AJNR. American journal of neuroradiology最新文献

{"title":"Concordance between Centiloid Quantification and Visual Interpretation of Amyloid PET Scans across the Alzheimer Disease Continuum.","authors":"Mohammad Khalafi, Seyed Hani Hojjati, Xiuyuan Hugh Wang, Liangdong Zhou, Anna Starikovsky Nordvig, Yi Li, Tracy A Butler, Qolamreza R Razlighi, Emily B Tanzi, Silky Pahlajani, Lidia Glodzik, Nancy S Foldi, Mony J de Leon, Gloria C Chiang","doi":"10.3174/ajnr.A8743","DOIUrl":"10.3174/ajnr.A8743","url":null,"abstract":"<p><strong>Background and purpose: </strong>Accurate identification of cerebral β-amyloid (Aβ) accumulation is crucial for diagnosing Alzheimer disease (AD) and determining eligibility for anti-Aβ therapies. The Centiloid (CL) scale has emerged as a standardized method to harmonize Aβ PET quantification across different tracers and sites. We aimed to evaluate the concordance between CL quantification and visual interpretation in a cohort of cognitively impaired (CI) and unimpaired (CU) participants who underwent Aβ PET.</p><p><strong>Materials and methods: </strong>Two hundred twenty-one participants (mean age 69 ± 12.3 years) were prospectively enrolled in AD studies and underwent 247 Aβ PET scans, including 157 with [¹¹C]-Pittsburgh compound B (PiB) and 90 with [¹⁸F]-florbetaben (FBB). Standardized uptake value ratios (SUVRs) were converted to the CL scale following Global Alzheimer's Association Interactive Network guidelines. Percent agreement and κ statistics were used to evaluate the concordance between CL thresholds and visual interpretation in determining Aβ positivity.</p><p><strong>Results: </strong>The highest concordance rate for the whole cohort was 93% by using a CL cutoff of 18 (κ coefficient 0.84). Using FBB, the concordance rate was highest by using a CL cutoff of 24 (97%), whereas the concordance rate for PiB peaked at 94% at a CL cutoff of 18. Concordance was higher in negative rather than positive Aβ PET cases, 98% versus 90%. Concordance was slightly higher in CI participants compared with CU (96% versus 93%). Disagreement commonly occurred when focal areas of Aβ positivity were identified on visual interpretation but did not meet the threshold globally by CL quantification.</p><p><strong>Conclusions: </strong>Global CL quantification of Aβ PET scans is highly concordant with visual interpretation. Combining both methods may provide a more complete assessment of the extent of Aβ deposition in the brain.</p>","PeriodicalId":93863,"journal":{"name":"AJNR. American journal of neuroradiology","volume":" ","pages":"1884-1892"},"PeriodicalIF":0.0,"publicationDate":"2025-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12453481/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143659898","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"In Plain Sight, a Radiology Workforce Crisis in the Making: Gap between Job Growth and the Radiology Training Pipeline.","authors":"James Y Chen, Karen C Chen, Karen Buch, Mari Hagiwara, Frank J Lexa","doi":"10.3174/ajnr.A8764","DOIUrl":"10.3174/ajnr.A8764","url":null,"abstract":"<p><strong>Background and purpose: </strong>This study aims to analyze the gap between the number of radiologist jobs listed in a single major US job posting center and the number of anticipated graduating general diagnostic radiology and neuroradiology trainees through the National Resident Matching Program (NRMP) as a primary source of radiologists to fulfill radiologist workforce needs.</p><p><strong>Materials and methods: </strong>Job listings between 2014 and 2023 from a single large US radiology job listing source were collected for the total number of unique annual job listings, divided amongst neuroradiology-only, some component of neuroradiology, and no component of neuroradiology. NRMP data were collected for postgraduate year-2 (PGY-2) Diagnostic Radiology Residency and Neuroradiology Fellowship Match to estimate the number of general radiologists and neuroradiologists in the training pipeline graduating in the corresponding job listing year. The difference between the number of job listings and anticipated graduating trainees was calculated and extrapolated for the future.</p><p><strong>Results: </strong>Between 2014 and 2023, 31,825 jobs were listed in the American College of Radiology Career Center with 10,180 anticipated diagnostic radiology residency graduates during the same time period, for a 10-year cumulative deficit of 21,645 anticipated diagnostic radiology graduates. For neuroradiology-only jobs, the mismatch between job listings and anticipated fellowship-trained neuroradiologists was 2748 jobs to 1933 graduates. For all jobs, the mismatch between anticipated radiology training graduates and job listings grew over this time period.