Clinical Neuroradiology最新文献

{"title":"Endovascular Thrombectomy for Large Ischemic Strokes with ASPECTS 0–2: a Meta-analysis of Randomized Controlled Trials","authors":"Laurens Winkelmeier, Máté Maros, Fabian Flottmann, Christian Heitkamp, Gerhard Schön, Götz Thomalla, Jens Fiehler, Uta Hanning","doi":"10.1007/s00062-024-01414-2","DOIUrl":"https://doi.org/10.1007/s00062-024-01414-2","url":null,"abstract":"<h3 data-test=\"abstract-sub-heading\">Purpose</h3><p>Randomized controlled trials (RCTs) demonstrated a treatment effect of endovascular thrombectomy in acute ischemic stroke with large infarct, commonly defined as an Alberta Stroke Program Early CT Score (ASPECTS) of 3–5. However, data on endovascular thrombectomy in patients with very low ASPECTS of 0–2 remain scarce.</p><h3 data-test=\"abstract-sub-heading\">Methods</h3><p>We conducted a systematic review and meta-analysis of RCTs comparing endovascular thrombectomy versus medical treatment alone in acute ischemic anterior circulation stroke with very large infarct, defined as ASPECTS of 0–2. The primary outcome was the shift toward better functional outcomes on the 90-day modified Rankin Scale (mRS). Random effects meta-analysis was performed using the generic inverse variance method.</p><h3 data-test=\"abstract-sub-heading\">Results</h3><p>Literature research identified four RCTs which evaluated the treatment effect of endovascular thrombectomy for large infarcts and provided a subgroup analysis of the mRS shift in patients with ASPECTS of 0–2. The pooled analysis showed a significant shift toward better 90-day mRS scores in favor of endovascular thrombectomy (pooled odds ratio, 1.62, 95% confidence interval, 1.29–2.04, <i>P</i> &lt; 0.001).</p><h3 data-test=\"abstract-sub-heading\">Conclusion</h3><p>This meta-analysis suggests a treatment effect of endovascular thrombectomy in specific patients with very low ASPECTS of 0–2, challenging the use of ASPECTS for treatment selection in acute ischemic stroke due to large vessel occlusion. An individual patient meta-analysis of RCTs would strengthen evidence in the treatment of patients with ASPECTS of 0–2.</p><h3 data-test=\"abstract-sub-heading\">Graphic abstract</h3>","PeriodicalId":10391,"journal":{"name":"Clinical Neuroradiology","volume":"6 1","pages":""},"PeriodicalIF":2.8,"publicationDate":"2024-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140840254","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":"Advanced diffusion MRI provides evidence for altered axonal microstructure and gradual peritumoral infiltration in GBM in comparison to brain metastases","authors":"U. Würtemberger, A. Rau, M. Diebold, L. Becker, M. Hohenhaus, J. Beck, P. C. Reinacher, D. Erny, M. Reisert, H. Urbach, T. Demerath","doi":"10.1007/s00062-024-01416-0","DOIUrl":"https://doi.org/10.1007/s00062-024-01416-0","url":null,"abstract":"<h3 data-test=\"abstract-sub-heading\">Purpose</h3><p>In contrast to peritumoral edema in metastases, GBM is histopathologically characterized by infiltrating tumor cells within the T2 signal alterations. We hypothesized that depending on the distance from the outline of the contrast-enhancing tumor we might reveal imaging evidence of gradual peritumoral infiltration in GBM and predominantly vasogenic edema around metastases. We thus investigated the gradual change of advanced diffusion metrics with the peritumoral zone in metastases and GBM.</p><h3 data-test=\"abstract-sub-heading\">Methods</h3><p>In 30 patients with GBM and 28 with brain metastases, peritumoral T2 hyperintensity was segmented in 33% partitions based on the total volume beginning at the enhancing tumor margin and divided into inner, middle and outer zones. Diffusion Tensor Imaging (DTI)-derived fractional anisotropy and mean diffusivity as well as Diffusion Microstructure Imaging (DMI)-based parameters Dax-intra, Dax-extra, V‑CSF and V-intra were employed to assess group-wise differences between inner and outer zones as well as within-group gradients between the inner and outer zones.