OBJECTIVE: Intensive surveillance in women at breast cancer risk is currently investigated in a French prospective, non-randomized, multicenter study, in which standard imaging - mammography±ultrasound ('Mx') and standard imaging combined with magnetic resonance imaging ('MRI') are compared with regard to perception of care and examination experience. METHODS: 1561 women were ...

Cancer is one of the main health problems in western countries. In 2008, it represented the first cause of death in men and the second one in women. When there is a diagnosis or suspicion of cancer, performing diagnostic imaging studies has an important role in the clinical activity and ...

Kurzepa J, Bielewicz J, Czekajska-Chehab E, Kurzepa J, Bartosik-Psujek H, Grabarska A, Stelmasiak Z. CT volume/density ratio as the marker of ischaemic brain injury. Acta Neurol Scand: 2011: 123: 310-315. © 2010 John Wiley & Sons A/S. Objectives -  We believe that the CT volume/density ratio (VDR) of infarcted area reflects ...

Coarctation of the aorta (CoA) is a common congenital defect whose overall incidence is 5-8% of all congenital cardiac anomalies. Associated cardiac anomalies have been well described in previous studies examining specific subgroups of CoA patients, particularly infants and necropsy specimens. The majority of studies, conducted from the 1970s to ...

diffusion-weighted magnetic resonance imaging (DWI) is a sensitive diagnostic tool for detecting acute ischaemic lesions in patients with transient ischaemic attacks (TIAs). The additional predictive value of DWI lesion patterns is not well known. two hundred and fifty-four consecutive patients with TIA underwent DWI within 7 days of symptom onset. ...

Reporter-based cell detection and localization in vivo may become an important imaging tool with the emergence of cellular therapy. With the strong signal enhancement provided by dynamic nuclear polarization, an NMR-based reporter probe system utilizing specific enzyme expression and activity can potentially provide stable, high-resolution visualization of the cells of ...

Cerebral small vessel disease (lacunar stroke and cerebral white matter hyperintensities) is caused by vessel abnormalities of unknown aetiology. Retinal vessels show developmental and pathophysiological similarities to cerebral small vessels and microvessel geometry may influence vascular efficiency. Retinal arteriolar branching angles or coefficients (the ratio of the sum of the ...

To assess the potential of a single-session multidetector computed tomography (CT) protocol, as compared with established methods, for the etiologic work-up of acute ischemic stroke. Patients found to have recently experienced an ischemic stroke were recruited for this prospective study after institutional review board approval was obtained. Each patient was ...

CTA-SI have been previously reported to correlate with CBV. We hypothesized that CTA-SI performed by modern multisection CT scanners are CBF-, not CBV-weighted. Sixty-four consecutive patients with anterior circulation stroke symptoms were selected from a stroke data base between June 2007 and January 2009. Two independent blinded readers calculated defect ...

Stroke is the third leading cause of death, after myocardial infarction and cancer, and the leading cause of permanent disability in Western countries. Although anti-inflammatory drugs have shown very promising results in preclinical rodent studies, they appeared to be ineffective against stroke in clinical trials. In this context, non-invasive detection ...

In this article the individual components of multimodal computed tomography and multimodal magnetic resonance imaging are discussed, the current status of neuroimaging for the evaluation of the acute ischemic stroke is presented, and the potential role of a combined multimodal stroke protocol is addressed.

Using magnetic resonance imaging (MRI) protocols of T(2)-, T(2)*-, diffusion- and susceptibility-weighted imaging (T2WI, T2*WI, DWI, and SWI, respectively) with a 7T system, we tested the hypothesis that treatment of embolic stroke with erythropoietin (EPO) initiated at 24 hr and administered daily for 7 days after stroke onset has benefit ...

Perfusion-weighted imaging-derived maps of time-to-maximum (Tmax) are increasingly used to identify the tissue at risk in clinical stroke studies (eg, DEFUSE and EPITHET). Using quantitative positron emission tomography (PET), we evaluated Tmax to define the penumbral flow threshold in stroke patients and compared its performance to nondeconvolved time-to-peak (TTP) maps. ...

