Journal of Neuroradiology最新文献

英文中文

CT- guided erector spinae plane block for low back pain: A technical note CT引导竖脊机脊柱平面阻滞治疗腰痛：技术要点。

IF 3 3区医学 Q2 CLINICAL NEUROLOGY

Journal of Neuroradiology

Pub Date : 2025-05-24 DOI: 10.1016/j.neurad.2025.101352

J. Gossner

引用次数: 0

Differentiation of tumor progression from pseudoprogression in glioblastoma patients with GRASP DCE-MRI and DSC-MRI 用GRASP DCE-MRI和DSC-MRI鉴别胶质母细胞瘤患者的肿瘤进展与假进展。

IF 3 3区医学 Q2 CLINICAL NEUROLOGY

Journal of Neuroradiology

Pub Date : 2025-05-24 DOI: 10.1016/j.neurad.2025.101354

Vichyat Var , Severina M. Leu , Nikki Rommers , Marios N. Psychogios , Dominik Cordier , Ramona A. Todea

Purpose

This study investigates the diagnostic accuracy of combined Golden Angle Radial Sparse Parallel Dynamic contrast-enhanced (GRASP DCE-) and Dynamic susceptibility contrast (DSC) MRI in differentiating PD from PsP following RCT in differentiating progressive disease (PD) from pseudoprogression (PsP) following radiochemotherapy (RCT) in glioblastoma patients.

Materials and methods

This retrospective study included glioblastoma patients who underwent surgery and RCT between 2017 and 2021 and developed contrast-enhancing lesions suspicious for PD or PsP and had GRASP DCE- and DSC-MRI. Diagnostic accuracy of perfusion parameters was evaluated using the area under the receiver operating characteristics curve (AUC) at both initial suspicion of progression and confirmation MRI.

Results

Among 83 patients, 62 were classified as PD and 21 as PsP on serial MRI for all patients, with additional histological confirmation in 18 patients. Median perfusion parameters values were higher in the PD group in comparison to the PsP group (rCBV: 3.48 vs. 1.60, p < .001; Vp: 0.08 vs. 0.05, p = .032). At initial suspicion of progression, the combination of Ktrans, Ve, Vp and rCBV improved diagnostic accuracy in differentiating PD from PsP (AUC = 0.77, 95 % CI [0.62–0.93]) compared to rCBV alone (AUC = 0.69, 95 % CI [0.54–0.85]). At confirmation MRI (>12 weeks post-RCT), the added value of DCE was more modest (AUC improvement from 0.88 to 0.90). Suggested optimal thresholds at confirmation were: rCBV 2.87 (Sensitivity 71 %, Specificity 94 %), Ktrans 0.12 min^-1 (73 %, 76 %), Ve 0.31 (75 %, 65 %), and Vp 0.05 (78 %, 59 %).

Conclusion

Combining DCE- with DSC-MRI may enhance diagnostic accuracy in distinguishing progressive disease from pseudoprogression in glioblastoma, particularly during the early post-radiochemotherapy phase when treatment decisions are critical. As the added value of DCE-MRI is limited beyond 12 weeks post-radiochemotherapy, the full protocol is best reserved for early suspicion of progression or unclear cases, while DSC-MRI alone may be sufficient for confirmation imaging after this period.

