Neuroradiology最新文献

{"title":"Feasibility, efficacy, and safety of sheathless transradial mechanical thrombectomy in acute ischemic stroke: A meta-analysis.","authors":"Ocílio Ribeiro Golçalves, Victor Arthur Ohannesian, Mariana Letícia de Bastos Maximiano, Henrique Maia, Marina Vilardo, Luis Fravio Fabrini Paleare, Christian Ken Fukunaga, João Victor Araujo de Oliveira, Társis Vinícius Cronemberger, Márcio Yuri Ferreira, Kelson James Almeida, João Paulo Mota Telles","doi":"10.1007/s00234-025-03747-2","DOIUrl":"https://doi.org/10.1007/s00234-025-03747-2","url":null,"abstract":"<p><strong>Introduction: </strong>Mechanical thrombectomy (MT) is the standard of care for large vessel occlusions (LVO) in acute ischemic stroke (AIS), traditionally performed using transfemoral access (TFA). However, the sheathless transradial approach (sTRA) has emerged as a viable alternative, particularly for patients with complex vascular anatomies.</p><p><strong>Objectives: </strong>This systematic review and meta-analysis aim to evaluate the feasibility, efficacy, and safety of sTRA in MT for AIS.</p><p><strong>Methods: </strong>We conducted a systematic review and meta-analysis following PRISMA guidelines, including observational studies that reported on MT using sTRA. Primary outcomes included the proportion of successful reperfusion (modified Treatment in Cerebral Infarction [mTICI] grade 2b-3), crossover rates from radial to femoral access, and symptomatic intracerebral hemorrhage (sICH). Secondary outcomes assessed were minor access site-related complications.</p><p><strong>Results: </strong>A total of four studies were included, comprising 138 patients who underwent MT with sTRA. The pooled analysis revealed a high rate of successful reperfusion (97%; 95% CI: 95-100%), with a low crossover rate to TFA (3%; 95% CI: 0-7%). The incidence of sICH was low, at 4% (95% CI: 0-8%), and minor access site-related complications occurred in 5% of patients (95% CI: 2-9%).</p><p><strong>Conclusion: </strong>This meta-analysis demonstrates that sTRA is a feasible and effective approach for MT in AIS, with a favorable safety profile. The technique offers high recanalization rates, low complication rates, and minimal need for crossover to TFA. Future randomized controlled trials comparing MT with sTRA and TFA are needed to confirm these results and refine patient selection criteria for this approach. Despite encouraging results, the small number of included studies and their observational design limit the generalizability of the findings. Therefore, further comparative and randomized trials are needed to validate these outcomes.</p>","PeriodicalId":19422,"journal":{"name":"Neuroradiology","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144963265","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 Derivo embolization device in intracranial aneurysms: A systematic review and Meta-Analysis.","authors":"Bardia Hajikarimloo, Salem M Tos, Abhishek Saha, Ibrahim Mohammadzadeh, Ali Mortezaei, Rana Hashemi, Dorsa Najari, Azin Ebrahimi, Adam A Dmytriw, Mohammad Amin Habibi","doi":"10.1007/s00234-025-03744-5","DOIUrl":"https://doi.org/10.1007/s00234-025-03744-5","url":null,"abstract":"<p><strong>Background: </strong>Derivo embolization device (DED) is a second-generation flow diverter (FD) that has been increasingly used in the management of intracranial aneurysms (IAs). DEDs consist of 48 nitinol wires with an inner platinum core and a blue-colored coating of oxides and oxynitrides, which mitigates these FDs' thrombogenicity. This systematic review and meta-analysis evaluate the efficacy and safety of DED in IAs.</p><p><strong>Methods: </strong>On February 25, 2025, a comprehensive search was conducted across PubMed, Embase, Scopus, and Web of Science in accordance with PRISMA guidelines. Studies reporting clinical and radiological outcomes of DED were included.</p><p><strong>Results: </strong>Thirteen studies involving 1125 patients and 1338 aneurysms were included. The meta-analysis revealed a pooled complete occlusion rate of 83% (95% CI: 79%-87%), an adequate occlusion rate of 92% (95% CI: 84%-97%), and a favorable outcomes rate of 97% (95% CI: 92%-100%). Additionally, the meta-analysis demonstrated a pooled adjuvant coiling rate of 15% (95% CI: 7%-26%), a major ischemic complication rate of 1% (95% CI: 0%-2%), and a major hemorrhagic complication rate of 0% (95% CI: 0%-1%).