American Journal of Neuroradiology: 40 (8)

August 01, 2019; Volume 40,Issue 8

Perspectives

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Perspectives
Bejoy Thomas

American Journal of Neuroradiology August 2019, 40 (8) 1251; DOI: https://doi.org/10.3174/ajnr.P0057

Practice Perspectives

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Risk Factors for Perceptual-versus-Interpretative Errors in Diagnostic Neuroradiology
S.H. Patel, C.L. Stanton, S.G. Miller, J.T. Patrie, J.N. Itri and T.M. Shepherd

American Journal of Neuroradiology August 2019, 40 (8) 1252-1256; DOI: https://doi.org/10.3174/ajnr.A6125

General Contents

EDITOR'S CHOICEPatient Safety

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Intrathecal Use of Gadobutrol for Glymphatic MR Imaging: Prospective Safety Study of 100 Patients
C.S. Edeklev, M. Halvorsen, G. Løvland, S.A.S. Vatnehol, Ø. Gjertsen, B. Nedregaard, R. Sletteberg, G. Ringstad and P.K. Eide

American Journal of Neuroradiology August 2019, 40 (8) 1257-1264; DOI: https://doi.org/10.3174/ajnr.A6136

The authors performed a prospective safety and feasibility study in 100 consecutive patients undergoing glymphatic MR imaging from September 2015 to August 2018. Short- and long-term serious and nonserious adverse events were registered clinically and by interview after intrathecal administration of 0.5 mL of gadobutrol (1.0 mmol/mL) along with 3 mL of iodixanol (270 mg I/mL). One serious adverse event (anaphylaxis) occurred in a patient with known allergy to iodine-containing contrast agents (1%). The main nonserious adverse events during the first 1–3 days after contrast injection included severe headache (28%) and severe nausea (34%), though the frequency depended heavily on the diagnosis. They conclude that intrathecal administration of gadobutrol in conjunction with iodixanol for glymphatic MR imaging is safe and feasible.
Adult Brain

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Gadolinium Retention in the Brain: An MRI Relaxometry Study of Linear and Macrocyclic Gadolinium-Based Contrast Agents in Multiple Sclerosis
Y. Forslin, J. Martola, Å. Bergendal, S. Fredrikson, M.K. Wiberg and T. Granberg

American Journal of Neuroradiology August 2019, 40 (8) 1265-1273; DOI: https://doi.org/10.3174/ajnr.A6112
Adult Brain

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Signal Hyperintensity on Unenhanced T1-Weighted Brain and Cervical Spinal Cord MR Images after Multiple Doses of Linear Gadolinium-Based Contrast Agent
G. Barisano, B. Bigjahan, S. Metting, S. Cen, L. Amezcua, A. Lerner, A.W. Toga and M. Law

American Journal of Neuroradiology August 2019, 40 (8) 1274-1281; DOI: https://doi.org/10.3174/ajnr.A6148
EDITOR'S CHOICEAdult Brain

Open Access
Convolutional Neural Network for Automated FLAIR Lesion Segmentation on Clinical Brain MR Imaging
M.T. Duong, J.D. Rudie, J. Wang, L. Xie, S. Mohan, J.C. Gee and A.M. Rauschecker

American Journal of Neuroradiology August 2019, 40 (8) 1282-1290; DOI: https://doi.org/10.3174/ajnr.A6138

This convolutional neural network was retrospectively trained on 295 brain MRIs to perform automated FLAIR lesion segmentation. Performance was evaluated on 92 validation cases using Dice scores and voxelwise sensitivity and specificity, compared with radiologists' manual segmentations. The authors' model demonstrated accurate FLAIR lesion segmentation performance (median Dice score, 0.79) on the validation dataset across a large range of lesion characteristics. Across 19 neurologic diseases, performance was significantly higher than existing methods (Dice, 0.56 and 0.41) and approached human performance (Dice, 0.81).
Adult Brain

Open Access
White Matter Lesion Penumbra Shows Abnormalities on Structural and Physiologic MRIs in the Coronary Artery Risk Development in Young Adults Cohort
I.M. Nasrallah, M.-K. Hsieh, G. Erus, H. Battapady, S. Dolui, J.A. Detre, L.J. Launer, D.R. Jacobs, C. Davatzikos and R.N. Bryan

American Journal of Neuroradiology August 2019, 40 (8) 1291-1298; DOI: https://doi.org/10.3174/ajnr.A6119
EDITOR'S CHOICEAdult Brain

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The Interpeduncular Angle: A Practical and Objective Marker for the Detection and Diagnosis of Intracranial Hypotension on Brain MRI
D.J. Wang, S.K. Pandey, D.H. Lee and M. Sharma