</p><p><strong>Conclusions: </strong>There is a growing mismatch between diagnostic radiology job listings on a major job listing board compared with the anticipated pipeline of general radiologists and neuroradiologists entering training through the NRMP. This mismatch between the current growing need for radiologists and the training pipeline may help inform practice and training leaders seeking to mitigate the radiologist shortage.</p>","PeriodicalId":93863,"journal":{"name":"AJNR. American journal of neuroradiology","volume":" ","pages":"1769-1775"},"PeriodicalIF":0.0,"publicationDate":"2025-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12453458/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143805097","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Delineation of the Centromedian Nucleus for Epilepsy Neuromodulation Using Deep Learning Reconstruction of White Matter-Nulled Imaging.","authors":"Megan V Ryan, David Satzer, Houchun Hu, Daniel V Litwiller, Dan W Rettmann, Jody Tanabe, John A Thompson, Steven G Ojemann, Daniel R Kramer","doi":"10.3174/ajnr.A8766","DOIUrl":"10.3174/ajnr.A8766","url":null,"abstract":"<p><strong>Background and purpose: </strong>Neuromodulation of the centromedian nucleus (CM) of the thalamus has shown promise in treating refractory epilepsy, particularly for idiopathic generalized epilepsy and Lennox-Gastaut syndrome. However, precise targeting of CM remains challenging. The combination of deep learning reconstruction (DLR) and fast gray matter acquisition T1 inversion recovery (FGATIR) offers potential improvements in visualization of CM for deep brain stimulation (DBS) targeting. The goal of the study was to evaluate the visualization of the putative CM on DLR-FGATIR and its alignment with atlas-defined CM boundaries, with the aim of facilitating direct targeting of CM for neuromodulation.</p><p><strong>Materials and methods: </strong>This retrospective study included 12 patients with drug-resistant epilepsy treated with thalamic neuromodulation by using DLR-FGATIR for direct targeting. Postcontrast-T1-weighted MRI, DLR-FGATIR, and postoperative CT were coregistered and normalized into Montreal Neurological Institute (MNI) space and compared with the Morel histologic atlas. Contrast-to-noise ratios were measured between CM and neighboring nuclei. CM segmentations were compared between an experienced rater, a trainee rater, the Morel atlas, and the Thalamus Optimized Multi Atlas Segmentation (THOMAS) atlas (derived from expert segmentation of high-field MRI) by using the Sorenson-Dice coefficient (Dice score, a measure of overlap) and volume ratios. The number of electrode contacts within the Morel atlas CM was assessed.</p><p><strong>Results: </strong>On DLR-FGATIR, CM was visible as an ovoid hypointensity in the intralaminar thalamus. Contrast-to-noise ratios were highest (<i>P</i> < .001) for the mediodorsal and medial pulvinar nuclei. Dice score with the Morel atlas CM was higher (median 0.49, interquartile range 0.40-0.58) for the experienced rater (<i>P</i> < .001) than the trainee rater (0.32, 0.19-0.46) and no different (<i>P</i> = .32) than the THOMAS atlas CM (0.56, 0.55-0.58). Both raters and the THOMAS atlas tended to under-segment the lateral portion of the Morel atlas CM, reflected by smaller segmentation volumes (<i>P</i> < .001). All electrodes targeting CM based on DLR-FGATIR traversed the Morel atlas CM.</p><p><strong>Conclusions: </strong>DLR-FGATIR permitted visualization and delineation of CM commensurate with a group atlas derived from high-field MRI. This technique provided reliable guidance for accurate electrode placement within CM, highlighting its potential use for direct targeting.</p>","PeriodicalId":93863,"journal":{"name":"AJNR. American journal of neuroradiology","volume":" ","pages":"1868-1874"},"PeriodicalIF":0.0,"publicationDate":"2025-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12453462/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144857157","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Erratum.","authors":"","doi":"10.3174/ajnr.A8941","DOIUrl":"10.3174/ajnr.A8941","url":null,"abstract":"","PeriodicalId":93863,"journal":{"name":"AJNR. American journal of neuroradiology","volume":" ","pages":"1965"},"PeriodicalIF":0.0,"publicationDate":"2025-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12453485/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144857158","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Efficacy of the Basilar Artery on Computed Tomography Angiography Score in Predicting Functional Outcomes after Thrombectomy for Basilar Arterial Occlusion: A Frequentist and Bayesian Meta-Analysis.","authors":"Ho-Chang Huang, Hui-An Lin, Jyun-Jhe Wang, Sheng-Feng Lin","doi":"10.3174/ajnr.A8706","DOIUrl":"10.3174/ajnr.A8706","url":null,"abstract":"<p><strong>Background: </strong>The Basilar Artery on Computed Tomography Angiography (BATMAN) score is a 10-point grading system assessing arterial opacification and thrombus burden in the posterior circulation. It predicts outcomes in endovascular thrombectomy, with lower scores reflecting poor opacification.