Clinical Neuroradiology最新文献

{"title":"Transient Horner's Syndrome Following CT-Guided C7 Nerve Root Block-A Case Report.","authors":"Leonhard Mann, Valentina Correa, Elke Hattingen, Christophe T Arendt","doi":"10.1007/s00062-024-01453-9","DOIUrl":"10.1007/s00062-024-01453-9","url":null,"abstract":"","PeriodicalId":49298,"journal":{"name":"Clinical Neuroradiology","volume":" ","pages":"203-205"},"PeriodicalIF":2.4,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11832622/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142114001","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":"MRI-based Quantitative Collateral Assessment in Acute Stroke : A Comparison with Single-phase CTA in Drip-and-ship Patients with Serial Imaging.","authors":"Christoph Polkowski, Niklas Helwig, Marlies Wagner, Alexander Seiler","doi":"10.1007/s00062-024-01456-6","DOIUrl":"10.1007/s00062-024-01456-6","url":null,"abstract":"<p><strong>Purpose: </strong>In acute ischemic stroke with large-vessel occlusion (LVO), collateral assessment with single-phase computed tomography angiography (CTA) might underestimate pial collateral supply in a considerable proportion of patients. We aimed to compare time-resolved magnetic resonance imaging (MRI)-based quantitative collateral mapping to conventional collateral imaging with CTA.</p><p><strong>Methods: </strong>This retrospective single-center study covering a period of 6 years (2012-2018) included drip-and-ship LVO patients who underwent MR imaging after initial imaging evaluation with CT. For MRI-based collateral assessment, T2*-weighted time series from perfusion-weighted imaging (PWI) were processed to compute a quantitative collateral vessel index (CVI_PWI) based on the magnitude of signal variance across the entire acquisition time. CTA-based collateral scores (Tan and Maas) and CVI_PWI were investigated in terms of inter-modality associations between collateral measures, as well as their relationships with stroke severity, infarct volume and early functional outcome.</p><p><strong>Results: </strong>The final analysis included n = 56 patients (n = 31 female, mean age 69.9 ± 14.21 years). No significant relationship was found between MR-based quantitative collateral supply (CVI_PWI) and CT-based collateral scores (r = -0.00057, p = 0.502 and r = -0.124, p = 0.797). In contrast to CVI_PWI, CTA-based collateral scores showed no significant relationship with clinical stroke severity and infarct volume. While MR-based CVI_PWI was independently associated with favorable early functional outcome in multivariate analysis (OR 1.075, 95% CI 1.001-1.153, p = 0.046), CTA-based collateral scores were not significantly associated with outcome.</p><p><strong>Conclusions: </strong>Since collateral scores based on single-phase CTA do not accurately reflect infarct progression and might underestimate pial collateralization in a relevant proportion of patients, they are not associated with early functional outcome in LVO patients. In contrast, CVI_PWI represents a robust imaging parameter of collateral supply and is independently associated with functional outcome.</p>","PeriodicalId":49298,"journal":{"name":"Clinical Neuroradiology","volume":" ","pages":"95-103"},"PeriodicalIF":2.4,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11832563/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142308900","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":"Non-contrast-enhanced MR-angiography of Extracranial Arteries in Acute Ischemic Stroke at 1.5 Tesla Using Relaxation-Enhanced Angiography Without Contrast and Triggering (REACT).","authors":"Jan P Janssen, Sarah Rose, Kenan Kaya, Robert Terzis, Robert Hahnfeldt, Roman J Gertz, Lukas Goertz, Andra-Iza Iuga, Jan-Peter Grunz, Christoph Kabbasch, Philip Rauen, Thorsten Persigehl, Kilian Weiss, Jan Borggrefe, Lenhard Pennig, Carsten Gietzen","doi":"10.1007/s00062-024-01458-4","DOIUrl":"10.1007/s00062-024-01458-4","url":null,"abstract":"<p><strong>Purpose: </strong>To evaluate a novel flow-independent sequence (Relaxation-Enhanced Angiography without Contrast and Triggering (REACT)) for imaging of the extracranial arteries in acute ischemic stroke (AIS) at 1.5 T.