Clinical Neuroradiology最新文献

{"title":"First Experience of Treatment of Multiple Shrapnel Traumatic Pseudoaneurysms During the War in Ukraine Using Tegus Telemedical System.","authors":"Dmytro Shchehlov, Mykola Vyval, Adnan H Siddiqui, Rene Chapot, Oleksandr Pastushyn, Oleksandr Hnelytsia, Jens Fiehler, Vladimir Kalousek, Anna A Kyselyova","doi":"10.1007/s00062-023-01319-6","DOIUrl":"10.1007/s00062-023-01319-6","url":null,"abstract":"","PeriodicalId":10391,"journal":{"name":"Clinical Neuroradiology","volume":" ","pages":"263-267"},"PeriodicalIF":2.8,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10881802/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9699077","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":"Nonenhanced Photon Counting CT of the Head : Impact of the keV Level, Iterative Reconstruction and Calvaria on Image Quality in Monoenergetic Images.","authors":"Arwed Elias Michael, Denise Schoenbeck, Matthias Michael Woeltjen, Jan Boriesosdick, Jan Robert Kroeger, Christoph Moenninghoff, Sebastian Horstmeier, Julius Henning Niehoff, Christoph Kabbasch, Lukas Goertz, Jan Borggrefe","doi":"10.1007/s00062-023-01331-w","DOIUrl":"10.1007/s00062-023-01331-w","url":null,"abstract":"<p><strong>Purpose: </strong>Nonenhanced computed tomography (CT) of the head is among the most commonly performed CT examinations. The spectral information acquired by photon counting CT (PCCT) allows generation of virtual monoenergetic images (VMI). At the same time, image noise can be reduced using quantum iterative reconstruction (QIR). In this study, the image quality of VMI was evaluated depending on the keV level and the QIR level. Furthermore, the influence of the cranial calvaria was investigated to determine the optimal reconstruction for clinical application.</p><p><strong>Methods: </strong>A total of 51 PCCT (NAEOTOM Alpha, Siemens Healthineers, Erlangen, Germany) of the head were retrospectively analyzed. In a quantitative analysis, gray and white matter ROIs were evaluated in different brain areas at all available keV levels and QIR levels with respect to signal, noise, signal-to-noise ratio (SNR), and contrast-to-noise ratio (CNR). The distance to the cranial calvaria of the ROIs was included in the analysis. This was followed by a qualitative reading by five radiologists including experienced neuroradiologists.</p><p><strong>Results: </strong>In most ROIs, signal and noise varied significantly between keV levels (p < 0.0001). The CNR had a focal maximum at 66 keV and an absolute maximum at higher keV, slightly differently located depending on ROI and QIR level. With increasing QIR level, a significant reduction in noise was achieved (p < 0.0001) except just beneath the cranial calvaria. The cranial calvaria had a strong effect on the signal (p < 0.0001) but not on gray and white matter noise. In the qualitative reading, the 60 keV VMI was rated best.</p><p><strong>Conclusion: </strong>In nonenhanced PCCT of the head the selected keV level of the VMI and the QIR level have a crucial influence on image quality in VMI. The 60 keV and 66 keV VMI with high QIR level provided optimal subjective and objective image quality for clinical use. The cranial calvaria has a significant influence on the visualization of the adjacent brain matter; currently, this substantially limits the use of low keV VMIs (< 60 keV).</p>","PeriodicalId":10391,"journal":{"name":"Clinical Neuroradiology","volume":" ","pages":"75-83"},"PeriodicalIF":2.8,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10881631/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10014354","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":"Improvement of Neurovascular Imaging Using Ultra-High-Resolution Computed Tomography Angiography.","authors":"Felix A Ucar, Marius Frenzel, Andrea Kronfeld, Sebastian Altmann, Antoine P Sanner, Mario Alberto Abello Mercado, Timo Uphaus, Marc A Brockmann, Ahmed E Othman","doi":"10.1007/s00062-023-01348-1","DOIUrl":"10.1007/s00062-023-01348-1","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate diagnostic image quality of ultra-high-resolution computed tomography angiography (UHR-CTA) in neurovascular imaging as compared to normal resolution CT-angiography (NR-CTA).