Clinical Neuroradiology最新文献

{"title":"Endovascular Treatment for Acute Isolated Internal Carotid Artery Occlusion : A Propensity Score Matched Multicenter Study.","authors":"Daniel P O Kaiser, Tilman Reiff, Ulrich Mansmann, Daniela Schoene, Davide Strambo, Patrik Michel, Mohamad Abdalkader, Thanh N Nguyen, Matthias Gawlitza, Markus A Möhlenbruch, Peter A Ringleb, Volker Puetz, Johannes C Gerber, Simon Nagel","doi":"10.1007/s00062-023-01342-7","DOIUrl":"10.1007/s00062-023-01342-7","url":null,"abstract":"<p><strong>Purpose: </strong>The benefit of endovascular treatment (EVT) in patients with acute symptomatic isolated occlusion of the internal carotid artery (ICA) without involvement of the middle and anterior cerebral arteries is unclear. We aimed to compare clinical and safety outcomes of best medical treatment (BMT) versus EVT + BMT in patients with stroke due to isolated ICA occlusion.</p><p><strong>Methods: </strong>We conducted a retrospective multicenter study involving patients with isolated ICA occlusion between January 2016 and December 2020. We stratified patients by BMT versus EVT and matched the groups using propensity score matching (PSM). We assessed the effect of treatment strategy on favorable outcome (modified Rankin scale ≤ 2) 90 days after treatment and compared reduction in NIHSS score at discharge, rates of symptomatic intracranial hemorrhage (sICH) and 3‑month mortality.</p><p><strong>Results: </strong>In total, we included 149 patients with isolated ICA occlusion. To address imbalances, we matched 45 patients from each group using PSM. The rate of favorable outcomes at 90 days was 56% for EVT and 38% for BMT (odds ratio, OR 1.89, 95% confidence interval, CI 0.84-4.24; p = 0.12). Patients treated with EVT showed a median reduction in NIHSS score at discharge of 6 points compared to 1 point for BMT patients (p = 0.02). Rates of symptomatic intracranial hemorrhage (7% vs. 4%; p = 0.66) and 3‑month mortality (11% vs. 13%; p = 0.74) did not differ between treatment groups. Periprocedural complications of EVT with early neurological deterioration occurred in 7% of cases.</p><p><strong>Conclusion: </strong>Although the benefit on functional outcome did not reach statistical significance, the results for NIHSS score improvement, and safety support the use of EVT in patients with stroke due to isolated ICA occlusion.</p>","PeriodicalId":10391,"journal":{"name":"Clinical Neuroradiology","volume":" ","pages":"125-133"},"PeriodicalIF":2.8,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10881648/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10146597","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":"Systematic Review and Meta-analysis of Radial or Femoral Access for Carotid Stenting.","authors":"Pang-Shuo Perng, Yu Chang, Hao-Kuang Wang, Yen-Ta Huang, Chia-En Wong, Kuan-Yu Chi, Jung-Shun Lee, Liang-Chao Wang, Chih-Yuan Huang","doi":"10.1007/s00062-023-01315-w","DOIUrl":"10.1007/s00062-023-01315-w","url":null,"abstract":"<p><strong>Purpose: </strong>There is a growing interest in performing coronary artery and neurovascular interventions via the radial artery; however, few studies have examined the outcomes of transradial carotid stenting. Therefore, our study aimed to compare cerebrovascular outcomes and crossover rates in carotid stenting between transradial and traditional transfemoral approaches.</p><p><strong>Methods: </strong>A systematic review was performed by searching three electronic databases from inception to June 2022 in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. In addition, random effect meta-analysis was used to pool the odds ratios (ORs) for stroke, transient ischemic attack, major adverse cardiac events, death, major vascular access site complications, and procedure crossover rates between the transradial and transfemoral approaches.</p><p><strong>Results: </strong>A total of 6 studies were included involving a total of n = 567 transradial and n = 6176 transfemoral procedures. The ORs for stroke, transient ischemic attack, and major adverse cardiac events were 1.43 (95% confidence interval, CI 0.72-2.86, I² = 0), 0.51 (95% CI 0.17-1.54, I² = 0), and 1.08 (95% CI 0.62-1.86, I² = 0), respectively. Neither the major vascular access site complication rate (OR 1.11, 95% CI 0.32-3.87, I² = 0) nor crossover rate (OR 3.94, 95% CI 0.62-25.11, I² = 57%) showed statistically significant differences between the two approaches.