AJNR. American journal of neuroradiology最新文献

{"title":"Erratum.","authors":"","doi":"10.3174/ajnr.A8711","DOIUrl":"10.3174/ajnr.A8711","url":null,"abstract":"","PeriodicalId":93863,"journal":{"name":"AJNR. American journal of neuroradiology","volume":" ","pages":"859"},"PeriodicalIF":0.0,"publicationDate":"2025-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143652639","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Fetal MRI Findings, Etiology, and Outcome in Prenatally Diagnosed Schizencephaly.","authors":"Elizabeth George, Rachel Vassar, Yolanda Yu, Mary E Norton, Dawn Gano, Orit A Glenn","doi":"10.3174/ajnr.A8523","DOIUrl":"10.3174/ajnr.A8523","url":null,"abstract":"<p><strong>Background and purpose: </strong>Schizencephaly is a rare brain anomaly that is increasingly detected in utero. There are limited data on the etiology and outcomes in fetal schizencephaly to guide work-up and counseling. We aimed to determine the associated imaging findings, etiology, and outcomes in schizencephaly detected in utero.</p><p><strong>Materials and methods: </strong>This retrospective cohort study included 22 fetuses with a total of 34 schizencephaly defects identified by keyword search of fetal MRI reports from 1996 to 2022 followed by image review. Follow-up fetal and postnatal imaging, when available, was reviewed. Data on demographics, etiology, and outcomes were extracted from the electronic medical record.</p><p><strong>Results: </strong>The schizencephaly defect was open in 28/34, most common in the MCA territory (23/34), and commonly involved the frontal lobe (16/34). Additional intracranial abnormalities were seen in all fetuses, including other cortical malformations (13/22), abnormal posterior fossa (12/22), abnormal corpus callosum (10/20), and intraparenchymal hemorrhage (9/22). The cause of schizencephaly was classified as secondary (as evidenced by intraparenchymal hemorrhage at schizencephaly, monochorionic twin gestation, infection, or maternal/placental risk factor) in 64% (14/22), potentially genetic in 9% (2/22), and unknown in 27% (6/22). Among those liveborn (<i>n</i> = 8), we observed the following outcomes: postnatal death (1/8), tube feeding (1/7), shunted hydrocephalus (1/7), and epilepsy (4/7). Among those older than 1 year of age, cerebral palsy (4/5) and speech delay or intellectual disability (3/5) were common. Cortical malformations remote from schizencephaly were associated with epilepsy (<i>P</i> = .03). On postnatal imaging, open defects were often involuted (8/11), and there were high rates of new/additional findings (4/6).</p><p><strong>Conclusions: </strong>In this cohort, fetal schizencephaly was always associated with additional intracranial abnormalities. In most cases, there was evidence that schizencephaly was likely secondary to prior injury. Imaging characteristics may provide clues regarding neurodevelopmental outcome. Postnatal imaging is crucial in assessing the evolution as well as detection of additional abnormalities.</p>","PeriodicalId":93863,"journal":{"name":"AJNR. American journal of neuroradiology","volume":" ","pages":"800-807"},"PeriodicalIF":0.0,"publicationDate":"2025-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142376414","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Diagnostic Value of PET Tracers in Differentiating Glioma Tumor Recurrence from Treatment-Related Changes: A Systematic Review and Meta-Analysis.","authors":"Chenchen Zhou, Yunpeng Kou, Wenqian Zhou, Wenjian Zhao, Zhicheng Fan, Yang Jiao, Yulong Zhai, Jinghui Liu, Shaochun Guo, Peigang Ji, Liang Wang","doi":"10.3174/ajnr.A8565","DOIUrl":"10.3174/ajnr.A8565","url":null,"abstract":"<p><strong>Background: </strong>It is often difficult to identify treatment-related changes (TRC) from tumor progression (TP) in patients with glioma, and the current application of PET scanning is expected to improve the diagnosis.</p><p><strong>Purpose: </strong>We used a systematic review and meta-analysis to reveal diagnostically more promising tracers by comparing the diagnostic accuracy of different PET tracers in identifying TRC and TP in patients with glioma.