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Tantalum sedimentation in Onyx® syringes: An in-vitro study of agitation strategies to maintain fluoroscopic visibility Onyx®注射器中的钽沉淀:搅拌策略的体外研究,以保持透视可视性。
IF 3.3 3区 医学 Q2 CLINICAL NEUROLOGY Pub Date : 2026-01-02 DOI: 10.1016/j.neurad.2025.101408
Thibault Agripnidis , Farouk Tradi , Quentin Holay , Alexis Ruimy , Ahmed-Ali El Ahmadi , Basile Kerleroux , Grégoire Boulouis , Paul Habert , Mathieu Di Bisceglie , Sophie Chopinet , Pauline Brige , Valentin Espinas , Samuel Guigo , Jan-Patrick Stellmann , Vincent Vidal , Jean-François Hak

Background and purpose

During Onyx® plug formation, pauses in injection can lead to tantalum powder sedimentation, reducing fluoroscopic visibility and increasing the risk of reflux and non-target embolization. Syringe agitation is commonly used to counteract this effect. This study aimed to assess sedimentation time and identify the most effective agitation method.

Materials and Methods

Standardized preparations of 1 mL syringes were subjected to nine agitation methods (no agitation, automated/manual; fast/slow, rotary/horizontal) at 3, 5, 7, and 10 min. Optical (absorbance, transmittance) and fluoroscopic measurements (visibility, signal-to-noise ratio [SNR]) were performed. A 3D-printed intracranial artery model was also used to assess fluoroscopy visibility.

Results

Tantalum sedimentation progressed gradually, with visible deposits after 35.3 ± 7.32 min. Transmittance remained stable for 150 ± 4.12 min before decreasing. All agitation methods significantly improved SNR and visibility versus no agitation. The most effective methods were observed with automatic slow rotary and manual fast rotary agitation, which consistently maintained higher SNR and visibility (p < 0.001). In the 3D model, time had less impact, and rotary agitation did not significantly impact visibility.

Conclusions

Agitation during waiting periods is necessary to preserve visibility. Awareness of early fluoroscopy visibility loss is critical — injecting visually opaque but fluoroscopically invisible Onyx® poses procedural risks. During prolonged procedures, preloaded syringes should be regularly agitated to ensure safe embolization.
背景和目的:在Onyx®栓子形成过程中,注射暂停会导致钽粉沉积,降低透视能见度,增加反流和非靶栓塞的风险。通常使用注射器搅拌来抵消这种影响。本研究旨在评估沉淀时间,并确定最有效的搅拌方法。材料和方法:1 mL注射器的标准制剂在3、5、7和10分钟进行9种搅拌方法(无搅拌、自动/手动、快/慢、旋转/水平)。进行光学(吸光度、透过率)和荧光测量(可见度、信噪比[SNR])。3d打印颅内动脉模型也用于评估透视可视性。结果:钽沉积进展缓慢,在35.3±7.32 min后出现明显沉积。透光率在150±4.12 min内保持稳定,然后下降。与不搅拌相比,所有搅拌方法都显著提高了信噪比和可见度。自动慢速旋转搅拌和手动快速旋转搅拌最有效,均保持较高的信噪比和可见性(p < 0.001)。在三维模型中,时间影响较小,旋转搅拌对能见度影响不显著。结论:在等待期间搅动是必要的,以保持能见度。早期透视可视性丧失的意识是至关重要的-注射视觉不透明但透视不可见的Onyx®会带来程序风险。在长时间的操作过程中,应定期搅动预载注射器,以确保安全栓塞。
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引用次数: 0
Does clinical experience still hold any meaning? What remains of clinical experience in the era of Google, AI and ChatGPT? 临床经验还有意义吗?b谷歌、AI和ChatGPT领域的临床经验还剩下什么?
IF 3.3 3区 医学 Q2 CLINICAL NEUROLOGY Pub Date : 2025-12-22 DOI: 10.1016/j.neurad.2025.101413
Frédéric Clarençon
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引用次数: 0
Ultrasound-guided carotid artery stenting without contrast in ESRD patients 超声引导下无造影剂的颈动脉支架植入在ESRD患者中的应用
IF 3.3 3区 医学 Q2 CLINICAL NEUROLOGY Pub Date : 2025-12-18 DOI: 10.1016/j.neurad.2025.101410
Ying Tan , Mingyao Li , Yujie Che , Xiaobo Liu , Jiabao Yang , Ning Ma
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引用次数: 0
Bias, accuracy, and trust: no GenAI in peer reviewing 偏见、准确性和信任:同行评议中没有基因。
IF 3.3 3区 医学 Q2 CLINICAL NEUROLOGY Pub Date : 2025-12-16 DOI: 10.1016/j.neurad.2025.101411
Douraied Ben Salem , Jean-Alix Barrat , Samy Ammari , Sara Lojo Lendoiro , Ahror Belaid , Arnaud Attyé , Mathilde Ducloyer , Myriam Edjlali Goujon , Claire Boutet , Julien Ognard
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引用次数: 0
Artificial intelligence in the detection of multiple sclerosis plaques: Can it influence the treatment decision? 人工智能在多发性硬化症斑块检测中的应用:能否影响治疗决策?
IF 3.3 3区 医学 Q2 CLINICAL NEUROLOGY Pub Date : 2025-12-04 DOI: 10.1016/j.neurad.2025.101406
Milica Mastilović , Verónica Muños-Ramírez , Andreas M. Rauschecker , Jasmina Boban , Marie Blanchere , Francois Cotton , Olivier Heinzlef , Myriam Edjlali

