Tara Srinivas, Dhairya A. Lakhani, Aneri B. Balar, Risheng Xu, Jee Moon, Caline Azzi, Nathan Hyson, Mona Shahriari, Sijin Wen, Cynthia Greene, Janet Mei, Farzad Maroufi, Jeremy J. Heit, Tobias D. Faizy, Gregory W. Albers, Hamza Salim, Meisam Hoseinyazdi, Vivek S. Yedavalli
Background and Purpose
Collateral status is an important predictor of reperfusion and mortality in patients with large vessel anterior circulation acute ischemic stroke (AIS). We assess the utility of multiphase computed tomography angiography (CTA) derived from CT perfusion (CTP) source imaging (dCTA) in determining collateral status compared to the reference standard American Society of Interventional and Therapeutic Neuroradiology/Society of Interventional Radiology (ASITN/SIR) collateral score on digital subtraction angiography (DSA).
Methods
We retrospectively analyzed AIS patients treated at our institution from January 9, 2017, to January 10, 2023. Inclusion criteria included CTA-confirmed anterior circulation large vessel occlusion, diagnostic CTP, and mechanical thrombectomy with documented DSA collateral score. The modified treatment in cerebral ischemia score was used to assess reperfusion. Logistic regression analyses evaluated associations between demographic and clinical factors, collateral status, ASITN/SIR, and reperfusion status.
Results
A total of 311 patients (mean age 67.35 ± 16.37, 57.4% female) were included. Univariate analysis showed that proximal M2 (PM2) occlusion site (odds ratio [OR] 4.45, p < 0.001), Alberta Stroke Program Early CT Score (OR 1.24, p = 0.006), dCTA (OR 3.81, p < 0.001), and CTA Tan (OR 6.05, p < 0.001) were associated with an ASITN score of ≥3, indicating collateral flow. Multivariate regression, adjusted for race, occlusion site, radiologic features, National Institutes of Health stroke score, and premorbid modified Rankin score, found PM2 occlusion site (aOR 5.99, p < 0.001), dCTA (adjusted OR [aOR] 2.24, p = 0.04), and CTA Tan (aOR 3.71, p < 0.01) to be significant predictors of ASITN ≥3.
Conclusions
dCTA is associated with favorable DSA collateral scores and may aid clinical decision-making in AIS patients with large vessel occlusions. Further studies can assess its role in outcome prediction.
背景与目的侧支状态是大血管前循环急性缺血性卒中（AIS）患者再灌注和死亡率的重要预测指标。我们评估了由CT灌注（CTP）源成像（dCTA）衍生的多期计算机断层血管造影（CTA）在确定侧支状态方面的效用，并与参考标准美国介入与治疗神经放射学会/介入放射学会（ASITN/SIR）数字减影血管造影（DSA）侧支评分进行了比较。方法回顾性分析2017年1月9日至2023年1月10日在我院治疗的AIS患者。纳入标准包括cta确认的前循环大血管闭塞，诊断性CTP和机械取栓并记录DSA侧支评分。采用改良后的脑缺血评分法评价再灌注。Logistic回归分析评估了人口统计学和临床因素、侧支状态、ASITN/SIR和再灌注状态之间的关系。结果共纳入311例患者，平均年龄67.35±16.37岁，女性占57.4%。单因素分析显示近端M2 （PM2）闭塞部位(优势比[OR] 4.45, p <；0.001)，阿尔伯塔卒中计划早期CT评分（OR 1.24, p = 0.006）， dCTA (OR 3.81, p <；0.001)和CTA Tan (OR 6.05, p <；0.001)与ASITN评分≥3分相关，表明侧支血流。多因素回归，调整种族、闭塞部位、放射学特征、美国国立卫生研究院卒中评分和病前改良Rankin评分，发现PM2闭塞部位(aOR 5.99, p <；0.001)、dCTA（调整后OR [aOR] 2.24, p = 0.04）和CTA Tan (aOR 3.71, p <；0.01)为ASITN≥3的显著预测因子。结论dCTA与良好的DSA侧支评分相关，可能有助于AIS大血管闭塞患者的临床决策。进一步的研究可以评估其在预后预测中的作用。
{"title":"Single- and Multiphase CT Angiography Is Associated With Digital Subtraction Angiography Collateral Score ≥3","authors":"Tara Srinivas, Dhairya A. Lakhani, Aneri B. Balar, Risheng Xu, Jee Moon, Caline Azzi, Nathan Hyson, Mona Shahriari, Sijin Wen, Cynthia Greene, Janet Mei, Farzad Maroufi, Jeremy J. Heit, Tobias D. Faizy, Gregory W. Albers, Hamza Salim, Meisam Hoseinyazdi, Vivek S. Yedavalli","doi":"10.1111/jon.70048","DOIUrl":"https://doi.org/10.1111/jon.70048","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background and Purpose</h3>\u0000 \u0000 <p>Collateral status is an important predictor of reperfusion and mortality in patients with large vessel anterior circulation acute ischemic stroke (AIS). We assess the utility of multiphase computed tomography angiography (CTA) derived from CT perfusion (CTP) source imaging (dCTA) in determining collateral status compared to the reference standard American Society of Interventional and Therapeutic Neuroradiology/Society of Interventional Radiology (ASITN/SIR) collateral score on digital subtraction angiography (DSA).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We retrospectively analyzed AIS patients treated at our institution from January 9, 2017, to January 10, 2023. Inclusion criteria included CTA-confirmed anterior circulation large vessel occlusion, diagnostic CTP, and mechanical thrombectomy with documented DSA collateral score. The modified treatment in cerebral ischemia score was used to assess reperfusion. Logistic regression analyses evaluated associations between demographic and clinical factors, collateral status, ASITN/SIR, and reperfusion status.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A total of 311 patients (mean age 67.35 ± 16.37, 57.4% female) were included. Univariate analysis showed that proximal M2 (PM2) occlusion site (odds ratio [OR] 4.45, <i>p</i> < 0.001), Alberta Stroke Program Early CT Score (OR 1.24, <i>p</i> = 0.006), dCTA (OR 3.81, <i>p</i> < 0.001), and CTA Tan (OR 6.05, <i>p</i> < 0.001) were associated with an ASITN score of ≥3, indicating collateral flow. Multivariate regression, adjusted for race, occlusion site, radiologic features, National Institutes of Health stroke score, and premorbid modified Rankin score, found PM2 occlusion site (aOR 5.99, <i>p</i> < 0.001), dCTA (adjusted OR [aOR] 2.24, <i>p</i> = 0.04), and CTA Tan (aOR 3.71, <i>p</i> < 0.01) to be significant predictors of ASITN ≥3.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>dCTA is associated with favorable DSA collateral scores and may aid clinical decision-making in AIS patients with large vessel occlusions. Further studies can assess its role in outcome prediction.</p>\u0000 </section>\u0000 </div>","PeriodicalId":16399,"journal":{"name":"Journal of Neuroimaging","volume":"35 3","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-05-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143950009","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}
