Your browser doesn't support javascript.
loading
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 42
Filtrar
1.
Neuroradiology ; 2024 Sep 05.
Artículo en Inglés | MEDLINE | ID: mdl-39235600

RESUMEN

BACKGROUND: Crossing Y-stent-assisted coiling (CYSAC) is a feasible yet technically challenging technique for the treatment of wide-neck bifurcation aneurysms (WNBAs). OBJECTIVE: To present mid-term results of Y-stent-assisted coiling (YSAC) using the LVIS EVO stent and to describe our "drill turn" technique for stent crossing. METHODS: This retrospective, observational study included 37 consecutive patients treated with YSAC using LVIS EVO stents at five centres between September 2020 and March 2023. RESULTS: Immediately after treatment, 31 of the 37 patients (83.8%) achieved Raymond-Roy occlusion classification (RROC) Class I occlusion, while 5 patients (13.5%) had Class II and 1 patient (2.7%) had Class III occlusion. The mean follow-up period was 32.8 months (range: 11-41 months), and all patients underwent follow-up imaging after ≥ 6 months. On follow-up imaging, 34 patients (92%), including all those with immediate RROC Class I occlusion, 2 with Class II, and 1 with Class III, showed Class I occlusion. One patient with RROC Class II occlusion demonstrated a gradual decrease in residual filling, while one large partially thrombosed middle cerebral artery aneurysm and one large basilar tip aneurysm (8%) with residual neck filling remained unchanged on the 6-month digital subtraction angiograph. CONCLUSION: Utilizing the described drill turn technique, CYSAC with LVIS EVO stents was found to be feasible and safe for WNBA treatment, with high and stable occlusion rates observed during mid-term follow-up.

2.
Clin Neuroradiol ; 2024 Sep 02.
Artículo en Inglés | MEDLINE | ID: mdl-39222145

RESUMEN

OBJECTIVE: In 2022, arterioectatic spinal angiopathy (AESA) of childhood was reported as a fatal, progressive, multi-segment myelopathy associated with a unique form of non-inflammatory spinal angiopathy involving diffuse dilatation of the anterior spinal artery and cord congestion in children. In this study, we present four more cases of AESA, using early and long-term conventional imaging and flat detector computed tomography angiography (FDCTA) imaging to assess the probability of disease regression and prevent unnecessary interventions. METHODS: We retrospectively reviewed the clinical and radiological findings of four patients with AESA seen in two neuroradiology departments between 2014 and 2023. RESULTS: The study included three boys and one girl. Two of the boys were siblings. Although the clinical and radiological presentation in the early stages of the clinical course overlapped the definition of AESA, the clinical course was more benign in three of the cases. The clinical courses of the two siblings with monosegmental cord involvement and largely reversible radiological findings suggest that some of the features in the initial definition of the disease cannot be standardized for all patients. The siblings had a mutation of the NDUFS gene, which is involved in mitochondrial function and clinical-radiological reversibility in these patients. CONCLUSION: Many mitochondrial diseases, such as this NDUFS mutation, present with myelopathy, and mitochondrial diseases can sometimes show spontaneous recovery. It is crucial to identify other genetic mutations or environmental factors that trigger the accompanying vascular ectatic findings in AESA in larger multicenter studies to prevent its potential lethal course and possible unnecessary surgical-endovascular interventions.

3.
Childs Nerv Syst ; 2024 Aug 09.
Artículo en Inglés | MEDLINE | ID: mdl-39120731

RESUMEN

BACKGROUND: Intracranial aneurysms are rare in the pediatric age group, especially in neonates. This article presents a novel case of a neonate with a dissected and ruptured giant anterior cerebral artery aneurysm, focusing on diagnosis and endovascular treatment with a review of the literature. CASE DESCRIPTION: A full-term female neonate presented with projectile vomiting, fever, and hyperkinetic movements. Diagnostic workup revealed a giant dissecting and partially thrombosed aneurysm along the anterior cerebral artery. The neonate underwent successful endovascular coil embolization. RESULTS: The intervention led to the cessation of symptoms, and the patient was discharged and followed with mild hypotonia as the only neurological deficit at 9 months. CONCLUSION: This case highlights the rarity and complexity of diagnosing and treating giant dissected anterior cerebral artery aneurysms in neonates. It underscores the importance of considering intracranial aneurysms in differential diagnosis for neonates with relevant symptoms and suggests endovascular embolization as an effective treatment option.