</p><h3 data-test=\"abstract-sub-heading\">Results</h3><p>In metastases, fractional anisotropy and Dax-extra were significantly reduced in the inner zone compared to the outer zone (FA <i>p</i> = 0.01; Dax-extra <i>p</i> = 0.03). In GBM, we noted a reduced Dax-extra and significantly lower intraaxonal volume fraction (Dax-extra <i>p</i> = 0.008, V‑intra <i>p</i> = 0.006) accompanied by elevated axial intraaxonal diffusivity in the inner zone (<i>p</i> = 0.035). Between-group comparison of the outer to the inner zones revealed significantly higher gradients in metastases over GBM for FA (<i>p</i> = 0.04) as well as the axial diffusivity in the intra- (<i>p</i> = 0.02) and extraaxonal compartment (<i>p</i> &lt; 0.001).</p><h3 data-test=\"abstract-sub-heading\">Conclusion</h3><p>Our findings provide evidence of gradual alterations within the peritumoral zone of brain tumors. These are compatible with predominant (vasogenic) edema formation in metastases, whereas our findings in GBM are in line with an axonal destructive component in the immediate peritumoral area and evidence of tumor cell infiltration with accentuation in the tumor’s vicinity.</p>","PeriodicalId":10391,"journal":{"name":"Clinical Neuroradiology","volume":"15 1","pages":""},"PeriodicalIF":2.8,"publicationDate":"2024-04-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140809973","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":"Association of Imaging-based Predictors with Outcome in Different Treatment Options for Intracerebral Hemorrhage.","authors":"R. Krzyżewski, B. Kwinta, Krzysztof Stachura, Tadeusz J Popiela, R. Pułyk, Agnieszka Słowik, Jerzy Gąsowski, K. Kliś","doi":"10.1007/s00062-024-01406-2","DOIUrl":"https://doi.org/10.1007/s00062-024-01406-2","url":null,"abstract":"","PeriodicalId":10391,"journal":{"name":"Clinical Neuroradiology","volume":"13 4","pages":""},"PeriodicalIF":2.8,"publicationDate":"2024-04-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140652260","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":"Thalamo-mesencephalic Branches of the Posterior Cerebral Artery: a 3D Rotational Angiography Study.","authors":"Maximilian Rauch, Joachim Berkefeld, Madleen Klonowski, E. Hattingen, S. Weidauer","doi":"10.1007/s00062-024-01418-y","DOIUrl":"https://doi.org/10.1007/s00062-024-01418-y","url":null,"abstract":"","PeriodicalId":10391,"journal":{"name":"Clinical Neuroradiology","volume":"5 12","pages":""},"PeriodicalIF":2.8,"publicationDate":"2024-04-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140652983","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":"Answer to: Complications During Ozone Therapy as a Result of Malpractice and Lack of Guidelines.","authors":"Daniel S. Marín-Medina, Adriana P Ortega-Quintero","doi":"10.1007/s00062-024-01411-5","DOIUrl":"https://doi.org/10.1007/s00062-024-01411-5","url":null,"abstract":"","PeriodicalId":10391,"journal":{"name":"Clinical Neuroradiology","volume":"57 9","pages":""},"PeriodicalIF":2.8,"publicationDate":"2024-04-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140671003","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":"Comparison of Flow Reduction Efficacy of Nominal and Oversized Flow Diverters Using a Novel Measurement-assisted in Silico Method.","authors":"B. Csippa, Levente Sándor, Gábor Závodszky, I. Szikora, György Paál","doi":"10.1007/s00062-024-01404-4","DOIUrl":"https://doi.org/10.1007/s00062-024-01404-4","url":null,"abstract":"","PeriodicalId":10391,"journal":{"name":"Clinical Neuroradiology","volume":"51 17","pages":""},"PeriodicalIF":2.8,"publicationDate":"2024-04-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140667179","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":"Complications During Ozone Therapy as a Result of Malpractice and Lack of Guidelines.","authors":"S. Chirumbolo, S. Pandolfi, L. Valdenassi, Marianna Chierchia, M. Franzini","doi":"10.1007/s00062-024-01412-4","DOIUrl":"https://doi.org/10.1007/s00062-024-01412-4","url":null,"abstract":"","PeriodicalId":10391,"journal":{"name":"Clinical