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Article ; Online: Assessment of the intrasinusidal volume before and after maxillary sinus augmentation using mri - a pilot study of eight patients.

Flick, K / Smeets, R / Gosau, M / Meyer, L / Hanning, U / Kyselyova, A A / Scheifele, C / Höhmann, B / Henningsen, A

2024 Volume 24, Issue 1, Page(s) 142

Abstract: Purpose: The purpose of this study was to evaluate the suitability, accuracy, and reliability of a non-invasive 3-Tesla magnetic resonance imaging technique (3 T-MRI) for the visualization of maxillary sinus grafts in comparison to conventional, X-ray- ... ...

Abstract	Purpose: The purpose of this study was to evaluate the suitability, accuracy, and reliability of a non-invasive 3-Tesla magnetic resonance imaging technique (3 T-MRI) for the visualization of maxillary sinus grafts in comparison to conventional, X-ray-based, established standard imaging techniques. Methods: A total of eight patients with alveolar bone atrophy who required surgical sinus floor augmentation in the course of dental implantation were included in this pilot study. Alongside pre-operative cone-beam computed tomography (CBCT), 3 T-MRI was performed before and 6 months after sinus floor augmentation. Two investigators measured the maxillary sinus volume preoperatively and after bone augmentation. Results: In all cases, MRI demonstrated accurately the volumes of the maxillary sinus grafts. Following surgery, the bony structures suitable for an implant placement increased at an average of 4.89 cm Conclusion: In this preliminary study, we could demonstrate the feasibility of MRI bone volume measurement as a radiation-free alternative with comparable accuracy to CT/CBCT before procedures like sinus floor augmentation. Nevertheless, costs and artifacts, also present in MRI, have to be taken into account. Larger studies will be necessary to justify the practicability of MRI bone volume evaluation.
MeSH term(s)	Humans ; Dental Implantation, Endosseous/methods ; Sinus Floor Augmentation/methods ; Maxillary Sinus/diagnostic imaging ; Maxillary Sinus/surgery ; Pilot Projects ; Reproducibility of Results ; Bone Transplantation/methods ; Cone-Beam Computed Tomography/methods ; Magnetic Resonance Imaging ; Dental Implants ; Maxilla/surgery
Chemical Substances	Dental Implants
Language	English
Publishing date	2024-01-29
Publishing country	England
Document type	Journal Article
ZDB-ID	2091511-1
ISSN	1472-6831 ; 1472-6831
ISSN (online)	1472-6831
ISSN	1472-6831
DOI	10.1186/s12903-024-03858-x
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Article ; Conference proceedings: Endovascular thrombectomy for acute ischemic stroke with very low ASPECTS of 0-2: a meta-analysis of randomized controlled trials

Winkelmeier, L / Maros, M / Flottmann, F / Schön, G / Thomalla, G / Fiehler, J / Hanning, U

RöFo - Fortschritte auf dem Gebiet der Röntgenstrahlen und der bildgebenden Verfahren

2024 Volume 196, Issue S 01

Event/congress	RÖKO 2024, RheinMain CongressCenter (RMCC) in Wiesbaden, 2024-05-08
Language	German
Publishing date	2024-04-01
Publisher	Georg Thieme Verlag
Publishing place	Stuttgart ; New York
Document type	Article ; Conference proceedings
ZDB-ID	554830-5
ISSN	1438-9010 ; 1438-9029 ; 0340-1618 ; 0936-6652 ; 1433-5972
ISSN (online)	1438-9010
ISSN	1438-9029 ; 0340-1618 ; 0936-6652 ; 1433-5972
DOI	10.1055/s-0044-1781599
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Article ; Online: In Reply: Early Prediction of Malignant Cerebellar Edema in Posterior Circulation Stroke Using Quantitative Lesion Water Uptake.

