Neurologia medico-chirurgica最新文献

{"title":"O-arm Navigation-assisted Extreme Lateral Interbody Fusion Utilizing SureTrak Device.","authors":"Yasunobu Itoh, Ryo Kitagawa, Ryuzaburo Kanazawa, Yota Zushi, Takao Kono, Shinichi Numazawa, Sadayoshi Watanabe","doi":"10.2176/jns-nmc.2026-0172","DOIUrl":"https://doi.org/10.2176/jns-nmc.2026-0172","url":null,"abstract":"<p><p>Currently, intraoperative guidance during conventional extreme lateral interbody fusion relies primarily on fluoroscopy, which can expose both surgical staff and the patient to radiation. The use of O-arm navigation during extreme lateral interbody fusion and percutaneous pedicle screw fixation is anticipated to enhance accuracy and substantially reduce radiation exposure. To date, there have been no published studies investigating the application of O-arm navigation in extreme lateral interbody fusion procedures. Thirty-three extreme lateral interbody fusion and percutaneous pedicle screw fixation procedures were performed using O-arm navigation in a semi-lateral setup, including 25 single-level and 8 2-level cases. Pathologies included 23 cases of lumbar degenerative spondylolisthesis, 8 canal stenosis, and 2 spondylolytic spondylolisthesis. For each patient, we collated key parameters, including operative time, blood loss, radiation exposure/doses, Japanese Orthopaedic Association score, and Oswestry Disability Index. Patients were placed in a single position. percutaneous pedicle screw fixation was first performed under O-arm guidance; subsequently, disc preparation and cage insertion were navigation-assisted using the SureTrak device. The control group included 33 patients who underwent extreme lateral interbody fusion with C-arm fluoroscopy. Operative time and blood loss were similar between the O-arm navigated extreme lateral interbody fusion and fluoroscopy-guided extreme lateral interbody fusion groups. The O-arm navigated extreme lateral interbody fusion group demonstrated an 85% reduction in radiation time (11.10 ± 5.44 seconds versus 72.94 ± 17.99 seconds), as well as a 77% decrease in radiation dose (1.50 ± 0.38 versus 6.52 ± 5.30 mGy). Both groups showed notable postoperative improvements in Japanese Orthopaedic Association and Oswestry Disability Index scores. Extreme lateral interbody fusion with O-arm navigation demonstrated practicality, reliability, accuracy, and precise cage placement. Enhanced anatomical visualization reduced radiation exposure among surgical personnel.</p>","PeriodicalId":19225,"journal":{"name":"Neurologia medico-chirurgica","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2026-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149168202","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":"Convex Hull-based Quantitative Assessment of Shape Irregularity in Cerebral Aneurysms: Diagnostic Performance of the Undulation Area Index.","authors":"Keiji Fukazawa, Masanori Tsuji, Fujimaro Ishida, Atsumu Toyoshima, Takenori Sato, Takuya Yamanaka, Munenari Ikezawa, Tomoyuki Kishimoto, Yoko Yamamoto, Kazuhiro Furukawa, Hidenori Suzuki","doi":"10.2176/jns-nmc.2026-0155","DOIUrl":"https://doi.org/10.2176/jns-nmc.2026-0155","url":null,"abstract":"<p><p>Irregular morphology is an important predictor of rupture risk in cerebral aneurysms. However, its evaluation has largely relied on subjective visual assessment of two-dimensional images, resulting in limited reproducibility. This study aimed to establish a quantitative method for assessing aneurysm shape irregularity and to identify morphological variables that best correspond to expert visual judgment.We retrospectively analyzed 184 aneurysms reconstructed from three-dimensional computed tomography angiography. Two independent neurosurgeons classified aneurysms as irregular shape only when both agreed on irregularity; all others were defined as regular shape. Morphological variables, including conventional geometric parameters and convex hull-based irregularity indices such as the undulation area index, which is derived from the difference in surface area between the aneurysm and its convex hull, were used to quantify deviations from an ideal shape. Receiver operating characteristic curve analysis was performed to evaluate their ability to discriminate irregular shape from regular shape.Interrater agreement was moderate (κ = 0.36). All irregularity indices and most conventional variables were significantly higher in the irregular shape group (all p < 0.001). The receiver operating characteristic analysis showed that undulation area index had the highest diagnostic performance (area under the curve = 0.818, sensitivity = 0.779, specificity = 0.738, and optimal cutoff = 0.013).Among the evaluated morphological variables, undulation area index demonstrated the highest ability to discriminate visually defined irregular shape aneurysms. Undulation area index provides an objective and reproducible measure of aneurysm shape irregularity and may contribute to improved risk assessment.