A new technique allowing prolonged temporary cerebral artery occlusion

2008 ◽  
Vol 109 (6) ◽  
pp. 1127-1133 ◽  
Author(s):  
Erik F. Hauck ◽  
Jingna Wei ◽  
Michael J. Quast ◽  
Haring J. W. Nauta
Keyword(s):  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Cerebral Artery ◽  
Low Flow ◽  
Control Group ◽  
Resonance Imaging ◽  
Vessel Occlusion ◽  
Cerebral Vessel ◽  
Occlusion Time ◽  
Temporary Occlusion

Object Clipping of complex cerebral aneurysms often requires temporary vessel occlusion. The risk of stroke, however, increases exponentially with occlusion time. The authors hypothesized that prolonged temporary occlusion might be tolerated if the occluded vessels were perfused with cold physiological saline solution (CPSS). A low-flow perfusion rate would permit surgical manipulation of an aneurysm distal to the occlusion. Methods To test this hypothesis, the authors temporarily occluded the middle cerebral artery (MCA) with an endovascular catheter in 6 rats. Three animals, the treatment group, were perfused with 5-ml CPSS/hour through the occluding endovascular catheter into the MCA, and the other 3 served as an ischemic control group. In both groups, the catheter was removed after 90 minutes of occlusion. The brain temperature was monitored with a stereotactically placed probe in the caudate–putamen in 2 separate experimental groups (11 animals). Results Magnetic resonance imaging perfusion scanning during vessel occlusion confirmed similar reduction of cerebral blood flow during MCA occlusion in both the simple-occlusion and perfusion-occlusion groups. Magnetic resonance imaging diffusion scans performed 24 hours after temporary occlusion revealed infarcts in the ischemic control group of 138.3 ± 28.0 mm3 versus 9.9 ± 9.9 mm3 in the cold saline group (p < 0.005). A focal cooling effect during perfusion with CPSS was demonstrated (p < 0.05). Conclusions Prolonged temporary cerebral vessel occlusion can be tolerated using superselective CPSS perfusion through an occluding endovascular catheter into the ischemic territory. This technique could possibly be applied in neurosurgery practice to the management of complex intracranial aneurysms.

Proximal hyper-intense vessel sign on initial FLAIR MRI in hyper-acute middle cerebral artery ischemic stroke: a retrospective observational study

2020 ◽  
pp. 028418512094671 ◽  
Author(s):  
Dong Hyuk Shin ◽  
Sang Kuk Han ◽  
Jang Hee Lee ◽  
Pil Cho Choi ◽  
Sang O Park ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Middle Cerebral Artery ◽  
Cerebral Artery ◽  
Cerebral Arteries ◽  
Brain Mri ◽  
Large Vessel ◽  
Resonance Imaging ◽  
Vessel Occlusion ◽  
Vessel Stenosis

Background A hyper-intense vessel sign on fluid attenuated inversion recovery magnetic resonance imaging (FHV) represents slow blood flow in the cerebral arteries. Purpose To investigate the relationship between the proximal FHV (pFHV) on initial magnetic resonance imaging (MRI) and the status of the culprit vessel (stenosis, obstruction) in hyper-acute strokes affecting the territory of the middle cerebral artery (MCA). Material and Methods The study participants consisted of 105 patients presenting to the emergency department (ED) with acute MCA infarction within 4.5 h of onset of symptoms. Patients underwent brain MRI within 45 min of arrival at the ED and angiography within 2 h of arrival. Culprit vessel status and presence of a pFHV on initial MRI were investigated retrospectively. Results The pFHV was observed in 71/105 (67.6%) patients who presented with a hyper-acute MCA infarction. All patients with hyper-acute MCA infarction caused by internal carotid artery (90.6% caused by M1 occlusion, 92.9% caused by M2 occlusion) showed a pFHV on initial MRI. After logistic regression analysis, the presence of a pFHV showed significant positive correlation with large vessel occlusion (adjusted odds ratio [OR] 34.533, 95% confidence interval [CI] 9.781–121.926; P < 0.001). A pFHV was not associated with severe large vessel stenosis. Conclusion A pFHV is independently representative of the acute occlusion of intervention-eligible proximal arteries within the territory of the MCA. If a patient with a hyper-acute MCA infarction shows a pFHV, aggressive flow augmentation strategies and early activation of intervention team should be warranted for best patient outcome.

Does diffusion-weighted magnetic resonance imaging have a place in the differential diagnosis of brucella sacroiliitis and seronegative spondyloarthropathy?

