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  • 1
    Online Resource
    Online Resource
    Magnetic resonance vessel wall imaging predicts morphological deterioration in unruptured intracranial artery dissection
    Elsevier BV ; 2020
    In:  Journal of Stroke and Cerebrovascular Diseases Vol. 29, No. 9 ( 2020-09), p. 105006-
    Details
    In: Journal of Stroke and Cerebrovascular Diseases, Elsevier BV, Vol. 29, No. 9 ( 2020-09), p. 105006-
    Type of Medium: Online Resource
    ISSN: 1052-3057
    URL: Article
    DOI: 10.1016/j.jstrokecerebrovasdis.2020.105006
    Language: English
    Publisher: Elsevier BV
    Publication Date: 2020
    detail.hit.zdb_id: 2052957-0
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  • 2
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    Focal Aneurysm Wall Enhancement in Vessel Wall Imaging as a Surrogate Marker for Predicting Aneurysm Instability
    Ovid Technologies (Wolters Kluwer Health) ; 2023
    In:  Stroke: Vascular and Interventional Neurology
    Details
    In: Stroke: Vascular and Interventional Neurology, Ovid Technologies (Wolters Kluwer Health)
    Abstract: The establishment of a risk stratification method for unruptured intracranial aneurysms (UIAs) remains an interdisciplinary challenge. The present study attempted to identify unstable UIAs using magnetic resonance vessel wall imaging in prospective data sets. Hemodynamic parameters in unstable UIAs were also examined to clarify the mechanisms by which segmented aneurysm wall enhancement (AWE) affects longitudinal morphological changes. METHODS Patients with UIAs who underwent contrast‐enhanced vessel wall imaging between 2017 and 2022 and were followed up for more than 6 months were included. Two readers independently rated AWE patterns (no, focal, and circumferential AWE) on vessel wall imaging and morphological changes on time‐of‐flight magnetic resonance angiography. Computational fluid dynamics studies were performed on unstable UIAs to evaluate the hemodynamic features of evolved or ruptured points in aneurysm walls. RESULTS Aneurysm growth was observed in 13 of 114 UIAs in the present study during a median follow‐up of 34 months. Of the 13 growing UIAs, their AWE patterns were as follows: no AWE in 6 and focal AWE (FAWE) in 7 UIAs. Univariable Cox regression analysis showed that aneurysm size and FAWE were associated with aneurysm growth. On multivariable Cox regression analysis, FAWE (hazard ratio, 4.59 [95% CI, 1.29–16.3]; P =0.019) was independently associated with aneurysm growth. Kaplan–Meier curve revealed significant differences between AWE patterns and UIA growth ( P 〈 0.001). Aneurysms ruptured in the 4 UIAs with FAWE during the follow‐up and all rupture points corresponded to nonenhanced lesions in aneurysm walls. Nonenhanced areas had higher wall shear stress than enhanced areas (1.59±1.02 versus 0.53±0.32; P =0.022). CONCLUSION FAWE may be associated with aneurysm growth and rupture during follow‐up. A comprehensive analysis of nonenhanced areas of UIAs with FAWE using vessel wall imaging and computational fluid dynamics provides insights into the mechanisms underlying aneurysm instability.