Madeleine Marshall, Kingkarn Aphiwatthanasumet, Olivier Mougin, Christine Stadelmann, Paul S. Morgan, Rob A. Dineen, Penny Gowland, Nikos Evangelou, Margareta A. Clarke
Background and Purpose
Chronic active multiple sclerosis (MS) lesions represent a particularly destructive subset of lesions on pathology. However, their imaging correlates, including paramagnetic rim lesions (PRLs) detected on susceptibility-weighted imaging, lack sensitivity and are difficult to implement in clinical practice. This exploratory, longitudinal study investigates the prevalence and temporal dynamics of a novel imaging marker, T1-dark rims, and their relationship with PRLs observed on quantitative susceptibility mapping (QSM).
Methods
Four untreated people with MS underwent 7-Tesla MRI scanning six times over a period of 36 weeks. New and pre-existing lesions were analyzed for the presence and temporal evolution of T1-dark and QSM rims. Quantitative T1 values were derived using B1 maps, and the relationship between rim status and lesion size was evaluated.
Results
Of the 159 baseline lesions, 22 (14%) had T1-dark rims, 11 (7%) had QSM rims, and five lesions had both. T1-dark and QSM rims showed temporal changes, with T1-dark rims preceding new QSM rim appearance in three out of four (75%) lesions. Eleven out of 20 (55%) newly formed lesions had T1-dark rims, with a T1-dark rim present in all new lesions over 100 mm3. Small new lesions lacked discernible rims, but their overall T1 values aligned with those of larger lesion T1-dark rims implying shared pathological processes.
Conclusions
T1-dark rims were more common than QSM rims, with greater prevalence in newly formed lesions. We propose they represent edema and inflammation associated with early stages of chronic active lesion formation visible despite, not because of, iron accumulation.
{"title":"T1-Dark Rim as a Marker of New and Chronic Active Multiple Sclerosis Lesions: A Serial Study With Frequent 7T MRI","authors":"Madeleine Marshall, Kingkarn Aphiwatthanasumet, Olivier Mougin, Christine Stadelmann, Paul S. Morgan, Rob A. Dineen, Penny Gowland, Nikos Evangelou, Margareta A. Clarke","doi":"10.1111/jon.70044","DOIUrl":"https://doi.org/10.1111/jon.70044","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background and Purpose</h3>\u0000 \u0000 <p>Chronic active multiple sclerosis (MS) lesions represent a particularly destructive subset of lesions on pathology. However, their imaging correlates, including paramagnetic rim lesions (PRLs) detected on susceptibility-weighted imaging, lack sensitivity and are difficult to implement in clinical practice. This exploratory, longitudinal study investigates the prevalence and temporal dynamics of a novel imaging marker, T<sub>1</sub>-dark rims, and their relationship with PRLs observed on quantitative susceptibility mapping (QSM).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Four untreated people with MS underwent 7-Tesla MRI scanning six times over a period of 36 weeks. New and pre-existing lesions were analyzed for the presence and temporal evolution of T<sub>1</sub>-dark and QSM rims. Quantitative T<sub>1</sub> values were derived using B<sub>1</sub> maps, and the relationship between rim status and lesion size was evaluated.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Of the 159 baseline lesions, 22 (14%) had T<sub>1</sub>-dark rims, 11 (7%) had QSM rims, and five lesions had both. T<sub>1</sub>-dark and QSM rims showed temporal changes, with T<sub>1</sub>-dark rims preceding new QSM rim appearance in three out of four (75%) lesions. Eleven out of 20 (55%) newly formed lesions had T<sub>1</sub>-dark rims, with a T<sub>1</sub>-dark rim present in all new lesions over 100 mm<sup>3</sup>. Small new lesions lacked discernible rims, but their overall T<sub>1</sub> values aligned with those of larger lesion T<sub>1</sub>-dark rims implying shared pathological processes.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>T<sub>1</sub>-dark rims were more common than QSM rims, with greater prevalence in newly formed lesions. We propose they represent edema and inflammation associated with early stages of chronic active lesion formation visible despite, not because of, iron accumulation.</p>\u0000 </section>\u0000 </div>","PeriodicalId":16399,"journal":{"name":"Journal of Neuroimaging","volume":"35 3","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-05-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jon.70044","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143944690","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Antonio Lorenzo, Joaquín Gil, Jose Ignacio Gallego, Alfonso González-Cruz, Fernando Aparici-Robles, Antoni Boscà, Antonio Sagredo, Marc Comas-Cufí, Josep Puig
Background and Purpose
Optima coils are a new type of embolic coils with complex and WAVE shape properties and variable degrees of softness. In patients with ruptured intracranial aneurysms, we examined the safety (periprocedural complications) and efficacy (occlusion rate immediately postprocedure) of the Optima coil.
