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Biomedical subjects

F Barkhof

Publications and source records attributed to F Barkhof.

247 records · Page 14Linked to original sources

Derangement of adipose tissue: a case report of multicentric retroperitoneal liposarcomas, retroperitoneal lipomatosis and multiple subcutaneous lipomas.

No aetiological factors are at present known in the pathogenesis of liposarcomas. Benign lipomatous disorders, such as lipomas and lipomatosis, generally do not predispose to the development of liposarcomas. A case is presented of a patient with multicentric retroperitoneal liposarcomas, associated with retroperitoneal lipomatosis and preceded by a long history of multiple subcutaneous lipomas. In the literature this combination has not been described. This rare combination of lipomatous disorders seems to indicate a common derangement of adipose tissue.

Humans↗

"Top of the basilar" syndrome: a comparison of clinical and MR findings.

Among 100 patients with an infarction of the brain reported on MR and clinically confirmed there were 4 with widespread lesions of the temporal and occipital lobes, thalamus, midbrain, pons and cerebellum, all supplied by arteries originating around the top of the basilar artery. Clinically these patients presented the "top of the basilar" syndrome, which is caused by a disturbance in circulation at the top of the basilar artery. Which brain areas are involved may be deduced theoretically from the vascular anatomy. These lesions can, we believe, be clearly detected using MR, because of its sensitivity to ischaemic disturbances and in the posterior fossa. We report our 4 patients here to illustrate the clinical presentation and MR findings of the "top of the basilar" syndrome.

Aged↗

MR venography of multiple sclerosis.

BACKGROUND AND PURPOSE: The distribution of multiple sclerosis (MS) lesions in the brain follows a specific pattern, with most lesions in the periventricular regions and in the deep white matter; histopathologic studies have shown a perivenous distribution. The aim of this study was to illustrate these distribution patterns in vivo using high-resolution MR venography. METHODS: Seventeen MS patients underwent MR imaging at 1.5 T. Venographic studies were obtained with a 3D gradient-echo technique. MS lesions were identified on T2-weighted images, and their shape, orientation, and location were compared with the venous anatomy on the venograms. RESULTS: The use of contrast material facilitated the visualization of small veins and increased the number of veins seen. A total of 95 MS lesions could be identified on both the T2-weighted series and the venograms; a central vein was visible in all 43 periventricular lesions and in all but one of the 52 focal deep white matter lesions. The typical ovoid shape and orientation of the long axis of the MS lesions correlated well with the course of these veins. CONCLUSION: With MR venography, the perivenous distribution of MS lesions in the brain can be visualized in vivo. The venous anatomy defines the typical form and orientation of these lesions.

Adult↗

Functional MR imaging in Alzheimer's disease during memory encoding.

BACKGROUND AND PURPOSE: We applied functional MR imaging with a learning task in healthy elderly volunteers and in patients with Alzheimer's disease to study brain activation during memory performance. The purpose was to determine the feasibility of functional MR imaging during a learning task in healthy elderly volunteers and in patients with Alzheimer's disease and to test our hypothesis that brain activation is decreased in the medial temporal lobe (MTL) memory system in patients with Alzheimer's disease compared with control volunteers. METHODS: In 12 patients with mild to moderate forms of Alzheimer's disease and 10 elderly control volunteers, activation of the MTL memory system was studied. We used two learning tasks that required the encoding of new information into memory. After the functional MR imaging experiment, participants were tested for recognition of the encoded objects. RESULTS: In the elderly control volunteers, activation during memory encoding was observed in medial and lateral temporal lobe structures (fusiform, parietal and occipital parts, and hippocampal formation) and in the frontal cortex, as reported previously in studies of young control volunteers. Focusing on the MTL, we observed that activation was significantly decreased in patients with Alzheimer's disease compared with control volunteers in the left hippocampus and parahippocampal gyrus bilaterally during the first encoding task but not during the second (P < .05, uncorrected). CONCLUSION: Functional MR imaging with a learning task seems feasible in elderly volunteers and in patients with Alzheimer's disease. The measured functional signal decrease in MTL areas warrants further exploration of the (early) diagnostic usefulness of functional MR imaging in cases of Alzheimer's disease and other dementias.

Aged↗

Gadopentetate dimeglumine enhancement of multiple sclerosis lesions on long TR spin-echo images at 0.6 T.

The authors sought to determine if Gd-DTPA enhancement of multiple sclerosis (MS) hampers lesion detection on long TR spin-echo images (TE 60 msec) at 0.6 T. They measured the signal intensity (SI) of 41 lesions (10 patients) and normal-appearing gray (NAGM) and white matter (NAWM) before and after administration of contrast. The change in SI of nonenhancing lesions and NAGM and NAWM was small (less than or equal to 1.5%), and of enhancing lesions (5.3%) moderate. The contrast of nonenhancing lesions to NAGM and NAWM changed insignificantly, but the contrast of enhancing lesions to NAGM and NAWM increased significantly. The authors conclude that long TR images can be obtained after Gd-DTPA without hampering lesion conspicuity in research MR protocols in multiple sclerosis.

Adult↗

Structural neuroimaging outcomes in clinical dementia trials, with special reference to disease modifying designs.

