P D Griffiths

The University of Sheffield, Sheffield, England, United Kingdom

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Publications (215)750.53 Total impact

  • [Show abstract] [Hide abstract]
    ABSTRACT: Objective The aim of this study was to quantify the risk of brain abnormalities in single twin demise of monochorionic pregnancies and to describe the type of brain injuries. using ultrasound and in utero MR imaging (iuMR).Methods Monochorionic twin pregnancies complicated by demise of one twin referred between 2004-2013 were reviewed. Ultrasound was performed in a tertiary centre prior to iuMR The cases were subdivided into those associated with co-twin loss following fetoscopic laser ablative treatment for twin/twin transfusion syndrome (TTTS) and those associated with spontaneous fetal demiseResultsSixty-eight cases were identified, 27/68 following treatment for TTTS and 41/68 with spontaneous fetal demise. Nine (13.2%) had brain abnormalities on iuMR and the rate of brain abnormalities was similar in the two groups. Expert ultrasound and iuMR findings agreed in 3/9 of those cases and in 6/9 cases ultrasound underestimated or missed the pathology.Conclusion Monochorionic twin pregnancies with single fetal demise are complex pregnancies with increased risk of acquired brain pathology, although the rate of brain abnormalities in our study is lower than other publications. iuMR in such complicated pregnancies is a useful adjuvant imaging technique which appears to detect brain pathologies better than prenatal ultrasonography. This article is protected by copyright. All rights reserved.
    Prenatal Diagnosis 02/2015; DOI:10.1002/pd.4577 · 2.51 Impact Factor
  • I Craven, M J Bradburn, P D Griffiths
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    ABSTRACT: To estimate the diagnostic performance of ultrasound in detecting agenesis of the corpus callosum (ACC). A retrospective review was performed of 1722 in utero MRI examinations. All cases were identified in which the fetus had been referred from ultrasonography with a diagnosis of ACC and those in which ACC was given as a diagnosis on the in utero MRI study. The MRI was assumed to provide the correct diagnosis of ACC and descriptive statistics of diagnostic accuracy for ultrasound were calculated. Of the 1722 ultrasound examinations performed, 121 had a diagnosis of ACC and approximately 50% were confirmed at MRI. Forty-two fetuses with ACC not suspected at ultrasonography were also identified at MRI. Ultrasonography had a positive predictive value of 47% (95% CI: 38-56%) and a negative predictive value of 97% (95% CI: 96-98%) for detecting ACC. Ultrasound is poor in diagnosing ACC and in utero MRI should be performed if there is any suspicion on antenatal ultrasonography. Copyright © 2014 The Royal College of Radiologists. Published by Elsevier Ltd. All rights reserved.
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    ABSTRACT: Paediatric diffuse intrinsic pontine glioma (DIPG) is noteworthy for its fibrillary infiltration through neuroparenchyma and its resultant irregular shape. Conventional volumetry methods aim to approximate such irregular tumours to a regular ellipse, which could be less accurate when assessing treatment response on surveillance MRI. Region-of-interest (ROI) volumetry methods, using manually traced tumour profiles on contiguous imaging slices and subsequent computer-aided calculations, may prove more reliable.
    Pediatric Radiology 08/2014; DOI:10.1007/s00247-014-3134-6 · 1.65 Impact Factor
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    ABSTRACT: To assess the sensitivity of the hyperpolarized (129) Xe chemical shift saturation recovery (CSSR) technique for noninvasive quantification of changes to lung microstructure and function in idiopathic pulmonary fibrosis (IPF) and systemic sclerosis (SSc).
