Clinical Neuroradiology最新文献

{"title":"Radiolucent Zone around Screws is Associated with Position Change of Screw-rod Constructs.","authors":"Satoru Tanioka,&nbsp;Masashi Fujimoto,&nbsp;Hirofumi Nishikawa,&nbsp;Katsuhiro Tanaka,&nbsp;Fujimaro Ishida,&nbsp;Atsushi Yamamoto,&nbsp;Munenari Ikezawa,&nbsp;Yusuke Kamei,&nbsp;Hidenori Suzuki,&nbsp;Masaki Mizuno","doi":"10.1007/s00062-021-01132-z","DOIUrl":"https://doi.org/10.1007/s00062-021-01132-z","url":null,"abstract":"<p><strong>Purpose: </strong>A radiologic assessment method to measure position change of screw-rod constructs over time by superposing the 3‑dimensional images assists in quantitative evaluation of screw loosening. We investigated the association between position change and radiolucent zone that was commonly used for diagnosing screw loosening.</p><p><strong>Methods: </strong>In this study 101 patients who underwent lumbar fusion were reviewed. Patient characteristics included age, sex, indications for surgery, number of fused levels, surgical procedures, and timing of follow-up computed tomography (CT, 1-5 months, 6-11 months, and ≥ 12 months). The Hounsfield unit values of L1 vertebra on preoperative CT were measured, and the radiolucent zone on each follow-up CT was evaluated. Using baseline CT on the day after surgery and follow-up CT, 3‑dimensional images of screw-rod constructs were generated and superposed. Position change was assessed by the median of the distances between the 3‑dimensional images at baseline and follow-up using the automated measurement method. Patient characteristics, the Hounsfield unit values of L1, and the amount of position change were categorized into the radiolucent zone presence and absence groups and compared.</p><p><strong>Results: </strong>The medians of position change were 0.281 mm and 0.136 mm in the radiolucent zone presence and absence groups, respectively (P < 0.001 by Mann-Whitney U-test). The area under the curve for position change in identifying radiolucent zone was 0.846; the cut-off value was 1.76 mm. In multivariable analysis, position change was independently associated with radiolucent zone (adjusted odds ratio per 0.1 mm, 2.80, 95% confidence interval 1.70-4.61).</p><p><strong>Conclusion: </strong>Radiolucent zone was associated with position change of screw-rod constructs.</p>","PeriodicalId":49298,"journal":{"name":"Clinical Neuroradiology","volume":"32 3","pages":"717-724"},"PeriodicalIF":2.8,"publicationDate":"2022-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39803045","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":"Comparison of Four International Guidelines on the Utility of Cranial Imaging Before Lumbar Puncture in Adults with Bacterial Meningitis.","authors":"Nicola Park,&nbsp;Masayuki Nigo,&nbsp;Rodrigo Hasbun","doi":"10.1007/s00062-022-01143-4","DOIUrl":"https://doi.org/10.1007/s00062-022-01143-4","url":null,"abstract":"<p><strong>Background: </strong>International guidelines exist for obtaining a head computed tomography (CT) scan before a lumbar puncture (LP) in adults with suspected meningitis but there are no studies comparing them in their ability to identify intracranial abnormalities.</p><p><strong>Methods: </strong>A retrospective study of 202 cases of adults with community-acquired bacterial meningitis at 16 hospitals in Houston from December 2004 until May 2019 to compare the 4 guidelines' ability in identifying minor and major intracranial findings, cases in which CT findings changed management, and patients who suffered cerebral herniation.</p><p><strong>Results: </strong>Minor and major intracranial findings were seen in 69 (34.1%) and in 24 (11.8%) of the patients, respectively. A total of nine (37.5%) of the major intracranial findings prompted a neurosurgical intervention. A total of four (1.9%) patients had cerebral herniation. The Infectious Diseases of America (IDSA), the United Kingdom (UK), the European Society of Clinical Microbiology and Infectious Diseases (ESCMID), and the Swedish guidelines for cranial imaging were met in 92.1%, 54%, 41.6%, and in 23.3% of the patients, respectively. The IDSA, UK, European, and the Swedish guidelines missed 0%, 20.8%, 41.7%, and 70.8% of the major intracranial findings and 0, 1, 3 and 4 of the 9 patients that prompted a neurosurgical intervention, respectively. All four patients with cerebral herniation met the criteria for all four guidelines.