Abstract:
:More studies on the natural history of carotid artery plaques are needed to predict more reliably which plaque types or features are the most dangerous (see Table 2). Studies on carotid and coronary endarterectomy specimens indicate a dynamic process of rupture, thrombus formation, healing, and remodeling of the plaque. A plaque from a symptomatic patient may not show any signs of plaque rupture if the plaque has healed or evolved since the debut of symptoms. Selection of high-risk symptomatic patients with carotid atherosclerosis for medical or surgical treatment requires reliable, noninvasive, and cost-effective imaging methods. B-mode ultrasonography can be used for detection of early (IMT) as well as late (plaque morphology) atherosclerotic disease. Plaque morphology evaluation on spiral CT imaging is only for research and not yet for clinical use. Asymptomatic patients with carotid atherosclerosis hardly benefit from surgical treatment, as the minimal decrease in ischemic stroke risk is almost equal to the risk of perioperative stroke or death. A high degree of carotid stenosis measured using conventional angiography is an accepted risk factor for stroke but does not identify all vulnerable plaques. Echolucency on ultrasound B-mode imaging can be included as an important parameter in this risk stratification, as it appears to predict rupture-prone, lipid-rich plaques in the mild to severely stenotic carotid artery of a symptomatic patient. The subjective evaluation of plaque morphology on B-mode ultrasound should be complemented or substituted with objective evaluation such as videodensitometric analysis. This method is commercially available and is a relatively cheap and investigator-independent solution, but more studies are required to determine the exact contribution of echolucency to stroke risk. Furthermore, the evaluation of plaque morphology using ultrasound B-mode is still subject to large variations and observer-dependence, limiting its clinical use. In contrast, carotid IMT measurements are reliable to monitor progression and regression of early carotid disease as well as the impact of interventions. This method, however, suffers when used in severely diseased vessels where the boundaries of the IMT complex are hard to distinguish in all segments of the artery. Spiral CT imaging is a preliminary test for plaque characterization, as it primarily identifies calcification but not the more relevant lipid component. Moreover, it is time and resource demanding and involves use of both contrast and radiation, increasing the risk of allergic events and cancer. Standardization and continuous quality control are important, as are consensus agreements on how to quantify lesions (especially IMT), calibrate and standardize B-mode images and outline the plaque, and analyze data. The development of imaging methods for atherosclerotic research is currently fast and promising. This progress is most necessary, considering the very high demands for surrogate endpoints and risk markers in clinical intervention studies. Whether ultrasonic plaque characterization can be implemented in broad general clinical practice, for example, in screening of individuals at high risk of developing atherosclerosis and ischemic events, has to be based upon data from large prospective studies with long-term follow-up. IMT is already used in population screening, as in the ARIC study [9,101].
journal_name
Neuroimaging Clin N Amjournal_title
Neuroimaging clinics of North Americaauthors
Grønholdt MLdoi
10.1016/s1052-5149(02)00015-1keywords:
subject
Has Abstractpub_date
2002-08-01 00:00:00pages
421-35issue
3eissn
1052-5149issn
1557-9867pii
S1052-5149(02)00015-1journal_volume
12pub_type
杂志文章,评审abstract::Proton magnetic resonance spectroscopy ((1)H-MRS) is an unconventional technique that allows noninvasive characterization of metabolic abnormalities in the central nervous system. (1)H-MRS provides important insights into the chemical-pathologic changes that occur in patients with multiple sclerosis (MS). In this revi...
journal_title:Neuroimaging clinics of North America
pub_type: 杂志文章,评审
doi:10.1016/j.nic.2013.03.005
更新日期:2013-08-01 00:00:00
abstract::Diffusion-weighted imaging of the musculoskeletal system including the spine is a new MR imaging method. Several studies have shown significantly different diffusivities for various pathologic conditions such as edema and tumor. The specificity of diagnosis may be increased and therapeutic effects may be monitored. Di...
