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Magon Stefano Tsagkas Charidimos Gaetano Laura Patel Raihaan Naegelin Yvonne Amann Michael Parmar Katrin Papadopoulou Athina Wuerfel Jens Stippich Christoph Kappos Ludwig Chakravarty M. Mallar Sprenger Till 《Journal of neurology》2020,267(5):1536-1546
Journal of Neurology - Volume loss in the deep gray matter (DGM) has been reported in patients with multiple sclerosis (MS) already at early stages of the disease and is thought to progress... 相似文献
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Aikaterini Mastoraki Felicia Toska Ioannis Tsiverdis Maria Kyriazi Athanasios Tsagkas Nikolaos Danias Vasilios Smyrniotis Nikolaos Arkadopoulos 《Journal of gastrointestinal cancer》2013,44(4):371-374
Introduction
Schwannomas are rare tumors arising from Schwan cells of the peripheral nerve sheath. The majority of the cases are sporadic and familial clustering is often observed in association with von Rechlinghausen’s disease. Cases of intrasacral (osseous) and spinal tumors have also been described. Histologically, schwannomas are distinguished by the presence of areas of high and low cellularity called Antoni A and B tissue, respectively.Clinical Presentation
Clinical features are highly non-specific and depend on the location and size of the lesion, with abdominal pain and neurological deficit being the most common abnormalities. Radiological studies are fundamental in the diagnostic evaluation of RSs.Therapeutic Management
Despite recent research on the therapeutic strategies against RS, surgical resection appears the only potentially curative approach. Unfortunately, a mere minority of patients is eligible to undergo surgical intervention. In addition, surgical removal of RS does not necessarily guarantee patient’s long-term survival. Laparoscopic approach and enucleation of the tumor have been suggested as well. Alternative therapies, such as radio- and chemotherapy often proved insufficient. The aim of this review was to evaluate the results of surgical treatment for RS with special reference to the extent of its histological spread and to analyze the recent literature in order to provide an update on the current concepts of therapeutic management of this entity. 相似文献3.
Zuber Priska Tsagkas Charidimos Papadopoulou Athina Gaetano Laura Huerbin Manuel Geiter Emanuel Altermatt Anna Parmar Katrin Ettlin Thierry Schuster-Amft Corina Suica Zorica Alrasheed Hala Wuerfel Jens Kesselring Jürg Kappos Ludwig Sprenger Till Magon Stefano 《Journal of neurology》2020,267(6):1744-1753
Journal of Neurology - Although multidisciplinary rehabilitation programs are commonly used in clinical practice for patients with multiple sclerosis (MS), they are currently underexamined. This... 相似文献
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Charidimos Tsagkas Katrin Parmar Simon Pezold Christian Barro Mallar M. Chakravarty Laura Gaetano Yvonne Naegelin Michael Amann Athina Papadopoulou Jens Wuerfel Ludwig Kappos Jens Kuhle Till Sprenger Cristina Granziera Stefano Magon 《Human brain mapping》2021,42(8):2399
There is evidence that multiple sclerosis (MS) pathology leads to distinct patterns of volume loss over time (VLOT) in different central nervous system (CNS) structures. We aimed to use such patterns to identify patient subgroups. MS patients of all classical disease phenotypes underwent annual clinical, blood, and MRI examinations over 6 years. Spinal, striatal, pallidal, thalamic, cortical, white matter, and T2‐weighted lesion volumes as well as serum neurofilament light chain (sNfL) were quantified. CNS VLOT patterns were identified using principal component analysis and patients were classified using hierarchical cluster analysis. 225 MS patients were classified into four distinct Groups A, B, C, and D including 14, 59, 141, and 11 patients, respectively). These groups did not differ in baseline demographics, disease duration, disease phenotype distribution, and lesion‐load expansion. Interestingly, Group A showed pronounced spinothalamic VLOT, Group B marked pallidal VLOT, Group C small between‐structure VLOT differences, and Group D myelocortical volume increase and pronounced white matter VLOT. Neurologic deficits were more severe and progressed faster in Group A that also had higher mean sNfL levels than all other groups. Group B experienced more frequent relapses than Group C. In conclusion, there are distinct patterns of VLOT across the CNS in MS patients, which do not overlap with clinical MS subtypes and are independent of disease duration and lesion‐load but are partially associated to sNfL levels, relapse rates, and clinical worsening. Our findings support the need for a more biologic classification of MS subtypes including volumetric and body‐fluid markers. 相似文献