</p><p><strong>Conclusion: </strong>Out of the four international guidelines, only the IDSA recommendations for cranial imaging did not miss any major intracranial abnormality or any finding that prompted a neurosurgical intervention but all guidelines identified herniation.</p>","PeriodicalId":49298,"journal":{"name":"Clinical Neuroradiology","volume":"32 3","pages":"857-862"},"PeriodicalIF":2.8,"publicationDate":"2022-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39936325","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Endovascular Treatment of Cavernous Sinus Dural Arteriovenous Fistulas. Institutional Series, Systematic Review and Meta-Analysis.","authors":"Andrea M Alexandre,&nbsp;Carmelo Lucio Sturiale,&nbsp;Andrea Bartolo,&nbsp;Andrea Romi,&nbsp;Alba Scerrati,&nbsp;Maria Elena Flacco,&nbsp;Francesco D'Argento,&nbsp;Luca Scarcia,&nbsp;Giuseppe Garignano,&nbsp;Iacopo Valente,&nbsp;Emilio Lozupone,&nbsp;Alessandro Pedicelli","doi":"10.1007/s00062-021-01107-0","DOIUrl":"https://doi.org/10.1007/s00062-021-01107-0","url":null,"abstract":"<p><strong>Purpose: </strong>Endovascular treatment represents the first-line therapy for cavernous sinus dural arteriovenous fistulas (CS-dAVF); however, different approaches and embolic agents as well as occlusion rates, complications and clinical outcomes are reported among the published series. In this study we performed a comprehensive meta-analysis to investigate clinical and radiological outcomes after endovascular treatment of CS-dAVFs.</p><p><strong>Methods: </strong>PubMed, Ovid Medline, Ovid EMBASE, Scopus, and Web of Science were screened for a comprehensive literature review from 1990 to 2020 regarding series of patients treated for CS-dAVF with endovascular approaches. We performed a proportion meta-analysis estimating the pooled rates of each outcome also including data of patients treated in our center.</p><p><strong>Results: </strong>A total of 22 studies reporting 1043 patients and 1066 procedures were included. Chemosis was reported in 559 out of 1043 patients (45.9%), proptosis in 498 (41.5%), and ophthalmoplegia in 344 (23.5%). A transvenous embolization was preferred in 753 cases (63.2%) and coils were used in 712 out of 1066 procedures (57.8%). Overall, 85% (95% confidence interval, CI 69.5-96.1%) of patients had a complete resolution of symptoms, while complications occurred in 7.75% (95% CI 3.82-12.7%) with minimal permanent deficits (0.15%). The mortality rate was 1 out of 1043 patients (< 0.001).</p><p><strong>Conclusion: </strong>A transvenous coiling is the most common endovascular approach for CS-dAVF, achieving a high percentage of radiological and clinical resolution and low complication rates. Transvenous approaches show less complications than transarterial ones, and coils appear safer than liquid embolic agents.</p>","PeriodicalId":49298,"journal":{"name":"Clinical Neuroradiology","volume":"32 3","pages":"761-771"},"PeriodicalIF":2.8,"publicationDate":"2022-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9424140/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39604453","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":"Hybrid [¹⁸F]-F-DOPA PET/MRI Interpretation Criteria and Scores for Glioma Follow-up After Radiotherapy.","authors":"Marc Bertaux,&nbsp;Arnaud Berenbaum,&nbsp;Anna-Luisa Di Stefano,&nbsp;Laura Rozenblum,&nbsp;Marine Soret,&nbsp;Sebastien Bergeret,&nbsp;Khé Hoang-Xuan,&nbsp;Laure-Eugenie Tainturier,&nbsp;Brian Sgard,&nbsp;Marie-Odile Habert,&nbsp;Jean-Yves Delattre,&nbsp;Caroline Dehais,&nbsp;Ahmed Idbaih,&nbsp;Nadya Pyatigorskaya,&nbsp;Aurelie Kas","doi":"10.1007/s00062-022-01139-0","DOIUrl":"https://doi.org/10.1007/s00062-022-01139-0","url":null,"abstract":"<p><strong>Objective: </strong>¹⁸F‑fluoro-L‑3,4‑dihydroxyphenylalanine positron emission tomography (F‑DOPA PET) is used in glioma follow-up after radiotherapy to discriminate treatment-related changes (TRC) from tumor progression (TP). We compared the performances of a combined PET and MRI analysis with F‑DOPA current standard of interpretation.