Scholars@Duke
Timothy James Amrhein

Timothy James Amrhein

Associate Professor of Radiology
Radiology, Neuroradiology
Box 3808 Med Ctr, Durham, NC 27710
Dept of Radiology, Durham, NC 27710

Selected Publications

MRI Predictors of Cognitive Function After Lacunar Infarction.

Journal Article Stroke · July 2025 BACKGROUND: Poststroke cognitive impairment is associated with disability and decreased quality of life. We assessed whether individual or collective magnetic resonance imaging (MRI) biomarkers can aid in predicting cognitive impairment after lacunar infar ... Full text Link to item Cite

Optimization of Photon-Counting CT Myelography for the Detection of CSF-Venous Fistulas Using Convolutional Neural Network Denoising: A Comparative Analysis of Reconstruction Techniques.

Journal Article AJNR Am J Neuroradiol · June 19, 2025 BACKGROUND AND PURPOSE: Photon-counting detector CT myelography (PCD-CTM) is a recently described technique used for detecting spinal CSF leaks, including CSF-venous fistulas. Various image reconstruction techniques, including smoother-versus-sharper kerne ... Full text Link to item Cite

Density and Time Characteristics of CSF-Venous Fistulas on CT Myelography in Patients with Spontaneous Intracranial Hypotension.

Journal Article AJNR Am J Neuroradiol · April 2, 2025 BACKGROUND AND PURPOSE: The conspicuity of CSF-venous fistulas (CVFs) on specialized myelographic imaging protocols varies, and the factors that determine their visibility have not yet been extensively studied. The purpose of this study was to determine th ... Full text Link to item Cite

Hypersensitivity Reactions to Fibrin Glue during Epidural Blood Patching.

Journal Article AJNR Am J Neuroradiol · April 2, 2025 BACKGROUND AND PURPOSE: Fibrin glue is increasingly incorporated as a component in epidural blood patching (EBP) for the treatment of spinal CSF leaks. Hypersensitivity reactions are a potential complication of its use but are not well studied in the setti ... Full text Link to item Cite

Photon-Counting CT Myelography for the Detection of Spinal CSF Leaks.

Journal Article AJNR Am J Neuroradiol · April 2, 2025 Photon-counting CT myelography is a relatively recently described technique for the detection of spinal CSF leaks in patients with spontaneous intracranial hypotension.1-3 In this Video, we outline the fundamental procedural techniques used in CT myelograp ... Full text Link to item Cite

Diagnostic Performance of Renal Contrast Excretion on Early-Phase CT Myelography in Spontaneous Intracranial Hypotension.

Journal Article AJNR Am J Neuroradiol · January 8, 2025 BACKGROUND AND PURPOSE: Early opacification of the renal collecting system during CT myelography (CTM) performed for the evaluation of spontaneous intracranial hypotension (SIH) has been demonstrated in prior studies. However, these investigations often in ... Full text Link to item Cite

Spontaneous Intracranial Hypotension in Children: A Multi-Institutional Review of Spinal CSF Leaks Localized on Advanced Myelography.

Journal Article AJNR Am J Neuroradiol · December 9, 2024 Spontaneous intracranial hypotension is an increasingly recognized syndrome caused by a spinal CSF leak, with most reported cases occurring in adults. The use of specialized or advanced myelography to localize spinal CSF leaks has evolved substantially in ... Full text Link to item Cite

Spinal CSF Leaks: The Neuroradiologist Transforming Care.

Journal Article AJNR Am J Neuroradiol · November 7, 2024 Spinal CSF leak care has evolved during the past several years due to pivotal advances in its diagnosis and treatment. To the reader of the American Journal of Neuroradiology (AJNR), it has been impossible to miss the exponential increase in groundbreaking ... Full text Link to item Cite

Myelographic Techniques for the Localization of CSF-Venous Fistulas: Updates in 2024.

Journal Article AJNR Am J Neuroradiol · October 3, 2024 CSF-venous fistulas (CVFs) are a common cause of spontaneous intracranial hypotension. Despite their relatively frequent occurrence, they can be exceedingly difficult to detect on imaging. Since the initial description of CVFs in 2014, the recognition and ... Full text Link to item Cite

Diagnostic Yield of Decubitus CT Myelography for Detection of CSF-Venous Fistulas.

