Applications of 3D CISS sequence for problem solving in neuroimaging

Hingwala, Divyata Rajendra; Chatterjee, Somnath; Kesavadas, Chandrasekharan; Thomas, Bejoy; Kapilamoorthy, Tirur Raman

doi:10.4103/0971-3026.82283

Cited by 93 publications

(41 citation statements)

References 14 publications

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“…En nuestro caso la RM lumbar mostró imágenes sugerentes de cisticercosis, aunque sin lograr definirlas con claridad. Ello podría deberse a que este paciente tenía un cisticerco único que fue lacerado en la primera punción lumbar y en las siguientes solo se encontraron restos que ya no serían visibles en la RM; además, las secuencias convencionales de RM con resolución de 5,13 , ello porque los cisticercos son isodensos con el LCR y estos protocolos permiten su visualización 3D 3 . Se ha comprobado que el protocolo FIESTA es mucho más efectivo para la visualización de quistes viables que otras secuencias como FLAIR o T1 y SPGR (Spoiled Gradient Recalled Echo) (87,2%, FLAIR en 38,3%, SPGR en 23,4%, y T2 en 17%) 14 , aunque no se ha descrito su validez para quistes espinales.…”

Section: Discussionunclassified

Neurocisticercosis raquídea diagnosticada por punción lumbar

2018

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La neurocisticercosis es una enfermedad frecuente, su principal ubicación es en el parénquima cerebral; sin embargo, menos del 5% de los casos son de ubicación espinal donde producen cuadros clínicos pseudotumorales u obstructivos. Presentamos el caso de un paciente que ingresa por cefalea crónica con signos de hipertensión endrocraneana, sin clínica medular, y en quien se obtuvo durante el estudio de punción lumbar una membrana cisticercótica y líquido cefalorraquídeo con gran consumo de glucosa (3mg/dL). El hallazgo de un cisticerco de ubicación intradural-extramedular durante una punción lumbar es un hallazgo muy raro, solo descrito en pacientes con clínica evidente. Recomendamos sospecharla cuando no haya evidencia clínica de compromiso medular pero se tenga sugerencia de cisticercosis cerebral y líquido cefalorraquídeo alterado, ampliando el estudio con neuroimágenes.

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Section: Discussionunclassified

Neurocisticercosis raquídea diagnosticada por punción lumbar

2018

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“…This is where three-dimensional CISS sequence scores over conventional MR sequences. [911] Previously CT ventriculography has also been used to detect intraventricular NCC in cases where it could not be detected on CT or conventional MRI. [10] In the present case, intraventricular NCC could be seen only on CISS sequence, which was added to assess unexplained hydrocephalus.…”

Section: Discussionmentioning

confidence: 99%

Intraventricular migration of an isolated fourth ventricular cysticercus following cerebrospinal fluid shunting

Khalid¹,

Obaid²,

Sharma³

et al. 2016

Surg Neurol Int

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Background:Isolated intraventricular neurocysticercosis (NCC) is less frequently seen and can be missed on plain magnetic resonance imaging (MRI). Three-dimensional constructive interference in steady state (CISS) sequence is an extremely helpful sequence in identifying the lesion but is rarely used routinely.Case Description:Here, we report a case of young male adult who presented with diminution of vision and headache. MRI of the brain revealed hydrocephalus, and on using CISS sequence only, the lesion could be identified in the fourth ventricle. He was treated with medical management, and ventriculoperitoneal shunting of cerebrospinal fluid was done to relieve the hydrocephalus. It resulted in immediate relief with aggravation of headache few days later. Repeat MRI revealed intraventricular migration into the left foramen of monro leading to left lateral ventricle dilatation necessitating endoscopic removal of the lesion.Conclusion:CISS sequence is definitely the sequence of choice in identifying intraventricular NCC. Ventriculoperitoneal shunting can result in the intraventricular migration of the cyst due to sudden decompression necessitating repeat surgery. Endoscopic removal of NCC has a high success rate with limited complications.

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“…This could diagnose various possible etiologies of IVH, including tumors and AVM as well as IVA. CISS-3D is a gradient-echo MRI sequence that is used to investigate a wide range of pathologies when routine MRI sequences do not provide the desired anatomic information [27]. However, these MRI sequences take time to perform, especially if applied to the whole brain.…”

Section: Discussionmentioning

confidence: 99%

Idiopathic Intraventricular Aneurysm Presenting with Intraventricular Hemorrhage: Case Report and Review of the Literature

Madhugiri¹,

Gundamaneni²,

Yadav³

et al. 2012

Pediatr Neurosurg

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Intraventricular hemorrhage (IVH) is a relatively commonly encountered problem in neurosurgical practice. The underlying causes could include hypertension, arteriovenous malformations (AVM), angiomas, trauma, tumors, aneurysms and moyamoya disease. Truly idiopathic intraventricular aneurysms (IVA) are rare. A high index of suspicion needs to be maintained since, with the appropriate treatment, the outcome is generally good.We report the case of a 14-year-old boy who presented with sudden onset headache and vomiting. CT angiogram pointed to the possibility of an IVA. This was confirmed by MRI with three-dimensional constructive interference in steady state (CISS-3D) sequences and digital subtraction angiography. The patient underwent microsurgical excision of the aneurysm and is doing well on follow-up.Idiopathic IVA can present with IVH at any age. MRI with CISS-3D and MR angiography would be the imaging modality of choice since it can also rule out other causes of intraventricular bleeding such as tumors and AVM. These lesions could be managed effectively by microsurgical excision/clipping. The necessity of investigating every patient who presents with IVH is debatable.

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Applications of 3D CISS sequence for problem solving in neuroimaging

Cited by 93 publications

References 14 publications

Neurocisticercosis raquídea diagnosticada por punción lumbar

Neurocisticercosis raquídea diagnosticada por punción lumbar

Intraventricular migration of an isolated fourth ventricular cysticercus following cerebrospinal fluid shunting

Idiopathic Intraventricular Aneurysm Presenting with Intraventricular Hemorrhage: Case Report and Review of the Literature

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