</p><p><strong>Methods: </strong>We included 76 consecutive patients showing at least one gadolinium-enhanced lesion on the T1‑w MRI sequence (T1G). Two nuclear medicine physicians blindly analyzed PET/MRI images. In addition to the conventional PET analysis, they looked for F‑DOPA uptake(s) outside T1G-enhanced areas (T1G/PET), in the white matter (WM/PET), for T1G-enhanced lesion(s) without sufficiently concordant F‑DOPA uptake (T1G+/PET), and F‑DOPA uptake(s) away from hemorrhagic changes as shown with a susceptibility weighted imaging sequence (SWI/PET). We measured lesions' F‑DOPA uptake ratio using healthy brain background (TBR) and striatum (T/S) as references, and lesions' perfusion with arterial spin labelling cerebral blood flow maps (rCBF). Scores were determined by logistic regression.</p><p><strong>Results: </strong>53 and 23 patients were diagnosed with TP and TRC, respectively. The accuracies were 74% for T/S, 76% for TBR, and 84% for rCBF, with best cut-off values of 1.3, 3.7 and 1.25, respectively. For hybrid variables, best accuracies were obtained with conventional analysis (82%), T1G+/PET (82%) and SWI/PET (81%). T1G+/PET, SWI/PET and rCBF ≥ 1.25 were selected to construct a 3-point score. It outperformed conventional analysis and rCBF with an AUC of 0.94 and an accuracy of 87%.</p><p><strong>Conclusions: </strong>Our scoring approach combining F‑DOPA PET and MRI provided better accuracy than conventional PET analyses for distinguishing TP from TRC in our patients after radiation therapy.</p>","PeriodicalId":49298,"journal":{"name":"Clinical Neuroradiology","volume":"32 3","pages":"735-747"},"PeriodicalIF":2.8,"publicationDate":"2022-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39606273","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":"Radiation Dose and Fluoroscopy Time of Diagnostic Angiography in Patients with Spinal Dural Arteriovenous Fistula.","authors":"Yigit Ozpeynirci,&nbsp;Christoph Trumm,&nbsp;Robert Stahl,&nbsp;David Fischer,&nbsp;Thomas Liebig,&nbsp;Robert Forbrig","doi":"10.1007/s00062-021-01130-1","DOIUrl":"https://doi.org/10.1007/s00062-021-01130-1","url":null,"abstract":"<p><strong>Purpose: </strong>Spinal dural arteriovenous fistulas (SDAVFs) represent the most common indication for a spinal angiography. The diagnostic reference level (DRL) for this specific endovascular procedure is still to be determined. This single-center study provides detailed dosimetrics of diagnostic spinal angiography performed in patients with SDAVFs.</p><p><strong>Methods: </strong>Retrospective analysis of all diagnostic spinal angiographies between December 2011 and January 2021. Only patients with an SDAVF who had baseline magnetic resonance angiography (MRA), diagnostic digital subtraction angiography (DSA), treatment and follow-up at this institution were included. Dose area product (DAP, Gy cm²) and fluoroscopy time were compared between preoperative and postoperative angiographies, according to SDAVF locations (common versus uncommon), MRA results at baseline (positive versus negative) and DSA protocols (low-dose, mixed-dose, normal-dose). The 75th percentile of the DAP distribution was used to define the local DRL.</p><p><strong>Results: </strong>A total of 62 spinal angiographies were performed in 25 patients with SDAVF. Preoperative angiographies (30/62, 48%) yielded a significantly higher DAP and longer fluoroscopy time when compared to postoperative angiographies (32/62, 53%) (p < 0.01). The local DRL was 329.41 Gy cm² for a nonspecific (n = 62), 395.59 Gy cm² for a preoperative and 138.6 Gy cm² for a postoperative spinal angiography. Preoperative angiography of uncommonly located SDAVFs yielded a significantly longer fluoroscopy time (p = 0.02). The MRA-based fistula detection had no significant impact on dosimetrics (p > 0.05). A low-dose protocol yielded a 61% reduction of DAP.