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Biomedical subjects

I Yousry

Publications and source records attributed to I Yousry.

13 recordsLinked to original sources

Dilated cervical epidural veins and extra arachnoid fluid collection in orthostatic headaches.

Cervical MRI of eight patients with severe orthostatic headache showed a convex-shaped, prominent, dilated anterior, internal vertebral venous plexus with a flow-void signal in all patients and in seven also extra arachnoid fluid collection. Follow-up MRI showed resolution of the abnormalities in all patients. The authors hypothesize that these findings reflect disturbed compensatory vascular mechanisms by which autoregulation of the CSF pressure tries to compensate for the reduced CSF volume.

Adult↗

Detection of hyperacute parenchymal hemorrhage of the brain using echo-planar T2*-weighted and diffusion-weighted MRI.

We investigated the usefulness of echo-planar imaging (EPI) as well as T2*-weighted and diffusion-weighted MRI (DWI) to identify hyperacute hemorrhage (within 24 h after ictus) in the brain. Seven patients were examined 3.5 to 24 h after onset of symptoms using a whole-body 1.5-T MR system. Two diffusion-weighted sequences were run to obtain isotropic and anisotropic diffusion images. Apparent diffusion coefficients (ADC) were calculated from the isotropic diffusion images. All DWI images as well as the T2*-weighted EPI images showed the hematomas as either discrete, deeply hypointense homogeneous lesions, or as lesions of mixed signal intensity containing hypointense areas. We conclude that even in the early phase after hemorrhage, sufficient amounts of paramagnetic deoxyhemoglobin are present in intracerebral hemorrhages to cause hypointensity on EPI T2*-weighted and DWI images; thus, use of ultrafast EPI allows identification of intracerebral hemorrhage.

Acute Disease↗

Identification and anatomic description of the anterior choroidal artery by use of 3D-TOF source and 3D-CISS MR imaging.

BACKGROUND AND PURPOSE: The importance of the anterior choroidal artery (AChA) is related to its supply of crucial anatomic structures, such as the internal capsule. Angiographically, the AChA can be detected in 71% to 98% of patients, but as yet, its visibility on MR images has not been evaluated. Our goal was to assess the sensitivity of MR imaging in the identification of the AChA and its anatomic characteristics. METHODS: Twenty volunteers underwent MR imaging with a 3D time-of-flight (3D-TOF) sequence, 10 of them additionally with a 3D Fourier transformation constructive interference in steady state (3D-CISS) sequence. The MR angiographic source images and the 3D-CISS images were analyzed independently by two neuroradiologists, who evaluated the ability to identify the different segments of the AChA and the posterior communicating artery (PComA) according to a previously defined scoring system (0 = not identified, 1 = most probably identified, 2 = identified with certainty). Additionally, three patients were examined who had an arteriovenous malformation (AVM) supplied by the AChA. RESULTS: In the volunteers, the PComA was identified with certainty in 87.5% on 3D-TOF sequences and in 95% on 3D-CISS sequences; the AChA was identified with certainty in 92.5% on 3D-TOF sequences and in 90% on 3D-CISS sequences. 3D-CISS images showed additional anatomic information in six of 20 vessels. In the three patients, the enlarged AChA was identified with certainty on both imaging sequences. CONCLUSION: The AChA can be reliably identified using both 3D-CISS sequences and the source images of the 3D-TOF sequence. MR imaging can be used to assess and follow-up AChA-related disorders, especially AVMs.

Adult↗

The motor cortex: anatomic substrates of function.

This article provides a firm foundation in the gross and microscopic anatomy of the motor cortex. It reviews the sites, Brodmann regions, normal function, and deficits associated with the primary motor cortex, supplementary motor area, presupplementary motor area, and the cingulate motor area in preparation for understanding the functional MR imaging studies that are reviewed in the later articles.

Brain Mapping↗

Functional magnetic resonance imaging: factors modulating the cortical activation pattern of the motor system.

The use of functional MR imaging (fMRI), especially in a clinical setting, requires knowledge and control of the physiologic factors that can affect the hemodynamic response of the brain. In this article, the authors review the influence of elementary parameters of the motor system such as hemispheric dominance, rate, and force of action, and complexity of a paradigm in determining the cortical fMRI signal change.

