Diagnostic and Interventional Neuroradiology

423 Pages·2002·40.74 MB·English

by  Sartor

Thieme

Diagnostic and Interventional
Neuroradiology
A Multimodality Approach
Klaus Sartor, M. D.
Professor
Division of Neuroradiology
Department of Neurology
University of Heidelberg Medical School
Heidelberg, Germany
With contributions by
G. Albrecht U. Grzyska R. Kachel M. Schumacher
K.-R. Atzor T. Hagen E. Keller A. Schwartz
S. Bien B. Haubitz R. Kraft M. Skalej
St. Bockenheimer S. Heiland R. von Kummer L. Solymosi
H. Bruckmann H. Henkes I. Mader H. Traupe
M. Deinzer F. Hentschel M. Mull S. Trittmacher
B. Dietrich M. Henze W. Muller-Forell H. Urbach
M. Forsting M. Hermes M. Orszagh M. Voges
H.J. Freitag Th. Herzog B. Ostertun J.-P. Wakat
A. Gass G. Huber J. Reul W. Weber
W. Grodd S.M. Hummel H. Sahl F.E. Zanella
Ch. Groden 0. Jansen K. Sartor C. Zimmer
771 Illustrations
IV
Library of Congress Cataloging-in-Publication Important Note: Medicine is an ever-changing
Data science undergoing continual development. Re-
Neuroradiologie. English. search and clinical experience are continually ex-
Neuroradiology / [edited by] Klaus Sartor ; with panding our knowledge, in particular our knowl-
contributions by G. Albrecht... [et al.; translated edge of proper treatment and drug therapy. Inso-
by T. Telger], far as this book mentions any dosage or applica-
p. ; cm. tion, readers may rest assured that the authors,
"Translation of the 2nd German edition pub- editors, and publishers have made every effort to
lished and copyrighted 2001" - T.p. verso. ensure that such references are in accordance
Includes bibliographical references and index. with the state of knowledge at the time of pro-
ISBN 1-58890-112-2 - ISBN 3131300817 duction of the book.
1. Nervous system-Radiography. 2. Nervous Nevertheless, this does not involve, imply, or
system-Diseases-Diagnosis. I. Sartor, Klaus. II. express any guarantee or responsibility on the
Title. part of the publishers in respect of any dosage in-
[DNLM: 1. Nervous System Diseases-diagnosis. 2. structions and forms of application stated in the
Diagnostic Imaging methods. book. Every user is requested to examine care-
WL 141 N4965 2002a] fully the manufacturers' leaflets accompanying
RC349.R3 N3713 2002 each drug and to check, if necessary in consulta-
616.8'04754-dc21 2002020321 tion with a physician or specialist, whether the
dosage schedules mentioned therein or the con-
traindications stated by the manufacturers differ
from the statements made in the present book.
Such examination is particularly important with
Translated by T. Telger, drugs that are either rarely used or have been
Ft. Worth, Tx, USA newly released on the market. Every dosage
schedule or every form of application used is en-
tirely at the user's own risk and responsibility.
This book is an authorized translation of the 2nd The authors and publishers request every user to
German edition published and copyrighted 2001 report to the publishers any discrepancies or in-
by Georg Thieme Verlag, Stuttgart, Germany. accuracies noticed.
Title of the German edition: Neuroradiologie.
Some of the product names, patents, and regis-
tered designs referred to in this book are in fact
© 2002 Georg Thieme Verlag, registered trademarks or proprietary names even
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This book, including all parts thereof, is legally
Cover design: Martina Berge, Erbach protected by copyright. Any use, exploitation, or
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Printed in Germany by Druckhaus Götz, consent, is illegal and liable to prosecution. This
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copying, mimeographing or duplication of any
ISBN 3-13-130081-7 kind, translating, preparation of microfilms, and
ISBN 1-58890-112-2 1 2 3 45 electronic data processing and storage.
