1
|
Schubert T, Husain HS, Thurner P, Madjidyar J, Barnaure I, Piccirelli M, Klarhöfer M, Schmidt M, Speier P, Forman C, Kulcsar Z. Ultra-High-Resolution Time-of-Flight MR-Angiography for the Noninvasive Assessment of Intracranial Aneurysms, Alternative to Preinterventional DSA? Clin Neuroradiol 2023; 33:1115-1122. [PMID: 37401949 PMCID: PMC10654166 DOI: 10.1007/s00062-023-01320-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2022] [Accepted: 05/29/2023] [Indexed: 07/05/2023]
Abstract
PURPOSE The 3D time-of-flight (TOF) magnetic resonance angiography (MRA) at 3T shows high sensitivity for intracranial aneurysms but is inferior to three-dimensional digital subtraction angiography (3D-DSA) regarding aneurysm characteristics. We applied an ultra-high-resolution (UHR) TOF-MRA using compressed sensing reconstruction to investigate the diagnostic performance in preinterventional evaluation of intracranial aneurysms compared to conventional TOF-MRA and 3D-DSA. METHODS In this study 17 patients with unruptured intracranial aneurysms were included. Aneurysm dimensions, configuration, image quality and sizing of endovascular devices were compared between conventional TOF-MRA at 3T and UHR-TOF with 3D-DSA as gold standard. Quantitatively, contrast-to-noise ratios (CNR) were compared between TOF-MRAs. RESULTS On 3D-DSA, 25 aneurysms in 17 patients were detected. On conventional TOF, 23 aneurysms were detected (sensitivity: 92.6%). On UHR-TOF, 25 aneurysms were detected (sensitivity: 100%). Image quality was not significantly different between TOF and UHR-TOF (p = 0.17). Aneurysm dimension measurements were significantly different between conventional TOF (3.89 mm) and 3D-DSA (4.2 mm, p = 0.08) but not between UHR-TOF (4.12 mm) and 3D-DSA (p = 0.19). Irregularities and small vessels at the aneurysm neck were more frequently correctly depicted on UHR-TOF compared to conventional TOF. Comparison of the planned framing coil diameter and flow-diverter (FD) diameter revealed neither a statistically significant difference between TOF and 3D-DSA (coil p = 0.19, FD p = 0.45) nor between UHR-TOF and 3D-DSA (coil: p = 0.53, FD 0.33). The CNR was significantly higher in conventional TOF (p = 0.009). CONCLUSION In this pilot study, ultra-high-resolution TOF-MRA visualized all aneurysms and accurately depicted aneurysm irregularities and vessels at the base of the aneurysm comparably to DSA, outperforming conventional TOF. UHR-TOF with compressed sensing reconstruction seems to represent a non-invasive alternative to pre-interventional DSA for intracranial aneurysms.
Collapse
Affiliation(s)
- Tilman Schubert
- Department of Neuroradiology, University Hospital Zurich, Zurich, Switzerland.
| | - Hakim Shakir Husain
- Department of Neuroradiology, University Hospital Zurich, Zurich, Switzerland
- Baby Memorial Hospital, Calicut, Kerala, India
- Parco Institute of Medical Sciences, Vatakara, Kerala, India
- Neo Hospital, Noida, Uttar Pradesh, India
| | - Patrick Thurner
- Department of Neuroradiology, University Hospital Zurich, Zurich, Switzerland
| | - Jawid Madjidyar
- Department of Neuroradiology, University Hospital Zurich, Zurich, Switzerland
| | - Isabelle Barnaure
- Department of Neuroradiology, University Hospital Zurich, Zurich, Switzerland
| | - Marco Piccirelli
- Department of Neuroradiology, University Hospital Zurich, Zurich, Switzerland
| | | | | | | | | | - Zsolt Kulcsar
- Department of Neuroradiology, University Hospital Zurich, Zurich, Switzerland
| |
Collapse
|
2
|
Madjidyar J, Keller E, Winklhofer S, Toth D, Barnaure I, Schubert T, Thurner P, Fierstra J, Willms JF, Regli L, Kulcsar Z. Single-antiplatelet regimen in ruptured cerebral blood blister and dissecting aneurysms treated with flow-diverter stent reconstruction. J Neurointerv Surg 2023; 15:953-957. [PMID: 36328478 DOI: 10.1136/jnis-2022-019361] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2022] [Accepted: 10/08/2022] [Indexed: 11/06/2022]
Abstract
BACKGROUND Flow diversion treatment of ruptured cerebral aneurysms remains challenging due to the need for double-antiplatelet therapy. We report our experience with flow-diverter stent (FDS) reconstruction with single-antiplatelet therapy of ruptured cerebral blood blister and dissecting aneurysms. METHODS In this case series we performed a retrospective analysis of all patients with ruptured cerebral aneurysms who were treated with a phosphoryl-bonded FDS between 2019 and 2022 in a single center. Periprocedurally, all patients received weight-adapted eptifibatide IV and heparin IV. After 6-24 hours, eptifibatide was switched to oral prasugrel as monotherapy. We analyzed the rate of bleeding complications, thromboembolic events, occlusion rate and clinical outcome. RESULTS Nine patients with subarachnoid hemorrhage were treated, eight within 24 hours of symptom onset. Seven patients were treated with one FDS and two patients received two FDS in a telescopic fashion. Two aneurysms were additionally coil embolized. Fatal re-rupture occurred in one case; eight patients survived and had no adverse events associated with the FDS. Six patients showed complete occlusion of the aneurysm after 3 months (n=2) and 1 year (n=4), respectively. Two patients showed subtotal occlusion of the aneurysm at the last follow-up after 3 months and 6 months, respectively. Favorable clinical outcome was achieved in five patients. CONCLUSIONS Peri-interventional single-antiplatelet therapy with eptifibatide followed by prasugrel was sufficient to prevent thromboembolic events and reduce re-bleeding using an anti-thrombogenic FDS. FDS with single-antiplatelet therapy might be a viable option for ruptured blood blister and dissecting cerebral aneurysms.
