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J Spreer

Publications and source records attributed to J Spreer.

26 records · Page 2Linked to original sources

Lhermitte-Duclos disease: assessment with MR imaging, positron emission tomography, single-photon emission CT, and MR spectroscopy.

SUMMARY: Lhermitte-Duclos disease (LDD) is a rare cerebellar lesion with features of both malformation and benign neoplasm. However, the fundamental nature of the entity, its pathogenesis, and the exact genetic alterations remain unknown. We describe MR findings (including perfusion- and diffusion-weighted images) in two patients with LDD, as well as findings from single-photon emission CT (SPECT), MR spectroscopy (MRS), and fluorodeoxyglucose (FDG) positron emission tomography (PET) that give additional information about tumor pathophysiology. MR imaging usually distinguishes the LDD by its characteristic "tiger-striped" appearance. The regions of increased regional cerebral blood volume (rCBV) within the lesion correlated closely to the regions of FDG-hypermetabolism and high thallium (201-Tl) uptake. Proton MRS revealed an increased level of lactate and decreased level of myo-inositiol and N-acetyl-aspartate, as observed in low-grade gliomas, but decreased levels of choline. Our cases indicate that the functional investigations give additional information about tumor pathophysiology and reflect the histopathologic controversial entity with both characteristics found in low-grade gliomas and characteristics not typical for tumors.

Adult↗

Radiological and histological findings in spinal intramedullary angiolipoma.

We report an intramedullary angiolipoma with spinal cord compression studied by MRI, angiography and CT. Angiolipomas of the spine are rare benign tumours containing vascular and mature adipose elements. They are epidural in more than 90 % of the cases; only three cases of intramedullary angiolipoma are described. The clinical picture is nonspecific, but MRI and CT suggest the diagnosis.

Adult↗

Connective tissue reactions in subdural haematomas: imaging with contrast-enhancement MRI.

The sensitivity of contrast enhanced magnetic resonance imaging (MRI) in the detection of connective tissue reactions accompanying the maturation of subdural haematomas (SDH) was studied. An outer enhancing layer between the SDH and the tabula interna of the vault was shown in 16 out of 17 cases. In early SDH this outer enhancing layer presumably is due to vascular congestion and/or increased vascular permeability. A thickening of the outer enhancing layer and/or an inner enhancing layer between the haematoma and the subarachnoid space was visible in 9 patients and represented a haematoma capsule formed by proliferating granulation tissue. In 5 SDH septations were found, 3 SDH consisted almost completely of enhancing granulation tissue. Thus, contrast enhanced MRI delivers additional information about the structure of SDH, which are useful for determining the extent of surgical treatment especially in chronic SDH.

Adolescent↗

Lesions of the corpus callosum in hydrocephalic patients with ventricular drainage--a CT-study.

Patients with ventricular drainage may develop lesions of the corpus callosum. In order to study frequency, pathogenesis and clinical relevance of callosal lesions, 301 routine CT investigations of 79 patients with ventricular drainage were reviewed. Hypodense lesions in the anterior part of the corpus callosum were observed in 7 patients with longstanding hydrocephalus of variable origin, in 2 cases the corpus callosum was slightly swollen. All 7 patients showed signs of forced ventricular drainage. The callosal alterations were clinically inapparent and potentially reversible. Knowledge of these lesions is important to avoid misinterpretation.

Adolescent↗

[Neuroradiological findings in perinatally HIV-infected children].

The neuroradiological studies (CT, MRI, angiography) in 21 children with perinatal HIV infection were reviewed retrospectively. No patient showed an intracranial mass lesion; after intravenous contrast medium application there was no case with disturbed blood-brain barrier. Common non-specific findings were atrophy and delayed myelination. In 7 cases atrophy was combined with multifocal nearly symmetric white matter lesions, which characteristically spared the U-fibres. Further findings included an intramedullary ring-shaped structure in the cervical cord, an AIDS-associated vasculopathy and symmetric calcifications in the basal ganglia. The spectrum of neuroradiological findings in paediatric AIDS patients differs from that in adults. Knowledge of these age-specific findings is important because the number of HIV-infected children is rising.

Age Factors↗

Spiral versus conventional CT in routine examinations of the neck.

OBJECTIVE: Our goal was to optimize the efficiency of contrast material (CM) application in routine examinations of the neck by the use of spiral CT and slow power injection. MATERIALS AND METHODS: Dynamic studies were performed in 14 patients to establish a set protocol for spiral CT examinations of the neck. Prospectively, 100 patients were examined either by use of the spiral technique with 100 ml CM (30 g iodine) injected in two phases or in conventional CT with 150 ml CM (45 g iodine). Vascular and parenchymal enhancement was evaluated at three distinct levels of the neck. RESULTS: Despite the reduced CM volume in spiral CT, vascular enhancement was significantly higher at all three levels. Parenchymal enhancement was comparable in both groups. CM exploitation in vascular opacification (ratio of mean enhancement to applied CM volume) was 0.87 in spiral CT compared with 0.43 in conventional CT. CONCLUSION: Spiral CT significantly increases the efficiency of CM application and is well suited for routine examinations of the neck.

Evaluation Studies as Topic↗

Functional MRI of language-related activation in left frontal schizencephaly.

Brain activation associated with covert verb generation was studied in a right-handed patient with an asymptomatic left frontal schizencephaly by functional magnetic resonance imaging. Activation of the dysplastic neuronal tissue lining the cleft and the adjacent cortex was found, indicating participation of the malformed region in physiologic cerebral functions. This finding may have clinical impact in patients with medically intractable seizures due to malformations of the cortical development prior to epilepsy surgery.

Adult↗