1
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Archambeaud A, Le Dreau C, Bigot A, Kosmider O, Taleb A, Boucher L, Temple M, Cottier JP, Maillot F, Audemard-Verger A. Trismus as a new feature of VEXAS syndrome. Rheumatology (Oxford) 2024:keae135. [PMID: 38450422 DOI: 10.1093/rheumatology/keae135] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2023] [Revised: 02/16/2024] [Accepted: 02/26/2024] [Indexed: 03/08/2024] Open
Affiliation(s)
| | | | - Adrien Bigot
- Department of Internal Medicine, CHU Tours, France
| | - Olivier Kosmider
- Department of Haematology, CHU Cochin, France
- University of Paris Cité, Paris, France
| | - Assia Taleb
- Department of Haematology, CHU Cochin, France
| | | | | | | | - François Maillot
- Department of Internal Medicine, CHU Tours, France
- University of Tours, Tours, France
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2
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Sim S, Maldonado IL, Castelnau P, Barantin L, El-Hage W, Andersson F, Cottier JP. Neural correlates of mindfulness meditation and hypnosis on magnetic resonance imaging: similarities and differences. A scoping review. J Neuroradiol 2024; 51:131-144. [PMID: 37981196 DOI: 10.1016/j.neurad.2023.11.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2023] [Revised: 10/23/2023] [Accepted: 11/12/2023] [Indexed: 11/21/2023]
Abstract
BACKGROUND Mindfulness meditation (MM) and hypnosis practices are gaining interest in mental health, but their physiological mechanisms remain poorly understood. This study aimed to synthesize the functional, morphometric and metabolic changes associated with each practice using magnetic resonance imaging (MRI), and to identify their similarities and differences. METHODS MRI studies investigating MM and hypnosis in mental health, specifically stress, anxiety, and depression, were systematically screened following PRISMA guidelines from four research databases (PubMed, Web of Science, Embase, PsycINFO) between 2010 and 2022. RESULTS In total, 97 references met the inclusion criteria (84 for MM and 13 for hypnosis). This review showed common and divergent points regarding the regions involved and associated brain connectivity during MM practice and hypnosis. The primary commonality between mindfulness and hypnosis was decreased default mode network intrinsic activity and increased central executive network - salience network connectivity. Increased connectivity between the default mode network and the salience network was observed in meditative practice and mindfulness predisposition, but not in hypnosis. CONCLUSIONS While MRI studies provide a better understanding of the neural basis of hypnosis and meditation, this review underscores the need for more rigorous studies.
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Affiliation(s)
- Sindy Sim
- CHRU de Tours, service de radiologie, Tours, France
| | | | - Pierre Castelnau
- UMR 1253, iBrain, Université de Tours, Inserm, Tours, France; Service de Neuropédiatrie et Handicaps, Hôpital Clocheville, CHRU, Tours, France; CUMIC, Collège Universitaire des Médecines Intégratives et Complémentaires, Nantes, France
| | | | - Wissam El-Hage
- UMR 1253, iBrain, Université de Tours, Inserm, Tours, France; CHRU de Tours, Clinique Psychiatrique Universitaire, Tours, France
| | | | - Jean-Philippe Cottier
- CHRU de Tours, service de radiologie, Tours, France; UMR 1253, iBrain, Université de Tours, Inserm, Tours, France; CUMIC, Collège Universitaire des Médecines Intégratives et Complémentaires, Nantes, France.
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3
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Hoche C, Henderson A, Ifergan H, Gaudron M, Magni C, Maldonado I, Cottier JP, Pasi M, Boulouis G, Cohen C. Determinants and Clinical Relevance of Iodine Contrast Extravasation after Endovascular Thrombectomy: A Dual-Energy CT Study. AJNR Am J Neuroradiol 2023; 45:30-36. [PMID: 38323978 PMCID: PMC10756568 DOI: 10.3174/ajnr.a8081] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2022] [Accepted: 10/29/2023] [Indexed: 02/08/2024]
Abstract
BACKGROUND AND PURPOSE Iodine contrast extravasation (ICE) is common in patients with acute ischemic stroke (AIS) after endovascular-thrombectomy (EVT). The aim of our study was to evaluate the incidence of ICE assessed by dual-energy CT (DECT), its determinants, and associations with clinical outcome. MATERIALS AND METHODS We retrospectively examined imaging parameters and clinical factors from consecutive patients with AIS treated with EVT who had a DECT 24 hours thereafter, identified at a single academic center. Associations between ICE, clinical, imaging, and procedural parameters, as well as clinical outcome were explored by using univariable and multivariable models. RESULTS A total of 197 consecutive patients were included (period 2019-2020), of which 53 (27%) demonstrated ICE that was pure ICE in 30/53 (57%) and mixed with intracranial hemorrhage (ICH) in 23/53 (43%). Low initial-ASPECTS, high per-procedural-contrast volume injected, and high admission-glycemia were independently associated with ICE (respectively, OR = 0.43, 95% CI, 0.16-1.13, P = .047; OR = 1.02, 95% CI, 1.00-1.04, P = .003; OR = 8.92, 95% CI, 0.63-125.77, P = .043). ICE was independently associated with ICH (P = .047), but not with poorer clinical outcome (6-month mRS >2, P = .223). Univariate analysis demonstrated that low ADC, higher ischemic volume, ICA occlusion, mass effect, longer procedure duration, combined thrombectomy technique, higher number of device passes, and lower recanalization rate were associated with ICE (respectively, P = .002; <.001; .002; <.001; .002; 0.011; <0.001; 0.015). CONCLUSIONS ICE evaluated with DECT is a relatively frequent finding after EVT, present in almost one-third of patients. Lower admission ASPECTS, higher glycemia, and high contrast volume injected per procedure were associated with ICE. We also found an association between ICE and ICH, confirming blood-brain barrier alteration as a major determinant of ICH.
