Search

Introduction: The imaging of carotid plaques has undergone a paradigm shift increasing importance being given to plaque characterization. Patients with “vulnerable” plaques are more prone to develop future neurovascular events. Purpose: The purpose of this study is to analyze the role of multimodality imaging techniques in the assessment of carotid atherosclerotic plaques. Materials and Methods: Twenty-six patients were prospectively enrolled in the study. Patients underwent multidetector computed tomography (CT) angiography, ultrasound, contrast-enhanced ultrasound, and high-resolution magnetic resonance imaging (MRI) of the carotid arteries with special emphasis on the carotid bifurcation. Results: The mean age of patients was 65.41 years. Twenty-one were males. Plaque neovascularization was seen in 10 of the 18 plaques studied (55.56%). Based on the predominant components of the plaque, plaques were characterized as lipid (3), lipid with recent hemorrhage (1), fibrous (7), fibrofatty (4), fibrofatty with some hemorrhagic components (3), and recent hemorrhage (2). Conclusions: Together, contrast-enhanced ultrasound, CT, and MRI provide complete information about the plaque characteristics.

Cervical cancer is a disease that develops in the cervix's tissue. Cervical cancer mortality is being reduced due to the growth of screening programmers. Cervical cancer screening is a big issue because the majority of cervical cancer screening treatments are invasive. Hence, there is apprehension about standard screening procedures, as well as the time it takes to learn the results. There are different methods for detecting problems in the cervix using Pap (Papanicolaou-stained) test, colposcopy, Computed Tomography (CT), Magnetic Resonance Image (MRI) and ultrasound. To obtain a clear sketch of the infected regions, using a decision tree approach, the captured image has to be segmented and analyzed. The goal of creating a decision tree is to establish prediction model that anticipate the feature vector based on the input variable. This paper deals with investigating various techniques of segmentation for detecting the cervical cancer. It proposes a novel method to develop an assistance system for the detection diagnosis of cervical cancer, based on work of Martin, Byriel and Norup. The analysis is focused on Pap smear pictures of single cells. Smear testing is a method of detecting abnormalities in the blood. Image processing is an effective method for extracting data. It is used to determine the size of cervical carcinoma and the length of the uterus. Martin's database, which is open source and utilised for analysis and validation, is obtainable for research purposes. Cervical malignancy information utilizing three grouping strategies to anticipate the disease and afterward analyzed the outcomes showed that choice tree is the best classifier indicator with the test dataset. Further investigations ought to be led to improve execution. [ABSTRACT FROM AUTHOR]

Background and Purpose: The aim of the research was to compare the efficiency of multiphase and single-phase computed tomography (CT) angiography in assessing the leptomeningeal collaterals and in predicting the long-term clinical outcome as well as the risk of hemorrhagic transformation.Materials and Methods: A prospective study was conducted from October 2016 to May 2018 in consecutive patients who presented within 8 hours of the onset of acute anterior circulation ischemic strokes, with NIHSS (National Institutes of Health Stroke Scale) scores ≥5. They underwent triple-phase cerebral CT angiography, and the collaterals were assessed separately using both single-phase and multiphase techniques. The ability of the collaterals to predict the 24-hour CT ASPECTS (Alberta Stroke Program Early CT score), risk of cerebral hemorrhagic transformation, and 90-day clinical outcome was assessed.Results: Fifty-six patients, which included 42 with an involvement of the middle cerebral artery and 14 with mixed occlusions, were assessed. In the multivariate logistic analysis, multiphase CT angiography collateral grading is one of the independent predictors of favorable outcomes. Area under the curve (AUC) was 0.853 (95% confidence interval [CI; 0.73, 0.97]) for multiphase CT collateral scoring in predicting the long-term functional independence, whereas single-phase CT (sCT) scoring displayed an AUC value of only 0.609 (95% CI [0.43, 0.78]). Eighty-two percent of the patients with good multiphase CT collaterals were functionally independent. CT ASPECTS at 24 hours was significantly better in patients with a good multiphase CT collateral score than in those with a good single-phase score. None of the patients with good collaterals in multiphase CT angiography had a significant hemorrhagic transformation. Good multiphase CT collaterals demonstrated 78% sensitivity, 81% specificity, and 80% accuracy in predicting the functional outcome.Conclusion: Multiphase CT collateral system was superior to single-phase angiography in predicting the long-term functional outcomes. Prediction of the hemorrhagic transformation risk was also observed to be better for multiphase CT. [ABSTRACT FROM AUTHOR]

