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https://www.readbyqxmd.com/read/29689135/intravenous-thrombolysis-in-unwitnessed-stroke-onset-mr-witness-trial-results
#1
Lee H Schwamm, Ona Wu, Shlee S Song, Lawrence L Latour, Andria L Ford, Amie W Hsia, Alona Muzikansky, Rebecca A Betensky, Albert J Yoo, Michael H Lev, Gregoire Boulouis, Arne Lauer, Pedro Cougo, William A Copen, Gordon J Harris, Steven Warach
OBJECTIVE: Most acute ischemic stroke (AIS) patients with unwitnessed symptom onset are ineligible for intravenous thrombolysis due to timing alone. Lesion evolution on FLAIR MRI correlates with stroke duration, and quantitative mismatch of diffusion-weighted MRI (DWI) with FLAIR (qDFM) might indicate stroke duration within guideline-recommended thrombolysis. We tested if intravenous thrombolysis ≤4.5 h from time of symptom discovery is safe in patients with qDFM in an open-label, phase 2a, prospective study (NCT01282242)...
April 24, 2018: Annals of Neurology
https://www.readbyqxmd.com/read/29688161/brain-injured-survivors-of-monochorionic-twin-pregnancies-complicated-by-single-intrauterine-death-mr-findings-in-a-multicenter-study
#2
Giorgio Conte, Andrea Righini, Paul D Griffiths, Mariangela Rustico, Mariano Lanna, Fiona L Mackie, Lorenzo Pinelli, Federico Prefumo, Nicola Persico, Mark S Igra, Cecilia Parazzini, Chiara Doneda, Anna Fichera, Claudia Ambrosi, Mark Kilby, Mariasavina Severino, Fabio Triulzi, Andrea Rossi, Nicholas Skipper
Purpose To describe and classify the range of brain injuries present at prenatal, in-utero magnetic resonance (MR) imaging in co-twin survivors of monochorionic (MC) twin pregnancies complicated by single intrauterine death (SIUD). Materials and Methods This retrospective, observational study from six tertiary fetal medicine centers that perform tertiary-level prenatal in-utero MR studies reviewed cases in which prenatal in-utero MR imaging had shown a brain injury in a surviving co-twin of a twin pregnancy with a MC component complicated by SIUD...
April 24, 2018: Radiology
https://www.readbyqxmd.com/read/29687703/surgical-myocardial-revascularization-in-patients-with-reduced-systolic-left-ventricular-function
#3
Piergiorgio Bruno, Mauro Iafrancesco, Massimo Massetti
Surgical myocardial revascularization in patients with reduced left ventricular function has been a matter of debate for decades. Recently published 10-years extension follow-up of the STICH trial have conclusively demonstrated benefit of surgical myocardial revascularization in patients with significant coronary artery disease and low left ventricular ejection fraction. However, selection of patients for surgery remains challenging as well as decision to perform percutaneous rather than surgical revascularization in this class of patients...
April 20, 2018: Minerva Cardioangiologica
https://www.readbyqxmd.com/read/29685534/three-dimensional-black-blood-contrast-enhanced-magnetic-resonance-imaging-in-patients-with-acute-ischemic-stroke-and-negative-susceptibility-vessel-sign
#4
Sung Hyun Baik, Hyo Sung Kwak, Seung Bae Hwang, Gyung Ho Chung
PURPOSE: The purpose of this study was to evaluate the enhancement patterns of three-dimensional (3D) black blood (BB) contrast enhanced magnetic resonance (MR) imaging in acute stroke patients with negative susceptibility vessel sign (SVS). MATERIALS AND METHODS: From January 2014 to August 2016 we retrospectively reviewed MR imaging and MR angiography findings of patients who presented with acute stroke symptoms of less than 24 h duration. For the 394 patients enrolled, we assessed the frequency of patients who exhibited negative SVS on susceptibility weighted MR imaging (SWI) and positive enhancement in 3D BB contrast enhanced MR imaging...