</p><p><strong>Conclusion: </strong>The results of the present study suggest novel DRLs for spinal angiography in patients with SDAVF. Dedicated low-dose protocols enable radiation dose optimization in these procedures.</p>","PeriodicalId":49298,"journal":{"name":"Clinical Neuroradiology","volume":"32 3","pages":"791-797"},"PeriodicalIF":2.8,"publicationDate":"2022-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9424156/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39793431","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":"Heterogeneity of the Relative Benefits of TICI 2c/3 over TICI 2b50/2b67 : Are there Patients who are less Likely to Benefit?","authors":"Christoph C Kurmann,&nbsp;Adnan Mujanovic,&nbsp;Eike I Piechowiak,&nbsp;Tomas Dobrocky,&nbsp;Felix Zibold,&nbsp;Morin Beyeler,&nbsp;Jan Vynckier,&nbsp;David Seiffge,&nbsp;Thomas R Meinel,&nbsp;Pasquale Mordasini,&nbsp;Marcel Arnold,&nbsp;Urs Fischer,&nbsp;Jan Gralla,&nbsp;Johannes Kaesmacher","doi":"10.1007/s00062-021-01131-0","DOIUrl":"https://doi.org/10.1007/s00062-021-01131-0","url":null,"abstract":"<p><strong>Purpose: </strong>Incomplete reperfusion after mechanical thrombectomy (MT) is associated with a poor outcome. Rescue therapy would potentially benefit some patients with an expanded treatment in cerebral ischemia score (eTICI) 2b50/2b67 reperfusion but also harbors increased risks. The relative benefits of eTICI 2c/3 over eTICI 2b50/67 in clinically important subpopulations were analyzed.</p><p><strong>Methods: </strong>Retrospective analysis of our institutional database for all patients with occlusion of the intracranial internal carotid artery (ICA) or the M1/M2 segment undergoing MT and final reperfusion of ≥eTICI 2b50 (903 patients). The heterogeneity in subgroups of different time metrics, age, National Institutes of Health Stroke Scale (NIHSS), number of retrieval attempts, Alberta Stroke Programme Early CT Score (ASPECTS) and site of occlusion using interaction terms (p_i) was analyzed.</p><p><strong>Results: </strong>The presence of eTICI 2c/3 was associated with better outcomes in most subgroups. Time metrics showed no interaction of eTICI 2c/3 over eTICI 2b50/2b67 and clinical outcomes (onset to reperfusion p_i = 0.77, puncture to reperfusion p_i = 0.65, onset to puncture p_i = 0.63). An eTICI 2c/3 had less consistent association with mRS ≤2 in older patients (>82 years, p_i = 0.038) and patients with either lower NIHSS (≤9) or very high NIHSS (>19, p_i = 0.01). Regarding occlusion sites, the beneficial effect of eTICI 2c/3 was absent for occlusions in the M2 segments (aOR 0.73, 95% confidence interval [CI] 0.33-1.59, p_i = 0.018).</p><p><strong>Conclusion: </strong>Beneficial effect of eTICI 2c/3 over eTICI 2b50/2b67 only decreased in older patients, M2-occlusions and patients with either low or very high NIHSS. Improving eTICI 2b50/2b67 to eTICI 2c/3 in those subgroups may be more often futile.</p>","PeriodicalId":49298,"journal":{"name":"Clinical Neuroradiology","volume":"32 3","pages":"817-827"},"PeriodicalIF":2.8,"publicationDate":"2022-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9424153/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39650714","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":"Functional Connectivity of Nucleus Accumbens Is Associated with Lifelong Premature Ejaculation in Male Adults : A Resting-state fMRI Study.","authors":"Bowen Geng,&nbsp;Ming Gao,&nbsp;Jiayu Wu,&nbsp;Chengxiang Liu,&nbsp;Ruiqing Piao,&nbsp;Guang Yang,&nbsp;Xiao Zeng,&nbsp;Peng Liu","doi":"10.1007/s00062-021-01105-2","DOIUrl":"https://doi.org/10.1007/s00062-021-01105-2","url":null,"abstract":"<p><strong>Purpose: </strong>Ejaculation represents a crucial component of sexual behavior in men, which is involved in reward functions of certain brain areas including the nucleus accumbens (NAcc). Lifelong premature ejaculation (PE) is one of the most prevalent sexual dysfunctions in men. It is suggested to be related to abnormal brain function. This study aimed to explore changes of the functional connectivity patterns of NAcc and possible correlations of the neuroimaging abnormalities with clinical features in lifelong PE patients.