Acta radiologica最新文献

{"title":"Diffusion-weighted imaging of bone and soft tissue tumors: a systematic review.","authors":"Mehul Mittal, Rahul Sharma, Lauren Kim, Mikaela Bankston, Cindy Weinschenk, Avneesh Chhabra, Robert C Weinschenk","doi":"10.1177/02841851261429386","DOIUrl":"10.1177/02841851261429386","url":null,"abstract":"<p><p>Diffusion-weighted magnetic resonance imaging (DWI) analyzes water diffusion in tissues, indirectly reflecting cellular density and aiding tumor characterization. Our objective was to explore the utility of DWI in three topics: (i) differentiation of bone and soft tissue sarcomas with respect to tumor type/grade; (ii) correlation with chemotherapy response in Ewing's sarcoma and osteosarcoma; and (iii) differentiation of benign from malignant soft tissue and bone tumors. The aim of the review article was to assess the existing literature detailing the insight that can be provided by DWI when addressing bone and soft tissue tumors. A search was conducted following the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines using Pubmed, Scopus, Embase, and CENTRAL databases from 1 January 2013 to 30 November 2023. Eligible studies were assessed for quality using the Quality Assessment of Diagnostic Accuracy Studies 2 (QUADAS-2) scoring system. In total, 22 studies met the inclusion criteria. DWI proved effective in select scenarios when distinguishing among bone and soft tissue sarcomas (sensitivity = 48%-89%, specificity = 75%-100%), correlating chemotherapy response with histopathology results (sensitivity = 25%-85%, specificity = 50%-100%), and differentiating between benign and malignant bone tumors (sensitivity = 54%-92%, specificity = 39%-92%) and soft tissue tumors (sensitivity = 68%-91%, specificity = 60%-81%). DWI is a valuable tool for the diagnosis and prognosis of bone and soft tissue sarcomas, treatment effect of primary bone tumors, and distinguishing benign from malignant bone/soft tissue tumors. Though promising, the technology has shown mixed results, warranting further research.</p>","PeriodicalId":7143,"journal":{"name":"Acta radiologica","volume":" ","pages":"446-462"},"PeriodicalIF":1.2,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147502738","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Inter-observer variability for detection of suspected ileocolonic Crohn's disease with magnetic resonance enterography.","authors":"Jacob Broder Brodersen, Michael Dam Jensen, Mathias Byriel, Claus Dam, Martina Loft, Søren Rafael Rafaelsen","doi":"10.1177/02841851261422702","DOIUrl":"10.1177/02841851261422702","url":null,"abstract":"<p><p>BackgroundMagnetic resonance enterography (MRE) can visualize Crohn's disease (CD) and its complications.PurposeTo determine the inter-observer agreement for the detection of ileocolonic CD.Material and MethodsThis post-hoc analysis included MRE scans from 48 patients selected from a prospective, blinded multicenter study of patients with suspected CD. Based on ileocolonoscopy in the main study, CD was diagnosed in 39 (81%) patients, with colonic involvement in 36 (69%). Two senior radiologists and two junior doctors undergoing specialist training, blinded to clinical data assessed the image quality, CD presence, and disease severity.ResultsThe inter-observer agreement for CD detection varied by location: terminal ileum (κ = 0.77, 95% confidence interval [CI] = 0.63-0.89), colon (κ = 0.59, 95% CI = 0.42-0.74), and ileocolon (κ = 0.65, 95% CI = 0.49-0.80). Agreement was higher among senior radiologists than juniors: terminal ileum (κ = 0.83 vs. 0.73; <i>P</i> = 0.60) and colon (κ = 0.73 vs. 0.41; <i>P</i> = 0.11), though differences were not statistically significant. The inter-observer agreement for disease severity was poor to moderate with intraclass correlation coefficients (ICCs) of 0.51 (95% CI = 0.35-0.67) for the MaRIA and 0.46 (95% CI = 0.29-0.62) for the simplified MaRIA. Senior radiologists showed higher consistency, with moderate to good agreement: ICC of 0.69 for the MaRIA, 0.70 for the simplified MaRIA, and 0.80 for bowel wall thickness.ConclusionIn early CD, MRE demonstrated moderate to substantial inter-observer agreement for ileocolonic evaluation. Limitations in colonic assessment likely reflect early disease detection rather than observer variability, highlighting the need for a complementary assessment.