    Magnetic Resonance in Medicine 08/2014; DOI:10.1002/mrm.25400 · 3.40 Impact Factor
  • D A Jarvis, P Armitage, A Dean, P D Griffiths
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    ABSTRACT: MRI of the foetal brain in utero is performed in routine clinical practice using sequences that produce two-dimensional (2D) images. Recent developments in image post-processing have allowed the construction of three-dimensional (3D) volume data sets from 2D images acquired in different anatomical planes, but these have limitations due to the unpredictable nature of foetal movement. These limitations have been overcome by development of several different advanced computer techniques, which require specialist knowledge, software, and processing methods, which are rarely available in routine clinical settings. Our aim was to develop a technique that can be used in routine clinical situations without the need for custom-developed or expensive software by utilizing MRI sequences that can produce a 3D data set in "ultrafast" timescales. The 3D dataset, combined with versatile image post-processing and visualization techniques, has resulted in the production of high-resolution images of foetal brain surfaces in utero. The aim of this paper is to demonstrate our methods and early results by way of a pictorial review illustrating a range of developmental brain disease in utero.
    Clinical Radiology 07/2014; 69(10). DOI:10.1016/j.crad.2014.06.014 · 1.66 Impact Factor
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    ABSTRACT: AIM: To study the associations between magnetic resonance proton spectroscopy (MRS) data and apparent diffusion coefficients (ADC) from the preterm brain with developmental outcome at 18 months corrected age and clinical variables. MATERIALS AND METHODS: A prospective observational cohort study of 67 infants born before 35 weeks gestational age who received both magnetic resonance imaging of the brain between 37 and 44 weeks corrected gestational age and developmental assessment around 18 months corrected age. RESULTS: No relationships were found between ADC values and MRS results or outcome. MRS ratios involving N-acetyl aspartate (NAA) from the posterior white matter were associated with "severe" and "moderate to severe" difficulties, and fine motor scores were significantly lower in participants with a visible lactate doublet in the posterior white matter. The presence of a patent ductus arteriosus (PDA) was the only clinical factor related to NAA ratios. CONCLUSION: Altered NAA levels in the posterior white matter may reflect subtle white matter injury associated with neuro-developmental difficulties, which may be related to a PDA. Further work is needed to assess the longer-term neuro-developmental implications of these findings, and to study the effect of PDAs on developmental outcome in later childhood/ adolescence.
    Clinical Radiology 06/2014; 69(8). DOI:10.1016/j.crad.2014.04.001 · 1.66 Impact Factor
  • F Williams, P D Griffiths
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    ABSTRACT: To review our experience of diagnosing hemimegalencephaly (HME) using in utero magnetic resonance imaging (MRI). The MRI database in the Academic Unit of Radiology, University of Sheffield was searched using "hemimegalencephaly" and "in utero MR" as search terms. The antenatal histories and reports of ultrasound imaging were reviewed as well as the in utero MRI images. Nine cases of foetal HME were located. One case was referred after ultrasound with the diagnosis of HME, one as a "complex brain malformation", and one as a "mass lesion". The other six were referred as "unilateral ventriculomegaly". A common finding in foetuses imaged in the second trimester was disruption of the normal "transient structures" found in the developing cerebral hemispheres. HME is a difficult diagnosis to make using antenatal ultrasound and in utero MRI should be considered in cases of unilateral ventriculomegaly diagnosed at ultrasound. Disruption of the transient structures of the cerebral hemispheres is a common finding on in utero MRI and can sometimes produce mass-like appearances in the region of the germinal matrix/ganglionic eminence.
