Volumetric Analysis of Intracranial Arteriovenous Malformations Contoured for CyberKnife Radiosurgery With 3-Dimensional Rotational Angiography vs Computed Tomography/Magnetic Resonance Imaging

Neurosurgery ◽  
2013 ◽  
Vol 73 (2) ◽  
pp. 262-270 ◽  
Author(s):  
Anand Veeravagu ◽  
Ake Hansasuta ◽  
Bowen Jiang ◽  
Aftab S. Karim ◽  
Iris C. Gibbs ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Computed Tomography ◽  
Magnetic Resonance ◽  
Confidence Interval ◽  
Cerebral Angiography ◽  
Resonance Imaging ◽  
3 Dimensional ◽  
Cyberknife Radiosurgery ◽  
The Mean ◽  
Volume Difference

Abstract BACKGROUND: Accurate target delineation has significant impact on brain arteriovenous malformation (AVM) obliteration, treatment success, and potential complications of stereotactic radiosurgery. OBJECTIVE: We compare the nidal contouring of AVMs using fused images of contrasted computed tomography (CT) and magnetic resonance imaging (MRI) with matched images of 3-dimensional (3-D) cerebral angiography for CyberKnife radiosurgery (CKRS) treatment planning. METHODS: Between May 2009 and April 2012, 3-D cerebral angiography was integrated into CKRS target planning for 30 consecutive patients. The AVM nidal target volumes were delineated using fused CT and MRI scans vs fused CT, MRI, and 3-D cerebral angiography for each patient. RESULTS: The mean volume of the AVM nidus contoured with the addition of 3-D cerebral angiography to the CT/MRI fusion (9.09 cm3, 95% confidence interval: 5.39 cm3-12.8 cm3) was statistically smaller than the mean volume contoured with CT/MRI fused scans alone (14.1 cm3, 95% confidence interval: 9.16 cm3-19.1 cm3), with a mean volume difference of δ = 5.01 cm3 (P = .001). Diffuse AVM nidus was associated with larger mean volume differences compared with a compact nidus (δ = 6.51 vs 2.11 cm3, P = .02). The mean volume difference was not statistically associated with the patient's sex (male δ = 5.61, female δ = 5.06, P = .84), previous hemorrhage status (yes δ = 5.69, no δ = 5.23, P = .86), or previous embolization status (yes δ = 6.80, no δ = 5.95, P = .11). CONCLUSION: For brain AVMs treated with CKRS, the addition of 3-D cerebral angiography to CT/MRI fusions for diagnostic accuracy results in a statistically significant reduction in contoured nidal volume compared with standard CT/MRI fusion-based contouring.

The Difference between Computed Tomography and Magnetic Resonance Imaging Measurements of Tibial Tubercle–Trochlear Groove Distance for Patients with or without Patellofemoral Instability: A Systematic Review and Meta-analysis

2019 ◽  
Vol 33 (08) ◽  
pp. 768-776 ◽  
Author(s):  
Si Heng Sharon Tan ◽  
Beatrice Ying Lim ◽  
Kiat Soon Jason Chng ◽  
Chintan Doshi ◽  
Francis K.L. Wong ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Computed Tomography ◽  
Magnetic Resonance ◽  
Patellofemoral Instability ◽  
Tibial Tubercle ◽  
Control Group ◽  
Trochlear Groove ◽  
Resonance Imaging ◽  
The Mean ◽  
Ct And Mri

AbstractThe tibial tubercle–trochlear groove (TT–TG) distance was originally described for computed tomography (CT) but has recently been used on magnetic resonance imaging (MRI) without sufficient evidence demonstrating its validity on MRI. The current review aims to evaluate (1) whether there is a difference in the TT–TG distances measured using CT and MRI, (2) whether both the TT–TG distances measured using CT and MRI could be used to differentiate between patients with or without patellofemoral instability, and (3) whether the same threshold of 15 to 20 mm can be applied for both TT–TG distances measured using CT and MRI. The review was conducted using the preferred reporting items for systematic reviews and meta-analyses (PRSIMA) guidelines. All studies that compared TT–TG distances either (1) between CT and MRI or (2) between patients with and without patellofemoral instability were included. A total of 23 publications were included in the review. These included a total of 3,040 patients. All publications reported the TT–TG distance to be greater in patients with patellofemoral instability as compared to those without patellofemoral instability. This difference was noted for both TT–TG distances measured on CT and on MRI. All publications also reported the TT–TG distance measured on CT to be greater than that measured on MRI (mean difference [MD] = 1.79 mm; 95% confidence interval [CI]: 0.91–2.68). Pooling of the studies revealed that the mean TT–TG distance for the control group was 12.85 mm (95% CI: 11.71–14.01) while the mean TT–TG distance for patients with patellofemoral instability was 18.33 mm (95% CI: 17.04–19.62) when measured on CT. When measured on MRI, the mean TT–TG distance for the control group was 9.83 mm (95% CI: 9.11–10.54), while the mean TT–TG distance for patients with patellofemoral instability was 15.33 mm (95% CI: 14.24–16.42). Both the TTTG distances measured on CT and MRI could be used to differentiate between patients with and without patellofemoral instability. Patients with patellofemoral instability had significantly greater TT–TG distances than those without. However, the TT–TG distances measured on CT were significantly greater than that measured on MRI. Different cut-off values should, therefore, be used for TT–TG distances measured on CT and on MRI in the determination of normal versus abnormal values. Pooling of all the patients included in the review then suggest for 15.5 ± 1.5 mm to be used as the cut off for TT–TG distance measured on CT, and for 12.5 ± 2 mm to be used as the cut-off for TT–TG distance measured on MRI. The Level of evidence for this study is IV.