</p><p><strong>Material and methods: </strong>In this retrospective single-center study brain and neck CT-angiography was performed using an ultra-high-resolution computed tomography scanner (n = 82) or a normal resolution CT scanner (NR-CTA; n = 73). Ultra-high-resolution images were reconstructed with a 1024 × 1024 matrix and a slice thickness of 0.25 mm, whereas NR-CT images were reconstructed with a 512 × 512 matrix and a slice thickness of 0.5 mm. Three blinded neuroradiologists assessed overall image quality, artifacts, image noise, overall contrast and diagnostic confidence using a 4-point Likert scale. Furthermore, the visualization and delineation of supra-aortic arteries with an emphasis on the visualization of small intracerebral vessels was assessed using a cerebral vascular score, also utilizing a 4-point Likert scale. Quantitative analyses included signal-to-noise ratio (SNR), contrast-to-noise ratio (CNR), noise and the steepness of gray value transition. Radiation exposure was determined by comparison of computed tomography dose index (CTDIvol), dose length product (DLP) and mean effective dose. Interrater agreement was evaluated via determining Fleiss-Kappa.</p><p><strong>Results: </strong>Ultra-high-resolution CT-angiography (UHR-CTA) yielded excellent image quality with superior quantitative (SNR: p < 0.001, CNR: p < 0.001, steepness of gray value transition: p < 0.001) and qualitative results (overall image quality: 4 (Inter quartile range (IQR) = 4-4); p < 0.001, diagnostic confidence: 4 (IQR = 4-4); p < 0.001) compared to NR-CT (overall image quality: 3 (IQR = 3-3), diagnostic confidence: 3 (IQR = 3-4)). Furthermore, UHR-CT enabled significantly superior delineation and visualization of all vascular segments, from proximal extracranial vessels to the smallest peripheral cerebral branches (e.g.</p><p><strong>, uhr-cta pica: </strong>4 (3-4) vs. NR-CTA PICA: 3 (2-3); UHR-CTA P4: 4 (IQR = 3-4) vs. NR-CTA P4: 2 (IQR = 2-3); UHR-CTA M4: 4 (IQR = 4-4) vs. NR-CTA M4: 3 (IQR = 2-3); UHR-CTA A4: 4 (IQR = 3-4) vs. NR-CTA A4: 2 (IQR = 2-3); all p < 0.001). Noteworthy, a reduced mean effective dose was observed when applying UHR-CT (NR-CTA: 1.8 ± 0.3 mSv; UHR-CTA: 1.5 ± 0.5 mSv; p < 0.001).</p><p><strong>Conclusion: </strong>Ultra-high-resolution CT-angiography improves image quality in neurovascular imaging allowing the depiction and evaluation of small peripheral cerebral arteries. It may thus improve the detection of pathologies in small cerebrovascular lesions and the resulting diagnosis.</p>","PeriodicalId":10391,"journal":{"name":"Clinical Neuroradiology","volume":" ","pages":"189-199"},"PeriodicalIF":2.8,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10881789/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41193602","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":"Prevalence, Risk Factors, and Clinical Outcomes of New Cerebral Microbleeds After Intravenous Thrombolysis in Acute Ischemic Stroke: a Systematic Review and Meta-analysis.","authors":"Zhenxiang Zhan, Fangwang Fu, Wenyuan Zhang, Zicheng Cheng","doi":"10.1007/s00062-023-01357-0","DOIUrl":"10.1007/s00062-023-01357-0","url":null,"abstract":"<p><strong>Background: </strong>Cerebral microbleeds (CMBs) are common in the elderly population, and are associated with an increased risk of stroke and dementia. An acute ischemic stroke event can make CMBs develop rapidly. However, the progression of CMBs after intravenous thrombolysis is not well understood.</p><p><strong>Methods: </strong>Following a previously registered protocol, PubMed, Web of Science, and Embase databases were systematically searched to identify relevant literature up to August 2022. Cohort studies that reported new CMBs in patients with acute ischemic stroke undergoing intravenous thrombolysis were included. Random effects models were used to calculate the pooled estimates.