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“Sticky Spine”: A Review of the Imaging Findings for Spinal Arachnoiditis “粘性脊柱”:脊髓蛛网膜炎的影像学表现综述
Q4 Medicine Pub Date : 2022-07-01 DOI: 10.3174/ng.2100062
A. C. Ottaiano, T. de Andrade Lourenção Freddi
Arachnoiditis is caused by inflammation of the meninges and subarachnoid space, and when it affects the cauda equina, it is referred to as adhesive or spinal arachnoiditis. The pathophysiology is related to an inflammatory process that results in adherence of the nerve roots to each other and the dura. Patients can experience chronic and persistent back pain, though some cases can present with neurologic impairment. MR imaging is the imaging technique of choice for the evaluation of these patients and enables the classification of arachnoiditis into 3 patterns based on its appearance: 1) the nerve roots are clumped together and distorted; 2) the nerve roots are adherent to the periphery of the thecal sac, creating the empty thecal sac sign; and 3) a large central soft-tissue mass replaces the thecal sac. Rarely, chronic inflammation and fibrosis can occur, leading to arachnoiditis ossificans. Recognition of the neuroimaging findings in the different phases of the inflammatory process and its precise description is essential to clinical counseling and surgical treatment planning.Learning Objectives: To review the pathophysiology and classification of arachnoiditis, to describe the clinical presentations and their imaging characteristics, and to discuss its main complications
蛛网膜炎是由脑膜和蛛网膜下腔的炎症引起的,当它影响到马尾时,被称为粘连性或脊髓性蛛网膜炎。病理生理学与炎症过程有关,炎症过程导致神经根相互粘附和硬脑膜粘附。患者可能会经历慢性和持续的背部疼痛,尽管有些病例可能会出现神经损伤。磁共振成像是评估这些患者的首选成像技术,可以根据其外观将蛛网膜炎分为三种类型:1)神经根聚集在一起并扭曲;2)神经根附着于鞘囊周围,形成空鞘囊征象;3)一个大的中央软组织肿块取代了鞘囊。很少,慢性炎症和纤维化可发生,导致蛛网膜炎骨化。认识炎症过程不同阶段的神经影像学表现及其精确描述对临床咨询和手术治疗计划至关重要。学习目的:回顾蛛网膜炎的病理生理学和分类,描述其临床表现和影像学特征,并讨论其主要并发症
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引用次数: 0
Neuroimaging Findings of SARS-CoV-2 Infection SARS-CoV-2感染的神经影像学表现
Q4 Medicine Pub Date : 2022-07-01 DOI: 10.3174/ng.2100021
A. Aein, S. Khanpara, R. Samant, Y. Cai, L. Nuñez, S. Savitz, Javier Mares Romero, R. Riascos
This review article is a pictorial review of the wide variety of brain and spine CT and MR imaging findings related to coronavirus disease 2019 (COVID-19) in patients with neurologic deficits. By classifying CNS manifestations according to their pathogenesis, we provide different examples of vascular, immunologic, infectious, and miscellaneous complications associated with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. We present cases encountered during the pandemic, retrieved from a large health system.Learning Objectives: To review the spectrum of common and uncommon brain and spine neuroimaging findings of COVID-19 and describe the key imaging features for each finding
这篇综述文章是对神经功能缺损患者与2019冠状病毒病(COVID-19)相关的各种脑和脊柱CT和MR成像结果的图片综述。通过根据发病机制对中枢神经系统的表现进行分类,我们提供了与严重急性呼吸综合征冠状病毒2 (SARS-CoV-2)感染相关的血管、免疫、感染和其他并发症的不同例子。我们介绍大流行期间遇到的病例,这些病例来自一个大型卫生系统。学习目标:回顾2019冠状病毒病常见和不常见的脑和脊柱神经影像学表现,并描述每种表现的关键影像学特征
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引用次数: 0
Superficial Soft-Tissue Masses of the Head and Neck: A Pictorial Review 头颈部浅表软组织肿块的图片回顾
Q4 Medicine Pub Date : 2022-07-01 DOI: 10.3174/ng.2100053
C. Ju, N. Pham
The differential diagnosis of superficial masses in the head and neck is broad and encompasses both benign and malignant soft-tissue tumors. Certain superficial masses of dermal origin do not fall under the World Health Organization classification for soft-tissue tumors but, nonetheless, present similarly and should be considered in the differential. Although many of these superficial masses cannot be definitively diagnosed on imaging alone, recognizing certain imaging patterns and ancillary clinical features may help narrow the differential diagnosis and distinguish benign and malignant lesions. The present article does not aim to provide a comprehensive review of all superficial head and neck masses but rather helps to organize the more common masses by cellular origin and provides an overview of pertinent demographics or risk factors to aid in informed decision-making.Learning Objective: To generate a differential diagnosis of head and neck superficial soft-tissue tumors based on clinical history and imaging features