Primary angiitis of central nervous system (PACNS) is a rare idiopathic disorder affecting blood vessels of brain, spinal cord, and meninges, consequently leading to infarct and less frequently hemorrhage. CNS vasculitis can also occur as part of systemic vasculitis or secondary to autoimmune diseases or infections. The clinical manifestations of PACNS are non specific and no single laboratory investigation or neuroimaging finding can reliably diagnose this condition. Histopathological evidence of transmural inflammation of blood vessels of CNS is the gold standard, but is generally pursued subsequent to conventional angiogram (CA) because of its invasive nature. The differentials of PACNS are exhaustive and include systemic vasculitis, secondary vasculitis, non inflammatory intracranial vasculopathies, demyelination, and neoplasm. These alternative conditions can often be distinguished by history, examination, immunological testing, cerebrospinal fluid analysis, and neuroimaging. CA can detect vasculitic changes in the large to medium cerebral arteries but the specificity is low. Recent advancements in vessel wall imaging techniques have further enabled the distinction of various intracranial vasculopathies from CNS vasculitis. The disease has considerable morbidity and fatality unless timely treatment with immunosuppressive agents is initiated. Induction therapy with glucocorticoids and cyclophosphamide followed by azathioprine, mycophenolate mofetil, or methotrexate as maintenance therapy is the cornerstone of management. Biological agents such as rituximab and anti tumour necrosis factor alpha inhibitors (infliximab and etanercept) may be used in refractory cases. This review discusses the approach to the diagnosis, determinants of outcome, and management. [ABSTRACT FROM AUTHOR]

Background: Non-contrast CT (NCCT) brain imaging biomarkers of hematoma expansion in intracerebral hemorrhage (ICH) has gained relevance in recent times. Though intra-hematoma hypodensities (IHH) can predict hematoma expansion and outcome, it is postulated to be time-dependent.Aim: To assess the differential prevalence of IHH in spontaneous ICH over time and assess its predictive valve in early hematoma expansion and functional outcome at 3 months.Material and Methods: Patients with ICH within 48 h of stroke onset were included. Baseline clinical and demographic data were collected. Baseline NCCT brain was analyzed for hematoma volume, characterization of IHH, with 24-hours follow-up NCCT hematoma volume calculated for identification of hematoma expansion. Poor functional outcome was defined as mRS ≥3.Results: Around 92 subjects were included in the study. IHH was found in 40%. Prevalence of IHH was higher in those with baseline NCCT performed within 3 h of symptom onset compared to those beyond 3 h (71% vs 29%, P = 0.002). The hematoma expansion was more common in patients with IHH compared to those without (54% vs 29%; P = 0.02). Multivariate analysis revealed the presence of IHH (rather than pattern or number) to be strongly associated with poor functional outcome at 3 months (OR 3.86; 95% CI: 1.11-13.42, P = 0.03).Conclusion: There is a decreasing prevalence of IHH as the time from symptom onset to NCCT increases. Nevertheless, its presence is significantly associated with hematoma expansion and predicted poor short-term functional outcomes in spontaneous ICH. [ABSTRACT FROM AUTHOR]

Introduction: Cerebral amyloid angiopathy (CAA) is a major cause of intracerebral hemorrhage (ICH) and cognitive decline in the elderly. Since it is rarely reported from the developing world, we looked into the clinical profile and neuroimaging associations of CAA.Materials and Methods: Ours was a retrospective case series of subjects diagnosed with probable/possible CAA between January 2006 and December 2015 as per Boston criteria. Clinical profile and neuroimaging were reviewed for markers of CAA. Details of any recurrent clinical events and functional status were collected from follow-up records.Results: We had 28 subjects in the series with men outnumbering women, and the mean age was 70.17 ± 8.85 years (55-87 years). At the initial presentation, ICH was most frequent-10/28 (35.7%) patients, followed by transient neurological events (TNE = 25%) and cognitive disturbances (21.4%). Less than half of the patients received a diagnosis of CAA at the initial presentation itself. In total, 68% of our patients had cognitive dysfunction at admission. In our series, 12 had seizures and 9 had a history of TNE. The majority of our patients had vascular risk factors also. Leukoaraiosis showed an association with cognitive dysfunction (P = 0.044). Superficial siderosis and subarachnoid hemorrhage (SAH) showed a positive association with seizures and TNE, respectively. However, ICH showed no association with risk factors or imaging markers of CAA.Conclusions: CAA patients, with a high prevalence of vascular risk factors mostly presented with ICH. The presence of SAH and superficial siderosis on MRI was associated with presentation as TNE and seizures, respectively. [ABSTRACT FROM AUTHOR]