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Affiliation(s)
- Clémence Hoche
- Neurology (C.H., M.G., M.P.), University Hospital of Tours, Tours, France
| | - Alba Henderson
- Department of Diagnostic Neuroradiology (A.H., C.M., C.C.), University Regional Hospital of Orleans, Orléans, France
| | - Héloïse Ifergan
- From the Departments of Diagnostic and Interventional Neuroradiology (H.I., J.-P.C.,G.B.), University Hospital of Tours, Tours, France
| | - Marie Gaudron
- Neurology (C.H., M.G., M.P.), University Hospital of Tours, Tours, France
| | - Christophe Magni
- Department of Diagnostic Neuroradiology (A.H., C.M., C.C.), University Regional Hospital of Orleans, Orléans, France
| | | | - Jean-Philippe Cottier
- From the Departments of Diagnostic and Interventional Neuroradiology (H.I., J.-P.C.,G.B.), University Hospital of Tours, Tours, France
| | - Marco Pasi
- Neurology (C.H., M.G., M.P.), University Hospital of Tours, Tours, France
| | - Grégoire Boulouis
- From the Departments of Diagnostic and Interventional Neuroradiology (H.I., J.-P.C.,G.B.), University Hospital of Tours, Tours, France
| | - Clara Cohen
- Department of Diagnostic Neuroradiology (A.H., C.M., C.C.), University Regional Hospital of Orleans, Orléans, France
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4
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Courtin C, Lacoin G, Remenieras JP, Rousselot CD, Dujardin PA, Zemmoura I, Cottier JP. Tumoral and peritumoral vascularization of brain tumours: a study comparing an intraoperative ultrasensitive Doppler and a preoperative first-pass perfusion MRI. Neurochirurgie 2023; 69:101493. [PMID: 37714376 DOI: 10.1016/j.neuchi.2023.101493] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2023] [Revised: 08/17/2023] [Accepted: 09/05/2023] [Indexed: 09/17/2023]
Abstract
INTRODUCTION Surgery for gliomas can be guided by neuronavigation using magnetic resonance imaging (MRI) and intraoperative B-mode ultrasound. An ultrasensitive Doppler (USD) using plane waves is a new method of microvascularization imaging which can be used intraoperatively and could identify tumoral and peritumoral areas with neoangiogenesis but its value requires evaluation. The aim of this pilot study then was to evaluate the correlations between ultrasound measurements of glioma vascularization (tumoral and peritumoral region) obtained by a USD intraoperatively and first-pass perfusion measurements obtained on preoperative MRI. METHODS 18 patients with proven glial tumors were selected for the analysis. They underwent preoperative MRI and intraoperative USD acquisition. The MRI scans were re-aligned to the reference ultrasound slice plane, and for each patient a segmentation of the tumoral and peritumoral zone was performed. Two perfusion parameters were studied: relative cerebral tumor blood volume (rCCBV) in MRI and fractional moving blood volume (FMBV) in a USD. We studied the correlations between mean rCCBV and mean FMBV measured in the tumoral and peritumoral zones in the reference ultrasound slice plane. RESULTS The mean rCCBV and mean FMBV measured in the tumoral zone were significantly and strongly correlated (r = 0.80; p < 0.001). The mean rCCBV and mean FMBV measured in the peritumoral zone were not statistically correlated, although a tendency towards a correlation was noted (r = 0.45; p = 0.067). CONCLUSION There was a good correlation between a tumor FMBV obtained by a USD intraoperatively and rCCBV on a preoperative MRI validating the reliability of USD for intraoperative analyses of tumor microvascularization in gliomas.
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Affiliation(s)
- Camille Courtin
- Service de Radiologie-Neuroradiologie Diagnostique et Interventionnelle, CHRU de Tours, Tours, France.
| | | | | | | | | | - Ilyess Zemmoura
- UMR 1253, iBrain, Université de Tours, Inserm, Tours, France; Service de Neurochirurgie, CHRU de Tours, Tours, France
| | - Jean-Philippe Cottier
- Service de Radiologie-Neuroradiologie Diagnostique et Interventionnelle, CHRU de Tours, Tours, France; UMR 1253, iBrain, Université de Tours, Inserm, Tours, France
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5
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Briend F, Barantin L, Cléry H, Cottier JP, Bonnet-Brilhault F, Houy-Durand E, Gomot M. Glutamate levels of the right and left anterior cingulate cortex in autistics adults. Prog Neuropsychopharmacol Biol Psychiatry 2023:110801. [PMID: 37245585 DOI: 10.1016/j.pnpbp.2023.110801] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/27/2023] [Revised: 05/22/2023] [Accepted: 05/23/2023] [Indexed: 05/30/2023]
Abstract
BACKGROUND The neurobiology of Autism Spectrum Disorder (ASD) is still unknown. Alteration in glutamate metabolism might translate into an imbalance of the excitation/inhibition equilibrium of cortical networks that in turn are related to autistic symptoms, but previous studies using voxel located in bilateral anterior cingulate cortex (ACC) failed to show abnormalities in total glutamate level. Due to the functional differences in the right and left ACC, we sought to determine whether a difference between right and left ACC glutamate levels could be found when comparing ASD patients and control subjects. METHODS Using single-voxel proton magnetic resonance spectroscopy (1H-MRS), we analyzed the glutamate + glutamine (Glx) concentrations in the left and right ACC of 19 ASD patients with normal IQs and 25 matched control subjects. RESULTS No overall group differences in Glx were shown, in the left ACC (p = 0.24) or in the right ACC (p = 0.11). CONCLUSIONS No significant alterations in Glx levels were detected in the left and right ACC in high-functioning autistic adults. In the excitatory/inhibitory imbalance framework, our data reinforce the critical need to analyze the GABAergic pathway, for better understanding of basic neuropathology in autism.