Journal Article AJNR. American journal of neuroradiology · October 2024 Background and purposeVarious imaging techniques have been described to detect CSF-venous fistulas in the setting of spontaneous intracranial hypotension, including decubitus CT myelography. The expected diagnostic yield of decubitus CT myelograph ... Full text Cite

The Importance of Planning Ahead: A Three-Dimensional Analysis of the Novel Trans-Facet Corridor for Posterior Lumbar Interbody Fusion Using Segmentation Technology.

Journal Article World Neurosurg · August 2024 BACKGROUND: The rise of minimally invasive lumbar fusions and advanced imaging technologies has facilitated the introduction of novel surgical techniques with the trans-facet approach being one of the newest additions. We aimed to quantify any pathology-dr ... Full text Open Access Link to item Cite

Diagnosis and Treatment of Spontaneous Intracranial Hypotension: Role of Epidural Blood Patching.

Journal Article Neurol Clin Pract · June 2024 PURPOSE OF REVIEW: This review focuses on the challenges of diagnosing and treating spontaneous intracranial hypotension (SIH), a condition caused by spinal CSF leakage. It emphasizes the need for increased awareness and advocates for early and thoughtful ... Full text Link to item Cite

Myelography Using Energy-Integrating Detector CT Versus Photon-Counting Detector CT for Detection of CSF-Venous Fistulas in Patients With Spontaneous Intracranial Hypotension.

Journal Article AJR Am J Roentgenol · April 2024 BACKGROUND. CSF-venous fistulas (CVFs), which are an increasingly recognized cause of spontaneous intracranial hypotension (SIH), are often diminutive in size and exceedingly difficult to detect by conventional imaging. OBJECTIVE. This purpose of this stud ... Full text Open Access Link to item Cite

Percutaneous Treatment and Post-treatment Management of CSF Leaks and CSF-Venous Fistulas in Spontaneous Intracranial Hypotension.

Journal Article Radiol Clin North Am · March 2024 Spontaneous intracranial hypotension (SIH) is a treatable cause of orthostatic headaches secondary to pathologic loss of cerebrospinal fluid (CSF) from the subarachnoid space. SIH has several known pathologic causes including dural tears from disc osteophy ... Full text Link to item Cite

Facets of facet joint interventions.

Journal Article Skeletal Radiol · October 2023 Facet joint (FJ) disease is a common cause of axial low back pain with many minimally invasive image-guided treatment options. This article discusses fluoroscopic and CT-guided intraarticular FJ injections, medial branch (MB) radiofrequency ablation (RFA), ... Full text Link to item Cite

Validity of the Bern Score as a Surrogate Marker of Clinical Severity in Patients with Spontaneous Intracranial Hypotension.

Journal Article AJNR Am J Neuroradiol · September 2023 BACKGROUND AND PURPOSE: The Bern score is a quantitative scale characterizing brain MR imaging changes in spontaneous intracranial hypotension. Higher scores are associated with more abnormalities on brain MR imaging, raising the question of whether the sc ... Full text Link to item Cite

Patient experience of spontaneous intracranial hypotension (SIH): qualitative interviews for concept elicitation.

Journal Article J Patient Rep Outcomes · August 15, 2023 BACKGROUND & OBJECTIVES: Spontaneous intracranial hypotension (SIH) is an underdiagnosed and debilitating condition caused by a spinal cerebrospinal fluid (CSF) leak. Although SIH can lead to substantial morbidity and disability, little data exists about p ... Full text Link to item Cite

Resisted Inspiration Improves Visualization of CSF-Venous Fistulas in Spontaneous Intracranial Hypotension.

Journal Article AJNR Am J Neuroradiol · August 2023 BACKGROUND AND PURPOSE: CSF-venous fistulas are an important cause of spontaneous intracranial hypotension but are challenging to detect. A newly described technique known as resisted inspiration has been found to augment the CSF-venous pressure gradient a ... Full text Link to item Cite

Utility of Photon-Counting Detector CT Myelography for the Detection of CSF-Venous Fistulas.

Journal Article AJNR Am J Neuroradiol · June 2023 CSF-venous fistulas are an increasingly recognized type of CSF leak that can be particularly challenging to detect, even with recently improved imaging techniques. Currently, most institutions use decubitus digital subtraction myelography or dynamic CT mye ... Full text Link to item Cite

Efficacy of Epidural Blood Patching or Surgery in Spontaneous Intracranial Hypotension: A Systematic Review and Evidence Map.

