Abstract 2997: The Severity of Intracranial Stenosis in Anterior Circulation Correlates with Asymmetrical Hemispheric Cerebral Volume on Magnetic Resonance Imaging

Background and Purpose: Chronic hypoperfusion associated with high grade intracranial atherosclerosis may results in regional atrophy. This study was performed to determine the effect of intracranial stenosis on ipsilateral regional cerebral volume. Methods: We included patients with intracranial stenosis >50% in the anterior circulation who underwent brain magnetic resonance image (MRI) who were admitted to a University hospital. The severity of intracranial atherosclerosis was evaluated by angiography and degree of stenosis was calculated using the WASID criteria. MRI images were acquired with a 1.5-T MR scanner and fluid attenuated inversion recovery (FLAIR) images were used for volumetric analysis. Volumetric analysis was performed by a single observer with the ANALYZE 9.0 software package. Hemispheric supratentorial volume was defined as hemispheric volume (HV) and included a cumulative value of grey and white matter volumes in frontal, parietal, and occipital lobes. Results: A total 42 hemispheres in 21 patients (12 men, mean age±standard deviation 56.4±16.2 years) with intracranial stenosis were studied. There was no statistical difference of HV in between non-stenotic and stenotic side (491.7±62.6 vs 486.7±57.8 cm3, p=0.3953, t-test). There was no statistical difference of HV in between moderate stenosis (50∼75%) and severe stenosis (>75%) (480.6±56.7 vs 490.5±60.4 cm3, p=0.3657, t-test). However, in regression analysis, difference between both HV (non stenotic-side - stenotic side HV) within individuals significantly correlated with degree of stenosis (R2=0.27, P=0.0152). Conclusion: The patients with intracranial stenosis of anterior circulation appear to have an asymmetry in regional cerebral volume directly related to the severity of stenosis. This observation supports the concept that regional cerebral atrophy may be seen with intracranial stenosis.

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Value of vessel wall magnetic resonance imaging in the diagnosis and management of cerebrovascular diseases

QJM ◽

10.1093/qjmed/hcab102.015 ◽

2021 ◽

Vol 114 (Supplement_1) ◽

Author(s):

Hany M Zaki El-Dine ◽

Yasser A Abbas ◽

Mohammad K Elewa ◽

Sherien M Farag ◽

Khaled E Mohamad

Keyword(s):

Magnetic Resonance ◽

Magnetic Resonance Angiography ◽

Mr Imaging ◽

Vessel Wall ◽

Intracranial Stenosis ◽

Intracranial Atherosclerosis ◽

Cns Vasculitis ◽

Moya Moya Disease ◽

Increased Risk ◽

Significant Difference

Abstract Background Intracranial atherosclerosis, one of the leading causes of ischemic stroke, is associated with an increased risk for recurrent stroke and dementia. Objective This work was carried out to assess suspicious lesions detected by Magnetic Resonance Angiography (MRA) and Computed Tomgraphy Angiography (CTA) for further evaluation by vessel wall MRI . Patients and methods This study was conducted on 16 patients who were admitted to Ain Shams University Specialized Hospital with establilished diagnosis of stroke (11 patients with intracranial atherosclerosis, 3 patients with CNS vasculitis and 2 patients with Moya-moya disease ) performing MRI brain including magnetic resonance angiography (MRA) that showed intracranial stenosis, who then referred to Misr Radiology Center for the evaluation of intracranial vasculopathies by vessel wall MR Imaging using 3.0-tesla (T) field strengths. Results The results showed statistically significant difference between groups as regard to significant intracranial stenosis (>50%). It was prominent among moya moya disease group (100.0%) followed by intracranial atherosclerotic groups (81.8%), whereas CNS vasculitis group shows mild intracranial stenosis (0.0%). Conclusion Intracranial vessel wall MR imaging is an adjunct to conventional angiographic imaging

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Imaging findings of cerebral fat embolism syndrome: a case report

Journal of International Medical Research ◽

10.1177/0300060520950559 ◽

2020 ◽

Vol 48 (9) ◽

pp. 030006052095055

Author(s):

Yali Wang ◽

Zhihua Si ◽

Jingzhe Han ◽

Shuangqing Cao

Keyword(s):

Magnetic Resonance ◽

Fat Embolism ◽

Magnetic Resonance Images ◽

Resonance Imaging ◽

Diffusion Weighted Images ◽

Embolism Syndrome ◽

Imaging Characteristics ◽

Fluid Attenuated Inversion Recovery ◽

Cerebral Fat Embolism Syndrome ◽

Head Computed Tomography

Cerebral fat embolism (CFE) syndrome is relatively rare in clinical practice. Currently, there is no uniform standard of magnetic resonance imaging for the diagnosis of the disease. In this report, we present head computed tomography and magnetic resonance images (T2-weighted images, fluid-attenuated inversion recovery images, diffusion-weighted images, and susceptibility-weighted images) in a case of CFE. This report explains the imaging characteristics of CFE and improves the clinician’s understanding of this disease and its etiology.

