AJNR. American journal of neuroradiology最新文献

{"title":"Correlation between P2-PCA Volume Flow Rate and BOLD Cerebrovascular Reactivity in Patients with Symptomatic Carotid Artery Occlusion.","authors":"Amely Walser, Jorn Fierstra, Lara Maria Höbner, Jacopo Bellomo, Tilman Schubert, Menno Germans, Vittorio Stumpo, Christiaan Hendrik Bas van Niftrik, Susanne Wegener, Andreas R Luft, Zsolt Kulcsár, Luca Regli, Giuseppe Esposito, Martina Sebök","doi":"10.3174/ajnr.A8626","DOIUrl":"10.3174/ajnr.A8626","url":null,"abstract":"<p><strong>Background and purpose: </strong>Identifying and assessing hemodynamic and flow status in patients with symptomatic ICA occlusion is crucial for evaluating recurrent stroke risk. The aim of this study was to analyze the correlation between 2 quantitative imaging modalities: 1) blood oxygenation level-dependent (BOLD) cerebrovascular reactivity (CVR) and 2) quantitative MR angiography (qMRA) with noninvasive optimal vessel analysis (NOVA), measuring volume flow rate (VFR). Comparing these modalities is relevant for assessing collateral circulation and hemodynamic impairment.</p><p><strong>Materials and methods: </strong>In this retrospective analysis of prospectively collected data, 37 symptomatic patients with unilateral ICA occlusion, who underwent both NOVA-qMRA and BOLD-CVR investigation, were included. The correlation analysis between NOVA-qMRA-derived second segment of the posterior cerebral artery (PCA-P2) VFR and BOLD-CVR (hemispheric and MCA territory CVR) was done by using a linear mixed-effects model.</p><p><strong>Results: </strong>A moderate correlation was found between P2-VFR and BOLD-CVR values for the ipsilateral MCA territory (<i>r</i> = 0.44, <i>R²</i> = 0.2, <i>P</i> < .001) and the ipsilateral hemisphere (<i>r</i> = 0.39, <i>R²</i> = 0.15, <i>P</i> < .001), indicating that 20% of the variance in P2-VFR can be explained by the BOLD-CVR of the MCA territory and 15% by the BOLD-CVR of the affected hemisphere.</p><p><strong>Conclusions: </strong>This correlation suggests that impaired BOLD-CVR is partly linked to an increased PCA-P2 volume flow rate, potentially indicating the activation of leptomeningeal collaterals in severe hemodynamic conditions. Both imaging techniques could aid clinicians in creating personalized treatment strategies for patients with symptomatic ICA occlusion.</p>","PeriodicalId":93863,"journal":{"name":"AJNR. American journal of neuroradiology","volume":" ","pages":"1353-1359"},"PeriodicalIF":0.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142856927","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":"Comparing CT-Like Bone Images Based on Fast Field Echo Resembling a CT Using Restricted Echo Spacing (FRACTURE) MR with CT in Pediatric Congenital Vertebral Anomalies.","authors":"Hirva Manek, Foram Gala","doi":"10.3174/ajnr.A8639","DOIUrl":"10.3174/ajnr.A8639","url":null,"abstract":"<p><strong>Background and purpose: </strong>Congenital vertebral anomalies are commonly associated with underlying spinal cord anomaly that necessitates imaging both the spinal cord and the bony vertebral column to understand the extent of the deformity better. While MRI is the standard for spinal cord imaging, it does not provide CT-like bone details. Many MR bone imaging techniques have been tested in various adult spine conditions in the past decade but not much has been described on their reliability in pediatric spine. We elaborate on our experience with fast field echo resembling a CT by using restricted echo spacing (FRACTURE) MR bone imaging in congenital vertebral anomalies in children.</p><p><strong>Materials and methods: </strong>Eleven pediatric patients referred to the imaging department for CT and MR study of congenital vertebral anomaly were prospectively included. After receiving informed consent from these patients' guardians, both studies were performed in a single setting and under a single sedation. FRACTURE MR was accelerated by using the compressed sensitivity encoding (CS) technique to reduce the imaging time. We then compared FRACTURE MR and CT images for image quality and studied parameters such as formation or segmentation anomalies, anomalous shape of vertebrae, and alignment deformities.