</p><p><strong>Data sources: </strong>We searched PubMed, Web of Science, and EMBASE databases, and we selected studies that used PET scans to identify TP and TRC in patients with glioma.</p><p><strong>Study selection: </strong>Twenty-eight studies were identified based on the set criteria. The studies involved a total of 10 different tracers and 1405 patients. TP occurred in 67.4% (947) of patients, while TRC occurred in 32.6% (458) of patients.</p><p><strong>Data analysis: </strong>The sensitivity, specificity, diagnostic odds ratio, positive likelihood ratio, and negative likelihood ratio of various PET tracers were calculated and summarized. Moreover, the diagnostic value of various tracers was compared.</p><p><strong>Data synthesis: </strong>This systematic review included 28 studies comparing 10 different PET tracers, including ¹⁸F-fluoro-deoxy-glucose FDG (¹⁸F-FDG), ¹¹C methionine (¹¹C -MET), ¹⁸F-fuoroethyl-L-tyrosine (¹⁸F-FET), 3,4-dihydroxy-6-18F-fluoro-L-phenylalanine (¹⁸F-FDOPA), ¹⁸F-fluorothymidine (¹⁸F-FLT), ¹⁸F-PSMA-1007, ⁶⁸Ga-PSMA-11, ¹⁸F-choline (¹⁸F-CHO), ¹⁸F-fluciclovine, and [¹¹]C-Alpha-Methyl-Tryptophan(¹¹C-AMT). The results revealed that ¹¹C-MET exhibited the highest diagnostic value, with an overall sensitivity and specificity of 0.89 [0.85, 0.93] and 0.91 [0.84, 0.99], respectively. Although the number of ¹⁸F-FDOPA studies is limited, it exhibited high diagnostic value, with an overall sensitivity and specificity of 1.00 [0.91, 1.00] and 0.92 [0.75, 0.99], respectively.</p><p><strong>Limitations: </strong>Most studies consisted of small sample sizes; however, the included studies differed to some extent regarding the reference standard for the final diagnosis and the standard of care. Additionally, most selected studies were retrospective.</p><p><strong>Conclusions: </strong>Amino acid-based tracers exhibited the highest diagnostic value in identifying TRC and TP in gliomas, with ¹¹C-MET and ¹⁸F-FDOPA having the most notable advantages. Research on other new tracers is limited, therefore, further studies are needed to prove their diagnostic value.</p>","PeriodicalId":93863,"journal":{"name":"AJNR. American journal of neuroradiology","volume":"46 4","pages":"758-765"},"PeriodicalIF":0.0,"publicationDate":"2025-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143775112","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Synthetic MRI in Progressive MS: Associations with Disability.","authors":"N Braga, F X Aymerich, J Alonso, N Mongay-Ochoa, D Pareto, X Montalban, A Vidal-Jordana, J Sastre-Garriga, À Rovira","doi":"10.3174/ajnr.A8605","DOIUrl":"10.3174/ajnr.A8605","url":null,"abstract":"<p><strong>Background and purpose: </strong>Synthetic MRI (SyMRI) is a short-time acquisition sequence that generates different contrast-weighted images based on the measurement of tissue properties and provides quantitative volumetric, relaxation, and myelin maps. It has been used as an alternative to conventional MRI sequences in relapsing-remitting MS for detecting focal lesions and volumetric analysis. This study aimed to find an SyMRI variable associated with an Expanded Disability Status Scale (EDSS) ≥ 6 in progressive patients.</p><p><strong>Materials and methods: </strong>Twenty-four patients with progressive MS underwent SyMRI with a 2D axial QRAPMASTER pulse sequence. We analyzed volumetric parameters, global myelin fraction (MyCF), and quantitative values derived from maps of proton density, R1, R2, and myelin for the masks: normal-appearing white and gray matter, lesion, and corpus callosum. A <i>t</i> test compared SyMRI variables between groups, followed by univariate binary logistic regression for significant (<i>P</i> < .05) or trending results (<i>P</i> < .09).