    Clinical Radiology 03/2014; DOI:10.1016/j.crad.2014.01.026 · 1.66 Impact Factor
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    ABSTRACT: Background Prevalence of neurological dysfunction in a prospective cohort of patients newly diagnosed with coeliac disease is yet to be determined. The spectrum of neurological deficit in patients with this disease remains unclear. We aimed to establish the prevalence of neurological deficit in patients newly diagnosed with coeliac disease and to compare the clinicoradiological features of this group with patients presenting with neurological changes that eventually led to diagnosis of the disorder. Methods Patients with newly diagnosed coeliac disease recruited from a tertiary referral gastrointestinal clinic at the Sheffield Teaching Hospitals NHS Foundation Trust were prospectively reviewed by a neurologist and underwent MRI of the brain. Clinicoradiological features of patients who presented with neurological dysfunction to a tertiary referral neurological clinic and who were subsequently diagnosed with coeliac disease were retrospectively reviewed. MRI biomarkers—cerebellar volume (percentage ratio of cerebellar volume to total intracranial volume [%CV:TIV]); N-acetylaspartate to creatine ratio (NAA/Cr), a marker of neuronal health, measured with cerebellar proton MR spectroscopy; and voxel-based morphometry (VBM)—were analysed. Data were also compared with those of healthy volunteers who underwent the same MRI protocol and who were recruited from the local area. Regional ethics committee approved the study and all participants gave informed consent. Findings 30 patients (mean age 47 years, SD 16, range 23–77; 12 men) with newly diagnosed coeliac disease were recruited. 20 patients (61 years, 10, 42–74, nine men) diagnosed with coeliac disease after initially presenting with neurological dysfunction (neurological dysfunction group) were reviewed. MRI data were obtained from a register of 55 healthy volunteers (41 years, 15, 20–77; 32 men). 11 patients (37%) with newly diagnosed coeliac disease had neurological deficits on clinical examination, ten with mild gait ataxia and one with peripheral neuropathy. 16 patients (80%) in the neurological dysfunction group had gait ataxia (nine mild, six moderate, one severe); four patients had peripheral sensory neuropathy. %CV:TIV and NAA/Cr were significantly reduced in the neurological dysfunction group compared with patients with newly diagnosed disease (mean %CV:TIV 7·5 [SD 1·5] vs 8·5 [0·8], 95% CI 0·24–1·76; p=0·01 and NAA/Cr 0·85 [0·13] vs 0·95 [0·07], 0·04–0·17; p=0·004). %CV:TIV and NAA/Cr were also significantly lower in the neurological dysfunction group than in healthy volunteers (mean %CV:TIV 7·5 [SD 1·5] vs 8·4 [1·2], 95% CI 0·05–1·83; p=0·039 and NAA/Cr 0·85 [0·13] vs 0·98 [0·09], 0·05–0·20; p=0·001). There was no significant difference in %CV:TIV or NAA/Cr between patients newly diagnosed with coeliac disease and healthy volunteers. Patients in the neurological dysfunction group showed multiple regions of reduced grey matter density, especially of the cerebellum but also involving supratentorial regions (p<0·05) compared with healthy volunteers. Patients newly diagnosed with coeliac disaese showed only modest reduction in grey matter in the cingulate gyrus (p<0·05). Interpretation Our results might not be generalisable because data were obtained from a tertiary referral centre. Moreover, analysis of the neurological dysfunction subgroup was retrospective. Nonetheless, to our knowledge this is the first study to attempt to provide a prevalence of neurological dysfunction prospectively in patients with coeliac disease while also examining MRI biomarkers of brain dysfunction. This study seems to show that a significant proportion of patients presenting with gastrointestinal symptoms who are diagnosed with coeliac disease already have some neurological dysfunction. The group of patients that present with neurological dysfunction are more severely affected. Serological testing for the disease should be incorporated into the investigation of patients with unexplained neurological symptoms. Increased awareness of the spectrum of neurological dysfunction in coeliac disease and close collaboration between neurologists and gastroenterologists might increase detection and prevent unnecessary delay to dietary treatment, which could lead to permanent neurological disability. Funding Coeliac UK, Bardhan Research & Education Trust.
    The Lancet 02/2014; 383:S39. DOI:10.1016/S0140-6736(14)60302-0 · 39.21 Impact Factor
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    ABSTRACT: Dural venous sinus ectasia with thrombosis (DVSET) in the fetus is a rare condition that can be diagnosed prenatally with the use of fetal MR imaging, yet with limited indication of long-term clinical significance. To describe and evaluate the diagnostic value of fetal MR imaging in the prenatal diagnosis of dural venous sinus ectasia with thrombosis and its clinical significance. We report a series of nine fetuses with dural venous sinus ectasia with thrombosis. The mothers, located in four feto-maternal centres, were referred for fetal MR imaging due to space occupying lesions identified on second-trimester antenatal ultrasound. In all but one case the dural venous sinus ectasia with thrombosis was in the vicinity of the venous confluence (VC) with various extension in the posterior dural sinuses. Antenatal follow-up imaging was performed in seven cases and showed progression in one, stable appearances in one and regression in five cases. Three pregnancies were terminated. In the remaining six cases there was no reported neurological deficit at up to 44 months of clinical follow-up. This is among the largest series of postnatal clinical follow-up in cases of prenatal diagnosis of dural venous sinus ectasia with thrombosis in the literature. Clinical follow-up suggests a good prognosis when antenatal follow-up shows partial or complete thrombus resolution.
