Clinical Neuroradiology最新文献

{"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":"https://doi.org/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":""},"PeriodicalIF":2.8,"publicationDate":"2025-02-18","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":"Pituitary Adenomas in Children: : Specific Imaging Features According to Hormonal Secretion.","authors":"Fares Kassem, Raphael Levy, Arnault Tauziède-Espariat, Charles-Joris Roux, Thomas Samoyeau, Alexis Ollitrault, Graziella Pinto, Dinane Samara-Boustani, Dulanjalee Kariyawasam, Michel Polak, Kevin Beccaria, Thomas Blauwblomme, Pascale Varlet, Nathalie Boddaert, Volodia Dangouloff-Ros","doi":"10.1007/s00062-025-01499-3","DOIUrl":"https://doi.org/10.1007/s00062-025-01499-3","url":null,"abstract":"<p><strong>Purpose: </strong>Pituitary adenomas are much rarer in children than in adults. We aimed to analyze their imaging characteristics in this age group and to compare them according to the hormonal secretion. We conducted an observational monocentric retrospective study on clinical and imaging data.</p><p><strong>Methods: </strong>We analyzed imaging features before surgery or drug treatment of pituitary adenomas in children confirmed by histopathology or hormonal secretion. We assessed tumoral signal intensity, volume and aggressiveness, and compared it according to the hormonal secretion.</p><p><strong>Results: </strong>We included 31 children (13 lactotroph (42%), 8 corticotroph (26%), 5 somatotroph (16%), 5 plurihormonal adenomas (16%) including 1 non-secreting macroadenoma) with a median age of 13 years (range 2-16 years-old), without age or sex difference between secretion types. Lactotroph and somatotroph adenomas were larger than corticotroph adenomas (p = 0.007) and were more aggressive (p = 0.01). They also had higher signal intensity on T2-weighted images (p = 0.04). T1 signal intensity was similar between the groups on pre and post-contrast images (lower enhancement than the normal pituitary). No non-secreting micro-adenoma became clinically significant enough to lead to a pathological confirmation or specific treatment. Genetic research was conducted on 20 children, finding MEN1 mutations in 80% of the patients.</p><p><strong>Conclusions: </strong>Pituitary adenomas in children are rare but should be considered when facing similar imaging features than in adults. Imaging characteristics may allow to suspect the hormonal secretion.</p>","PeriodicalId":10391,"journal":{"name":"Clinical Neuroradiology","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2025-02-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143363964","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":"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":"https://doi.org/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":""},"PeriodicalIF":2.8,"publicationDate":"2025-02-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","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":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Angioarchitecture of Twig-like Middle Cerebral Artery: the Looping Lenticulostriate Artery Anastomoses as an Angiographic Landmark for Hemorrhagic Presentation.","authors":"Bikei Ryu, Alessandro Sgreccia, Silvia Pizzuto, Federico Di Maria, Yasunari Niimi, Georges Rodesch, Arturo Consoli","doi":"10.1007/s00062-025-01506-7","DOIUrl":"https://doi.org/10.1007/s00062-025-01506-7","url":null,"abstract":"<p><strong>Purpose: </strong>The twig-like middle cerebral artery (TL-MCA) is a vascular anomaly reconstituting the MCA-M1 segment through a plexiform arterial network. Most patients with TL-MCA have a high risk of hemorrhage, but the associated vascular anatomical risk factors are poorly understood. To investigate the angioarchitecture of TL-MCA in detail to distinguish the radiological differences between hemorrhagic and non-hemorrhagic onset.</p><p><strong>Methods: </strong>3214 cerebral digital subtraction angiography procedures were performed, and patients with TL-MCA were included and their clinical and anatomical characteristics were retrospectively reviewed.