Clinical Neuroradiology最新文献_第3页

Thrombectomy Outcomes for Anterior Circulation Stroke in the 6-24 h Time Window Solely Based On NCCT and CTA: A Single Center Study. 仅根据 NCCT 和 CTA 在 6-24 小时时间窗内对前循环卒中进行血栓清除术的结果：单中心研究。

IF 2.8 3区医学

Clinical Neuroradiology Pub Date : 2024-10-01 DOI: 10.1007/s00062-024-01462-8

Dmytro Shchehlov, Stanislav Konotopchk, Valentyna Pankiv, Farida Rzayeva, Sergii Kolomiichenko, Mykola Vyval, Fabian Flottmann, Jens Fiehler, Anna A Kyselyova

{"title":"Thrombectomy Outcomes for Anterior Circulation Stroke in the 6-24 h Time Window Solely Based On NCCT and CTA: A Single Center Study.","authors":"Dmytro Shchehlov, Stanislav Konotopchk, Valentyna Pankiv, Farida Rzayeva, Sergii Kolomiichenko, Mykola Vyval, Fabian Flottmann, Jens Fiehler, Anna A Kyselyova","doi":"10.1007/s00062-024-01462-8","DOIUrl":"https://doi.org/10.1007/s00062-024-01462-8","url":null,"abstract":"Purpose: Since perfusion imaging may be unavailable in smaller hospitals, alternative imaging selection methods for acute ischemic stroke can improve outcomes and optimize resources. This study assessed the safety and effectiveness of using imaging criteria other than DEFUSE 3 and DAWN for thrombectomy beyond 6 h from symptom onset in patients stroke in the anterior circulation.Methods: This is a retrospective, single-center analysis of consecutive patients with large vessel occlusion in the anterior circulation undergoing thrombectomy. Patients were categorized into two groups based on the collateral status (moderate collaterals and good collaterals).Results: Among 198 patients, 106 (54%) met the inclusion criteria and were analyzed. Good collateral status was observed in 78 (74%) patients. Patients with good collaterals showed significantly lower mRS scores at discharge and at 90 days compared to their counterparts with moderate collateral status (4 (3-4) vs. 4 (4-5); p = 0.001 and 2 (0-4) vs. 6 (3-6); p < 0.001, respectively). More patients with good collateral status achieved favorable outcomes at 90 days compared to those with moderate status (48 (61.5%) vs. 5 (17.9%); p < 0.001). Good collaterals were an independent predictor of good clinical outcomes at 90 days (OR = 1.31, 95% CI: 1.13-1.53, p < 0.001).Conclusion: Selecting patients for endovascular treatment of acute ischemic stroke using non-contrast CT and CT angiography shows 90-day outcomes similar to the DAWN and DEFUSE-3 trials. Using collateral status on CT angiography can predict favorable outcomes after mechanical thrombectomy in resource-limited settings where perfusion imaging is unavailable.","PeriodicalId":10391,"journal":{"name":"Clinical Neuroradiology","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142342856","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}

引用次数: 0

An Artificial Intelligence Algorithm Integrated into the Clinical Workflow Can Ensure High Quality Acute Intracranial Hemorrhage CT Diagnostic. 融入临床工作流程的人工智能算法可确保高质量的急性颅内出血 CT 诊断。

IF 2.8 3区医学

Clinical Neuroradiology Pub Date : 2024-09-26 DOI: 10.1007/s00062-024-01461-9

K Villringer, R Sokiranski, R Opfer, L Spies, M Hamann, A Bormann, M Brehmer, I Galinovic, J B Fiebach

