Clinical Neuroradiology最新文献

{"title":"Expert Panel Consensus Guidelines of the German Society of Neuroradiology on the Use of Magnetic Resonance Imaging in the Diagnosis and Monitoring of Multiple Sclerosis.","authors":"Mike P Wattjes, Carsten Lukas, Sönke Langner, Hagen H Kitzler, Michael Scheel, Andreas J Bartsch, Benedikt Wiestler","doi":"10.1007/s00062-026-01670-4","DOIUrl":"10.1007/s00062-026-01670-4","url":null,"abstract":"<p><p>The recently published 2024 revisions of the McDonald criteria unified and expanded the diagnosis of MS towards a \"biological diagnosis\" and incorporated new MR imaging (bio)markers. Most prominently, they now incorporate imaging of the optic nerve as the fifth topography for dissemination in space (DIS), as well as the central vein sign (CVS) and paramagnetic rim lesions (PRLs), to facilitate an earlier diagnosis of MS. In addition, certain new MRI measures, such as slowly expanding lesions (SELs) and particularly PRLs, are increasingly used in clinical trials and may enter routine clinical practice in the near future. These developments, along with the 2024 MAGNIMS-NAIMS-CMSC consensus recommendations, suggest a different role for MRI in managing patients with MS and expansion of the MRI acquisition protocols, reading, and interpretation. Here, an imaging expert panel of the German Society of Neuroradiology (DGNR) established consensus recommendations on the role of MRI in the management of patients with suspected or definite MS, endorsed by the German Society of Neurology (DGN). These recommendations incorporate these new developments into the context of the German healthcare system. We suggest minor modifications to the acquisition protocol outlined in the 2024 McDonald criteria and the MAGNIMS-NAIMS-CMSC consensus recommendations. For patients with inconclusive imaging findings and in specific diagnostic situations, we recommend changes to MRI acquisition protocols that incorporate susceptibility-weighted imaging (SWI) sequences to demonstrate CVS and PRLs, as well as optic nerve imaging. Additionally, we provide recommendations on the use of MRI for treatment monitoring, including progressive MS patients.</p>","PeriodicalId":49298,"journal":{"name":"Clinical Neuroradiology","volume":" ","pages":"831-854"},"PeriodicalIF":3.2,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13522060/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148036990","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":"Thrombolysis in Cerebral Infarction (TICI) 2b Versus TICI 3 Reperfusion in Stroke Patients with Mild Symptoms.","authors":"Christian Heitkamp, Uta Hanning, Alexander Heitkamp, Luca Meucci, Susan Klapproth, Felix Schlicht, Gabriel Broocks, Tobias D Faizy, Helge C Kniep, Fabian Flottmann, Maxim Bester, Maximilian Schell, Christian Thaler, Götz Thomalla, Jens Fiehler, Laurens Winkelmeier","doi":"10.1007/s00062-026-01631-x","DOIUrl":"10.1007/s00062-026-01631-x","url":null,"abstract":"<p><strong>Purpose: </strong>The treatment effect of mechanical thrombectomy in patients with mild stroke symptoms and large vessel occlusion remains unclear. Furthermore, it is uncertain whether achieving complete reperfusion (modified Thrombolysis in Cerebral Infarction [mTICI] 3) offers additional clinical benefit compared to incomplete reperfusion (mTICI 2b) in patients with mild stroke.</p><p><strong>Methods: </strong>In this retrospective, multicenter analysis, all patients enrolled in the German Stroke Registry-Endovascular Treatment between 2015 and 2023 (n = 18,069) were evaluated. The study included patients with a National Institutes of Health Stroke Scale (NIHSS) score of < 6 and anterior circulation large vessel occlusion. Clinical outcomes were compared between mTICI 2b and mTICI 3. The primary endpoint was excellent functional outcome at 90 days, defined as a modified Rankin Scale (mRS) score of 0-1.</p><p><strong>Results: </strong>Of the 747 included patients, 37% achieved mTICI 2b and 63% mTICI 3. An excellent functional outcome was observed at similar rates in both groups (mTICI 2b: 59% vs. mTICI 3: 60%; P = 0.83; adjusted OR: 0.96 [95% CI: 0.66-1.40]; P = 0.84). The rates of symptomatic intracranial hemorrhage (4% vs. 3%; P = 0.36) and 90-day mortality (10% vs. 7%; P = 0.26; adjusted OR: 0.80 [95% CI: 0.42-1.50]; P = 0.49) were also comparable between the two groups.