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Affiliation(s)
- Frédéric Briend
- UMR 1253 iBrain, Inserm, Université de Tours, Tours, France; Excellence Center for Autism and Neurodevelopmental Disorders, CHRU de Tours, Tours, France.
| | - Laurent Barantin
- UMR 1253 iBrain, Inserm, Université de Tours, Tours, France; Department of Radiology, Tours Hospital, Tours, France
| | - Helen Cléry
- UMR 1253 iBrain, Inserm, Université de Tours, Tours, France
| | - Jean-Philippe Cottier
- UMR 1253 iBrain, Inserm, Université de Tours, Tours, France; Department of Radiology, Tours Hospital, Tours, France
| | - Frédérique Bonnet-Brilhault
- UMR 1253 iBrain, Inserm, Université de Tours, Tours, France; Excellence Center for Autism and Neurodevelopmental Disorders, CHRU de Tours, Tours, France
| | | | - Marie Gomot
- UMR 1253 iBrain, Inserm, Université de Tours, Tours, France; Excellence Center for Autism and Neurodevelopmental Disorders, CHRU de Tours, Tours, France
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6
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Tandt D, Le Lez ML, Level C, Stach É, Cottier JP, Pisella PJ, Khanna RK. [Management of binocular diplopia in the department of ophthalmic emergencies at the Regional University Hospital of Tours]. J Fr Ophtalmol 2023; 46:449-460. [PMID: 37029068 DOI: 10.1016/j.jfo.2022.12.025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2022] [Revised: 12/04/2022] [Accepted: 12/17/2022] [Indexed: 04/09/2023]
Abstract
OBJECTIVES To describe the etiologies of binocular diplopia for patients presenting to the ophthalmologic emergency department of the Regional University Center Hospital (CHRU) of Tours. METHODS This is a retrospective study of the medical records of patients who presented with binocular diplopia in the ophthalmic emergency department of the CHRU of Tours between January 1st and December 31st, 2019. Binocular diplopia was classified as paralytic or non-paralytic according to the ocular motility examination. RESULTS One hundred twelve patients were included. The median age was 61 years. Internal referral from other hospital services represented 44.6% of the patients. On ophthalmological examination, 73.2% had paralytic diplopia, 13.4% non-paralytic diplopia and 13.4% normal examination. Neuroimaging was performed in 88.3% of cases, with 75.7% of patients receiving it on the same day. Oculomotor nerve palsy was the most frequent cause of diplopia in 58.9%, the majority represented by abducens nerve palsy (60.6%). The most frequent etiology of binocular diplopia was ischemic, with microvascular damage in 26.8% of cases and stroke in 10.7% of cases. CONCLUSION Among patients assessed in an ophthalmological emergency department setting, one in ten patients had stroke. It is essential to inform patients of the urgent nature of ophthalmological evaluation in the case of acute binocular diplopia. Urgent neurovascular management is also mandatory and should be based on the clinical description provided by the ophthalmologist. Neuroimaging should be performed as soon as possible, based on the ophthalmologic and neurological findings.
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Affiliation(s)
- Delphine Tandt
- Service d'ophtalmologie, centre hospitalier régional universitaire de Tours, Tours, France
| | - Marie-Laure Le Lez
- Service d'ophtalmologie, centre hospitalier régional universitaire de Tours, Tours, France
| | - Claude Level
- Service de gérontologie, centre hospitalier d'Agen, Agen, France
| | - Émilie Stach
- Neurologue, pôle santé Léonard-de-Vinci, Tours, France
| | - Jean-Philippe Cottier
- Service de neuroradiologie, centre hospitalier régional universitaire de Tours, Tours, France; Inserm UMR 1253 iBrain, université de Tours, Tours, France
| | - Pierre-Jean Pisella
- Service d'ophtalmologie, centre hospitalier régional universitaire de Tours, Tours, France
| | - Raoul Kanav Khanna
- Service d'ophtalmologie, centre hospitalier régional universitaire de Tours, Tours, France; Inserm UMR 1253 iBrain, université de Tours, Tours, France.
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7
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Lacasse M, Derolez S, Bonnet E, Amelot A, Bouyer B, Carlier R, Coiffier G, Cottier JP, Dinh A, Maldonado I, Paycha F, Ziza JM, Bemer P, Bernard L. 2022 SPILF - Clinical Practice guidelines for the diagnosis and treatment of disco-vertebral infection in adults. Infect Dis Now 2023; 53:104647. [PMID: 36690329 DOI: 10.1016/j.idnow.2023.01.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2022] [Revised: 12/12/2022] [Accepted: 01/10/2023] [Indexed: 01/22/2023]
Abstract
These guidelines are an update of those made in 2007 at the request of the French Society of Infectious Diseases (SPILF, Société de Pathologie Infectieuse de Langue Française). They are intended for use by all healthcare professionals caring for patients with disco-vertebral infection (DVI) on spine, whether native or instrumented. They include evidence and opinion-based recommendations for the diagnosis and management of patients with DVI. ESR, PCT and scintigraphy, antibiotic therapy without microorganism identification (except for emergency situations), therapy longer than 6 weeks if the DVI is not complicated, contraindication for spinal osteosynthesis in a septic context, and prolonged dorsal decubitus are no longer to be done in DVI management. MRI study must include exploration of the entire spine with at least 2 orthogonal planes for the affected level(s). Several disco-vertebral samples must be performed if blood cultures are negative. Short, adapted treatment and directly oral antibiotherapy or early switch from intravenous to oral antibiotherapy are recommended. Consultation of a spine specialist should be requested to evaluate spinal stability. Early lifting of patients is recommended.
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Affiliation(s)
- M Lacasse
- Medecine Interne et Maladies Infectieuses, 2 Bd Tonnelé, CHU Bretonneau, 37044 Tours Cedex 09, France
| | - S Derolez
- Rhumatologie, 125 rue de Stalingrad, CHU Avicenne, 93000 Bobigny, France
| | - E Bonnet
- Maladies Infectieuses, Pl. Dr Baylac, CHU Purpan, 31000 Toulouse, France.