</p><p><strong>Results: </strong>Patients were categorized into 2 groups (EDSS < 6 versus ≥ 6). Variables with significant differences between groups were: brain parenchymal fraction (<i>P</i> = .05), white matter fraction (<i>P</i> = .05), MyCF (<i>P</i> = .04), and corpus callosum volume (<i>P</i> = .04). In the binary logistic regression analysis, the best predictor of the EDSS category was MyCF, with a <i>P</i> value of .08, and an OR of 0.59.</p><p><strong>Conclusions: </strong>Our results confirm differences in volumetric parameters by EDSS by using a single MRI acquisition. Additionally, higher MyCF values were associated with lower disability, highlighting SyMRI and myelin quantification as potential tools for clinical practice.</p>","PeriodicalId":93863,"journal":{"name":"AJNR. American journal of neuroradiology","volume":"46 4","pages":"847-851"},"PeriodicalIF":0.0,"publicationDate":"2025-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143775123","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparison of Diffusion-Weighted MRI Using Single-Shot Echo-Planar Imaging and Split Acquisition of Fast Spin-Echo Signal Imaging, a Non-EPI Technique, in Tumors of the Head and Neck.","authors":"Hedda J van der Hulst, Loes Braun, Bram Westerink, Georgios Agrotis, Leon C Ter Beek, Renaud Tissier, Milad Ahmadian, Roland M Martens, Jan W Casselman, Regina G H Beets-Tan, Michiel W M van den Brekel, Jonas A Castelijns","doi":"10.3174/ajnr.A8529","DOIUrl":"10.3174/ajnr.A8529","url":null,"abstract":"<p><strong>Background and purpose: </strong>DWI using single-shot echo-planar imaging (DWI-EPI) is susceptible to distortions around air-filled cavities and dental fillings, typical for the head and neck area. Non-EPI, split acquisition of fast spin-echo signals for diffusion imaging (DW-SPLICE) could reduce these distortions and enhance image quality, thereby potentially improving recurrence assessment in squamous cell carcinoma (SCC) of the head and neck region. This study evaluated whether DW-SPLICE is a viable alternative to DWI-EPI through quantitative and qualitative analyses.</p><p><strong>Materials and methods: </strong>The DW-SPLICE sequence was incorporated into the standard 3T head and neck MRI protocol with DWI-EPI. Retrospective analysis was conducted on 2 subgroups: first benign or malignant lesions, and second, posttreatment SCC recurrence. In both subgroups, image quality and distortion were scored by 2 independent radiologists, blinded to the DWI technique and evaluated using mixed-effect linear models. Lesion ADC values were assessed with interclass correlation and Bland-Altman analyses. The delineation geometric similarity of DWI to T1-weighted postcontrast MRI was evaluated using the DSC before and after registration. Recurrence in posttreatment SCC scans was evaluated by the same 2 radiologists blinded to the DWI technique. Recurrence detection rates were then compared between DW-SPLICE and DWI-EPI using mixed logistic regression at 6 months and 1 year postscan follow-up data.</p><p><strong>Results: </strong>From August 2020 to January 2022, fifty-five benign or malignant lesion scans (55 patients) and 74 posttreatment SCC scans (66 patients) were analyzed. DW-SPLICE scored better on image quality and showed less overall distortion than DWI-EPI (0.04<<i>P</i> < .001). There was high ADC measurement reliability (intraclsss correlation coefficient = 0.93, <i>P</i> < .001), though a proportional bias was also observed (β = 0.11, <i>P</i> = .03), indicating that the bias increases as ADC values increase. DW-SPLICE exhibited greater geometric similarity to T1WI with gadolinium contrast before registration (DSC 0.63 versus 0.47, <i>P</i> < .001) and outperformed DWI-EPI by more accurately identifying recurrences after 1 year (OR  = 0.96, <i>P</i> = .05) but not after 6 months (OR  = 0.72, <i>P</i> = .13).</p><p><strong>Conclusions: </strong>DW-SPLICE surpasses DWI-EPI on image distortion and quality and improves diagnostic reliability for detecting recurrent or residual SCC on 3T MRI of the head and neck. Consistent use of 1 method for follow-up is advised, because ADC values are not completely interchangeable. Integrating DW-SPLICE can significantly improve tumor assessments in clinical practice.