</p>","PeriodicalId":19225,"journal":{"name":"Neurologia medico-chirurgica","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2026-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149167132","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":"Two-point Loop Suture Fixation May Reduce Catheter Displacement in Cisternal and External Ventricular Drains.","authors":"Daisuke Wajima, Tomoya Kamide, Kenshu Nogami, Taishi Tsutsui, Yuichiro Kikkawa, Hiroki Kurita, Mitsutoshi Nakada","doi":"10.2176/jns-nmc.2026-0191","DOIUrl":"https://doi.org/10.2176/jns-nmc.2026-0191","url":null,"abstract":"<p><p>In this retrospective, single-center, before-and-after comparison study, we report a simple and reliable method for securing cisternal or external ventricular drain catheters to the scalp to prevent accidental catheter displacement. This method involves fixation of the catheter at 2 points with loop sutures. A 10-year retrospective review was conducted in 39 consecutive patients with aneurysmal subarachnoid hemorrhage who underwent placement of either a cisternal drainage catheter (n = 15) or an external ventricular drainage catheter (n = 24) at our institution. Conventional single-point suture fixation (non-loop method, n = 15) was compared with two-point loop suture fixation (loop method, n = 24).No accidental pullout occurred in the loop method group, whereas one pullout was observed in the non-loop method. The mean duration of catheter placement did not differ significantly between the 2 groups (4.93 vs. 4.13 days, p = 0.25). However, the mean daily catheter displacement was greater with the non-loop method than with the loop method (1.05 vs. 0.28 mm/day, p = 0.01). These findings suggest that the loop method was associated with reduced daily catheter displacement. The loop suture fixation method is a simple and reliable method for securing cisternal drainage catheter or external ventricular drainage catheters to the scalp and may reduce the risk of accidental catheter displacement.</p>","PeriodicalId":19225,"journal":{"name":"Neurologia medico-chirurgica","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2026-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149167269","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":"Optimal Catheter Size for Medium Vessel Occlusion in Aspiration Thrombectomy.","authors":"Ryo Hamamoto, Takeru Umemura, Yu Abekura, Takeshi Miyata, Takenori Ogura, Yuji Agawa, Tomoya Ogawa, Hiroshi Miyachi, Hiroki Sakamoto, Daisuke Abe, Takashi Nagahori, Jun Hashimoto, Kan Sumita, Wataru Shiraishi, Yusuke Nakazawa, Yuta Honkawa, Taketo Hatano","doi":"10.2176/jns-nmc.2026-0219","DOIUrl":"https://doi.org/10.2176/jns-nmc.2026-0219","url":null,"abstract":"<p><p>The efficacy of mechanical thrombectomy for medium vessel occlusion remains controversial, and optimal recanalization strategies are lacking. We investigated factors associated with successful recanalization using aspiration thrombectomy in patients with medium vessel occlusion. We conducted a retrospective study on patients with acute ischemic stroke who underwent aspiration thrombectomy for M2 occlusion between July 2021 and November 2025. We examined the factors associated with successful recanalization by focusing on the ratio of the catheter outer diameter to the target vessel inner diameter (Catheter-to-vessel ratio). Overall, 64 patients were included. First-pass successful recanalization (modified Thrombolysis in Cerebral Infarction ≥ 2c) was achieved in 24 patients. In patients with successful recanalization, the ratio of the catheter outer diameter to the target vessel inner diameter (Catheter-to-vessel ratio) was significantly higher than in those without successful recanalization (p = 0.029). In multivariate analysis, the Catheter-to-vessel ratio was independently associated with successful recanalization after adjustment for catheter position and thrombus size (odds ratio per 0.1 increase, 3.688; 95% confidence interval, 1.478-9.202; p = 0.0007). In the receiver operating characteristic analysis, the threshold for the Catheter-to-vessel ratio distinguishing successful recanalization was 0.70, with a sensitivity of 79% and a specificity of 63%.In aspiration thrombectomy for medium vessel occlusion, a Catheter-to-vessel ratio ≥ 0.70 may be an exploratory indicator associated with first-pass successful reperfusion.