A CT-study of the Cranial Suture Morphology and its Reorganization during the Obliteration

Obliteration of the cranial sutures is an age-dependent process. Its premature occurrence (craniosynostosis) causes different craniofacial deformations, dependent on the affected suture(s). The understanding of the suture morphology and the remodeling processes during the obliteration is essential for early diagnosis and treatment of the premature closure. This study aimed to investigate the morphology of open and obliterated sutures and to perform comparison analysis on the 3D images obtained by both industrial and medical computed tomography (CT) systems with various resolutions. A segment of the sagittal suture of dry skulls of known age and sex was scanned using Nikon XTH 225, an industrial CT system, developed by Nikon Metrology. The same section of the sagittal suture was observed on patients undergoing CT scanning with a multislice system Toshiba Aquilion 64 with 0.5 mm slice thickness. For 3D visualization, VGStudioMax 2.2 were used. The suture morphology was observed in coronal section on sequential 2D slices. Micro-CT (μCT) scanning of dry skulls enabled calculation of the morphometric parameters and visualization of the microarchitecture of the suture and its reorganization during the obliteration, unlike the CT imaging of patients, where the sutures were scarcely discernable. In the entirely open sections of the suture the bone edges were separated by a gap of various widths. As the obliteration proceeded, the gap gradually reduced and the bone edges got into a contact. In the fi nal stages, the traces from the contact faded away and the sutural area became a homogenous structure of increased integrity. The μCT scanning of dry bones is a powerful non-destructive technique for examination of the suture morphology. Remodeling of the suture during the obliteration leads to gradually diminishing of the gap between the bone edges to their entire coalescence

European recommendations on practices in pediatric neuroradiology: consensus document from the European Society of Neuroradiology (ESNR), European Society of Paediatric Radiology (ESPR) and European Union of Medical Specialists Division of Neuroradiology (UEMS)

Pediatric neuroradiology is a subspecialty within radiology, with possible pathways to train within the discipline from neuroradiology or pediatric radiology. Formalized pediatric neuroradiology training programs are not available in most European countries. We aimed to construct a European consensus document providing recommendations for the safe practice of pediatric neuroradiology. We particularly emphasize imaging techniques that should be available, optimal site conditions and facilities, recommended team requirements and specific indications and protocol modifications for each imaging modality employed for pediatric neuroradiology studies. The present document serves as guidance to the optimal setup and organization for carrying out pediatric neuroradiology diagnostic and interventional procedures. Clinical activities should always be carried out in full agreement with national provisions and regulations. Continued education of all parties involved is a requisite for preserving pediatric neuroradiology practice at a high level

Modern Imaging Modalities in the Assessment of Acute Stroke

The AIM of this review was to present the modern concepts of diagnostic imaging in acute stroke. Neuroimaging in acute stroke aims at diagnosing the condition as early as possible and assessing the extent of parenchymal perfusion and the intracranial vessels patency. A modern approach would involve a combination of various imaging modalities as multidetector computed tomography and high field magnetic resonance imaging. A non-enhanced computed tomography (CT) is used to detect hemorrhage or to identify early signs of ischemic stroke. CT angiography finds evidence of intravascular thrombi or significant stenoses, and CT perfusion displays brain tissue at risk of irreversible alterations that can be salvaged therapeutically. Magnetic resonance imaging (MRI) is a more sensitive modality than CT in diagnosing acute brain ischemia. MR diffusion-weighted imaging is more sensitive than conventional MR sequences in hyperacute stage. MR angiography as a non-invasive and non-ionizing imaging method is used as an alternative modality to CT angiography. To find brain tissue at risk diffusion- and perfusion-weighted magnetic resonance imaging modalities are used. The authors present briefly the modern neuroimaging modalities used in patients with transient ischemic attack, minor stroke and venous infarction. By combining different imaging techniques in a multimodal approach we can acquire the information necessary for therapeutic planning and differentiate patients who need thrombolysis

Adnexal masses characterized on 3 tesla magnetic resonance imaging - added value of diffusion techniques.