</p><p><strong>Conclusion: </strong>Among thrombectomy patients with mild stroke, complete reperfusion was not associated with better functional outcomes than incomplete reperfusion. These findings suggest that mTICI 2b may be an acceptable final angiographic result and raise questions about the risk-benefit ratio of additional retrieval maneuvers aimed at achieving mTICI 3.</p>","PeriodicalId":49298,"journal":{"name":"Clinical Neuroradiology","volume":" ","pages":"879-886"},"PeriodicalIF":3.2,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13522090/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147460615","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":"Detection of Hemorrhagic Transformation of Cerebral Infarcts with Ultra-low Field MRI.","authors":"Dimah Hasan, Julian Sauer, Clara Heller, Annika Rieder, Konstantin Ueffing, Frederic de Beukelaer, Jörg Schulz, Johannes Schiefer, Manuel Dafotakis, Arno Reich, Martin Wiesmann, Florian Holtbernd, Charlotte Weyland","doi":"10.1007/s00062-026-01666-0","DOIUrl":"10.1007/s00062-026-01666-0","url":null,"abstract":"<p><strong>Purpose: </strong>Hemorrhagic transformation (HT) within ischemic infarcts is a critical post-stroke complication that significantly influences secondary prevention strategies, particularly the timing and safety of anticoagulation. Ultra-low field (ULF) MRI (0.064 T, Swoop, Hyperfine) offers bedside neuroimaging, but its ability to detect hemorrhagic transformation compared to standard MRI (1.5 T or 3 T) and CT remains uncertain. This study aimed to evaluate the diagnostic accuracy of ULF-pMRI for detecting hemorrhagic transformation in ischemic stroke patients.</p><p><strong>Methods: </strong>We retrospectively analyzed 97 patients with ischemic infarcts who underwent both ULF-pMRI and standard neuroimaging (standard MRI or CT). The presence of hemorrhagic transformation was assessed by two independent readers (trained neuroradiologists) and by consensus reading in univariate analysis using the Heidelberg Bleeding Classification (HBC). Diagnostic accuracy metrics sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) were calculated with the standard method (standard MRI or CT within two days of ULF-pMRI) as the reference. Agreement was quantified using Cohen's Kappa.</p><p><strong>Results: </strong>Of 97 stroke patients, n = 21 (21.6%) showed hemorrhagic transformation on standard imaging. Most findings corresponded to scattered small petechia and subarachnoid hemorrhage. Reader 1 detected hemorrhagic transformation in ULF-pMRI with a sensitivity of 5/21 (23.8%), specificity 100%, positive predictive value (PPV) 100%, and negative predictive value (NPV) 82% and Reader 2 showed a sensitivity of 3/21 (14.3%), specificity 100%, PPV 100%, and NPV 81%, while consensus reading showed sensitivity of 3/21 (14.3%), specificity 100%, PPV 100%, NPV 81%. ULF-pMRI failed to detect petechial hemorrhages (0/13 HBC1a; 0/3 HBC1b), while detection improved for more extensive hemorrhagic transformations (HBC 1c and 3). After exclusion of petechial hemorrhages (HBC1a and HBC1b), ULF-pMRI detected 5 of 9 remaining hemorrhagic transformation subtypes (55.6%).</p><p><strong>Conclusion: </strong>Ultra-low-field MRI demonstrated low sensitivity for detecting hemorrhagic transformation in ischemic stroke, particularly for petechial hemorrhages (HBC class 1a and 1b). Detection was higher for non-petechial hemorrhagic transformations (HBC class 1c and 3), but overall performance remains insufficient for reliable therapy-guiding decisions.</p>","PeriodicalId":49298,"journal":{"name":"Clinical Neuroradiology","volume":" ","pages":"1103-1111"},"PeriodicalIF":3.2,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13521962/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147934589","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":"Association between the triglyceride-glucose index and collateral status in ischemic stroke patients undergoing endovascular therapy.","authors":"Wei Deng, Xiaojun Zhu, Tongyu Liu, Fanyu Zhang, Zhengqiao Bao, Zhihua Cao, Jun Han, Yanli Sun","doi":"10.1007/s00062-026-01660-6","DOIUrl":"10.1007/s00062-026-01660-6","url":null,"abstract":"<p><strong>Background: </strong>Collateral status provides compensatory flow to ischemic regions in acute large vessel occlusion (LVO) patients and is closely linked to clinical outcomes after endovascular therapy (EVT). This study aimed to evaluate the association between the triglyceride-glucose (TyG) index and collateral status in ischemic stroke patients undergoing EVT, focusing on sex-based differences.