</p>","PeriodicalId":7143,"journal":{"name":"Acta radiologica","volume":" ","pages":"418-425"},"PeriodicalIF":1.2,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147375663","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Transcatheter artery embolization for hemoptysis in patients with destroyed lung: risk factors for recurrence.","authors":"Menglan Chu, Qikun Guo, Tongqiang Li, Weijie Luo, Liguo Dai, Wei Luo, Bin Xiong","doi":"10.1177/02841851261420814","DOIUrl":"10.1177/02841851261420814","url":null,"abstract":"<p><p>BackgroundTranscatheter arterial embolization (TAE) is an established treatment of hemoptysis in patients with destroyed lung.PurposeTo identify the relevant risk factors for the recurrence of hemoptysis after TAE in patients with destroyed lung combined with hemoptysis.Material and MethodsA retrospective analysis was performed on 179 patients with destroyed lung and hemoptysis who underwent TAE between January 2014 and September 2023. Immediate and clinical success rates were assessed after TAE. Kaplan-Meier analysis estimated hemoptysis-free survival. The Cox regression model was used to identify factors associated with recurrence.ResultsAmong 179 patients (124 men, 55 women; mean age = 57.24 ± 12.30 years), immediate and clinical success rates were 92.2% and 89.5%, respectively. Freedom from hemoptysis at 24 h was achieved in 91.5% of patients. Cox regression analysis identified the average number of embolized vessels per damaged lobe as an independent predictor of recurrence (hazard ratio [HR] = 1.346, 95% confidence interval [CI] = 1.001-1.810; <i>P</i> <0.05). Patients with ≥4 embolized vessels per lobe had a significantly higher risk of recurrence than those with fewer vessels. Non-bronchial systemic arteries (NBSAs), particularly intercostal and subclavian artery branches, were key bleeding sources, with the ratio of NBSAs to bronchial arteries (BAs) embolized being approximately 1.38:1.ConclusionAlthough meticulous attention to NBSAs during TAE is essential, our study identifies the average number of embolized vessels per lobe as an independent predictor of recurrence. This indicates a disease state with high revascularization potential, necessitating long-term strategies that also address the underlying lung pathology.</p>","PeriodicalId":7143,"journal":{"name":"Acta radiologica","volume":" ","pages":"379-387"},"PeriodicalIF":1.2,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147324160","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Non-contrast coronary magnetic resonance angiography in myocardial bridge assessment: a CCTA-referenced diagnostic evaluation.","authors":"Feng Wang, Shaobin Zhuang, Xi Liu, Ruiquan Chen, Zhen Xing","doi":"10.1177/02841851261419022","DOIUrl":"10.1177/02841851261419022","url":null,"abstract":"<p><p>BackgroundMyocardial bridge (MB) may lead to myocardial ischemia. Non-contrast coronary magnetic resonance angiography (CMRA) offers a non-invasive, radiation-free alternative to computed tomography coronary angiography (CCTA); however, the performance of whole-heart versus volume-targeted CMRA for MB detection remains unclear.PurposeTo evaluate and compare the diagnostic efficacy of non-contrast whole-heart and volume-targeted CMRA using balanced SSFP sequences in MB detection.Material and MethodsThis prospective study enrolled 30 consecutive patients with suspected or confirmed MB. All patients underwent both whole-heart and volume-targeted CMRA. Image quality was scored on a 3-point scale. MB detection confidence was rated on a 5-point scale. Using CCTA as the reference standard, diagnostic performance was evaluated by biserial rank correlation (rb) and receiver operating characteristic (ROC) analysis with calculation of areas under the curve (AUCs). MB thickness and tunneled coronary segment length were additionally measured and compared between CMRA and CCTA.ResultsBoth CMRA techniques achieved a 97.04% diagnostic rate across coronary segments. Image quality scores (whole-heart=2.27-2.87; volume-targeted=2.37-2.93) showed no significant differences. At the patient level, strong correlations with CCTA were observed for whole-heart (rb = 0.66), volume-targeted (rb = 0.70), and combined CMRA (rb = 0.72) (all <i>P</i> <0.001). At the segment level, correlations remained strong for whole-heart (rb = 0.82), volume-targeted (rb = 0.70), and combined CMRA (rb = 0.82) (all <i>P</i> <0.001). ROC analysis showed comparable diagnostic performance among the three approaches at both LAD level (AUC=0.86, 0.89, 0.91; all <i>P</i> >0.05) and segment level (AUC=0.97, 0.89, 0.95; all <i>P</i> >0.05). No significant differences were observed between CMRA and CCTA in MB thickness or tunneled segment length for either whole-heart or volume-targeted CMRA (all <i>P</i> >0.05).ConclusionWhole-heart and volume-targeted CMRA provide high-quality, non-contrast coronary imaging for MB detection with diagnostic performance comparable to CCTA. The combined approach offers complementary advantages.