Cysticerci located in the fourth ventricle causing obstructive hydrocephalus: a radiological emergency requiring prompt diagnosis

Documenta Hosp Sao Francisco, Div Neurorradiol, Sao Paulo, BrazilUniv Sao Paulo, Fac Med Ribeirao Preto, Hosp Clin, Div Neurorradiol, Sao Paulo, BrazilMED Hosp Sao Lucas, Div Neurorradiol, Sao Paulo, BrazilHosp Santa Casa, Div Neurocirurgia, Sao Paulo, BrazilUniv Fed Sao Paulo, Div Radiol, Sao Paulo, BrazilUniv Fed Sao Paulo, Div Radiol, Sao Paulo, BrazilWeb of Scienc

Hemibalismo-hemicoreia associada à hiperglicemia não-cetótica: uma rara causa de distúrbios hipercinéticas do movimento

Hosp Sao Francisco, Div Neurorradiol, Documenta, Ribeirao Preto, SP, BrazilUniv Sao Paulo, Hosp Clin, Fac Med Ribeirao Preto, Div Neurorradiol Diagnost, BR-14049 Ribeirao Preto, SP, BrazilUniv Fed Sao Paulo, Dept Radiol, Sao Paulo, SP, BrazilUniv Sao Paulo, Hosp Clin, Fac Med Ribeirao Preto, Div Neurorradiol Intervencionista, BR-14049 Ribeirao Preto, SP, BrazilUniv Fed Sao Paulo, Dept Radiol, Sao Paulo, SP, BrazilWeb of Scienc

O valor da sequência de difusão por ressonância magnética na caracterização de lesões císticas pancreáticas

Universidade Federal de São Paulo (UNIFESP)UNIFESPSciEL

Partial epilepsy: A pictorial review of 3 TESLA magnetic resonance imaging features

Epilepsy is a disease with serious consequences for patients and society. In many cases seizures are sufficiently disabling to justify surgical evaluation. In this context, Magnetic Resonance Imaging (MRI) is one of the most valuable tools for the preoperative localization of epileptogenic foci. Because these lesions show a large variety of presentations (including subtle imaging characteristics), their analysis requires careful and systematic interpretation of MRI data. Several studies have shown that 3 Tesla (T) MRI provides a better image quality than 1.5 T MRI regarding the detection and characterization of structural lesions, indicating that high-field-strength imaging should be considered for patients with intractable epilepsy who might benefit from surgery. Likewise, advanced MRI postprocessing and quantitative analysis techniques such as thickness and volume measurements of cortical gray matter have emerged and in the near future, these techniques will routinely enable more precise evaluations of such patients. Finally, the familiarity with radiologic findings of the potential epileptogenic substrates in association with combined use of higher field strengths (3 T, 7 T, and greater) and new quantitative analytical post-processing techniques will lead to improvements regarding the clinical imaging of these patients. We present a pictorial review of the major pathologies related to partial epilepsy, highlighting the key findings of 3 T MRI

Multimodal quantitative magnetic resonance imaging analysis with individualized postprocessing in patients with drug-resistant focal epilepsy and conventional visual inspection negative for epileptogenic lesions

OBJECTIVES: Approximately one-third of candidates for epilepsy surgery have no visible abnormalities on conventional magnetic resonance imaging. This is extremely discouraging, as these patients have a less favorable prognosis. We aimed to evaluate the utility of quantitative magnetic resonance imaging in patients with drug-resistant neocortical focal epilepsy and negative imaging. METHODS: A prospective study including 46 patients evaluated through individualized postprocessing of five quantitative measures: cortical thickness, white and gray matter junction signal, relaxation rate, magnetization transfer ratio, and mean diffusivity. Scalp video-electroencephalography was used to suggest the epileptogenic zone. A volumetric fluid-attenuated inversion recovery sequence was performed to aid visual inspection. A critical assessment of follow-up was also conducted throughout the study. RESULTS: In the subgroup classified as having an epileptogenic zone, individualized postprocessing detected abnormalities within the region of electroclinical origin in 9.7% to 31.0% of patients. Abnormalities outside the epileptogenic zone were more frequent, up to 51.7%. In five patients initially included with negative imaging, an epileptogenic structural abnormality was identified when a new visual magnetic resonance imaging inspection was guided by information gleaned from postprocessing. In three patients, epileptogenic lesions were detected after visual evaluation with volumetric fluid-attenuated sequence guided by video electroencephalography. CONCLUSION: Although quantitative magnetic resonance imaging analyses may suggest hidden structural lesions, caution is warranted because of the apparent low specificity of these findings for the epileptogenic zone. Conversely, these methods can be used to prevent visible lesions from being ignored, even in referral centers. In parallel, we need to highlight the positive contribution of the volumetric fluid-attenuated sequence