    Type of Medium: Online Resource
    ISSN: 2694-5746
    URL: Article
    DOI: 10.1161/SVIN.123.001029
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 2023
    detail.hit.zdb_id: 3144224-9
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  • 3
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    High signal intensity of the intraaneurysmal sac on T1 CUBE imaging as a predictor of aneurysm stability after coil embolization
    Journal of Neurosurgery Publishing Group (JNSPG) ; 2023
    In:  Journal of Neurosurgery ( 2023-07-01), p. 1-9
    Details
    In: Journal of Neurosurgery, Journal of Neurosurgery Publishing Group (JNSPG), ( 2023-07-01), p. 1-9
    Abstract: Histopathological studies of aneurysms after coil embolization showed that thrombus formation during the first month after endovascular treatment (EVT) played an important role in the healing process. The authors hypothesized that dedicated T1-weighted imaging may be used to predict stable aneurysms by visualizing the thrombus status within coil-treated aneurysms. Therefore, this study investigated the relationship between the signal intensity (SI) of the intraaneurysmal sac after coil embolization and aneurysm stability. METHODS The study population included 82 patients with 86 aneurysms who underwent T1-weighted 3D black-blood fast spin-echo (T1 CUBE) imaging within 1 month after coil embolization between 2019 and 2022. The relative SI of a coil-treated aneurysm (RSI coiled ) was calculated as follows: the mean SI of the intraaneurysmal sac/the mean SI of the genu of the corpus callosum. Aneurysms with enlarged remnants on MR angiography (MRA) within 6 months after EVT were defined as recurrence, while a decrease of intraaneurysmal flow on MRA was defined as improved embolization status. Stable aneurysms were defined as improvement or no change in embolization status 6 months after coil embolization. The volume embolization ratio (VER) was calculated as the ratio of the packed coil volume to the aneurysm volume. Differences between stable and recurrent aneurysms were examined. All aneurysms were divided into high and low RSI coiled groups based on the cutoff value of RSI coiled , and differences between the two groups were also evaluated. RESULTS Recurrence was confirmed for 26 of 86 aneurysms. A univariable analysis showed that small aneurysms, high VER, and high RSI coiled were associated with aneurysm stability. In the receiver operating characteristic curve analysis, the optimal cutoff value for RSI coiled to differentiate stable from recurrent aneurysms was 0.54. The cutoff value for RSI coiled was selected as 0.50 (sensitivity 0.77, specificity 0.70) because it was half the value of the SI of the corpus callosum and close to the optimal cutoff value. In a multivariable analysis, RSI coiled 〉 0.50 (OR 8.1, 95% CI 2.5–27) remained a significant factor for aneurysm stability. The high RSI coiled group showed a higher rate of an improved embolization status (26% vs 6.1%, p = 0.022) and stable aneurysms (85% vs 15%, p = 0.0002). CONCLUSIONS RSI coiled was associated with postcoiling aneurysm stability. High RSI coiled might imply intraaneurysmal thrombus formation associated with the healing process of coil-treated aneurysms.
    Type of Medium: Online Resource
    ISSN: 0022-3085 , 1933-0693
    URL: Article
    DOI: 10.3171/2023.5.JNS23616
    RVK:
    XA 10000
    RVK:
    XA 55270
    Language: Unknown
    Publisher: Journal of Neurosurgery Publishing Group (JNSPG)
    Publication Date: 2023
    detail.hit.zdb_id: 2026156-1
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  • 4
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    Focal Aneurysm Wall Enhancement on Magnetic Resonance Imaging Indicates Intraluminal Thrombus and the Rupture Point
    Elsevier BV ; 2019
    In:  World Neurosurgery Vol. 127 ( 2019-07), p. e578-e584
    Details
    In: World Neurosurgery, Elsevier BV, Vol. 127 ( 2019-07), p. e578-e584
    Type of Medium: Online Resource
    ISSN: 1878-8750
    URL: Article
    DOI: 10.1016/j.wneu.2019.03.209
    Language: English
    Publisher: Elsevier BV
    Publication Date: 2019
    detail.hit.zdb_id: 2530041-6
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  • 5
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    Abstract 44: Histopathological Interpretation of Vessel Wall Imaging of Intracranial Aneurysms
    Ovid Technologies (Wolters Kluwer Health) ; 2019
    In:  Stroke Vol. 50, No. Suppl_1 ( 2019-02)
    Details
    In: Stroke, Ovid Technologies (Wolters Kluwer Health), Vol. 50, No. Suppl_1 ( 2019-02)
    Abstract: Background and purpose: It remains a challenge to predict unruptured intracranial aneurysms (UIAs) that are prone to rupture. MR- Vessel wall imaging (VWI) is a current topic whether it could predict unstable aneurysms. We investigated the correlations between aneurysm wall imaging findings and aneurysmal risk factors with a focus on the histopathological vessel wall architecture to clarify the interpretation of VWI of intracranial aneurysms. Methods: A total of 117 intracranial aneurysms, including 21 ruptured and 96 UIAs were investigated by VWI and visualization of the aneurysm wall enhancement (AWE) was evaluated. Univariate analysis was performed to assess the correlation between VWI findings and the PHASES score (calculating patient demographic and aneurysm morphologic risk factors). Fifteen intracranial aneurysms, including 6 ruptured and 9 UIAs were available for histopathological examination. Results: In UIAs, AWE was identified in 30 of 96 UIAs (31%). The PHASES score was associated with AWE (9.1 ± 0.7 versus 6.0 ± 0.3, p= 0.001). Histopathological studies revealed that wall thickening accompanied by atherosclerosis, neovascularization, and macrophage infiltration corresponded to AWE. The thicken wall was characterized by loss of mural cells and mucinous degeneration as well. On contrary, AWE was identified in 17 of 21 ruptured aneurysms (81%). Three AWE patterns (focal, circumferential, and both) were identified in ruptured ones. Histopathological studies revealed that focal AWE was associated with very thin aneurysm wall and fresh intraluminal thrombus at the rupture site, whereas circumferential AWE suggested wall thickening with abundant neovascularization and inflammatory cells. Conclusions: In the present study, one-third of UIAs showed AWE and might not provide informative rupture risk estimation beyond PHASES score at this moment. However, VWI of intracranial aneurysms can detect what is going on in the aneurysm wall. Histopathological interpretation of VWI in ruptured aneurysms differed from that of UIAs, especially in focal AWE. Focal AWE could identify the intraluminal thrombus suggesting rupture site of the wall before treatments.