Broocks, Gabriel / Fiehler, Jens / Hanning, Uta

Neurosurgery

2021 Volume 88, Issue 5, Page(s) E476–E477

MeSH term(s)	Brain Edema/diagnostic imaging ; Brain Edema/etiology ; Cerebellum ; Edema ; Humans ; Stroke/complications ; Water
Chemical Substances	Water (059QF0KO0R)
Language	English
Publishing date	2021-02-08
Publishing country	United States
Document type	Letter ; Comment
ZDB-ID	135446-2
ISSN	1524-4040 ; 0148-396X
ISSN (online)	1524-4040
ISSN	0148-396X
DOI	10.1093/neuros/nyab032
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Zs.A 1424: Show issues			Location: Je nach Verfügbarkeit (siehe Angabe bei Bestand) bis Jg. 1994: Bestellungen von Artikeln über das Online-Bestellformular Jg. 1995 - 2021: Lesesall (1.OG) ab Jg. 2022: Lesesaal (EG)
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Article ; Online: Endovascular Thrombectomy for Large Ischemic Strokes with ASPECTS 0-2: a Meta-analysis of Randomized Controlled Trials.

Winkelmeier, Laurens / Maros, Máté / Flottmann, Fabian / Heitkamp, Christian / Schön, Gerhard / Thomalla, Götz / Fiehler, Jens / Hanning, Uta

Clinical neuroradiology

2024

Abstract: Purpose: Randomized controlled trials (RCTs) demonstrated a treatment effect of endovascular thrombectomy in acute ischemic stroke with large infarct, commonly defined as an Alberta Stroke Program Early CT Score (ASPECTS) of 3-5. However, data on ... ...

Abstract	Purpose: Randomized controlled trials (RCTs) demonstrated a treatment effect of endovascular thrombectomy in acute ischemic stroke with large infarct, commonly defined as an Alberta Stroke Program Early CT Score (ASPECTS) of 3-5. However, data on endovascular thrombectomy in patients with very low ASPECTS of 0-2 remain scarce. Methods: We conducted a systematic review and meta-analysis of RCTs comparing endovascular thrombectomy versus medical treatment alone in acute ischemic anterior circulation stroke with very large infarct, defined as ASPECTS of 0-2. The primary outcome was the shift toward better functional outcomes on the 90-day modified Rankin Scale (mRS). Random effects meta-analysis was performed using the generic inverse variance method. Results: Literature research identified four RCTs which evaluated the treatment effect of endovascular thrombectomy for large infarcts and provided a subgroup analysis of the mRS shift in patients with ASPECTS of 0-2. The pooled analysis showed a significant shift toward better 90-day mRS scores in favor of endovascular thrombectomy (pooled odds ratio, 1.62, 95% confidence interval, 1.29-2.04, P < 0.001). Conclusion: This meta-analysis suggests a treatment effect of endovascular thrombectomy in specific patients with very low ASPECTS of 0-2, challenging the use of ASPECTS for treatment selection in acute ischemic stroke due to large vessel occlusion. An individual patient meta-analysis of RCTs would strengthen evidence in the treatment of patients with ASPECTS of 0-2.
Language	English
Publishing date	2024-04-30
Publishing country	Germany
Document type	Journal Article
ZDB-ID	2234662-4
ISSN	1869-1447 ; 0939-7116 ; 1869-1439
ISSN (online)	1869-1447
ISSN	0939-7116 ; 1869-1439
DOI	10.1007/s00062-024-01414-2
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Article ; Online: Effect of short- versus long-term serum glucose levels on early ischemic water homeostasis and functional outcome in patients with large vessel occlusion stroke.

Klapproth, Susan / Meyer, Lukas / Kniep, Helge / Bechstein, Matthias / Kyselyova, Anna / Hanning, Uta / Schön, Gerhard / Rimmele, Leander / Fiehler, Jens / Broocks, Gabriel

European journal of neurology

2023 Volume 31, Issue 3, Page(s) e16166

Abstract: Background and purpose: In ischemic stroke, the impact of short- versus long-term blood glucose level (BGL) on early lesion pathophysiology and functional outcome has not been assessed. The purpose of this study was to directly compare the effect of ... ...

