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Differentiation of periapical granulomas and cysts by using dental MRI: a pilot study

International Journal of Oral Science 2018年第3期10卷 152-159页

作者： Alexander Juerchott Thorsten Pfefferle Christa Flechtenmacher Johannes Mente Martin Bendszus Sabine Heiland Tim Hilgenfeld Department of neuroradiology Heidelberg University Hospital division of Endodontics and Dental Traumatology Department of Conservative Dentistry Heidelberg University Hospital Institute of Pathology Heidelberg University Hospital division of Experimental Radiology Department of Neuroradiology Heidelberg University Hospital

The purpose of this pilot study was to evaluate whether periapical granulomas can be differentiated from periapical cysts in vivo by using dental magnetic resonance imaging(MRI). Prior to apicoectomy, 11 patients with radiographically confirmed periapical lesions underwent dental MRI, including fat-saturated T2-weighted(T2 wFS) images, non-contrast-enhanced T1-weighted images with and without fat saturation(T1 w/T1 wFS), and contrast-enhanced fat-saturated T1-weighted(T1 wFS+C) images. Two independent observers performed structured image analysis of MRI datasets twice. A total of 15 diagnostic MRI criteria were evaluated, and histopathological results(6 granulomas and 5 cysts) were compared with MRI characteristics. Statistical analysis was performed using intraclass correlation coefficient(ICC), Cohen’s kappa(κ), Mann–Whitney U-test and Fisher’s exact test. Lesion identification and consecutive structured image analysis was possible on T2 wFS and T1 wFS+C MRI images. A high reproducibility was shown for MRI measurements of the maximum lesion diameter(intraobserver ICC = 0.996/0.998; interobserver ICC = 0.997), for the "peripheral rim" thickness(intraobserver ICC = 0.988/0.984; interobserver ICC = 0.970), and for all non-quantitative MRI criteria(intraobserver-κ = 0.990/0.995; interobserver-κ = 0.988). In accordance with histopathological results, six MRI criteria allowed for a clear differentiation between cysts and granulomas:(1) outer margin of lesion,(2) texture of "peripheral rim" in T1 wFS+C,(3)texture of "lesion center" in T2 wFS,(4) surrounding tissue involvement in T2 wFS,(5) surrounding tissue involvement in T1 wFS+C and(6) maximum "peripheral rim" thickness(all: P < 0.05). In conclusion, this pilot study indicates that radiation-free dental MRI enables a reliable differentiation between periapical cysts and granulomas in vivo. Thus, MRI may substantially improve treatment strategies and help to avoid unnecessary surgery in apical periodontitis.

关键词： Differentiation of periapical granulomas and cysts by using dental MRI a pilot study

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Toward imaging of alpha-synuclein with PET

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四川生理科学杂志 2023年第9期45卷 1457-1457页

作者： Kejal Kantarci Department of Radiology Division of Neuroradiology Mayo Clinic Rochester MN USA

Development of radiopharmaceuticals for in vivo positron emission tomography imaging of alpha-synuclein aggregates has the potential to revolutionize Lewy body disease diagnosis and treatment.Reporting in this issue o... 详细信息

关键词： positron treatment. diagnosis

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Transjugular intrahepatic portosystemic shunt vs conservative treatment for recurrent ascites:A propensity score matched comparison

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World Journal of Gastroenterology 2022年第41期28卷 5944-5956页

作者： Martin Philipp Theresia Blattmann Jörn Bienert Kristian Fischer Luisa Hausberg Jens-Christian Kröger Thomas Heller Marc-AndréWeber Georg Lamprecht Department of Medicine Division of Gastroenterology and EndocrinologyRostock University Medical CenterRostock 18057Germany Institute of Diagnostic and Interventional Radiology Pediatric Radiology and NeuroradiologyRostock University Medical CentreRostock 18057Germany