4.
Biomark Med ; 18(10-12): 555-565, 2024.
Artículo en Inglés | MEDLINE | ID: mdl-39140394

RESUMEN

Aim: To reveal factors affecting 2-year mortality in geriatric patients hospitalized with COVID-19.Methods: Demographic characteristics, clinical and laboratory data, thorax computed tomography (CT) images, second-year survival status, and causes of death were analyzed.Results: The 2-year post-discharge mortality rate of 605 patients was 21.9%. Mean age of patients in the deceased group was 76.8 ± 8.1 years, which was shorter than the life expectancy at birth in Türkiye. Older age (≥85), delirium, some co-morbidities, and atypical thorax CT involvement were associated with a significant increase in 2-year mortality (p < 0.05).Conclusion: This is the first study to evaluate factors associated with 2-year mortality in older COVID-19 patients. Identifying risk factors for long-term mortality in geriatric COVID-19 patients is important.


[Box: see text].


Asunto(s)
COVID-19 , Hospitalización , SARS-CoV-2 , Humanos , COVID-19/mortalidad , COVID-19/complicaciones , Anciano , Masculino , Femenino , Anciano de 80 o más Años , Estudios Retrospectivos , SARS-CoV-2/aislamiento & purificación , Factores de Riesgo , Tomografía Computarizada por Rayos X , Comorbilidad , Delirio/mortalidad , Delirio/diagnóstico
5.
Semin Arthritis Rheum ; 68: 152509, 2024 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-39003953

RESUMEN

OBJECTIVES: To evaluate the microstructural integrity of brain white matter tracts in patients with Neuro-Behcet's syndrome (NBS) and Behcet's syndrome (BS) without neurological manifestations using diffusion tensor imaging (DTI) and to investigate potential utility of DTI as a surrogate biomarker of neurocognitive functioning and disease severity. METHODS: This cross-sectional study comprised 34 NBS patients and 32 BS patients without neurological involvement, identified based on the International Study Group of the Behcet's disease (ISGBD) and the International Consensus Recommendation (ICR) criteria, as well as 33 healthy controls. Cognitive functions, including attention, memory, language, abstraction, executive control, visuospatial skills, and sensorimotor performance were assessed using standardized questionnaires. DTI data were analyzed using tract-based spatial statistics (TBSS) and automated probabilistic tractography to investigate inter-group differences. Subsequently, correlations between tensor-derived parameters of white matter tracts, neurocognitive test scores, and disease severity measures were examined. RESULTS: DTI revealed decreased fractional anisotropy and increased radial diffusivity, mean diffusivity, and axial diffusivity in both supratentorial and infratentorial white matter in NBS patients, indicating widespread loss of microstructural integrity. Moreover, this loss of integrity was also observed in BS patients without neurological manifestations, albeit to a lesser extent. In NBS patients, certain white matter tracts, including cingulum bundle, were associated with poor cognitive performance across multiple domains and disease severity. DISCUSSION: DTI findings might potentially serve as a neuroimaging marker to predict the extent of neurocognitive impairment and disease severity associated with central nervous system involvement in BS.


Asunto(s)
Síndrome de Behçet , Disfunción Cognitiva , Imagen de Difusión Tensora , Índice de Severidad de la Enfermedad , Sustancia Blanca , Humanos , Síndrome de Behçet/diagnóstico por imagen , Síndrome de Behçet/complicaciones , Síndrome de Behçet/patología , Masculino , Femenino , Adulto , Estudios Transversales , Sustancia Blanca/diagnóstico por imagen , Sustancia Blanca/patología , Disfunción Cognitiva/diagnóstico por imagen , Disfunción Cognitiva/etiología , Persona de Mediana Edad , Encéfalo/diagnóstico por imagen , Encéfalo/patología , Pruebas Neuropsicológicas
6.
Acta Radiol ; 65(7): 784-791, 2024 Jul.
Artículo en Inglés | MEDLINE | ID: mdl-38613353

