Pub Date : 2024-09-01Epub Date: 2024-05-21DOI: 10.1007/s00234-024-03380-5
Giuseppe Pontillo, Mario Tranfa, Alessandra Scaravilli, Serena Monti, Ivana Capuano, Eleonora Riccio, Manuela Rizzo, Arturo Brunetti, Giuseppe Palma, Antonio Pisani, Sirio Cocozza
Purpose: How to measure brain globotriaosylceramide (Gb3) accumulation in Fabry Disease (FD) patients in-vivo is still an open challenge. The objective of this study is to provide a quantitative, non-invasive demonstration of this phenomenon using quantitative MRI (qMRI).
Methods: In this retrospective, monocentric cross-sectional study conducted from November 2015 to July 2018, FD patients and healthy controls (HC) underwent an MRI scan with a relaxometry protocol to compute longitudinal relaxation rate (R1) maps to evaluate gray (GM) and white matter (WM) lipid accumulation. In a subgroup of 22 FD patients, clinical (FAbry STabilization indEX -FASTEX- score) and biochemical (residual α-galactosidase activity) variables were correlated with MRI data. Quantitative maps were analyzed at both global ("bulk" analysis) and regional ("voxel-wise" analysis) levels.
Results: Data were obtained from 42 FD patients (mean age = 42.4 ± 12.9, M/F = 16/26) and 49 HC (mean age = 42.3 ± 16.3, M/F = 28/21). Compared to HC, FD patients showed a widespread increase in R1 values encompassing both GM (pFWE = 0.02) and WM (pFWE = 0.02) structures. While no correlations were found between increased R1 values and FASTEX score, a significant negative correlation emerged between residual enzymatic activity levels and R1 values in GM (r = -0.57, p = 0.008) and WM (r = -0.49, p = 0.03).
Conclusions: We demonstrated the feasibility and clinical relevance of non-invasively assessing cerebral Gb3 accumulation in FD using MRI. R1 mapping might be used as an in-vivo quantitative neuroimaging biomarker in FD patients.
{"title":"In vivo demonstration of globotriaosylceramide brain accumulation in Fabry Disease using MR Relaxometry.","authors":"Giuseppe Pontillo, Mario Tranfa, Alessandra Scaravilli, Serena Monti, Ivana Capuano, Eleonora Riccio, Manuela Rizzo, Arturo Brunetti, Giuseppe Palma, Antonio Pisani, Sirio Cocozza","doi":"10.1007/s00234-024-03380-5","DOIUrl":"10.1007/s00234-024-03380-5","url":null,"abstract":"<p><strong>Purpose: </strong>How to measure brain globotriaosylceramide (Gb3) accumulation in Fabry Disease (FD) patients in-vivo is still an open challenge. The objective of this study is to provide a quantitative, non-invasive demonstration of this phenomenon using quantitative MRI (qMRI).</p><p><strong>Methods: </strong>In this retrospective, monocentric cross-sectional study conducted from November 2015 to July 2018, FD patients and healthy controls (HC) underwent an MRI scan with a relaxometry protocol to compute longitudinal relaxation rate (R1) maps to evaluate gray (GM) and white matter (WM) lipid accumulation. In a subgroup of 22 FD patients, clinical (FAbry STabilization indEX -FASTEX- score) and biochemical (residual α-galactosidase activity) variables were correlated with MRI data. Quantitative maps were analyzed at both global (\"bulk\" analysis) and regional (\"voxel-wise\" analysis) levels.</p><p><strong>Results: </strong>Data were obtained from 42 FD patients (mean age = 42.4 ± 12.9, M/F = 16/26) and 49 HC (mean age = 42.3 ± 16.3, M/F = 28/21). Compared to HC, FD patients showed a widespread increase in R1 values encompassing both GM (p<sub>FWE</sub> = 0.02) and WM (p<sub>FWE</sub> = 0.02) structures. While no correlations were found between increased R1 values and FASTEX score, a significant negative correlation emerged between residual enzymatic activity levels and R1 values in GM (r = -0.57, p = 0.008) and WM (r = -0.49, p = 0.03).</p><p><strong>Conclusions: </strong>We demonstrated the feasibility and clinical relevance of non-invasively assessing cerebral Gb3 accumulation in FD using MRI. R1 mapping might be used as an in-vivo quantitative neuroimaging biomarker in FD patients.</p>","PeriodicalId":19422,"journal":{"name":"Neuroradiology","volume":null,"pages":null},"PeriodicalIF":2.4,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11322198/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141071603","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-09-01Epub Date: 2024-07-16DOI: 10.1007/s00234-024-03412-0
Yongsik Sim, Kaeum Choi, Kyunghwa Han, Seo Hee Choi, Narae Lee, Yae Won Park, Na-Young Shin, Sung Soo Ahn, Jong Hee Chang, Se Hoon Kim, Seung-Koo Lee
Purpose: To investigate prognostic markers for H3 K27-altered diffuse midline gliomas (DMGs) in adults with clinical, qualitative and quantitative imaging phenotypes, including tumor oxygenation characteristics.
