Neuroradiology最新文献

{"title":"Endovascular treatment versus microsurgical clipping in elderly patients with aneurysmal subarachnoid hemorrhage: A systematic review and meta-analysis.","authors":"George Brown, Danesh Sivanesan, Siddarth Kannan, Conor Gillespie, Isabel Siow, Rory Fairhead, Marco Mancuso-Marcello, Paul Bhogal, Nivedh Dinesh, Bolem Nagarjun, Shiong Wen Low, Ira Sun, Jia Xu Lim, Anil Gopinathan, Tze Phei Kee, Wickly Lee, Nicole Keong, Tien Meng Cheong, Tseng Tsai Yeo, Vincent Diong Weng Nga, Julian Han, Ramez Kirollos, Keng Siang Lee","doi":"10.1007/s00234-026-04009-5","DOIUrl":"https://doi.org/10.1007/s00234-026-04009-5","url":null,"abstract":"<p><strong>Background: </strong>The optimal treatment strategy for elderly patients with aneurysmal subarachnoid hemorrhage (aSAH) remains uncertain. While endovascular coiling and surgical clipping are both established interventions, age-related physiological vulnerability and comorbidity burden may alter the risk-benefit profile. We performed a systematic review and meta-analysis to compare outcomes between these two modalities in elderly patients with aSAH.</p><p><strong>Methods: </strong>Searches of PubMed, Embase, Scopus, and Cochrane CENTRAL were conducted from inception to 20th July 2025. The definition of elderly patients aged ≥ 60 years was adopted as per the World Health Organization. Primary outcomes were favorable functional outcome (modified Rankin Scale [mRS] 0-2) and mortality. Secondary outcomes were delayed cerebral ischemia (DCI), delayed hydrocephalus and rebleed.</p><p><strong>Results: </strong>Twenty studies (2 randomized controlled trials, 18 observational) were included. A total of 44,526 patients were included with 24,724 aneurysms clipped and 19,802 coiled. The mean age was 72.1 years in the coiling cohort and 72.8 years in the clipping cohort. Aneurysm location was anterior in 94% of cases. Hypertension was more prevalent in the coiling cohort (OR 1.25, 95% CI 1.03-1.51; p = 0.024). There was no association between poor-grade WFNS score 4-5 and treatment modality (OR = 0.89, 95% CI: 0.62-1.27; p = 0.471). There was no significant difference between coiling and clipping in achieving favorable outcomes (OR 1.07, 95% CI 0.75-1.52; p = 0.712) or mortality (OR 0.89, 95% CI 0.64-1.23; p = 0.471). Rates of delayed cerebral ischemia, hydrocephalus, and rebleeding were also comparable.</p><p><strong>Conclusions: </strong>Current evidence, derived from mainly observational studies, does not suggest difference in functional outcomes nor mortality between endovascular coiling and surgical clipping in elderly patients with aSAH. However, significant selection bias, variability in age definitions and the lack of randomized comparisons should be considered when interpreting these findings.</p>","PeriodicalId":19422,"journal":{"name":"Neuroradiology","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2026-05-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147818336","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":"Efficacy and safety of bridging intravenous thrombolysis prior to endovascular treatment in patients over 80 years old with acute ischemic stroke.","authors":"Yimin Chen, Isabel Siow, Keng Siang Lee, Qibei Dai, Xiao Xiao, Apar Garg, Anil Gopinathan, Cunli Yang, Benjamin Tan, Mingxue Jing, May Zin, Hock Luen Teoh, Ching Hui Sia, Mingzhu Feng, Jicai Ma, Lue Chen, Sijie Zhou, Zunbao Xu, Yongting Zhou, Yuzheng Lai, Wenhong Peng, Yihua He, Mohammad Mofatteh, Thanh Nguyen, Suyue Pan, Leonard Yeo","doi":"10.1007/s00234-026-03997-8","DOIUrl":"https://doi.org/10.1007/s00234-026-03997-8","url":null,"abstract":"<p><strong>Introduction: </strong>Endovascular treatment (EVT) is an effective treatment for patients with acute ischemic stroke (AIS); however, it remains to be determined if treatment with intravenous thrombolysis (IVT) prior to EVT confers any benefit in octogenarians and older. This study aimed to address if bridging tPA has improved functional outcomes or complications in patients 80 years and older.