journal_title:Neuroimaging clinics of North America
pub_type: 杂志文章
doi:10.1016/s1052-5149(03)00074-1
更新日期:2002-02-01 00:00:00
abstract::Primary brain tumors are the most common solid tumor in children and the second most common cancer after leukemia and lymphoma to affect the pediatric population. The incidence, clinical presentation, imaging features, and treatment outcomes of various pediatric brain tumors are discussed. ...
journal_title:Neuroimaging clinics of North America
pub_type: 杂志文章,评审
doi:
更新日期:1999-11-01 00:00:00
abstract::A variable effectiveness of reparative and recovery mechanisms following tissue damage is among the factors that might contribute to explaining resolution of symptoms and maintenance of a normal level of function in patients who have multiple sclerosis (MS). The application of functional MR imaging in MS has shown tha...
journal_title:Neuroimaging clinics of North America
pub_type: 杂志文章,评审
doi:10.1016/j.nic.2008.08.004
更新日期:2009-02-01 00:00:00
abstract::This article discusses the broad topic of thyroid cancer, with a focus on giving the reader an understanding of the basis for surgical decision making. The reader will gain an understanding of the embryology, anatomy, and various cancer pathologies than can affect the thyroid gland. The reader will also be exposed to ...
journal_title:Neuroimaging clinics of North America
pub_type: 杂志文章,评审
doi:10.1016/j.nic.2008.03.009
更新日期:2008-08-01 00:00:00
abstract::Fungal sinusitis is characterized into invasive and noninvasive forms. The invasive variety is further classified into acute, chronic and granulomatous forms; and the noninvasive variety into fungus ball and allergic fungal sinusitis. Each of these different forms has a unique radiologic appearance. The clinicopatholo...
journal_title:Neuroimaging clinics of North America
pub_type: 杂志文章,评审
doi:10.1016/j.nic.2015.07.004
更新日期:2015-11-01 00:00:00
abstract::The classic multiple sclerosis variants including Devic's neuromyelitis optica (NMO), Balo's concentric Sclerosis, Schilder's disease, and Marburg MS are both interesting and instructive from a disease pathophysiology perspective. Although rare, the variants are important as they often arise in the differential diagno...
journal_title:Neuroimaging clinics of North America
pub_type: 杂志文章,评审
doi:10.1016/j.nic.2008.06.003
更新日期:2008-11-01 00:00:00
abstract::This article reviews the current status and trends in the treatment of primary gliomas, focusing predominantly on glioblastoma. It also discusses the current standard of care and new targeted agents currently under investigation. Furthermore, the concepts of pseudoprogression and pseudoresponse are introduced, which a...
journal_title:Neuroimaging clinics of North America
pub_type: 杂志文章,评审
doi:10.1016/j.nic.2009.08.015
更新日期:2009-11-01 00:00:00
abstract::The neuroimaging of hydrocephalus from the perspective of the pediatric neurosurgeon is discussed. Processes with new developments in therapy and imaging are described, including congenital causes of hydrocephalus, unilateral hydrocephalus, trapped fourth ventricle, and benign external hydrocephalus. ...
journal_title:Neuroimaging clinics of North America
pub_type: 杂志文章,评审
doi:
更新日期:1999-02-01 00:00:00
abstract::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. Di...
journal_title:Neuroimaging clinics of North America
pub_type: 杂志文章
doi:10.1016/j.nic.2011.01.010
更新日期:2011-02-01 00:00:00
abstract::One of the major pitfalls faced by physicians is a basic lack of understanding of the legal aspects of medical malpractice. It is the authors' hope that the brief review of the history of malpractice law provided here affords the radiologist insights that could prove helpful in understanding how one must conduct onese...
journal_title:Neuroimaging clinics of North America
pub_type: 杂志文章,评审
doi:10.1016/j.nic.2012.05.012
更新日期:2012-08-01 00:00:00
abstract::Increased iron deposition in cerebral deep gray matter has been considered a global marker for neurodegeneration in multiple sclerosis (MS); it scales with disease duration and severity. Iron accumulation in white matter and MS lesions might be more directly related to disease activity and has been discussed as a cont...