</p>","PeriodicalId":93863,"journal":{"name":"AJNR. American journal of neuroradiology","volume":" ","pages":"774-783"},"PeriodicalIF":0.0,"publicationDate":"2025-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142395917","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Data-Driven Prognostication in Distal Medium Vessel Occlusions Using Explainable Machine Learning.","authors":"Mert Karabacak, Burak Berksu Ozkara, Tobias D Faizy, Trevor Hardigan, Jeremy J Heit, Dhairya A Lakhani, Konstantinos Margetis, J Mocco, Kambiz Nael, Max Wintermark, Vivek S Yedavalli","doi":"10.3174/ajnr.A8547","DOIUrl":"10.3174/ajnr.A8547","url":null,"abstract":"<p><strong>Background and purpose: </strong>Distal medium vessel occlusions (DMVOs) are estimated to cause acute ischemic stroke in 25%-40% of cases. Prognostic models can inform patient counseling and research by enabling outcome predictions. However, models designed specifically for DMVOs are lacking.</p><p><strong>Materials and methods: </strong>This retrospective study developed a machine learning model to predict 90-day unfavorable outcome (defined as an mRS score of 3-6) in 164 patients with primary DMVO. A model developed with the TabPFN algorithm used selected clinical, laboratory, imaging, and treatment data with the least absolute shrinkage and selection operator feature selection. Performance was evaluated via 5-repeat 5-fold cross-validation. Model discrimination and calibration were evaluated. SHapley Additive Explanations (SHAP) identified influential features. A Web application deployed the model for individualized predictions.</p><p><strong>Results: </strong>The model achieved an area under the receiver operating characteristic curve of 0.815 (95% CI, 0.79-0.841) for predicting unfavorable outcome, demonstrating good discrimination, and a Brier score of 0.19 (95% CI, 0.177-0.202), demonstrating good calibration. SHAP analysis ranked admission NIHSS score, premorbid mRS, type of thrombectomy, modified TICI score, and history of malignancy as top predictors. The Web application enables individualized prognostication.</p><p><strong>Conclusions: </strong>Our machine learning model demonstrated good discrimination and calibration for predicting 90-day unfavorable outcomes in primary DMVO strokes. This study demonstrates the potential for personalized prognostic counseling and research to support precision medicine in stroke care and recovery.</p>","PeriodicalId":93863,"journal":{"name":"AJNR. American journal of neuroradiology","volume":" ","pages":"725-732"},"PeriodicalIF":0.0,"publicationDate":"2025-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142514457","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evidence of Small Vessel Disease in Patients with Transient Global Amnesia Based on the Peak Width of Skeletonized Mean Diffusivity.","authors":"Dong Ah Lee, Ho-Joon Lee, Kang Min Park","doi":"10.3174/ajnr.A8530","DOIUrl":"10.3174/ajnr.A8530","url":null,"abstract":"<p><strong>Background and purpose: </strong>The peak width of skeletonized mean diffusivity (PSMD) is a novel marker of small vessel disease. In this study, we aimed to investigate the presence of small vessel disease in patients with transient global amnesia (TGA) by using the PSMD.</p><p><strong>Materials and methods: </strong>We enrolled 75 patients newly diagnosed with TGA and included 65 age- and sex-matched healthy controls. DTI was performed by using a 3T MR imaging scanner. We measured the PSMD based on DTI by using the FSL program. This measure was compared between patients with TGA and healthy controls. Additionally, we conducted a correlation analysis to explore the relationship between PSMD and clinical factors.