</p><p><strong>Methods: </strong>This multicentre retrospective cohort study included patients 80 years old and above who underwent endovascular therapy for large vessel occlusion acute ischaemic stroke in 10 compressive stroke centres across China and Singapore between 2018 and 2024. Clinical and procedural factors of patients in Singapore and China were compared using multivariate binary logistic regression. The primary outcome measured was 3-month functional independence defined as modified rankin scale (mRS) 0-2. Secondary outcomes included 3-month independent ambulation as defined as mRS 0-3, 3-month mortality rates and achieving successful recanalization. Data on intracranial haemorrhage was also collected.</p><p><strong>Results: </strong>Bridging IVT was not associated with improvement in 3-month functional independence (24.47% vs. 20.97%; p = 0.505), improvement in 3-month independent ambulation (32.80% vs. 41.49%; p = 0.512), 3-month mortality rates (36.17% vs. 33.33%; p = 0.637) or increased rates of successful recanalisation (89.36% vs. 87.63%; p = 0.672),. Instead, patients who underwent bridging IVT had higher rates of haemorrhage compared to patients who did not undergo bridging IVT even after adjusting for confounding factors (OR = 1.921; 95% CI 1.026-3.596; p = 0.041).</p><p><strong>Conclusion: </strong>The findings of this study suggest that bridging IVT prior to EVT may not improve functional outcomes or mortality rates. However, it appears to be associated with an increase in risk of intracranial haemorrhage.</p>","PeriodicalId":19422,"journal":{"name":"Neuroradiology","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2026-05-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147818319","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":"First clinical experience with the surpass elite flow diverter in the treatment of intracranial aneurysms.","authors":"Om H Gandhi, Sami Almasri, Warda Ahmed, Suraj R Dumasia, Nathan Yu, Mohammad S Rashad, Linda J Bagley, Matthew Fiesta, Omar A Choudhri","doi":"10.1007/s00234-026-04010-y","DOIUrl":"https://doi.org/10.1007/s00234-026-04010-y","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;The Surpass Elite (Stryker Neurovascular) is a third-generation flow diverter featuring modified braid architecture with increased braid angle and novel surface charge neutralization treatment. This study presents the first clinical experience with the Surpass Elite globally.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;A retrospective analysis of 81 consecutive cases (78 unique patients) treated with the Surpass Elite across four centers by two operators from January to July 2025 was performed. Data collected included patient demographics, aneurysm characteristics, procedural details, technical success, complications, and angiographic/clinical outcomes. Primary endpoints were technical success rate, perioperative safety profile, and aneurysm occlusion rates at approximately 6-month follow-up.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;The cohort comprised 78 unique patients (76.9% female, mean age 59.2 ± 14.5 years) with 81 aneurysms treated using 112 total devices (mean 1.38 devices per case). Aneurysms were predominantly located in the internal carotid artery (75.3%). Technical success was achieved in 100% of cases regardless of access site. Balloon angioplasty was required in only 13.6% of cases. Among 61 aneurysms with complete angiographic follow-up at a mean of 6 months, complete occlusion (RROC Class I or OKM Grade D) was achieved in 78.7%. In-stent stenosis (&lt; 50%) was observed in only 3.3% of cases with follow-up imaging, suggesting favorable vessel remodeling with minimal intimal hyperplasia. The immediate intraprocedural complication rate was 2.5% (2/81), including one device-related microperforation (complete recovery) and one intraoperative thrombosis (managed successfully intraprocedurally; delayed stroke from subsequent medication noncompliance). Delayed complications within 30 days included one stroke from antiplatelet noncompliance (fatal) and one access-site hematoma (recovered). One delayed adverse event beyond 30 days (delayed right temporal intraparenchymal hemorrhage at 10 months) was observed in a patient on dual antiplatelet therapy plus apixaban and was attributed to cerebral amyloid angiopathy; this event was not considered device- or procedure-related. Overall mortality was 7.4% (6/81): one death (1.2%) was procedure-related (stroke from medication noncompliance), one death occurred within 30 days from post-SAH vasospasm in a ruptured aneurysm case, and four deaths occurred after 30 days (recurrent ICH at 3 weeks, acute respiratory failure with acute on chronic heart failure at 5 months, homicide at approximately 6 months, and one of unknown cause), none of which were device- or procedure-related.