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The Social Science Journal
Available online 20 December 2017
Apparent diffusion coefficient histogram analysis for prediction of prognosis in glioblastoma
Publication date: Available online 21 December 2017
Source:Journal of Neuroradiology Author(s): Masatoshi Kondo, Yoshikazu Uchiyama Background To investigate the potential to predict prognosis of glioblastoma (GBM) patients by analysis of the broader and lower values in the lower distribution of apparent diffusion coefficient (ADCL) (B&L-ADCL) values in the ADC histogram. Background Presurgical publicly available diffusion-weighted images (DWI) and contrast-enhanced T1-weighted images from 76 GBM patients were analyzed. With applied 2-mixture normal distribution in the ADC histogram of enhanced lesions on T1-weighted images, the mean and width of ADCL were analyzed. We dichotomized the lower mean of ADCL (L-ADCL) and the broader width of ADCL (B-ADCL) at their own average. B&L-ADCL was defined as B-ADCL with L-ADCL. Progression-free survival (PFS) and overall survival (OS) were determined by using Cox proportional hazards analysis and the Kaplan–Meier method with the log-rank test. The difference between PFS and OS was calculated. Results Six (7.89%) patients had B&L-ADCL values. B&L-ADCL was strongly associated with poor PFS (hazard risk: 5.747; P =0.002) and OS (hazard risk: 3.331; P =0.018). There were significant differences in PFS (median, 77 vs. 302 days; P <0.001) and OS (median, 199 vs. 472 days; P =0.004) between the patents with and without B&L-ADCL. There was no significant difference in the OS–PFS duration difference between the patients with (median, 79 days) and without B&L-ADCL (median, 132 days) (P =0.348). Conclusion In this study, B&L-ADCL from pretreatment ADC analysis predicted poor PFS. B&L-ADCL may indicate higher cellularity and heterogeneity in GBM tumor tissue.
Available online 19 December 2017
A new time-resolved 3D angiographic technique (4D DSA): Description, and assessment of its reliability in Spetzler–Martin grading of cerebral arteriovenous malformations
Publication date: Available online 20 December 2017
Source:Journal of Neuroradiology Author(s): Julien Ognard, Elsa Magro, Jildaz Caroff, Douraied Ben Salem, Sebastien Andouard, Michel Nonent, Jean-Christophe Gentric Background and purpose The Spetzler and Martin (SM) cerebral arteriovenous malformation (AVM) classification is a widely used 5-tier classification. This common language allows specialists to exchange about AVMs and must be reliably characterized by the imaging methods. We presented an agreement study on a new method of digital subtracted 3D rotational angiography resolved in time (four-dimensional DSA: 4D DSA) compared to the gold standard (two-dimensional DSA: 2D DSA) in AVM grading using the SM classification. Methods Ten patients with AVMs were included during one year, they had an angiographic exploration with both 4D DSA and 2D DSA. Three readers assessed the SM classification. One reader conducted a second reading. The inter-, intra-observer and intermodality agreements were calculated by Kappas. Dose to patient was reported. Results Considering the SM grade, the inter-observer agreement between 4D DSA and 2D DSA was equivalent (
Available online 19 December 2017
Variability of stroke patients meeting endovascular stroke trial criteria in a non-clinical trial setting
Publication date: Available online 19 December 2017
Source:Journal of Neuroradiology Author(s): Jennifer E. Fugate, Waleed Brinjikji, Harry Cloft, David F. Kallmes, Alejandro A. Rabinstein Background Five randomized trials proving the efficacy and safety of mechanical embolectomy for ischemic stroke within 8hours used differing radiological methods to select patients. We aimed to evaluate the proportion of patients in clinical practice that would meet radiological criteria for inclusion in these trials. Methods Retrospective study of ischemic stroke patients at a large academic medical center who were considered for endovascular stroke therapy based on confirmed intracranial large vessel occlusion from April 2010–November 2014. All patients underwent computed tomography (CT) perfusion and CT angiogram. Results Of 119 patients, median age was 69 years (IQR 57–79) and median NIHSS 18 (IQR 14–21). Most patients had ASPECTS
Available online 19 December 2017
Primary versus secondary mechanical thrombectomy for anterior circulation stroke in children: An update
Publication date: Available online 19 December 2017
Source:Journal of Neuroradiology Author(s): Manuel Cappellari, Giuseppe Moretto, Andrea Grazioli, Giuseppe Kenneth Ricciardi, Paolo Bovi, Elisa Francesca Maria Ciceri This review of the literature on the use of mechanical thrombectomy (MT) in children with acute ischemic stroke from occlusion of the internal carotid artery and the proximal middle cerebral artery (MCA) compares the efficacy and safety of primary and secondary MT. We analyzed the data reported for 24 case reports from 20 relevant articles published up to 31 December 2016 and the data of a patient treated at our institution. Eighteen cases received primary MT and 7 received secondary MT. The proportions of complete MCA recanalization, small infarcts, and asymptomatic intracranial hemorrhage were similar in both MT groups (73% [11/15] vs. 67% [4/6], 58% [7/12] vs. 60% [3/5], and 15% [2/13] vs. 17% [1/6], respectively). The proportion of favorable neurological outcomes was higher for the primary MT group (69% [11/16] vs. 43% [3/7]). We found no substantial differences in efficacy and safety between primary and secondary MT for anterior circulation stroke in children.
