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BACKGROUND The proper diagnosis and management of patients after surgery for pituitary tumors are of great importance in clinical practice. The purpose of this study was to investigate the magnetic resonance features of the postoperative sella with fast spin echo T2-weighted imaging and to evaluate the benefits of this sequence compared to the classically performed contrast-enhanced T1-weighted imaging at 1.5T unit. MATERIAL/METHODS The study group consisted of 101 patients who underwent resection of pituitary tumors. There were 58 women (57.4%), aged 22 to 75 (mean age, 52.67 years) and 43 men (42.6%), aged 21 to 79 (mean age, 49 years). In all patients preoperative and multiple postoperative MR studies were performed. Post-contrast T1 and pre-contrast T2 images were interpreted by 2 independent readers (neuroradiologists). RESULTS Contrast-enhanced T1-weighted imaging was significantly superior to T2-weighted imaging in assessment of infundibulum (p

The aim of the study was to assess the relationship between cognitive impairment according to the Mini Mental State Examination (MMSE) and values of cerebral blood flow (CBF), cerebral blood volume (CBV), and mean transit time (MTT) obtained in perfusion CT (pCT).Sixty-four patients with dementia (36 with Alzheimer's disease, 15 with vascular dementia, and 13 with mixed dementia), aged 45-92 years (mean: 69.9 years) with different degrees of cognitive impairment (mean MMSE score: 17.0) were involved in the study. All subjects underwent pCT at the level of the basal ganglia (50 scans, 1 scan/s, 40 ml contrast medium at 4 ml/s, delay: 7 s). CBF, CBV, and MTT values from 31 regions of interest (ROIs) in the gray and white matter of the frontal and temporal lobes, lentiform nuclei, and internal capsules were correlated with the MMSE scores.Statistical analysis of CBF and MMSE revealed significant correlations in 22/31 ROIs including the gray and white matter of the frontal and temporal lobes, both internal capsules, right and left hemispheres, and total gray and white matter. Analysis of CBV and MMSE showed significant correlations in 21/31 ROIs in the gray and white matter of the frontal and temporal lobes, both internal capsules, left lentiform nucleus, right and left hemispheres, as well as total gray matter. There were no significant correlations between MTT and MMSE.CBF and CBV calculated with pCT correlate with cognitive impairment in patients with dementia and thus may play a role in monitoring disease progression or therapeutic response.

Despite high efficiency of magnetic resonance (MR) imaging in degenerative disease of lumbar spine (DDLS), in many cases its appearance is ambiguous or not compatible with clinical findings. Therefore, different new techniques have been proposed to improve the quality of MR images. One of them is CBASS (Completely Balanced Steady State) sequence. The aim of our study was the evaluation of CBASS sequence in DDLS based on analysis of 78 consecutive cases.The material consists of 78 consecutive patients referred to MR study of the lumbar spine due to low back pain and radicular symptoms. MR examinations, including CBASS sequence, were performed with open low field (0.23 Tesla)MR unit. In all patients, degenerative findings in CBASS and FSE T2-weighted images were scored using 0-3 point scale, and analyzed statistically.The superiority of CBASS to FSE T2-weighted images was found in evaluation of disc herniation and bulging disc outlines, the relationship of disc herniation to the dural sac and nerve roots, visualization of the osteophytes, facet joint degeneration and thick- ening of the ligamenta flava. CBASS was inferior in the assessment of the degenerated disc signal and type 1 degenerative changes of the vertebral bodies.CBASS is superior to T2-weighted images in the evaluation of many symptoms. Therefore, it should be included in routine diagnostic protocol in low-field MR units. In our opinion, CBASS supplements T1-and T2-weighted images in sagittal planes and can entirely replace T2-weighted transverse images.

Magnetic resonance (MR) has become the most important imaging method in the diagnosis of intracranial tumours. However, conventional MR protocol often fails to obtain all morphological details which are necessary for precise planning of the treatment. Therefore, there are attempts of introducing other MR techniques, to gain new information concerning tumour morphology. One such technique is FLAIR sequence. In previous papers we presented the value of plain FLAIR in patients with intracranial tumours. The aim of the present study was evaluation of contrast enhanced FLAIR (CE FLAIR) in assessment of intracranial tumours.MR examinations, including conventional T1 (pre-and postcontrast) and T2 images, as well as plain and contrast-enhanced FLAIR sequences were performed in 27 patients with intracranial tumours. In all patients the degree and localization of contrast enhancement in post-contrast T1-weighted sequence (CE T1w) and CE FLAIR images have been compared.Contrast enhancement of the tumour in both CE T1-w and CE FLAIR sequences was found in 18 patients. In 5 patients the enhancement was visible only on T1-weighted images, while in 2 cases only on FLAIR images. Among 18 patients, who demonstrated enhancement both in T1-weighted and FLAIR sequences, in 9 cases the effect of enhancement was better on T1-weighted images, in 7-CE FLAIR gave superior results, and in 2 patients - both methods were equivalent. In the whole material in 9 cases CE-FLAIR was superior in 14-inferior and in 4-equal to CE-T1-w. Among 9 cases in which CE- FLAIR was superior, in 7 patients the enhancement concerned the border of the tumour or postoperative cave.Contrast-enhanced FLAIR has limited value in assessment of intracranial tumours and should be used as a supplementary technique if there are difficulties in evaluation of tumour morphology in other sequences.

CT-angiography is a non-invasive method, alternative to cerebral angiography in the diagnosis of intracranial aneurysms. The aim of the study was the assessment of the efficiency of CT-angiography in a large material, which has been mostly verified with angiography and/or surgery.CT-angiography was performed in 196 patients with intracranial bleeding. Seventy-three (73) patients underwent also cerebral angiography (CA), 121 were operated on, 74 of them solely on the basis of CT-angiography. A spiral CT scanning (2 mm slices, 1-1.5 pitch, 1 mm-gap reconstruction) combined with an injection of 120 mL of contrast medium (5 mL/sec) was used. Subsequently three-dimensional MIP reconstructions were received, supplemented in some cases with SSD, VRT and MPR.CT-angiography revealed 128 aneurysms in 106 patients, located mostly in anterior communicating, middle cerebral and internal carotid arteries. The size of most aneurysms was 6-10 mm, but nearly one-third of them did not exceed 5 mm. In the group of patients who underwent CA, there was only 1 false negative CT-angiography result, while in 7 patients CT-angiography allowed for the diagnosis of small aneurysms which were not clearly visible on CA. CT-angiography was superior to CA in assessment of aneurysm morphology by 3 independent radiologists in 17 out of 22 cases. CT-angiography findings were confirmed during surgery in all 74 patients.CT-angiography is highly effective in the diagnosis of intracranial aneurysms and the evaluation of their morphology. In our opinion, in most cases, CT-angiography is precise enough to plan a surgical or endovascular procedure.