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1.
Payam Sajedi Lydia Chelala Joel Nunez-Gonalez Carolyn Cronin Steven Kittner Jiachen Zhuo Yang Zhang Dheeraj Gandhi Prashant Raghavan 《Journal of neuroradiology. Journal de neuroradiologie》2019,46(2):136-140
Background and purpose
Carotid webs are intraluminal filling defects at the carotid bulb which are considered rare, though possibly underappreciated entities with recent studies demonstrating a likely casual association with ischemic stroke. The purpose of the study is to describe our recent experience with clinical and imaging manifestations of carotid webs.Materials and methods
A retrospective review of CTA neck studies in all adult patients presenting to our institution during the 19-month study interval was performed to determine the presence of carotid webs. Subsequent chart review of these patients with webs was performed to assess their clinical history and to obtain demographic detail.Results
A total of 14 patients were identified with carotid webs in the study population. The mean age of patients with webs was 42.1?years (range: 28–54), consisting mostly of African Americans (86%) and females (64%). Ten (71%) of web patients had a history of ischemic stroke, each ipsilateral to the side of web, and at least four of these patients had recurrent ischemic stroke.Conclusion
We provide one of the largest sample sizes of webs gathered in a single study. Given its association with ischemic stroke, carotid webs should be assessed for in all patients presenting with ischemic stroke, especially younger African Americans. 相似文献2.
A. Sanabria-Castro F. Henríquez-Varela C. Monge-Bonilla S. Lara-Maier M. Sittenfeld-Appel 《Neurología (Barcelona, Spain)》2019,34(4):234-240
Introduction
Given that epileptic seizures and non-epileptic paroxysmal events have similar clinical manifestations, using specific diagnostic methods is crucial, especially in patients with drug-resistant epilepsy. Prolonged video electroencephalography monitoring during epileptic seizures reveals epileptiform discharges and has become an essential procedure for epilepsy diagnosis. The main purpose of this study is to characterise paroxysmal events and compare patterns in patients with refractory epilepsy.Methods
We conducted a retrospective analysis of medical records from 91 patients diagnosed with refractory epilepsy who underwent prolonged video electroencephalography monitoring during hospitalisation.Results
During prolonged video electroencephalography monitoring, 76.9% of the patients (n = 70) had paroxysmal events. The mean number of events was 3.4 ± 2.7; the duration of these events was highly variable. Most patients (80%) experienced seizures during wakefulness. The most common events were focal seizures with altered levels of consciousness, progressive bilateral generalized seizures and psychogenic non-epileptic seizures. Regarding all paroxysmal events, no differences were observed in the number or type of events by sex, in duration by sex or age at onset, or in the number of events by type of event. Psychogenic nonepileptic seizures were predominantly registered during wakefulness, lasted longer, started at older ages, and were more frequent in women.Conclusions
Paroxysmal events recorded during prolonged video electroencephalography monitoring in patients with refractory epilepsy show similar patterns and characteristics to those reported in other latitudes. 相似文献3.
P. Brandicourt C. Blanc L. Bonnet Y. Béjot F. Ricolfi C. Drouet T. Moulin L. Thines 《Revue neurologique》2019,175(4):247-251
Introduction
Moyamoya angiopathy (MMA) is a progressive steno-occlusive disease of the distal internal carotid arteries mainly described in Asia. It induces the development of collateral vascular networks to reduce chronic cerebral hypoperfusion. Symptoms depend on the patient's age in Asia: children are at greater risk of transient or constituted ischemic events, whereas adults are more exposed to hemorrhagic stroke. Data from the literature seem to show that the pattern of MMA in western countries differs from that in Asia.Material and methods
A retrospective study of patients with MMA was conducted in Bourgogne-Franche-Comté (mid-eastern France). Clinical data (symptoms, risk factors, age at diagnosis, number and timing of recurrences, type of treatment) as well as radiological data (angiographic findings, Suzuki's grade) were analyzed.Results
Seventeen adult patients (9 men, 53%) were followed at the university hospitals of Besançon and Dijon from 2009 to 2016. Fourteen patients (83%) had bilateral disease. The mean age at diagnosis was 49 years (± 16), 83% of the patients were Caucasian and 17% originated from Maghreb. Only 17% of the hemispheres had a hemorrhagic form. Ischemic form was more frequent before diagnosis with transient ischemic attack (24% of patients) and stroke (83% of patients). With medical treatment, 9 patients suffered from stroke recurrence (53% of patients) with an average delay of 22.7 ± 34 months. Three patients (18%) had combined surgical management by encephelo-synangiosis and superficial temporal artery-to-middle cerebral artery (STA-MCA) anastomosis, without symptom recurrence after treatment with an average follow up of 14 months.Conclusion
MMA remains a rare cerebrovascular disease in Europe and requires multidisciplinary care. Epidemiological analysis showed differences with the Asian population, especially the predominance of ischemic forms in adults. 相似文献4.
