinical applications are being explored. With this comes the question whether QSM is sufficiently robust and reproducible to be directly used in a clinical setting where patients are possibly not cooperative and/or unable to suppress involuntary movements sufficiently. Subjects and Methods: Twenty-nine patients with Alzheimers Disease (AD), 31 patients with Mild Cognitive Impairment (MCI) and 41 healthy controls (HC) were scanned on a 3T scanner, including a multi-echo gradient-echo sequence for QSM and an inversion-prepared segmented gradient-echo sequence (T1-TFE, MPRAGE). The severity of motion artifacts (excessive/strong /noticeable/invisible) was categorized via visual inspection by two independent raters. Quantitative susceptibility was reconstructed using Joint background-field removal and segmentation-Enhanced Dipole Inversion (JEDI), based on segmented subcortical gray-matter regions, as well as using ...
TY - JOUR. T1 - Magnetic resonance imaging appropriate for construction of subject-specific head models for diffuse optical tomography. AU - Kurihara, Kazuki. AU - Kawaguchi, Hiroshi. AU - Obata, Takayuki. AU - Ito, Hiroshi. AU - Okada, Eiji. PY - 2015. Y1 - 2015. N2 - Subject-specific head models of which their geometry is based on structural magnetic resonance images are essential to accurately estimate the spatial sensitivity profiles for image reconstruction in diffuse optical tomography. T1-weighted magnetic resonance images, which are commonly used for structural imaging, are not sufficient for the thresholdbased segmentation of the superficial tissues. Two types of pulse sequences, which provide a high contrast among the superficial tissues, are introduced to complement the segmentation to construct the subject-specific head models. The magnetic resonance images acquired by the proposed pulse sequences are robust to the threshold level and adequate for the thresholdbased segmentation of ...
Recent Notus Publications Bigler, E. D. , Allen, M. D. , Stimac, G. K, (2012). MRI and functional MRI. In Simpson, J. R. (Ed. ) Neuroimaging in Forensic Psychiatry: From the clinic to the courtroom. Wiley-Blackwell Press. Abstract Woon, F. L. , Allen, M. D. , Hedges, D. , Miller, C. (2012). The functional magnetic resonance imaging-based verbal fluency test in Obsessive Compulsive Disorder. Neurocase. Abstract Allen, M. D. , Hedges, D. W. , Farrer, T. J. , and Larson, M. J. (2012). Assessment of Brain Activity during Memory Encoding in a Narcolepsy Patient On and Off Modafinil using Normative f. MRI data. Neurocase, 18, 13 -25. Abstract Allen, M. D. , Owens, T. E. , Fong, A. K. , Richards, D. R. (2011). A Functional Neuroimaging Analysis of the Trail Making Test-B: Implications for Clinical Application. Behavioural Neurology, 24, 159 -171. Abstract Allen, M. D. , Wu, T. C. , & Bigler, E. , (2011). Traumatic Brain Injury Alters Word Memory Test Performance by Slowing Response Time and Increasing ...
Figure. . . Maps showing axial fluid attenuated inversion recovery (FLAIR), diffusion-weighted imaging (DWI), and apparent diffusion coefficient (ADC) at the level of the basal nuclei (top row) and dorsal frontoparietal cortex (bottom row) of the brain of a 33.8-year-old man with agenesis of the corpus callosum, schizencephaly, and heterotopia. Note the symmetrical DWI signal hyperintensities in the striatum and dorsomedial part of the thalami. In addition, DWI signal hyperintensities occurred in the cingulate, precuneus and in the dysplastic gray matter along the anterior lips of the schizencephalic clefts at the level of the precentral gyri. The signal abnormalities are associated with decreased diffusivity on ADC maps and are much less prominent on FLAIR images. These findings are highly suggestive of Creutzfeldt-Jakob disease. ...
