Clinical Neuroradiology最新文献

{"title":"Endovascular Treatment of Large Core Infarcts: no Limits?","authors":"Martin Bendszus","doi":"10.1007/s00062-024-01472-6","DOIUrl":"10.1007/s00062-024-01472-6","url":null,"abstract":"","PeriodicalId":10391,"journal":{"name":"Clinical Neuroradiology","volume":"34 4","pages":"747-748"},"PeriodicalIF":2.8,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11564248/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142616136","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":"Stroke Evaluation in the Interventional Suite Using Dual-Layer Detector Cone-Beam CT: a First-in-human Prospective Cohort Study (the Next Generation X-ray Imaging System Trial).","authors":"Fredrik Ståhl, Håkan Almqvist, Åsa Aspelin, Jens Kolloch, Odett Ghalamkari, Vamsi Gontu, Dirk Schäfer, Peter van de Haar, Klaus-Jürgen Engel, Fred van Nijnatten, Åke Holmberg, Michael V Mazya, Michael Söderman, Anna Falk Delgado","doi":"10.1007/s00062-024-01439-7","DOIUrl":"10.1007/s00062-024-01439-7","url":null,"abstract":"<p><strong>Purpose: </strong>Cone-beam CT in the interventional suite could be an alternative to CT to shorten door-to-thrombectomy time. However, image quality in cone-beam CT is limited by artifacts and poor differentiation between gray and white matter. This study compared non-contrast brain dual-layer cone-beam CT in the interventional suite to reference standard CT in stroke patients.</p><p><strong>Methods: </strong>A prospective single-center study enrolled consecutive participants with ischemic or hemorrhagic stroke. The hemorrhage detection accuracy, per-region ASPECTS accuracy and subjective image quality (Likert scales for gray-white matter differentiation, structure perception and artifacts) were assessed by three neuroradiologists blinded to clinical data on dual-layer cone-beam CT 75 keV monoenergetic images compared to CT. Objective image quality was assessed by region-of-interest metrics. Non-inferiority for hemorrhage detection and ASPECTS accuracy was determined by the exact binomial test with a one-sided lower performance boundary prospectively set to 80% (98.75% CI).</p><p><strong>Results: </strong>27 participants were included (74 years ± 9; 19 female) in the hyperacute or acute stroke phase. One reader missed a small bleeding, but all hemorrhages were detected in the majority analysis (100% accuracy, CI lower boundary 86%, p = 0.002). ASPECTS majority analysis showed 90% accuracy (CI lower boundary 85%, p < 0.001). Sensitivity was 66% (individual readers 67%, 69%, and 76%), specificity was 97% (97%, 96%, 89%). Subjective and objective image quality were inferior to CT.</p><p><strong>Conclusion: </strong>In a small single-center cohort, dual-layer cone-beam CT showed non-inferior hemorrhage detection and ASPECTS accuracy to CT. Despite inferior image quality, the technique may be useful for stroke evaluation in the interventional suite.</p><p><strong>Trial registration number: </strong>NCT04571099 (clinicaltrials.gov). Prospectively registered 2020-09-04.</p>","PeriodicalId":10391,"journal":{"name":"Clinical Neuroradiology","volume":" ","pages":"929-937"},"PeriodicalIF":2.8,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11564390/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141757540","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":"Roles of Nontraditional Lipid Parameters for Predicting Restenosis in Patients with Intracranial Atherosclerotic Stenosis After Endovascular Treatment.","authors":"Guoming Li, Xuecheng Cen, Zelan Ma, Fajun Chen","doi":"10.1007/s00062-024-01409-z","DOIUrl":"10.1007/s00062-024-01409-z","url":null,"abstract":"<p><strong>Purpose: </strong>Nontraditional lipid parameters are associated with intracranial atherosclerotic stenosis (ICAS) progression. This study aimed to investigate the association of nontraditional lipid parameters with the risk of restenosis in patients with ICAS after endovascular treatment (EVT).</p><p><strong>Methods: </strong>This study retrospectively enrolled consecutive patients with symptomatic ICAS after successful EVT followed by at least 3 months of angiography. Participants were divided into restenosis or non-restenosis groups based on the angiographic follow-up results. The nontraditional lipid parameters were calculated from conventional lipid parameters. The COX regression models and restricted cubic splines (RCS) were used to explore the association between nontraditional lipid parameters and restenosis.