</p><p><strong>Methods: </strong>This retrospective single-center study included 47 AIS patients who received REACT (scan time: 3:01 min) and contrast-enhanced MRA (CE-MRA) of the extracranial arteries at 1.5 T in clinical routine. Two radiologists assessed scans for proximal internal carotid artery (ICA) stenosis, stated their diagnostic confidence and rated the image quality of cervical arteries, impact of artifacts and image noise. Apparent signal- and contrast-to-noise ratios (aSNR/aCNR) were measured for the common carotid artery and ICA.</p><p><strong>Results: </strong>REACT achieved a sensitivity of 95.0% and a specificity of 97.3% for ICA stenoses in high agreement with CE-MRA (κ = 0.83) with equal diagnostic confidence (p = 0.22). Image quality was rated higher for CE-MRA at the aortic arch (p = 0.002) and vertebral arteries (p < 0.001), whereas REACT provided superior results for the extracranial ICA (p = 0.008). Both sequences were only slightly affected by artifacts (p = 0.60), while image noise was more pronounced in CE-MRA (p < 0.001) in line with higher aSNR (p < 0.001) and aCNR (p < 0.001) values in REACT for all vessels.</p><p><strong>Conclusion: </strong>Given its good diagnostic performance while yielding comparable image quality and scan time to CE-MRA, REACT may be suitable for the imaging of the extracranial arteries in acute ischemic stroke at 1.5 T.</p>","PeriodicalId":49298,"journal":{"name":"Clinical Neuroradiology","volume":" ","pages":"105-114"},"PeriodicalIF":2.4,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11832615/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142308901","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":"A New Fibrin-Heparine Coated Self-Expanding Stent for the Rescue Treatment of Intracranial Stenosis-a Multicentric Study.","authors":"Franziska Dorn, Yves Leonard Voss, Mousa Zidan, Stephanie Neuhaus, Nils Lehnen, Paul Stracke, Wolfram Schwindt, Mostafa Ergawy, Christian Dyzmann, Markus Moehlenbruch, Jessica Jesser, Dominik Vollherbst, Manuel Moreu, Carlos Pérez-García, Maxim Bester, Fabian Flottmann, Andreas Simgen, Stefan Schob, Ansgar Berlis, Christoph Maurer, Jan Hendrik Buhk, Hannah Hentschel, Christian Loehr, Bernd Eckert, Javier Saura, Fernando Delgado, Daniel Paech, Hannes Nordmeyer","doi":"10.1007/s00062-024-01448-6","DOIUrl":"10.1007/s00062-024-01448-6","url":null,"abstract":"<p><strong>Introduction: </strong>Rescue intracranial stenting is necessary to provide sufficient recanalization after mechanical thrombectomy (MT) in patients with acute large vessel occlusions (LVO) due to an underlying intracranial atherosclerotic disease (ICAD). The CREDO heal is a novel stent that provides a potentially lower thrombogenicity due to surface modification. We present the first multicentric experience with the CREDO heal for acute rescue stenting.</p><p><strong>Methods: </strong>Data of 81 patients who underwent rescue stenting after MT at 12 centers in Germany and Spain were prospectively collected and retrospectively evaluated.</p><p><strong>Results: </strong>Final mTICI 2b‑3 was reached in 95.1% after median two MT maneuvers and stenting. Four periprocedural complications resulted in clinical deterioration (4.9%). Intraparenchymal hemorrhage occurred in one patient (1.2%) and functional independence at FU was reached by 42% of the patients. Most interventions were performed under Gp IIb/IIIa inhibitors.</p><p><strong>Conclusion: </strong>CREDO heal was effective and safe in our case series. However, more data is needed to define the optimal antithrombotic regime. The use under single antiplatelet medication is not supported by our study.</p>","PeriodicalId":49298,"journal":{"name":"Clinical Neuroradiology","volume":" ","pages":"43-50"},"PeriodicalIF":2.4,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11832549/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142037522","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":"Clinically Silent Microinfarct Incidence and Risk Factors After Treatment of Unruptured Intracranial Aneurysms with Hydrophilic Polymer-Coated Flow Diverters.","authors":"Ali Khanafer, Pablo Albiña-Palmarola, Philipp von Gottberg, Kamran Hajiyev, Sebastian J Müller, Jose E Cohen, Hans Henkes","doi":"10.1007/s00062-025-01497-5","DOIUrl":"https://doi.org/10.1007/s00062-025-01497-5","url":null,"abstract":"<p><strong>Purpose: </strong>Although flow diverters (FDs) revolutionized the treatment of unruptured intracranial aneurysms (UIAs), clinically silent microinfarcts (SMs) are consistently detected in postprocedural diffusion-weighted imaging (DWI), and their clinical consequences remain unknown. This study examined the incidence of, and factors associated with, SM development after the use of two surface-modified FDs: the p48MW-HPC and p64MW-HPC.