Clinical Neuroradiology最新文献

{"title":"Sex-Related Differences in Outcomes of Endovascular Treatment of Distal Medium Vessel Occlusion Strokes.","authors":"Hamza Adel Salim, Vivek Yedavalli, Dhairya Lakhani, Fathi Milhem, Basel Musmar, Nimer Adeeb, Davide Simonato, Yan-Lin Li, Orabi Hajjeh, Muhammed Amir Essibayi, Nils Henninger, Sri Hari Sundararajan, Anna Luisa Kühn, Jane Khalife, Sherief Ghozy, Luca Scarcia, Leonard Ll Yeo, Benjamin Yq Tan, Robert W Regenhardt, Jeremy J Heit, Aymeric Rouchaud, Jens Fiehler, Sunil Sheth, Ajit S Puri, Christian Dyzmann, Marco Colasurdo, Leonardo Renieri, João Pedro Filipe, Pablo Harker, Răzvan Alexandru Radu, Mohamad Abdalkader, Piers Klein, Takahiro Ota, Ashkan Mowla, Kareem El Naamani, Pascal Jabbour, Arundhati Biswas, Frédéric Clarençon, James E Siegler, Thanh N Nguyen, Ricardo Varela, Amanda Baker, David Altschul, Nestor R Gonzalez, Markus A Möhlenbruch, Vincent Costalat, Benjamin Gory, Christian Paul Stracke, Constantin Hecker, Gaultier Marnat, Hamza Shaikh, Christoph J Griessenauer, David S Liebeskind, Alessandro Pedicelli, Andrea M Alexandre, Tobias D Faizy, Illario Tancredi, Erwah Kalsoum, Boris Lubicz, Aman B Patel, Maurizio Fuschi, Max Wintermark, Adrien Guenego, Adam A Dmytriw","doi":"10.1007/s00062-026-01632-w","DOIUrl":"10.1007/s00062-026-01632-w","url":null,"abstract":"<p><strong>Background: </strong>Sex-related differences in outcomes after mechanical thrombectomy (MT) for distal medium vessel occlusion (DMVO) stroke remain uncertain. While unadjusted differences have been reported in stroke populations, it is unclear whether biological sex independently influences outcomes after accounting for major prognostic factors.</p><p><strong>Methods: </strong>We performed a retrospective, multicenter analysis of the MAD-MT registry. Patients with acute DMVO who underwent MT were included. Propensity score matching (PSM) was employed. The primary outcome was functional independence (modified Rankin Scale [mRS] score 0-2) at 90 days. Secondary outcomes included excellent outcome (mRS 0-1), day 1 NIHSS shift, and reperfusion success. Safety outcomes included mortality and symptomatic intracerebral hemorrhage.</p><p><strong>Results: </strong>Before matching, 1147 females and 1062 males were included. After 1:1 PSM (748 patients in each group), the groups were balanced in baseline characteristics. The median age was 75 years in both groups. At 90 days, 51% of females and 54% of males achieved mRS 0-2 (P = 0.38). NIHSS shift from baseline to day 1 was similar (median -2 in both groups), and successful reperfusion (Thrombolysis in Cerebral Infarction 2b-3) was achieved in 86% of females and 89% of males (P = 0.18). Mortality was 18.4% in females and 15.5% in males (P = 0.11). Symptomatic intracerebral hemorrhage occurred in 8.3% of females and 7.7% of males (P = 0.67).</p><p><strong>Conclusions: </strong>After adjustment for age, baseline disability, and vascular risk factors, biological sex was not independently associated with functional or safety outcomes following mechanical thrombectomy for DMVO stroke.</p>","PeriodicalId":10391,"journal":{"name":"Clinical Neuroradiology","volume":" ","pages":"757-770"},"PeriodicalIF":2.6,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13319196/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147431323","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":"Quantitative Assessment of Signal Intensity in PETRA-MRA Vs. TOF-MRA After Flow Diverter Stent Placement.","authors":"Yosuke Ishii, Toshihiko Hayashi, Haruna Furuya, So Akutsu, Aya Namba, Shigeru Nemoto","doi":"10.1007/s00062-025-01607-3","DOIUrl":"10.1007/s00062-025-01607-3","url":null,"abstract":"<p><strong>Purpose: </strong>Digital subtraction angiography (DSA) is the gold standard for evaluating outcomes after flow diverter (FD) stent placement, though its invasive nature presents limitations. Time-of-flight magnetic resonance angiography (TOF-MRA) is commonly used as a non-invasive alternative; however, it is susceptible to artifacts related to magnetic susceptibility and phase dispersion. Recently, Pointwise Encoding Time Reduction with Radial Acquisition (PETRA)-MRA, which employs an ultra-short echo time technique, has emerged as a promising option for post-endovascular imaging. This study aimed to quantitatively assess and compare the signal properties of PETRA-MRA and TOF-MRA in patients following FD treatment, in order to minimize observer-dependent variability.