    Pediatric Radiology 10/2013; DOI:10.1007/s00247-013-2745-7 · 1.65 Impact Factor
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    ABSTRACT: The mechanisms of cerebellar degeneration attributed to prolonged and excessive alcohol intake remain unclear. Additional or even alternative causes of cerebellar degeneration are often overlooked in suspected cases of alcohol-related ataxia. The objectives of this study were two fold: (1) to investigate the prevalence of gluten-related serological markers in patients with alcohol-related ataxia and; (2) to compare the pattern of brain involvement on magnetic resonance imaging between patients with alcohol and gluten ataxias. Patients diagnosed with alcohol and gluten ataxias were identified from a retrospective review of patients attending a tertiary clinic. HLA genotype and serological markers of gluten-related disorders were recorded. Cerebellar volumetry, MR spectroscopy and voxel-based morphometric analyses were performed on patients and compared with matched control data. Of 904 registered patients, 104 had alcohol ataxia and 159 had gluten ataxia. 61% of the alcohol ataxia group and 70% of the gluten ataxia group had HLA DQ2/DQ8 genotype compared to 30% in healthy local blood donors. 44% of patients with alcohol ataxia had antigliadin antibodies compared to 12% in the healthy local population and 10% in patients with genetically confirmed ataxias. None of the patients with alcohol ataxia and antigliadin antibodies had celiac disease compared to 40% in patients with gluten ataxia. The pattern of structural brain abnormality in patients with alcohol ataxia who had antigliadin antibodies differed from gluten ataxia and was identical to that of alcohol ataxia. Alcohol related cerebellar degeneration may, in genetically susceptible individuals, induce sensitization to gluten. Such sensitization may result from a primary cerebellar insult, but a more systemic effect is also possible. The duration and amount of exposure to alcohol may not be the only factors responsible for the cerebellar insult.
    PLoS ONE 10/2013; 8(10):e77638. DOI:10.1371/journal.pone.0077638 · 3.53 Impact Factor
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    ABSTRACT: Objective: To evaluate the capacity of a rapid T2 weighted three-dimensional (3D) sequence to diagnose foetal brain abnormalities by comparing the results with current two-dimensional (2D) methods. We have also made assessments of the estimates of energy deposition using those methods. Methods: 50 pregnant females were included in this study under the guidance of the institutional review board. All their foetuses had suspected brain abnormalities on antenatal ultrasonography or were at increased risk of a brain malformation based on the results of an earlier pregnancy. All the foetuses had a routine MR protocol that includes three orthogonal plane single-shot fast-spin echoes and 2D steady-state sequences. In addition, a 3D rapid steady-state sequence of the foetal brain was performed (acquisition time approximately 40 s), and the standard and 3D sequences were reported independently and the results were compared. The specific absorption rate (SAR) predicted by the scanner was recorded in 12 cases in order to estimate the energy deposited by the three sequences. Results: The 3D rapid steady-state sequences produced diagnostic-quality images in 41/50 (82%) cases. All the failures were in second trimester foetuses (9/26-35% failure rate). There was a discrepancy between the standard report and findings using the 3D sequence in 2/41 of the foetuses with good-quality 3D imaging. The predicted SAR deposition of the 3D steady-state sequences was comparable with the single-shot fast-spin echo sequence. Conclusion: Our initial assessments of a 3D rapid steady-state sequence to image the foetus are encouraging in terms of diagnostic information and acceptable energy deposition values. The high failure rate in second trimester foetuses probably relates to the greater mobility of the smaller foetuses, and improvements in the 3D sequence are required in terms of reduced acquisition time and higher resolution. Advances in knowledge: We have shown that 3D T2 weighted images of the foetal brain can be acquired in a clinical setting and produce diagnostic-quality imaging in a high proportion of cases. The success rate in acquiring diagnostic-quality images is related to gestational age. Good-quality images were obtained in all third trimester foetuses but only in approximately two-thirds of second trimester foetuses. This probably reflects the problem of the greater mobility of second trimester foetuses. 3D T2 weighted acquisitions have great potential for improving the antenatal diagnosis of foetal brain abnormalities and may reduce the time that a pregnant female needs to spend on the MR scanner.
