BACKGROUND AND PURPOSE: Postgadolinium MR imaging is crucial for brain tumor diagnosis and morphometric assessment. We compared brain tumor enhancement visualization and the "target" object morphometry obtained with the most commonly used 3D MR imaging technique, MPRAGE, with 2 other routinely available techniques: sampling perfection with application-optimized contrasts by using different flip angle evolutions (SPACE) and volumetric interpolated brain examination (VIBE). MATERIALS AND METHODS: Fifty-four contrast-enhancing tumors (38 gliomas and 16 metastases) were assessed using MPRAGE, VIBE, and SPACE techniques randomly acquired after gadolinium-based contrast agent administration on a 3T scanner. Enhancement conspicuity was assessed quantitatively by calculating the contrast rate and contrast-to-noise ratio, and qualitatively, by consensus visual comparative ratings. The total enhancing tumor volume and between-sequence discrepancy in the margin delineation were assessed on the corresponding 3D target objects contoured with a computer-assisted software for neuronavigation. The Wilcoxon signed rank and Pearson 2 nonparametric tests were used to investigate between-sequence discrepancies in the contrast rate, contrast-to-noise ratio, visual conspicuity ratings, tumor volume, and margin delineation estimates. Differences were also tested for 1D (Response Evaluation Criteria in Solid Tumors) and 2D (Response Assessment in Neuro-Oncology) measurements. RESULTS: Compared with MPRAGE, both SPACE and VIBE obtained higher contrast rate, contrast-to-noise ratio, and visual conspicuity ratings in both gliomas and metastases (P range, Ͻ.001-.001). The between-sequence 3D target object margin discrepancy ranged between 3% and 19.9% of lesion tumor volume. Larger tumor volumes, 1D and 2D measurements were obtained with SPACE (P range, Ͻ.01-.007). CONCLUSIONS: Superior conspicuity for brain tumor enhancement can be achieved using SPACE and VIBE techniques, compared with MPRAGE. Discrepancies were also detected when assessing target object size and morphology, with SPACE providing more accurate estimates. ABBREVIATIONS: CEL ϭ contrast-enhancing lesion; GBCA ϭ gadolinium-based contrast agent; RANO ϭ Response Assessment in Neuro-Oncology; RECIST ϭ Response Evaluation Criteria in Solid Tumors; SPACE ϭ sampling perfection with application-optimized contrasts using different flip angle evolution; TV ϭ tumor volume; VIBE ϭ volumetric interpolated brain examination

POE of meningiomas using PVA particles is effective in reducing surgical time, when extensive tumor devascularization is achieved. However, radiation exposure, the duration of procedures and complications related to POE with PVA particles do not justify this technique in most patients.

La finalità del nostro lavoro è di valutare le caratteristiche di risonanza magnetica (RM) tipiche dei tumori parotidei maligni e benigni. Questo studio retrospettivo si basa sulla valutazione di esami RM pre-chirurgici di 94 pazienti con tumori parotidei. I risultati istologici erano disponibili in tutti i casi; abbiamo analizzato 69 lesioni erano benigne (73%) e 25 maligne (27%): 44 adenomi pleomorfi, 18 tumori di Warthin, 7 tumori benigni di diverso istotipo, 6 carcinomi squamocellulari, 3 carcinomi ex-adenomi pleomorfi, 2 carcinomi mucoepidermoidi, 1 tumore adenoidocistico, 13 tumori maligni di diverso istotipo. Sono state valutate le seguenti caratteristiche RM: morfologia, sede, dimensioni, margini, intensità di segnale nelle sequenze T2-pesate e T1-pesate, impregnazione dopo mezzo di contrasto (mdc), intensità di segnale della porzione cistica, presenza o assenza di una capsula, diffusione perineurale, pattern di crescita extraghiandolare e linfoadenopatie laterocervicali. È stata effettuata un’analisi statistica per identificare le caratteristiche RM più indicative di malignità e per definire l’aspetto tipico degli istotipi più comuni. I parametri significativamente predittivi di malignità sono risultati i margini mal-definiti (p < 0,001), le linfoadenopatie (p < 0,001) ed il pattern di crescita infiltrativo (p < 0,001). Le caratteristiche tipiche dell’adenoma pleomorfo sono risultate l’iperintensità di segnale nelle immagini T2-pesate (p = 0,02), l’intensa impregnazione dopo mdc (p < 0,001) ed i margini lobulati (p = 0,04). Le caratteristiche tipiche del tumore di Warthin sono risultate le componenti iperintense nelle immagini T1-pesate (p < 0,001), la localizzazione nel processo parotideo inferiore (p < 0,001) e l’impregnazione post-contrastografica lieve/incompleta (p = 0,01). L’intensità di segnale nelle immagini T1-pesate e T2- pesate e l’impregnazione post-contrastografica si sono rivelate utili nella diagnosi differenziale tra adenoma pleomorfo e tumore di Warthin.

Percutaneous endovascular aneurysm repair in "unselected" patients is safe and efficient, with a very low risk of access-related complications, comparable to P-EVAR in selected populations and to the best O-EVAR series.

By understanding the pathophysiology of OP the neuroradiologist can discuss clinical cases with the referring clinician and determine a timely, accurate method of imaging to achieve the most precise differential diagnosis.