</p><p><strong>Results: </strong>FRACTURE MR showed acceptable image quality with diagnostically limiting artifacts in only 1 patient. The interreader agreement was perfect in the assessment of vertebral body segmentation or formation anomaly and alignment abnormalities, and it was substantial for posterior element anomalies. The bone signal was lower in children under the age of 3 years due to a more immature and cartilaginous skeleton.</p><p><strong>Conclusions: </strong>FRACTURE MR provides images of acceptable quality in pediatric spinal anomalies. The addition of this novel sequence can be complementary to conventional MR in providing osseous details and CT can be reserved for certain specific indications like postoperative cases. This can help in reducing the radiation dose to this group of pediatric patients who will be serially followed up with imaging during their management.</p>","PeriodicalId":93863,"journal":{"name":"AJNR. American journal of neuroradiology","volume":" ","pages":"1471-1477"},"PeriodicalIF":0.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142901075","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":"CPT Codes for MRI Safety-A User's Guide.","authors":"Colin M Segovis, Jacob W Ormsby, Cindy X Yuan, Matthew J Goette, Melissa M Chen, Heidi A Edmonson","doi":"10.3174/ajnr.A8661","DOIUrl":"10.3174/ajnr.A8661","url":null,"abstract":"<p><p>The magnetic fields of the MR environment present unique safety challenges. Medical implants and retained foreign bodies can prevent patients from undergoing MR imaging due to interactions between the magnetic fields of the MR environment and the implant or foreign body. These hazards can be addressed through careful MR safety screening and MR examination customization, often allowing these patients with implants to undergo management-altering MR imaging. However, mitigating these risks takes additional time, expertise, and effort. Effective in 2025, this additional work is formally acknowledged with a new series of Current Procedural Terminology codes to report the work of assessing and addressing safety concerns associated with implants and foreign bodies in the MR environment. This user guide provides guidance on how to report these codes so physician-led MR safety teams can be appropriately reimbursed for the additional work performed in preparing patients with implants or foreign bodies for MR imaging.</p>","PeriodicalId":93863,"journal":{"name":"AJNR. American journal of neuroradiology","volume":" ","pages":"1289-1291"},"PeriodicalIF":0.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143018006","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":"The Sensitivity of Arterial Spin-Labeling Imaging for Detection of Head and Neck Paragangliomas.","authors":"Yannan Yu, Brian Q Tsui, Christine M Glastonbury, Xin Cynthia Wu","doi":"10.3174/ajnr.A8727","DOIUrl":"10.3174/ajnr.A8727","url":null,"abstract":"<p><strong>Background and purpose: </strong>Head and neck paragangliomas (HNPGs) are rare neuroendocrine tumors whose hypervascular nature allows differentiation from many other head and neck neoplasms. We aimed to investigate the sensitivity of arterial spin-labeling (ASL) MR sequences for the detection of HNPGs.</p><p><strong>Materials and methods: </strong>All head and neck MR examinations performed at a single tertiary institution between 2015 and 2023 were searched. Studies using ASL sequences that indicated either clinical suspicion for or ultimate imaging diagnosis of HNPG were identified. These studies were independently reviewed by 2 neuroradiologists blinded to the original radiology reports to determine, in a stepwise fashion, the following: 1) whether there was asymmetrically elevated blood flow on ASL imaging, 2) whether ASL findings correlated with lesions identifiable on conventional anatomic images, and 3) whether lesions likely reflected paragangliomas on the basis of correlations with clinical, laboratory, pathology, and other radiology data (Disagreement between raters was resolved by consensus.). The Cohen κ coefficient and the sensitivity of ASL in identifying HNPGs were calculated.