L M Tartaglino

IMAGING OF SELLAR AND PARASELLAR PATHOLOGY

This article reviews the complex anatomic relationships between structures in the sellar and parasellar regions. Normal anatomy and the normal imaging spectrum are reviewed, with emphasis on the diversity of pathology that originates from this region. Both CT and MR imaging may be used to evaluate the sellar and parasellar regions. This article discusses how modern imaging techniques enable characterization of the many lesions that alter the structure and function of normal sellar and parasellar anatomy.

Intramedullary causes of myelopathy

This article addresses imaging of intramedullary processes of the spinal cord. MRI, as the procedure of choice for the intramedullary space, is the primary imaging modality that is focused on. Patterns of signal abnormality, enhancement, and morphology are described that can be used to separate neoplasms, inflammation, infarction, vascular anomalies, degenerative processes, and congenital anomalies as they affect the spinal cord. Recognition of these patterns is essential for prompt and appropriate medical and surgical treatment.

Intradural extramedullary causes of myelopathy

This article emphasizes the utility of contrast-enhanced MRI in the detection of intradural extramedullary causes of myelopathy. Recognition of morphological patterns, signal intensities, and enhancement patterns frequently permits a specific diagnosis or a limited differential diagnosis.

Advanced Imaging Applications for Endovascular Procedures

Advanced imaging techniques, particularly in CT and MRI, have become state-of-the-art to support the performance of interventional neuroradiologic procedures. Multidetector CT scanners with submillimeter detectors and real-time workstations have allowed the use of a noninvasive study, CT angiography, as a first-line diagnostic study at many institutions to detect and evaluate the morphology of aneurysms. Follow-up for postsubarachnoid spasm now includes transcranial Doppler, CT angiography, and sometimes perfusion to guide therapy. While both intracranial and extracranial stenosis have long been well evaluated by MR and CT angiography, information about the intimal wall and plaque morphology is now possible. In the setting of acute ischemia, CT with perfusion or MR with diffusion and perfusion has increased the ability to separate territory at risk from infarcted tissue, and can help to guide more appropriate intervention. This article addresses current state-of the-art imaging applications as well as a few techniques on the horizon that show great promise in helping to characterize those lesions amenable to endovascular therapy.