V
Preface
This volume is a translation of the second revised vision chiefs. Few of the original set of-mostly
and expanded edition of Neuroradiologie, a text- academic—authors have left the team.
book first published in 1996 that has met with re- Although the emphasis of the book lies on CT
markable success in German-speaking countries. and MRI, a substantial part is devoted to the dis-
Neuroradiologie was conceived in the early nine- cussion of invasive techniques and therapeutic
ties as a multi-author book to be written mainly interventions. The book is divided into five parts.
by "young" neuroradiologists. By "young" I mean Part 1 deals with craniocerebral diseases: it
that, to understand the prospective reader better covers the pertinent methods of radiologic diag-
and to write accordingly, the typical author was nosis, including normal anatomy, as well as the
to be on the level of instructor or assistant profes- various disease categories with their radiologic
sor and not on the level of the seasoned profes- manifestations and differential diagnoses. Part 2
sor, who is more likely to be out of touch with the deals with spinal diseases in the same way. Part 3
needs of residents and fellows. Eventually, with is a short treatise of neuromuscular diseases. In
the support of many colleagues in the field, I Parts 4 and 5 craniocerebral and spinal neuroiri-
gathered together more experienced "young" terventions, respectively, are described at length.
neuroradiologists than would be required to The staff at Thieme Verlag, myself, and particu-
form four soccer teams. It is clearly already an ac- larly the translator, Terry Telger, worked hard to
complishment to shape a team of 11 people, and I make this book as attractive as possible to read-
am quite proud of having shaped one of 48. ers outside the German-speaking realm. Al-
Judging by the reception of the two German though much of my own neuroradiologic ex-
editions, our team did a great job, and if winning perience was gained during the 8 years that I
the approval of residents and fellows was the worked in the USA, especially during my tenure
goal, we scored nicely. We even received praise at the Mallinckrodt Institute of Radiology, Wash-
from "older" neuroradiologists and neuroclinici- ington University School of Medicine in St. Louis,
ans who generally no longer consult introductory the book may still contain some features of neu-
textbooks. The following features of the book roradiology considered "foreign." If this is a fault,
were stressed by "younger" and "older" readers it is clearly mine. Personally, however, I believe
and critics alike: its homogeneity, despite the that some transcultural influence will do no
large number of authors; its lucid organization; harm; in fact, it may be beneficial.
its thoroughness; and its practical value in daily It remains for me to express my sincere hope
work. The quality of the team may be further that this volume will be received equally well in
judged by the fact that many of the authors of the the English-speaking realm. This would make our
first German edition have in the interim moved young team of authors very proud indeed.
up the academic ladder, though without losing
their youthfulness; several have since become di- Heidelberg, Spring 2002 Klaus Sartor
VI
Contributors
G. Albrecht, M.D. B. Dietrich, M.D. U. Grzyska, M.D.
Instructor Partner Instructor
Neuroradiological Institute Joint radiology practice Division of Neuroradiology
Katharinenhospital Hanover, Germany Department of Radiology
Stuttgart, Germany University of Hamburg Medical
M. Forsting, M.D. School
Professor Hamburg, Germany
K.-R. Atzor, M.D.
Division of Neuroradiology
Partner
Radiological Center
Joint radiology practice T. Hagen, M.D.
University of Essen Medical
Friedberg, Germany Clinical Assistant Professor
School
Joint radiology practice
Essen, Germany
Augsburg, Germany
S. Bien, M.D.
Professor H.J. Freitag, M.D.
Division of Neuroradiology Partner and Clinical Professor B. Haubitz, M.D.
Neurological and Psychiatric Radiology practice Professor
Center Tesdorpfhaus Division of Neuroradiology
University of Marburg Medical Lübeck, Germany Department of Diagnostic
School Radiology
Marburg, Germany A. Gass, M.D. Medical College of Hanover
Assistant Professor Hanover, Germany
St. Bockenheimer, M.D. NMR Research
Clinical Professor Department of Neurology, S. Heiland, Ph.D.
Neuroradiology Unit Mannheim Campus Assistant Professor
Krankenhaus Nordwest University of Heidelberg Division of Neuroradiology
Frankfurt am Main, Germany Medical School Department of Neurology
Mannheim, Germany University of Heidelberg
Medical School
H. Bruckmann, M.D.
W. Grodd, M.D. Heidelberg, Germany
Professor
Professor
Division of Neuroradiology
MRI Research
Department of Diagnostic H. Henkes, M.D.