</p><p><strong>Conclusion: </strong>The current study's findings revealed that DEDs are associated with promising complete and adequate occlusion rates concurrent with low rates of major ischemic and hemorrhagic complications.</p>","PeriodicalId":19422,"journal":{"name":"Neuroradiology","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144963309","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":"Endovascular therapy vs. conventional medical treatment for symptomatic intracranial atherosclerotic stenosis: an updated meta-analysis of randomized controlled trials.","authors":"Husam Abu Suilik, Mohammed Baker, Ahmed Naeem, AlMothana Manasrah, Mohamed Elnady, Bashar M Al Zoubi, Mohamed Abouzid, Mohamed Abuelazm","doi":"10.1007/s00234-025-03736-5","DOIUrl":"https://doi.org/10.1007/s00234-025-03736-5","url":null,"abstract":"<p><strong>Background: </strong>Symptomatic intracranial atherosclerotic stenosis is a common cause of ischemic stroke, with high recurrence rates despite medical management. The present study investigated the short-term and long-term outcomes of endovascular therapy (ET) versus conventional medical therapy (CMT) in intracranial atherosclerotic stenosis (sICAS) management.</p><p><strong>Methods: </strong>We conducted a systematic review and meta-analysis. Searches were performed in PubMed (MEDLINE), Cochrane Central Register of Controlled Trials (CENTRAL), Web of Science (WOS), SCOPUS, and Embase. Odds ratios (ORs) with 95% confidence intervals (CIs) were calculated. PROSPERO ID: (CRD42024601551).</p><p><strong>Results: </strong>Five RCTs involving 1,531 patients were included, with 743 in the ET + CMT group and 748 in the CMT group. ET was associated with increased odds of short-term mortality or stroke (OR, 3.19; 95% CI [1.96, 5.19], P < 0.01), including higher risks of mortality (OR, 4.35; 95% CI [1.23, 15.35], P = 0.02), ischemic stroke (OR, 2.26; 95% CI [1.34, 3.82], P < 0.01), and hemorrhagic stroke (OR, 10.74; 95% CI [2.52, 45.90], P < 0.01), but no difference between both groups in transient ischemic attack (OR, 0.87; 95% CI [0.32, 2.34], P = 0.78). For long-term outcomes, no significant differences were observed. However, ET significantly increased long-term hemorrhagic stroke risk (OR, 5.14; 95% CI [1.48, 17.77], P < 0.01).</p><p><strong>Conclusion: </strong>In patients with ischemic stroke due to sICAS, ET plus CMT has increased the risk of all-cause mortality, ischemic stroke, and hemorrhagic stroke compared to CMT alone. Hence, current evidence does not support adjuvant ET for patients with sICAS.</p>","PeriodicalId":19422,"journal":{"name":"Neuroradiology","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-08-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144963253","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":"Correlations between hemodynamics and radiomic features in thrombosed intracranial aneurysms.","authors":"Zonghan Lyu, Andres Gudino, Navami Shenoy, Carlos Dier, Elena Sagues, Jingfeng Jiang, Edgar A Samaniego","doi":"10.1007/s00234-025-03730-x","DOIUrl":"https://doi.org/10.1007/s00234-025-03730-x","url":null,"abstract":"<p><strong>Purpose: </strong>Evaluating intracranial aneurysm (IA) rupture risk is essential for guiding management. Although intrasaccular thrombosis (IST) is less common, it can contribute to aneurysm growth, mass effect, and rupture. Aneurysm wall enhancement (AWE) on high-resolution MRI (HR-MRI) offers valuable insight into IST and IA progression. Using radiomics, we extracted spatial information of the aneurysm wall to characterize AWE. This study aimed to explore correlations between radiomics-based AWE profiles and gross hemodynamic parameters, integrating imaging and flow dynamics to better understand IST.