目的：探讨黄金角径向稀疏平行动态对比增强（GRASP DCE-）与动态敏感性对比（DSC） MRI联合应用在胶质母细胞瘤放化疗（RCT）后进展性疾病（PD）与假性进展（PsP）鉴别PD与PsP的诊断准确性。材料和方法：本回顾性研究纳入了2017年至2021年间接受手术和RCT的胶质母细胞瘤患者，这些患者出现了怀疑PD或PsP的对比增强病变，并进行了GRASP DCE-和DSC-MRI检查。灌注参数的诊断准确性在最初怀疑进展和确认MRI时使用受者工作特征曲线下面积（AUC）进行评估。结果：83例患者中，所有患者的MRI序列显示62例为PD， 21例为PsP，另有18例患者的组织学证实。PD组灌注参数中位数值高于PsP组(rCBV: 3.48 vs. 1.60, p < 0.001；Vp: 0.08 vs. 0.05, p = .032)。在最初怀疑进展时，与单独使用rCBV （AUC = 0.69,95% CI[0.54-0.85]）相比，Ktrans、Ve、Vp和rCBV联合使用可提高PD与PsP的诊断准确性（AUC = 0.77,95% CI[0.62-0.93]）。在MRI确认时（rct后12周），DCE的附加值更为温和（AUC从0.88改善到0.90）。建议的最佳确认阈值为：rCBV 2.87（敏感性71%，特异性94%），Ktrans 0.12 (73%, 76%), Ve 0.31 (75%, 65%), Vp 0.06（79%, 59%）。结论：DCE-联合DSC-MRI可提高胶质母细胞瘤进行性疾病和假进展的诊断准确性，特别是在放化疗后早期，治疗决策至关重要。由于放化疗后12周后DCE-MRI的附加价值有限，因此完整方案最好用于早期怀疑进展或不明确的病例，而在此期间后仅DSC-MRI可能足以进行确认成像。

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引用次数: 0

Magnetizable flow diverters can magnetically capture and retain endothelial cells to promote healing in rabbit arteries 磁化分流器可以磁性捕获和保留内皮细胞，以促进兔动脉的愈合

IF 3 3区医学 Q2 CLINICAL NEUROLOGY

Journal of Neuroradiology

Pub Date : 2025-05-24 DOI: 10.1016/j.neurad.2025.101353

Alexander A. Oliver , Julien Ognard , Jonathan Cortese , Esref A. Bayraktar , Aleksandra M. Zielonka , David F. Kallmes , Brandon J. Tefft , Ramanathan Kadirvel

Flow diverters are effective endovascular devices used to treat intracranial aneurysms by facilitating aneurysm occlusion through endothelial growth across the aneurysm neck. Rapid endothelialization reduces complications such as thrombosis and stenosis. This technical note describes braided, magnetizable flow diverters made from stainless steel alloy 2205 (SS2205) wires designed to magnetically capture autologous blood outgrowth endothelial cells (BOECs) labeled with superparamagnetic iron oxide nanoparticles (SPIONs). Preclinical rabbit artery deployments demonstrated successful magnetic capture and retention of SPION-labeled BOECs, indicating feasibility for accelerated endothelialization. Detailed technical specifications provided in this manuscript ensure precise reproducibility, aiding future studies exploring advanced endothelialization strategies in neuroradiology.

血流分流器是一种有效的血管内装置，用于治疗颅内动脉瘤，通过动脉瘤颈部的内皮生长促进动脉瘤闭塞。快速内皮化可减少血栓和狭窄等并发症。本技术说明描述了由不锈钢合金2205 （SS2205）丝制成的编织磁化分流器，设计用于磁性捕获带有超顺磁性氧化铁纳米颗粒（SPIONs）标记的自体血液外生内皮细胞（boec）。兔临床前动脉部署成功地磁捕获和保留了spion标记的boec，表明加速内皮化的可行性。本文提供的详细技术规范确保了精确的可重复性，有助于未来研究探索神经放射学中先进的内皮化策略。

引用次数: 0

Interventional neuroradiology in France in 2025: Scaling up expertise, access, and innovation 2025年法国介入神经放射学：扩大专业知识、获取和创新。

IF 3 3区医学 Q2 CLINICAL NEUROLOGY

Journal of Neuroradiology

Pub Date : 2025-05-14 DOI: 10.1016/j.neurad.2025.101350

Julien Burel, Thibault Agripnidis, Aymeric Rouchaud, Gaultier Marnat, Jildaz Caroff, François Zhu, Basile Kerleroux, Jérôme Berge, Jean-Pierre Pruvo, Hubert Desal, Grégoire Boulouis , SFNR Board

