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<meta name="DC.Title" content="Safety and Effectiveness of Sacroplasty: A Large Single-Center Experience" />
<meta name="DC.Identifier" content="10.3174/ajnr.A4027" />
<meta name="DC.Date" content="2014-07-10" />
<meta name="DC.Publisher" content="American Journal of Neuroradiology" />
<meta name="DC.Rights" content="© 2014 American Society of Neuroradiology" />
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<meta name="DC.Description" content="BACKGROUND AND PURPOSE: Sacral insufficiency fractures are a common cause of severe low back pain and immobilization in patients with osteoporosis or cancer. Current practice guideline recommendations range from analgesia and physical therapy to resection with surgical fixation. We sought to assess the safety and effectiveness of sacroplasty, an emerging minimally invasive treatment.

MATERIALS AND METHODS: We performed a retrospective review of institutional databases for percutaneous sacroplasty performed between January 2004 and September 2013. Demographic and procedural data and pre- and posttreatment Visual Analog Scale, Functional Mobility Scale, and Analgesic Scale scores were reviewed. Overall response was rated by using a 4-point scale (1, complete resolution of pain; 2, improvement of pain; 3, no change; 4, worsened pain) assessed at short-term follow-up.

RESULTS: Fifty-three patients were included; most (83%) were female. Fracture etiology was cancer-related (55%), osteoporotic insufficiency (30%), and minor trauma (15%). No major complication or procedure-related morbidity occurred. There were statistically significant decreases in the Visual Analog Scale ( P &lt; .001), Functional Mobility Scale ( P &lt; .001), and Analgesic Scale scores ( P &lt; .01) in 27 patients with recorded data: pretreatment Visual Analog Scale (median [interquartile range], 9.0 [8.0–10.0]); Functional Mobility Scale, 3.0 (2.0–3.0); and Analgesic Scale scores, 3.0 (3.0–4.0) were reduced to 3.0 (0.0–5.8), 1.0 (0.25–2.8), and 3.0 (2.0–3.8) posttreatment. When we used the overall 4-point score at a mean of 27 days, 93% ( n = 45) reported complete resolution or improvement in overall pain.

CONCLUSIONS: In this single-center cohort, sacroplasty was a safe and effective procedure. There were significant short-term gains in pain relief, increased mobility, and decreased dependence on pain medication.