Journal Article AJNR Am J Neuroradiol · June 2023 BACKGROUND: Spontaneous intracranial hypotension is an important cause of treatable secondary headaches. Evidence on the efficacy of epidural blood patching and surgery for spontaneous intracranial hypotension has not been synthesized. PURPOSE: Our aim was ... Full text Link to item Cite

Image-Guided Spine Interventions for Pain: Ongoing Controversies.

Journal Article AJR Am J Roentgenol · May 2023 An expanding array of image-guided spine interventions have the potential to provide immediate and effective pain relief. Innovations in spine intervention have proceeded rapidly, with clinical adoption of new techniques at times occurring before the devel ... Full text Link to item Cite

The role of Artificial intelligence in the assessment of the spine and spinal cord.

Journal Article Eur J Radiol · April 2023 Artificial intelligence (AI) application development is underway in all areas of radiology where many promising tools are focused on the spine and spinal cord. In the past decade, multiple spine AI algorithms have been created based on radiographs, compute ... Full text Link to item Cite

Treatment Patterns and Health Care Resource Utilization of Iatrogenic Spinal Cerebrospinal Fluid Leaks in the United States.

Journal Article Clin Spine Surg · November 1, 2022 STUDY DESIGN: Retrospective cohort study. OBJECTIVE: We aimed to characterize the treatment patterns and the associated costs in patients with cerebrospinal fluid (CSF) leak after spine procedures in the United States. BACKGROUND: CSF leak is a common comp ... Full text Link to item Cite

Digital manometry to measure cerebrospinal fluid pressure during lumbar puncture.

Journal Article Neuroradiol J · August 2022 RATIONALE AND OBJECTIVES: Accurate cerebrospinal fluid (CSF) pressure measurements are critical for diagnosis and treatment of pathologic processes involving the central nervous system. Measuring opening CSF pressure using an analog device takes several mi ... Full text Link to item Cite

Efficacy of epidural blood patching or surgery in spontaneous intracranial hypotension: an evidence map protocol.

Journal Article Syst Rev · June 7, 2022 BACKGROUND: Spontaneous intracranial hypotension (SIH) is a debilitating disorder caused by non-iatrogenic spinal cerebrospinal fluid leaks. SIH is increasingly recognized as an important treatable cause of secondary headaches. Treatment involves either ep ... Full text Link to item Cite

Differentiation of Chiari malformation type 1 and spontaneous intracranial hypotension using objective measurements of midbrain sagging.

Journal Article J Neurosurg · June 1, 2022 OBJECTIVE: Chiari malformation type 1 (CM-1) and spontaneous intracranial hypotension (SIH) are causes of headache in which cerebellar tonsillar ectopia (TE) may be present. An accurate method for differentiating these conditions on imaging is needed to av ... Full text Link to item Cite

Dual energy CT for the identification of CSF-Venous Fistulas and CSF leaks in spontaneous intracranial hypotension: Report of four cases.

Journal Article Radiol Case Rep · May 2022 Spontaneous intracranial hypotension (SIH) is a debilitating condition caused by spinal CSF leaks or CSF-venous fistulas (CVFs). Localizing the causative CSF leak or CVF is critical for definitive treatment but can be difficult using conventional myelograp ... Full text Link to item Cite

Popping the balloon: Abrupt onset of a spinal CSF leak and spontaneous intracranial hypotension in idiopathic intracranial hypertension, a case report.

Journal Article Headache · February 2022 OBJECTIVES: Spontaneous intracranial hypotension (SIH) is a debilitating neurologic condition that is often thought of as separate from idiopathic intracranial hypertension (IIH). The unique case presented here details a spontaneous spinal cerebrospinal fl ... Full text Link to item Cite

CSF-Venous Fistulas: Anatomy and Diagnostic Imaging.

Journal Article AJR Am J Roentgenol · December 2021 CSF-venous fistulas (CVFs), first described in 2014, are an important cause of spontaneous intracranial hypotension. CVFs can be challenging to detect on conventional anatomic imaging because, unlike other types of spinal CSF leak, they do not typically re ... Full text Link to item Cite

Magnetic Resonance Imaging Abnormalities of the Optic Nerve Sheath and Intracranial Internal Carotid Artery in Giant Cell Arteritis.