Blood-brain-barrier (BBB) breakdown due to matrix metalloproteinase (MMP) activity following stroke is often associated with cerebral edema, larger infarct volumes and bad outcome. In the present study we examined a novel MMP-inhibitor (Ro 28-2653) with high selectivity for MMP2, MMP9 and membrane type 1-MMP in an acute stroke model comparing ...

Multimodal CT, including noncontrast CT (NCCT), CT with contrast, CT angiography (CTA), and perfusion CT (CTP), is increasingly used in acute stroke patients to identify candidates for endovascular therapy. Our goal is to explore the cost-effectiveness of multimodal CT as a diagnostic test. A Markov model compared multimodal CT to ...

OBJECTIVE: Early identification of patients at risk of space-occupying "malignant" middle cerebral artery (MCA) infarction (MMI) is needed to enable timely decision for potentially life-saving treatment such as decompressive hemicraniectomy. We tested the hypothesis that acute stroke magnetic resonance imaging (MRI) predicts MMI within 6 hours of stroke onset. METHODS: ...

A previously healthy girl, age 3 years 9 months, presented with right-sided hemiparesis and seizures. Ischemic infarction was confirmed through magnetic resonance imaging and magnetic resonance angiography. Extensive evaluation to discover the underlying etiologies and risk factors predisposing this patient to stroke included coagulation defects, cardiac anomalies, congenital inborn metabolism ...

To evaluate quantitative cerebral blood flow (qCBF) with traditional time-based measurements or metrics of cerebral perfusion: time to peak (Tmax) and mean transit time (MTT) in stroke patients. Nine ischemic stroke patients (four male, five female, 63 ± 16 years old) were included in the study which was Health Insurance ...

In acute stroke, mismatch between lesions seen on diffusion- (DWI) and perfusion-weighted (PWI) MRI has been used to identify ischemic tissue before irreversible damage. Nevertheless, the concept of PWI/DWI mismatch is oversimplified and the ischemic tissue metabolic status and outcome are often heterogeneous. Tissue pH, a well-regulated physiological index that ...

Data from the European Cooperative Acute Stroke Study (ECASS) III trial demonstrated that tissue plasminogen activator given up to 4.5 h after stroke onset improves outcome and treatment guidelines support its use during this time window. Intra-arterial therapy with tissue plasminogen activator or devices is commonly used at large tertiary ...

Patent foramen ovale (PFO) has been implicated in the pathogenesis of cryptogenic stroke through paradoxical embolization to the cerebral circulation. This study evaluated the relationship between the morphological and functional size of the PFO by echocardiography compared with cerebral infarct volume identified on MRI. Patients who were referred to interventional ...

OBJECTIVES: The purpose of this study was to examine the prognostic value of midregional pro-atrial natriuretic peptide (MR-proANP) in patients with acute ischemic stroke. BACKGROUND: The rapid and reliable estimation of prognosis in acute ischemic stroke is pivotal to optimize clinical care. MR-proANP, a recently described, stable fragment of the ...

We investigated the utility of computed tomographic (CT) perfusion (CTP) with 64-row multi-detector row CT (MDCT) to diagnose acute infarction and ischemic penumbra. We reviewed 58 clinical cases with acute ischemic stroke with CTP, compared the size of the area with long mean transit time (MTT) to that with abnormal ...

Brain imaging provides an objective basis for the clinical inferences that direct individual patient management in the acute stroke setting. A brain CT or MRI scan is required for all patients with suspected stroke or transient ischemic attack. Thrombolytic therapy is arguably the most important aspect of acute stroke management; ...

OBJECTIVE: The purpose of this study was to evaluate the usefulness of z-score mapping method on neuroradiologists' performance in quantification of the extent of hypoattenuation regions of hyperacute stroke on unenhanced computed tomographic (CT) images by using the Alberta Stroke Programme Early CT Score system. METHODS: Twenty-one patients with infarction ...