    Type of Medium: Online Resource
    ISSN: 0039-2499 , 1524-4628
    URL: Article
    DOI: 10.1161/str.50.suppl_1.44
    RVK:
    XA 10000
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 2019
    detail.hit.zdb_id: 1467823-8
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  • 6
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    Vessel Wall Imaging Predicts the Presence of Atherosclerotic Lesions in Unruptured Intracranial Aneurysms
    Elsevier BV ; 2019
    In:  World Neurosurgery Vol. 132 ( 2019-12), p. e775-e782
    Details
    In: World Neurosurgery, Elsevier BV, Vol. 132 ( 2019-12), p. e775-e782
    Type of Medium: Online Resource
    ISSN: 1878-8750
    URL: Article
    DOI: 10.1016/j.wneu.2019.08.019
    Language: English
    Publisher: Elsevier BV
    Publication Date: 2019
    detail.hit.zdb_id: 2530041-6
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  • 7
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    Segmentation of aneurysm wall enhancement in evolving unruptured intracranial aneurysms
    Journal of Neurosurgery Publishing Group (JNSPG) ; 2021
    In:  Journal of Neurosurgery ( 2021-08), p. 1-7
    Details
    In: Journal of Neurosurgery, Journal of Neurosurgery Publishing Group (JNSPG), ( 2021-08), p. 1-7
    Abstract: Morphological changes in unruptured intracranial aneurysms (UIAs) are an imaging marker of aneurysm instability. Recent studies have indicated the ability of MR vessel wall imaging (VWI) to stratify unstable UIAs based on a correlation with histopathological aneurysm wall inflammation. In the present study the authors investigated the relationships between aneurysm growth patterns and the segmentation of aneurysm wall enhancement (AWE) in VWI. METHODS A total of 120 aneurysms with serial angiography from a follow-up period of at least 2 years (mean 65 months, range 24–215 months) were assessed by VWI. Two readers independently evaluated the patterns of morphological changes (stable, whole sac expansion, and secondary aneurysm formation) and the segmentation of AWE (no, focal, and circumferential AWE). The contrast enhancement ratio of the aneurysm wall versus the pituitary stalk (CR stalk ) was calculated for the quantitative assessment of AWE. Statistical analyses were performed to investigate the relationships between AWE patterns and patient baseline profiles, aneurysm characteristics, and morphological modifications. RESULTS Forty-one of 120 UIAs (34%) exhibited aneurysm growth (whole sac expansion in 19 and secondary aneurysm formation in 22). AWE was detected in 35 of 120 UIAs (focal AWE in 25 and circumferential AWE in 10). The maximum diameter of, irregularities in, and morphological modifications in aneurysms were associated with the segmentation of AWE. Focal AWE correlated with secondary aneurysm formation, and circumferential AWE correlated with whole sac expansion. In focal AWE, CR stalk was significantly higher in secondary aneurysm formation than in stable UIAs. UIAs without AWE (categorized as no AWE) correlated with aneurysm stability. CONCLUSIONS The segmentation of AWE was associated with aneurysm growth scenarios and may provide a novel insight into the evaluation of unstable UIAs.