</p><p><strong>Methods: </strong>Radiomic analysis was conducted on a cohort of 3T HR-MRI scans from IA with IST. Three-dimensional vascular reconstructions and CFD simulations were conducted to quantify hemodynamic parameters. Spearman's correlation was performed to correlate aneurysm morphology, AWE patterns, and aneurysmal hemodynamic characteristics.</p><p><strong>Results: </strong>A total of 37 thrombosed IAs were included in the analysis, comprising 22 fusiform (59.5%) and 15 saccular (40.5%) aneurysms. Six AWE RFs demonstrated strong correlations with aneurysm volume and surface area (ρ > 0.7 for both). Ten AWE RFs were highly correlated with flow vortex parameters (ρ > 0.7), and one showed a strong correlation with wall shear stress (WSS)-related metrics (ρ > 0.7). In the subset of saccular IAs, 20 AWE RFs were strongly associated with WSS-related metrics. In contrast, fusiform IAs showed stronger correlations between AWE RFs and vortex core characteristics. These findings suggest that elevated AWE is closely associated with regions of high oscillatory shear index and unstable flow vortices, indicating a potential link between wall enhancement and disturbed intra-aneurysmal hemodynamics. Conclusions Stagnant flow may promote degenerative remodeling of the aneurysm wall and IST. A combined spatiotemporal analysis of hemodynamic parameters and AWE patterns provide information about underlying biological processes of IAs, including the development of IST.</p>","PeriodicalId":19422,"journal":{"name":"Neuroradiology","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-08-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144874324","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":"Reproducible meningioma grading across multi-center MRI protocols via hybrid radiomic and deep learning features.","authors":"Mohamed J Saadh, Rafid Jihad Albadr, Dharmesh Sur, Anupam Yadav, R Roopashree, Gargi Sangwan, T Krithiga, Zafar Aminov, Waam Mohammed Taher, Mariem Alwan, Mahmood Jasem Jawad, Ali M Ali Al-Nuaimi, Bagher Farhood","doi":"10.1007/s00234-025-03725-8","DOIUrl":"https://doi.org/10.1007/s00234-025-03725-8","url":null,"abstract":"<p><strong>Objective: </strong>This study aimed to create a reliable method for preoperative grading of meningiomas by combining radiomic features and deep learning-based features extracted using a 3D autoencoder. The goal was to utilize the strengths of both handcrafted radiomic features and deep learning features to improve accuracy and reproducibility across different MRI protocols.</p><p><strong>Materials and methods: </strong>The study included 3,523 patients with histologically confirmed meningiomas, consisting of 1,900 low-grade (Grade I) and 1,623 high-grade (Grades II and III) cases. Radiomic features were extracted from T1-contrast-enhanced and T2-weighted MRI scans using the Standardized Environment for Radiomics Analysis (SERA). Deep learning features were obtained from the bottleneck layer of a 3D autoencoder integrated with attention mechanisms. Feature selection was performed using Principal Component Analysis (PCA) and Analysis of Variance (ANOVA). Classification was done using machine learning models like XGBoost, CatBoost, and stacking ensembles. Reproducibility was evaluated using the Intraclass Correlation Coefficient (ICC), and batch effects were harmonized with the ComBat method. Performance was assessed based on accuracy, sensitivity, and the area under the receiver operating characteristic curve (AUC).</p><p><strong>Results: </strong>For T1-contrast-enhanced images, combining radiomic and deep learning features provided the highest AUC of 95.85% and accuracy of 95.18%, outperforming models using either feature type alone. T2-weighted images showed slightly lower performance, with the best AUC of 94.12% and accuracy of 93.14%. Deep learning features performed better than radiomic features alone, demonstrating their strength in capturing complex spatial patterns. The end-to-end 3D autoencoder with T1-contrast images achieved an AUC of 92.15%, accuracy of 91.14%, and sensitivity of 92.48%, surpassing T2-weighted imaging models. Reproducibility analysis showed high reliability (ICC > 0.75) for 127 out of 215 features, ensuring consistent performance across multi-center datasets.