Collapse
Affiliation(s)
- Jawid Madjidyar
- Department of Neuroradiology, Clinical Neuroscience Center, University Hospital Zurich, University of Zurich, Zurich, Switzerland
| | - Emanuela Keller
- Department of Neurosurgery, Clinical Neuroscience Center, University Hospital Zurich, University of Zurich, Zurich, Switzerland
| | - Sebastian Winklhofer
- Department of Neuroradiology, Clinical Neuroscience Center, University Hospital Zurich, University of Zurich, Zurich, Switzerland
| | - Daniel Toth
- Department of Neuroradiology, Clinical Neuroscience Center, University Hospital Zurich, University of Zurich, Zurich, Switzerland
| | - Isabelle Barnaure
- Department of Neuroradiology, Clinical Neuroscience Center, University Hospital Zurich, University of Zurich, Zurich, Switzerland
| | - Tilman Schubert
- Department of Neuroradiology, Clinical Neuroscience Center, University Hospital Zurich, University of Zurich, Zurich, Switzerland
| | - Patrick Thurner
- Department of Neuroradiology, Clinical Neuroscience Center, University Hospital Zurich, University of Zurich, Zurich, Switzerland
| | - Jorn Fierstra
- Department of Neurosurgery, Clinical Neuroscience Center, University Hospital Zurich, University of Zurich, Zurich, Switzerland
| | - Jan Folkard Willms
- Department of Neurosurgery, Clinical Neuroscience Center, University Hospital Zurich, University of Zurich, Zurich, Switzerland
| | - Luca Regli
- Department of Neurosurgery, Clinical Neuroscience Center, University Hospital Zurich, University of Zurich, Zurich, Switzerland
| | - Zsolt Kulcsar
- Department of Neuroradiology, Clinical Neuroscience Center, University Hospital Zurich, University of Zurich, Zurich, Switzerland
| |
Collapse
|
3
|
Ma Y, Madjidyar J, Schubert T, Thurner P, Barnaure I, Kulcsar Z. Single antiplatelet regimen in flow diverter treatment of cerebral aneurysms: The drug matters. A systematic review and meta-analysis. Interv Neuroradiol 2023:15910199231177745. [PMID: 37221854 DOI: 10.1177/15910199231177745] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/25/2023] Open
Abstract
BACKGROUND Hemorrhagic and thromboembolic complications (TECs) are the main concerns in the endovascular treatment of intracranial aneurysms using flow diverter devices (FDs). The clinical demand for single antiplatelet therapy (SAPT) is increasing especially with the development of devices with lower thrombogenicity profile. However, the safety of SAPT is not well established. OBJECTIVE To analyze the safety and efficacy of SAPT in terms of ischemic and hemorrhagic complications in patients undergoing FDs treatment for cerebral aneurysms. METHODS A systematic literature search and meta-analysis were conducted in PubMed, Ovid MEDLINE, Ovid Embase, and Web of Science from January 2010 until October 2022. Twelve articles which reported SAPT and data on hemorrhagic, TECs, and mortality following FDs treatment were included. RESULTS Overall, the 12 studies involved 237 patients with 295 aneurysms. Five investigated the safety and efficacy of SAPT in 202 unruptured aneurysms. Six studies focused on 57 ruptured aneurysms. One study included both ruptured and unruptured aneurysms. Among the 237 patients, prasugrel was most often used as SAPT in 168 cases (70.9%), followed by aspirin in 42 (17.7%) patients, and by ticagrelor in 27 (11.4%). Overall, the hemorrhagic complication rate was 0.1% (95% CI 0% to 1.8%). The TEC rate was 7.6% (95% CI 1.7% to 16.1%). In the subgroup analysis, the TEC rates of prasugrel monotherapy of 2.4% (95% CI 0% to 9.3%) and ticagrelor monotherapy of 4.2% (95% CI 0.1% to 21.1%) were lower than of aspirin monotherapy 20.2% (95% CI 5.9% to 38.6%). The overall mortality rate was 1.3% (95% CI 0% to 6.1%). CONCLUSION According to the available data, SAPT regimen in patients undergoing FDs treatment for cerebral aneurysms has an acceptable safety profile, especially with the use of ADP-receptor antagonists.
Collapse
Affiliation(s)
- Yihui Ma
- Department of Neurosurgery, Zhongnan Hospital of Wuhan University, Wuhan, China
| | - Jawid Madjidyar
- Department of Neuroradiology, Clinical Neuroscience Center, University Hospital Zurich, University of Zurich, Zurich, Switzerland
| | - Tilman Schubert
- Department of Neuroradiology, Clinical Neuroscience Center, University Hospital Zurich, University of Zurich, Zurich, Switzerland
| | - Patrick Thurner
- Department of Neuroradiology, Clinical Neuroscience Center, University Hospital Zurich, University of Zurich, Zurich, Switzerland
| | - Isabelle Barnaure
- Department of Neuroradiology, Clinical Neuroscience Center, University Hospital Zurich, University of Zurich, Zurich, Switzerland
| | - Zsolt Kulcsar
- Department of Neuroradiology, Clinical Neuroscience Center, University Hospital Zurich, University of Zurich, Zurich, Switzerland
| |
Collapse
|
4
|
Barnaure I, Kulcsár Z, Schubert T. Supra-aortic Vessel Catheterization in Hostile Anatomy. Clin Neuroradiol 2023; 33:247-249. [PMID: 36036256 DOI: 10.1007/s00062-022-01212-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2022] [Accepted: 08/07/2022] [Indexed: 11/26/2022]
Affiliation(s)
- Isabelle Barnaure
- Department of Neuroradiology, University Hospital Zurich, Frauenklinikstr. 10, 8091, Zurich, Switzerland
| | - Zsolt Kulcsár
- Department of Neuroradiology, University Hospital Zurich, Frauenklinikstr. 10, 8091, Zurich, Switzerland
| | - Tilman Schubert
- Department of Neuroradiology, University Hospital Zurich, Frauenklinikstr. 10, 8091, Zurich, Switzerland.