{"title":"An Artificial Intelligence Algorithm Integrated into the Clinical Workflow Can Ensure High Quality Acute Intracranial Hemorrhage CT Diagnostic.","authors":"K Villringer, R Sokiranski, R Opfer, L Spies, M Hamann, A Bormann, M Brehmer, I Galinovic, J B Fiebach","doi":"10.1007/s00062-024-01461-9","DOIUrl":"https://doi.org/10.1007/s00062-024-01461-9","url":null,"abstract":"Purpose: Intracranial hemorrhage (ICH) is a life-threatening condition requiring rapid diagnostic and therapeutic action. This study evaluates whether Artificial intelligence (AI) can provide high-quality ICH diagnostics and turnaround times suitable for routine radiological practice.Methods: A convolutional neural network (CNN) was trained and validated to detect ICHs on DICOM images of cranial CT (CCT) scans, utilizing about 674,000 individually labeled slices. The CNN was then incorporated into a commercial AI engine and seamlessly integrated into three pilot centers in Germany. A real-world test-dataset was extracted and manually annotated by two experienced experts. The performance of the AI algorithm against the two raters was assessed and compared to the inter-rater agreement. The overall time ranging from data acquisition to the delivery of the AI results was analyzed.Results: Out of 6284 CCT examinations acquired in three different centers, 947 (15%) had ICH. Breakdowns of hemorrhage types included 8% intraparenchymal, 3% intraventricular, 6% subarachnoidal, 7% subdural, < 1% epidural hematomas. Comparing the AI's performance on a subset of 255 patients with two expert raters, it achieved a sensitivity of 0.90, a specificity of 0.96, an accuracy of 0.96. The corresponding inter-rater agreement was 0.84, 0.98, and 0.96. The overall median processing times for the three centers were 9, 11, and 12 min, respectively.Conclusion: We showed that an AI algorithm for the automatic detection of ICHs can be seamlessly integrated into clinical workflows with minimal turnaround time. The accuracy was on par with radiology experts, making the system suitable for routine clinical use.","PeriodicalId":10391,"journal":{"name":"Clinical Neuroradiology","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2024-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142342855","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}

引用次数: 0

Focally Enlarged Perivascular Spaces in Pediatric and Adolescent Patients with Polymicrogyria—an MRI Study 小儿和青少年多发性微小病变患者血管周围间隙局部增大--磁共振成像研究

IF 2.8 3区医学

Clinical Neuroradiology Pub Date : 2024-09-13 DOI: 10.1007/s00062-024-01457-5

Maximilian Rauch, Karsten Lachner, Lea Frickel, Monika Lauer, Simon Jonas Adenauer, Elisabeth Neuhaus, Elke Hattingen, Luciana Porto

{"title":"Focally Enlarged Perivascular Spaces in Pediatric and Adolescent Patients with Polymicrogyria—an MRI Study","authors":"Maximilian Rauch, Karsten Lachner, Lea Frickel, Monika Lauer, Simon Jonas Adenauer, Elisabeth Neuhaus, Elke Hattingen, Luciana Porto","doi":"10.1007/s00062-024-01457-5","DOIUrl":"https://doi.org/10.1007/s00062-024-01457-5","url":null,"abstract":"<h3 data-test=\"abstract-sub-heading\">Purpose</h3>Polymicrogyria (PMG) is a cortical malformation frequently associated with epilepsy. Our aim was to investigate the frequency and conspicuity of enlarged perivascular spaces (EPVS) underneath dysplastic cortex as a potentially underrecognized feature of PMG in pediatric and adolescent patients undergoing clinical magnetic resonance imaging (MRI).<h3 data-test=\"abstract-sub-heading\">Methods</h3>We analyzed data from 28 pediatric and adolescent patients with PMG and a matched control group, ranging in age from 2 days to 21 years, who underwent MRI at 1.5T or 3T. T2-weighted MR images were examined for the presence of EPVS underneath the dysplastic cortex. The quantity of EPVS was graded from 0 to 4 (0: none, 1: < 10, 2: 11–20, 3: 21–40, 4: > 40 EPVS). We then compared the presence and quantity of EPVS to the matched controls in terms of total EPVS scores, and EPVS scores underneath the dysplastsic cortex depending on the age groups, the localization of PMG, and the MRI field strength.<h3 data-test=\"abstract-sub-heading\">Results</h3>In 23/28 (82%) PMG patients, EPVS spatially related to the dysplastic cortex were identified. EPVS scores were significantly higher in PMG patients compared to controls, independent from age or PMG location. No significant differences were observed in EPVS scores in patients examined at 1.5T compared to those examined at 3T.<h3 data-test=\"abstract-sub-heading\">Conclusion</h3>EPVS underneath the dysplastic cortex were identified in 82% of patients. EPVS may serve as an important clue for PMG and a marker for cortical malformation.","PeriodicalId":10391,"journal":{"name":"Clinical Neuroradiology","volume":"16 1","pages":""},"PeriodicalIF":2.8,"publicationDate":"2024-09-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142217367","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}

