Clinical Neuroradiology最新文献

{"title":"60. Jahrestagung der Deutschen Gesellschaft für Neuroradiologie e. V. und 32. Jahrestagung der Österreichischen Gesellschaft für Neuroradiologie e. V. Salzburg Congress.","authors":"","doi":"10.1007/s00062-025-01556-x","DOIUrl":"10.1007/s00062-025-01556-x","url":null,"abstract":"","PeriodicalId":10391,"journal":{"name":"Clinical Neuroradiology","volume":" ","pages":"1-115"},"PeriodicalIF":2.6,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145198598","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Tmax 10 Volume Is Independently Associated with NWU Delta in Large Core Stroke.","authors":"Vivek Yedavalli, Hamza Adel Salim, Dhairya A Lakhani, Aneri Balar, Janet Mei, Thanh N Nguyen, Adrien Guenego, Adam A Dmytriw, Jens Fiehler, Paul Stracke, Gabriel Broocks, Christian Heitkamp, Max Wintermark, Gregory W Albers, Jeremy J Heit, Tobias D Faizy","doi":"10.1007/s00062-025-01569-6","DOIUrl":"10.1007/s00062-025-01569-6","url":null,"abstract":"<p><strong>Background: </strong>In patients with acute ischemic stroke due to large vessel occlusion (AIS-LVO) and large ischemic cores, there is a need for reliable imaging biomarkers to predict cerebral edema growth. We investigated the association between severely hypoperfused tissue, measured by time-to-maximum greater than 10 s (Tmax > 10 s) volume, and net water uptake (∆NWU) progression.</p><p><strong>Methods: </strong>This multicenter retrospective cohort study involved AIS-LVO patients with ASPECTS ≤ 5, undergoing EVT at two comprehensive stroke centers between January 2013 and December 2019. We investigated the relationship between Tmax > 10 s volume derived from perfusion imaging and ∆NWU measured on non-contrast head CT images, hypothesizing that larger Tmax > 10 s volumes are indicative of greater edema growth in large core strokes.</p><p><strong>Results: </strong>A total of 95 patients (median age, 74 years; 55% women) were included. After adjustment for age, sex, glucose, intravenous thrombolysis, admission NIHSS, ASPECTS, Tan collateral score, last known well-to-CT time, and EVT, higher Tmax > 10 s volume (β, -0.34; P = 0.043) and lower ASPECTS (β, -0.30; P = 0.035) were independently associated with greater ∆NWU.</p><p><strong>Conclusion: </strong>The study highlights the importance of considering severe pretreatment hypoperfusion, as reflected by larger Tmax > 10 s volumes, in predicting cerebral edema growth in AIS-LVO patients, which could inform clinical strategies, emphasizing the need for larger prospective studies to validate and explore implications.</p>","PeriodicalId":10391,"journal":{"name":"Clinical Neuroradiology","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145198639","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Midsagittal Midbrain Area and Midbrain-to-Pons-Ratio Cannot Distinguish Overlap Syndromes Between Amyotrophic Lateral Sclerosis and Progressive Supranuclear Palsy.","authors":"Daniel Cantré, Jochem König, Caroline Makowsky, Martin Dyrba, Johannes Prudlo","doi":"10.1007/s00062-025-01564-x","DOIUrl":"https://doi.org/10.1007/s00062-025-01564-x","url":null,"abstract":"<p><strong>Purpose: </strong>When amyotrophic lateral sclerosis (ALS), a TDP-43 proteinopathy, and progressive supranuclear palsy (PSP), a tauopathy, are associated with frontotemporal dementia (ALS-FTD or PSP-FTD), clinical differentiation can be challenging. There are no established imaging biomarkers to differentiate ALS-FTD from PSP-FTD.</p><p><strong>Methods: </strong>We evaluated the midsagittal midbrain area (MBA) and the midbrain-to-pons-(MB/P)-ratios in T1 MPRAGE MRI of 36 PSP cases (n = 14 PSP-FTD), 77 ALS cases (n = 10 ALS-FTD), and 72 healthy controls (HC).</p><p><strong>Results: </strong>In ALS, both parameters were indistinguishable from HC. Patients with ALS-FTD had low MBA-values and MB/P-ratios not significantly different from cases of PSP. While ROC-analyses provided an excellent diagnostic accuracy of both parameters for differentiating PSP from HC (AUC_MBA = 0.974) as well as PSP from ALS (AUC_MBA = 0.982), midbrain morphometry provided poor diagnostic accuracy for distinguishing ALS-FTD from PSP-FTD (AUC_MBA = 0,614).</p><p><strong>Conclusion: </strong>The MBA and the MB/P-ratio are morphometric parameters that have proven reliable in atypical Parkinsonian syndromes. Both can distinguish between PSP and ALS in their typical clinical forms. However, they cannot differentiate between PSP-FTD and ALS-FTD.