</p><p><strong>Conclusion: </strong>The modest quality of the data suggested comparable procedural outcomes between the transradial and transfemoral approaches when performing carotid stenting; however, high level evidence regarding postoperative brain images and risk of stroke in transradial carotid stenting are lacking. Therefore, it is reasonable for interventionists to weigh up the risks of neurological events and potential benefits, including fewer access site complications, before choosing the radial or femoral arteries as access sites. Future large-scale randomized controlled trials are imperative.</p>","PeriodicalId":10391,"journal":{"name":"Clinical Neuroradiology","volume":" ","pages":"3-12"},"PeriodicalIF":2.8,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9738674","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":"Photon Counting Versus Energy-integrated Detector CT in Detection of Superior Semicircular Canal Dehiscence.","authors":"Nathan S Doyle, John C Benson, Carrie M Carr, Felix E Diehn, Matthew L Carlson, Shuai Leng, John I Lane","doi":"10.1007/s00062-023-01368-x","DOIUrl":"10.1007/s00062-023-01368-x","url":null,"abstract":"<p><strong>Background: </strong>Superior semicircular canal dehiscence (SSCD), an osseous defect overlying the SSC, is associated with a constellation of audiovestibular symptoms. This study sought to compare conventional energy-integrated detector (EID) computed tomography (CT) to photon-counting detector (PCD)-CT in the detection of SSCD.</p><p><strong>Material and methods: </strong>Included patients were prospectively recruited to undergo a temporal bone CT on both EID-CT and PCD-CT scanners. Two blinded neuroradiologists reviewed both sets of images for 1) the presence or absence of SSCD (graded as present, absent, or indeterminate), and 2) the width of the bone overlying the SSC (if present). Any discrepancies in the presence or absence of SSCD were agreed upon by consensus.</p><p><strong>Results: </strong>In the study 31 patients were evaluated, for a total of 60 individual temporal bones (2 were excluded). Regarding SSCD presence or absence, there was substantial agreement between EID-CT and PCD-CT (k = 0.76; 95% confidence interval, CI 0.54-0.97); however, SSCD was present in only 9 (15.0%) temporal bones on PCD-CT, while EID-CT examinations were interpreted as being positive in 14 (23.3%) temporal bones. This yielded a false positive rate of 8.3% on EID-CT. The bone overlying the SSC was thinner on EID-CT images (0.66 mm; SD = 0.64) than on PCD-CT images (0.72 mm; SD = 0.66) (p < 0.001).</p><p><strong>Conclusion: </strong>The EID-CT examinations tend to overcall the presence of SSCD compared to PCD-CT and also underestimate the thickness of bone overlying the SSC.</p>","PeriodicalId":10391,"journal":{"name":"Clinical Neuroradiology","volume":" ","pages":"251-255"},"PeriodicalIF":2.8,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138486853","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":"Diagnosis of Small Unruptured Intracranial Aneurysms : Comparison of 7 T versus 3 T MRI.","authors":"Piotr Radojewski, Tomas Dobrocky, Mattia Branca, William Almiri, Manuel Correia, Andreas Raabe, David Bervini, Jan Gralla, Roland Wiest, Pasquale Mordasini","doi":"10.1007/s00062-023-01282-2","DOIUrl":"10.1007/s00062-023-01282-2","url":null,"abstract":"<p><strong>Purpose: </strong>Differentiating normal anatomical variants such as an infundibulum or a vascular loop from true intracranial aneurysms is crucial for patient management. We hypothesize that high-resolution 7 T magnetic resonance imaging (MRI) improves the detection and characterization of normal anatomical variants that may otherwise be misdiagnosed as small unruptured aneurysms.</p><p><strong>Methods: </strong>This is a retrospective, single-center study. All patients were scanned on a clinically approved 7 T MRI scanner and on a 3 T scanner. Image analysis was performed independently by three neuroradiologists blinded to clinical information. The presence of an unruptured intracranial aneurysm (UIA) and level of diagnostic certainty were assessed and the interrater agreement was calculated. If an aneurysm was present, the anatomic location and shape were recorded and compared.