Brain tumor care at every phase benefits from the utility of neuroimaging. parasitic co-infection The clinical diagnostic power of neuroimaging has been enhanced by technological progress, a crucial component to supplementing patient histories, physical assessments, and pathological evaluations. Presurgical assessments are augmented by cutting-edge imaging, exemplified by functional MRI (fMRI) and diffusion tensor imaging, resulting in improved differential diagnostics and more efficient surgical approaches. Novel perfusion imaging, susceptibility-weighted imaging (SWI), spectroscopy, and new positron emission tomography (PET) tracers offer improved diagnostic capabilities in the often challenging clinical differentiation between treatment-related inflammatory changes and tumor progression.
Employing cutting-edge imaging methods will contribute to superior clinical outcomes in treating brain tumor patients.
Clinical practice for patients with brain tumors can be greatly enhanced by incorporating the most modern imaging techniques.
Imaging modalities' contributions to the understanding of skull base tumors, specifically meningiomas, and their implications for patient surveillance and treatment are outlined in this article.
Greater accessibility to cranial imaging procedures has contributed to a higher frequency of incidental skull base tumor diagnoses, requiring thoughtful decision-making regarding management strategies, including observation or intervention. The initial location of a tumor dictates how it expands and encroaches upon the surrounding structures. A precise study of vascular encroachment on CT angiography, in conjunction with the pattern and extent of bone invasion visualized through CT, effectively assists in treatment planning strategies. Future quantitative analyses of imaging, specifically radiomics, may provide more insight into the correlation between phenotype and genotype.
By combining CT and MRI imaging, the diagnostic clarity of skull base tumors is improved, revealing their point of origin and determining the appropriate treatment boundaries.
By combining CT and MRI analyses, a more accurate diagnosis of skull base tumors is possible, specifying their point of origin and determining the necessary treatment extent.
Employing the International League Against Epilepsy's Harmonized Neuroimaging of Epilepsy Structural Sequences (HARNESS) protocol, this article examines the fundamental role of optimal epilepsy imaging and the use of multimodality imaging in evaluating patients with drug-resistant epilepsy. Abemaciclib nmr To assess these images, a systematic approach is detailed, especially when correlated with clinical information.
The evolving field of epilepsy imaging underscores the vital role of high-resolution MRI protocols in evaluating epilepsy, encompassing newly diagnosed, chronic, and drug-resistant cases. A review of MRI findings across the spectrum of epilepsy and their clinical importance is presented. Protein Detection Multimodality imaging, a valuable tool, effectively enhances presurgical epilepsy evaluation, especially in instances where MRI findings are unrevealing. Identification of subtle cortical lesions, such as focal cortical dysplasias, is facilitated by correlating clinical presentation with video-EEG, positron emission tomography (PET), ictal subtraction SPECT, magnetoencephalography (MEG), functional MRI, and advanced neuroimaging techniques including MRI texture analysis and voxel-based morphometry, leading to improved epilepsy localization and optimal surgical candidate selection.
The neurologist's unique role involves a deep understanding of the clinical history and seizure phenomenology, which are fundamental to neuroanatomic localization. The clinical context, combined with advanced neuroimaging, critically improves the identification of subtle MRI lesions and the subsequent localization of the epileptogenic lesion in the presence of multiple lesions. A 25-fold higher probability of achieving seizure freedom through epilepsy surgery is observed in patients with MRI-confirmed lesions, when contrasted with those without.
The neurologist has a singular role in dissecting the intricacies of clinical history and seizure phenomena, thereby providing the foundation for neuroanatomical localization. Advanced neuroimaging, when used in conjunction with the clinical context, facilitates the identification of subtle MRI lesions, particularly the epileptogenic lesion when multiple lesions are present. Individuals with MRI-confirmed lesions experience a 25-fold increase in the likelihood of seizure freedom post-epilepsy surgery compared to those without demonstrable lesions.
The focus of this article is on educating readers about different types of non-traumatic central nervous system (CNS) hemorrhages and the varying neuroimaging methods utilized for their diagnosis and management.