</p><p><strong>Methods: </strong>A retrospective review was conducted on patients treated with a Pipeline Flex with Shield Technology stent for internal carotid artery aneurysms between April 2021 and March 2024. All patients underwent both TOF-MRA and PETRA-MRA scans on the day after treatment, using a 3‑T MRI system. Signal intensities were evaluated in the FD, contralateral internal carotid artery (ICA), aneurysm, and background across three slices for each patient. For aneurysm analysis, the slice with the largest visible aneurysm diameter was selected. Contrast-to-noise ratios (CNR) were computed in relation to the background signal, and signal intensity ratios (SIR) were calculated with reference to the contralateral ICA. These metrics were then compared between TOF-MRA and PETRA-MRA.</p><p><strong>Results: </strong>The analysis included 21 patients (mean age 60.2 years; 14 female), with 7 (33%) receiving additional coiling. The average aneurysm diameter was 9.2 ± 5.6 mm. PETRA-MRA yielded significantly higher CNR values for both the FD (3.80 ± 1.21) and aneurysm (8.04 ± 5.79) compared with TOF-MRA (FD 2.51 ± 0.95, p < 0.001; aneurysm 3.92 ± 2.41, p = 0.001). Similarly, SIR values were notably greater with PETRA-MRA for the FD (0.44 ± 0.07 vs. 0.35 ± 0.08, p < 0.001) and the aneurysm (0.95 ± 0.19 vs. 0.62 ± 0.23, p < 0.001).</p><p><strong>Conclusions: </strong>Compared to TOF-MRA, PETRA-MRA provided higher CNR and SIR in the evaluation of both FD and aneurysm visualization. These findings indicate that PETRA-MRA is a promising noninvasive technique for early postprocedural assessment after FD treatment.</p>","PeriodicalId":10391,"journal":{"name":"Clinical Neuroradiology","volume":" ","pages":"535-543"},"PeriodicalIF":2.6,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145932499","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":"RCBVmax from DSC Perfusion MRI as a Supportive Imaging Biomarker for Differentiating IDH-Mutant Astrocytomas and Oligodendroglioma.","authors":"Manoj Mannil, Christian Rubbert, Manfred Musigmann, Mathias Prokop, Paola Feraco, Frederick J A Meijer, Marion Smits, Anja G Van der Kolk, Dylan Henssen","doi":"10.1007/s00062-026-01624-w","DOIUrl":"10.1007/s00062-026-01624-w","url":null,"abstract":"<p><strong>Background: </strong>Gliomas, particularly astrocytomas (IDH-mutated, 1p/19q intact) and oligodendrogliomas (IDH-mutated, 1p/19q co-deleted), differ significantly in their clinical behavior and prognosis. Accurate differentiation between these subtypes is crucial for guiding therapeutic decisions. Non-invasive imaging biomarkers, such as T2-Flair mismatch sign and relative cerebral blood volume (rCBV), have shown promise in glioma classification.</p><p><strong>Methods: </strong>This retrospective multicenter study analyzed 42 patients with astrocytoma and 21 with oligodendroglioma. Demographic, histopathological, and imaging data were collected, with a focus on rCBV parameters derived from dynamic susceptibility contrast perfusion MRI. Statistical analyses were conducted to assess differences between the groups and evaluate the discriminatory power of rCBV metrics. After correction for multiple corrections, level of significance was set at p < 0.01.</p><p><strong>Results: </strong>Patients with astrocytoma and oligodendroglioma were similar in age and gender distribution (mean age and male-female-ratio; p = 0.01 respectively p = 0.04). The rCBVmax value was significantly higher in oligodendrogliomas (11.64 vs. 7.69, p < 0.001) and demonstrated a good discriminatory power (AUC = 0.764). Median and mean rCBV values showed non-significant differences between oligodendroglioma and astrocytoma (p = 0.02 respectively p = 0.03).