</p><p><strong>Conclusions: </strong>The proposed framework effectively integrates radiomic and deep learning features to provide a robust, non-invasive, and reproducible approach for meningioma grading. Future research should validate this framework in real-world clinical settings and explore adding clinical parameters to enhance its prognostic value.</p>","PeriodicalId":19422,"journal":{"name":"Neuroradiology","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-08-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144874370","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":"Multicentric prospective study on computed tomography-guided periradicular infiltration and facet joint infiltration.","authors":"Daniel Cantré, Lars Gerigk, Simon David Sprengel, Christian Plathow, Iris Burkholder, Marc-André Weber, Anna Schedler, Christoph Rehnitz","doi":"10.1007/s00234-025-03741-8","DOIUrl":"https://doi.org/10.1007/s00234-025-03741-8","url":null,"abstract":"<p><strong>Purpose: </strong>Evaluation of the success of periradicular infiltration and facet joint infiltration in a multicenter and prospective approach.</p><p><strong>Materials and methods: </strong>114 patients undergoing therapeutic nerve root or facet joint infiltration for radicular and/or facet joint symptoms between the first lumbar and the first sacral segments were prospectively and consecutively enrolled across nine participating study centers in Germany. These centers provide CT-guided pain procedures continuously over a period of 96 months. Assessment was carried out by means of a systematic patient survey including pain questionnaires. The severity of the pain and the impairment caused by pain were assessed using 11-point Numerical Rating Scales.</p><p><strong>Results: </strong>CT-guided periradicular infiltration and facet joint infiltration significantly reduced pain levels and substantially reduced pain frequency at all time points and up to three months after the last intervention. All pain related characteristics (i.e. actual pain, average pain level, maximum pain level) were significantly (95% confidence intervals (CI) ranging between - 1.0 and - 5.0) reduced at all time points when compared to the baseline. Besides the pure pain levels, the presented data also provide detailed insights into the complex associated issues the patient collective is facing including impairment in everyday life, fitness for work and leisure time activities. These parameters were also substantially improved (95% CI between - 0.0 and - 5.0) at all time points indicating a comprehensive patient benefit. Self-reported patient satisfaction, recommendation of the procedure and personal success were rated high (62-100%). The rate of patients on sick leave dropped from 23.7 to 1.9%. Accordingly, patients reported a high rate of satisfaction with the procedures. There was a high technical and clinical success rate with no major complications.</p><p><strong>Conclusion: </strong>CT-guided pain therapy on the lumbar spine is effective and safe with a comprehensive benefit for patients, including not only pain levels in the narrow meaning but also regarding everyday life, fitness for work and leisure time activities at all investigated time points including 3 months follow-up.</p>","PeriodicalId":19422,"journal":{"name":"Neuroradiology","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-08-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144859405","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":"MRI evaluation of hyperostosis frontalis interna: differentiation and diagnostic insights.","authors":"Anish Bhandari, Samuel N Rogers, Srinivasan Vedantham, Richard Joseph Wruble, Unni Udayasankar, Hasan Ozgur, Raza Mushtaq","doi":"10.1007/s00234-025-03708-9","DOIUrl":"https://doi.org/10.1007/s00234-025-03708-9","url":null,"abstract":"<p><strong>Introduction: </strong>To delineate the MRI characteristics of Hyperostosis Frontalis Interna (HFI) and evaluate its imaging features to aid in accurate diagnosis and differentiation from other pathologies, particularly metastatic disease.