The normative diffusion values of the human median nerve can be used as a reference in evaluation, diagnosis, and follow-up of entrapment, trauma, and regeneration of the median nerve.

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The intrinsic safety of MRI and its ability to accurately show abdominal and pelvic disease in pregnant patients make it highly useful in the evaluation of these patients.

ObjectThe exploration of lesions in the mediobasal temporal region (MTR) has challenged generations of neurosurgeons to achieve an appropriate approach. To address this challenge, the extensive use of the paramedian supracerebellar-transtentorial (PST) approach to expose the entire length of the MTR, as well as the fusiform gyrus, was investigated.MethodsThe authors studied the microsurgical aspects of the PST approach in 20 cadaver brains and 5 cadaver heads under the operating microscope. They evaluated the features, advantages, difficulties, and limitations of the PST approach and refined the surgical technique. They then used the PST approach in 15 patients with large intrinsic MTR tumors (6 patients), tumor in the posterior fusiform gyrus with mediobasal temporal epilepsy (MTE) (1 patient), cavernous malformations in the posterior MTR including the fusiform gyrus (2 patients), or intractable MTE with hippocampal sclerosis (6 patients) from December 2007 to May 2010. Patients ranged in age from 11 to 63 years (mean 35.2 years), and in 9 patients (60%) the lesion was located on the left side.ResultsIn all patients with neuroepithelial tumors or cavernous malformations, the lesions were completely and safely resected. In all patients with intractable MTE with hippocampal sclerosis, the anterior two-thirds of the parahippocampal gyrus and hippocampus, as well as the amygdala, were removed selectively through the PST approach. There was no surgical morbidity or mortality in this series. Three patients (20%) with high-grade neuroepithelial tumors underwent postoperative radiotherapy and chemotherapy but needed a second surgery for recurrence during the follow-up period. In all patients with MTE, antiepileptic medication could be decreased to a single drug at lower doses, and no seizure activity has occurred until this point.ConclusionsThe PST approach provides the surgeon precise anatomical orientation when exposing the entire length of the MTR, as well as the fusiform gyrus, for removing any lesion. This is a novel technique especially for removing tumors involving the entire MTR in a single session without damaging neighboring neural or vascular structures. This approach can also be a viable alternative for selective removal of the parahippocampal gyrus, hippocampus, and amygdala in patients with MTE due to hippocampal sclerosis.

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The aim of this study was to assess the feasibility of diffusion tensor imaging (DTI) of the prostate and to determine normative fractional anisotropy (FA) and apparent diffusion coefficient (ADC) values of healthy prostate with a 3-Tesla magnetic resonance imaging (MRI) system. Thirty volunteers with a mean age of 28 (25-35) years were scanned with a 3-Tesla MRI (Intera Achieva; Philips, The Netherlands) system using a six-channel phased array coil. Initially, T2-weighted turbo spin-echo (TSE) axial images of the prostate were obtained. In two subjects, a millimetric hypointense signal change was detected in the peripheral zones on T2-weighted TSE images. These two subjects were excluded from the study. DTI with single-shot echo-planar imaging (ssEPI) was performed in the remaining 28 subjects. ADC and FA values were measured using the manufacturer supplied software by positioning 9-pixel ROIs on each zone. Differences between parameters of the central and peripheral zones were assessed. Mean ADC value of the central (1.220 +/- 0.271 x 10(-3) mm(2)/s) was found to be significantly lower when compared with the peripheral gland (1.610 +/- 0.347 x 10(-3) mm(2)/s) (P < 0.01). Mean FA of the central gland was significantly higher (0.26), compared with the peripheral gland (0.16) (P < 0.01). This study shows the feasibility of prostate DTI with a 3-Tesla MR system and the normative FA and ADC values of peripheral and central zones of the normal prostate. The results are compatible with the microstructural organization of the gland.

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