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Hyperdense artery sign on computed tomography in acute ischemic stroke

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World Journal of Radiology 2010年第9期2卷 354-357页

作者： Ulf Jensen-Kondering Christian Riedel Olav Jansen Institute of neuroradiology University of Schleswig-Holstein

Despite the advent and growing availability of magnetic resonance imaging,the imaging modality of choice in the acute care of stroke patients in many institutions remains computed *** hyperdense artery sign is the earliest marker of acute ischemic *** this short review,we discuss the pathology,incidence,clinical aspects,imaging findings,significance and future questions that need to be addressed concerning this important sign.

关键词： Computed tomography Early ischemic signs Hyperdense artery Stroke

Characterising acute ischaemic stroke thrombi:insights from histology,imaging and emerging impedance-based technologies

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Stroke & Vascular Neurology 2022年第4期7卷 353-363页

作者： Smita Patil Jean Darcourt Pierluca Messina Franz Bozsak Christophe Cognard Karen Doyle CÚRAM SFI Research Centre for Medical DevicesNational University of Ireland GalwayGalwayIreland neuroradiology CHU de ToulouseToulouseFrance Sensome MassyFrance Physiology National University of Ireland GalwayGalwayIreland

Treatment of acute ischaemic stroke(AIS)focuses on rapid recanalisation of the occluded *** recent years,advent of mechanical thrombectomy devices and new procedures have accelerated the analysis of thrombi retrieved during the endovascular thrombectomy *** ongoing developments and progress in AIS imaging techniques,it is not yet possible to conclude definitively regarding thrombus characteristics that could advise on the probable efficacy of thrombolysis or thrombectomy in advance of *** devices with dignostic capabilities or new clinical imaging approaches are needed for better treatment of AIS *** this review,what is known about the composition of the thrombi that cause strokes and the evidence that thrombus composition has an impact on success of acute stroke treatment has been *** review also discusses the evidence that AIS thrombus composition varies with aetiology,questioning if suspected aetiology could be a useful indicator to stroke physicians to help decide the best acute course of ***,this review discusses the evidence that current widely used radiological imaging tools can predict thrombus *** use of new emerging technologies based on bioimpedance,as imaging modalities for diagnosing AIS and new medical device tools for detecting thrombus composition in situ has been *** bioimpedance would be beneficial for gaining new insights into in situ thrombus composition that could guide choice of optimum treatment approach is also reviewed.

关键词： throm acute impedance

Expression of L amino acid transport system 1 and analysis of iodine-123-methyltyrosine tumor uptake in a pancreatic xenotransplantation model using fused high-resolution-micro-SPECT-MRI

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Hepatobiliary & Pancreatic Diseases International 2011年第1期10卷 30-37页

作者： Corinna von Forstner Maaz Zuhayra Ole Ammerpohl Sanjay Tiwari Olav Jansen Holger Kalthoff Eberhard Henze Jan-Hendrik Egberts Department of Nuclear Medicine University Hospital of Schleswig-Holstein Institute for Experimental Cancer Research University Hospital of Schleswig-Holstein Institute of neuroradiology University Hospital of Schleswig-Holstein Department of General Surgery and Thoracic Surgery University Hospital of Schleswig-Holstein

BACKGROUND:The specificity in discriminating pancreatitis is limited in the positron emission tomography(PET)using ***,PET is not widely available compared to the single photon emission computed tomography(SPECT).Since amino acids play a minor role in metabolism of inflammatory cells,the potential of the SPECT tracer,3-[ 123 I]iodo-L-α-methyltyrosine(123I-IMT),for detecting pancreatic cancer was examined in xenotransplantation models of human pancreatic carcinoma in mice. METHODS: 123 I-IMT was injected to eight mice inoculated with subcutaneous or orthotopic pancreatic *** high-resolution-micro-SPECT(Hi-SPECT)and magnetic resonance imaging were *** gene expression level of L amino acid transport-system 1(LAT1)was analyzed and correlated with tumor uptake of 123 I-IMT. RESULTS:A high uptake of 123 I-IMT was detected in all tumor-bearing *** median tumor-to-background ratio (T/B)was 12.1(2.0-13.2)for orthotopic and 8.4(1.8-11.1)for subcutaneous xenotransplantation,***, the LAT1 expression in transplanted Colo357 cells was increased compared to non-malignant ***:Our mouse model could show a high 123 I-IMT uptake in pancreatic *** MRI scans facilitate precise evaluation of uptake in the specific regions of *** studies are required to confirm these findings in tumors derived from other human pancreatic cancer *** amino acids play a minor role in the metabolism of inflammatory cells,the potential for application of 123 I-IMT to distinguish pancreatic tumor from inflammatory pancreatitis warrants further investigation.