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;This first published clinical experience with Surpass Elite flow diverter demonstrates reliable technical deliverability, favorable early occlusion rates comparable to established flow diverters, and a satisfactory safety profile. The low rates of required balloon angioplasty support","PeriodicalId":19422,"journal":{"name":"Neuroradiology","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2026-05-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147818343","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":"High-resolution vessel wall MRI and spectral CT in intracranial arterial occlusion: comparative diagnostic performance for plaque vs. thrombus.","authors":"Liangfan Jia, Xiaona Li, Yingshuai Zhang, Yifan Liu, Hongran Liu, Cuicui Liu, Zhigang Peng","doi":"10.1007/s00234-026-04014-8","DOIUrl":"https://doi.org/10.1007/s00234-026-04014-8","url":null,"abstract":"<p><strong>Purpose: </strong>The etiology of intracranial arterial occlusion (plaque vs. thrombus) dictates treatment but is challenging to determine using conventional imaging. We aimed to compare the diagnostic performance of high-resolution vessel wall magnetic resonance imaging (HR-VWI) and spectral CT (SCT) for this differentiation.</p><p><strong>Methods: </strong>This retrospective study included 108 patients with cerebral infarction and intracranial arterial occlusion, classified into an HR-VWI group (n = 54) and an SCT group (n = 54) based on the first-line imaging modality. Using postoperative histopathology or multidisciplinary clinical consensus as the reference standard, the diagnostic performances of both techniques in differentiating plaque from thrombotic occlusion were compared. The quantitative parameters of SCT were analyzed.</p><p><strong>Results: </strong>The overall diagnostic accuracy of HR-VWI and SCT was comparable (90.74% vs. 94.44%). However, they exhibited complementary diagnostic strengths: HR-VWI demonstrated higher sensitivity in diagnosing plaque occlusion (100% vs. 86.96%), whereas SCT showed superior sensitivity in diagnosing thrombotic occlusion (100% vs. 84.62%). Quantitative analysis of SCT revealed that the standardized iodine concentration (nIC), effective atomic number (Zeff), and energy spectrum curve slope (λHU) in the plaque occlusion group were significantly higher than those in the thrombotic occlusion group (all p < 0.05), with nIC exhibiting the best diagnostic efficacy (AUC = 0.9355).</p><p><strong>Conclusions: </strong>HR-VWI and SCT are highly accurate and complementary for determining occlusion etiology. HR-VWI excels in plaque characterization, whereas SCT, with rapid acquisition and quantitative biomarkers like nIC, is advantageous for thrombus identification in acute settings.</p>","PeriodicalId":19422,"journal":{"name":"Neuroradiology","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2026-05-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147818365","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":"Prevalence of basilar artery variants: a systematic review with meta-analysis of radiological studies.","authors":"George Triantafyllou, Ioannis Paschopoulos, Panagiotis Papadopoulos-Manolarakis, Nikolaos-Achilleas Arkoudis, Georgios Velonakis, Panagiotis Papanagiotou, Maria Piagkou","doi":"10.1007/s00234-026-04008-6","DOIUrl":"https://doi.org/10.1007/s00234-026-04008-6","url":null,"abstract":"","PeriodicalId":19422,"journal":{"name":"Neuroradiology","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2026-04-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147777641","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":"Radiomics-based artificial intelligence models in brain tumors: A systematic review and meta-analysis of diagnostic performance.","authors":"Jheremy S Reyes, Timoteo Almeida, Alexandros Bouras, Joseph Mettenburg, Ajay