</p><p><strong>Purpose: </strong>This systematic review and meta-analysis evaluated the efficacy of the BATMAN score in predicting 90-day functional outcomes after thrombectomy.</p><p><strong>Data sources: </strong>We systematically searched PubMed, EMBASE, Scopus, and Cochrane Library and adhered to Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines for relevant English and Chinese articles published between January 1, 2017, and December 1, 2024.</p><p><strong>Study selection: </strong>The inclusion criteria were as follows: including patients who had undergone endovascular therapy (EVT) for posterior circulation acute ischemic stroke; assessing the BATMAN score through angiographic examinations, such as CTA, DSA, and MRA before EVT; and assessing functional outcomes on day 90 by using the mRS. We excluded duplicate articles, conference summaries, review articles, articles lacking original data, and articles for which the full text was unavailable.</p><p><strong>Data analysis: </strong>We determined the standardized mean difference in BATMAN scores between patients with favorable and unfavorable outcomes. Binormal receiver operating characteristic curve analysis determined the BATMAN score's diagnostic performance and the optimal threshold. The Bayesian approach validated the mean between-group difference in the BATMAN scores.</p><p><strong>Data synthesis: </strong>A higher BATMAN score was significantly associated with a favorable functional outcome (standardized mean difference in Cohen <i>d</i>: 0.82; 95% CI: 0.56-1.08). Binormal receiver operating characteristic curve analysis revealed an optimal BATMAN score threshold of ≥6, indicating a sensitivity of 76.1%, a specificity of 52.0%, and an area under the curve value of 0.71 (95% CI: 0.69-0.73). The Bayesian estimate of the mean between-group difference in BATMAN score was 1.52 (95% highest posterior attenuation: 1.41-1.62).</p><p><strong>Limitations: </strong>All of the included studies were observational in design and varied in terms of sample size. Nonetheless, our comprehensive statistical approach, with both frequentist and Bayesian approaches, might have overcome the limitations associated with sample size discrepancies.</p><p><strong>Conclusions: </strong>Our findings suggest the BATMAN score of ≥6 predicts post-thrombectomy favorable functional outcomes in patients with posterior circulation acute ischemic stroke.</p>","PeriodicalId":93863,"journal":{"name":"AJNR. American journal of neuroradiology","volume":" ","pages":"1805-1813"},"PeriodicalIF":0.0,"publicationDate":"2025-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12453479/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143460635","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"ASNR International Collaboration Committee's Anne Osborn International Outreach Program: Tools and Barriers, Lessons Learned.","authors":"Noushin Yahyavi-Firouz-Abadi, Bruno A Policeni, Amy F Juliano","doi":"10.3174/ajnr.A8762","DOIUrl":"10.3174/ajnr.A8762","url":null,"abstract":"<p><p>The Anne Osborn International Outreach Professor Program, founded by the American Society of Neuroradiology (ASNR), is dedicated to advancing global neuroradiology education through meaningful collaboration and engagement. This review integrates findings from surveys of host countries and participating professors to evaluate the program's impact, strengths, and areas for improvement. Host countries praised the program's high educational value and interactive teaching formats, while professors highlighted the opportunity to make meaningful contributions. Survey data identified logistical challenges, resource limitations, and the need for longer-lasting collaboration. Recommendations include enhancing program continuity, expanding outreach, and addressing infrastructure variability for sustained global impact.