Neuroradiology最新文献

{"title":"Diagnostic value of MRI and diffusion-weighted imaging in dysthyroid optic neuropathy: a cross-sectional study providing insights into predictive parameters and pathogenesis.","authors":"Arnaud R G G Potvin, Maartje M L de Win, Peter H Bisschop, Michael W T Tanck, Robert Loontjens, Pim de Graaf, Ioana C Lacraru, Hinke Marijke Jellema, Peerooz Saeed","doi":"10.1007/s00234-025-03695-x","DOIUrl":"10.1007/s00234-025-03695-x","url":null,"abstract":"<p><strong>Purpose: </strong>To compare magnetic resonance imaging (MRI) and clinical characteristics between patients with moderate-to-severe Graves orbitopathy (GO) and dysthyroid optic neuropathy (DON), and to assess the diagnostic value of these factors for DON.</p><p><strong>Methods: </strong>Monocentric prospective cross-sectional study. Thirty-four orbits with DON and 62 orbits with moderate-to-severe GO were included. Patients were older than 18 years, had never undergone surgical decompression, and did not receive glucocorticoid or radiotherapy within 6 months prior to participation. A standardized orbital MRI protocol was performed followed by ophthalmic and orthoptic examination within 4 weeks. Main outcome measures were: maximal radial diameter of the extraocular muscles (EOMs), signal intensity ratio of the EOMs (relative to the temporalis muscle), relative apparent diffusion coefficient (rADC) of the EOMs (relative to the temporalis muscle), apical crowding index, optic nerve stretching, clinical activity score (CAS), and duction scores. Data were analyzed using a multivariable generalized linear mixed model to identify measures associated with DON.</p><p><strong>Results: </strong>The combination of medial rectus diameter and superior rectus rADC resulted in an area under the curve of 0.937 with a sensitivity of 85.2%, specificity of 93.2%, positive predictive value of 85.2%, and negative predictive value of 93.2% at a cutoff of 0.461. Apical crowding and optic nerve stretching were not independently associated with DON.</p><p><strong>Conclusions: </strong>MRI with diffusion-weighted imaging sequences can be a useful adjunct in the diagnosis of DON. Medial rectus diameter and superior rectus rADC are independently associated with DON. Apical crowding and optic nerve stretching may be less important pathogenically.</p><p><strong>Key messages: </strong>1. What is already known? The diagnosis of dysthyroid optic neuropathy (DON) can be challenging due to the lack of validated diagnostic imaging features. 2.</p><p><strong>What this study adds: </strong>a. Medial rectus diameter and superior rectus relative apparent diffusion coefficient measured by magnetic resonance imaging are independent predictors of DON. b. Apical crowding and optic nerve stretching are not independently associated with DON. 3. How this study might affect research: MRI with diffusion-weighted imaging sequences can be a useful adjunct in the diagnosis of DON.</p>","PeriodicalId":19422,"journal":{"name":"Neuroradiology","volume":" ","pages":"2563-2572"},"PeriodicalIF":2.6,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12546493/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145075751","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effects of hyperprolactinemia and bromocriptine treatment on cerebral blood flow and functional brain States.","authors":"Manxi Xu, Bing Liu, Aocai Yang, Jixin Luan, Shijun Li, Li Zhu, Ni Shu, Gaoxiang Ouyang, Yuli Wang, Yao Wang, Guolin Ma","doi":"10.1007/s00234-025-03686-y","DOIUrl":"10.1007/s00234-025-03686-y","url":null,"abstract":"<p><strong>Purpose: </strong>Hyperprolactinemia (HPRL) affects both reproductive function and the central nervous system. However, its specific effects on brain function and blood flow remain unclear.</p><p><strong>Methods: </strong>This study used multimodal magnetic resonance imaging to examine cerebral blood flow (CBF) and functional network characteristics in 32 HPRL patients, including those undergoing bromocriptine treatment, and 40 healthy controls.