RESUMEN

BACKGROUND: Differential diagnosis of hypothalamic-optic chiasmatic gliomas (HOCGs) and craniopharyngiomas on magnetic resonance imaging (MRI) can be quite challenging. PURPOSE: To compare the MRI features of HOCGs and cranipharyngiomas. MATERIAL AND METHODS: Patients diagnosed with HOCG or craniopharyngioma in histopathological evaluation between 2012 and 2022 and who underwent preoperative contrast-enhanced brain MRI were included. Various MRI features were retrospectively evaluated for each lesion: T2-weighted imaging and fluid attenuation inversion recovery hyperintensity, calcification, cystic change, T1-weighted (T1W) imaging hyperintensity of the cystic component, hemorrhage, involvement of sellar, suprasellar or other adjacent structures, lobulated appearance, presence of hydrocephalus, and contrast enhancement pattern. Apparent diffusion coefficient (ADC) values were also evaluated and compared. RESULTS: Among 38 patients included, 13 (34%) had HOCG and 25 (66%) had craniopharyngioma. Craniopharyngiomas had a significantly higher rate of cystic changes, calcification, and T1W imaging hyperintensity of the cystic component than HOCGs (P <0.05). Of HOCGs, 92% had chiasm involvement, 23% had optic nerve involvement, and 31% had brain stem involvement. On the other hand, chiasm involvement was observed in 8% of craniopharyngiomas, but none had optic nerve and/or brain stem involvement (P <0.05). While 62% (8/13) of HOCGs had diffuse homogeneous enhancement, 80% (20/25) of craniopharyngiomas had a diffuse heterogeneous enhancement pattern. Mean ADC values were significantly higher in craniopharyngiomas compared to HOCGs (2.1 vs. 1.6 ×10-3mm2/s, P <0.05). CONCLUSION: Although some neuroimaging findings may overlap, features such as presence of cyst and calcification, brain stem and optic pathway involvement, different enhancement patterns, and ADC values may be helpful in the differential diagnosis of HOCGs and craniopharyngiomas.


Asunto(s)
Craneofaringioma , Glioma , Imagen por Resonancia Magnética , Quiasma Óptico , Neoplasias Hipofisarias , Humanos , Craneofaringioma/diagnóstico por imagen , Masculino , Femenino , Imagen por Resonancia Magnética/métodos , Adulto , Persona de Mediana Edad , Neoplasias Hipofisarias/diagnóstico por imagen , Neoplasias Hipofisarias/patología , Estudios Retrospectivos , Diagnóstico Diferencial , Adolescente , Glioma/diagnóstico por imagen , Glioma/patología , Quiasma Óptico/diagnóstico por imagen , Quiasma Óptico/patología , Adulto Joven , Niño , Anciano , Neoplasias Hipotalámicas/diagnóstico por imagen , Preescolar , Medios de Contraste
7.
World Neurosurg ; 187: 42-45, 2024 Jul.
Artículo en Inglés | MEDLINE | ID: mdl-38548055

RESUMEN

BACKGROUND: Delayed enhancing white matter lesions are a rare complication that develops after endovascular treatment of cerebral aneurysms, the etiology of which remains unclear. METHODS AND RESULTS: We present a 52-year-old female patient who was symptomatic with a seizure-like condition and showed reversible cranial parenchymal changes with high-dose cortisone treatment after endovascular stent-assisted coil embolization for an unruptured aneurysm in the internal cerebral artery. CONCLUSIONS: Clinicians should be alert to this rare complication and should follow patients for a long time due to its fluctuating and long-term course.


Asunto(s)
Embolización Terapéutica , Aneurisma Intracraneal , Stents , Humanos , Femenino , Persona de Mediana Edad , Embolización Terapéutica/efectos adversos , Embolización Terapéutica/métodos , Stents/efectos adversos , Aneurisma Intracraneal/cirugía , Aneurisma Intracraneal/terapia , Leucoencefalopatías/etiología , Leucoencefalopatías/diagnóstico por imagen , Complicaciones Posoperatorias/etiología , Complicaciones Posoperatorias/diagnóstico por imagen , Sustancia Blanca/diagnóstico por imagen , Procedimientos Endovasculares/efectos adversos
8.
Artículo en Inglés | MEDLINE | ID: mdl-38501466