</p>","PeriodicalId":7143,"journal":{"name":"Acta radiologica","volume":" ","pages":"344-351"},"PeriodicalIF":1.2,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146256935","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prediction of tumor regression grade and identification of prognostic factors using CT and biological features in patients with pancreatic cancer who underwent surgery after neoadjuvant therapy.","authors":"Jeongin Yoo, Sae-Jin Park, Haeryoung Kim, Kyung Bun Lee, Jung Hoon Kim","doi":"10.1177/02841851261424497","DOIUrl":"10.1177/02841851261424497","url":null,"abstract":"<p><p>BackgroundRadiological response of pancreatic ductal adenocarcinoma (PDAC) to neoadjuvant chemoradiation therapy (CRT) is challenging to assess.PurposeTo evaluate whether computed tomography (CT) and biological features can predict tumor regression grade (TRG), recurrence-free survival (RFS), and overall survival (OS) of patients who undergo surgery after CRT for PDAC.Material and MethodsThis retrospective study included 125 patients who underwent surgery after CRT for non-metastatic PDAC between January 2013 and March 2021. Two board-certified radiologists independently reviewed initial and post-CRT CT images and assessed the primary tumor extent and regional lymph node metastasis. Another board-certified radiologist quantitatively assessed the primary tumor on pre- and post-CRT diffusion-weighted and positron emission tomography images. Logistic regression and Cox regression analyses were performed to identify predictors of TRG 0/1, RFS, and OS.ResultsIn total, 44 (35.2%) patients had a TRG of 0/1. The normalized post-CRT carbohydrate antigen (CA) 19-9 level (<37 IU) (odds ratio [OR] = 3.69; <i>P</i> = 0.024) and adjacent organ invasion on post-CRT CT images (OR = 0.24; <i>P</i> = 0.042) were independent predictors of TRG 0/1. During follow-up (mean = 33.6 months), 68 (54.4%) patients experienced tumor recurrence and 65 (52.0%) died. The normalized post-CRT CA 19-9 level (<37 IU) (hazard ratio [HR] = 0.51; <i>P</i> = 0.028) was a significant predictor of RFS, and size change (%) after CRT (HR = 0.24; <i>P</i> = 0.044) was an independent predictor of OS.ConclusionThe normalized post-CRT CA 19-9 level and adjacent organ invasion on post-CRT CT images predicted TRG. The normalized post-CRT CA 19-9 level was associated with RFS, whereas size change was an independent predictor of OS.</p>","PeriodicalId":7143,"journal":{"name":"Acta radiologica","volume":" ","pages":"388-398"},"PeriodicalIF":1.2,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147346912","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Fully automated segmentation of foot bones using machine learning and convolutional neural networks.","authors":"Timo Schmid, Arnaud Klopfenstein, Matthias Mottini, Jonas Gasser, Fabian Krause","doi":"10.1177/02841851261422700","DOIUrl":"10.1177/02841851261422700","url":null,"abstract":"<p><p>BackgroundRecent advancements in medical imaging technology have significantly increased the prevalence of automatic and semi-automatic segmentation techniques for foot bones, offering promising potential for improving diagnostic accuracy and efficiency. However, a critical challenge remains the scarcity of literature on the reliability and validation of these automated systems, underscoring the need for comprehensive studies to ensure their trustworthiness in clinical practice.PurposeTo implement a fully automated foot bone segmentation method processed exclusively using convolutional neuronal networks (CNNs).Material and MethodsFoot bones of 50 computed tomography (CT) scans were manually segmented. Of them, 48 were used to train three CNNs of a customized and optimized three-dimensional (3D) U-Net structure for the segmentation process. The so trained networks were then applied on the remaining two CT scans. The Dice coefficient and the Intersection over Union (IoU) metric were calculated to evaluate the CNN's ability of proper foot bone segmentation.ResultsThe CNN accurately segmented 5,090,689/5,434,749 voxels in the test sets, achieving an overall Dice coefficient of 0.97 and IoU of 0.94. Excellent segmentation results were obtained for the hindfoot, midfoot, hallux, sesamoids, and proximal phalanges, while lower performance was noted for the intermediate and distal phalanges of the lesser toes.ConclusionThe CNN networks demonstrated excellent ability to recognize foot bone structures on CT. Our findings underscore the potential of deep learning models in providing reliable and accurate segmentation of foot bones, paving the way for more widespread clinical adoption.