Marinus J. Becks Rashindra Manniesing Jeroen Vister Sjoert A.H. Pegge Stefan C.A. Steens Ewoud J. van Dijk Mathias Prokop Frederick J.A. Meijer 《Journal of neuroradiology. Journal de neuroradiologie》2019,46(2):124-129
Background and purpose
To evaluate whether brain CT perfusion (CTP) aids in the detection of intracranial vessel occlusion on CT angiography (CTA) in acute ischemic stroke.Materials and methods
Medical-ethical committee approval of our hospital was obtained and informed consent was waived. Patients suspected of acute ischemic stroke who underwent non-contrast CT(NCCT), CTA and whole-brain CTP in our center in the year 2015 were included. Three observers with different levels of experience evaluated the imaging data of 110 patients for the presence or absence of intracranial arterial vessel occlusion with two strategies. In the first strategy, only NCCT and CTA were available. In the second strategy, CTP maps were provided in addition to NCCT and CTA. Receiver-operating-characteristic (ROC) analysis was used for the evaluation of diagnostic accuracy.Results
Overall, a brain perfusion deficit was scored present in 87–89% of the patients with an intracranial vessel occlusion, more frequently observed in the anterior than in the posterior circulation. Performance of intracranial vessel occlusion detection on CTA was significantly improved with the availability of CTP maps as compared to the first strategy (P = 0.023), due to improved detection of distal and posterior circulation vessel occlusions (P-values of 0.032 and 0.003 respectively). No added value of CTP was found for intracranial proximal vessel occlusion detection, with already high accuracy based on NCCT and CTA alone.Conclusion
The performance of intracranial vessel occlusion detection on CTA was improved with the availability of brain CT perfusion maps due to the improved detection of distal and posterior circulation vessel occlusions. 相似文献5.
R. López Ruiz S. Quintas P. Largo M. de Toledo M.T. Carreras A. Gago-Veiga R. Manzanares J. Vivancos 《Neurología (Barcelona, Spain)》2019,34(2):73-79
Objective
Thirty percent of the patients for whom code stroke is activated have stroke mimics, the most common being epilepsy. Our purpose was to evaluate the usefulness of multiparametric CT for differentiating between seizure-related symptoms and vascular events.Material and methods
We conducted a retrospective observational study; data were gathered prospectively during one year. We studied multiparametric CT images of patients admitted following code stroke activation and finally diagnosed with epilepsy.Results
The study included a total of 11 patients; 36% were men and mean age was 74.5 years. Three patients had right hemisphere syndrome, 4 displayed left hemisphere syndrome, and the remaining 4 had isolated aphasia. Maximum time from symptom onset to multiparametric CT study was 8.16 hours. Perfusion CT results were normal in 2 patients. Nine patients showed longer or shorter times to peak (Tmax); cerebral blood volume (CBV) and cerebral blood flow (CBF) maps varied. EEG was performed a maximum of 47.6 hours after symptom onset. Four patients showed findings compatible with status epilepticus, 2 displayed focal epileptiform activity, and 5 showed post-ictal slowing ipsilateral to perfusion CT abnormalities.Conclusion
The most sensitive parameter for differentiating between stroke and epilepsy in our series was increased time to peak in multilobar cortical locations in the absence of large-vessel occlusion and basal ganglia involvement. Multiparametric CT is a fast, readily available, and useful tool for the differential diagnosis of acute-onset neurological signs of epileptic origin in patients initially attended after code stroke activation. 相似文献6.
