J. Valk

Imaging of brain metastases

SummaryFor the demonstration of brain metastases both CT and MRI are available as diagnostic modalities. To compare both imaging methods as to their sensitivity in detecting brain metastases CT scans and MR images of 60 patients with suspected brain metastases were evaluated. Comparing contrast-enhanced CT and plain MRI neither modality was found to be clearly superior in this respect.

Contrast Enhanced Magnetic Resonance Imaging of the Brain Using Gadolinium-DTPA

This report concerns a clinical trial with gadolinium-DTPA (Gd-DTPA) as an intravenous contrast medium for magnetic resonance imaging (MRI) in patients with disorders of the central nervous system. Fifty patients, 30 females and 20 males, were examined without and with Gd-DTPA. The contrast medium was well tolerated by all patients. The results of MRI scanning without and with Gd-DTPA and those obtained with computed tomography (CT) using intravenous contrast enhancement were compared. This investigation comprised mainly patients with intracranial tumors, multiple sclerosis, and nasopharyngeal tumors. The results may be summarized as follows: 1) MRI with Gd-DTPA (MRI+) gave better results than MRI without Gd as regards delineation of the lesion, blood vessels and edema in cerebral tumors, pituitary adenomas and acute forms of multiple sclerosis (MS). 2) MRI+ was better than CT in 32 of the 50 cases examined; with intracerebral tumors it was better in 15 out of 18 cases. 3) MRI+ was always better than CT in patients with MS. In 3 out of 7 cases MRI demonstrated the acute MS lesions. 4) MRI+ seemed to have advantages also in nasopharyngeal tumors as ascertained from this limited experience.

Bilateral white matter lesions following severe meningococcal meningoencephalitis.

Abstract Occasionally, striking abnormalities are found on MRI in patients with mild neurological disturbances. In most of these cases the diagnosis is not immediately evident and the history does not provide an unequivocal explanation. We present a patient with extensive symmetrical white matter abnormalities in the posterior temporal, temporo-occipital and parietal regions, 24 years after documented severe meningococcal meningoencephalitis. A meningitic vasculitis, affecting the insular branches of the middle cerebral arteries, could have been responsible for these changes.

Gadolinium — DTPA in magnetic resonance imaging of the brain

This report concerns a clinical trial with Gd-DTPA as an intravenous contrast medium for MRI in patients with neurological disorders. 50 patients (30 female, 20 male) were examined without and with Gd-DTPA and the results of CT scanning and MR scanning without and with Gd-DTPA were compared. All patients tolerated the contrast medium very well. In the various patient groups, Gd-DTPA often added to the information. This was especially true in the tumor group, where better delineation of tumor, blood, and edema was obtained.

The role of CT and NMRI in neurosurgical diagnosis

SummaryA brief survey is given of the state of art of NMRI in neurosurgical diagnosis and its advantages and disadvantages in comparison to CT scanning are discussed. Specificity and sensitivity of these methods are also considered.

Sonography of the postoperative brain: a report on 2 years of experience

SummaryThirty-seven patients were examined by post-operative high resolution real-time ultrasound over a period of 2 years. Useful data were obtained in all cases but the quality of information obtained was directly related to the size of the cranial window. In each patient, the first sonogram was performed during the 10th to 12th postoperative day to assess ventricular size and midline shift and any fluid collections present. This initial sonogram then served as a baseline study for further follow-up. Subsequent sonograms provided different information about tumor response to chemotherapy and/or irradiation, information not readily obtained by computed tomography.