</p><p><strong>Methods: </strong>A retrospective analysis of 74 patients with HFI was conducted. MRI sequences, including pre-contrast T1-weighted, post-contrast T1-weighted, and T2-weighted fat-saturation imaging, were evaluated. Quantitative and qualitative assessments of HFI signal intensity and enhancement patterns were performed. The Hershkovitz classification categorized the extent of HFI.</p><p><strong>Results: </strong>Pre-contrast T1-weighted imaging showed varied signal intensities, with hypointense regions more common in advanced HFI stages. Hypointense HFI was associated with a lower likelihood (OR: 0.303, CI: 0.113-0.808) and heterogeneous distribution was associated with a higher likelihood (OR: 5.128, CI: 1.982-13.265) of higher Hershkovitz classification (P = 0.0008). Post-contrast T1-weighted imaging revealed that 31% of subjects demonstrated enhancement, with focal geographic enhancement associated with lower CT attenuation values (P = 0.0138), indicating higher fat content. T2-weighted fat-saturation imaging supported the correlation between hypointense signals on pre-contrast T1 imaging and lower T2 signal intensities (P = 0.0022). No significant differences were found in enhancement patterns between different MRI sequences (P > 0.1326).</p><p><strong>Conclusions: </strong>HFI demonstrates varying appearances on pre- and post-contrast MRI sequences, crucial for differentiating benign HFI from metastatic lesions. Understanding these imaging characteristics can enhance diagnostic accuracy, reduce the risk of misdiagnosis, and improve patient management. Future studies should focus on larger, more diverse populations and explore advanced MRI techniques to further understand HFI.</p>","PeriodicalId":19422,"journal":{"name":"Neuroradiology","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-08-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144855929","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":"Predictor value of pCASL maps on final core in acute ischemic stroke: an observational single‑center study.","authors":"Fabrizio Giammello, Agostino Tessitore, Francesco Grillo, Cristina Dell'Aera, Ludovica Ferraù, Valentina Tudisco, Antonio Ciacciarelli, Davide Vicari, Valeria Garufi, Sergio Lucio Vinci, Sara Rosa Maria Martino, Luigi Simonetti, Michele Romoli, Rosa Fortunata Musolino, Mauro Silvestrini, Danilo Toni, Andrea Zini, Antonio Toscano","doi":"10.1007/s00234-025-03721-y","DOIUrl":"https://doi.org/10.1007/s00234-025-03721-y","url":null,"abstract":"<p><strong>Purpose: </strong>The three-compartment model of acute ischemic stroke (AIS) includes non-viable tissue (NVT), tissue at risk (TAR), and benign oligoemia. After assessing a multimodal computed tomography (CT)-based protocol, we assessed a hyperacute stroke imaging protocol with magnetic resonance imaging (MRI), aiming to better characterize the reliability of the two methods in predicting follow-up infarction.</p><p><strong>Methods: </strong>We retrospectively reviewed 627 consecutive AIS patients evaluated for the selection for reperfusive treatments at comprehensive stroke center. We employed an MRI-based protocol for proper patient selection, including pseudocontinuous arterial spin labeling (pCASL) and diffusion-weighted imaging (DWI). To assess prognostic accuracy of pCASL maps in predicting final infact, we assumed the best correlation between NVT and final infarct in patients with favorable clinico-radiological outcomes. On the other hand, the TAR should better correlate with final infarct in untreated patients and in treatment failure.</p><p><strong>Results: </strong>We recruited 349 patients undergoing MRI-based protocol with DWI and pCASL, showing diagnostic accuracy of 84.8%. In anterior circulation perfusion deficit, DWI was highly reliable for NVT in patients with favorable clinical-instrumental outcomes. PCASL tended to overestimate TAR in patients with unfavorable outcome, but the rate of complete overlap with the final infarct was high. The previously assessed CT-based protocol showed a lower prognostic accuracy, as the CT-perfusion using time-to-maximum overestimated both the NVT and the TAR.