| | - A Amelot
- Neurochirurgie, 2 Bd Tonnelé, CHU Bretonneau, 37044 Tours Cedex 09, France
| | - B Bouyer
- Chirurgie orthopédique et traumatologique, CHU de Bordeaux, Place Amélie Raba-léon, 33076 Bordeaux, France
| | - R Carlier
- Imagerie, Hôpital Raymond Poincaré, 104 Bd R Poincaré, 92380 Garches, France
| | - G Coiffier
- Rhumatologie, GH Rance-Emeraude, Hôpital de Dinan, 22100 Dinan, France
| | - J P Cottier
- Radiologie, 2 Bd Tonnelé, CHU Bretonneau, 37044 Tours Cedex 09, France
| | - A Dinh
- Maladies Infecteiuses, CHU Raymond Poicaré, 92380 Garches, France
| | - I Maldonado
- Radiologie, 2 Bd Tonnelé, CHU Bretonneau, 37044 Tours Cedex 09, France
| | - F Paycha
- Médecine Nucléaire, Hôpital Lariboisière, 2 rue Ambroise Paré 75010 Paris, France
| | - J M Ziza
- Rhumatologie et Médecine Interne. GH Diaconesses Croix Saint Simon, 75020 Paris, France
| | - P Bemer
- Microbiologie, CHU de Nantes, 1 Place A. Ricordeau, Nantes 44000 Cedex 1, France
| | - L Bernard
- Medecine Interne et Maladies Infectieuses, 2 Bd Tonnelé, CHU Bretonneau, 37044 Tours Cedex 09, France
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8
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Salem A, Cohen C, Leung C, Magni C, Cazeneuve N, Layly J, Lemoine T, Adoum A, Cottier JP. Incidence du diagnostic fortuit des lacunes sequellaires ischemiques sur la sequence DWI-B0. J Neuroradiol 2023. [DOI: 10.1016/j.neurad.2023.01.056] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/02/2023]
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9
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Courtin C, Guillaume L, Remenieras JP, Zemmoura I, Cottier JP. Étude des corrélations entre les mesures ultrasonores de la vascularisation tumorale et péritumorale des gliomes obtenues par doppler ultrasensible en peropératoire et les mesures de perfusion de premier passage obtenues sur l'irm préopératoire. J Neuroradiol 2023. [DOI: 10.1016/j.neurad.2023.01.038] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/02/2023]
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10
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Seners P, Arquizan C, Fontaine L, Ben Hassen W, Heldner MR, Strambo D, Nagel S, Carrera E, Mechtouff L, McCullough-Hicks M, Mohammaden MH, Cottier JP, Henon H, Aignatoaie A, Laksiri N, Papassin J, Lucas L, Garnier P, Triquenot A, Mione G, Hajdu S, Costalat V, Potreck A, Detante O, Bonneville F, Berthezene Y, Bracard S, Sibon I, Bricout N, Boutet C, Mordasini P, Michel P, Oppenheim C, Olivot JM, Nogueira RG, Albers GW, Baron JC, Turc G, Cognard C, Marnat G, Menegon P, Ledure S, Dargazanli C, Cho TH, Nighoghossian N, Eker O, Gouttard S, Haussen D, Debiais S, Charron V, Charron N, Leys D, Ozsancak C, Delpech M, Brunel H, Papagiannaki C, Girardin E, Richard S, Gory B, Zbinden M, Dobrocky T, Ringelb P, Möhlenbruch M. Perfusion Imaging and Clinical Outcome in Acute Minor Stroke With Large Vessel Occlusion. Stroke 2022; 53:3429-3438. [DOI: 10.1161/strokeaha.122.039182] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND:
Whether bridging therapy (intravenous thrombolysis [IVT] followed by mechanical thrombectomy) is superior to IVT alone in minor stroke with large vessel occlusion is unknown. Perfusion imaging may identify subsets of large vessel occlusion–related minor stroke patients with distinct response to bridging therapy.
METHODS:
We conducted a multicenter international observational study of consecutive IVT-treated patients with minor stroke (National Institutes of Health Stroke Scale score ≤5) who had an anterior circulation large vessel occlusion and perfusion imaging performed before IVT, with a subset undergoing immediate thrombectomy. Propensity score with inverse probability of treatment weighting was used to account for baseline between-groups differences. The primary outcome was 3-month modified Rankin Scale score 0 to 1. We searched for an interaction between treatment group and mismatch volume (critical hypoperfusion–core volume).
RESULTS:
Overall, 569 patients were included (172 and 397 in the bridging therapy and IVT groups, respectively). After propensity-score weighting, the distribution of baseline variables was similar across the 2 groups. In the entire population, bridging was associated with lower odds of achieving modified Rankin Scale score 0 to 1: odds ratio, 0.73 [95% CI, 0.55–0.96];
P
=0.03. However, mismatch volume modified the effect of bridging on clinical outcome (
P
interaction
=0.04 for continuous mismatch volume); bridging was associated with worse outcome in patients with, but not in those without, mismatch volume <40 mL (odds ratio, [95% CI] for modified Rankin Scale score 0–1: 0.48 [0.33–0.71] versus 1.14 [0.76–1.71], respectively). Bridging was associated with higher incidence of symptomatic intracranial hemorrhage in the entire population, but this effect was present in the small mismatch subset only (
P
interaction
=0.002).
CONCLUSIONS:
In our population of large vessel occlusion-related minor stroke patients, bridging therapy was associated with lower rates of good outcome as compared with IVT alone. However, mismatch volume was a strong modifier of the effect of bridging therapy over IVT alone, notably with worse outcome with bridging therapy in patients with mismatch volume ≤40 mL. Randomized trials should consider adding perfusion imaging for patient selection.
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Affiliation(s)
- Pierre Seners
- Neurology Department, GHU Paris psychiatrie et neurosciences, Sainte-Anne Hospital, Université de Paris, INSERM U1266, FHU NeuroVasc, France (P.S., J.-C.B., G.T.)
- Neurology Department, Hôpital Fondation A. de Rothschild, Paris, France (P.S.)
| | - Caroline Arquizan
- Neurology Department, CHRU Gui de Chauliac, Montpellier, France (C.A.)
| | - Louis Fontaine
- Acute Stroke Unit, Hôpital Pierre-Paul Riquet, Centre Hospitalier Universitaire de Toulouse and Toulouse NeuroImaging Center, Université de Toulouse, Inserm, UPS, France (L.F., J.-M.O.)
| | - Wagih Ben Hassen
- Radiology Department, GHU Paris psychiatrie et neurosciences, Sainte-Anne Hospital, Université de Paris, INSERM UMR 1266, FHU NeuroVasc,France (W.B.H., C.O.)
| | - Mirjam R. Heldner
- Department of Neurology, Inselspital, University Hospital and University of Bern, Switzerland (M.R.H.)
| | - Davide Strambo
- Stroke Center, Neurology Service, Lausanne University Hospital and University of Lausanne, Switerland (D.S., S.H., P. Michel)
| | - Simon Nagel
- Neurology Department, Heidelberg University Hospital, Germany (S.N.)