### Abbreviations

AS
:   Analgesic Scale
FMS
:   Functional Mobility Scale
PMMA
:   polymethylmethacrylate
VAS
:   Visual Analog Scale" />
<meta name="DC.Contributor" content="A.C. Gupta" />
<meta name="DC.Contributor" content="R.V. Chandra" />
<meta name="DC.Contributor" content="A.J. Yoo" />
<meta name="DC.Contributor" content="T.M. Leslie-Mazwi" />
<meta name="DC.Contributor" content="D.L. Bell" />
<meta name="DC.Contributor" content="B.P. Mehta" />
<meta name="DC.Contributor" content="T.L. Vanderboom" />
<meta name="DC.Contributor" content="J.D. Rabinov" />
<meta name="DC.Contributor" content="M. Larvie" />
<meta name="DC.Contributor" content="J.A. Hirsch" />
<meta name="article:published_time" content="2014-07-10" />
<meta name="article:section" content="SPINE" />
<meta name="citation_title" content="Safety and Effectiveness of Sacroplasty: A Large Single-Center Experience" />
<meta name="citation_abstract" lang="en" content="&lt;h3&gt;BACKGROUND AND PURPOSE:&lt;/h3&gt;
&lt;p&gt;Sacral insufficiency fractures are a common cause of severe low back pain and immobilization in patients with osteoporosis or cancer. Current practice guideline recommendations range from analgesia and physical therapy to resection with surgical fixation. We sought to assess the safety and effectiveness of sacroplasty, an emerging minimally invasive treatment.&lt;/p&gt;&lt;h3&gt;MATERIALS AND METHODS:&lt;/h3&gt;
&lt;p&gt;We performed a retrospective review of institutional databases for percutaneous sacroplasty performed between January 2004 and September 2013. Demographic and procedural data and pre- and posttreatment Visual Analog Scale, Functional Mobility Scale, and Analgesic Scale scores were reviewed. Overall response was rated by using a 4-point scale (1, complete resolution of pain; 2, improvement of pain; 3, no change; 4, worsened pain) assessed at short-term follow-up.&lt;/p&gt;&lt;h3&gt;RESULTS:&lt;/h3&gt;
&lt;p&gt;Fifty-three patients were included; most (83%) were female. Fracture etiology was cancer-related (55%), osteoporotic insufficiency (30%), and minor trauma (15%). No major complication or procedure-related morbidity occurred. There were statistically significant decreases in the Visual Analog Scale (&lt;i&gt;P&lt;/i&gt; &amp;lt; .001), Functional Mobility Scale (&lt;i&gt;P&lt;/i&gt; &amp;lt; .001), and Analgesic Scale scores (&lt;i&gt;P&lt;/i&gt; &amp;lt; .01) in 27 patients with recorded data: pretreatment Visual Analog Scale (median [interquartile range], 9.0 [8.0–10.0]); Functional Mobility Scale, 3.0 (2.0–3.0); and Analgesic Scale scores, 3.0 (3.0–4.0) were reduced to 3.0 (0.0–5.8), 1.0 (0.25–2.8), and 3.0 (2.0–3.8) posttreatment. When we used the overall 4-point score at a mean of 27 days, 93% (&lt;i&gt;n&lt;/i&gt; = 45) reported complete resolution or improvement in overall pain.&lt;/p&gt;&lt;h3&gt;CONCLUSIONS:&lt;/h3&gt;
&lt;p&gt;In this single-center cohort, sacroplasty was a safe and effective procedure. There were significant short-term gains in pain relief, increased mobility, and decreased dependence on pain medication.&lt;/p&gt;" />
<meta name="citation_journal_title" content="American Journal of Neuroradiology" />
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<meta name="citation_author_institution" content="From the Department of Radiology (A.C.G., A.J.Y., T.M.L.-M., D.L.B., B.P.M., T.L.V., J.D.R., M.L., J.A.H.), Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts; and Department of Radiology (R.V.C.), Monash Health, and Department of Surgery, Monash University, Melbourne, Australia." />
<meta name="citation_author" content="J.D. Rabinov" />
<meta name="citation_author_institution" content="From the Department of Radiology (A.C.G., A.J.Y., T.M.L.-M., D.L.B., B.P.M., T.L.V., J.D.R., M.L., J.A.H.), Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts; and Department of Radiology (R.V.C.), Monash Health, and Department of Surgery, Monash University, Melbourne, Australia." />
<meta name="citation_author" content="M. Larvie" />
<meta name="citation_author_institution" content="From the Department of Radiology (A.C.G., A.J.Y., T.M.L.-M., D.L.B., B.P.M., T.L.V., J.D.R., M.L., J.A.H.), Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts; and Department of Radiology (R.V.C.), Monash Health, and Department of Surgery, Monash University, Melbourne, Australia." />
<meta name="citation_author" content="J.A. Hirsch" />
<meta name="citation_author_institution" content="From the Department of Radiology (A.C.G., A.J.Y., T.M.L.-M., D.L.B., B.P.M., T.L.V., J.D.R., M.L., J.A.H.), Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts; and Department of Radiology (R.V.C.), Monash Health, and Department of Surgery, Monash University, Melbourne, Australia." />
<meta name="twitter:title" content="Safety and Effectiveness of Sacroplasty: A Large Single-Center Experience" />
<meta name="twitter:card" content="summary" />
<meta name="twitter:description" content="BACKGROUND AND PURPOSE: Sacral insufficiency fractures are a common cause of severe low back pain and immobilization in patients with osteoporosis or cancer. Current practice guideline recommendations range from analgesia and physical therapy to resection with surgical fixation. We sought to assess the safety and effectiveness of sacroplasty, an emerging minimally invasive treatment.

MATERIALS AND METHODS: We performed a retrospective review of institutional databases for percutaneous sacroplasty performed between January 2004 and September 2013. Demographic and procedural data and pre- and posttreatment Visual Analog Scale, Functional Mobility Scale, and Analgesic Scale scores were reviewed. Overall response was rated by using a 4-point scale (1, complete resolution of pain; 2, improvement of pain; 3, no change; 4, worsened pain) assessed at short-term follow-up.