引用次数: 0

Seeing more than the Tip of the Iceberg: Approaches to Subthreshold Effects in Functional Magnetic Resonance Imaging of the Brain. 看到的不仅仅是冰山一角：大脑功能磁共振成像中的阈下效应研究方法。

IF 2.8 3区医学

Clinical Neuroradiology Pub Date : 2024-09-01 Epub Date: 2024-06-06 DOI: 10.1007/s00062-024-01422-2

Benedikt Sundermann, Bettina Pfleiderer, Anke McLeod, Christian Mathys

引用次数: 0

Retrograde Parent Artery Occlusion for Ruptured Intracranial Vertebral Artery Dissecting Aneurysms Involving the Posterior Inferior Cerebellar Artery: The "Breakwater" Technique. 逆行母动脉闭塞术治疗涉及小脑后下动脉的颅内椎动脉破裂夹层动脉瘤：防波堤 "技术。

IF 2.8 3区医学

Clinical Neuroradiology Pub Date : 2024-09-01 Epub Date: 2024-02-02 DOI: 10.1007/s00062-024-01388-1

Satoshi Kitamura, Yoshiki Hanaoka, Jun-Ichi Koyama, Daisuke Yamazaki, Takuya Nakamura, Tetsuyoshi Horiuchi

引用次数: 0

Hemodynamic Impairments of Evaluating Symptomatic Intracranial Atherosclerotic Stenosis using Quantitative Flow Ratio on Digital Subtraction Angiography : A Comparison with Computed Tomography Perfusion, MRI and Fractional Flow Reserve. 利用数字减影血管造影术的定量血流比评估有症状的颅内动脉粥样硬化性狭窄的血流动力学损伤：与计算机断层扫描灌注、核磁共振成像和分数血流储备的比较。

IF 2.8 3区医学

Clinical Neuroradiology Pub Date : 2024-09-01 Epub Date: 2024-03-15 DOI: 10.1007/s00062-024-01395-2

Yingchun Wu, Feng Gao, Honglin Feng

{"title":"Hemodynamic Impairments of Evaluating Symptomatic Intracranial Atherosclerotic Stenosis using Quantitative Flow Ratio on Digital Subtraction Angiography : A Comparison with Computed Tomography Perfusion, MRI and Fractional Flow Reserve.","authors":"Yingchun Wu, Feng Gao, Honglin Feng","doi":"10.1007/s00062-024-01395-2","DOIUrl":"10.1007/s00062-024-01395-2","url":null,"abstract":"Purpose: Cerebral hemodynamics are important for the management of intracranial atherosclerotic stenosis (ICAS). The quantitative flow ratio (QFR) is a novel angiography-derived index for assessing the functional relevance of ICAS without pressure wires and adenosine. Good diagnostic yield with the hyperemic fractional flow reserve (FFR) have been reported, while data on the comparison of QFR to FFR are scarce.Methods: In this prospective study 56 patients with anterior circulation symptomatic ICAS who received endovascular treatment were included. The new method of computing QFR from a single angiographic view, i.e., the Murray law-based QFR (μQFR), was applied to the examined vessels. An artificial intelligence algorithm was developed to realize the automatic delineation of vascular contour. Pressure gradients were measured before and after treatment within the lesion vessel using a pressure guidewire and the FFR was calculated.Results: There was a good correlation between μQFR and FFR. Preoperative FFR predicted DWI watershed infarction (FFR optimal cut-off level: 0.755). Preoperative μQFR predicted DWI watershed infarction (μQFR optimal cut-off level: 0.51). Preoperative FFR predicted CTP hypoperfusion (FFR best predictive value: 0.62). Preoperative μQFR predicted CTP hypoperfusion (μQFR best predictive value: 0.375).Conclusion: The μQFR based on DSA images can be used as an indicator to assess the functional status of the lesion in patients with ICAS.","PeriodicalId":10391,"journal":{"name":"Clinical Neuroradiology","volume":" ","pages":"613-624"},"PeriodicalIF":2.8,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140136578","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}