Methods: Retrospective chart and imaging reviews were conducted on 32 adults with H3 K27-altered DMGs between 2017 and 2023. Clinical and qualitative imaging characteristics were analyzed. Quantitative imaging assessment was performed from the tumor mask via automatic segmentation to calculate normalized cerebral blood volume (nCBV), capillary transit time heterogeneity (CTH), oxygen extraction fraction (OEF), relative cerebral metabolic rate of oxygen (rCMRO2), and mean ADC values. Leptomeningeal metastases (LM) was diagnosed with imaging. Cox analyses were conducted to determine predictors of overall survival (OS) in entire patients and a subgroup of patients with contrast-enhancing (CE) tumor.
Results: The median patient age was 40.5 years (range 19.9-75.7), with an OS of 30.3 months (interquartile range 11.3-32.3). In entire patients, the presence of LM was the only independent predictor of OS (hazard ratio [HR] = 6.01, P = 0.009). In the subgroup of 23 (71.9%) patients with CE tumors, rCMRO2 of CE tumor (HR = 1.08, P = 0.019) and the presence of LM (HR = 5.92, P = 0.043) were independent predictors of OS.
Conclusion: The presence of LM was independently associated with poor prognosis in adult patients with H3 K27-altered DMG. In patients with CE tumors, higher rCMRO2 of CE tumor, which may reflect higher metabolic activity in the tumor oxygenation microenvironment, may be a useful imaging biomarker to predict poor prognosis.
{"title":"Identification of prognostic imaging biomarkers in H3 K27-altered diffuse midline gliomas in adults: impact of tumor oxygenation imaging biomarkers on survival.","authors":"Yongsik Sim, Kaeum Choi, Kyunghwa Han, Seo Hee Choi, Narae Lee, Yae Won Park, Na-Young Shin, Sung Soo Ahn, Jong Hee Chang, Se Hoon Kim, Seung-Koo Lee","doi":"10.1007/s00234-024-03412-0","DOIUrl":"10.1007/s00234-024-03412-0","url":null,"abstract":"<p><strong>Purpose: </strong>To investigate prognostic markers for H3 K27-altered diffuse midline gliomas (DMGs) in adults with clinical, qualitative and quantitative imaging phenotypes, including tumor oxygenation characteristics.</p><p><strong>Methods: </strong>Retrospective chart and imaging reviews were conducted on 32 adults with H3 K27-altered DMGs between 2017 and 2023. Clinical and qualitative imaging characteristics were analyzed. Quantitative imaging assessment was performed from the tumor mask via automatic segmentation to calculate normalized cerebral blood volume (nCBV), capillary transit time heterogeneity (CTH), oxygen extraction fraction (OEF), relative cerebral metabolic rate of oxygen (rCMRO<sub>2</sub>), and mean ADC values. Leptomeningeal metastases (LM) was diagnosed with imaging. Cox analyses were conducted to determine predictors of overall survival (OS) in entire patients and a subgroup of patients with contrast-enhancing (CE) tumor.</p><p><strong>Results: </strong>The median patient age was 40.5 years (range 19.9-75.7), with an OS of 30.3 months (interquartile range 11.3-32.3). In entire patients, the presence of LM was the only independent predictor of OS (hazard ratio [HR] = 6.01, P = 0.009). In the subgroup of 23 (71.9%) patients with CE tumors, rCMRO<sub>2</sub> of CE tumor (HR = 1.08, P = 0.019) and the presence of LM (HR = 5.92, P = 0.043) were independent predictors of OS.</p><p><strong>Conclusion: </strong>The presence of LM was independently associated with poor prognosis in adult patients with H3 K27-altered DMG. In patients with CE tumors, higher rCMRO<sub>2</sub> of CE tumor, which may reflect higher metabolic activity in the tumor oxygenation microenvironment, may be a useful imaging biomarker to predict poor prognosis.</p>","PeriodicalId":19422,"journal":{"name":"Neuroradiology","volume":null,"pages":null},"PeriodicalIF":2.4,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141620555","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-09-01Epub Date: 2024-06-14DOI: 10.1007/s00234-024-03391-2
Shuchen Ding, Lunhao Chen, Chudi Fu, Miao Liu, Ying Yuan, Michele C Battié, Yue Wang
Objectives: To determine the characteristics of lumbar foraminal stenosis (LFS) on magnetic resonance (MR) images and their association with back pain and radiating leg pain in a population-based sample of Chinese subjects.
