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Article: Dual energy computed tomomgraphy in acute stroke, where are we and where are we going?

Mangesius, S / Grams, A E

Journal of neuroradiology = Journal de neuroradiologie

2021 Volume 48, Issue 2, Page(s) 71–74

MeSH term(s)	Brain Ischemia ; Humans ; Stroke/diagnostic imaging
Language	English
Publishing date	2021-02-16
Publishing country	France
Document type	Editorial
ZDB-ID	131763-5
ISSN	1773-0406 ; 0150-9861
ISSN (online)	1773-0406
ISSN	0150-9861
DOI	10.1016/j.neurad.2021.02.003
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Article: Preoperative prediction of language function by diffusion tensor imaging.

Freyschlag, C F / Kerschbaumer, J / Pinggera, D / Bodner, T / Grams, A E / Thomé, C

Brain informatics

2017 Volume 4, Issue 3, Page(s) 201–205

Abstract: For surgery of eloquent tumors in language areas, the accepted gold standard is functional mapping through direct cortical stimulation (DCS) in awake patients. Ever since, neuroscientists are searching for reliable noninvasive detection of function in ... ...

Abstract	For surgery of eloquent tumors in language areas, the accepted gold standard is functional mapping through direct cortical stimulation (DCS) in awake patients. Ever since, neuroscientists are searching for reliable noninvasive detection of function in the human brain, with variable success. The potential of diffusion tensor imaging (DTI) in combination with computational cortical parcellation to predict functional areas in language eloquent tumors has not been assessed so far. We present a proof-of-concept report involving awake surgery for a temporodorsal tumor. Postoperatively, the imaging was extensively studied and a predictive value of multimodal MR imaging for the possible extent of resection was analyzed. After resection using DCS, the extent of resection and functional outcome were correlated with the processed imaging. Preoperative imaging of our patient was taken to compute the lesion volume as a seed for tractography (DTI) and combined with a tractography of the entire hemisphere. For better spatial resolution, an elastic image fusion was performed to correct the distortion of DTI data. After subtotal resection and imaging analysis, the status of the superior part of the lesion could be identified and predicted as functional cortex. There was a strong correlation between the tumor remnant during surgery and the imaging parameters of DTI connectivity of the eloquent tissue. A combination of complex DTI processing may be able to predict function in a patient suffering eloquent brain tumors and thus allow estimation of extent of resection.
Language	English
Publishing date	2017-05-04
Publishing country	Germany
Document type	Journal Article
ISSN	2198-4018
ISSN	2198-4018
DOI	10.1007/s40708-017-0064-8
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Article ; Online: Feed-forward neural networks using cerebral MR spectroscopy and DTI might predict neurodevelopmental outcome in preterm neonates.

Janjic, T / Pereverzyev, S / Hammerl, M / Neubauer, V / Lerchner, H / Wallner, V / Steiger, R / Kiechl-Kohlendorfer, U / Zimmermann, M / Buchheim, A / Grams, A E / Gizewski, E R

European radiology

2020 Volume 30, Issue 12, Page(s) 6441–6451

Abstract: Objectives: We aimed to evaluate the ability of feed-forward neural networks (fNNs) to predict the neurodevelopmental outcome (NDO) of very preterm neonates (VPIs) at 12 months corrected age by using biomarkers of cerebral MR proton spectroscopy (: ... ...