</p>","PeriodicalId":93863,"journal":{"name":"AJNR. American journal of neuroradiology","volume":" ","pages":"1765-1768"},"PeriodicalIF":0.0,"publicationDate":"2025-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12453456/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144710235","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Enhancing Neuroradiology Procedural Competency in Diagnostic Radiology Residency: Threats and Opportunities.","authors":"Nadja Kadom, Nolan J Kagetsu, Sammy Chu, Ryan K Lee","doi":"10.3174/ajnr.A8947","DOIUrl":"10.3174/ajnr.A8947","url":null,"abstract":"","PeriodicalId":93863,"journal":{"name":"AJNR. American journal of neuroradiology","volume":"46 9","pages":"1747-1748"},"PeriodicalIF":0.0,"publicationDate":"2025-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12453482/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144982160","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Language and Memory Network Alterations in Temporal Lobe Epilepsy: A Functional and Structural Connectivity Study.","authors":"Alireza Fallahi, Mohammad-Reza Nazem-Zadeh, Narges Hoseini-Tabatabaei, Jafar Mehvari Habibabadi, Seyed Sohrab Hashemi Fesharaki, Hamid Soltanian-Zadeh","doi":"10.3174/ajnr.A8737","DOIUrl":"10.3174/ajnr.A8737","url":null,"abstract":"<p><strong>Background and purpose: </strong>This study evaluated preoperative alterations and postoperative reorganization of the joint language-memory network (LMN) from the perspective of resting-state functional and structural connectivity in temporal lobe epilepsy (TLE). Graph theory and machine learning approaches were used to explore automatic lateralization.</p><p><strong>Materials and methods: </strong>Resting-state fMRI and DTI data were obtained from 20 healthy subjects and 35 patients with TLE. Functional and structural connectivity were calculated within the LMN before and after temporal lobectomy. ANOVA was performed to identify significant connectivity differences between groups. Four local graph measures were extracted from functional and structural connectivity matrices. Standard feature selection techniques and genetic algorithm methods were applied to select the optimal features. Subsequently, K-nearest neighbor, support vector machine, Naive Bayes, and logistic regression classification methods were used to classify healthy controls (HC) and presurgical TLE groups, as well as presurgical left TLE (L-TLE) and right TLE (R-TLE) groups. Also, relationships between psychological scores and the selected features were evaluated using a linear regression method.</p><p><strong>Results: </strong>The results demonstrated increased functional and decreased structural connectivity in patients with TLE before surgery. After surgery, significant connections revealed reduced functional connectivity and increased structural connectivity in patients with TLE. Functional analysis identified the left parahippocampal region in L-TLE and the right temporal regions in R-TLE as key areas. Structural connectivity analysis showed that memory-related areas in the bilateral occipital region and the left language-related area were the origins of alterations. The genetic algorithm method achieved the highest classification performance using a support vector machine for fMRI and DTI graph measures, with accuracy rates of 97% and 88% for distinguishing L-TLE from R-TLE, and 93% and 87% for distinguishing patients with TLE from HC, respectively. Moreover, a significant relationship was observed between the best-selected features and memory-assisted cognitive tests.</p><p><strong>Conclusions: </strong>Presurgical functional hyperconnectivity, postsurgical hypoconnectivity, and newly observed bilateral structural connectivity after surgery highlight both functional and structural alterations in the LMN network. Additionally, the study underscores the potential for machine learning for TLE diagnosis and lateralization. A limited sample size, particularly in the postsurgical group, was one of the constraints of this study.</p>","PeriodicalId":93863,"journal":{"name":"AJNR. American journal of neuroradiology","volume":" ","pages":"1953-1962"},"PeriodicalIF":0.0,"publicationDate":"2025-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12453475/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143627146","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of Smoking on Recurrence and Angiographic Outcomes after Endovascular Treatment of Intracranial Aneurysms: A Systematic Review and Meta-Analysis.","authors":"Sherief Ghozy, Seyed Behnam Jazayeri, Alireza Hasanzadeh, Julien Ognard, Hassan Kobeissi, Ali Ahmadzade, Ehsan Naseh, Mobina Motaghian Fard, Alzhraa S Abbas, Rachana R Borkar, David F Kallmes, Ramanathan Kadirvel","doi":"10.3174/ajnr.A8712","DOIUrl":"10.3174/ajnr.A8712","url":null,"abstract":"<p><strong>Background: </strong>Cerebral aneurysm recurrence remains a critical endpoint in evaluating the success of endovascular treatment. While smoking is a recognized risk factor for aneurysm formation and rupture, its impact on post-treatment angiographic outcomes is unclear due to conflicting evidence.</p><p><strong>Purpose: </strong>To systematically assess the association between smoking and angiographic outcomes-including occlusion, recurrence, and retreatment-following endovascular treatment of intracranial aneurysms.