RESULTS: Fifty-three patients were included; most (83%) were female. Fracture etiology was cancer-related (55%), osteoporotic insufficiency (30%), and minor trauma (15%). No major complication or procedure-related morbidity occurred. There were statistically significant decreases in the Visual Analog Scale ( P &lt; .001), Functional Mobility Scale ( P &lt; .001), and Analgesic Scale scores ( P &lt; .01) in 27 patients with recorded data: pretreatment Visual Analog Scale (median [interquartile range], 9.0 [8.0–10.0]); Functional Mobility Scale, 3.0 (2.0–3.0); and Analgesic Scale scores, 3.0 (3.0–4.0) were reduced to 3.0 (0.0–5.8), 1.0 (0.25–2.8), and 3.0 (2.0–3.8) posttreatment. When we used the overall 4-point score at a mean of 27 days, 93% ( n = 45) reported complete resolution or improvement in overall pain.

CONCLUSIONS: In this single-center cohort, sacroplasty was a safe and effective procedure. There were significant short-term gains in pain relief, increased mobility, and decreased dependence on pain medication.

### Abbreviations

AS
:   Analgesic Scale
FMS
:   Functional Mobility Scale
PMMA
:   polymethylmethacrylate
VAS
:   Visual Analog Scale" />
<meta name="og-title" property="og:title" content="Safety and Effectiveness of Sacroplasty: A Large Single-Center Experience" />
<meta name="og-url" property="og:url" content="http://ajnr-stage2.stage.highwire.org/content/early/2014/07/10/ajnr.A4027" />
<meta name="og-site-name" property="og:site_name" content="American Journal of Neuroradiology" />
<meta name="og-description" property="og:description" content="BACKGROUND AND PURPOSE: Sacral insufficiency fractures are a common cause of severe low back pain and immobilization in patients with osteoporosis or cancer. Current practice guideline recommendations range from analgesia and physical therapy to resection with surgical fixation. We sought to assess the safety and effectiveness of sacroplasty, an emerging minimally invasive treatment.

MATERIALS AND METHODS: We performed a retrospective review of institutional databases for percutaneous sacroplasty performed between January 2004 and September 2013. Demographic and procedural data and pre- and posttreatment Visual Analog Scale, Functional Mobility Scale, and Analgesic Scale scores were reviewed. Overall response was rated by using a 4-point scale (1, complete resolution of pain; 2, improvement of pain; 3, no change; 4, worsened pain) assessed at short-term follow-up.

RESULTS: Fifty-three patients were included; most (83%) were female. Fracture etiology was cancer-related (55%), osteoporotic insufficiency (30%), and minor trauma (15%). No major complication or procedure-related morbidity occurred. There were statistically significant decreases in the Visual Analog Scale ( P &lt; .001), Functional Mobility Scale ( P &lt; .001), and Analgesic Scale scores ( P &lt; .01) in 27 patients with recorded data: pretreatment Visual Analog Scale (median [interquartile range], 9.0 [8.0–10.0]); Functional Mobility Scale, 3.0 (2.0–3.0); and Analgesic Scale scores, 3.0 (3.0–4.0) were reduced to 3.0 (0.0–5.8), 1.0 (0.25–2.8), and 3.0 (2.0–3.8) posttreatment. When we used the overall 4-point score at a mean of 27 days, 93% ( n = 45) reported complete resolution or improvement in overall pain.

CONCLUSIONS: In this single-center cohort, sacroplasty was a safe and effective procedure. There were significant short-term gains in pain relief, increased mobility, and decreased dependence on pain medication.

### Abbreviations

AS
:   Analgesic Scale
FMS
:   Functional Mobility Scale
PMMA
:   polymethylmethacrylate
VAS
:   Visual Analog Scale" />
<meta name="og-type" property="og:type" content="article" />
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      <h1 class="highwire-cite-title" id="page-title">Safety and Effectiveness of Sacroplasty: A Large Single-Center Experience</h1>  
    	<div class="highwire-cite-authors"><span  class="highwire-citation-authors"><span class="highwire-citation-author first" data-delta="0">A.C. Gupta</span>, <span class="highwire-citation-author" data-delta="1">R.V. Chandra</span>, <span class="highwire-citation-author" data-delta="2">A.J. Yoo</span>, <span class="highwire-citation-author" data-delta="3">T.M. Leslie-Mazwi</span>, <span class="highwire-citation-author" data-delta="4">D.L. Bell</span>, <span class="highwire-citation-author" data-delta="5">B.P. Mehta</span>, <span class="highwire-citation-author" data-delta="6">T.L. Vanderboom</span>, <span class="highwire-citation-author" data-delta="7">J.D. Rabinov</span>, <span class="highwire-citation-author" data-delta="8">M. Larvie</span> and <span class="highwire-citation-author" data-delta="9">J.A. Hirsch</span></span></div>
  