Background and purpose

To monitor multiple sclerosis (MS) progression, follow-up MRIs are used to detect new or enlarging lesions (ELs), typically through manual comparison - a time-consuming, error-prone process. This retrospective study used Pixyl.Neuro.MS®, an AI-based tool, to assess whether AI-assisted readings improve lesion detection and influence treatment decisions.

Materials and Methods

The study was conducted retrospectively on MS patients. For the comparison of previous and new MRIs, the deep-learning-based software Pixyl.Neuro.MS® was used. This tool performs lesion segmentation and characterization according to their temporal evolution, facilitating the analysis of new lesions and ELs. Subsequently, a new AI-assisted radiological report was generated and compared with the conventional radiological report. By integrating the AI report with neurological assessments, its potential impact on treatment decisions, in contrast to those based solely on the standard radiological report, was evaluated.

Results

In this cohort of 83 MS patients (mean age 49 years, predominantly female), MRI analysis performed by radiologists with AI assistance significantly outperformed standard radiological interpretation. New lesions were identified in 30.1 % of patients using AI-assisted analysis, compared to 14.6 % with conventional reporting (p < 0.001). ELs were detected in 33.7 % of patients through AI-supported evaluation (p < 0.001), while none were identified with standard interpretation. On average, radiologists, aided by AI, identified more new lesions per patient (0.82 vs. 0.46) and achieved a higher true-positive lesion count. Importantly, integrating AI-assisted findings with clinical data led to treatment modification in 10.8 % of patients, underscoring the potential clinical impact of this approach.