journal_title:Neuroimaging clinics of North America
pub_type: 杂志文章,评审
doi:10.1016/j.nic.2016.12.003
更新日期:2017-05-01 00:00:00
abstract::CT scanning of the jaws with cross-sectional images perpendicular to the curvature of the alveolar processes can be used to facilitate surgical planning for placement of dental implants. After ruling out pathologic changes, the radiographic evaluation concentrates on the dimensions of the alveolar processes relative t...
journal_title:Neuroimaging clinics of North America
pub_type: 杂志文章,评审
doi:
更新日期:1996-05-01 00:00:00
abstract::Functional magnetic resonance imaging is able to define noninvasively the location of eloquent cortex responsible for speech, motor, and visual function, and it holds promise for localizing other important functional tissues in the future. Such localization is extremely important to the epileptologist and surgeon plan...
journal_title:Neuroimaging clinics of North America
pub_type: 杂志文章,评审
doi:
更新日期:1995-11-01 00:00:00
abstract::Pyogenic spondylitis and discitis are usually seen following a recent infection or surgery. A septic embolus causes an infarcted area within the bone. Pyogenic spondylitis is characterized by edema, vascular leakage, and supportive inflammatory reaction characterized with polymorphonuclear leukocytes. In tuberculosis ...
journal_title:Neuroimaging clinics of North America
pub_type: 杂志文章,评审
doi:10.1016/j.nic.2015.01.011
更新日期:2015-05-01 00:00:00
abstract::Neuroimaging is a potentially valuable tool to link individual differences in the human genome to structure and functional variations, narrowing the gaps in the casual chain from a given genetic variation to a brain disorder. Because genes are not usually expressed at the level of mental behavior, but are mediated by ...
journal_title:Neuroimaging clinics of North America
pub_type: 杂志文章,评审
doi:10.1016/j.nic.2014.09.005
更新日期:2015-02-01 00:00:00
abstract::Arterial supply of hippocampal formation in humans has been studied by many investigators in the past. More recently, investigation of correlation of complex partial seizure with mesial temporal sclerosis has brought a resurgence of interest in studying the hippocampus. This article discusses arterial architecture of ...
journal_title:Neuroimaging clinics of North America
pub_type: 杂志文章
doi:
更新日期:1997-02-01 00:00:00
abstract::Carotid blowout syndrome can be a life-threatening late complication of surgical and radiation therapy for head and neck tumors in the vicinity of the cervical carotid artery. The syndrome spans a spectrum of pathology from impending to acute rupture of the artery. These cases are uncommon, can be dramatic in terms of...
journal_title:Neuroimaging clinics of North America
pub_type: 杂志文章,评审
doi:10.1016/j.nic.2009.01.001
更新日期:2009-05-01 00:00:00
abstract::Congenital malformations encompass a diverse group of disorders present at birth as result of genetic abnormalities, infection, errors of morphogenesis, or abnormalities in the intrauterine environment. Congenital disorders affecting the brain and spinal cord are often diagnosed before delivery with the use of prenata...
journal_title:Neuroimaging clinics of North America
pub_type: 杂志文章,评审
doi:10.1016/j.nic.2011.05.009
更新日期:2011-08-01 00:00:00
abstract::Proton MR spectroscopy allows differentiation of normal tissues from pathologic ones. There is now evidence that this technique may be able to distinguish different histological grades of tumors. The proton MR spectroscopic changes due to treatment of brain tumors is discussed in this article. ...
journal_title:Neuroimaging clinics of North America
pub_type: 杂志文章,评审
doi:
更新日期:1998-11-01 00:00:00
abstract::Tumors of the head and neck are primary sites for radiation treatment. In combination with surgery, the role of radiation is further expanded; however, localization of the primary tumor and its metastases, actual or potential, and the relationship to critical structures are quintessential to the application of radiati...