</p>","PeriodicalId":10391,"journal":{"name":"Clinical Neuroradiology","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145039257","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Vertebral Artery Dominance Patterns in Embolic Basilar Artery Occlusion: Insights Toward Embolus Trajectory.","authors":"Daryl Goldman, Emery Monnig, Amol Mehta, Christopher P Kellner, J Mocco, Johanna Fifi, Reade De Leacy, Hazem Shoirah, Shahram Majidi, Mehrdad Emami, Michael Travis Caton, Tomoyoshi Shigematsu","doi":"10.1007/s00062-025-01566-9","DOIUrl":"https://doi.org/10.1007/s00062-025-01566-9","url":null,"abstract":"<p><strong>Purpose: </strong>Embolic basilar artery occlusion (eBAO) is less common than embolic anterior circulation stroke. The anatomic basis for this discrepancy is not understood. Vertebral artery dominance (VAD) correlates with blood flow to the basilar artery. We hypothesized that left VAD is less common in eBAO, as the right vertebral artery is the more proximal to the heart in typical aortic arch anatomy.</p><p><strong>Methods: </strong>This retrospective single-center, case-control study identified cases of eBAO. Right, left, and co-dominant (RVAD, LVAD, and CVAD) prevalence was calculated in standardized fashion by CTA. To estimate the VAD prevalence in asymptomatic patients, a systematic review and metanalysis was performed. The pooled estimate of VAD prevalence in the asymptomatic group was compared to the eBAO cohort using χ² test.</p><p><strong>Results: </strong>In total, 72 eBAO were identified in the institutional cohort, and prevalence of LVAD, RVAD, and CVAD was 23.6%, 33.3%, and 43.1% respectively. Systematic review included eight studies and 1813 asymptomatic patients. Mean VAD prevalence in the asymptomatic population was LVAD 47.0% (39.0-55.1%), RVAD 26.9% (22.7-31.5%), and CVAD 25.9% (18.8-34.7%). VAD proportions differed significantly in the eBAO group (p < 0.001), with lower proportion of LVAD (OR 0.37, CI 0.20-0.67, p < 0.001), higher proportion of CVAD (OR 1.89, CI 1.13-3.13, p = 0.01) but no difference in RVAD (1.39, CI 0.81-2.35, p = 0.22).</p><p><strong>Conclusion: </strong>LVAD is significantly less common in patients with eBAO compared to asymptomatic patients. Non-LVAD anatomy (RVAD and CVAD) may represent a novel anatomic risk factor for eBAO. This finding could influence techniques for endovascular thrombectomy.</p>","PeriodicalId":10391,"journal":{"name":"Clinical Neuroradiology","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145032753","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Intracranial Rescue Stenting in Pediatric Focal Cerebral Arteriopathy.","authors":"Saujanya Rajbhandari, Philipe Breiding, Iciar Sanchez-Albisua, Daniel Brechbühl, Sandrine Cornaz Buros, Gabriela Oesch Nemeth, Johannes Kaesmacher, Lorenz Grunder, Petra Cimflova, Eike Piechowiak, David Seiffge, Maja Steinlin, Jan Gralla, Andrea Klein, Tomas Dobrocky","doi":"10.1007/s00062-025-01563-y","DOIUrl":"https://doi.org/10.1007/s00062-025-01563-y","url":null,"abstract":"<p><strong>Background: </strong>Pediatric acute ischemic stroke is a rare yet severe condition with multifactorial etiology, often associated with vasculopathies. Endovascular intervention in children with focal cerebral arteriopathy is seldom reported.</p><p><strong>Purpose: </strong>Our aim was to report feasibility of intracranial rescue stenting for the management of pediatric focal cerebral arteriopathy with flow-limiting stenosis.</p><p><strong>Methods: </strong>We report a toddler with acute ischemic stroke due to flow-limiting focal cerebral arteriopathy of the left middle cerebral artery, treated with intracranial stenting. A comprehensive literature search was conducted in PubMed, Web of Science, Embase, and Scopus to identify case reports and series involving pediatric patients with acute ischemic stroke treated with intracranial stenting. Six cases met inclusion criteria. Extracted data included demographics (age, sex), clinical presentation, time of onset, medical history, occlusion location and etiology, stent type, pre- and post-stent NIHSS scores, antiplatelet therapy, and clinical outcomes at follow-up.</p><p><strong>Results: </strong>A total of six pediatric acute ischemic stroke cases with intracranial stent deployment in the acute stage were analyzed. The supraclinoid internal carotid artery was the most common site of stent deployment (4/6), while intracranial dissection was the most frequent cause of vessel occlusion (3/6). All included patients achieved resolution of the initial neurological deficit on follow-up (range: 6 weeks to 6 months). Variation in the use of intraoperative and postoperative antiplatelet regimens was observed.