Animals↗

Functional magnetic resonance imaging of human olfaction.

Olfaction is our basic sense phylogenetically and embryologically. Little is known, however, about how the human brain encodes the quality of odors, odor-associated memories, and emotions. Olfactory information is projected from the olfactory bulb to the primary olfactory cortex, which is composed of the anterior olfactory nucleus, the olfactory tubercle, the piriform cortex, the amygdala, the periamygdaloid region, and the entorhinal cortex. From there, the primary olfactory cortex projects to secondary olfactory regions including the hippocampus, ventral striatum and pallidum, hypothalamus, thalamus, orbitofrontal cortex, agranular insular cortex, and cingulate gyrus. Functional MR studies using olfactory stimuli as paradigms show activation of many of these areas and can advance our understanding of odor perception in humans.

Adult↗

Anatomic substrates of language: emphasizing speech.

This article reviews in detail the gross anatomy of the auditory and language areas, the present concepts of unimodal and multimodal association cortices, the classic model of language, problems with the classic model, and newer approaches to conceptualizing the structural interconnections that subserve audition and language.

Adult↗

Cervical MR imaging in postural headache: MR signs and pathophysiological implications.

BACKGROUND AND PURPOSE: Postural headache most often occurs after lumbar puncture as post-lumbar puncture headache (PLPH) or, rarely, spontaneously as spontaneous intracranial hypotension headache (SIHH). In this prospective study, we used spinal MR imaging to determine the findings that would assist in the diagnosis of PLPH and SIHH and that would further our pathophysiological understanding of postural headache. METHODS: The study group consisted of 15 healthy volunteers and 20 patients with postural headache: nine with SIHH and 11 with PLPH. The craniocervical junction and the cervical spine were studied using T2-weighted fast spin-echo and T1-weighted spin-echo sequences in the axial and sagittal planes. Follow-up studies were performed in 13 patients. RESULTS: Dilatation of the anterior internal vertebral venous plexus was the most constant finding, present in 17 (85%) of 20 patients with postural headache. Spinal hygromas, whose location as subdural or epidural could not be exactly determined, were present in 14 patients (70%). A focal fluid collection was detected in the retrospinal region at the C1-C2 level in six patients with SIHH and in four patients with PLPH (50%). Tonsillar descent was detected in only one patient, and subtentorial hygroma in five patients. No abnormalities were found in the volunteers. CONCLUSION: The MR signs of dilatation of the venous plexus, presence of spinal hygromas, and presence of retrospinal fluid collections can help to establish the diagnosis of intracranial hypotension. They are probably the result of decreased CSF volume, with the retrospinal fluid collections being a transudate from the venous plexus rather than frank extravasation. Resolution of these signs parallels resolution of the headache.

Adult↗

Visualization of cranial nerves I-XII: value of 3D CISS and T2-weighted FSE sequences.

The aim of this study was to evaluate the sensitivity of the three-dimensional constructive interference of steady state (3D CISS) sequence (slice thickness 0.7 mm) and that of the T2-weighted fast spin echo (T2-weighted FSE) sequence (slice thickness 3 mm) for the visualization of all cranial nerves in their cisternal course. Twenty healthy volunteers were examined using the T2-weighted FSE and the 3D CISS sequences. Three observers evaluated independently the cranial nerves NI-NXII in their cisternal course. The rates for successful visualization of each nerve for 3D CISS (and for T2-weighted FSE in parentheses) were as follows: NI, NII, NV, NVII, NVIII 40 of 40 (40 of 40), NIII 40 of 40 (18 of 40), NIV 19 of 40 (3 of 40), NVI 39 of 40 (5 of 40), NIX, X, XI 40 of 40 (29 of 40), and NXII 40 of 40 (4 of 40). Most of the cranial nerves can be reliably assessed when using the 3D CISS and the T2-weighted FSE sequences. Increasing the spatial resolution when using the 3D CISS sequence increases the reliability of the identification of the cranial nerves NIII-NXII.

Adult↗

Serial gadolinium-DTPA of spinal cord MRI in multiple sclerosis: triple vs. single dose.

