Imaging of cervical lymph nodes in head and neck cancer: The basics

Imaging can identify pathologie cervical adenopathy in a significant number of patients with head and neck cancer who have no palpable adenopathy on physical examination. This artide reviews nocial classification, drainage pattems of different head and neck cancers, various cross-sectional imaging features of metastatic lymph nodes from head and neck cancer, nodal staging, and certain features like extracapsular spread and carotid and vertebral invasion that the radiologist should know because they have therapeutic and prognostic implications. New imaging techniques and the role of fluorodeoxyglucose positron emission tomography imaging in recurrent disease are discussed

Diffusion-tensor MR tractography of somatotopic organization of corticospinal tracts in the internal capsule: initial anatomic results in contradistinction to prior reports.

The goal of this study was to use diffusion-tensor magnetic resonance (MR) imaging to define the location and organization of corticospinal tracts (CSTs) in the posterior limb of the internal capsule (PLIC). The Institutional Review Board approved the study, and informed consent was obtained from all subjects. Eight volunteers and two patients with brain tumor were imaged at 3 T. All CSTs were found to lie in a compact area in one part of the PLIC: If the PLIC is divided into four equal quarters from anterior to posterior, the CST was shown to be in the third quarter. Seventeen of 20 CSTs were organized somatotopically, with hand fibers anterolateral to foot fibers, not anteromedial as is currently believed. In three of 20, hand and foot fibers were intermixed. Classically, it was thought that the CST was located in the anterior third of the PLIC. The present data confirm recent results that the CST is located more posteriorly. In the majority of cases, however, the CST is organized somatotopically

Angle-corrected imaging transcranial doppler sonography versus imaging and nonimaging transcranial doppler sonography in children with sickle cell disease.

BACKGROUND AND PURPOSE: Nonimaging transcranial Doppler sonography (TCD) and imaging TCD (TCDI) are used for determination of the risk of stroke in children with sickle cell disease (SCD). The purpose was to compare angle-corrected, uncorrected TCDI, and TCD blood flow velocities in children with SCD. MATERIALS AND METHODS: A total of 37 children (mean age, 7.8 +/- 3.0 years) without intracranial arterial narrowing determined with MR angiography, were studied with use of TCD and TCDI at the same session. Depth of insonation and TCDI mean velocities with and without correction for the angle of insonation in the terminal internal carotid artery (ICA) and middle (MCA), anterior (ACA), and posterior (PCA) cerebral arteries were compared with TCD velocities with use of a paired t test. RESULTS: Two arteries were not found on TCDI compared with 15 not found on TCD. Average angle of insonation in the MCA, ACA, ICA, and PCA was 31 degrees , 44 degrees , 25 degrees , and 29 degrees , respectively. TCDI and TCD mean depth of insonation for all arteries did not differ significantly; however, individual differences varied substantially. TCDI velocities were significantly lower than TCD velocities, respectively, for the right and left sides (mean +/- SD): MCA, 106 +/- 22 cm/s and 111 +/- 33 cm/s versus 130 +/- 19 cm/s and 134 +/- 26 cm/s; ICA, 90 +/- 14 cm/s and 98 +/- 27 cm/s versus 117 +/- 18 cm/s and 119 +/- 23 cm/s; ACA, 74 +/- 24 cm/s and 88 +/- 25 cm/s versus 105 +/- 23 cm/s and 105 +/- 31 cm/s; and PCA, 84 +/- 27 cm/s and 82 +/- 21 cm/s versus 95 +/- 23 cm/s and 94 +/- 20 cm/s. TCD and angle-corrected TCDI velocities were not statistically different except for higher angle-corrected TCDI values in the left ACA and right PCA. CONCLUSION: TCD velocities are significantly higher than TCDI velocities but are not different from the angle-corrected TCDI velocities. TCDI identifies the major intracranial arteries more effectively than TCD