Clinical Neuroradiology最新文献

{"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}

{"title":"Breath-Hold-Triggered BOLD fMRI in Drug-Resistant Nonlesional Focal Epilepsy—A Pilot Study","authors":"Christian M. Boßelmann, Josua Kegele, Leonie Zerweck, Uwe Klose, Silke Ethofer, Constantin Roder, Alexander M. Grimm, Till-Karsten Hauser","doi":"10.1007/s00062-023-01363-2","DOIUrl":"https://doi.org/10.1007/s00062-023-01363-2","url":null,"abstract":"<h3 data-test=\"abstract-sub-heading\">Purpose</h3><p>Individuals with drug-resistant epilepsy may benefit from epilepsy surgery. In nonlesional cases, where no epileptogenic lesion can be detected on structural magnetic resonance imaging, multimodal neuroimaging studies are required. Breath-hold-triggered BOLD fMRI (bh-fMRI) was developed to measure cerebrovascular reactivity in stroke or angiopathy and highlights regional network dysfunction by visualizing focal impaired flow increase after vasodilatory stimulus. This regional dysfunction may correlate with the epileptogenic zone. In this prospective single-center single-blind pilot study, we aimed to establish the feasibility and safety of bh-fMRI in individuals with drug-resistant non-lesional focal epilepsy undergoing presurgical evaluation.</p><h3 data-test=\"abstract-sub-heading\">Methods</h3><p>In this prospective study, 10 consecutive individuals undergoing presurgical evaluation for drug-resistant focal epilepsy were recruited after case review at a multidisciplinary patient management conference. Electroclinical findings and results of other neuroimaging were used to establish the epileptogenic zone hypothesis. To calculate significant differences in cerebrovascular reactivity in comparison to the normal population, bh-fMRIs of 16 healthy volunteers were analyzed. The relative flow change of each volume of interest (VOI) of the atlas was then calculated compared to the flow change of the whole brain resulting in an atlas of normal cerebral reactivity. Consequently, the mean flow change of every VOI of each patient was tested against the healthy volunteers group. Areas with significant impairment of cerebrovascular reactivity had decreased flow change and were compared to the epileptogenic zone localization hypothesis in a single-blind design.</p><h3 data-test=\"abstract-sub-heading\">Results</h3><p>Acquisition of bh-fMRI was feasible in 9/10 cases, with one patient excluded due to noncompliance with breathing maneuvers. No adverse events were observed, and breath-hold for intermittent hypercapnia was well tolerated. On blinded review, we observed full or partial concordance of the local network dysfunction seen on bh-fMRI with the electroclinical hypothesis in 6/9 cases, including cases with extratemporal lobe epilepsy and those with nonlocalizing 18F-fluorodeoxyglucose positron emission tomography (FDG-PET).</p><h3 data-test=\"abstract-sub-heading\">Conclusion</h3><p>This represents the first report of bh-fMRI in individuals with epilepsy undergoing presurgical evaluation. We found bh-fMRI to be feasible and safe, with a promising agreement to electroclinical findings. Thus, bh-fMRI may represent a potential modality in the presurgical evaluation of epilepsy. Further studies are needed to establish clinical utility.</p>","PeriodicalId":10391,"journal":{"name":"Clinical Neuroradiology","volume":"9 1","pages":""},"PeriodicalIF":2.8,"publicationDate":"2023-12-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138576806","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":"Preoperative Direct Puncture Embolization Using a Nonadhesive Ethylene Vinyl Alcohol (EVOH) Liquid Embolic Agent for Head and Neck Paragangliomas","authors":"Andrea M. Alexandre, Luca Scarcia, Frédéric Clarençon, Arianna Camilli, Andrea Bartolo, Francesca Incandela, Dario Antonio Mele, Mario Rigante, Marco Natola, Iacopo Valente, Francesco D’Argento, Jacopo Galli, Yamume Tshomba, Alessandro Pedicelli","doi":"10.1007/s00062-023-01364-1","DOIUrl":"https://doi.org/10.1007/s00062-023-01364-1","url":null,"abstract":"<h3 data-test=\"abstract-sub-heading\">Purpose</h3><p>This retrospective study aimed to assess the safety and technical efficacy of preoperative direct puncture embolization using a nonadhesive ethylene vinyl alcohol (EVOH) copolymer-based liquid embolic agent (LEA) combined with balloon occlusion at the origin of the external carotid artery for head and neck paragangliomas (HNP).