We compared the sensitivity of single and triple dose Gd-DTPA magnetic resonance imaging (MRI) in detecting enhancing lesions in the spinal cord (SC) from 15 patients with multiple sclerosis (MS). The patients were examined monthly on four occasions. We detected two enhancing lesions in two of 15 (13%) patients when a single dose of Gd-DTPA was used. No additional lesions were detected when a triple dose of Gd-DTPA was used. These results 1) confirm that enhanced spinal cord imaging does not significantly increase the detection of active lesions in MS, 2) they do not support the general application of triple dose Gd-DTPA when examining the SC but 3) suggest that further studies taking into account SC symptoms are necessary.

Adult↗

Lesion load quantification on fast-FLAIR, rapid acquisition relaxation-enhanced, and gradient spin echo brain MRI scans from multiple sclerosis patients.

Previous studies have addressed the issue of the usefullness of fast fluid-attenuated (fast-FLAIR), rapid acquisition relaxation-enhanced (RARE), and gradient spin echo (GRASE) sequences in small groups of patients with multiple sclerosis (MS). The aim of this study was to assess and compare the lesion volumes and the intra-rater reproducibility of such measurements using fast-FLAIR, dual echo RARE, and dual echo GRASE brain scans from a large sample of MS patients. Using a 1.5 Tesla scanner, fast-FLAIR, dual echo RARE, and dual echo GRASE scans (24 axial, 5-mm thick contiguous interleaved slices) of the brain were obtained from 50 MS patients. Total lesion loads (TLL) were assessed twice using a semi-automated local thresholding segmentation technique by the same rater from the scans obtained with the three techniques. Mean TLL were 20.3 mL for fast-FLAIR, 16.6 mL for RARE, and 17.6 mL for GRASE sequences. Mean TLL detected by the three techniques were significantly heterogeneous (p < 0.001); at post-hoc analysis, the mean lesion volume detected on fast-FLAIR images was significantly higher than that on both RARE and GRASE images (p < 0.001) and the mean TLL on GRASE scans was significantly higher than that on RARE scans (p = 0.001). The mean values of intra-observer coefficient of variation for TLL measurements were similar for the three techniques (2.69% for fast-FLAIR, 2.33% for RARE, and 2.65% for GRASE). Our results confirm that fast-FLAIR sequences detect higher lesion volumes than those detected by other magnetic resonance imaging (MRI) sequences with shorter acquisition times. However, the reproducibility of TLL measurements is comparable among fast-FLAIR, RARE, and GRASE. This suggests that when assessing MS disease burden with MRI, the choice of the pulse sequence to be used should be dictated by the clinical setting.

Adult↗

Detailed magnetic resonance imaging anatomy of the cisternal segment of the abducent nerve: Dorello's canal and neurovascular relationships and landmarks.

OBJECT: The goal of this study was to identify reliably the cisternal segment of the abducent nerve by using the three-dimensional Fourier transform constructive interference in steady-state (3-D CISS) magnetic resonance (MR) imaging sequence to define landmarks that assist in the identification of the abducent nerve on MR imaging and to describe the nerve's relationship to the anterior inferior cerebellar artery (AICA). METHODS: A total of 26 volunteers underwent 3-D CISS MR imaging, and 10 of these volunteers also underwent MR angiography in which a time-of-flight sequence was used to identify the facial colliculus, the abducent nerve and its apparent origin, Dorello's canal, and the AICA. The authors identified the abducent nerve with certainty in 96% of 3-D CISS sequences obtained in the axial and sagittal planes and in 94% obtained in the coronal plane. The nerve emerged from the pontomedullary sulcus in 94% of cases. The facial colliculus could always be identified, and Dorello's canal was identified in 94% of cases. In 76.6% of cases, the abducent nerve was seen to contact the AICA, which passed inferior to the nerve in 63.8% of cases and superior to it in 29.8%. CONCLUSIONS: The anatomical course of the abducent nerve and its relationship to the AICA and other blood vessels can be reliably identified using a 3-D CISS MR sequence with the facial colliculus and Dorello's canal serving as landmarks.

Abducens Nerve↗