Based on its character, this tract was named the Broca-LSFG pathway. These findings suggest a close relationship between this pathway and language organization. The structural anatomy of the Broca-LSFG pathway may explain speech disturbances induced by LSFG stimulation that are sometimes observed during intraoperative language mapping.

The frequency and anatomical features of the occipital sinus (OS) were analyzed in this study by contrast-enhanced magnetic resonance venography (MRV) with enhanced fast gradient echo three-dimensional (EFGRE3D) and we discuss the clinical usefulness of this method. The study included 555 patients who underwent contrast-enhanced MRV with EFGRE3D, and maximum intensity projection (MIP), multiplanar reformation (MPR) and multiprojection volume reconstruction (MPVR) images were obtained for the regions of interest. The frequency, size and communication of the OS with other vessels were assessed. The OS was identified in 209 of the 555 patients (37.7%). There were no statistically significant sex-related differences. The OS was observed less frequently in subjects younger than 50 years. Cranially and/or caudally, some OS were separated and communicated with multiple vessels. In five patients, the straight sinus (StS) communicated directly with the OS and not with the other sinuses; in two patients, the StS communicated with veins other than the OS only via small anastomotic veins. Many morphological differences in the OS can be seen. In addition, some OS function as the main drainage route of the intracranial veins instead of the transverse sinus or sigmoid sinus. In addition to MIP, detailed examination by MPR and MPVR is required for the preoperative evaluation of posterior cranial fossa lesions.

Metastasis of systemic cancer to intracranial tumors is a rare event. The authors report a case of 49-year-old woman with such occurrence, whose breast cancer metastasized to a preexisting parasagittal meningioma at a postoperative interval of 1.5 years. She was admitted to our hospital because of progressive right hemiparesis. Magnetic resonance imaging revealed newly emerged perifocal edema and inhomogeneous contrast enhancement of the meningioma. High choline/creatine ratio and lactate/lipid peak on proton magnetic resonance spectroscopy suggested malignancy. She underwent a tumor resection, and pathologic examination revealed intratumoral metastasis of breast cancer in a transitional meningioma. Immunoreactivity of E-cadherin was detected in both meningioma and breast cancer cells. It is suggested that abrupt appearance of symptoms, inhomogeneous enhancement, and perifocal edema of meningioma is a sign of intratumoral metastasis from systemic cancers.

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Quantitative and qualitative tissue characterization of carotid plaques using MDCT might be a useful predictor for silent ischemic lesions after CAS.

BACKGROUND AND PURPOSE:The hemodynamics of the inflow zone of cerebral aneurysms may be a key factor in coil compaction and recanalization after endovascular coil embolization. We performed 4D flow MR imaging in conjunction with 3D TOF MRA and compared their ability to identify the inflow zone of unruptured cerebral aneurysms.

Abstract:Purpose: The present study aimed to distinguish between glioblastomas and primary central nervous system lymphomas (PCNSLs) using 1 H-Magnetic Resonance Spectroscopy (MRS), especially glutamate (Glu) / creatine (Cr) and Glu/Glu + glutamine (Gln) ratios.Materials and methods: A total of 46 patients (31 cases diagnosed with glioblastoma, 15with PCNSL) were examined by in vivo single-voxel proton 1 H-MRS with a 3-T MR imaging system. Differences in absolute concentration of Cr, choline/Cr, lipid (1.3ppm)/Cr, Glu+Gln/Cr, Glu /Cr, and Glu/Glu+Gln ratios among groups were evaluated with Mann-Whitney U test.Results: PCNSLs (3.408 ± 1.194 [standard deviation]) showed significantly higher Glu/Cr ratios as compared to glioblastomas (2.220 ± 0.942; P= 0.003) (Glu/Cr cutoff ratio of 2.509showed a sensitivity of 88% (7/8) and a specificity of 92% (22/24)), while glioblastomas (0.539 ± 0.098) showed significantly lower Glu/Glu+Gln ratios as compared to PCNSLs (0.728 ± 0.147; P<0.001) (Glu/Glu+Gln cutoff ratio of 0.558 showed a sensitivity of 69%(18/26) and a specificity of 100% (13/13)). And PCNSLs (1.101 ± 0.387) showed significantly higher Cho/Cr ratios as compared to glioblastomas (0.850 ± 0.465; P= 0.026). Conclusion:Glu/Cr, Glu/Glu+Gln, and Cho/Cr ratios may be useful in distinguishing (Figure 1d, 1e). The independent quantification of Glu and Gln can be considerably improved by moving from 1.5T to 3T.With regard to Glu+Gln, it has been reported that Glu+Gln/Cr ratios from contrast-enhancing regions do not differ significantly between glioblastomas and PCNSLs [2]. No differences inGlu or Gln alone in in vivo 1 H-MRS between them have been reported, to the extent that we could determine.On the other hand, it has been reported that in high-grade gliomas (World HealthOrganization grades III and IV), microdialysates in the tumor periphery consistently show significantly higher extracellular Glu relative to microdialysates in non-tumoral regions, unlike PCNSL [5]. And, high extracellular Glu has been noted to stimulate Gln synthetase and promote the synthesis of Gln from Glu in cultured astrocytes [6].Based on these reports, we hypothesized that in glioblastomas due to high extracellular Glu the synthesis of Gln from Glu would be promoted [6], and so Glu/Glu+Gln ratios might be lower than those in PCNSLs. The purpose of this study was to analyze the differences in the 1 H-MRS findings among glioblastomas and PCNSLs with special reference to Glu and Gln expression. Materials and Methods:Patients:This retrospective analysis of the data was approved by the institutional review board of our university. All patients gave informed consent prior to inclusion in this study. All patients Clinical parameters in the analyzed groups are summarized in Table 1. All tumors were confirmed histopathologically after preoperative diagnosis with magnetic resonance imaging (MRI) and 1 H-MRS, and were not subjected to biopsy, surgical resection, chemotherapy or radiation therapy before the preoperative diagnosis with MRI and 1 H-MRS. We...

The purpose of this study was to review the normal in vivo neurovascular relationship between the trigeminal nerve and surrounding arteries without the use of volunteers. 290 nerves in 145 cases were reviewed during a 1-year period. Axial source images and multiplanar reconstructed (MPR) images were used to determine the neurovascular contact and direction of contact. Multiplanar volume reformation (MPVR) was used to identify the contact vessels and to demonstrate the relationship between the nerve and arteries. Vascular contact was found in 29% of the 290 nerves (83 nerves). The arteries involved were the superior cerebellar artery (SCA) or the anterior inferior cerebellar artery (AICA). Vascular contact with two arteries was found in 3%. Of the 286 asymptomatic nerves, the nerve was located between the two vessels in 3% and compression was seen in 1%. Three points of vascular contact by the two arteries were identified in one asymptomatic nerve. The direction of contact between the SCA and the nerve was superior (38%), superomedial (32%) or medial (15%) in most cases. The direction of contact between the AICA and the nerve was inferior, inferolateral or lateral in all cases. Vascular contact at the root entry zone (REZ) was noted in 90%. Four nerves were affected by trigeminal neuralgia, one of which touched an artery and two were compressed. It was concluded that arterial contact can be assessed without difficulty but evaluation of vascular compression is not easy.