Background/aim. The safety of amateur and professional boxing is a contentious issue. We hypothesised that advanced magnetic resonance imaging and neuropsychological testing could provide evidence of acute and early brain injury in amateur boxers.. Methods. We recruited 30 participants from a university amateur boxing club in a prospective cohort study. Magnetic resonance imaging (MRI) and neuropsychological testing was performed at three time points: prior to starting training; within 48 h following a first major competition to detect acute brain injury; and one year follow-up. A single MRI acquisition was made from control participants. Imaging analysis included cortical thickness measurements with Advanced Normalization Tools (ANTS) and FreeSurfer, voxel based morphometry (VBM), and Tract Based Spatial Statistics (TBSS). A computerized battery of neuropsychological tests was performed assessing attention, learning, memory and impulsivity.. Results. During the study period, one boxer developed ...
PURPOSE: The purpose of this study was to measure potential changes of the apparent diffusion coefficient (ADC) in diffusion-weighted imaging of the liver before and after caloric challenge in correlation to the induced changes in portal vein flow. MATERIALS AND METHODS: The study was approved by the local ethics committee. Each of 10 healthy volunteers underwent 4 measurements in a 1.5-T whole-body magnetic resonance scanner on 2 different days: a first scan after fasting for at least 8 hours and a second scan 30 minutes after intake of a standardized caloric either a protein- or carbohydrate-rich meal. Diffusion-weighted spin-echo echo-planar magnetic resonance images were acquired at b values of 0, 50, 150, 250, 500, 750, and 1000 s/mm. In addition, portal vein flow was quantified with 2-dimensional phase-contrast imaging (velocity encoding parallel to flow direction, 60 cm/s). Mean ADC values for regions of interest in 3 different slices were measured from b50 to b250 and from b500 to b1000 ...
Most of the resting-state functional magnetic resonance imaging (fMRI) studies demonstrated the correlations between spatially distinct brain areas from the perspective of functional connectivity or functional integration. The functional connectivity approaches do not directly provide information of the amplitude of brain activity of each brain region within a network. Alternatively, an index named amplitude of low-frequency fluctuation (ALFF) of the resting-state fMRI signal has been suggested to reflect the intensity of regional spontaneous brain activity. However, it has been indicated that the ALFF is also sensitive to the physiological noise. The current study proposed a fractional ALFF (fALFF) approach, i.e., the ratio of power spectrum of low-frequency (0.01-0.08 Hz) to that of the entire frequency range and this approach was tested in two groups of resting-state fMRI data. The results showed that the brain areas within the default mode network including posterior cingulate cortex, ...
We describe an MRI phenotype seen in a series of patients with mutations in PTEN who have clinical features consistent with PTEN hamartoma tumor syndrome (PHTS). Retrospective review of clinical data and MRI was performed in 23 subjects evaluated in four different tertiary care centers with clinical programs in inherited disorders of the white matter. Patients were referred due to abnormal MRI features and abnormal PTEN sequencing was identified. All subjects had significant macrocephaly (on average |4 SD above the mean), developmental delay with or without autism spectrum disorder and uniform MRI features of enlarged perivascular spaces and multifocal periventricular white matter abnormalities. The phenotype of PHTS may include MRI abnormalities such as multifocal periventricular white matter abnormalities and enlarged perivascular spaces. These neuroimaging findings, in association with macrocephaly and developmental delay, should prompt consideration of PTEN as a diagnostic possibility.
Spondylodiscitis is an infection of the intervertebral disc and adjacent vertebral bodies. Magnetic resonance imaging is the method of choice for the spondylodiscitis. The characteristic findings in the spondylodiscitis are hypointense on T1-weighted (W) image and hyperintense on T2W and fat-saturation T2W images, contrast enhancement on contrast-enhanced T1W with fat saturation images in the disc space and adjacent vertebral bodies, and phlegmon or abscess of the paraspinal soft tissues and epidural space. Phlegmon shows homogenous contrast enhancement, while abscess shows peripheral ring-enhancement on contrast-enhanced T1W with fat saturation images. Differentiation of tuberculous, brucellar and pyogenic spondylodiscitis is radiological difficult. Features that also favor tuberculosis infection include multilevel disease, large paravertebral abscess, meningeal involvement and subligamentous spread. Brucellar spondylodiscitis most commonly affects the lumbar spine. Bone destruction is less ...