引用次数: 0

Efficient Organization of a Stroke Center : Using Modern Communication Methods. 高效组织卒中中心：使用现代交流方法。

IF 2.8 3区医学

Clinical Neuroradiology Pub Date : 2024-09-01 Epub Date: 2024-02-07 DOI: 10.1007/s00062-024-01386-3

Marios-Nikos Psychogios, Nikos Ntoulias, Urs Fischer, Marc Luethi, Peter B Sporns

引用次数: 0

Freiburg Neuropathology Case Conference : Mild Disorientation and Mild Anomic Aphasia in a 79-Year-Old Female. 弗莱堡神经病理学病例会议：一名 79 岁女性的轻度定向障碍和轻度失语症。

IF 2.8 3区医学

Clinical Neuroradiology Pub Date : 2024-09-01 Epub Date: 2024-07-29 DOI: 10.1007/s00062-024-01441-z

A Rau, M Schwabenland, R Watzlawick, M Prinz, H Urbach, D Erny, C A Taschner

引用次数: 0

Anatomical Flow Diversion by Hybrid Strategy for Intractable Large Cerebral Aneurysms. 通过混合策略对难治性大面积脑动脉瘤进行解剖学血流分流。

IF 2.8 3区医学

Clinical Neuroradiology Pub Date : 2024-08-27 DOI: 10.1007/s00062-024-01452-w

Wataro Tsuruta, Takayuki Hara, Satoshi Miyamoto, Jun Isozaki, Daiichiro Ishigami, Hisayuki Hosoo, Yoshiro Ito, Mikito Hayakawa, Aiki Marushima, Yuji Matsumaru

{"title":"Anatomical Flow Diversion by Hybrid Strategy for Intractable Large Cerebral Aneurysms.","authors":"Wataro Tsuruta, Takayuki Hara, Satoshi Miyamoto, Jun Isozaki, Daiichiro Ishigami, Hisayuki Hosoo, Yoshiro Ito, Mikito Hayakawa, Aiki Marushima, Yuji Matsumaru","doi":"10.1007/s00062-024-01452-w","DOIUrl":"https://doi.org/10.1007/s00062-024-01452-w","url":null,"abstract":"Background and importance: Flow diverters (FDs) provide curative endovascular treatment for wide-necked sidewall aneurysms. The efficacy of FDs for bifurcation or branching sidewall aneurysms is probably limited. We used anatomical flow diversion (AFD) for intractable large cerebral aneurysms. We report our experiences with AFD.Methods: The concept of AFD is the transformation from the bifurcation or branching sidewall type to the nonbranching sidewall type. Linearization of the parent artery by stenting, intentional branch occlusion, and aneurysmal coil embolization were performed. Furthermore, bypass surgery is performed for patients intolerant to branch occlusions. We evaluated the clinical outcomes of intractable aneurysms treated with AFD.Results: AFD was performed in seven unruptured large aneurysms. Aneurysmal locations were the top of the basilar artery (BA), BA-superior cerebellar artery (SCA), internal carotid artery (IC)-posterior communicating artery (PcomA), and IC terminal. The mean dome diameter was 17.0 ± 4.6 mm. Six patients underwent bypass surgery. The occluded branches were the PCA + SCA, PcomA, and anterior cerebral artery (ACA) A1. An FD was used in three patients and a neck bridge stent in four patients. No intraprocedural complications occurred. Two postprocedural ischemic complications occurred in one patient. Six (86%) patients demonstrated a modified Rankin Scale (mRS) 0 at the 3-month follow-up, and one with an ischemic complication showed an mRS 5. Complete occlusion of all aneurysms was maintained with a median follow-up duration of 60 months.Conclusion: AFD is useful for intractable large cerebral aneurysms with high curability, although safety verification is required.","PeriodicalId":10391,"journal":{"name":"Clinical Neuroradiology","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2024-08-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142072162","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}

引用次数: 0

Need of Fine-Tuned Radiology Aware Open-Source Large Language Models for Neuroradiology. 神经放射学需要微调的放射学感知开源大语言模型。

IF 2.8 3区医学

Clinical Neuroradiology Pub Date : 2024-08-19 DOI: 10.1007/s00062-024-01454-8

Partha Pratim Ray

引用次数: 0