Methods: This study was an extension of the Hangzhou Lumbar Spine Study, a cross-sectional study focusing on back pain and lumbar spine MR imaging findings. Questionnaire data, including demographics, lifestyle, occupational exposures, back pain and radiating leg pain were included. On lumbar spine MR images, disc degeneration was assessed using Pfirrmann grade and Modic changes were evaluated. Using Lee's scale, the L3-S1 intervertebral foramina were evaluated, with grade 2-3 representing substantial LFS and grade 0-1 no LFS. Characteristics of LFS were noted, and associations of LFS with back pain and radiating leg pain were examined.
Results: Among the 644 study subjects, 141 (21.9%) had at least one LFS, and its occurrence was associated with greater age (OR = 1.93 for each 10 years, p < 0.001). Substantial LFS was associated with the presence of back pain (OR = 1.92, p = 0.001) and the intensity of the worst back pain (Coef = 8.30, p < 0.001) over the past 12 months, and disabling back pain during their lifetime (OR = 2.25, p < 0.001). Substantial LFS was also associated with leg pain (OR = 14.27, p < 0.001), with a sensitivity of 75.7% for the presence of radiating leg pain and a specificity of 81.4%.
Conclusion: Substantial LFS on MR images was a common age-related degenerative phenotype in adults, and appears to be an independent risk factor for back pain and leg pain.
{"title":"Lumbar foraminal stenosis was associated with back pain and leg pain: epidemiological evidence from a population-based cohort.","authors":"Shuchen Ding, Lunhao Chen, Chudi Fu, Miao Liu, Ying Yuan, Michele C Battié, Yue Wang","doi":"10.1007/s00234-024-03391-2","DOIUrl":"10.1007/s00234-024-03391-2","url":null,"abstract":"<p><strong>Objectives: </strong>To determine the characteristics of lumbar foraminal stenosis (LFS) on magnetic resonance (MR) images and their association with back pain and radiating leg pain in a population-based sample of Chinese subjects.</p><p><strong>Methods: </strong>This study was an extension of the Hangzhou Lumbar Spine Study, a cross-sectional study focusing on back pain and lumbar spine MR imaging findings. Questionnaire data, including demographics, lifestyle, occupational exposures, back pain and radiating leg pain were included. On lumbar spine MR images, disc degeneration was assessed using Pfirrmann grade and Modic changes were evaluated. Using Lee's scale, the L3-S1 intervertebral foramina were evaluated, with grade 2-3 representing substantial LFS and grade 0-1 no LFS. Characteristics of LFS were noted, and associations of LFS with back pain and radiating leg pain were examined.</p><p><strong>Results: </strong>Among the 644 study subjects, 141 (21.9%) had at least one LFS, and its occurrence was associated with greater age (OR = 1.93 for each 10 years, p < 0.001). Substantial LFS was associated with the presence of back pain (OR = 1.92, p = 0.001) and the intensity of the worst back pain (Coef = 8.30, p < 0.001) over the past 12 months, and disabling back pain during their lifetime (OR = 2.25, p < 0.001). Substantial LFS was also associated with leg pain (OR = 14.27, p < 0.001), with a sensitivity of 75.7% for the presence of radiating leg pain and a specificity of 81.4%.</p><p><strong>Conclusion: </strong>Substantial LFS on MR images was a common age-related degenerative phenotype in adults, and appears to be an independent risk factor for back pain and leg pain.</p>","PeriodicalId":19422,"journal":{"name":"Neuroradiology","volume":null,"pages":null},"PeriodicalIF":2.4,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141317927","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-09-01Epub Date: 2024-06-18DOI: 10.1007/s00234-024-03405-z
Marianna Angelo Palmejani Albacete, Gustavo Novelino Simão, Charles Marques Lourenço, Antonio Carlos Dos Santos
Purpose: To characterize Vanishing White Matter Disease (VWM) cases from a Brazilian University Tertiary hospital, focusing on brain magnetic resonance image (MRI) aspects, clinical and molecular data.
