Interventional Neuroradiology最新文献

{"title":"Arterial spin labeling detects trapped labeled spins in flow-diverted aneurysms and it reflects intra-aneurysmal flow stasis.","authors":"Tatsuya Oki, Atsushi Tsuji, Shota Ishida, Jun Matsubayashi, Kazumichi Yoshida, Yoshiyuki Watanabe","doi":"10.1177/15910199241286130","DOIUrl":"10.1177/15910199241286130","url":null,"abstract":"<p><strong>Background: </strong>This study evaluated arterial spin labeling (ASL) imaging findings in flow-diverted aneurysms (FD-ANs).</p><p><strong>Methods: </strong>Twenty-one patients with internal carotid artery aneurysms treated with flow-diverter stent (FDS) were included. Time-of-flight magnetic resonance angiography (TOF-MRA) and ASL were performed before and after follow-up digital subtraction angiography (DSA) on the day, 6 months, and/or 1 year after treatment. Two radiologists rated the clarity of the depiction of FD-ANs for MRA on a 3-point scale and the ASL signal intensity of the aneurysm as negative or positive. A neurosurgeon assessed DSA findings using the O'Kelly-Marotta (OKM) grading scale, categorizing them into filling and stasis grades. The 23 examinations were classified according to the OKM grading scale, and the proportion of ASL-positive cases and the proportion of cases with MRA scores of 1-2 (detectable) were calculated for each grade. The relationship between the OKM grading scale and ASL positivity or MRA detectable was examined using Fisher's exact test.</p><p><strong>Results: </strong>Of seven examinations where the statis grade was 1 or 2, no examinations showed ASL positivity. However, among the 16 examinations in which the stasis grade was 3, 9 examinations showed ASL positivity. A significant association was observed between stasis grade and ASL positivity (<i>p </i>= 0.035). In contrast, no significant relationship was observed between the OKM grading scale and the MRA 3-point scale.</p><p><strong>Conclusion: </strong>High-signal ASL in FD-ANs could reflect stasis within the aneurysm; therefore, noninvasive ASL can indicate reduction in intra-aneurysmal blood flow after treatment and reperfusion during posttreatment observation.</p>","PeriodicalId":14380,"journal":{"name":"Interventional Neuroradiology","volume":" ","pages":"15910199241286130"},"PeriodicalIF":1.7,"publicationDate":"2024-09-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11559746/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142346730","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Shining light on neurovascular disease.","authors":"Adnan H Siddiqui, Tommy Andersson","doi":"10.1177/15910199241285962","DOIUrl":"10.1177/15910199241285962","url":null,"abstract":"<p><p>Tortuosity and fragility of the intracranial vasculature have precluded the application of novel intravascular imaging modalities during the treatment of cerebrovascular pathologies. In other circulatory beds, these technologies have transformed clinical and therapeutic decision-making. A new report demonstrates the clinical use of high-resolution intravascular imaging in the human cerebrovasculature using neuro optical coherence tomography. This technology provides an unprecedented opportunity to examine the luminal dimensions of cerebrovascular disease. We expect that the neurointerventional community will rapidly adopt this technology-similar to wider adoptions by other vascular specialties-for both a better understanding of underlying disease and clarity of endovascular therapeutic safety and effectiveness.</p>","PeriodicalId":14380,"journal":{"name":"Interventional Neuroradiology","volume":" ","pages":"15910199241285962"},"PeriodicalIF":1.7,"publicationDate":"2024-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11559757/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142346734","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Radiographic predictors of neurologic outcomes in patients with basilar artery occlusion: A single-center experience.","authors":"Daryl Goldman, Mais Al-Kawaz, Preethi Reddi, Amol Mehta, Puneet Belani, Milad Shafizadeh, Stavrous Matsoukas, Christopher P Kellner, J Mocco, Johanna T Fifi, Shahram Majidi","doi":"10.1177/15910199241285581","DOIUrl":"10.1177/15910199241285581","url":null,"abstract":"<p><strong>Background: </strong>Randomized controlled trials indicate functional and mortality benefits in endovascular therapy for basilar artery occlusion (BAO). However, these studies only include patients who meet specific prognostic scores. This study investigates radiographic predictors of posterior circulation territory infarcts that may predict neurologic outcome at 90-day post-intervention.