</p><p><strong>Results: </strong>In total, 53 patients with equivocal cerebrovascular findings on 1.5 T or 3 T MRI referred for a 7T MRI examination were included. Aneurysms were suspected in 42 patients examined at 3 T and in 23 patients at 7 T (rate difference 36%, 95% confidence interval, CI, 19-53%, p-value < 0.001). Major disagreement between the field strengths was observed in the A1 segment of anterior cerebral artery/anterior communicating artery (A1/ACOM) complex. The interrater agreement among the readers on the presence of an aneurysm on 7 T MRI was higher than that for 3 T MRI (0.925, 95% CI 0.866-0.983 vs. 0.786, 95% CI 0.700-0.873).</p><p><strong>Conclusion: </strong>Our analysis demonstrates a significantly higher interrater agreement and improved diagnostic certainty when small intracranial aneurysms are visualized on 7 T MRI compared to 3 T. In a selected patient cohort, clinical implementation of 7 T MRI may help to establish the definitive diagnosis and thus have a beneficial impact on patient management.</p>","PeriodicalId":10391,"journal":{"name":"Clinical Neuroradiology","volume":" ","pages":"45-49"},"PeriodicalIF":2.8,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10881608/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9222875","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":"Long-term Follow-up After Aneurysm Treatment with the Flow Redirection Endoluminal Device (FRED) Flow Diverter.","authors":"Sophia Hohenstatt, Christian Ulfert, Christian Herweh, Tim Hilgenfeld, Niclas Schmitt, Silvia Schönenberger, Min Chen, Martin Bendszus, Markus A Möhlenbruch, Dominik F Vollherbst","doi":"10.1007/s00062-023-01346-3","DOIUrl":"10.1007/s00062-023-01346-3","url":null,"abstract":"<p><strong>Introduction: </strong>This study focuses on long-term outcomes after aneurysm treatment with either the Flow Re-Direction Endoluminal Device (FRED) or the FRED Jr. to investigate the durability of treatment effect and long-term complications.</p><p><strong>Methods: </strong>This study is based on a retrospective analysis of a prospectively maintained patient data base. Patients treated with either FRED or FRED Jr. between 2013 and 2017 at our institution, and thus a possibility for ≥ 5 years of follow-up, were included. Aneurysm occlusion rates, recurrence rates, modified Rankin scale score shifts to baseline, and delayed complications were assessed.</p><p><strong>Results: </strong>In this study 68 patients with 84 aneurysms had long-term follow-up with a mean duration of 57.3 months and 44 patients harboring 52 aneurysms had a follow-up ≥ 5 years with a mean follow-up period of 69.2 months. Complete occlusion was reached in 77.4% at 2 years and increased to 84.9% when the latest available imaging result was considered. Younger age and the absence of branch involvement were predictors for aneurysm occlusion in linear regression analysis. After the 2‑year threshold, there were 3 reported symptomatic non-serious adverse events. Of these, one patient had a minor stroke, one a transitory ischemic attack and one had persistent mass effect symptoms due to a giant aneurysm, none of these resulted in subsequent neurological disability.</p><p><strong>Conclusion: </strong>This long-term follow-up study demonstrates that the FRED and FRED Jr. are safe and effective for the treatment of cerebral aneurysms in the long term, with high rates of complete occlusion and low rates of delayed adverse events.</p>","PeriodicalId":10391,"journal":{"name":"Clinical Neuroradiology","volume":" ","pages":"181-188"},"PeriodicalIF":2.8,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10881684/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41193603","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":"Predicting 3-month Functional Outcome After Endovascular Thrombectomy in Patients with Anterior Circulation Occlusion with an Arterial Transit Artifact Grading System.","authors":"Xiaobo Zhang, Nannan Han, Yu Zhang, Wenting Yuan, Shangguang Kan, Gejuan Zhang, Haojun Ma, Hanming Ge, Chengxue Du, Yanjun Gao, Shilin Li, Xudong Yan, Wenzhen Shi, Ye Tian, Mingze Chang","doi":"10.1007/s00062-023-01362-3","DOIUrl":"10.1007/s00062-023-01362-3","url":null,"abstract":"<p><strong>Purpose: </strong>The objective of this study was to evaluate the relationship between arterial transit artifact (ATA), arterial spin labeling (ASL) perfusion imaging, and the outcome of patients with acute ischemic stroke (AIS) due to occlusion of large vessels in anterior circulation after endovascular thrombectomy (EVT).