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Abstract: Acute stroke is one of the three major causes of death and disability in the United States. Now that new, and possibly effective therapy is becoming available, accurate, rapid diagnosis is important to provide timely treatment, while avoiding the risk of complications from unnecessary intervention. Our objective was to test the hypothesis that use of echo-planar (EPI) diffusion-weighted imaging (DWI) is more accurate than conventional T2 weighted MRI in predicting progression to stroke in patients with acute ischemic neurologic deficits. We studied 134 patients presenting with acute neurologic deficits to a community hospital emergency room with both conventional MRI and DWI within 72 h of the onset of the acute deficit. We found DWI significantly more sensitive to permanent neurologic deficit at discharge (sensitivity 0.81) than conventional MRI (sensitivity 0.41). When available, DWI should be considered for routine use in patients being imaged for acute stroke.

Interventional procedures using magnetic resonance (MR) image-guidance have recently increased in interest. A variety of methodologies for visualising and automatically tracking instruments, including endoscopes, RF ablation electrodes and catheters, have been developed and introduced to help the interventionist to safely guide the device towards the target tissue. This article describes and compares characteristics of the four most commonly-used localisation and tracking systems for MRI-guided interventional procedures: those based on the susceptibility artifact of the device; those which intentionally created field inhomogeneity along the device; those relying on an optical tracking system; and active tracking systems using micro-receive coils.

Disparity in prognosis and management between primary and secondary pancreatic tumours makes recognition of metastases to the pancreas on CT and MRI an important goal. Three different patterns of secondary pancreatic tumours may be seen: localized, multifocal, or diffuse enlargement. CT findings include hypodense lesions, which show rim enhancement following intravenous contrast medium. On MR examination, the lesions are usually hypointense on T1 weighted and hyperintense on T2 weighted images.

We studied activation of the human visual cortex (VC) using susceptibility-sensitized MRI at 1.5 Tesla. Three albinos and six healthy controls underwent a series of monocular and binocular photic flash stimulation. Monocular stimulation in albinos caused predominant contralateral activation with a small, well-delineated area in the anterior part of the VC in the ipsilateral hemisphere. This finding was consistent with a chiasmal crossing anomaly in albinism. All controls had symmetric patterns of activation during monocular stimulation. Functional MEI represents a promising method for evaluation of the visual pathways in humans.

Hypodense regions demonstrated by CT within 6 hours of the onset of stroke may reflect irreversibly damaged tissue, and some have suggested that patients with such findings should be spared the risks of thrombolytic therapy since they are unable to benefit from it.We report here a patient with a low-density area demonstrated by CT less than 6 hours after onset of symptoms who improved dramatically after successful intra-arterial thrombolysis.