American Journal of Neuroradiology August 2019, 40 (8) 1299-1303; DOI: https://doi.org/10.3174/ajnr.A6120

MRIs of 30 patients with intracranial hypotension and 30 age-matched controls were evaluated by 2 neuroradiologists for classic findings of intracranial hypotension and the interpeduncular angle. Group analysis was performed with a Student t test, and receiver operating characteristic analysis was used to identify an ideal angle threshold to maximize sensitivity and specificity. The interpeduncular angle had excellent interobserver reliability (intraclass correlation coefficient value = 0.833) and was significantly lower in the intracranial hypotension group compared with the control group (25.3° versus 56.3°). There was significant correlation between the interpeduncular angle and the presence of brain stem slumping. With a threshold of 40.5°, sensitivity and specificity were 80% and 96.7%, respectively.
Adult Brain

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Cytotoxic Lesions of the Corpus Callosum Caused by Thermogenic Dietary Supplements
J.A. Galnares-Olalde, A.J. Vázquez-Mézquita, G. Gómez-Garza, D. Reyes-Vázquez, V. Higuera-Ortiz, M.A. Alegría-Loyola and A. Mendez-Dominguez

American Journal of Neuroradiology August 2019, 40 (8) 1304-1308; DOI: https://doi.org/10.3174/ajnr.A6116
Adult Brain

Open Access
Manganese-Enhanced MRI of the Brain in Healthy Volunteers
D.M. Sudarshana, G. Nair, J.T. Dwyer, B. Dewey, S.U. Steele, D.J. Suto, T. Wu, B.A. Berkowitz, A.P. Koretsky, I.C.M. Cortese and D.S. Reich

American Journal of Neuroradiology August 2019, 40 (8) 1309-1316; DOI: https://doi.org/10.3174/ajnr.A6152
Adult Brain

Open Access
The Association between FLAIR Vascular Hyperintensity and Stroke Outcome Varies with Time from Onset
W.J. Shang, H.B. Chen, L.M. Shu, H.Q. Liao, X.Y. Huang, S. Xiao and H. Hong

American Journal of Neuroradiology August 2019, 40 (8) 1317-1322; DOI: https://doi.org/10.3174/ajnr.A6142
Adult Brain

Open Access
Leukoaraiosis May Confound the Interpretation of CT Perfusion in Patients Treated with Mechanical Thrombectomy for Acute Ischemic Stroke
S. Rudilosso, C. Laredo, C. Vivancos, X. Urra, L. Llull, A. Renú, V. Obach, Y. Zhao, J.L. Moreno, A. Lopez-Rueda, S. Amaro and Á. Chamorro

American Journal of Neuroradiology August 2019, 40 (8) 1323-1329; DOI: https://doi.org/10.3174/ajnr.A6139
FELLOWS' JOURNAL CLUBAdult Brain

Open Access
One-Stop Management with Perfusion for Transfer Patients with Stroke due to a Large-Vessel Occlusion: Feasibility and Effects on In-Hospital Times
A. Brehm, I. Tsogkas, I.L. Maier, H.J. Eisenberger, P. Yang, J.-M. Liu, J. Liman and M.-N. Psychogios

American Journal of Neuroradiology August 2019, 40 (8) 1330-1334; DOI: https://doi.org/10.3174/ajnr.A6129

The authors report the first 15 consecutive transfer patients with stroke with externally confirmed large-vessel occlusions who underwent flat panel detector CT perfusion and thrombectomy in the same room. Preinterventional imaging consisted of noncontrast flat panel detector CT and flat panel detector CT perfusion, acquired with a biplane angiography system. The flat panel detector CT perfusion was used to reconstruct a flat panel detector CT angiography to confirm the large-vessel occlusions. After confirmation of the large-vessel occlusion, the patient underwent mechanical thrombectomy. Fifteen transfer patients underwent flat panel detector CT perfusion and were treated with mechanical thrombectomy from June 2017 to January 2019. The median time from symptom onset to admission was 241 minutes. Median door-to-groin time was 24 minutes. Compared with 23 transfer patients imaged with multidetector CT, time was reduced significantly (24 minutes versus53 minutes).
Interventional

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A Standardized Aspiration-First Approach for Thrombectomy to Increase Speed and Improve Recanalization Rates
D. O'Neill, E. Griffin, K.M. Doyle, S. Power, P. Brennan, M. Sheehan, A. O'Hare, S. Looby, A.M. da Silva Santos, R. Rossi and J. Thornton

American Journal of Neuroradiology August 2019, 40 (8) 1335-1341; DOI: https://doi.org/10.3174/ajnr.A6117
FELLOWS' JOURNAL CLUBInterventional