</p><p><strong>Results: </strong>This study recruited 222 cases with 224 lesions eligible for our study, of which 56 (25%) had restenosis. Compared with the non-restenosis group, patients in the restenosis group had higher levels of the atherogenic index of plasma (AIP) (0.211, interquartile range, IQR, 0.065-0.404 vs. 0.083, IQR, -0.052-0.265, P = 0.001), remnant cholesterol (RC) (0.55, IQR, 0.33-0.77 vs. 0.30, IQR, 0.18-0.49, P < 0.001) and Castelli's index‑I (CRI-I) (4.13, IQR, 3.39-5.34 vs. 3.74, IQR, 2.94-4.81, P = 0.030). In the multivariable COX regression analysis, a 0.1 unit increase of AIP was an independent risk factor for restenosis (hazard ratio, HR = 1.20, 95% confidence interval, CI 1.05-1.35, P = 0.005) whereas such an association was not observed for RC (HR = 1.01, 95% CI 0.90-1.15, P = 0.835). The restricted cubic spline (RCS) plot revealed a linear relationship between AIP and restenosis (P for nonlinear = 0.835) but a nonlinear relationship for RC (P for nonlinear = 0.012). Patients were stratified according to tertiles (T) of AIP and RC and the risk of restenosis increased in T3 compared to T1 (HR = 3.21, 95% CI 1.35-7.62, P = 0.008 and HR = 2.99, 95% CI 1.11-8.03, P = 0.030, respectively). Furthermore, this association remained stable within each LDL‑C level subgroup.</p><p><strong>Conclusion: </strong>The AIP and RC were positively and independently associated with restenosis in patients with ICAS after EVT.</p>","PeriodicalId":10391,"journal":{"name":"Clinical Neuroradiology","volume":" ","pages":"827-840"},"PeriodicalIF":2.8,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141418196","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":"Thrombectomy Plus Intra-Arterial Thrombolysis Versus Thrombectomy for Acute Large Vessel Occlusions: a Matched-Control Study.","authors":"Bin Han, Xu Tong, Raynald, Baixue Jia, Anxin Wang, Dapeng Mo, Feng Gao, Ning Ma, Zhongrong Miao","doi":"10.1007/s00062-024-01431-1","DOIUrl":"10.1007/s00062-024-01431-1","url":null,"abstract":"<p><strong>Aim: </strong>We conducted a matched-control analysis to compare the outcomes of large vessel occlusion (LVO) patients treated with mechanical thrombectomy (MT) plus Intra-arterial thrombolysis (IAT) versus those treated with MT alone.</p><p><strong>Methods: </strong>The subjects of this study were chosen from ANGEL-ACT registry. All patients who received MT were identified and categorized into two groups: \"MT + IAT\" and \"MT,\" based on whether or not they received additional intra-arterial medication IAT during the MT procedure. After being subjected to 1:1 propensity score matching, the outcome measures, including modified Rankin Scale (mRS) score at 90 days, successful recanalization at the final angiogram, symptomatic intracranial hemorrhage (sICH) within 36 h, and death within 90 days, were compared.</p><p><strong>Results: </strong>The study encompassed a total of 1607 patients, with 641 individuals assigned to the MT + IAT group and 966 to the MT group. After applying propensity score matching, a total of 524 pairs were identified for comparison. The results indicated that there were no significant differences between the two groups with regard to the modified Rankin Scale (mRS) score (median: 3 vs. 3 points; P = 0.83), successful recanalization (89.9 vs. 88.9%; P = 0.62), sICH (8.3 vs. 8.7%; P = 0.79), and death (15.5 vs. 16.4%; P = 0.70).</p><p><strong>Conclusions: </strong>IAT during MT does not confer an elevated risk of sICH or mortality. Furthermore, the combination of MT and IAT may produce comparable functional outcomes in comparison to MT alone, when treating acute LVO patients.