</p><p><strong>Results: </strong>Seven studies with 1079 patients were included in the meta-analysis. The pooled new CMBs prevalence was 7.6% (95% CI 3.9-14.3%) and 63.6% new CMBs were located in the cerebral lobes. Compared with patients without new CMBs, those with new CMBs were older, had a higher proportion of hypertension, and had higher systolic blood pressure and baseline CMBs burden. The presence of new CMBs increased the likelihood of remote intracerebral hemorrhage (OR 28.75, 95% CI 8.58-96.38) and symptomatic intracerebral hemorrhage (OR 15.49, 95% CI 3.21-74.73) but was not related to functional outcomes or hemorrhagic transformation.</p><p><strong>Conclusions: </strong>The prevalence of new CMBs after intravenous thrombolysis was approximately 7.6%. The presence of new CMBs is associated with remote and symptomatic intracerebral hemorrhage following intravenous thrombolysis. Considering the potential long-term adverse effects of CMBs progression, patients at a high risk of developing new CMBs should be identified based on potential risk factors.</p>","PeriodicalId":10391,"journal":{"name":"Clinical Neuroradiology","volume":" ","pages":"209-218"},"PeriodicalIF":2.8,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49674985","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":"Long-Term Effect of Mechanical Thrombectomy in Stroke Patients According to Advanced Imaging Characteristics.","authors":"Morin Beyeler, Fabienne Pohle, Loris Weber, Madlaine Mueller, Christoph C Kurmann, Adnan Mujanovic, Leander Clénin, Eike Immo Piechowiak, Thomas Raphael Meinel, Philipp Bücke, Simon Jung, David Seiffge, Sara M Pilgram-Pastor, Tomas Dobrocky, Marcel Arnold, Jan Gralla, Urs Fischer, Pasquale Mordasini, Johannes Kaesmacher","doi":"10.1007/s00062-023-01337-4","DOIUrl":"10.1007/s00062-023-01337-4","url":null,"abstract":"<p><strong>Purpose: </strong>Data on long-term effect of mechanical thrombectomy (MT) in patients with large ischemic cores (≥ 70 ml) are scarce. Our study aimed to assess the long-term outcomes in MT-patients according to baseline advanced imaging parameters.</p><p><strong>Methods: </strong>We performed a single-centre retrospective cohort study of stroke patients receiving MT between January 1, 2010 and December 31, 2018. We assessed baseline imaging to determine core and mismatch volumes and hypoperfusion intensity ratio (with low ratio reflecting good collateral status) using RAPID automated post-processing software. Main outcomes were cross-sectional long-term mortality, functional outcome and quality of life by May 2020. Analysis were stratified by the final reperfusion status.</p><p><strong>Results: </strong>In total 519 patients were included of whom 288 (55.5%) have deceased at follow-up (median follow-up time 28 months, interquartile range 1-55). Successful reperfusion was associated with lower long-term mortality in patients with ischemic core volumes ≥ 70 ml (adjusted hazard ratio (aHR) 0.20; 95% confidence interval (95% CI) 0.10-0.44) and ≥ 100 ml (aHR 0.26; 95% CI 0.08-0.87). The effect of successful reperfusion on long-term mortality was significant only in the presence of relevant mismatch (aHR 0.17; 95% CI 0.01-0.44). Increasing reperfusion grade was associated with a higher rate of favorable outcomes (mRS 0-3) also in patients with ischemic core volume ≥ 70 ml (aOR 3.58, 95% CI 1.64-7.83).</p><p><strong>Conclusion: </strong>Our study demonstrated a sustainable benefit of better reperfusion status in patients with large ischemic core volumes. Our results suggest that patient deselection based on large ischemic cores alone is not advisable.