Neuroradiology最新文献

Objective: This systematic review and meta-analysis aimed to evaluate the safety and efficacy of intravenous (IV) nerinetide in acute ischemic stroke (AIS) patients undergoing endovascular thrombectomy (EVT) without prior or concurrent IV thrombolysis (IVT).

Methods: A systematic search of PubMed, Web of Science, and Scopus was conducted through March 15, 2025, identifying randomized controlled trials (RCTs) comparing EVT plus nerinetide versus EVT plus placebo without IVT. Screening and data extraction were performed independently by two reviewers, with conflicts resolved by a third. Risk of bias was assessed using RoB 2.0. Data were synthesized using RevMan 5.4 with random-effects models, and heterogeneity was evaluated via chi-square and I² statistics.

Results: Three RCTs comprising 726 patients in the IV nerinetide group and 668 in the placebo group were included. Nerinetide did not significantly improve functional outcomes: 90-day modified Rankin Scale (mRS) 0-1 (RR: 1.02, 95% CI: [0.71, 1.47], P = 0.92) and mRS 0-2 (RR: 1.07, 95% CI: [0.93, 1.22], P = 0.35). No significant differences were observed in 90-day mortality (RR: 0.89, 95% CI: [0.60, 1.34], P = 0.59) or adverse events, including symptomatic intracranial hemorrhage (RR: 0.80, 95% CI: [0.44, 1.45], P = 0.46).

Conclusion: Nerinetide administration during EVT in AIS patients without IVT did not significantly improve functional independence, survival, or safety outcomes compared to placebo. Although preclinical data supported neuroprotection, clinical benefits were not observed, highlighting the challenges in translating neuroprotective strategies into effective stroke therapies.

Purpose: Cortical thickness (CTh) is a valuable imaging biomarker of brain development and aging. The assessment of CTh using the two most widely utilized software packages, Computational Anatomy Toolbox (CAT12) and FreeSurfer, reveals systematic differences between the two tools. Nonetheless, longitudinal results are supposed to be less affected by such differences. To date, there is no comparison of longitudinal CTh data obtained with these preprocessing pipelines.

Methods: We evaluated cross-sectional and longitudinal measurements of CTh using CAT12 and FreeSurfer in healthy older individuals with structural brain MRI. First, we compared cross-sectional CTh values obtained with these two methods using paired t-tests and correlation analyses. Second, we compared longitudinal CAT12 and FreeSurfer-based data using annualized percent change (APC) of CTh between two timepoints.

Results: Cross-sectional CTh values were higher in FreeSurfer compared to CAT12 in most regions, albeit highly correlated and similarly distributed. In contrast, longitudinal analyses revealed significant differences in APC values with only weak to moderate correlation between the two methods.

Conclusion: Significant differences in longitudinal results between CAT12 and FreeSurfer emphasize the need to consider the preprocessing methods used when interpreting MRI data in brain aging research. Further technical developments are warranted for reliable longitudinal CTh assessment in elderly cohorts.

Background: The woven EndoBridge (WEB) device has been introduced for the treatment of wide-neck bifurcation aneurysms; however, device selection remains a major challenge inWEB treatment. This study aimed to demonstrate the effectiveness of WEB selection using volumetric analysis and its 1-year radiological outcomes.

Methods: We retrospectively analysed patients with unruptured wide-neck bifurcation aneurysms who underwent WEB treatment between August 2021 and January 2023. Aneurysm volume was measured semi-automatically using a three-dimensional volume-rendering programme. Radiological outcomes were analysed using the WEB Occlusion Scale (WOS) at 1-year catheter angiography follow-up. Receiver operating characteristic (ROC) curve analysis was conducted to evaluate the prognostic performance of the device-to-aneurysm volume (DAV) ratio for predicting complete occlusion. Univariate and multivariate analyses were performed to assess the predictive factors for complete occlusion.

Results: Fifty-seven unruptured intracranial aneurysms, in 56 patients were treated with the WEB device. The device was changed in 14 patients (24.6%) following the + 1/-1 rule, and volume-based recommendations were appropriate for all patients. At the 1-year follow-up, complete occlusion (WOS A and B) was confirmed in 35 patients (61.4%), and adequate occlusion (WOS A, B, and C) was confirmed in 87.7% (50 of 57 patients). The ROC curve analysis showed a significant relationship for 1-year complete occlusion (area under the curve: 0.74, 95% confidence interval [CI]: 0.59-0.88) with an optimal cut-off of 0.92. The DAV ratio was the only significant predictive factor for 1-year complete occlusion in the univariate (odds ratio [OR]: 7.0, 95% CI: 2.20-24.7, p = 0.001) and multivariate (OR: 20.39, 95% CI: 3.56-111.73, p = 0.0007) analyses.

Conclusions: Volume-based WEB selection was appropriate for initial device selection and 1-year radiological outcomes. The selection of a WEB device with a volume exceeding 92% of that of the targeted aneurysm could be considered for 1-year radiological outcomes.

Purpose: The aim of this study was to leverage fluorodeoxyglucose-positron emission tomography (FDG-PET) and blood oxygen level dependent-functional magnetic resonance imaging (BOLD-fMRI) to perform a comprehensive multi-modal analysis of metabolic alteration and individualized functional connectivity in Alzheimer's Disease (AD) and mild cognitive impairment (MCI) and characterize the relationship of these alterations with neurocognitive scores.