Methods: Medical records and brain MRI of 13 genetically confirmed VWM patients were reviewed. Epidemiological data such as age at symptom onset, gender and main symptoms were analyzed, along with genetic mutations and MRI characteristics, such as the distribution of white matter lesions and atrophy.
Results: The majority of patients were female, with the age of symptom onset ranging from 1 year and 6 months to 40 years. All mutations were identified in the EIF2B5 gene, the most prevalent being c.338G > A (p.Arg113His), and a novel mutation related to the disease was discovered, c.1051G > A (p.Gly351Ser). Trauma or infection were significant triggers. The most frequent symptoms were ataxia and limb spasticity. All MRI scans displayed deep white matter involvement, cystic degeneration, with U-fibers relatively spared and a predilection for the frontoparietal region. Lesions in the corpus callosum and posterior fossa were present in all patients. Follow-up exams revealed the evolution of white matter lesions and cerebral atrophy, which correlated with clinical deterioration.
Conclusions: VWM affects various age groups, with a significant clinical and genetic variability. A novel mutation associated with the disease is highlighted. MRI reveals a typical pattern of white matter involvement, characterized by diffuse lesions in the periventricular and deep regions, with subsequent extension to the subcortical areas, accompanied by cystic degeneration, and plays a crucial role in diagnosis and follow-up.
目的:分析巴西一所大学附属三级医院的消失的白质病(VWM)病例,重点关注脑磁共振成像(MRI)、临床和分子数据:方法:研究人员查阅了 13 名经基因证实的 VWM 患者的病历和脑磁共振成像。分析了发病年龄、性别和主要症状等流行病学数据,以及基因突变和磁共振成像特征,如白质病变和萎缩的分布:大多数患者为女性,发病年龄从1岁6个月到40岁不等。所有突变均在EIF2B5基因中被发现,其中最常见的突变为c.338G > A (p.Arg113His),同时还发现了一个与该病相关的新型突变,即c.1051G > A (p.Gly351Ser)。创伤或感染是重要的诱发因素。最常见的症状是共济失调和肢体痉挛。所有核磁共振扫描均显示深部白质受累、囊性变性,U-纤维相对幸免,并偏爱额顶区。所有患者的胼胝体和后窝均出现病变。随访检查显示白质病变和脑萎缩在不断发展,这与临床病情恶化有关:结论:VWM 影响着不同年龄段的人群,具有显著的临床和遗传变异性。与该病相关的一种新型基因突变得到了强调。磁共振成像显示了典型的白质受累模式,其特点是脑室周围和深部的弥漫性病变,随后扩展到皮层下区域,并伴有囊性变性,在诊断和随访中起着至关重要的作用。
{"title":"Vanishing white matter disease: imaging, clinical and molecular correlation in Brazilian families.","authors":"Marianna Angelo Palmejani Albacete, Gustavo Novelino Simão, Charles Marques Lourenço, Antonio Carlos Dos Santos","doi":"10.1007/s00234-024-03405-z","DOIUrl":"10.1007/s00234-024-03405-z","url":null,"abstract":"<p><strong>Purpose: </strong>To characterize Vanishing White Matter Disease (VWM) cases from a Brazilian University Tertiary hospital, focusing on brain magnetic resonance image (MRI) aspects, clinical and molecular data.</p><p><strong>Methods: </strong>Medical records and brain MRI of 13 genetically confirmed VWM patients were reviewed. Epidemiological data such as age at symptom onset, gender and main symptoms were analyzed, along with genetic mutations and MRI characteristics, such as the distribution of white matter lesions and atrophy.</p><p><strong>Results: </strong>The majority of patients were female, with the age of symptom onset ranging from 1 year and 6 months to 40 years. All mutations were identified in the EIF2B5 gene, the most prevalent being c.338G > A (p.Arg113His), and a novel mutation related to the disease was discovered, c.1051G > A (p.Gly351Ser). Trauma or infection were significant triggers. The most frequent symptoms were ataxia and limb spasticity. All MRI scans displayed deep white matter involvement, cystic degeneration, with U-fibers relatively spared and a predilection for the frontoparietal region. Lesions in the corpus callosum and posterior fossa were present in all patients. Follow-up exams revealed the evolution of white matter lesions and cerebral atrophy, which correlated with clinical deterioration.</p><p><strong>Conclusions: </strong>VWM affects various age groups, with a significant clinical and genetic variability. A novel mutation associated with the disease is highlighted. MRI reveals a typical pattern of white matter involvement, characterized by diffuse lesions in the periventricular and deep regions, with subsequent extension to the subcortical areas, accompanied by cystic degeneration, and plays a crucial role in diagnosis and follow-up.</p>","PeriodicalId":19422,"journal":{"name":"Neuroradiology","volume":null,"pages":null},"PeriodicalIF":2.4,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141420069","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Bifurcations are a common site for saccular aneurysms, but rarely can be a site for dissecting aneurysms. Identification of these aneurysms is extremely important because the management plan depends on it. We describe a rare case of a ruptured dissecting aneurysm at the right ICA bifurcation in a pre-teen child which posed a diagnostic dilemma but ultimately was successfully managed with flow diversion.