关键词： pancreatic ductal adenocarcinoma iodine-123-methyltyrosine high-resolution-micro-SPECT L amino acid transport-system 1 xenotransplantation model

Middle cerebellar peduncles:Magnetic resonance imaging and pathophysiologic correlate

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World Journal of Radiology 2015年第12期7卷 438-447页

作者： Humberto Morales Thomas Tomsick Department of neuroradiology University of Cincinnati Medical Center

We describe common and less common diseases that can cause magnetic resonance signal abnormalities of middle cerebellar peduncles(MCP), offering a systematicapproach correlating imaging findings with clinical clues and pathologic mechanisms. Myelin abnormalities, different types of edema or neurodegenerative processes, can cause areas of abnormal T2 signal, variable enhancement, and patterns of diffusivity of MCP. Pathologies such as demyelinating disorders or certain neurodegenerative entities(e.g., multiple system atrophy or fragile X-associated tremor-ataxia syndrome) appear to have predilection for MCP. Careful evaluation of concomitant imaging findings in the brain or brainstem; and focused correlation with key clinical findings such as immunosuppression for progressive multifocal leukoencephalopahty; hypertension, post-transplant status or high dose chemotherapy for posterior reversible encephalopathy; electrolyte disorders for myelinolysis or suspected toxic-drug related encephalopathy; would yield an appropriate and accurate differential diagnosis in the majority of cases.

关键词： Middle cerebellar peduncle Brachium pontis Magnetic resonance imaging Multiple sclerosis Progressive multifocal leukoencephalopathy Posterior reversible encephalopathy Toxic encephalopathy

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 *** To better understand the risks of TIPS in this challenging setting and to compare them with those of conservative *** 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 *** 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 *** TIPS placement for recurrent tense as

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

Saccular trilobed aneurysm of azygos anterior cerebral artery

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World Journal of Clinical Cases 2015年第4期3卷 377-380页

作者： Arsen Seferi Ridvan Alimehmeti Mentor Petrela Arben Rroji Service of Neurosurgery University Hospital Centre "Mother Theresa" Rruga Kongresi i Manastirit neuroradiology University Hospital Centre "Mother Theresa" Rruga Kongresi i Manastirit

Multiple saccular or giant aneurysms of azygos anteriorcerebral artery(AACA) at the distal segments A2-A5 are very rarely reported. Distal anterior cerebral artery(DACA) aneurysms represent approximately 2%-7% of all cerebral aneurysms. We present the case of an Albanian 62-year-old male, admitted at our service after sudden onset of severe headache and vomiting. Computerized tomography(CT) of the head showed hemorrhage in the front of corpus callosum. CT angiography followed by digitally subtracted angiography(DSA) documented a large necked aneurysm with three lobes at the origin of calloso-marginal artery and a single DACA, also known as AACA. A frontal parasagittal craniotomy was performed. Obliteration of the aneurysm was done only by separate clipping of each three lobes at the respective neck. Postoperative DSA demonstrated complete exclusion of the aneurysm and a regular flow of AACA. The patient recovered uneventfully. Despite it is a rare occurrence, an aneurysm of distal segments of anterior cerebral artery A2-A5, concomitant to AACA should be studied with DSA. In the era of embolization, conserving good microsurgical skills is fundamental for dealing with multilobar cerebral aneurysms, associated with rare anatomical variations.

关键词： Azygos Cerebral Aneurysm Clipping

COmbination of Targeted temperature management and Thrombectomy after acute Ischemic Stroke(COTTIS):a pilot study

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Stroke & Vascular Neurology 2024年第3期9卷 258-267页

作者： Jürgen Bardutzky Rainer Kollmar Forat Al-Rawi Johann Lambeck Mohammad Fazel Christian Taschner Wolf-Dirk Niesen Department of Neurology and Neurophysiology Medical Center-University of FreiburgFaculty of MedicineUniversity of FreiburgFreiburgGermany Neurology and Neurointensive Care Darmstadt HospitalDarmstadtGermany BrainCool AB LundSweden Department of neuroradiology Medical Center-University of FreiburgFaculty of MedicineUniversity of FreiburgFreiburgGermany

Background To evaluate the feasibility and safety of a fast initiation of cooling to a target temperature of 35℃by means of transnasal cooling in patients with anterior circulation large vessel occlusion(LVO)undergoing endovascular thrombectomy(EVT).Methods Patients with an LVO onset of<24hour who had an indication for EVT were included in the *** cooling(RhinoChill)was initiated immediately after the patient was intubated for EVT and continued until an oesophageal target temperature of 35℃was *** was maintained with surface cooling for 6-hour postrecanalisation,followed by active rewarming(+0.2℃/hour).The primary outcome was defined as the time required to reach 35℃,while secondary outcomes comprised clinical,radiological and safety *** Twenty-two patients(median age,77 years)were included in the study(14 received additional thrombolysis,4 additional stenting of the proximal internal carotid artery).The median time intervals were 309min for last-seen-normal-to-groin,58min for door-to-cooling-initiation,65min for door-to-groin and 123min for *** target temperature of 35℃was reached within 30min(range 13–78min),corresponding to a cooling rate of 2.6℃/*** recanalisation,86%of the patients had a body temperature of≤35℃.The median National Institutes of Health Stroke Scale at admission was 15 and improved to 2 by day 7,and 68%of patients had a good outcome(modified Rankin Scale 0–2)at 3 *** complications included asymptomatic bradycardia(32%),pneumonia(18%)and asymptomatic haemorrhagic transformation(18%).Conclusion The combined application of hypothermia and thrombectomy was found to be feasible in sedated and ventilated *** events were comparable to those previously described for EVT in the absence of *** effect of this procedure will next be evaluated in the randomised COmbination of Targeted temperature management and Thrombectomy after acute Ischemic Stro

