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Neurologic disorders in pregnancy
Published in Hung N. Winn, Frank A. Chervenak, Roberto Romero, Clinical Maternal-Fetal Medicine Online, 2021
Robert Burger, Terry Rolan, David Lardizabal, Upinder Dhand, Aarti Sarwal, Pradeep Sahota
Though longitudinal studies are lacking, MRI is generally considered safe during pregnancy. American College of Obstetricians and Gynecologists have reported no adverse fetal effects but still advise against the use of MRI in first trimester. Risk of gadolinium to fetus is not known; it is classified as category C by FDA. Magnetic resonance angiography might avoid the risk of radiation associated with computed tomography and angiography while evaluating blood vessel in stroke or AVM.
Paper 1
Published in Amanda Rabone, Benedict Thomson, Nicky Dineen, Vincent Helyar, Aidan Shaw, The Final FRCR, 2020
Amanda Rabone, Benedict Thomson, Nicky Dineen, Vincent Helyar, Aidan Shaw
What other finding is magnetic resonance angiography most likely to reveal?Aortic root dilatationPulmonary arterial aneurysmScoliosisTruncus arteriosusVentricular septal defect
Advanced autologous tissue flaps for whole breast reconstruction
Published in Steven J. Kronowitz, John R. Benson, Maurizio B. Nava, Oncoplastic and Reconstructive Management of the Breast, 2020
Steven J. Kronowitz, John R. Benson, Maurizio B. Nava
All patients undergo vascular imaging with magnetic resonance angiography or computerized tomographic angiography. Imaging is essential for planning this procedure because it is extremely important to know exactly where the primary perforator enters the flap. This point (or points) is designated by coordinates determined by the radiologist and confirmed by reviewing the imaging study. The coordinates of the perforators are established according to specific landmarks. The main perforators are identified in their vertical orientation by their distance caudal to the most inferior point of the infra-gluteal crease. Its distance from the midline establishes the perforator’s horizontal orientation. This gives the surgeon two points of reference. With the patient prone, these points can be located with a tape measure and marked. The marked points of the perforators are then confirmed with a Doppler signal.
Carotid-Cavernous Fistula Presenting as Isolated Painful Anisocoria
Published in Neuro-Ophthalmology, 2023
Rasha Mosleh, Andre Aung, Amit M. Saindane, Nancy J. Newman, Valérie Biousse
A repeat head CT scan without contrast was normal. CT angiography (CTA) of the brain with contrast was also normal. The severity of the pain kept her from staying still, which delayed the brain magnetic resonance imaging (MRI) by 48 hours. When this was performed the MRI of the brain and orbits with contrast demonstrated asymmetrical enhancement of the cavernous sinuses with the right being larger than the left (Figure 2a). The superior ophthalmic veins were mildly enlarged. Three-dimensional time-of-flight magnetic resonance angiography (MRA) without contrast showed high concentration of arterialised venous vasculature where the third cranial nerve entered the cavernous sinus on the right (Figure 2b,c). Time-resolved contrast-enhanced MRA demonstrated early arterial contrast enhancement of the cavernous sinuses, superior ophthalmic veins, and petrosal sinuses suggestive of a CCF (Figure 2d). Cerebral angiography confirmed a dural CCF, supplied by the bilateral distal branches of the internal maxillary arteries as well as a minor contribution from the right meningohypophyseal trunk draining out mostly into the bilateral inferior petrosal sinuses, but also some into the ophthalmic veins, consistent with a Barrow type D CCF (Figure 3). She underwent bilateral transvenous coil embolisation with resultant rapid resolution of her facial pain, but worsening of the anisocoria and development of a small right hypotropia and binocular diplopia, which improved over a few weeks.
Giant cell arteritis
Published in Postgraduate Medicine, 2023
MRI/magnetic resonance angiography (MRA) can be used to evaluate vessels with high-resolution multiplanar images. These studies can be supplemental to the diagnosis of both cranial and LV GCA. MRI studies can reveal vessel wall thickening and contrast enhancement as signs of vasculitis in the superficial temporal and occipital arteries. Contrast enhanced MRI is superior to T2 sequences for the demonstration of arterial wall edema but T2 sequences can still detect edema if application of contrast-medium is contraindicated [122]. In a systemic literature review of imaging modalities in cranial GCA, a pooled sensitivity of 73% and specificity of 88% was found comparing MRI with the clinical diagnosis of cranial GCA and when TAB was used as reference, MRI sensitivity was 93% and specificity 81% [114].
Mycobacterium tuberculosis infection of an intralobar pulmonary sequestration
Published in Baylor University Medical Center Proceedings, 2022
Anila Vasireddy, Aadithiyavikram Venkatesan, Akhilesh Gonuguntla, Revanth Maramreddy, Guruprasad D. Rai, Ganesh S. Kamath, Arvind K. Bishnoi
Chest x-ray usually reveals a triangular-shaped mass pointing medially toward the long axis of the lung and features of complications like pneumonia or abscess.1,3 However, CT is a better modality to visualize the ILS and anomalous blood supply. In addition, CT angiography can display homogeneous/heterogeneous opacities, cavities, cystic spaces, or calcifications.3 Alternatively, three-dimensional reconstruction by magnetic resonance angiography can be performed to visualize the origin, anatomic relations, and supply of the blood vessel.3 If these modalities fail to provide satisfactory description, conventional angiography may be done, especially if coil embolization is the desired treatment modality.1,9