</p><p><strong>Results: </strong>A significant difference in the PSMD between patients with TGA and healthy controls was observed. Patients with TGA exhibited higher a PSMD compared with healthy controls (2.297 ± 0.232 versus 2.188 ± 0.216 × 10^-4 mm²/s, <i>P</i> = .005). Additionally, patients with TGA but without any vascular risk factors, such as diabetes, hypertension, or dyslipidemia, also exhibited higher a PSMD compared with healthy controls (2.278 ± 0.253 versus 2.188 ± 0.216 × 10^-4 mm²/s, <i>P</i> = .036). The PSMD positively correlated with age (<i>r</i> = 0.248, <i>P</i> = .032); however, it was not associated with duration of amnesia.</p><p><strong>Conclusions: </strong>This finding underscores the feasibility of using PSMD as a marker for detecting small vessel diseases in patients with neurologic disorders. Furthermore, our study also implies the presence of small vessel disease may be present in patients with TGA.</p>","PeriodicalId":93863,"journal":{"name":"AJNR. American journal of neuroradiology","volume":" ","pages":"675-680"},"PeriodicalIF":0.0,"publicationDate":"2025-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142395918","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Subacute Stent Deformities as an Underlying Reason for Vessel Stenosis after Flow Diversion with the p64 Stent: Review and Discussion of Biologic Mechanisms and Consequences.","authors":"G Vladev, A Sirakov, S Matanov, K Sirakova, K Ninov, S Sirakov","doi":"10.3174/ajnr.A8564","DOIUrl":"10.3174/ajnr.A8564","url":null,"abstract":"<p><strong>Background and purpose: </strong>Flow-diverter stents are a potent and efficient tool in the instrumentarium of neurointerventional radiologists for the treatment of intracranial aneurysms. With their implementation, some adverse effects and complications such as hemorrhagic and ischemic ones, have been seen as a potential downfall of the method. In-stent stenosis is one such complication, which until now has not received enormous attention due to its seemingly benign characteristic. In our study we propose a different point of view on this matter and aim to establish a potential mechanism for its development: a subacute postprocedural stent deformation, due to segmental vessel constriction as a reaction to the implant.</p><p><strong>Materials and methods: </strong>We enrolled 48 patients between the ages of 31 and 71 (8 men) with aneurysms on the distal portions of the ICA, all of whom were treated with the p64 flow-diverter stent, to assess the incidence of this phenomenon, as well as establish a correlation between it and subsequent clinical symptoms. A protocol for short-term follow-up, consisting only of a high-dose fluoroscopy image of the implant (conducted on the 14th postprocedural day) was implemented to assess the state of the implant before endothelization was to be expected.</p><p><strong>Results: </strong>Stent deformities were seen in 58% of cases. One patient with an observed stent deformity presented with several episodes of acute contralateral 1-sided weakness of the limbs. Seventy-one percent of those patients presented with a mild/moderate unilateral headache postprocedurally. A correlation between the deformity and a subsequent narrowing of the parent vessel diameter was established on follow-ups. Notable in-stent stenosis was reported in 35% of all cases.</p><p><strong>Conclusions: </strong>Cases with subacute stent deformities are presented in a nonnegligible percent of flow-diversion therapies with the p64 stent. A statistically significant association between the observed deformation and subsequent in-stent stenosis was observed on follow-up.</p>","PeriodicalId":93863,"journal":{"name":"AJNR. American journal of neuroradiology","volume":" ","pages":"712-719"},"PeriodicalIF":0.0,"publicationDate":"2025-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143672036","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Embolization of Ruptured and Unruptured Aneurysms with the Contour Neurovascular System-Summary of 106 Cases.","authors":"Fritz Wodarg, Fernando Bueno Neves, Friederike Gärtner, Naomi Larsen, Sönke Peters, Johannes Hensler, Tristan Klintz, Justus Mahnke, Hajrullah Ahmeti, Alexander Doukas, Olav Jansen, Karim Mostafa","doi":"10.3174/ajnr.A8606","DOIUrl":"10.3174/ajnr.A8606","url":null,"abstract":"<p><strong>Background and purpose: </strong>Aneurysmal disease of the intracranial vasculature poses a relevant threat, warranting effective interventions. Minimally invasive interventional techniques for aneurysm treatment have evolved to the application of flow-diversion stents and devices. This study focuses on the Contour Neurovascular System (CNS), aiming to add knowledge regarding its mid- to long-term outcomes in treating wide-necked intracranial aneurysms.