引用次数: 0

Efficacy and safety of intra-arterial chemoperfusion as palliative treatment of symptomatic primary brain malignancies 动脉内化疗灌注作为有症状的原发性脑恶性肿瘤姑息性治疗的疗效和安全性。

IF 3 3区医学 Q2 CLINICAL NEUROLOGY

Journal of Neuroradiology

Pub Date : 2025-05-14 DOI: 10.1016/j.neurad.2025.101351

Thomas J. Vogl , Leon Vincent Stein , Claus Rödel , John Bielfeldt , Hamzah Adwan

Background

To retrospectively analyze the safety and efficacy of intra-arterial chemoperfusion (IAC) for symptomatic patients with recurrent or post-therapeutic progressive primary malignant brain tumors in regard to safety, survival and therapy response as a palliative treatment.

Methods

Thirty-nine patients (24 men, 15 women; mean age: 52) who were treated by IAC in 181 sessions (mean: 4.6 sessions/patient) were enrolled and evaluated in this study. Out of total 39 patients with primary malignant brain tumor, 27 (69 %) were diagnosed with glioblastoma. The overall survival (OS) was calculated using the Kaplan-Meier method. Therapy response was determined according to RECIST 1.1.

Results

All IAC treatments were performed without major adverse events or treatment-related deaths. The median OS time was 10.3 months (95 %CI: 0.6 – 19.9). The median PFS time was 5.9 months (95 %CI: 3.6 – 8.3). The rate of partial response was 10.8 % (4/37) and stable disease was achieved in 56.8 % (21/37) of patients. Progressive disease was observed in 32.4 % of cases (12/37). There were no cases of complete response. In two cases RECIST could not be analyzed due to loss of radiological follow-up.

Conclusion

This study could show that IAC may serve as a safe palliative strategy for symptomatic patients with recurrent or post-therapeutic progressive primary malignant brain tumors.

背景：回顾性分析动脉内化疗灌流（IAC）作为一种姑息性治疗对复发或治疗后进展性原发性恶性脑肿瘤患者的安全性、生存率和治疗反应。方法：39例患者(男24例，女15例；平均年龄：52岁)，他们接受了181次IAC治疗（平均4.6次/例），并在本研究中进行了登记和评估。在39例原发性恶性脑肿瘤患者中，27例（69%）被诊断为胶质母细胞瘤。采用Kaplan-Meier法计算总生存期（OS）。根据RECIST 1.1标准确定治疗反应。结果：所有IAC治疗均未发生重大不良事件或治疗相关死亡。中位OS时间为10.3个月（95%CI: 0.6 - 19.9）。中位PFS时间为5.9个月（95%CI: 3.6 - 8.3）。部分缓解率为10.8%(4/37)，病情稳定率为56.8%（21/37）。32.4%（12/37）的病例出现进展性疾病。没有完全缓解的病例。在两例病例中，由于缺少放射学随访，RECIST无法分析。结论：本研究表明，对于复发性或治疗后进展性原发性恶性脑肿瘤患者，IAC可作为一种安全的姑息策略。

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引用次数: 0

Application of optical neuronavigation in interventional neuroradiology 光学神经导航在介入神经放射学中的应用

IF 3 3区医学 Q2 CLINICAL NEUROLOGY

Journal of Neuroradiology

Pub Date : 2025-05-08 DOI: 10.1016/j.neurad.2025.101348

Laura Tello Arnas , Andres Javier Barrios López , Alberto Álvarez Muelas , Celia Del Peso Ley , Andrés Francisco Fernández Prieto , Pedro Navia Álvarez

引用次数: 0

Revisiting WOSP occlusions: A clinical lens on ICAS-related MCA stroke 重访WOSP闭塞：icas相关MCA脑卒中的临床镜头