Journal Article J Neuroophthalmol · March 1, 2021 BACKGROUND: Giant cell arteritis (GCA) is an important diagnostic consideration in elderly patients with vision changes. Superficial temporal artery biopsy (TAB) has long been considered the gold standard diagnostic approach for GCA, but MRI has gained int ... Full text Link to item Cite

Respiratory Phase Affects the Conspicuity of CSF-Venous Fistulas in Spontaneous Intracranial Hypotension.

Journal Article AJNR Am J Neuroradiol · September 2020 Spinal CSF-venous fistulas are a cause of spontaneous intracranial hypotension that can be difficult to detect on imaging. We describe how the respiratory phase affects the visibility of CSF-venous fistulas during myelography. ... Full text Link to item Cite

Risk for Nephrogenic Systemic Fibrosis After Exposure to Newer Gadolinium Agents: A Systematic Review.

Journal Article Ann Intern Med · July 21, 2020 BACKGROUND: The risk for nephrogenic systemic fibrosis (NSF) after exposure to newer versus older gadolinium-based contrast agents (GBCAs) remains unclear. PURPOSE: To synthesize evidence about NSF risk with newer versus older GBCAs across the spectrum of ... Full text Link to item Cite

Clinical Outcomes Following Surgical Ligation of Cerebrospinal Fluid-Venous Fistula in Patients With Spontaneous Intracranial Hypotension: A Prospective Case Series.

Journal Article Oper Neurosurg (Hagerstown) · March 1, 2020 BACKGROUND: Cerebrospinal fluid-venous fistula (CVF) is a recently described cause of spontaneous intracranial hypotension (SIH). Surgical ligation of CVF has been reported, but clinical outcomes are not well described. OBJECTIVE: To determine the clinical ... Full text Link to item Cite

Optimizing Diffusion-Tensor Imaging Acquisition for Spinal Cord Assessment: Physical Basis and Technical Adjustments.

Journal Article Radiographics · 2020 Diffusion-tensor imaging (DTI) has been used in the assessment of the central nervous system for the past 3 decades and has demonstrated great utility for the functional assessment of normal and pathologic white matter. Recent technical advances have permi ... Full text Link to item Cite

Author Correction: Human-machine partnership with artificial intelligence for chest radiograph diagnosis.

Journal Article NPJ Digit Med · December 10, 2019 An amendment to this paper has been published and can be accessed via a link at the top of the paper. ... Full text Link to item Cite

The Source and the Course of the Articular Branches to the T4-T8 Zygapophysial Joints.

Journal Article Pain Med · December 1, 2019 OBJECTIVE: To define the source and the course of the articular branches to the midthoracic zygapophysial ("z") joints. DESIGN: Cadaveric dissection. SETTING: The Gross Anatomy Laboratory of the Duke University School of Medicine. SUBJECTS: Ten human cadav ... Full text Link to item Cite

Spontaneous Intracranial Hypotension: Pathogenesis, Diagnosis, and Treatment.

Journal Article Neuroimaging Clin N Am · November 2019 Spontaneous intracranial hypotension (SIH) is a clinical syndrome that is increasingly recognized as an important and treatable secondary cause of headaches. Insight into the condition has evolved significantly over the past decade, resulting in a greater ... Full text Link to item Cite

CSF volume provocation maneuvers during lumbar puncture as a possible predictive tool for diagnosing spontaneous intracranial hypotension.

Journal Article Clin Neurol Neurosurg · November 2019 OBJECTIVES: Spontaneous intracranial hypotension (SIH) is a pathologic state of low CSF volume caused by a CSF to venous fistula or CSF leak. It is diagnosed based on symptoms, imaging, and CSF pressure but is often a diagnostic challenge because no single ... Full text Link to item Cite

Cross-sectional CT Assessment of the Extent of Injectate Spread at CT Fluoroscopy-guided Cervical Epidural Interlaminar Steroid Injections.

Journal Article Radiology · September 2019 Background Previous studies analyzed contrast agent spread during cervical interlaminar epidural steroid injections (CILESIs) by using planar fluoroscopy and reported wide variance of the rate of spread to the ventral epidural space (VES). Cross-sectional ... Full text Open Access Link to item Cite

Development and Performance of the Pulmonary Embolism Result Forecast Model (PERFORM) for Computed Tomography Clinical Decision Support.