</p><p><strong>Conclusions: </strong>We found a highly reliable prognostic accuracy for DWI-pCASL. Even if pCASL proved reliable to identify the area of total hypoperfusion, there was an overestimation of TAR in many cases, with a tendency to incorporate the benign oligoemia.</p>","PeriodicalId":19422,"journal":{"name":"Neuroradiology","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-08-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144855930","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":"Endovascular management of a ruptured complex ACoM aneurysm in a 9-month-old infant: a rare case report and literature review.","authors":"Vinayagamani Selvadasan, Arunkumar Natarajan, Arunkumar M J, Uday S Limaye","doi":"10.1007/s00234-025-03743-6","DOIUrl":"https://doi.org/10.1007/s00234-025-03743-6","url":null,"abstract":"<p><p>Ruptured intracranial aneurysms in infants are exceptionally rare, particularly saccular aneurysms of the anterior communicating artery (ACoM). We report a 9-month-old infant presenting with subarachnoid and intraventricular hemorrhage due to a ruptured complex ACoM aneurysm, along with two small right A2 saccular aneurysms. The child underwent successful balloon-assisted endovascular coiling, with clinically silent vasospasm and full neurological recovery. To our knowledge, this is the first reported case of a ruptured infantile saccular ACoM aneurysm treated with endovascular coiling resulting in a good functional outcome. This case supports the feasibility of endovascular treatment in selected pediatric aneurysm cases.</p>","PeriodicalId":19422,"journal":{"name":"Neuroradiology","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-08-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144822094","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":"Improved CTA imaging for stroke evaluation - deep learning and iterative reconstruction comparative study.","authors":"Michal Pula, Emilia Kucharczyk, Marcin Piersiak, Maciej Ziomek, Agata Zdanowicz-Ratajczyk, Maciej Guzinski","doi":"10.1007/s00234-025-03733-8","DOIUrl":"https://doi.org/10.1007/s00234-025-03733-8","url":null,"abstract":"<p><strong>Purpose: </strong>This study compares a novel reconstruction algorithm deep learning-based image reconstruction (DLIR) and adaptive statistical iterative reconstruction-Veo (ASIR-V) for CTA in acute ischemic stroke (AIS) patients, emphasizing DLIR's potential to improve diagnostic accuracy and visualization of large vessel occlusion.</p><p><strong>Methods: </strong>This study retrospectively assessed 108 consecutive AIS-suspected emergency department patients (mean age 72.3 years +/- 17) who underwent head and neck CTA with DLIR and ASIR-V reconstructions. The analysis compared the impact of DLIR versus ASIR-V on image quality, assessing signal-to-noise (SNR), contrast-to-noise ratios (CNR), and contrast-enhanced arteries homogeneity computed on mean HU values and SD in six regions of interest located in head and neck including three arteries.</p><p><strong>Results: </strong>The DLIR reconstruction allowed for significant SNR and CNR improvement, with the largest SNR distinction obtained in the common carotid artery (52.29% increased SNR) and white matter of the pons (63.98% increased SNR). Among the three regions subject to CNR evaluation DLIR yielded superiority in the neck and posterior cerebral fossa while ASIR-V accounted for higher CNR in the medial cerebral fossa (MCF). Additionally, DLIR-reconstructed images achieved a 21.10% improvement in arterial homogeneity, enhancing the visualization of potential occlusion.</p><p><strong>Conclusion: </strong>DLIR yields superior image quality of the contrast-enhanced head and neck structures in CTA, providing artery images with increased homogeneity and potentially allowing for more proficient occlusion evaluation specifically in the area of the posterior cerebral fossa. However, this technique faces challenges in the visualization of MCF.</p>","PeriodicalId":19422,"journal":{"name":"Neuroradiology","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-08-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144822096","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}