Methods
We studied 103 consecutive patients with ruptured intracranial aneurysms who were treated exclusively with the Optima coil, without the use of accompanying implanted devices, at five centers in Spain. Endovascular techniques included stand-alone or balloon-assisted coiling. Postprocedural occlusion and periprocedural device-related adverse events were the endpoints. Aneurysm occlusion was graded according to the modified Raymond–Roy Occlusion scale.
Results
Of the 103 enrolled patients (70 female; median age 59 years), 59 (57.3%) presented with an IV Fischer Scale grade, and 61 (59.2%) of the ruptured aneurysms were wide-necked. Thirty-eight (36.9%) aneurysms were located in the anterior communicating artery. Simple-coiling and balloon-assisted coiling were performed in 36 (34.9%) and 65 (63.1%) patients, respectively. Raymond–Roy Class I, II, and III were reached in 64 (60.3%), 29 (28.1%), and ten (9.7%) following the procedure. The periprocedural device-related serious adverse event rate was 12 (13.5%), of which eight (7.7%) were due to coil protrusion. Four (3.8%) patients had intraprocedural aneurysm rupture. No early rebleeding or death was reported.
Conclusion
This analysis suggests that the Optima coil is safe and effective for treating ruptured aneurysms, with satisfactory occlusion rates and low rates of periprocedural device-related serious adverse events.
{"title":"Safety/Efficacy of a Pusher, Thermal Detachment Coil for Ruptured Intracranial Aneurysms: A Multicenter Real-World Study","authors":"Antonio Lorenzo, Joaquín Gil, Jose Ignacio Gallego, Alfonso González-Cruz, Fernando Aparici-Robles, Antoni Boscà, Antonio Sagredo, Marc Comas-Cufí, Josep Puig","doi":"10.1111/jon.70050","DOIUrl":"https://doi.org/10.1111/jon.70050","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background and Purpose</h3>\u0000 \u0000 <p>Optima coils are a new type of embolic coils with complex and WAVE shape properties and variable degrees of softness. In patients with ruptured intracranial aneurysms, we examined the safety (periprocedural complications) and efficacy (occlusion rate immediately postprocedure) of the Optima coil.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We studied 103 consecutive patients with ruptured intracranial aneurysms who were treated exclusively with the Optima coil, without the use of accompanying implanted devices, at five centers in Spain. Endovascular techniques included stand-alone or balloon-assisted coiling. Postprocedural occlusion and periprocedural device-related adverse events were the endpoints. Aneurysm occlusion was graded according to the modified Raymond–Roy Occlusion scale.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Of the 103 enrolled patients (70 female; median age 59 years), 59 (57.3%) presented with an IV Fischer Scale grade, and 61 (59.2%) of the ruptured aneurysms were wide-necked. Thirty-eight (36.9%) aneurysms were located in the anterior communicating artery. Simple-coiling and balloon-assisted coiling were performed in 36 (34.9%) and 65 (63.1%) patients, respectively. Raymond–Roy Class I, II, and III were reached in 64 (60.3%), 29 (28.1%), and ten (9.7%) following the procedure. The periprocedural device-related serious adverse event rate was 12 (13.5%), of which eight (7.7%) were due to coil protrusion. Four (3.8%) patients had intraprocedural aneurysm rupture. No early rebleeding or death was reported.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>This analysis suggests that the Optima coil is safe and effective for treating ruptured aneurysms, with satisfactory occlusion rates and low rates of periprocedural device-related serious adverse events.</p>\u0000 </section>\u0000 </div>","PeriodicalId":16399,"journal":{"name":"Journal of Neuroimaging","volume":"35 3","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-05-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jon.70050","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143930411","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Josep Puig, Sebastià Remollo, Isabel Rodríguez-Caamaño, Carlos Castaño, Marc Comas-Cufí, Mariano Werner, Guillem Dolz, Jordi Blasco, Luis SanRoman, Juan Manuel Sanchis, Fernando Aparici-Robles, Eva González, Jon Fondevila, Pedro Vega, Eduardo Murias, Elvira Jiménez, Rafael Oteros, Alfonso López-Frias, Manuel Moreu, Saima Bashir, Yolanda Silva, Enric Ripoll, Javier Martínez-Fernández, Yeray Aguilar, José Méndez, Fernando Sánchez, Gonzalo de Paco, Alan Flores, Juan Carlos Llibre, Waleed Brinjikji, ROSSETTI Group
Background and Purpose
Large-bore aspiration catheters (LBACs) are used for thrombectomy in large vessel occlusion (LVO), either as a standalone direct aspiration first-pass technique or combined with a stent retriever (ASR). LBAC design may influence ASR thrombectomy efficacy. We compared the safety and performance of the novel MIVI Q segmental catheter with the well-established SOFIA aspiration device in ASR thrombectomy.
Methods
We analyzed data from the Registry cOmbined vS SinglE Thrombectomy TechnIques registry of consecutive patients with anterior circulation LVO and compared the outcomes of those treated with first-line ASR thrombectomy using Q (Q5 or Q6) or SOFIA (5F or 6F Plus) catheters. Demographic, clinical, angiographic, and clinical outcome data (24-h National Institute of Health Stroke Scale [NIHSS] and modified Rankin Scale score at 3 months) were compared.
Results
Of the 853 patients, 155 (18.2%) were treated with MIVI Q and 698 (81.8%) with SOFIA catheters. After adjusting for age, sex, NIHSS score at baseline, tPA use, site occlusion, anesthesia type, and diameter and length of SR, the MIVI Q group was comparable to the SOFIA group in terms of first-pass effect or successful final recanalization and safety. However, the MIVI Q group had a shorter mechanical thrombectomy time (20 [10–45] min vs. 33 [20–51] min; odds ratio [OR] = 7.4, 95% confidence interval [CI]: 1.1–14; p = 0.021) and a lower rate of symptomatic intracerebral hemorrhage (3.3% vs. 8.8%; OR = 3.59, 95% CI: 1.45–10.9; p = 0.011).