</p><p><strong>Conclusion: </strong>rCBVmax emerges as a potential imaging marker for differentiating oligodendrogliomas from astrocytomas. These findings can be explained by biological properties of oligodendrogliomas and thereby underscore the potential of advanced imaging techniques in non-invasive glioma classification. However, larger prospective studies are required to validate these results and standardize imaging protocols.</p>","PeriodicalId":10391,"journal":{"name":"Clinical Neuroradiology","volume":" ","pages":"673-679"},"PeriodicalIF":2.6,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13319155/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146218803","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":"Opportunistic Assessment of Dental Pathologies in Cervical Computed Tomography Angiography: A Proof of Concept Study.","authors":"Tim Halstenbach, Maximilian F Russe, Sabrina Zimmermann, Fabian Cieplik, Rainer Schmelzeisen, Horst Urbach, Wiebke Semper-Hogg, Alexander Rau","doi":"10.1007/s00062-026-01630-y","DOIUrl":"10.1007/s00062-026-01630-y","url":null,"abstract":"<p><strong>Objective: </strong>Computed tomography angiography (CTA) of the head and neck routinely encompasses dentoalveolar structures within the field of view, yet dental findings are rarely reported. Opportunistic detection of dental pathologies could provide valuable information for patient management. This feasability study evaluated the diagnostic potential of CTA for identifying common dental pathologies compared with panoramic radiography (orthopantomogram, OPG).</p><p><strong>Materials and methods: </strong>Fifty-seven patients (39% female, mean age: 63 years), who underwent both OPG and head-and-neck CTA within 100 days were retrospectively included. Three experienced dental radiological examiners independently assessed each tooth for periapical radiolucencies, periodontal bone lesions, carious lesions, root residues, retained teeth, and dental implants in cervical CTA and vascular kernel. Cohen's κ and Fleiss' κ were calculated to determine intra- and inter-rater-intramodality agreement between OPG and CTA findings.</p><p><strong>Results: </strong>CTA demonstrated good intermodality agreement with OPG regarding the detection of periapical lesions and periodontal bone defects, root canal-filled, retained teeth, and root residues (κ = 0.60-0.98). Carious lesions demonstrated moderate concordance. OPG identified more periodontal bone defects (mean number of detections per rater: CTA: 141.3; OPG: 173) and carious lesions (CTA: 48; OPG: 77; both p < 0.001).</p><p><strong>Conclusions: </strong>This systematic comparison of CTA and OPG demonstrated the feasability of CTA for opportunistic screening of dental status. While CTA can not replace dedicated dental imaging and clinical assessment, integrating dental evaluation into CTA interpretation may support early detection of oral infection sources and streamline interdisciplinary patient management in neurovascular imaging workflows.</p>","PeriodicalId":10391,"journal":{"name":"Clinical Neuroradiology","volume":" ","pages":"701-709"},"PeriodicalIF":2.6,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13319318/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146257528","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":"Contemporary Neurovascular Guidelines Between Historical Evidence and Technological Reality.","authors":"M Bendszus","doi":"10.1007/s00062-026-01682-0","DOIUrl":"10.1007/s00062-026-01682-0","url":null,"abstract":"","PeriodicalId":10391,"journal":{"name":"Clinical Neuroradiology","volume":" ","pages":"263-264"},"PeriodicalIF":2.6,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13320038/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148148667","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":"Structural MRI Biomarkers of Intracranial Pressure in IIH: Linking Optic Nerve Sheath, Pituitary Morphology, and Hormonal Changes.","authors":"Zeynep Bendella, Barbara Daria Wichtmann, Ralf Clauberg, Wiebke Fenske, Charlotte Fries, Monika Jeub, Martina Minnerop, Arndt-Hendrik Schievelkamp, Franziskus M Schützeichel, Bettina Wabbels, Christina Schaub, Max Witry, Berkan Koyak, Alexander Radbruch, Jennifer Linder, Ullrich Wüllner, Christine Kindler","doi":"10.1007/s00062-026-01618-8","DOIUrl":"10.1007/s00062-026-01618-8","url":null,"abstract":"<p><strong>Purpose: </strong>To investigate the relationship between intracranial pressure (ICP), anterior pituitary hormones, and structural brain changes in women with idiopathic intracranial hypertension (IIH).