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Diagnostics
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Advances in Cerebrovascular Imaging and Interventions
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Advances in Cerebrovascular Imaging and Interventions

A special issue of Diagnostics (ISSN 2075-4418). This special issue belongs to the section "Medical Imaging and Theranostics".

Deadline for manuscript submissions: 30 June 2024 | Viewed by 3056

Special Issue Editor

Dr. Seyedmehdi Payabvash

E-Mail Website
Guest Editor
Department of Radioogy and Biomedica Imaging, Yale University, 333 Cedar Street, P.O. Box 208042, New Haven, CT 06520, USA
Interests: cerebrovascular disease; neuroradiology; artificial intelligence; thrombectomy

Special Issue Information

Dear Colleagues, 

Recent advances in neuroimaing technologies, artificial intelligence and emergence of novel imaging biomarkers set the groundwork for the translation of quantitative and emerging imaging techniques to clinical practice to inform diagnosis, treatment planning, disease monitoring, prognostication, and clinical trial design. As a natural progression, many of the new technologies can inform treatment decisions and improve outcome prediction in patients with cerebrovascular disease. In this issue, we will cover the most recent advances in cerebrovascular imaging and interventions.

Dr. Seyedmehdi Payabvash
Guest Editor

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Diagnostics is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2600 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • cerebrovascular disease
  • stroke
  • transient ischemic attack
  • intracerebral hemorrhage
  • brain microhemorrhage
  • genomics
  • radiomics
  • artificial intelligence
  • MRI
  • CT
  • perfusion imaging
  • thrombectomy
  • hemostatic therapy
  • prevention

Published Papers (4 papers)