Alexis Palpan Flores Pablo García Feijoo Alberto Isla Guerrero 《Neurocirugía (Asturias, Spain)》2019,30(2):69-76
Objectives
Lumbar spine surgery causes a muscular injury during its approach that could worsen long-term postoperative functional results. This study aims to analyze the postoperative paraspinal atrophy associated with two types of intervention.Material and methods
Clinical records and lumbar magnetic resonance imaging were collected from a group of 41 patients, 20 underwent laminectomy with lumbar fixation due to lumbar spinal stenosis (fixation group) and another group of 21 underwent hemilaminectomy without fixation due to lumbar disc disease (non-fixation group). In which muscle atrophy was analyzed quantitatively.Results
We found a negative correlation between age and preoperative muscle, which was higher in those who underwent lumbar fixation (rho = ?0.64 p = .002). We also found a positive correlation between preoperative muscle and postoperative atrophy (rho = 0.32 p = .041). In the age, sex and fixation adjusted multivariate linear regression model (R2 = 0.31), laminectomy with fixation is attributed to 5.3% atrophy (IC95 1.4-9.5%, p = .017); preoperative musculature > 70% is attributed to atrophy of 13.8% (95% CI 5.5%-22%, p = .002). Age did not correlate with postoperative atrophy.Conclusions
Paraspinal muscle atrophy after lumbar spinal surgery is greater if an extensive approach is performed such as complete laminectomy with bilateral facetectomy and transpedicular fixation. A greater previous musculature regardless of age, sex and type of surgery also predicts greater postoperative atrophy. 相似文献7.
L.A. Crespo Araico R. Vera Lechuga A. Cruz-Culebras C. Matute Lozano A. de Felipe Mimbrera P. Agüero Rabes E. Viedma Guiard C. Estévez Fraga J. Masjuan Vallejo 《Neurología (Barcelona, Spain)》2019,34(3):153-158
Introduction
Cervical artery dissection (CAD) is responsible for up to 20% of all ischaemic strokes in patients younger than 45. The benefits of acute-phase reperfusion therapy in these patients have yet to be confirmed.Methods
We conducted a retrospective review of patients with CAD admitted to a comprehensive stroke centre between 2010 and 2015. We recorded baseline clinical characteristics, treatments, functional outcomes, and mortality.Results
We identified 35 cases of CAD (23 carotid/12 vertebral); mean age was 43.5 ± 9.5 years and 67.7% were men. Ten patients (32.3%) had a history of trauma. The most frequent risk factors were arterial hypertension (29%) and smoking (35.5%). The most common clinical presentation was ischaemic stroke (29 patients, 93.5%). The median baseline National Institute of Health Stroke Scale score was 6 (range, 0-41). The most frequently used diagnostic method was CT angiography (74.2%), followed by MRI (64.5%) and digital subtraction angiography (45.6%). Seven patients (22.6%) were treated with intravenous fibrinolysis and 11 (35.5%) with endovascular treatment plus intravenous fibrinolysis; at 3 months, functional independence (modified Rankin Scale scores 0-2) was achieved by 57.1% and 63.6% of these cases, respectively. One patient died (3.2%).Conclusions
In our sample, the most common form of presentation of CAD was ischaemic stroke. Reperfusion therapy seems to be a safe and effective option for these patients, and outcomes resemble those of other patients with ischaemic stroke. Larger comparative studies are necessary to better assess response to reperfusion therapy in acute ischaemic stroke. 相似文献8.
C. Richomme 《Motricité Cérébrale》2019,40(1):6-10
Introduction
We measured the pain of children with disabilities before and after their physiotherapy session in a CAMSP. Then we identified all the elements related to the intervention of the therapist whose presence or not of stretching or load of the child during the sessions as well as external events likely to disturb the child.Materials and methods
This prospective observational prospective study of the tolerance of a treatment technique was conducted in 34 children aged zero to six years. The paired-series Student test was used for the main objective with a significance level of 0.05.Results
The children present a significant discomfort at the end of physiotherapy session. Stretching or loading is not a significant source of discomfort. The other identified causes could not be significantly demonstrated as uncomfortable. 相似文献9.