    The British journal of radiology 10/2013; 86(1030):20130168. DOI:10.1259/bjr.20130168 · 1.53 Impact Factor
  • 09/2013; 03(04):285-298. DOI:10.1055/s-0032-1326504
  • F Williams, P D Griffiths
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    ABSTRACT: Spinal neural tube defects are a heterogeneous group of disorders, which remain relatively common, with a prevalence of 1-2 per 1000 live births despite advances in maternal antenatal care. They range from mild disorders with limited neurodevelopmental sequelae to extensive abnormalities with significant morbidity and mortality. The advent of in utero magnetic resonance imaging has enabled accurate anatomical characterization of an increasing number of abnormalities with increasing confidence. Recognition of the salient radiological features of these disorders and their relationship to the embryogenesis of the spinal cord and its coverings is now possible. This review describes the radiological appearances of these disorders with examples from Fetal Imaging Unit, University of Sheffield to illustrate the key anatomical and radiological features to aid the radiologist in their recognition.
    Clinical Radiology 09/2013; DOI:10.1016/j.crad.2013.07.019 · 1.66 Impact Factor
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    ABSTRACT: We have developed a Magnetic Resonance Imaging (MRI)-compatible system to enable gating of a scanner to the heartbeat of a foetus for cardiac, umbilical cord flow and other possible imaging applications. We performed radiofrequency safety testing prior to a fetal electrocardiogram (fECG) gated imaging study in pregnant volunteers (n = 3). A compact monitoring device with advanced software capable of reliably detecting both the maternal electrocardiogram (mECG) and fECG simultaneously was modified by the manufacturer (Monica Healthcare, Nottingham, UK) to provide an external TTL trigger signal from the detected fECG which could be used to trigger a standard 1.5 T MR (GE Healthcare, Milwaukee, WI, USA) gating system with suitable attenuation. The MR scanner was tested by triggering rapidly during image acquisition at a typical fetal heart rate (123 beats per minute) using a simulated fECG waveform fed into the gating system. Gated MR images were also acquired from volunteers who were attending for a repeat fetal Central Nervous System (CNS) examination using an additional rapid cardiac imaging sequence triggered from the measured fECG. No adverse safety effects were encountered. This is the first time fECG gating has been used with MRI and opens up a range of new possibilities to study a developing foetus.
    Sensors 09/2013; 13(9):11271-9. DOI:10.3390/s130911271 · 2.05 Impact Factor
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    ABSTRACT: Absent common carotid artery with independent origin of internal and external carotid arteries from the subclavian artery is a rare but recognized phenomenon. We describe one such case with an associated symptomatic proximal high-grade stenosis of the right internal carotid artery. The abnormal carotid anatomy was not initially well appreciated, resulting in a failed surgical exploration and subsequent successful endovascular carotid stenting. To our knowledge, this is the first reported case of carotid stent in a right internal carotid artery originating from the subclavian artery.