Available online 19 December 2017
Greater Occipital Nerve Cryoneurolysis in the management of intractable Occipital Neuralgia
Publication date: Available online 19 December 2017
Source:Journal of Neuroradiology Author(s): Adrian Kastler, Arnaud Atty
Available online 19 December 2017
CNS aspergilloma mimicking tumors: review of CNS aspergillus infection imaging characteristics in the immunocompetent population
Publication date: Available online 19 December 2017
Source:Journal of Neuroradiology Author(s): Devendra Kumar, Pankaj Nepal, Sumit Singh, Subraminayan ramanathan, Maneesh khanna, Rakesh Sheoran, S K Bansal, Santosh Patil Background And Purpose CNS Aspergillosis is very rare and difficult to diagnose clinically and on imaging. Our objective was to elucidate distinct neuroimaging pattern of CNS aspergillosis in the immunocompetent population that helps to differentiate from other differential diagnosis. Methods Retrospective analysis of brain imaging findings was performed in eight proven cases of central nervous system aspergillosis in immunocompetent patients. Immunocompetent status was screened with clinical and radiological information. Cases were evaluated for anatomical distribution, T1 and T2 signal pattern in MRI and attenuation characteristics in CT scan, post contrast enhancement pattern, internal inhomogeneity, vascular involvement, calvarial involvement and concomitant paranasal, cavernous sinus or orbital extension. All patients were operated and diagnosis was confirmed on histopathology. Results The age range was 19-50 years with mean age of 33.7 years. Concomitant sinonasal disease was seen in six patients (75%). Three patients had orbital extensions. Most of the lesions (n=7) were profoundly hypointense in T2-weighted imaging. The most common enhancement pattern was bright, solid and homogenous enhancement (n=7). Cavernous extension with ICA encasement was always associated with paranasal sinus disease. Six patients showed demineralization or complete resorption of involved bone. All of the fungal masses appear hyperdense on available CT scan images. Conclusion CNS aspergillus infection in immunocompetent patients has distinct imaging features as compared to CNS aspergillosis in immunocompromised patients. A high index of suspicion in proper clinical settings, even with immunocompetent status and typical imaging features allow us to diagnose CNS aspergillosis in such patients.
Available online 19 December 2017
Eagle's syndrome: A rare cause of cervical internal carotid pseudo-aneurysmal dissection
Publication date: Available online 19 December 2017
Source:Journal of Neuroradiology Author(s): Benjamin Langlet, Xavier Barreau, Gaultier Marnat, Vincent Dousset
Available online 19 December 2017
Altered functional connectivity of the subthalamic nucleus during self-initiated movement in Parkinson's disease
Publication date: Available online 19 December 2017
Source:Journal of Neuroradiology Author(s): Qian Jia, Linlin Gao, Jiarong Zhang, Tao Wu, Piu Chan Background and purpose Patients with Parkinson's disease (PD) have difficulty performing self-initiated movements. The neural mechanism of this deficiency remains unclear. In the present study, we used functional magnetic resonance imaging (fMRI) to investigate the functional connectivity of the subthalamic nucleus (STN) during self-initiated movement in patients with PD. Materials and Methods fMRI were acquired from patients with PD and age- and sex-matched healthy control subjects during a self-initiated right hand tapping task. We selected the bilateral sensorimotor subregions of the STN as regions of interest for our connectivity analysis. Results and Conclusions We found that the STN contralateral to voluntary hand movement exhibited enhanced connectivity with the midbrain, thalamus, putamen, and so on in patients with PD compared to control subjects. In contrast, the STN ipsilateral to the hand movement exhibited enhanced connectivity with the midbrain and insula in PD patients compared to control subjects. Connectivity between the STN contralateral to the hand movement and the primary motor cortex and supplementary motor area was positively correlated with the severity of bradykinesia. Our findings suggest that STN-related connectivity in the hyperdirect and indirect basal ganglia pathways is strengthened during self-initiated movement in patients with PD. These disrupted network connections may contribute to bradykinesia.
Available online 19 December 2017
Congenital involvement of the central nervous system by the Zika virus in a child without microcephaly – spectrum of congenital syndrome by the Zika virus
Publication date: Available online 19 December 2017
Source:Journal of Neuroradiology Author(s): Bruno Niemeyer de Freitas Ribeiro, Bernardo Carvalho Muniz, Emerson Leandro Gasparetto, Edson Marchiori
Available online 19 December 2017
Feasibility of improved motion-sensitized driven-equilibrium (iMSDE) prepared 3D T1-weighted imaging in the diagnosis of vertebrobasilar artery dissection
Publication date: Available online 19 December 2017
Source:Journal of Neuroradiology Author(s): Jin Wook Choi, Miran Han, Ji Man Hong, Jin Soo Lee, Sun Yong Kim, Sam Soo Kim Background and purpose This study was to evaluate the diagnostic value of improved motion-sensitized driven-equilibrium (iMSDE)-prepared 3D T1-weighted magnetic resonance imaging (MRI) (iMSDE-3DMRI) in intracranial vertebrobasilary dissection (VBD) and to compare iMSDE-3DMRI images with those obtained using 2D high-resolution (HR) MRI with respect to their diagnostic performance in VBD. Materials and methods We retrospectively reviewed 105 lesions from 102 patients who underwent multimodal imaging and contrast-enhanced iMSDE-3DMRI (CE-iMSDE-3DMRI). The 2D-HRMRI protocol comprised four axial HR images. The CE-iMSDE-3DMRI images were reformatted in the axial, coronal, and sagittal planes. The 2D-HRMRI-based diagnosis was compared with the final diagnosis. The 2D-HRMRI and CE-iMSDE-3DMRI images were examined independently for the diagnosis performance of dissection. Results VBD was confirmed in 66 lesions in 63 patients; 17 patients had confirmed atherosclerosis, and 22 had no lesions in the vertebrobasilar artery. Diagnostic performances of 2D-HRMRI (AUC, 0.839±0.04; sensitivity, 94.0; specificity, 79.5; diagnostic accuracy, 88.6) CE-iMSDE-3DMRI (AUC, 0.847±0.04; sensitivity, 84.8; specificity, 84.6; diagnostic accuracy, 84.7) and 2D-HRMRI+CE-iMSDE-3DMRI (AUC, 0.893±0.03; sensitivity, 97.0; specificity, 85.0; diagnostic accuracy, 92.5) were good. Comparisons of the diagnostic performance of 2D-HRMRI andCE-iMSDE-3DMRI showed that combined interpretation of 2D-HRMRI and iMSDE-3DMRI yields a significantly higher diagnostic performance than that of 2D-HRMRI (P =0.042). Conclusions CE-iMSDE-3DMRI showed good diagnostic performance for the diagnosis of intracranial VBD. These results suggest that CE-iMSDE-3DMRI can be used in combination with 2D-HRMRI for the diagnosis of intracranial VBD.