</p><p><strong>Results: </strong>Results revealed a significant reduction in global mean CBF in HPRL patients, particularly in the right inferior frontal gyrus, left middle temporal gyrus, and bilateral rectus gyrus. In contrast, the right middle frontal gyrus exhibited increased CBF. Following bromocriptine treatment, global CBF showed an upward trend. Additionally, the hierarchical structure of functional networks in HPRL patients was diminished and negatively correlated with serum prolactin levels, potentially related to reduced connectivity between the default mode and sensorimotor networks.</p><p><strong>Conclusion: </strong>These findings provide new insights into how HPRL and bromocriptine influence brain function, enhancing the understanding of the underlying neurophysiological mechanisms.</p>","PeriodicalId":19422,"journal":{"name":"Neuroradiology","volume":" ","pages":"2551-2561"},"PeriodicalIF":2.6,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144668120","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":"Prognostic value of cerebral venous outflow profiles for outcomes prediction following reperfusion therapy in acute ischemic stroke: a meta-analysis.","authors":"Hesham Kelani, Mohamed R Abdelraouf, Shree Rath, Shrouk F Mohamed, Hazem Mohamed Salamah, Qasim Mehmood, Muhammad Ansab, Danisha Kumar, Ahmed Abd Elazim, Diana Greene-Chandos, Ketevan Berekashvili, Ambooj Tiwari, Volodymyr Vulkanov, David P Lerner, Eytan Raz","doi":"10.1007/s00234-025-03688-w","DOIUrl":"10.1007/s00234-025-03688-w","url":null,"abstract":"<p><strong>Background: </strong>Recent studies have suggested that favorable venous outflow (VO) may be a promising imaging biomarker to predict clinical outcomes following reperfusion therapy in patients with acute ischemic stroke caused by large vessel occlusion (AIS-LVO).</p><p><strong>Methods: </strong>A comprehensive literature search was conducted in PubMed, Scopus, WOS, and Cochrane to identify studies that evaluated VO profiles, assessed using the Cortical Vein Opacification Score (COVES). The risk ratio (RR) and 95% confidence interval (CI) for the outcomes, including functional independence, assessed by modified rankin scale at 90 days (mRS 0-2), hemorrhagic infarction, parenchymal hematoma, 90-day mortality, intracranial hemorrhage (ICH), and symptomatic ICH (sICH), were calculated and analyzed using the 'meta' package in R version 4.4.1.</p><p><strong>Results: </strong>A total of six studies encompassing 2249 patients were included. Patients with favorable VO had a higher likelihood of achieving functional independence at 90 days (RR = 2.15; 95% CI: 1.35, 3.42; p = 0.01) and a lower incidence of 90-day mortality (RR = 0.39; 95% CI: 0.30, 0.51; p < 0.01), parenchymal hematoma (RR = 0.36; 95% CI: 0.27, 0.47; p < 0.01). Furthermore, sICH was less frequent in patients with favorable VO (RR = 0.39; 95% CI: 0.17, 0.89; p = 0.03). However, hemorrhagic infarction and any ICH did not differ significantly between the two groups (p-values: 0.06 and 0.32, respectively).</p><p><strong>Conclusion: </strong>VO is a promising imaging biomarker for predicting outcomes in patients with AIS-LVO following reperfusion therapy. Prospective clinical trials are warranted to investigate the predictive value of VO, assessed on multiphasic computed tomography angiography (CTA), as a prognostic marker in this patient population.</p>","PeriodicalId":19422,"journal":{"name":"Neuroradiology","volume":" ","pages":"2283-2294"},"PeriodicalIF":2.6,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12546523/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144584448","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Stent-assisted coiling and flow diversion with hpc-coated devices under prasugrel monotherapy in ruptured wide-neck aneurysms: a multicenter case series.","authors":"Abdallah Aburub, Stephan Felber, Hans Henkes, André Kemmling, Michael Forsting, Christopher Nimsky, Zakarya Ali, Kamran Hajiyev, Philip von Gottberg, Mohammad Almohammad, Weis Naziri, Andrei Filioglo, Ali Khanafer","doi":"10.1007/s00234-025-03715-w","DOIUrl":"10.1007/s00234-025-03715-w","url":null,"abstract":"<p><strong>Purpose: </strong>To evaluate the safety, efficacy, and clinical outcomes of stent-assisted coiling (SAC) and flow diversion (FD) with hydrophilic polymer-coated (HPC) devices under prasugrel single antiplatelet therapy (SAPT) in the treatment of acutely ruptured wide-neck intracranial aneurysms.