Journal of neuroimaging : official journal of the American Society of Neuroimaging
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Ultra-high-field 7.0 Tesla (T) MRI offers substantial gains in signal-to-noise ratio (SNR) over 3T and 1.5T, but for over two decades has remained a research tool, while 3T scanners have achieved widespread clinical use. This much slower translation of 7T relates to daunting technical challenges encountered in ultra-high-field human MR imaging. The recent introduction of United States Food and Drug Administration (FDA)-approved clinical 7T scanners promises to be a watershed for many 7T neuroimaging applications, including epilepsy imaging. ⋯ We describe a tiered epilepsy imaging strategy and protocols designed to optimize 7T value and work around signal intensity variation and signal loss artifacts, which remain significant challenges to full exploitation of 7T clinical value. We describe FDA-approved techniques for mitigating these artifacts and briefly outline techniques currently under development, but not yet FDA approved. Finally, we discuss the major issues in 7T patient safety and toleration, outlining their physical causes and effects on workflow, and provide references to more comprehensive technical reviews for readers seeking greater technical detail.
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Angiocentric gliomas (AGs) are epileptogenic low-grade gliomas in young patients. We aimed to investigate the MRI findings of AGs and systematically review previous publications and three new cases. ⋯ Intratumoral T1-weighted high-intensity areas, stalk-like signs, and regional brain atrophy were frequent imaging features in AG. We also found that affected age was different between supratentorial and brainstem AGs.
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The availability of cone-beam CT perfusion (CBCTP) in angiography suites may improve large-vessel occlusion (LVO) triage and reduce reperfusion times for patients presenting during extended time window. We aim to evaluate the perfusion maps correlation and agreement between multidetector CT perfusion (MDCTP) and CBCTP when obtained sequentially in patients undergoing endovascular therapy. ⋯ These results demonstrate promising accuracy of CBCTP in evaluating ischemic tissue in patients presenting with LVO ischemic stroke.
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Stent retriever (SR) thrombectomy is commonly used for the treatment of emergent large vessel occlusion (ELVO) in acute ischemic stroke. Clot imaging parameters such as clot length, diameter, distance to the internal carotid artery terminus, and vessel angle where the SR is deployed may predict the likelihood of achieving first pass effect (FPE). Most of the proposed factors that seem to affect recanalization success have been studied individually, and conflicting data derived from clinical versus in vitro studies using 3-dimensional printed models of intracranial circulation currently exist. ⋯ Comparison of SR thrombectomy performed during actual MCA occlusion cases versus patient-specific 3-dimensional replicas revealed MCA angulation as an independent predictor of procedure success or failure. However, the opposite direction of effect was observed between the two studied environments, indicating potential limitations of studying SR thrombectomy using 3-dimensional models of LVO.