Successful localization of CSF leaks on dynamic CT myelography requires a refined technical approach. In this video article, methods are presented to select and optimize patient position, as well as highlight potential pitfalls and strategies to augment utility in the setting of a difficult examination. Careful understanding and refinement of patient positioning in dynamic CT myelography ensures the performance of high-fidelity examinations with maximal diagnostic yield, decreasing the need for …
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Evaluation of Spontaneous Intracranial Hypotension Probabilistic Brain MRI Scoring Systems in Normal Patients [RESEARCH]
BACKGROUND AND PURPOSE:
Probabilistic brain MRI scoring systems have been introduced to stratify the likelihood of identifying a CSF leak at myelography in spontaneous intracranial hypotension (SIH). The Bern scoring system by Dobrocky and colleagues is now well recognized, with a scoring system by Benson and colleagues introduced more recently (referred to as the Mayo score in this study). Neither of these scoring systems have been thoroughly evaluated in patients without SIH. The goal of this … -
CSF-Venous Fistula Transvenous Onyx Embolization: Evaluation of Onyx Migration into the CSF and Potential One-Way Physiology [CLINICAL]
BACKGROUND AND PURPOSE:
CSF-venous fistulas (CVFs) are abnormal connections between the subarachnoid space and a paraspinal vein. Transvenous Onyx embolization is a recently adopted treatment method for CVF closure, however no studies have specifically evaluated for Onyx migration into the CSF. The purpose of our study was to evaluate patients who underwent transvenous CVF embolization for Onyx migration into the CSF.MATERIALS AND METHODS:
We evaluated 100 patients who underwent transvenous CV… -
Diagnostic Performance of Ultrasound in Neck Node NI-RADS Category 2 [CLINICAL]
BACKGROUND AND PURPOSE:
The Neck Imaging Reporting and Data System (NI-RADS) scoring system standardized imaging surveillance of head and neck (H&N) cancer with risk classification. A nodal NI-RADS score of 2 on contrast-enhanced CT (CECT) of the neck indicates low suspicion for recurrence/persistent disease, and close follow-up or addition of PET is recommended. The unclear follow-up imaging findings and/or mild FDG uptake raise the patient’s anxiety about potential delay in diagnosis… -
3D MR Neurography of Craniocervical Nerves: Comparing Double-Echo Steady-State and Postcontrast STIR with Deep Learning-Based Reconstruction at 1.5T [ARTIFICIAL INTELLIGENCE]
BACKGROUND AND PURPOSE:
3D MR neurography is a useful diagnostic tool in head and neck disorders, but neurographic imaging remains challenging in this region. Optimal sequences for nerve visualization have not yet been established and may also differ between nerves. While deep learning (DL) reconstruction can enhance nerve depiction, particularly at 1.5T, studies in the head and neck are lacking. The purpose of this study was to compare double echo steady-state (DESS) and postcontrast STIR seque… -
Automated Midline Shift Detection in Head CT Using Localization and Symmetry Techniques Based on User-Selected Slice [ARTIFICIAL INTELLIGENCE]
BACKGROUND AND PURPOSE:
Midline shift (MLS) is an intracranial pathology characterized by the displacement of brain parenchyma across the skull’s midsagittal axis, typically caused by mass effect from space-occupying lesions or traumatic brain injuries. Prompt detection of MLS is crucial, because delays in identification and intervention can negatively impact patient outcomes. The gap we have addressed in this work is the development of a deep learning algorithm that encompasses the full s… -
Systematic Review and Meta-Analysis of Radiation Dose Reduction Studies in Pediatric Head CT [CLINICAL]
BACKGROUND:
Conventional imaging protocols used in pediatric head CT scanning without specific adaptations to lower radiation dose or “standard dose” pediatric head CTs increase unnecessary radiation exposure. Modifying CT parameters, utilizing iterative reconstruction, and adopting specialized protocols are ongoing strategies to lower radiation dose in pediatric head CTs.PURPOSE:
This article reviews studies reducing radiation exposure in pediatric patients undergoing head CT and provides met… -
Predicting White Matter Hyperintensity: Leveraging Portable MRI for Accessible Brain Health Screening [CLINICAL]
BACKGROUND AND PURPOSE:
Portable MRI (pMRI) has emerged as a cost-effective and accessible tool for the identification of white matter hyperintensities (WMH), an independent risk factor for stroke and dementia. Our objective was to confirm that pMRI can produce accurate WMH measurements and to develop and validate a risk model to predict WMH on pMRI for the purpose of identifying patients who may benefit from pMRI screening.MATERIALS AND METHODS:
The development (n = 143) and validation (n = 1… -
The Effect of Diagnostic Hypercapnic Cerebrovascular Reactivity Imaging on Vital Signs and Acute and Follow-Up Ischemic Adverse Events in Patients with Flow-Limiting Intracranial Arterial Stenosis [CLINICAL]
BACKGROUND AND PURPOSE:
Anatomical imaging is a hallmark for visualizing chronic and acute infarcts but provides incomplete information on stroke risk. Respiratory hypercapnic gas challenges show promise for noninvasively assessing hemodynamic function and mapping cerebrovascular reserve capacity, an indicator of how near parenchyma is to exhausting autoregulatory capacity. However, limited safety information exists for this method in high-risk patients with flow-limiting stenosis. This study re… -
Recent Trends in Neuroradiologist Compensation and Clinical Productivity in Academic versus Non-Academic Settings [CLINICAL]
SUMMARY:
Awareness of trends in compensation and clinical productivity are important, especially in a competitive market for hiring radiologists. This study shows that in the last decade, clinical productivity as measured by median Work Relative Value Units for academic neuroradiologists remained greater (by 30%–40%) than for academic diagnostic radiologists overall throughout the study period. The median compensation for academic neuroradiologists remains approximately 20% less than that …