[Imaging technics in the evaluation of malformations, traumatic and expansive disorders of the orbital region]

In this paper the authors evaluate the usefulness of the new radiological techniques in the study of the orbital region. They describe the role of modern computerized imaging in the planning of their correction of malformative and traumatic diseases of the orbit. Furthermore, the authors evaluate the usefulness of US, CT, and MR imaging in the differential diagnosis of growing masses of the orbit.

MRI in Smith-Lemli-Opitz syndrome type I

We describe a single case of a polymalformational syndrome in which the MR findings were of great help in the final diagnosis of Smith-Lemli-Opitz syndrome (SLOS) type I. MRI was performed for evaluation of the brain morphology since the clinical and laboratory findings were suggestive but not unequivocally indicative of SLOS. MRI findings of frontal lobe hypoplasia, cortical migration defect, and abnormalities of median line structures prompted the final diagnosis of SLOS.

Bilateral simultaneous cerebellar infarction in the medial branches of the posterior inferior cerebellar artery territories

We present an unusual case of simultaneous bilateral cerebellar infarction in the territory of the medial and intermediate branches of the posterior inferior cerebellar arteries (mPICA). The patient, a 57-yr-old woman, had no risk factors for cerebrovascular disease but a long-standing hypertension. Pathogenetic hypotheses of this unusual ischemic site of lesion may be referred to: A) two PICAs arising from an occluded basilar artery; B) both medial branches arising from the same PICA on one side; C) a haemodynamic mechanism with hypoperfusion in the most peripheral branches of the arteries; D) a double, simultaneous embolic stroke in mPICAs territory. Based on clinical course, supraortic duplex-scan, echocardiography, MRI, angioMRI and CT scans, and digital subtraction angiography, none of these hypotheses could be clearly associated with the pathogenesis of the lesion. Nevertheless, we propose that an anomalous common mPICA for both cerebellar territories should represent the necessary condition for the ischemic insult and, simultaneously, other factors should intervene as possible determining events.

High-dose contrast-enhanced MRI in multiple sclerosis

Contrast-enhanced MRI is effective for assessing disease activity in multiple sclerosis (MS) and may provide an outcome measure for testing the efficacy of treatment in clinical trials. To compare the sensitivity of high-dose gadolinium-HP-DO3A with that of a standard dose of gadolinium-DTPA, we studied 16 patients with relapsing-remitting MS in the acute phase of the disease. Each underwent two MRI examinations within at most 48 h. The initial MRI study was with a standard dose of gadolinium-DTPA (0.1 mmol/kg), and the second one an experimental dose of gadolinium-HP-DO3A (0.3 mmol/kg). No adverse effects were attributed to the contrast media. The high-dose study revealed more enhancing lesions than the standard-dose study (56 vs 38). This difference was found to be more relevant for infratentorial and small lesions. Furthermore, with the higher dose, there was a marked qualitative improvement in the visibility and delineation of the lesions.

[Role of CT and MR in the assessment of lumbar degenerative disk disease]

The application of CT and MR techniques for the evaluation of degenerative disease of lumbar disk is illustrated in this work. A critical review of the literature was done.

[Tumors of the temporal bone and the cerebellopontine angle. Diagnosis, characterization and assessment of extension by using imaging technics]

We discuss in this paper the reliability of neuroimaging techniques in the diagnosis of neoplastic masses of the posterior-lateral skull base. We also discuss the role of TC and MRI in the evaluation of the extension pattern of these masses.

[Role of CT and MRI in the evaluation of tumoral pathology in the rhinopharynx, the parapharyngeal space and the masticatory apparatus]

In this paper we discussed the usefulness of CT and MR imaging in the study of tumors of nasopharynx, paraphararyngeal space and masticatory space. We also stressed the role of the techniques in the characterization and in assessing the extension of these diseases.

Intracerebral schwannoma: CT and MR findings

A case of intracerebral schwannoma in a 19-year-old man is reported. CT and MR findings were nonspecific, suggesting a primary glioma. The histologic features were of schwannoma.

[Neoplastic involvement of the cranial base. Role of computerized tomography and magnetic resonance]

We discussed in this paper the abilities and limits of CT Scan and MR Imaging in the diagnosis of skull base tumors. We stressed the role of computerized neuroimaging in the characterization and evaluation of the extension of these tumor masses involving the skull base.

[Magnetic resonance spectroscopy]

Although the usefulness and feasibility of MR spectroscopy in clinical practice has not been proven, this technique has shown to be useful for the understanding of pathogenetic mechanisms of several diseases. In this work we reviewed the most important fields of application of MR spectroscopy and discussed its diagnostic potential.

