Clinical Neuroradiology最新文献

{"title":"Diagnostic Value of Perfusion Parameters for Differentiation of Underlying Etiology in Internal Carotid Artery Occlusions.","authors":"Daniel Weiss, Henrik Lang, Christian Rubbert, Kai Jannusch, Marius Kaschner, Vivien Lorena Ivan, Julian Caspers, Bernd Turowski, Robin Jansen, John-Ih Lee, Tobias Ruck, Sven Günther Meuth, Michael Gliem","doi":"10.1007/s00062-023-01349-0","DOIUrl":"10.1007/s00062-023-01349-0","url":null,"abstract":"<p><strong>Purpose: </strong>Occlusions of the internal carotid artery (ICA) may be caused by dissection, embolic or macroangiopathic pathogenesis, which partially influences the treatment; however, inferring the underlying etiology in computed tomography angiography can be challenging. In this study, we investigated whether computed tomography perfusion (CT-P) parameters could be used to distinguish between etiologies.</p><p><strong>Methods: </strong>Patients who received CT‑P in acute ischemic stroke due to ICA occlusion between 2012 and 2019 were retrospectively analyzed. Group comparisons between etiologies regarding the ratios of CT‑P parameters between both hemispheres for relative cerebral blood volume (rCBV), relative cerebral blood flow (rCBF), time to maximum (Tmax), and mean transit time (MTT) were calculated by one-factorial analysis of variance (ANOVA) and compared by pairwise Bonferroni post hoc tests. An receiver operating characteristics (ROC) analysis was performed if differences in group comparisons were found. Multinomial logistic regression (MLR) including pretherapeutic parameters was calculated for etiologies.</p><p><strong>Results: </strong>In this study 69 patients (age = 70 ± 14 years, dissection = 10, 14.5%, embolic = 19, 27.5% and macroangiopathic = 40, 58.0%) were included. Group differences in ANOVA were only found for MTT ratio (p = 0.003, η² = 0.164). In the post hoc test, MTT ratio showed a differentiability between embolic and macroangiopathic occlusions (p = 0.002). ROC analysis for differentiating embolic and macroangiopathic ICA occlusions based on MTT ratio showed an AUC of 0.77 (p < 0.001, CI = 0.65-0.89) and a cut-off was yielded at a value of 1.15 for the MTT ratio (sensitivity 73%, specificity 68%). The MLR showed an overall good model performance.</p><p><strong>Conclusion: </strong>It was possible to differentiate between patients with embolic and macroangiopathic ICA occlusions based on MTT ratios and to define a corresponding cut-off. Differentiation from patients with dissection versus the other etiologies was not possible by CT‑P parameters in our sample.</p>","PeriodicalId":49298,"journal":{"name":"Clinical Neuroradiology","volume":" ","pages":"219-227"},"PeriodicalIF":2.8,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10881783/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"54231903","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":"Elevated Intraocular Pressure Moderated Brain Morphometry in High-tension Glaucoma: a Structural MRI Study.","authors":"Liang Jing, Tingqin Yan, Jian Zhou, Yuanzhong Xie, Jianfeng Qiu, Yi Wang, Weizhao Lu","doi":"10.1007/s00062-023-01351-6","DOIUrl":"10.1007/s00062-023-01351-6","url":null,"abstract":"<p><p>High-tension glaucoma (HTG) is one of the most common forms of primary open angle glaucoma. The purpose of this study was to assess in HTG brain, whether the elevated intraocular pressure (IOP) had an effect on the brain morphological alterations via structural MRI. We acquired T1WI structural MRI images from 56 subjects including 36 HTG patients and 20 healthy controls. We tested whether the brain morphometry was associated with the mean IOP in HTG patients. Moreover, we conducted moderation analysis to assess the interactions between subject type (HTG - healthy controls) and IOP. In HTG group, cortical thickness was negatively correlated with the mean IOP in the left rostral middle frontal gyrus, left pars triangularis, right precentral gyrus, left postcentral gyrus, left superior temporal gyrus (p < 0.05, FDR corrected). Four of the five regions negatively correlated with mean IOP showed reduced cortical thickness in HTG