Available online 11 November 2017
Spontaneous healing of a symptomatic basilar artery dissection
Publication date: Available online 19 December 2017
Source:Journal of Neuroradiology Author(s): Enrico Giordan, Waleed Brinjikji, Giuseppe Lanzino
Available online 11 November 2017
Bullseye's representation of cerebral white matter hyperintensities
Publication date: Available online 11 November 2017
Source:Journal of Neuroradiology Author(s): C.H. Sudre, B. Gomez Anson, I. Davagnanam, A. Schmitt, A.F. Mendelson, F. Prados, L. Smith, D. Atkinson, A.D. Hughes, N. Chaturvedi, M.J. Cardoso, F. Barkhof, H.R. Jaeger, S. Ourselin Background and purpose Visual rating scales have limited capacities to depict the regional distribution of cerebral white matter hyperintensities (WMH). We present a regional-zonal volumetric analysis alongside a visualization tool to compare and deconstruct visual rating scales. Materials and methods 3D T1-weighted, T2-weighted spin-echo and FLAIR images were acquired on a 3T system, from 82 elderly participants in a population-based study. Images were automatically segmented for WMH. Lobar boundaries and distance to ventricular surface were used to define white matter regions. Regional-zonal WMH loads were displayed using bullseye plots. Four raters assessed all images applying three scales. Correlations between visual scales and regional WMH as well as inter and intra-rater variability were assessed. A multinomial ordinal regression model was used to predict scores based on regional volumes and global WMH burdens. Results On average, the bullseye plot depicted a right-left symmetry in the distribution and concentration of damage in the periventricular zone, especially in frontal regions. WMH loads correlated well with the average visual rating scores (e.g. Kendall's tau [Volume, Scheltens]=0.59 CI=[0.53 0.62]). Local correlations allowed comparison of loading patterns between scales and between raters. Regional measurements had more predictive power than global WMH burden (e.g. frontal caps prediction with local features: ICC=0.67 CI=[0.53 0.77], global volume=0.50 CI=[0.32 0.65], intra-rater=0.44 CI=[0.23 0.60]). Conclusion Regional-zonal representation of WMH burden highlights similarities and differences between visual rating scales and raters. The bullseye infographic tool provides a simple visual representation of regional lesion load that can be used for rater calibration and training.
Available online 11 November 2017
Endovascular management of extracranial occlusions at the hyperacute phase of stroke with tandem occlusions
Publication date: Available online 11 November 2017
Source:Journal of Neuroradiology Author(s): M.-A. Labeyrie, C. Ducroux, V. Civelli, P. Reiner, E. Cognat, A. Aymard, A. Bisdorff, J.-P. Saint-Maurice, E. Houdart Background and purpose The management of cervical artery occlusions in hyperacute stroke with tandem cervical/intracranial occlusions has not yet become standardized, especially when the circle of Willis is effective. Methods We retrospectively analyzed the safety and accuracy of current approaches to manage the cervical occlusion in consecutive patients with tandem occlusions addressed for intracranial mechanical thrombectomy (MT) in our department from January 2012 to May 2017. The different approaches that could be performed in a same patient during the same procedure or hospitalization were analyzed separately. Results We reported 64 approaches to manage the cervical occlusion in 49 patients with tandem occlusion (14% of MT): medical treatment alone in 16/64 (25%), stenting/angioplasty in 16/64 (25%), occlusion with coils in 12/64 (19%), angioplasty alone in 9/64 (14%), stent-retriever in 8/64 (12%), and/or thromboaspiration in 3/64 (5%). Early ipsilateral embolic recurrence occurred after 9/64 (14%) of them. It was strongly associated with the presence of a cervical intraluminal thrombus (P =0.001) and was then lower after occlusion with coils and stent-retriever compared to medical treatment alone and thromboaspiration (P=0.002). Occlusion with coils had a lower rate of radiological intracranial hemorrhage at 48-hour compared to other approaches (P =0.009). The 3-month rates of favorable outcome (P =0.806) and mortality (P =0.878) were similar. One delayed stroke was imputable to an occlusion with coils, for a median (Q1–Q3) follow-up of 10 (3–20) months. Conclusions Cervical occlusion with coils and thrombectomy with stent-retrievers may be relevant to prevent early embolic recurrence in cervical occlusions with intraluminal thrombus. Stent-retrievers should be further assessed as a first-line approach, since delayed stroke may occur following occlusion with coils. Medical treatment alone may be sufficient when no cervical intraluminal thrombus is present, the Willis polygon is effective, and the cervical occlusion can be crossed easily to perform the intracranial thrombectomy.
Available online 14 October 2017
Automated brain tissue and myelin volumetry based on quantitative MR imaging with various in-plane resolutions
Publication date: Available online 11 November 2017
Source:Journal of Neuroradiology Author(s): C. Andica, A. Hagiwara, M. Hori, M. Nakazawa, M. Goto, S. Koshino, K. Kamagata, K.K. Kumamaru, S. Aoki Background and purpose Segmented brain tissue and myelin volumes can now be automatically calculated using dedicated software (SyMRI), which is based on quantification of R1 and R2 relaxation rates and proton density. The aim of this study was to determine the validity of SyMRI brain tissue and myelin volumetry using various in-plane resolutions. Methods We scanned 10 healthy subjects on a 1.5T MR scanner with in-plane resolutions of 0.8, 2.0 and 3.0mm. Two scans were performed for each resolution. The acquisition time was 7-min and 24-sec for 0.8mm, 3-min and 9-sec for 2.0mm and 1-min and 56-sec for 3.0mm resolutions. The volumes of white matter (WM), gray matter (GM), cerebrospinal fluid (CSF), non-WM/GM/CSF (NoN), brain parenchymal volume (BPV), intracranial volume (ICV) and myelin were compared between in-plane resolutions. Repeatability for each resolution was then analyzed. Results No significant differences in volumes measured were found between the different in-plane resolutions, except for NoN between 0.8mm and 2.0mm and between 2.0mm and 3.0mm. The repeatability error value for the WM, GM, CSF, NoN, BPV and myelin volumes relative to ICV was 0.97%, 1.01%, 0.65%, 0.86%, 1.06% and 0.25% in 0.8mm; 1.22%, 1.36%, 0.73%, 0.37%, 1.18% and 0.35% in 2.0mm and 1.18%, 1.02%, 0.96%, 0.45%, 1.36%, and 0.28% in 3.0mm resolutions. Conclusion SyMRI brain tissue and myelin volumetry with low in-plane resolution and short acquisition times is robust and has a good repeatability so could be useful for follow-up studies.