</p><p><strong>Methods: </strong>This multicenter retrospective case series included patients with ruptured saccular intracranial aneurysms treated through SAC or FD with HPC-coated devices under SAPT at four specialized neurovascular centers. Baseline demographics, aneurysm characteristics, procedural details, and clinical outcomes were analyzed. The primary outcomes included technical success, periprocedural complications, aneurysm occlusion rates at follow-up (FU), and functional outcomes assessed with the modified Rankin Scale (mRS).</p><p><strong>Results: </strong>A total of 46 patients were included (mean age 57.4 years). SAC and FD were performed in equal proportions. Technical success was achieved in 100% of cases. The immediate complete occlusion rate was significantly higher for SAC (95.7%) than FD (21.7%, p < 0.001). However, the occlusion rates at 12-month FU were comparable (SAC 100% vs. FD 95%, p = 0.364). The overall periprocedural complication rate was low (4.3%), and mortality before discharge was 10.9%. Favorable functional outcomes (mRS ≤ 2) at the last FU were achieved in 84% of patients, and no significant differences were observed between the SAC and FD groups.</p><p><strong>Conclusion: </strong>SAC and FD with HPC-coated devices under prasugrel SAPT appeared to be safe and effective in treating ruptured wide-neck aneurysms. Whereas SAC achieved higher immediate occlusion rates, the long-term outcomes were comparable between groups. These findings support the feasibility of SAPT in this high-risk population and warrant further prospective validation.</p>","PeriodicalId":19422,"journal":{"name":"Neuroradiology","volume":" ","pages":"2505-2518"},"PeriodicalIF":2.6,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12546290/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144675394","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Characterizing iron rim lesions in multiple sclerosis: a biomarker for disease activity and progression: a systematic review and meta-analysis.","authors":"Nogol Motamedgorji, Ashkan Bahrami, Hayder Jasim Taher, Ahmed Mohamedbaqer Easa, Sadaf Salehi, Armin Tafazolimoghadam, Mahan Farzan, Zohreh Sadeghi, Saharnaz Mofidinaeini, Ramtin Hajibeygi, Yaser Khakpour, Mobina Fathi, Anahita Zoghi, Long H Tu","doi":"10.1007/s00234-025-03663-5","DOIUrl":"10.1007/s00234-025-03663-5","url":null,"abstract":"<p><strong>Background: </strong>Iron rim lesions (IRLs) have emerged as important biomarkers in multiple sclerosis (MS), indicating chronic active inflammation and neurodegeneration. The purpose of this systematic review and meta-analysis is to assess the prognostic value of IRLs in MS, their impact on clinical outcomes, and their relationship with therapeutic responses.</p><p><strong>Methods: </strong>A thorough search was conducted across PubMed, Scopus, Web of Science, and Google Scholar, covering studies published until June 10, 2024. The inclusion criteria included studies on MS patients who had IRLs detected using advanced MRI techniques, particularly susceptibility-weighted imaging (SWI). The meta-analysis included 13 studies and a total of 924 MS patients. The data on clinical outcomes (EDSS scores, relapse rates), brain volume, and white matter lesion (WML) burden were combined. For continuous variables, effect sizes were calculated using standardized mean differences (SMDs), and for binary outcomes, relative risks (RRs).