Abstract	Background and purpose: In ischemic stroke, the impact of short- versus long-term blood glucose level (BGL) on early lesion pathophysiology and functional outcome has not been assessed. The purpose of this study was to directly compare the effect of long-term blood glucose (glycated hemoglobin [HbA1c]) versus serum BGL on early edema formation and functional outcome. Methods: Anterior circulation ischemic stroke patients who underwent mechanical thrombectomy after multimodal computed tomography (CT) on admission were analyzed. Endpoints were early ischemic cerebral edema, measured by quantitative net water uptake (NWU) on initial CT and functional independence at Day 90. Results: A total of 345 patients were included. Patients with functional independence had significantly lower baseline NWU (3.1% vs. 8.3%; p < 0.001) and lower BGL (113 vs. 123 mg/dL; p < 0.001) than those without functional independence, while HbA1c levels did not differ significantly (5.7% vs. 5.8%; p = 0.15). A significant association was found for NWU and BGL (ß = 0.02, 95% confidence interval [CI] 0.006-0.03; p = 0.002), but not for HbA1c and NWU (ß = -0.16, 95% CI -0.53-0.21; p = 0.39). Mediation analysis showed that 67% of the effect of BGL on functional outcome was mediated by early edema formation. Conclusion: Aggravated early edema and worse functional outcome was associated with elevated short-term serum BGL, but not with HbA1c levels. Hence, the link between short-term BGL and early edema development might be used as a target for adjuvant therapy in patients with ischemic stroke.
MeSH term(s)	Humans ; Stroke ; Blood Glucose ; Glycated Hemoglobin ; Water ; Retrospective Studies ; Ischemic Stroke ; Homeostasis ; Edema ; Treatment Outcome ; Thrombectomy ; Brain Ischemia/complications ; Brain Ischemia/diagnostic imaging
Chemical Substances	Blood Glucose ; Glycated Hemoglobin ; Water (059QF0KO0R)
Language	English
Publishing date	2023-11-28
Publishing country	England
Document type	Journal Article
ZDB-ID	1280785-0
ISSN	1468-1331 ; 1351-5101 ; 1471-0552
ISSN (online)	1468-1331
ISSN	1351-5101 ; 1471-0552
DOI	10.1111/ene.16166
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Zs.A 4738: Show issues			Location: Je nach Verfügbarkeit (siehe Angabe bei Bestand) bis Jg. 1994: Bestellungen von Artikeln über das Online-Bestellformular Jg. 1995 - 2021: Lesesall (2.OG) ab Jg. 2022: Lesesaal (EG)
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Article ; Online: How much of the outcome improvement after successful recanalization is explained by follow-up infarct volume reduction?

Kniep, Helge / Meyer, Lukas / Broocks, Gabriel / Bechstein, Matthias / Austein, Friederike / McDonough, Rosalie V / Brekenfeld, Caspar / Flottmann, Fabian / Deb-Chatterji, Milani / Alegiani, Anna / Hanning, Uta / Thomalla, Goetz / Fiehler, Jens / Gellissen, Susanne

Journal of neurointerventional surgery

2024 Volume 16, Issue 5, Page(s) 459–465

Abstract: Background: Follow-up infarct volume (FIV) is used as surrogate for treatment efficiency in mechanical thrombectomy (MT). However, previous works suggest that MT-related FIV reduction has only limited association with outcome comparing MT independently ... ...