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Use of magnetic resonance venography for inferior petrosal sinus sampling

The Journal of Vascular Access ◽

10.1177/1129729821997263 ◽

2021 ◽

pp. 112972982199726

Author(s):

Kikutaro Tokairin ◽

Toshiya Osanai ◽

Noriyuki Fujima ◽

Kinya Ishizaka ◽

Hiroaki Motegi ◽

...

Keyword(s):

Magnetic Resonance ◽

Radiation Dose ◽

Interventional Procedure ◽

Anatomical Variations ◽

Magnetic Resonance Venography ◽

University Hospital ◽

Inferior Petrosal Sinus ◽

Success Rates ◽

Intravenous Catheter ◽

Patient Demographics

Background: Inferior petrosal sinus (IPS) sampling (IPSS) is a transvenous interventional procedure performed to diagnose Cushing’s disease. The reported IPSS failure rate is approximately 10% because IPS catheter delivery is conducted blindly and is challenging because of IPS anatomical variations. This study aimed to evaluate the usefulness of preprocedural magnetic resonance venography (MRV) for assessing IPS access routes before IPSS. Methods: Nineteen consecutive patients who underwent IPSS at a single university hospital in Japan were retrospectively studied. A preprocedural MRV protocol optimized to visualize the IPS before IPSS was established and utilized in the eight most recent cases. An IPSS procedure was considered successful when bilateral IPS catheterization was accomplished. Patient demographics, IPSS success rate, and radiation dose required during IPSS were compared between two groups: MRV group ( N = 8) and no-MRV group ( N = 11) before IPSS. Results: There were no significant differences in age, sex, and IPSS success rates between the groups. The average radiation dose was 663.6 ± 246.8 (SD) mGy and 981.7 ± 389.5 (SD) mGy in the MRV group and no-MRV group, respectively. Thus, there was a significant reduction in radiation exposure in the MRV group ( p = 0.044). Catheterization of the left IPS was unsuccessful in only one patient in the MRV group owing to IPS hypoplasty, as found on the MRV. Conclusions: Hypoplastic IPSs occur in patients and can complicate IPSS. Preprocedural MRV assessment is useful for understanding venous anatomy and preventing unnecessary intravenous catheter manipulation during IPSS, which involves blind manipulation around the IPS.

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Predictors for affected stroke territory and outcome of acute stroke treatments are different for posterior versus anterior circulation stroke

Scientific Reports ◽

10.1038/s41598-021-89871-4 ◽

2021 ◽

Vol 11 (1) ◽

Author(s):

H. Handelsmann ◽

L. Herzog ◽

Z. Kulcsar ◽

A. R. Luft ◽

S. Wegener

Keyword(s):

Acute Stroke ◽

Functional Outcome ◽

Patient Characteristics ◽

Posterior Circulation ◽

University Hospital ◽

Outcome Predictors ◽

Anterior Circulation ◽

Stroke Treatment ◽

The University ◽

Median Admission

AbstractDistinct patient characteristics have been proposed for ischaemic stroke in the anterior versus posterior circulation. However, data on functional outcome according to stroke territory in patients with acute stroke treatment are conflicting and information on outcome predictors is scarce. In this retrospective study, we analysed functional outcome in 517 patients with stroke and thrombolysis and/or thrombectomy treated at the University Hospital Zurich. We compared clinical factors and performed multivariate logistic regression analyses investigating the effect of outcome predictors according to stroke territory. Of the 517 patients included, 80 (15.5%) suffered a posterior circulation stroke (PCS). PCS patients were less often female (32.5% vs. 45.5%, p = 0.031), received thrombectomy less often (28.7% vs. 48.3%, p = 0.001), and had lower median admission NIHSS scores (5 vs. 10, p < 0.001) as well as a better median three months functional outcome (mRS 1 vs. 2, p = 0.010). Predictors for functional outcome were admission NIHSS (OR 0.864, 95% CI 0.790–0.944, p = 0.001) in PCS and age (OR 0.952, 95% CI 0.935–0.970, p < 0.001), known symptom onset (OR 1.869, 95% CI 1.111–3.144, p = 0.018) and admission NIHSS (OR 0.840, 95% CI 0.806–0.876, p < 0.001) in ACS. Acutely treated PCS and ACS patients differed in their baseline and treatment characteristics. We identified specific functional outcome predictors of thrombolysis and/or thrombectomy success for each stroke territory.

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Magnetic Resonance Imaging of the Brain in Alcoholics: Cerebral Atrophy, Lifetime Alcohol Consumption, and Cognitive Deficits

Alcoholism Clinical and Experimental Research ◽

10.1111/j.1530-0277.1989.tb00369.x ◽

1989 ◽

Vol 13 (4) ◽

pp. 512-518 ◽

Cited By ~ 42

Author(s):

J. D. Chick ◽

M. A. Smith ◽

H. M. Engleman ◽

D. M. Kean ◽

A. J. Mander ◽

...

