Fellows’ Journal Club Choices for May 2015

Jiang XY, Zhang SH, Xie QZ, et al. Evaluation of Virtual Noncontrast Images Obtained from Dual-Energy CTA for Diagnosing Subarachnoid Hemorrhage. http://www.ajnr.org/content/36/5/855.full

A group of 37 patients underwent noncontrast CT and dual-energy CTA for diagnosis of SAH. From the latter, virtual noncontrast images were reconstructed and assessed for SAH. Agreement between true and virtual noncontrast images for diagnosis of SAH was 92%. Thus, virtual noncontrast CT images reliably diagnosed SAH while reducing radiation dose. (See accompanying commentary by Brisman.)

Prager AJ, Martinez N, Beal K, et al. Diffusion and Perfusion MRI to Differentiate Treatment-Related Changes Including Pseudoprogression from Recurrent Tumors in High-Grade Gliomas with Histopathologic Evidence. http://www.ajnr.org/content/36/5/877.full

Sixty-eight patients with treated high-grade gliomas who developed increasing enhancing masses of indeterminate nature underwent DWI and DSC as part of their studies. Pseudoprogression was found in 15% who showed higher ADC as well as lower relative cerebral blood volume when compared with those with recurrent tumors.

Kranz PG, Amrhein TJ, Gray L. Incidence of Inadvertent Intravascular Injection during CT Fluoroscopy–Guided Epidural Steroid Injections. http://www.ajnr.org/content/36/5/1000.full

Retrospective analysis of 575 CT fluoroscopy-guided epidural injections was done to detect inadvertent arterial or venous injections. Intravascular injections occurred in 26% of cervical transforaminal injections, 9% of cervical interlaminar injections, 8% of lumbar transforaminal injections, and 2% of lumbar interlaminar injections. These findings are similar to previous reports using conventional fluoroscopy and demonstrate that intravascular injections may be detected with CT fluoroscopy.

Fellows’ Journal Club Choices for May 2015
Mauricio Castillo • Univ of North Carolina

I am Division Chief of Neuroradiology at the University of North Carolina in Chapel Hill. In addition, I am a Professor of Radiology and the current Editor-in-Chief of the American Journal of Neuroradiology. I trained in Diagnostic Radiology at the University of Miami and was a Neuroradiology fellow at Emory University.