</p><p><strong>Methods: </strong>A total of 789 patients undergoing EVT between September 2018 and January 2024 were retrospectively included in this study. Collateral status was assessed using the ASITN/SIR grading system based on digital subtraction angiography (DSA), classifying patients into poor (grades 0-1) and good (grades 2-4) collateral groups. The association between the TyG index and collateral status was evaluated using multivariable logistic regression analysis, and restricted cubic spline modeling.</p><p><strong>Results: </strong>Among EVT patients (median age 69 years, 55.8% male), 256 were included in poor collateral group. The TyG index was significantly elevated in patients with poor collaterals compared to those with good collaterals (8.86 [8.43, 9.54] vs. 8.74 [8.35, 9.30], P = 0.021). Logistic regression analysis revealed that an elevated TyG index was independently associated with the risk of poor collateral status (OR = 1.30, 95% CI: 1.05-1.62, P = 0.017), with the association being significant in males (OR = 1.50, 95% CI: 1.08-2.08, P = 0.016) but not in females (OR = 1.21, 95% CI: 0.90-1.64, P = 0.205). In addition, restricted cubic spline modeling showed a positive linear association between the TyG index and poor collateral status in the total patients and males.</p><p><strong>Conclusion: </strong>In this study, we found that the TyG index was significantly associated with poor collateral status in patients undergoing EVT, particularly in males.</p>","PeriodicalId":49298,"journal":{"name":"Clinical Neuroradiology","volume":" ","pages":"1093-1101"},"PeriodicalIF":3.2,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13522026/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147876310","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":"Migratory Venous Sinus Stenosis After Stenting for Idiopathic Intracranial Hypertension: a Single-Center Case Series.","authors":"Lizhang Chen, Jian Wang, Xue Lin, Fayun Hu, Hongbo Zheng","doi":"10.1007/s00062-026-01653-5","DOIUrl":"10.1007/s00062-026-01653-5","url":null,"abstract":"<p><strong>Background and purpose: </strong>Venous sinus stenting (VSS) is an effective intervention for medically refractory idiopathic intracranial hypertension (IIH) with hemodynamically significant dural venous sinus stenosis. However, some patients develop de novo stenosis in venous segments that were angiographically normal at the index procedure-a phenomenon we define as migratory venous sinus stenosis (mVSS). We aimed to characterize the incidence, anatomical distribution, and clinical management of symptomatic mVSS in a consecutive VSS cohort.</p><p><strong>Methods: </strong>We retrospectively reviewed of all consecutive IIH patients who underwent VSS at West China Hospital (November 2011-October 2025). Patients developing symptomatic mVSS were identified, and clinical presentations, anatomical localization, hemodynamic parameters, and treatment outcomes were analyzed.</p><p><strong>Results: </strong>Among 65 patients, 4 (6.2%) developed symptomatic mVSS (3 women, 1 man; age range 15-44 years). Symptom recurrence occurred 4 days to 9 months after index VSS. New stenoses localized to the venous segment immediately distal to the original stent in all cases. Recurrent trans-stenotic pressure gradients ranged from 16 to 30 mm Hg (manometry was unavailable in one patient). Three patients underwent successful repeat stenting with immediate hemodynamic normalization and durable symptom resolution. One patient with concurrent paraspinal infection improved with conservative management alone.</p><p><strong>Conclusions: </strong>Symptomatic mVSS is an uncommon but clinically significant failure mode after VSS for IIH, characteristically arising at or immediately beyond the distal stent margin. Structured post-stenting surveillance and timely consideration of repeat intervention are warranted in symptomatic cases.