- Klinikum Ludwigshafen am Rhein gGmbH, Germany (S.N.)
| | - Emmanuel Carrera
- Neurology Department, Geneve University Hospital, Switzerland (E.C.)
| | | | | | - Mahmoud H. Mohammaden
- Department of Neurology, Marcus Stroke & Neuroscience Center, Emory University School of Medicine, Atlanta, GA (M.H.M., R.G.N.)
| | | | - Hilde Henon
- University of Lille, Inserm, CHU Lille, U1172 - LilNCog - Lille Neuroscience & Cognition, France (H.H.)
| | | | - Nadia Laksiri
- Neurology Department, La Timone University Hospital, Marseille, France (N.L.)
| | - Jérémie Papassin
- Neurology Department, Stroke Unit, CHU Grenoble Alpes, Univ. Grenoble Alpes, Inserm U1216, Grenoble Institut des Neurosciences, France (J.P., O.D., I.S.)
| | - Ludovic Lucas
- Stroke Unit, Bordeaux University Hospital, France (L.L.)
| | - Pierre Garnier
- Neurology Department, St Etienne University Hospital, France (P.G.)
| | - Aude Triquenot
- Neurology Department, Rouen University Hospital, France (A.T.)
| | - Gioia Mione
- Neurology Department, Nancy University Hospital, France (G.M.)
| | - Steven Hajdu
- Stroke Center, Neurology Service, Lausanne University Hospital and University of Lausanne, Switerland (D.S., S.H., P. Michel)
| | - Vincent Costalat
- Radiology Department, CHRU Gui de Chauliac, Montpellier, France (V.C.)
| | - Arne Potreck
- Neuroradiology Department, Heidelberg University Hospital, Germany (A.P.)
| | - Olivier Detante
- Neurology Department, Stroke Unit, CHU Grenoble Alpes, Univ. Grenoble Alpes, Inserm U1216, Grenoble Institut des Neurosciences, France (J.P., O.D., I.S.)
| | - Fabrice Bonneville
- Neuroradiology Department, Centre Hospitalier Universitaire de Toulouse, Université de Toulouse, France (F.B.)
| | - Yves Berthezene
- Neuroradiology Department, Hospices Civils de Lyon, France (Y.B.)
| | - Serge Bracard
- Neuroradiology Department, Nancy University Hospital, France (S.B.)
| | - Igor Sibon
- Neurology Department, Stroke Unit, CHU Grenoble Alpes, Univ. Grenoble Alpes, Inserm U1216, Grenoble Institut des Neurosciences, France (J.P., O.D., I.S.)
| | | | - Claire Boutet
- Radiology Department, St Etienne University Hospital, France (C.B.)
| | - Pasquale Mordasini
- Neuroradiology Department, Inselspital, University Hospital and University of Bern, Switzerland (P. Mordasini)
| | - Patrik Michel
- Stroke Center, Neurology Service, Lausanne University Hospital and University of Lausanne, Switerland (D.S., S.H., P. Michel)
| | - Catherine Oppenheim
- Radiology Department, GHU Paris psychiatrie et neurosciences, Sainte-Anne Hospital, Université de Paris, INSERM UMR 1266, FHU NeuroVasc,France (W.B.H., C.O.)
| | - Jean-Marc Olivot
- Acute Stroke Unit, Hôpital Pierre-Paul Riquet, Centre Hospitalier Universitaire de Toulouse and Toulouse NeuroImaging Center, Université de Toulouse, Inserm, UPS, France (L.F., J.-M.O.)
| | - Raul G. Nogueira
- Department of Neurology, Marcus Stroke & Neuroscience Center, Emory University School of Medicine, Atlanta, GA (M.H.M., R.G.N.)
| | | | - Jean-Claude Baron
- Neurology Department, GHU Paris psychiatrie et neurosciences, Sainte-Anne Hospital, Université de Paris, INSERM U1266, FHU NeuroVasc, France (P.S., J.-C.B., G.T.)
| | - Guillaume Turc
- Neurology Department, GHU Paris psychiatrie et neurosciences, Sainte-Anne Hospital, Université de Paris, INSERM U1266, FHU NeuroVasc, France (P.S., J.-C.B., G.T.)
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11
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Gallet Q, Bouteloup V, Locatelli M, Habert MO, Chupin M, Delrieu J, Lebouvier T, Robert G, David R, Bulteau S, Balageas AC, Surget A, Belzung C, Arlicot N, Ribeiro MJ, Barantin L, Andersson F, Cottier JP, Gissot V, El-Hage W, Camus V, Gohier B, Desmidt T. Benzodiazepine use and neuroimaging markers of Alzheimer's disease in nondemented older individuals: an MRI and 18F Florbetapir PET study in the MEMENTO cohort. Neuropsychopharmacology 2022; 47:1114-1120. [PMID: 34893757 PMCID: PMC8938511 DOI: 10.1038/s41386-021-01246-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/02/2021] [Revised: 11/15/2021] [Accepted: 11/19/2021] [Indexed: 11/09/2022]
Abstract
Recent evidence suggests an association between benzodiazepines (BZDs) use and lower brain amyloid load, a hallmark of AD pathophysiology. Other AD-related markers include hippocampal atrophy, but the effect of BZDs on hippocampal volume remains unclear. We aimed at 1) replicating findings on BZDs use and brain amyloid load and 2) investigating associations between BZDs use and hippocampal volume, in the MEMENTO clinical cohort of nondemented older adults with isolated memory complaint or light cognitive impairment at baseline. Total Standardized Uptake Value Ratio (SUVR) of brain amyloid load and hippocampal volume (HV) were obtained, respectively, from 18F Florbetapir positron emission tomography (PET) and magnetic resonance imaging (MRI), and compared between BZD chronic users and nonusers using multiple linear regressions adjusted for age, sex, educational level, ApoE ε4 genotype, cognitive and neuropsychiatric assessments, history of major depressive episodes and antidepressant intake. BZD users were more likely to manifest symptoms of depression, anxiety and apathy. In the MRI subgroup, BZD users were also more frequently females with low education and greater clinical impairments as assessed with the clinical dementia rating scale. Short- versus long-acting BZDs, Z-drugs versus non-Z-drugs BZDs, as well as dose and duration of BZD use, were also considered in the analyses. Total SUVR and HV were significantly lower and larger, respectively, in BZD users (n = 38 in the PET subgroup and n = 331 in the MRI subgroup) than in nonusers (n = 251 in the PET subgroup and n = 1840 in the MRI subgroup), with a medium (Cohen's d = -0.43) and low (Cohen's d = 0.10) effect size, respectively. Short-acting BZDs and Z-drugs were more significantly associated with larger HV. We found no effect of dose and duration of BZD use. Our results support the involvement of the GABAergic system as a potential target for blocking AD-related pathophysiology, possibly via reduction in neuronal activity and neuroinflammation. Future longitudinal studies may confirm the causal effect of BZDs to block amyloid accumulation and hippocampal atrophy.