{"title":"Bifurcation dissecting aneurysm: tips and tricks to differentiate from saccular aneurysm.","authors":"Neha Choudhary, Vivek Gupta, Pratibha Singhi, Anandh Balasubramaniam, Priyanka Madaan, Pradeep Sharma","doi":"10.1007/s00234-024-03421-z","DOIUrl":"10.1007/s00234-024-03421-z","url":null,"abstract":"<p><p>Bifurcations are a common site for saccular aneurysms, but rarely can be a site for dissecting aneurysms. Identification of these aneurysms is extremely important because the management plan depends on it. We describe a rare case of a ruptured dissecting aneurysm at the right ICA bifurcation in a pre-teen child which posed a diagnostic dilemma but ultimately was successfully managed with flow diversion.</p>","PeriodicalId":19422,"journal":{"name":"Neuroradiology","volume":null,"pages":null},"PeriodicalIF":2.4,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141620554","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-09-01Epub Date: 2024-07-04DOI: 10.1007/s00234-024-03410-2
Max Wintermark, Jason W Allen, Yoshimi Anzai, Tilak Das, Adam E Flanders, Damien Galanaud, Alisa Gean, Sven Haller, Han Lv, Jussi Hirvonen, John E Jordan, Roland Lee, Yvonne W Lui, Pia C Sundgren, Pratik Mukherjee, Kent Gøran Moen, Mario Muto, Karelys Ng, Sumit N Niogi, Alex Rovira, Niloufar Libre de Bruxellas, Marion Smits, A John Tsiouris, Johan Van Goethem, Thijs Vande Vyvere, Chris Whitlow, Martin Wiesmann, Kei Yamada, Natalia Zakharova, Paul M Parizel
Background and purpose: Traumatic brain injury (TBI) is a major source of health loss and disability worldwide. Accurate and timely diagnosis of TBI is critical for appropriate treatment and management of the condition. Neuroimaging plays a crucial role in the diagnosis and characterization of TBI. Computed tomography (CT) is the first-line diagnostic imaging modality typically utilized in patients with suspected acute mild, moderate and severe TBI. Radiology reports play a crucial role in the diagnostic process, providing critical information about the location and extent of brain injury, as well as factors that could prevent secondary injury. However, the complexity and variability of radiology reports can make it challenging for healthcare providers to extract the necessary information for diagnosis and treatment planning.
Methods/results/conclusion: In this article, we report the efforts of an international group of TBI imaging experts to develop a clinical radiology report template for CT scans obtained in patients suspected of TBI and consisting of fourteen different subdivisions (CT technique, mechanism of injury or clinical history, presence of scalp injuries, fractures, potential vascular injuries, potential injuries involving the extra-axial spaces, brain parenchymal injuries, potential injuries involving the cerebrospinal fluid spaces and the ventricular system, mass effect, secondary injuries, prior or coexisting pathology).