Division of Neuroradiology
Radiology Assistant Professor
Department of Radiology
Medical Center Grosshadern Division of Neuroradiology
University of Tubingen Medical
Ludwig-Maximilians- Department of Radiology
School
University Alfried-Krupp-Krankenhaus
Tubingen, Germany
Munich, Germany Essen, Germany
Ch. Groden, M.D.
M. Deinzer, M.D. Professor F. Hentschel, M.D.
Instructor Division of Neuroradiology Professor
Division of Neuroradiology Department of Radiology, Division of Neuroradiology
Department of Radiology Mannheim Campus Institute for Mental Health,
University of the Saarland University of Heidelberg Mannheim
Medical School Medical School University of Heidelberg
Homburg/Saar, Germany Mannheim, Germany Mannheim, Germany
Contributors VII
M. Henze, M.D. E. Keller, M.D. B. Ostertun, M.D.
Instructor Assistant Professor Clinical Assistant Professor
Division of Nuclear Medicine MRI Unit MRI Unit
Department of Radiology Department of Radiology Osnabrück Medical Center
University of Heidelberg Rhenish Friedrich-Wilhelms- Osnabrück, Germany
Heidelberg, Germany University
Bonn, Germany
J. Reul, M.D.
M. Hermes, M.D. Clinical Professor
R. Kraft, M.D.
Instructor Department of Diagnostic and
Instructor
Division of Neuroradiology Therapeutic Neuroradiology
Neuroradiological Institute
Department of Radiology Medical Center Bonn
Katharinenhospital
University of the Saarland Bonn, Germany
Stuttgart, Germany
Medical School
Homburg/Saar, Germany
R. von Kummer, M.D.
H. Sahl, M.D.
Professor
Instructor
Th. Herzog, M.D. Division of Neuroradiology
Institute of Diagnostic
Partner Department of Diagnostic
Radiology
Joint practice for neurology, Radiology
Municipal Medical Center
psychiatry and radiology University of Technology Dresden
Braunschweig, Germany
Mosbach, Germany Dresden, Germany
I. Mader, M.D. K. Sartor, M.D.
G. Huber, M.D.
Instructor Professor
Professor
MRI Research Division of Neuroradiology
Division of Neuroradiology
Division of Neuroradiology Department of Neurology
Department of Radiology
Department of Radiology University of Heidelberg
University of the Saarland
University of Tubingen Medical Medical School
Medical School
School Heidelberg, Germany
Homburg/Saar, Germany
Tubingen, Germany
M. Schumacher, M.D.
S.M. Hummel, M.D. W. Miiller-Forell, M.D.
Professor
Instructor Assistant Professor
Division of Neuroradiology
Division of Neuroradiology Division of Neuroradiology
Neurological Center
Neurological Center Department of Radiology
University of Freiburg Medical
University of Freiburg Medical University of Mainz Medical
School
School School
Freiburg/Br, Germany
Freiburg/Br, Germany Mainz, Germany
M. Mull
0. Jansen, M.D. A. Schwartz, M.D.
Instructor
Professor Clinical Professor
Division of Neuroradiology
Division of Neuroradiology Department of Neurology
Department of Radiology
Department of Neurosurgery Medical Center Hanover-
University of Technology Aachen
University of Kiel Medical Nordstadt
Aachen, Germany
School Hanover, Germany
Kiel, Germany
M. Orszagh, M.D.
Instructor M. Skalej, M.D.
R. Kachel, M.D. Division of Stereotactic Assistant Professor
Clinical Professor Neurosurgery Division of Neuroradiology
Neuroradiology and MRI Unit Department of Neurosurgery Department of Radiology
Institute of Medical Imaging University of Freiburg Medical University of Tubingen Medical
Erfurt Medical Center School School
Erfurt, Germany Freiburg/Br, Germany Tubingen, Germany
VIII Contributors
L Solymosi, M.D. H. Urbach, M.D. W. Weber, M.D.