| |
Collapse
|
5
|
Barnaure I, Galley J, Fritz B, Sutter R. Magnetic resonance imaging in the evaluation of cervical foraminal stenosis: comparison of 3D T2 SPACE with sagittal oblique 2D T2 TSE. Skeletal Radiol 2022; 51:1453-1462. [PMID: 35006279 PMCID: PMC9098590 DOI: 10.1007/s00256-022-03988-9] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/16/2021] [Revised: 12/30/2021] [Accepted: 01/02/2022] [Indexed: 02/02/2023]
Abstract
OBJECTIVE The oblique orientation of the cervical neural foramina challenges the implementation of a short MRI protocol with concurrent excellent visualization of the spine. While sagittal oblique T2-weighted sequences permit good evaluation of the cervical neuroforamina, all segments may not be equally well depicted on a single sequence and conspicuity of foraminal stenosis may be limited. 3D T2-weighted sequences can be reformatted in arbitrary planes, including the sagittal oblique. We set out to compare 3D T2w SPACE sequences with sagittal oblique reformations and sagittal oblique 2D T2w TSE sequences for the evaluation of cervical foraminal visibility and stenosis. MATERIALS AND METHODS Sixty consecutive patients who underwent MRI of the cervical spine with sagittal oblique 2D T2w TSE and 3D T2w SPACE sequences were included. Image homogeneity of the sequences was evaluated. Imaging sets were assessed for structure visibility and foraminal stenosis by two independent readers. Results of the sequences were compared by Wilcoxon matched-pairs tests. Interreader agreement was evaluated by weighted κ. RESULTS Visibility of most structures was rated good to excellent on both sequences (mean visibility scores ≥ 4.5 of 5), though neuroforaminal contents were better seen on sagittal oblique T2w TSE (mean scores 4.1-4.6 vs. 3.1-4.1 on 3D T2w SPACE, p < 0.01). Stenosis grades were comparable between sequences (mean 1.1-2.6 of 4), with slightly higher values for 3D T2w SPACE at some levels (difference ≤ 0.3 points). CONCLUSION 3D T2w SPACE is comparable with sagittal oblique 2D T2w TSE in the evaluation of cervical neural foramina.
Collapse
Affiliation(s)
- I Barnaure
- Department of Radiology, Balgrist University Hospital, Forchstrasse 340, 8008, Zurich, Switzerland.
| | - J Galley
- Department of Radiology, Balgrist University Hospital, Forchstrasse 340, 8008, Zurich, Switzerland
| | - B Fritz
- Department of Radiology, Balgrist University Hospital, Forchstrasse 340, 8008, Zurich, Switzerland
| | - R Sutter
- Department of Radiology, Balgrist University Hospital, Forchstrasse 340, 8008, Zurich, Switzerland
| |
Collapse
|
6
|
Brozova H, Barnaure I, Ruzicka E, Stochl J, Alterman R, Tagliati M. Short- and Long-Term Effects of DBS on Gait in Parkinson's Disease. Front Neurol 2021; 12:688760. [PMID: 34690908 PMCID: PMC8531078 DOI: 10.3389/fneur.2021.688760] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2021] [Accepted: 08/11/2021] [Indexed: 12/18/2022] Open
Abstract
The aim was to compare the short and long-term effects of subthalamic nucleus (STN) deep brain stimulation (DBS) on gait dysfunction and other cardinal symptoms of Parkinson's disease (PD). Two groups of patients were studied. The first group (short-term DBS, n = 8) included patients recently implanted with STN DBS (mean time since DBS 15.8 months, mean age 58.8 years, PD duration 13 years); the second group (long-term DBS, n = 10) included patients with at least 5 years of DBS therapy (mean time since DBS 67.6 months, mean age 61.7 years, PD duration 17.1 years). Both groups were examined using the Unified Parkinson's Disease Rating Scale (UPDRS) and Gait and Balance scale (GABS) during four stimulation/medication states (ON/OFF; OFF/OFF; OFF/ON; ON/ON). Data were analyzed using repeated measures ANOVA with time since implantation (years) between groups and medication or DBS effect (ON, OFF) within groups. In the short-term DBS group, stimulation improved all UPDRS subscores similar to dopaminergic medications. In particular, average gait improvement was over 40% (p = 0.01), as measured by the UPDRS item 29 and GABS II. In the long-term DBS group, stimulation consistently improved all clinical subscores with the exception of gait and postural instability. In these patients, the effect of levodopa on gait was partially preserved. Short-term improvement of gait abnormalities appears to significantly decline after 5 years of STN DBS in PD patients, while effectiveness for other symptoms remains stable. Progressive non-dopaminergic (non-DBS responsive) mechanisms or deleterious effects of high frequency STN stimulation on gait function may play a role.
Collapse
Affiliation(s)
- Hana Brozova
- Department of Neurology and Centre of Clinical Neuroscience, First Faculty of Medicine, Charles University and General University Hospital in Prague, Prague, Czechia
| | - Isabelle Barnaure
- Department of Neuroradiology, Kantonsspital Aarau, Aarau, Switzerland
| | - Evzen Ruzicka
- Department of Neurology and Centre of Clinical Neuroscience, First Faculty of Medicine, Charles University and General University Hospital in Prague, Prague, Czechia
| | - Jan Stochl
- Department of Kinanthropology, Charles University in Prague, Prague, Czechia.,Department of Psychiatry, University of Cambridge, Cambridge, United Kingdom
| | - Ron Alterman
- Department of Neurosurgery, Beth Israel Deaconess Medical Center, Boston, MA, United States
| | - Michele Tagliati
- Department of Neurology, Cedars-Sinai Medical Center, Los Angeles, CA, United States
| |
Collapse
|
7
|
Agten CA, Kobe A, Barnaure I, Galley J, Pfirrmann CW, Brunner F. MRI of complex regional pain syndrome in the foot. Eur J Radiol 2020; 129:109044. [PMID: 32534352 DOI: 10.1016/j.ejrad.2020.109044] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2020] [Revised: 02/24/2020] [Accepted: 04/29/2020] [Indexed: 01/04/2023]
Abstract
PURPOSE To evaluate the diagnostic potential of MRI in patients with suspected CRPS (complex regional pain syndrome). METHOD A retrospective health-record search was conducted for patients with suspected CRPS (foot). Fifty patients with initially suspected CRPS were included (37 females (51 ± 13 years) and 13 males (44 ± 15 years)). All patients underwent MRI. Two radiologists assessed skin, bone, and soft tissue parameters on MRI. The final diagnosis was CRPS (Gold standard: Budapest criteria) or non-CRPS. MRI parameters were compared between CRPS patients and non-CRPS patients. RESULTS CRPS was diagnosed in 22/50(44 %) patients. Skin thickness (1.9 ± 0.5 mm vs. 1.7 ± 0.3 mm, p = 0.399), enhancement, and subcutaneous edema showed no differences between CRPS and non-CRPS patients. Bone marrow edema presence and pattern were not different between groups. Up to 50 % of CRPS patients showed no bone marrow edema. Subcortical enhancement and periosteal enhancement were not different between groups. For reader 1, muscle edema score was higher in the non-CRPS group compared to the CRPS group (0.1 ± 0.2 vs. 0.6 ± 1.0, p = 0.008), but not different for reader 2 (0.1 ± 0.5 vs. 0.2 ± 0.8, p = 0.819). Perfusion pattern was more extensive in non-CRPS patients for reader 1 (p = 0.048), but not for reader 2 (p = 0.157). Joint effusions showed no difference between groups. CONCLUSIONS MRI cannot distinguish between CRPS and non-CRPS patients. The role of MR imaging in patients with suspected CRPS is to exclude alternative diagnoses that would better explain patients' symptoms.