</p><p><strong>Methods: </strong>Patients with anterior circulation occlusion treated with EVT between October 2017 and December 2021 were enrolled in this retrospective study, and ATA was quantified by a 4-point scale. A favorable outcome was defined by modified Rankin Scale (mRS) scores of 0-2 at 3 months. To identify independent predictors of favorable outcome, age, sex, risk factors, baseline National Institutes of Health Stroke Scale (NIHSS) score, site of occlusion, cause of stroke, and early reperfusion were evaluated with univariate and multivariate analyses. Predictive accuracy was evaluated by calculating the area under the receiver operating characteristic (ROC) curve (AUC) for the model.</p><p><strong>Results: </strong>In this study 187 patients (age, 65.0 ± 12.5 years; men, 55%) were evaluated. Younger age (odds ratio, OR, 0.95; 95% confidence interval, CI, 0.92-0.98, p = 0.002), lower baseline NIHSS score (OR, 0.88; 95% CI, 0.82-0.94, p < 0.001), and lower ATA score (OR, 1.14; 95% CI, 1.06-1.22, p < 0.001) were independently associated with favorable outcomes in multivariate analysis. The ATA score has moderate to good accuracy in predicting favorable outcomes (AUC, 0.753).</p><p><strong>Conclusion: </strong>A high ATA score as a potential predictor, can help identify patients who may benefit from EVT.</p>","PeriodicalId":10391,"journal":{"name":"Clinical Neuroradiology","volume":" ","pages":"241-249"},"PeriodicalIF":2.8,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138486854","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":"Age-stratified Assessment of Brain Volumetric Segmentation on the Indian Population Using Quantitative Magnetic Resonance Imaging","authors":"Nisha Syed Nasser, Vasantha K. Venugopal, Cynthia Veenstra, Peter Johansson, Sriram Rajan, Kabir Mahajan, Swati Naik, Ravi Masand, Pratiksha Yadav, Sachin Khanduri, Suman Singhal, Rajat Bhargava, Utkarsh Kabra, Sanjay Gupta, Kavita Saggar, Balaji Varaprasad, Kushagra Aggrawal, Adinarayana Rao, Manoj K.S., Atul Dakhole, Abhimanyu Kelkar, Geena Benjamin, Varsha Sodani, Pradeep Goyal, Harsh Mahajan","doi":"10.1007/s00062-023-01374-z","DOIUrl":"https://doi.org/10.1007/s00062-023-01374-z","url":null,"abstract":"<h3 data-test=\"abstract-sub-heading\">Background and Purpose</h3><p>Automated methods for quantifying brain tissue volumes have gained clinical interest for their objective assessment of neurological diseases. This study aimed to establish reference curves for brain volumes and fractions in the Indian population using Synthetic MRI (SyMRI), a quantitative imaging technique providing multiple contrast-weighted images through fast postprocessing.</p><h3 data-test=\"abstract-sub-heading\">Methods</h3><p>The study included a cohort of 314 healthy individuals aged 15–65 years from multiple hospitals/centers across India. The SyMRI-quantified brain volumes and fractions, including brain parenchymal fraction (BPF), gray matter fraction (GMF), white matter fraction (WMF), and myelin.</p><h3 data-test=\"abstract-sub-heading\">Results</h3><p>Normative age-stratified quantification curves were created based on the obtained data. The results showed significant differences in brain volumes between the sexes, but not after normalization by intracranial volume.</p><h3 data-test=\"abstract-sub-heading\">Conclusion</h3><p>The findings provide normative data for the Indian population and can be used for comparative analysis of brain structure values. Furthermore, our data indicate that the use of fractions rather than absolute volumes in normative curves, such as BPF, GMF, and WMF, can mitigate sex and population differences as they account for individual differences in head size or brain volume.