Magnetic Resonance Imaging of Central Nervous System Diseases

1 Physical Principles and Techniques of MR Imaging.- 1.1 Physical Principles.- 1.1.1 Historical Background.- 1.1.2 Properties of Atomic Nuclei.- 1.1.3 Situation in the Absence of an Applied Magnetic Field.- 1.1.4. Situation in the Presence on an Applied Magnetic Field.- 1.1.5 Resonance.- 1.1.6 Induction.- 1.1.7 Relaxation.- 1.1.8 Significance of Relaxation Times.- 1.1.9 Chemical Shift.- 1.2 Techniques of MR Imaging.- 1.2.1 Magnet.- 1.2.2 Radiofrequency Equipment.- 1.2.3 Surface Coils.- 1.2.4 Gradient System.- 1.2.5 Forming an Image.- 1.2.6 Central Control Unit.- 1.3 Pulse Sequences and Image Contrasts.- 1.3.1 Aspects of MR Image Quality.- 1.3.2 Pulse Sequences.- 1.3.3 Contrast Agents.- 1.3.4 Flow Phenomena.- 1.3.5 Image Artifacts.- 1.4 New Approaches in Clinical MR.- 1.4.1 Fast Imaging.- 1.4.2 Blood Flow and MR Angiography.- 1.4.3 Tissue Characterization.- 1.4.4 Spectroscopy and Chemical Shift Imaging.- References.- 2 Normal Anatomy of the Central Nervous System.- 2.1 Orientation.- 2.1.1 Organization of the Atlas.- 2.1.2 Coordinate Systems for the Central Nervous System.- 2.1.3 Ventricular System.- 2.1.4 Functional Systems.- 2.2 Cerebral Cortex.- 2.2.1 Lobes, Gyri, and Sulci.- 2.2.2 Functional Anatomy.- 2.3 Diencephalon and Basal Ganglia.- 2.3.1 Basic Anatomy.- 2.3.2 Pituitary Gland.- 2.3.3 Hypothalamus.- 2.3.4 Thalamus.- 2.3.5 Functional Anatomy.- 2.4 Midbrain.- 2.4.1 Basic Anatomy.- 2.4.2 Functional Anatomy.- 2.5 Posterior Fossa.- 2.5.1 Basic Anatomy.- 2.5.2 Pons and Medulla Oblongata.- 2.5.3 Cerebellum.- 2.5.4 Basal Cranial Nerves.- 2.5.5 Functional Anatomy.- 2.6 Optical System.- 2.6.1 Basic Anatomy.- 2.6.2 Functional Anatomy.- 2.7 Acoustic System.- 2.7.1 Basic Anatomy.- 2.7.2 Functional Anatomy.- 2.8 Cerebral Blood Supply.- 2.8.1 Basic Anatomy.- 2.8.2 Arterial System.- 2.8.3 Venous System.- 2.8.4 Supply Areas of the Cerebral Arteries.- 2.9 Spinal Cord.- 2.9.1 Basic Anatomy.- 2.9.2 Cervical Cord.- 2.9.3 Thoracic Cord.- 2.9.4 Lumbosacral Region.- 2.9.5 Functional Anatomy.- References.- 3 Practical Aspects of the MR Examination.- 3.1 Preparations.- 3.1.1 Explaining the Procedure to the Patient.- 3.1.2 Positioning.- 3.2 Examination Procedure.- 3.2.1 Anatomic Orientation.- 3.2.2 Demonstration or Exclusion of Disease.- 3.2.3 Differentiation of Disease.- 3.3 Sedation, Anesthesia, and Anesthesiology Monitoring During MR Examinations.- 3.3.1 Monitoring.- 3.3.2 Sedation.- 3.3.3 General Anesthesia.- 3.4 Side Effects and Contraindications.- 3.4.1 Biological Effects.- 3.4.2 Practical Effects.- References.- 4 Symptoms and Pathologic Anatomy: A Tabular Listing.- 5 General Aspects of the MR Signal Pattern of Certain Normal and Pathologic Structures.- 5.1 Brain Edema.- 5.2 Intracranial Hemorrhage and Iron Metabolism.- 5.3 Practical Aspects of Blood and CSF Flow.- 5.4 Effects of Radiotherapy on Brain and Spinal Cord Tumors.- 5.5 Effect of Contrast Agent (Gadolinium-DTPA) on the MR Appearance of Normal Tissue.- References.- 6 Magnetic Resonance Imaging of the Brain in Childhood: Development and Pathology.- 6.1 Introduction.- 6.2 Technical Aspects.- 6.3 Normal Appearance.- 6.4 Intracranial Hemorrhage.- 6.5 Infarction.- 6.6 Cysts and Leukomalacias.- 6.7 Hydrocephalus.- 6.8 Congenital Malformations.- 6.9 White Matter Disease.- 6.10 Infection.- 6.11 Delays or Deficits in Myelination.- 6.12 Tumors.- 6.13 Other Diseases.- 6.14 Follow-Up Examination.