Table of Contents
State of Practice
- Perspectives from the Inaugural “Spinal CSF Leak: Bridging the Gap” Conference: A Convergence of Clinical and Patient Expertise
The “Spinal CSF Leak: Bridging the Gap” Conference highlighted collective insights from a diverse cohort of clinicians, researchers, and patients. This manuscript discusses the clinical, diagnostic, and treatment challenges of spinal CSF leak, concluding that a collaborative, multidisciplinary care team needs to provide a standardized-yet-flexible diagnostic protocol to address the variability in clinical presentations and often-subtle radiographic findings.
Radiology-Pathology Correlation
General Contents
- Association between CT Perfusion Parameters and Hemorrhagic Transformation after Endovascular Treatment in Acute Ischemic Stroke: Results from the ESCAPE-NA1 Trial
A total of 408 patients from the ESCAPE-NA1 trial were assessed for hemorrhagic transformation following endovascular treatment. At 24-hour follow-up imaging, the authors found that larger “core” volumes of relative CBF<30% were associated with an increased risk of parenchymal hemorrhage. In conjunction with other clinical and imaging variables, this metric may help estimate the risk of post-endovascular treatment hemorrhagic complications.
- The Differentiation between Progressive Disease and Treatment-Induced Effects with Perfusion-Weighted Arterial Spin-Labeling in High-Grade Gliomas
In this retrospective, single-center cohort study, 141 patients (173 lesions) with a new or increasing contrast-enhancing lesion after radiotherapy with or without chemotherapy were assessed with ASL perfusion. Although ASL performed poorly in differentiating progressive disease from treatment-induced effects in high-grade gliomas within 6 months after radiation therapy, it showed fair performance after this period.
- Territory-Related Functional Connectivity Changes Associated with Verbal Memory Decline in Patients with Unilateral Asymptomatic Internal Carotid Stenosis
Fifteen healthy controls, 22 patients with left asymptomatic ICS, and 33 patients with right asymptomatic ICS underwent fMRI, Mini-Mental State Examination, Digit Span Test, and Verbal Learning Tests. Patients with asymptomatic ICS had significant impairment in delayed recall of verbal memory. Patients with left and right asymptomatic ICS showed different patterns of FC alterations in both anterior and posterior circulation territories.
- MR Imaging Features of Critical Spinal Demyelinating Lesions Associated with Progressive Motor Impairment
This retrospective, observational MRI study compared spinal cord critical demyelinating lesions anatomically associated with progressive motor impairment with any additional “noncritical” spinal cord demyelinating lesions. MRI characteristics that favored critical spinal cord demyelinating lesions included moderate-to-severe, focal, lesion-associated spinal cord atrophy; lateral column axial location; central region; ventral column; and larger lesion size. In particular, the presence of focal, lesion-associated atrophy, lateral column axial location, and larger lesion size may be associated with the development of progressive motor impairment in MS.
- Comparison of a Whole-Brain Contrast-Enhanced 3D TSE T1WI versus Orbits Contrast-Enhanced 2D Coronal T1WI at 3T MRI for the Detection of Optic Nerve Enhancement in Patients with Acute Loss of Visual Acuity
This retrospective, single-center study of 1023 patients presenting with acute loss of vision compared orbits contrast-enhanced 2D coronal T1WI with a whole-brain contrast-enhanced 3D TSE T1WI at 3T for the detection of optic nerve enhancement. The latter (WBCE-3D T1WI) demonstrated higher sensitivity and specificity in diagnosing optic neuritis, particularly in cases involving the canalicular segments.