Conclusion

Artificial intelligence may play a key role in improving detection of new lesions and ELs in patients with MS. The use of Pixyl.Neuro.MS® enhanced radiological interpretation, yielding a more comprehensive assessment of MRI findings compared to conventional analysis. This improved diagnostic precision contributed to revised treatment decisions in a subset of patients.
背景和目的为了监测多发性硬化症(MS)的进展,后续mri通常通过人工比较来检测新的或扩大的病变(el),这是一个耗时且容易出错的过程。本回顾性研究使用Pixyl.Neuro。MS®是一种基于人工智能的工具,用于评估人工智能辅助读数是否能改善病变检测并影响治疗决策。材料与方法对多发性硬化症患者进行回顾性研究。为了比较以前和新的核磁共振成像,基于深度学习的软件Pixyl.Neuro。采用MS®。该工具根据病灶的时间演变进行病灶分割和表征,便于分析新病灶和el。随后,生成一份新的人工智能辅助放射报告,并与常规放射报告进行比较。通过将人工智能报告与神经学评估相结合,与仅基于标准放射学报告相比,评估了其对治疗决策的潜在影响。结果在83例MS患者(平均年龄49岁,主要为女性)中,放射科医生在人工智能辅助下进行的MRI分析明显优于标准放射学解释。使用人工智能辅助分析,30.1%的患者发现了新的病变,而传统报告的这一比例为14.6% (p < 0.001)。通过人工智能支持的评估,33.7%的患者检测到el (p < 0.001),而标准解释中没有发现el。平均而言,在人工智能的帮助下,放射科医生在每位患者中发现了更多的新病变(0.82比0.46),并获得了更高的真阳性病变计数。重要的是,将人工智能辅助的发现与临床数据相结合,导致10.8%的患者改变了治疗方法,强调了这种方法的潜在临床影响。结论人工智能可能在提高ms患者新发病变和el的检出率方面发挥关键作用。与传统分析相比,MS®增强了放射学解释,对MRI结果进行了更全面的评估。这种诊断精度的提高有助于修改一部分患者的治疗决策。
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引用次数: 0
Predicting ventricular volume reduction and overdrainage in idiopathic normal pressure hydrocephalus after ventriculoperitoneal shunt implantation: a radiological study 预测脑室腹腔分流器植入后特发性常压脑积水的心室容量减少和过引流:一项放射学研究。
IF 3.3 3区 医学 Q2 CLINICAL NEUROLOGY Pub Date : 2025-11-08 DOI: 10.1016/j.neurad.2025.101405
Pei-Yu Yeh , Ue-Cheung Ho , Hsueh-Yi Lu , Shih-Hao Huang , Chi-Ling Chen , Chien-Chia Chen , Lu-Ting Kuo

Background and purpose

Radiological evaluation plays a crucial role in assessing the outcomes of ventriculoperitoneal shunt (VPS) surgery in patients with idiopathic normal pressure hydrocephalus (iNPH). Ventricular volume reduction and overdrainage remain critical concerns after shunt implantation. This study aimed to investigate the radiological changes following VPS surgery and identify predictors of ventricular volume change and overdrainage.

Methods and methods

This retrospective study included 75 patients with iNPH who underwent VPS implantation using Medtronic Strata NSC adjustable pressure shunts (initial pressure setting: 1.5). Preoperative and postoperative (3–8 weeks) brain imaging was analyzed to measure ventricular volume changes. Patients were stratified into an overdrainage group (with postoperative subdural effusion) and a non-overdrainage group. Univariate and multivariate analyses were performed to identify factors associated with ventricular volume changes and overdrainage risk.

Results

The median preoperative ventricular volume was 100.84 cm³ (IQR: 78.3–130.5 cm³), and the median postoperative volume was 77.57 cm³ (IQR: 55.4–113.4). The median absolute ventricular volume decrease was 19.62 cm³, corresponding to a median percentage reduction of 21.74% (IQR: 4.64–34.87%). Subdural effusion occurred in 18 patients (24.0%), but no subdural hematomas were observed. Multivariate analysis identified older age (p = 0.004) and history of hypertension (p = 0.039) as significant predictors of ventricular volume reduction. Additionally, a greater percentage decrease in ventricular volume (p = 0.005) and absence of hypertension (p = 0.017) were independent risk factors for postoperative subdural effusion.