Journal Article JAMA Netw Open · August 2, 2019 IMPORTANCE: Pulmonary embolism (PE) is a life-threatening clinical problem, and computed tomographic imaging is the standard for diagnosis. Clinical decision support rules based on PE risk-scoring models have been developed to compute pretest probability b ... Full text Link to item Cite

Comparative effectiveness of convolutional neural network (CNN) and recurrent neural network (RNN) architectures for radiology text report classification.

Journal Article Artif Intell Med · June 2019 This paper explores cutting-edge deep learning methods for information extraction from medical imaging free text reports at a multi-institutional scale and compares them to the state-of-the-art domain-specific rule-based system - PEFinder and traditional m ... Full text Link to item Cite

Decubitus CT Myelography for Detecting Subtle CSF Leaks in Spontaneous Intracranial Hypotension.

Journal Article AJNR Am J Neuroradiol · April 2019 Spontaneous intracranial hypotension is caused by spinal CSF leaks, but the site of the leak is not always detected on spinal imaging. We report on the additional value of decubitus positioning during CT myelography in enhancing the detection of subtle lea ... Full text Link to item Cite

Imaging Approach to Myelopathy: Acute, Subacute, and Chronic.

Journal Article Radiol Clin North Am · March 2019 Myelopathy refers to any pathologic process that involves the spinal cord, and can be caused by a variety of different diseases. MR imaging is the primary modality for evaluating the patient presenting with myelopathy. The first step must be the exclusion ... Full text Link to item Cite

Spontaneous Intracranial Hypotension: Imaging in Diagnosis and Treatment.

Journal Article Radiol Clin North Am · March 2019 This article reviews the role of imaging in the diagnosis, management, and treatment of spontaneous intracranial hypotension (SIH). SIH is a debilitating and often misdiagnosed condition caused by either a spinal cerebrospinal fluid (CSF) leak or a CSF to ... Full text Link to item Cite

Human-machine partnership with artificial intelligence for chest radiograph diagnosis.

Journal Article NPJ Digit Med · 2019 Human-in-the-loop (HITL) AI may enable an ideal symbiosis of human experts and AI models, harnessing the advantages of both while at the same time overcoming their respective limitations. The purpose of this study was to investigate a novel collective inte ... Full text Link to item Cite

Erratum: Author Correction: Human-machine partnership with artificial intelligence for chest radiograph diagnosis.

Journal Article NPJ Digit Med · 2019 [This corrects the article DOI: 10.1038/s41746-019-0189-7.]. ... Full text Link to item Cite

Deep learning for chest radiograph diagnosis: A retrospective comparison of the CheXNeXt algorithm to practicing radiologists.

Journal Article PLoS Med · November 2018 BACKGROUND: Chest radiograph interpretation is critical for the detection of thoracic diseases, including tuberculosis and lung cancer, which affect millions of people worldwide each year. This time-consuming task typically requires expert radiologists to ... Full text Link to item Cite

Combination of exome sequencing and immune testing confirms Aicardi-Goutières syndrome type 5 in a challenging pediatric neurology case.

Journal Article Cold Spring Harb Mol Case Stud · October 2018 Exome sequencing is increasingly being used to help diagnose pediatric neurology cases when clinical presentations are not specific. However, interpretation of equivocal results that include variants of uncertain significance remains a challenge. In those ... Full text Link to item Cite

CT Fluoroscopy-Guided Interlaminar Epidural Steroid Injections in the Cervical Spine: Rate of Nontarget Injection Into the Retrodural Space of Okada.

Journal Article AJR Am J Roentgenol · August 2018 OBJECTIVE: The purpose of this study was to assess the rate of inadvertent injection into the retrodural space of Okada during CT fluoroscopy-guided interlaminar epidural steroid injection in the cervical spine. MATERIALS AND METHODS: Images from cases of ... Full text Link to item Cite

Approach to Imaging in Patients with Spontaneous Intracranial Hemorrhage.

Journal Article Neuroimaging Clin N Am · August 2018 Spontaneous intracranial hemorrhage is a commonly encountered neurologic emergency. Imaging plays important roles in both guiding the emergent stabilization of patients with ICH and in elucidating the etiology of the hemorrhage to prevent rebleeding. A tho ... Full text Link to item Cite

Spontaneous Intracranial Hypotension: 10 Myths and Misperceptions.