Available online 13 October 2017
Assessment of the cervical spine denticulate ligament using MRI volumetric sequence: Comparison between 1.5 Tesla and 3.0 Tesla
Publication date: Available online 14 October 2017
Source:Journal of Neuroradiology Author(s): Rafael Seragioli, Marcelo Novelino Simao, Gustavo Novelino Simao, Carlos Fernando P.S. Herrero, Marcello H. Nogueira-Barbosa Background Denticulate ligaments (DLs) are pial extensions on each side of the spinal cord, comprising about 20 to 21 pairs of fibrous structures connecting the dura mater to the spinal cord. These ligaments are significant anatomical landmarks in the surgical approach to intradural structures. To our knowledge, there is no previous study on the detection of DLs using MRI. Methods After IRB approval, we retrospectively evaluated 116 consecutive MRI scans of the cervical spine, using the volumetric sequence 3D COSMIC, 65 and 51 studies with 1.5T and 3.0T respectively. We did not include trauma and tumor cases. Two independent radiologists assessed the detection of cervical spine DLs independently and blinded for each cervical vertebral level. We compared the frequency of detection of these ligaments in 1.5 Tesla and 3.0 Tesla MRI using Fisher exact test considering P <0.05 as significant. We evaluated interobserver agreement with Kappa coefficient. Results We observed high detection frequency of the cervical spine DLs using both 1.5T (70 to 91%) and 3.0T (68 to 98%). We found no statistically significant difference in the detection frequency of ligaments between the 1.5T and 3.0T MRI in all vertebral levels. Using 3.0T, radiologists identified ligaments better in higher vertebral levels than for lower cervical levels (P =0.0003). Interobserver agreement on the identification of DL was poor both for 1.5T (k =0.3744; CI 95% 0.28–0.46) and 3.0T (k =0.3044; CI 95% 0.18–0.42) MRI. Conclusions Radiologists identified most of the cervical DLs using volumetric MRI acquisition. Our results suggest 1.5T and 3.0T MRI performed similarly in the detection of DLs.
Available online 13 October 2017
Weekly follow up of acute lesions in three early multiple sclerosis patients using MR spectroscopy and diffusion
Publication date: Available online 13 October 2017
Source:Journal of Neuroradiology Author(s): Gabriel Kocevar, Claudio Stamile, Salem Hannoun, Jean-Am
Available online 5 October 2017
Progressive white-matter demyelination in delayed CO poisoning encephalopathy
Publication date: Available online 13 October 2017
Source:Journal of Neuroradiology Author(s): B. Law-ye, P. Dodet, B. Hermann, S. Trunet, D. Dormont, N. Pyatigorskaya, D. Leclercq
Available online 5 October 2017
Dual-lumen balloon to increase onyx venous penetration in the treatment of spinal dural arteriovenous fistulas
Publication date: Available online 5 October 2017
Source:Journal of Neuroradiology Author(s): Felipe Padovani Trivelato, Marco T
October 2017
Radiation dose and image quality of computed tomography of the supra-aortic arteries: A comparison between single-source and dual-source CT Scanners
Publication date: Available online 5 October 2017
Source:Journal of Neuroradiology Author(s): Luca Saba, Michele di Martino, Paolo Siotto, Michele Anzidei, Giovanni Maria Argiolas, Michele Porcu, Jasjit S. Suri, Max Wintermark Purpose The purpose of this work was to compare the image quality and radiation dose delivered to patients during computed tomography (CT) angiography (CTA) of the supra-aortic arteries using two single-source (SS) and two dual-energy (DE) CT scanners. Material and methods In this retrospective study, 120 patients who underwent CTA of supra-aortic arteries were studied using four different types of CT scanners: a sixteen and forty-detector-row SS and two DE CT scanners. Seventy milliters of contrast medium were injected at a flow rate of 4mL/s using a power injector. For each patient the dose-length product (DLP), the volume computed tomography dose index (CDTIvol), the length of the scan and the effective dose (ED) were calculated. Qualitative and quantitative [image noise, signal-to-noise ratio (SNR) and contrast-to-noise ratio (CNR)] image quality assessment was performed. Results A statistically significant lower value of the DE compared to the SS technology (P <0.0001) for the CDTI, DLP and ED was found, whereas we did not find any statistically significant difference between the four scanners for the measurements of the image noise, SNR and CNR. Conclusion DS CT scanners allow performing CTAs with a reduced dose compared to SS CT scanner with comparable image quality.
October 2017
Editorial Board
Publication date: October 2017
Source:Journal of Neuroradiology, Volume 44, Issue 6

October 2017
Diffusion weighted imaging and time in acute ischemic stroke, is there any relation?