Conclusions

Ventricular volume reduction following VPS surgery in iNPH is significantly associated with patient age and hypertension history. Overdrainage risk correlates with greater ventricular volume reduction and the absence of hypertension. These findings provide valuable radiological insights for optimizing shunt pressure settings and minimizing complications in iNPH patients undergoing VPS surgery.
背景与目的:影像学评价在特发性常压脑积水(iNPH)患者脑室-腹膜分流术(VPS)的预后评估中起着至关重要的作用。心室容量减少和过度引流仍然是分流器植入后的关键问题。本研究旨在探讨VPS手术后的放射学变化,并确定心室容量变化和过度引流的预测因素。方法和方法:本回顾性研究纳入75例使用美敦力Strata NSC可调压力分流器(初始压力设置:1.5)行VPS植入的iNPH患者。术前和术后(3-8周)分析脑成像测量心室容积变化。患者被分为过引流组(术后有硬膜下积液)和非过引流组。进行单因素和多因素分析,以确定与心室容积变化和过度引流风险相关的因素。结果:术前中位心室容积为100.84 cm³(IQR: 78.3-130.5 cm³),术后中位心室容积为77.57 cm³(IQR: 55.4-113.4)。中位心室绝对容积减少19.62 cm³,对应于中位百分比减少21.74% (IQR: 4.64-34.87%)。硬膜下积液18例(24.0%),未见硬膜下血肿。多因素分析发现,年龄较大(p = 0.004)和高血压史(p = 0.039)是心室容积减小的重要预测因素。此外,较大百分比的心室容积减少(p = 0.005)和无高血压(p = 0.017)是术后硬膜下积液的独立危险因素。结论:心室容量减小与患者年龄和高血压病史显著相关。过度引流风险与心室容量减少和无高血压相关。这些发现为优化分流压力设置和减少接受VPS手术的iNPH患者的并发症提供了有价值的放射学见解。
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引用次数: 0
Assessment of glymphatic dysfunction in ulcerative colitis using DKI-ALPS: An innovative imaging biomarker 使用DKI-ALPS评估溃疡性结肠炎的淋巴功能障碍:一种创新的成像生物标志物
IF 3.3 3区 医学 Q2 CLINICAL NEUROLOGY Pub Date : 2025-11-08 DOI: 10.1016/j.neurad.2025.101402
Cuiping Bao , Yue Ma , Muran Li , Yiming Li , Chunze Zhang , Xuehuan Liu , Ran Fan , Weiwei Cui , Xiaomeng Fan , Feifei Zheng , Feng Duan , Jun Liu

Purpose

Ulcerative colitis (UC) is associated with higher anxiety, depression, and cognitive disorders linked to brain glymphatic dysfunction. In this study, we used along-the-perivascular-space (ALPS) index (based on DTI and DKI) to determine if UC relates to glymphatic dysfunction and explore how microbiota dysbiosis and inflammation affect brain glymphatic function.

Materials and Methods

In this study, 63 patients with UC and 68 healthy controls underwent 3-Tesla MRI scans to evaluate DTI-ALPS and DKI-ALPS index. The protocol included diffusion-weighted imaging (DWI) and diffusion kurtosis imaging (DKI) sequences to calculate the ALPS index, which quantifies glymphatic system function. All participants completed cognitive (MMSE) and depression (SAS/SDS) assessments (SAS/SDS). Patients with UC also underwent assessment for inflammation and gut microbiota (based on metagenomic analysis). Data analysis was performed using correlation analysis and linear regression.

Results

Patients with UC showed lower DTI-ALPS index (1.25) and DKI-ALPS index (1.40) compared to controls (1.40 vs. 1.69; P < 0.001). In multi-adjusted linear regression models, UC was associated with lower DTI-ALPS index and DKI-ALPS index (β =-0.142 vs.-0.284), with DKI-ALPS showing higher sensitivity. The results remained significant even after stratification by age and sex. The Mayo score correlated negatively with DTI and DKI-ALPS index. The ALPS index correlates with gut microbiota, particularly those involved in butyrate and short-chain fatty acid (SCFA) production. DTI-ALPS index was significantly correlated with ESR (β =-0.003), CRP (β =-0.035), SII (β =-0.062), INFLA (β =-0.010), and SIRI (β =-0.058). We also observed significant correlations between DKI ALPS index and ESR (β =-0.006), CRP (β =-0.051), SII (β =-0.130), INFLA (β =-0.017), SIRI (β =-0.095), IL-6 (β =-0.081) and NLR (β =-0.108).

