L. Celso Hygino da Cruz

Evaluation of hippocampal volume based on MR imaging in patients with bipolar affective disorder applying manual and automatic segmentation techniques.

To compare the hippocampal volumes in patients with bipolar disorder (BD) and healthy controls, obtained by applying different segmentation methods (manual, Freesurfer [FS], and FSL).

Diffusion tensor imaging of the cervical spinal cord of patients with relapsing-remising multiple sclerosis: a study of 41 cases

OBJECTIVE To evaluate the fractional anisotropy (FA) values of the multiple sclerosis (MS) plaques and normal-appearing cervical spinal cord (NASC) by diffusion tensor MRI imaging (DTI). METHOD Forty-one patients with relapsing-remising MS and 37 controls were evaluated. All MRI exams were performed using a conventional protocol, as well as diffusion tensor MR imaging. Regions of interest were placed within the spinal cord lesions and in the normal appearing spinal cord adjacent to the plaque. RESULTS The FA values were statistically reduced in the plaques compared to the surrounding NASC and to equivalent location in controls. A reduction in FA values was also observed in the spinal cord of MS patients without visible lesions on T2WI. CONCLUSION We observed reduced fractional anisotropy in the demyelinating plaques and in the NASC of MS patients, corroborating the hypothesis that the histological extension of the MS lesions is more severe than the abnormalities seen in the conventional MRI sequences.

Diffusion MR Imaging: An Important Tool in the Assessment of Brain Tumors

For over 20 years, conventional MR imaging has been used for assessing brain tumors. However, conventional MR imaging tends to underestimate the extent of the tumor, perhaps leading to suboptimal treatment. New MR imaging tools have been widely used to determine the grade, heterogeneity, and extent of brain tumors. Diffusion-weighted imaging has been studied extensively, helping in tumor grading, differential diagnosis, and postoperative evaluation. Diffusion tensor imaging can apparently delineate more accurately the tumor versus the infiltrating tumor between the peritumoral edema and the normal brain parenchyma. This article shows the main clinical applications of these sequences.

Diffusion MR imaging in central nervous system.

Diffusion-weighted imaging has been used extensively in clinical practice for the early diagnosis of central nervous system conditions that restrict the diffusion of water molecules because it provides information about tumor cellularity or abscesses containing viscous fluid. DTI can detect brain lesions before any conventional imaging. Even though the role of these modalities is well defined for many neurologic lesions that affect the brain, its clinical application in spinal cord diseases is increasing. This article discusses the several central nervous system conditions that may be diagnosed with diffusion imaging.

Diffusion Magnetic Resonance Imaging in Multiple Sclerosis

Multiple sclerosis (MS) is considered the most common inflammatory autoimmune neurologic disorder and the most frequent cause of nontraumatic neurologic disability in young and middle-age adults. This article reviews the basic features of its magnetic resonance (MR) imaging lesions and, primarily, the use of diffusion MR imaging, which is increasingly applied to assess patients with MS, not only to investigate plaques but also the normal-appearing white matter, gray matter, optic nerve, and spinal cord, because of its ability to detect and quantify disease-related pathologic conditions of the central nervous system.

Diffusion-weighted MR images and pineoblastoma: diagnosis and follow-up

Pineoblastomas are uncommon pineal tumors, which demonstrate rapid growing and poor prognosis. We report the case of a 43-year-old man with an enhancing pineal region mass, which showed restriction of the diffusion on diffusion-weighted (DW) MR images. The surgical biopsy defined the diagnosis of pineoblastoma and the therapy was initiated with radiation and chemotherapy. Three months later, the follow-up MR imaging showed areas suggestive of necrosis and the DW images demonstrate no significant areas of restricted diffusion. The differential diagnosis of pineal region masses that could show restriction of diffusion is discussed.

Diffusion imaging in brain infections.

Diffusion-weighted magnetic resonance imaging (DWI) provides image contrasts that are different from conventional magnetic resonance techniques. DWI is particularly sensitive for detecting acute ischemic stroke, but it also has many other clinical applications, including the evaluation of central nervous system (CNS) infections. This article addresses the role of DWI in the differential diagnosis of CNS infections, and discusses the most common DWI findings for each type of infection.

Diffusion Magnetic Resonance Imaging in Brain Tumors

Abstract This chapter discusses the role of diffusion magnetic resonance imaging in the diagnostic evaluation of brain tumors. The physical basis of diffusion, diffusion tensor imaging, and diffusion kurtosis imaging; the clinical role of these tools in diagnosis; and the use of diffusion tensor imaging in surgical planning are discussed. There is also discussion of intraoperative and postoperative uses, as well as a limited exploration of future applications.

Pseudotumor cerebral secundário a trombose venosa dural: relato de caso pediátrico

Pseudotumor cerebri is a relatively common neurologic syndrome in adolescence. In most cases, etiology is idiopathic, but it may have serious complications, such as blindness, that are related to increased intracranial pressure. The aim of this article is to emphasize the differential diagnosis of pseudotumor cerebri, with special attention to treatable etiologies. We report a case of an 12 year-old adolescent who presented with diplopia and headache 9 days after right-sided otitis media and mastoiditis. Head computerized tomography was normal, but brain magnetic resonance imaging demonstrated thrombosis of ipsilateral transverse and sigmoid sinuses, which responded promptly to early anticoagulation. The conclusion is that magnetic resonance imaging is essential for patients with a clinical diagnosis of pseudotumor cerebri in order to exclude treatable causes, such as dural sinus thrombosis.Pseudotumor cerebri is a relatively common neurologic syndrome in adolescence. In most cases, etiology is idiopathic, but it may have serious complications, such as blindness, that are related to increased intracranial pressure. The aim of this article is to emphasize the differential diagnosis of pseudotumor cerebri, with special attention to treatable etiologies. We report a case of an 12 year-old adolescent who presented with diplopia and headache 9 days after right-sided otitis media and mastoiditis. Head computerized tomography was normal, but brain magnetic resonance imaging demonstrated thrombosis of ipsilateral transverse and sigmoid sinuses, which responded promptly to early anticoagulation. The conclusion is that magnetic resonance imaging is essential for patients with a clinical diagnosis of pseudotumor cerebri in order to exclude treatable causes, such as dural sinus thrombosis.

Neuroimaging and Genetic Influence in Treating Brain Neoplasms

The current treatment of glioblastoma patients based on surgery, radiation, and chemotherapy has achieved modest improvement in progression-free survival. In this direction, personalized treatment is the next achievement for better patient management and increased overall survival. Genetic characterization of high-grade gliomas by MR imaging is the goal in neuroimaging. The main genetic alterations described in these neoplasms, implications in patient treatment, and prognosis are reviewed. MR imaging features and novel techniques are correlated with the main genetic aspects of such tumors. Posttreatment phenomena, such as pseudoprogression and pseudoresponse, are analyzed in association with the genetic expression of these tumors.