</p>","PeriodicalId":10391,"journal":{"name":"Clinical Neuroradiology","volume":"16 1","pages":""},"PeriodicalIF":2.8,"publicationDate":"2024-01-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139518223","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":"Multiparametric Analysis Combining DSC-MR Perfusion and [18F]FET-PET is Superior to a Single Parameter Approach for Differentiation of Progressive Glioma from Radiation Necrosis","authors":"Jürgen Panholzer, Gertraud Walli, Bettina Grün, Ognian Kalev, Michael Sonnberger, Robert Pichler","doi":"10.1007/s00062-023-01372-1","DOIUrl":"https://doi.org/10.1007/s00062-023-01372-1","url":null,"abstract":"<h3 data-test=\"abstract-sub-heading\">Purpose</h3><p>Perfusion-weighted (PWI) magnetic resonance imaging (MRI) and O‑(2-[18F]fluoroethyl-)-l-tyrosine ([18F]FET) positron emission tomography (PET) are both useful for discrimination of progressive disease (PD) from radiation necrosis (RN) in patients with gliomas. Previous literature showed that the combined use of FET-PET and MRI-PWI is advantageous; hhowever the increased diagnostic performances were only modest compared to the use of a single modality. Hence, the goal of this study was to further explore the benefit of combining MRI-PWI and [18F]FET-PET for differentiation of PD from RN. Secondarily, we evaluated the usefulness of cerebral blood flow (CBF), mean transit time (MTT) and time to peak (TTP) as previous studies mainly examined cerebral blood volume (CBV).</p><h3 data-test=\"abstract-sub-heading\">Methods</h3><p>In this single center study, we retrospectively identified patients with WHO grades II–IV gliomas with suspected tumor recurrence, presenting with ambiguous findings on structural MRI. For differentiation of PD from RN we used both MRI-PWI and [18F]FET-PET. Dynamic susceptibility contrast MRI-PWI provided normalized parameters derived from perfusion maps (r(relative)CBV, rCBF, rMTT, rTTP). Static [18F]FET-PET parameters including mean and maximum tumor to brain ratios (TBR_mean, TBR_max) were calculated. Based on histopathology and radioclinical follow-up we diagnosed PD in 27 and RN in 10 cases. Using the receiver operating characteristic (ROC) analysis, area under the curve (AUC) values were calculated for single and multiparametric models. The performances of single and multiparametric approaches were assessed with analysis of variance and cross-validation.</p><h3 data-test=\"abstract-sub-heading\">Results</h3><p>After application of inclusion and exclusion criteria, we included 37 patients in this study. Regarding the in-sample based approach, in single parameter analysis rTBR_mean (AUC = 0.91, <i>p</i> &lt; 0.001), rTBR_max (AUC = 0.89, <i>p</i> &lt; 0.001), rTTP (AUC = 0.87, <i>p</i> &lt; 0.001) and rCBV_mean (AUC = 0.84, <i>p</i> &lt; 0.001) were efficacious for discrimination of PD from RN. The rCBF_mean and rMTT did not reach statistical significance. A classification model consisting of TBR_mean, rCBV_mean and rTTP achieved an AUC of 0.98 (<i>p</i> &lt; 0.001), outperforming the use of rTBR_mean alone, which was the single parametric approach with the highest AUC. Analysis of variance confirmed the superiority of the multiparametric approach over the single parameter one (<i>p</i> = 0.002). While cross-validation attributed the highest AUC value to the model consisting of TBR_mean and rCBV_mean, it also suggested that the addition of rTTP resulted in the highest accuracy. Overall, multiparametric models performed better than single parameter ones.</p><h3 data-test","PeriodicalId":10391,"journal":{"name":"Clinical Neuroradiology","volume":"31 1","pages":""},"PeriodicalIF":2.8,"publicationDate":"2023-12-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139069839","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":"Symptomatic Non-stenotic Carotid Disease in Embolic Stroke of Undetermined Source","authors":"Martha Marko, Nishita Singh, Johanna M. Ospel, Kazutaka Uchida, Mohammed A. Almekhlafi, Andrew M. Demchuk, Raul G. Nogueira, Ryan A. McTaggart, Alexandre Y. Poppe, Jeremy L. Rempel, Michael Tymianski, Michael D. Hill, Mayank Goyal, Bijoy K. Menon","doi":"10.1007/s00062-023-01365-0","DOIUrl":"https://doi.org/10.1007/s00062-023-01365-0","url":null,"abstract":"<h3 data-test=\"abstract-sub-heading\">Purpose</h3><p>Non-stenotic (&lt; 50%) carotid disease may play an important etiological role in ischemic stroke classified as embolic stroke of undetermined source (ESUS). We aimed to assess the prevalence of non-stenotic carotid disease and its association with ipsilateral ischemic stroke.