Collapse
Affiliation(s)
- Christoph A Agten
- University Hospital Balgrist, Radiology, Forchstrasse 340, 8008 Zurich, Switzerland; University of Zurich, Faculty of Medicine, Pestalozzistrasse 3, 8091 Zurich Switzerland.
| | - Adrian Kobe
- University Hospital Zurich, Radiology, Rämistrasse 100, 8091 Zurich, Switzerland; University of Zurich, Faculty of Medicine, Pestalozzistrasse 3, 8091 Zurich Switzerland
| | - Isabelle Barnaure
- University Hospital Balgrist, Radiology, Forchstrasse 340, 8008 Zurich, Switzerland; University of Zurich, Faculty of Medicine, Pestalozzistrasse 3, 8091 Zurich Switzerland
| | - Julien Galley
- University Hospital Balgrist, Radiology, Forchstrasse 340, 8008 Zurich, Switzerland; University of Zurich, Faculty of Medicine, Pestalozzistrasse 3, 8091 Zurich Switzerland
| | - Christian W Pfirrmann
- University Hospital Balgrist, Radiology, Forchstrasse 340, 8008 Zurich, Switzerland; University of Zurich, Faculty of Medicine, Pestalozzistrasse 3, 8091 Zurich Switzerland
| | - Florian Brunner
- University Hospital Balgrist, Rheumatology, Forchstrasse 340, 8008 Zurich, Switzerland; University of Zurich, Faculty of Medicine, Pestalozzistrasse 3, 8091 Zurich Switzerland
| |
Collapse
|
8
|
Romero JM, Liberato ACP, Montes D, Barnaure I, Xu J, Maza N, Gonzalez RG. Accuracy of MRI T2*-weighted sequences (GRE-EPI) compared to CTA for detection of anterior circulation large vessel thrombus. Emerg Radiol 2020; 27:269-275. [DOI: 10.1007/s10140-020-01754-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2019] [Accepted: 01/09/2020] [Indexed: 01/02/2023]
|
9
|
Soun JE, Montes D, Yu F, Morotti A, Qureshi AI, Barnaure I, Rosand J, Goldstein JN, Romero JM. Spot Sign in Secondary Intraventricular Hemorrhage Predicts Early Neurological Decline. Clin Neuroradiol 2019; 30:761-768. [DOI: 10.1007/s00062-019-00857-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2019] [Accepted: 11/04/2019] [Indexed: 10/25/2022]
|
10
|
Agten CA, Kobe A, Barnaure I, Galley J, Pfirrmann CWA, Brunner F. Role of MR Imaging in Complex Regional Pain Syndrome Revisited. Semin Musculoskelet Radiol 2019. [DOI: 10.1055/s-0039-1692568] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
|
11
|
Tuttle C, Boto J, Martin S, Barnaure I, Korchi AM, Scheffler M, Vargas MI. Neuroimaging of acute and chronic unilateral and bilateral thalamic lesions. Insights Imaging 2019; 10:24. [PMID: 30796553 PMCID: PMC6386756 DOI: 10.1186/s13244-019-0700-3] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2018] [Accepted: 11/08/2018] [Indexed: 11/10/2022] Open
Abstract
The thalami are bilateral ovoid grey matter cerebral structures bordering the third ventricle on both sides, which participate in functions such as relaying of sensory and motor signals, regulation of consciousness, and alertness. Pathologies affecting the thalami can be of neoplastic, infectious, vascular, toxic, metabolic, or congenital origin.The purpose of this review is to provide a comprehensive approach to the thalamus focusing on its anatomy, the main pathologies affecting this structure and their radiological semiology on CT and MRI. We will also illustrate the importance of multimodal MR imaging (morphologic sequences, diffusion-weighted imaging, perfusion, spectroscopy) for the diagnosis and treatment of these conditions.
Collapse
Affiliation(s)
- C Tuttle
- Division of Radiology, Faculty of Medicine, Geneva University Hospital, Geneva, Switzerland
| | - J Boto
- Division of Neuroradiology, DISIM, Faculty of Medicine, Geneva University Hospital, Rue Gabrielle-Perret-Gentil 4, 1211, Geneva 14, Switzerland
| | - S Martin
- Division of Radiology, Faculty of Medicine, Geneva University Hospital, Geneva, Switzerland
| | - I Barnaure
- Division of Neuroradiology, DISIM, Faculty of Medicine, Geneva University Hospital, Rue Gabrielle-Perret-Gentil 4, 1211, Geneva 14, Switzerland
| | - A M Korchi
- Division of Neuroradiology, DISIM, Faculty of Medicine, Geneva University Hospital, Rue Gabrielle-Perret-Gentil 4, 1211, Geneva 14, Switzerland
| | - M Scheffler
- Division of Radiology, Faculty of Medicine, Geneva University Hospital, Geneva, Switzerland
| | - M I Vargas
- Division of Neuroradiology, DISIM, Faculty of Medicine, Geneva University Hospital, Rue Gabrielle-Perret-Gentil 4, 1211, Geneva 14, Switzerland.
| |
Collapse
|
12
|
Vargas MI, Barnaure I, Gariani J, Boto J, Pellaton A, Dietemann JL, Kulcsar Z. Vascular Imaging Techniques of the Spinal Cord. Semin Ultrasound CT MR 2017; 38:143-152. [DOI: 10.1053/j.sult.2016.07.004] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
|
13
|
Cuvinciuc V, Viallon M, Barnaure I, Vargas MI, Lovblad KO, Haller S. Dynamic Contrast-Enhanced MR Perfusion of Intradural Spinal Lesions. AJNR Am J Neuroradiol 2017; 38:192-194. [PMID: 27856434 DOI: 10.3174/ajnr.a4995] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2016] [Accepted: 08/03/2016] [Indexed: 11/07/2022]
Abstract
Fifteen patients with intradural spinal lesions were examined with an optimized dynamic contrast-enhanced MR perfusion sequence at 1.5T and 3T. SNR and mean contrast-to-noise ratio were better on 3T compared with 1.5T (P ≤ .05). The goodness of fit of the Tofts and Tofts extended pharmacokinetic models was similar between 1.5T and 3T. Thus, dynamic contrast-enhanced MR perfusion of intradural spinal canal lesions is technically feasible at 1.5T and 3T, with better image quality at 3T.