Journal Article Headache · July 2018 OBJECTIVE: To discuss common myths and misperceptions about spontaneous intracranial hypotension (SIH), focusing on common issues related to diagnosis and treatment, and to review the evidence that contradicts and clarifies these myths. BACKGROUND: Recogni ... Full text Link to item Cite

Deep Learning to Classify Radiology Free-Text Reports.

Journal Article Radiology · March 2018 Purpose To evaluate the performance of a deep learning convolutional neural network (CNN) model compared with a traditional natural language processing (NLP) model in extracting pulmonary embolism (PE) findings from thoracic computed tomography (CT) report ... Full text Link to item Cite

CSF Venous Fistulas in Spontaneous Intracranial Hypotension: Imaging Characteristics on Dynamic and CT Myelography.

Journal Article AJR Am J Roentgenol · December 2017 OBJECTIVE: The objective of this study is to describe the anatomic and imaging features of CSF venous fistulas, which are a recently reported cause of spontaneous intracranial hypotension (SIH). MATERIALS AND METHODS: We retrospectively reviewed the record ... Full text Link to item Cite

Incidence of Inadvertent Dural Puncture During CT Fluoroscopy-Guided Interlaminar Epidural Corticosteroid Injections in the Cervical Spine: An Analysis of 974 Cases.

Journal Article AJR Am J Roentgenol · September 2017 OBJECTIVE: The objective of this study is to determine the rate of inadvertent dural puncture during CT fluoroscopy-guided cervical interlaminar epidural corticosteroid injection. In addition, in a subanalysis, we aim to assess the rate of inadvertent dura ... Full text Link to item Cite

Update on the Diagnosis and Treatment of Spontaneous Intracranial Hypotension.

Journal Article Curr Pain Headache Rep · August 2017 PURPOSE OF REVIEW: The purpose of this study is to provide an update on recent developments in the understanding, diagnosis, and treatment of spontaneous intracranial hypotension (SIH). RECENT FINDINGS: SIH is an important cause of headaches caused by spin ... Full text Link to item Cite

Performance of a Machine Learning Classifier of Knee MRI Reports in Two Large Academic Radiology Practices: A Tool to Estimate Diagnostic Yield.

Journal Article AJR Am J Roentgenol · April 2017 OBJECTIVE: The purpose of this study is to evaluate the performance of a natural language processing (NLP) system in classifying a database of free-text knee MRI reports at two separate academic radiology practices. MATERIALS AND METHODS: An NLP system tha ... Full text Link to item Cite

Reformatted images improve the detection rate of acute traumatic subdural hematomas on brain CT compared with axial images alone.

Journal Article Emerg Radiol · February 2017 Subdural hematomas (SDHs) comprise a significant percentage of missed intracranial hemorrhage on axial brain CT. SDH detection rates could be improved with the addition of reformatted images. Though performed at some centers, the potential additional diagn ... Full text Link to item Cite

Inadvertent Intrafacet Injection during Lumbar Interlaminar Epidural Steroid Injection: A Comparison of CT Fluoroscopic and Conventional Fluoroscopic Guidance.

Journal Article AJNR Am J Neuroradiol · February 2017 BACKGROUND AND PURPOSE: Inadvertent intrafacet injection can occur during interlaminar epidural steroid injection, resulting in a false-positive loss of resistance and nontarget injection of medication. The purpose of this investigation was to compare the ... Full text Link to item Cite

Non-dysbaric arterial gas embolism associated with chronic necrotizing pneumonia, bullae and coughing: a case report.

Journal Article Undersea Hyperb Med · 2017 Arterial gas embolism (AGE) can be clinically devastating, and is most often associated with exposure to changes in ambient pressure, medical procedure or congenital malformation. Here we report a case of AGE in a 78-year-old male without these traditional ... Full text Link to item Cite

Time-Dependent Changes in Dural Enhancement Associated With Spontaneous Intracranial Hypotension.

Journal Article AJR Am J Roentgenol · December 2016 OBJECTIVE: The objective of our study was to determine whether the presence of individual imaging signs of spontaneous intracranial hypotension (SIH) is correlated with increasing duration of headache symptoms. Of particular interest is the relationship of ... Full text Link to item Cite

How common is normal cerebrospinal fluid pressure in spontaneous intracranial hypotension?