</p>","PeriodicalId":10391,"journal":{"name":"Clinical Neuroradiology","volume":" ","pages":"105-114"},"PeriodicalIF":2.8,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10881753/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10109406","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":"Endovascular Treatment for Acute Isolated Internal Carotid Artery Occlusion : A Propensity Score Matched Multicenter Study.","authors":"Daniel P O Kaiser, Tilman Reiff, Ulrich Mansmann, Daniela Schoene, Davide Strambo, Patrik Michel, Mohamad Abdalkader, Thanh N Nguyen, Matthias Gawlitza, Markus A Möhlenbruch, Peter A Ringleb, Volker Puetz, Johannes C Gerber, Simon Nagel","doi":"10.1007/s00062-023-01342-7","DOIUrl":"10.1007/s00062-023-01342-7","url":null,"abstract":"<p><strong>Purpose: </strong>The benefit of endovascular treatment (EVT) in patients with acute symptomatic isolated occlusion of the internal carotid artery (ICA) without involvement of the middle and anterior cerebral arteries is unclear. We aimed to compare clinical and safety outcomes of best medical treatment (BMT) versus EVT + BMT in patients with stroke due to isolated ICA occlusion.</p><p><strong>Methods: </strong>We conducted a retrospective multicenter study involving patients with isolated ICA occlusion between January 2016 and December 2020. We stratified patients by BMT versus EVT and matched the groups using propensity score matching (PSM). We assessed the effect of treatment strategy on favorable outcome (modified Rankin scale ≤ 2) 90 days after treatment and compared reduction in NIHSS score at discharge, rates of symptomatic intracranial hemorrhage (sICH) and 3‑month mortality.</p><p><strong>Results: </strong>In total, we included 149 patients with isolated ICA occlusion. To address imbalances, we matched 45 patients from each group using PSM. The rate of favorable outcomes at 90 days was 56% for EVT and 38% for BMT (odds ratio, OR 1.89, 95% confidence interval, CI 0.84-4.24; p = 0.12). Patients treated with EVT showed a median reduction in NIHSS score at discharge of 6 points compared to 1 point for BMT patients (p = 0.02). Rates of symptomatic intracranial hemorrhage (7% vs. 4%; p = 0.66) and 3‑month mortality (11% vs. 13%; p = 0.74) did not differ between treatment groups. Periprocedural complications of EVT with early neurological deterioration occurred in 7% of cases.</p><p><strong>Conclusion: </strong>Although the benefit on functional outcome did not reach statistical significance, the results for NIHSS score improvement, and safety support the use of EVT in patients with stroke due to isolated ICA occlusion.</p>","PeriodicalId":10391,"journal":{"name":"Clinical Neuroradiology","volume":" ","pages":"125-133"},"PeriodicalIF":2.8,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10881648/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10146597","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":"Systematic Review and Meta-analysis of Radial or Femoral Access for Carotid Stenting.","authors":"Pang-Shuo Perng, Yu Chang, Hao-Kuang Wang, Yen-Ta Huang, Chia-En Wong, Kuan-Yu Chi, Jung-Shun Lee, Liang-Chao Wang, Chih-Yuan Huang","doi":"10.1007/s00062-023-01315-w","DOIUrl":"10.1007/s00062-023-01315-w","url":null,"abstract":"<p><strong>Purpose: </strong>There is a growing interest in performing coronary artery and neurovascular interventions via the radial artery; however, few studies have examined the outcomes of transradial carotid stenting. Therefore, our study aimed to compare cerebrovascular outcomes and crossover rates in carotid stenting between transradial and traditional transfemoral approaches.</p><p><strong>Methods: </strong>A systematic review was performed by searching three electronic databases from inception to June 2022 in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. In addition, random effect meta-analysis was used to pool the odds ratios (ORs) for stroke, transient ischemic attack, major adverse cardiac events, death, major vascular access site complications, and procedure crossover rates between the transradial and transfemoral approaches.</p><p><strong>Results: </strong>A total of 6 studies were included involving a total of n = 567 transradial and n = 6176 transfemoral procedures. The ORs for stroke, transient ischemic attack, and major adverse cardiac events were 1.43 (95% confidence interval, CI 0.72-2.86, I² = 0), 0.51 (95% CI 0.17-1.54, I² = 0), and 1.08 (95% CI 0.62-1.86, I² = 0), respectively. Neither the major vascular access site complication rate (OR 1.11, 95% CI 0.32-3.87, I² = 0) nor crossover rate (OR 3.94, 95% CI 0.62-25.11, I² = 57%) showed statistically significant differences between the two approaches.