N. Kaboré G. Marnat F. Rouanet X. Barreau E. Verpillot P. Menegon I. Maachi J. Berge I. Sibon A. Bénard 《Revue neurologique》2019,175(4):252-260
Background and purpose
Recent studies demonstrated the benefit of mechanical thrombectomy (MT) plus intravenous tissue-type plasminogen activator (IV-tPA) (MT-IV-tPA) in acute ischemic stroke. This study aimed to estimate the cost-utility of MT-IV-tPA compared with IV-tPA alone from the perspective of the French National Health Insurance.Methods
We developed a decision tree for the first 3 months after stroke onset and a Markov model until 10 years post-stroke. The health states of the Markov model were according to the modified Rankin Scale (mRS): independent (mRS = 0-2), dependent (mRS = 3-5), dead (mRS = 6). Recurrent stroke was the fourth health stage of our model. We conducted systematic literature reviews and meta-analyses to estimate the cost and utility of each health state, and the transition probabilities between health states. A microcosting study was conducted to estimate the cost of MT. We estimated the incremental cost-effectiveness ratio of MT-IV-tPA and conducted a probabilistic analysis in order to estimate the probability that MT-IV-tPA is cost-effective compared to IV-tPA, the expected value of perfect information (EVPI), and the expected value of partial perfect information (EVPPI), given the uncertainty surrounding the value of our model's parameters.Results
The total mean (standard deviation (SD) cost of MT was €6708.9 (2357.0). The incremental cost-effectiveness ratio (ICER) of the strategy using IV-tPA combined to MT costs was €14,715 per QALY gained as compared to a strategy using IV-tPA alone. The probabilistic analysis showed that the probability of MT-IV-TPA being cost-effective was 85.4% at threshold willingness-to-pay of €30,000 per QALY gained, reaching 98% at €50,000 per QALY gained.Conclusion
Although there is no universally accepted willingness-to-pay threshold in France, our analysis suggest that MT combined to IV-tPA can be considered a cost-effective treatment compared with IV-tPA alone. 相似文献10.
Lakshmi Leishangthem Pooja SirDeshpande Dharti Dua Sudhakar R. Satti 《Journal of neuroradiology. Journal de neuroradiologie》2019,46(2):148-154
Background
Dural venous sinus stenting (DVSS) is an accepted treatment option in selected patients with medically refractory idiopathic intracranial hypertension and obstructive venous outflow physiology prior to cerebrospinal flow diversion (CSFD) surgery. There are no randomized controlled studies focusing on outcomes and complication rates for dural venous sinus stenting.Purpose
We present the largest comprehensive meta-analysis on DVSS for idiopathic intracranial hypertension (IIH) focusing on success rates, complications, and re-stenting rates to date. We also present a simplified approach to direct retrograde internal jugular vein (IJ) access for DVSS that allows for expedited procedures.Materials and methods
We performed a retrospective electronic PubMed query of all peer-reviewed articles in the last 15 years between 2003 to 2018. We included all patients who underwent dural venous sinus stenting for a medically refractive IIH and excluded articles without sufficient data on outcomes, complication rates and re-stenting rates. We also evaluated and compared outcomes in patients undergoing direct retrograde IJ access DVSS to traditional transfemoral vein access.Results
A total of 29 papers and 410 patients who underwent DVSS met criteria for inclusion. DVSS was associated with high technical success [99.5%], low rates of repeated procedure [10%], and low major complication rates [1.5%].Conclusion
Our retrospective comprehensive review of DVSS for medically refractory IIH suggests that stenting in appropriately chosen patients is associated with low complication rates, high technical success, and low repeat procedure rates. 相似文献11.
12.