Neuroradiology","volume":"23 12","pages":""},"PeriodicalIF":2.8,"publicationDate":"2024-04-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140667531","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":"Societies' Communications.","authors":"","doi":"10.1007/s00062-024-01413-3","DOIUrl":"https://doi.org/10.1007/s00062-024-01413-3","url":null,"abstract":"","PeriodicalId":10391,"journal":{"name":"Clinical Neuroradiology","volume":"85 18","pages":""},"PeriodicalIF":2.8,"publicationDate":"2024-04-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140675405","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":"Endovascular Thrombectomy for Extensive Infarction (ASPECTS 0-2) in Acute Ischemic Stroke.","authors":"P. Dhillon, Vinicius Carraro do Nascimento, L. de Villiers, Hal Rice","doi":"10.1007/s00062-024-01408-0","DOIUrl":"https://doi.org/10.1007/s00062-024-01408-0","url":null,"abstract":"","PeriodicalId":10391,"journal":{"name":"Clinical Neuroradiology","volume":"22 25","pages":""},"PeriodicalIF":2.8,"publicationDate":"2024-04-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140674735","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":"Multi-Dynamic-Multi-Echo-based MRI for the Pre-Surgical Determination of Sellar Tumor Consistency: a Quantitative Approach for Predicting Lesion Resectability","authors":"Mehmet Salih Yildirim, Victor Ulrich Schmidbauer, Alexander Micko, Lisa Lechner, Michael Weber, Julia Furtner, Stefan Wolfsberger, Intesar-Victoria Malla Houech, Anna Cho, Gregor Dovjak, Gregor Kasprian, Daniela Prayer, Wolfgang Marik","doi":"10.1007/s00062-024-01407-1","DOIUrl":"https://doi.org/10.1007/s00062-024-01407-1","url":null,"abstract":"<h3 data-test=\"abstract-sub-heading\">Purpose</h3><p>Pre-surgical information about tumor consistency could facilitate neurosurgical planning. This study used multi-dynamic-multi-echo (MDME)-based relaxometry for the quantitative determination of pituitary tumor consistency, with the aim of predicting lesion resectability.</p><h3 data-test=\"abstract-sub-heading\">Methods</h3><p>Seventy-two patients with suspected pituitary adenomas, who underwent preoperative 3 T MRI between January 2020 and January 2022, were included in this prospective study. Lesion-specific T1-/T2-relaxation times (T1R/T2R) and proton density (PD) metrics were determined. During surgery, data about tumor resectability were collected. A Receiver Operating Characteristic (ROC) curve analysis was performed to investigate the diagnostic performance (sensitivity/specificity) for discriminating between easy- and hard-to-remove by aspiration (eRAsp and hRAsp) lesions. A Mann-Whitney-U-test was done for group comparison.</p><h3 data-test=\"abstract-sub-heading\">Results</h3><p>A total of 65 participants (mean age, 54 years ± 15, 33 women) were enrolled in the quantitative analysis. Twenty-four lesions were classified as hRAsp, while 41 lesions were assessed as eRAsp. There were significant differences in T1R (hRAsp: 1221.0 ms ± 211.9; eRAsp: 1500.2 ms ± 496.4; <i>p</i> = 0.003) and T2R (hRAsp: 88.8 ms ± 14.5; eRAsp: 137.2 ms ± 166.6; <i>p</i> = 0.03) between both groups. The ROC analysis revealed an area under the curve of 0.72 (95% CI: 0.60–0.85) at <i>p</i> = 0.003 for T1R (cutoff value: 1248 ms; sensitivity/specificity: 78%/58%) and 0.66 (95% CI: 0.53–0.79) at <i>p</i> = 0.03 for T2R (cutoff value: 110 ms; sensitivity/specificity: 39%/96%).</p><h3 data-test=\"abstract-sub-heading\">Conclusion</h3><p>MDME-based relaxometry enables a non-invasive, pre-surgical characterization of lesion consistency and, therefore, provides a modality with which to predict tumor resectability.</p>","PeriodicalId":10391,"journal":{"name":"Clinical Neuroradiology","volume":"51 1","pages":""},"PeriodicalIF":2.8,"publicationDate":"2024-04-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140627290","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}