</p><p><strong>Results: </strong>Eighty-four patients were included in the analysis (mean age, 54 [SD, 14] years and 47 women). Thirty patients had lesions confirmed or found likely to be HNPG, and 54 patients had lesions found unlikely to be HNPG or had no identifiable lesion. Among 46 of 84 patients with ASL blood flow asymmetry, 43 (93%) had lesions correlated with a lesion identifiable on anatomic imaging. Asymmetrically elevated ASL blood flow that correlated with a lesion demonstrated a sensitivity of 100% for reader A and 97% for reader B for identifying HNPG. The Cohen κ coefficient was 0.90 (SD, 0.11) between the 2 readers (<i>P</i> < .001). Among 18 cases with pathology- or dotatate PET-proved HNPG, the sensitivity was 100% for reader A and 94% for reader B.</p><p><strong>Conclusions: </strong>Asymmetrically elevated blood flow on ASL imaging demonstrates high sensitivity for the detection of HNPG, with almost perfect interrater agreement.</p>","PeriodicalId":93863,"journal":{"name":"AJNR. American journal of neuroradiology","volume":" ","pages":"1458-1463"},"PeriodicalIF":0.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144236114","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":"Management Outcomes after Image-Guided Percutaneous Biopsy for Suspected Vertebral Osteomyelitis-Discitis.","authors":"Dania G Malik, Mathew V Smith, Gabriel M Swenson, Robert E Grady, Felix E Diehn, Erik H Middlebrooks, Jeffrey S Ross, Tanya J Rath","doi":"10.3174/ajnr.A8630","DOIUrl":"10.3174/ajnr.A8630","url":null,"abstract":"<p><strong>Background and purpose: </strong>Studies show a modest yield for image-guided biopsy of suspected vertebral osteomyelitis-discitis. Many studies evaluate factors to improve diagnostic yield, and few studies assess how biopsy results impact clinical management. We aim to evaluate the impact of biopsy results on clinical management in suspected vertebral osteomyelitis-discitis.</p><p><strong>Materials and methods: </strong>We performed a retrospective study of patients who underwent image-guided biopsy for suspected vertebral osteomyelitis-discitis. Data collected included risk factors, imaging findings, laboratory values, antibiotics, biopsy procedure details, microbiology and pathology results, and clinical course. Factors assessed for management change included whether biopsy results affected antibiotic type or course, decision to start or stop antibiotics, surgical decisions, or if an alternate diagnosis was determined.</p><p><strong>Results: </strong>Three hundred ten biopsies were included. Biopsy yield with true-positive culture results was 34% (104/310) and similar for patients on antibiotics (36%, 34/94) and off antibiotics (32%, 66/204). Yield was greater when disc was sampled (36%, 82/228) versus bone only (8%, 2/24) and with aspiration of disc and/or bone (42%, 39/92) versus core only (29%, 56/193). With positive blood cultures before biopsy, biopsy yield was 50% (22/44) with concordance and discordance rates of 75% (18/24) and 17% (4/24), respectively, and 8% (2/24) of positive biopsy results deemed contaminants. Management was affected in 36% (113/310) of all biopsies and in 78% (81/104) of biopsies with a positive culture result. No management change occurred in 57% (177/310) of biopsies. Management change was unclear in 6% (20/310). Biopsy results changed antibiotics in 27% (85/310). Management change occurred in 23% (10/44) of cases with prior positive blood culture compared with 41% (93/233) without a prior culture source (<i>P</i> = .024). Negative culture results influenced management in 16% (32/194).</p><p><strong>Conclusions: </strong>Image-guided biopsy for vertebral osteomyelitis-discitis has a meaningful impact on management despite modest yield. Greatest management impact is seen with positive culture results, no prior culture source, and patients not on antibiotics at the time of biopsy. Biopsy culture yield is not affected by preceding antibiotics, and yield is greater with disc sampling and aspiration.</p>","PeriodicalId":93863,"journal":{"name":"AJNR. American journal of neuroradiology","volume":" ","pages":"1478-1485"},"PeriodicalIF":0.