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  1. Article ; Online: Advanced MR imaging techniques in the diagnosis of intraaxial brain tumors in adults.

    Al-Okaili, Riyadh N / Krejza, Jaroslaw / Wang, Sumei / Woo, John H / Melhem, Elias R

    Radiographics : a review publication of the Radiological Society of North America, Inc

    2006  Volume 26 Suppl 1, Page(s) S173–89

    Abstract: Intraaxial brain masses are a significant health problem and present several imaging challenges. The role of imaging is no longer limited to merely providing anatomic details. Sophisticated magnetic resonance (MR) imaging techniques allow insight into ... ...

    Abstract Intraaxial brain masses are a significant health problem and present several imaging challenges. The role of imaging is no longer limited to merely providing anatomic details. Sophisticated magnetic resonance (MR) imaging techniques allow insight into such processes as the freedom of water molecule movement, the microvascular integrity and hemodynamic characteristics, and the chemical makeup of certain compounds of masses. The role of the most commonly used advanced MR imaging techniques-perfusion imaging, diffusion-weighted imaging, and MR spectroscopy-in the diagnosis and classification of the most common intraaxial brain tumors in adults is explored. These lesions include primary neoplasms (high- and low-grade), secondary (meta-static) neoplasms, lymphoma, tumefactive demyelinating lesions, abscesses, and encephalitis. Application of a diagnostic algorithm that integrates advanced MR imaging features with conventional MR imaging findings may help the practicing radiologist make a more specific diagnosis for an intraaxial tumor.
    MeSH term(s) Algorithms ; Brain/pathology ; Brain Neoplasms/diagnosis ; Humans ; Image Enhancement/methods ; Image Interpretation, Computer-Assisted/methods ; Practice Guidelines as Topic ; Practice Patterns, Physicians'
    Language English
    Publishing date 2006-10
    Publishing country United States
    Document type Journal Article ; Review
    ZDB-ID 603172-9
    ISSN 1527-1323 ; 0271-5333
    ISSN (online) 1527-1323
    ISSN 0271-5333
    DOI 10.1148/rg.26si065513
    Database MEDical Literature Analysis and Retrieval System OnLINE

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    Zs.A 1751: Show issues Location:
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  2. Article: Displaced plaque in retroperitoneal adenopathy.

    Al-Okaili, Riyadh N / Schable, Stephen I / Marlow, Troy J

    Southern medical journal

    2002  Volume 95, Issue 8, Page(s) 857–859

    Abstract: Background: This study was designed to determine when to consider incidental retroperitoneal masses on the basis of a displaced calcified atheromatous abdominal aorta on lateral radiographs.: Methods: We did a retrospective review of 143 normal ... ...

    Abstract Background: This study was designed to determine when to consider incidental retroperitoneal masses on the basis of a displaced calcified atheromatous abdominal aorta on lateral radiographs.
    Methods: We did a retrospective review of 143 normal abdominal helical computed tomography scans of individuals aged 50 years and older to measure the distance between the posterior aortic wall and anterior cortex of vertebral bodies from T12 through L3.
    Results: The normal abdominal aorta maintains a close relationship to the vertebral column. The distance should not be more than 10 mm in men and 7.3 mm in women.
    Conclusion: Displacement of aortic calcified atheroma greater than these distances should prompt a search for a retroperitoneal mass.
    MeSH term(s) Aged ; Aorta, Abdominal/diagnostic imaging ; Aortic Diseases/complications ; Aortic Diseases/diagnostic imaging ; Arteriosclerosis/complications ; Arteriosclerosis/diagnostic imaging ; Calcinosis/complications ; Calcinosis/diagnostic imaging ; Female ; Humans ; Lymphatic Diseases/complications ; Lymphatic Diseases/diagnostic imaging ; Male ; Middle Aged ; Radiography ; Reproducibility of Results ; Retroperitoneal Neoplasms/complications ; Retroperitoneal Neoplasms/diagnostic imaging ; Retrospective Studies ; Sensitivity and Specificity ; Spine/diagnostic imaging
    Language English
    Publishing date 2002-08
    Publishing country United States
    Document type Journal Article
    ZDB-ID 185329-6
    ISSN 1541-8243 ; 0038-4348
    ISSN (online) 1541-8243
    ISSN 0038-4348
    Database MEDical Literature Analysis and Retrieval System OnLINE

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    Zs.MO 336: Show issues

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  3. Article ; Online: Middle cerebral artery vasospasm: transcranial color-coded duplex sonography versus conventional nonimaging transcranial Doppler sonography.

    Swiat, Maciej / Weigele, John / Hurst, Robert W / Kasner, Scott E / Pawlak, Mikolaj / Arkuszewski, Michal / Al-Okaili, Riyadh N / Swiercz, Miroslaw / Ustymowicz, Andrzej / Opala, Grzegorz / Melhem, Elias R / Krejza, Jaroslaw

    Critical care medicine

    2009  Volume 37, Issue 3, Page(s) 963–968

    Abstract: Objective: To prospectively compare accuracies of transcranial color-coded duplex sonography (TCCS) and transcranial Doppler sonography (TCD) in the diagnosis of middle cerebral artery (MCA) vasospasm.: Design: Prospective blinded head-to-head ... ...

