Penetrating craniocerebral injury by chopsticks in a Japanese boy confirmed by combined brain computed tomography and magnetic resonance imaging

Background and purpose There are great variations in how different technologists create the different imaging planes that can make a precise comparison of computed tomography and magnetic resonance imaging difficult. We aimed to identify a reference line for the coronal images on a computed tomography topography parallel to the posterior borderline of the brainstem (PB), matching standard coronal magnetic resonance imaging planes. Methods We retrospectively reviewed computed tomography topography images of 80 consecutive patients to determine a computed tomography plane to match the PB on magnetic resonance imaging. These included the tuberculum sella (TS)–anterior arch of the C1 vertebra (C1), TS–tip of dens axis (D), dorsum sellae (DS)–C1 and DS–D. We compared these methods of prescribing the coronal computed tomography plane to coronal magnetic resonance imaging planes by measuring the angles between TS–C1 and PB, TS–M and PB, DS–C1 and PB, DS–D and PB on midsagittal brain magnetic resonance images. Bland–Altman plots were created to assess intra-observer reliability. Results The angles between the PB line and each topogram-determined line are as follows: TS–C1, 10.40° ± 4.86°; TS–D, 22.46° ± 5.23°; DS–C1, 3.01° ± 3.16°; and DS–D, 11.53° ± 4.10°. The mean angles between the DS–C1 and the PB lines were significantly smaller than the mean angle between any other line (DS–D, TS–C1, or TS–D, all P < 0.001). Intra-observer agreement regarding the angular position of the reformatted coronal images on the lateral scout image was excellent (intraclass correlation coefficient >0.900, P < 0.05). Conclusions The DS–C1 is almost parallel to the PB and easily identifiable on the lateral scout topography of brain computed tomography. Utilising the DS–C1 line as the baseline for brain computed tomography could allow better corroboration with coronal magnetic resonance imaging angulation.

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Altered Brain Computed Tomography Perfusion in Patients With Fluctuating Lacunar Syndrome and Normal Magnetic Resonance Imaging

JAMA Neurology ◽

10.1001/jamaneurol.2015.4026 ◽

2016 ◽

Vol 73 (3) ◽

pp. 348 ◽

Cited By ~ 2

Author(s):

Salvatore Rudilosso ◽

Xabier Urra ◽

Oscar Chirife ◽

Ángel Chamorro

Keyword(s):

Magnetic Resonance Imaging ◽

Computed Tomography ◽

Magnetic Resonance ◽

Resonance Imaging ◽

Computed Tomography Perfusion ◽

Brain Computed Tomography ◽

Lacunar Syndrome

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The Usefulness of Brain Magnetic Resonance Imaging with Mild Head Injury and the Negative Findings of Brain Computed Tomography

Journal of Korean Neurosurgical Society ◽

10.3340/jkns.2013.54.2.100 ◽

2013 ◽

Vol 54 (2) ◽

pp. 100 ◽

Cited By ~ 2

Author(s):

Du Su Kim ◽

Min Ho Kong ◽

Se Youn Jang ◽

Jung Hee Kim ◽

Dong Soo Kang ◽

...

Keyword(s):

Magnetic Resonance Imaging ◽

Computed Tomography ◽

Head Injury ◽

Magnetic Resonance ◽

Brain Magnetic Resonance Imaging ◽

Mild Head Injury ◽

Resonance Imaging ◽

Brain Computed Tomography ◽

Negative Findings

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Diagnostic accuracy of whole-brain computed tomography perfusion for detection of ischemic stroke in patients with mild neurological symptoms

The Neuroradiology Journal ◽

10.1177/1971400918770898 ◽

2018 ◽

Vol 31 (5) ◽

pp. 464-472 ◽

Cited By ~ 1

Author(s):

Robert A Frank ◽

Santanu Chakraborty ◽

Trevor McGrath ◽

Alexander Mungham ◽

James Ross ◽

...

Keyword(s):

Magnetic Resonance Imaging ◽

Computed Tomography ◽

Magnetic Resonance ◽

Resonance Imaging ◽

Whole Brain ◽

Computed Tomography Perfusion ◽

Brain Computed Tomography ◽

Diffusion Weighted ◽

Weighted Magnetic Resonance Imaging

Mild and minor acute neurological symptoms may lead to diagnostic uncertainty, resulting in a heterogeneous group of patients with true ischemic events and stroke mimics with a potential for poor outcomes. More than half of ischemic stroke patients present as minor strokes (National Institutes of Health Stroke Scale score <6). Whole-brain computed tomography perfusion can be used as a diagnostic test for minor stroke, offering a potential method of reducing diagnostic uncertainty in these patients. We hypothesize that whole-brain computed tomography perfusion imaging features could accurately predict infarction in patients with minor neurological deficits. This retrospective chart review enrolled consecutive patients suspected of acute ischemic stroke with a National Institutes of Health Stroke Scale score <6, who underwent whole-brain computed tomography perfusion and follow-up diffusion-weighted magnetic resonance imaging at our institution. Sensitivity, specificity, positive and negative predictive values, and positive and negative likelihood ratios were calculated for whole-brain computed tomography perfusion, using follow-up diffusion-weighted magnetic resonance imaging as a reference standard. A total of 524 patients (mean age: 67 years; range: 17–96 years; 56% men) met the inclusion criteria. Patients were excluded for non-diagnostic ( n = 25) or missing maps ( n = 8) scans, non-ischemic findings ( n = 7), and lack of follow-up magnetic resonance imaging ( n = 336). The final analysis included 148 patients who underwent diffusion-weighted magnetic resonance imaging. Whole-brain computed tomography perfusion has a sensitivity of 0.57 (95% CI: 0.45–0.69) and a specificity of 0.82 (95% CI: 0.71–0.90). The positive and negative predictive values and positive and negative likelihood ratios were 75%, 67%, 3.09, and 0.53, respectively. Our analysis suggests that although whole-brain computed tomography perfusion may offer some value as an adjunctive test for improving confidence in offering stroke treatment, it is not sufficiently sensitive or specific to accurately predict cerebral infarcts in patients with minor neurological symptoms.

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