</p>","PeriodicalId":10391,"journal":{"name":"Clinical Neuroradiology","volume":" ","pages":"871-879"},"PeriodicalIF":2.8,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141491142","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":"Freiburg Neuropathology Case Conference : Posterior fossa tumour 15 years after microsurgical resection of a cerebellar pilocytic astrocytoma.","authors":"M Schwabenland, L Becker, C J Gizaw, M Prinz, H Urbach, D Erny, C A Taschner","doi":"10.1007/s00062-024-01468-2","DOIUrl":"10.1007/s00062-024-01468-2","url":null,"abstract":"","PeriodicalId":10391,"journal":{"name":"Clinical Neuroradiology","volume":" ","pages":"983-989"},"PeriodicalIF":2.8,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11564267/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142496318","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":"Role and Safety of Tirofiban in Peri-Interventional Antiplatelet Management for Aneurysm Treatment.","authors":"Rana Garayzade, Ansgar Berlis, Tim Tobias Arndt, Christina Wolfert, Björn Sommer, Gernot Müller, Christoph J Maurer","doi":"10.1007/s00062-024-01480-6","DOIUrl":"https://doi.org/10.1007/s00062-024-01480-6","url":null,"abstract":"<p><strong>Background: </strong>Tirofiban is administered for the treatment of aneurysms in cases of thromboembolic complications, as well as in cases of acute stenting or flow-diverter implantation required within the scope of aneurysm treatment. We aimed to investigate the efficacy and safety of tirofiban in this group of patients.</p><p><strong>Methods: </strong>We conducted a retrospective analysis of all patients undergoing aneurysm treatment and receiving peri-interventional tirofiban administration at our institution between 2009 and 2019.</p><p><strong>Results: </strong>A total of 105 patients were included, with 61% women and 39% men (mean age = 53 years, IQR: 44-60 years). Sixty-seven patients underwent emergency aneurysm treatment, and thirty-eight were treated electively. Hemorrhagic events occurred in 22% (15/67) of the patients treated acutely, with 7.46% (5/67) exhibiting symptoms. Patients undergoing elective aneurysm treatment experienced no hemorrhagic events (p = 0.002). Among the 35 patients who required an external ventricular drain (EVD), 22.86% (8/35) developed EVD-related hemorrhages; however, none were symptomatic (p = 0.007). Of the five patients who required a craniotomy, two experienced significant bleeding, and one experienced non-significant craniotomy-related bleeding (p = 0.20).</p><p><strong>Conclusion: </strong>Tirofiban may be safe for use during peri-interventional complications or emergency stenting in aneurysm treatment. However, caution is necessary when craniotomy is required. In elective aneurysm treatments, administering Tirofiban in response to periprocedural complications appears to be safe.</p>","PeriodicalId":10391,"journal":{"name":"Clinical Neuroradiology","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2024-11-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142738590","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":"Acute Occlusion of One Side of Bilateral Infraoptic Anterior Cerebral Arteries.","authors":"Kengo Kishida, Hideki Oka, Hitoshi Kawano, Hidesato Takezawa","doi":"10.1007/s00062-024-01479-z","DOIUrl":"https://doi.org/10.1007/s00062-024-01479-z","url":null,"abstract":"","PeriodicalId":10391,"journal":{"name":"Clinical Neuroradiology","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2024-11-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142738589","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":"Optic Nerve Sheath Dilation Is a Possible Marker of CSF Dyshomeostasis in Idiopathic Intracranial Hypertension.","authors":"Derrek Schartz, Alan J Finkelstein, Emily Schartz, Saanya Lingineni, Matthew Sipple, Zoe Williams, Matthew T Bender, Henry Wang","doi":"10.1007/s00062-024-01476-2","DOIUrl":"https://doi.org/10.1007/s00062-024-01476-2","url":null,"abstract":"<p><strong>Purpose: </strong>Idiopathic intracranial hypertension (IIH) is a complex neurological disease characterized by symptoms of raised intracranial pressure of unclear etiology. Although optic nerve sheath dilation is a common MR neuroimaging feature of IIH, how and why it occurs remains poorly understood. The purpose of the presented analysis was to investigate if optic nerve sheath dilation might be associated with neuroimaging correlates of cerebrospinal and interstitial fluid homeostasis.