</p><p><strong>Conclusion: </strong>The modest quality of the data suggested comparable procedural outcomes between the transradial and transfemoral approaches when performing carotid stenting; however, high level evidence regarding postoperative brain images and risk of stroke in transradial carotid stenting are lacking. Therefore, it is reasonable for interventionists to weigh up the risks of neurological events and potential benefits, including fewer access site complications, before choosing the radial or femoral arteries as access sites. Future large-scale randomized controlled trials are imperative.</p>","PeriodicalId":10391,"journal":{"name":"Clinical Neuroradiology","volume":" ","pages":"3-12"},"PeriodicalIF":2.8,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9738674","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":"Photon Counting Versus Energy-integrated Detector CT in Detection of Superior Semicircular Canal Dehiscence.","authors":"Nathan S Doyle, John C Benson, Carrie M Carr, Felix E Diehn, Matthew L Carlson, Shuai Leng, John I Lane","doi":"10.1007/s00062-023-01368-x","DOIUrl":"10.1007/s00062-023-01368-x","url":null,"abstract":"<p><strong>Background: </strong>Superior semicircular canal dehiscence (SSCD), an osseous defect overlying the SSC, is associated with a constellation of audiovestibular symptoms. This study sought to compare conventional energy-integrated detector (EID) computed tomography (CT) to photon-counting detector (PCD)-CT in the detection of SSCD.</p><p><strong>Material and methods: </strong>Included patients were prospectively recruited to undergo a temporal bone CT on both EID-CT and PCD-CT scanners. Two blinded neuroradiologists reviewed both sets of images for 1) the presence or absence of SSCD (graded as present, absent, or indeterminate), and 2) the width of the bone overlying the SSC (if present). Any discrepancies in the presence or absence of SSCD were agreed upon by consensus.</p><p><strong>Results: </strong>In the study 31 patients were evaluated, for a total of 60 individual temporal bones (2 were excluded). Regarding SSCD presence or absence, there was substantial agreement between EID-CT and PCD-CT (k = 0.76; 95% confidence interval, CI 0.54-0.97); however, SSCD was present in only 9 (15.0%) temporal bones on PCD-CT, while EID-CT examinations were interpreted as being positive in 14 (23.3%) temporal bones. This yielded a false positive rate of 8.3% on EID-CT. The bone overlying the SSC was thinner on EID-CT images (0.66 mm; SD = 0.64) than on PCD-CT images (0.72 mm; SD = 0.66) (p < 0.001).</p><p><strong>Conclusion: </strong>The EID-CT examinations tend to overcall the presence of SSCD compared to PCD-CT and also underestimate the thickness of bone overlying the SSC.</p>","PeriodicalId":10391,"journal":{"name":"Clinical Neuroradiology","volume":" ","pages":"251-255"},"PeriodicalIF":2.8,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138486853","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":"Diagnosis of Small Unruptured Intracranial Aneurysms : Comparison of 7 T versus 3 T MRI.","authors":"Piotr Radojewski, Tomas Dobrocky, Mattia Branca, William Almiri, Manuel Correia, Andreas Raabe, David Bervini, Jan Gralla, Roland Wiest, Pasquale Mordasini","doi":"10.1007/s00062-023-01282-2","DOIUrl":"10.1007/s00062-023-01282-2","url":null,"abstract":"<p><strong>Purpose: </strong>Differentiating normal anatomical variants such as an infundibulum or a vascular loop from true intracranial aneurysms is crucial for patient management. We hypothesize that high-resolution 7 T magnetic resonance imaging (MRI) improves the detection and characterization of normal anatomical variants that may otherwise be misdiagnosed as small unruptured aneurysms.