Professor Assistant Professor Instructor
Division of Neuroradiology Neuroradiology Unit Division of Neuroradiology
Department of Diagnostic Department of Radiology Department of Radiology
Radiology Rhenish Friedrich-Wilhelms- Alfried-Krupp-Krankenhaus
Bavarian Julius-Maximilians- University Essen, Germany
University Bonn, Germany
Wurzburg, Germany F.E. Zanella, M.D.
M. Voges, M.D. Professor
H. Traupe, M.D. Institute for Radiology and Division of Neuroradiology
Professor Nuclear Medicine Radiological Center
Division of Neuroradiology Bundesknappschaft Medical Johann-Wolfgang-Goethe-
Department of Radiology Center University
Justus-Liebig-University Puttlingen/Saar, Germany Frankfurt am Main, Germany
Giessen
Giessen, Germany J.-P. Wakat, M.D. C. Zimmer, M.D.
Instructor Assistant Professor
S. Trittmacher, M.D. Division of Neuroradiology Division of Neuroradiology
Instructor Neurological and Psychiatric Department of Radiology
Division of Neuroradiology Center Medical Center Charite
Department of Radiology University of Marburg Medical Humboldt-University Berlin
Justus-Liebig-University School Berlin, Germany
Giessen Marburg, Germany
Giessen, Germany
IX
List of Abbreviations
ACA Anterior cerebral artery CW Doppler Continuous-wave Doppler
ACTH Adrenocorticotropic hormone D2 Dopamine (receptor subtype 2)
AD Alzheimer dementia 2-D Two-dimensional
ADC Apparent diffusion coefficient 2-DFT Two-dimensional fourier
ADEM Acute disseminated transformation
encephalomyelitis 3-D Three-dimensional
ADH Antidiuretic hormone DAT Dementia of Alzheimer type
ADL Adrenoleukodystrophy DFOV Display field of vision
AFP Alpha-fetoprotein DMT Dysembryoplastic neuroepithelial
AICA Anterior inferior cerebellar artery tumor
AIDS Acquired immunodeficiency DOTATOC DOTA-D ph1-tyr3-octreotide
syndrome DSA Digital subtraction angiography
ALS Amyotrophic lateral sclerosis DTPA Diethylenetriaminepentaacetic
AP Anteroposterior acid
APLD Automatic percutaneous lumbar DVA Developmental venous anomaly
discectomy DWI Diffusion-weighted imaging
ARC AIDS-related complex ECASS European Cooperation of Acute
ATP Adenosine triphosphate Stroke Studies
AV Arteriovenous ECD Ethyl cysteinate dimer
BCNU Bis-chlorethyl-nitrosourea ECST European Carotid Surgery Trial
BBB Blood-brain barrier EEC Electroencephalogram
BCO Bismuth germanate EPI Echo-planar imaging
nC Carbon-11 18F Fluorine-18
14C Carbon-14 F French
c Cervical vertebral (Cl, etc.) FDG-PET 18F-deoxyglucose positron
CADASIL Cerebral autosomal dominant emission tomography
arteriopathy with subcortical FET Fluoroethyl tyrosine
infarcts and FID Free induction decay
leukoencephalopathy FLAIR Fluid-attenuated inversion
CAVATAS Carotid and vertebral artery recovery
transluminal angioplasty study fMRI Functional magnetic resonance
CBV Cerebral blood volume imaging
CDS Color duplex sonography FOV Field of view
Cho Choline FTD Frontotemporal dementia
CISS Constructive interference in the FWHM Full width at half maximum
steady state (measure of system resolution)
CIT Carbomethoxy-iodophenyl- 67GA Gallium-67
tropane 68Ga Gallium-68
CNS Central nervous system G Gauge
CPM Central pontine myelinolysis GABA Gamma-aminobutyric acid
CSF Cerebrospinal fluid Gd Gadolinium
CSI Chemical shift imaging GPH Phase encoding gradient
CT Computed tomography, G Readout gradient
R
computed tomogram GRE Gradient echo
CTA CT aneiography G Slice selection gradient
s