ABSTRACT BACKGROUND: Cerebrovascular disease (CVD) is a leading cause of morbidity and mortality in Nigeria. Non-contrast computerized axial tomography (CT) is the routine imaging modality of choice for acute stroke evaluation, because it is widely accessible, convenient, has a short imaging time, and is sensitive for detection of haemorrhage. To ...

"Telestroke" is emerging as a potential timesaving, efficient means for evaluating patients experiencing acute ischemic stroke. It provides an opportunity for administration of thrombolytic drugs within the short therapeutic time window associated with AIS. We describe our experiences of the feasibility and safety of remote radiology interpretation with telephone consultation. ...

To assess the effect of a modified window width and center level setting in promoting residents' interpretation of acute ischemic infarct on nonenhanced brain computed tomography (CT). Nonenhanced brain CT images of 11 acute ischemic infarct patients were mixed with 11 control patients. Twelve residents reviewed the randomized images on ...

Animal experiments suggest that 2 different types of activated microglia (AMG) cells occur in the brain after a stroke: local AMG in the area of the infarct and remote AMG, which occurs along affected fiber tracts. We used (11)C-PK11195 PET to image AMG in vivo after stroke in humans in ...

Ischemic myelopathy is a disorder of acute onset that is characterized by nonprogressive paresis/plegia. Magnetic resonance imaging (MRI) is particularly helpful in supporting the antemortem diagnosis of ischemic myelopathy. Cats, which were suspected to have ischemic myelopathy between 2005 and 2008, were reviewed retrospectively. The acute onset of nonprogressive and ...

Spectacular shrinking deficit (SSD) is characterized by abrupt onset of a major hemispheric stroke syndrome, followed by dramatic and rapid improvement. We retrospectively identified patients with SSD diagnosed at our institution between December 1, 2007, and June 30, 2009. We reviewed computed tomography perfusion (CTP) imaging to determine perfusion defect ...

Transcranial Doppler (TCD) ultrasound can demonstrate dynamic information. We aimed to evaluate whether TCD generates useful additional information in the emergency room after a multimodal stroke imaging protocol and also whether this modified the management of patients with cerebral infarction. Patients admitted between April 2006 and June 2007 with ischemic ...

A striatocapsular infarct (SCI) is a subcortical infarct in the territory of the lenticulostriate arteries, most likely due to transient occlusion of the main stem of the middle cerebral artery (MCA). Presence of the hyperdense middle cerebral artery sign (HMCAS) is a reliable marker of occlusion of the MCA. We ...

BACKGROUND AND PURPOSE: The ABCD system was developed to predict early stroke risk after transient ischemic attack. Incorporation of brain imaging findings has been suggested, but reports have used inconsistent methods and been underpowered. We therefore performed an international, multicenter collaborative study of the prognostic performance of the ABCD(2) score ...

OBJECTIVE: To assess the evidence for the use of diffusion-weighted imaging (DWI) and perfusion-weighted imaging (PWI) in the diagnosis of patients with acute ischemic stroke. METHODS: We systematically analyzed the literature from 1966 to January 2008 to address the diagnostic and prognostic value of DWI and PWI. RESULTS AND RECOMMENDATIONS: ...

BACKGROUND AND PURPOSE: The role of CT perfusion (CT-P) imaging for the selection of patients with acute ischemic stroke who may benefit from endovascular treatment is not defined. The objective of this study was to determine whether CT-P-guided endovascular treatment improves clinical outcomes compared with standard endovascular treatment based on ...

Mitochondrial myopathy, encephalopathy, lactic acidosis and stroke-like episodes (MELAS) shows sudden neurological deficits that are called 'stroke-like episodes'. With regard to the pathophysiology of stroke-like episodes, so-called mitochondrial angiopathy and cytopathy theories have been proposed, but the subject is still controversial. To clarify this matter and to contribute to the ...