group compared with healthy controls, which were the left rostral middle frontal gyrus, left pars triangularis, left postcentral gyrus and left superior temporal gyrus (p < 0.05, FDR corrected). IOP moderated the interaction between subject type and cortical thickness of the left rostral middle frontal gyrus (p = 0.0017), left pars triangularis (p = 0.0011), left postcentral gyrus (p = 0.0040) and left superior temporal gyrus (p = 0.0066). Elevated IOP may result brain morphometry alterations such as cortical thinning. The relationship between IOP and brain morphometry underlines the importance of the IOP regulation for HTG patients.</p>","PeriodicalId":49298,"journal":{"name":"Clinical Neuroradiology","volume":" ","pages":"173-179"},"PeriodicalIF":2.8,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41172469","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":"Subcortical Infarction After Transarterial Embolization of a Borden Type III Transverse Sinus Dural Arteriovenous Fistula.","authors":"How-Chung Cheng, Antti Lindgren, Timo Krings","doi":"10.1007/s00062-023-01352-5","DOIUrl":"10.1007/s00062-023-01352-5","url":null,"abstract":"","PeriodicalId":49298,"journal":{"name":"Clinical Neuroradiology","volume":" ","pages":"275-278"},"PeriodicalIF":2.8,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41144683","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 Dual Antiplatelet Therapy with the Routine Use of Prasugrel for Flow Diversion of Cerebral Unruptured Aneurysms.","authors":"Kenichiro Suyama, Ichiro Nakahara, Shoji Matsumoto, Jun Morioka, Jun Tanabe, Akiko Hasebe, Sadayoshi Watanabe","doi":"10.1007/s00062-023-01355-2","DOIUrl":"10.1007/s00062-023-01355-2","url":null,"abstract":"<p><strong>Purpose: </strong>Prasugrel is not approved for patients treated with flow diverters, which have a high metal coverage ratio. However, robust antiplatelet therapy with prasugrel may prevent thromboembolic complications. We administered prasugrel and aspirin to all patients treated with flow diverters and reported the safety of the antiplatelet therapy regimen.</p><p><strong>Methods: </strong>This retrospective, single-center study evaluated the angiographic and clinical data of consecutive patients treated with flow diverters for cerebral unruptured aneurysms between June 2020 and May 2022. All patients received dual antiplatelet therapy, including prasugrel and aspirin. The administration of prasugrel ended 3 or 6 months after the procedure, whereas aspirin use continued for at least 12 months. Periprocedural complications (< 30 days post-procedure) and delayed complications (> 30 days post-procedure) were recorded.</p><p><strong>Results: </strong>During the study period, 120 unruptured aneurysms were treated with flow diverters in 110 patients. All patients, except one, survived longer than 12 months after the procedure. The rate of thromboembolic complications was 6.4%, and more than half of the patients had transient symptoms; one (0.9%) had a major ischemic stroke. One patient (0.9%) each had an asymptomatic, small subarachnoid hemorrhage and significant hemorrhagic complications with melena. The rate of permanent neurological deficits was 1.8%, and the mortality rate was 0.9%.</p><p><strong>Conclusions: </strong>Dual antiplatelet therapy comprising routine use of prasugrel and aspirin for flow diverter-implanted patients possibly contributed to a low rate of thromboembolic complications and low risk of hemorrhagic complications.</p>","PeriodicalId":49298,"journal":{"name":"Clinical Neuroradiology","volume":" ","pages":"201-208"},"PeriodicalIF":2.8,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10881594/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41240270","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":"Low Dose Pediatric CT Head Protocol using Iterative Reconstruction Techniques: A Comparison with Standard Dose Protocol.","authors":"Priyanka, Rajagopal Kadavigere, Suresh Sukumar","doi":"10.1007/s00062-023-01361-4","DOIUrl":"10.1007/s00062-023-01361-4","url":null,"abstract":"<p><strong>Purpose: </strong>Pediatric computed tomography (CT) head examination has also increased in recent years with the advancement in CT technology; however, children exposed to radiation at the youngest age are more vulnerable to the risks of radiation. The aim of the study is to evaluate radiation dose and image quality of low dose pediatric CT head protocol compared to standard dose pediatric CT head protocol.