</p><p><strong>Conclusions: </strong>This case demonstrates off-label rescue stenting in pediatric acute ischemic stroke due to focal cerebral arteriopathy, emphasizing the importance of individualized multidisciplinary management in this rare setting.</p>","PeriodicalId":10391,"journal":{"name":"Clinical Neuroradiology","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145022975","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Safety and Efficacy of Intracranial Stenting in Acute Stroke Patients Using a Pharmacological Treatment Protocol Including Low-Dose Intra-arterial Eptifibatide-A Single-center Retrospective Analysis.","authors":"Itamar Gothelf, Gal Ben Arie, Farouq Alguyan, Adi Shiloh, Dar Margalit, Liraz Henkin, Lior Abulaf, Ksenia Shabad, Asaf Honig, Anat Horev","doi":"10.1007/s00062-025-01565-w","DOIUrl":"https://doi.org/10.1007/s00062-025-01565-w","url":null,"abstract":"<p><strong>Purpose: </strong>Emergent intracranial stenting (EICS) has demonstrated efficacy in managing intracranial stenosis in patients undergoing mechanical thrombectomy (MT) for acute ischemic stroke. However, an optimal pharmacological regimen balancing thrombosis prevention and hemorrhagic risk following stent deployment remains undefined. This study aimed to assess the safety and efficacy of prophylactic low-dose intra-arterial Eptifibatide following EICS.</p><p><strong>Methods: </strong>This single-center retrospective study included 57 consecutive patients who underwent EICS following MT due to an underlying intracranial stenosis. Patients received intravenous heparin and Aspirin pre-stenting, followed by prophylactic low-dose intra-arterial Eptifibatide post-stenting. Univariate and multivariable logistic regression analyses were conducted to identify factors associated with 90-day functional outcomes, categorized as favorable (modified Rankin Scale [mRS] 0-2) and non-favorable (mRS 3-6).</p><p><strong>Results: </strong>Among 57 patients who underwent EICS, 93.0% (n = 53) received a balloon-mounted coronary stent. Successful recanalization (TICI 2b/3) was achieved in 93.0% of cases. Intracranial hemorrhage was detected in 8.8% within 24 h post-procedure. The median mRS score at 90 days was 3.5 (IQR 1-6), with 40.4% of patients achieving favorable functional outcomes (mRS 0-2). Advanced age was independently associated with a non-favorable functional prognosis (OR = 1.06, 95% CI: 1.00-1.11, P = 0.034).</p><p><strong>Conclusions: </strong>In cases of MT requiring EICS, the administration of low-dose intra-arterial Eptifibatide immediately post-stenting, in addition to post-procedure dual anti-platelet therapy, demonstrated high recanalization rates with a favorable safety profile.</p>","PeriodicalId":10391,"journal":{"name":"Clinical Neuroradiology","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-09-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145023011","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Mechanical Thrombectomy for Middle Cerebral Artery Medium Vessel Occlusions Using Single Plane Angiography.","authors":"Krishna Amuluru, Jimmy Nguyen, Andrew DeNardo, John Scott, Daniel Gibson, Fawaz Al-Mufti, Dileep Yavagal, Daniel H Sahlein","doi":"10.1007/s00062-024-01492-2","DOIUrl":"10.1007/s00062-024-01492-2","url":null,"abstract":"<p><strong>Background and purpose: </strong>Endovascular thrombectomy is now the standard of care for large vessel occlusion acute ischemic stroke. However, acute stroke due to medium-vessel occlusions often result in unfavorable outcomes, and guidelines for thrombectomy are lacking. Moreover, nearly all clinical data and thrombectomy trials are based on biplane angiography systems. This study aims to compare the safety and efficacy of stroke thrombectomy procedures performed on single-plane versus biplane angiography systems in patients presenting with medium-vessel occlusions of the middle cerebral artery.</p><p><strong>Materials and methods: </strong>This retrospective study included consecutive patients with acute ischemic stroke due to primary middle cerebral artery medium-vessel occlusions treated with thrombectomy between 7/1/2020 and 8/1/2022 at a single high-volume practice. Patients were dichotomized into those treated on single plane and biplane systems. Demographic, procedural, clinical and follow-up characteristics were compared.