Theoretical principles of image formation in magnetic resonance tomography are outlined in the paper, with special emphasis on the phenomena of spin of atomic nuclei, precession of protons in the magnetic field, and magnetic resonance itself. Principles underlying MR imaging with various temporal parameters in sequences T1, T2 and PD are presented.
Criteria of diagnosing neoplastic cerebral tumors on the grounds of CT scans and MR images are presented. Practical value of these criteria for CT diagnostics of various types of neoplasms is discussed in detail, with general comments on MRI potential for evaluation of tumors. Typical features of hypophyseal tumors ill both these imaging techniques are described in a separate part of the paper.
Proliferating process within the vertebral canal is one of the main indications for MRI examination. The latter allows to differentiate between intra- and extramedullary tumors, as well as between sub- and extradural ones. The tumor may be precisely localized; besides, its size and relation to the vertebral column and its surrounding tissues can be evaluated. Assessment of both the degree and type of post-contrast enhancement helps to define the structure of the tumor. In the case of intramedullary processes, the tumor can be distinguished from the swelling area, and the image of real magnitude of the alteration can be obtained. In cases of supradural tumors contrast agents are administered in order to evaluate treatment efficacy and the degree of the medulla infiltration.
The great potential of MRI for the diagnosis of inflammatory processes in the brain and spinal cord is discussed in the paper. The technique can produce images in all planes, precisely locate pathological changes in relation to bones, meninges and the cerebrospinal fluid spaces. Besides, it can show deep subcortical structures. Examples are presented of multifocal bacterial encephalitis and of abscesses of the brain on MR images without and with enhancement by means of contrast media containing Gadolinium. MR images of viral encephalitis frequently manifest specific patterns due to different neurotropism of particular viruses.
The most frequently occurring phakomatosis, as well as their etiology, histological structure, and clinical pattern in radiological and MR tomography are outlined in the paper. Special attention is paid to the diagnostic value of MRI in this group of diseases.
An overview of the present knowledge on the causes and treatment of trigeminal neuralgia is presented. Compression of the trigeminal nerve root by a blood vessel is discussed as a possible pathogenic factor in this condition, and perspectives of its surgical treatment are considered.
The introduction of MRI MS opened new perspectives, also in the traumatology of the vertebral column. Using this method it is possible to show post-traumatic pathology of intervertebral disks and of the ligament apparatus, which is of crucial importance not only for the diagnostics of alterations resulting from pressure exerted by the damaged disk, but also for the evaluation of the vertebral column stability. On these grounds all appropriate treatment method can be chosen. A clinical MRI study of 70 patients with injury of the vertebral column and post-traumatic spinal cord lesions is presented in the paper.
Etymology and meaning of the term "leukoaraiosis", as well as hypothetical mechanisms of the condition development are discussed. In the literature relations are reported between periventricular lesions of the white matter and arterial hypertension, arteriosclerosis, other vascular diseases, diabetes, etc. Moreover, relationship between leukoaraiosis and the Alzheimer disease has been investigated. The pathogenesis of leukoaraiosis is not quite clear yet, nevertheless, pathology of small vessels penetrating deep into the white matter of the cerebral hemispheres is considered to be an important etiological factor in the disease. Some research findings reported in the literature indicate marked cognitive deficits in patient with MRI changes typical of leukoaraiosis. Reduced dynamics and drive, characteristic of the frontal lobe dysfunction, seem to predominate in the clinical pattern of leukoaraiosis.
The paper presents etiopathogenesis, diagnostic criteria, clinical symptoms and laboratory tests in systemic lupus erythematosus (SLE), a condition difficult to diagnose. The recommended treatment is also described, consisting in a combined immunosuppressive medication, significantly improving prognosis in this disease.
Crucial problems of the systemic angiitis are discussed. including current views, on the condition pathogenesis, classification and treatment. Clinical patterns of major nosological units, taking into account changes in the central and peripheral nervous system are presented.
Immunomodulatory treatment by means of the inductor of the endogenous KP-45 interferon injected either intrathecally or intraventricularly with simultaneous oral administration of Isoprinosine is discussed. A follow-up study indicated that this method of treatment, as compared to other immunomodulatory medications and to outcome in a control group of untreated patients, yielded the best results.
Immunopathogenesis of myasthenia was discussed on the grounds of current experimental and clinical studies. Reported research findings indicate the autoimmunological character of the disease. They also suggest that neuromuscular transmission disorders found in this condition result from blacking the postsynaptic membrane receptor sites by blood antibodies directed against acetylcholine receptors. In the second part of the paper methods used presently in the treatment of myasthenia are described.
The paper presents various types of osteomalacia, with the focus on that being a side effect of anti-epileptic drugs. The clinical pattern and risk factors affecting the mineral and bone metabolism are discussed. The importance of early prevention of bone alterations in patients receiving long-term anticonvulsant medication is emphasized.
Inflammatory demyelinating polyradiculoneuropathy, especially in its acute form (the Guillain-Barre syndrome) is often the cause of flaccid pareses. Etiology of this immunological condition is frequently unknown. In severe forms of the disease good therapeutic effects may be obtained with plasmaferesis or intravenous injections of human immunoglobulin. The monitoring of respiratory and vascular sufficiency is most important, and so is symptomatic treatment. In justifiable cases immunosuppressive medication may be applied.
An attempt was made to outline the development of approaches to one of the basic cognitive processes – attention. It is difficult not only to define attention, but also to investigate its underlying mechanisms. In the paper general theories and experimental models of attention are discussed, as well as concepts concerning the relationship between various forms and aspects of the process in question, and the CNS structures and neurochemical mechanisms. In the final part of the paper theoretical concepts dealing with attention-concentration deficits in schizophrenic patients are briefly outlined. According to hypotheses put forward by many authors, the latter deficits are the core of schizophrenia.