</p><p><strong>Methods: </strong>IIH patients were retrospectively identified from 2016-2023 from our tertiary healthcare system. Brain MRIs were computationally segmented using FreeSurfer. Additionally, diffusion tensor imaging along the perivascular space (DTI-ALPS) was employed to assess cerebral glymphatic flow. The mean perioptic subarachnoid space (PSAS) to optic nerve sheath diameter (ONSD) ratio from both eyes was correlated with neuroimaging markers of CSF and interstitial fluid homeostasis (choroid plexus, ventricle, and gray and white matter volume) and glymphatic flow. All volumes of interest were normalized to total intracranial volume. Multiple linear regression was used to evaluate for associations between continuous variables accounting for covariates of patient age, sex, and body mass index.</p><p><strong>Results: </strong>In total, 55 IIH patients (89% female; mean age: 30.3 years [SD: 7.6]) were included. Increasing PSAS/ONSD was found to be significantly associated with increasing normalized total choroid plexus volume (p = 0.001, R = 0.48) and total ventricle volume (P = 0.014, R = 0.39). Additionally, increasing PSAS/ONSD was associated with declining/worsening cerebral glymphatic clearance based on DTI-APLS (p = 0.043, R = 0.34). Additionally, there was a significant association between increasing PSAS/ONSD and increasing normalized total gray matter volume (p = 0.025, R = 0.36) and declining normalized total white matter volume (p = 0.012, R = 0.40).</p><p><strong>Conclusion: </strong>These findings suggest that MR optic nerve sheath dilation in IIH might be associated with CSF dyshomeostasis with possible choroid plexus hyperplasia and impaired cerebral glymphatic flow based on DTI-ALPS. These findings encourage future research into the ocular glymphatic system in IIH patients.</p>","PeriodicalId":10391,"journal":{"name":"Clinical Neuroradiology","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2024-11-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142709770","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":"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><p>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).</p><h3 data-test=\"abstract-sub-heading\">Methods</h3><p>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: &lt; 10, 2: 11–20, 3: 21–40, 4: &gt; 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.</p><h3 data-test=\"abstract-sub-heading\">Results</h3><p>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.</p><h3 data-test=\"abstract-sub-heading\">Conclusion</h3><p>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.</p>","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}

{"title":"Seeing more than the Tip of the Iceberg: Approaches to Subthreshold Effects in Functional Magnetic Resonance Imaging of the Brain.","authors":"Benedikt Sundermann, Bettina Pfleiderer, Anke McLeod, Christian Mathys","doi":"10.1007/s00062-024-01422-2","DOIUrl":"10.1007/s00062-024-01422-2","url":null,"abstract":"<p><p>Many functional magnetic resonance imaging (fMRI) studies and presurgical mapping applications rely on mass-univariate inference with subsequent multiple comparison correction. Statistical results are frequently visualized as thresholded statistical maps. This approach has inherent limitations including the risk of drawing overly-selective conclusions based only on selective results passing such thresholds. This article gives an overview of both established and newly emerging scientific approaches to supplement such conventional analyses by incorporating information about subthreshold effects with the aim to improve interpretation of findings or leverage a wider array of information. Topics covered include neuroimaging data visualization, p-value histogram analysis and the related Higher Criticism approach for detecting rare and weak effects. Further examples from multivariate analyses and dedicated Bayesian approaches are provided.</p>","PeriodicalId":10391,"journal":{"name":"Clinical Neuroradiology","volume":" ","pages":"531-539"},"PeriodicalIF":2.8,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11339104/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141261205","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}