Abstract	Objectives: We aimed to evaluate the ability of feed-forward neural networks (fNNs) to predict the neurodevelopmental outcome (NDO) of very preterm neonates (VPIs) at 12 months corrected age by using biomarkers of cerebral MR proton spectroscopy ( Methods: In this prospective study, 300 VPIs born before 32 gestational weeks received an MRI scan at TEA between September 2013 and December 2017. Due to missing or poor-quality spectroscopy data and missing neurodevelopmental tests, 173 VPIs were excluded. Data sets consisting of 103 and 115 VPIs were considered for prediction of motor and cognitive developmental delay, respectively. Five metabolite ratios and two DTI characteristics in six different areas of the brain were evaluated. A feature selection algorithm was developed for receiving a subset of characteristics prevalent for the VPIs with a developmental delay. Finally, the predictors were constructed employing multiple fNNs and fourfold cross-validation. Results: By employing the constructed fNN predictors, we were able to predict cognitive delays of VPIs with 85.7% sensitivity, 100% specificity, 100% positive predictive value (PPV) and 99.1% negative predictive value (NPV). For the prediction of motor delay, we achieved a sensitivity of 76.9%, a specificity of 98.9%, a PPV of 90.9% and an NPV of 96.7%. Conclusion: FNNs might be able to predict motor and cognitive development of VPIs at 12 months corrected age when employing biomarkers of cerebral Key points: • A feed-forward neuronal network is a promising tool for outcome prediction in premature infants. • Cerebral proton magnetic resonance spectroscopy and diffusion tensor imaging can be used for the construction of early prognostic biomarkers. • Premature infants that would most benefit from early intervention services can be spotted at the time of optimal neuroplasticity.
MeSH term(s)	Brain/diagnostic imaging ; Brain/physiopathology ; Developmental Disabilities/diagnosis ; Developmental Disabilities/physiopathology ; Diffusion Tensor Imaging/methods ; Female ; Humans ; Image Interpretation, Computer-Assisted/methods ; Infant ; Infant, Newborn ; Infant, Premature ; Infant, Premature, Diseases/diagnosis ; Infant, Premature, Diseases/physiopathology ; Magnetic Resonance Spectroscopy/methods ; Male ; Neural Networks, Computer ; Predictive Value of Tests ; Prognosis ; Prospective Studies ; Sensitivity and Specificity
Language	English
Publishing date	2020-07-18
Publishing country	Germany
Document type	Journal Article
ZDB-ID	1085366-2
ISSN	1432-1084 ; 0938-7994 ; 1613-3749
ISSN (online)	1432-1084
ISSN	0938-7994 ; 1613-3749
DOI	10.1007/s00330-020-07053-8
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Article: Schlaganfallpravention: intrakranielle arterielle Stenosen. Stroke Prevention: Intracranial Arterial Stenoses

Gizewski, E. R. / Grams, A. E. / Kaps, M.

Aktuelle Neurologie

2011 Volume 38, Issue 8, Page(s) 428

Language	German
Document type	Article
ZDB-ID	124980-0
ISSN	0302-4350 ; 1431-4886
Database	Current Contents Medicine

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Article: Schlaganfallprävention: intrakranielle arterielle Stenosen

Gizewski, E. R. / Grams, A. E. / Kaps, M.

Aktuelle Neurologie

2011 Volume 38, Issue 08, Page(s) 428–435

Abstract: Intrakranielle arterielle Stenosen (IAS) sind für etwa 6,5–8% aller ischämischen Schlaganfälle verantwortlich. Für Patienten mit einer symptomatischen IAS wurde bislang trotz medikamentöser Sekundärprophylaxe innerhalb eines Jahres ein hohes ... ...

