3D fat-saturated T1 SPACE sequence for the diagnosis of cervical artery dissection

Introduction: This study aims to demonstrate the added value of a 3D fat-saturated (FS) T1 sampling perfection with application-optimised contrast using different flip angle evolutions (SPACE) sequence compared to 2D FS T1 spin echo (SE) for the diagnosis of cervical artery dissection. Methods: Thirty-one patients were prospectively evaluated on a 1.5-T MR system for a clinical suspicion of acute or subacute cervical artery dissection with 3D T1 SPACE sequence. In 23 cases, the axial 2D FS T1 SE sequence was also used; only these cases were subsequently analysed. Two neuroradiologists independently and blindly assessed the 2D and 3D T1 sequences. The presence of recent dissection (defined as a T1 hyperintensity in the vessel wall) and the quality of fat suppression were assessed. The final diagnosis was established in consensus, after reviewing all the imaging and clinical data. Results: Overall sensitivity and specificity were 0.929 and 1 for axial T1 SE, and 0.965 and 0.945 for T1 SPACE (P > 0.05), respectively. The two readers had excellent agreement for both sequences (k = 1 and 0.8175 for T1 SE and T1 SPACE, respectively; P > 0.05). The quality of the fat saturation was similar. Very good fat saturation was obtained in the upper neck. Multiplanar reconstructions were very useful in tortuous regions, such as the atlas loop of the vertebral artery or the carotid petrous entry. 3D T1 SPACE sequence has a shorter acquisition time (3min 25s versus 5min 32s for one T1 SE sequence) and a larger coverage area. Conclusion: 3D T1 SPACE sequence offers similar information with its 2D counterpart, in a shorter acquisition time and larger coverage are

Dynamic Contrast-Enhanced MR Perfusion of Intradural Spinal Lesions

Fifteen patients with intradural spinal lesions were examined with an optimized dynamic contrast-enhanced MR perfusion sequence at 1.5T and 3T. SNR and mean contrast-to-noise ratio were better on 3T compared with 1.5T (P ≤ .05). The goodness of fit of the Tofts and Tofts extended pharmacokinetic models was similar between 1.5T and 3T. Thus, dynamic contrast-enhanced MR perfusion of intradural spinal canal lesions is technically feasible at 1.5T and 3T, with better image quality at 3T

Imaging of the cavernous sinus lesions

This educational paper reviews the normal anatomy of the cavernous sinus (CS) and the imaging findings of common and uncommon lesions of this region. CS lesions may arise from different components of the CS or from adjacent structures and spaces. They can be classified as tumoral, inflammatory/infectious, vascular and congenital. Tumoral lesions include benign (meningiomas, pituitary adenomas, schwannomas) and malignant neoplasms (chondrosarcomas, chordomas, nasopharyngeal carcinomas, leukemia, metastases). Inflammatory/infectious conditions comprise: Tolosa Hunt, abscess, Lemierre syndrome and thrombophlebitis. Vascular lesions include: hemangiomas, carotido-cavernous fistula, aneurysms, arteriovenous malformations. Congenital conditions include the epidermoid cyst, dermoid cyst and fatty deposits. Although imaging features of non-vascular CS diseases are most often non-specific, careful analysis of the adjacent structures suggests the correct diagnosis. In vascular pathology, characteristic MR imaging findings are observed

Peripheral nerves, tumors, and hybrid PET-MRI.

The study of peripheral nerves (PN) is a challenge because of the orientation, size, and also because of the fact that these pathologies are not well known. The diagnosis of PN damage was based exclusively on clinical examination and electrophysiologic testing until few years ago. MRI is the examination of choice for studying peripheral nerves; recently, magnetic resonance neurography has been added as a part of clinical routine. However, the analysis of PN after surgical treatment remains difficult. This clinical case of a sarcoma of the right brachial plexus illustrates how hybrid PET-MRI in postsurgical evaluation will clearly improve the exact delimitation of residual metabolically active tumor after surgery

Magnetic resonance imaging of metabolic diseases of the cerebral white matter

Metabolic diseases of the brain are a rare occurrence. They may be either occurring as inherited diseases causing a destruction of myelin, or they may be the result of toxicity. Neuroimaging, especially magnetic resonance imaging, plays an important role in the detection and classification of these rare diseases. Magnetic resonance spectroscopy is an important tool in the characterization and diagnosis of inherited metabolic diseases

3D fat-saturated T1 SPACE sequence for the diagnosis of cervical artery dissection

This study aims to demonstrate the added value of a 3D fat-saturated (FS) T1 sampling perfection with application-optimised contrast using different flip angle evolutions (SPACE) sequence compared to 2D FS T1 spin echo (SE) for the diagnosis of cervical artery dissection