Journal Article Cephalalgia · November 2016 Objectives To determine the proportion of patients with spontaneous intracranial hypotension (SIH) who had a cerebrospinal fluid (CSF) pressure >6 cm H2O and to investigate the clinical and imaging variables associated with CSF pressure ( PCSF) in this con ... Full text Link to item Cite

CT Fluoroscopy-Guided Blood Patching of Ventral CSF Leaks by Direct Needle Placement in the Ventral Epidural Space Using a Transforaminal Approach.

Journal Article AJNR Am J Neuroradiol · October 2016 BACKGROUND AND PURPOSE: Epidural blood patch treatment of spontaneous intracranial hypotension arising from ventral CSF leaks can be difficult secondary to challenges in achieving ventral spread of patching material. The purpose of this study was to determ ... Full text Link to item Cite

Technique for CT Fluoroscopy-Guided Lumbar Medial Branch Blocks and Radiofrequency Ablation.

Journal Article AJR Am J Roentgenol · September 2016 OBJECTIVE: The purpose of this study is to describe the procedure for CT fluoroscopy-guided lumbar medial branch blocks and facet radiofrequency ablation. CONCLUSION: CT fluoroscopic guidance allows more-precise needle tip positioning and is an alternative ... Full text Link to item Cite

Childhood-onset Systemic Lupus Erythematosus Complicated by Posterior Reversible Encephalopathy Syndrome in the Context of Kidney Dialysis and Plasma Exchange in Pediatric Lupus

Journal Article Journal of Pediatric Neurology · September 1, 2016 Posterior reversible encephalopathy syndrome (PRES) is a neurotoxic condition characterized by reversible vasogenic edema on neuroimaging. Its various manifestations include altered mental status, headache, visual changes, and seizure activity along with a ... Full text Cite

The "Hyperdense Paraspinal Vein" Sign: A Marker of CSF-Venous Fistula.

Journal Article AJNR Am J Neuroradiol · July 2016 CSF-venous fistula is a recently reported cause of spontaneous intracranial hypotension that may occur in the absence of myelographic evidence of CSF leak. Information about this entity is currently very limited, but it is of potential importance given the ... Full text Link to item Cite

Imaging Signs in Spontaneous Intracranial Hypotension: Prevalence and Relationship to CSF Pressure.

Journal Article AJNR Am J Neuroradiol · July 2016 BACKGROUND AND PURPOSE: Patients with spontaneous intracranial hypotension often exhibit low CSF pressure and changes on brain MR imaging and/or evidence of CSF leak on myelography. We investigated whether individual imaging signs of spontaneous intracrani ... Full text Link to item Cite

Reducing Patient Radiation Exposure From CT Fluoroscopy-Guided Lumbar Spine Pain Injections by Targeting the Planning CT.

Journal Article AJR Am J Roentgenol · February 2016 OBJECTIVE: CT fluoroscopy-guided lumbar spine pain injections typically include a preprocedural planning CT that contributes considerably to patient dose. The purpose of this study was to quantify the degree of radiation exposure reduction achieved by modi ... Full text Link to item Cite

Myelographic Techniques for the Detection of Spinal CSF Leaks in Spontaneous Intracranial Hypotension.

Journal Article AJR Am J Roentgenol · January 2016 OBJECTIVE: Spinal leakage of CSF causes almost all cases of spontaneous intracranial hypotension. Leak detection and localization are important for both diagnosis and treatment. The myelographic appearance of the leaks may vary, however, depending on the c ... Full text Link to item Cite

Incidence of Inadvertent Intravascular Injection during CT Fluoroscopy-Guided Epidural Steroid Injections.

Journal Article AJNR Am J Neuroradiol · May 2015 BACKGROUND AND PURPOSE: Inadvertent intravascular injection during epidural steroid injection can result in complications and has been investigated previously with conventional fluoroscopy, but not CT fluoroscopy. The purpose of this study was to determine ... Full text Link to item Cite

Spontaneous brain parenchymal hemorrhage: an approach to imaging for the emergency room radiologist.