Conclusions

UC is associated with brain glymphatic dysfunction, correlating with inflammation level. DKI-ALPS serves as a more sensitive method than DTI-ALPS, offering a new approach for managing ulcerative colitis through glymphatic dysfunction.
目的溃疡性结肠炎(UC)与高度焦虑、抑郁和与脑淋巴功能障碍相关的认知障碍有关。在本研究中,我们使用沿血管周围空间(ALPS)指数(基于DTI和DKI)来确定UC是否与淋巴功能障碍有关,并探讨微生物群失调和炎症如何影响脑淋巴功能。材料与方法本研究对63例UC患者和68名健康对照者进行3-Tesla MRI扫描,评估DTI-ALPS和DKI-ALPS指数。该方案包括弥散加权成像(DWI)和弥散峰度成像(DKI)序列来计算ALPS指数,该指数量化淋巴系统功能。所有参与者完成认知(MMSE)和抑郁(SAS/SDS)评估(SAS/SDS)。UC患者还接受了炎症和肠道微生物群评估(基于宏基因组分析)。数据分析采用相关分析和线性回归。结果UC患者DTI-ALPS指数(1.25)和DKI-ALPS指数(1.40)低于对照组(1.40 vs. 1.69; P < 0.001)。在多元调整线性回归模型中,UC与较低的DTI-ALPS指数和DKI-ALPS指数相关(β =-0.142 vs.-0.284),其中DKI-ALPS具有较高的敏感性。即使在按年龄和性别分层后,结果仍然显著。Mayo评分与DTI、DKI-ALPS指数呈负相关。ALPS指数与肠道微生物群有关,特别是与丁酸盐和短链脂肪酸(SCFA)生产有关的微生物群。DTI-ALPS指数与ESR (β =-0.003)、CRP (β =-0.035)、SII (β =-0.062)、INFLA (β =-0.010)、SIRI (β =-0.058)显著相关。我们还发现DKI ALPS指数与ESR (β =-0.006)、CRP (β =-0.051)、SII (β =-0.130)、INFLA (β =-0.017)、SIRI (β =-0.095)、IL-6 (β =-0.081)和NLR (β =-0.108)之间存在显著相关性。结论血清素与脑淋巴功能障碍有关,与炎症程度相关。DKI-ALPS是一种比DTI-ALPS更灵敏的方法,为通过淋巴功能障碍治疗溃疡性结肠炎提供了新的途径。
{"title":"Assessment of glymphatic dysfunction in ulcerative colitis using DKI-ALPS: An innovative imaging biomarker","authors":"Cuiping Bao ,&nbsp;Yue Ma ,&nbsp;Muran Li ,&nbsp;Yiming Li ,&nbsp;Chunze Zhang ,&nbsp;Xuehuan Liu ,&nbsp;Ran Fan ,&nbsp;Weiwei Cui ,&nbsp;Xiaomeng Fan ,&nbsp;Feifei Zheng ,&nbsp;Feng Duan ,&nbsp;Jun Liu","doi":"10.1016/j.neurad.2025.101402","DOIUrl":"10.1016/j.neurad.2025.101402","url":null,"abstract":"<div><h3>Purpose</h3><div>Ulcerative colitis (UC) is associated with higher anxiety, depression, and cognitive disorders linked to brain glymphatic dysfunction. In this study, we used along-the-perivascular-space (ALPS) index (based on DTI and DKI) to determine if UC relates to glymphatic dysfunction and explore how microbiota dysbiosis and inflammation affect brain glymphatic function.</div></div><div><h3>Materials and Methods</h3><div>In this study, 63 patients with UC and 68 healthy controls underwent 3-Tesla MRI scans to evaluate DTI-ALPS and DKI-ALPS index. The protocol included diffusion-weighted imaging (DWI) and diffusion kurtosis imaging (DKI) sequences to calculate the ALPS index, which quantifies glymphatic system function. All participants completed cognitive (MMSE) and depression (SAS/SDS) assessments (SAS/SDS). Patients with UC also underwent assessment for inflammation and gut microbiota (based on metagenomic analysis). Data analysis was performed using correlation analysis and linear regression.</div></div><div><h3>Results</h3><div>Patients with UC showed lower DTI-ALPS index (1.25) and DKI-ALPS index (1.40) compared to controls (1.40 vs. 1.69; <em>P</em> &lt; 0.001). In multi-adjusted linear regression models, UC was associated with lower DTI-ALPS index and DKI-ALPS index (β =-0.142 vs.-0.284), with DKI-ALPS showing higher sensitivity. The results remained significant even after stratification by age and sex. The Mayo score correlated negatively with DTI and DKI-ALPS index. The ALPS index correlates with gut microbiota, particularly those involved in butyrate and short-chain fatty acid (SCFA) production. DTI-ALPS index was significantly correlated with ESR (β =-0.003), CRP (β =-0.035), SII (β =-0.062), INFLA (β =-0.010), and SIRI (β =-0.058). We also observed significant correlations between DKI ALPS index and ESR (β =-0.006), CRP (β =-0.051), SII (β =-0.130), INFLA (β =-0.017), SIRI (β =-0.095), IL-6 (β =-0.081) and NLR (β =-0.108).</div></div><div><h3>Conclusions</h3><div>UC is associated with brain glymphatic dysfunction, correlating with inflammation level. DKI-ALPS serves as a more sensitive method than DTI-ALPS, offering a new approach for managing ulcerative colitis through glymphatic dysfunction.</div></div>","PeriodicalId":50115,"journal":{"name":"Journal of Neuroradiology","volume":"53 1","pages":"Article 101402"},"PeriodicalIF":3.3,"publicationDate":"2025-11-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145467145","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}
引用次数: 0
The rabbit superior mesenteric artery as an in vivo model for perforator artery occlusion assessment after flow diversion 以家兔肠系膜上动脉为动物模型,评价分流后穿支动脉闭塞程度。
IF 3.3 3区 医学 Q2 CLINICAL NEUROLOGY Pub Date : 2025-11-01 DOI: 10.1016/j.neurad.2025.101404
Jonathan Cortese , Esref A Bayraktar , Julien Ognard , Daying Dai , Armin Zarrintan , Sherief Ghozy , Sarah Lortscher , Yong Hong Ding , Juan R Cebral , Waleed Brinjikji , David F Kallmes , Ramanathan Kadirvel