The 2019 Global Burden of Diseases, Injuries, and Risk Factors Study revealed that intraparenchymal hemorrhage is responsible for 28% of the total global stroke impact. Within the United States, 13% of all strokes are attributable to hemorrhagic stroke. The frequency of intraparenchymal hemorrhage is tied to age, rising substantially; thus, while blood pressure control programs are developed through public health measures, the incidence doesn't decrease as the populace grows older. A recent, longitudinal study of aging, when examined through autopsy, exhibited intraparenchymal hemorrhage and cerebral amyloid angiopathy in 30% to 35% of the participants.
Either a computed tomography (CT) scan of the head or a magnetic resonance imaging (MRI) of the brain is essential for the prompt identification of CNS hemorrhage, which includes intraparenchymal, intraventricular, and subarachnoid hemorrhages. A screening neuroimaging study's demonstration of hemorrhage informs the subsequent selection of neuroimaging, laboratory, and ancillary tests, guided by the blood's pattern in conjunction with the patient's history and physical examination to assess the underlying cause. Once the source of the problem is established, the key goals of the treatment plan are to mitigate the spread of hemorrhage and to prevent subsequent complications, including cytotoxic cerebral edema, brain compression, and obstructive hydrocephalus. In the context of this broader discussion, a summary of nontraumatic spinal cord hemorrhage will also be undertaken.
A timely determination of central nervous system hemorrhage, encompassing intraparenchymal, intraventricular, and subarachnoid hemorrhage, is achieved through either head CT or brain MRI. Identification of hemorrhage within the screening neuroimaging, in combination with the patient's history and physical examination and the blood's pattern, can dictate subsequent neuroimaging, laboratory, and supplementary tests to determine the etiology. Following the identification of the causative agent, the central objectives of the treatment protocol center on mitigating the expansion of hemorrhage and preventing subsequent complications, including cytotoxic cerebral edema, brain compression, and obstructive hydrocephalus. Beyond that, a brief look into nontraumatic spinal cord hemorrhage will also be given.
This article discusses the imaging modalities applied to patients with presenting symptoms of acute ischemic stroke.
The year 2015 saw the initiation of a new epoch in the treatment of acute strokes, marked by the widespread adoption of mechanical thrombectomy. Further randomized, controlled trials in 2017 and 2018 propelled the stroke research community into a new phase, expanding eligibility criteria for thrombectomy based on image analysis of patients. This development significantly boosted the application of perfusion imaging techniques. The continuous use of this additional imaging, after several years, has not resolved the debate about its absolute necessity and the resultant possibility of delays in time-sensitive stroke treatment. More than ever, a substantial and insightful understanding of neuroimaging techniques, their use in practice, and their interpretation is vital for any practicing neurologist.
Due to its broad accessibility, speed, and safety profile, CT-based imaging serves as the initial evaluation method for patients experiencing acute stroke symptoms in most treatment centers. Noncontrast head CT scans alone provide adequate information for determining the need for IV thrombolysis interventions. For accurately identifying large-vessel occlusions, CT angiography is a highly sensitive and reliable imaging technique. Advanced imaging, comprising multiphase CT angiography, CT perfusion, MRI, and MR perfusion, offers additional data that can help with therapeutic choices in specific clinical situations. To ensure timely reperfusion therapy, it is imperative that neuroimaging is conducted and interpreted promptly in all instances.
Because of its wide availability, rapid performance, and inherent safety, CT-based imaging forms the cornerstone of the initial assessment for stroke patients in many medical centers. The sole use of a noncontrast head CT scan is sufficient for determining the appropriateness of intravenous thrombolysis. Large-vessel occlusion detection is reliably accomplished through the highly sensitive technique of CT angiography. In specific clinical situations, advanced imaging, encompassing multiphase CT angiography, CT perfusion, MRI, and MR perfusion, provides extra information that may be useful in the context of therapeutic planning. The ability to execute and interpret neuroimaging rapidly is essential for enabling timely reperfusion therapy in all situations.
The diagnosis of neurologic diseases depends critically on MRI and CT imaging, each method uniquely suited to answering specific clinical queries. Thanks to concerted and devoted work, the safety profiles of these imaging techniques are exceptional in clinical practice. Nevertheless, potential physical and procedural risks are associated with each modality and are explored within this paper.
Recent breakthroughs have enhanced our ability to grasp and lessen the dangers posed by MR and CT imaging. The magnetic fields used in MRI procedures can cause dangerous projectile accidents, radiofrequency burns, and adverse interactions with implanted devices, ultimately resulting in severe patient injuries and even deaths.