May 2018: European Journal of Radiology
https://www.readbyqxmd.com/read/29674417/value-of-quantitative-collateral-scoring-on-ct-angiography-in-patients-with-acute-ischemic-stroke
#5
A M M Boers, R Sales Barros, I G H Jansen, O A Berkhemer, L F M Beenen, B K Menon, D W J Dippel, A van der Lugt, W H van Zwam, Y B W E M Roos, R J van Oostenbrugge, C H Slump, C B L M Majoie, H A Marquering
BACKGROUND AND PURPOSE: Many studies have emphasized the relevance of collateral flow in patients presenting with acute ischemic stroke. Our aim was to evaluate the relationship of the quantitative collateral score on baseline CTA with the outcome of patients with acute ischemic stroke and test whether the timing of the CTA acquisition influences this relationship. MATERIALS AND METHODS: From the Multicenter Randomized Clinical Trial of Endovascular Treatment of Acute Ischemic Stroke in the Netherlands (MR CLEAN) data base, all baseline thin-slice CTA images of patients with acute ischemic stroke with intracranial large-vessel occlusion were retrospectively collected...
April 19, 2018: AJNR. American Journal of Neuroradiology
https://www.readbyqxmd.com/read/29665290/timely-visualization-of-the-collaterals-formed-during-acute-ischemic-stroke-with-fe-3-o-4-nanoparticle-based-mr-imaging-probe
#6
Ting Wang, Yi Hou, Bo Bu, Wenxin Wang, Tiancong Ma, Chunyan Liu, Lan Lin, Lin Ma, Xin Lou, Mingyuan Gao
Ischemic stroke is one of the major leading causes for long-term disability and mortality. Collateral vessels provide an alternative pathway to protect the brain against ischemic injury after arterial occlusion. Aiming at visualizing the collaterals occurring during acute ischemic stroke, an integrin αv β3 -specific Fe3 O4 -Arg-Gly-Asp (RGD) nanoprobe is prepared for magnetic resonance imaging (MRI) of the collaterals. Rat models are constructed by occluding the middle cerebral artery for imaging studies of cerebral ischemia and ischemia-reperfusion on 7...
April 17, 2018: Small
https://www.readbyqxmd.com/read/29663187/mri-patient-selection-for-endovascular-thrombectomy-in-acute-ischemic-stroke-correlation-between-pretreatment-diffusion-weighted-imaging-and-outcome-scores
#7
Marcello Longo, Gianmarco Bernava, Alessandro Calamuneri, Antonio A Caragliano, Antonio Pitrone, Rosario Papa, Enricomaria Mormina, Francesca Granata, Rosa Musolino, Agostino Tessitore, Giuseppe Centorrino, Federico Midiri, Federica Vernuccio, Sergio L Vinci
INTRODUCTION: Eligibility for endovascular treatment (EVT) in patients with acute ischemic stroke (AIS) depends, amongst other factors, on CT- or MR-based scores. The aim of this study was to investigate the role of Alberta Stroke Program Early CT score based on diffusion weighted imaging (MR-ASPECT) in the assessment of brain damage pre-EVT, patient selection for EVT and outcome. MATERIALS AND METHODS: We included in this study patients with National Institute of Health stroke score (NIHSS) at admission ≥ 8, MR-ASPECT ≥ 5 and anterior AIS, who were treated with EVT in our hospital...
April 16, 2018: La Radiologia Medica
https://www.readbyqxmd.com/read/29652306/-assessment-of-clinical-manifestations-and-treatment-of-post-stroke-depression-in-young-patients-with-ischemic-stroke
#8
M L Chukhlovina, A A Chukhlovin
AIM: To consider clinical manifestations and treatment of post-stroke depression in young patients with carotid ischemic stroke. MATERIAL AND METHODS: Forty patients, 24 women and 16 men, aged from 18 to 45 years old, diagnosed with ICD-10 post-stroke depression were examined. All patients underwent neurological examination, brain MRI and MR-angiography of cerebral vessels. The following psychometric tests were used: MMSE, Hamilton depression scale, CES-D depression scale, a questionnaire on nocturnal sleep assessment, and Epworth Sleepiness Scale...