Objective

Covering side branches with flow diverters (FDs) raises concerns regarding side branch occlusion and potentially delayed ischemic complications. Existing preclinical models fail to replicate these risks. We developed a novel preclinical model using the rabbit superior mesenteric artery (SMA) to investigate FD-associated branch occlusion and neointimal changes.

Material and methods

Eighteen rabbits were enrolled; three were excluded for periprocedural complications. Fifteen animals completed follow-up, each with a single FD implanted in the SMA (one of three Pipeline Embolization Devices: 5 Bare-Flex, 4 Shield-Flex, and 6 Vantage). Branch patency (using Digital subtraction angiography DSA and histology) and ostial coverage/neointima (using optical coherence tomography OCT), were assessed at 1 or 3 months. Results were compared between-(FD and time) groups using Mann-Whitney and Kruskal-Wallis test.

Results

Fifteen animals completed the study. Among 35 covered branches, 30 (85.7%) remained patent, 4 (11.4%) were pre-occlusive, and 1 (2.9%) occluded. Median ostium coverage by OCT was 77.0%. Mean in-stent stenosis was 35.0%. No significant difference were found across FD types or timepoints comparing patency, medium ostium coverage, in-stent stenosis. Histology confirmed progressive neointimal maturation and partial to full ostium coverage, with strong correlation to OCT findings. No correlation was found between neointimal thickness and ostium coverage.