</p><p><strong>Results: </strong>Among the 149 patients included, 44 underwent thrombectomy on single-plane systems, and 93 on biplane systems. No significant differences were detected in rates of good functional outcomes (mRS < 2; SP 54% vs BP 42%, p = 0.19), successful recanalization (TICI ≥ 2B; SP 91% vs BP 86%, p = 0.77), intra-procedural vascular injury (SP 0% vs BP 3%; p = 0.56), or time from groin puncture to reperfusion (SP 25 min vs BP 27 min; p = 0.97). No significant differences were detected in peri-procedural complications, or symptomatic intracerebral hemorrhage.</p><p><strong>Conclusion: </strong>Thrombectomy for middle cerebral artery medium-vessel occlusions performed on single-plane angiography systems is as safe and efficacious as biplane procedures. Our results may have implications for increasing access to care, especially in regions with limited resources.</p>","PeriodicalId":10391,"journal":{"name":"Clinical Neuroradiology","volume":" ","pages":"473-481"},"PeriodicalIF":2.6,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143448336","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Susceptibility Vessel Sign and Intravenous Alteplase in Stroke Patients Treated with Thrombectomy : A Secondary Analysis of the SWIFT DIRECT Trial.","authors":"Morin Beyeler, Roman Rohner, Petra Ijäs, Omer F Eker, Christophe Cognard, Romain Bourcier, Igor Sibon, Margaux Lefebvre, Sébastien Richard, Arturo Consoli, Solène Moulin, Marielle Ernst, Marc Ribo, Charlotte Barbier, Omid Nikoubashman, David S Liebeskind, Martina B Goeldlin, Eike I Piechowiak, Lukas Bütikofer, Jan Gralla, Urs Fischer, Johannes Kaesmacher","doi":"10.1007/s00062-025-01501-y","DOIUrl":"10.1007/s00062-025-01501-y","url":null,"abstract":"<p><strong>Background: </strong>The susceptibility vessel sign (SVS) on baseline MRI in acute ischemic stroke patients has been associated with better outcomes post-thrombectomy. This study aimed to investigate whether the presence of the SVS modifies the treatment effect of intravenous thrombolysis plus endovascular thrombectomy (IVT + EVT) versus thrombectomy alone (EVT alone).</p><p><strong>Methods: </strong>In this secondary analysis of the SWIFT DIRECT trial, comparing IVT + EVT versus EVT alone, treatment effect and its heterogeneity were assessed with rates of pre-interventional reperfusion (eTICI 2a-3) and successful post-interventional reperfusion (eTICI of 2b-3) according to the SVS status using adjusted multivariable logistic regression. Secondary objectives were to analyze whether the presence of SVS or its individual characteristics (location, length, width, overestimation ratio, two-layered sign) were associated with outcomes.</p><p><strong>Results: </strong>197 of the initial 408 trial participants were included in this secondary analysis, of which 52% received IVT + EVT. SVS was present in 92% of the participants (n = 181). There was no evidence for treatment effect heterogeneity regarding the post-interventional radiological and clinical effects of IVT + EVT versus EVT alone with strata of SVS. In SVS+ participants, IVT favored pre-interventional reperfusion (aOR 7.95, 95% CI 1.42-44.46), whereas in SVS-patients, it did not (P for interaction = 0.02). The individual SVS characteristics showed no significant associations with outcomes.</p><p><strong>Conclusion: </strong>Presence of SVS does not seem to modify the effect of IVT + EVT versus EVT alone. In SVS+ patients, IVT might improve pre-interventional reperfusion. There is insufficient evidence to recommend using SVS to inform IVT decisions prior to EVT.</p>","PeriodicalId":10391,"journal":{"name":"Clinical Neuroradiology","volume":" ","pages":"483-493"},"PeriodicalIF":2.6,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12454450/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143457040","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"In Vivo Discrimination of Iodine and Tantalum-Based Liquid Embolics After Intracranial or Spinal Embolization Using Photon-Counting Detector CT.","authors":"Christoph Johannes Maurer, Ansgar Berlis, Franz Josef Stangl, Lars Behrens","doi":"10.1007/s00062-025-01502-x","DOIUrl":"10.1007/s00062-025-01502-x","url":null,"abstract":"<p><strong>Purpose: </strong>In vitro differentiation of iodine and tantalum-based liquid embolics post-embolization can be achieved using spectral computed tomography. This study evaluates the in vivo ability of clinical photon-counting computed tomography (PCD-CT) to distinguish these embolic agents in patients undergoing endovascular treatments for cerebrovascular and spinal pathologies.