AJNR. American journal of neuroradiology
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AJNR Am J Neuroradiol · Sep 2008
Comparative Study Controlled Clinical TrialCharacterization of aneurysm remnants after endovascular treatment: contrast-enhanced MR angiography versus catheter digital subtraction angiography.
A substantial percentage of coiled aneurysms are associated with persistent filling of an aneurysmal component due to incomplete initial treatment or re-growth. Traditionally follow-up of coiled aneurysms has consisted of repeated intra-arterial cerebral catheter angiography, an invasive procedure with associated risks. Hence, many authors have advocated the use of non-invasive imaging techniques for this purpose. Our aim was to compare contrast-enhanced MR angiography (CE-MRA) with digital subtraction angiography (DSA) for depiction of aneurysmal remnants of coiled cerebral aneurysms. ⋯ In patients with known aneurysm remnants, CE-MRA is at least equivalent to DSA for characterization of aneurysmal remnants after coiling. Contrast filling within the coil mass was more clearly seen with CE-MRA than with DSA.
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AJNR Am J Neuroradiol · Sep 2008
Attenuation of lower-thoracic, lumbar, and sacral spinal cord motion: implications for imaging human spinal cord structure and function.
Recent literature indicates that cervical and upper-thoracic spinal cord motion adversely affect both structural and functional MR imaging (fMRI; particularly diffusion tensor imaging [DTI] and spinal fMRI), ultimately reducing the reliability of these methods for both research and clinical applications. In the present study, we investigated motion of the lower-thoracic, lumbar, and sacral cord segments to evaluate the incidence of similar motion-related confounds in these regions. ⋯ Motion-related errors in spinal fMRI and DTI are expected to be significantly reduced throughout caudal regions of the spinal cord, thus yielding higher sensitivity and specificity compared with rostral regions. The paucity of such errors is expected to provide a means of observing the specific impact of motion (in rostral regions) and to enable the acquisition of uncorrupted DTI and fMRI data for studies of structure and function throughout lumbar and sacral regions.
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AJNR Am J Neuroradiol · Sep 2008
Case ReportsRescue retrieval of AngioGuard embolic capture system after failure of capture sheath retrieval in carotid angioplasty and stenting.
This report describes the cases of 2 patients with failed retrieval of an AngioGuard distal protection device after carotid stent placement with rescue retrieval by use of a vertebral catheter. An AngioGuard was deployed before carotid angioplasty and stent placement. ⋯ A 5F 120-cm vertebral catheter was used to recapture and remove the AngioGuard. This technique is a simple and readily available solution for the retrieval of failed removal of a protection device.
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AJNR Am J Neuroradiol · Sep 2008
Clinical TrialIntra-arterial thrombolysis of occluded middle cerebral artery by use of collateral pathways in patients with tandem cervical carotid artery/middle cerebral artery occlusion.
Cervical internal carotid artery (ICA) occlusion with middle cerebral artery (MCA) embolic occlusion is associated with a low rate of recanalization and poor outcome after intravenous thrombolysis. Prompt revascularization is required to prevent disabling stroke. We report our experience on acute ischemic stroke patients with tandem ICA or MCA occlusions treated with microcathether navigation and intra-arterial thrombolysis by use of collateral pathways including the posterior or anterior communicating arteries, or both pathways. ⋯ In this small number of patients with tandem occlusions of the ICA and MCA, intra-arterial thrombolysis and recanalization of the MCA by use of collateral pathways to bypass the occluded ICA is a safe and efficacious therapeutic option.
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AJNR Am J Neuroradiol · Sep 2008
Sinonasal inverted papilloma: value of convoluted cerebriform pattern on MR imaging.
A convoluted cerebriform pattern (CCP) has been reported as a valuable MR imaging feature of inverted papilloma (IP). The purpose of this study was to validate the usefulness of CCP for distinguishing IP from various malignant sinonasal tumors in a relatively large number of patients. ⋯ Although a CCP is a reliable MR imaging feature of sinonasal IPs, it can also be seen in various malignant sinonasal tumors. A focal loss of a CCP might be a clue to the diagnosis of IPs concomitant with malignancy.