Abstracts of 30th Year Annual Meeting of Turkish Society of Neuroradiology with International Participation

Abstract

Abstracts of 30th Year Annual Meeting of Turkish Society of Neuroradiology with International Participations of 30th Year Annual Meeting of Turkish Society of Neuroradiology with International Participation # Springer-Verlag GmbH Germany, part of Springer Nature 2021 1005-CAN PERFUSION CHANGES EXPLAIN NEUROLOGIC SYMPTOMS IN SUBDURAL HEMATOMA Zakir Sakcı , Mehmet Gencturk 2 Ümraniye Training and Research Hospital, Department of Radiology Radiology İstanbul-Turkey 1 University of Minesota, Department of Radiology Radiology Mineapolis-United States 2 Introduction:Chronic subdural hematoma is not an uncommon disorder in elderly1. Although intensively investigated, numerous aspects, including the pathophysiology of clinical symptoms remain unclear2-4. Perfusion deficits may induce the transient neurologic symptoms seen in chronic subdural hematoma (cSDH). The aim of the present study was to quantify cerebral perfusion impairment in cSDH. Materials andMethods:We retrospectively evaluated the CT perfusion (CTP) images of 15 patients with SDH who were scanned for the clinical suspicion of acute infarct. Hematoma volume was measured using Vitrea software (Vital Images, division of Toshiba Medical, Minnetonka, MN), “3D tumor volume technique” in which radiologist selects the target density and software elects adjacent, contagious densities .CTP parameters of the cortex underlying the hematomawas comparedwith unaffected normal cortex on the contralateral side in unilateral SDH and unaffected cortex anterior or posterior to SDH in bilateral SDH. Correlation between the hematoma volume and CTP parameters were statistically searched. Results: Mean hematoma volume was 45.3 +/ 32.4 ml. The cerebral blood volume (CBV) and cerebral blood flow (CBF) were not significantly increased in the area under the hematoma (AUH) compared to the corresponding unaffected normal cortex (UNC). The mean CBVwas 3.05 /+ 1.29 in AUH and 2.83 /+ 0.96 in UNC (P=0.097). The mean CBF was 32.89 /+ 14.79 in AUH and 29.47 /+ 10.58 in UNC (P=0.11). The mean transit time was not significantly elevated in AUH compared to theNUC (6.07 /+ 1.05 vs 5.85 /+ 0.85, p=0.12). Time to peak (TTP) was almost equal between these areas ( 17.58 /+ 6.88 vs 17.38 /+ 5.59 ,p=0.82). In addition, no statistical significant correlation was found between hematoma volume and any of the global or hemispheric cerebral perfusion parameters. Conclusion: Our study finds no evidence that neurologic symptoms associated with cSDH are due to changes in perfusion. There was no significant difference between perfusion parameters adjacent to and contralateral to cSDH. The study is limited by sample size. Also, as we compared perfusion between hemispheres in the same subjects, we could not determing if cSDH produced global rather than regional perfusion changes. 1044-DIAGNOSTIC VALUE OF HEMOSEQUENCE IN CRANIAL IMAGING Nurdan Gocgun 1 Haseki Research And Training Hospital Radiology İstanbul-Turkey 1 Hemosequence is a sequence that helps standard magnetic resonance imaging (MRI) sequences separating blood products such as deoxyhemoglobin, methemoglobin, hemosiderin, calcium, metallic bodies, fat, and air intensities in the tissue. Although it is valuable especially in cerebrovascular diseases such as intracranial hemorrhage, it can also be helpful in more rare diagnoses. We aimed to present our case series in which we strengthen the diagnosis with the help of hemosequence. Clinical and radiological features of 47 cases were analyzed retrospectively. The cases were classified into three groups according to their etiological reasons; 1. vascular 2. mass 3.other reasons. 35 of the cases were due to vascular reasons, 5 were in themass, and 7 were in the other group. Vascular lesions included hypertensive and amyloid microangiopathy, superficial siderosis, hemorrhagic infarction, sinus or cortical vein thrombosis, and vascular malformation. Two of the masses were hemorrhagic metastases, others were calcific meningioma, oligoastrocytoma, hemangioblastoma. In the Other group, there was an infection, stroke mimicker, leukodystrophy, pituitary apoplexy, FAHR syndrome, and metabolic substance accumulation. Since the majori ty of microhemorrhages in hemosequence in ischemic stroke may predict secondary major hemorrhage that may occur with anticoagulant and or antiaggregant treatment; It is also important in terms of the treatment decision. Observation of bleeding in hemorrhagic metastases and hemangioblastoma and calcification in oligodendroglioma in our cases supported the diagnosis. Detection of hyperdense lesions on Computed Tomography (CT) in patients presenting with a clinical picture mimicking stroke made the distinction between sequela-calcification and hemorrhage difficult, but adding hemosequence to standard sequences in MRI helped in the differential diagnosis. In our case with leukodystrophy, the normal hemosequence excluded other metabolic causes with substance accumulation. In this case series, we wanted to emphasize the importance of hemosequence in the differential diagnosis in nonvascular central nervous system diseases as well as its known value in vascular diseases. 1046-IMAGING FINDINGS OF LATE PHASE BRAIN DEATH Oğuzhan Yıldız , Şafak Parlak , Gökçen Çoban Çifçi 1 Hacettepe University School of Medicine Radiology Ankara-Turkey 1 Purpose: Brain death (BD) is a well-described entity with its clinical findings, confirmatory tests, and imaging features. Radiographymay help diagnose BD, especially when clinical assessment is inadequate, or the supportive tests are impossible. Although the radiologists are quite familiar with imaging findings in the early phase, the late phase findings are unknown. To our knowledge, there is no report addressing the magnetic resonance imaging (MRI) findings of the late phase of BD in the literature. In this paper, we present and highlightMRI findings of the late phase of BD in a patient with diffuse midline glioma (DMG). https://doi.org/10.1007/s00234-021-02654-6 Published online: 6 February 2021 Neuroradiology (2021) 63:453–469