Publication date: October 2017
Source:Journal of Neuroradiology, Volume 44, Issue 6 Author(s): Daniel Mantilla-Garc
October 2017
Prediction of hemorrhagic transformation after acute thrombolysis following major artery occlusion using relative ADC ratio: A retrospective study
Publication date: October 2017
Source:Journal of Neuroradiology, Volume 44, Issue 6 Author(s): N. Shinoda, S. Hori, K. Mikami, T. Bando, D. Shimo, T. Kuroyama, Y. Kuramoto, M. Matsumoto, O. Hirai, Y. Ueno Background The relative apparent diffusion coefficient (ADC) ratio can be used to evaluate the extent of ischemia. We investigated the risk factors for, and correlation between, relative ADC ratio and hemorrhagic transformation (HT) after thrombolysis. Methods This single-center, retrospective study involved 105 patients with acute occlusion of the anterior circulation. Relative ADC ratio was calculated as the ratio of ADC pixel values, within the affected territory to ADC pixel values in the contralateral normal region. HT was determined by computed tomography and T2* weighted magnetic resonance imaging after endovascular revascularization. Results Data for 80 of the 105 patients were analyzed. Comparing the number of patients between the HT group (n =25) and the non-HT group (n =55), a significant difference was noted in tissue plasminogen activator (tPA) use (P =0.028), time from onset to reperfusion
October 2017
Endovascular treatment of acute ischemic stroke with ERIC device
Publication date: October 2017
Source:Journal of Neuroradiology, Volume 44, Issue 6 Author(s): Laurent Pierot, Jean-Yves Gauvrit, Vincent Costalat, Michel Piotin, Charbel Mounayer, Denis Herbreteau, Sophie Gallas, Ren
October 2017
Dynamics of cerebral perfusion deficits after aneurysmal SAH – predictive value of early MTT for subsequent MTT deterioration
Publication date: October 2017
Source:Journal of Neuroradiology, Volume 44, Issue 6 Author(s): Christian Rubbert, Julian Caspers, Athanasios Konstandinou Petridis, Bernd Turowski, Rebecca May Background and purpose The pathogenesis of poor functional outcome after aneurysmal subarachnoid hemorrhage (aSAH) is not fully understood. Microcirculatory dysfunction, which can be indirectly measured by CT perfusion (CTP), is assumed to play a central role. We evaluated the predictive value of early changes in microcirculation for secondary critical perfusion changes. Materials and methods Out of 351 consecutive aSAH patients, 166 patients with
October 2017
Evaluation of ex-vivo 9.4T MRI in post-surgical specimens from temporal lobe epilepsy patients
Publication date: October 2017
Source:Journal of Neuroradiology, Volume 44, Issue 6 Author(s): Benjamin Y.M. Kwan, Fateme Salehi, Ryan Kope, Donald H. Lee, Manas Sharma, Robert Hammond, Jorge G. Burneo, David Steven, Terry Peters, Ali R. Khan Purpose This study evaluates hippocampal pathology through usage of ultra-high field 9.4T ex-vivo imaging of resected surgical specimens in patients who have undergone temporal lobe epilepsy surgery. Method and materials This is a retrospective interpretation of prospectively acquired data. MRI scanning of resected surgical specimens from patients who have undergone temporal lobe epilepsy surgery was performed on a 9.4T small bore Varian MR magnet. Structural images employed a balanced steady-state free precession sequence (TrueFISP). Six patients (3 females; 3 males) were included in this study with an average age at surgery of 40.7 years (range 20Y_"60) (one was used as a control reference). Two neuroradiologists qualitatively reviewed the ex-vivo MRIs of resected specimens while blinded to the histopathology reports for the ability to identify abnormal features in hippocampal subfield structures. Results The hippocampal subfields were reliably identified on the 9.4T ex-vivo scans in the hippocampal head region and hippocampal body region by both neuroradiologists in all 6 patients. There was high concordance to pathology for abnormalities detected in the CA1, CA2, CA3 and CA4 subfields. Detection of abnormalities in the dentate gyrus was also high with detection in 4 of 5 cases. The Cohen's kappa between the two neuroradiologists was calculated at 0.734 SE=0.102. Conclusions Ex-vivo 9.4T specimen imaging can detect abnormalities in CA1, CA2, CA3, CA4 and DG in both the hippocampal head and body. There was good concordance between qualitative findings and histopathological abnormalities for CA1, CA2, CA3, CA4 and DG.
October 2017
A six-month longitudinal evaluation significantly improves accuracy of predicting incipient Alzheimer's disease in mild cognitive impairment
Publication date: October 2017
Source:Journal of Neuroradiology, Volume 44, Issue 6 Author(s): Asim M. Mubeen, Ali Asaei, Alvin H. Bachman, John J. Sidtis, Babak A. Ardekani Rationale and objectives Early prediction of incipient Alzheimer's disease (AD) dementia in individuals with mild cognitive impairment (MCI) is important for timely therapeutic intervention and identifying participants for clinical trials at greater risk of developing AD. Methods to predict incipient AD in MCI have mostly utilized cross-sectional data. Longitudinal data enables estimation of the rate of change of variables, which along with the variable levels have been shown to improve prediction power. While some efforts have already been made in this direction, all previous longitudinal studies have been based on observation periods longer than one year, hence limiting their practical utility. It remains to be seen if follow-up evaluations within shorter intervals can significantly improve the accuracy of prediction in this problem. Our aim was to determine the added value of incorporating 6-month longitudinal data for predicting progression from MCI to AD. Materials and methods Using 6-months longitudinal data from 247 participants with MCI, we trained two Random Forest classifiers to distinguish between progressive MCI (n =162) and stable MCI (n =85) cases. These models utilized structural MRI, neurocognitive assessments, and demographic information. The first model (cross-sectional) only used baseline data. The second model (longitudinal) used data from both baseline and a 6-month follow-up evaluation allowing the model to additionally incorporate biomarkers’ rate of change. Results The longitudinal model (AUC=0.87; accuracy=80.2%) performed significantly better (P <0.05) than the cross-sectional model (AUC=0.82; accuracy=71.7%). Conclusion Short-term longitudinal assessments significantly enhance the performance of AD prediction models.
