Journal of neuroimaging : official journal of the American Society of Neuroimaging
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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.
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Differentiation of meningiomas, paragangliomas, and schwannomas in the cerebellopontine angle and jugular foramen remains challenging when conventional MRI findings are inconclusive. This study aimed to assess the clinical utility of diffusion-weighted imaging (DWI) and dynamic contrast-enhanced MRI (DCE-MRI) findings for tumor type differentiation and to identify the most significant diagnostic parameters. ⋯ DCE-MRI can provide promising parameters to differentiate meningiomas, paragangliomas, and schwannomas in the cerebellopontine angle and jugular foramen.
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Cerebral tissue oxygenation is a critical brain viability parameter, and the magnetic properties of hemoglobin offer the opportunity to noninvasively quantify oxygen extraction fraction (OEF) by magnetic resonance imaging (MRI). Ultrahigh-field MRI shows advantages such as increased sensitivity to magnetic susceptibility differences and improved signal-to-noise ratio that can be translated into smaller voxel size, but also increased sensitivity to static and B1 field inhomogeneities. The aim was to produce a systematic comparison of three MRI-based methods for estimation of OEF. ⋯ The results indicate that QSM is a promising candidate for assessment of OEF estimates, for example, providing reasonably robust estimates across a wide range of vessel orientations.
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Corpus callosum (CC) atrophy is a strong predictor of multiple sclerosis (MS) disability but the contributing pathological mechanisms remain uncertain. We aimed to apply advanced MRI to explore what drives the often nonuniform callosal atrophy. ⋯ Both white matter and cortical lesions contribute to regional corpus callosal atrophy. The lobe-specific lesion topology does not fully explain the inhomogeneous CC atrophy.