Elif Bulut Abdulsamet Erden Omer Karadag Kader Karli Oguz Seza Ozen 《Journal of neuroradiology. Journal de neuroradiologie》2019,46(3):193-198
Purpose
To increase the knowledge of central nervous system (CNS) imaging features in deficiency of adenosine deaminase 2 (DADA2) by examining magnetic resonance imaging (MRI) studies of a relatively large number of patients.Methods
We retrospectively examined neuroimages of 12 patients (7 male, 5 female) diagnosed with DADA2. The mean age of the patients at the time of initial brain MRI was 16.7 ± 10.2 years. Seven patients (58.3%) fulfilled the classification criteria of polyarteritis nodosa. Brain MRI studies were assessed with respect to findings of ischemia, intracranial hemorrhages, focal parenchymal signal abnormalities, cerebral/cerebellar volume loss, and abnormal contrast enhancement. Angiographic studies of 7 patients were evaluated for the signs of vasculitis.Results
The most frequent finding was acute and/or chronic lacunar ischemic lesions in the brainstem and/or deep gray matter (n = 9, 75%). Six patients (50%) revealed MRI findings compatible with recurrent ischemic attacks. Small nodular contrast enhancement (n = 2, 16.6%), acute putaminal hemorrhage (n = 1, 8.3%) and findings compatible with posterior reversible encephalopathy syndrome (n = 1, 8.3%) were also detected. Slight-to-moderate diffuse cerebral and/or cerebellar volume loss (n = 7, 58.3%), decreased T1 signal of the bone marrow (n = 6, 50%) and optic atrophy (n = 1, 8.3%) were the other findings on brain MRI. The only abnormal angiographic finding was reduced caliber of the right distal posterior cerebral artery in MRA of a patient (14.6%).Conclusion
DADA2 should be included in the differential diagnosis of young patients presenting with ischemic and/or hemorrhagic lesions located in the brainstem and deep gray matter, especially if they have a family history or additional systemic abnormalities. 相似文献13.
Huipan Wu Xiaojian Yin Xiaojiang Chai Yuqiang Li Guodong Wang Xiaofang Yang Yi Sun Sien Ren Cunjian Bi Ming Li Yuan Liu 《Annales médico-psychologiques》2019,177(4):313-318
Objective
Explore the mental sub-health of Chinese Han adolescents with different nutritional statuses.Method
In all, 8457 Han adolescents were selected by random case method, and were conducted mental sub-health test by Multidimensional Sub-health Questionnaire of Adolescents (MSQA).Result
Detection rates of mental sub-health state among Chinese junior high school students with wasting, normal weight, overweight and obesity were 25.9%, 22.2%, 25.3% and 30.7%, and the detection rates of mental sub-health symptoms were 35.1%, 35.9%, 37.5% and 39.0% respectively. Detection rates of mental sub-health state among senior high school students were 20.5%, 17.7%, 22.8% and 21.8%, and the detection rates of mental sub-health symptoms were 34.7%, 31.4%, 31.1% and 42.3% respectively, and the comparison between different groups has statistical significance.Conclusion
Obesity group has the most obvious mental sub-health, and then the overweight, wasting and normal weight group in sequence. 相似文献14.
B. Fernández Rodríguez C. Simonet D.M. Cerdán N. Morollón P. Guerrero C. Tabernero J. Duarte 《Neurología (Barcelona, Spain)》2019,34(4):229-233
Introduction
The classic form of trigeminal neuralgia is usually sporadic (no familial clustering). However, around 2% of all cases of trigeminal neuralgia may be familial. Describing this entity may be useful for diagnosing this process and may also be key to determining the underlying causes of sporadic classical trigeminal neuralgia. We report on cases in a series of 5 families with at least 2 members with classic trigeminal neuralgia, amounting to a total of 11 cases.Material and methods
We recorded cases of familial classical trigeminal neuralgia between March 2014 and March 2015 by systematically interviewing all patients with a diagnosis of trigeminal neuralgia who visited the neurology department on an outpatient basis.Results
In our sample, most patients with familial classic trigeminal neuralgia were women. Mean age at onset was 62.9 ± 13.93 years, decreasing in subsequent generations. V2 was the most frequently affected branch. Most of our patients responded well to medical treatment, and surgery was not effective in all cases.Conclusions
These family clusters support the hypothesis that classic trigeminal neuralgia may have a genetic origin. Several causes have been suggested, including inherited anatomical changes affecting the base of the skull which would promote compression of the trigeminal nerve by vascular structures, familial AHT (resulting in tortuous vessels that would compress the trigeminal nerve), and mutations in the gene coding for calcium channels leading to hyperexcitability. Classic trigeminal neuralgia may be an autosomal dominant disorder displaying genetic anticipation. 相似文献15.