October 2017
Detection of cholesteatoma: High-resolution DWI using RS-EPI and parallel imaging at 3 tesla
Publication date: October 2017
Source:Journal of Neuroradiology, Volume 44, Issue 6 Author(s): O. Algin, H. Ayd
October 2017
Imaging features of intracranial psammomatous meningioma
Publication date: October 2017
Source:Journal of Neuroradiology, Volume 44, Issue 6 Author(s): L. Liu, Y. Lu, W. Peng, D. Geng, J. Wen, J. Xiong, L. Zou, B. Yin Purpose This study was conducted to describe the imaging features of intracranial psammomatous meningioma (IPM). Materials and methods Twenty-three patients with a histopathological diagnosis of IPM between January 2007 and August 2016 were retrospectively reviewed. Twenty-two patients underwent contrast-enhanced MRI scanning, and 16 underwent non-enhanced CT. Results A total of 23 adult patients (3 men, 20 women; mean age, 55.3±7.0 years) with 30 IPMs, including 3 patients with multiple IPMs, were recruited. Twenty tumours (66.7%) were located at the cerebral convexity. The mean size of the lesions was 2.42±0.92cm (range, 1.2–4.8cm). All tumours had a regular shape. On CT scans, 13 masses (13/22) were totally replaced with calcifications, and calcifications were observed in 21 cases (21/22) with higher density. There were 22 cases (22/30) of IPMs presenting adjacent hyperostosis, while 8 cases (8/30) presented no skull changes that were not close to the skull. Nearly half of the cases (14/29) showed mixed hypo- and hyperintensity on T2-weighted images and DWI. PTBE was present in 8 tumours and absent in the other 22, among which only 4 tumours were accompanied by severe oedema. Conclusions These radiological findings may facilitate correct diagnosis for IPMs and thus presurgical planning, prognosis evaluation and treatment of meningiomas.
October 2017
Metastatic fusiform aneurysms from atrial myxoma: A case report and literature review
Publication date: October 2017
Source:Journal of Neuroradiology, Volume 44, Issue 6 Author(s): J. Castier, T. Portella, F. Ricolfi, P. Thouant
Available online 29 September 2017
Secondary cerebral abscess of an ischemic stroke treated by thrombectomy
Publication date: October 2017
Source:Journal of Neuroradiology, Volume 44, Issue 6 Author(s): Adrien Guenego, Marie Rafiq, Caterina Michelozzi, Anne-Christine Januel, Jean-Fran
Available online 28 September 2017
Evaluation of cerebral arterial and venous system in tuberculous meningitis
Publication date: Available online 29 September 2017
Source:Journal of Neuroradiology Author(s): Jayantee Kalita, Rajesh K. Singh, Usha K. Misra, Sunil Kumar Background Central nervous system infection especially pyogenic results in cerebral venous sinus thrombosis. Tuberculous meningitis (TBM) although associated with infarctions but there is no comprehensive study evaluating the role of CVST contributing in infarction. Purpose To evaluate cerebral arterial and venous system using MR angiography (MRA) and MR venography (MRV) in TBM, and correlate with clinical and MRI findings. Materials and methods Consecutive patients with TBM were evaluated clinically and their consciousness was assessed by using Glasgow Coma scale. Cerebrospinal fluid analysis was done. Patients were subjected to MRI, MRA and MRV studies. The severity of TBM was categorized as grades I to III. Presence of infarction on MRI and its cause as arterial or venous was noted based on MRA and MRV abnormalities. Results Twenty-six patients were included whose median age was 23 years. Seven (26.9%) patients had stage I, 12 (46.2%) stage II and 7 (26.9%) stage III TBM. MRI revealed infarction in 13 (50%) patients and were in tubercular zone (caudate, lentiform nuclei, anterior limb and genu of internal capsule, and anterior thalamus) in all except one. MRA was abnormal in 11/25 (42.3%) patients; 7 had middle cerebral artery, 2 both posterior cerebral artery and middle cerebral artery, and 2 had narrowing of all intracranial vessels. MRV however did not reveal any evidence of CVST although revealed variation in normal anatomy in 14 (53.8%) patients, commonest being hypoplastic transverse sinus. Conclusion In TBM, infarction occurs in 50% patients, and is of arterial in origin. Cerebral venous system is usually spared in TBM.
Available online 28 September 2017
Critical carotid bulb stenosis with intraluminal thrombus: Importance of delayed carotid stenting
Publication date: Available online 28 September 2017
Source:Journal of Neuroradiology Author(s): Anshu Mahajan, Gaurav Goel, Biplab Das
Available online 28 September 2017
Greater occipital nerve MR tractography: Feasibility and anatomical considerations
Publication date: Available online 28 September 2017
Source:Journal of Neuroradiology Author(s): Adrian Kastler, Arnaud Attye, Olivier Heck, Florence Tahon, Kamel Boubagra, Ir
Available online 28 September 2017
Pediatric aortic coarctation discovered during endovascular treatment of a ruptured intracranial aneurysm
Publication date: Available online 28 September 2017
Source:Journal of Neuroradiology Author(s): Federico Cagnazzo, Cyril Dargazanli, Thomas Roujeau, Daniel Mantilla, Vincent Costalat
Available online 18 September 2017
Magnetic resonance spectroscopy abnormalities in traumatic brain injury: A meta-analysis
Publication date: Available online 28 September 2017
Source:Journal of Neuroradiology Author(s): Matthew Brown, Hediyeh Baradaran, Paul J. Christos, Drew Wright, Ajay Gupta, Apostolos J. Tsiouris Background and purpose Despite traumatic brain injury (TBI) being common, evaluation with imaging remains challenging. Magnetic resonance spectroscopy (MRS) shows promise in detecting changes of brain metabolite concentrations following TBI; however, currently there are only small studies available without conclusive evidence of the technique's efficacy. The purpose of this systematic review and meta-analysis was to evaluate the association between TBI and MRS metabolite changes. Materials & methods A comprehensive literature search was performed looking for studies reporting brain metabolite concentrations in both TBI and control subjects. Included studies reported values for both adult TBI and control subjects. Cumulative and subgroup meta-analyses were performed using a random effects model. Results The literature search returned an initial 898 manuscripts, of which 36 (which included 748 unique subjects) met study criteria. Cumulatively, NAA/Cr ratios in TBI patients showed a significant decrease as compared to controls (standardized mean deviation [SMD]=
Available online 17 September 2017
Hippocampal infarction: Identification of three new types
Publication date: Available online 18 September 2017
Source:Journal of Neuroradiology Author(s): A. F
Available online 17 September 2017
Arterial spin labeling hyperperfusion in Rasmussen's encephalitis: Is it due to focal brain inflammation or a postictal phenomenon?