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Affiliation(s)
- Quentin Gallet
- grid.411147.60000 0004 0472 0283Department of Psychiatry, University Hospital, Angers, France
| | - Vincent Bouteloup
- Centre Inserm U1219 Bordeaux Population Health, CIC1401-EC, Institut de Santé Publique, d’Epidémiologie et de Développement, Université de Bordeaux, CHU de Bordeaux, Pôle Santé Publique, Bordeaux, France
| | - Maxime Locatelli
- grid.462844.80000 0001 2308 1657Paris Brain Institute - Institut du Cerveau (ICM), CNRS UMR 7225, INSERM, U 1127, Sorbonne Université, F-75013 Paris, France ,grid.462844.80000 0001 2308 1657Sorbonne Université, CNRS, INSERM, Laboratoire d’Imagerie Biomédicale, LIB, F-75006 Paris, France
| | - Marie-Odile Habert
- grid.462844.80000 0001 2308 1657Paris Brain Institute - Institut du Cerveau (ICM), CNRS UMR 7225, INSERM, U 1127, Sorbonne Université, F-75013 Paris, France ,grid.462844.80000 0001 2308 1657Sorbonne Université, CNRS, INSERM, Laboratoire d’Imagerie Biomédicale, LIB, F-75006 Paris, France
| | - Marie Chupin
- grid.462844.80000 0001 2308 1657Paris Brain Institute - Institut du Cerveau (ICM), CNRS UMR 7225, INSERM, U 1127, Sorbonne Université, F-75013 Paris, France ,grid.462844.80000 0001 2308 1657Sorbonne Université, CNRS, INSERM, Laboratoire d’Imagerie Biomédicale, LIB, F-75006 Paris, France ,Inserm, U1127 / CNRS, UMR 7225 / Sorbonne Universités, UPMC Univ Paris 06, UMR S 1127 / ICM CATI, 1er étage, Paris, UK
| | - Julien Delrieu
- grid.414282.90000 0004 0639 4960Gérontopôle, Department of Geriatrics, CHU Toulouse, Purpan University Hospital, Toulouse, France ,grid.15781.3a0000 0001 0723 035XUMR1027, Université de Toulouse, UPS, INSERM, Toulouse, France
| | - Thibaud Lebouvier
- grid.410463.40000 0004 0471 8845University of Lille, Inserm U1171, CHU, DISTALZ, Lille, France
| | - Gabriel Robert
- grid.411154.40000 0001 2175 0984Behavior and Basal Ganglia host team 4712, University of Rennes 1, Rennes, France Department of Psychiatry, Rennes University Hospital, Guillaume Régnier Hospital Centre, Rennes, France
| | - Renaud David
- grid.410528.a0000 0001 2322 4179Department of Psychiatry, Memory Research and Resources Center, CHU Nice, Nice, France
| | - Samuel Bulteau
- grid.277151.70000 0004 0472 0371CHU de Nantes, addictology and liaison psychiatry department, 44000 Nantes, France
| | | | | | | | - Nicolas Arlicot
- UMR 1253, iBrain, Université de Tours, Inserm, Tours, France ,grid.12366.300000 0001 2182 6141INSERM CIC 1415, Université de Tours, Tours, France
| | - Maria-Joao Ribeiro
- grid.411167.40000 0004 1765 1600CHU de Tours, Tours, France ,UMR 1253, iBrain, Université de Tours, Inserm, Tours, France ,grid.12366.300000 0001 2182 6141INSERM CIC 1415, Université de Tours, Tours, France
| | | | | | - Jean-Philippe Cottier
- grid.411167.40000 0004 1765 1600CHU de Tours, Tours, France ,UMR 1253, iBrain, Université de Tours, Inserm, Tours, France
| | - Valérie Gissot
- grid.411167.40000 0004 1765 1600CHU de Tours, Tours, France ,grid.12366.300000 0001 2182 6141INSERM CIC 1415, Université de Tours, Tours, France
| | - Wissam El-Hage
- grid.411167.40000 0004 1765 1600CHU de Tours, Tours, France ,UMR 1253, iBrain, Université de Tours, Inserm, Tours, France ,grid.12366.300000 0001 2182 6141INSERM CIC 1415, Université de Tours, Tours, France
| | - Vincent Camus
- grid.411167.40000 0004 1765 1600CHU de Tours, Tours, France ,UMR 1253, iBrain, Université de Tours, Inserm, Tours, France
| | - Bénédicte Gohier
- grid.411147.60000 0004 0472 0283Department of Psychiatry, University Hospital, Angers, France
| | - Thomas Desmidt
- CHU de Tours, Tours, France. .,UMR 1253, iBrain, Université de Tours, Inserm, Tours, France.