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Distal Balloon Angioplasty of Cerebral Vasospasm Decreases the Risk of Delayed Cerebral Infarction
M.-A. Labeyrie, S. Gaugain, G. Boulouis, A. Zetchi, J. Brami, J.-P. Saint-Maurice, V. Civelli, S. Froelich and E. Houdart

American Journal of Neuroradiology August 2019, 40 (8) 1342-1348; DOI: https://doi.org/10.3174/ajnr.A6124

A group of 392 patients was analyzed (160 before versus 232 after January 2015). Distal balloon angioplasty was associated with the following: higher rates of angioplasty (43% versus 27%) and intravenous milrinone (31% versus 9%); lower rates of postangioplasty delayed cerebral infarction (2.2% versus 7.5%) and new angioplasty (8% versus 19%) independent of the rate of patients treated by angioplasty and milrinone; and the same rates of stroke related to angioplasty (3.6% versus 3.1%), delayed cerebral infarction (7.7% versus 12.5%), mortality (10% versus 11%), and favorable outcome (79% versus 73%). The authors conclude that distal balloon angioplasty is safe and decreases the risk of delayed cerebral infarction and the recurrence of vasospasm compared with conventional angioplasty. It fails to show a clinical benefit possibly because of confounding changes in adjuvant therapies of vasospasm during the study period.
Interventional

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Pretreatment Anterior Choroidal Artery Infarction Predicts Poor Outcome after Thrombectomy in Intracranial ICA Occlusion
B.H. Baek, Y.Y. Lee, S.K. Kim and W. Yoon

American Journal of Neuroradiology August 2019, 40 (8) 1349-1355; DOI: https://doi.org/10.3174/ajnr.A6126
Interventional

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GUide sheath Advancement and aspiRation in the Distal petrocavernous internal carotid artery (GUARD) Technique during Thrombectomy Improves Reperfusion and Clinical Outcomes
S.A. Ansari, M. Darwish, R.N. Abdalla, D.R. Cantrell, A. Shaibani, M.C. Hurley, B.S. Jahromi and M.B. Potts

American Journal of Neuroradiology August 2019, 40 (8) 1356-1362; DOI: https://doi.org/10.3174/ajnr.A6132
FELLOWS' JOURNAL CLUBInterventional

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Posterior Fossa Dural Arteriovenous Fistulas with Subarachnoid Venous Drainage: Outcomes of Endovascular Treatment
L. Détraz, K. Orlov, V. Berestov, V. Borodetsky, A. Rouchaud, L.G. de Abreu Mattos and C. Mounayer

American Journal of Neuroradiology August 2019, 40 (8) 1363-1368; DOI: https://doi.org/10.3174/ajnr.A6140

Twenty-six patients treated endovascularly for posterior fossa dural AVFs, type III, IV, or V, were included in this study. One hundred percent of the dural AVFs were occluded. A transarterial approach was performed in 23 dural AVFs; a combined transarterial and transvenous approach, in 2 dural AVFs; and a transvenous approach alone, in 1 dural AVF. The middle meningeal artery was the most common artery chosen to inject embolic liquid (12/26). Procedure-related morbidity was 15.4% at 24 hours, 7.7% at discharge, and 0% at 6 months. Procedure-related mortality was 0%. The authors conclude that endovascular treatment offers high occlusion rates for posterior fossa dural AVFs with low morbidity and mortality rates.
Extracranial Vascular

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Carotid Artery Stiffness Accurately Predicts White Matter Hyperintensity Volume 20 Years Later: A Secondary Analysis of the Atherosclerosis Risk in the Community Study
A. de Havenon, K.-H. Wong, A. Elkhetali, J.S. McNally, J.J. Majersik and N.S. Rost

American Journal of Neuroradiology August 2019, 40 (8) 1369-1373; DOI: https://doi.org/10.3174/ajnr.A6115
Extracranial Vascular

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Carotid CTA at the Lowest Tube Voltage (70 kV) in Comparison with Automated Tube Voltage Adaption
A. Eller, M. Wiesmüller, W. Wüst, R. Heiss, M. Kopp, M. Saake, M. Brand, M. Uder and M.M. May

American Journal of Neuroradiology August 2019, 40 (8) 1374-1382; DOI: https://doi.org/10.3174/ajnr.A6108
Head & Neck

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Standardization of Temporal Bone CT Planes across a Multisite Academic Institution
J.P. Guenette, L. Hsu, B. Czajkowski and D.B. Nunez

American Journal of Neuroradiology August 2019, 40 (8) 1383-1387; DOI: https://doi.org/10.3174/ajnr.A6111
Head & Neck