Collapse
Affiliation(s)
- V Cuvinciuc
- From the Departments of Neuroradiology (V.C., I.B., M.I.V., K.-O.L., S.H.)
- Centre d'Imagerie Rive Droite (V.C.), Geneva, Switzerland
| | - M Viallon
- Radiology (M.V.), Geneva University Hospitals, Geneva, Switzerland
- Université de Lyon, INSA de Lyon, Université Jean-Monnet, CHU de Saint-Etienne, CREATIS CNRS 5220, INSERM 1206, F-42055, Saint-Etienne, France (M.V.)
| | - I Barnaure
- From the Departments of Neuroradiology (V.C., I.B., M.I.V., K.-O.L., S.H.)
| | - M I Vargas
- From the Departments of Neuroradiology (V.C., I.B., M.I.V., K.-O.L., S.H.)
| | - K-O Lovblad
- From the Departments of Neuroradiology (V.C., I.B., M.I.V., K.-O.L., S.H.)
| | - S Haller
- From the Departments of Neuroradiology (V.C., I.B., M.I.V., K.-O.L., S.H.)
- Affidea Centre de Diagnostique Radiologique de Carouge (S.H.), Geneva, Switzerland
| |
Collapse
|
14
|
Barnaure I, Montandon ML, Rodriguez C, Herrmann F, Lövblad KO, Giannakopoulos P, Haller S. Clinicoradiologic Correlations of Cerebral Microbleeds in Advanced Age. AJNR Am J Neuroradiol 2017; 38:39-45. [PMID: 27686485 DOI: 10.3174/ajnr.a4956] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2016] [Accepted: 08/15/2016] [Indexed: 12/23/2022]
Abstract
BACKGROUND AND PURPOSE The presence of cerebral microbleeds has been associated with dementia and cognitive decline, although studies report conflicting results. Our aim was to determine the potential role of the presence and location of cerebral microbleeds in early stages of cognitive decline. MATERIALS AND METHODS Baseline 3T MR imaging examinations including SWI sequences of 328 cognitively intact community-dwelling controls and 72 subjects with mild cognitive impairment were analyzed with respect to the presence and distribution of cerebral microbleeds. A neuropsychological follow-up of controls was performed at 18 months post inclusion and identified cases with subtle cognitive deficits were referred to as controls with a deteriorating condition. Group differences in radiologic parameters were studied by using nonparametric tests, 1-way analysis of variance, and Spearman correlation coefficients. RESULTS Cerebral microbleed prevalence was similar in subjects with mild cognitive impairment and controls with stable and cognitively deteriorating conditions (25%-31.9%). In all diagnostic groups, lobar cerebral microbleeds were more common. They occurred in 20.1% of all cases compared with 6.5% of cases with deep cerebral microbleeds. None of the investigated variables (age, sex, microbleed number, location and depth, baseline Mini-Mental State Examination score, and the Fazekas score) were significantly associated with cognitive deterioration with the exception of education of >12 years showing a slight but significant protective effect (OR, 0.44; 95% CI, 0.22-0.92; P = .028). The Mini-Mental State Examination and the Buschke total score were correlated with neither the total number nor lobar-versus-deep location of cerebral microbleeds. CONCLUSIONS Cerebral microbleed presence, location, and severity are not related to the early stages of cognitive decline in advanced age.
Collapse
Affiliation(s)
- I Barnaure
- From the Division of Neuroradiology (I.B., K.O.L.)
| | - M-L Montandon
- Department of Mental Health and Psychiatry (M.-L.M., C.R., P.G.)
| | - C Rodriguez
- Department of Mental Health and Psychiatry (M.-L.M., C.R., P.G.)
| | - F Herrmann
- Departments of Internal Medicine, Rehabilitation, and Geriatrics (F.H.), Geneva University Hospitals, Geneva, Switzerland
| | - K O Lövblad
- From the Division of Neuroradiology (I.B., K.O.L.)
| | - P Giannakopoulos
- Department of Mental Health and Psychiatry (M.-L.M., C.R., P.G.)
| | - S Haller
- Affidea Centre de Diagnostique Radiologique de Carouge CDRC (S.H.), Geneva, Switzerland
- Departments of Surgical Sciences and Radiology (S.H.), Uppsala University, Uppsala, Sweden
- Department of Neuroradiology (S.H.), University Hospital Freiburg, Germany
- Faculty of Medicine (S.H.), University of Geneva, Geneva, Switzerland
| |
Collapse
|
15
|
Abstract
While intraventricular haemorrhage is frequently found in association with intraparenchymal or subarachnoid haemorrhage, isolated intraventricular haemorrhage (iIVH) is rare in adults and seldom described. Awareness of possible causes is important in order to guide patient management. After elimination of a traumatic cause, numerous aetiologies remain possible. The most frequently found underlying lesions are arteriovenous malformations and aneurysms, but other vascular causes should also be sought, including cavernous malformations and moyamoya disease. Arterial hypertension, anticoagulant use, coagulopathies and certain toxic substances are also associated with iIVH. Finally, iIVH may be caused by intraventricular tumours. In a high number of cases, the cause remains unknown. Vascular and non-vascular causes should be searched through an imaging work-up (with CT angiography, MRI and catheter angiography when necessary) and correlation with clinical information to yield a diagnosis. The aim of this pictorial essay was to review the aetiologies of iIVH in adults.