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142883815","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":"Antiamyloid Therapy and Cerebral Blood Flow Changes on MRI: A Potential Longitudinal Biomarker of Treatment Response?","authors":"Andres Ricaurte-Fajardo, Jana Ivanidze, Deborah Zhang, Meem Mahmud, Weiye Yasen, Lisa Ravdin, Silky Pahlajani, Mony de Leon, Anna S Nordvig, Gloria C Chiang","doi":"10.3174/ajnr.A8654","DOIUrl":"10.3174/ajnr.A8654","url":null,"abstract":"<p><p>Amyloid-targeting therapy has recently become widely available in the United States for the treatment of patients with symptomatic mild Alzheimer disease (AD). At present, there are no biomarkers that have been clinically validated to assess treatment response in routine clinical practice; longitudinal amyloid PET could play a role but is not cost-effective. This report presents a case series of 6 patients with AD, whose amyloid positivity was confirmed by PET or CSF biomarkers, who underwent baseline and longitudinal arterial spin-labeling MR imaging (ASL-MR) as part of Food and Drug Administration-mandated, clinical standard-of-care, noncontrast MR monitoring to assess for amyloid-related imaging abnormalities (ARIA). We and others have previously reported that ASL-MR can screen for neurodegenerative disease as a proxy for FDG-PET and can be easily added on as a cost-effective, repeatable method to monitor post therapy changes. This series highlights varied CBF changes in response to lecanemab therapy. For instance, Cases 1, 3, and 5 showed increased CBF after multiple infusions, with subjective cognitive improvement in Case 1 and improved MoCA scores in Case 3. Case 2 showed improved CBF initially before the fifth infusion, but this returned to baseline in the subsequent study, with no cognitive improvement over the course of therapy. Cases 4 and 6 have demonstrated no substantial changes in regional CBF thus far on therapy, with cognitive decline in Case 4. This case series underscores the potential utility of ASL-MR as an adjunct sequence to current imaging protocols to monitor treatment response to antiamyloid therapy.</p>","PeriodicalId":93863,"journal":{"name":"AJNR. American journal of neuroradiology","volume":" ","pages":"1439-1445"},"PeriodicalIF":0.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142980991","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":"Image-Based Search in Radiology: Identification of Brain Tumor Subtypes within Databases Using MRI-Based Radiomic Features.","authors":"Marc von Reppert, Saahil Chadha, Klara Willms, Arman Avesta, Nazanin Maleki, Tal Zeevi, Jan Lost, Niklas Tillmanns, Leon Jekel, Sara Merkaj, MingDe Lin, Karl-Titus Hoffmann, Sanjay Aneja, Mariam S Aboian","doi":"10.3174/ajnr.A8805","DOIUrl":"10.3174/ajnr.A8805","url":null,"abstract":"<p><strong>Background and purpose: </strong>Existing neuroradiology reference materials do not cover the full range of primary brain tumor presentations, and text-based medical image search engines are limited by the lack of consistent structure in radiology reports. To address this, an image-based search approach is introduced here, leveraging an institutional database to find reference MRIs visually similar to presented query cases.</p><p><strong>Materials and methods: </strong>Two hundred ninety-five patients (mean age and standard deviation, 51 ± 20 years) with primary brain tumors who underwent surgical and/or radiotherapeutic treatment between 2000 and 2021 were included in this retrospective study. Semiautomated convolutional neural network-based tumor segmentation was performed, and radiomic features were extracted. The data set was split into reference and query subsets, and dimensionality reduction was applied to cluster reference cases. Radiomic features extracted from each query case were projected onto the clustered reference cases, and nearest neighbors were retrieved. Retrieval performance was evaluated by using mean average precision at k, and the best-performing dimensionality reduction technique was identified. Expert readers independently rated visual similarity by using a 5-point Likert scale.</p><p><strong>Results: </strong>t-Distributed stochastic neighbor embedding with 6 components was the highest-performing dimensionality reduction technique, with mean average precision at 5 ranging from 78%-100% by tumor type. The top 5 retrieved reference cases showed high visual similarity Likert scores with corresponding query cases (76% 'similar' or 'very similar').</p><p><strong>Conclusions: </strong>We introduce an image-based search method for exploring historical MR images of primary brain tumors and fetching reference cases closely resembling queried ones. Assessment involving comparison of tumor types and visual similarity Likert scoring by expert neuroradiologists validates the effectiveness of this method.