Niranjan, L Dade Lunsford, Constantinos G Hadjipanayis","doi":"10.1007/s00234-026-03983-0","DOIUrl":"https://doi.org/10.1007/s00234-026-03983-0","url":null,"abstract":"","PeriodicalId":19422,"journal":{"name":"Neuroradiology","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2026-04-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147777600","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":"European Society of Neuroradiology (ESNR).","authors":"","doi":"10.1007/s00234-026-04004-w","DOIUrl":"https://doi.org/10.1007/s00234-026-04004-w","url":null,"abstract":"","PeriodicalId":19422,"journal":{"name":"Neuroradiology","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2026-04-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147777609","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":"Integrated quantitative susceptibility mapping and radiomics for multiple system atrophy subtypes classification.","authors":"Xiaohan Mao, Di Zhang, Jiayu Bai, Yumei Liu, Juncheng Yu, Zhongzheng Jia","doi":"10.1007/s00234-026-04007-7","DOIUrl":"https://doi.org/10.1007/s00234-026-04007-7","url":null,"abstract":"","PeriodicalId":19422,"journal":{"name":"Neuroradiology","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2026-04-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147777649","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":"Amide proton transfer and arterial spin labeling for non-invasive molecular stratification of glioma: a multi-dataset imaging biomarker study.","authors":"Rajeev Essed, Ivar J Wamelink, Jan Petr, Joost Kuijer, Alle Meije Wink, Shuncong Wang, Frederik Barkhof, Vera C Keil","doi":"10.1007/s00234-026-04006-8","DOIUrl":"https://doi.org/10.1007/s00234-026-04006-8","url":null,"abstract":"","PeriodicalId":19422,"journal":{"name":"Neuroradiology","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2026-04-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147777635","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":"Pathological signatures of white matter lesions in multiple sclerosis versus stroke: a synthetic MRI study.","authors":"Evangelos Katsarogiannis, Johan Wikström, Johan Virhammar, Shala Ghaderi Berntsson, Anne-Marie Landtblom","doi":"10.1007/s00234-026-04002-y","DOIUrl":"10.1007/s00234-026-04002-y","url":null,"abstract":"<p><strong>Purpose: </strong>To evaluate whether quantitative synthetic MRI (SyMRI) parameters can differentiate non-specific white matter lesions (nsWMLs) in patients with multiple sclerosis (MS) and ischemic stroke, and to assess differences in normal-appearing white matter (NAWM) between these groups.</p><p><strong>Methods: </strong>Thirty MS patients and nineteen ischemic stroke patients underwent standardized MRI including SyMRI. Three lesion categories were analyzed: typical MS lesions (MSL), non-specific lesions in MS (nsWML-MS), and non-specific lesions in stroke (nsWML-S). SyMRI-derived parameters (R1, R2, proton density, and myelin content) were extracted from each region of interest (ROI), and one ROI was placed in NAWM per patient. Group differences were evaluated using non-parametric tests. Logistic regression models, both unadjusted and age-adjusted, assessed predictors of MS diagnosis.</p><p><strong>Results: </strong>Typical MS lesions showed lower myelin content and R1 and higher proton density than nsWML-MS (all p < 0.0001). Compared with nsWML-S, nsWML-MS demonstrated lower myelin content and higher proton density (p < 0.05), while R1 and R2 values did not differ. NAWM differences between MS and stroke emerged only after age adjustment. Age alone discriminated MS from stroke (AUC 0.83), with modest improvement when NAWM measures were added (AUC 0.86).</p><p><strong>Conclusion: </strong>SyMRI captures both lesion-specific and diffuse NAWM differences between MS and stroke. Age strongly influences quantitative white matter measures, and adjusting for age reveals subtle NAWM pathology in MS. SyMRI may support differential diagnosis in patients with ambiguous white matter lesions.</p>","PeriodicalId":19422,"journal":{"name":"Neuroradiology","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2026-04-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147777607","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}