{"title":"Standardized reporting for Head CT Scans in patients suspected of traumatic brain injury (TBI): An international expert endeavor.","authors":"Max Wintermark, Jason W Allen, Yoshimi Anzai, Tilak Das, Adam E Flanders, Damien Galanaud, Alisa Gean, Sven Haller, Han Lv, Jussi Hirvonen, John E Jordan, Roland Lee, Yvonne W Lui, Pia C Sundgren, Pratik Mukherjee, Kent Gøran Moen, Mario Muto, Karelys Ng, Sumit N Niogi, Alex Rovira, Niloufar Libre de Bruxellas, Marion Smits, A John Tsiouris, Johan Van Goethem, Thijs Vande Vyvere, Chris Whitlow, Martin Wiesmann, Kei Yamada, Natalia Zakharova, Paul M Parizel","doi":"10.1007/s00234-024-03410-2","DOIUrl":"10.1007/s00234-024-03410-2","url":null,"abstract":"<p><strong>Background and purpose: </strong>Traumatic brain injury (TBI) is a major source of health loss and disability worldwide. Accurate and timely diagnosis of TBI is critical for appropriate treatment and management of the condition. Neuroimaging plays a crucial role in the diagnosis and characterization of TBI. Computed tomography (CT) is the first-line diagnostic imaging modality typically utilized in patients with suspected acute mild, moderate and severe TBI. Radiology reports play a crucial role in the diagnostic process, providing critical information about the location and extent of brain injury, as well as factors that could prevent secondary injury. However, the complexity and variability of radiology reports can make it challenging for healthcare providers to extract the necessary information for diagnosis and treatment planning.</p><p><strong>Methods/results/conclusion: </strong>In this article, we report the efforts of an international group of TBI imaging experts to develop a clinical radiology report template for CT scans obtained in patients suspected of TBI and consisting of fourteen different subdivisions (CT technique, mechanism of injury or clinical history, presence of scalp injuries, fractures, potential vascular injuries, potential injuries involving the extra-axial spaces, brain parenchymal injuries, potential injuries involving the cerebrospinal fluid spaces and the ventricular system, mass effect, secondary injuries, prior or coexisting pathology).</p>","PeriodicalId":19422,"journal":{"name":"Neuroradiology","volume":null,"pages":null},"PeriodicalIF":2.4,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141498592","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-09-01Epub Date: 2024-06-07DOI: 10.1007/s00234-024-03397-w
Mousa Zidan, Christian Gronemann, Nils Christian Lehnen, Felix Bode, Johannes Weller, Gabor Petzold, Alexander Radbruch, Daniel Paech, Franziska Dorn
Purpose: Double-layer design carotid stents have been cast in a negative light since several investigations reported high rates of in-stent occlusions, at least in the acute setting of tandem occlusions. CGuard is a new generation double-layered stent that was designed to prevent periinterventional embolic events. The aim of this study was to analyze the safety and efficacy of the CGuard in emergent CAS and for the acute treatment of tandem occlusions in comparison with the single-layer Carotid Wallstent (CWS) system.
Methods: All patients who underwent CAS with CGuard or CWS after intracranial mechanical thrombectomy (MT) between 11/2018 and 12/2022 were identified from our local thrombectomy registry. Clinical, interventional and neuroimaging data were analyzed. Patency of the stent was assessed within 72 h. Intracranial hemorrhage and modified Rankin score (mRS) at discharge were the main endpoints.
Results: In total, 86 stent procedures in 86 patients were included (CWS: 44, CGuard: 42). CGuard had a lower, but not statistically significant rate (p = 0.431) of in-stent occlusions (n = 2, 4.8%) when compared to the CWS (n = 4, 9.1%). Significant in-stent stenosis was found in one case in each group. There was no statistically significant difference in functional outcome at discharge between the two groups with a median mRS for CGuard of 2 (IQR:1-5) vs. CWS 3 (IQR:2-4).
Conclusion: In our series, the rate of in-stent occlusions after emergent CAS was lower with the dual-layer CGuard when compared to the monolayer CWS. Further data are needed to evaluate the potential benefit of the design in more detail.
目的:自从几项研究报告了高支架内闭塞率(至少在急性串联闭塞的情况下)后,双层设计的颈动脉支架就一直受到负面评价。CGuard 是新一代双层支架,旨在预防介入周围栓塞事件。本研究旨在分析 CGuard 与单层颈动脉壁支架(CWS)系统相比,在紧急 CAS 和串联闭塞的急性治疗中的安全性和有效性:方法:从本地血栓切除术登记册中筛选出2018年11月至2022年12月期间所有在颅内机械血栓切除术(MT)后使用CGuard或CWS进行CAS手术的患者。对临床、介入和神经影像学数据进行了分析。颅内出血和出院时改良Rankin评分(mRS)是主要终点:共有86名患者接受了86例支架手术(CWS:44例,CGuard:42例)。与CWS(4例,9.1%)相比,CGuard的支架内闭塞率(2例,4.8%)较低,但无统计学意义(P = 0.431)。两组中均有一例发现明显的支架内狭窄。两组患者出院时的功能预后无明显统计学差异,CGuard的中位mRS为2(IQR:1-5),CWS为3(IQR:2-4):在我们的系列研究中,与单层CWS相比,双层CGuard的急诊CAS术后支架内闭塞率更低。要更详细地评估这种设计的潜在益处,还需要更多数据。