2018: Zhurnal Nevrologii i Psikhiatrii Imeni S.S. Korsakova
https://www.readbyqxmd.com/read/29643681/mismatch-in-brain-perfusion-and-metabolism-detected-with-99m-tc-hexamethyl-propylene-amine-oxime-single-photon-emission-computed-tomography-and-18-f-fluorodeoxyglucose-positron-emission-tomography-in-moyamoya-disease
#9
Justo Serrano Vicente, Luis Fernández Prudencio, José Rafael Infante Torre, Juan Ignacio Rayo Madrid
We report a 47-year-old woman who developed an ischemic stroke with diplopia and dysarthria. Emergency computed tomography (CT) showed no pathological findings, and magnetic resonance (MR) showed mild ischemic-degenerative lesions. MR angiography and angiogram showed severe stenosis of both internal carotid and main intracranial arteries with plenty collateral vessels with "puff of smoke" suggesting a moyamoya disease (MMD). Brain perfusion single-photon emission CT showed global diminished perfusion in the brain lobes and a marked relative hyperperfusion in the cerebellum...
April 2018: Indian Journal of Nuclear Medicine: IJNM: the Official Journal of the Society of Nuclear Medicine, India
https://www.readbyqxmd.com/read/29628944/is-the-efficacy-of-endovascular-treatment-for-acute-ischemic-stroke-sex-related
#10
Andreia Carvalho, André Cunha, Tiago Gregório, Ludovina Paredes, Henrique Costa, Miguel Veloso, Sérgio Castro, Manuel Ribeiro, Pedro Jorge Gonçalves Barros
Background: Several reports refer to differences in stroke between females and males, namely in incidence and clinical outcome, but also in response to treatments. Driven by a recent analysis of the MR CLEAN trial, which showed a higher benefit from acute stroke endovascular treatment (EVT) in males, we intended to determine if clinical outcomes after EVT differ between sexes, in a real-world setting. Methods: We analyzed 145 consecutive patients submitted to EVT for anterior circulation large-vessel occlusion, between January 2015 and September 2016, and compared the outcomes between sexes...
February 2018: Interventional Neurology
https://www.readbyqxmd.com/read/29626079/acute-versus-chronic-ischemic-mitral-regurgitation-an-echocardiographic-study-of-anatomy-and-physiology
#11
Shun Nishino, Nozomi Watanabe, Toshiyuki Kimura, Nehiro Kuriyama, Yoshisato Shibata
BACKGROUND: Little is known on the mechanism of acute ischemic mitral regurgitation (IMR) caused by sudden-onset left ventricular dysfunction in acute myocardial infarction (MI). We sought to investigate the mitral valve (MV) complex geometry in acute IMR in comparison with chronic IMR by 2-dimensional and 3-dimensional transthoracic echocardiography. METHODS AND RESULTS: Forty-four first-onset acute MI and 36 previous MI with ≥moderate IMR were examined by 2-dimensional/3-dimensional transthoracic echocardiography...
April 2018: Circulation. Cardiovascular Imaging
https://www.readbyqxmd.com/read/29622556/accuracy-of-ct-angiography-for-differentiating-pseudo-occlusion-from-true-occlusion-or-high-grade-stenosis-of-the-extracranial-ica-in-acute-ischemic-stroke-a-retrospective-mr-clean-substudy
#12
M Kappelhof, H A Marquering, O A Berkhemer, J Borst, A van der Lugt, W H van Zwam, J A Vos, G Lycklama À Nijeholt, C B L M Majoie, B J Emmer
BACKGROUND AND PURPOSE: The absence of opacification on CTA in the extracranial ICA in acute ischemic stroke may be caused by atherosclerotic occlusion, dissection, or pseudo-occlusion. The latter is explained by sluggish or stagnant flow in a patent artery caused by a distal intracranial occlusion. This study aimed to explore the accuracy of CTA for differentiating pseudo-occlusion from true occlusion of the extracranial ICA. MATERIALS AND METHODS: All patients from the Multicenter Randomized Clinical Trial of Endovascular Treatment for Acute Ischemic Stroke in the Netherlands (MR CLEAN) with an apparent ICA occlusion on CTA and available DSA images were included...