Abstract	Intrakranielle arterielle Stenosen (IAS) sind für etwa 6,5–8% aller ischämischen Schlaganfälle verantwortlich. Für Patienten mit einer symptomatischen IAS wurde bislang trotz medikamentöser Sekundärprophylaxe innerhalb eines Jahres ein hohes Reinsultrisiko bis zu 12% in dem zugehörigen Gefäßterritorium beschrieben. Dabei haben IAS mit einem Stenosegrad ≥ 70% das höchste Reinsultrisiko (18%). Die Warfarin vs. Aspirin for Symptomatic Intracranial Stenosis Studie (WASID) führte zu der Empfehlung, dass bei symptomatischen IAS zunächst eine medikamentöse Sekundärprophylaxe mit Azetylsalizylsäure erfolgen sollte. Bei einem unter Thrombozytenfunktionshemmern auftretenden erneuten ischämischen Schlaganfall/TIA im Gefäßterritorium der symptomatischen IAS kann insbesondere bei Stenosen ≥ 70% eine interventionelle (stentgestützte) Angioplastie in einem spezialisierten Zentrum empfohlen werden. Zahlreiche aktuelle Veröffentlichungen legten nahe, dass durch die zunehmende Erfahrung der interventionell tätigen Neuroradiologen die periprozedurale Komplikationsrate zwischen 6 und 7% liegt, das Reinfraktrisiko bei bis zu 7,8% bei IAS > 70% liegen. Allerdings zeigte eine neue randomisierte Studie (SAMMPRIS), die bei symptomatischen IAS eine aggressive medikamentöse Sekundärprophylaxe mit der interventionellen Therapie vergliechen hat, dass in dieser Kohorte die Letalität im interventionellen Arm bei 14% lag, im medikamentösen Arm nur bei 5,8%. Eine abschließende Bewertung dieser noch sehr neuen Daten kann aktuell noch nicht erfolgen; ein Zwischenfazit könnte sein, dass eine endovaskuläre Therapie an speziellen Zentren in Betracht gezogen werden sollte wenn Patienten unter doppelter Thrombozytenfunktionshemmung weiterhin symptomatisch sind. Die Leitlinien werden sicher eine Weiterentwicklung und erneute Diskussion erfahren.
Keywords	Angioplastie ; intrakranielle Stenose ; Prävention Schlaganfall ; angioplasty ; intracranial stenosis ; prevention of ischaemic stroke
Language	German
Publishing date	2011-10-01
Publisher	© Georg Thieme Verlag KG
Publishing place	Stuttgart ; New York
Document type	Article
ZDB-ID	124980-0
ISSN	1438-9428 ; 0302-4350 ; 1431-4886
ISSN (online)	1438-9428
ISSN	0302-4350 ; 1431-4886
DOI	10.1055/s-0031-1297240
Database	Thieme publisher's database

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Article ; Online: Residual Thromboembolic Material in Cerebral Arteries after Endovascular Stroke Therapy Can Be Identified by Dual-Energy CT.

Grams, A E / Knoflach, M / Rehwald, R / Willeit, J / Sojer, M / Gizewski, E R / Glodny, B

AJNR. American journal of neuroradiology

2015 Volume 36, Issue 8, Page(s) 1413–1418

Abstract: Background and purpose: Dual-energy CT features the opportunity to differentiate among up to 3 different materials because the absorption of x-rays depends on the applied tube voltage and the atomic number of the material. For example, it is possible to ...

Abstract	Background and purpose: Dual-energy CT features the opportunity to differentiate among up to 3 different materials because the absorption of x-rays depends on the applied tube voltage and the atomic number of the material. For example, it is possible to distinguish between blood-brain barrier disruption and an intracerebral hemorrhage following treatment for a stroke. The aim of this study was to evaluate whether dual-energy CT is capable of distinguishing intra-arterial contrast agent from residually clotted vessels immediately after endovascular stroke therapy. Materials and methods: Sixteen patients (9 women, 7 men; mean age, 63.6 ± 13.09 years) were examined. Measurements were made on the postinterventional dual-energy CT virtual noncontrast, iodine map, and "weighted" brain window (weighted dual-energy) series. Postinterventional conventional angiography was used as the criterion standard method. Results: A residual clot was found in 10 patients. On the virtual noncontrast series, the Hounsfield attenuation of the clotted arteries was higher than that in the corresponding perfused contralateral arteries (53.72 ± 9.42 HU versus 41.64 ± 7.87 HU; P < .05). The latter had higher absorption values on the weighted dual-energy series than on the virtual noncontrast series (49.37 ± 7.44 HU versus 41.64 ± 7.87 HU; P < .05). The sensitivity for the detection of a residual clot was 90%; the specificity was 83.3%, and the accuracy was 87.5%. Interrater agreement was good (κ = 0.733). Conclusions: Dual-energy CT may be valuable in the detection of clot persistence or early re-thrombosis without the necessity of additional contrast administration. However, its relevance for the prediction of outcomes remains to be determined in further studies.
MeSH term(s)	Adult ; Aged ; Aged, 80 and over ; Brain/diagnostic imaging ; Cerebral Arteries/diagnostic imaging ; Cerebral Arteries/pathology ; Cerebral Hemorrhage/diagnostic imaging ; Endovascular Procedures ; Female ; Humans ; Intracranial Embolism/pathology ; Intracranial Embolism/therapy ; Intracranial Thrombosis/pathology ; Intracranial Thrombosis/therapy ; Male ; Middle Aged ; Radiography, Interventional/methods ; Stroke/diagnostic imaging ; Stroke/therapy ; Tomography, X-Ray Computed/methods
Language	English
Publishing date	2015-05-21
Publishing country	United States
Document type	Journal Article
ZDB-ID	603808-6
ISSN	1936-959X ; 0195-6108
ISSN (online)	1936-959X
ISSN	0195-6108
DOI	10.3174/ajnr.A4350
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Article ; Online: Non-convulsive status epilepticus with negative phenomena--a SMART syndrome variant.