头颈部浅表肿块的鉴别诊断是广泛的,包括良性和恶性软组织肿瘤。某些皮肤来源的浅表肿块不属于世界卫生组织的软组织肿瘤分类,但尽管如此,表现相似,应在鉴别中予以考虑。虽然许多这些浅表肿块不能仅凭影像学确诊,但认识某些影像学模式和辅助临床特征可能有助于缩小鉴别诊断范围,区分良恶性病变。本文的目的不是提供所有浅表头颈部肿块的全面回顾,而是帮助按细胞起源组织更常见的肿块,并提供相关人口统计学或风险因素的概述,以帮助知情决策。学习目的:根据临床病史和影像学特征对头颈部浅表软组织肿瘤进行鉴别诊断
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引用次数: 0
An Eye for Eyes: Pediatric Ophthalmologic Diseases on MRI 以眼还眼:小儿眼科疾病的MRI
Q4 Medicine Pub Date : 2022-04-01 DOI: 10.3174/ng.2100032
Jerry A. Morris, S. Chiu, T. A. Rahim, S. R. Schaffner, M. Bajaj
The orbit is predisposed to a wide range of possible pathologic processes due to a complex histologic and anatomic composition within a confined space. The clinical presentation of orbital pathology is often nonspecific, particularly in young children, making radiologic evaluation an important step in the diagnosis. Additionally, while suspected ophthalmologic pathology may be the primary purpose for an imaging study, incidental lesions encompassing a broad range of infectious, inflammatory, neoplastic, and congenital processes are not uncommonly encountered and may serve as important clues to alert the radiologist and clinical team to evaluate other associated pathology. High-resolution MR imaging is the examination of choice for detailed evaluation of orbital and ocular soft tissues, and this article will review characteristic MR imaging features and the clinical significance of various ophthalmologic pathologies in the pediatric population, while highlighting pearls essential to making accurate imaging diagnoses.Learning Objective: To recognize the imaging appearance of pediatric orbital disease from major pathologic categories and describe common imaging features
由于狭窄空间内复杂的组织和解剖组成,眼眶易发生多种可能的病理过程。眼眶病理的临床表现通常是非特异性的,特别是在幼儿中,因此放射学评估是诊断的重要步骤。此外,虽然可疑的眼科病理可能是影像学研究的主要目的,但偶然病变包括广泛的感染性、炎症性、肿瘤性和先天性病变并不罕见,这可能是提醒放射科医生和临床团队评估其他相关病理的重要线索。高分辨率磁共振成像是详细评估眼眶和眼部软组织的首选检查,本文将回顾儿童人群中各种眼科病理的特征性磁共振成像特征和临床意义,同时强调准确影像学诊断所必需的珍珠。学习目的:从主要的病理分类中认识小儿眼窝疾病的影像学表现,描述常见的影像学特征
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引用次数: 0
Optic Pathway Edema Mimicking Multifocal/Multicentric Glioblastoma Multiforme: A Case Report and Review 视神经通路水肿模拟多灶/多中心多形性胶质母细胞瘤:一例报告和回顾
Q4 Medicine Pub Date : 2022-04-01 DOI: 10.3174/ng.2100026
E. Liang, C. Winter, K. Murthy
Multifocal/multicentric glioblastoma is a rare variant of glioblastoma that carries a worse prognosis than singular glioblastoma. We report a case of optic nerve edema mimicking multifocal/multicentric glioblastoma in a 24-year-old man. It was suspected that the pathophysiology of edema was due to mechanical compression of the optic nerve causing axonal transport disruption as well as vasogenic edema from inflammatory response to the tumor.
多灶性/多中心性胶质母细胞瘤是一种罕见的胶质母细胞瘤,其预后比单发性胶质母细胞瘤差。我们报告一例视神经水肿模拟多灶/多中心胶质母细胞瘤在一个24岁的男子。我们怀疑水肿的病理生理是由于视神经的机械压迫导致轴突运输中断以及肿瘤炎症反应引起的血管源性水肿。
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引用次数: 0
Primary Meningeal Melanomatosis: A Case Report 原发性脑膜黑色素瘤病1例报告
Q4 Medicine Pub Date : 2022-04-01 DOI: 10.3174/ng.2100024
J. Lowenthal, P. Girgis, M. Labib
Primary meningeal melanomatosis is a rare tumor of the central nervous system accounting for only up to 0.1% of all CNS tumors and 1% of all melanocytic tumors. We present a case of primary meningeal melanomatosis involving the entire neuroaxis and review the relevant imaging findings and literature.