April 5, 2018: AJNR. American Journal of Neuroradiology
https://www.readbyqxmd.com/read/29622554/slow-collateral-flow-is-associated-with-thrombus-extension-in-patients-with-acute-large-artery-occlusion
#13
R Zhang, Y Zhou, S Yan, S Zhang, X Ding, M Lou
BACKGROUND AND PURPOSE: It is still poorly understood about the dynamic changes of the thrombus after intravenous thrombolysis and how the remaining thrombus affects clinical outcome in human stroke. Collateral flow was assumed to help to deliver endo/exogenous tissue-type plasminogen activator to the clot. We aimed to analyze the impact of collateral flow on the dynamic changes of the thrombus in patients with acute large-artery occlusion who received intravenous thrombolysis. MATERIALS AND METHODS: We reviewed consecutive patients with acute ischemic stroke with M1 segment or distal internal carotid artery occlusion who underwent multimodal MR imaging or CT perfusion before and 24 hours after intravenous thrombolysis without recanalization...
April 5, 2018: AJNR. American Journal of Neuroradiology
https://www.readbyqxmd.com/read/29617497/opcabg-for-moderate-cimr-in-elderly-patients-a-superior-option
#14
Amber Malhotra, Chandrasekaran Ananthanarayanan, Vivek Wadhawa, Sumbul Siddiqui, Pranav Sharma, Kartik Patel, Komal Shah, Pratik Shah
OBJECTIVE: To compare the early and late outcomes of off-pump coronary artery bypass grafting and coronary artery bypass graft + mitral valve repair in elderly patients with moderate chronic ischemic mitral regurgitation. METHODS: One hundred and fifty elderly (age > 70 years) patients with moderate chronic ischemic mitral regurgitation who underwent off-pump coronary artery bypass grafting (n=95) or coronary artery bypass graft + mitral valve repair (n=55) between January 2007 and December 2014 were studied...
January 2018: Brazilian Journal of Cardiovascular Surgery
https://www.readbyqxmd.com/read/29617449/assessment-of-veins-in-t2-weighted-mr-angiography-predicts-infarct-growth-in-hyperacute-ischemic-stroke
#15
Susumu Yamaguchi, Nobutaka Horie, Minoru Morikawa, Yohei Tateishi, Takeshi Hiu, Yoichi Morofuji, Tsuyoshi Izumo, Kentaro Hayashi, Takayuki Matsuo
BACKGROUND AND PURPOSE: T2*-weighted magnetic resonance angiography (SWAN) detects hemodynamic insufficiency as hypointense areas in medullary or cortical veins. We therefore investigated whether SWAN can help predict ischemic penumbra-like lesions in patients with acute ischemic stroke (AIS). MATERIALS AND METHODS: Magnetic resonance imaging (MRI) records-including SWAN, diffusion-weighted imaging (DWI), and magnetic resonance angiography (MRA)-of consecutive patients with major vessel occlusion within 6 h from AIS onset were analyzed...
2018: PloS One
https://www.readbyqxmd.com/read/29611451/permeability-imaging-as-a-predictor-of-delayed-cerebral-ischemia-after-aneurysmal-subarachnoid-hemorrhage
#16
Jonathan J Russin, Axel Montagne, Francesco D'Amore, Shuhan He, Mark S Shiroishi, Robert C Rennert, Jena Depetris, Berislav V Zlokovic, William J Mack
Blood-brain barrier (BBB) dysfunction has been implicated in ischemic risk following aneurysmal subarachnoid hemorrhage (aSAH), but never directly imaged. We prospectively examined whether post-bleed day 4 dynamic contrast-enhanced magnetic resonance (DCE-MR) BBB permeability imaging could predict development of delayed cerebral ischemia (DCI). Global MR-derived BBB permeability ( Ktrans ) was significantly higher in aSAH patients who subsequently developed DCI (five patients; 2.28 ± 0.09 × 10-3 min-1 ) compared to those who experienced radiographic vasospasm only (three patients; 1...
