In the diagnosis of cerebral cavernous malformations (CCMs) magnetic resonance imaging is established as the gold standard. Conventional MRI techniques have their drawbacks in the diagnosis of CCMs and associated venous malformations (DVAs). The aim of our study was to evaluate susceptibility weighted imaging SWI for the detection of CCM and associated DVAs at 7 T in comparison with 3 T. 24 patients (14 female, 10 male; median age: 38.3 y (21.1 y-69.1 y) were included in the study. Patients enrolled in the study received a 3 T and a 7 T MRI on the same day. The following sequences were applied on both field strengths: a T1 weighted 3D GRE sequence (MP-RAGE) and a SWI sequence. After obtaining the study MRIs, eleven patients underwent surgery and 13 patients were followed conservatively or were treated radio-surgically. Patients initially presented with haemorrhage (n = 4, 16.7%), seizures (n = 2, 8.3%) or other neurology (n = 18, 75.0%). For surgical resected lesions histopathological findings verified the diagnosis of CCMs. A significantly higher number of CCMs was diagnosed at 7 T SWI sequences compared with 3 T SWI (p < 0.05). Additionally diagnosed lesions on 7 T MRI were significantly smaller compared to the initial lesions on 3 T MRIs (p < 0.001). Further, more associated DVAs were diagnosed at 7 T MRI compared to 3 T MRI. SWI sequences at ultra-high-field MRI improve the diagnosis of CCMs and associated DVAs and therefore add important pre-operative information.
Background/objectives: This study prospectively evaluated clinical outcomes and osseous consolidation in patients with symptomatic scaphoid non-union treated with avascular bone grafting and percutaneous screw fixation. Two imaging methods, MDCT (multi-detector computed tomography) and HR-pQCT (high-resolution peripheric quantitative computer tomography), were employed to assess bone healing. Methods: In Vienna, eight consecutive patients with nine symptomatic scaphoid non-unions underwent revision surgery. Clinical outcomes were measured using DASH and PRWE scores, grip strength, and thumb strength. MDCT and HR-pQCT imaging were conducted 6 and 12 weeks post-operatively. Results: The median DASH score improved significantly from 43.3 (range 3.3–76.7) pre-operatively to 26.6 (p = 0.024) at 3 months and 16.2 (p = 0.06) at 12 months post-operatively. At 5–6 years, the median DASH score was 2 (range 0–15). At 6 weeks, both MDCT and HR-pQCT detected >50% bone healing at the distal interface. At the proximal interface, HR-pQCT detected >50% healing in all cases, whereas MDCT still showed 50% osseous consolidation at both interfaces. Conclusions: Avascular iliac grafting with screw fixation achieved excellent long-term clinical outcomes for symptomatic scaphoid non-union. HR-pQCT proved superior to MDCT for assessing early bone healing.