Background To assess different types of adnexal masses as identified by 3T MRI and to discuss the added value of diffusion techniques compared with conventional sequences. Patients and methods 174 women age between 13 and 87 underwent an MRI examination of the pelvis for a period of three years. Patients were examined in two radiology departments - 135 of them on 3 Tesla MRI Siemens Verio and 39 on 3 Tesla MRI Philips Ingenia. At least one adnexal mass was diagnosed in 98 patients and they are subject to this study. Some of them were reviewed retrospectively. Data from patients\u27 history, physical examination and laboratory tests were reviewed as well. Results 124 ovarian masses in 98 females\u27 group of average age 47.2 years were detected. Following the MRI criteria, 59.2% of the cases were considered benign, 30.6% malignant and 10.2% borderline. Out of all masses 58.1% were classified as cystic, 12.9% as solid and 29% as mixed. Оf histologically proven tumors 74.4% were benign and 25.6% were malignant. All of the malignant tumors had restricted diffusion. 64 out of all patients underwent contrast enhancement. (34 there were a subject of contraindications). 39 (61%) of the masses showed contrast enhancement. Conclusions Classifying adnexal masses is essential for the preoperative management of the patients. 3T MRI protocols, in particular diffusion techniques, increase significantly the accuracy of the diagnostic assessment

Cognitive Impairment and Brain Imaging Characteristics of Patients with Congenital Cataracts, Facial Dysmorphism, Neuropathy Syndrome

Congenital cataracts, facial dysmorphism, neuropathy (CCFDN) syndrome is a complex autosomal recessive multisystem disorder. The aim of the current study is to evaluate the degree of cognitive impairment in a cohort of 22 CCFDN patients and its correlation with patients’ age, motor disability, ataxia, and neuroimaging changes. Twenty-two patients with genetically confirmed diagnosis of CCFDN underwent a detailed neurological examination. Verbal and nonverbal intelligence, memory, executive functions, and verbal fluency wеre assessed in all the patients aged 4 to 47 years. Brain magnetic resonance imaging was performed in 20 affected patients. Eighteen affected were classified as having mild intellectual deficit, whereas 4 had borderline intelligence. In all psychometric tests, evaluating different cognitive domains, CCFDN patients had statistically significant lower scores when compared to the healthy control group. All cognitive domains seemed equally affected. The main abnormalities on brain MRI found in 19/20 patients included diffuse cerebral atrophy, enlargement of the lateral ventricles, and focal lesions in the subcortical white matter, different in number and size, consistent with demyelination more pronounced in the older CCFDN patients. The correlation analysis of the structural brain changes and the cognitive impairment found a statistically significant correlation only between the impairment of short-term verbal memory and the MRI changes

A Geometric Morphometric Study on Sexual Dimorphism in Viscerocranium

The level of sexual dimorphism manifested by human bones is an important factor for development of effective sex estimation methods. The aim of the study was to investigate the sexual dimorphism in the size and shape of the viscerocranium using geometric morphometric techniques. It also aimed to explore the sex differences in distinct viscerocranial regions and to establish the most dimorphic region with regard to size and shape. Computed tomography images of 156 males and 184 females were used in the study. Three-dimensional coordinates of 31 landmarks were acquired. Five landmark configurations were constructed from the viscerocranium and its orbital, nasal, maxillary, and zygomatic region. Generalized Procrustes superimposition, principal component analysis, and discriminant analysis were applied to each configuration. The significance of the sex differences in size and shape was assessed and significant differences were found in all configurations. The highest accuracy was obtained from both shape and size of the whole viscerocranium. Based on size only, the highest accuracy was achieved by the nasal region. The accuracy based on shape was generally low for all configurations, but the highest result was attained by the orbital region. Hence, size is a better sex discriminator than shape

Transient perivascular inflammation of the carotid artery—A transient but potentially recurrent disease

Key Clinical Message Transient perivascular inflammation of the carotid artery (TIPIC syndrome) is a rare, unclassified vascular syndrome that usually affects the distal part of the common carotid artery and has a favorable prognosis. The disease is often misdiagnosed even by neurologists due to the moderate intensity of clinical symptoms and their transient character. We present a case of a 52‐year‐old man who experienced two episodes of transient neck pain and moderate local tenderness one and a half years apart. Different imaging modalities, such as ultrasound, CT angiography, and high‐resolution 3T MR, were applied to better visualize the perivascular inflammation of the common carotid arteries. Based on the clinical‐radiological characteristics of our case and applying the diagnostic criteria, we established the diagnosis of TIPIC syndrome. The patient was treated with nonsteroidal anti‐inflammatory drugs for few weeks, and reduction in perivascular changes was observed in both episodes. The case raises questions about the phases of the disease, its duration and the intervals between follow‐ups. Our article also increases the awareness of this rare clinical‐radiological entity and presents recent data from the literature