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Henderson A, Hoche C, Boulouis G, Ifergan H, Cottier JP, Pasi M, Gaudron M, Cohen C. Incidence, facteurs prédictifs et pronostic de l'extravasation de produit de contraste post-thrombectomie. J Neuroradiol 2022. [DOI: 10.1016/j.neurad.2022.01.034] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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13
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Laurent E, Bonnaud I, Gaudron M, Lahondère A, Godillon L, Vannier S, Bouilleau G, De Toffol B, Cottier JP, Laribi S, Grammatico-Guillon L. Factors associated with delayed revascularization in patients with ischemic stroke: a prospective study in one French region. Eur J Emerg Med 2022; 29:56-62. [PMID: 34483249 DOI: 10.1097/mej.0000000000000875] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND AND IMPORTANCE Optimizing the care pathway of stroke is crucial for the revascularization of ischemic stroke. OBJECTIVES to identify factors associated with (1) a time interval over 4 h between the symptom onset and cerebral imaging in suspected stroke patients and (2) the absence of revascularization in patients with ischemic stroke. DESIGN, SETTINGS AND PARTICIPANTS Patients over 18 years old with a suspected stroke admitted in 22 emergency rooms or stroke units in one French region between 1 March 2019 and 30 April 2019 were prospectively included by filling a dedicated form. OUTCOME MEASURES AND ANALYSIS Factors associated with the previously mentioned outcome measures were identified using logistic regression models. MAIN RESULTS In total 991 patients were included; 537 patients (64% of 845 with available time intervals) were admitted more than 4 h after symptom onset. Three predictors were identified: not calling emergency medical services (EMS) [odds-ratio (OR) 5.2; 95% confidence interval (3.4-8.1)], a preexisting autonomy loss [2.0 (1.3-2.9)] and atypical clinical presentation [2.0 (1.3-3.1)]. A total of 385 patients had an ischemic stroke of whom 93 underwent a revascularization procedure (24%). The same three predictors were associated with the absence of revascularization procedure, added to an initial admission in a hospital without stroke unit [3.1 (1.1-8.6)]. CONCLUSION This study shows that efforts to organize the care chain for stroke need to be intensified in the region to reduce treatment time intervals, which could include information campaigns focused on the impact of EMS call and the clinical presentation recognition.
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Affiliation(s)
- Emeline Laurent
- Public Health and Epidemiology Unit (EpiDcliC), Teaching hospital of Tours
- Research Team « Education, Ethics and Health » (EA 7505), University of Tours
| | | | | | - Alexia Lahondère
- Public Health and Epidemiology Unit (EpiDcliC), Teaching hospital of Tours
- University of Tours
| | - Lucile Godillon
- Public Health and Epidemiology Unit (EpiDcliC), Teaching hospital of Tours
| | - Sophie Vannier
- Emergency Department and SAMU 37 (Emergency Medical Services), Teaching hospital of Tours, Chambray-les-Tours
| | | | - Bertrand De Toffol
- Stroke unit, Teaching hospital of Tours, Tours
- University of Tours
- Inserm 930 Department, Teaching hospital of Tours
| | | | - Saïd Laribi
- University of Tours
- Emergency Department and SAMU 37 (Emergency Medical Services), Teaching hospital of Tours, Chambray-les-Tours
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14
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Hobson CA, Desoubeaux G, Carvalho-Schneider C, Destrieux C, Cottier JP, Garot D, Le Brun C, Maakaroun Z, Lemaignen A, Bailly É, Bernard L. Challenging diagnosis of chronic cerebral fungal infection: Value of (1→3)-ß-D-glucan and mannan antigen testing in cerebrospinal fluid and of cerebral ventricle puncture. Med Mycol 2021; 59:74-80. [PMID: 32470986 DOI: 10.1093/mmy/myaa035] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2019] [Revised: 04/09/2020] [Accepted: 04/27/2020] [Indexed: 12/14/2022] Open
Abstract
Primary fungal infection of the central nervous system (CNS) is rare but often associated with severe prognosis. Diagnosis is complicated since cerebrospinal fluid (CSF) samples obtained from lumbar puncture usually remain sterile. Testing for fungal antigens in CSF could be a complementary diagnostic tool. We conducted such measurements in CSF from patients with CNS fungal infection and now discuss the usefulness of ventricular puncture. Mannan and (1→3)ß-D-glucan (BDG) testing were retrospectively performed in CSF samples from three patients with proven chronic CNS fungal infection (excluding Cryptococcus), and subsequently compared to 16 controls. Results from lumbar punctures and those from cerebral ventricles were confronted. BDG detection was positive in all the CSF samples (from lumbar and/or ventricular puncture) from the three confirmed cases. In case of Candida infection, mannan antigen measurement was positive in 75% of the CSF samples. In the control group, all antigen detections were negative (n = 15), except for one false positive. Faced with suspected chronic CNS fungal infection, measurement of BDG levels appears to be a complementary diagnostic tool to circumvent the limitations of mycological cultures from lumbar punctures. In the event of negative results, more invasive procedures should be considered, such as ventricular puncture.
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Affiliation(s)
- Claire A Hobson
- Department of Infectious Diseases, University Hospital of Tours, France
| | - Guillaume Desoubeaux
- Department of Parasitology and Mycology, University Hospital of Tours, France.,CEPR INSERM U1100 / Team 3
| | | | - Christophe Destrieux
- Department of Neuro-surgery, University Hospital of Tours, France.,UMR1253, iBrain, INSERM, Tours, France
| | - Jean-Philippe Cottier
- UMR1253, iBrain, INSERM, Tours, France.,Department of Neuro-imaging, University Hospital of Tours, France
| | - Denis Garot
- Intensive Care Unit, University Hospital of Tours, France
| | - Cécile Le Brun
- Department of Microbiology, University Hospital of Tours, France
| | - Zoha Maakaroun
- Department of Infectious Diseases, University Hospital of Tours, France
| | - Adrien Lemaignen
- Department of Infectious Diseases, University Hospital of Tours, France
| | - Éric Bailly
- Department of Parasitology and Mycology, University Hospital of Tours, France
| | - Louis Bernard
- Department of Infectious Diseases, University Hospital of Tours, France
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15
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Haméon C, Rousselot C, Arbion F, Cibron J, Cottier JP, Destrieux C, Hérault O, Gyan E. Cerebral localization of chronic myelomonocytic leukemia: a case report. J Med Case Rep 2021; 15:368. [PMID: 34303369 PMCID: PMC8310603 DOI: 10.1186/s13256-021-02947-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2020] [Accepted: 06/07/2021] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND Chronic myelomonocytic leukemia is a myelodysplastic/myeloproliferative neoplasm characterized by the infiltration of blood and bone marrow by immature monocytes. Cerebral localization of chronic myelomonocytic leukemia has never been described. CASE PRESENTATION We report the case of a Caucasian 59 year-old man with multiorgan chronic myelomonocytic leukemia infiltration, associated with uncommon brain involvement. There was no evidence of evolution to acute myeloid leukemia. The evidence of cerebral infiltration by chronic myelomonocytic leukemia was made after autopsy. CONCLUSIONS The fatal outcome of the patient raises the question of the potential benefit of early specific treatment, such as demethylating agents or intensive chemotherapy. Sharing such images of atypical and rapidly evolving chronic myelomonocytic leukemia and the disease history may help clinical decision-making in the future.