Conclusions
In ASR neurothrombectomy, SOFIA aspiration catheters were not superior to MIVI Q in achieving successful and complete first-passage recanalization; however, MIVI Q had shorter procedural times and a lower rate of symptomatic intracranial hemorrhage.
{"title":"Aspiration Catheter Design Impacts Combined Approach Mechanical Thrombectomy in Anterior Circulation Large Vessel Stroke","authors":"Josep Puig, Sebastià Remollo, Isabel Rodríguez-Caamaño, Carlos Castaño, Marc Comas-Cufí, Mariano Werner, Guillem Dolz, Jordi Blasco, Luis SanRoman, Juan Manuel Sanchis, Fernando Aparici-Robles, Eva González, Jon Fondevila, Pedro Vega, Eduardo Murias, Elvira Jiménez, Rafael Oteros, Alfonso López-Frias, Manuel Moreu, Saima Bashir, Yolanda Silva, Enric Ripoll, Javier Martínez-Fernández, Yeray Aguilar, José Méndez, Fernando Sánchez, Gonzalo de Paco, Alan Flores, Juan Carlos Llibre, Waleed Brinjikji, ROSSETTI Group","doi":"10.1111/jon.70046","DOIUrl":"https://doi.org/10.1111/jon.70046","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background and Purpose</h3>\u0000 \u0000 <p>Large-bore aspiration catheters (LBACs) are used for thrombectomy in large vessel occlusion (LVO), either as a standalone direct aspiration first-pass technique or combined with a stent retriever (ASR). LBAC design may influence ASR thrombectomy efficacy. We compared the safety and performance of the novel MIVI Q segmental catheter with the well-established SOFIA aspiration device in ASR thrombectomy.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We analyzed data from the Registry cOmbined vS SinglE Thrombectomy TechnIques registry of consecutive patients with anterior circulation LVO and compared the outcomes of those treated with first-line ASR thrombectomy using Q (Q5 or Q6) or SOFIA (5F or 6F Plus) catheters. Demographic, clinical, angiographic, and clinical outcome data (24-h National Institute of Health Stroke Scale [NIHSS] and modified Rankin Scale score at 3 months) were compared.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Of the 853 patients, 155 (18.2%) were treated with MIVI Q and 698 (81.8%) with SOFIA catheters. After adjusting for age, sex, NIHSS score at baseline, tPA use, site occlusion, anesthesia type, and diameter and length of SR, the MIVI Q group was comparable to the SOFIA group in terms of first-pass effect or successful final recanalization and safety. However, the MIVI Q group had a shorter mechanical thrombectomy time (20 [10–45] min vs. 33 [20–51] min; odds ratio [OR] = 7.4, 95% confidence interval [CI]: 1.1–14; <i>p</i> = 0.021) and a lower rate of symptomatic intracerebral hemorrhage (3.3% vs. 8.8%; OR = 3.59, 95% CI: 1.45–10.9; <i>p</i> = 0.011).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>In ASR neurothrombectomy, SOFIA aspiration catheters were not superior to MIVI Q in achieving successful and complete first-passage recanalization; however, MIVI Q had shorter procedural times and a lower rate of symptomatic intracranial hemorrhage.</p>\u0000 </section>\u0000 </div>","PeriodicalId":16399,"journal":{"name":"Journal of Neuroimaging","volume":"35 3","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-05-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143897003","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}
Juan Ignacio García-García, Josep Puig, Óscar Chirife, Andrés Paipa, Sònia Aixut, Jordi Blasco, Mariano Werner, Marc Comas-Cufí, Pedro Vega, Eduardo Murias, Fernando Aparici-Robles, Lluís Morales-Caba, Eva González, Ion Labayen, Veredas Romero, Isabel Bravo, Manuel Moreu, Alfonso López-Frías, Sebastià Remollo, Isabel Rodríguez-Caamaño, Mikel Terceño, Juan Álvarez-Cienfuegos, Javier Martínez-Fernández, Yeray Aguilar, José Carlos Méndez, Fernando Sánchez, Joaquín Zamarro, Víctor Cuba, Miguel Castaño, Antonio López-Rueda, ROSSETTI Group
Background and Purpose
The superiority of achieving modified Treatment in Cerebral Ischemia (mTICI) from multiple passes versus mTICI 2b from a single pass remains uncertain. We aimed to assess whether additional passes in M1 occlusion patients with a first-pass mTICI 2b score improved clinical and functional outcomes.
Methods
We analyzed Registry Combined vs. Single Thrombectomy Techniques registry data of consecutive M1-occlusion patients, comparing outcomes of those with mTICI 2b-stopped after the first pass versus continued mechanical thrombectomy (MT) to improve angiographic results (mTICI 2b or mTICI 2c/3). We compared demographic, clinical, angiographic, and clinical outcome data (National Institute of Health Stroke Scale [NIHSS] at 24 h and modified Rankin Scale at 3 months).
Results
Patients with first-pass mTICI 2b had lower NIHSS scores at admission, fewer left-side occlusions, and longer last-seen-well times. Endovascular techniques and time from groin puncture to revascularization were similar across groups. Patients with final mTICI 2c/3 had the highest distal embolism rates in a new territory (0% for mTICI2b-stopped vs. 3% for final mTICI2b-continued; 7.7% for final mTICI2c/3; p = 0.02). The groups had similar rates of death, symptomatic intracranial hemorrhage, same-area distal embolism, other MT-related complications, NIHSS at 24 h, NIHSS change from admission to 24 h, and same-territory distal embolism.
Conclusion
Achieving mTICI 2b after the first pass in M1-occlusion patients proved relevant. These patients had comparable clinical and functional outcomes and a lower risk of new territory distal embolisms compared to those with final mTICI 2c/3 scores.