原发性脑膜黑色素瘤病是一种罕见的中枢神经系统肿瘤,仅占所有中枢神经系统肿瘤的0.1%和所有黑色素细胞肿瘤的1%。我们报告一例累及整个神经轴的原发性脑膜黑色素瘤病,并回顾相关影像学表现及文献。
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引用次数: 0
Primary Melanocytic Tumors of the Central Nervous System in Children: Imaging Features with Pathologic Correlation 儿童中枢神经系统原发性黑色素细胞瘤:影像学特征与病理相关性
Q4 Medicine Pub Date : 2022-04-01 DOI: 10.3174/ng.2100033
M. Quinn, J. Aw-Zoretic, N. Wadhwani, A. Jaju
Primary melanocytic tumors of the central nervous system are rare neoplasms arising from proliferation of multipotent melanin-containing neural crest cells found in the leptomeninges. This review describes the imaging appearance of the entire spectrum of primary melanocytic tumors of the brain and spine in the pediatric population, in correlation with histopathology, clinical features, and prognosis, using sample cases from our institution. These tumors are subclassified by the World Health Organization on the basis of disease distribution and pathologic aggressiveness into the following 4 subtypes: meningeal melanocytoma, meningeal melanoma, meningeal melanocytosis, and meningeal melanomatosis. They can occur in any age group, though the diffuse form of the disease is more prevalent in children and has an association with giant cutaneous melanocytic nevi. Imaging is characterized by hyperattenuation on CT and intrinsic T1 hyperintensity on MR imaging from the presence of melanin and/or hemorrhage. The focal forms usually manifest as dural-based hemorrhagic masses, and the diffuse forms demonstrate dural thickening and enhancement, with or without hydrocephalus. There is a predilection for the medial temporal lobes, posterior fossa, and upper cervical spine. The prognosis is often poor, with a high incidence of malignant transformation of benign disease.Learning Objective: To describe the imaging appearance of the spectrum of primary melanocytic tumors of the brain and spine in the pediatric population and to review the histopathology, clinical, and prognostic data available
中枢神经系统原发性黑色素细胞肿瘤是由软脑膜中发现的含有多能黑色素的神经嵴细胞增殖引起的罕见肿瘤。这篇综述使用我们机构的样本病例,描述了儿科人群中大脑和脊椎原发性黑色素细胞肿瘤的全谱影像学表现,与组织病理学、临床特征和预后的相关性。世界卫生组织根据疾病分布和病理侵袭性将这些肿瘤分为以下4种亚型:脑膜黑色素细胞瘤、脑膜黑色素瘤、脑膜黑素瘤和脑膜黑色素增多症。它们可以发生在任何年龄组,尽管这种疾病的弥漫型在儿童中更常见,并与巨大的皮肤黑色素细胞痣有关。影像学的特征是CT上的过度注意和由于存在黑色素和/或出血而在MR成像上的固有T1高信号。局灶型通常表现为硬膜基出血性肿块,弥漫型表现为硬膜增厚和强化,伴有或不伴有脑积水。颞叶内侧、后颅窝和上颈椎是一种偏好。预后往往较差,良性疾病恶变发生率高。学习目的:描述儿童脑和脊柱原发性黑色素细胞肿瘤的影像学表现,并回顾现有的组织病理学、临床和预后数据
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引用次数: 0
Cerebral Amyloid Angiopathy‐related Inflammation: American Society of Neuroradiology 2020 Case of the Year 脑淀粉样血管病相关炎症:美国神经放射学会2020年度病例
Q4 Medicine Pub Date : 2022-04-01 DOI: 10.3174/ng.2100028
G. Kadam, S. Supple, M. Jhaveri
Cerebral amyloid angiopathy‐related inflammation (CAARI) presents as a syndrome of acute/subacute encephalopathy. Currently, the underlying etiopathogenesis of this entity is not well established, though the amyloid deposits and resulting perivascular inflammation and cellular infiltrate are said to be the underlying cause. A definitive diagnosis of CAARI may require brain biopsy, which is not often clinically feasible in every case. Furthermore, CAARI does not affect the parenchyma uniformly, and biopsy could be falsely negative at times. When present, the combination of helpful imaging findings and a high index of suspicion may help avoid the morbidity associated with invasive brain biopsy and establish a timely diagnosis. This article describes one of the commonly encountered imaging and clinical presentations of CAARI.