</p><p><strong>Methods: </strong>This retrospective study included 25 patients treated between April 2021 and March 2024, who underwent PCD-CT imaging post-embolization for intracranial arteriovenous malformations (AVM), dural arteriovenous fistulas (dAVF), spinal tumors, or middle meningeal artery (MMA) embolization for chronic subdural hematomas (cSDH). Imaging analysis involved iterative reconstruction, using conventional images (CI), iodine maps (IM), and virtual non-contrast (VNC) series. Two blinded neuroradiologists assessed the suppression quality of the embolic agents on a Likert scale.</p><p><strong>Results: </strong>Of the 25 patients, 22 underwent intracranial and 3 spinal embolizations. The differentiation between iodine and tantalum-based embolics achieved 92% accuracy for reader 1 and 88% for reader 2, with a Cohen's kappa coefficient of 0.92 indicating high inter-reader agreement. Iodine-based agents were moderately suppressed, whereas tantalum-based agents exhibited superior suppression. Errors arose from mistaking suppressed platinum coils for tantalum-based embolics. Hemorrhage detection accuracy was high, with a Cohen's kappa of 0.92.</p><p><strong>Conclusions: </strong>PCD-CT effectively differentiates between iodine- and tantalum-based embolics in vivo, demonstrating high diagnostic accuracy and inter-reader reliability. This capability facilitates improved post-procedural assessment and may enhance the management of endovascularly treated patients by reducing imaging artifacts and aiding in hemorrhage detection.</p>","PeriodicalId":10391,"journal":{"name":"Clinical Neuroradiology","volume":" ","pages":"443-450"},"PeriodicalIF":2.6,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12454468/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143363962","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Post-contrast Susceptibility Weighted Imaging in Multiple Sclerosis MRI Improves the Detection of Enhancing Lesions.","authors":"Pablo Naval-Baudin, Karen Pérez-Alfonso, Albert Castillo-Pinar, Ignacio Martínez-Zalacaín, Pablo Arroyo-Pereiro, Lucía Romero-Pinel, Nahum Calvo, Antonio Martinez-Yélamos, Mónica Cos, Sergio Martínez-Yélamos, Albert Pons-Escoda, Carles Majós","doi":"10.1007/s00062-025-01508-5","DOIUrl":"10.1007/s00062-025-01508-5","url":null,"abstract":"<p><strong>Objectives: </strong>MRI is essential for monitoring multiple sclerosis (MS). Contrast-enhanced T1-weighted imaging (T1WI+C) detects active inflammatory lesions indicating blood-brain barrier breakdown and is relevant for disease monitoring and treatment optimization. Susceptibility-weighted imaging (SWI) may be included in the imaging protocol for detecting MS-specific features, such as the presence of central veins or paramagnetic rim lesions. However, post-contrast SWI (SWI+C) has an inherent \"T1 shine-through effect\" that enables the visualization of contrast-enhancing lesions. This study evaluates whether SWI+C in addition to standard T1WI+C improves the detection of enhancing lesions in patients with MS.</p><p><strong>Materials and methods: </strong>The images of 310 patients with MS who underwent a standardized MRI protocol including T1WI+C and SWI+C using a 3T scanner were retrospectively reviewed. A neuroradiologist and radiology resident independently evaluated the images obtained on T1WI+C alone and T1WI+C plus SWI+C. The efficacy of T1WI+C alone was compared with that of T1WI+C plus SWI+C for detecting active enhancing MS lesions.</p><p><strong>Results: </strong>The neuroradiologist detected 117 lesions on T1WI+C and 123 lesions on T1WI+C plus SWI+C. The resident detected 108 lesions on T1WI+C and 121 lesions on T1WI+C plus SWI+C. The interobserver agreement improved from 0.981 to 1.00 with the addition of SWI+C.</p><p><strong>Conclusion: </strong>Adding SWI+C to standard T1WI+C consistently enhances the detection of active enhancing inflammatory MS lesions and the interobserver agreement. If standardized, this combined approach may allow for earlier detection of disease activity and improve monitoring of MS progression, potentially leading to optimized treatment decisions and improved patient outcomes.</p>","PeriodicalId":10391,"journal":{"name":"Clinical Neuroradiology","volume":" ","pages":"533-539"},"PeriodicalIF":2.6,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12454511/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143572238","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}