Collapse
Affiliation(s)
- Isabelle Barnaure
- 1 Division of Neuroradiology, Massachusetts General Hospital, Boston, MA, USA.,2 Service de Neuroradiologie, Hôpitaux Universitaires de Genève, Geneva, Switzerland
| | - Afonso C Liberato
- 1 Division of Neuroradiology, Massachusetts General Hospital, Boston, MA, USA
| | - R Gilberto Gonzalez
- 1 Division of Neuroradiology, Massachusetts General Hospital, Boston, MA, USA
| | - Javier M Romero
- 1 Division of Neuroradiology, Massachusetts General Hospital, Boston, MA, USA
| |
Collapse
|
16
|
Pellaton A, Bijlenga P, Bouchez L, Cuvinciuc V, Barnaure I, Garibotto V, Lövblad KO, Haller S. CO 2BOLD assessment of moyamoya syndrome: Validation with single photon emission computed tomography and positron emission tomography imaging. World J Radiol 2016; 8:887-894. [PMID: 27928470 PMCID: PMC5120248 DOI: 10.4329/wjr.v8.i11.887] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/21/2016] [Revised: 08/25/2016] [Accepted: 09/22/2016] [Indexed: 02/06/2023] Open
Abstract
AIM To compare the assessment of cerebrovascular reserve (CVR) using CO2BOLD magnetic resonance imaging (MRI) vs positron emission tomography (PET) and single photon emission computed tomography (SPECT) as reference standard.
METHODS Ten consecutive patients (8 women, mean age of 41 ± 26 years) with moyamoya syndrome underwent 14 pre-surgical evaluations for external-internal carotid artery bypass surgery. CVR was assessed using CO2BOLD and PET (4)/SPECT (11) with a maximum interval of 36 d, and evaluated by two experienced neuroradiologists.
RESULTS The inter-rater agreement was 0.81 for SPECT (excellent), 0.43 for PET (fair) and 0.7 for CO2BOLD (good). In 9/14 cases, there was a correspondence between CO2BOLD and PET/SPECT. In 4/14 cases, CVR was over-estimated in CO2BOLD, while in 1/14 case, CVR was underestimated in CO2BOLD. The sensitivity of CO2BOLD was 86% and a specificity of 43%.
CONCLUSION CO2BOLD can be used for pre-surgical assessment of CVR in patients with moyamoya syndrome and combines the advantages of absent irradiation, high availability of MRI and assessment of brain parenchyma, cerebral vessels and surrogate CVR in one stop.
Collapse
|
17
|
Romero JM, Hito R, Dejam A, Ballesteros LS, Cobos CJ, Liévano JO, Ciura VA, Barnaure I, Ernst M, Liberato AP, Gonzalez GR. Negative spot sign in primary intracerebral hemorrhage: potential impact in reducing imaging. Emerg Radiol 2016; 24:1-6. [PMID: 27553777 DOI: 10.1007/s10140-016-1428-8] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2016] [Accepted: 08/04/2016] [Indexed: 11/25/2022]
Abstract
Intracerebral hemorrhage (ICH) is one of the most devastating and costly diagnoses in the USA. ICH is a common diagnosis, accounting for 10-15 % of all strokes and affecting 20 out of 100,000 people. The CT angiography (CTA) spot sign, or contrast extravasation into the hematoma, is a reliable predictor of hematoma expansion, clinical deterioration, and increased mortality. Multiple studies have demonstrated a high negative predictive value (NPV) for ICH expansion in patients without spot sign. Our aim is to determine the absolute NPV of the spot sign and clinical characteristics of patients who had ICH expansion despite the absence of a spot sign. This information may be helpful in the development of a cost effective imaging protocol of patients with ICH. During a 3-year period, 204 patients with a CTA with primary intracerebral hemorrhage were evaluated for subsequent hematoma expansion during their hospitalization. Patients with intraventricular hemorrhage were excluded. Clinical characteristics and antithrombotic treatment on admission were noted. The number of follow-up NCCT was recorded. Of the resulting 123 patients, 108 had a negative spot sign and 7 of those patients subsequently had significant hematoma expansion, 6 of which were on antithrombotic therapy. The NPV of the CTA spot sign was calculated at 0.93. In patients without antithrombotic therapy, the NPV was 0.98. In summary, the negative predictive value of the CTA spot sign for expansion of ICH, in the absence of antithrombotic therapy and intraventricular hemorrhage (IVH) on admission, is very high. These results have the potential to redirect follow-up imaging protocols and reduce cost.
Collapse
Affiliation(s)
- Javier M Romero
- Department of Radiology, Neuroradiology Division, Massachusetts General Hospital, 55 Fruit Street, Boston, MA, 02114, USA.
| | - Rania Hito
- Department of Radiology, Neuroradiology Division, Massachusetts General Hospital, 55 Fruit Street, Boston, MA, 02114, USA
| | - Andre Dejam
- Division of Cardiology, Beth Israel Deaconess Medical Center, 330 Brookline Ave, Boston, MA, 02215, USA
| | - Laia Sero Ballesteros
- Department of Radiology, Neuroradiology Division, Massachusetts General Hospital, 55 Fruit Street, Boston, MA, 02114, USA
| | - Camilo Jaimes Cobos
- Department of Radiology, Neuroradiology Division, Massachusetts General Hospital, 55 Fruit Street, Boston, MA, 02114, USA
| | - J Ortiz Liévano
- Department of Radiology, Neuroradiology Division, Massachusetts General Hospital, 55 Fruit Street, Boston, MA, 02114, USA
| | - Viesha A Ciura
- Department of Radiology, Neuroradiology Division, Massachusetts General Hospital, 55 Fruit Street, Boston, MA, 02114, USA
| | - Isabelle Barnaure
- Department of Radiology, Neuroradiology Division, Massachusetts General Hospital, 55 Fruit Street, Boston, MA, 02114, USA
- Service de Neuroradiologie, Hôpitaux Universitaires de Genève, Rue Gabrielle-Perret-Gentil 4, 1205, Genève, Switzerland
| | - Marielle Ernst
- Department of Diagnostic and Interventional Neuroradiology, University Medical Center Hamburg-Eppendorf, Haus Ost 22 Martinistr 52, 20246, Hamburg, Germany
| | - Afonso P Liberato
- Department of Radiology, Neuroradiology Division, Massachusetts General Hospital, 55 Fruit Street, Boston, MA, 02114, USA
| | - Gilberto R Gonzalez
- Department of Radiology, Neuroradiology Division, Massachusetts General Hospital, 55 Fruit Street, Boston, MA, 02114, USA
| |
Collapse
|
18
|
Botsikas D, Barnaure I, Terraz S, Becker CD, Kalovidouri A, Montet X. Value of liver computed tomography with iodixanol 270, 80 kVp and iterative reconstruction. World J Radiol 2016; 8:693-699. [PMID: 27551339 PMCID: PMC4965353 DOI: 10.4329/wjr.v8.i7.693] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/28/2016] [Revised: 04/20/2016] [Accepted: 05/11/2016] [Indexed: 02/06/2023] Open
Abstract
AIM: To evaluate the image quality of hepatic multidetector computed tomography (MDCT) with dynamic contrast enhancement.