2020 ◽  
pp. 028418512093837
Author(s):  
Sunay Sibel Karayol ◽  
Kudret Cem Karayol
Keyword(s):  
Magnetic Resonance Imaging ◽  
Bone Marrow ◽  
Differential Diagnosis ◽  
Magnetic Resonance ◽  
Control Group ◽  
Resonance Imaging ◽  
Visual Evaluation ◽  
Mean Values ◽  
Diffusion Weighted ◽  
The Mean

Background The aim of this study is to investigate the role of diffusion-weighted imaging (DWI) in the differential diagnosis of sacroiliitis. Purpose To compare the sacroiliac magnetic resonance imaging (MRI) examinations of patients with suspected active sacroiliitis with patients with acute SpA MR findings and the DWI examinations of patients with acute brucella sacroiliitis, and thereby determine whether DWI can contribute to the differential diagnosis. Material and Methods A total of 84 patients were included in the study and were separated into three groups: group 1 (13 women, 6 men) comprised cases with brucella positive for sacroiliitis; group 2 (17 women, 19 men) comprised cases negative for brucella but with sacroiliitis; and group 3 (16 women, 13 men) comprised cases negative for brucella and sacroiliitis. Results The mean bone marrow apparent diffusion coefficient (ADC) values independently of edema were determined as 0.71 × 10−3 in sacroiliitis and brucella-positive patients, as 0.53 × 10−3 in brucella-negative and sacroiliitis-positive patients, and as 0.43 × 10−3 in the control group of brucella-negative sacroiliitis-negative patients. In the ADC measurements taken from areas of evident edema in patients with sacroiliitis, the mean values were 0.13 × 10−3 in the brucella-positive group and 0.12 × 10−3 in the brucella-negative group. Conclusion By adding DWI, which is a rapid MR sequence, to sacroiliac joint MR examination, normal bone marrow and bone marrow with sacroiliitis can be objectively differentiated with ADC measurements in addition to visual evaluation.

scholarly journals Automated Cerebral Vessel Segmentation of Magnetic Resonance Imaging in Patients with Intracranial Atherosclerotic Diseases

2021 ◽  
Author(s):  
Tatsat R. Patel ◽  
Nandor Pinter ◽  
Seyyed M.M.J. Sarayi ◽  
Adnan H. Siddiqui ◽  
Vincent M. Tutino ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Vessel Segmentation ◽  
Resonance Imaging ◽  
Cerebral Vessel

scholarly journals Analysis of Combined Treatment of Embolic Stroke in Rat with r-tPA and a GPIIb/IIIa Inhibitor

2005 ◽  
Vol 25 (1) ◽  
pp. 87-97 ◽  
Author(s):  
Guangliang Ding ◽  
Quan Jiang ◽  
Li Zhang ◽  
Zheng Gang Zhang ◽  
Lian Li ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Thrombolytic Therapy ◽  
Combination Treatment ◽  
Infarct Volume ◽  
Embolic Stroke ◽  
Control Group ◽  
Resonance Imaging ◽  
Cerebral Microvessels ◽  
Magnetic Resonance Imaging Mri

Suppression of platelet activation improves the efficacy of thrombolytic therapy for stroke. Thus, combination treatment with recombinant tissue plasminogen activator (r-tPA) and 7E3 F(ab′)2, a GPIIb/IIIa inhibitor that binds the platelet to fibrin, may improve the efficacy of thrombolytic therapy in embolic stroke. Magnetic resonance imaging (MRI) was used to monitor treatment response in rats subjected to embolic middle cerebral artery (MCA) occlusion (MCAo). Animals were randomized into treated ( n = 12) and control ( n = 10) groups and received intravenous combination therapy or saline, respectively, 4 hours after MCAo. Magnetic resonance imaging (MRI) measurements performed 1 hour after MCAo showed no difference between groups. However, an increased incidence (50%) of MCA recanalization was found in the treated group at 24 hours compared with 20% in the control group. The area of low cerebral blood flow at 24 and 48 hours was significantly smaller in the combination treatment group, and the lesion size, as indicated from the T2 and T1 maps, differed significantly between groups. Fluorescence microscopy measurements of cerebral microvessels perfused with fluorescein isothiocyanate-dextran and measurements of infarct volume revealed that the combination treatment significantly increased microvascular patency and reduced infarct volume, respectively, compared with the control rats. The efficacy of combination treatment 4 hours after ischemia is reflected by MRI indices of tissue perfusion, MCA recanalization, and reduction of lesion volume. The treatment also reduced secondary microvascular perfusion deficits.