    Type of Medium: Online Resource
    ISSN: 0022-3085 , 1933-0693
    URL: Article
    DOI: 10.3171/2021.2.JNS2114
    RVK:
    XA 10000
    RVK:
    XA 55270
    Language: Unknown
    Publisher: Journal of Neurosurgery Publishing Group (JNSPG)
    Publication Date: 2021
    detail.hit.zdb_id: 2026156-1
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  • 8
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    Online Resource
    Vessel Wall Imaging of Evolving Unruptured Intracranial Aneurysms
    Ovid Technologies (Wolters Kluwer Health) ; 2019
    In:  Stroke Vol. 50, No. 7 ( 2019-07), p. 1891-1894
    Details
    In: Stroke, Ovid Technologies (Wolters Kluwer Health), Vol. 50, No. 7 ( 2019-07), p. 1891-1894
    Abstract: Unruptured intracranial aneurysms (UIAs) have various scenarios of growth and rupture. Magnetic resonance vessel wall imaging can detect aneurysmal wall thickening with inflammation and neovascularization. This study was performed to explore the vessel wall imaging findings of UIAs with consecutive follow-up. Methods— A total of 60 aneurysms with serial angiography over 2 years (mean period, 49 months, range, 24–192 months) were evaluated by vessel wall imaging. UIAs were morphologically categorized into 3 patterns: stable, whole sac expansion, or daughter sac formation. Aneurysm wall enhancement (AWE) was evaluated after administration of gadolinium. Results— Thirty-three of the 60 UIAs (55%) demonstrated no morphological changes, whereas 16 UIAS (27%) showed whole sac expansion and 11 UIAs (18%) demonstrated daughter sac formation. AWE was significantly less frequent in stable UIAs compared with UIAs showing morphological changes ( P 〈 0.01). Aneurysms with daughter sac formation showed a significantly higher frequency of AWE than those demonstrating whole sac expansion. In the majority of UIAs with daughter sac formation, AWE was detected in the main aneurysm and not in the developing component. Conclusions— UIAs demonstrate various modes of growth. The pattern of AWE might be useful for identifying unfavorable morphological changes of UIAs.
    Type of Medium: Online Resource
    ISSN: 0039-2499 , 1524-4628
    URL: Article
    DOI: 10.1161/STROKEAHA.119.025245
    RVK:
    XA 10000
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 2019
    detail.hit.zdb_id: 1467823-8
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  • 9
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    Online Resource
    Polyclonal Proliferation of Lymphocytes Containing the Epstein-Barr Virus Genome in a Patient Dying of Myocarditis in Chronic Active Epstein-Barr Virus Infection
    Ovid Technologies (Wolters Kluwer Health) ; 2003
    In:  Journal of Pediatric Hematology/Oncology Vol. 25, No. 1 ( 2003-01), p. 85-88
    Details
    In: Journal of Pediatric Hematology/Oncology, Ovid Technologies (Wolters Kluwer Health), Vol. 25, No. 1 ( 2003-01), p. 85-88
    Type of Medium: Online Resource
    ISSN: 1077-4114
    URL: Article
    DOI: 10.1097/00043426-200301000-00018
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 2003
    detail.hit.zdb_id: 2047125-7
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  • 10
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    Online Resource
    Clinicopathological Insights From Vessel Wall Imaging of Unruptured Intracranial Aneurysms
    Ovid Technologies (Wolters Kluwer Health) ; 2018
    In:  Stroke Vol. 49, No. 10 ( 2018-10), p. 2516-2519
    Details
    In: Stroke, Ovid Technologies (Wolters Kluwer Health), Vol. 49, No. 10 ( 2018-10), p. 2516-2519
    Abstract: The clinical significance of vessel wall imaging (VWI) remains unclear in patients with unruptured intracranial aneurysms. This study was performed to investigate the correlations between aneurysm wall imaging findings and histopathologic aneurysm wall architectures. Methods— A total of 9 aneurysms was evaluated by VWI and subsequently characterized with histopathology. We used VWI to visualize the aneurysm wall and determine if there was aneurysm wall enhancement after gadolinium contrast administration. Results— Aneurysm wall structures were identified in 6 of 9 unruptured intracranial aneurysms by native VWI, and wall enhancement was identified in 5 of these 6 aneurysms. Histopathologic studies revealed that wall thickening accompanied by atherosclerosis, neovascularization, and macrophage infiltration corresponded to visualization of the aneurysm wall by native VWI and to aneurysm wall enhancement. Conclusions— VWI can visualize thickening of the aneurysm wall, and wall enhancement corresponded to histologically confirmed degenerative changes accompanied by neovascularization and prominent macrophage infiltration.
    Type of Medium: Online Resource
    ISSN: 0039-2499 , 1524-4628
    URL: Article
    DOI: 10.1161/STROKEAHA.118.021819
    RVK:
    XA 10000
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 2018
    detail.hit.zdb_id: 1467823-8
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