Methods: We analyzed data from 71 subjects, including those with AD, MCI and Health Control (HC), using FDG-PET and BOLD-fMRI acquired from Alzheimer's Disease Neuroimaging Initiative (ADNI). We examined network functional connectivities (FC) base on Independent Component Analysis (ICA), analyzed regional standardized uptake value ratios (SUVR) and their relationships with neurocognitive scores.

Results: Both AD and MCI showed metabolic and functional connectivity abnormalities in Default Mode Network (DMN) region. We also found abnormalities in the somatomotor system in AD, which may be an early predictive indicator of AD. In MCI, both metabolic and functional connectivity abnormalities appear in precuneus, and these two modes were closely related, indicating that the precuneus may be a core region in the transition of healthy individuals to MCI.

Conclusion: This study demonstrated that the individual brain network technology based on ICA, combined with the metabolic characteristics of FDG-PET, facilitates the development of personalized early diagnosis for AD/MCI, enhances our understanding of the underlying neuropathological mechanisms, and also promotes the development of interdisciplinary technologies.

Purpose: The Woven EndoBridge (WEB) device is an intrasaccular flow disruptor designed for the treatment of wide-neck intracranial bifurcation aneurysms. The purpose of this study was to evaluate various factors associated with clinical and angiographic outcomes following WEB treatment.

Methods: This multicenter, retrospective study analyzed 405 patients with 412 aneurysms treated with the WEB device across 22 neurovascular centers. Clinical and radiologic data were reviewed to identify factors influencing patients' clinical outcome and target aneurysmal occlusion at short-term (within 6 months) and long-term (beyond 1 year) follow-up. Occlusion status of target aneurysms was analyzed in relation to the various clinical and morphological factors. Outcomes were also compared based on institutional treatment volume.

Results: Centers with higher WEB treatment volumes (more than 30 cases) demonstrated lower thromboembolic events with sequelae (0.8% vs. 5.9%, p = 0.003). The rate of aneurysmal adequate occlusion, defined by Raymond-Roy occlusion class 1 and 2, increased from 70.2% at short-term (mean, 133 ± 42 days) to 83.2% at long-term (mean, 499 ± 134 days) follow-up (p = 0.003). Aneurysm diameter was inversely correlated with complete occlusion, with a 6-mm cutoff identified. Wide-neck aneurysms exhibited lower occlusion rates at short-term period, but this effect was not observed at later periods. Aneurysms at the basilar apex and internal carotid artery terminus demonstrated higher rates of complete occlusion (p = 0.046). Smoking acted as an inhibitor of long-term occlusion of target aneurysms.

Conclusion: Institutional experience appeared to play a role in reducing procedure-related thromboembolic complications. Aneurysmal diameter, neck width, location and patients' smoking status influenced angiographic outcomes.

Purpose: Traumatic brain injury (TBI) often leads to blood-brain barrier (BBB) disruption, contributing to secondary brain damage. Perfusion computed tomography (PCT) may assess BBB permeability through the transfer constant (K^trans), while serum S100 calcium-binding protein B (S100B) serves as a biomarker of BBB integrity. However, the relationship between PCT derived K^trans and serum S100B concentrations in TBI has not been fully explored.

Methods: This observational study included 26 adult patients with moderate or severe TBI. PCT was performed 12-24 h after admission to measure K^trans values in the pericontusional edema region. Serum S100B levels were measured at regular intervals during the first 36 h. Correlations between K^trans and S100B were analyzed using Spearman's rank correlation, and the predictive capacity of mean K^trans for serum S100B rise was evaluated using receiver operating characteristic (ROC) analysis.

Results: A significant positive correlation was found between both initial and peak serum S100B concentrations and mean K^trans (r_s = 0.52, p = 0.018 and r_s = 0.47, p = 0.029, respectively) and maximum K^trans values (r_s = 0.47, p = 0.029 and r_s = 0.56, p = 0.011, respectively). ROC analysis showed that mean K^trans values predicted serum S100B rise with AUC of 0,74 (CI 95%: 0.55, 0.91).

Conclusions: Our findings demonstrated a significant correlation between pericontusional K^trans values and serum S100B concentrations, with mean K^trans values showing potential as an early predictor for serum S100B rise. These findings suggest that combining PCT and serum biomarkers could improve assessment of BBB integrity and aid in the management of TBI.

Purpose: This study aims to investigate microstructural changes in the corpus callosum (CC) of multiple sclerosis (MS) patients using texture analysis (TA), even in the absence of visible lesions on conventional MRI, and to assess its diagnostic value in distinguishing patients from healthy controls.

Methods: A retrospective analysis was conducted on midsagittal T2-weighted MRI scans of 54 MS patients without CC lesions and 50 healthy controls. Histogram-based texture analysis was performed using MATLAB software, and statistical evaluations were conducted with SPSS version 25. Texture parameters were compared between groups, and a logistic regression model was developed to predict MS diagnosis. Given that our study involves a retrospective radiology analysis, obtaining consent forms is not necessary.

Results: Statistically significant differences were found between MS patients and controls in most histogram-derived texture features, including mean, median, standard deviation, and multiple percentiles (p < 0.001). The logistic regression model incorporating selected parameters achieved a diagnostic accuracy of 94.23%, successfully identifying patients with MS despite the absence of radiologically visible lesions.

Conclusion: Texture analysis of the CC can detect subtle tissue changes in MS patients, offering a promising, non-invasive method for early diagnosis. These findings highlight the potential of TA as a complementary imaging tool in MS diagnostics and warrant further research in larger populations.