脑淀粉样血管病相关炎症(CAARI)是一种急性/亚急性脑病综合征。目前,虽然淀粉样蛋白沉积和由此产生的血管周围炎症和细胞浸润被认为是潜在的原因,但这种实体的潜在发病机制尚不清楚。对CAARI的明确诊断可能需要进行脑活检,这在临床上并不总是可行的。此外,CAARI对实质的影响并不均匀,活检有时可能出现假阴性。当出现时,结合有用的影像学发现和高怀疑指数可能有助于避免与侵入性脑活检相关的发病率,并建立及时的诊断。本文描述了CAARI常见的影像学和临床表现之一。
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引用次数: 1
A Comprehensive Clinical Review of Adult-Type Diffuse Glioma Incorporating the 2021 World Health Organization Classification 纳入2021年世界卫生组织分类的成人型弥漫性胶质瘤综合临床综述
Q4 Medicine Pub Date : 2022-04-01 DOI: 10.3174/ng.2100034
S. Currie, K. Fatania, R. Matthew, H. Wurdak, A. Chakrabarty, L. Murray, S. Short
The intent of this article is to provide a comprehensive, educational review of adult-type diffuse gliomas, bringing together the role of the multidisciplinary team and giving the reader biologic, surgical, radiologic, and oncologic insight into these tumors. The reader will be guided through subsections that explain the molecular pathophysiology, diagnosis, treatment, prognosis and natural history of the disease. The 2021 World Health Organization Classification will be explained through a combination of concise historic review of glioma diagnosis and contemporary knowledge of the molecular pathways. Accompanying illustrations will act as powerful tools for comprehension. These concepts will be underpinned by frequent reference to neuroradiology and a grounding of normal brain composition.Learning Objective: To understand the pathophysiologic concepts that underly the World Health Organization Classification and natural history of adult-type diffuse gliomas and how these relate to imaging and treatment strategies
本文旨在对成人型弥漫性胶质瘤进行全面、教育性的综述,汇集多学科团队的作用,让读者对这些肿瘤有生物学、外科、放射学和肿瘤学的了解。读者将被引导阅读解释该疾病的分子病理生理学、诊断、治疗、预后和自然史的小节。2021年世界卫生组织分类将通过对神经胶质瘤诊断的简要历史回顾和分子途径的当代知识相结合来解释。随附的插图将成为理解的有力工具。这些概念将通过经常参考神经放射学和正常大脑组成的基础来支持。学习目的:了解世界卫生组织成人型弥漫性胶质瘤分类和自然史的病理生理学概念,以及这些概念与成像和治疗策略的关系
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引用次数: 2
Pictorial Review of Calcified Pseudoneoplasm of the Neuroaxis and Other Calcified Intracranial Lesions 神经轴钙化假肿瘤及其他钙化颅内病变的影像学回顾
Q4 Medicine Pub Date : 2022-01-01 DOI: 10.3174/ng.2100006
R. Zelaya, C. J. Atkinson
Neuroimaging is an essential tool in characterizing calcified intracranial lesions. This article outlines a pictorial review of different calcified lesions of the neuroaxis with discussion of distinguishing radiologic features and clinical and histologic characteristics. There will be an emphasis on the uncommon histologic entity known as calcified pseudoneoplasm of the neuroaxis (CAPNON), a non-neoplastic lesion that is sometimes mistaken for the more common neoplastic and non-neoplastic lesions. It is essential for radiologists to identify key distinguishing imaging features of various calcified intracranial lesions to narrow diagnostic considerations and collaborate with management decisions.Learning Objective: To offer a review of the uncommon histologic entity called calcified pseudoneoplasm of the neuroaxis (CAPNON) and to provide a differential diagnosis and several sample cases of other calcified lesions of the neuroaxis to help the reader differentiate and distinguish CAPNON from more common neoplastic and non-neoplastic lesions
神经影像学是表征颅内钙化病变的重要工具。本文概述了神经轴不同钙化病变的影像学回顾,并讨论了其放射学特征、临床和组织学特征。将重点关注被称为神经轴钙化假肿瘤(CAPNON)的罕见组织学实体,这是一种非肿瘤性病变,有时被误认为是更常见的肿瘤和非肿瘤性损伤。放射科医生必须识别各种钙化颅内病变的关键区别成像特征,以缩小诊断考虑范围并与管理决策合作。学习目的:回顾一种罕见的组织学实体,称为神经轴钙化假肿瘤(CAPNON),并提供其他神经轴钙化病变的鉴别诊断和几个样本病例,以帮助读者区分和区分CAPNON与更常见的肿瘤和非肿瘤病变
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引用次数: 0
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Neurographics
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