REMNANTS OF OCCIPITAL VERTEBRAE

Neurosurgery ◽  
2009 ◽  
Vol 64 (5) ◽  
pp. 945-954 ◽  
Author(s):  
Arnold H. Menezes ◽  
Kathleen A. Fenoy
Keyword(s):  
Magnetic Resonance Imaging ◽  
Computed Tomography ◽  
Magnetic Resonance ◽  
Prospective Study ◽  
Cranial Nerves ◽  
Foramen Magnum ◽  
Occipital Condyle ◽  
Resonance Imaging ◽  
Lower Cranial Nerve ◽  
3 Dimensional

Abstract OBJECTIVE Developmental remnants around the foramen magnum, or proatlas segmentation abnormalities, have been recorded in postmortem studies but very rarely in a clinical setting. Because of their rarity, the pathological anatomy has been misunderstood, and treatment has been fraught with failures. The objectives of this prospective study were to understand the correlative anatomy, pathology, and embryology and to recognize the clinical presentation and gain insights on the treatment and management. METHODS Our craniovertebral junction (CVJ) database started in 1977 and comprises 5200 cases. This prospective study has retrieval capabilities. Neurodiagnostic studies changed with the evolution of imaging. Seventy-two patients were recognized as having symptomatic proatlas segmentation abnormalities. RESULTS Ventral bony masses from the clivus or medial occipital condyle occurred in 66% (44/72), lateral or anterolateral compressive masses in 37% (27 of 72 patients), and dorsal bony compression in 17% (12 of 72 patients). Hindbrain herniation was associated in 33%. The age at presentation was 3 to 23 years. Motor symptoms occurred in 72% (52 of 72 patients); palsies in Cranial Nerves IX, X, and XII in 33% (24 of 72 patients); and vertebrobasilar symptoms in 25% (18 of 72 patients). Trauma precipitated symptoms in 55% (40 of 72 patients). The best definition of the abnormality was demonstrated by 3-dimensional computed tomography combined with magnetic resonance imaging. Treatment was aimed at decompression of the pathology and stabilization. CONCLUSION Remnants of the occipital vertebrae around the foramen magnum were recognized in 72 of 5200 CVJ cases (7.2%). Magnetic resonance imaging with 3-dimensional computed tomography of the CVJ provides the best definition and understanding of the lesions. Brainstem myelopathy and lower cranial nerve deficits are common clinical presentations in the first and second decades of life. Treatment is aimed at decompression of the pathology and CVJ stabilization.

A new reference line for coronal head CT to align with MRI: development of a standardised approach

2020 ◽  
pp. 197140092097283
Author(s):  
Kerem Ozturk ◽  
Anthony Spano ◽  
David Nascene
Keyword(s):  
Magnetic Resonance Imaging ◽  
Computed Tomography ◽  
Magnetic Resonance ◽  
Intraclass Correlation ◽  
Angular Position ◽  
Magnetic Resonance Images ◽  
Reference Line ◽  
Resonance Imaging ◽  
Brain Computed Tomography ◽  
The Mean

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.

Comparison of 2- and 3-Dimensional Shoulder Ultrasound to Magnetic Resonance Imaging in a Community Hospital for the Detection of Supraspinatus Rotator Cuff Tears with Improved Worktime Room Efficiency

2012 ◽  
Vol 63 (3) ◽  
pp. 170-176 ◽  
Author(s):  
Steven Co ◽  
Sonny Bhalla ◽  
Kevin Rowan ◽  
Sven Aippersbach ◽  
Simon Bicknell
Keyword(s):  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Rotator Cuff ◽  
Wilcoxon Test ◽  
Rotator Cuff Tears ◽  
Resonance Imaging ◽  
3 Dimensional ◽  
Significant Difference ◽  
The Mean ◽  
2D And 3D

Purpose The purpose of this study was to evaluate whether 3-dimensional (3D) volumetric acquisition of shoulder ultrasound (US) data for supraspinatus rotator cuff tears is as sensitive when compared with conventional 2-dimensional (2D) US and routine magnetic resonance imaging (MRI), and whether there is improved workroom time efficiency when using the 3D technique compared with the 2D technique. Methods In this prospective study, 39 shoulders underwent US and MRI examination of their rotator cuff to confirm the accuracy of both the 2D and 3D techniques. The difference in sensitivities was compared by using confidence interval analysis. The mean times required to obtain the 2D and 3D US data and to review the scans were compared by using a 1-tailed Wilcoxon test. Results Sensitivity and specificity of 2D US in detecting supraspinatus full- and partial-thickness tears was 100% and 96%, and 80% and 100%, respectively, and similar values were obtained with 3D US at 100% and 100%, and 90% and 96.6%, respectively. Analysis of the confidence limits of the sensitivities showed no significant difference. The mean time (± SD) of the overall 2D examination of the shoulder, including interpretation was 10.02 ± 3.28 minutes, whereas, for the 3D examination, it was 7.08 ± 0.35 minutes. Comparison between the 2 cohorts when using a 1-tailed Wilcoxon test showed a statistically significant difference ( P < .05). Conclusion 3D US of the shoulder is as accurate as 2D US when compared with MRI for the diagnosis of full- and partial-thickness supraspinatus rotator cuff tears, and 3D US examination significantly reduced the time between the initial scan and the radiologist interpretation, ultimately improving workplace efficiency.

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