RESUMEN

OBJECTIVE: This study aimed to develop machine learning (ML) algorithms for the differential diagnosis of adrenocorticotropic hormone (ACTH)-dependent Cushing's syndrome (CS) based on biochemical and radiological features. METHODS: Logistic regression algorithms were used for ML, and the area under the receiver operating characteristics curve (AUROC) was used to measure performance. We used Shapley Contributed Comments (SHAP) values, which help explain the results of the ML models to identify the meaning of each feature and facilitate interpretation. RESULTS: A total of 106 patients, 80 with Cushing's disease (CD) and 26 with ectopic ACTH syndrome (EAS), were enrolled in the study. The ML task was created to classify patients with ACTH-dependent CS into CD and EAS. The average AUROC value obtained in the cross-validation of the logistic regression model created for the classification task was 0.850. The diagnostic accuracy of the algorithm was 86%. The SHAP values indicated that the most important determinants for the model were the 2-day 2-mg dexamethasone suppression test, the > 50% suppression in the 8-mg high-dose dexamethasone test, late-night salivary cortisol, and the diameter of the pituitary adenoma. We have also made our algorithm available to all clinicians via a user-friendly interface. CONCLUSION: ML algorithms have the potential to serve as an alternative decision support tool to invasive procedures in the differential diagnosis of ACTH-dependent CS.

9.
Neuroradiology ; 66(1): 129-133, 2024 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-37993730

RESUMEN

PURPOSE: Treatment of brain arteriovenous malformation (bAVM) includes microsurgical excision, stereotactic radiosurgery, endovascular embolization, or combination. With bAVM embolization, complete angiographic obliteration ranges from 12.5 to 51%, and higher total occlusion rate is seen in SM grades I to III, ranging from 96 to 100%. METHODS: In this paper, we illustrate the use of 3D rotational angiography and dynamic (live) 3D roadmap functions in endovascular treatment of bAVM. A single dynamic 3D roadmap or two dynamic 3D roadmaps obtained help tremendously in navigation of microcatheters and wires along the parent artery and bAVM feeders. RESULTS: This method eliminates the need for repeated 2D angiograms and roadmaps for new working projections every time the C-arm position is changed for cannulation of different feeders, thereby reducing radiation dose. No instances of misalignment error, vascular perforation, or thromboembolic phenomena were observed in the 21 embolization cases performed within the previous 2 years while utilizing this feature. CONCLUSION: The dynamic 3D roadmap is an extremely useful tool for multiple-feeder cannulation, by reducing the use of multiple 2D angiograms, providing intraprocedural live and adjustable 3D roadmap for better mental orientation to angioarchitecture of the bAVM, which further aids in the overall complete angiographic obliteration rate of bAVM in a single session especially in multiplug embolization technique.


Asunto(s)
Embolización Terapéutica , Malformaciones Arteriovenosas Intracraneales , Radiocirugia , Humanos , Malformaciones Arteriovenosas Intracraneales/diagnóstico por imagen , Malformaciones Arteriovenosas Intracraneales/terapia , Encéfalo , Embolización Terapéutica/métodos , Angiografía Cerebral/métodos , Cateterismo , Resultado del Tratamiento , Estudios Retrospectivos
11.
Br J Radiol ; 96(1152): 20220598, 2023 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-37660368

RESUMEN

OBJECTIVE: The aim of this study is to present the clinical and imaging findings of 16 patients with intraventricular pilocytic astrocytomas (PAs). METHODS: 16 patients with histopathological diagnosis of intraventricular PA between February 2016 and January 2022 were evaluated retrospectively. Imaging and clinical findings of the patients, as well as apparent diffusion coefficient (ADC) measurements were analyzed. RESULTS: Of 16 patients, 8 (%50) were male and 8 (%50) were female. The mean age of the patients was 20.8 years (2-44 years range). The most common symptoms in the patients were headache and ataxia. The mean long-axis size of lesions was found to be 48.19 ± 21.59 (range, 15-92 mm). 9 out of 16 lesions (56.2%) were located in the fourth ventricle. The majority of the lesions were iso-hypointense in T1W and hyperintense in T2W images. The mean ADC value of PAs was 1.57 × 10-3 ± 0.2 mm2/s, while the mean thalamic ADC and white matter ADC values were found to be 0.78 × 10-3 ± 0.04 and 0.76 × 10-3 ± 0.06 mm2/s, respectively. There was a statistically significant difference between the ADC values obtained from the solid components of the lesions and the thalami/white matter (p < 0.001). CONCLUSION: PAs often originate from midline structures, however, they can also be located intraventricularly. Although intraventricular PAs are frequently seen in pediatric population, it should be kept in mind that they can also be seen in adults, albeit rarely. ADVANCES IN KNOWLEDGE: PA should be considered in the differential diagnosis of intraventricular neoplasms in case of high ADC values.


