Sinais em neurorradiologia: parte 2

Abstract

The use of signs for interpretation of images in neuroradiology is extremely useful. Some signs are quite specific and, in some cases, pathognomonic. In this second part of their essay, the authors describe 15 additional neuroradiological signs. Main characteristics of imaging findings will be approached and the significance of their role in the clinical practice will be discussed. Keywords: Radiological signs; Neuroradiology; Computed tomography; Magnetic resonance imaging.O uso de sinais na interpretação de imagens na neurorradiologia é extremamente útil. Muitos sinais são bastante específicos e em alguns casos, patognomônicos. Nesta segunda parte os autores descreverão 15 sinais neurorradiológicos adicionais. Serão novamente abordadas as principais características de imagem de cada um e sua importân-cia na prática clínica. Unitermos: Sinais radiológicos; Neurorradiologia; Tomografia computadorizada; Imagem por ressonância magnética. Abstract "High heel foot print sign" in the skull baseThe high heel foot print sign (Figure 1) is useful in the understanding of the intricate anatomy of the skull base and represent two relevant foramina. The anterior aspect of the high heel footprint represents the foramen ovale (FO), and the posterior aspect (the heel itself) the foramen spinosum (FS). The mandibular nerve, one of the three branches of the trigeminal nerve, is the main FO component (1) . Also, the otic Figure 1. Axial CT image demonstrating normal appearance of the skull base. The high heel foot print sign is evidenced. The small arrow indicates the foramen spinosum, and the large arrow, the foramen ovale. Anteriorly to the high heel footprint is the Vesalius foramen (venous foramen) (arrowhead). ganglion, the accessory meningeal artery, the lesser petrosal nerve and the emissary veins are found in this foramen. The middle meningeal artery is in the FS (2) , and the absence of such artery is related to the persistent stapedial artery (3) . "Lemon sign" in spina bifidaThe lemon sign (Figure 2) is an useful sign in the detection of spina bifida and is commonly associated with hydrocephalus and Arnold-Chiari II malformation (4) . Such sign can be found in up to 98% of cases of spina bifida (5) . The lemon sign is not exclusive to spina bifida and can be observed in cases of encephalocele, thanatophoric dys-

Evaluation of occupational and patient dose in cerebral angiography procedures

“…The technology of medical imaging, such as digital cerebral angiography and three-dimensional (3D) mapping of brain vessels, has achieved relevant advances in interventional neuroradiology. A number of recent publications in Brazil highlight the importance of neuroradiology for diagnosis and treatment of several diseases (1)(2)(3)(4)(5)(6)(7)(8)(9)(10) .…”

Diagnóstico e acompanhamento evolutivo dos meningiomas através da ressonância magnética

“…Nos meningiomas, apresenta baixa especificidade e boa sensibilidade, podendo variar entre 50-80%. Pode representar alterações vasculares isoladas, invasão tumoral, crescimento tumoral adjacente e não contíguo e micronódulos tumorais 13,31 .…”

Síndrome de Parry-Romberg: achados nas sequências avançadas de ressonância magnética - relato de caso

“…Parry-Romberg syndrome, also known as progressive hemifacial atrophy, is a sporadic neurocutaneous disease characterized by slow and progressive hemifacial atrophy of the skin, muscles and bone structures, occasionally involving the central nervous system (CNS) ( 1 , 2 ) . Its origin is still unknown, although some authors believe that it is a manifestation of focal scleroderma ( 3 ) . As regards the physiopathology of this disease, some authors have raised the hypothesis of an inflammation meningoencephalic associated with vasculitis, and others, the hypothesis of a chronic vasomotor disorder related to hyperactivity of the sympathetic nervous system ( 4 ) .…”