</p><p><strong>Methods: </strong>The sample consisted with 42 lifelong PE patients and 30 healthy controls. All participants underwent functional magnetic resonance imaging scans and clinical symptoms. The functional connectivity (FC) approach was applied to investigate differences of NAcc-seed intrinsic connectivity between two groups and correlation analysis was used to access possible relationships between the imaging findings and clinical features, such as premature ejaculation diagnostic tool (PEDT) or intravaginal ejaculatory latency time (IELT).</p><p><strong>Results: </strong>Results showed that lifelong PE patients had decreased FC between the NAcc and thalamus, superior temporal pole, superior temporal cortex (STC), inferior frontal gyrus (IFG), orbitofrontal cortex, caudate and putamen. A significantly negative correlation between the PEDT score and NAcc-STC connectivity (r = -0.46) was found in lifelong PE patients, while IELT score positively correlated with the NAcc-IFG connectivity (r = 0.48) and NAcc-thalamus connectivity (r = 0.46).</p><p><strong>Conclusion: </strong>The findings may facilitate a more sophisticated understanding of neural mechanisms of lifelong PE, particularly associated with the NAcc-related intrinsic connectivity during the resting state.</p>","PeriodicalId":49298,"journal":{"name":"Clinical Neuroradiology","volume":"32 3","pages":"655-663"},"PeriodicalIF":2.8,"publicationDate":"2022-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39574030","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":"Navigating the Parotid Glands: Anatomy, Imaging Work-up and Next Steps.","authors":"Ryan McGeary,&nbsp;Patricia A Rhyner,&nbsp;Amit B Desai,&nbsp;Alok A Bhatt","doi":"10.1007/s00062-021-01108-z","DOIUrl":"https://doi.org/10.1007/s00062-021-01108-z","url":null,"abstract":"<p><p>Evaluation of lesions affecting the parotid gland is often challenging to both clinicians and radiologists. This article reviews parotid anatomy and function, as it relates to various lesions that may occur within the gland. Key morphlogic features of lesions are discussed with an emphasis on those that warrant biopsy and those that do not need biopsy. Various biopsy methods using ultrasound and computed tomography are reviewed.</p>","PeriodicalId":49298,"journal":{"name":"Clinical Neuroradiology","volume":"32 3","pages":"615-623"},"PeriodicalIF":2.8,"publicationDate":"2022-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39845081","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":"Flow Diverter Treatment of Ruptured Basilar Artery Perforator Aneurysms : A Multicenter Experience.","authors":"Samer Elsheikh,&nbsp;Markus Möhlenbruch,&nbsp;Fatih Seker,&nbsp;Ansgar Berlis,&nbsp;Christoph Maurer,&nbsp;Naci Kocer,&nbsp;Ala Jamous,&nbsp;Daniel Behme,&nbsp;Christian Taschner,&nbsp;Horst Urbach,&nbsp;Stephan Meckel","doi":"10.1007/s00062-021-01133-y","DOIUrl":"https://doi.org/10.1007/s00062-021-01133-y","url":null,"abstract":"<p><strong>Purpose: </strong>Ruptured basilar artery perforator aneurysms (BAPAs) represent a very rare cause of subarachnoid hemorrhage and an under-reported subtype of cerebral aneurysm. There is no consensus for the optimal treatment strategy (conservative vs. surgical vs. various endovascular approaches). We aim to present a multicenter experience of BAPA treatment using flow-diverter (FD) stents.</p><p><strong>Methods: </strong>At five tertiary neurovascular centers, all cases of ruptured BAPAs treated by FD were retrospectively collected. Baseline imaging and clinical characteristics, complications, as well as early and long-term angiographic and clinical outcome (mRS) were analyzed.