</p>","PeriodicalId":49298,"journal":{"name":"Clinical Neuroradiology","volume":" ","pages":"977-982"},"PeriodicalIF":3.2,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147700542","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":"Factors Associated with Short Hospital Stay After Combined Middle Meningeal Artery Embolization and Surgical Evacuation for Chronic Subdural Hematoma.","authors":"Anthony Terraciano, Bluyé DeMessie, Muhammed Amir Essibayi, Abdulrhman Alsalama, Khushal Gupta, Hamza Adel Salim, Alireza Karandish, Nimer Adeeb, Dhairya A Lakhani, Yan-Lin Li, Diego Alejandro Ortega, Joseph Carnevale, Atakan Orscelik, Zachary Abecassis, Georgios Sioutas, Giancarlo Salsano, Rahim Abo Kasem, Andrew Falzon, Jefferson O Abaricia, Pedram D Maleknia, Leonardo Cruz-Criollo, Samantha Schimmel, Basel Musmar, Matthew Alexander, Ahmed Aljuboori, Dominik F Vollherbst, Domagoj Gajski, Jared Cooper, Omar Alwakaa, Mohamad Ezzeldin, Christopher S Ogilvy, Fawaz Al-Mufti, Vladimir Kalousek, Markus A Möhlenbruch, Luca Scarcia, Tang Si Zhao, Peter B Sporns, Anil Gopinathan, Robert W Regenhardt, Spiros L Blackburn, Clemens M Schirmer, Thien Huynh, Rabih G Tawk, Fabio Settecase, Pascal Jabbour, Kunal Vakharia, Mario Zanaty, Santiago Ortega-Gutierrez, Jesse G Jones, Marco Colasurdo, Hussein H Nasser, Sri Hari Sundararajan, Pascal J Mosimann, Erez Nossek, Eytan Raz, Alejandro M Spiotta, Bruno Del Sette, Ali Alaraj, Caterina Michelozzi, Davide Saraceno, Pietro Panni, Visish M Srinivasan, Jan-Karl Burkhardt, Gaultier Marnat, Pietro Mario Santini, Michael R Levitt, Giuseppe Lanzino, Jared Knopman, Vitor Mendes Pereira, Tufail Patankar, Adam A Dmytriw, David J Altschul, Mesh Collaborators","doi":"10.1007/s00062-026-01713-w","DOIUrl":"10.1007/s00062-026-01713-w","url":null,"abstract":"<p><strong>Background: </strong>Middle meningeal artery embolization (MMAE) plus surgical evacuation is increasingly used for chronic subdural hematoma (cSDH), but predictors of length of stay (LOS) and outcomes associated with early discharge remain unclear.</p><p><strong>Methods: </strong>We performed a multicenter MESH Registry study (2019-2024) of patients undergoing MMAE and surgical evacuation for symptomatic cSDH. Short-stay discharge was defined as LOS ≤4 days. Predictors were identified using multivariable logistic regression. The 90-day composite adverse event was defined as cSDH recurrence requiring intervention, reintervention (repeat MMAE or surgical evacuation), or 30-day all-cause readmission. Safety was assessed using adjusted logistic regression, generalized estimating equations (GEE), inverse probability of treatment weighting (IPTW), and multiple imputation by chained equations (MICE).</p><p><strong>Results: </strong>Among 647 patients (mean age 72.6 years; 74.0% male), 156 (24.1%) had short-stay discharge. Median LOS was 8 days (IQR 5-15). Older age (aOR 0.76 per 10 years; 95% CI 0.62-0.93; P = 0.008), higher baseline modified Rankin Scale score (aOR 0.79 per point; 95% CI 0.67-0.94; P = 0.007), and greater midline shift (aOR 0.90 per mm; 95% CI 0.85-0.96; P = 0.001) were independently associated with lower odds of short-stay discharge. C‑statistic was 0.683. The 90-day composite event rate was 17.1% in short-stay versus 23.7% in long-stay patients. Short-stay discharge was not significantly associated with the composite outcome on adjusted analysis (aOR 0.56; 95% CI 0.30-1.07; P = 0.08), GEE (aOR 0.61; 95% CI 0.33-1.12; P = 0.11), or MICE (aOR 0.74; 95% CI 0.44-1.25; P = 0.26). IPTW showed a discordant association (OR 0.47; 95% CI 0.24-0.92; P = 0.03).</p><p><strong>Conclusions: </strong>Older age, worse baseline function, and midline shift were associated with longer hospitalization. Short-stay discharge was not associated with a statistically significant increase in adverse-event rates; however, the study was not powered to establish non-inferiority or safety equivalence, and clinically meaningful differences cannot be excluded.</p>","PeriodicalId":49298,"journal":{"name":"Clinical Neuroradiology","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2026-08-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148800644","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":"Twelve-Month Outcomes of the J-Tube Flow-Diverting Stent for Unruptured Intracranial Aneurysms: a Prospective Multicenter Study.","authors":"Jingwei Li, Jie Zhang, Youxiang Li, Changwei Zhang, Guangsen Cheng, Guangzhong Chen, Wenfeng Feng, Tian Tian, Hui Huang, Guanjie Liang, Haojin Huang, Xuebin Hu, Sheng Guan, Hongqi Zhang","doi":"10.1007/s00062-026-01711-y","DOIUrl":"10.1007/s00062-026-01711-y","url":null,"abstract":"<p><strong>Background: </strong>Flow-diverting stents are widely used for the endovascular treatment of intracranial aneurysms. Prospective clinical evaluation of newly developed flow-diverting devices is necessary to characterize their procedural performance, angiographic efficacy, and safety outcomes.