Hametner, E / Unterberger, I / Lutterotti, A / Beer, R / Prieschl, M / Grams, A E / Donnemiller, E / Stockhammer, G

Seizure

2015 Volume 25, Page(s) 49–51

MeSH term(s)	Adult ; Brain/diagnostic imaging ; Brain/pathology ; Brain/physiopathology ; Brain Neoplasms/therapy ; Chemoradiotherapy, Adjuvant/adverse effects ; Diagnosis, Differential ; Electroencephalography ; Glioblastoma/therapy ; Humans ; Magnetic Resonance Imaging ; Male ; Positron-Emission Tomography ; Status Epilepticus/diagnosis ; Status Epilepticus/diagnostic imaging ; Status Epilepticus/pathology ; Status Epilepticus/physiopathology ; Syndrome
Language	English
Publishing date	2015-02
Publishing country	England
Document type	Case Reports ; Letter
ZDB-ID	1137610-7
ISSN	1532-2688 ; 1059-1311
ISSN (online)	1532-2688
ISSN	1059-1311
DOI	10.1016/j.seizure.2014.12.007
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Article ; Online: Indication, technique and benefit of intraoperative spinal digital subtraction angiography with a new setting in a patient with spinal arteriovenous malformation.

Grams, A E / Gizewski, E R / Sandalcioglu, I E / Forsting, M / Sure, U

Central European neurosurgery

2011 Volume 72, Issue 3, Page(s) 149–151

Abstract: Background and object: A new setting of intraoperative spinal angiography within an angiography suite is presented.: Patient and methods: In a patient with thoracic arteriovenous malformation, the resection was performed within an angiography suite. ... ...

Abstract	Background and object: A new setting of intraoperative spinal angiography within an angiography suite is presented. Patient and methods: In a patient with thoracic arteriovenous malformation, the resection was performed within an angiography suite. Therefore a long sheath was applied, which remained sterile during the procedure and allowed a catheter to be introduced which is navigated into the noted segmental artery for contrast injection. Results: Digital subtraction angiography was performed prior to and after the resection at the AVM in order to visualize recent feeders and to ensure the complete occlusion. Conclusions: This method leads to an increased image quality and a shorter operation time in comparison to an angiography within an operating room.
MeSH term(s)	Adult ; Angiography, Digital Subtraction/methods ; Arteries/pathology ; Arteriovenous Fistula/diagnosis ; Arteriovenous Fistula/surgery ; Central Nervous System Vascular Malformations/complications ; Central Nervous System Vascular Malformations/diagnosis ; Central Nervous System Vascular Malformations/surgery ; Female ; Humans ; Intraoperative Period ; Monitoring, Intraoperative ; Paraparesis/etiology ; Prone Position ; Regional Blood Flow ; Spinal Diseases/complications ; Spinal Diseases/diagnosis ; Spinal Diseases/surgery ; Thorax/blood supply ; Vascular Surgical Procedures
Language	English
Publishing date	2011-08
Publishing country	Germany
Document type	Case Reports ; Journal Article
ZDB-ID	2041774-3
ISSN	1868-4912 ; 1438-9746 ; 0044-4251
ISSN (online)	1868-4912 ; 1438-9746
ISSN	0044-4251
DOI	10.1055/s-0030-1268494
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Article ; Online: Dual energy CT myelography after lumbar osteosynthesis.

Grams, A E / Sender, J / Moritz, R / Obert, M / Stein, M / Oertel, M / Krombach, G A / Gizewski, E R / Schmidt, T

RoFo : Fortschritte auf dem Gebiete der Rontgenstrahlen und der Nuklearmedizin

2014 Volume 186, Issue 7, Page(s) 670–674

Abstract: Purpose: The purpose of this study was to evaluate the benefits of CT myelography in the DE technique in patients with lumbar osteosynthesis.: Materials and methods: In 30 patients a DE-CT scan of the spine with tube voltages of 80 kV and 140 kV was ... ...

