Physiologic Evaluation of the Brain With Magnetic Resonance Imaging

MR imaging of the brain has advanced significantly in terms of quality, technique, and available advanced imaging sequences. It is crucial for the neurosurgeon to be aware of the available imaging tools in the diagnostic, treatment planning, and posttreatment stages, not only with regard to requesting specific imaging studies, but also to understand the value and limitations of specific techniques. In this chapter, we review conventional and advanced MR imaging techniques as they pertain to diagnostic and treatment planning, with descriptions tailored to provide an appropriate understanding for the neurosurgeon. Specific topics include conventional MR sequences, diffusion-weighted imaging, diffusor tensor imaging and tractography, MR angiography, cerebrospinal fluid (CSF) flow and CSF leak, MR imaging, perfusion imaging, permeability-weighted imaging, functional MRI, vessel wall imaging, MR spectroscopy, MR elastography, PET/MRI, and an introduction to simulation MR preoperative imaging.