Keyword(s):

Magnetic Resonance Imaging ◽

Magnetic Resonance ◽

Alcohol Consumption ◽

Cognitive Deficits ◽

Cerebral Atrophy ◽

Resonance Imaging ◽

The Brain

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Pyogenic and tuberculous discitis: magnetic resonance imaging findings for differential diagnosis

Radiologia Brasileira ◽

10.1590/s0100-39842013000300012 ◽

2013 ◽

Vol 46 (3) ◽

pp. 173-177 ◽

Cited By ~ 9

Author(s):

Cristiano Gonzaga de Souza ◽

Emerson Leandro Gasparetto ◽

Edson Marchiori ◽

Paulo Roberto Valle Bahia

Keyword(s):

Magnetic Resonance Imaging ◽

Magnetic Resonance ◽

Correct Diagnosis ◽

Cord Compression ◽

Intervertebral Discs ◽

University Hospital ◽

Imaging Findings ◽

Resonance Imaging ◽

Radiographic Findings ◽

Vertebral Bodies

Spondylodiscitis represents 2%–4% of all bone infections cases. The correct diagnosis and appropriate treatment can prevent complications such as vertebral collapse and spinal cord compression, avoiding surgical procedures. The diagnosis is based on characteristic clinical and radiographic findings and confirmed by blood culture and biopsy of the disc or the vertebra. The present study was developed with Clementino Fraga Filho University Hospital patients with histopathologically and microbiologically confirmed diagnosis of spondylodiscitis, submitted to magnetic resonance imaging of the affected regions. In most cases, pyogenic spondylodiscitis affects the lumbar spine. The following findings are suggestive of the diagnosis: segmental involvement; ill-defined abscesses; early intervertebral disc involvement; homogeneous vertebral bodies and intervertebral discs involvement. Tuberculous spondylodiscitis affects preferentially the thoracic spine. Most suggestive signs include: presence of well-defined and thin-walled abscess; multisegmental, subligamentous involvement; heterogeneous involvement of vertebral bodies; and relative sparing of intervertebral discs. The present pictorial essay is aimed at showing the main magnetic resonance imaging findings of pyogenic and tuberculous discitis.

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Feasibility and safety of the strategy of first stenting without retrieval using Solitaire FR as a treatment for emergent large-vessel occlusion due to underlying intracranial atherosclerosis

Journal of Neurosurgery ◽

10.3171/2020.8.jns202504 ◽

2021 ◽

pp. 1-9

Author(s):

Jong-Hoon Kim ◽

Young-Jin Jung ◽

Chul-Hoon Chang

Keyword(s):

Functional Outcomes ◽

Medical Center ◽

Large Vessel ◽

Intracranial Atherosclerosis ◽

Large Vessel Occlusion ◽

Anterior Circulation ◽

Vessel Occlusion ◽

Stent Retrieval ◽

First Pass ◽

Solitaire Fr

OBJECTIVEThe optimal treatment for underlying intracranial atherosclerosis (ICAS) in patients with emergent large-vessel occlusion (ELVO) remains unclear. Reocclusion during endovascular treatment (EVT) occurs frequently (57.1%–77.3%) after initial recanalization with stent retriever (SR) thrombectomy in ICAS-related ELVO. This study aimed to compare treatment outcomes of the strategy of first stenting without retrieval (FRESH) using the Solitaire FR versus SR thrombectomy in patients with ICAS-related ELVO.METHODSThe authors retrospectively reviewed consecutive patients with acute ischemic stroke and intracranial ELVO of the anterior circulation who underwent EVT between January 2017 and December 2019 at Yeungnam University Medical Center. Large-vessel occlusion (LVO) of the anterior circulation was classified by etiology as follows: 1) no significant stenosis after recanalization (embolic group) and 2) remnant stenosis > 70% or lesser degree of stenosis with a tendency toward reocclusion and/or flow impairment during EVT (ICAS group). The ICAS group was divided into the SR thrombectomy group (SR thrombectomy) and the FRESH group.RESULTSA total of 105 patients (62 men and 43 women; median age 71 years, IQR 62.5–79 years) were included. The embolic, SR thrombectomy, and FRESH groups comprised 66 (62.9%), 26 (24.7%), and 13 (12.4%) patients, respectively. There were no significant differences between the SR thrombectomy and FRESH groups in symptom onset–to-door time, but puncture-to-recanalization time was significantly shorter in the latter group (39 vs 54 minutes, p = 0.032). There were fewer stent retrieval passes but more first-pass recanalizations in the FRESH group (p < 0.001). Favorable functional outcomes were significantly more frequent in the FRESH group (84.6% vs 42.3%, p = 0.017).CONCLUSIONSThis study’s findings suggest that FRESH, rather than rescue stenting, could be a treatment option for ICAS-related ELVO.

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