BACKGROUND Transjugular intrahepatic portosystemic shunt(TIPS) placement is an effective intervention for recurrent tense ascites. Some studies show an increased risk of acute on chronic liver failure(ACLF) associated with TIPS placement. It is not clear whether ACLF in this context is a consequence of TIPS or of the pre-existing liver disease.AIM To better understand the risks of TIPS in this challenging setting and to compare them with those of conservative therapy.METHODS Two hundred and fourteen patients undergoing their first TIPS placement for recurrent tense ascites at our tertiary-care center between 2007 and 2017 were identified(TIPS group). Three hundred and ninety-eight patients of the same time interval with liver cirrhosis and recurrent tense ascites not undergoing TIPS placement(No TIPS group) were analyzed as a control group. TIPS indication,diagnosis of recurrent ascites, further diagnoses and clinical findings were obtained from a database search and patient records. The in-hospital mortality and ACLF incidence of both groups were compared using 1:1 propensity score matching and multivariate logistic regressions.RESULTS After propensity score matching, the TIPS and No TIPS groups were comparable in terms of laboratory values and ACLF incidence at hospital admission. There was no detectable difference in mortality(TIPS: 11/214, No TIPS 13/214). During the hospital stay, ACLF occurred more frequently in the TIPS group than in the No TIPS group(TIPS: 70/214, No TIPS: 57/214, P = 0.04). This effect was confined to patients with severely impaired liver function at hospital admission as indicated by a significant interaction term of Child score and TIPS placement in multivariate logistic regression. The TIPS group had a lower ACLF incidence at Child scores < 8 points and a higher ACLF incidence at ≥ 11 points. No significant difference was found between groups in patients with Child scores of 8 to 10 points.CONCLUSION TIPS placement for recurrent tense ascites is associated with an increased rate of AC

关键词： Liver cirrhosis Ascites Transjugular intrahepatic portosystemic shunt Acute on chronic liver failure Mortality Propensity score

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To bridge or not to bridge:summary of the new evidence in endovascular stroke treatment

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Stroke & Vascular Neurology 2022年第3期7卷 179-181页

作者： Anna Podlasek Permesh Singh Dhillon Waleed Butt Iris Q Grunwald Timothy J England Tayside Innovation MedTech Ecosystem(TIME) University of DundeeDundeeUK NIHR Nottingham Biomedical Research Centre University of NottinghamNottinghamUK Interventional neuroradiology Nottingham University Hospitals NHS TrustNottinghamUK Interventional neuroradiology University Hospitals Birmingham NHS TrustBirminghamUK Stroke Division of Mental Health and Clinical NeurosciencesSchool of MedicineUniversity of NottinghamNottinghamUK Stroke University Hospitals of Derby and Burton NHS Foundation TrustDerbyUK

WHAT IS ALREADY KNOWN Recently published summaries and meta-analyses of four randomised controlled trials(RCTs)1-5 comparing direct mechan-ical thrombectomy(dMT)and bridging therapy with intravenous(IV)thrombolytics(alteplase)suggested that dMT is non-inferior to bridging therapy to achieve good functional outcome 3 months after stroke(modified Rankin Score 0-2)with the non-inferiority margin(NIM)<−5%.

关键词： intravenous bridging treatment

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Endovascular treatment of extracranial vertebral artery stenosis

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World Journal of Radiology 2012年第9期4卷 391-400页

作者： Burak Kocak Bora Korkmazer Civan Islak Naci Kocer Osman Kizilkilic Department of Radiology Division of NeuroradiologyCerrahpasa School of MedicineIstanbul University

Percutaneous angioplasty and stenting for the treatment of extracranial vertebral artery(VA) stenosis seems a safe,effective and useful technique for resolving symptoms and improving blood flow to the posterior circulation,with a low complication rate and good long-term results.In patients with severe tortuosity of the vessel,stent placement is a real challenge.The new coronary balloon-expandable stents may be preferred.A large variability of restenosis rates has been reported.Drug-eluting stents may be the solution.After a comprehensive review of the literature,it can be concluded that percutaneous angioplasty and stenting of extracranial VA stenosis is technically feasible,but there is insufficient evidence from randomized trials to demonstrate that endovascular management is superior to best medical management.