</p><p><strong>Results: </strong>This meta-analysis indicated significant correlations between IRLs and poorer clinical outcomes. IRL-positive individuals had higher EDSS scores (SMD 0.77, 95% CI: 0.34-1.21, p = 0.000), indicating a more severe impairment. They also had a larger WML load (SMD 0.52, 95% CI: 0.01-1.03, p = 0.000) and a smaller brain volume (SMD -0.50, 95% CI -0.82 to -0.19, p = 0.015). The relapse rate ratio was 1.10 (95% CI 0.73-1.65, p = 0.499), indicating a trend toward more frequent relapses in IRL-positive patients, though not statistically significant. Treatment response to disease-modifying treatments (DMTs) was similar in IRL-positive and negative individuals (RR 0.97, 95% CI: 0.89-1.06, p = 0.424). However, IRL-positive patients who received high-dose DMTs (HDMT) had a trend toward better outcomes (RR 1.2, 95% CI 0.94-1.52, p = 0.424).</p><p><strong>Conclusions: </strong>IRLs are strongly linked to higher disease severity, lesion burden, and neurodegeneration in MS patients. These lesions should be considered in routine medical evaluations since they are reliable prognostic indicators. Early intervention with high-dose treatment might offer potential benefits for IRL-positive patients, but further research is needed to determine the long-term clinical implications.</p>","PeriodicalId":19422,"journal":{"name":"Neuroradiology","volume":" ","pages":"2249-2265"},"PeriodicalIF":2.6,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144675393","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":"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":"2357-2369"},"PeriodicalIF":2.6,"publicationDate":"2025-09-01","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":"The best diagnostic approach for classifying ischemic stroke onset time: A systematic review and meta-analysis.","authors":"Seyed Salman Zakariaee, Dler Hussein Kadir, Mikaeil Molazadeh, Shahab Abdi","doi":"10.1007/s00234-025-03745-4","DOIUrl":"10.1007/s00234-025-03745-4","url":null,"abstract":"<p><strong>Background: </strong>The success of intravenous thrombolysis with tPA (IV-tPA) as the fastest and easiest treatment for stroke patients is closely related to time since stroke onset (TSS). Administering IV-tPA after the recommended time interval (< 4.5 h) increases the risk of cerebral hemorrhage. Despite advances in diagnostic approaches have been made, the determination of TSS remains a clinical challenge. In this study, the performances of different diagnostic approaches were investigated to classify TSS.</p><p><strong>Materials and methods: </strong>A systematic literature search was conducted in Web of Science, Pubmed, Scopus, Embase, and Cochrane databases until July 2025. The overall AUC, sensitivity, and specificity magnitudes with their 95%CIs were determined for each diagnostic approach to evaluate their classification performances.</p><p><strong>Results: </strong>This systematic review retrieved a total number of 9030 stroke patients until July 2025. The results showed that the human readings of DWI-FLAIR mismatch as the current gold standard method with AUC = 0.71 (95%CI: 0.66-0.76), sensitivity = 0.62 (95%CI: 0.54-0.71), and specificity = 0.78 (95%CI: 0.72-0.84) has a moderate performance to identify the TSS. ML model fed by radiomic features of CT data with AUC = 0.89 (95%CI: 0.80-0.98), sensitivity = 0.85 (95%CI: 0.75-0.96), and specificity = 0.86 (95%CI: 0.73-1.00) has the best performance in classifying TSS among the models reviewed.</p><p><strong>Conclusion: </strong>ML models fed by radiomic features better classify TSS than the human reading of DWI-FLAIR mismatch. An efficient AI model fed by CT radiomic data could yield the best classification performance to determine patients' eligibility for IV-tPA treatment and improve treatment outcomes.