OBJECTIVE: We describe the first clinical application of transient hyperoxia ("oxygen challenge") during T2*-weighted magnetic resonance imaging (MRI), to detect differences in vascular deoxyhemoglobin between tissue compartments following stroke. METHODS: Subjects with acute ischemic stroke were scanned with T2*-weighted MRI and oxygen challenge. For regions defined as infarct core (diffusion-weighted ...

OBJECTIVE: Recent technical developments have led to an extension of perfusion computed tomography (PCT) scan range to cover nearly the entire brain and to reconstruct time resolved (4d) CT-angiography (CTA) datasets from the PCT data. The purpose of this study was to compare the results of simulated standard PCT and ...

Stroke is the second most common cause of death worldwide and the third most common in the UK. 'Time is brain' in ischaemic stroke; early reperfusion has been shown to lead to improved clinical outcomes, yet the majority of patients with acute stroke do not attend in time for thrombolysis ...

Background Diffusion-weighted (DWI) MRI is recommended in UK guidelines to evaluate minor strokes, yet can produce negative results. Objective The authors determined the rate of negative MRI (including DWI) and associated features in patients presenting to hospital with minor strokes. Methods The authors performed a prospective observational cross-sectional study in ...

Diffusion-weighted magnetic resonance imaging (MRI) is sensitive for detecting acute ischemic lesions. The present study evaluated risk factors associated with small cortical infarction (SCI) on diffusion-weighted MRI. We analyzed 123 patients with acute ischemic stroke retrospectively. We defined an SCI as a cortical lesions < 1.5 cm in diameter detected ...

Improved selection of patients with stroke for IV tPA treatment may enhance clinical outcomes. Given the limited availability of MR imaging in hospitals, we examined the cost-effectiveness of adding CTP to the usual CT-based methods for selecting patients on the basis of the presence and extent of penumbra. A decision-analytic ...

Transient ischemic attack (TIA) has recently been redefined to incorporate the latest clinical and neuroimaging information that has shed new light on TIA pathophysiology. Patients suffering from TIA are at a substantial risk of subsequent stroke, but quantifying this risk is difficult as TIA patients are a heterogeneous population and ...

Stroke is a major cause of mortality and long-term disability worldwide. The initial changes in local perfusion and tissue status underlying loss of brain function are increasingly investigated with noninvasive imaging methods. In addition, there is a growing interest in imaging of processes that contribute to post-stroke recovery. In this ...

The past three decades of clinical disappointments in treating stroke must compel us to rethink our strategy. Given the enormous complexity of the clinical disease, the "one size fits all" approach to stroke treatment is unlikely to succeed. The effective treatment of stroke aimed at reversing ischemic injury will require ...

OPINION STATEMENT: Results of acute MRI studies may help guide the management of acute stroke. Patients with a malignant MRI pattern may be poor candidates for reperfusion therapies yet may benefit from hemicraniectomy. Preliminary data suggest that patients with a carefully identified diffusion weighted imaging (DWI)/perfusion weighted imaging (PWI) mismatch ...

320-row CT enables dynamic CT angiography (4D CTA) of the entire intracranial circulation and whole-brain perfusion imaging (CTP). Sixty acute patients with neurological symptoms underwent various 320-row CT-specific protocols, including combined 4D CTA and CTP. Clinical and neuroradiological records were assessed for presumptive diagnoses, final diagnoses, supplementary and follow-up imaging ...

The presence of vertical ocular motor apraxia should prompt a careful assessment to detect an underlying neurometabolic condition. But congenital vertical ocular motor apraxia is a rare entity that may be attributed to perinatal stroke, hypoxia or kernicterus. We report a case of a 5-year old girl with congenital vertical ...

OBJECTIVES: To compare the sensitivity and specificity of 1.5-T and 3.0-T diffusion-weighted MRI (DWI) to detect hyperacute ischemic stroke lesions. METHODS: We blindly reviewed the DWI of 135 acute stroke patients and 34 controls performed at 1.5 T (n = 108) or 3.0 T (n = 61). The stroke patients ...