Asunto(s)
Astrocitoma , Imagen de Difusión por Resonancia Magnética , Adulto , Humanos , Niño , Masculino , Femenino , Adulto Joven , Estudios Retrospectivos , Imagen de Difusión por Resonancia Magnética/métodos , Astrocitoma/diagnóstico por imagen , Astrocitoma/patología , Diagnóstico Diferencial , Tálamo
12.
Eur Spine J ; 32(12): 4321-4327, 2023 12.
Artículo en Inglés | MEDLINE | ID: mdl-37530950

RESUMEN

PURPOSE: The aim of this study was to investigate the efficacy of diffusion tensor tractography (DTT) of spinal cord on surgical planning and postoperative neurological outcomes in patients with spinal intramedullary tumors. METHODS: The study was conducted retrospectively from the radiological and clinical data of our hospital database. Patients with intramedullary spinal cord tumors who underwent diffusion tensor imaging for spinal cord lesions were selected between 2019 and 2022. Demographic characteristics and intraoperative neurophysiological monitoring data were evaluated. The McCormick scale was used to grade the pre- and postoperative neurological status of the patients. The tumoral lesions were categorized into 3 types according to the fiber course on DTT. RESULTS: Eleven patients were found to have radiological findings that were compatible with intramedullary tumor; eight (72.7%) of them ultimately underwent surgery following being approved as surgical candidates in the spinal diffusion tensor imaging studies. Six cases had Type 1, one case had Type 2, and 4 cases had Type 3 tumors according to the fiber course. All Type 1 tumors were classified as resectable and all of them were gross totally resected. Type 2 lesion that was rated as resectable by DTI was subtotally resected. Type 3 lesions were followed without surgery except the one with tumoral progression and neurological deficit. The postoperative neurological outcomes were compatible with intraoperative neurophysiological monitoring results. CONCLUSION: Diffusion tensor imaging and tractography may be beneficial regarding the selection of patients suitable for surgery and in the subsequent surgical planning.


Asunto(s)
Neoplasias de la Médula Espinal , Neoplasias de la Columna Vertebral , Humanos , Imagen de Difusión Tensora/métodos , Estudios Retrospectivos , Neoplasias de la Médula Espinal/diagnóstico por imagen , Neoplasias de la Médula Espinal/cirugía , Neoplasias de la Médula Espinal/patología
13.
J Pediatr Orthop B ; 2023 May 22.
Artículo en Inglés | MEDLINE | ID: mdl-37266919

RESUMEN

The Dias-Tachdjian classification is the most commonly used system for the classification of pediatric ankle fractures, but its inter- and intra-observer reliability has not been studied in detail. Also, the impact of the clinician's experience and expertise on the reliability of this system is unknown. This study aimed: (1) to determine the intra- and inter-observer reliability of the Dias-Tachdjian classification and (2) to investigate the effect of the clinician's experience and expertise on the reliability of this system. Anteroposterior and lateral ankle radiographs of 56 children (34 male, 22 female) with ankle fractures, aged between 3 and 14 years, with open growth cartilages, were retrospectively identified and included in the study. Each patient radiograph was examined by 10 observers from two different specialties with different levels of clinical experience (two orthopedic surgeons with interest in pediatric orthopedics, three orthopedic surgeons with no interest in pediatric orthopedics, three orthopedic residents, and two radiology specialists) from two different specialties (orthopedics and radiology). All observers were then asked to classify pediatric ankle fractures at 6-week intervals per the Dias-Tachdjian classification system. Overall, intra-observer reliability as substantial to very good (κ = 0.77-0.95, P < 0.01), but inter-observer reliability as fair for both assessments (κ = 0.21, P < 0.01 and κ = 0.20, P < 0.01 for the first and second occasions, respectively). Inter-observer reliability among pediatric orthopedic surgeons as very good (κ = 0.90, 95% CI = 0.86-0.94, P < 0.01 and κ = 0.82, 95% CI = 0.71-0.93, P < 0.01 for the first and second occasions, respectively). Orthopedic surgeons with no special interest in pediatric orthopedics demonstrated substantial agreement in the first occasion (κ = 0.63, 95% CI = 0.53-0.72, P < 0.01) but moderate in the second one. Orthopedic residents exhibited moderate levels of agreement in each assessment period (κ = 0.58, 95% CI = 0.47-0.68, P < 0.01 and κ = 0.44, 95% CI = 0.37-0.51, P < 0.01 for the first and second occasion, respectively). Considering that the specialists dealing with pediatric orthopedics show very good consistency for Dias-Tachdjian classification, both within and between observers, consistency in the identification of the ankle fracture models increases as the interest in the field of pediatric orthopedics intensifies.

