Comparison of MR angiography with contrast angiography for the diagnosis of carotid artery stenosis

To assess the accuracy of MR angiography for screening vascular stenosis of the extracranial carotid arteries, 20 consecutive patients with suspected extracranial carotid atherosclerotic disease were evaluated with time-of-flight MR angiography and intra-arterial contrast angiography. Both studies were independently reviewed by three observers in a blinded manner. The internal carotid arteries were graded as either normal or mildly stenotic (0%-29%), moderately stenotic (30%-69%), severely stenotic (70%-99%) or occluded. Results of the study indicate that time-of-flight MR angiography has a high rate of agreement with contrast angiography and is an accurate screening technique of the common carotid bifurcation in patients with suspected carotid stenosis.

Cervical myelopathy caused by an intracranial dural arteriovenous fistula

We report a case of progressive myelopathy in a 50-year-old lady with an intracranial dural arteriovenous fistula. Transcatheter embolization followed by surgical resection of the intracranial fistula resulted in reversal of the myelopathy. The diagnosis and management of this potentially reversible condition is discussed and the literature reviewed.

Pituitary hyperplasia mimicking pituitary tumor

Reactive enlargement of the pituitary gland in primary end organ failure may be indistinguishable from primary pituitary lesions in clinical presentation and on magnetic resonance imaging. The diagnosis of pituitary hyperplasia secondary to end organ failure must be based on endocrinologic investigations. Recognition of this condition and distinguishing it from primary pituitary tumors is important and may eliminate unnecessary surgery.