</p><p><strong>Results: </strong>12 patients (median age 47 years, and 9 women) with TL-MCA were included (incidence rate, 0.37%). Among them, four had hemorrhagic stroke, five had ischemic stroke, and three had no symptoms. Perforator anastomoses were identified in five patients (41.6%). Among the four patients with intraparenchymal hemorrhage (IPH), three had looping lenticulostriate artery (LSA) anastomoses and one had non-looping LSA anastomosis. One looping LSA anastomosis was discovered fortuitously in a patient explored for headaches. The recurrent artery of Heubner, which is responsible for the plexiform arterial network, was identified in 10 patients (83.3%). Angiographic evolutions (de novo TL-MCA) were observed in three patients, and one patient experienced a clinical evolution of a TL-MCA with non-looping LSA anastomosis, progressing from no symptoms to IPH.</p><p><strong>Conclusions: </strong>In this small series, looping LSA anastomoses were mainly observed in TL-MCA with IPH. This anatomical disposition could represent a potential risk factor. The TL-MCA always affects the subpallial segment of the MCA-M1, and may be a subpallium-related pathology.</p>","PeriodicalId":10391,"journal":{"name":"Clinical Neuroradiology","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2025-02-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143187774","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":"Predictors and Implications of Myocardial Injury in Intracerebral Hemorrhage.","authors":"Felix Hess, Julian McGinnis, Enayatullah Baki, Tun Wiltgen, Arne Müller, Christian Maegerlein, Jan Kirschke, Claus Zimmer, Bernhard Hemmer, Silke Wunderlich, Mark Mühlau","doi":"10.1007/s00062-025-01498-4","DOIUrl":"https://doi.org/10.1007/s00062-025-01498-4","url":null,"abstract":"<p><strong>Purpose: </strong>Myocardial injury, indicated by an elevation of high-sensitive cardiac Troponin (hs-cTnT), is a frequent stroke-related complication. Most studies investigated patients with ischemic stroke, but only little is known about its occurrence in patients with intracerebral hemorrhage (ICH). This study aimed to assess the frequency, predictors, and implications of myocardial injury in ICH patients.</p><p><strong>Methods: </strong>Our retrospective analysis included 322 ICH patients. We defined myocardial injury as an elevation of hs-cTnT above the 99th percentile (i.e. 14 ng/L). Acute myocardial injury was defined as either a changing pattern of > 50% within 24 h or an excessive elevation of initial hs-cTnT (> 52 ng/L). 3D brain scans were assessed for ICH visually and quantitatively by a deep learning algorithm. Multiple regression models and Voxel-based Lesion-Symptom Mapping (VLSM) were applied.</p><p><strong>Results: </strong>63.0% (203/322) of patients presented with myocardial injury, which was associated with more severe strokes and worse outcomes during the in-hospital phase (P < 0.01). Acute myocardial injury occurred in 24.5% (79/322) of patients. The only imaging finding associated with acute myocardial injury was midline shift (69.8% vs. 44.6% for normal or stable hs-cTnT, P < 0.01), which also independently predicted it (odds ratio 3.29, confidence interval 1.38-7.87, P < 0.01). In contrast, VLSM did not identify any specific brain region significantly associated with acute myocardial injury. Acute myocardial injury did not correlate with preexisting cardiac diseases; however, the frequency of adverse cardiac events was higher in the acute myocardial injury group (11.4% vs. 4.1% in patients with normal and/or stable patterns of hs-cTnT, P < 0.05).</p><p><strong>Conclusion: </strong>Myocardial injury occurs frequently in ICH and is linked to poor outcomes. Acute myocardial injury primarily correlates to space-occupying effects of ICH but is less dependent on premorbid cardiac status. Nonetheless, it is associated with a higher rate of adverse cardiac events.