In the past clinical trials in dementia, symptomatic or disease modifycing in nature, relied mostly on clinical/neuropsychological endpoints. In the recent past much effort has been put into incorporating imaging, notably MRI, into trials in order to provide a surrogate marker for progression and measure a disease modifying effect, and to provide more insight into the homogeneity, or absence of, the included sample. In the following review an update will be given on the current thinking on how and when MRI should be used in the design of a clinical trial in Alzheimer's disease and mild cognitive impairment, with particular emphasis on trials focusing on disease modification.

Alzheimer Disease↗

Hippocampal sulcus width and cavities: comparison between patients with Alzheimer disease and nondemented elderly subjects.

BACKGROUND AND PURPOSE: The hippocampal fissure is a fetal sulcus that, except for its most medial part (the superficial hippocampal sulcus), is normally obliterated. Hippocampal cavities are residual cysts attributable to lack of hippocampal fissure obliteration. We hypothesized that either hippocampal sulcus enlargement or an increase in number or size of hippocampal cavities could be associated with medial temporal lobe atrophy (MTA) occurring in Alzheimer disease. METHODS: Two observers assessed the maximal hippocampal sulcus width by means of the fimbriosubicular distance at the anterior part of the hippocampal body; as well as the occurrence, number, and size of hippocampal cavities; and the visual rating score of MTA on magnified coronal high-resolution T1-weighted MR images of 21 patients with Alzheimer disease and 15 nondemented elderly controls. RESULTS: Both observers found the maximal hippocampal sulcus width significantly larger in patients with Alzheimer disease than in controls (P < .0001). The interobserver averaged fimbriosubicular distance in patients with Alzheimer disease was 2.84 mm (SD = 0.94), approximately twice that of the corresponding distance in nondemented subjects (1.41 mm; SD, 0.58). Both observers found a significant correlation between the fimbriosubicular distance and MTA score (observer 1, r(s) = 0.71; observer 2, r(s) = 0.74; P < .0001). None of the observers found significant differences between patients with Alzheimer disease and nondemented subjects with respect to occurrence, number, or size of hippocampal cavities, nor did they find a significant correlation between the number or size of hippocampal cavities and MTA. Interobserver agreement ranged from moderate to very good. CONCLUSION: Enlargement of the hippocampal sulcus, assessed by the fimbriosubicular distance, is associated with MTA in Alzheimer disease, but enlargement of the hippocampal cavities is not.

Aged↗

MR of the spinal cord in multiple sclerosis: relation to clinical subtype and disability.

PURPOSE: To determine whether the MR appearance of the spinal cord in patients with multiple sclerosis (MS) differs according to clinical subtype. METHODS: The spinal cords of 20 healthy control subjects and 60 patients with MS (22 with relapsing-remitting disease, 22 with secondary-progressive disease, and 16 with primary-progressive disease) were examined with sagittal dual-echo spin-echo MR imaging and with axial T2*-weighted gradient-echo MR imaging. Two interpreters scored the images for focal lesions and for diffuse abnormalities. Cross-sectional areas of the cords were measured at the C-2 level. RESULTS: No abnormalities were found in any of the control subjects nor in two of the patients. Fifty (83%) of 60 patients had focal lesions. Diffuse abnormality and focal lesions were found in 50% of patients with secondary-progressive MS, in 25% of patients with primary-progressive disease, and in 18% of patients with relapsing-remitting disease. Diffuse abnormality without focal lesions was found in seven patients with primary-progressive MS and in one patient with secondary-progressive MS. Patients with diffuse abnormalities had a smaller cross-sectional area of the spinal cord and they suffered from more disability than did patients without diffuse abnormalities. CONCLUSION: The MR appearance of the spinal cord differs among clinical subgroups of MS. Diffuse abnormality of the spinal cord is associated with a progressive clinical course and greater disability.

Activities of Daily Living↗

MR outcome parameters in multiple sclerosis: comparison of surface-based thresholding segmentation and magnetization transfer ratio histographic analysis in relation to disability (a preliminary note).

BACKGROUND AND PURPOSES: MR imaging is now widely used to monitor disease progression in patients with multiple sclerosis (MS). The purpose of this study was to explore the relationship between disability status and existing and new MR parameters in MS patients. METHODS: Forty-one patients with clinically definitive MS were studied. MR imaging included T2- and T1-weighted imaging as well as gradient-echo imaging with and without magnetization transfer contrast. We used surface-based thresholding segmentation techniques to obtain T2 and T1 lesion load, T1/T2 ratio, and several magnetization transfer ratio (MTR) lesion load parameters. MTR histographic analysis included measurements of absolute peak height (aHp), relative peak height (rHp), MTR of the peak (MTRp), mean MTR (MTRm), and MTR25, MTR50, and MTR75, relating to the integrals of the histogram at 25%, 50%, and 75%, respectively, of the total area under the curve. All MR parameters were correlated with Expanded Disability Status Scale (EDSS) score, disease duration, and patient's age. RESULTS: Using surface-based thresholding segmentation techniques, we found relatively low correlations with EDSS. T1 lesion load and T1/T2 ratios correlated most strongly. Regarding MTR histographic parameters, EDSS correlated best with rHp but only weakly with others. Similar correlations were found with disease duration, but not with age. CONCLUSION: The best MR correlations with disability were several MTR histographic parameters. Our findings may favor the use of these MR parameters over T2 lesion load to monitor disease progression in patients with MS, findings that should be explored further in longitudinal studies.

Adolescent↗