</p>","PeriodicalId":93863,"journal":{"name":"AJNR. American journal of neuroradiology","volume":" ","pages":"1421-1428"},"PeriodicalIF":0.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144033792","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":"Perfusion Showdown: Comparison of Multiple MRI Perfusion Techniques in the Grading of Pediatric Brain Tumors.","authors":"Chang Y Ho, Nucharin Supakul, Greg Anthony, Qiuting Wen, Paula Chen, Maryann Allen, Jason G Parker, Benjamin R Gray, Eric Chen, Paul R Territo, Scott A Persohn, Stephen F Kralik, Gary D Hutchins","doi":"10.3174/ajnr.A8635","DOIUrl":"10.3174/ajnr.A8635","url":null,"abstract":"<p><strong>Background and purpose: </strong>There are multiple MRI perfusion techniques, with limited available literature comparing these techniques in the grading of pediatric brain tumors. For efficiency and limiting scan time, ideally only one MRI perfusion technique can be used in initial imaging. We compared DSC, dynamic contrast enhancement (DCE), and intravoxel incoherent motion (IVIM) along with ADC from DWI for differentiating high- versus low-grade pediatric brain tumors.</p><p><strong>Materials and methods: </strong>Presurgical MRI at a single pediatric hospital for primary brain tumor of glial, neuronal, or embryonal origin including DWI, DSC, DCE, and IVIM with postsurgical histopathology results with World Health Organization (WHO) tumor grading were included. Tumor VOI was drawn on T2-weighted images registered to selected parametric maps from DWI, DSC, DCE, and IVIM. Multiple Bonferroni-corrected <i>t</i> tests were performed on the mean tumor values for each selected parameter, including histogram analysis of 95th percentile relative CBV (rCBV), 5th percentile ADC, and 5th percentile D, to evaluate for significance between high- and low-grade tumors. Receiver operating characteristic (ROC) analysis was performed for significant <i>t</i> test results.</p><p><strong>Results: </strong>Seventy-two subjects were included with 36 low-grade and 36 high-grade tumors. <i>t</i> test after Bonferroni correction yielded significant results for 5th percentile ADC (<i>P</i> = .003), mean ADC (<i>P</i> = .006), mean D (<i>P</i> = .009), and 5th percentile D (<i>P</i> = .02). Specifically, 95th percentile rCBV, mean rCBV, D*, f, and all DCE parameters were not significant for high- versus low-grade pediatric brain tumors after correction. Only mean rCBV was significant before but not after Bonferroni correction (<i>P</i> = .04 → <i>P</i> = .35). ROC analysis for the parameters with <i>t</i> test significance before and after Bonferroni correction had the following AUC, in descending order: 5th percentile ADC (0.791, 0.68-0.88, <i>P</i> < .001), 5th percentile D (0.789, 0.68-0.88, <i>P</i> < .001), mean D (0.76, 0.64-0.85, <i>P</i> < .001), mean ADC (0.754,0.64-0.85, <i>P</i> < .001), and mean rCBV (0.683, 0.56-0.79, <i>P</i> = .004).</p><p><strong>Conclusions: </strong>Perfusion parameters from IVIM, DCE, and DSC were not able to significantly differentiate between high- versus low-grade pediatric brain tumors compared with ADC in our study. Fifth percentile ADC performed the best and can be the primary technique for grading pediatric brain tumors.</p>","PeriodicalId":93863,"journal":{"name":"AJNR. American journal of neuroradiology","volume":" ","pages":"1464-1470"},"PeriodicalIF":0.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142883818","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":"Circle of Willis Variants and Their Association with Outcome after Successful Revascularization of Anterior Large Vessel Occlusion.","authors":"Aakanksha Sriwastwa, Michael K Oswald, Achala S Vagal, Stacie L Demel, Bin Zhang, Sriharsha Voleti, Arafat Ali, Daniel Morgan, Trevor Thompson, Johnathan Vidovich, Yasmin N Aziz, Lily Li-Li Wang","doi":"10.3174/ajnr.A8643","DOIUrl":"10.3174/ajnr.A8643","url":null,"abstract":"<p><strong>Background and purpose: </strong>Leptomeningeal collaterals have been associated with better outcomes in large-vessel stroke, but little is known about how the circle of Willis (CoW) collaterals affect stroke outcomes. We aimed to determine the relationship between 3 anatomically distinct CoW subtypes and 90-day outcomes in patients with acute ischemic stroke after successful revascularization via endovascular thrombectomy (EVT).