{"title":"Stenting with dual-layer CGuard stent in acute sub-occlusive carotid artery stenosis and in tandem occlusions: a monocentric study.","authors":"Mousa Zidan, Christian Gronemann, Nils Christian Lehnen, Felix Bode, Johannes Weller, Gabor Petzold, Alexander Radbruch, Daniel Paech, Franziska Dorn","doi":"10.1007/s00234-024-03397-w","DOIUrl":"10.1007/s00234-024-03397-w","url":null,"abstract":"<p><strong>Purpose: </strong>Double-layer design carotid stents have been cast in a negative light since several investigations reported high rates of in-stent occlusions, at least in the acute setting of tandem occlusions. CGuard is a new generation double-layered stent that was designed to prevent periinterventional embolic events. The aim of this study was to analyze the safety and efficacy of the CGuard in emergent CAS and for the acute treatment of tandem occlusions in comparison with the single-layer Carotid Wallstent (CWS) system.</p><p><strong>Methods: </strong>All patients who underwent CAS with CGuard or CWS after intracranial mechanical thrombectomy (MT) between 11/2018 and 12/2022 were identified from our local thrombectomy registry. Clinical, interventional and neuroimaging data were analyzed. Patency of the stent was assessed within 72 h. Intracranial hemorrhage and modified Rankin score (mRS) at discharge were the main endpoints.</p><p><strong>Results: </strong>In total, 86 stent procedures in 86 patients were included (CWS: 44, CGuard: 42). CGuard had a lower, but not statistically significant rate (p = 0.431) of in-stent occlusions (n = 2, 4.8%) when compared to the CWS (n = 4, 9.1%). Significant in-stent stenosis was found in one case in each group. There was no statistically significant difference in functional outcome at discharge between the two groups with a median mRS for CGuard of 2 (IQR:1-5) vs. CWS 3 (IQR:2-4).</p><p><strong>Conclusion: </strong>In our series, the rate of in-stent occlusions after emergent CAS was lower with the dual-layer CGuard when compared to the monolayer CWS. Further data are needed to evaluate the potential benefit of the design in more detail.</p>","PeriodicalId":19422,"journal":{"name":"Neuroradiology","volume":null,"pages":null},"PeriodicalIF":2.4,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11322317/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141284340","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-09-01Epub Date: 2024-06-13DOI: 10.1007/s00234-024-03389-w
Antti Lindgren, Syed Uzair Ahmed, Vivek Bodani, Emily Chung, Ronit Agid, Hugo Andrade Barazarte, Patrick Joseph Nicholson, Joanna Danielle Schaafsma, Ivan Radovanovic, Karel Terbrugge, Pascal Roger Mosimann, Timo Krings, Eef J Hendriks
Purpose: Spontaneous direct carotid-cavernous fistula (CCF) are usually caused by a ruptured carotid cavernous aneurysm. We studied treatment of spontaneous direct CCFs in a single-center cohort of a high-volume tertiary referral center, reporting anatomical details, technical approaches of treatment, and outcomes.
Methods: Adult patients with a spontaneous direct CCF treated between 2010-2022 with follow-up MRI and/or DSA imaging available were retrospectively analyzed. We studied age, sex, clinical presentation, angiographic findings, treatment techniques, outcomes, and complications.
Results: Out of 80 patients with CCFs, twelve patients were treated for a non-traumatic direct CCF (15%) in 13 sessions. Median age was 65 years. Two patients had an underlying connective tissue disorder. In 10 cases, the direct CCF was caused by a ruptured cavernous carotid aneurysm. The direct CCFs were treated by endovascular transarterial embolization (10 cases), transvenous embolization (1 case), or surgery (1 case). Selective closure of the shunt was possible in 10 patients. Two patients were treated with parent vessel occlusion (PVO; one endovascular; one surgical, with bypass). Complications occurred in 2 / 12 patients (17%), with permanent morbidity in two patients (17%): trigeminal neuralgia after PVO and new infarct after surgical PVO and bypass. Selective closure of CCF resulted in no morbidity. There was no mortality in our series.
Conclusion: Spontaneous direct CCFs are caused by rupture of a cavernous carotid aneurysm in most cases. Selective closure of the shunt, usually feasible transarterially with coils, achieves good results. Reconstructive endovascular techniques are preferred to minimize treatment related neurological complications.