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Charidimos?Tsagkas Anna?Altermatt Ulrike?Bonati Simon?Pezold Julia?Reinhard Michael?Amann Philippe?Cattin Jens?Wuerfel Dirk?Fischer Katrin?ParmarEmail author Arne?Fischmann 《European radiology》2018,28(11):4488-4495
Objective
To validate the precision and accuracy of the semi-automated cord image analyser (Cordial) for lumbar spinal cord (SC) volumetry in 3D T1w MRI data of healthy controls (HC).Materials and methods
40 3D T1w images of 10 HC (w/m: 6/4; age range: 18–41 years) were acquired at one 3T-scanner in two MRI sessions (time interval 14.9±6.1 days). Each subject was scanned twice per session, allowing determination of test-retest reliability both in back-to-back (intra-session) and scan-rescan images (inter-session). Cordial was applied for lumbar cord segmentation twice per image by two raters, allowing for assessment of intra- and inter-rater reliability, and compared to a manual gold standard.Results
While manually segmented volumes were larger (mean: 2028±245 mm3 vs. Cordial: 1636±300 mm3, p<0.001), accuracy assessments between manually and semi-automatically segmented images showed a mean Dice-coefficient of 0.88±0.05. Calculation of within-subject coefficients of variation (COV) demonstrated high intra-session (1.22–1.86%), inter-session (1.26–1.84%), as well as intra-rater (1.73–1.83%) reproducibility. No significant difference was shown between intra- and inter-session reproducibility or between intra-rater reliabilities. Although inter-rater reproducibility (COV: 2.87%) was slightly lower compared to all other reproducibility measures, between rater consistency was very strong (intraclass correlation coefficient: 0.974).Conclusion
While under-estimating the lumbar SCV, Cordial still provides excellent inter- and intra-session reproducibility showing high potential for application in longitudinal trials.Key Points
? Lumbar spinal cord segmentation using the semi-automated cord image analyser (Cordial) is feasible.? Lumbar spinal cord is 40-mm cord segment 60 mm above conus medullaris.? Cordial provides excellent inter- and intra-session reproducibility in lumbar spinal cord region.? Cordial shows high potential for application in longitudinal trials.6.
Charidimos Tsagkas M. Mallar Chakravarty Laura Gaetano Yvonne Naegelin Michael Amann Katrin Parmar Athina Papadopoulou Jens Wuerfel Ludwig Kappos Till Sprenger Stefano Magon 《Human brain mapping》2020,41(8):2198-2215
In multiple sclerosis (MS), cortical atrophy is correlated with clinical and neuropsychological measures. We aimed to examine the differences in the temporospatial evolution of cortical thickness (CTh) between MS‐subtypes and to study the association of CTh with T2‐weighted white matter lesions (T2LV) and clinical progression. Two hundred and forty‐three MS patients (180 relapsing–remitting [RRMS], 51 secondary‐progressive [SPMS], and 12 primary‐progressive [PPMS]) underwent annual clinical (incl. expanded disability status scale [EDSS]) and MRI‐examinations over 6 years. T2LV and CTh were measured. CTh did not differ between MS‐subgroups. Higher total T2LV was associated with extended bilateral CTh‐reduction on average, but did not correlate with CTh‐changes over time. In RRMS, CTh‐ and EDSS‐changes over time were negatively correlated in large bilateral prefrontal, frontal, parietal, temporal, and occipital areas. In SPMS, CTh was not associated with the EDSS. In PPMS, CTh‐ and EDSS‐changes over time were correlated in small clusters predominantly in left parietal areas. Increase of brain lesion load does not lead to an immediate CTh‐reduction. Although CTh did not differ between MS‐subtypes, a dissociation in the correlation between CTh‐ and EDSS‐changes over time between RRMS and progressive‐MS was shown, possibly underlining the contribution of subcortical pathology to clinical progression in progressive‐MS. 相似文献
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