    Journal of vascular surgery: official publication, the Society for Vascular Surgery [and] International Society for Cardiovascular Surgery, North American Chapter 06/2013; 59(5). DOI:10.1016/j.jvs.2012.11.138 · 2.98 Impact Factor
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    ABSTRACT: Objective. To assess the natural history of isolated syringomyelia in children. Methods. MRI reports from February 2007 to August 2011 mentioning syrinx were identified on Sheffield Children's PACS database. Scans with syringes having an AP diameter of > 1 mm and extending over at least two vertebral bodies were reviewed. Patients with an identifiable cause such as a Chiari malformation were then excluded. Results. Thirty-nine patients were included with a mean age at diagnosis of 10.6 years. The average syrinx AP diameter was 3.30 mm. The rostrocaudal length of the syringes varied between 2 and 19 vertebral bodies. Twenty-seven out of 39 syringes were thoracic in origin. There were 3 and 6 syringes involving the cervicothoracic and thoracolumbar regions, respectively, with 3 involving the cervical area only. Eleven out of 39 (Group I) patients were found "incidentally" during work-up for adolescent idiopathic scoliosis and these were considered as a separate group. These patients did not have any significant symptoms and were discharged following their scoliosis correction surgery. Syrinx was incidental in 14 further patients (Group II). Of the 14 patients, 11 remained asymptomatic with no change in syrinx morphology throughout follow up. Of the 14 patients, 3 were lost to follow-up. Of the 39 patients, 14 (Group III) presented with progressive back pain without any obvious clinical cause. Of the 14, 10 either improved or remained the same. Of the14 patients, 3 underwent lumbar puncture, 1/14 having myelography. All 4/14 patients reported significant pain reduction on follow up following intervention. Conclusion. Idiopathic syrinx is a benign pathology, which can be managed expectantly. Most cases remain stable or improve over time. In a small minority who have progressive back pain, we have found that lumbar puncture may be helpful in reducing symptoms.
    British Journal of Neurosurgery 03/2013; 27(5). DOI:10.3109/02688697.2013.771728 · 0.95 Impact Factor
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    ABSTRACT: INTRODUCTION: Risk of further haemorrhage in patients suffering from arteriovenous malformation (AVM) would be eliminated only if complete obliteration of the AVM is obtained. Therefore, these patients frequently need long-term follow-up. Conventional catheter angiography (CCA) with a risk of 0.5 %.to 1.6 % of significant neurological complications has traditionally been used for this purpose. However, magnetic resonance imaging (MRI) at 3T may be a safer alternative. The aim of this study was to evaluate if MRI at 3T can accurately evaluate closure of AVM in 2 years after stereotactic radiosurgery. METHODS: Twenty-three patients with both MRI at 3T and a CCA study were examined. The residual AVMs were evaluated by MRI at 3T against CCA in a prospective study. RESULTS: The time interval between radiosurgery and neuroimaging was on average of 25 months (range, 15-30 months) for MRI study and 33 months (range, 25-46 months) for CCA study. Ten patients showed closure of the AVM on MRI, all of which were confirmed on CCA. CONCLUSION: There was a complete agreement between late MRI at 3T scan and CCA in evaluation of AVM patency.
    Neuroradiology 02/2013; 55(6). DOI:10.1007/s00234-013-1153-x · 2.37 Impact Factor
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    ABSTRACT: Purpose:To re-engineer a standard clinical magnetic resonance (MR) imaging system to enable the acquisition, in the same breath hold, of lung images from two hyperpolarized gases (helium 3 [(3)He] and xenon 129 [(129)Xe]) with simultaneous registered anatomic proton (hydrogen 1 [(1)H]) MR images of lung structure.Materials and Methods:Studies with (3)He and (129)Xe were performed with National Research Ethics Committee approval, with informed consent from the volunteer. (1)H-(3)He-(129)Xe MR imaging was achieved in the same breath by using mutually decoupled nested radiofrequency coil hardware capable of transmit and receive on each respective nucleus without power cross talk. MR pulse sequences were also developed for rapid switching between each nucleus. The system is demonstrated with triple-nuclear lung images in a healthy individual following inhalation of a mixture of (3)He and (129)Xe gases.Results:Spatially and temporally registered images of all three nuclei were obtained with high signal to noise ratio and high spatial resolution in the same breath.Conclusion:The multinuclear technique is capable of providing registered lung images with mutually complementary functional and structural spatial information.© RSNA, 2012.
