Editor’s choices:

Characterization of aneurysm remnants after… by R. Agid et al.

It is well known that many aneurysms will be incompletely occluded by coils initially or will later recanalize. A non-invasive method would be ideal to identify these aneurysms. Here the authors performed a retrospective study that included residual or recurrent aneurysms (n= 44) measuring more than 2 mm that were imaged with contrast enhanced MRA and catheter DSA. They concluded that in patients with known remnants, MRA was equal to DSA and in some cases even better.

R. Agid, R.A. Willinsky, S.-K. Lee, K.G. TerBrugge, and R.I. Farb
Characterization of Aneurysm Remnants after Endovascular Treatment: Contrast-Enhanced MR Angiography versus Catheter Digital Subtraction Angiography
http://www.ajnr.org/cgi/content/full/29/8/1570

Flat panel detector angiographic CT… T. Engelhorn et al.

Although this is a case report I include it in this month’s selections because it illustrates the use of a relatively new technique in a important clinical scenario: subarachnoid hemorrhage during treatment of aneurysms. The degree of hemorrhage not only may have prognostic implications but immediate treatment ones. I have the impression that many clinical neurointerventionalists use this technique but our journal contains scant evidence of its utility.

T. Engelhorn, T. Struffert, G. Richter, M. Doelken, O. Ganslandt, W. Kalender, and A. Doerfler
Flat Panel Detector Angiographic CT in the Management of Aneurysmal Rupture During Coil Embolization
http://www.ajnr.org/cgi/content/full/29/8/1581

Association between cerebral microbleeds on… H. Ueno et al.

Brain microhemorrhages place patients at increased risk for subsequent larger bleeds. The authors aimed to determine of these small bleeds were associated with recurrent hemorrhages in patients receiving warfarin. Their results revealed that cerebral microbleeds were associated with increased risk of developing larger bleeds independently of increased INR (international normalized ratio) and hypertension.

H. Ueno, H. Naka, T. Ohshita, K. Kondo, E. Nomura, T. Ohtsuki, T. Kohriyama, S. Wakabayashi, and M. Matsumoto
Association between Cerebral Microbleeds on T2*-Weighted MR Images and Recurrent Hemorrhagic Stroke in Patients Treated with Warfarin following Ischemic Stroke
http://www.ajnr.org/cgi/content/full/29/8/1483

Journal Club:

In vivo differentiation of aerobic brain abscesses… P. Lai et al.

On conventional MRI, cerebral abscesses may look identical to GBMs. Additionally, if only the central necrotic cavity of both is studied using MRS, results may also be similar. Here the authors sampled using multivolume MRS the ring enhancing portion of lesions to determine if their levels of choline allowed differentiation of infections from tumor. As expected, nearly 50% of abscesses showed cytosolic amino acids. GBMs showed higher levels of choline when compared to creatine and NAA than abscesses.

P.H. Lai, H.H. Weng, C.Y. Chen, S.S. Hsu, S. Ding, C.W. Ko, J.H. Fu, H.L. Liang, and K.H. Chen
In Vivo Differentiation of Aerobic Brain Abscesses and Necrotic Glioblastomas Multiforme Using Proton MR Spectroscopic Imaging
http://www.ajnr.org/cgi/content/full/29/8/1511

No increased risk for contrast induced nephropathy… S. Langner et al.

Contrast induced nephropathy is something in the mind of all radiologists particularly when multiple contrast enhanced imaging studies are obtained in the same patient over a short period of time. The authors prospectively measured serum creatinine in 100 stroke patients undergoing contrast enhanced CT and CT perfusion within 32 hours of each other. They concluded that using this type of contrast in multiple studies did not increase the risk of contrast induced nephropathy.

S. Langner, S. Stumpe, M. Kirsch, M. Petrik, and N. Hosten
No Increased Risk for Contrast-Induced Nephropathy after Multiple CT Perfusion Studies of the Brain with a Nonionic, Dimeric, Iso-Osmolal Contrast Medium
http://www.ajnr.org/cgi/content/full/29/8/1525

Prognostic value of perfusion MR imaging… T. Hirai et al.

The MR perfusion patterns of low and high grade astrocytomas are well known. In this retrospective study, the authors aim was to determine of maximum rCBV in high grade gliomas (grades 3 and 4) could be used to predict patient prognosis. After measuring a variety of clinical parameters, patients with tumors showing low rCVB showed a longer survival (67%) than those that had a high rCBV (9%). Thus, rCVB may be used to predict prognosis of patients with high grade gliomas.

T. Hirai, R. Murakami, H. Nakamura, M. Kitajima, H. Fukuoka, A. Sasao, M. Akter, Y. Hayashida, R. Toya, N. Oya, K. Awai, K. Iyama, J.-i. Kuratsu, and Y. Yamashita
Prognostic Value of Perfusion MR Imaging of High-Grade Astrocytomas: Long-Term Follow-Up Study
http://www.ajnr.org/cgi/content/full/29/8/1505