</p><p><strong>Methods: </strong>This is a retrospective cohort study of a prospectively maintained thrombectomy database of all patients who underwent mechanical thrombectomy for BAO. Baseline demographics, comorbidities, baseline functional status (mRS), and severity of presenting neurologic deficits (NIHSS) were collected. Pc-ASPECTS, posterior circulation collateral score (PCCS), and basilar artery on computed tomography angiography (BATMAN) measured radiographic characteristics. Core infarct territory was identified. Primary outcomes were good neurologic outcome (mRS 0-3) and poor neurologic outcome (mRS 4-6) at 90-day post-thrombectomy. 90-day mortality was a secondary outcome.</p><p><strong>Results: </strong>About 21.5% of patients achieved a good neurologic outcome. About 32.3% of patients were deceased at 90 days. Receiver operating characteristic analysis shows PCCS collateral scores (AUC = 0.74, SE = 0.03, CI = 0.62-0.74) and BATMAN (AUC = 0.72, SE = 0.04, CI = 0.35-0.49) have potential to differentiate between those with good neurologic outcome from those with poor neurologic outcome. Although there was no statistically significant difference in AUC between the three curves, pc-ASPECTS score trended toward being weaker predictor of neurologic outcome (AUC = 0.49, SE = 0.04, CI = 0.35-0.49). There were significant associations between 90-day poor neurologic outcome and established infarcts within the pons (<i>p</i> = 0.01), left cerebellum (<i>p</i> = 0.01), and left occipital lobe (<i>p</i> = 0.03) on pre-thrombectomy CT.</p><p><strong>Conclusion: </strong>Low BATMAN and PCCS collateral scores can be predictors of poor neurologic outcomes at 90-day post-thrombectomy for BAO while pc-ASPECTS score may be a weaker predictor of outcome.</p>","PeriodicalId":14380,"journal":{"name":"Interventional Neuroradiology","volume":" ","pages":"15910199241285581"},"PeriodicalIF":1.7,"publicationDate":"2024-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11559930/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142287270","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Hemorrhagic versus non-hemorrhagic presentation of presumed reversible cerebral vasoconstriction syndrome (RCVS): Presentations and outcomes.","authors":"Adrusht Madapoosi, Laura Stone McGuire, Angelica Fuentes, Mpuekela Tshibangu, Peter Theiss, Tatiana Abou Mrad, Sepideh Amin-Hanjani, Ali Alaraj","doi":"10.1177/15910199241285501","DOIUrl":"https://doi.org/10.1177/15910199241285501","url":null,"abstract":"<p><strong>Introduction: </strong>Reversible cerebral vasoconstriction syndrome (RCVS) can present with hemorrhage, ischemia, or both. We aim to compare the differences in presentation and outcomes between patients with RCVS.</p><p><strong>Methods: </strong>The hemorrhagic presentation group had 58 patients, and the non-hemorrhagic presentations had 30 patients. Subgroup analysis compared patients with evidence of one or more types of hemorrhage (<i>n</i> = 53), no evidence of hemorrhage or infarction (<i>n</i> = 23), evidence of infarction only (<i>n</i> = 7), and combination of hemorrhage and infarction (<i>n</i> = 5). Clinical and radiographic data were analyzed.</p><p><strong>Results: </strong>Migraine (<i>p</i> = 0.030) and intracranial tumors (<i>p</i> = 0.004) were more frequent in non-hemorrhagic presentation. Seizures on admission (<i>p</i> = 0.047) and higher than average C-reactive protein (CRP) (<i>p</i> = 0.037) were seen at a higher rate in patients with hemorrhagic presentation. RCVS2 scores were not unexpectedly higher in patients with hemorrhage than non-hemorrhagic presentations (<i>p</i> = 0.010). Outcomes between the hemorrhagic and non-hemorrhagic groups were comparable. Subgroup analysis found a higher subset of patients with opiate use (<i>p</i> = 0.046) in the hemorrhage-only group. Patients with hemorrhage presented with a thunderclap headache (<i>p</i> < 0.001) more often when compared to the other three groups. RCVS2 score was not unexpectedly higher in the hemorrhage-only group compared with the other groups (<i>p</i> = 0.004).</p><p><strong>Conclusion: </strong>A history of migraines was associated with ischemia, while intracranial tumor was significantly associated with evidence of either an infarct, or no changes on imaging. Exposure to opiates, and seizures or thunderclap headache on presentation were associated with hemorrhage. If our data are reproducible, the RCVS2 score may benefit from inclusion of other, small hemorrhages as criterion for diagnosis for RCVS.