Sergio Nappini Nicola Limbucci Giuseppe Leone Andrea Rosi Leonardo Renieri Arturo Consoli Antonio Laiso Iacopo Valente Francesco Rosella Riccardo Rosati Salvatore Mangiafico 《Journal of neuroradiology. Journal de neuroradiologie》2019,46(2):141-147
Background
Recent trials established the efficacy of mechanical stent-retriever thrombectomy for treatment of stroke patients with large vessel occlusion (LVO) in the anterior circulation. However, stent-retriever thrombectomy may not accomplish successful recanalization in all patients. The aim of this study is to report the role of bail-out permanent stenting after failure of mechanical thrombectomy.Methods
Among 430 patients included in a prospectively maintained database, we analysed 325 cases of anterior circulation LVO. Mechanical thrombectomy (mTICI 2b-3) was effective in 213/325 (65%) and failed in 112/325 (35%). Bail-out intracranial stenting was performed in 17/325 (5.2%) patients. In all cases a fully retrievable detachable stent was used (Solitaire AB, Medtronic).Results
No intraprocedural technical complications occurred. Successful reperfusion (mTICI 2b/3) was achieved in 12/17 patients (70.6%). Three (17.6%) patients died: one extensive infarction in the internal carotid artery territory, one large intracerebral haemorrhage, and one massive pulmonary embolism. Haemorrhagic conversion, both symptomatic and asymptomatic, occurred in 2/17 (11.7%). Good clinical outcome (mRS 0–2) at 3-months was achieved in 41.2% of patients.Conclusion
Bail-out intracranial stenting after unsuccessful thrombectomy is technically feasible and the associated haemorrhagic risk seems acceptable in selected patients. We suggest that bail-out intracranial stenting, is safe and effective in selected patients with LVO stroke who failed to respond to thrombectomy. 相似文献16.
M. Mendibe Bilbao S. Boyero Durán J. Bárcena Llona A. Rodriguez-Antigüedad 《Neurología (Barcelona, Spain)》2019,34(4):259-269
Background
The course of multiple sclerosis (MS) is influenced by sex, pregnancy and hormonal factors.Aims
To analyse the influence of the above factors in order to clarify the aetiopathogenic mechanisms involved in the disease.Methods
We conducted a comprehensive review of scientific publications in the PubMed database using a keyword search for ‘multiple sclerosis’, ‘MS’, ‘EAE’, ‘pregnancy’, ‘hormonal factors’, ‘treatment’, and related terms. We reviewed the advances presented at the meeting held by the European Committee for Treatment and Research in Multiple Sclerosis (ECTRIMS) in March 2013 in London, as well as recommendations by international experts.Results and conclusions
We provide recommendations for counselling and treating women with MS prior to and during pregnancy and after delivery. Current findings on the effects of treatment on the mother, fetus, and newborn are also presented. We issue recommendations for future research in order to address knowledge gaps and clarify any inconsistencies in currently available data. 相似文献17.
Etienne Santos Sophie Broussy Emilie Lesaine Florence Saillour François Rouanet Patrick Dehail Pierre-Alain Joseph Florence Aly Igor Sibon Bertrand Glize 《Revue neurologique》2019,175(1-2):59-64
Background/Objective
General practitioners (GPs) are pivotal in the organization of the entire post-stroke management system. This study aimed to examine the sequelae of chronic post-stroke patients and to assess whether the medical follow-up organized by GPs is truly in accordance with current recommendations and patients’ clinical needs.Methods
This was an observational study including chronic post-stroke patients after a first stroke. Their post-stroke follow-ups (visits to GPs and specialist doctors) were compared with guidelines and with clinical needs as evaluated through a number of questionnaires.Results
Overall, 53.2% of patients visited a neurologist as recommended and, although 49.4% had neuropsychiatric consequences, only 6.3% visited a psychiatrist. Similarly, while 34.2% had significant post-stroke disability, only 6.3% saw a rehabilitation physician.Conclusion
Taking into account not only cardiovascular prevention, but all post-stroke consequences, medical follow-ups as organized by GPs were not in accordance with recommendations and failed to take advantage of the currently available multidisciplinary resources required to improve patients’ needs. 相似文献18.