</p>","PeriodicalId":7143,"journal":{"name":"Acta radiologica","volume":" ","pages":"361-367"},"PeriodicalIF":1.2,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147289048","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Breast cancer and liver metastases: an imaging perspective on the potential of resectability.","authors":"Erik Baubeta, Hanna Valind, Oskar Hagberg, Kristina Lång, Anna-Maria Larsson, Bodil Andersson, Hanna Sartor","doi":"10.1177/02841851261420593","DOIUrl":"10.1177/02841851261420593","url":null,"abstract":"<p><p>BackgroundLiver metastases occur in approximately 50% of patients with metastatic breast cancer (MBC). Currently, few patients with breast cancer liver metastases (BCLM) are considered for surgical intervention.PurposeTo estimate the proportion of BCLM patients potentially eligible for targeted liver intervention.Material and MethodsA total of 17,035 women were included (1991-1996) in the prospective Malmö Diet and Cancer Study. Diagnostic liver imaging (performed in 2003-2018) of women within the cohort later diagnosed with breast cancer (BC) was evaluated according to a predefined protocol. A multidisciplinary conference assessed BCLM resectability based on liver imaging and overall metastatic burden. Patients with non-skeletal, extrahepatic BC metastases were considered unresectable. Fisher's exact test and Kruskal-Wallis test were used for statistical comparisons.ResultsAmong 1242 women initially diagnosed with BC, 249 were further diagnosed with MBC of which 57 had liver metastases; of these, 48 had available and assessable images. Based on liver imaging and the overall metastatic burden, 10 (21%) patients had liver metastasis that were considered resectable. No statistically significant differences were found between resectable and unresectable groups in age at primary BC diagnosis, age at BCLM diagnosis, mode of BC detection, or primary BC tumor parameters.ConclusionApproximately one-fifth of BCLM patients in this cohort could potentially have been eligible for targeted intervention of liver metastases. These findings contribute to the limited evidence on BCLM resectability and may inform future treatment strategies.</p>","PeriodicalId":7143,"journal":{"name":"Acta radiologica","volume":" ","pages":"335-343"},"PeriodicalIF":1.2,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146218353","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Incidental cardiovascular calcifications detected on screening CT: prognostic impact over long-term follow-up.","authors":"Jong Eun Lee, Yun-Hyeon Kim","doi":"10.1177/02841851261419832","DOIUrl":"10.1177/02841851261419832","url":null,"abstract":"<p><p>BackgroundThe prognostic significance of incidental cardiovascular calcifications-including coronary artery calcification (CAC), thoracic aortic calcification (TAC), aortic valve calcification (AVC), and mitral annular calcification (MAC)-detected on non-gated, non-contrast low-dose chest computed tomography (LDCT) remains unclear.PurposeTo evaluate the long-term prognostic significance of incidental cardiovascular calcifications detected on screening LDCT.Material and MethodsThis retrospective cohort study included individuals who underwent LDCT at a single health promotion center between 2007 and 2013. A cardiovascular radiologist quantified CAC, TAC, AVC, and MAC using dedicated software. Multivariable Cox proportional hazards regression was used to assess associations with all-cause mortality (ACM) and major adverse cardiovascular events (MACE), defined as revascularization, myocardial infarction, stroke, or cardiovascular death. Incremental prognostic performance was evaluated using Harrell's concordance index (C-index).ResultsAmong the 2434 included individuals (1863 men; median age = 54.2 years), CAC, TAC, AVC, and MAC were identified in 506 (20.8%), 1215 (49.9%), 159 (6.5%), and 49 (2.0%), respectively. The highest TAC category (≥1000) showed the strongest association with ACM (hazard ratio [HR] = 3.11, 95% confidence interval [CI] = 1.57-6.16; <i>P</i> = 0.001). The highest CAC category (≥400) showed the strongest association with MACE (HR = 8.67, 95% CI = 4.46-16.88; <i>P</i> <0.001). However, a combined model incorporating CAC, TAC, AVC, and MAC did not provide significant incremental prognostic value beyond CAC alone for ACM or MACE.ConclusionIncidental TAC was associated with increased long-term risk of ACM, while CAC was associated with MACE. However, their combined incorporation did not provide significant incremental prognostic value.