</p><p><strong>Methods: </strong>A non-concurrent cohort study was conducted in 404 consecutive patients with UIAs treated with these two FDs between January 2020 and July 2023. The primary endpoint was the number of asymptomatic DWI lesions within 72 h after the procedure.</p><p><strong>Results: </strong>SMs were detected in 58.2% of the cases, and ≥ 20 lesions were identified in 7.2% of cases. Multivariate analysis revealed that the use of two specific types of microcatheters-Prowler Select Plus (P < 0.001; IRR, 3.2) and RapidTransit (P = 0.001; IRR, 2.2)-and difficulty in microcatheter navigation to the target vessel (P = 0.039; IRR, 1.8) were significantly associated with greater numbers of lesions. After exclusion of outlier cases, these devices remained associated with a significant 2‑ to 3‑fold increase in SMs. Diabetes was associated with fewer SMs (P = 0.024; IRR, 0.5), although this association disappeared after exclusion of outlier cases.</p><p><strong>Conclusion: </strong>The postprocedural incidence of SMs associated with hydrophilic polymer-coated FDs was similar to that previously reported. Interestingly, the main factor contributing to this phenomenon was the use of certain microcatheters. Careful device selection is crucial, and further research is needed to improve the safety of neurovascular interventions.</p>","PeriodicalId":49298,"journal":{"name":"Clinical Neuroradiology","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-02-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143425770","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":"Treatment of Intracranial Aneurysms with the FRED X Flow Diverter Stent: Mid-term Angiographic and Safety Results.","authors":"David W Wen, James Ayre, Mani Puthuran, Paul Maliakal, Souhyb Masri, Richard Pullicino, Aubrey Smith, Feyi Babatola, Gilbert Gravino, Nasr Abdelsalam, Hamed Nejadhamzeeigilani, Arun Chandran","doi":"10.1007/s00062-024-01487-z","DOIUrl":"https://doi.org/10.1007/s00062-024-01487-z","url":null,"abstract":"<p><strong>Purpose: </strong>The aim of our study was to assess the mid-term efficacy and safety of the FRED X flow diverting stent (FDS) in the treatment of intracranial aneurysms. The FRED X FDS is relatively new with limited data on its longer-term effectiveness and safety profile.</p><p><strong>Methods: </strong>Patients with intracranial aneurysms treated with the FRED X FDS at two UK centres, between March 2021 and July 2022 with at least 18 months follow-up, were retrospectively reviewed. Clinical, procedural and imaging data was analyzed.</p><p><strong>Results: </strong>Twenty-two patients with 24 aneurysms treated with the FRED X device, and had completed at least 18 months of follow-up, were included in this study. The rate of complete aneurysm occlusion (Raymond-Roy Class I) was 83.3% at a mean follow-up duration of 21.5 months. One case of major adverse event (4.3%) related to a post-procedural stroke which is also the only case of permanent neurological deficit (4.3%) in our cohort. Three cases of minor adverse events (13.0%) and 2 cases of asymptomatic adverse events (8.7%) were also recorded.</p><p><strong>Conclusion: </strong>Use of the FRED X FDS to treat intracranial aneurysms has acceptable safety profile and efficacy in the mid-term.