Amyotrophic lateral sclerosis as a system failure is a concept supported by the finding of consistent extramotor as well as motor cerebral pathology. The functional correlates of the structural changes detected using advanced magnetic resonance imaging techniques such as diffusion tensor imaging and voxel-based morphometry have not been extensively studied. A group of 25 patients with amyotrophic lateral sclerosis was compared to healthy control subjects using a multi-modal neuroimaging approach comprising T(1)-weighted, diffusion-weighted and resting-state functional magnetic resonance imaging. Using probabilistic tractography, a grey matter connection network was defined based upon the prominent corticospinal tract and corpus callosum involvement demonstrated by white matter tract-based spatial statistics. This amyotrophic lateral sclerosis-specific network included motor, premotor and supplementary motor cortices, pars opercularis and motor-related thalamic nuclei. A novel analysis protocol, using
Amyotrophic lateral sclerosis as a system failure is a concept supported by the finding of consistent extramotor as well as motor cerebral pathology. The functional correlates of the structural changes detected using advanced magnetic resonance imaging techniques such as diffusion tensor imaging and voxel-based morphometry have not been extensively studied. A group of 25 patients with amyotrophic lateral sclerosis was compared to healthy control subjects using a multi-modal neuroimaging approach comprising T(1)-weighted, diffusion-weighted and resting-state functional magnetic resonance imaging. Using probabilistic tractography, a grey matter connection network was defined based upon the prominent corticospinal tract and corpus callosum involvement demonstrated by white matter tract-based spatial statistics. This amyotrophic lateral sclerosis-specific network included motor, premotor and supplementary motor cortices, pars opercularis and motor-related thalamic nuclei. A novel analysis protocol, using
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Previous studies have detected abnormal serum ferritin levels in patients with depression; however, the results have been inconsistent. This study used quantitative susceptibility mapping (QSM) for the first time to examine brain iron concentration in depressed patients and evaluated whether it is related to severity. We included three groups of age- and gender-matched participants: 30 patients with mild-moderate depression (MD), 14 patients with major depression (MDD) and 20 control subjects. All participants underwent MR scans with a 3D gradient-echo sequence reconstructing for QSM and performed the 17-item Hamilton Depression Rating Scale (HDRS) test. In MDD, the susceptibility value in the bilateral putamen was significantly increased compared with MD or control subjects. In addition, a significant difference was also observed in the left thalamus in MDD patients compared with controls. However, the susceptibility values did not differ between MD patients and controls. The susceptibility values
Functional MRI studies have identified a distributed set of brain activations to be associated with auditory verbal hallucinations (AVH). However, very little is known about how activated brain regions may be linked together into AVH-generating networks. Fifteen volunteers with schizophrenia or schizoaffective disorder pressed buttons to indicate onset and offset of AVH during fMRI scanning. When a general linear model was used to compare blood oxygenation level dependence signals during periods in which subjects indicated that they were versus were not experiencing AVH (
Coronary heart disease (CHD) has been linked with cognitive decline and dementia in several studies. CHD is strongly associated with blood pressure, but it is not clear how blood pressure levels or changes in blood pressure over time affect the relation between CHD and dementia-related pathology. The aim of this study was to investigate relations between CHD and cortical thickness, gray matter volume and white matter lesion (WML) volume on MRI, considering CHD duration and blood pressure levels from midlife to three decades later. The study population included 69 elderly at risk of dementia who participated in the Cardiovascular Risk Factors, Aging and Dementia (CAIDE) study. CAIDE participants were examined in midlife, re-examined 21 years later, and then after additionally 7 years (in total up to 30 years follow-up). MRIs from the second re-examination were used to calculate cortical thickness, gray matter and WML volume. CHD diagnoses were obtained from the Finnish Hospital Discharge ...