Most intracranial vascular disorders like atherosclerosis, vasculitis, and reversible cerebral vasoconstriction syndrome (RCVS) share similar lumenographic findings in traditional imaging modalities like computed tomography (CT), magnetic resonance imaging (MRI) and digital subtraction angiographic studies. Hence, there is a need for an advanced imaging modality like vessel wall imaging (VWI) to confirm the diagnosis so that appropriate clinical management could be done. Now, currently vessel wall imaging could be done in a high resolution manner with three dimensional (3D) imaging sequences. The aim of this article is to deal with the protocol as well as the current imaging applications of the high resolution VWI. [ABSTRACT FROM AUTHOR]

Introduction: The imaging of carotid plaques has undergone a paradigm shift increasing importance being given to plaque characterization. Patients with “vulnerable” plaques are more prone to develop future neurovascular events. Purpose: The purpose of this study is to analyze the role of multimodality imaging techniques in the assessment of carotid atherosclerotic plaques. Materials and Methods: Twenty‑six patients were prospectively enrolled in the study. Patients underwent multidetector computed tomography (CT) angiography, ultrasound, contrast‑enhanced ultrasound, and high‑resolution magnetic resonance imaging (MRI) of the carotid arteries with special emphasis on the carotid bifurcation. Results: The mean age of patients was 65.41 years. Twenty‑one were males. Plaque neovascularization was seen in 10 of the 18 plaques studied (55.56%). Based on the predominant components of the plaque, plaques were characterized as lipid (3), lipid with recent hemorrhage (1), fibrous (7), fibrofatty (4), fibrofatty with some hemorrhagic components (3), and recent hemorrhage (2). Conclusions: Together, contrast‑enhanced ultrasound, CT, and MRI provide complete information about the plaque characteristics. [ABSTRACT FROM AUTHOR]

Background In ischemic stroke, functional outcomes vary depending on site of intracranial occlusion. We tested the prognostic value of a semiquantitative computed tomography angiography-based clot burden score. Methods Clot burden score allots major anterior circulation arteries 10 points for presence of contrast opacification on computed tomography angiography. Two points each are subtracted for thrombus preventing contrast opacification in the proximal M1, distal M1 or supraclinoid internal carotid artery and one point each for M2 branches, A1 and infraclinoid internal carotid artery. We retrospectively studied patients with disabling neurological deficits (National Institute of Health Stroke Scale score ≥5) and computed tomography angiography within 24-hours from symptom onset. We analyzed percentages independent functional outcome (modified Rankin Scale score ≤2), final infarct Alberta Stroke Program Early Computed Tomography Score and parenchymal hematoma rates across categorized clot burden score groups and performed multivariable analysis. Results We identified 263 patients (median age 73-years, National Institute of Health Stroke Scale score 10, onset-to-computed tomography angiography time 165 min). Clot burden score<10 was associated with reduced odds of independent functional outcome (odds ratio 0·09 for clot burden score≤5; odds ratio 0·22 for clot burden score 6–7; odds ratio 0·48 for clot burden score 8–9; all versus clot burden score 10; P<0·02 for all). Lower clot burden scores were associated with lower follow-up Alberta Stroke Program Early Computed Tomography Scores (P<0·02 for all). Lower clot burden scores were associated with lower follow-up Alberta Stroke Program Early CT Scores (P<0·001) and higher parenchymal hematoma rates (P=0·008). Inter-rater reliability for clot burden score was 0·87 (lower 95% confidence interval 0·71) and intra-rater reliability 0·96 (lower 95% confidence interval 0·92). Conclusion The quantification of intracranial thrombus extent with the clot burden score predicts functional outcome, final infarct size and parenchymal hematoma risk acutely. The score needs external validation and could be useful for patient stratification in stroke trials. [ABSTRACT FROM AUTHOR]

The article presents a case study of a 36-year-old male who was presented for the evaluation of posterior circulation strokes with a strong history of acroparaesthesia. The patient was performed with his physical examination which revealed extensive angiokeratoma over his trunk ans was diagnosed with Fabry disease (FD). His magnetic resonance imaging (MRI) of brain and computed tomography (CT) Brain showed extensive extrapulvinar calcification.

The article presents a case study of a 64‑year‑old male patient with a history of Paget's disease and coronary artery disease having macular degeneration along with retinal hemorrhage. It mentions that the patient has underwent vitrectomy and the antiplatelet medication. It also mentions the use of computed tomogram (CT) for examine the brain.