Journal Article Emerg Radiol · February 2015 Spontaneous intracranial hemorrhage is a neurological emergency commonly encountered by the emergency radiologist. This article reviews the approach to spontaneous brain parenchymal hemorrhage, including common causes and the role of various neuroimaging m ... Full text Link to item Cite

Instituting a radiology residency scholarly activity program.

Journal Article Educ Health (Abingdon) · 2015 BACKGROUND: The purpose of this manuscript is to present a newly instituted program for resident scholarly activity that includes a curriculum designed to enhance resident training with regard to research while meeting requirements established by the Accre ... Full text Link to item Cite

Physician self-referral and imaging use appropriateness: negative cervical spine MRI frequency as an assessment metric.

Journal Article AJNR Am J Neuroradiol · December 2014 BACKGROUND AND PURPOSE: Imaging self-referral is increasingly cited as a contributor to diagnostic imaging overuse. The purpose of this study was to determine whether ownership of MR imaging equipment by ordering physicians influences the frequency of nega ... Full text Link to item Cite

Neuroradiology: Brain

Chapter · November 3, 2014 Cite

Rebound intracranial hypertension: a complication of epidural blood patching for intracranial hypotension.

Journal Article AJNR Am J Neuroradiol · June 2014 Rebound intracranial hypertension is a complication of epidural blood patching for treatment of intracranial hypotension characterized by increased intracranial pressure, resulting in potentially severe headache, nausea, and vomiting. Because the symptoms ... Full text Link to item Cite

Back pain

Chapter · January 1, 2014 Low-back pain (LBP) is a common presenting complaint to the primary care physician and in the emergency department. In the majority of cases, symptoms arise from benign conditions that do not merit emergent imaging studies. There are several causes, howeve ... Full text Cite

Physician self-referral: frequency of negative findings at MR imaging of the knee as a marker of appropriate utilization.

Journal Article Radiology · December 2013 PURPOSE: To determine whether ownership of magnetic resonance (MR) imaging equipment by ordering physicians affects the likelihood of positive findings at MR imaging of the knee and to evaluate rates of knee abnormalities seen at MR imaging as a metric for ... Full text Link to item Cite

Journal Club: Shoulder MRI utilization: relationship of physician MRI equipment ownership to negative study frequency.

Journal Article AJR Am J Roentgenol · September 2013 OBJECTIVE: The purpose of this article is to determine whether ownership of MRI equipment by ordering physicians influences the frequency of negative shoulder MRI scans. MATERIALS AND METHODS: A retrospective review was performed of 1140 consecutive should ... Full text Link to item Cite

Mn porphyrins as novel molecular magnetic resonance imaging contrast agents.

Journal Article J Endourol · November 2012 BACKGROUND AND PURPOSE: In this study, we investigated the potential of a new class of therapeutic Mn porphyrins as molecular MRI probes for prostate cancer imaging. Two compounds of different bioavailibility were investigated: Mn(III) meso-tetrakis(N-ethy ... Full text Link to item Cite

Vascular radiology

Chapter · January 19, 2012 Cite

Vascular radiology: Case 20

Chapter · January 19, 2012 Cite

T2 Contrast

Chapter · 2012 Full text Cite

Phase Contrast

Chapter · 2012 Full text Cite

Mn-porphyrins as novel molecular magnetic resonance imaging contrast agents.

Journal Article J Endourol · November 3, 2011 BACKGROUND AND PURPOSE: In this study, we investigated the potential of a new class of therapeutic Mn porphyrins as molecular MRI probes for prostate cancer imaging. Two compounds of different bioavailibility were investigated: Mn(III) meso-tetrakis(N-ethy ... Full text Link to item Cite

Bronchial artery arising from the left vertebral artery: case report and review of the literature.

Journal Article J Clin Imaging Sci · 2011 Knowledge of bronchial artery anatomy, including the possible locations of anomalous origin, is essential for complete catheter directed embolization for massive hemoptysis. Undetected anomalous bronchial arteries can be a source of failed bronchial artery ... Full text Link to item Cite

Perioperative management of intracranial aneurysms and otologic disease.

Journal Article Laryngoscope · January 2007 OBJECTIVE: Diagnosis and treatment of asymptomatic, unruptured intracranial aneurysms (UIA) are areas of longstanding controversy in the neurologic and neurosurgical literature. Treatment decisions require careful consideration of both the potential for an ... Full text Link to item Cite