Identification of the cortical area responsible for motor hand function was similar with functional MR imaging and with direct stimulation at surgery. A space-occupying lesion can change the cortical representation of motor hand function.

Bifurcations of the corticospinal tract may not be solely responsible for mirror movements. Bilateral activity of the primary motor cortex seems to play an additional role.

Gadodiamide-enhanced MR angiography performed with single and triple doses is safe and effective for assessing major abdominal arterial stenoses. Although high agreement between MR angiography and DSA was achieved with both doses, triple-dose MR angiography was superior in the evaluations of image quality, degree of arterial stenoses, and confidence in diagnosis.

The authors evaluated the anatomical location of the central sulcus (CS) in 24 cerebral hemispheres (eight in which tumors were located centrally, 16 in controls) using: 1) classic anatomical landmarks seen on magnetic resonance (MR) imaging (24 hemispheres); 2) functional MR imaging (24 hemispheres); and 3) intraoperative electrical stimulation mapping (eight hemispheres). On MR imaging the CS was identified with certainty in 79% of hemispheres (four of eight in patients, 15 of 16 in controls). Functional MR imaging identified a parenchymal "motor hand area" in only 83% (20 of 24 hemispheres; five of eight in patients, 15 of 16 in controls); this area was located in the precentral gyrus in 16 (80%) of 20, additionally in the postcentral gyrus in 10 (50%) of 20, and exclusively in the postcentral gyrus in four (20%) of 20. In contrast, functional MR imaging detected one to three sulcal veins presumably draining blood from the adjacent motor hand area in 100% (24 of 24) of the hemispheres studied, and anatomical MR imaging and intraoperative mapping localized these veins in the CS. It is concluded that sulcal veins lying deep within the CS: 1) drain activated blood from the adjacent pre- or postcentral cortex during performance of a motor hand task; 2) can be identified easily with functional MR imaging; and 3) are an anatomical landmark for noninvasive identification of the CS and thus the sensorimotor strip. The detection of these veins provides a more consistent landmark than the detection of parenchymal motor areas by functional MR imaging; this technique may be used when classic anatomical landmarks fail to identify the sensorimotor strip.

The aim of this study was to correlate lesions of the pituitary gland with hormonal dysregulation. The hormonal status of 63 children was correlated with MRI findings of the pituitary gland. Two radiologists judged the MRI examinations without knowledge of the hormonal situation. The reliability of the diagnosis "adenoma" was evaluated in five steps from 0-100% for each sequence. A microadenoma was found in six of 14 children with hyperprolactinemia and in six of eight patients with increased IGF-I/IGFBP-3. However, microadenomas were also detected in eight of 28 children without hormonal dysfunction (clinical feature: obesity). The adenomas were seen best in a dynamic sequence after gadolinium administration. An expansive growing macroadenoma was found in one of 13 patients with hypopituitarism. We found a relatively high number of microadenomas even in children without any hormonal dysfunction. Taking into account the reported autopsy results (6.1-27% occult microadenomas), we suggest that the MRI diagnosis "microadenoma" is made too frequently if usual MRI criteria are used. Patients with increased levels of IGF-I/IGFBP-3 had a high incidence of microadenoma (up to 87.5%). Hyperprolactinemia was associated with microadenomas in about 43% (-57%) of patients (nearly on the same level as children without hormonal dysfunction). Therefore unspecific stimulation of the pituitary gland with consecutive increased volume seems to be responsible for hyperprolactinemia in many of these patients.

The authors evaluated the anatomical location of the central sulcus (CS) in 24 cerebral hemispheres (eight in which tumors were located centrally, 16 in controls) using: 1) classic anatomical landmarks seen on magnetic resonance (MR) imaging (24 hemispheres); 2) functional MR imaging (24 hemispheres); and 3) intraoperative electrical stimulation mapping (eight hemispheres). On MR imaging the CS was identified with certainty in 79% of hemispheres (four of eight in patients, 15 of 16 in controls). Functional MR imaging identified a parenchymal “motor hand area” in only 83% (20 of 24 hemispheres; five of eight in patients, 15 of 16 in controls); this area was located in the precentral gyrus in 16 (80%) of 20, additionally in the postcentral gyrus in 10 (50%) of 20, and exclusively in the postcentral gyrus in four (20%) of 20. In contrast, functional MR imaging detected one to three sulcal veins presumably draining blood from the adjacent motor hand area in 100% (24 of 24) of the hemispheres studied, and anatomical MR imaging and intraoperative mapping localized these veins in the CS. It is concluded that sulcal veins lying deep within the CS: 1) drain activated blood from the adjacent pre- or postcentral cortex during performance of a motor hand task; 2) can be identified easily with functional MR imaging; and 3) are an anatomical landmark for noninvasive indentification of the CS, and thus the sensorimotor strip. The detection of these veins provides a more consistent landmark than the detection of parenchymal motor areas by functional MR imaging; this technique may be used when classic anatomical landmarks fail to identify the sensorimotor strip.

The histomorphology of carotid plaques with necrotic core and fibrous cap, basic for understanding the concept of unstable high-risk plaques, is presented on MRI in vitro and in vivo. Further clinical studies should follow.

McCune-Albright syndrome is a rare syndrome presenting with polyostotic dysplasia, cafe-au-lait spots and multiple endocrinopathies that is very often combined with precocious puberty. We examined the clinical, endocrinological and radiological features in a boy with McCune-Albright syndrome and pituitary adenoma. X-rays, magnetic resonance (MRI) scan, whole body scintigraphy, single photon emission computer tomography (SPECT) and 3D-reconstruction from bone SPECT was performed to evaluate clinical improvement after treatment with sandostatin and pamidronic acid. After a six-month period of treatment with sandostatin and pamidronate, bone scintigraphy revealed significantly reduced activity. Treatment with bromocriptine and methimazole led to normalization of prolactin and thyroid hormone levels. Mobility of the patient improved. A significant improvement as a result of treatment with sandostatin and pamidronic acid was found in this patient with generalized fibrous dysplasia. So far, this condition has been treated with pamidronate only in adults, but severely affected children also benefit from this treatment regimen.