Abstract	Purpose: The purpose of this study was to evaluate the benefits of CT myelography in the DE technique in patients with lumbar osteosynthesis. Materials and methods: In 30 patients a DE-CT scan of the spine with tube voltages of 80 kV and 140 kV was performed and a virtual monochromatic series of 120 kV was generated after intrathecal contrast injection. The impact of metal artifacts on the spinal canal and the spinal foramina was evaluated. The visualization of nerve roots was compared between a VRT series of the dural sac and conventional myelography. Results: With tube voltages of 140 kV, the artifacts were least pronounced. As no overlay disturbance was present, VRT visualization of the nerve roots was more reliable than conventional myelography. Conclusion: In patients after osteosynthesis, CT in the DE technique provides minimal artifact disturbance using a tube voltage of 140 kV. "Virtual myelography" seems to be superior to conventional myelography for the evaluation of nerve roots. This could reduce additional conventional radiography, may shorten the entire examination and radiation time and diminish unnecessary painful movements for the patient.
MeSH term(s)	Adult ; Aged ; Aged, 80 and over ; Female ; Fracture Fixation, Internal/methods ; Humans ; Lumbar Vertebrae/diagnostic imaging ; Lumbar Vertebrae/surgery ; Male ; Middle Aged ; Myelography/methods ; Prognosis ; Radiation Dosage ; Radiation Protection/methods ; Radiography, Dual-Energy Scanned Projection/methods ; Reproducibility of Results ; Sensitivity and Specificity ; Spinal Stenosis/diagnostic imaging ; Spinal Stenosis/surgery ; Tomography, X-Ray Computed/methods ; Treatment Outcome
Language	English
Publishing date	2014-07
Publishing country	Germany
Document type	Clinical Trial ; Journal Article
ZDB-ID	554830-5
ISSN	1438-9010 ; 0340-1618 ; 0936-6652 ; 1433-5972 ; 1438-9029
ISSN (online)	1438-9010
ISSN	0340-1618 ; 0936-6652 ; 1433-5972 ; 1438-9029
DOI	10.1055/s-0033-1356199
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Article ; Online: 7 Tesla MRI demonstrates vascular pathology in Balo's concentric sclerosis.

Berghoff, M / Schlamann, M U / Maderwald, S / Grams, A E / Kaps, M / Ladd, M E / Gizewski, E R

Multiple sclerosis (Houndmills, Basingstoke, England)

2013 Volume 19, Issue 1, Page(s) 120–122

Abstract: Baló's concentric sclerosis (BCS) is an inflammatory demyelinating disease related to multiple sclerosis; its underlying pathology remains unclear. At 7 T MRI in a 19-year-old female BCS patient, microhaemorrhages and ectatic veins were found in T2 ... ...

Abstract	Baló's concentric sclerosis (BCS) is an inflammatory demyelinating disease related to multiple sclerosis; its underlying pathology remains unclear. At 7 T MRI in a 19-year-old female BCS patient, microhaemorrhages and ectatic veins were found in T2 hyperintense regions, features which have not been previously reported in conjunction with BCS, and these findings may support the view that vascular pathology plays a role in BCS. MRS data suggest that neuron loss and lipid turnover still took place months after a remission. Plasma exchange was effective in treating a relapse with severe motor deficits, and the off-label use of natalizumab was successful in maintaining remission in this patient.
MeSH term(s)	Antibodies, Monoclonal, Humanized/therapeutic use ; Brain/pathology ; Diffuse Cerebral Sclerosis of Schilder/pathology ; Female ; Humans ; Immunologic Factors/therapeutic use ; Magnetic Resonance Imaging/methods ; Natalizumab ; Young Adult
Chemical Substances	Antibodies, Monoclonal, Humanized ; Immunologic Factors ; Natalizumab
Language	English
Publishing date	2013-01
Publishing country	England
Document type	Case Reports ; Journal Article
ZDB-ID	1290669-4
ISSN	1477-0970 ; 1352-4585
ISSN (online)	1477-0970
ISSN	1352-4585
DOI	10.1177/1352458512445302
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