</p>","PeriodicalId":49298,"journal":{"name":"Clinical Neuroradiology","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-01-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143025399","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":"Ocular Involvement in Non-Ischemic Cerebral Enhancing (NICE) Lesions Following Intracranial Aneurysm Endovascular Treatment.","authors":"Julien Burel, Adrien Lefevre, Julie Gueudry, Chrysanthi Papagiannaki","doi":"10.1007/s00062-024-01495-z","DOIUrl":"https://doi.org/10.1007/s00062-024-01495-z","url":null,"abstract":"","PeriodicalId":49298,"journal":{"name":"Clinical Neuroradiology","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-01-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143025397","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":"Longitudinal Dentate Nucleus MRI Changes in Hypertrophic Olivary Degeneration: a Case Report.","authors":"Lorenzo Gualco, Giacomo Rebella, Laura Saitta, Luca Roccatagliata","doi":"10.1007/s00062-024-01488-y","DOIUrl":"https://doi.org/10.1007/s00062-024-01488-y","url":null,"abstract":"","PeriodicalId":49298,"journal":{"name":"Clinical Neuroradiology","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-01-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142980461","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":"Epstein-Barr Virus Encephalitis Mimicking Herpes Encephalitis On Neuroimaging: A Case Report.","authors":"Negin Eissazade, Mahsa Peykani, Mostafa Almasi-Dooghaee","doi":"10.1007/s00062-024-01485-1","DOIUrl":"https://doi.org/10.1007/s00062-024-01485-1","url":null,"abstract":"","PeriodicalId":49298,"journal":{"name":"Clinical Neuroradiology","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-01-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142928565","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":"Non-Stenotic Carotid Plaques and Rate of DWI-positive MRI in Patients with Lower-Risk Transient or Persistent Minor Neurologic Events: DOUBT Sub Study.","authors":"Nishita Singh, Fouzi Bala, Francois Moreau, Thalia S Field, Mayank Goyal, Michael D Hill, Shelagh B Coutts, Mohammed Almekhlafi","doi":"10.1007/s00062-024-01483-3","DOIUrl":"https://doi.org/10.1007/s00062-024-01483-3","url":null,"abstract":"<p><strong>Background & purpose: </strong>Non-stenotic (< 50%) carotid plaques are increasingly recognized as a potential mechanism for ischemic stroke. We assessed the prevalence of such plaques in patients with low-risk neurologic events and evidence of DWI (Diffusion Weighted Imaging)-positive ischemia.</p><p><strong>Methods: </strong>This is a post-hoc exploratory analysis from the DOUBT study, a prospective, observational, multicenter study of patients with low-risk transient or persistent minor focal neurological symptoms. Patients who had baseline CT angiography (CTA) and an MRI within 8 days of their event were included in the study. We aimed to assess the prevalence of non-stenotic carotid disease in patients with versus without DWI-positive events, and in patients with ipsilateral DWI-positive events. A carotid-level analysis with univariable logistic regression analysis was performed to assess whether any of the assessed plaque features were associated with ipsilateral stroke.</p><p><strong>Results: </strong>Of the 334 patients (mean age 62.7 years, 50.4% females) with available vascular neuroimaging, 153 (45.9%) had non-stenotic carotid plaques (≤50% stenosis), 174 (52.1%) had no stenosis and 7 (2.1%) patients had >50% stenosis. Of those with non-stenotic carotid plaques, 31/153 (20.3%) had evidence of DWI-positive ischemia, approximately half (15/31; 48.4%) of which was in the territory of the carotid plaque. Amongst patients with DWI-positive ischemia, non-stenotic plaques were significantly more common on the side of DWI-positive lesions [31/49 (63.3%) versus 18/49(36.7%)]. Presence of non-stenotic plaque was a risk marker for DWI-positive events (RR 1.4, 95% CI 1.1-1.8, p 0.012). On matched analysis, non-stenotic plaques were more likely on the side of DWI+ ischemia (odds ratio 1.14, 95% CI 0.36-3.70, McNemar's p value 0.80). Plaque features, including hypodensity, irregularity and greater plaque thickness were significantly associated with a higher likelihood of ipsilateral DWI+ ischemia.</p><p><strong>Conclusion: </strong>In patients with low-risk transient or persistent neurologic events, non-stenotic carotid plaques are more common in patients with DWI-positive ischemia. Plaque features like hypodense and irregular plaque were more common with DWI-positive changes in the territory of the affected carotid.</p>","PeriodicalId":49298,"journal":{"name":"Clinical Neuroradiology","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2024-12-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142873305","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}