</p>","PeriodicalId":10391,"journal":{"name":"Clinical Neuroradiology","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2025-01-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143064086","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":"Intradermal Advanced Glycation End-products Relate to Reduced Sciatic Nerve Structural Integrity in Type 2 Diabetes.","authors":"Christoph M Mooshage, Dimitrios Tsilingiris, Lukas Schimpfle, Thomas Fleming, Stephan Herzig, Julia Szendroedi, Sabine Heiland, Martin Bendszus, Stefan Kopf, Felix Kurz, Johann Jende, Zoltan Kender","doi":"10.1007/s00062-024-01493-1","DOIUrl":"https://doi.org/10.1007/s00062-024-01493-1","url":null,"abstract":"<p><strong>Background: </strong>Cardiovascular risk management is beneficial, but stringent glycemic control does not prevent the progression of distal sensorimotor polyneuropathy (DSPN). Persistent hyperglycemia-induced alterations and cardiovascular factors may contribute to diabetes-associated nerve damage. This study aimed to evaluate the correlation between skin auto-fluorescence (sAF), an indicator of dermal advanced glycation end-product (AGE) accumulations, cardiovascular risk, and changes in peripheral nerve integrity.</p><p><strong>Methods: </strong>Sixty-two individuals with type 2 diabetes (T2D) (20 women and 42 men), including 29 diagnosed with DSPN (7 women and 22 men), and 10 healthy controls (HC) underwent diffusion tensor MR imaging of the sciatic nerve to assess fractional anisotropy (FA), an indicator of nerve structural integrity. sAF measurements were combined with clinical, serological, and electrophysiological evaluations. Arterial stiffness was assessed via pulse wave velocity (PWV).</p><p><strong>Results: </strong>sAF (HC 2.1 ± 0.25 AU, nDSPN 2.3 ± 0.47, DSPN 2.6 ± 0.43; p = 0.005) was higher in individuals with DSPN compared to HC (p = 0.010) and individuals without DSPN (p = 0.035). Within the group of T2D FA correlated negatively with sAF (r = -0.49, p < 0.001), PWV (r = -0.40, p = 0.009) and high-sensitivity troponin T (hsTNT), a marker of microvascular damage (r = -0.39, p < 0.001). In DSPN, sAF correlated positively with hsTNT (r = 0.58, p = 0.005) and with PWV (r = 0.52, p = 0.007), the sciatic nerve's FA correlated negatively with PWV (r = -0.47, p = 0.010).</p><p><strong>Conclusions: </strong>This study is the first to show close correlations between reduced peripheral nerve integrity and both intradermal AGE deposition and arterial stiffness in individuals with T2D. These findings highlight a mechanistic link between glycation-related vascular injury and neuronal damage emphasizing the importance of cardiovascular risk management in preventing DSPN.</p>","PeriodicalId":10391,"journal":{"name":"Clinical Neuroradiology","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2025-01-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143064079","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":"Modulating Cognitive Function with Antihypertensive Medications: a Comprehensive Systematic Review On FMRI Studies.","authors":"Sama Rahnemayan, Elham Mehdizadehfar, Arezoo Fathalizadeh","doi":"10.1007/s00062-024-01494-0","DOIUrl":"https://doi.org/10.1007/s00062-024-01494-0","url":null,"abstract":"<p><strong>Background: </strong>Hypertension (HTN) is a prevalent cardiovascular condition associated with cognitive impairments, including memory deficits and attention lapses. Understanding the neural mechanisms underlying HTN-related cognitive dysfunction is crucial for optimizing treatment strategies.</p><p><strong>Method: </strong>A systematic review was conducted to explore the impact of antihypertensive medications on cognition, focusing on memory, attention, and emotion processing using functional magnetic resonance imaging (fMRI). Searches were performed in PubMed and Scopus up to March 10, 2024, with no language restrictions.</p><p><strong>Results: </strong>A total of 108 articles were identified, of which 12 systematic reviews and meta-analyses met the inclusion criteria. Included studies investigated various antihypertensive drugs, including losartan, propranolol, spironolactone, and telmisartan, and their effects on cognitive processes. Losartan improved negative memory encoding and facilitated fear extinction via hippocampal and prefrontal modulation. Propranolol disrupted fear reconsolidation and reduced emotional memory retrieval, affecting the amygdala and hippocampus. Spironolactone prevented stress-induced memory shifts in the amygdala. Findings indicated distinct impacts of these medications on memory encoding, fear extinction, and stress-induced memory modulation, as evidenced by alterations in neural activity patterns observed on fMRI.