关键词： Vertebral artery stenosis Endovascular treatment Stent Angioplasty

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Rarity among benign gastric tumors: Plexiform fibromyxoma-Report of two cases

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World Journal of Gastroenterology 2017年第31期23卷 5817-5822页

作者： Kinga Szurian Holger Till Eva Amerstorfer Nicole Hinteregger Hans-Jorg Mischinger Bernadette Liegl-Atzwanger Iva Brcic Institute of Pathology Medical University of Graz Department of Paediatric and Adolescent Surgery Medical University of Graz Department of Radiology Division of NeuroradiologyVascular and Interventional RadiologyMedical University of Graz Department of Surgery Medical University of Graz

Plexiform fibromyxoma is a very rare mesenchymal tumor of the stomach, found almost exclusively in the antrum/pylorus region. The most common presenting symptoms are anemia, hematemesis, nausea and unintentional weight loss, without sex or age predilection. We describe here two cases of plexiform fibromyxoma, involving a 16-year-old female and a 34-year-old male. Both patients underwent complete resection(R0) by distal gastrectomy and retrocolic gastrojejunostomy(according to Billroth 2); for both, the postoperative course was uneventful. Histology showed multiple intramural and subserosal nodules with characteristic plexiform growth, featuring bland spindle cells situated in an abundant myxoid stroma with low mitotic activity. Immunohistochemistry showed α-smooth muscle actin-positive spindle cells, focal positivity for CD10, and negative staining for KIT, DOG1, CD34, S100, β-catenin, STAT-6 and anaplastic lymphoma kinase. One of the cases showed focal positivity for h-caldesmon and desmin. Upon followup, no sign of disease was found. In the differential diagnosis of plexiform fibromyxoma, it is important to exclude the more common gastrointestinal stromal tumors as they have greater potential for aggressivebehavior. Other lesions, like neuronal and vascular tumors, inflammatory fibroid polyps, abdominal desmoid-type fibromatosis, solitary fibrous tumors and smooth muscle tumors, must also be excluded.

关键词： Plexiform fibromyxoma Plexiform angiomyxoid myofibroblastic 肿瘤胃肠的 stromal 肿瘤胃良性的胃的肿瘤

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Endovascular therapy in acute anterior circulation large vessel occlusive patients with a large infarct core(ANGEL-ASPECT):protocol of a multicentre randomised trial

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Stroke & Vascular Neurology 2023年第2期8卷 169-174页

作者： Xiaochuan Huo Gaoting Ma Xuelei Zhang Yuesong Pan Xu Tong Dapeng Sun Liping Liu Yilong Wang David S Liebeskind Yongjun Wang Vitor Mendes Pereira Zeguang Ren Zhongrong Miao Department of Interventional neuroradiology Beijing Tiantan HospitalBeijingChina Department of Neurology Beijing Tiantan HospitalBeijingChina Clinical Research Center Capital Medical UniversityInstitute of Brain DisordersBeijingChina China National Clinical Research Center for Neurological Diseases Beijing Tiantan HospitalBeijingChina Department of Neurology University of CaliforniaLos AngelesCaliforniaUSA division of Neurosurgery Department of SurgerySt Michael's HospitalUniversity of TorontoTorontoOntarioCanada Department of Neurosurgery The Affiliated Hospital of Guizhou Medical UniversityGuiyangGuizhouChina

Background The benefit of stroke thrombectomy for large infarct core still lacks robust randomised controlled studies.Aim To demonstrate the design of a clinical trial on endovascular therapy for acute anterior circulation large vessel occlusion(LVO)patients with large infarct core volume.Design ANGEL-ASPECT is a multicentre,prospective,randomised,open-label,blinded End-point trial to evaluate whether best medical management(BMM)combined with endovascular therapy improves neurological functional outcomes as compared with BMM alone in acute LVO patients with Alberta Stroke Program Early CT Score(ASPECTS)of 3-5 on non-contrast CT or infarct core volume range of 70-100 mL(defined as rCBF<30%on CT perfusion or ADC<620 on MRI)up to 24 hours from symptom onset or last seen well.Study outcomes The primary efficacy outcome is 90(±7)days modified Rankin Scale.Symptomatic intracranial haemorrhage within 48 hours from randomisation is the primary safety outcome.Discussion The ANGEL-ASPECT trial will screen patients with large infarct core(ASPECTS 3-5 or 70-100 mL)through image evaluation criteria within 24 hours and explore the efficacy and safety of endovascular therapy compared with BMM.