</p><p><strong>Methods: </strong>This is a retrospective, single-center study. All patients were scanned on a clinically approved 7 T MRI scanner and on a 3 T scanner. Image analysis was performed independently by three neuroradiologists blinded to clinical information. The presence of an unruptured intracranial aneurysm (UIA) and level of diagnostic certainty were assessed and the interrater agreement was calculated. If an aneurysm was present, the anatomic location and shape were recorded and compared.</p><p><strong>Results: </strong>In total, 53 patients with equivocal cerebrovascular findings on 1.5 T or 3 T MRI referred for a 7T MRI examination were included. Aneurysms were suspected in 42 patients examined at 3 T and in 23 patients at 7 T (rate difference 36%, 95% confidence interval, CI, 19-53%, p-value < 0.001). Major disagreement between the field strengths was observed in the A1 segment of anterior cerebral artery/anterior communicating artery (A1/ACOM) complex. The interrater agreement among the readers on the presence of an aneurysm on 7 T MRI was higher than that for 3 T MRI (0.925, 95% CI 0.866-0.983 vs. 0.786, 95% CI 0.700-0.873).</p><p><strong>Conclusion: </strong>Our analysis demonstrates a significantly higher interrater agreement and improved diagnostic certainty when small intracranial aneurysms are visualized on 7 T MRI compared to 3 T. In a selected patient cohort, clinical implementation of 7 T MRI may help to establish the definitive diagnosis and thus have a beneficial impact on patient management.</p>","PeriodicalId":10391,"journal":{"name":"Clinical Neuroradiology","volume":" ","pages":"45-49"},"PeriodicalIF":2.8,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10881608/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9222875","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":"Long-term Follow-up After Aneurysm Treatment with the Flow Redirection Endoluminal Device (FRED) Flow Diverter.","authors":"Sophia Hohenstatt, Christian Ulfert, Christian Herweh, Tim Hilgenfeld, Niclas Schmitt, Silvia Schönenberger, Min Chen, Martin Bendszus, Markus A Möhlenbruch, Dominik F Vollherbst","doi":"10.1007/s00062-023-01346-3","DOIUrl":"10.1007/s00062-023-01346-3","url":null,"abstract":"<p><strong>Introduction: </strong>This study focuses on long-term outcomes after aneurysm treatment with either the Flow Re-Direction Endoluminal Device (FRED) or the FRED Jr. to investigate the durability of treatment effect and long-term complications.</p><p><strong>Methods: </strong>This study is based on a retrospective analysis of a prospectively maintained patient data base. Patients treated with either FRED or FRED Jr. between 2013 and 2017 at our institution, and thus a possibility for ≥ 5 years of follow-up, were included. Aneurysm occlusion rates, recurrence rates, modified Rankin scale score shifts to baseline, and delayed complications were assessed.</p><p><strong>Results: </strong>In this study 68 patients with 84 aneurysms had long-term follow-up with a mean duration of 57.3 months and 44 patients harboring 52 aneurysms had a follow-up ≥ 5 years with a mean follow-up period of 69.2 months. Complete occlusion was reached in 77.4% at 2 years and increased to 84.9% when the latest available imaging result was considered. Younger age and the absence of branch involvement were predictors for aneurysm occlusion in linear regression analysis. After the 2‑year threshold, there were 3 reported symptomatic non-serious adverse events. Of these, one patient had a minor stroke, one a transitory ischemic attack and one had persistent mass effect symptoms due to a giant aneurysm, none of these resulted in subsequent neurological disability.</p><p><strong>Conclusion: </strong>This long-term follow-up study demonstrates that the FRED and FRED Jr. are safe and effective for the treatment of cerebral aneurysms in the long term, with high rates of complete occlusion and low rates of delayed adverse events.</p>","PeriodicalId":10391,"journal":{"name":"Clinical Neuroradiology","volume":" ","pages":"181-188"},"PeriodicalIF":2.8,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10881684/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41193603","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}