</p><p><strong>Conclusion: </strong>Antihypertensive medications, such as losartan and propranolol, demonstrate potential in modulating memory, fear-related memory reconsolidation, and stress-induced memory modulation, highlighting their therapeutic implications for conditions like posttraumatic stress disorder (PTSD) and anxiety disorders. This review underscores the importance of fMRI studies in elucidating the neural correlates of HTN-related cognitive impairments and optimizing treatment approaches.</p>","PeriodicalId":10391,"journal":{"name":"Clinical Neuroradiology","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2025-01-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143001224","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":"Volumetry of Selected Brain Regions-Can We Compare MRI Examinations of Different Manufacturers and Field Strengths?","authors":"Svea Seehafer, Lars-Patrick Schmill, Sönke Peters, Olav Jansen, Schekeb Aludin","doi":"10.1007/s00062-024-01489-x","DOIUrl":"https://doi.org/10.1007/s00062-024-01489-x","url":null,"abstract":"<p><strong>Purpose: </strong>Magnetic Resonance Imaging based brain segmentation and volumetry has become an important tool in clinical routine and research. However the impact of the used hardware is only barely investigated. This study aims to assess the influence of scanner manufacturer, field strength and head-coil on volumetry results.</p><p><strong>Methods: </strong>10 healthy subjects (27.4 ± 1.71 years) were prospectively examined in a Philips Achieva 1.5T, Philips Ingenia CX 3T, Siemens MAGNETOM Aera 1.5T and Siemens MAGNETOM Vida 3T, the latter equipped with three different head coils, within one day. Brain volumetry of the whole brain, total white and grey matter, the cortical grey matter of the supratentorial lobes as well as regions important for the differentiation of neurodegenerative diseases of the dementia and movement disorder spectrum and the ventricular system was performed using the CE-certified software mdbrain by mediaire (Berlin, Germany). Both raw volumetry results and percentile allocation provided by the software were analysed.</p><p><strong>Results: </strong>This study reveals significantly different volumetry results for all examined brain regions beside the ventricular system between the different MRI devices but comparable results between the different head coils. When examining the percentile allocation provided by used software, the Intraclass-Correlation-Coefficient (ICC) values were even lower than the raw volume ICC values ranging from poor to excellent correlation.</p><p><strong>Conclusion: </strong>The present study reveals highly relevant results that need to be considered both in clinical routine when analysing follow-up examinations from different scanner types and clinical research, especially when planning longitudinal and/or multicentre studies.</p>","PeriodicalId":10391,"journal":{"name":"Clinical Neuroradiology","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2025-01-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143001227","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":"CT Angiography, MR Angiography, and Their Combined Use for Detection of Unruptured Intracranial Aneurysms: Comparison with Digital Subtraction Angiography and 3-dimensional Rotational Angiography.","authors":"Jee Hyun Lim, Dae Young Yoon, Eun Soo Kim, Hong Jun Jeon, Jong Young Lee, Young Lan Seo, Eun Joo Yun","doi":"10.1007/s00062-024-01491-3","DOIUrl":"https://doi.org/10.1007/s00062-024-01491-3","url":null,"abstract":"<p><strong>Purpose: </strong>To compare the diagnostic accuracy of CT angiography (CTA), MR angiography (MRA), and their combined use for detecting unruptured intracranial aneurysms (UIAs).