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Prolapse of Orbital Fat through the Inferior Orbital Fissure: Description, Prevalence, and Assessment of Possible Pathologic Associations
P.M. Bunch, K. Buch and H.R. Kelly

American Journal of Neuroradiology August 2019, 40 (8) 1388-1391; DOI: https://doi.org/10.3174/ajnr.A6113
Head & Neck

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Detection of Local Recurrence in Patients with Head and Neck Squamous Cell Carcinoma Using Voxel-Based Color Maps of Initial and Final Area under the Curve Values Derived from DCE-MRI
J.Y. Lee, K.L. Cheng, J.H. Lee, Y.J. Choi, H.W. Kim, Y.S. Sung, S.R. Chung, K.H. Ryu, M.S. Chung, S.Y. Kim, S.-W. Lee and J.H. Baek

American Journal of Neuroradiology August 2019, 40 (8) 1392-1401; DOI: https://doi.org/10.3174/ajnr.A6130
Head & Neck

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Prevalence of Spontaneous Asymptomatic Facial Nerve Canal Meningoceles: A Retrospective Review
J.C. Benson, K. Krecke, J.R. Geske, J. Dey, M.L. Carlson, J. Van Gompel and J.I. Lane

American Journal of Neuroradiology August 2019, 40 (8) 1402-1405; DOI: https://doi.org/10.3174/ajnr.A6133
Pediatrics

Open Access
Evaluating Tissue Contrast and Detecting White Matter Injury in the Infant Brain: A Comparison Study of Synthetic Phase-Sensitive Inversion Recovery
D.Y. Kim, W.S. Jung, J.W. Choi, J. Choung and H.G. Kim

American Journal of Neuroradiology August 2019, 40 (8) 1406-1412; DOI: https://doi.org/10.3174/ajnr.A6135
Pediatrics

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Comparison of CSF and MRI Findings among Neonates and Infants with E coli or Group B Streptococcal Meningitis
S.F. Kralik, M.K. Kukreja, M.J. Paldino, N.K. Desai and J.G. Vallejo

American Journal of Neuroradiology August 2019, 40 (8) 1413-1417; DOI: https://doi.org/10.3174/ajnr.A6134
Pediatrics

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Human Parechovirus Meningoencephalitis: Neuroimaging in the Era of Polymerase Chain Reaction–Based Testing
A. Sarma, E. Hanzlik, R. Krishnasarma, L. Pagano and S. Pruthi

American Journal of Neuroradiology August 2019, 40 (8) 1418-1421; DOI: https://doi.org/10.3174/ajnr.A6118
Pediatrics

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The Complex Spine in Children with Spinal Muscular Atrophy: The Transforaminal Approach—A Transformative Technique
R. Towbin, C. Schaefer, R. Kaye, T. Abruzzo and D.J. Aria

American Journal of Neuroradiology August 2019, 40 (8) 1422-1426; DOI: https://doi.org/10.3174/ajnr.A6131
Spine

Open Access
MRI Predictors of Recurrence and Outcome after Acute Transverse Myelitis of Unidentified Etiology
E. Bulut, T. Shoemaker, J. Karakaya, D.M. Ray, M.A. Mealy, M. Levy and I. Izbudak

American Journal of Neuroradiology August 2019, 40 (8) 1427-1432; DOI: https://doi.org/10.3174/ajnr.A6121
Spine

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CT-Guided Block and Radiofrequency Ablation of the C2 Dorsal Root Ganglion for Cervicogenic Headache
J.L. Chazen, E.J. Ebani, M. Virk, J.F. Talbott and V. Shah

American Journal of Neuroradiology August 2019, 40 (8) 1433-1436; DOI: https://doi.org/10.3174/ajnr.A6127

Online Features

Letters
- LETTER
  
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  Epidural Spinal Injections in Spinal Stenosis due to Lipomatosis: With or without Steroids?
  J. Gossner
  
  American Journal of Neuroradiology August 2019, 40 (8) E40; DOI: https://doi.org/10.3174/ajnr.A6128
- LETTER
  
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  Blood-Brain Barrier Permeability in Patients with Systemic Lupus Erythematosus
  A. Lecler, J.C. Sadik and J. Savatovsky
  
  American Journal of Neuroradiology August 2019, 40 (8) E41; DOI: https://doi.org/10.3174/ajnr.A6137
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  Reply:
  J.M. Chi, M. Mackay, A. Hoang, K. Cheng, C. Aranow, J. Ivanidze, B. Volpe, B. Diamond and P.C. Sanelli
  
  American Journal of Neuroradiology August 2019, 40 (8) E42-E43; DOI: https://doi.org/10.3174/ajnr.A6166

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