METHODS: It uses iodixanol 270 mg/mL (Visipaque 270) and 80 kVp acquisitions reconstructed with sinogram affirmed iterative reconstruction (SAFIRE®) in comparison with a standard MDCT protocol. Fifty-three consecutive patients with known or suspected hepatocellular carcinoma underwent 55 CT examinations, with two different four-phase CT protocols. The first group of 30 patients underwent a standard 120 kVp acquisition after injection of Iohexol 350 mg/mL (Accupaque 350®) and reconstructed with filtered back projection. The second group of 25 patients underwent a dual-energy CT at 80-140 kVp with iodixanol 270. The 80 kVp component of the second group was reconstructed iteratively (SAFIRE®-Siemens). All hyperdense and hypodense hepatic lesions ≥ 5 mm were identified with both protocols. Aorta and portal vessels/liver parenchyma contrast to noise ratio (CNR) in arterial phase, hypervascular lesion/liver parenchyma CNR in arterial phase, hypodense lesion/liver parenchyma CNR in portal and late phase were calculated in both groups.
RESULTS: Aorta/liver and focal lesions altogether/liver CNR were higher for the second protocol (P = 0.0078 and 0.0346). Hypervascular lesions/liver CNR was not statistically different (P = 0.86). Hypodense lesion/liver CNR in the portal phase was significantly higher for the second group (P = 0.0107). Hypodense lesion/liver CNR in the late phase was the same for both groups (P = 0.9926).
CONCLUSION: MDCT imaging with 80 kVp with iterative reconstruction and iodixanol 270 yields equal or even better image quality.
Collapse
|
19
|
Liberato AP, Shah S, Maza N, Barnaure I, Gonzalez RG, Romero JM. Abstract TP39: High Accuracy of Magnetic Resonance T2*- Weighted Sequences for Detection of Intracranial Arterial Thrombus. Stroke 2016. [DOI: 10.1161/str.47.suppl_1.tp39] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Introduction:
Rapid detection and location of vessel occlusion are pivotal in the intra-arterial management of patients with acute stroke in the emergency room. MRI has demonstrated to detect intravascular thrombus but its accuracy compared to CT angiography has not been well established.
Hypothesis:
Our purpose is to determine the accuracy of 1.5 T MRI T2*-weighted (W) sequences compared to immediate CT angiography as the standard reference imaging modality, for detection of intra-arterial thrombus in patients with suspected acute MCA infarction.
Methods:
Consecutive patients with suspected middle cerebral artery (MCA) territory stroke were selected from 2008 to 2009. The inclusion criteria for the study subjects: CTA, T2*W sequences included on MRI protocol and restricted diffusion in MCA territory on DWI within 12 hrs of clinical onset. Two investigators reviewed DWI and T2*W sequences for the presence of infarction and thrombus. Intracranial internal carotid artery (ICA), M1 and M2 segments of the MCA were accessed. Consensus was reached with a third reviewer for data analyses. Accuracy, sensitivity, specificity, positive and negative predictive values (PPV/NPV) were calculated.
Results:
Fifty-one patients were included in the study, of which 40 patients had confirmed arterial thrombus and 11 patients had normal studies on CTA. Of the subjects with arterial occlusion on CTA, the mean time interval from stroke onset to CTA was 4.2 h +/- 2.3 h (range, 0.4-12h). The mean time interval from CTA to MRI was 29.5 min +/- 11.1 min. Twenty-six cases showed M1 thrombus on CTA, of these, 22 cases had corresponding thrombus and 4 cases had no abnormality in T2*W sequences on MRI. Nevertheless, 25 patients demonstrated no M1 thrombus, either on CTA or MRI. After statistical analyses, we observed an accuracy of 92%, sensitivity of 85%, specificity of 100%, PPV 100% and NPV of 86% for M1 occlusion. The Kappa obtained was 0.79.
Conclusion:
In conclusion, T2*W sequences demonstrated overall high accuracy and specificity for detection of arterial thrombus in the M1 segment of the MCA in patients with suspected acute MCA ischemic stroke.
Collapse
Affiliation(s)
| | - Santosh Shah
- Div of Neuroradiology, Massachusetts General Hosp, Boston, MA
| | - Noor Maza
- Div of Neuroradiology, Massachusetts General Hosp, Boston, MA
| | | | | | - Javier M Romero
- Div of Neuroradiology, Massachusetts General Hosp, Boston, MA
| |
Collapse
|
20
|
Barnaure I, Pollak P, Momjian S, Horvath J, Lovblad KO, Boëx C, Remuinan J, Burkhard P, Vargas MI. Evaluation of electrode position in deep brain stimulation by image fusion (MRI and CT). Neuroradiology 2015; 57:903-8. [PMID: 26022355 DOI: 10.1007/s00234-015-1547-z] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2015] [Accepted: 05/21/2015] [Indexed: 10/23/2022]
Abstract
INTRODUCTION Imaging has an essential role in the evaluation of correct positioning of electrodes implanted for deep brain stimulation (DBS). Although MRI offers superior anatomic visualization of target sites, there are safety concerns in patients with implanted material; imaging guidelines are inconsistent and vary. The fusion of postoperative CT with preoperative MRI images can be an alternative for the assessment of electrode positioning. The purpose of this study was to assess the accuracy of measurements realized on fused images (acquired without a stereotactic frame) using a manufacturer-provided software. METHODS Data from 23 Parkinson's disease patients who underwent bilateral electrode placement for subthalamic nucleus (STN) DBS were acquired. Preoperative high-resolution T2-weighted sequences at 3 T, and postoperative CT series were fused using a commercially available software. Electrode tip position was measured on the obtained images in three directions (in relation to the midline, the AC-PC line and an AC-PC line orthogonal, respectively) and assessed in relation to measures realized on postoperative 3D T1 images acquired at 1.5 T. RESULTS Mean differences between measures carried out on fused images and on postoperative MRI lay between 0.17 and 0.97 mm. CONCLUSION Fusion of CT and MRI images provides a safe and fast technique for postoperative assessment of electrode position in DBS.