January 1, 2018: Journal of Cerebral Blood Flow and Metabolism
https://www.readbyqxmd.com/read/29603482/3d-image-fusion-of-whole-heart-dynamic-cardiac-mr-perfusion-and-late-gadolinium-enhancement-intuitive-delineation-of-myocardial-hypoperfusion-and-scar
#17
Jochen von Spiczak, Manoj Mannil, Sebastian Kozerke, Hatem Alkadhi, Robert Manka
BACKGROUND: Since patients with myocardial hypoperfusion due to coronary artery disease (CAD) with preserved viability are known to benefit from revascularization, accurate differentiation of hypoperfusion from scar is desirable. PURPOSE: To develop a framework for 3D fusion of whole-heart dynamic cardiac MR perfusion and late gadolinium enhancement (LGE) to delineate stress-induced myocardial hypoperfusion and scar. STUDY TYPE: Prospective feasibility study...
March 30, 2018: Journal of Magnetic Resonance Imaging: JMRI
https://www.readbyqxmd.com/read/29601139/myocardial-fibrosis-evaluated-by-diffusion-weighted-imaging-and-its-relationship-to-3d-contractile-function-in-patients-with-hypertrophic-cardiomyopathy
#18
Rui Wu, Dong-Aolei An, Ruo-Yang Shi, Bing-Hua Chen, Meng Jiang, Andrew Bacyinski, Tong-Tong Han, Jiani Hu, Jian-Rong Xu, Lian-Ming Wu
BACKGROUND: Previous studies have shown that diffusion-weighted imaging (DWI) is sensitive to myocardial fibrosis in ischemic and nonischemic cardiomyopathy. PURPOSE: To explore the prognostic value of apparent diffusion coefficient (ADC) for detecting myocardial fibrosis and its relationship to the contractile function in hypertrophic cardiomyopathy (HCM). STUDY TYPE: Prospective. POPULATION: A total of 45 HCM patients and 20 controls...
March 30, 2018: Journal of Magnetic Resonance Imaging: JMRI
https://www.readbyqxmd.com/read/29598851/first-magnetic-resonance-managed-by-a-cardiology-department-in-the-spanish-public-healthcare-system-experience-and-difficulties-of-an-innovative-model
#19
Manuel Barreiro-Pérez, Elena Tundidor-Sanz, Ana Martín-García, Elena Díaz-Peláez, Alberto Íscar-Galán, Soraya Merchán-Gómez, María Gallego-Delgado, Javier Jiménez-Candil, Ignacio Cruz-González, Pedro L Sánchez
Magnetic resonance (MR) is considered the gold standard in the assessment of myocardial morphology, function, perfusion, and viability. However, its main limitation is its scarce availability. In 2014, we installed the first MR scanner exclusively managed by a cardiology department within the publicly-funded Spanish healthcare system with the aim of improving patient-care, training and research in the department. In the time interval analyzed, July 2014 to May 2017, 3422 cardiac MR scans were performed (32minutes used per study; 96% with good quality; 75% with contrast media administration)...
March 26, 2018: Revista Española de Cardiología
https://www.readbyqxmd.com/read/29588148/spontaneous-chordae-tendineae-rupture-during-peripartum
#20
Feng-Han Chiu, Chih-Jen Yang, Chih-Kang Huang, Chih-Yuan Lin, Shih-Hung Tsai
Acute cardiopulmonary distress in pregnancy always carries exceptionally arduous challenge for physicians. Here we report a patient who sustained spontaneous chordae tendineae rupture complicated with severe mitral regurgitation and acute pulmonary edema during peripartum period. Probable causes of chordae tendineae rupture include mitral valve prolapse, infectious endocarditis, congenital heart disease, rheumatic heart disease, ischemic heart disease, connective tissue diseases, previous mitral valve surgery or pregnancy itself...
March 19, 2018: American Journal of Emergency Medicine
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