</p><h3 data-test=\"abstract-sub-heading\">Methods</h3><p>We conducted a review of all consecutive cases of HNPs treated with direct puncture embolization using EVOH-based LEAs between 2017 and 2022 in 2 tertiary high-volume hospitals.</p><h3 data-test=\"abstract-sub-heading\">Results</h3><p>A total of 25 cases of HNPs in 24 patients underwent direct puncture embolization (12 males, 12 females, mean age 50.9 ± 15.6 years). The average lesion volume was 299.95 mm³. The mean procedure time was 139.11 min, and the mean volume of EVOHs used per case was 19.38 mL. Successful complete devascularization was achieved in all cases, with a homogeneous and deep penetration of the embolic agent into the tumor vessel bed regardless of the LEA type.</p><h3 data-test=\"abstract-sub-heading\">Conclusion</h3><p>Preoperative embolization of HNPs using a direct puncture technique and EVOHs is a safe, efficient, and feasible treatment option with a low risk of complications. This procedure facilitates surgery by transforming tumors into avascular masses that are well-delineated against the surrounding normal tissue.</p>","PeriodicalId":10391,"journal":{"name":"Clinical Neuroradiology","volume":"5 1","pages":""},"PeriodicalIF":2.8,"publicationDate":"2023-12-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138562663","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":"Radiation Exposure in Interventional Stroke Treatment : Analysis of the German Neurointerventional Database (DeGIR/DGNR) from 2019 to 2021.","authors":"Felix Bärenfänger, Peter Schramm, Stefan Rohde","doi":"10.1007/s00062-023-01303-0","DOIUrl":"10.1007/s00062-023-01303-0","url":null,"abstract":"<p><strong>Purpose: </strong>To evaluate patient-related radiation exposure in interventional stroke treatment by analyzing data from the German Society for Interventional Radiology and Minimally Invasive Therapy (DeGIR) and the German Society of Neuroradiology (DGNR) quality registry from 2019-2021.</p><p><strong>Methods: </strong>The DeGIR/DGNR registry is the largest database of radiological interventions in Germany. Since the introduction of the registry in 2012, the participating hospitals have entered clinical and dose-related data on the procedures performed. To evaluate the current diagnostic reference level (DRL) for mechanical thrombectomy (MT) in stroke patients, we analyzed interventional data from 2019 to 2021 with respect to the reported dose area product (DAP) and factors that might contribute to the radiation dose, such as the localization of the occlusion, technical success using the modified treatment in cerebral ischemia (mTICI) score, number of passages, technical approach, additional intracranial/extracranial stenting, and case volume per center.</p><p><strong>Results: </strong>A total of 41,538 performed MTs from 180 participating hospitals were analyzed. The median DAP for MT was 7337.5 cGy∙cm² and the corresponding interquartile range (IQR) Q₂₅ = 4064 cGy∙cm² to Q₇₅ = 12,263 cGy∙cm². In addition, we discovered that the dose was significantly influenced by occlusion location, number of passages, case volume per center, recanalization score, and additional stenting.</p><p><strong>Conclusion: </strong>We conducted a retrospective study on radiation exposure during MT in Germany. Based on the results of more than 41,000 procedures, we observed that the DRL of 14,000 cGy·cm² is currently appropriate but may be lowered over the next years. Furthermore, we identified several factors that contribute to high radiation exposure. This can aid in detecting the cause of an exceeded DRL and optimize the treatment workflow.</p>","PeriodicalId":10391,"journal":{"name":"Clinical Neuroradiology","volume":" ","pages":"1023-1033"},"PeriodicalIF":2.8,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10654203/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9585970","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":"Sacral Dural Tears as a Cause of Spontaneous Intracranial Hypotension.","authors":"Niklas Lützen, Enrique Barvulsky Aleman, Amir El Rahal, Florian Volz, Christian Fung, Jürgen Beck, Horst Urbach","doi":"10.1007/s00062-023-01292-0","DOIUrl":"10.1007/s00062-023-01292-0","url":null,"abstract":"<p><strong>Purpose: </strong>Dural tears at the level of the cervical, thoracic, and lumbar spine cause spontaneous intracranial hypotension (SIH) in patients with a spinal longitudinal extradural CSF collection (SLEC); however, sacral dural tears have rarely been reported so far. This study focuses on sacral dural tears as a cause of SIH.