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Research

12 pages, 836 KiB  
Article
Could Phosphorous MR Spectroscopy Help Predict the Severity of Vasospasm? A Pilot Study
by Malik Galijasevic, Ruth Steiger, Stephanie Alice Treichl, Wing Man Ho, Stephanie Mangesius, Valentin Ladenhauf, Johannes Deeg, Leonhard Gruber, Miar Ouaret, Milovan Regodic, Lukas Lenhart, Bettina Pfausler, Astrid Ellen Grams, Ondra Petr, Claudius Thomé and Elke Ruth Gizewski
Diagnostics 2024, 14(8), 841; https://doi.org/10.3390/diagnostics14080841 - 18 Apr 2024
Viewed by 331
Abstract
One of the main causes of the dismal prognosis in patients who survive the initial bleeding after aneurysmal subarachnoidal hemorrhage is the delayed cerebral ischaemia caused by vasospasm. Studies suggest that cerebral magnesium and pH may potentially play a role in the pathophysiology [...] Read more.
One of the main causes of the dismal prognosis in patients who survive the initial bleeding after aneurysmal subarachnoidal hemorrhage is the delayed cerebral ischaemia caused by vasospasm. Studies suggest that cerebral magnesium and pH may potentially play a role in the pathophysiology of this adverse event. Using phosphorous magnetic resonance spectrocopy (31P-MRS), we calculated the cerebral magnesium (Mg) and pH levels in 13 patients who suffered from aSAH. The values between the group that developed clinically significant vasospasm (n = 7) and the group that did not (n = 6) were compared. The results of this study show significantly lower cerebral Mg levels (p = 0.019) and higher pH levels (p < 0.001) in the cumulative group (all brain voxels together) in patients who developed clinically significant vasospasm. Further clinical studies on a larger group of carefully selected patients are needed in order to predict clinically significant vasospasm. Full article
(This article belongs to the Special Issue Advances in Cerebrovascular Imaging and Interventions)
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13 pages, 1087 KiB  
Article
Radiomics-Based Prediction of Collateral Status from CT Angiography of Patients Following a Large Vessel Occlusion Stroke
by Emily W. Avery, Anthony Abou-Karam, Sandra Abi-Fadel, Jonas Behland, Adrian Mak, Stefan P. Haider, Tal Zeevi, Pina C. Sanelli, Christopher G. Filippi, Ajay Malhotra, Charles C. Matouk, Guido J. Falcone, Nils Petersen, Lauren H. Sansing, Kevin N. Sheth and Seyedmehdi Payabvash
Diagnostics 2024, 14(5), 485; https://doi.org/10.3390/diagnostics14050485 - 23 Feb 2024
Viewed by 686
Abstract
Background: A major driver of individual variation in long-term outcomes following a large vessel occlusion (LVO) stroke is the degree of collateral arterial circulation. We aimed to develop and evaluate machine-learning models that quantify LVO collateral status using admission computed tomography angiography (CTA) [...] Read more.
Background: A major driver of individual variation in long-term outcomes following a large vessel occlusion (LVO) stroke is the degree of collateral arterial circulation. We aimed to develop and evaluate machine-learning models that quantify LVO collateral status using admission computed tomography angiography (CTA) radiomics. Methods: We extracted 1116 radiomic features from the anterior circulation territories from admission CTAs of 600 patients experiencing an acute LVO stroke. We trained and validated multiple machine-learning models for the prediction of collateral status based on consensus from two neuroradiologists as ground truth. Models were first trained to predict (1) good vs. intermediate or poor, or (2) good vs. intermediate or poor collateral status. Then, model predictions were combined to determine a three-tier collateral score (good, intermediate, or poor). We used the receiver operating characteristics area under the curve (AUC) to evaluate prediction accuracy. Results: We included 499 patients in training and 101 in an independent test cohort. The best-performing models achieved an averaged cross-validation AUC of 0.80 ± 0.05 for poor vs. intermediate/good collateral and 0.69 ± 0.05 for good vs. intermediate/poor, and AUC = 0.77 (0.67–0.87) and AUC = 0.78 (0.70–0.90) in the independent test cohort, respectively. The collateral scores predicted by the radiomics model were correlated with (rho = 0.45, p = 0.002) and were independent predictors of 3-month clinical outcome (p = 0.018) in the independent test cohort. Conclusions: Automated tools for the assessment of collateral status from admission CTA—such as the radiomics models described here—can generate clinically relevant and reproducible collateral scores to facilitate a timely treatment triage in patients experiencing an acute LVO stroke. Full article
(This article belongs to the Special Issue Advances in Cerebrovascular Imaging and Interventions)
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20 pages, 12103 KiB  
Article
Vertebro-Vertebral Arteriovenous Fistulae: A Case Series of Endovascular Management at a Single Center
by Pattarawit Withayasuk, Ritthikrai Wichianrat, Boonrerk Sangpetngam, Thaweesak Aurboonyawat, Ekawut Chankaew, Saowanee Homsud and Anchalee Churojana
Diagnostics 2024, 14(4), 414; https://doi.org/10.3390/diagnostics14040414 - 13 Feb 2024
Viewed by 557
Abstract
Objective: Vertebro-vertebral arteriovenous fistulae (VVFs) are a rare disorder characterized by a direct shunt between the extracranial vertebral artery and the veins of the vertebral venous plexus. This study aims to comprehensively review the characteristics and outcomes of endovascular treatments for VVFs at [...] Read more.
Objective: Vertebro-vertebral arteriovenous fistulae (VVFs) are a rare disorder characterized by a direct shunt between the extracranial vertebral artery and the veins of the vertebral venous plexus. This study aims to comprehensively review the characteristics and outcomes of endovascular treatments for VVFs at our center. Methods: A retrospective review was conducted on 14 patients diagnosed with a VVF who underwent endovascular treatment at Siriraj Hospital from January 2000 to January 2023. The study assessed patient demographics, presentation, fistula location, treatment strategies, endovascular techniques employed, and treatment outcomes. Results: Among the 14 patients, 11 (78.6%) were female, with an age range from 25 to 79 years (median: 50 years). Spontaneous VVFs were observed in 64.3% of the cases, including three associated with neurofibromatosis type 1 (NF-1). Iatrogenic injury accounted for two cases, and three patients had VVFs resulting from traffic accidents. A pulsatile neck mass and tinnitus, with or without neurological deficits, were common presenting symptoms. Active bleeding was observed in three cases with vascular injury, while unilateral proptosis, congestive heart failure, and incidental findings each presented in one patient. All the VVFs were successfully obliterated without major treatment complications. Parent vessel sacrifice was performed in 85.7% of the cases, while vertebral artery preservation was achieved in the remaining two patients. Embolic materials included detachable balloons, detachable coils, and n-butyl cyanoacrylate (NBCA) glue. All the presenting symptoms showed improvement, and no morbidity or mortality was observed. Conclusions: Endovascular embolization is a feasible and effective approach for achieving complete VVF obliteration with safety. Parent artery sacrifice should not be reluctantly performed, particularly when adequate collateral circulation is demonstrated. Full article
(This article belongs to the Special Issue Advances in Cerebrovascular Imaging and Interventions)
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14 pages, 1839 KiB  
Article
Time-Dependent Changes in Hematoma Expansion Rate after Supratentorial Intracerebral Hemorrhage and Its Relationship with Neurological Deterioration and Functional Outcome
by Gaby Abou Karam, Min-Chiun Chen, Dorin Zeevi, Bendix C. Harms, Victor M. Torres-Lopez, Cyprien A. Rivier, Ajay Malhotra, Adam de Havenon, Guido J. Falcone, Kevin N. Sheth and Seyedmehdi Payabvash
Diagnostics 2024, 14(3), 308; https://doi.org/10.3390/diagnostics14030308 - 31 Jan 2024
Viewed by 701
Abstract
Background: Hematoma expansion (HE) following an intracerebral hemorrhage (ICH) is a modifiable risk factor and a treatment target. We examined the association of HE with neurological deterioration (ND), functional outcome, and mortality based on the time gap from onset to baseline CT. Methods: [...] Read more.
Background: Hematoma expansion (HE) following an intracerebral hemorrhage (ICH) is a modifiable risk factor and a treatment target. We examined the association of HE with neurological deterioration (ND), functional outcome, and mortality based on the time gap from onset to baseline CT. Methods: We included 567 consecutive patients with supratentorial ICH and baseline head CT within 24 h of onset. ND was defined as a ≥4-point increase on the NIH stroke scale (NIHSS) or a ≥2-point drop on the Glasgow coma scale. Poor outcome was defined as a modified Rankin score of 4 to 6 at 3-month follow-up. Results: The rate of HE was higher among those scanned within 3 h (124/304, 40.8%) versus 3 to 24 h post-ICH onset (53/263, 20.2%) (p < 0.001). However, HE was an independent predictor of ND (p < 0.001), poor outcome (p = 0.010), and mortality (p = 0.003) among those scanned within 3 h, as well as those scanned 3–24 h post-ICH (p = 0.043, p = 0.037, and p = 0.004, respectively). Also, in a subset of 180/567 (31.7%) patients presenting with mild symptoms (NIHSS ≤ 5), hematoma growth was an independent predictor of ND (p = 0.026), poor outcome (p = 0.037), and mortality (p = 0.027). Conclusion: Despite decreasing rates over time after ICH onset, HE remains an independent predictor of ND, functional outcome, and mortality among those presenting >3 h after onset or with mild symptoms. Full article
(This article belongs to the Special Issue Advances in Cerebrovascular Imaging and Interventions)
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