关键词： patients infarct acute

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Direct puncture of the cavernous sinus for treatment of fistula involving the cavernous sinus

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介入放射学杂志 2004年第S1期13卷 94-96页

作者： Michael Mu Huo Teng National Yang Ming University and Chief Division of Neuroradiology Department of Radiology Taipei Veterans General Hospital

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Microglia activation,classification and microglia-mediated neuroinflammatory modulators in subarachnoid hemorrhage

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Neural Regeneration Research 2022年第7期17卷 1404-1411页

作者： Junfan Chen Zhiyuan Vera Zheng Gang Lu Wai Yee Chan Yisen Zhang George Kwok Chu Wong division of Neurosurgery Department of SurgeryThe Chinese University of Hong KongHong Kong Special Administrative RegionChina Department of Neurosurgery Hainan Branch of Chinese People’s Liberation Army General HospitalSanyaHainan ProvinceChina CUHK-SDU Joint Laboratory on Reproductive Genetics School of Biomedical Sciencesthe Chinese University of Hong KongHong Kong Special Administrative RegionChina Bioinformatics Unit SDIVF R&D CentreHong Kong Science and Technology ParksHong Kong Special Administrative RegionChina Department of Interventional neuroradiology Beijing Neurosurgical InstituteBeijing Tiantan HospitalCapital Medical UniversityBeijingChina

Subarachnoid hemorrhage is a devastating disease with significant mortality and morbidity,despite advances in treating cerebral aneurysms.There has been recent progress in the intensive care management and monitoring of patients with subarachnoid hemorrhage,but the results remain unsatisfactory.Microglia,the resident immune cells of the brain,are increasingly recognized as playing a significant role in neurological diseases,including subarachnoid hemorrhage.In early brain injury following subarachnoid hemorrhage,microglial activation and neuroinflammation have been implicated in the development of disease complications and recovery.To understand the disease processes following subarachnoid hemorrhage,it is important to focus on the modulators of microglial activation and the pro-inflammatory/anti-inflammatory cytokines and chemokines.In this review,we summarize research on the modulators of microglia-mediated inflammation in subarachnoid hemorrhage,including transcriptome changes and the neuroinflammatory signaling pathways.We also describe the latest developments in single-cell transcriptomics for microglia and summarize advances that have been made in the transcriptome-based classification of microglia and the implications for microglial activation and neuroinflammation.

关键词： activation inflammation microglia modulator neuroinflammation sequencing signal pathway single-cell analysis stroke subarachnoid hemorrhage treatment

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Susceptibility weighted imaging: Clinical applications and future directions

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World Journal of Radiology 2018年第4期10卷 30-45页

作者： Ahmet Mesrur Halefoglu David Mark Yousem Department of Radiology Sisli Hamidiye Etfal Training and Research Hospital University of Health Sciences division of neuroradiology Department of Radiology Johns Hopkins Medical Institution

Susceptibility weighted imaging(SWI) is a recently developed magnetic resonance imaging(MRI) technique that is increasingly being used to narrow the differential diagnosis of many neurologic disorders. It exploits the magnetic susceptibility differences of various compounds including deoxygenated blood, blood products, iron and calcium, thus enabling a new source of contrast in MR. In this review, we illustrate its basic clinical applications in neuroimaging. SWI is based on a fully velocity-compensated, high-resolution, three dimensional gradientecho sequence using magnitude and phase images either separately or in combination with each other, in order to characterize brain tissue. SWI is particularly useful in the setting of trauma and acute neurologic presentations suggestive of stroke, but can also characterize occult low-flow vascular malformations, cerebral microbleeds, intracranial calcifications, neurodegenerative diseases and brain tumors. Furthermore, advanced MRI post-processing technique with quantitative susceptibility mapping, enables detailed anatomical differentiation based on quantification of brain iron from SWI raw data.

关键词： Quantitative susceptibility mapping Brain Ischemia Magnetic resonance imaging Susceptibility weighted imaging

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