</p>","PeriodicalId":14380,"journal":{"name":"Interventional Neuroradiology","volume":" ","pages":"15910199241285501"},"PeriodicalIF":1.7,"publicationDate":"2024-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142287258","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"FreeClimb 88 catheter with Tenzing 8 delivery for contact aspiration mechanical thrombectomy of anterior circulation large vessel occlusions.","authors":"Matthew D Alexander, James Caldwell, Shane Sh Lee, Warren T Kim, Joey D English, Jaehyun Kim, Ben J McGuinness, Matthew Page, Nebiyat F Belachew, Jonathan A Grossberg, Daniel Tonetti, Jane Khalife, Hamza Shaikh, Omar Kass-Hout, Marco Colasurdo, Ryan Priest, Bahram Varjavand, Rajkamal S Khangura, Thymur A Chaudhry, Fabio Settecase","doi":"10.1177/15910199241284792","DOIUrl":"10.1177/15910199241284792","url":null,"abstract":"<p><strong>Purpose: </strong>Contact aspiration mechanical thrombectomy (CAMT) with 0.088-inch catheters may improve first-pass success rates, but delivery of such catheters can be challenging and limit effectiveness. This study examines the initial multicenter experience using the FreeClimb 88 catheter paired with the Tenzing 8 delivery catheter.</p><p><strong>Materials and methods: </strong>Retrospective analysis was performed of consecutive patients with large vessel occlusion (LVO) of the internal carotid artery (ICA) or M1 segment of the middle cerebral artery treated with off-label CAMT using the FreeClimb 88 and Tenzing 8 at eight sites participating in the early limited release for these devices. Demographic and procedural variables were collected and analyzed with descriptive statistics and multivariable analysis.</p><p><strong>Results: </strong>Fifty-three consecutive patients were treated. Large vessel occlusion was located in the ICA in 19/53 (35.8%) patients; 34/53 (64.2%) were in the M1 segment. FreeClimb 88 was successfully delivered to the site of occlusion in 50/53 (94.3%) of patients. First-pass TICI 2c or 3 was achieved with FreeClimb 88 delivered by Tenzing 8 in 36 (67.9%) cases. Among cases with successful FreeClimb 88 delivery 9/50 (18.0%) required additional smaller devices to perform thrombectomy of distal occlusions after recanalization of the initial LVO. No complications or symptomatic hemorrhages occurred following thrombectomy.</p><p><strong>Conclusion: </strong>Contact aspiration mechanical thrombectomy performed for ICA or M1 LVOs using FreeClimb 88 delivered with Tenzing 8 was safe, effective, and efficient in this early experience, with first-pass TICI 2c or 3 was achieved in 68% of patients without procedural complications occurring in any cases.</p>","PeriodicalId":14380,"journal":{"name":"Interventional Neuroradiology","volume":" ","pages":"15910199241284792"},"PeriodicalIF":1.7,"publicationDate":"2024-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142287257","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Parasagittal dural arteriovenous fistulas.","authors":"Xin Su, Jiabin Zhu, Yuying Li, Zihao Song, Liyong Sun, Ming Ye, Tao Hong, Yongjie Ma, Hongqi Zhang, Peng Zhang","doi":"10.1177/15910199241286009","DOIUrl":"10.1177/15910199241286009","url":null,"abstract":"<p><strong>Background: </strong>The majority of studies on parasagittal dural arteriovenous fistulas (DAVFs) have been limited to case reports or case series, and they are frequently reported alongside true superior sagittal sinus (SSS) DAVFs. Because of the selective bias present in the reporting of dispersed small numbers of parasagittal DAVFs, the results of each study may influence the findings. As a result, we present a large sequential cohort of parasagittal DAVFs from our institution spanning a 20-year period.</p><p><strong>Methods: </strong>This study was a retrospective analysis involving 80 patients with parasagittal DAVFs who were hospitalized at a single medical center from 2002 to 2022. We explore their clinical manifestations, angioarchitecture, clinical and radiographic outcomes.</p><p><strong>Results: </strong>We identified 80 patients with 85 parasagittal DAVFs. The cohort consisted of 69 men and 11 women, with a M ± SD age of 50.5 ± 11.1 years. Seventy-six patients underwent trans-arterial embolization (TAE), two underwent surgery, and two received conservative treatment. Immediate complete occlusion was achieved in 74 cases (94.9%). Fifty (96.2%) patients were cured, with no recurrence detected on final follow-up imaging. One patient died 6 months after the final subtotal occlusion, while the other patients experienced improvement or resolution of clinical symptoms following treatment.</p><p><strong>Conclusions: </strong>These lesions carry a high risk of hemorrhage and nonhemorrhagic neurological deficits. In our series, TAE achieved a high cure rate for these lesions, with no major complications reported.