    	<div class="highwire-cite-metadata"><span  class="highwire-cite-metadata-journal highwire-cite-metadata">American Journal of Neuroradiology </span><span  class="highwire-cite-metadata-date highwire-cite-metadata">July 2014,  </span><span  class="highwire-cite-metadata-doi highwire-cite-metadata">DOI: https://doi.org/10.3174/ajnr.A4027 </span></div>
  
  
  
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<div id="hw-article-author-popups-top-node-50731--61530287323" style="display: none;"><div class="author-tooltip-0"><div class="author-tooltip-name">A.C. Gupta </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'>From the Department of Radiology (A.C.G., A.J.Y., T.M.L.-M., D.L.B., B.P.M., T.L.V., J.D.R., M.L., J.A.H.), Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts; and Department of Radiology (R.V.C.), Monash Health, and Department of Surgery, Monash University, Melbourne, Australia.</div></span></div><ul class="author-tooltip-find-more"><li class="author-tooltip-gs-link first"><a href="/lookup/google-scholar?link_type=googlescholar&amp;gs_type=author&amp;author%5B0%5D=A.C.%2BGupta%2B" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on Google Scholar</a></li><li class="author-tooltip-pubmed-link"><a href="/lookup/external-ref?access_num=Gupta%20A&amp;link_type=AUTHORSEARCH" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on PubMed</a></li><li class="author-site-search-link last"><a href="/search/author1%3AA.C.%2BGupta%2B" rel="nofollow" class="" data-icon-position="" data-hide-link-title="0">Search for this author on this site</a></li></ul></div><div class="author-tooltip-1"><div class="author-tooltip-name">R.V. Chandra </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'>From the Department of Radiology (A.C.G., A.J.Y., T.M.L.-M., D.L.B., B.P.M., T.L.V., J.D.R., M.L., J.A.H.), Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts; and Department of Radiology (R.V.C.), Monash Health, and Department of Surgery, Monash University, Melbourne, Australia.</div></span></div><ul class="author-tooltip-find-more"><li class="author-tooltip-gs-link first"><a href="/lookup/google-scholar?link_type=googlescholar&amp;gs_type=author&amp;author%5B0%5D=R.V.%2BChandra%2B" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on Google Scholar</a></li><li class="author-tooltip-pubmed-link"><a href="/lookup/external-ref?access_num=Chandra%20R&amp;link_type=AUTHORSEARCH" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on PubMed</a></li><li class="author-site-search-link last"><a href="/search/author1%3AR.V.%2BChandra%2B" rel="nofollow" class="" data-icon-position="" data-hide-link-title="0">Search for this author on this site</a></li></ul></div><div class="author-tooltip-2"><div class="author-tooltip-name">A.J. Yoo </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'>From the Department of Radiology (A.C.G., A.J.Y., T.M.L.-M., D.L.B., B.P.M., T.L.V., J.D.R., M.L., J.A.H.), Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts; and Department of Radiology (R.V.C.), Monash Health, and Department of Surgery, Monash University, Melbourne, Australia.</div></span></div><ul class="author-tooltip-find-more"><li class="author-tooltip-gs-link first"><a href="/lookup/google-scholar?link_type=googlescholar&amp;gs_type=author&amp;author%5B0%5D=A.J.%2BYoo%2B" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on Google Scholar</a></li><li class="author-tooltip-pubmed-link"><a href="/lookup/external-ref?access_num=Yoo%20A&amp;link_type=AUTHORSEARCH" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on PubMed</a></li><li class="author-site-search-link last"><a href="/search/author1%3AA.J.%2BYoo%2B" rel="nofollow" class="" data-icon-position="" data-hide-link-title="0">Search for this author on this site</a></li></ul></div><div class="author-tooltip-3"><div class="author-tooltip-name">T.M. Leslie-Mazwi </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'>From the Department of Radiology (A.C.G., A.J.Y., T.M.L.