Publication date: Available online 17 September 2017
Source:Journal of Neuroradiology Author(s): Savith Kumar, Chinmay P. Nagesh, Bejoy Thomas, Ashalatha Radhakrishnan, Ramshekhar N. Menon, Chandrasekharan Kesavadas Background and purpose The study evaluated the utility of arterial spin labeling (ASL) perfusion imaging in Rasmussen's encephalitis (RE). Material and methods The hospital electronic database was searched using the search words “encephalitis,” “autoimmune encephalitis” and “Rasmussen's encephalitis” for the period of 1 Jan 2015 to 31 Jan 2017. Clinically diagnosed cases of RE for which epilepsy protocol magnetic resonance imaging (MRI) with perfusion imaging (ASL) performed on a 3T scanner were retrieved. The diagnosis of RE was based on Bien's criteria (Bien et al., 2005). We obtained patient's demographic details, clinical features, electrophysiological studies, and follow-up data from electronic hospital records. Results We included nine patients with RE of whom seven patients showed increased perfusion, and two patients decreased perfusion. Among these patients, MRI changes of gyral hyperintensity without volume loss corresponded to regional ASL hyperperfusion in six patients and ASL hypoperfusion in one patient. Two patients who showed ASL hypoperfusion had corresponding atrophy on MRI. Eight patients of RE had epilepsia partialis continua (EPC) or daily seizures, and one patient was seizure-free post-surgery. Five patients showed a concordance of ASL hyperperfusion with clinical ictal onset zone. Among the seven patients with ASL hyperperfusion, the finding was concordant (complete or partial) with the electroencephalogram (EEG) ictal onset zone in six patients and with interictal epileptiform discharges (IED) in seven patients. Conclusion Increased perfusion in ASL of the involved brain parenchyma in RE is a common MRI finding and may be due to either active inflammation of the brain involved or a seizure-related finding.
Available online 15 September 2017
Transfer of stroke patients impairs eligibility for endovascular stroke treatment
Publication date: Available online 17 September 2017
Source:Journal of Neuroradiology Author(s): Omid Nikoubashman, Franziska Pauli, Kolja Sch
September 2017
Can MRI water apparent diffusion coefficient (ADC) value discriminate between idiopathic normal pressure hydrocephalus, Alzheimer's disease and subcortical vascular dementia?
Publication date: Available online 15 September 2017
Source:Journal of Neuroradiology Author(s): Adrien Goujon, Mehdi Mejdoubi, Yvonne Purcell, Rishika Banydeen, Sylvie Colombani, Alessandro Arrigo Numerous similarities in MRI and clinical symptoms exist between Alzheimer's disease (AD), subcortical vascular dementia (sVD) and possible idiopathic normal pressure hydrocephalus (iHPN). The aim of this study is to explore mean apparent coefficient diffusion (ADC) difference between theses diseases in different periventricular and deep white matter areas, as compared to healthy controls. This retrospective study analyzed mean ADC values of 120 patients in normal appearing deep white matter and lenticular nuclei, frontal, caudate nuclei corpus and parietal periventricular and deep white matter areas INPH group showed significantly lower ADC than sVD group in frontal periventricular region (1567.10
September 2017
Editorial Board
Publication date: September 2017
Source:Journal of Neuroradiology, Volume 44, Issue 5

September 2017
Randomize the first patient
Publication date: September 2017
Source:Journal of Neuroradiology, Volume 44, Issue 5 Author(s): Jean Raymond, Robert Fahed, Tim E. Darsaut
September 2017
New techniques in interventional neuroradiology: Should we really randomize the first patient?
Publication date: September 2017
Source:Journal of Neuroradiology, Volume 44, Issue 5 Author(s): L. Pierot, L. Kanagaratnam, M. Gawlitza, S. Soize, M. Dram
September 2017
Risk factors for angiographic recurrence after treatment of unruptured intracranial aneurysms: Outcomes from a series of 178 unruptured aneurysms treated by regular coiling or surgery
Publication date: September 2017
Source:Journal of Neuroradiology, Volume 44, Issue 5 Author(s): Anne-Laure Bernat, Fr
September 2017
Total mismatch of diffusion-weighted imaging and susceptibility-weighted imaging in patients with acute cerebral ischemia
Publication date: September 2017
Source:Journal of Neuroradiology, Volume 44, Issue 5 Author(s): Min-Gyu Park, Jeong A. Yeom, Seung Kug Baik, Kyung-Pil Park Background and purpose Multiple hypointense vessels (MHV) on susceptibility-weighted imaging (SWI) is associated with an increased oxygen demand in acute cerebral ischemia. Occasionally, some patients exhibit extensive MHV on SWI despite of negative diffusion-weighted imaging (DWI), which is a phenomenon called total mismatch DWI-SWI. We analyzed the clinical characteristics and imaging findings in patients with the total DWI-SWI mismatch. Materials and methods We selected patients with total DWI-SWI mismatch who underwent MRI within 12hours from onset. To evaluate the degree of collateral flow, we graded vessels on post-contrast time-of-flight MR angiography as 3 groups. Perfusion lesion volume was measured using threshold of>6seconds of mean transit time on perfusion-weighted imaging. Results Total DWI-SWI mismatch was found in 10 (2.7%) out of 370 patients. Four out of 10 patients were excluded due to lack of data on perfusion studies. Hence 6 patients were finally selected in the study. Two patients with internal carotid artery dissection were treated with emergent stenting, one patient with intravenous thrombolysis and mechanical thrombectomy, and two patients with drug-induced hypertension. All of the enrolled patients exhibited extensive MHV on SWI and good collateral flows. The mean perfusion lesion volume was 72.6±15.3ml (range 0–325.0ml). Clinical outcome was favorable in all of the patients (mRS at 3 months, 0). Conclusions Our results demonstrate that total mismatch of DWI-SWI is associated with good collateral flow and may be a predictor of good response to treatment in patients with acute cerebral ischemia.