</p>","PeriodicalId":19225,"journal":{"name":"Neurologia medico-chirurgica","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2026-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149167173","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":"Early Volumetric and Biochemical Effects of Embolization in Head and Neck Paragangliomas.","authors":"Hiroki Sakamoto, Takao Hashimoto, Ken Matsushima, Kyosuke Matsunaga, Muneaki Kikuno, Michihiro Kohno","doi":"10.2176/jns-nmc.2026-0251","DOIUrl":"https://doi.org/10.2176/jns-nmc.2026-0251","url":null,"abstract":"<p><p>Preoperative embolization is commonly performed for head and neck paragangliomas to reduce intraoperative bleeding; however, its early effects on tumor volume and catecholamine secretion remain unclear. We retrospectively reviewed 14 consecutive patients with head and neck paragangliomas who underwent embolization followed by surgical resection. Tumor volume was measured on contrast-enhanced T1-weighted imaging before and shortly after embolization. Serum and urinary norepinephrine levels were assessed in patients with catecholamine-secreting tumors. Post-embolization imaging was available for all 14 patients, and the mean interval between embolization and imaging was 4.1 ± 2.0 days. Mean tumor volume decreased by 10.5 ± 7.5% after embolization (p = 0.003). Among 5 patients with catecholamine-secreting tumors, tumor volume decreased by 11.2 ± 5.7% (p = 0.04). The mean interval between embolization and norepinephrine assessment was 3.0 ± 1.2 days. Serum and urinary norepinephrine levels decreased by 46.6 ± 12.5% (p = 0.04) and 22.2 ± 12.4%, respectively, although the latter did not reach statistical significance (p = 0.11). No significant correlation was observed between tumor volume reduction and changes in norepinephrine levels. Embolization for head and neck paragangliomas was associated with early tumor volume reduction and short-term decreases in norepinephrine levels, suggesting that embolization may contribute to early anatomical and biochemical changes beyond its traditional role as a preoperative adjunct.</p>","PeriodicalId":19225,"journal":{"name":"Neurologia medico-chirurgica","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2026-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149168592","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":"Prospective Evaluation of Standalone Endovascular Embolization for Growing Meningiomas: A Multicenter Study Protocol.","authors":"Jun Haruma, Kenji Sugiu, Yusuke Tomita, Yosuke Shimazu, Yuta Soutome, Masato Kawakami, Juntaro Fujita, Yuichi Hirata, Fukiko Baba, Hiroyuki Takagoshi, Kenichiro Muraoka, Nobuyuki Hirotsune, Akira Handa, Yoshihiro Otani, Joji Ishida, Masafumi Hiramatsu, Shota Tanaka","doi":"10.2176/jns-nmc.2026-0212","DOIUrl":"https://doi.org/10.2176/jns-nmc.2026-0212","url":null,"abstract":"<p><p>Endovascular embolization for meningiomas has traditionally been performed as a preoperative adjunct; however, embolization alone can induce tumor necrosis and volume reduction. This study aims to prospectively evaluate the efficacy and safety of standalone embolization in patients with growing meningiomas. This multicenter, prospective, single-arm study will include patients diagnosed with meningioma using imaging findings that showed interval growth. The primary end point is tumor growth control at 180 days after treatment, defined as a stable or reduced tumor volume based on quantitative volumetric assessment of the contrast-enhancing portion on magnetic resonance imaging. The secondary end points include the tumor volume change rate, embolized vessels, embolic materials, embolization results and characteristics, procedure-related complications, perioperative complications, functional outcomes (Karnofsky Performance Status and modified Rankin Scale), changes in clinical symptoms, and the need for additional treatment. Exploratory analyses will also assess the association between intratumoral penetration of embolic material and treatment outcomes. Patient recruitment is ongoing, and the results will be reported upon completion of the study. This study represents a prospective attempt to evaluate the efficacy and safety of standalone embolization for meningiomas. If safe tumor growth control can be achieved, this study may provide preliminary evidence supporting standalone embolization as a potential less-invasive treatment strategy.