</p><p><strong>Methods: </strong>This was a prospective study. Group 1 included 73 patients aged < 1 year and 70 patients in the 1-5 years age group and had undergone CT head examination using the standard dose protocol. Group 2 included 31 patients aged < 1 year and 40 patients in the 1-5 years age group and had undergone CT head examination using the low dose protocol. The radiation dose was measured and image quality was assessed quantitatively and qualitatively.</p><p><strong>Results: </strong>There was a significant difference in radiation dose between the standard and low dose protocols (p > 0.05) with lower radiation dose for low dose group. The qualitative analysis did not show a significant difference between the standard and low dose protocols. The gray-white matter differentiation (GWMD), attenuation, contrast to noise ratio (CNR) and figure of merit (FOM) were higher in the low dose protocol compared to the standard dose with a significant difference (p > 0.05).</p><p><strong>Conclusion: </strong>The study concludes that a low dose protocol at 80 kV tube voltage/150 mAs tube current exposure time product/iterative reconstruction-iDose⁴ (level 3) for < 1 year age group and 100 kV/200m As/iDose⁴ (level 3) for 1-5 years age group provides ultra-low effective dose with diagnostically acceptable image quality for pediatric CT head examination compared with standard dose protocol.</p>","PeriodicalId":49298,"journal":{"name":"Clinical Neuroradiology","volume":" ","pages":"229-239"},"PeriodicalIF":2.8,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138446771","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":"Societies' Communications.","authors":"","doi":"10.1007/s00062-023-01360-5","DOIUrl":"10.1007/s00062-023-01360-5","url":null,"abstract":"","PeriodicalId":49298,"journal":{"name":"Clinical Neuroradiology","volume":" ","pages":"1165-1167"},"PeriodicalIF":2.8,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"54231904","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":"Freiburg Neuropathology Case Conference : Headache, Mental Confusion and Mild Hemiparesis in a 68-year-old Patient.","authors":"M Frosch, T Demerath, C Fung, M Prinz, H Urbach, D Erny, C A Taschner","doi":"10.1007/s00062-023-01359-y","DOIUrl":"10.1007/s00062-023-01359-y","url":null,"abstract":"","PeriodicalId":49298,"journal":{"name":"Clinical Neuroradiology","volume":" ","pages":"1159-1164"},"PeriodicalIF":2.8,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10654210/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49693390","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":"58. Jahrestagung der Deutschen Gesellschaft für Neuroradiologie e.V. und 30. Jahrestagung der Österreichischen Gesellschaft für Neuroradiologie e.V.","authors":"","doi":"10.1007/s00062-023-01336-5","DOIUrl":"https://doi.org/10.1007/s00062-023-01336-5","url":null,"abstract":"","PeriodicalId":49298,"journal":{"name":"Clinical Neuroradiology","volume":"33 Suppl 1","pages":"1-140"},"PeriodicalIF":2.8,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41171439","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":"Comaneci plus Balloon-assisted Embolization of Ruptured Wide-necked Cerebral Aneurysms.","authors":"A Sirakov,&nbsp;P Bhogal,&nbsp;S Bogovski,&nbsp;S Matanov,&nbsp;K Minkin,&nbsp;H Hristov,&nbsp;K Ninov,&nbsp;V Karakostov,&nbsp;M Penkov,&nbsp;S Sirakov","doi":"10.1007/s00062-021-01115-0","DOIUrl":"https://doi.org/10.1007/s00062-021-01115-0","url":null,"abstract":"<p><strong>Background and purpose: </strong>Recently, avant-garde combinations of ancillary devices as an adjunct to coil embolization for acutely ruptured and wide-necked cerebral aneurysms have emerged. This study sought to investigate the feasibility, safety and durability of the simultaneous combination of temporary neck-bridging devices plus balloon-assisted coiling (BAC) to treat acutely ruptured and wide-necked cerebral aneurysms.