{"title":"Embolization techniques of spontaneous direct carotid-cavernous fistulae: a single-center experience.","authors":"Antti Lindgren, Syed Uzair Ahmed, Vivek Bodani, Emily Chung, Ronit Agid, Hugo Andrade Barazarte, Patrick Joseph Nicholson, Joanna Danielle Schaafsma, Ivan Radovanovic, Karel Terbrugge, Pascal Roger Mosimann, Timo Krings, Eef J Hendriks","doi":"10.1007/s00234-024-03389-w","DOIUrl":"10.1007/s00234-024-03389-w","url":null,"abstract":"<p><strong>Purpose: </strong>Spontaneous direct carotid-cavernous fistula (CCF) are usually caused by a ruptured carotid cavernous aneurysm. We studied treatment of spontaneous direct CCFs in a single-center cohort of a high-volume tertiary referral center, reporting anatomical details, technical approaches of treatment, and outcomes.</p><p><strong>Methods: </strong>Adult patients with a spontaneous direct CCF treated between 2010-2022 with follow-up MRI and/or DSA imaging available were retrospectively analyzed. We studied age, sex, clinical presentation, angiographic findings, treatment techniques, outcomes, and complications.</p><p><strong>Results: </strong>Out of 80 patients with CCFs, twelve patients were treated for a non-traumatic direct CCF (15%) in 13 sessions. Median age was 65 years. Two patients had an underlying connective tissue disorder. In 10 cases, the direct CCF was caused by a ruptured cavernous carotid aneurysm. The direct CCFs were treated by endovascular transarterial embolization (10 cases), transvenous embolization (1 case), or surgery (1 case). Selective closure of the shunt was possible in 10 patients. Two patients were treated with parent vessel occlusion (PVO; one endovascular; one surgical, with bypass). Complications occurred in 2 / 12 patients (17%), with permanent morbidity in two patients (17%): trigeminal neuralgia after PVO and new infarct after surgical PVO and bypass. Selective closure of CCF resulted in no morbidity. There was no mortality in our series.</p><p><strong>Conclusion: </strong>Spontaneous direct CCFs are caused by rupture of a cavernous carotid aneurysm in most cases. Selective closure of the shunt, usually feasible transarterially with coils, achieves good results. Reconstructive endovascular techniques are preferred to minimize treatment related neurological complications.</p>","PeriodicalId":19422,"journal":{"name":"Neuroradiology","volume":null,"pages":null},"PeriodicalIF":2.4,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141311293","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-09-01Epub Date: 2024-07-02DOI: 10.1007/s00234-024-03398-9
Francisco Sepulveda, Raffaella Scotto Opipari, Fiorenza Coppola, Antonia Ramaglia, Kshitij Mankad, Cesar A P Alves, Brigitte Bison, Ulrike Löbel
The differential diagnosis of supratentorial brain tumours in children can be challenging, especially considering the recent changes to the WHO classification of CNS tumours published in 2021. Many new tumour types have been proposed which frequently present in children and young adults and their imaging features are currently being described by the neuroradiology community. The purpose of this article is to provide guidance to residents and fellows new to the field of paediatric neuroradiology on how to evaluate an MRI of a patient with a newly diagnosed supratentorial tumour. Six different approaches are discussed including: 1. Tumour types, briefly discussing the main changes to the recent WHO classification of CNS tumours, 2. Patient age and its influence on incidence rates of specific tumour types, 3. Growth patterns, 4. Tumour location and how defining the correct location helps in narrowing down the differential diagnoses and 5. Imaging features of the tumour on DWI, SWI, FLAIR and post contrast sequences.
{"title":"Approaches to supratentorial brain tumours in children.","authors":"Francisco Sepulveda, Raffaella Scotto Opipari, Fiorenza Coppola, Antonia Ramaglia, Kshitij Mankad, Cesar A P Alves, Brigitte Bison, Ulrike Löbel","doi":"10.1007/s00234-024-03398-9","DOIUrl":"10.1007/s00234-024-03398-9","url":null,"abstract":"<p><p>The differential diagnosis of supratentorial brain tumours in children can be challenging, especially considering the recent changes to the WHO classification of CNS tumours published in 2021. Many new tumour types have been proposed which frequently present in children and young adults and their imaging features are currently being described by the neuroradiology community. The purpose of this article is to provide guidance to residents and fellows new to the field of paediatric neuroradiology on how to evaluate an MRI of a patient with a newly diagnosed supratentorial tumour. Six different approaches are discussed including: 1. Tumour types, briefly discussing the main changes to the recent WHO classification of CNS tumours, 2. Patient age and its influence on incidence rates of specific tumour types, 3. Growth patterns, 4. Tumour location and how defining the correct location helps in narrowing down the differential diagnoses and 5. Imaging features of the tumour on DWI, SWI, FLAIR and post contrast sequences.</p>","PeriodicalId":19422,"journal":{"name":"Neuroradiology","volume":null,"pages":null},"PeriodicalIF":2.4,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141492888","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}