Abstract	Background: Follow-up infarct volume (FIV) is used as surrogate for treatment efficiency in mechanical thrombectomy (MT). However, previous works suggest that MT-related FIV reduction has only limited association with outcome comparing MT independently of recanalization success versus medical care. It remains unclear to what extent the relationship between successful recanalization versus persistent occlusion and functional outcome is explained by FIV reduction. Objective: To determine whether FIV mediates the relationship between successful recanalization and functional outcome. Methods: All patients from our institution enrolled in the German Stroke Registry (May 2015-December 2019) with anterior circulation stroke; availability of the relevant clinical data, and follow-up-CT were analyzed. The effect of FIV reduction on functional outcome (90-day modified Rankin Scale (mRS) score ≤2) after successful recanalization (Thrombolysis in Cerebral Infarction ≥2b) was quantified using mediation analysis. Results: 429 patients were included, of whom, 309 (72 %) had successful recanalization and 127 (39%) had good functional outcome. Good outcome was associated with age (OR=0.89, P<0.001), pre-stroke mRS score (OR=0.38, P<0.001), FIV (OR=0.98, P<0.001), hypertension (OR=2.08, P<0.05), and successful recanalization (OR=3.57, P<0.01). Using linear regression in the mediator pathway, FIV was associated with Alberta Stroke program Early CT Score (coefficient (Co)=-26.13, P<0.001), admission National Institutes of Health Stroke Scale score (Co=3.69, P<0.001), age (Co=-1.18, P<0.05), and successful recanalization (Co=-85.22, P<0.001). Successful recanalization increased the probability of good outcome by 23 percentage points (pp) (95% CI 16pp to 29pp). 56% (95% CI 38% to 78%) of the improvement in good outcome was explained by FIV reduction. Conclusion: 56% (95% CI 38% to 78%) of outcome improvement after successful recanalization was explained by FIV reduction. Results corroborate pathophysiological assumptions and confirm the value of FIV as an imaging endpoint in clinical trials. 44% (95% CI 22% to 62%) of the improvement in outcome was not explained by FIV reduction and reflects the remaining mismatch between radiological and clinical outcome measures.
MeSH term(s)	Humans ; Male ; Female ; Aged ; Middle Aged ; Treatment Outcome ; Registries ; Aged, 80 and over ; Thrombectomy/methods ; Follow-Up Studies ; Ischemic Stroke/surgery ; Ischemic Stroke/diagnostic imaging ; Ischemic Stroke/therapy
Language	English
Publishing date	2024-04-23
Publishing country	England
Document type	Journal Article
ZDB-ID	2514982-9
ISSN	1759-8486 ; 1759-8478
ISSN (online)	1759-8486
ISSN	1759-8478
DOI	10.1136/jnis-2023-020296
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Article ; Online: Letter by Sporns et al Regarding Article, "Thrombus Permeability in Admission Computed Tomographic Imaging Indicates Stroke Pathogenesis Based on Thrombus Histology".

Sporns, Peter B / Hanning, Uta / Kemmling, André

Stroke

2019 Volume 50, Issue 2, Page(s) e35

MeSH term(s)	Brain Ischemia ; Humans ; Permeability ; Stroke ; Thrombosis ; Tomography, X-Ray Computed
Language	English
Publishing date	2019-01-07
Publishing country	United States
Document type	Letter ; Comment
ZDB-ID	80381-9
ISSN	1524-4628 ; 0039-2499 ; 0749-7954
ISSN (online)	1524-4628
ISSN	0039-2499 ; 0749-7954
DOI	10.1161/STROKEAHA.118.023891
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Article ; Online: Letter by Sporns et al Regarding Article, "Predictive Value of Susceptibility Vessel Sign for Arterial Recanalization and Clinical Improvement in Ischemic Stroke".

Sporns, Peter B / Hanning, Uta / Kemmling, André

Stroke

2019 Volume 50, Issue 5, Page(s) e134

MeSH term(s)	Brain Ischemia ; Humans ; Stroke ; Thrombolytic Therapy ; Tissue Plasminogen Activator
Chemical Substances	Tissue Plasminogen Activator (EC 3.4.21.68)
Language	English
Publishing date	2019-05-24
Publishing country	United States
Document type	Letter ; Comment
ZDB-ID	80381-9
ISSN	1524-4628 ; 0039-2499 ; 0749-7954
ISSN (online)	1524-4628
ISSN	0039-2499 ; 0749-7954
DOI	10.1161/STROKEAHA.119.024827
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Article ; Online: Thrombectomy in Patients With Ischemic Stroke Without Salvageable Tissue on CT Perfusion.