</p><p><strong>Objective: </strong>To report the 12-month clinical and angiographic outcomes of the J‑Tube flow-diverting stent in patients with unruptured intracranial aneurysms.</p><p><strong>Methods: </strong>This prospective, multicenter, single-arm study was conducted between September 2022 and June 2024 at nine tertiary clinical centers in China. A total of 149 patients were enrolled, of whom 148 received treatment with the J‑Tube flow-diverting stent. The primary efficacy endpoint was complete occlusion of the target aneurysm at 12 months. Secondary outcomes included procedural success, complete occlusion at 6 months, parent artery patency at 12 months, and device performance. Safety outcomes included all-cause mortality, stroke, adverse events, serious adverse events, target aneurysm hemorrhage, and device defects.</p><p><strong>Results: </strong>A total of 157 J-Tube flow-diverting stents were implanted in 148 patients, resulting in a procedural success rate of 100%. Complete aneurysm occlusion rates at 6 months were 73.9% in the full analysis set and 74.8% in the per-protocol set. At 12 months, complete occlusion rates were 87.2% and 90.8%, respectively. Parent artery patency was observed in 136 of 140 evaluable patients (97.1%). Mid-stent stenosis of greater than 50% was observed in four patients (2.9%), whereas no stenosis was observed at the proximal or distal stent ends. No patient underwent clinically driven target vessel revascularization because of parent artery stenosis. Eight patients (5.4%) experienced stroke within 12 months. No target aneurysm rupture or device defect was observed.</p><p><strong>Conclusion: </strong>In this prospective, multicenter, single-arm study, the J‑Tube flow-diverting stent showed high technical success and favorable 12-month angiographic outcomes in selected patients with unruptured intracranial aneurysms. Because no comparative device group was included, these findings should be interpreted as preliminary clinical evidence of feasibility and safety rather than evidence of superiority over existing flow diverters. Further comparative and longer-term studies are warranted to confirm these findings.</p>","PeriodicalId":49298,"journal":{"name":"Clinical Neuroradiology","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2026-08-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148800731","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":"Impact of Heart Failure Phenotype on Functional Outcomes After Carotid Artery Stenting.","authors":"Youssef Soliman, Farhan Siddiq, Ameer E Hassan, Amer Alshekhlee, M Shazam Hussain, Muhammad Niazi, Faheem Sheriff, Saif Bushnaq, Omar Tanweer, Ali Alaraj, Ramesh Grandhi, Daniel Vela-Duarte, Alzahra'a Al Matairi, Chizoba Ezepue, Zuhair Ali, Omid Shoraka, Tatiana Abou-Mrad, Ibrahim A Bhatti, Mohammad AlMajali, Zain Tariq, M Zakir Hussain, Osama Zaidat, Mohamad Ezzeldin","doi":"10.1007/s00062-026-01712-x","DOIUrl":"https://doi.org/10.1007/s00062-026-01712-x","url":null,"abstract":"<p><strong>Background: </strong>Heart failure (HF) is a common comorbidity in patients undergoing carotid artery stenting (CAS), but its impact on outcomes by HF phenotype is unclear. This is the first study to compare short-term CAS outcomes between patients with heart failure with reduced ejection fraction (HFrEF) and those with preserved ejection fraction (HFpEF).</p><p><strong>Methods: </strong>This multicenter, prospective observational study started by screening 889 patients from the CASSH registry. After applying predefined criteria, 105 patients with heart failure undergoing CAS were included (69 HFpEF, 36 HFrEF). Baseline demographics, comorbidities, and procedural details were compared. The primary outcome was a composite of 30-day procedure-related mortality, stroke, or myocardial infarction. Secondary outcomes included disability, measured by the modified Rankin Scale (mRS), at 30 days and at 90 days. Multivariable ordinal regression was used to assess the independent association between HF phenotype and poor functional outcome.