</p><p><strong>Results: </strong>Eighteen patients (mean age, 57 years; SD, ±10.7 years) with acute SAH related to a BAPA were treated using 18 FD stents. Aneurysms were detected on initial imaging study in 28%; delayed diagnosis was triggered by clinical deterioration due to rebleeding in 15%. No rebleeding after FD was seen, 28% developed FD-related ischemic complications. At long term (n = 16), overall mortality was 13% (2/16), and favorable outcome (mRS 0-2) was 81% (13/16). All BAPAs (n = 13) were completely occluded at long-term angiographic follow-up.</p><p><strong>Conclusion: </strong>In our multicenter experience, FD treatment of ruptured BAPAs appears to have comparable safety and efficacy outcomes to FD treatment of other ruptured posterior circulation aneurysms as well as to the conservative management of BAPAs. This treatment strategy for a ruptured BAPA achieved a high rate of angiographic occlusion and favorable clinical outcome; however, as the conservative management also seems to offer similar clinical outcomes an individualized treatment decision is warranted. Future prospective studies comparing both approaches are required.</p>","PeriodicalId":49298,"journal":{"name":"Clinical Neuroradiology","volume":"32 3","pages":"783-789"},"PeriodicalIF":2.8,"publicationDate":"2022-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9424161/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39845082","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 Novel Subtraction Method to Reduce Metal Artifacts of Cerebral Aneurysm Embolism Coils.","authors":"Hanpei Zheng,&nbsp;Ming Yang,&nbsp;Yuxi Jia,&nbsp;Lan Zhang,&nbsp;Xiaojie Sun,&nbsp;Yangjing Zhang,&nbsp;Zhuang Nie,&nbsp;Hongying Wu,&nbsp;Xiaohui Zhang,&nbsp;Ziqiao Lei,&nbsp;Wang Jing","doi":"10.1007/s00062-021-01125-y","DOIUrl":"https://doi.org/10.1007/s00062-021-01125-y","url":null,"abstract":"<p><strong>Objective: </strong>To investigate a novel subtraction method (S-MAR), combing metal artifact reduction (MAR), virtual monochromatic imaging (VMI), and subtraction CT angiography (CTA) to remove the metal artifacts of coils after endovascular embolotherapy of intracranial aneurysms.</p><p><strong>Method: </strong>In this retrospective study, 29 patients with 38 coils after endovascular embolotherapy of intracranial aneurysms who underwent cerebral CTA using a dual-layer detector spectral CT were included. Conventional CT images (CI), virtual non-enhanced (VNC) images and VMI ranging from 40 to 120 KeV in steps of 10 were reconstructed. These images were then postprocessed to CI_MAR, VMI_MAR and VNC_MAR with MAR software (O-MAR; Philips Healthcare, Cleveland, OH, USA). The novel subtraction method (S-MAR) was derived from subtraction imaging between VNC_MAR and the optimal VMI_MAR. Contrast-to-noise (CNR) and Noise_(Background) of CI, CI_MAR, VMI, and VMI_MAR were calculated quantitatively. Two Independent radiologists qualitatively assessed artifacts in all images using coil artifact score (CA score), a 5-point Likert scale. Besides, all coils were divided into two groups (group 1: diameter < 5.0 mm, group 2: diameter ≥ 5.0 mm). Differences between two groups were statistically analyzed.</p><p><strong>Results: </strong>The optimal KeV was 40 KeV. Strong correlations between diameter of coils and the CA score of CI were found (r_s = 0.652, P < 0.05). CNR, Noise and CA score were significantly improved by CI_MAR and VMI_MAR compared with CI (P < 0.05). The S‑MAR showed significantly better performance compared with CI, CI_MAR, VMI, and VMI_MAR in reducing metal coil artifacts according to the CA score (P < 0.05), especially in group 2.</p><p><strong>Conclusion: </strong>The novel S‑MAR proved to be a promising method to reduce coil metal artifacts and elevate the vessel visualization adjacent to coils. It could develop to be widely used in cerebral CTA after coiled aneurysms.</p>","PeriodicalId":49298,"journal":{"name":"Clinical Neuroradiology","volume":"32 3","pages":"687-694"},"PeriodicalIF":2.8,"publicationDate":"2022-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39847909","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}