The Difference between Computed Tomography and Magnetic Resonance Imaging Measurements of Tibial Tubercle–Trochlear Groove Distance for Patients with or without Patellofemoral Instability: A Systematic Review and Meta-analysis

2019 ◽  
Vol 33 (08) ◽  
pp. 768-776 ◽  
Author(s):  
Si Heng Sharon Tan ◽  
Beatrice Ying Lim ◽  
Kiat Soon Jason Chng ◽  
Chintan Doshi ◽  
Francis K.L. Wong ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Computed Tomography ◽  
Magnetic Resonance ◽  
Patellofemoral Instability ◽  
Tibial Tubercle ◽  
Control Group ◽  
Trochlear Groove ◽  
Resonance Imaging ◽  
The Mean ◽  
Ct And Mri

AbstractThe tibial tubercle–trochlear groove (TT–TG) distance was originally described for computed tomography (CT) but has recently been used on magnetic resonance imaging (MRI) without sufficient evidence demonstrating its validity on MRI. The current review aims to evaluate (1) whether there is a difference in the TT–TG distances measured using CT and MRI, (2) whether both the TT–TG distances measured using CT and MRI could be used to differentiate between patients with or without patellofemoral instability, and (3) whether the same threshold of 15 to 20 mm can be applied for both TT–TG distances measured using CT and MRI. The review was conducted using the preferred reporting items for systematic reviews and meta-analyses (PRSIMA) guidelines. All studies that compared TT–TG distances either (1) between CT and MRI or (2) between patients with and without patellofemoral instability were included. A total of 23 publications were included in the review. These included a total of 3,040 patients. All publications reported the TT–TG distance to be greater in patients with patellofemoral instability as compared to those without patellofemoral instability. This difference was noted for both TT–TG distances measured on CT and on MRI. All publications also reported the TT–TG distance measured on CT to be greater than that measured on MRI (mean difference [MD] = 1.79 mm; 95% confidence interval [CI]: 0.91–2.68). Pooling of the studies revealed that the mean TT–TG distance for the control group was 12.85 mm (95% CI: 11.71–14.01) while the mean TT–TG distance for patients with patellofemoral instability was 18.33 mm (95% CI: 17.04–19.62) when measured on CT. When measured on MRI, the mean TT–TG distance for the control group was 9.83 mm (95% CI: 9.11–10.54), while the mean TT–TG distance for patients with patellofemoral instability was 15.33 mm (95% CI: 14.24–16.42). Both the TTTG distances measured on CT and MRI could be used to differentiate between patients with and without patellofemoral instability. Patients with patellofemoral instability had significantly greater TT–TG distances than those without. However, the TT–TG distances measured on CT were significantly greater than that measured on MRI. Different cut-off values should, therefore, be used for TT–TG distances measured on CT and on MRI in the determination of normal versus abnormal values. Pooling of all the patients included in the review then suggest for 15.5 ± 1.5 mm to be used as the cut off for TT–TG distance measured on CT, and for 12.5 ± 2 mm to be used as the cut-off for TT–TG distance measured on MRI. The Level of evidence for this study is IV.

scholarly journals The Glycosaminoglycan Content of Hip Cartilage in Osteonecrosis of Femoral Head: Evaluation with Delayed Gadolinium-Enhanced Magnetic Resonance Imaging of Cartilage

Cartilage ◽  
2018 ◽  
Vol 12 (1) ◽  
pp. 70-75
Author(s):  
Qidong Zhang ◽  
Wanshou Guo ◽  
Yan Chen ◽  
Qichao Zhao ◽  
Zhaohui Liu ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Femoral Head ◽  
Early Stage ◽  
Control Group ◽  
Resonance Imaging ◽  
Osteonecrosis Of Femoral Head ◽  
Joint Preserving Surgery ◽  
Hip Cartilage ◽  
Arco Classification

Objective Hip cartilage quality is essential for the success of joint-preserving surgery for osteonecrosis. This study aimed to characterize cartilage changes in osteonecrosis of femoral head (ONFH) using delayed gadolinium-enhanced magnetic resonance imaging of cartilage (dGEMRIC). Design Fifteen asymptomatic (control) and 60 ONFH subjects were included in this study. The ONFH subjects were stratified in accordance with the Association Research Circulation Osseous (ARCO) classification ( n = 15 hips per ARCO stage). All participant hips were investigated using dGEMRIC and theT1Gd data were collected and analyzed. Results T1Gd value was significantly lower in the ONFH group (365.1 ± 90.5 ms; range 200-498 ms) compared with the control group (546.1 ± 26.0 ms; range 504-580 ms) ( P < 0.001). The T1Gd values of ARCO stage I-IV ONFH were 460.2 ± 17.3 ms (439-498 ms), 408.9 ± 43.4 ms (337-472 ms), 359.9 ± 34.5 ms (303-412 ms), 231.5 ± 15.1 ms (200-253 ms), respectively. Decreased T1Gd value was found to correlate significantly with increased ONFH severity ( P < 0.001). T1Gd value in collapse stage was significantly lower than that of noncollapse stage (295.7 ± 70.3 ms [range 200-412 ms] vs. 434.6 ± 41.7 ms [range 337-498 ms]; P < 0.001). Conclusions dGEMRIC identified hip cartilage as abnormal in ONFH, even at early-stage, as represented by decreased T1Gd, and this was further aggravated by ONFH collapse.