14.
Turk J Med Sci ; 53(1): 282-288, 2023 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-36945917

RESUMEN

BACKGROUND: The aim of this study was to assess the effectiveness of a new quantitative index for the diagnosis of idiopathic normal pressure hydrocephalus. METHODS: This retrospective study was conducted at Istanbul University Cerrahpasa Medical Faculty between January 2016 and November 2022. A total of 31 patients diagnosed with idiopathic normal pressure hydrocephalus were included in the study group and 48 patients were included in the control group. Measurement via the new Index was performed on a coronal section of magnetic resonance imaging at the level of the anterior commissure. RESULTS: The new Index's mean diagnostic performance was 1.16 ± 0.08 in the study group, significantly lower (p < 0.0001) than the mean of 1.43 ± 0.10 in the control group. When a cutoff value of 1.23 was used for the new index, the sensitivity, specificity, positive predictive value, negative predictive value, and accuracy rates were 96.1%, 90.7%, 80.6%, 98%, and 91.3%, respectively. DISCUSSION: The new Index described here is an effective, feasible, reproducible, highly sensitive, and specific quantitative method that can contribute to the improved diagnosis of patients with idiopathic normal pressure hydrocephalus.


Asunto(s)
Hidrocéfalo Normotenso , Humanos , Hidrocéfalo Normotenso/diagnóstico por imagen , Estudios Retrospectivos , Espacio Subaracnoideo/patología , Imagen por Resonancia Magnética/métodos , Encéfalo/patología
15.
J Neurointerv Surg ; 16(1): 8-14, 2023 Dec 19.
Artículo en Inglés | MEDLINE | ID: mdl-36963822

RESUMEN

BACKGROUND: Flow diverter (FD) devices provide a safe and effective treatment option especially for wide-necked intracranial aneurysms. One of the main concerns in patients treated with FD devices is patency of arterial branches jailed by the stent. However, there are no long-term data from magnetic resonance perfusion (MRP) studies regarding jailed branches. In this study we aimed to reveal the MRP findings in patients with jailed middle cerebral artery (MCA) cortical branches during long-term follow-up after flow diversion. METHODS: Patients who underwent FD stent treatment for MCA aneurysms with a resulting jailed cortical branch were included. Follow-up clinical, angiographic, and MRP examination findings were recorded. Different MRP parameters were measured in the MCA territory regarding the jailed branches. RESULTS: Eighteen patients treated endovascularly with flow diversion for a total of 20 MCA aneurysms were included. At angiographic follow-up (median 35 months, range 7-95 months) complete occlusion was observed in 13 (65%) aneurysms and partial occlusion was observed in 6 (30%). The mean transit time (MTT) prolongation, MTT ratio, time-to peak (TTP) prolongation, and TTP ratio were 1.34, 1.20, 1.18, and 1.06 s, respectively, when compared with the contralateral side in the MCA territory. MTT, TTP, and cerebral blood volume values of the patients showed statistically significant differences compared with the contralateral side (P<0.05). CONCLUSIONS: Flow diversion treatment of complex bifurcation aneurysms can be effective and safe. MRP examination may reveal perfusion changes in the territory vascularized via a jailed branch, and these changes are rarely accompanied by clinical findings.