</p><p><strong>Methods: </strong>Between September 2019 and August 2023, 235 patients suspected of having UIA underwent CTA, MRA, and digital subtraction angiography (DSA)/3-dimensional rotational angiography (3DRA). Two neuroradiologists retrospectively reviewed these images for UIA presence. The value of combining modalities was assessed using confidence rating scores for each. The sensitivity, specificity, and accuracy of these modalities were calculated on a per-aneurysm basis and compared using DSA/3DRA as the reference standard. Subgroup analyses were performed based on aneurysm size (≤ 3 or > 3 mm).</p><p><strong>Results: </strong>DSA/3DRA detected 252 UIAs in 182 patients, no aneurysms detected in 53 (mean age: 61.9 years ±11.6, 83 men). The overall sensitivity/specificity/accuracy of the combined analysis of CTA and MRA were 91.3%/88.7%/90.7%, respectively, which were significantly higher than those of CTA alone (86.9%/71.8%/83.6%) (P = 0.006/0.003/<0.001) and MRA alone (86.9%/80.3%/85.5%) (P =0.003/0.041/<0.001). No significant differences were found in sensitivity, specificity, or accuracy between the use of CTA and MRA (P = 1/0.26/0.45). CTA and MRA sensitivity and accuracy for aneurysms ≤3 mm were significantly lower than for those aneurysms larger. (P < 0.001, each).</p><p><strong>Conclusion: </strong>Combining CTA and MRA analysis improves sensitivity, specificity, and accuracy for UIA detection compared to using each modality alone.</p>","PeriodicalId":10391,"journal":{"name":"Clinical Neuroradiology","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2025-01-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143001223","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":"Deep-Learning-based Automated Identification of Ventriculoperitoneal-Shunt Valve Models from Skull X-rays.","authors":"Marius Vach, Daniel Weiss, Vivien Lorena Ivan, Christian Boschenriedter, Luisa Wolf, Thomas Beez, Björn B Hofmann, Christian Rubbert, Julian Caspers","doi":"10.1007/s00062-024-01490-4","DOIUrl":"https://doi.org/10.1007/s00062-024-01490-4","url":null,"abstract":"<p><strong>Introduction: </strong>Ventriculoperitoneal shunts (VPS) are an essential part of the treatment of hydrocephalus, with numerous valve models available with different ways of indicating pressure levels. The model types often need to be identified on X‑rays to assess pressure levels using a matching template. Artificial intelligence (AI), in particular deep learning, is ideally suited to automate repetitive tasks such as identifying different VPS valve models. The aim of this work was to investigate whether AI, in particular deep learning, allows the identification of VPS models in cranial X‑rays.</p><p><strong>Methods: </strong>959 cranial X‑rays of patients with a VPS were included and reviewed for image quality and complete visualization of VPS valves. The images included four VPS model types: Codman Hakim (n = 774, 81%), Codman Certas Plus (n = 117, 12%), Sophysa Sophy Mini SM8 (n = 35, 4%) and proGAV 2.0 (n = 33, 3%). A Convolutional Neural Network (CNN) was trained using stratified five-fold cross-validation to classify the four VPS model types in the dataset. A finetuned CNN pretrained on the ImageNet dataset as well as a model trained from scratch were compared. The averaged performance and uncertainty metrics were evaluated across the cross-validation splits.</p><p><strong>Results: </strong>The fine-tuned model identified VPS valve models with a mean accuracy of 0.98 ± 0.01, macro-averaged F1 score of 0.93 ± 0.04, a recall of 0.94 ± 0.03 and a precision of 0.95 ± 0.08 across the five cross-validation splits.</p><p><strong>Conclusion: </strong>Automatic classification of VPS valve models in skull X‑rays, using fully automatable preprocessing steps and a CNN, is feasible. This is an encouraging finding to further explore the possibility of automating VPS valve model identification and pressure level reading in skull X‑rays.</p>","PeriodicalId":10391,"journal":{"name":"Clinical Neuroradiology","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2025-01-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142982631","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}