IF 3 3区医学 Q2 CLINICAL NEUROLOGY

Journal of Neuroradiology

Pub Date : 2025-04-30 DOI: 10.1016/j.neurad.2025.101349

Hui Guo, Ziyu Yang, Xiongfei Zhao

引用次数: 0

Concomitant progressive supranuclear palsy and multiple system atrophy: A rare case report of tauopathy and synucleinopathy interface 伴进行性核上性麻痹及多系统萎缩：牛头病及突触核蛋白病交界面一例罕见报告

IF 3 3区医学 Q2 CLINICAL NEUROLOGY

Journal of Neuroradiology

Pub Date : 2025-04-28 DOI: 10.1016/j.neurad.2025.101347

Nitesh Shekhrajka, Márcio Luís Duarte, Leonardo Furtado Freitas

Progressive supranuclear palsy (PSP) and multiple system atrophy (MSA) are neurodegenerative disorders characterized by parkinsonian symptoms. PSP typically presents with supranuclear gaze palsy, postural instability, and subcortical dementia, while dysautonomia and cerebellar signs are hallmark features of MSA. We report the case of a 77-year-old male patient with a four-year history of progressive parkinsonian symptoms that have shown poor response to treatment. His clinical manifestations included bradykinesia, rigidity, swallowing difficulties, urinary frequency, nocturia, downward gaze palsy, hypometric saccades, and finger-nose dysmetria. Examination revealed increased tone in both upper extremities, more pronounced on the right side, along with bradykinesia, slow hand movements, and bilateral decrement in finger tapping. Brain magnetic resonance imaging (MRI) revealed mixed MRI findings consistent with atypical parkinsonian syndrome, showing signs of MSA-C with pontocerebellar atrophy and the "hot cross bun" sign, as well as PSP with midbrain atrophy (hummingbird sign) and tegmental hypersignal.

进行性核上性麻痹（PSP）和多系统萎缩（MSA）是以帕金森症状为特征的神经退行性疾病。PSP通常表现为核上凝视性麻痹、体位不稳定和皮质下痴呆，而自主神经异常和小脑体征是MSA的标志性特征。我们报告的情况下，77岁的男性患者与四年的进行性帕金森症状的历史，已显示不良反应的治疗。临床表现为运动迟缓、强直、吞咽困难、尿频、夜尿、向下凝视性麻痹、低血压性扫视、手指-鼻子发育障碍。检查显示双上肢张力增加，右侧更明显，同时运动迟缓，手部运动缓慢，双侧手指敲击减少。脑磁共振成像（MRI）显示与非典型帕金森综合征一致的混合MRI表现，表现为MSA-C伴桥小脑萎缩和“热十字面包”征，以及PSP伴中脑萎缩（蜂鸟征）和被盖高信号。

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引用次数: 0

Evaluating the role of HR 3D-CBCT and squid 12® embolic agent in meningioma management: Insights from MRI modifications at follow-Up 评估HR 3D-CBCT和squid 12®栓塞剂在脑膜瘤治疗中的作用：来自随访MRI修改的见解

IF 3 3区医学 Q2 CLINICAL NEUROLOGY

Journal of Neuroradiology

Pub Date : 2025-04-26 DOI: 10.1016/j.neurad.2025.101346

Guglielmo Pero , Antonio Macera , Claudia Rollo , Amedeo Cervo , Branko Popadic , Alessandro La Camera

We report three cases of meningiomas treated with Squid 12® with their peculiar technical aspects. High-resolution 3D cone-beam CT angiography (HR 3D-CBCT) was used to evaluate the tumor’s vascular anatomy and guide embolization, revealing pial arterial supplies not readily visible on standard angiography. Squid 12® achieved deep tumor penetration, abolishing contrast enhancement on immediate post-procedural MRI. Follow-up MRIs showed progressive tumor shrinkage, with peripheral ring enhancement and decreased edema. Tumor volume was reduced by approximately 50% at the 4-6 months follow-up, leading to a delay in SRS for further stabilization and clinical improvement in the symptomatic patients.

