Background: Phase contrast (PC) cine magnetic resonance imaging (MRI) is a valuable imaging method in estimating cerebrospinal fluid (CSF) dynamics that concerns several disease processes. The aim of this work was to estimate the usefulness of cine- PC MRI CSF flowmetry in patients with normal pressure hydrocephalus (NPH) and to differentiate them from involutional brain atrophy. Methods: This prospective study included 30 patients with overlapping symptoms of NPH with involutional brain changes and 10 healthy volunteers as controls with no clinical symptoms and normal imaging results. Two imaging planes were applied: one in the sagittal plane with plane velocity encoded in the caudo-cranial direction for a qualitative assessment & one in the axial plane with through-plane velocity encoded in the caudo-cranial direction for quantitative measurements. Results: Pathological CSF flow dynamics in NPH, peak systolic velocity and systolic SV values were greater than controls; these findings imply that cases with NPH had hyper dynamic aqueductal CSF flow. In cerebral atrophy, blood flow to the brain is reduced; we reported lower peak systolic velocity and lower SV values compared to healthy participants, suggesting hypo dynamic CSF circulation. Conclusion: PC MRI CSF flowmetry is shown to be a valuable method especially in the elderly, in diagnosing NPH & differentiating it from age associated brain atrophy where differentiation based on conventional and clinical radiological basis may be complicated.
Background: In certain regions of the brain, aphasia arises from a lack of understanding and regulating language following damage. About 35-40 percent of the people receiving hospitalization after stroke are identified with aphasia. The recently developed imaging methods for the analysis of the impact of brain lesion sites and sizes on aphasia are the Diffusion Tensor Imaging (DTI) and Fractional Anisotropy (FA). In order to reflect micro-structural integrity DTI may give data on the damage level of the white matter of the brain and subcortical neural structure. Objective: We examined the relationship between arcuate fasciculus (AF) and the prognosis of aphasia outcome after ischemic stroke utilizing DTI, and FA. Patients and Methods: In this study, which included 34 patients with post stroke aphasia, we investigated DTI and FA of arcuate fasciculus in predicting post-stroke aphasia outcome. Results: There was no significant association between the sex and Aphasia Handicap Scale (AHS) (P>0.05), while the age was significantly correlate with AHS (P<0.05). The vascular risk factors (hypertension, diabetes mellitus, smoking, dyslipidemia) were associated with poor aphasia outcome. In our study, we found that lesion size had significant effect on aphasia outcome. Also, the site of ischemic infarction site was important factor in determining aphasia outcome. In the Broca and Wernicke regions, AHS was greater than in the cortical injury, and in the insula and cortical injuries (1.92 ± 1.26) were the least common in patients. Conclusion:The site and the size of ischemic infarction significantly predicted s aphasia outcome, also the extent and mechanism of AF injury, which can be detected in DTI and FA, stood as a significant indicator on aphasia severity for patients with ischemic stroke.
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