</p>","PeriodicalId":7143,"journal":{"name":"Acta radiologica","volume":" ","pages":"368-378"},"PeriodicalIF":1.2,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147300784","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Percutaneous metallic stent placement for malignant extrahepatic biliary obstruction: single-center experience in 612 patients.","authors":"Jihoon Kim, Dong Il Gwon, Jeongyeon Kim, Eunbyeol Ko, Jin Hyoung Kim, Gi-Young Ko, Hyun-Ki Yoon","doi":"10.1177/02841851261420817","DOIUrl":"10.1177/02841851261420817","url":null,"abstract":"<p><p>BackgroundMalignant extrahepatic biliary obstruction is most commonly caused by pancreatic cancer or cholangiocarcinoma and is frequently diagnosed at an advanced stage. Palliation with percutaneous metallic stent placement is often required, but data on large-scale outcomes remain limited.PurposeTo investigate the technical and clinical outcomes of percutaneous metallic stent placement in patients with malignant extrahepatic biliary obstruction and to examine the factors that influence patient survival and stent patency duration.Material and MethodsBetween January 2007 and December 2020, 612 patients (370 men, 242 women, mean age = 63.6 years; age range = 25-90 years) with malignant extrahepatic biliary obstruction were included in this retrospective study.ResultsPercutaneous metallic stents were successfully placed in all 612 patients. A total of 76 (12%) patients had major (n = 50, 8%) or minor (n = 26, 4%) complications. The percutaneous drainage catheter was successfully removed in 553 (90%) patients. In total, 53 patients were lost to follow-up and seven patients underwent subsequent biliary operation after stent placement. Stent occlusion occurred in 158/493 (32%) patients and median stent patency time was 274 days. Multivariate Cox regression analyses revealed that primary malignancy (<i>P</i> <0.001), stent patency (<i>P</i> <0.001), chemotherapy (<i>P</i> <0.001), and isolated biliary obstruction (<i>P</i> = 0.001) were independently associated with longer survival.ConclusionPercutaneous metallic stent placement is safe and effective in patients with malignant extrahepatic biliary obstruction. In addition, primary malignancy, stent patency, chemotherapy, and isolated biliary obstruction are significantly associated with longer survival within this poor-prognosis cohort.</p>","PeriodicalId":7143,"journal":{"name":"Acta radiologica","volume":" ","pages":"352-360"},"PeriodicalIF":1.2,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147275443","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Subtype-tailored endovascular management of basilar trunk aneurysms: safety, efficacy, and technical insights from a cohort of 33 patients.","authors":"Haibin Chen, Linbo Zhao, Jian Chen, Guosai Zhang, Zhenyu Jia, Haibin Shi, Sheng Liu","doi":"10.1177/02841851261417268","DOIUrl":"10.1177/02841851261417268","url":null,"abstract":"<p><p>BackgroundThe optimal endovascular treatment strategy for basilar artery trunk aneurysms (BATAs) remains a subject of ongoing debate.PurposeTo report the experience of management strategies for different types of BATA, with a focus on safety, efficacy, and mid-term outcomes.Material and MethodsA total of 33 consecutive BATAs (19 dissecting, 9 lateral saccular, 5 fusiform) were retrospectively analyzed. The treatment protocol consisted of overlapping stent-assisted coiling (SAC) for dissecting and ruptured cases, single SAC for lateral saccular aneurysms, and flow diverters (FDs) for most fusiform aneurysms; giant fusiform BATAs were treated with dual Leo-plus stents. The primary outcome measure was the 3-month clinical outcome.ResultsSAC was performed in 30 patients (8 single SAC; 22 overlapping SAC), and FD was used in 3 patients. Immediate occlusion was Raymond class 1 in 14/30 (46.7%), class 2 in 11/30 (36.7%), and class 3 in 5/30 (16.7%) among SAC-treated aneurysms; all FD-treated aneurysms (3/33) were OKM-B immediately. One patient died due to intraprocedural re-rupture of a dissecting aneurysm. Periprocedural ischemic complications occurred in 1 (3.0%) patient. A periprocedural hemorrhagic event occurred in 1/4 ruptured cases (overlapping SAC). One delayed ischemic stroke followed FD (mRS at 3 months = 4). At the 3-month follow-up, 30 patients (90.9%, 95% CI=75.1-97.3) achieved favorable outcomes. DSA follow-up (n = 27) demonstrated complete occlusion in 21 aneurysms (77.8%, 95% CI=59.2-89.4).ConclusionEndovascular treatment of BATAs is technically feasible and encouraging, characterized by high occlusion rates and acceptable morbidity rates. The use of overlapping SAC and judicious FD application may optimize treatment outcomes, especially for complex subtypes.</p>","PeriodicalId":7143,"journal":{"name":"Acta radiologica","volume":" ","pages":"295-303"},"PeriodicalIF":1.2,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146117489","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}