Broocks, Gabriel / McDonough, Rosalie V / Bechstein, Matthias / Klapproth, Susan / Faizy, Tobias D / Schön, Gerhard / Kniep, Helge C / Bester, Maxim / Hanning, Uta / Kemmling, André / Zeleñák, Kamil / Fiehler, Jens / Meyer, Lukas

Stroke

2024 Volume 55, Issue 5, Page(s) 1317–1325

Abstract: Background: Computed tomography perfusion (CTP) imaging is regularly used to guide patient selection for mechanical thrombectomy (MT). However, the effect of MT in patients without salvageable tissue on CTP has not been investigated. The purpose of this ...

Abstract	Background: Computed tomography perfusion (CTP) imaging is regularly used to guide patient selection for mechanical thrombectomy (MT). However, the effect of MT in patients without salvageable tissue on CTP has not been investigated. The purpose of this study was to assess the effect of MT in patients with stroke without perfusion mismatch profiles. Methods: This observational study analyzed patients with ischemic stroke consecutively treated between March 1, 2015, and January 31, 2022, triaged by multimodal-computed tomography undergoing MT. CTP lesion-core mismatch profiles were defined using a mismatch volume/ratio of ≥10 mL/1.2, respectively. The primary end point was the rate of functional independence at 90 days, defined as the modified Rankin Scale score of 0 to 2. Recanalization was evaluated with the modified Thrombolysis in Cerebral Infarction scale. The effect of baseline variables on functional outcome was assessed using multivariable logistic regression analysis. Outcomes of patients with and without CTP-mismatch profiles were compared using 1:1 propensity score matching. Results: Of 724 patients who met the inclusion criteria of this retrospective observational study, 110 (15%) patients had no CTP mismatch and were analyzed. The median age was 74 (interquartile range, 62-80) years and 53% were women. Successful recanalization (modified Thrombolysis in Cerebral Infarction score, ≥2b) was achieved in 66% (73) and associated with functional independence at 90 days (adjusted odds ratio, 7.33 [95% CI, 1.22-43.70]; Conclusions: In patients without CTP-mismatch profiles defined according to the EXTEND (Extending the Time for Thrombolysis in Emergency Neurological Deficits) criteria, recanalization was associated with improved functional outcomes. This effect was associated with baseline Alberta Stroke Program Early Computed Tomography Score and age, but not with the time from onset to imaging.
Language	English
Publishing date	2024-04-04
Publishing country	United States
Document type	Journal Article
ZDB-ID	80381-9
ISSN	1524-4628 ; 0039-2499 ; 0749-7954
ISSN (online)	1524-4628
ISSN	0039-2499 ; 0749-7954
DOI	10.1161/STROKEAHA.123.044916
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Article ; Conference proceedings: Neoplastic and Non-Neoplastic Acute Intracerebral Hemorrhage in CT brain scans: Machine Learning-based Prediction using Radiomic Image Features

Nawabi, J / Kniep, H / Broocks, G / Schön, G / Fiehler, J / Hanning, U

RöFo - Fortschritte auf dem Gebiet der Röntgenstrahlen und der bildgebenden Verfahren

2020 Volume 192, Issue S 01

Event/congress	101. Deutscher Röntgenkongress und 9. Gemeinsamer Kongress der DRG und ÖRG, Leipzig, 2020-05-20
Language	German
Publishing date	2020-04-01
Publisher	© Georg Thieme Verlag KG
Publishing place	Stuttgart ; New York
Document type	Article ; Conference proceedings
ZDB-ID	554830-5
ISSN	1438-9010 ; 1438-9029 ; 0340-1618 ; 0936-6652 ; 1433-5972
ISSN (online)	1438-9010
ISSN	1438-9029 ; 0340-1618 ; 0936-6652 ; 1433-5972
DOI	10.1055/s-0040-1703313
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