Celine Grand

Magnetic resonance angiography of intravascular endoprostheses: Investigation of three devices

PurposeTo assess the value of magnetic resonance angiography (MRA) in the evaluation of vascular patency after intravascular endoprosthesis placement.MethodsThree different metallic stents (Wallstent, Strecker, Palmaz) were studied in vitro, and in vivo in six patients with spin-echo (SE) and gradient-echo (GRE) MR imaging. Time-of-flight, two-dimensional (2D) gadolinium-enhanced MRA was performed with GRE and flow-compensation technique, and reconstructed with a maximum-intensity projection (MIP) algorithm. MRA was compared to digital angiograms.ResultsIn vitro studies demonstrated that the signal intensity (SI) within the stent differed according to the device employed, the lowest SI being observed within the Palmaz stent (p = .001). There was no difference in SI or apparent diameter of the stent according to the sequence (SE vs GRE) or length of echo time (TE). In patients, the endoprostheses recorded as a well-defined area of signal void or drop-out (p = 0.004), whereas vessels above and below the stent displayed high signal intensities.ConclusionMRA does not seem as yet to be well suited for evaluating vascular patency after endoprosthesis placement, even if the Strecker and Wallstent endoprostheses provide fewer artifacts than the Palmaz stent.

Emergency embolization of a mycotic aneurysm of the superior gluteal artery : case report

The authors report the unusual presentation of a mycotic aneurysm of the superior gluteal artery in a patient with unsuspected bacterial endocarditis. The diagnosis of this atypically large lesion, the therapeutic considerations, and the technical aspects of the endovascular occlusion are discussed.

Gadolinium enhancement of vertebral endplates following lumbar disc surgery

Gadolinium enhancement may be normal in the vertebral endplates adjacent to previously operated intervertebral discs. To determine the frequency of this finding and to differentiate this normal healing process from early lesions due to focal infection, we studied 135 patients who had undergone surgery for herniated lumbar disc, and compared them with 249 unoperated patients with radicular symptoms and 15 with known spondylodiscitis. Hypointense foci which enhanced with gadolinium were identified in the endplates of 25 (18.5%) of the operated patients, 9 of whom required a second operation for recurrent disc herniation, at which time the absence of infection was confirmed. Gadolinium enhancement within the endplates adjacent to the operated disc occurs during normal healing after surgery. Care should be taken before invoking a diagnosis of focal infection or secondary spondylodiscitis.

Agenesis of the internal carotid artery and cavernous sinus hypoplasia with contralateral cavernous sinus meningioma

We report a cavernous sinus meningioma encasing the cavernous internal carotid artery in a patient with congenital agenesis of the contralateral internal carotid artery and cavernous sinus hypoplasia.

Cervical neuroma associated with multiple intracranial arachnoid cysts

SummaryA case of dumbbell cervical neuroma associated with multiple intracranial arachnoid cysts is described.