</p><h3 data-test=\"abstract-sub-heading\">Methods</h3><p>Data are from ESCAPE-NA1, a randomized controlled trial investigating the neuroprotectant nerinetide in patients with acute ischemic stroke and large vessel occlusion (LVO). The degree of stenosis of the extracranial internal carotid artery (ICA) and high-risk plaque features were assessed on baseline computed tomography (CT) angiography. We evaluated the association of non-stenotic carotid disease and ipsilateral stroke by age-adjusted and sex-adjusted logistic regression and calculated the attributable risk of ipsilateral stroke caused by non-stenotic carotid disease.</p><h3 data-test=\"abstract-sub-heading\">Results</h3><p>After excluding patients with non-assessable imaging, symptomatic &gt; 50% carotid stenosis and extracranial dissection, 799/1105 (72.1%) patients enrolled in ESCAPE-NA1 remained for this analysis. Of these, 127 (15.9%) were classified as ESUS. Non-stenotic carotid disease occurred in 34/127 ESUS patients (26.8%) and was associated with the presence of ipsilateral ischemic stroke (odds ratio, OR 1.6, 95% confidence interval, CI 1.0–2.6, <i>p</i> = 0.049). The risk of ipsilateral ischemic stroke attributable to non-stenotic carotid disease in ESUS was estimated to be 19.7% (95% CI −5.7% to 39%), the population attributable risk was calculated as 4.3%. Imaging features such as plaque thickness, plaque irregularity or plaque ulceration were not different between non-stenotic carotids with vs. without ipsilateral stroke.</p><h3 data-test=\"abstract-sub-heading\">Conclusion</h3><p>Non-stenotic carotid disease frequently occurs in patients classified as ESUS and is associated with ipsilateral ischemic stroke. Our findings support the role of non-stenotic carotid disease as stroke etiology in ESUS, but further prospective research is needed to prove a causal relationship.</p>","PeriodicalId":10391,"journal":{"name":"Clinical Neuroradiology","volume":"93 1","pages":""},"PeriodicalIF":2.8,"publicationDate":"2023-12-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138715759","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":"Integrity of Clinical Neuroradiological Research","authors":"Robert M. Kwee, Maan T. Almaghrabi, Thomas C. Kwee","doi":"10.1007/s00062-023-01280-4","DOIUrl":"https://doi.org/10.1007/s00062-023-01280-4","url":null,"abstract":"<h3 data-test=\"abstract-sub-heading\">Purpose</h3><p>It is unclear if undesired practices such as scientific fraud, publication bias, and honorary authorship are present in neuroradiology. Therefore, the objective was to explore the integrity of clinical neuroradiological research using a survey method.</p><h3 data-test=\"abstract-sub-heading\">Methods</h3><p>Corresponding authors who published in one of four top clinical neuroradiology journals were invited to complete a survey about integrity in clinical neuroradiology research.</p><h3 data-test=\"abstract-sub-heading\">Results</h3><p>A total of 232 corresponding authors participated in our survey. Confidence in the integrity of published scientific work in clinical neuroradiology (0–10 point scale) was rated as a median score of 8 (range 3–10). In linear regression analysis, respondents from Asia had significantly higher confidence (beta coefficient of 0.569, 95% confidence interval, CI: 0.049–1.088, <i>P</i> = 0.032). Of the respondents 8 (3.4%) reported to have committed scientific fraud in the past 5 years, whereas 66 respondents (28.4%) reported to have witnessed or suspected scientific fraud by anyone from their department in the past 5 years. A total of 192 respondents (82.8%) thought that a study with positive results is more likely to be accepted by a journal than a similar study with negative results and 96 respondents (41.4%) had an honorary author on any of their publications in the past 5 years.</p><h3 data-test=\"abstract-sub-heading\">Conclusion</h3><p>Experts in the field have overall high confidence in published clinical neuroradiology research; however, scientific integrity concerns are not negligible, publication bias is a problem and honorary authorship is common. The findings from this survey may help to increase awareness and vigilance among anyone involved in clinical neuroradiological research.</p>","PeriodicalId":10391,"journal":{"name":"Clinical Neuroradiology","volume":"16 1","pages":""},"PeriodicalIF":2.8,"publicationDate":"2023-12-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138630462","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}