</p><p><strong>Methods: </strong>Eighteen women with therapy-refractory IIH underwent lumbar puncture, endocrine assessment, and high-resolution brain MRI. Serum levels of pituitary hormones were correlated with ICP and radiological parameters including pituitary volume, flattening, and optic nerve (ON) and optic nerve sheath (ONS) volume. Group comparisons and partial correlations were used to evaluate associations.</p><p><strong>Results: </strong>ICP showed a significant positive association with thyroid-stimulating hormone (TSH) levels (r = 0.628, p = 0.016), and a significant negative association with growth hormone (GH) (r = -0.602, p = 0.023). Regarding structural parameters, only the volume of the right ON showed a strong positive association within the subgroup with elevated ICP (r = 0.90, p = 0.005). Correlations between ONS volumes and ICP in the normal pressure subgroup narrowly missed statistical significance. TSH was the only hormone showing a significant association, with higher TSH levels relating to larger pituitary volume in the normal ICP subgroup (r = 0.88, p = 0.020), but not in the elevated ICP subgroup.</p><p><strong>Conclusion: </strong>Our exploratory findings suggest potential interactions between ICP, endocrine markers, and structural MRI measures. However, due to the limited sample size and variability in endocrine parameters, the results should be interpreted cautiously and considered hypothesis generating rather than clinically directive. Larger studies are needed to determine whether endocrine MRI associations hold true and whether they have diagnostic or clinical relevance.</p>","PeriodicalId":10391,"journal":{"name":"Clinical Neuroradiology","volume":" ","pages":"585-594"},"PeriodicalIF":2.6,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13319219/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146050491","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":"Intracranial Rescue Stenting in Pediatric Focal Cerebral Arteriopathy.","authors":"Saujanya Rajbhandari, Philipe Breiding, Iciar Sanchez-Albisua, Daniel Brechbühl, Sandrine Cornaz Buros, Gabriela Oesch Nemeth, Johannes Kaesmacher, Lorenz Grunder, Petra Cimflova, Eike Piechowiak, David Seiffge, Maja Steinlin, Jan Gralla, Andrea Klein, Tomas Dobrocky","doi":"10.1007/s00062-025-01563-y","DOIUrl":"10.1007/s00062-025-01563-y","url":null,"abstract":"<p><strong>Background: </strong>Pediatric acute ischemic stroke is a rare yet severe condition with multifactorial etiology, often associated with vasculopathies. Endovascular intervention in children with focal cerebral arteriopathy is seldom reported.</p><p><strong>Purpose: </strong>Our aim was to report feasibility of intracranial rescue stenting for the management of pediatric focal cerebral arteriopathy with flow-limiting stenosis.</p><p><strong>Methods: </strong>We report a toddler with acute ischemic stroke due to flow-limiting focal cerebral arteriopathy of the left middle cerebral artery, treated with intracranial stenting. A comprehensive literature search was conducted in PubMed, Web of Science, Embase, and Scopus to identify case reports and series involving pediatric patients with acute ischemic stroke treated with intracranial stenting. Six cases met inclusion criteria. Extracted data included demographics (age, sex), clinical presentation, time of onset, medical history, occlusion location and etiology, stent type, pre- and post-stent NIHSS scores, antiplatelet therapy, and clinical outcomes at follow-up.</p><p><strong>Results: </strong>A total of six pediatric acute ischemic stroke cases with intracranial stent deployment in the acute stage were analyzed. The supraclinoid internal carotid artery was the most common site of stent deployment (4/6), while intracranial dissection was the most frequent cause of vessel occlusion (3/6). All included patients achieved resolution of the initial neurological deficit on follow-up (range: 6 weeks to 6 months). Variation in the use of intraoperative and postoperative antiplatelet regimens was observed.