Prognostic Value of Neonatal CT Scans in Asphyxiated Term Babies: Low Density Score Compared with Neonatal Neurological Signs

✓ Thirteen cases of cerebral cavernous angiomas are reported, and their radiological and pathological features are reviewed. The clinical presentation was variable: 53.8% of patients had seizures, 30.8% intracerebral hemorrhage, and 15.4% focal neurological signs, including one unusual case that presented as a cerebellopontine angle tumor. The computerized tomography (CT) scans were abnormal in all cases. Angiography was positive only when there was mass effect due to associated hematoma. Surgery was performed in 12 cases with good results. The prognosis of the 13 cases was favorable, with no mortality in this series. These data suggest that the combination of a recent seizure disorder with a hyperdense intracerebral nodule on the CT scanning should alert the neurosurgeon to the possibility of a cavernous angioma.

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Regrowth Patterns of Supratentorial Gliomas: Estimation from Computed Tomographic Scans

Neurosurgery ◽

10.1227/00006123-198612000-00008 ◽

1986 ◽

Vol 19 (6) ◽

pp. 946-951 ◽

Cited By ~ 15

Author(s):

Koji Tsuboi ◽

Yoshihiko Yoshii ◽

Kunio Nakagawa ◽

Yutaka Maki

Keyword(s):

Radiation Necrosis ◽

Malignant Gliomas ◽

Clinical Information ◽

Ct Scans ◽

Enhancement Effect ◽

Low Density ◽

Computed Tomographic ◽

Supratentorial Gliomas ◽

Malignant Astrocytomas ◽

Significant Difference

Abstract To clarify the regrowth patterns of benign and malignant gliomas, we chose 27 intervals (between two operations or between an operation and autopsy) from 21 patients with pathologically verified recurrent supratentorial gliomas. Serial computed tomographic (CT) scans of these cases were analyzed to determine (a) the doubling time (Td) calculated from the change in volume of enhanced and low density areas, (b) the enhancement effect graded from 0 to 4 according to the Hounsfield number, and (c) the presence of dissemination and contralateral extension. We studied 5 benign gliomas (including 1 case of radiation necrosis), 8 malignant astrocytomas, and 8 glioblastomas. The Td's of enhanced areas on CT scans of benign gliomas, malignant astrocytomas, and glioblastomas were 937 ± 66.5 days, 65.1 ± 29.4 days, and 48.1 ± 20.9 days, respectively. The Td's of low density areas were 895 ± 130.6 days, 70.8 ± 22.2 days, and 50.5 ± 14.7 days. There was a significant correlation between the Td's of the enhanced and low density areas (0.97). The enhancement effect increased at recurrence in 55% of the cases, with an average increase of 1.1 grades. The increase in enhancement effect at recurrence showed a tendency to become smaller as the tumor's degree of anaplasia increased. Radiotherapy was effective in significantly retarding the growth rate of malignant gliomas, whose Td's were doubled. Although the Td's of both enhanced and low density areas of benign gliomas were significantly longer than those of malignant gliomas, there was no significant difference in the Td's of enhanced areas between malignant astrocytomas and glioblastomas. Dissemination and contralateral extension occurred at almost the same ratios in malignant astrocytomas and glioblastomas at recurrence. These data indicate that the regrowth pattern of malignant astrocytoma closely resembles that of glioblastoma in spite of morphological distinction. This method was easy and practical for evaluating the biological malignancy of supratentorial gliomas from CT scans, and it can offer us useful clinical information.

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Blood pressure in the artery distal to an intraarterial embolus during thrombolytic therapy for occlusion of a major artery: a predictor of cerebral infarction following good recanalization

Journal of Neurosurgery ◽

10.3171/jns.2005.102.5.0870 ◽

2005 ◽

Vol 102 (5) ◽

pp. 870-878 ◽

Cited By ~ 8

Author(s):

Takatoshi Sorimachi ◽

Yukihiko Fujii ◽

Naoto Tsuchiya ◽

Takeo Nashimoto ◽

Masatsune Saito ◽

...