</p>","PeriodicalId":14380,"journal":{"name":"Interventional Neuroradiology","volume":" ","pages":"15910199241286009"},"PeriodicalIF":1.7,"publicationDate":"2024-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11559956/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142287260","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pipeline embolization device as a standalone curative approach for recurrent sigmoid sinus DAVF.","authors":"Vera Sharashidze, Charlotte Chung, Peter Kim Nelson, Maksim Shapiro, Howard Riina, Erez Nossek, Eytan Raz","doi":"10.1177/15910199241282780","DOIUrl":"10.1177/15910199241282780","url":null,"abstract":"<p><p>Dural arteriovenous fistulas (dAVFs) can occur as complications after surgical procedures, especially following the resection of meningiomas near the dural sinus. This case report presents a 74-year-old male who developed a recurrent sigmoid dAVF following meningioma resection. Initially treated with transvenous embolization and middle meningeal artery embolization, the dAVF recurred with worsening clinical symptoms. Conventional treatment options, including sinus sacrifice and transarterial embolization, were unsuitable due to the critical role of the patient's dominant right sigmoid sinus in cerebral venous drainage. Consequently, a reconstructive approach was employed using a pipeline embolization device (PED) construct. The PED successfully occluded the dAVF while preserving the function of the sigmoid sinus. A follow-up angiogram confirmed stable occlusion and normalization of intracranial venous drainage. This case underscores the potential of flow diversion as a viable treatment option for dAVFs, particularly in scenarios where preserving venous sinus function is paramount.</p>","PeriodicalId":14380,"journal":{"name":"Interventional Neuroradiology","volume":" ","pages":"15910199241282780"},"PeriodicalIF":1.7,"publicationDate":"2024-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11559946/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142287261","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Optimizing the hemodynamics of hand injections in neuroangiography.","authors":"Esref Alperen Bayraktar, Jiahui Li, Jonathan Cortese, Cem Bilgin, Yasuhito Ueki, Ramanathan Kadirvel, Waleed Brinjikji, Harry J Cloft, David F Kallmes","doi":"10.1177/15910199241285944","DOIUrl":"https://doi.org/10.1177/15910199241285944","url":null,"abstract":"<p><strong>Purpose: </strong>Optimizing the preparation of a 10 ml syringe for manual injection of contrast media can help operators obtain easier and faster injections. This study aims to compare the flow rates of different contrast media injection methods.</p><p><strong>Methods: </strong>Different contrast media solutions were compared: 100% contrast (10 ml contrast), mixed contrast solution (8:2 contrast/saline), and layered contrast below saline (\"Parfait\") in different volumes. Contrast media were injected at room temperature (20°C) and after heating (37°C). Four operators injected 10 ml syringes filled with different mediums through 5-French angiographic catheters. The average flow rate was used to compare different contrast injection mediums. The Kruskal-Wallis test with post-hoc pairwise comparisons using Bonferroni correction or Mann-Whitney U-tests were employed depending on the type of comparison.</p><p><strong>Results: </strong>Compared to the 100% contrast solution, every Parfait media and mixed contrast solution demonstrated significantly higher flow rates (p < 0.001). The 5 ml saline Parfait had the highest flow rate among the Parfait solutions. The 5 ml saline Parfait and the mixed solution had comparable flow rates (p = 0.237). Higher flow rates were observed upon heating both 100% contrast (p < 0.001) and mixed contrast solutions (p < 0.001) in comparison to their flow rates at room temperature.</p><p><strong>Conclusion: </strong>This study demonstrates the capability of the Parfait and mixed contrast injections to achieve higher flow rates than the 100% contrast solutions. Heating the contrast media to 37°C also proves to be a viable strategy for further enhancing the flow rates for 100% and mixed contrast solutions.</p>","PeriodicalId":14380,"journal":{"name":"Interventional Neuroradiology","volume":" ","pages":"15910199241285944"},"PeriodicalIF":1.7,"publicationDate":"2024-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142287259","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Some minutes matter more: Groin-to-recanalization is the main time-related predictor of outcome in acute ischemic stroke.","authors":"Antonio De Mase, Emanuele Spina, Giovanna Servillo, Stefano Barbato, Giuseppe Leone, Flavio Giordano, Rosaria Renna, Angelo Ranieri, Walter Di Iorio, Massimo Muto, Gianluigi Guarnieri, Mario Muto, Paolo Candelaresi, Vincenzo Andreone","doi":"10.1177/15910199241282714","DOIUrl":"10.1177/15910199241282714","url":null,"abstract":"<p><strong>Introduction: </strong>Endovascular thrombectomy (EVT) is the standard of care for selected patients with acute ischemic stroke (AIS) and large vessel occlusion (LVO), associated with intravenous thrombolysis, when indicated. While many studies focused on pre-hospital and in-hospital pathways, only few analyzed the relationship between groin-to-recanalization (GTR) time and functional outcome.