</p><p><strong>Conclusions: </strong>This case demonstrates off-label rescue stenting in pediatric acute ischemic stroke due to focal cerebral arteriopathy, emphasizing the importance of individualized multidisciplinary management in this rare setting.</p>","PeriodicalId":10391,"journal":{"name":"Clinical Neuroradiology","volume":" ","pages":"265-271"},"PeriodicalIF":2.6,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13319476/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145022975","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":"Evaluation of Carotid Plaque Vulnerability Using Dual-energy Computed Tomography Angiography: a Prospective Observational Study.","authors":"Sakyo Hirai, Takuya Watanabe, Satoru Takahashi, Hiroto Hada, Hikaru Wakabayashi, Mariko Ishikawa, Kosuke Umeda, Hirotaka Sagawa, Shoko Fujii, Kyohei Fujita, Jun Oyama, Kazutaka Sumita","doi":"10.1007/s00062-026-01629-5","DOIUrl":"10.1007/s00062-026-01629-5","url":null,"abstract":"<p><strong>Purpose: </strong>This study aimed to assess the utility of dual-energy computed tomography (DECT) for evaluating carotid plaque vulnerability.</p><p><strong>Methods: </strong>This prospective observational study included consecutive patients who underwent DECT for preoperative evaluation of carotid plaques before elective carotid artery stenting between June 2023 and May 2025. DECT parameters-including effective atomic number (Z), electron density (Rho), virtual non-contrast CT value (VNC), fat fraction (FF), and iodine concentration (IC)-were measured. Relative signal intensity (rSI) was calculated on T1-weighted magnetic resonance images as the ratio of plaque to adjacent sternocleidomastoid muscle signal.</p><p><strong>Results: </strong>A total of 46 carotid plaques, asymptomatic (n = 27) and symptomatic (n = 19), were analyzed. Both Rho and VNC were significantly lower in symptomatic compared to asymptomatic lesions (Rho, 29.6 [IQR, 26.5-33.6] vs 37.4 [IQR, 30.4-42.7], p < 0.05; VNC, 25.0 [IQR, 19.5-30.9] vs 31.2 [IQR, 21.9-41.4], p < 0.05), and FF was significantly higher in symptomatic compared to asymptomatic ones (21.5 [IQR, 17.4-23.3] vs 15.1 [IQR, 11.6-20.1], p < 0.05). No significant correlation was observed between the rSI and any of the DECT parameters. Multivariate logistic regression analysis showed that FF was significantly associated with symptomatic lesions in a model including rSI and VNC (OR, 1.39 [95% CI, 1.03-1.99], p < 0.05). Receiver operating characteristic analysis showed that adding FF to rSI improved discrimination of symptomatic plaques compared with rSI alone (AUC, 0.792 vs 0.560, p < 0.05).</p><p><strong>Conclusion: </strong>In this exploratory study, DECT-derived FF was associated with symptomatic carotid plaques and may provide complementary information beyond MRI-based plaque assessment in patients with moderate-to-severe carotid artery stenosis.</p>","PeriodicalId":10391,"journal":{"name":"Clinical Neuroradiology","volume":" ","pages":"731-741"},"PeriodicalIF":2.6,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147343914","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":"Tmax 10 Volume Is Independently Associated with NWU Delta in Large Core Stroke.","authors":"Vivek Yedavalli, Hamza Adel Salim, Dhairya A Lakhani, Aneri Balar, Janet Mei, Thanh N Nguyen, Adrien Guenego, Adam A Dmytriw, Jens Fiehler, Paul Stracke, Gabriel Broocks, Christian Heitkamp, Max Wintermark, Gregory W Albers, Jeremy J Heit, Tobias D Faizy","doi":"10.1007/s00062-025-01569-6","DOIUrl":"10.1007/s00062-025-01569-6","url":null,"abstract":"<p><strong>Background: </strong>In patients with acute ischemic stroke due to large vessel occlusion (AIS-LVO) and large ischemic cores, there is a need for reliable imaging biomarkers to predict cerebral edema growth. We investigated the association between severely hypoperfused tissue, measured by time-to-maximum greater than 10 s (Tmax > 10 s) volume, and net water uptake (∆NWU) progression.