J. Uthoff F.A. De Stefano K. Panzer B.W. Darbro T.S. Sato R. Khanna D.E. Quelle D.K. Meyerholz J. Weimer J.C. Sieren 《Journal of neuroradiology. Journal de neuroradiologie》2019,46(3):179-185
Background
This study explores whether objective, quantitative radiomic biomarkers derived from magnetic resonance (MR), positron emission tomography (PET), and computed tomography (CT) may be useful in reliably distinguishing malignant peripheral nerve sheath tumors (MPNST) from benign plexiform neurofibromas (PN).Methods
A registration and segmentation pipeline was established using a cohort of NF1 patients with histopathological diagnosis of PN or MPNST, and medical imaging of the PN including MR and PET-CT. The corrected MR datasets were registered to the corresponding PET-CT via landmark-based registration. PET standard-uptake value (SUV) thresholds were used to guide segmentation of volumes of interest: MPNST-associated PET-hot regions (SUV ≥ 3.5) and PN-associated PET-elevated regions (2.0 < SUV < 3.5). Quantitative imaging features were extracted from the MR, PET, and CT data and compared for statistical differences. Intensity histogram features included (mean, media, maximum, variance, full width at half maximum, entropy, kurtosis, and skewness), while image texture was quantified using Law's texture energy measures, grey-level co-occurrence matrices, and neighborhood grey-tone difference matrices.Results
For each of the 20 NF1 subjects, a total of 320 features were extracted from the image data. Feature reduction and statistical testing identified 9 independent radiomic biomarkers from the MR data (4 intensity and 5 texture) and 4 PET (2 intensity and 2 texture) were different between the PET-hot versus PET-elevated volumes of interest.Conclusions
Our data suggests imaging features can be used to distinguish malignancy in NF1-realted tumors, which could improve MPNST risk assessment and positively impact clinical management of NF1 patients. 相似文献19.
A. Olascoaga Arrate M.M. Freijo Guerrero C. Fernández Maiztegi I. Azkune Calle R. Silvariño Fernández M. Fernández Rodríguez P. Vazquez Naveira A. Anievas Elena I. Iturraspe González Y. Pérez Díez R. Ruiz Fernández 《Neurología (Barcelona, Spain)》2019,34(2):80-88
Introduction
According to numerous studies, using emergency medical services (EMS) to transport stroke patients to hospitals decreases diagnostic and treatment delays.Objectives
To determine the frequency of use of EMS by stroke patients in Bizkaia (Spain), analyse the factors associated with using EMS, and study the impact of EMS on time to care.Methods
We gathered data from 545 patients hospitalised for acute ischaemic stroke and recruited consecutively. Data were obtained from the patients’ medical histories and interviews with the patients themselves or their companions. We studied the following variables: previous health status, stroke symptoms and severity (NIHSS), type of transport, and time to medical care. Univariate and multivariate analyses were performed to identify factors associated with use of EMS and care delays.Results
Patients transported to hospital by the EMS accounted for 47.2% of the total. Greater stroke severity, arriving at the hospital at night, and poor functional status at baseline were found to be independently associated with use of EMS. Use of EMS was linked to earlier arrival at the hospital. Door-to-imaging times were shorter in the EMS group; however, this association disappeared after adjusting for stroke severity. Revascularisation was more frequent among patients transported by the EMS.Conclusions
EMS transport was associated with shorter prehospital delays. Effective health education programmes should be developed to promote EMS transport for patients with stroke symptoms. In-hospital stroke management should also be improved to reduce time to medical care. 相似文献20.
J.M. Viveros-Paredes R.E. Gonzalez-Castañeda A. Escalante-Castañeda A.R. Tejeda-Martínez F. Castañeda-Achutiguí M.E. Flores-Soto 《Neurología (Barcelona, Spain)》2019,34(3):143-152