{"title":"Modified Treatment in Brain Ischemia 2b Stopped or Continued After First-Pass Mechanical Thrombectomy for M1 Occlusions","authors":"Juan Ignacio García-García, Josep Puig, Óscar Chirife, Andrés Paipa, Sònia Aixut, Jordi Blasco, Mariano Werner, Marc Comas-Cufí, Pedro Vega, Eduardo Murias, Fernando Aparici-Robles, Lluís Morales-Caba, Eva González, Ion Labayen, Veredas Romero, Isabel Bravo, Manuel Moreu, Alfonso López-Frías, Sebastià Remollo, Isabel Rodríguez-Caamaño, Mikel Terceño, Juan Álvarez-Cienfuegos, Javier Martínez-Fernández, Yeray Aguilar, José Carlos Méndez, Fernando Sánchez, Joaquín Zamarro, Víctor Cuba, Miguel Castaño, Antonio López-Rueda, ROSSETTI Group","doi":"10.1111/jon.70047","DOIUrl":"https://doi.org/10.1111/jon.70047","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background and Purpose</h3>\u0000 \u0000 <p>The superiority of achieving modified Treatment in Cerebral Ischemia (mTICI) from multiple passes versus mTICI 2b from a single pass remains uncertain. We aimed to assess whether additional passes in M1 occlusion patients with a first-pass mTICI 2b score improved clinical and functional outcomes.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We analyzed Registry Combined vs. Single Thrombectomy Techniques registry data of consecutive M1-occlusion patients, comparing outcomes of those with mTICI 2b-stopped after the first pass versus continued mechanical thrombectomy (MT) to improve angiographic results (mTICI 2b or mTICI 2c/3). We compared demographic, clinical, angiographic, and clinical outcome data (National Institute of Health Stroke Scale [NIHSS] at 24 h and modified Rankin Scale at 3 months).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Patients with first-pass mTICI 2b had lower NIHSS scores at admission, fewer left-side occlusions, and longer last-seen-well times. Endovascular techniques and time from groin puncture to revascularization were similar across groups. Patients with final mTICI 2c/3 had the highest distal embolism rates in a new territory (0% for mTICI2b-stopped vs. 3% for final mTICI2b-continued; 7.7% for final mTICI2c/3; p = 0.02). The groups had similar rates of death, symptomatic intracranial hemorrhage, same-area distal embolism, other MT-related complications, NIHSS at 24 h, NIHSS change from admission to 24 h, and same-territory distal embolism.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Achieving mTICI 2b after the first pass in M1-occlusion patients proved relevant. These patients had comparable clinical and functional outcomes and a lower risk of new territory distal embolisms compared to those with final mTICI 2c/3 scores.</p>\u0000 </section>\u0000 </div>","PeriodicalId":16399,"journal":{"name":"Journal of Neuroimaging","volume":"35 2","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-04-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143875587","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}
Maria Martucci, Mohamad Ezzeldin, Kaho Adachi, Adam Delora, Rime Ezzeldin, Ameer E. Hassan, Farhan Siddiq, Faheem G. Sheriff, Peter Kan, Nazli Janjua, Kaiz S. Asif, Ramesh Grandhi, Ali Alaraj, Muhammad Niazi, Ossama Mansour, Saif Bushnaq, Omar Tanweer, Samantha Miller, Navpreet K. Bains, Gabriela Colina, Mohammad AlMajali, Gautam Edhayan, Musaab Froukh, Walid K. Salah, Elsa Nico, Shehab Ashraf, Yazan Radaideh, Darko Quispe-Orozco, Osama Zaidat, M. Shazam Hussain
Background and Purpose
Carotid artery stenting is a well-established method for treating carotid artery stenosis; however, there are conflicting data on prestenting versus post-stenting balloon angioplasty. Our study aims to understand the risk and safety of pre-stent balloon angioplasty (Pre-SB) and post-stent balloon angioplasty (Post-SB), or both techniques.
Methods
Multicenter retrospective data on angioplasty balloons, stents, complications, and modified Rankin score (mRS) before and after the procedure were collected. Statistical analysis was performed to correlate with complication risks and clinical outcomes.
Results
1,355 patients were enrolled. Post-SB predicted fewer complications (p = 0.035) than Pre-SB or combined Pre-SB and Post-SB. Female sex was a predictor of complications (p = 0.041), while utilization of an embolic protection device predicted fewer complications (p < 0.001). Increasing age (p < 0.001) and smoking (p = 0.027) predicted increased length of stay. Using open-cell stents versus closed-cell stents did not predict follow-up modified rankin score (mRS) or complications, but using open-cell stents did predict a shorter length of stay. Conversely, open-cell stents were more likely to undergo Post-SB (p < 0.001), while closed-cell stents were more likely to undergo Pre-SB (p = 0.002).
Conclusions
Unlike previous literature, our results showed that Post-SB alone was associated with fewer complications compared to either Pre-SB alone or the combination of Pre-SB and Post-SB. Open-cell stents required a higher rate of Post-SB.