</p><p><strong>Methods: </strong>This multicenter retrospective cohort study involved AIS-LVO patients with ASPECTS ≤ 5, undergoing EVT at two comprehensive stroke centers between January 2013 and December 2019. We investigated the relationship between Tmax > 10 s volume derived from perfusion imaging and ∆NWU measured on non-contrast head CT images, hypothesizing that larger Tmax > 10 s volumes are indicative of greater edema growth in large core strokes.</p><p><strong>Results: </strong>A total of 95 patients (median age, 74 years; 55% women) were included. After adjustment for age, sex, glucose, intravenous thrombolysis, admission NIHSS, ASPECTS, Tan collateral score, last known well-to-CT time, and EVT, higher Tmax > 10 s volume (β, -0.34; P = 0.043) and lower ASPECTS (β, -0.30; P = 0.035) were independently associated with greater ∆NWU.</p><p><strong>Conclusion: </strong>The study highlights the importance of considering severe pretreatment hypoperfusion, as reflected by larger Tmax > 10 s volumes, in predicting cerebral edema growth in AIS-LVO patients, which could inform clinical strategies, emphasizing the need for larger prospective studies to validate and explore implications.</p>","PeriodicalId":10391,"journal":{"name":"Clinical Neuroradiology","volume":" ","pages":"321-328"},"PeriodicalIF":2.6,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145198639","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":"Radiological Prevalence of Superior Semicircular Canal Dehiscence with Ultra-High-Resolution Photon-Counting Detector CT.","authors":"Hiroshi Sakaida, Yasutaka Ichikawa, Akio Yamazaki, Hajime Sakuma","doi":"10.1007/s00062-025-01591-8","DOIUrl":"10.1007/s00062-025-01591-8","url":null,"abstract":"<p><strong>Purpose: </strong>To determine the radiological prevalence of superior semicircular canal (SSC) dehiscence in a Japanese cohort using ultra-high-resolution (0.2 mm slice thickness) photon-counting detector CT (PCD-CT) and compare it with historical data from cadaveric and conventional CT studies.</p><p><strong>Methods: </strong>This study involved a retrospective analysis of 402 temporal bones from consecutive 201 patients (age range 0-87 years; mean 41.0 ± 26.5 years) who underwent temporal bone PCD-CT for various otologic indications, none of whom had a pre-existing diagnosis of superior semicircular canal dehiscence syndrome (SSCDS). SSC bone thickness was measured, and the presence of dehiscence or thinning was assessed using multiplanar reconstructions, primarily in the Pöschl plane. For cases with identified dehiscence or thinning, a retrospective review of clinical and audiological data was performed.</p><p><strong>Results: </strong>The mean thickness of the bone overlying the SSC was 0.87 ± 0.50 mm (range 0-3.52 mm). A definite dehiscence was identified in only 1 of the 402 temporal bones, yielding a radiological prevalence of 0.25% (95% CI: 0.00%-1.54%). Significant thinning of the SSC roof, where the bone was present but too thin to be resolved by the measurement caliper, was noted in an additional 12 temporal bones (2.99%, 95% CI: 1.66%-5.20%). Clinical review revealed that the single case of dehiscence was asymptomatic, and in the thinning cases, otologic symptoms were attributable to co-existing pathologies.</p><p><strong>Conclusions: </strong>The radiological prevalence of SSC dehiscence identified with 0.2 mm PCD-CT is substantially lower than that reported by most conventional CT studies and closely approximates the true anatomical prevalence of 0.4-0.6% established in cadaveric studies. This finding suggests that the ultra-high spatial resolution of PCD-CT significantly reduces or eliminates false-positive findings attributable to partial volume effects, representing a new benchmark for the accurate radiological assessment of SSCDS.</p>","PeriodicalId":10391,"journal":{"name":"Clinical Neuroradiology","volume":" ","pages":"379-386"},"PeriodicalIF":2.6,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145494830","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}