Collapse
Affiliation(s)
- I Barnaure
- Department of Neuroradiology, Geneva University Hospital, Gabrielle Perret Gentil, 4, 1211, Geneva 14, Switzerland
| | - P Pollak
- Department of Neurology, Geneva University Hospital, Geneva, Switzerland
| | - S Momjian
- Department of Neurosurgery, Geneva University Hospital, Geneva, Switzerland
| | - J Horvath
- Department of Neurology, Geneva University Hospital, Geneva, Switzerland
| | - K O Lovblad
- Department of Neuroradiology, Geneva University Hospital, Gabrielle Perret Gentil, 4, 1211, Geneva 14, Switzerland
| | - C Boëx
- Department of Neurology, Geneva University Hospital, Geneva, Switzerland
| | - J Remuinan
- Department of Radiology, Geneva University Hospital, Geneva, Switzerland
| | - P Burkhard
- Department of Neurology, Geneva University Hospital, Geneva, Switzerland
| | - M I Vargas
- Department of Neuroradiology, Geneva University Hospital, Gabrielle Perret Gentil, 4, 1211, Geneva 14, Switzerland.
| |
Collapse
|
21
|
Stefanelli S, Barnaure I, Momjian S, Seeck M, Constantinescu I, Lovblad KO, Vargas MI. Incidental intrasphenoidal encephalocele(ise). J Neuroradiol 2014; 41:358-60. [PMID: 24998600 DOI: 10.1016/j.neurad.2014.02.005] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2014] [Revised: 02/27/2014] [Accepted: 02/28/2014] [Indexed: 10/25/2022]
Affiliation(s)
- S Stefanelli
- Service de neuro-diagnostic et neuro-interventionel, DISIM, Geneva University Hospitals, Geneva, Switzerland
| | - I Barnaure
- Service de neuro-diagnostic et neuro-interventionel, DISIM, Geneva University Hospitals, Geneva, Switzerland
| | - S Momjian
- Service de neuro-diagnostic et neuro-interventionel, DISIM, Geneva University Hospitals, Geneva, Switzerland
| | - M Seeck
- Service de neuro-diagnostic et neuro-interventionel, DISIM, Geneva University Hospitals, Geneva, Switzerland
| | - I Constantinescu
- Service de neuro-diagnostic et neuro-interventionel, DISIM, Geneva University Hospitals, Geneva, Switzerland
| | - K O Lovblad
- Service de neuro-diagnostic et neuro-interventionel, DISIM, Geneva University Hospitals, Geneva, Switzerland
| | - M I Vargas
- Service de neuro-diagnostic et neuro-interventionel, DISIM, Geneva University Hospitals, Geneva, Switzerland.
| |
Collapse
|
22
|
Haller S, Badoud S, Nguyen D, Barnaure I, Montandon ML, Lovblad KO, Burkhard PR. Differentiation between Parkinson disease and other forms of Parkinsonism using support vector machine analysis of susceptibility-weighted imaging (SWI): initial results. Eur Radiol 2012; 23:12-9. [PMID: 22797981 DOI: 10.1007/s00330-012-2579-y] [Citation(s) in RCA: 66] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2012] [Revised: 06/03/2012] [Accepted: 06/05/2012] [Indexed: 12/26/2022]
Abstract
OBJECTIVES To diagnose Parkinson disease (PD) at the individual level using pattern recognition of brain susceptibility-weighted imaging (SWI). METHODS We analysed brain SWI in 36 consecutive patients with Parkinsonism suggestive of PD who had (1) SWI at 3 T, (2) brain (123)I-ioflupane SPECT and (3) extensive neurological testing including follow-up (16 PD, 67.4 ± 6.2 years, 11 female; 20 OTHER, a heterogeneous group of atypical Parkinsonism syndromes 65.2 ± 12.5 years, 6 female). Analysis included group-level comparison of SWI values and individual-level support vector machine (SVM) analysis. RESULTS At the group level, simple visual analysis yielded no differences between groups. However, the group-level analyses demonstrated increased SWI in the bilateral thalamus and left substantia nigra in PD patients versus other Parkinsonism. The inverse comparison yielded no supra-threshold clusters. At the individual level, SVM correctly classified PD patients with an accuracy above 86 %. CONCLUSIONS SVM pattern recognition of SWI data provides accurate discrimination of PD among patients with various forms of Parkinsonism at an individual level, despite the absence of visually detectable alterations. This pilot study warrants further confirmation in a larger cohort of PD patients and with different MR machines and MR parameters.
Collapse
Affiliation(s)
- S Haller
- Service neuro-diagnostique et neuro-interventionnel DISIM, Hôpitaux Universitaires de Genève, Rue Gabrielle Perret-Gentil 4, 1211, Genève 14, Switzerland.
| | | | | | | | | | | | | |
Collapse
|
23
|
Brozova H, Barnaure I, Ruzicka E, Stochl J, Alterman R, Tagliati M. 220 SHORT- AND LONG-TERM EFFECTS OF DBS ON GAIT IN PARKINSON'S DISEASE. Parkinsonism Relat Disord 2010. [DOI: 10.1016/s1353-8020(10)70221-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
|
24
|
Brozova H, Barnaure I, Alterman RL, Tagliati M, Moreau C, Defebvre L, Destee A, Bleuse S, Clement F, Blatt JL, Krystkowiak P, Devos D. STN-DBS FREQUENCY EFFECTS ON FREEZING OF GAIT IN ADVANCED PARKINSON DISEASE. Neurology 2009; 72:770; author reply 770-1. [DOI: 10.1212/01.wnl.0000339385.187472.7d] [Citation(s) in RCA: 50] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
|