September 2017
CT perfusion diagnoses delayed cerebral ischemia in the early stage of the time-window after aneurysmal subarachnoid hemorrhage
Publication date: September 2017
Source:Journal of Neuroradiology, Volume 44, Issue 5 Author(s): Haogeng Sun, Wanjiang Li, Junpeng Ma, Yi Liu, Chao You Background and purpose It has been acknowledged that delayed cerebral ischemia (DCI) after aneurysmal subarachnoid hemorrhage (SAH) can be diagnosed by CT perfusion (CTP) in the DCI time-window. We evaluated the diagnostic accuracy of CTP for DCI during the early stage of the time-window. Materials and methods We prospectively enrolled patients with aneurysmal SAH. DCI was defined as both new cerebral infarction and clinical deterioration after SAH. CTP was performed by using a standardized protocol with predefined regions of interest in 4 to 6 days after SAH. We quantitatively evaluated the diagnostic accuracy of eight CTP parameters (4 for absolute parameters and 4 for relative parameters). The receiver operator characteristic (ROC) curves of all parameters were generated and the optimal threshold values were derived for the calculation of sensitivities and specificities. Results Fifty-three patients were enrolled and 20 patients were diagnosed with DCI. In the analysis of absolute CTP parameters, CBF and MTT had areas under the curve (AUC) >0.75 and the optimal threshold value was 40.4mL/100g/min and 3.78seconds, respectively. Through the evaluation of relative CTP parameters, all 4 parameters had AUC >0.75 and the optimal threshold value was 0.9 for CBV ratio, 0.85 for CBF ratio, 0.32seconds for MTT difference and 1.31seconds for TTP difference. Conclusions Besides two absolute CTP parameters (CBV and TTP), all six CTP parameters can be used as good diagnostic tests for DCI in the early stage of the time-window.
September 2017
Susceptibility-weighted angiography and diffusion-weighted imaging in posterior reversible encephalopathy syndrome – Is there an association between hemorrhage, cytotoxic edema, blood pressure and imaging severity?
Publication date: September 2017
Source:Journal of Neuroradiology, Volume 44, Issue 5 Author(s): Shivaprakash Basavanthaiah Hiremath, Amol Anantrao Gautam, Shilpa Anil, Reji Thomas, Geena Benjamin Purpose To assess the significance of association and possible correlation between hemorrhage, cytotoxic edema, blood pressure and imaging severity in posterior reversible encephalopathy syndrome (PRES). Materials and methods This retrospective study included the medical and imaging records of 35 consecutive patients with PRES. The clinical data analysis included the highest recorded blood pressure (BP) on the day of the ictus, MRI including spin-echo echo planar diffusion-weighted imaging (DWI), susceptibility weighted angiography (SWAN) and conventional sequences. The presence of hemorrhage and cytotoxic edema was evaluated for the significance of correlation and association with each other and with blood pressure and imaging severity. Results On MR imaging, hemorrhage was found in 25.7%, and cytotoxic edema in 20% of patients. There was no statistically significant association of hemorrhage (P =0.403) and cytotoxic edema (P =0.162) with BP in contrast to significant association of hemorrhage (P <0.001) and cytotoxic edema (P =0.011) with imaging severity and with each other (P =0.002). There was a significant correlation of hemorrhage (Cramer's V – 0.672) and cytotoxic edema (Cramer's V – 0.506) with imaging severity and with each other (Cramer's V – 0.523). Conclusion The extent of imaging severity in PRES showed significant association and correlation with hemorrhage and cytotoxic edema. There was no statistically significant association of blood pressure with imaging severity, hemorrhage, and cytotoxic edema. Further prospective studies are needed to elucidate the pathophysiological mechanisms and their correlation with imaging findings in PRES.
September 2017
Anatomical localization of the cavernous sinus dural fistula by 3D rotational angiography with emphasis on clinical and therapeutic implications
Publication date: September 2017
Source:Journal of Neuroradiology, Volume 44, Issue 5 Author(s): Santhosh Kumar Kannath, Jayadevan Enakshy Rajan, Sankara P. Sarma Background and purpose Carotid cavernous sinus dural arteriovenous fistulas (CSDAVFs) are presumed to be located within the walls of the cavernous sinus, however the exact fistulous site has not yet been studied by angiographic or anatomical methods. The present study aimed to localize CSDAVFs with the help of 3D rotational angiography (RA) and correlated the observations with clinical and angiographic findings. Materials and methods The CSDAVFs were categorized as dural, extradural or osseous based on the site of convergence of feeders into the venous sac. Extradural CSDAVFs were further subcategorized into posteromedial, posterolateral and anterior subtypes, depending on proximity to a possible venous plexus. This classification was correlated with various clinical presentations and angiographic subtypes. Results Thirty-seven patients were included in the final analysis. The sac was identified in all the patients and the mean sac size of the fistula was small (<4mm). Dural type was associated with exclusive cortical venous drainage. Extradural anterior CSDAVF showed tendency towards younger age predilection. Extradural posterolateral CSDAVF was more often associated with initial oculomotor nerve palsy and this observation was statistically significant. Discordancy between the location of the fistula and the side of clinical affection was observed in midline fistulas such as osseous CSDAVF and posteromedial type of extradural CSDAVF. Conclusions CSDAVF is a heterogeneous vascular disorder involving the sphenoclival bone, extradural space and dura, homologous to the epidural-dural shunts of vertebra with a common clinical presentation of orbital manifestations. Preoperative localization of the fistula could explain enigmatic observations and potentially simplify its interventional management.
September 2017
The relationship between post-traumatic ossicular injuries and conductive hearing loss: A 3D-CT study
Publication date: September 2017
Source:Journal of Neuroradiology, Volume 44, Issue 5 Author(s): Olivier Maillot, Arnaud Atty
September 2017
Influence of inversion time on endolymphatic hydrops evaluation in 3D-FLAIR imaging
Publication date: September 2017
Source:Journal of Neuroradiology, Volume 44, Issue 5 Author(s): Michael Eliezer, Andr

Crown abnormality in osmotic demyelination syndrome
Publication date: September 2017
Source:Journal of Neuroradiology, Volume 44, Issue 5 Author(s): Akifumi Hagiwara, Mihoko Yamazaki, Noritaka Onoda
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