</p><p><strong>Materials and methods: </strong>We performed a retrospective analysis of patients treated with successful EVT for large-vessel occlusion at a comprehensive stroke center between May 2016 and November 2023. The CoW anatomy was trichotomized by using baseline CT angiography as follows: 1) complete circle of Willis (C-CoW), 2) nonisolating incomplete circle of Willis (NI-CoW), and 3) isolating incomplete circle of Willis (I-CoW). χ² and logistic regression analyses were utilized to determine the association of the CoW subtype with 2 coprimary outcomes: the 90-day mRS and 90-day mortality.</p><p><strong>Results: </strong>A total of 465 patients were included in the analysis. Multivariable logistic regression analysis demonstrated a significant association between I-CoW and 90-day mRS compared with NI-CoW (OR [95% CI], 1.83 [1.08-3.09]; <i>P</i> = .02). Additionally, I-CoW anatomy was associated with a higher 90-day mortality than C-CoW (OR [95% CI], 2.58 [1.01-6.60]; <i>P</i> = .04) and NI-CoW (OR [95% CI], 1.89 [1.13-3.18]; <i>P</i> = .01).</p><p><strong>Conclusions: </strong>CoW variants are associated with functional and mortality outcomes in patients treated with EVT for anterior circulation large vessel occlusion. Further research is needed to determine how CoW vessel anatomy may impact clinical assessment, triage, and treatment in acute ischemic stroke.</p>","PeriodicalId":93863,"journal":{"name":"AJNR. American journal of neuroradiology","volume":" ","pages":"1367-1373"},"PeriodicalIF":0.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142960163","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":"Catheter-Vessel Interactions During Aspiration Thrombectomy: A Comprehensive Analysis Using a Novel Swine Model.","authors":"Timothy K Shimizu, Ichiro Yuki, Hemdeep Kaur, Zachary W Hsu, Earl Steward, Tracy Nguyen, Shuichi Suzuki","doi":"10.3174/ajnr.A8898","DOIUrl":"https://doi.org/10.3174/ajnr.A8898","url":null,"abstract":"<p><strong>Background and purpose: </strong>Catheter-vessel interactions during aspiration thrombectomy may vary depending on vessel size, potentially affecting reperfusion outcomes. This study aimed to assess how vessel diameter influences procedural dynamics and reperfusion success rates using a swine model with real-time, direct vessel visualization.</p><p><strong>Materials and methods: </strong>An animal model utilizing Yorkshire swine was used to evaluate catheter-vessel interactions during aspiration thrombectomy. The common carotid artery (CCA, 4-6 mm) and superficial cervical artery (SCA, 2-3 mm) represented large and small vessels, respectively. Each vessel was surgically exposed, occluded using clot analogs, and monitored using a high-resolution digital microscope camera. Aspiration thrombectomy was performed starting with remote aspiration, followed by contact aspiration. Vessel behavior, including collapse and traction, was evaluated in relation to vessel size and reperfusion success.</p><p><strong>Results: </strong>A total of 33 thrombectomy procedures were performed on 14 vessels in 4 swine. In the CCA group (mean diameter: 5.14 mm), remote aspiration achieved 85.7% reperfusion success without vessel collapse, leading to 100% final reperfusion. In the SCA group (mean diameter: 2.27 mm), all remote aspiration attempts caused immediate vessel collapse with no successful reperfusion (0%), requiring contact aspiration, which resulted in 71.4% final reperfusion. Vessel collapse was significantly more frequent in SCA vs. CCA (p < 0.001). Two distinct patterns of vessel traction were observed exclusively in the SCA group.</p><p><strong>Conclusions: </strong>Vessel size strongly influences aspiration thrombectomy efficacy. Smaller vessels are more susceptible to vessel collapse and catheter-induced traction during aspiration thrombectomy, reducing the success rate of reperfusion and increasing reliance on true contact aspiration.</p><p><strong>Abbreviations: </strong>CCA＝ common carotid artery; SCA＝ superficial cervical artery; LVO＝ large-vessel occlusion.</p>","PeriodicalId":93863,"journal":{"name":"AJNR. American journal of neuroradiology","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144546527","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}