Asunto(s)
Procedimientos Endovasculares , Aneurisma Intracraneal , Humanos , Aneurisma Intracraneal/diagnóstico por imagen , Aneurisma Intracraneal/cirugía , Arteria Cerebral Media/diagnóstico por imagen , Arteria Cerebral Media/cirugía , Resultado del Tratamiento , Stents , Procedimientos Endovasculares/métodos , Espectroscopía de Resonancia Magnética , Imagen de Perfusión , Estudios Retrospectivos , Angiografía Cerebral
16.
Neuroradiology ; 65(4): 785-791, 2023 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-36651939

RESUMEN

PURPOSE: This study aimed to evaluate the feasibility, safety, and efficacy of Y-stent-assisted coiling (Y-SAC) using LEO Baby® stents in treating of bifurcation aneurysms. METHODS: Patients who underwent Y-SAC using a braided stent (LEO Baby®, Montmorency, France) for wide-necked intracranial aneurysms between 2009 and 2019 and whose radiological and clinical follow-up data for at least 6 months could be obtained were evaluated. Data were obtained from patient records and analyzed retrospectively. RESULTS: We evaluated 111 patients with a mean age of 56.0 ± 10.8 years (range, 25-88 years). Most of the aneurysms were detected incidentally. Three patients had ruptured aneurysms. LEO Baby deployment and coiling were successful in all patients. Immediate aneurysm occlusion rates were determined as modified Raymond-Roy classification (mRRC) I 95.5% (n = 106), mRRC II 3.6% (n = 4), mRRC IIIa 0.9% (n = 1). In the sixth month, aneurysm occlusion rates were found to be complete and nearly complete in all patients (mRRC I 94.6%, n = 105 and mRRC II 4.5%; n = 5, respectively). Follow-up data of 91 patients for > 2 years were obtained. Of these, 88 had MRRCI obstruction and 3 had MRRC II obstruction. The overall complication rate was 4.8%, and one patient died during the post-procedural follow-up. CONCLUSION: The long-term follow-up results of Y-stenting with LEO Baby revealed that it provides stable closure of the aneurysm sac while preserving the main arterial structures. Therefore, it is a safe, durable, and effective method for treating wide-necked and complex bifurcation aneurysms.


Asunto(s)
Embolización Terapéutica , Reparación Endovascular de Aneurismas , Aneurisma Intracraneal , Stents , Aneurisma Intracraneal/cirugía , Humanos , Masculino , Femenino , Adulto , Persona de Mediana Edad , Anciano , Anciano de 80 o más Años , Resultado del Tratamiento , Turquía
17.
Acad Radiol ; 30(1): 14-21, 2023 01.
Artículo en Inglés | MEDLINE | ID: mdl-35659854

RESUMEN

RATIONALE AND OBJECTIVES: To investigate the efficacy of the advanced imaging methods, superb microvascular imaging (SMI) and shear wave elastography (SWE) in predicting molecular subtypes in invasive breast carcinomas. MATERIALS AND METHODS: A total of 210 biopsy-proven breast carcinomas in 200 patients who underwent ultrasound (US) imaging with SMI and SWE were included in this study. Quantitative analyses were performed using mean elasticity (Emean) score by SWE and vascular index (VI) by SMI. For qualitative assessment of microvascularity, first, lesions were graded according to Adler's classification in four types. Then, a new morphological model was used to classify the microvascular architecture into six patterns: type one, no signal; type two, penetrant; type three, rim-like; type four, dot-like/linear/regional; type five, wheel-like and type six, irregular signals. The correlation between these variables and molecular subtypes, nuclear grade, the Ki-67 levels and axillary status was investigated. RESULTS: The average VI and Emean values were relatively higher in non-luminal subtypes (VI, p = 0.002; Emean, p > 0.05). The two microvascularisation models were significantly able to differentiate the molecular subtypes according to the Kruskal Wallis test (p < 0.05). Rim-like, penetrant and regional patterns were primarily observed in luminal subtypes. The dominant pattern in non-luminal subtypes was wheel-like pattern. VI, Emean, Adler's classification and morphological vascularisation model were not significantly correlated with the nuclear grade, Ki-67 index or axillary status. CONCLUSION: The proposed microvascular categorization model may be more valuable in predicting molecular subtypes of breast carcinomas compared to VI and Emean and may contribute to the management of breast carcinomas as a non-invasive variable.