-M., D.L.B., B.P.M., T.L.V., J.D.R., M.L., J.A.H.), Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts; and Department of Radiology (R.V.C.), Monash Health, and Department of Surgery, Monash University, Melbourne, Australia.</div></span></div><ul class="author-tooltip-find-more"><li class="author-tooltip-gs-link first"><a href="/lookup/google-scholar?link_type=googlescholar&amp;gs_type=author&amp;author%5B0%5D=T.M.%2BLeslie-Mazwi%2B" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on Google Scholar</a></li><li class="author-tooltip-pubmed-link"><a href="/lookup/external-ref?access_num=Leslie-Mazwi%20T&amp;link_type=AUTHORSEARCH" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on PubMed</a></li><li class="author-site-search-link last"><a href="/search/author1%3AT.M.%2BLeslie-Mazwi%2B" rel="nofollow" class="" data-icon-position="" data-hide-link-title="0">Search for this author on this site</a></li></ul></div><div class="author-tooltip-4"><div class="author-tooltip-name">D.L. Bell </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'>From the Department of Radiology (A.C.G., A.J.Y., T.M.L.-M., D.L.B., B.P.M., T.L.V., J.D.R., M.L., J.A.H.), Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts; and Department of Radiology (R.V.C.), Monash Health, and Department of Surgery, Monash University, Melbourne, Australia.</div></span></div><ul class="author-tooltip-find-more"><li class="author-tooltip-gs-link first"><a href="/lookup/google-scholar?link_type=googlescholar&amp;gs_type=author&amp;author%5B0%5D=D.L.%2BBell%2B" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on Google Scholar</a></li><li class="author-tooltip-pubmed-link"><a href="/lookup/external-ref?access_num=Bell%20D&amp;link_type=AUTHORSEARCH" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on PubMed</a></li><li class="author-site-search-link last"><a href="/search/author1%3AD.L.%2BBell%2B" rel="nofollow" class="" data-icon-position="" data-hide-link-title="0">Search for this author on this site</a></li></ul></div><div class="author-tooltip-5"><div class="author-tooltip-name">B.P. 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Vanderboom </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'>From the Department of Radiology (A.C.G., A.J.Y., T.M.L.-M., D.L.B., B.P.M., T.L.V., J.D.R., M.L., J.A.H.), Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts; and Department of Radiology (R.V.C.), Monash Health, and Department of Surgery, Monash University, Melbourne, Australia.</div></span></div><ul class="author-tooltip-find-more"><li class="author-tooltip-gs-link first"><a href="/lookup/google-scholar?link_type=googlescholar&amp;gs_type=author&amp;author%5B0%5D=T.L.%2BVanderboom%2B" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on Google Scholar</a></li><li class="author-tooltip-pubmed-link"><a href="/lookup/external-ref?access_num=Vanderboom%20T&amp;link_type=AUTHORSEARCH" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on PubMed</a></li><li class="author-site-search-link last"><a href="/search/author1%3AT.L.%2BVanderboom%2B" rel="nofollow" class="" data-icon-position="" data-hide-link-title="0">Search for this author on this site</a></li></ul></div><div class="author-tooltip-7"><div class="author-tooltip-name">J.D. 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<p id="p-1"><strong>BACKGROUND AND PURPOSE:</strong> Sacral insufficiency fractures are a common cause of severe low back pain and immobilization in patients with osteoporosis or cancer. Current practice guideline recommendations range from analgesia and physical therapy to resection with surgical fixation. We sought to assess the safety and effectiveness of sacroplasty, an emerging minimally invasive treatment.</p></div>
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<p id="p-2"><strong>MATERIALS AND METHODS:</strong> We performed a retrospective review of institutional databases for percutaneous sacroplasty performed between January 2004 and September 2013. Demographic and procedural data and pre- and posttreatment Visual Analog Scale, Functional Mobility Scale, and Analgesic Scale scores were reviewed. Overall response was rated by using a 4-point scale (1, complete resolution of pain; 2, improvement of pain; 3, no change; 4, worsened pain) assessed at short-term follow-up.</p></div>