</p><p><strong>Aim: </strong>To explore whether GTR time is an independent predictor of outcome in patients undergoing EVT.</p><p><strong>Methods: </strong>All patients with anterior circulation stroke treated with EVT at a high-volume center from January 2021 to December 2023 were included. The cohort was divided into two groups according to GTR time shorter or longer than 30 min. Regression analysis assessed the association between GTR time and 3-month good outcome, defined as modified Rankin Scale 0-2.</p><p><strong>Results: </strong>The study included 419 patients. The groups had similar baseline characteristics and similar onset to recanalization (OTR) time. Regression analysis showed shorter GTR time is an independent predictor of favorable outcome (OR 2.49 [95% CI 1.26-4.94]). Age, baseline NIHSS, ASPECT score and bridging IVT were also found to be independently associated with outcome.</p><p><strong>Discussion and conclusions: </strong>Our study showed GTR time is an independent predictor of good outcome in patients undergoing EVT with similar OTR time, emphasizing procedural time as a key prognostic factor, even greater than other well-known pre-hospital and in-hospital time-dependent variables. These findings may raise the issue of developing alternative approaches or early \"rescue\" strategies for complicated procedures.</p>","PeriodicalId":14380,"journal":{"name":"Interventional Neuroradiology","volume":" ","pages":"15910199241282714"},"PeriodicalIF":1.7,"publicationDate":"2024-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11562242/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142287271","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparison of the imaging performance of time-of-flight MRA and ultrashort echo time MRA in flow diverters: A phantom study.","authors":"Toshiya Akatsu, Akihiko Wada, Michimasa Suzuki, Haruyuki Fukuchi, Yutaka Ikenouchi, Nao Takano, Fumihiro Yagisawa, Kosuke Teranishi, Akira Ishii, Akihide Kondo, Shigeki Aoki","doi":"10.1177/15910199241285471","DOIUrl":"10.1177/15910199241285471","url":null,"abstract":"<p><strong>Objective: </strong>Flow diverters (FD) are innovative treatments for wide-neck intracranial aneurysms. After-treatment verification of embolization and parent vessel patency is crucial. While evaluation using time-of-flight magnetic resonance angiography (TOF-MRA) is useful, it suffers from signal loss within the FD due to susceptibility effects. This study evaluates the usefulness of ultrashort echo time MRA (UTE-MRA) for after-FD assessment compared to TOF-MRA.</p><p><strong>Methods: </strong>Vascular phantom experiments were conducted using FDs (FRED^®, Pipeline^®, Surpass Streamline^®). TOF-MRA and UTE-MRA were performed under steady (10, 30, 50 cm/s) and pulsatile (17-61 cm/s, mean 34 cm/s) flow conditions using a 3 T MRI system. As evaluation metrics, relative in-FD signal (RIS) was calculated by comparing the signal intensity inside the FD to that without the FD to assess signal retention, and FD luminal to background signal ratio (FD-LBR) was calculated by comparing the signal intensity inside the FD to that of the surrounding background to evaluate vessel visibility.</p><p><strong>Results: </strong>UTE-MRA showed higher FD-LBR values than TOF-MRA for all FDs (<i>p</i> < 0.01). For RIS, UTE-MRA was significantly higher for FRED^® (<i>p</i> < 0.01), but different for other FDs except at 50 cm/s. FRED^® exhibited the highest RIS and FD-LBR values under all conditions, followed by Pipeline^® and Surpass Streamline^®. Flow velocity changes resulted in minimal variations in RIS and FD-LBR values.</p><p><strong>Conclusion: </strong>UTE-MRA provides superior image quality for after-FD assessment, particularly in terms of FD-LBR, compared to TOF-MRA. Differences in FD materials and structures affect image quality. These findings suggest UTE-MRA's clinical utility in follow-up after-FD assessment.</p>","PeriodicalId":14380,"journal":{"name":"Interventional Neuroradiology","volume":" ","pages":"15910199241285471"},"PeriodicalIF":1.7,"publicationDate":"2024-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11559876/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142287256","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}