{"title":"Clinical Outcomes and Complications of Carotid Artery Stenting With or Without Pre-Stent and Post-Stent Balloon Angioplasty","authors":"Maria Martucci, Mohamad Ezzeldin, Kaho Adachi, Adam Delora, Rime Ezzeldin, Ameer E. Hassan, Farhan Siddiq, Faheem G. Sheriff, Peter Kan, Nazli Janjua, Kaiz S. Asif, Ramesh Grandhi, Ali Alaraj, Muhammad Niazi, Ossama Mansour, Saif Bushnaq, Omar Tanweer, Samantha Miller, Navpreet K. Bains, Gabriela Colina, Mohammad AlMajali, Gautam Edhayan, Musaab Froukh, Walid K. Salah, Elsa Nico, Shehab Ashraf, Yazan Radaideh, Darko Quispe-Orozco, Osama Zaidat, M. Shazam Hussain","doi":"10.1111/jon.70041","DOIUrl":"https://doi.org/10.1111/jon.70041","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background and Purpose</h3>\u0000 \u0000 <p>Carotid artery stenting is a well-established method for treating carotid artery stenosis; however, there are conflicting data on prestenting versus post-stenting balloon angioplasty. Our study aims to understand the risk and safety of pre-stent balloon angioplasty (Pre-SB) and post-stent balloon angioplasty (Post-SB), or both techniques.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Multicenter retrospective data on angioplasty balloons, stents, complications, and modified Rankin score (mRS) before and after the procedure were collected. Statistical analysis was performed to correlate with complication risks and clinical outcomes.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>1,355 patients were enrolled. Post-SB predicted fewer complications (<i>p</i> = 0.035) than Pre-SB or combined Pre-SB and Post-SB. Female sex was a predictor of complications (<i>p</i> = 0.041), while utilization of an embolic protection device predicted fewer complications (<i>p</i> < 0.001). Increasing age (<i>p</i> < 0.001) and smoking (<i>p</i> = 0.027) predicted increased length of stay. Using open-cell stents versus closed-cell stents did not predict follow-up modified rankin score (mRS) or complications, but using open-cell stents did predict a shorter length of stay. Conversely, open-cell stents were more likely to undergo Post-SB (<i>p</i> < 0.001), while closed-cell stents were more likely to undergo Pre-SB (<i>p</i> = 0.002).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Unlike previous literature, our results showed that Post-SB alone was associated with fewer complications compared to either Pre-SB alone or the combination of Pre-SB and Post-SB. Open-cell stents required a higher rate of Post-SB.</p>\u0000 </section>\u0000 </div>","PeriodicalId":16399,"journal":{"name":"Journal of Neuroimaging","volume":"35 2","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-04-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143861693","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}
Aniruddha R. Upadhye, Eleana Cintron, Jichu Zhang, Jennifer Coleman, Chaitanya Kolluru, Michael W. Jenkins, David Wilson, Nicole A. Pelot, Andrew J. Shoffstall
Background and Purpose
Peripheral nerve stimulation is approved by the US Food and Drug Administration for treating various disorders, but it is often limited by side effects, highlighting the need for a clear understanding of fascicular and fiber organization to design selective therapies. Micro-CT imaging of contrast-stained nerves enables the visualization of tissue microstructures, such as the fascicular perineurium and vasculature. In this work, we evaluated phosphotungstic acid (PTA) as a contrast agent and assessed its compatibility with downstream histology.
Methods
Human vagus nerve samples were collected from three embalmed cadavers and subjected to three different staining methods, followed by micro-CT imaging: Lugol's iodine, osmium tetroxide, and PTA. Contrast ratios of adjacent tissue microstructures (perineurium, interfascicular epineurium, and fascicle) were quantified for each stain and compared. We further developed a pipeline to optimize micro-CT scan acquisition parameters based on objective metrics for sharpness, noise, and pixel saturation. The PTA-stained samples underwent subsequent histological processing and staining with hematoxylin and eosin, Masson's trichrome, and immunohistochemistry and were assessed for tissue degradation.
Results
PTA enhanced the visualization of perineurium, providing high contrast ratios compared to iodine and osmium tetroxide. Optimized scanning parameters for PTA-stained nerves (55 kV and 109 µA) effectively balanced noise and sharpness. While we found that PTA is generally nondestructive for downstream histology, higher concentrations and longer exposure could alter the optical density of nuclei and affect stain differentiation in special stains.
Conclusion
PTA serves as a valuable micro-CT contrast agent for nerve imaging, effective in visualizing the perineurium with minimal impact on histological integrity.
{"title":"Phosphotungstic Acid Staining to Visualize the Vagus Nerve Perineurium Using Micro-CT","authors":"Aniruddha R. Upadhye, Eleana Cintron, Jichu Zhang, Jennifer Coleman, Chaitanya Kolluru, Michael W. Jenkins, David Wilson, Nicole A. Pelot, Andrew J. Shoffstall","doi":"10.1111/jon.70040","DOIUrl":"https://doi.org/10.1111/jon.70040","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background and Purpose</h3>\u0000 \u0000 <p>Peripheral nerve stimulation is approved by the US Food and Drug Administration for treating various disorders, but it is often limited by side effects, highlighting the need for a clear understanding of fascicular and fiber organization to design selective therapies. Micro-CT imaging of contrast-stained nerves enables the visualization of tissue microstructures, such as the fascicular perineurium and vasculature. In this work, we evaluated phosphotungstic acid (PTA) as a contrast agent and assessed its compatibility with downstream histology.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Human vagus nerve samples were collected from three embalmed cadavers and subjected to three different staining methods, followed by micro-CT imaging: Lugol's iodine, osmium tetroxide, and PTA. Contrast ratios of adjacent tissue microstructures (perineurium, interfascicular epineurium, and fascicle) were quantified for each stain and compared. We further developed a pipeline to optimize micro-CT scan acquisition parameters based on objective metrics for sharpness, noise, and pixel saturation. The PTA-stained samples underwent subsequent histological processing and staining with hematoxylin and eosin, Masson's trichrome, and immunohistochemistry and were assessed for tissue degradation.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>PTA enhanced the visualization of perineurium, providing high contrast ratios compared to iodine and osmium tetroxide. Optimized scanning parameters for PTA-stained nerves (55 kV and 109 µA) effectively balanced noise and sharpness. While we found that PTA is generally nondestructive for downstream histology, higher concentrations and longer exposure could alter the optical density of nuclei and affect stain differentiation in special stains.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>PTA serves as a valuable micro-CT contrast agent for nerve imaging, effective in visualizing the perineurium with minimal impact on histological integrity.</p>\u0000 </section>\u0000 </div>","PeriodicalId":16399,"journal":{"name":"Journal of Neuroimaging","volume":"35 2","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-04-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jon.70040","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143809776","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Sebastian Johannes Müller, Eya Khadhraoui, Olga Kukhlenko, Johannes Schwarzer, Jürgen Voges, I. Erol Sandalcioglu, Daniel Behme, Friedhelm Schmitt, Lars Büntjen
Background and Purpose
Temporal lobe epilepsy is the most common form of focal epilepsy. MR-guided laser interstitial thermal therapy (LITT) of the amygdalohippocampal complex has become an established therapy option in case of drug resistance. Long-term anatomic network effects on the brain due to deafferentiation have not yet been evaluated.
