Journal of neuroimaging : official journal of the American Society of Neuroimaging
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Meta Analysis Observational Study
Cyclical aspiration using a novel mechanical thrombectomy device is associated with a high TICI 3 first pass effect in large-vessel strokes.
Complete reperfusion (TICI 3) after the first thrombectomy attempt or first pass effect (FPE) is associated with best clinical outcomes in large-vessel occlusion (LVO) acute ischemic stroke. While endovascular therapy techniques have improved substantially, FPE remains low (24-30%), and new methods to improve reperfusion efficiency are needed. ⋯ Cyclical aspiration using the CLEARTM Aspiration System is safe, effective, and achieved a high TICI 3 FPE for large-vessel strokes.
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Multicenter Study
Novel robotic TCD ultrasound with bubbles versus standard care to detect right to left shunt: Study methods.
Right to left shunt (RLS), from patent foramen ovale (PFO) or elsewhere, is a recognized risk factor for stroke. Current standard of care for RLS diagnosis includes transthoracic echocardiography (TTE) which is insensitive, transesophageal echocardiography (TEE) which is invasive, and transcranial Doppler (TCD) which has excellent sensitivity and specificity for RLS but is heavily operator dependent and expertise is scarce. The purpose of this study was to evaluate the RLS detection rate of a novel robotic-assisted TCD (ra-TCD) to standard of care diagnostic techniques, including TTE, TEE, and TCD. ⋯ This is the first multicenter, prospective study evaluating the accuracy, feasibility, and safety of novel ra-TCD for the diagnosis of RLS as compared to standard of care diagnostics.
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While diffusely abnormal white matter (DAWM) is a nonlesional MRI abnormality identified in ∼25% of patients with multiple sclerosis (MS), it has yet to be investigated in patients at an earlier disease stage, namely clinically isolated syndrome (CIS). The goals of this study were to (1) determine the prevalence of DAWM in patients with a CIS suggestive of MS, (2) evaluate the association between DAWM and demographic, clinical, and MRI features, and (3) evaluate the prognostic significance of DAWM on conversion from CIS to MS. ⋯ DAWM is present in a similar proportion of patients with CIS and clinically definite MS, and it is associated with increased risk of conversion to MS over 6 months.
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The significance of a bright vessel sign (BVS) at the site of a large vessel occlusion (LVO) on MR arterial spin labeling (ASL) sequence is not widely reported. We compared the utility of the ASL BVS to the gradient echo (GRE) susceptibility vessel sign (SVS) in heralding and localizing LVOs in a large cohort; most underwent digital subtraction angiography (DSA) and endovascular therapy for acute stroke. ⋯ ASL BVS is significantly more sensitive than GRE SVS for identification of LVO on both MRA and DSA.
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Identification of changesin brain microstructure following mild traumatic brain injury (mTBI) could be instrumental in understanding the underlying pathophysiology. The purpose of this study was to apply neurite orientation dispersion and density imaging (NODDI) to a rodent model of mTBI to determine whether microstructural changes could be detected immediately following injury. ⋯ Changes in NODDI metrics were detected as early as 1 h following mTBI. No changes were detected with conventional diffusion tensor imaging (DTI) metrics, suggesting that NODDI provides greater sensitivity to microstructural changes than conventional DTI.