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<p id="p-3"><strong>RESULTS:</strong> Fifty-three patients were included; most (83%) were female. Fracture etiology was cancer-related (55%), osteoporotic insufficiency (30%), and minor trauma (15%). No major complication or procedure-related morbidity occurred. There were statistically significant decreases in the Visual Analog Scale (<em>P</em> &lt; .001), Functional Mobility Scale (<em>P</em> &lt; .001), and Analgesic Scale scores (<em>P</em> &lt; .01) in 27 patients with recorded data: pretreatment Visual Analog Scale (median [interquartile range], 9.0 [8.0–10.0]); Functional Mobility Scale, 3.0 (2.0–3.0); and Analgesic Scale scores, 3.0 (3.0–4.0) were reduced to 3.0 (0.0–5.8), 1.0 (0.25–2.8), and 3.0 (2.0–3.8) posttreatment. When we used the overall 4-point score at a mean of 27 days, 93% (<em>n</em> = 45) reported complete resolution or improvement in overall pain.</p></div>
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<p id="p-4"><strong>CONCLUSIONS:</strong> In this single-center cohort, sacroplasty was a safe and effective procedure. There were significant short-term gains in pain relief, increased mobility, and decreased dependence on pain medication.</p>
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<h3>Abbreviations</h3>
<dl id="def-list-1"><dt id="def-item-1">AS<span class="def-item-dt-sep"></span></dt><dd>Analgesic Scale<span class="def-item-dd-sep"></span></dd><dt id="def-item-2">FMS<span class="def-item-dt-sep"></span></dt><dd>Functional Mobility Scale<span class="def-item-dd-sep"></span></dd><dt id="def-item-3">PMMA<span class="def-item-dt-sep"></span></dt><dd>polymethylmethacrylate<span class="def-item-dd-sep"></span></dd><dt id="def-item-4">VAS<span class="def-item-dt-sep"></span></dt><dd>Visual Analog Scale</dd></dl>
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      <div class="highwire-cite-title">Safety and Effectiveness of Sacroplasty: A Large Single-Center Experience</div>  
    	<div class="highwire-cite-authors"><span  class="highwire-citation-authors"><span class="highwire-citation-author first" data-delta="0"><span class="nlm-given-names">A.C.</span> <span class="nlm-surname">Gupta</span></span>, <span class="highwire-citation-author" data-delta="1"><span class="nlm-given-names">R.V.</span> <span class="nlm-surname">Chandra</span></span>, <span class="highwire-citation-author" data-delta="2"><span class="nlm-given-names">A.J.</span> <span class="nlm-surname">Yoo</span></span>, <span class="highwire-citation-author" data-delta="3"><span class="nlm-given-names">T.M.</span> <span class="nlm-surname">Leslie-Mazwi</span></span>, <span class="highwire-citation-author" data-delta="4"><span class="nlm-given-names">D.L.</span> <span class="nlm-surname">Bell</span></span>, <span class="highwire-citation-author" data-delta="5"><span class="nlm-given-names">B.P.</span> <span class="nlm-surname">Mehta</span></span>, <span class="highwire-citation-author" data-delta="6"><span class="nlm-given-names">T.L.</span> <span class="nlm-surname">Vanderboom</span></span>, <span class="highwire-citation-author" data-delta="7"><span class="nlm-given-names">J.D.</span> <span class="nlm-surname">Rabinov</span></span>, <span class="highwire-citation-author" data-delta="8"><span class="nlm-given-names">M.</span> <span class="nlm-surname">Larvie</span></span>, <span class="highwire-citation-author" data-delta="9"><span class="nlm-given-names">J.A.</span> <span class="nlm-surname">Hirsch</span></span></span></div>
  
    	<div class="highwire-cite-metadata"><span  class="highwire-cite-metadata-journal highwire-cite-metadata">American Journal of Neuroradiology </span><span  class="highwire-cite-metadata-date highwire-cite-metadata">Jul 2014, </span><span  class="highwire-cite-metadata-doi highwire-cite-metadata"><span class="label">DOI:</span> 10.3174/ajnr.A4027 </span></div>
  
  
  
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