Conclusion

The rabbit SMA model successfully detected rare occlusions and common pre-occlusive changes, approaching clinical data. This model may help to evaluate FD safety, optimize design, and investigate endothelial responses.
目的:用分流器(FDs)覆盖侧支引起了对侧支闭塞和潜在的延迟性缺血性并发症的关注。现有的临床前模型无法复制这些风险。我们建立了一种新的临床前模型,利用兔肠系膜上动脉(SMA)来研究fd相关的分支闭塞和内膜变化。材料与方法:入组18只家兔;3例因围手术期并发症被排除。15只动物完成了随访,每只动物在SMA中植入一个FD(三种管道栓塞装置中的一种:5个Bare-Flex, 4个Shield-Flex和6个Vantage)。在1或3个月时评估分支通畅(使用数字减影血管造影DSA和组织学)和口覆盖/新生内膜(使用光学相干断层扫描OCT)。采用Mann-Whitney检验和Kruskal-Wallis检验比较两组间的差异。结果:15只动物完成了研究。在35个被覆盖的分支中,30个(85.7%)保持通畅,4个(11.4%)为预闭塞,1个(2.9%)为闭塞。OCT的中位口覆盖率为77.0%。平均支架内狭窄为35.0%。不同FD类型或时间点比较通畅、中口覆盖、支架内狭窄无显著差异。组织学证实了进行性内膜成熟和部分到完全的口覆盖,与OCT的发现有很强的相关性。新内膜厚度和口覆盖之间没有相关性。结论:家兔SMA模型成功检测出罕见的闭塞和常见的闭塞前病变,接近临床数据。该模型有助于评估FD安全性、优化设计和研究内皮反应。
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引用次数: 0
Computational fluid dynamics analysis of blood blister aneurysms: A comparative study with normal supraclinoid internal carotid arteries 血泡动脉瘤的计算流体动力学分析:与正常的颈内动脉的比较研究。
IF 3.3 3区 医学 Q2 CLINICAL NEUROLOGY Pub Date : 2025-11-01 DOI: 10.1016/j.neurad.2025.101403
Te-Chang Wu , Zhen-Ye Chen , Yi-Lin Wu , Tzu-Ching Shih

Background and Purpose

The purpose of this study was to evaluate hemodynamic differences between blood blister aneurysms (BBAs) and normal supraclinoid internal carotid arteries (ICAs) using patient-specific vascular models.

Materials and Methods

Thirteen models of ruptured BBA and 13 models of normal ICA were constructed from the petrous ICA proximally to M1 and A1 segments distally via 3D rotational angiography or MR angiography. Computational fluid dynamics (CFD) simulation was employed to calculate hemodynamic parameters, including time-average wall shear stress (TAWSS), wall shear stress gradient (WSSG), pressure difference (PD), oscillatory shear index (OSI), and relative residence time (RRT). Mann-Whitney U Test was used to identify differences between BBA and normal ICAs

Results

Compared with normal ICAs, BBAs exhibited significantly higher OSI (average and maximum: 0.0097/ 0.22 vs 0.0035/ 0.0135, p < 0.01), higher RRT (average and maximum: 0.60/ 8.50 vs 0.28/ 0.54, p = 0.018 & < 0.01), higher maximum WSSG (20,492 vs 9208, p = 0.012), higher maximum PD (1.34 vs 0.89, p = 0.027) and lower minimum TAWSS (0.35,Pa vs 2.55,Pa, P < 0.01). A swirling TAWSS pattern was identified in three of the four BBAs with early rebleeding post-treatment and in the two cases with in-hospital mortality.