</p><p><strong>Materials and methods: </strong>Conducted in accordance with STROBE guidelines, this study retrospectively evaluated all patients with intracranial aneurysms treated with CNS embolization. Demographic and interventional data were collected retrospectively, including aneurysm characteristics, procedural details, and angiographic follow-up evaluations up to 24 months after CNS implantation.</p><p><strong>Results: </strong>A total of 106 patients with 109 aneurysms were included in this study, whereby 72 patients were treated for an incidental aneurysm, while 34 patients presented with subarachnoid hemorrhage. Implantation was successful in 95.5% of patients. Occlusion rates were as follows: 6 months (69/106, 65.1%): Raymond-Roy-Scale (RRS) 1 44/69 (63.4%), RRS 2 16/69 (23.1%), RRS 3a 4/69 (5.8%), RRS 3b 5/69 (7.2%); 12 months (44/106, 41.5%): RRS 1 24/44 (55.5%), RRS 2 12/44 (27.3%), RRS 3a 4/44 (9.0%), RRS 3b 4/44 (9.0%); 24 months (30/106, 28.3%): RRS 1 21/30 (70.0%), RRS 2 8/30 (26.7%), RRS 3b 1/30 (3.3%). Periprocedural complications: Overall 8/106 (7.5%); elective cases 4/72 (5.5%); aneurysm rupture 4/34 (11.7%). Adjunctive devices were used in 13/106 cases (12.2%).</p><p><strong>Conclusions: </strong>The present work reports the long-term angiographic and clinical follow-up results of a single-center cohort of 106 patients with intracranial aneurysms treated with the CNS. The CNS demonstrated a high rate of successful implantation and promising mid- and long-term stability, with a low reintervention rate beyond 24 months in patients exhibiting early occlusion at 6 months. While acknowledging the limitations, these findings contribute valuable information about the safety and efficacy of the CNS, and warrant continued exploration in larger, prospective studies to validate its role in aneurysm treatment.</p>","PeriodicalId":93863,"journal":{"name":"AJNR. American journal of neuroradiology","volume":" ","pages":"698-705"},"PeriodicalIF":0.0,"publicationDate":"2025-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143733547","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Photon-Counting CT Myelography for the Detection of Spinal CSF Leaks.","authors":"Ajay A Madhavan, Peter G Kranz, Waleed Brinjikji, Ian T Mark, Timothy J Amrhein","doi":"10.3174/ajnr.A8736","DOIUrl":"10.3174/ajnr.A8736","url":null,"abstract":"<p><p>Photon-counting CT myelography is a relatively recently described technique for the detection of spinal CSF leaks in patients with spontaneous intracranial hypotension.^1-3 In this Video, we outline the fundamental procedural techniques used in CT myelography for CSF leak detection, as well as specific advantages and reconstruction options available when using photon-counting CT.^4-7 Additionally, we show examples demonstrating the typical appearance of common spinal CSF leaks detected on photon-counting CT myelography, which mainly include dural tears and CSF-venous fistulas.⁸ This Video draws on technical insights gleaned from a multi-institutional perspective, while specific techniques continue to vary at different centers. Future refinement of photon-counting CT myelographic techniques at multiple centers will be helpful to maximally leverage this nascent technology.</p>","PeriodicalId":93863,"journal":{"name":"AJNR. American journal of neuroradiology","volume":"46 4","pages":"846"},"PeriodicalIF":0.0,"publicationDate":"2025-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143775122","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}