Keyword(s):

Mr Imaging ◽

Pressure Measurement ◽

Back Pressure ◽

Ct Scans ◽

Low Density ◽

Mr Images ◽

Content Type ◽

Intraarterial Thrombolysis ◽

Scale Scores ◽

Fine Print

Object. The aim in this study was the investigation of back pressure in arteries distal to the occlusion site during intraarterial thrombolysis as well as the usefulness of back pressure measurement in combination with diffusion-weighted (DW) magnetic resonance (MR) imaging to predict the occurrence of ischemic lesions following good recanalization. Methods. Twenty-five consecutive patients with severe hemiparesis caused by embolism of the internal carotid artery (10 patients) and the proximal middle cerebral artery (15 patients) were treated using intraarterial thrombolysis. Systolic back pressure, measured through a microcatheter in the artery just distal to the emboli, ranged from 22 to 78 mm Hg. According to an angiographic inclusion criterion for good recanalization—that is, recanalization of the M2 or more distal arteries at the end of thrombolysis—21 of 25 patients underwent evaluation in this study. In 14 patients volumes of low-density areas on computerized tomography (CT) scans obtained 2 months postthrombolysis were smaller in comparison with volumes of hyperintense areas on DW MR images acquired before treatment, whereas these low-density areas were larger in seven patients. Compared with those on initial DW MR images, the volume of abnormalities on CT scans obtained 2 months posttreatment were significantly reduced in patients with a systolic back pressure greater than 30 mm Hg (16 patients) than in those with a back pressure of 30 mm Hg or less (five patients) (p < 0.05). Systolic back pressures greater than 30 mm Hg were associated with significantly better modified Rankin Scale scores than those 30 mm Hg or less (p < 0.05). Conclusions. Back pressure measurement in combination with DW MR imaging can be used to predict the occurrence of infarction as demonstrated on CT scans following thrombolysis.

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Topographic anatomy and CT correlations in the untreated glioblastoma multiforme

Journal of Neurosurgery ◽

10.3171/jns.1988.68.5.0698 ◽

1988 ◽

Vol 68 (5) ◽

pp. 698-704 ◽

Cited By ~ 304

Author(s):

Peter C. Burger ◽

E. Ralph Heinz ◽

Taichiro Shibata ◽

Paul Kleihues

Keyword(s):

Glioblastoma Multiforme ◽

Histological Study ◽

Three Dimensional ◽

Local Therapy ◽

Ct Scans ◽

Low Density ◽

Neoplastic Tissue ◽

Neoplastic Cells ◽

Content Type ◽

Histological Sections

✓ To provide baseline information for the “local” therapy of the glioblastoma multiforme (GBM), whole-brain histological sections of 15 untreated GBM's were studied to determine the distribution of neoplastic cells. These findings were then compared with the computerized tomography (CT) scans in 11 cases in order to determine the extent to which the peripheral portion of the neoplasm can be estimated by the presence of a low-density area without contrast enhancement. The results of the histological study confirmed the marked heterogeneity of GBM's and disclosed a great variability in the geometry, extent, and character of the peripheral “infiltrating” margin. In spite of the widely held concept that glioblastomas are localized within 2 cm of the contrast-enhanced rim, there were three cases in this two-dimensional study in which this distance was exceeded, and it seems likely that three-dimensional reconstructions would have detected additional cases in which neoplastic cells extended beyond this arbitrary limit. Only three of the 15 GBM's were restricted to the distribution of one internal carotid or one vertebral artery. To the extent that the neoplasms in the present series are representative, this suggests that glioblastomas will be difficult to treat successfully by intra-arterial therapy using existing therapeutic agents. Correlations of histological sections with the CT scans revealed that the vast majority of the neoplastic tissue was contained within the contrast-enhancing and “peritumoral” areas of low density, but that in five cases fingers of neoplasm extended for short distances beyond the outer margin of the latter region. This indicates that the distribution of cells of a GBM cannot be inferred from CT images since the “peritumoral” area of low density can over- or underestimate the extent of the lesion.

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CT findings and the prognostic value of the Koret CT score in cats with traumatic brain injury

Journal of Feline Medicine and Surgery ◽

10.1177/1098612x211005306 ◽

2021 ◽

pp. 1098612X2110053

Author(s):

Ohad Mann ◽

Dana Peery ◽

Ronnie Bader Segev ◽

Sigal Klainbart ◽

Efrat Kelmer ◽

...