Conclusions

BBAs demonstrated low and multi-directional wall shear stress on the aneurysmal wall with higher OSI and RRT compared to normal ICAs. A swirling pattern in the TAWSS map was identified as a poor prognostic factor. The findings support CFD as a promising tool for assessing rupture risk and guiding clinical decisions of BBAs.
背景和目的:本研究的目的是通过患者特异性血管模型来评估血泡动脉瘤(BBAs)和正常的颈内动脉(ICAs)之间的血流动力学差异。材料和方法:采用三维旋转血管造影或MR血管造影方法,从岩质ICA近端至M1和A1段,构建13个BBA破裂模型和13个正常ICA模型。采用计算流体力学(CFD)模拟计算血流动力学参数,包括时间平均壁面剪切应力(TAWSS)、壁面剪切应力梯度(WSSG)、压差(PD)、振荡剪切指数(OSI)和相对停留时间(RRT)。结果:与正常ica相比,BBA表现出更高的OSI(平均值和最大值分别为0.0097/ 0.22 vs 0.0035/ 0.0135)。结论:BBA对动脉瘤壁表现出低且多向的壁剪应力,与正常ica相比,BBA具有更高的OSI和RRT。TAWSS图中的漩涡模式被确定为不良预后因素。研究结果支持CFD作为一个有前途的工具来评估破裂风险和指导临床决策的BBAs。
{"title":"Computational fluid dynamics analysis of blood blister aneurysms: A comparative study with normal supraclinoid internal carotid arteries","authors":"Te-Chang Wu ,&nbsp;Zhen-Ye Chen ,&nbsp;Yi-Lin Wu ,&nbsp;Tzu-Ching Shih","doi":"10.1016/j.neurad.2025.101403","DOIUrl":"10.1016/j.neurad.2025.101403","url":null,"abstract":"<div><h3>Background and Purpose</h3><div>The purpose of this study was to evaluate hemodynamic differences between blood blister aneurysms (BBAs) and normal supraclinoid internal carotid arteries (ICAs) using patient-specific vascular models.</div></div><div><h3>Materials and Methods</h3><div>Thirteen models of ruptured BBA and 13 models of normal ICA were constructed from the petrous ICA proximally to M1 and A1 segments distally via 3D rotational angiography or MR angiography. Computational fluid dynamics (CFD) simulation was employed to calculate hemodynamic parameters, including time-average wall shear stress (TAWSS), wall shear stress gradient (WSSG), pressure difference (PD), oscillatory shear index (OSI), and relative residence time (RRT). Mann-Whitney U Test was used to identify differences between BBA and normal ICAs</div></div><div><h3>Results</h3><div>Compared with normal ICAs, BBAs exhibited significantly higher OSI (average and maximum: 0.0097/ 0.22 vs 0.0035/ 0.0135, <em>p</em> &lt; 0.01), higher RRT (average and maximum: 0.60/ 8.50 vs 0.28/ 0.54, <em>p</em> = 0.018 &amp; &lt; 0.01), higher maximum WSSG (20,492 vs 9208, <em>p</em> = 0.012), higher maximum PD (1.34 vs 0.89, <em>p</em> = 0.027) and lower minimum TAWSS (0.35,Pa vs 2.55,Pa, <em>P</em> &lt; 0.01). A swirling TAWSS pattern was identified in three of the four BBAs with early rebleeding post-treatment and in the two cases with in-hospital mortality.</div></div><div><h3>Conclusions</h3><div>BBAs demonstrated low and multi-directional wall shear stress on the aneurysmal wall with higher OSI and RRT compared to normal ICAs. A swirling pattern in the TAWSS map was identified as a poor prognostic factor. The findings support CFD as a promising tool for assessing rupture risk and guiding clinical decisions of BBAs.</div></div>","PeriodicalId":50115,"journal":{"name":"Journal of Neuroradiology","volume":"53 1","pages":"Article 101403"},"PeriodicalIF":3.3,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145432869","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}
引用次数: 0
Sporadic progressive ataxia and palatal tremor syndrome 散发性进行性共济失调和腭震颤综合征
IF 3.3 3区 医学 Q2 CLINICAL NEUROLOGY Pub Date : 2025-10-24 DOI: 10.1016/j.neurad.2025.101392
Iasmim Portela Maifrede , Daniel Sabino de Oliveira , Thiago Cardoso Vale
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引用次数: 0
期刊
Journal of Neuroradiology
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