- 6.15 Conclusion.- References.- 7 Malformations of the CNS.- 7.1 Review of Ontogeny.- 7.2 MR Imaging of CNS Malformations.- 7.3 Midline Closure Defects (Neural Tube Defects, Dysraphic Disorders).- 7.3.1 Midline Closure Defects of the Brain.- 7.3.2 Midline Closure Defects of the Cerebellum.- 7.3.3 Midline Closure Defects of the Spine.- 7.3.4 Dysraphic Disorders of the Spinal Cord.- 7.4 Malformations of the Commissures and Midline Structures.- 7.4.1 Holoprosencephaly.- 7.4.2 Agenesis of the Corpus Callosum.- 7.4.3 Anomalies of the Septum Pellucidum.- 7.5 Anomalies of Cell Migration.- 7.5.1 Ectopias and Heterotopias.- 7.5.2 Agyria, Pachygyria, Lissencephaly; Polymicrogyria, Stenogyria; Status Verrucosus.- 7.6 Destructive Anomalies.- 7.6.1 Hydranencephaly.- 7.6.2 Porencephaly.- 7.6.3 Schizencephaly.- 7.6.4 Multicystic Encephalopathy.- 7.6.5 Amnion's Horn Sclerosis, Status Marmoratus, Status Demyelinisatus.- 7.6.6 Ulegyria.- 7.6.7 Hemispheric Atrophy.- 7.6.8 Putaminal Necrosis.- 7.7 Neuroectodermal Dysplasias.- 7.7.1 Tuberous Sclerosis.- 7.7.2 Neurofibromatosis.- 7.7.3 Encephalofacial Angiomatosis.- 7.7.4 Von Hippel-Lindau Disease.- 7.7.5 Other Neuroectodermal Dysplasias.- 7.8 Miscellaneous Abnormalities.- 7.8.1 Congenital Hydrocephalus.- 7.8.2 Microcephaly, Micrencephaly.- 7.8.3 Macrencephaly.- 7.8.4 Arachnoid Cyst.- References.- 8 Degenerative Disorders of the Brain and White Matter Diseases.- 8.1 Primary Neuronal (Gray Matter) Involvement.- 8.1.1 Congenital Causes.- 8.1.2 Acquired and Unexplained Causes.- 8.2 Primary Myelin (White Matter) Involvement.- 8.2.1 Congenital Causes.- 8.2.2 Acquired and Unexplained Causes.- 8.3 Primary Involvement of the Basal Ganglia and Brainstem.- 8.3.1 Congenital Causes.- 8.3.2 Acquired and Unexplained Causes.- 8.4 Primary Involvement with No Sites of Predilection.- 8.4.1 Congenital Causes.- 8.4.2 Acquired and Unexplained Causes.- References.- 9 Temporal Lobe Epilepsy.- 9.1 MR Findings.- References.- 10 Intracranial Tumors.- 10.1 General Aspects of the Detection of Intracranial Tumors with MR.- 10.2 Tumors of Neuroepithelial Tissue.- 10.2.1 Astrocytic Tumors.- 10.2.2 Oligodendroglial Tumors.- 10.2.3 Poorly Differentiated and Embryonal Tumors.- 10.2.4 Ependymal and Choroid Plexus Tumors.- 10.2.5 Pineal Cell Tumors.- 10.2.6 Neuronal Tumors.- 10.3 Tumors of the Nerve Sheath Cells.- 10.4 Tumors of Meningeal and Related Tissues.- 10.4.1 Meningiomas.- 10.4.2 Meningeal Sarcomas.- 10.4.3 Primary Melanotic Tumors.- 10.5 Primary Malignant Lymphomas.- 10.5.1 Histiocytosis X.- 10.6 Tumors of Blood Vessel Origin.- 10.6.1 Hemangioblastoma.- 10.6.2 Monstrocellular Sarcoma.- 10.7 Germ Cell Tumors.- 10.7.1 Germinomas.- 10.7.2 Embryonal Carcinomas.- 10.7.3 Teratomas.- 10.8 Other Malformative Tumors and Tumor-Like Lesions.- 10.8.1 Craniopharyngiomas.- 10.8.2 Rathke's Cleft Cysts.- 10.8.3 Epidermoid and Dermoid Cysts.- 10.8.4 Colloid Cysts.- 10.8.5 Enterogenous Cysts.- 10.8.6 Ependymal Cysts.- 10.8.7 Lipomas.- 10.8.8 Hypothalamic Neuronal Hamartomas.- 10.9 Tumors of the Pituitary.- 10.9.1 Tumors of the Anterior Lobe.- 10.9.2 Lesions of the Posterior Lobe.- 10.9.3 Other Lesions Related to the Pituitary.- 10.10 Local Extensions from Regional Tumors.- 10.10.1 Glomus Jugulare Tumors, Chordomas.- 10.10.2 Chondromas.- 10.10.3 Chondrosarcomas.- 10.10.4 Olfactory Neuroblastomas.- 10.10.5 Adenoid Cystic Carcinomas.- 10.11 Metastatic Tumors.- 10.12 Pseudotumor Cerebri.- References.