Imaging of Infections and Inflammations of the Central Nervous System: Computed Tomography, Ultrasound, and Nuclear Magnetic Resonance [antikvár]

The medical field has seen extremely rapid advancement in image technology in recent years, especially in x-ray computed tomography (CT), ultrasound (US), and nuclear magnetic resonance (NMR). Investigation of the central nervous system (CNS) has been a great beneficiary of this remarkable technologic progress. Infections and inflammations involving the CNS have in the past been difficult to diagnose, but the advent of the CT scan has greatly improved diagnostic accuracy. The new, burgeoning image technology of NMR promises to further enhance our diagnostic abilities. Although high resolution ultrasound's appli- cation to the central nervous system is more limited, it already has had great impact in the neonate. Ultrasound will also prove useful in the adult, especially in intraoperative applications. In short, all of these new imaging modalities will greatly extend the boundaries and refine our capability in diagnosing CNS infections and inflammations. An enormous amount of information is available from a wide variety of sources regarding CNS infections. These sources vary from basic pathology books to the most recent and up-to-date radiologic literature. The data base spans classic neuropathology to the underlying chemical or structural principles of new imaging technology. Integrating this variegate data in rapidly moving fields is a difficult task but crucial to expanded understanding. It takes consid- erable time to clinically investigate even a limited topic such as CNS infection with one technology such as x-ray CT. The problem is compounded when either new, competing, or complementary imaging techniques, i.e., NMR, loom on the horizon. This book is an attempt to distill and integrate the important information regarding the diagnosis of CNS infections by imaging. A need exists to link imaging with pathology and pathogenesis. This foundation greatly improves the prospect of extracting the pertinent information from an image to make a correct diagnosis. The basic principles of x-ray CT and the use of water soluble, iodinated contrast agents to investigate the blood-brain barrier exemplify this type of interaction. The need for this link will intensify as NMR is increasingly used, since that technology allows much greater flexibility in manipulating image parameters. Understanding the basic mechanisms of disease will permit intelligent selection of those parameters. The greater com- plexity and versatility of NMR has the potential to yield actual chemical in- formation about the CNS. Since clinical material is very limited at this writing, NMR is discussed only briefly in this book, but mention is made of the ap- propriate disease entities in which our present state of knowledge suggests NMR will have an important role.