journal_title:Neuroimaging clinics of North America
pub_type: 杂志文章,评审
doi:
更新日期:1996-05-01 00:00:00
abstract::Only through a combined understanding of contrast agent properties and fundamental contrast mechanisms, optimal administration and imaging techniques can be applied to contrast-enhanced MR imaging. It is impossible to cover all aspects of the physics of paramagnetic contrast agents in a short review. The basic theorie...
journal_title:Neuroimaging clinics of North America
pub_type: 杂志文章,评审
doi:
更新日期:1994-02-01 00:00:00
abstract::Approximately 30,000 spinal injuries occur in the United States every year. Injuries to the spine and its contents affect predominately young, healthy individuals and are a major cause of disability, with significant socioeconomic consequences. The main cause for spinal injuries is blunt trauma, most commonly caused b...
journal_title:Neuroimaging clinics of North America
pub_type: 杂志文章,评审
doi:10.1016/j.nic.2006.11.006
更新日期:2007-02-01 00:00:00
abstract::CT and MR imaging increasingly are being used for the evaluation of the skull base. New innovative techniques have revolutionized radiologic understanding of normal skull base anatomy. Thus, normal anatomic relationships with radiographic correlation are vital for accurate pathologic assessment. ...
journal_title:Neuroimaging clinics of North America
pub_type: 杂志文章,评审
doi:
更新日期:1994-08-01 00:00:00
abstract::Spondylitis or infection of the spine is a spectrum of diseases involving the bone, disks, and/or ligaments. Because of a significant increase in the immunocompromised patient population, spinal infections are a growing and changing group of conditions, making the diagnosis based on imaging more challenging. Most case...
journal_title:Neuroimaging clinics of North America
pub_type: 杂志文章,评审
doi:10.1016/j.nic.2015.01.007
更新日期:2015-05-01 00:00:00
abstract::Magnetic resonance (MR) imaging, in addition to its excellent depiction of neuroanatomy, is being developed as a major technique for functional imaging of cerebrospinal fluid motion and for measurement of velocity, strain, and diffusional processes within the brain parenchyma. Functional MR imaging studies are reveali...
journal_title:Neuroimaging clinics of North America
pub_type: 杂志文章,评审
doi:
更新日期:1995-02-01 00:00:00
abstract::Functional MR imaging (fMRI) is being used increasingly to explore the human central auditory system. The considerable background noise produced by echo-planar imaging (EPI) and other fMRI sequences, however, interferes in an unpredictable way with the experimental stimuli. Several approaches exist to overcome this pr...
journal_title:Neuroimaging clinics of North America
pub_type: 杂志文章,评审
doi:
更新日期:2001-05-01 00:00:00
abstract::This article is an update and literature review of the clinical and neuroimaging findings of the commonly known rickettsial, spirochetal, and eukaryotic parasitic infections. Being familiar with clinical presentation and imaging findings of these infections is crucial for early diagnosis and treatment especially in pa...
journal_title:Neuroimaging clinics of North America
pub_type: 杂志文章,评审
doi:10.1016/j.nic.2012.05.015
更新日期:2012-11-01 00:00:00
abstract::Resting-state functional connectivity is the synchronization of brain regions with each another. Alterations are suggestive of neurologic or psychological disorders. This article discusses methods and approaches used to describe resting-state brain connectivity and the results in neurotypical and diseased brains. ...
journal_title:Neuroimaging clinics of North America
pub_type: 杂志文章,评审
doi:10.1016/j.nic.2017.06.001
更新日期:2017-11-01 00:00:00
abstract::Aneurysms arising along the arterial trunk are uncommon and not well-characterized lesions in contrast to saccular aneurysms. According to pathological studies, most of spontaneous trunkal aneurysms are related to dissecting phenomena. On the basis of clinical presentation, dissecting aneurysms can be separated into a...
journal_title:Neuroimaging clinics of North America
pub_type: 杂志文章,评审
doi:10.1016/j.nic.2006.05.006
更新日期:2006-08-01 00:00:00