</p><p><strong>Data sources: </strong>A comprehensive search of PubMed, Embase, Scopus, and Web of Science was conducted from inception to June 25, 2024. Bibliographies of included studies were also screened.</p><p><strong>Study selection: </strong>Studies were eligible if they involved adult patients with intracranial aneurysms treated via endovascular approaches and reported outcomes stratified by smoking status. Case reports, abstracts, and studies not reporting smoking data were excluded.</p><p><strong>Data analysis: </strong>Risk of bias was assessed using the Newcastle-Ottawa Scale. Random-effects meta-analyses were conducted using generalized linear mixed models to estimate risk ratios (RRs) with 95% confidence intervals (CIs). Subgroup, sensitivity, and meta-regression analyses were also performed.</p><p><strong>Data synthesis: </strong>Twenty-five studies involving 5,828 patients were included. Smokers had a higher rate of complete aneurysm occlusion (RR 1.12, 95% CI 1.06-1.19; <i>P</i> < .01), especially among those undergoing flow diversion (RR 1.14, 95% CI 1.07-1.21; <i>P</i> < .01). No significant differences were found in recurrence/recanalization rates (RR 1.20, 95% CI 0.91-1.60; <i>P</i> = .20) or retreatment rates (RR 0.81, 95% CI 0.58-1.13; <i>P</i> = .22) between smokers and non-smokers. Heterogeneity was moderate to high for some outcomes but reduced after sensitivity analyses.</p><p><strong>Limitations: </strong>Heterogeneity in smoking definitions, variable follow-up durations, reliance on retrospective data, and limited granularity on smoking intensity (eg, pack-years) may affect interpretation. Results are not generalizable to surgical clipping or long-term outcomes.</p><p><strong>Conclusions: </strong>Smoking is associated with increased complete occlusion rates following flow diversion, but does not significantly impact recurrence or retreatment rates. While smoking cessation remains essential for vascular health, its influence on endovascular treatment efficacy may be limited. Standardized reporting and further mechanistic studies are needed to elucidate smoking's role in aneurysm healing.</p>","PeriodicalId":93863,"journal":{"name":"AJNR. American journal of neuroradiology","volume":" ","pages":"1821-1829"},"PeriodicalIF":0.0,"publicationDate":"2025-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12453459/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143473244","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"CSF-Venous Fistula Transvenous Onyx Embolization: Evaluation of Onyx Migration into the CSF and Potential One-Way Physiology.","authors":"Charlotte Michaelcheck, Waleed Brinjikji, Ajay A Madhavan, John C Benson, Jared Verdoorn, Ben Johnson-Tesch, Jeremy Cutsforth-Gregory, Ian T Mark","doi":"10.3174/ajnr.A8746","DOIUrl":"10.3174/ajnr.A8746","url":null,"abstract":"<p><strong>Background and purpose: </strong>CSF-venous fistulas (CVFs) are abnormal connections between the subarachnoid space and a paraspinal vein. Transvenous Onyx embolization is a recently adopted treatment method for CVF closure, however no studies have specifically evaluated for Onyx migration into the CSF. The purpose of our study was to evaluate patients who underwent transvenous CVF embolization for Onyx migration into the CSF.</p><p><strong>Materials and methods: </strong>We evaluated 100 patients who underwent transvenous CVF embolization with posttreatment CT of the spine. Images were reviewed for Onyx migration into the CSF at the level of the embolization as well as distally in the lumbar spine. Basic demographic information including age and sex were recorded.</p><p><strong>Results: </strong>The mean age was 59.2 years (±10.9, 28-88). Sixty-eight patients were women. Forty-eight patients had postembolization imaging of the treated level, and none had Onyx migration into the CSF at the level of the CVF. Thirty-four patients had imaging of the lumbar spine, and none had Onyx migration distally in the lumbar spine.</p><p><strong>Conclusions: </strong>Our study did not find any cases of unintended Onyx migration into the subarachnoid space in patients who underwent transvenous CVF embolization. This speaks to the safety profile of transvenous CVF embolization and suggests possible one-way physiology of CVF that allows for egress from the CSF to the veins only.</p>","PeriodicalId":93863,"journal":{"name":"AJNR. American journal of neuroradiology","volume":" ","pages":"1939-1942"},"PeriodicalIF":0.0,"publicationDate":"2025-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12453486/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144236213","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}