[Magnetic resonance angiography in the study of cervical and endocranial vascular pathology]

The principles of MR angiography techniques for the detection of vascular anatomy are discussed in this review. We underlined the possibilities and limits of this technique with its advantages and disadvantages. We also discuss the applications of MR angiography in diagnosing of cerebrovascular or neoplastic diseases. Finally we stress the role of MR angiography in clinical practice, and its reliability, in comparison with digital angiography, conventional angiography, and spiral CT.

[Diffusion and perfusion studies with magnetic resonance imaging in cerebral ischemia]

The results of diffusion-perfusion RM studies in cerebrovascular diseases are reviewed in this paper. We discussed the role of these techniques for the understanding of the pathogenesis of cerebral ischemia, in experimental studies as well as in humans and their future application in diagnostic clinical trials, for early detection and management.

[Characterization of space occupying masses in the diencephalic-hypothalamic region. MRI vs. TC]

All morphologic aspects of neoplastic and non neoplastic masses, arising from the diencephalic-hypothalamic region are discussed in this paper. We describe the densitometric characteristics on CT scan and the MRI appearance of masses affecting this region, both of benign lesions and malignant neoplastic masses. We describe separately masses arising from within the III ventricle and those of extraventricular origin and all semiotic findings of neuroradiological techniques of computed imaging.

[Diagnostic imaging in the evaluation of non-neoplastic space occupying pathology in the sellar and suprasellar region]

Before the introduction of computed imaging techniques like CT scan and MR, the differential diagnosis of lesions affecting the sellar and suprasellar regions was very difficult, more often impossible. These techniques contributed to ameliorate the typing of pathological tissues. Non neoplastic pathological findings of this region are very different and they can variate between phlogistic processes, vascular lesions, hamartomatous formations or congenital malformations. In this work we describe the characteristic changes of morphology and radiologic aspect in the diagnostic study of this region, using CT scan and MR imaging.

[Computerized tomography and magnetic resonance in the evaluation of neoplastic processes localized on the floor of the third ventricle]

In our experience, neoplastic lesions of the floor of the third ventricle are frequently responsible for neurologic and dysendocrine symptoms. Ct scan and MR imaging are the most reliable techniques of neuroimaging in the diagnostic study of neoplastic masses affecting this region. In this work, CT and MR appearance of lesions of the III ventricle floor are discussed with the aim of contributing to the differential diagnosis of neoplasms and their surgical and medical management.

[The role of tomography (X-ray and magnetic resonance) in the diagnosis and determination of the extension of tumors in the roof of the third ventricle]

We describe the CT scan and MR appearance of neoplastic lesions affecting the roof of the third ventricle. The neoplastic lesions of this region may be of neuroepithelial origin (sub-ependymoma, colloid cyst), meningeal cell origin (meningiomas), metastatic or primary localization of lymphoproliferative tumors (lymphomas) and dysembryogenetic origin (epidermoid tumor). CT scan and MR imaging are useful techniques for diagnosis and planning of surgical or medical treatment. The primary role of these imaging techniques, is discussed in the quantification of extension, biologic malignancy and anatomical relationships between pathologic lesion and normal nervous tissue.

[Diagnostic imaging in the evaluation of masses developing in the cerebral ventricles]

CT scan and MR imaging of intraventricular masses are discussed in this work. The lesions affecting this region may be of neoplastic, vascular or phlogistic origin. CT scan and MR imaging are useful for diagnosis and management of these lesions. Intraventricular masses are well documented by high resolution CT scan after administration of endo-rachideal metrizamide, during ventriculographic studies. This technique gives important informations about peripheral relationship of intraventricular masses with increased liquoral fluid. MR imaging is also available for characterizing pathologic tissues, and for detecting the anatomic relationships between pathologic and normal structures.

Sleep patterns in acute ischemic stroke

We studied polysomnographic recordings using an Oxford Medilog 9000 System in 18 patients with ischemic stroke in the middle cerebral artery territory. All patients underwent neurologic examination and brain CT scan within 5 h after the onset of symptoms. Polysomnographic recordings were started immediately thereafter and went on for three nights. Clinical and polysomnographic follow-up were performed 3 weeks after admission. The number and duration of REM phases were significantly reduced in the acute phase. This reduction correlated with the severity of neurological deficit at outcome and with the anatomical site of the lesion on CT scan. Our data provide evidence that polysomnographic recording is useful to detect symptoms of patients with different clinical outcomes during the acute phase of ischemic stroke.