Methods
We analyzed brain volumes of 11 patients with temporal lobe epilepsy before and 1-year after hippocampal LITT with FastSurfer segmenting T1-weighted data. Additionally, we performed visual ratings and measurements.
Results
A total of 11 patients with temporal lobe epilepsy (7 left-sided, 4 right-sided) were included (5 females); the mean age years (±standard deviation) at surgery was 41.5 (±18.4) years. The mean postoperative defect size was 1427 (±517) mm3. Volumetry as well as visual ratings found a progressive volume loss after left-sided surgery in the ipsilateral temporal lobe, the contralateral (right) part of the thalamus, and especially contralateral (right) fusiform cortex. These changes could not be detected for right-sided surgery.
Conclusion
A (partial) ablation of the left (dominant) hippocampus appears to exert long-term effects on the right thalamus and right-sided temporal cortices. However, we could not observe this effect in the reverse direction. Volumetric studies for larger cohorts should be conducted to investigate these findings.
{"title":"Brain Volume Loss After Stereotactic Laser Interstitial Thermal Therapy in Patients With Temporal Lobe Epilepsy","authors":"Sebastian Johannes Müller, Eya Khadhraoui, Olga Kukhlenko, Johannes Schwarzer, Jürgen Voges, I. Erol Sandalcioglu, Daniel Behme, Friedhelm Schmitt, Lars Büntjen","doi":"10.1111/jon.70039","DOIUrl":"https://doi.org/10.1111/jon.70039","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background and Purpose</h3>\u0000 \u0000 <p>Temporal lobe epilepsy is the most common form of focal epilepsy. MR-guided laser interstitial thermal therapy (LITT) of the amygdalohippocampal complex has become an established therapy option in case of drug resistance. Long-term anatomic network effects on the brain due to deafferentiation have not yet been evaluated.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We analyzed brain volumes of 11 patients with temporal lobe epilepsy before and 1-year after hippocampal LITT with FastSurfer segmenting T1-weighted data. Additionally, we performed visual ratings and measurements.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A total of 11 patients with temporal lobe epilepsy (7 left-sided, 4 right-sided) were included (5 females); the mean age years (±standard deviation) at surgery was 41.5 (±18.4) years. The mean postoperative defect size was 1427 (±517) mm<sup>3</sup>. Volumetry as well as visual ratings found a progressive volume loss after left-sided surgery in the ipsilateral temporal lobe, the contralateral (right) part of the thalamus, and especially contralateral (right) fusiform cortex. These changes could not be detected for right-sided surgery.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>A (partial) ablation of the left (dominant) hippocampus appears to exert long-term effects on the right thalamus and right-sided temporal cortices. However, we could not observe this effect in the reverse direction. Volumetric studies for larger cohorts should be conducted to investigate these findings.</p>\u0000 </section>\u0000 </div>","PeriodicalId":16399,"journal":{"name":"Journal of Neuroimaging","volume":"35 2","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-04-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jon.70039","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143793332","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Robert W. Regenhardt, Penina P. Krieger, Anna K. Bonkhoff, Markus D. Schirmer, Christopher G. Favilla, Vincent M. Tutino, Alvin S. Das, Adam A. Dmytriw, Raj Gupta, James D. Rabinov, Christopher J. Stapleton, Thabele M. Leslie-Mazwi, Aman B. Patel, Eng H. Lo, Natalia S. Rost
Background and Purpose
Parenchymal hematomas (PHs) represent an important complication in ischemic stroke after endovascular thrombectomy (EVT), but the risk factors are incompletely understood. Neuroimaging data preintervention, such as infarct topography, may help elucidate predisposing factors and inform more nuanced patient care intra- and postprocedurally.
Methods
Large vessel occlusion patients with pre-EVT MRI were included from a single quaternary center. Diffusion-weighted imaging (DWI) lesions underwent manual segmentation and registration onto a standard brain space for topographical mapping. The presence of PH postintervention was determined. Associations between infarct topography, clinical characteristics, and PH were evaluated.
Results
A total of 165 patients (median age: 69; 56% female) were identified. Intravenous alteplase was administered to 52%, 70% achieved thrombolysis in cerebral infarction 2b-3 reperfusion, and 8% had PH postintervention. The preintervention DWI lesions were 48% (38%–60%) white matter, 23% (6%–47%) cortex, and 15% (4%–28%) basal ganglia. Basal ganglia infarct volume was independently associated with PH (adjusted odds ratio = 1.342, 95% confidence interval 1.002–1.797, p = 0.049), accounting for white matter and cortex infarct volume, among other key factors. Basal ganglia infarct volume was associated with susceptibility-weighted imaging vessel sign (betaadjusted = 0.233, p = 0.006) and the National Institutes of Health Stroke Scale (betaadjusted = 0.220, p = 0.012), controlling for other factors.
Conclusions
Preintervention basal ganglia infarct volume may provide important insights into the risk of PH after intervention. Improved understanding of the biology of basal ganglia infarction and hemorrhagic transformation has implications for the management of patients undergoing EVT and may represent a future therapeutic target for neuroprotective strategies.