Converging evidence from epidemiological, clinical and neuropsychological research suggests a link between cannabis use and increased risk of psychosis. Long-term cannabis use has also been related to deficit-like negative symptoms and cognitive impairment that resemble some of the clinical and cognitive features of schizophrenia. The current functional brain imaging study investigated the impact of a history of heavy cannabis use on impaired executive function in first-episode schizophrenia patients. Whilst performing the Tower of London task in a magnetic resonance imaging scanner, event-related blood oxygenation level-dependent (BOLD) brain activation was compared between four age and gender-matched groups: 12 first-episode schizophrenia patients; 17 long-term cannabis users; seven cannabis using first-episode schizophrenia patients; and 17 healthy control subjects. BOLD activation was assessed as a function of increasing task difficulty within and between groups as well as the main effects ...
Functional magnetic resonance imaging (fMRI) studies of the human brain have suggested that low-frequency fluctuations in resting fMRI data collected using blood oxygen level dependent (BOLD) contrast correspond to functionally relevant resting state networks (RSNs). Whether the fluctuations of resting fMRI signal in RSNs are a direct consequence of neocortical neuronal activity or are low-frequency artifacts due to other physiological processes (e.g., autonomically driven fluctuations in cerebral blood flow) is uncertain. In order to investigate further these fluctuations, we have characterized their spatial and temporal properties using probabilistic independent component analysis (PICA), a robust approach to RSN identification. Here, we provide evidence that: i. RSNs are not caused by signal artifacts due to low sampling rate (aliasing); ii. they are localized primarily to the cerebral cortex; iii. similar RSNs also can be identified in perfusion fMRI data; and iv. at least 5 distinct RSN patterns
TY - JOUR. T1 - Endometrial polyps. T2 - MR imaging features and distinction from endometrial carcinoma. AU - Grasel, Ralf P.. AU - Outwater, Eric K.. AU - Siegelman, Evan S.. AU - Capuzzi, David. AU - Parker, Laurence. AU - Hussain, Shahid M.. PY - 2000. Y1 - 2000. N2 - PURPOSE: To determine the magnetic resonance (MR) imaging characteristics of endometrial polyps and the accuracy or MR imaging in distinguishing endometrial polyps from endometrial carcinomas in a case- control study. MATERIALS AND METHODS: Cross-referencing pathology records with MR studies from two institutions disclosed 35 patients with surgically proved endometrial polyp or carcinoma after controlling for tumor size. All MR examinations were performed at 1.5 T with T2-weighted fast spin-echo sequences in multiple planes. Three independent readers blinded to histologic diagnoses and clinical data scored each image for the presence of several defined findings. RESULTS: A central fibrous core (low signal intensity on ...
The Framingham Offspring Cohort were recruited in 1971 and consisted of 5124 children and spouses of children of the original Framingham Cohort.28 Offspring subjects have been examined 7 times since 1971, and between 1999 and 2001, they were invited to undergo a brain MRI using a standard protocol. For the current analysis, only subjects attending examination 5 were included, and risk factor data from this examination were related to findings from brain MRI examinations. Data from examination 5 were used because a larger number of subjects had risk factor and MRI data available than from exam 6 or 7. Subjects were excluded from MRI examination if they had metal in the eyes or central nervous system, claustrophobia, valvular prosthesis, cardiac pacemaker, vascular clip, cochlear implant or other implantable device, or if they refused.. Of those offspring who attended examination 5, 3562 were alive as of September 2001, the cutoff for the analysis. Of them, 1939 had an MRI examination of the brain ...
A 30-year-old female has experienced amenorrhea and progressive loss of vision for four years. Physical examinations were normal except bitemporal hemianopsia revealed by ophthalmic examination. Preoperative neuroendocrine examinations showed a mild hyperprolactinemia of 72.3ng/ml (normal range, 2.8 ng/ml-29.2 ng/ml). MRI scan revealed a 31 mm 34 mm 31 mm well-circumscribed roundness mass in the suprasellar region, with intermediate signal intensity on T1-weighted images, intermediate to slightly increased signal intensity on T2-weighted images, and homogeneous enhancement with gadolinium administration with obviously homogeneous enhancement after gadolinium administration (Fig. 1). Extended endoscopic endonasal transsphenoidal approach was chosen to resect the tumor. Intraoperatively, we encountered active bleeding, however, the bleeding stopped after the tumor was completely resected. Postoperative, the patient had serious diabetes insipidus and electrolyte disturbance. Blood sodium was as ...