Keyword(s):

Prognostic Value ◽

Intracranial Haemorrhage ◽

Ct Scans ◽

Short Term ◽

Term Survival ◽

Long Term Survival ◽

Head Ct ◽

Ct Findings ◽

Short Term Survival

Objectives The aims of this study were to evaluate associations between abnormal head CT findings and outcome, and to examine the prognostic value of the Koret CT score (KCTS) in cats sustaining acute traumatic brain injury (TBI). Methods The medical records of cats hospitalised with TBI that underwent head CT scans within 72 h of admission were retrospectively reviewed. CT scans were evaluated independently by a radiologist and a neurologist who were blinded to the outcome. A KCTS and modified Glasgow Coma Scale (MGCS) were assigned to each cat and the association between abnormal CT findings, KCTS, MGCS and outcome were analysed. Results Fourteen cats were included in the study: nine (64.2%) survivors and five (35.7%) non-survivors. Of the nine cats that were discharged, one was a short-term survivor (10 days) and eight (57.1%) were long-term survivors (⩾6 months). Abnormal CT findings included lateral ventricle asymmetry/midline shift (42.8%), intracranial haemorrhage (35.7%), caudotentorial lesions (14.2%) and cranial vault fractures (14.2%), all of which were depressed. Intracranial haemorrhage was found to be significantly and negatively associated with short-term ( P = 0.005) and long-term ( P = 0.023) survival. KCTS was significantly associated with short-term survival ( P = 0.002) and long-term survival ( P = 0.004). A KCTS cut-off value of 2 yielded a 100% sensitivity and 100% specificity for short-term survival and 100% sensitivity and 80% specificity for long-term survival. A MGCS cut-off value of ⩾13 was associated with a 100% sensitivity and 100% specificity for short-term survival, and with a 100% sensitivity and 80% specificity for long-term survival. Conclusions and relevance KCTS, performed up to 72 h from injury, can be used as an additional diagnostic tool for the prediction of survival in cats with TBI.

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Prognostic significance of microRNA 17–92 cluster expression in Egyptian chronic lymphocytic leukemia patients

Journal of the Egyptian National Cancer Institute ◽

10.1186/s43046-021-00097-x ◽

2021 ◽

Vol 33 (1) ◽

Author(s):

M. M. Khalifa ◽

N. E. Zaki ◽

A. A. Nazier ◽

M. A. Moussa ◽

R. Abdel Haleem ◽

...

Keyword(s):

Chronic Lymphocytic Leukemia ◽

Prognostic Value ◽

Significant Positive Correlation ◽

Expression Patterns ◽

Lymphocytic Leukemia ◽

High Expression ◽

Ct Scans ◽

Significant Relation ◽

Expression Levels ◽

Positive Correlation

Abstract Background Abnormal expression patterns of microRNAs (miRs) play an important role in the development and progression of malignancy. Identification of the clinical significance and prognostic value of these small molecules in chronic lymphocytic leukemia (CLL); a disease of heterogeneous biological landscape and clinical course, has always been of tremendous translational value. Aim To evaluate the prognostic value of microRNA17-92 cluster members in Egyptian CLL patients. Methods The expression levels of miR17-92 cluster members were evaluated by qRT-PCR, including miR17, miR18a, miR19a, miR19b-1, miR20a, and miR92a-1. Other investigations included serum LDH, serum β2 microglobulin (β2M), CD38 and ZAP70 expression by flow cytometry, fluorescence in situ hybridization (FISH) for 17p deletion, and imaging studies (computerized tomography (CT) scans of neck, chest, abdomen, and pelvis or PET-CT scans). Results Overexpression of all members of the miRNA17-92 cluster was detected in CLL patients compared to controls (p = < 0.001 for all miRs while p = 0.01 for miR19b-1). A significant positive correlation between Hb and miR17 and a significant negative correlation between Hb and miR19b-1 were observed (p = 0.041, 0.017 respectively). A statistically significant positive correlation between miR19b-1 expression and each of the WBCs and absolute lymphocytic count (ALC) was detected (p = 0.023, 0.022 respectively). Moreover, a statistically significant relation between miR19b-1 expression and advanced Binet stages was also found (p = 0.05). Regarding miR18a, a statistically significant positive correlation with LDH level was found (p = 0.003). We also found a significant positive correlation between miR92a-1 and β2M level (p = 0.005), as well as a significant relation between miR17 and negative CD38 expression (p = 0.034). However, no significant relationships between any of studied miRNA expression levels and 17p deletion or response to treatment were observed. Patients who expressed miR19b-1 were significantly indicated to start therapy at diagnosis (p = 0.05). The overall survival of CLL patients included in our study was 90.2% after 1 year from the time of diagnosis. Patients with high expression of miR19a had better OS than those with low expression (p = 0.04). Conclusions Overexpression of all members of the miR17-92 cluster was detected in Egyptian CLL patients. MiR18a, miR19b-1, and miR92a-1 also have an adverse prognostic value while miR17 can be considered a good prognostic marker. High expression of miR19a is associated with better OS.

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