- 11 Tumors of the Posterior Fossa.- 11.1 Intra-axial Tumors.- 11.1.1 Tumors of the Brainstem.- 11.1.2 Cerebellar Tumors.- 11.1.3 Differential Diagnosis of Intra-axial Expansive Lesions.- 11.2 Extra-axial Tumors.- 11.2.1 Neurinomas.- 11.2.2 Meningiomas.- 11.2.3 Epidermoid and Dermoid Cysts.- 11.2.4 Glomus Jugulare Tumors.- 11.2.5 Chordomas.- 11.2.6 Differential Diagnosis of Expansive Extra-axial Lesions of the Posterior Fossa.- References.- 12 Diseases of the Eyeball, Orbit, and Accessory Structures.- 12.1 Technical Requirements.- 12.2 Examination Technique.- 12.3 Eyeball.- 12.3.1 Malignant Melanoma.- 12.3.2 Retinoblastoma.- 12.3.3 Choroidal Osteoma.- 12.3.4 Drusen of the Optic Disc.- 12.3.5 Rare Diseases of the Eyeball.- 12.4 Optic Nerve.- 12.4.1 Optic Nerve Glioma.- 12.4.2 Optic Nerve/Sheath Meningioma.- 12.5 Lacrimal Glands.- 12.5.1 Inflammations.- 12.5.2 Benign Tumors.- 12.5.3 Malignant Tumors.- 12.6 Ocular Muscles.- 12.6.1 Myositis.- 12.6.2 Endocrine Orbitopathy.- 12.6.3 Rhabdomyosarcoma.- 12.7 Orbit.- 12.7.1 Malignant Tumors.- 12.7.2 Benign Tumors.- 12.7.3 Osseous Lesions.- 12.8 Malformations.- 12.8.1 Neurofibromatosis.- 12.8.2 Meningocele and Meningoencephalocele.- 12.9 Trauma.- References.- 13 Vascular Diseases of the Brain.- 13.1 Disturbances of Arterial Blood Flow.- 13.1.1 Infarction.- 13.1.2 Peripheral Angiopathies.- 13.2 Disturbances of Venous Blood Flow.- 13.3 Hemorrhages.- 13.3.1 Intracerebral Hematomas Related to Vascular Disease.- 13.3.2 Extracerebral Hematomas.- References.- 14 Vascular Malformations.- 14.1 Vascular Malformations of the Brain.- 14.1.1 Angiographically Demonstrable Vascular Anomalies.- 14.1.2 Angiographically Occult Vascular Anomalies.- 14.2 Vascular Malformations Involving the Vertebral Canal.- 14.2.1 Localization.- 14.2.2 Classification.- References.- 15 Inflammatory Diseases of the Central Nervous System.- 15.1 General Aspects of the Inflammatory Process.- 15.1.1 Exudative Inflammation.- 15.1.2 Proliferative or Granulating Inflammation.- 15.2 Classification.- 15.3 Infections of the Meninges.- 15.3.1 Pyogenic Infections.- 15.3.2 Viral Infections: Aseptic Meningitis.- 15.4 Infections of the Brain Tissue.- 15.4.1 Bacterial (Pyogenic) Infections.- 15.4.2 Viral Infections.- 15.4.3 Parasitic Infections.- 15.4.4 Fungal Infections.- 15.5 Acquired Immune Deficiency Syndrome.- 15.6 Summary.- References.- 16 Head Injury.- 16.1 Intracranial Extracerebral Hemorrhages.- 16.1.1 Epidural Hematoma.- 16.1.2 Subdural Hematoma.- 16.2 Blunt Brain Injuries.- 16.2.1 Focal Injuries.- 16.2.2 Diffuse Injury.- 16.3 Open Head Injuries.- 16.3.1 Cerebrospinal Fluid Fistula.- 16.4 Other Sequelae of Injuries.- 16.4.1 Fat Embolism.- 16.4.2 Air Embolism.- 16.5 Late Sequelae of Head Injuries.- References.- 17 Diseases of the Vertebral Column and Spinal Cord.- 17.1 Examination Technique.- 17.2 Intraspinal Processes.- 17.2.1 Intramedullary Processes.- 17.2.2 Extramedullar Processes.- 17.3 Spinal Tumors.- 17.3.1 Tumors Arising from Bone.- 17.3.2 Tumors Arising from the Bone Marrow and Blood Cells.- 17.3.3 Tumors of Vascular Origin.- 17.3.4 Other Tumors and Tumor-Like Lesions.- 17.4 Degenerative Diseases of the Spine.- 17.4.1 Intervertebral Disc Disease.- 17.4.2 Degenerative Changes in Bone.- 17.4.3 Spinal Stenosis.- 17.4.4 Postoperative Changes.- 17.4.5 Relative Values of Imaging Procedures in the Diagnosis of Disc Disease.- 17.5 Trauma.- References.- Glossary of Magnetic Resonance Terms.