</p><p><strong>Methods: </strong>A retrospective review was performed of patients with ruptured and wide-necked intracranial bifurcation aneurysms treated with temporary stent plus balloon-assisted coiling. Anatomical features, technical details, intraprocedural complications, clinical and angiographic results were reviewed. Preprocedural and follow-up clinical statuses were evaluated using the modified Rankin scale (mRS).</p><p><strong>Results: </strong>A total of 21 patients (mean age 54.5 years, range 37-72 years) were identified. The immediate postprocedural angiography revealed complete aneurysm occlusion in 85.7% (18/21) of the cases. A periprocedural complication developed in 9.5% of the cases. There was no mortality in this study. The permanent morbidity rate was 4.7%. Long-term follow-up angiography was performed in 18 of 21 patients (85.7%) (the mean follow-up period was 21 months). The rate of complete aneurysm occlusion at final follow-up was 89.4%.</p><p><strong>Conclusion: </strong>The results of this study confirmed that temporary stent plus balloon-assisted coiling is a durable and relatively safe endovascular technique for the treatment of ruptured wide-necked bifurcation aneurysms located in both the posterior and anterior cerebral circulation.</p>","PeriodicalId":49298,"journal":{"name":"Clinical Neuroradiology","volume":"32 3","pages":"773-782"},"PeriodicalIF":2.8,"publicationDate":"2022-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39942962","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":"Benefits from Exclusion Treatment of Unruptured Brain Arteriovenous Malformations on Epilepsy in Adults.","authors":"Romain Capocci,&nbsp;Michaela Bustuchina Vlaicu,&nbsp;Eimad Shotar,&nbsp;Bertrand Mathon,&nbsp;Mariette Delaitre,&nbsp;Kévin Premat,&nbsp;Maichael Talaat,&nbsp;Atika Talbi,&nbsp;Anne-Laure Boch,&nbsp;Stéphanie Lenck,&nbsp;Alexandre Carpentier,&nbsp;Vincent Degos,&nbsp;Nader Antoine Sourour,&nbsp;Frédéric Clarençon","doi":"10.1007/s00062-021-01119-w","DOIUrl":"https://doi.org/10.1007/s00062-021-01119-w","url":null,"abstract":"<p><strong>Purpose: </strong>In approximately 30% of the patients, brain arteriovenous malformations (bAVMs) are revealed by seizures, which may alter the patients' quality of life. Our objective was to evaluate the benefits of exclusion treatment (radiosurgery, embolization and/or surgery) on posttherapeutic epilepsy in bAVM patients without intracranial hemorrhage prior to treatment.</p><p><strong>Methods: </strong>Our retrospective observational single-center study included all consecutive adult patients with an unruptured bAVM and epilepsy, treated at our institution from 1995 to 2019 and who were followed for at least 1 year. Data on angioarchitectural characteristics of bAVMs, on epilepsy and posttreatment modified Rankin Scale (mRS) were collected. The primary endpoint was a seizure-free status (defined as Engel class IA) after exclusion treatment versus conservative management.</p><p><strong>Results: </strong>In this study one hundred and one consecutive adult patients with bAVMs, epilepsy and without bAVM rupture before any treatment were included; 21 (21%) in the conservative management group vs. 80 (79%) in the exclusion treatment group. After exclusion treatment, 55% of the patients from the group were Engel IA after treatment vs. 10% of the conservative management group (odds ratio [OR] 11.37, 95% confidence interval [CI] 2.48-107.24, p < 0.001).</p><p><strong>Conclusion: </strong>Our results suggest that exclusion treatment in unruptured bAVMs with epilepsy is associated with a higher seizure-free rate in comparison with conservative management. Data from randomized controlled studies are necessary to confirm these findings.</p>","PeriodicalId":49298,"journal":{"name":"Clinical Neuroradiology","volume":"32 3","pages":"749-760"},"PeriodicalIF":2.8,"publicationDate":"2022-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39646341","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}