</p><p><strong>Methods: </strong>Retrospective data from SIH patients with confirmed sacral dural tears studied between October 2020 and November 2022 were analyzed with respect to demographic, clinical and imaging features. Digital subtraction myelography (DSM) and lumbar epidural blood patch (EBP) were modified by placing the patient in reversed Trendelenburg position.</p><p><strong>Results: </strong>Of the SIH patients, 9 (all women; mean age, 38.5 years; mean body mass index, BMI, 22.9) out of 149 had a sacral dural leak (6%) that occurred spontaneously in 7/9, while 2/9 were likely associated with minor trauma. None had a sacral fracture. The mean SIH score was 6.8. All patients showed SLEC on heavily T2-weighted MR myelography (T2-MRM), 4/9 exclusively sacral and 5/9 with partial or complete involvement of the remaining spine. 4/9 had none, but 5/9 had meningeal sacral cysts, 2/5 had large cysts/ectasia. Confirmation of the sacral origin of the leak was provided in 4/9 by T2-MRM, in 2/9 by DSM and 3/9 by CT myelography (CTM) whereas 0/9 revealed the exact site of leak within the sacrum.</p><p><strong>Conclusion: </strong>Sacral dural tears should be considered as a possible cause for SIH. It is concluded to implement T2-MRM covering the entire sacrum in the standard MRI protocol and propose EBP in the reverse Trendelenburg position as a therapeutic approach.</p>","PeriodicalId":10391,"journal":{"name":"Clinical Neuroradiology","volume":" ","pages":"957-964"},"PeriodicalIF":2.8,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10654183/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9740371","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":"Tumefactive Demyelinating Lesion Around a Developmental Venous Anomaly : A Rare Association.","authors":"Alessandra Cicia, Vincenzo Carlomagno, Massimiliano Mirabella, Matteo Lucchini","doi":"10.1007/s00062-023-01307-w","DOIUrl":"10.1007/s00062-023-01307-w","url":null,"abstract":"","PeriodicalId":10391,"journal":{"name":"Clinical Neuroradiology","volume":" ","pages":"1155-1158"},"PeriodicalIF":2.8,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9622330","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":"Early Outcomes of the Pipeline Vantage Flow Diverter : A Multicentre Study.","authors":"Sara Sciacca, Ahmed Bassiouny, Nina Mansoor, Thais Minett, Parthiban Balasundaram, Juveria Siddiqui, Yogish Joshi, Shahram Derakhshani, Naga Kandasamy, Thomas Calvert Booth, Jeremy Lynch","doi":"10.1007/s00062-023-01314-x","DOIUrl":"10.1007/s00062-023-01314-x","url":null,"abstract":"<p><strong>Purpose: </strong>The recently introduced Pipeline Vantage Embolization Device with Shield Technology is the fourth generation of Pipeline flow diverter devices. Due to the relatively high rate of intraprocedural technical complications, modifications were subsequently made to the device after a limited release of the device in 2020. This study aimed to evaluate the safety and efficacy of the modified version of this device.</p><p><strong>Methods: </strong>This was a multicentre retrospective series. The primary efficacy endpoint was aneurysm occlusion in the absence of retreatment. The primary safety endpoint was any neurological morbidity or death. Ruptured and unruptured aneurysms were included in the study.</p><p><strong>Results: </strong>A total of 52 procedures were performed for 60 target aneurysms. Treatment was performed on 5 patients with ruptured aneurysms. The technical success rate was 98%. The mean clinical follow-up time was 5.5 months. In patients presenting with unruptured aneurysms there were no deaths, 3 (6.4%) major complications and 7 (13%) minor complications. In the five patients presenting with subarachnoid haemorrhage there were 2 (40%) major complications with 1 (20%) of these resulting in death, and 1 (20%) minor complication. Of the patients 29 (56%) had undergone 6‑monthly postprocedural angiographic imaging with a mean time of 6.6 months demonstrating that 83% of patients had achieved adequate occlusion (RROC1/2) of the aneurysm.</p><p><strong>Conclusions: </strong>In this non-industry-sponsored study, the occlusion rates and safety outcomes were similar to those seen in previously published studies with flow diverter devices and earlier generation Pipeline devices. Modifications to the device appear to have improved ease of deployment.</p>","PeriodicalId":10391,"journal":{"name":"Clinical Neuroradiology","volume":" ","pages":"887-896"},"PeriodicalIF":2.8,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9690767","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}