Our preliminary findings indicate that DTI may show abnormalities in the spinal cord before the development of T2 hyperintensity on conventional sequences in patients with CSM.
We aimed to investigate the variances in especially the origin, course and termination of the sinoatrial node (SAN) artery in this study, using coronary CT angiography. The coronary CT angiography images of 251 patients (190 men and 61 women; age range, 20-82 years; mean age, 54.4 ± 13.6 years) were retrospectively analyzed. The SAN artery (arteries) in each case was named according to a special nomenclature with regard to their origin, course and termination. The sinoatrial node was being vascularized by a single artery in 241 (96%) cases and by two arteries in 10 (4%) cases. It was arising from RCA in 139 (55.4%) cases, from LCX in 99 (39.4%) cases, from the aorta in 2 (0.8%) cases, and from the bronchial artery in 1 (0.4%) case. The mean diameter of the SAN arteries was 2.3 mm. The mean distance between the origin of the SAN artery from RCA and the RCA ostium was 16.2 mm, from LCX and the origin of LCX was 19.3 mm. Frequency of the atrial branch was 35.9%. S-shaped SAN artery is determined in 51 (20.3%) cases. Coronary CT angiography is considerably effective in depicting the various vascularization types of SAN.
Our findings supported the findings of previous functional neuroimaging studies, which concluded that the brainstem might have a role in the pathogenesis of a migraine episode. We think that the increase of ADC values in red nuclei may reflect vasogenic edema, which cannot be detected in conventional sequences. However, the exact underlying mechanism for this observation is unclear and we do not know whether these changes are responsible for triggering an attack or if they are the consequents of the attack itself.
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