</p><p><strong>Results: </strong>Baseline characteristics were similar between groups. The primary outcome occurred in 5.6% of HFrEF patients versus 1.4% of HFpEF patients (p = 0.561). However, functional outcomes were significantly worse in the HFrEF group, with higher mean mRS scores at 30 days (2.7 vs. 1.6, p = 0.003) and 90 days (2.7 vs. 1.4, p = 0.001). All-cause mortality was 11.1% in HFrEF vs. 1.4% in HFpEF (p = 0.085). After adjustment for age, sex, atrial fibrillation, and preprocedural mRS, HFrEF was independently associated with a higher risk of poor functional outcome at 30 days (β = 0.89, p = 0.018) and 90 days (β = 1.05, p = 0.006).</p><p><strong>Conclusion: </strong>HFrEF, but not HFpEF, independently predicts poorer functional recovery following CAS. These findings highlight the importance of incorporating heart failure phenotype into risk stratification and clinical guidelines to improve patient selection and peri-procedural management.</p>","PeriodicalId":49298,"journal":{"name":"Clinical Neuroradiology","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2026-08-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148800678","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":"Bilateral Eagle Syndrome: Is Simultaneous Resection of the Elongated Styloid Process a Preventive Option?","authors":"Mohamed Mehdi Ladhari, Patrick Samp, Stefan Weidauer","doi":"10.1007/s00062-026-01710-z","DOIUrl":"https://doi.org/10.1007/s00062-026-01710-z","url":null,"abstract":"","PeriodicalId":49298,"journal":{"name":"Clinical Neuroradiology","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2026-08-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148800544","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":"Clinical Feasibility of PETRA-MRA for Long-Term Surveillance of Clipped Intracranial Aneurysms: a Retrospective Single-Center Study in 546 Aneurysms.","authors":"Hee Sang Oh, Bio Joo, Mina Park, Sung Jun Ahn, Kwon-Duk Seo, Sang Kyu Park, Sang Hyun Suh","doi":"10.1007/s00062-026-01702-z","DOIUrl":"https://doi.org/10.1007/s00062-026-01702-z","url":null,"abstract":"<p><strong>Purpose: </strong>To evaluate the diagnostic capability and vessel visibility of Pointwise Encoding Time Reduction with Radial Acquisition MR angiography (PETRA-MRA) in a large cohort of patients with clipped intracranial aneurysms.</p><p><strong>Materials and methods: </strong>This retrospective single-center study included patients who underwent surgical clipping and follow-up MRI with PETRA-MRA sequence between January 2021 and August 2024. Two radiologists independently assessed PETRA-MRA and TOF-MRA for vessel visibility and recurrent aneurysms. Diagnostic performance was evaluated using DSA or CTA as reference standards.</p><p><strong>Results: </strong>A total of 368 patients with 546 clipped intracranial aneurysms were evaluated (mean age, 64 ± 10.6 years; median follow-up, 8.9 years). Twenty recurrent aneurysms (3.7%; incidence 0.61% per patient-year) were identified. In the DSA/CTA-verified subset, PETRA-MRA detected 18 of 20 recurrent aneurysms (sensitivity, 90.0%), whereas TOF-MRA detected 7 of 19 (36.8%). PETRA-MRA demonstrated a specificity of 91.7%. For recurrent aneurysms smaller than 3 mm, PETRA-MRA detected more lesions than TOF-MRA (80.0% vs. 11.1%). Vessel visibility at the clipped aneurysm was higher in PETRA-MRA (72.3%) than TOF-MRA (12.5%). Interobserver agreement for PETRA-MRA was moderate (weighted κ = 0.51).</p><p><strong>Conclusion: </strong>PETRA-MRA showed higher sensitivity and improved adjacent-vessel visualization compared with TOF-MRA in verified and strictly paired analyses. These findings suggest that PETRA-MRA may be a useful imaging tool for the postoperative surveillance of clipped intracranial aneurysms. Because reference-standard angiography was selectively performed, specificity, PPV, NPV, and accuracy should be interpreted as verified-subset estimates.</p>","PeriodicalId":49298,"journal":{"name":"Clinical Neuroradiology","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2026-07-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148438590","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}