{"title":"Parenchymal Hematoma After Endovascular Thrombectomy Is Associated With Pretreatment Basal Ganglia Infarct Volume","authors":"Robert W. Regenhardt, Penina P. Krieger, Anna K. Bonkhoff, Markus D. Schirmer, Christopher G. Favilla, Vincent M. Tutino, Alvin S. Das, Adam A. Dmytriw, Raj Gupta, James D. Rabinov, Christopher J. Stapleton, Thabele M. Leslie-Mazwi, Aman B. Patel, Eng H. Lo, Natalia S. Rost","doi":"10.1111/jon.70031","DOIUrl":"https://doi.org/10.1111/jon.70031","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background and Purpose</h3>\u0000 \u0000 <p>Parenchymal hematomas (PHs) represent an important complication in ischemic stroke after endovascular thrombectomy (EVT), but the risk factors are incompletely understood. Neuroimaging data preintervention, such as infarct topography, may help elucidate predisposing factors and inform more nuanced patient care intra- and postprocedurally.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Large vessel occlusion patients with pre-EVT MRI were included from a single quaternary center. Diffusion-weighted imaging (DWI) lesions underwent manual segmentation and registration onto a standard brain space for topographical mapping. The presence of PH postintervention was determined. Associations between infarct topography, clinical characteristics, and PH were evaluated.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A total of 165 patients (median age: 69; 56% female) were identified. Intravenous alteplase was administered to 52%, 70% achieved thrombolysis in cerebral infarction 2b-3 reperfusion, and 8% had PH postintervention. The preintervention DWI lesions were 48% (38%–60%) white matter, 23% (6%–47%) cortex, and 15% (4%–28%) basal ganglia. Basal ganglia infarct volume was independently associated with PH (adjusted odds ratio = 1.342, 95% confidence interval 1.002–1.797, <i>p</i> = 0.049), accounting for white matter and cortex infarct volume, among other key factors. Basal ganglia infarct volume was associated with susceptibility-weighted imaging vessel sign (beta<sub>adjusted</sub> = 0.233, <i>p</i> = 0.006) and the National Institutes of Health Stroke Scale (beta<sub>adjusted</sub> = 0.220, <i>p</i> = 0.012), controlling for other factors.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Preintervention basal ganglia infarct volume may provide important insights into the risk of PH after intervention. Improved understanding of the biology of basal ganglia infarction and hemorrhagic transformation has implications for the management of patients undergoing EVT and may represent a future therapeutic target for neuroprotective strategies.</p>\u0000 </section>\u0000 </div>","PeriodicalId":16399,"journal":{"name":"Journal of Neuroimaging","volume":"35 2","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143717067","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}
Gary Ka Wai Chan, Tsz Kit Chow, Ryan Wui Hang Ho, William C. Y. Leung, Yan Ho Hui, Wai Yin Ho
Background and Purpose
99mTc-TRODAT-1 SPECT imaging is an imaging technique, more commonly used in Asia, to diagnose Parkinson's disease (PD). This study evaluates the use of automated three-dimensional volume-of-interest (VOI) analysis in diagnosing PD.
Methods
99mTc-TRODAT-1 SPECT images of 76 patients (50 with PD and 26 without PD) were retrospectively analyzed. The specific binding ratio (SBR) was calculated using an automated program. Multiple linear regression and receiver operating characteristic curve analyses were performed to identify the factors that affect SBR value and determine the optimal cutoff values.
Results
Multiple regression analysis revealed disease status as the strongest predictor of SBR values, followed by age and sex. Receiver operating characteristic curve analysis demonstrated good diagnostic performance for the striatum (area under the curve [AUC] = 0.922), putamen (AUC = 0.922), and caudate (AUC = 0.881). Optimal cutoff values were determined for the striatum (0.515; sensitivity 88.5%, specificity 90.0%), putamen (0.445; sensitivity 92.3%, specificity 86.0%), and caudate (0.655; sensitivity 84.6%, specificity 90.0%).
Conclusions
Semiautomatic quantitative analysis of 99mTc-TRODAT-1 SPECT using automated three-dimensional VOI shows excellent diagnostic performance in differentiating PD from non-Parkinson's cases. Age and sex significantly influence SBR values, suggesting the need for demographic-adjusted cutoff values in clinical practice.
{"title":"Semiautomatic Quantification of 99mTc-TRODAT-1 SPECT Images in Patients With Idiopathic Parkinson's Disease","authors":"Gary Ka Wai Chan, Tsz Kit Chow, Ryan Wui Hang Ho, William C. Y. Leung, Yan Ho Hui, Wai Yin Ho","doi":"10.1111/jon.70038","DOIUrl":"https://doi.org/10.1111/jon.70038","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background and Purpose</h3>\u0000 \u0000 <p><sup>99m</sup>Tc-TRODAT-1 SPECT imaging is an imaging technique, more commonly used in Asia, to diagnose Parkinson's disease (PD). This study evaluates the use of automated three-dimensional volume-of-interest (VOI) analysis in diagnosing PD.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p><sup>99m</sup>Tc-TRODAT-1 SPECT images of 76 patients (50 with PD and 26 without PD) were retrospectively analyzed. The specific binding ratio (SBR) was calculated using an automated program. Multiple linear regression and receiver operating characteristic curve analyses were performed to identify the factors that affect SBR value and determine the optimal cutoff values.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Multiple regression analysis revealed disease status as the strongest predictor of SBR values, followed by age and sex. Receiver operating characteristic curve analysis demonstrated good diagnostic performance for the striatum (area under the curve [AUC] = 0.922), putamen (AUC = 0.922), and caudate (AUC = 0.881). Optimal cutoff values were determined for the striatum (0.515; sensitivity 88.5%, specificity 90.0%), putamen (0.445; sensitivity 92.3%, specificity 86.0%), and caudate (0.655; sensitivity 84.6%, specificity 90.0%).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Semiautomatic quantitative analysis of <sup>99m</sup>Tc-TRODAT-1 SPECT using automated three-dimensional VOI shows excellent diagnostic performance in differentiating PD from non-Parkinson's cases. Age and sex significantly influence SBR values, suggesting the need for demographic-adjusted cutoff values in clinical practice.</p>\u0000 </section>\u0000 </div>","PeriodicalId":16399,"journal":{"name":"Journal of Neuroimaging","volume":"35 2","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143698985","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}
扫码关注我们
求助内容：
应助结果提醒方式：
京公网安备 11010802042870号