| 1. |
- Cronqvist, Mats, et al.
(författare)
-
Diffusion and perfusion MRI in patients with ruptured and unruptured intracranial aneurysms treated by endovascular coiling: complications, procedural results, MR findings and clinical outcome.
- 2005
-
Ingår i: Neuroradiology. - : Springer Science and Business Media LLC. - 1432-1920 .- 0028-3940. ; 47:11, s. 855-873
-
Tidskriftsartikel (refereegranskat)abstract
- Our purpose was to evaluate treatment safety as well as complications frequency and management in endovascular coiling of intracerebral aneurysms using MR diffusion and perfusion imaging. In this prospective study, 77 MR examinations were performed in conjunction with 43 procedures in 40 patients, 14 patients presented with ruptured and 26 with unruptured aneurysms. Mean time interval between treatment and post-procedure MRI was 29 and 25 h for the ruptured and unruptured aneurysm group, respectively. Peri-procedural complications, including five major events and five minor transient events, occurred in 10/43 procedures (23%), necessitating thrombolytic therapy in two patients and angioplasty in one, all three within the unruptured aneurysm group. Fifty-one new lesions were found on post-treatment DWI and 47 of them were regarded as of ischemic origin. Most lesions were small (< 3 mm), ipsilateral to the treated aneurysm and asymptomatic (37/40 patients). Sixty-seven percent of the lesions were found in the ruptured and 33% in the unruptured aneurysm group. The ischemic lesions did occur more frequently in patients treated for aneurysm of large neck size and according to the remodelling technique. The overall morbidity and mortality rates were 14.6 and 7.3% whereas morbidity and mortality rates related to the technique were only 2.6 and 0%, respectively. Silent embolism seems to be more common than clinically evident and partially related to patient presentation, heparinazation and treatment strategy. The capability to depict early complications and analyse their potential causes by using MR with DWI has been of great importance in our modification and improvement of therapeutic protocols, evaluations and strategies.
|
|
| 2. |
|
|
| 3. |
- Elias, Erik, 1979, et al.
(författare)
-
Independent somatic evolution underlies clustered neuroendocrine tumors in the human small intestine.
- 2021
-
Ingår i: Nature communications. - : Springer Science and Business Media LLC. - 2041-1723. ; 12:1
-
Tidskriftsartikel (refereegranskat)abstract
- Small intestine neuroendocrine tumor (SI-NET), the most common cancer of the small bowel, often displays a curious multifocal phenotype with several tumors clustered together in a limited intestinal segment. SI-NET also shows an unusual absence of driver mutations explaining tumor initiation and metastatic spread. The evolutionary trajectories that underlie multifocal SI-NET lesions could provide insight into the underlying tumor biology, but this question remains unresolved. Here, we determine the complete genome sequences of 61 tumors and metastases from 11 patients with multifocal SI-NET, allowing for elucidation of phylogenetic relationships between tumors within single patients. Intra-individual comparisons revealed a lack of shared somatic single-nucleotide variants among the sampled intestinal lesions, supporting an independent clonal origin. Furthermore, in three of the patients, two independent tumors had metastasized. We conclude that primary multifocal SI-NETs generally arise from clonally independent cells, suggesting a contribution from a cancer-priming local factor.
|
|
| 4. |
|
|
| 5. |
|
|
| 6. |
|
|
| 7. |
|
|
| 8. |
- Ramgren, Birgitta, et al.
(författare)
-
Follow-up of intracranial aneurysms treated with detachable coils: comparison of 3D inflow MRA at 3T and 1.5T and contrast-enhanced MRA at 3T with DSA.
- 2008
-
Ingår i: Neuroradiology. - : Springer Science and Business Media LLC. - 1432-1920 .- 0028-3940. ; 50, s. 947-954
-
Tidskriftsartikel (refereegranskat)abstract
- INTRODUCTION: The purpose of this prospective study was to compare 3T and 1.5T magnetic resonance angiography (MRA) with digital subtraction angiography (DSA) for the follow-up of endovascular treated intracranial aneurysms to assess the grade of occlusion. MATERIALS AND METHODS: Thirty-seven patients with 41 aneurysms who had undergone endovascular treatment with detachable coils were included. MRA was performed on the same day using an eight-channel sensitivity encoding head-coil with 3D axial inflow technique. At 3T, a contrast-enhanced transverse 3D fast gradient echo acquisition was also performed. Most patients underwent DSA the following day. MRA scans and DSA were classified first independently by two neuroradiologists and an interventional neuroradiologist. Secondly, a consensus was done. Source images, maximum intensity projection, multiplanar reconstruction and volume rendering reconstructions were used for MRA evaluations. A modification of the Raymond classification, previously used for DSA evaluation of recanalization, was used. RESULTS: Statistical comparison of the consensus showed that 3T MRA with 3D axial inflow technique had better agreement with DSA (kappa = 0.43) than 1.5T MRA(kappa = 0.21) and contrast-enhanced MRA (CE-MRA) at 3T (kappa = 0.17). The susceptibility artefacts from the coil mesh were significally smaller at 3T (p = 0.002-0.007) than at 1.5T. CONCLUSION: 3T MRA, using a sensitivity encoding head-coil, showed better agreement with DSA than 1.5T and CE-MRA at 3T for evaluation of aneurysms treated with endovascular coiling.
|
|