    Abstract Objective: To prospectively compare accuracies of transcranial color-coded duplex sonography (TCCS) and transcranial Doppler sonography (TCD) in the diagnosis of middle cerebral artery (MCA) vasospasm.
    Design: Prospective blinded head-to-head comparison TCD and TCCS methods using digital subtraction angiography (DSA) as the reference standard.
    Setting: Department of Radiology in a tertiary university health center in a metropolitan area.
    Patients: Eighty-one consecutive patients (mean age, 53.9 +/- 13.9 years; 48 women). The indication for DSA was subarachnoid hemorrhage in 71 patients (87.6%), stroke or transient ischemic attack in five patients (6.2%), and other reasons in five patients (6.2%).
    Interventions: The MCA was graded as normal, narrowed <50%, and >50% using DSA. The accuracy of ultrasound methods was estimated by total area (Az) under receiver operator characteristic curve. To compare sensitivities of ultrasound methods, McNemar's test was used with mean velocity thresholds of 120 cm/sec for the detection of less advanced, and 200 cm/sec for the more advanced MCA narrowing.
    Measurements and main results: Angiographic MCA narrowing <or=50% was found in 21, and >50% in 10 of 135 arteries. Accuracy of TCCS was insignificantly higher than that of TCD in the detection of <or=50% and >50% narrowing, total Az for mean velocity being 0.83 +/- 0.05, 0.77 +/- 0.05, and 0.95 +/- 0.02, 0.86 +/- 0.08, respectively. Sensitivity of TCCS at commonly used threshold of 120 cm/sec for less advanced MCA spasm was significantly better than that of TCD at similar specificity, 55% vs. 39%, p = 0.038, whereas at a threshold of 200 cm/sec used for more advanced spasm, sensitivities and specificities of both methods were not different.
    Conclusion: The accuracy of TCCS and TCD is similar, but TCCS is more sensitive than TCD in the detection of MCA spasm. Sensitivity of both techniques in the detection of mild and more advanced spasm using 120 cm/sec and 200 cm/sec thresholds, respectively, is poor; however, a larger sample is required to increase precision of our sensitivity estimates.
    MeSH term(s) Adult ; Aged ; Aged, 80 and over ; Female ; Humans ; Male ; Middle Aged ; Middle Cerebral Artery ; Prospective Studies ; Reproducibility of Results ; Ultrasonography, Doppler, Color ; Ultrasonography, Doppler, Transcranial ; Vasospasm, Intracranial/diagnostic imaging ; Young Adult
    Language English
    Publishing date 2009-03
    Publishing country United States
    Document type Comparative Study ; Journal Article ; Research Support, Non-U.S. Gov't
    ZDB-ID 197890-1
    ISSN 1530-0293 ; 0090-3493
    ISSN (online) 1530-0293
    ISSN 0090-3493
    DOI 10.1097/CCM.0b013e31819b8165
    Database MEDical Literature Analysis and Retrieval System OnLINE

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    Zs.A 1261: Show issues Location:
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  4. Article: Intraaxial brain masses: MR imaging-based diagnostic strategy--initial experience.

    Al-Okaili, Riyadh N / Krejza, Jaroslaw / Woo, John H / Wolf, Ronald L / O'Rourke, Donald M / Judy, Kevin D / Poptani, Harish / Melhem, Elias R

    Radiology

    2007  Volume 243, Issue 2, Page(s) 539–550

    Abstract: Purpose: To develop and retrospectively determine the accuracy of a magnetic resonance (MR) imaging strategy to differentiate intraaxial brain masses, with histologic findings or clinical diagnosis as the reference standard.: Materials and methods: ... ...

    Abstract Purpose: To develop and retrospectively determine the accuracy of a magnetic resonance (MR) imaging strategy to differentiate intraaxial brain masses, with histologic findings or clinical diagnosis as the reference standard.
    Materials and methods: The study was HIPAA compliant and was approved by the institutional review board. A waiver of informed consent was obtained. A strategy was developed on the basis of conventional MR imaging, diffusion-weighted MR imaging, perfusion MR imaging, and proton MR spectroscopy to classify intraaxial masses as low-grade primary neoplasms, high-grade primary neoplasms, metastatic neoplasms, abscesses, lymphomas, tumefactive demyelinating lesions (TDLs), or encephalitis. The strategy was evaluated by using data from 111 patients (46 women, 65 men; mean age, 48.9 years) with imaging results available on a departmental picture archiving and communication system from a 5-year search period. Bayesian statistics of the strategy elements and three clinical tasks were calculated.
    Results: Search results identified 44 patients with high-grade and 14 with low-grade primary neoplasms, 24 with abscesses, 12 with lymphoma, 11 with TDLs, five with metastases, and one with encephalitis who had undergone conventional and advanced MR imaging. However, only 40 patients (25 women, 15 men; mean age, 45 years) had undergone all studies and had data to allow completion of the entire strategy. Accuracy, sensitivity, and specificity of the strategy, respectively, were 90%, 97%, and 67% for discrimination of neoplastic from nonneoplastic diseases, 90%, 88%, and 100% for discrimination of high-grade from low-grade neoplasms, and 85%, 84%, and 87% for discrimination of high-grade neoplasms and lymphoma from low-grade neoplasms and nonneoplastic diseases.
    Conclusion: An integrated MR imaging-based strategy, which is accurate in differentiation of several intraaxial brain masses, was proposed.
    MeSH term(s) Algorithms ; Brain Neoplasms/diagnosis ; Diagnosis, Differential ; Encephalitis/diagnosis ; Female ; Humans ; Image Enhancement/methods ; In Vitro Techniques ; Magnetic Resonance Imaging/methods ; Male ; Middle Aged ; Pilot Projects ; Reproducibility of Results ; Sensitivity and Specificity
    Language English
    Publishing date 2007-05
    Publishing country United States
    Document type Evaluation Studies ; Journal Article
    ZDB-ID 80324-8
    ISSN 1527-1315 ; 0033-8419
    ISSN (online) 1527-1315
    ISSN 0033-8419
    DOI 10.1148/radiol.2432060493
    Database MEDical Literature Analysis and Retrieval System OnLINE

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    Ue I Zs.106: Show issues Location:
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