我们报告三例脑膜瘤与鱿鱼12®治疗其特殊的技术方面。高分辨率三维锥束CT血管造影（HR 3D- cbct）用于评估肿瘤的血管解剖和指导栓塞，显示标准血管造影不容易看到的动脉供应。Squid 12®实现了深层肿瘤穿透，消除了术后立即MRI的对比增强。后续mri显示肿瘤逐渐缩小，外周环增强，水肿减少。在4-6个月的随访中，肿瘤体积减少了约50%，导致延迟SRS以进一步稳定和有症状患者的临床改善。

引用次数: 0

Clinical impact of occlusion location in the middle cerebral artery during endovascular reperfusion therapy for acute ischemic stroke with underlying intracranial atherosclerotic stenosis 脑中动脉闭塞位置对急性缺血性脑卒中伴颅内动脉粥样硬化性狭窄血管内再灌注治疗的临床影响

IF 3 3区医学 Q2 CLINICAL NEUROLOGY

Journal of Neuroradiology

Pub Date : 2025-04-14 DOI: 10.1016/j.neurad.2025.101340

Joong-Goo Kim , Chul-Hoo Kang , Hong Jun Kim , Jong Kook Rhim , Jay Chol Choi , Doo Hyuk Kwon

Background and Purpose

This study examines the clinical outcomes of endovascular reperfusion therapy and emergent intracranial stenting based on the angiographically defined occlusion location of the middle cerebral artery (MCA).

Materials and Methods

We reviewed consecutive patients with acute MCA infarct associated with intracranial atherosclerotic stenosis (ICAS) who underwent rescue intracranial stenting and balloon angioplasty after initial mechanical thrombectomy. We compared patient demographics, baseline characteristics, clinical outcomes, and periprocedural complications, including in-stent thrombosis and re-occlusion, according to the MCA occlusion location. The occlusion location was categorized based on the presence of the proximal MCA stump in enrolled ICAS patients.

Results

Of 47 patients, 30 (63.8 %) were classified as having a stump group. The initial NIHSS was more severe in the without-stump group compared to the with-stump group (13.0 [8.0–16.0] vs. 8.0 [8.0–13.0] p = 0.078). There were no significant differences in procedure time, technique, and devices. However, the successful revascularization rate was significantly lower in the without-stump group (64.7 % vs. 100 %, p = 0.002). Additionally, the immediate re-occlusion rate after the first endovascular reperfusion therapy tended to be higher in the without-stump group (76.5 % vs. 36.7 %, p = 0.02). No significant association was found between periprocedural complications, including intracerebral hemorrhage and mortality.

Conclusions

Angiographically presented MCA occlusion without a stump in acute large vessel occlusion underlying ICAS predicts more complicated intracranial stenting and poorer clinical outcomes than patients with a stump.

背景与目的本研究基于血管造影确定的大脑中动脉（MCA）闭塞位置，探讨血管内再灌注治疗和紧急颅内支架植入术的临床效果。材料和方法我们回顾了连续的急性MCA梗死合并颅内动脉粥样硬化性狭窄（ICAS）患者，这些患者在首次机械取栓后接受了颅内支架置入术和球囊血管成形术。我们比较了患者的人口统计学特征、基线特征、临床结果和围手术期并发症，包括支架内血栓形成和再闭塞，根据MCA闭塞的位置。在入组的ICAS患者中，根据MCA近端残端是否存在来分类闭塞位置。结果47例患者中30例（63.8%）为残肢组。无残肢组初始NIHSS较残肢组更严重（13.0 [8.0 - 16.0]vs. 8.0 [8.0 - 13.0] p = 0.078）。两组在手术时间、技术和设备上无显著差异。然而，无残肢组血运重建成功率明显较低（64.7% vs 100%, p = 0.002）。此外，无残端组首次血管内再灌注治疗后立即再闭塞率更高（76.5% vs 36.7%, p = 0.02）。围手术期并发症（包括脑出血）与死亡率之间无显著相关性。结论在ICAS下的急性大血管闭塞中，造影表现为无残端MCA闭塞的患者比残端患者更容易出现颅内支架置入术的并发症和更差的临床结果。

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