</p>","PeriodicalId":19225,"journal":{"name":"Neurologia medico-chirurgica","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2026-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149167295","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":"Nationwide Analysis of Initial Surgical Management for Newly Diagnosed Glioblastoma in Japan (2018-2023): Part 1. Regional Practice Patterns in an Aging Society.","authors":"Toshihiro Kumabe, Hajime Handa, Ryota Shigeeda, Jun Oikawa, Ichiyo Shibahara","doi":"10.2176/jns-nmc.2026-0055","DOIUrl":"10.2176/jns-nmc.2026-0055","url":null,"abstract":"<p><p>Japan is undergoing rapid population aging, and glioblastoma is increasingly diagnosed in older adults. However, nationwide data on regional variation in age distribution, surgical volume, population-adjusted incidence, and treatment selection for newly diagnosed glioblastoma remain limited. Using anonymized data from the Japan Neurosurgical Database between 2018 and 2023, we analyzed patients with newly diagnosed glioblastoma who underwent initial tumor resection or biopsy and examined inter-prefectural heterogeneity in surgical practice patterns. Patient age was categorized into 5-year groups and stratified as <75 and ≥75 years, and prefecture-specific population data from the 2020 national census were used to calculate population-adjusted incidence.Across all 47 prefectures, the age distribution of surgically treated patients differed significantly from that of the general population, with older patients being consistently overrepresented. The magnitude of this difference varied substantially among prefectures, indicating marked regional heterogeneity in the age profile of patients undergoing surgical management. Significant inter-prefectural differences were also observed in the surgical volume, the population-adjusted incidence, and the balance between resection and biopsy. Patients undergoing biopsy were older than those undergoing resection, although the magnitude of this difference varied regionally. The proportion of tumor resection ranged widely across regions and persisted even among patients aged ≥75 years. Importantly, baseline functional status (modified Rankin Scale) and admission consciousness level (Japan Coma Scale) were largely comparable across the prefectures.These findings demonstrate substantial regional heterogeneity in the initial surgical management of glioblastoma in Japan that cannot be fully explained by population aging or patient condition alone.</p>","PeriodicalId":19225,"journal":{"name":"Neurologia medico-chirurgica","volume":" ","pages":"623-634"},"PeriodicalIF":1.6,"publicationDate":"2026-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13649609/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148701828","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":"Preoperative Magnetic Resonance Imaging Findings Associated with Preexisting Basilar Artery Stenosis in Endovascular Revascularization for Basilar Artery Occlusion.","authors":"Hirofumi Asano, Tatsuya Shimizu, Kazuki Wakabayashi, Masashi Yoshizawa, Masanori Aihara, Rei Yamaguchi, Ryosuke Shintoku, Naoto Mukada, Soichi Oya","doi":"10.2176/jns-nmc.2026-0063","DOIUrl":"10.2176/jns-nmc.2026-0063","url":null,"abstract":"<p><p>Underlying atherosclerotic stenosis is more common in acute basilar artery occlusion than in anterior circulation, and often necessitates additional procedures such as balloon angioplasty or stent placement during endovascular revascularization. Preoperative recognition of underlying basilar artery stenosis may be clinically relevant, but reliable imaging indicators remain unclear. This study aimed to identify preoperative magnetic resonance imaging findings associated with underlying basilar artery stenosis in patients undergoing acute endovascular revascularization. We retrospectively analyzed patients at three institutions between 2018 and 2023. Patients were divided into stenosis and non-stenosis groups based on post-recanalization angiographic findings. Stenosis was identified in 13 patients and was found to be absent in 35 patients. Pontine hyperintensity on diffusion-weighted imaging was more frequent in the stenosis group and remained independently associated with preexisting basilar artery stenosis after adjustment for preoperative National Institutes of Health Stroke Scale score. Non-visualization of the proximal basilar artery on magnetic resonance angiography was also more frequent in the stenosis group, but did not remain independently associated after adjustment. Additional endovascular procedures were more frequently required in the stenosis group, whereas recanalization was achieved with mechanical thrombectomy alone in the non-stenosis group. Functional outcomes at discharge were comparable between the groups. In acute basilar artery occlusion, pontine hyperintensity on diffusion-weighted imaging was independently associated with preexisting basilar artery stenosis. Its absence may help exclude underlying stenosis, whereas concordant positivity of pontine hyperintensity and proximal basilar artery non-visualization may support suspicion of stenosis before treatment.