关键词： maintained continued initiated

Accuracy of combined PET/CT in image-guided interventions of liver lesions: An ex-vivo study

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World Journal of Gastroenterology 2006年第15期12卷 2388-2393页

作者： Patrick Veit Christiane Kuehle Thomas Beyer Hilmar Kuehl Andreas Bockisch Gerald Antoch Department of Diagnostic and Interventional Radiology and neuroradiology Department of Nuclear Medicine university Hospital Essen

AIM： Positioning of interventional devices in liver lesions is a challenging task if only CT is available. We investigated the potential benefit of combined PET/CT images for localization of interventional devices in interventional liver studies. METHODS： Thirty lesions each of hyperdense, isodense and hypodense attenuation compared to normal liver parenchyma were injected into 15 ex-vivo pig livers. All lesions were composed of the same amounts of gelatine containing 0.5 MBq of ^18F-FDG. Following lesion insertion, an interventional needle was placed in each lesion under CT-guidance solely. After that, a PET/CT study was performed. The localization of the needle within the lesion was assessed for CT alone and PET/CT and the root mean square （RMS） was calculated. Results were compared with macroscopic measurements after lesion dissection serving as the standard of reference. RESULTS： In hypo- and isodense lesions PET/CT proved more accurate in defining the position of the interventional device when compared with CT alone. The mean RMS for CT and PET/CT differed significantly in isodense and hypodense lesions. No significant difference was found for hyperdense lesions. CONCLUSION： Combined FDG-PET/CT imaging provides more accurate information than CT alone concerning the needle position in FDG-PET positive liver lesions. Therefore combined PET/CT might be potentially beneficial not only for localization of an interventional device, but may also be beneficial for guidance in interventional liver procedures.

关键词： Liver biopsy Radiofrequency ablation Combined PET/CT ex-vivo study Image guided interventions

Staged carotid artery angioplasty and stenting for patients with high-grade carotid stenosis with high risk of developing hyperperfusion injury:a retrospective analysis of 44 cases

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Stroke & Vascular Neurology 2016年第4期1卷 147-153页

作者： Dapeng Mo Gang Luo Bo Wang Ning Ma Feng Gao Xuan Sun Xiaotong Xu Zhongrong Miao Department of Interventional neuroradiology Beijing Tiantan HospitalCapital Medical UniversityChina National Clinical Research Center for Neurological DiseasesCenter of StrokeBeijing Institute for Brain DisordersBeijingChina

Background:Hyperperfusion syndrome(HPS)is a rare but potentially a life-threatening complication after carotid artery angioplasty and stenting(CAS).Staged CAS has been an alternative to prevent *** and methods:44 of 908 patients with high-grade internal carotid artery stenosis or near occlusion were at risk of HPS because of poor collateral flow and impaired cerebral blood flow(CBF).They were treated with first(stage 1),followed by a full CAS(stage 2)1 month *** 30-day outcomes were tabulated and ***:During follow-up,1 of the 44(2.2%)patients developed HPS immediately,3(7%)had postprocedural HPS(ie,transcranial Doppler(TCD)>120%)without clinical symptoms and 3(7%)required stenting at stage 1 for carotid *** stage 1,there were significant improvement between the preprocedural and postprocedural CBF(0.98±0.06 vs 0.85±0.05,p<0.05),mean transit time(MTT;1.05±0.05 vs 1.15±0.05,p<0.05),time to peak(TTP;1.04±0.06 vs 1.20±0.06,p<0.05)on CT perfusion(CTP),and CBF(66.41±7.41 vs 44.44±6.43,p<0.05)on *** stage 2,improvement was seen in CBF(1.01±0.07 vs 0.98±0.06,p<0.05),MTT(1.01±0.05 vs 1.05±0.05,p<0.05),TTP(0.99±0.06 vs 1.04±0.06,p<0.05)on CTP and CBF(66.41±7.41 vs 93.78±18.81,p<0.05)on TCD.2 had postoperative increase of middle cerebral artery mean flow velocity of 120%after stage 2 without clinical ***:Staged carotid artery stenting probably decreased the chance of developing HPS in this group of selected *** requiring a 2-step intervention,staged CAS may be a safe and effective alternative.

关键词： patients carotid perfusion