    Radiology 12/2012; DOI:10.1148/radiol.12121153 · 6.21 Impact Factor
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    ABSTRACT: Osteogenesis imperfecta is a rare genetic disorder that leads to progressive skeletal deformities due to deficits in type I collagen, the main pathophysiologic effect of the disease. In addition, it may lead to a wide range of associated neurologic abnormalities: The central nervous system is usually involved because of softening of bone at the base of the skull, with resultant upward migration of the upper cervical spine and odontoid process into the skull base. Upward migration of the spine may cause compression of the brainstem, mechanical impingement of the spinal canal with restriction of cerebrospinal fluid circulation, and impingement of the cranial nerves. Osteogenesis imperfecta also may directly involve neurovascular structures, leading to cavernous fistulas of the carotid artery, dissection of the cervical arteries, and cerebral aneurysms. The brain parenchyma is frequently affected by the disease, with manifestations including cerebral atrophy, communicating hydrocephalus, and cerebellar hypoplasia. The imaging features of the disorder vary as widely as its clinical manifestations, depending on the severity of disease. Severe forms accompanied by debilitating skeletal fractures and progressive neurologic impairments may lead to perinatal death, whereas milder asymptomatic forms might cause only a modest reduction in life span. The most important advance in medical therapy for osteogenesis imperfecta has been the introduction of bisphosphonate therapy to slow the resorption of bone in patients with moderate to severe forms of the disease (ie, type III or IV). In some patients, neurosurgery may be necessary to correct the effects of severe basilar invagination by the odontoid process. © RSNA, 2012.
    Radiographics 11/2012; 32(7):2101-2112. DOI:10.1148/rg.327125716 · 2.73 Impact Factor
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    ABSTRACT: Proton magnetic resonance (MR) spectroscopy of the brain is a non-invasive, in vivo technique that allows investigation into regional chemical environments. Its complementary use with MR imaging sequences provides valuable insights into brain tumour characteristics, progression and response to treatment. Additionally, its sensitivity to brain dysfunction in the presence of apparently normal structural imaging has galvanised interest in its use as a biomarker of neurodegenerative disorders such as Alzheimer's disease. Accordingly, its integration into clinical imaging protocols within many neuroscience centres throughout the world is increasing. This growing attention is encouraging but if the potential of MR spectroscopy is to be realised, fundamental questions need to be addressed, such as reproducibility of the technique and the biochemistry that underpins the neurometabolites measured. Failure to resolve these issues will continue to hinder the extent and accuracy of conclusions that can be drawn from its data. In this review we discuss the issues regarding MR spectroscopy in the brain with particular attention paid to its technique. Key examples of current clinical applications are provided and future directions are discussed.
    Postgraduate medical journal 09/2012; 89(1048). DOI:10.1136/postgradmedj-2011-130471 · 1.55 Impact Factor

Publication Stats

3k Citations
750.53 Total Impact Points


  • 1998–2015
    • The University of Sheffield
      • • Department of Cardiovascular Science
      • • Academic Urology Unit
      Sheffield, England, United Kingdom
    • University of Cambridge
      • Department of Radiology
      Cambridge, ENG, United Kingdom
  • 2002–2012
    • Royal Berkshire NHS Foundation Trust
      Reading, England, United Kingdom
    • Johannes Gutenberg-Universität Mainz
      • Institute of Physics
      Mayence, Rheinland-Pfalz, Germany
  • 2009
    • Sheffield Teaching Hospitals NHS Foundation Trust
      Sheffield, England, United Kingdom
    • German Cancer Research Center
      • Division of Radiology
      Heidelberg, Baden-Wuerttemberg, Germany
  • 2007
    • University of Bath
      Bath, England, United Kingdom
    • Sheffield Children's NHS Foundation Trust
      Sheffield, England, United Kingdom
  • 2006
    • University of Oxford
      Oxford, England, United Kingdom
  • 1996
    • The Newcastle upon Tyne Hospitals NHS Foundation Trust
      • Department of Neuroradiology
      Newcastle upon Tyne, ENG, United Kingdom