</p>","PeriodicalId":19422,"journal":{"name":"Neuroradiology","volume":" ","pages":"2267-2281"},"PeriodicalIF":2.6,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145040944","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":"Fast 3D wheel acquisition versus conventional parallel imaging in cerebral magnetic resonance angiography for the evaluation of intracranial aneurysms : Original Article.","authors":"Satomu Hanamatsu, Kazuhiro Murayama, Yoshiharu Ohno, Aoi Tahara, Reina Fujisawa, Yunosuke Kumazawa, Tomoki Takahashi, Kaori Yamamoto, Masato Ikedo, Masanori Inoue","doi":"10.1007/s00234-025-03776-x","DOIUrl":"10.1007/s00234-025-03776-x","url":null,"abstract":"<p><strong>Purpose: </strong>This study aimed to evaluate the effectiveness of the Fast 3D wheel (Fast 3Dw) technique in cerebral magnetic resonance angiography (MRA) and compare it with the conventional parallel imaging (PI) technique. The primary objective was to determine whether Fast 3Dw could reduce the examination time while maintaining image quality and diagnostic accuracy in patients with cerebral aneurysms.</p><p><strong>Methods: </strong>This retrospective study included 50 patients with unruptured cerebral aneurysms who underwent 3D time-of-flight MRA using either PI or Fast 3Dw techniques on a 3T magnetic resonance imaging scanner. The image quality was quantitatively assessed using the signal-to-noise ratio (SNR), contrast-to-noise ratio (CNR), aneurysm diameter, and vessel diameter. Qualitative image assessments included vascular clarity, artifacts, and diagnostic confidence level and were evaluated using a 5-point scale. Statistical comparisons were performed using t-tests, Wilcoxon signed-rank tests, and weighted kappa statistics.</p><p><strong>Results: </strong>The mean examination time for Fast 3Dw (171.5 ± 4.9 s) was significantly shorter than that for PI (383.8 ± 13.2 s; p < 0.05). Fast 3Dw exhibited a significantly higher SNR (50.0 ± 14.2) than PI (46.6 ± 12.9; p < 0.05), while CNR showed no significant difference between the two techniques. No significant differences in aneurysm diameters and vessel diameters were observed between the two methods. Qualitative evaluations demonstrated no significant differences in vascular clarity, artifacts, and diagnostic confidence levels between the two methods.</p><p><strong>Conclusion: </strong>The Fast 3Dw technique significantly reduces examination time while maintaining image quality and diagnostic accuracy in cerebral MRA compared to PI. This method may be a viable alternative for routine cerebral MRA in clinical practice.</p>","PeriodicalId":19422,"journal":{"name":"Neuroradiology","volume":" ","pages":"2389-2398"},"PeriodicalIF":2.6,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145091989","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Multiparametric MRI to stratify risk factors for hemorrhagic complications in inoperable glioblastomas following stereotactic needle biopsy.","authors":"Matia Martucci, Claudia Tocilă-Mătășel, Luigi Ruscelli, Giuseppe Varcasia, Giammaria Marziali, Francesco Schimperna, Giovanni Pentassuglia, Amato Infante, Quintino Giorgio D'Alessandris, Alessandro Olivi, Simona Gaudino","doi":"10.1007/s00234-025-03769-w","DOIUrl":"10.1007/s00234-025-03769-w","url":null,"abstract":"<p><strong>Purpose: </strong>Histological confirmation of glioblastoma (GB) is essential for therapeutic planning, even in inoperable cases where stereotactic needle biopsy (STNB) is the only option. However, post-procedural bleeding remains a known risk. This study aimed to evaluate the association between MRI features of GB and hemorrhagic complications following STNB.</p><p><strong>Methods: </strong>This retrospective, single-center study included 78 patients with IDH-wildtype GB (mean age: 61 years; 33 females) who underwent pre-biopsy MRI (including SWI and DSC-perfusion) and post-biopsy CT within 72 h. Lesions were anatomically classified into four groups based on their location: cortical/superficial grey matter (sGM n = 12), subependymal white matter (sWM; n = 36), deep nuclei/thalamus (n = 26), or brainstem (n = 4). Hemorrhage incidence and area were correlated with lesion location, intratumoral susceptibility signal (ITSS) grade, rCBVmax values, and peritumoral edema. Clinical outcomes were also recorded.