scholarly journals Prediction of the Outcome of Cochlear Implantation in the Patients with Congenital Cytomegalovirus Infection based on Magnetic Resonance Imaging Characteristics

2019 ◽  
Vol 8 (2) ◽  
pp. 136
Author(s):  
Jae Han ◽  
Yun Bae ◽  
Seul Song ◽  
Jae-Jin Song ◽  
Ja-Won Koo ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Cochlear Implantation ◽  
Brain Mri ◽  
Brain Magnetic Resonance Imaging ◽  
Control Group ◽  
Resonance Imaging ◽  
Mri Findings ◽  
Congenital Cytomegalovirus ◽  
Imaging Characteristics

The goal of this study was to elucidate radiologic biomarker that can predict the outcome of cochlear implantation (CI) in congenital cytomegalovirus (cCMV) related deafness. A retrospective survey of speech perception after CI and an evaluation of brain magnetic resonance imaging (MRI) findings were performed in 10 cochlear implantees with cCMV-related prelingual deafness. Specifically, a special attention was paid to the degree of white matter (WM) abnormality shown in brain MRI, which was used to divide our cohort into two groups: The mild and severe pathology groups. Age-matched prelingual deaf patients with idiopathic sensorineural hearing loss were selected as controls. Subjects in mild pathology groups showed higher a Category of Auditory Performance (CAP) score (5.2 ± 0.8) than those with severe pathologies (3.4 ± 1.5) (P = 0.041). Importantly, speech performance from subjects with mild pathology was comparable to that of the control group (mean CAP score of 5.2 ± 0.8 vs. 5.1 ± 1.2) (P = 0.898). Mild pathologies related to the limited WM lesion in MRI not accompanied by severe MRI pathologies, such as diffuse WM abnormality, myelination delay, ventriculomegaly, migration abnormality, and cerebellar hypoplasia, can be tolerated and do not adversely affect the CI outcome in cCMV deafness.

scholarly journals Relationship Between Magnetic Resonance T2-Mapping and Matrix Metalloproteinase 1,3 in Knee Osteoarthritis

2020 ◽  
Author(s):  
Lei Shi ◽  
Kexin Wang ◽  
Jinghong Yu ◽  
Mingkai Li ◽  
Guangmei Men ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Matrix Metalloproteinase ◽  
Knee Osteoarthritis ◽  
T2 Mapping ◽  
Cartilage Degeneration ◽  
Pathological Examination ◽  
Lesion Group ◽  
Control Group ◽  
Resonance Imaging

Abstract Objective To investigate the relationship between quantitative analysis of MRI (T2-mapping) and the expression of matrix metalloproteinase (MMP-1, MMP-3) in osteoarthritis of the knee joint and the role of MMP-1,3 in the pathogenesis of osteoarthritis. Methods Thirty cases of knee osteoarthritis (KOA) patients with total knee arthroplasty (TKA) (lesion group) and 30 healthy adult volunteers (control group) were scanned with 1.5 T routine MR and T2-mapping, and their T2 values were measured and statistically analyzed. The pathological examination of the knee cartilage that was replaced during the operation and the immunohistochemical assay were used to measure the expression of MMP-1,3. The correlation between the T2 value of magnetic resonance imaging and the expression of MMP-1,3 was analyzed. Results (1) According to the Recht grading standard for magnetic resonance, the T2 value of magnetic resonance increased significantly with the increase of cartilage degeneration. The differences in T2 values between each level and the normal group were statistically significant (P  < 0.05). (2) The T2 value of magnetic resonance imaging increased with the severity of the cartilage degeneration pathological Mankin grading, and the difference was statistically significant (P  <  0.05). (3) The expression of MMP-1,3 increased with cartilage degeneration. (4) The T2 value and the expression of MMP-1 in cartilage showed a linear trend. The result of Spearman correlation analysis showed that the expression of MMP-1,3 increased as the cartilage T2 value increased. There was a positive linear correlation between the two. Conclusion The T2 value of magnetic resonance increased with the degeneration of KOA cartilage. The expression of MMP-1,3 increased with the severity of articular cartilage destruction. The T2 value of KOA magnetic resonance was positively correlated with the expression of MMP-1,3.

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