</p>","PeriodicalId":19225,"journal":{"name":"Neurologia medico-chirurgica","volume":" ","pages":"635-640"},"PeriodicalIF":1.6,"publicationDate":"2026-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13649606/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148701833","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":"Achievement and Future Prospectives from Translational Research Targeting Intracranial Aneurysm.","authors":"Tomohiro Aoki","doi":"10.2176/jns-nmc.2026-0108","DOIUrl":"10.2176/jns-nmc.2026-0108","url":null,"abstract":"<p><p>Our understanding of the pathogenesis of intracranial aneurysms has been deepened through a series of studies. In this process, animal models of intracranial aneurysms have contributed greatly by providing experimental evidence with the causative relationship. Currently, intracranial aneurysms are considered a chronic inflammatory disease affecting the bifurcation site of intracranial arteries driven by non-physiological hemodynamic loading due to unique morphology of the lesions. On the basis of elucidated molecular mechanisms regulating intracranial aneurysm pathology, a clear possibility for the development of a novel therapy or a diagnostic tool to prevent or predict the formation, growth, or rupture of these lesions has been suggested.</p>","PeriodicalId":19225,"journal":{"name":"Neurologia medico-chirurgica","volume":" ","pages":"579-588"},"PeriodicalIF":1.6,"publicationDate":"2026-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13649608/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148562637","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":"Correlation of Preoperative Diffusion-weighted Magnetic Resonance Imaging-based Virtual Elastography with Intraoperative Quantitative Tumor Stiffness in Meningiomas.","authors":"Mitsuyoshi Abe, Yuki Sakaeyama, Ryo Matsuzaki, Syuhei Kubota, Yutaka Fuchinoue, Sayaka Terazono, Kohei Kamiya, Masaaki Hori, Masaaki Nemoto, Nobuo Sugo","doi":"10.2176/jns-nmc.2026-0118","DOIUrl":"10.2176/jns-nmc.2026-0118","url":null,"abstract":"<p><p>Tumor stiffness strongly influences exposure, extent of resection, operative time, and approach in meningioma surgery, but magnetic resonance imaging-based prediction still relies mainly on qualitative assessment. We evaluated whether a diffusion-derived stiffness surrogate calculated from diffusion-weighted magnetic resonance imaging-based virtual elastography correlates with intraoperative quantitative tumor stiffness in meningiomas and assessed its usefulness for preoperative stiffness prediction. Of 33 patients who underwent meningioma surgery between May 2022 and January 2025, 22 with both preoperative virtual elastography and intraoperative stiffness measurements were analyzed. Preoperative 3-Tesla diffusion-weighted magnetic resonance imaging with 2 b values was used to generate shifted apparent diffusion coefficient maps, and a single-slice volume of interest with a 5.51 mm slice thickness was manually delineated on the axial slice showing the largest tumor cross-sectional area. Intraoperative tumor stiffness of approximately 1-cm³ fresh specimens was measured with a rheometer and expressed as Young's modulus. The relationship between the diffusion-derived stiffness surrogate and stiffness was examined using Pearson correlation and multivariate linear regression. The diffusion-derived stiffness surrogate showed a significant negative correlation with tumor stiffness (r = -0.655, p = 0.00094), and this association remained significant after exclusion of embolized cases. Lower diffusion-derived stiffness surrogate values were associated with firmer tumors, whereas higher values were associated with softer tumors. These findings indicate that diffusion-weighted magnetic resonance imaging-based virtual elastography may provide a noninvasive, quantitative preoperative surrogate marker for estimating the stiffness of selected solid components of meningiomas and may offer adjunctive information for surgical planning.</p>","PeriodicalId":19225,"journal":{"name":"Neurologia medico-chirurgica","volume":" ","pages":"615-622"},"PeriodicalIF":1.6,"publicationDate":"2026-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13649612/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148701886","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}