Asunto(s)
Neoplasias de la Mama , Diagnóstico por Imagen de Elasticidad , Humanos , Femenino , Diagnóstico por Imagen de Elasticidad/métodos , Antígeno Ki-67 , Neoplasias de la Mama/diagnóstico por imagen , Neoplasias de la Mama/patología , Ultrasonografía Doppler , Ultrasonografía , Ultrasonografía Mamaria/métodos , Mama/diagnóstico por imagen , Mama/patología
18.
Childs Nerv Syst ; 39(4): 1101-1105, 2023 04.
Artículo en Inglés | MEDLINE | ID: mdl-36369383

RESUMEN

Craniocervical dissection is one of the most common causes of stroke in children. Although the most common cause of dissection is trauma, spontaneous dissections in which no cause can be revealed may also occur. The diagnosis of this type of dissection in children can be challenging with the preferred non-invasive imaging methods (MRA, CTA). Intracranial vessel wall imaging is a promising novel method for identifying specific signs of dissection. We report an 11-year-old girl with spontaneous ICA dissection, whose diagnosis was confirmed by an MRI of the intracranial vessel wall. Vessel wall imaging has contributed substantially to the diagnosis and follow-up of this case.


Asunto(s)
Disección de la Arteria Carótida Interna , Accidente Cerebrovascular , Femenino , Humanos , Niño , Disección de la Arteria Carótida Interna/diagnóstico por imagen , Disección de la Arteria Carótida Interna/complicaciones , Arteria Carótida Interna , Imagen por Resonancia Magnética/métodos , Accidente Cerebrovascular/etiología
19.
Clin Neuroradiol ; 33(2): 545-554, 2023 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-36577853

RESUMEN

BACKGROUND AND PURPOSE: This study aimed to investigate the potential contribution of quantitative measurements of dural venous sinuses to the diagnosis of idiopathic intracranial hypertension (IIH) and the relationship between IIH and dural venous sinus dimensions on 3D post-gadolinium T1-weighted magnetic resonance (MR) images. MATERIAL AND METHODS: A total of 129 individuals (57 IIH patients and 72 controls) who complained of headache and underwent both magnetic resonance venography (MRV) and precontrast/postcontrast 3D T1-weighted MR imaging between 2018 and 2021 were included in this retrospective study. Dural venous sinus and jugular vein diameters were measured in all cases using post-gadolinium 3D T1 TFE images. The presence of transverse sinus (TS) hypoplasia and occipital sinus variation, the number and size of arachnoid granulations in the TS, and the presence of brain parenchymal herniation were also evaluated. Cut-off values that maximized accurate diagnosis of IIH were established on the receiver operating characteristic curve. The sensitivity and specificity of the diagnosis of IIH based on quantitative measurements of the dural sinus were calculated. RESULTS: The ratios of the maximum to minimum TS diameters and the minimum TS diameters to minimum sigmoid sinus (SS) diameters were significantly higher in IIH patients than in the control group (p < 0.001). The diagnostic sensitivity and specificity values of TSmax/TSmin and TSmin sum/SSmin sum parameters for the detection of IIH were 84.2%, 84.7% and 83.3%, 84.2%, respectively. CONCLUSION: Practical measurements from multiplanar T1 sequences can be useful for both quantitative assessment and overcoming misinterpretation due to anatomical variation.


Asunto(s)
Seudotumor Cerebral , Humanos , Seudotumor Cerebral/diagnóstico por imagen , Estudios Retrospectivos , Gadolinio , Senos Craneales/patología , Imagen por Resonancia Magnética/métodos , Flebografía/métodos
20.
Ear Nose Throat J ; : 1455613221113818, 2022 Jul 19.
Artículo en Inglés | MEDLINE | ID: mdl-35855585

RESUMEN

Acute onset Facial palsy was reported in four vaccinated participants in the BNT162b2 (Pfizer-BioNTech) vaccine clinical trials published on December 10, 2020. So far, few cases of Facial palsy among the mRNA vaccine groups have been previously documented in the literature. Facial palsy is cited as medically attended adverse event following immunization on April 12, 2021, after the first dose of the approved Pfizer-BioNTech COVID-19 vaccines for preventive immunization for SARS-CoV-2 is administrated to the population in Turkey. This study is aimed to describe clinical and magnetic resonance imaging features of three patients, who developed acute onset peripheral facial paralysis after administration of the BNT162b2 vaccine, without any previous medical condition. The first patient presented with right sided facial palsy within the same day following the vaccine was administrated, while the second patient presented with left sided facial palsy 2 months after vaccination. The third patient, on the other hand, presented with right sided facial palsy and abducens nerve (CN VI) paralysis two days after vaccine was administrated.

SELECCIÓN DE REFERENCIAS
DETALLE DE LA BÚSQUEDA