</p><p><strong>Results: </strong>Hemorrhage incidence significantly differed by lesion location (p = 0.009), with the highest frequency in deep lesions (85%). Most non-hemorrhagic cases (53%) occurred in sWM. While rCBVmax did not correlate with hemorrhage incidence, a significant linear association with hemorrhage area was noted (p = 0.016, r = 0.331). Grade 3 ITSS lesions showed more extensive bleeding. No correlation was found between peritumoral edema and bleeding. Most hemorrhages were asymptomatic; only two patients experienced transient neurological symptoms.</p><p><strong>Conclusions: </strong>Lesion location was the strongest predictor of post-biopsy hemorrhage. The absence of correlation between rCBVmax and bleeding risk suggests biopsies can be safely performed even in hyperperfused (and potentially more aggressive) tumor areas. STNB remains a safe and valuable diagnostic tool when appropriate preoperative evaluation and postoperative monitoring are ensured.</p>","PeriodicalId":19422,"journal":{"name":"Neuroradiology","volume":" ","pages":"2379-2387"},"PeriodicalIF":2.6,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12546386/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145069982","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Fetal-type posterior communicating artery increases hemodynamic stress in posterior communicating artery bifurcation aneurysms: a CFD-based analysis.","authors":"Roland Schwab, Rebecca Janiszewski, Erelle Fuchs, Maximilian Thormann, Belal Neyazi, Vanessa Magdalena Swiatek, I Erol Sandalcioglu, Philipp Berg, Daniel Behme, Samuel Voß, Janneck Stahl","doi":"10.1007/s00234-025-03785-w","DOIUrl":"10.1007/s00234-025-03785-w","url":null,"abstract":"<p><strong>Backround: </strong>The flow characteristics of bifurcation aneurysms in the posterior communicating artery (PCOM) have rarely been studied. The likelihood of a complete PCOM aneurysm occlusion after endovascular treatment is reduced with the presence of a fetal posterior communicating artery (fPCOM). As a result, anatomical variations in PCOM aneurysms represent a major challenge for the endovascular treatment. This study addresses hemodynamic variations in PCOM aneurysms of either fetal or adult type.</p><p><strong>Methods: </strong>3D-DSA data of 14 patients with bifurcation aneurysms located in the PCOM junction were collected. Nine patients presented with a fPCOM and five patients an adult PCOM (aPCOM). Patient-specific 3D models containing at least one bifurcation distal the aneurysm in the anterior circulation as well as the PCOM itself were extracted using image-based blood flow simulations. Seven hemodynamic parameters were calculated for all aneurysm models to characterize the intra-aneurysmal blood flow. The PCOM outflow was artificially varied to represent both fPCOM and aPCOM conditions for each model resulting in 28 simulations.</p><p><strong>Results: </strong>Fetal‑type PCOM showed higher intra‑aneurysmal mean velocity (median 0.09 vs. 0.06 m/s), maximum velocity (0.17 vs. 0.14 m/s), averaged wall shear stress (1.67 vs. 1.27 Pa), neck inflow rate (40.9 vs. 22.4 ml/min), and inflow concentration index (0.56 vs. 0.40), with lower pulsatility index (1.73 vs. 1.89). Those differences were significant whereas mean oscillatory shear index did not differ significantly.</p><p><strong>Conclusion: </strong>The presence of anatomical variations affects the hemodynamic parameters of PCOM bifurcation aneurysms. In particular, the presence of an fPCOM has an unfavorable effect on the intra-aneurysmal flow dynamics.</p>","PeriodicalId":19422,"journal":{"name":"Neuroradiology","volume":" ","pages":"2471-2481"},"PeriodicalIF":2.6,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12546534/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145091996","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}