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Affiliation(s)
| | | | - Flavie Arbion
- Department of Anatomopathology, Tours Hospital, Tours, France
| | | | | | | | | | - Emmanuel Gyan
- Department of Hematology, Tours Hospital, Tours, France
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16
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Siragusa MA, Rufin T, Courtois R, Belzung C, Andersson F, Brizard B, Dujardin PA, Cottier JP, Patat F, Réméniéras JP, Gissot V, El-Hage W, Camus V, Desmidt T. Left amygdala volume and brain tissue pulsatility are associated with neuroticism: an MRI and ultrasound study. Brain Imaging Behav 2021; 15:1499-1507. [PMID: 32761564 DOI: 10.1007/s11682-020-00348-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Brain changes associated with the personality trait of neuroticism have been partly elucidated. While subcortical brain volume changes, especially a larger amygdala, appear consistent in high neuroticism, functional changes, such as cerebral blood flow (CBF) differences, have shown conflicting results, possibly because of the limitations in methods of CBF measurement. In our study, we investigated changes in amygdala volume and CBF-related function associated with neuroticism in healthy and depressed subjects using both conventional magnetic resonance imaging (MRI) measures of brain volume and the innovative technique of ultrasound Tissue Pulsatility Imaging (TPI), which has a high level of detection in measuring brain tissue pulsatility (BTP). Middle-aged females with depression (n = 25) and without depression (n = 25) underwent clinical examination, magnetic resonance imaging (MRI) and ultrasound assessment (TPI). Neuroticism was positively associated with left amygdala volume and mean BTP in individuals without depression, in both simple and multiple regressions that included potential confounding factors such as age and body mass index. No association was found in the depressed group. We confirmed the role of the left amygdala in the brain physiology of neuroticism in nondepressed individuals. Moreover, we identified a novel mechanism associated with high neuroticism, namely BTP, that may reflect greater CBF and account for the increased risk of cerebrovascular disease in individuals with high neuroticism. Because neuroticism is considered a risk factor for depression, our paper provides potential objective biomarkers for the identification of subjects at risk for depression.
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Affiliation(s)
| | | | - Robert Courtois
- CRIAVS Centre-Val de Loire, CHRU de Tours, Tours, France
- Département de Psychologie, EE 1901 'Qualipsy' (Qualité de vie et Santé psychologique), Université François Rabelais de Tours, Tours, France
| | | | | | - Bruno Brizard
- UMR 1253, iBrain, Inserm, Université de Tours, Tours, France
| | | | - Jean-Philippe Cottier
- UMR 1253, iBrain, Inserm, Université de Tours, Tours, France
- CHRU de Tours, Tours, France
| | - Frédéric Patat
- UMR 1253, iBrain, Inserm, Université de Tours, Tours, France
- CHRU de Tours, Tours, France
- CIC 1415, CHU de Tours, Inserm, Tours, France
| | | | | | - Wissam El-Hage
- UMR 1253, iBrain, Inserm, Université de Tours, Tours, France
- CHRU de Tours, Tours, France
- CIC 1415, CHU de Tours, Inserm, Tours, France
| | - Vincent Camus
- UMR 1253, iBrain, Inserm, Université de Tours, Tours, France
- CHRU de Tours, Tours, France
| | - Thomas Desmidt
- UMR 1253, iBrain, Inserm, Université de Tours, Tours, France.
- CHRU de Tours, Tours, France.
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17
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Lersy F, Royer-Leblond J, Lhermitte B, Chammas A, Schneider F, Hansmann Y, Lefebvre N, Denis J, Sabou M, Lafitte F, Cotton F, Boncoeur-Martel MP, Tourdias T, Pruvo JP, Cottier JP, Herbrecht R, Kremer S. Cerebral mucormycosis: neuroimaging findings and histopathological correlation. J Neurol 2021; 269:1386-1395. [PMID: 34240320 DOI: 10.1007/s00415-021-10701-8] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2021] [Revised: 07/04/2021] [Accepted: 07/05/2021] [Indexed: 10/20/2022]
Abstract
INTRODUCTION Mucormycosis are infections caused by molds of the order Mucorales. These opportunistic infections are rare, difficult to diagnose, and have a poor prognosis. We aimed to describe common radiographic patterns that may help to diagnose cerebral mucormycosis and search for histopathological correlations with imaging data. METHODS We studied the radiological findings (CT and MRI) of 18 patients with cerebral mucormycosis and four patients' histopathological findings. RESULTS All patients were immunocompromised and/or diabetic. The type of lesions depended on the infection's dissemination pathway. Hematogenous dissemination lesions were most frequently abscesses (59 lesions), cortical, cortical-subcortical, or in the basal ganglia, with a halo aspect on DWI for lesions larger than 1.6 cm. Only seven lesions were enhanced after contrast injection, with different presentations depending on patients' immune status. Ischemia and hemorrhagic areas were also seen. Vascular lesions were represented by stenosis and thrombosis. Direct posterior extension lesions were bi-fronto basal hypodensities on CT and restricted diffusion without enhancement on MRI. A particular extension, perineural spread, was seen along the trigeminal nerve. Histopathological analysis found endovascular lesions with destruction of vessel walls by Mucorales, microbleeds around vessels, as well as acute and chronic inflammation. CONCLUSIONS MRI is the critical exam for cerebral mucormycosis. Weak ring enhancement and reduced halo diffusion suggest the diagnosis of fungal infections. Involvement of the frontal lobes should raise suspicion of mucormycosis (along with aspergillosis). The perineural spread can be considered a more specific extension pathway of mucormycosis.
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Affiliation(s)
- François Lersy
- Service d'imagerie 2, Hôpital de Hautepierre, Hôpitaux Universitaires de Strasbourg, 1 avenue Molière 67200, Strasbourg, France
| | | | - Benoit Lhermitte
- Department of Pathology, Hautepierre University Hospital, 1 avenue Molière, 67200, Strasbourg, France
| | - Agathe Chammas
- Service d'imagerie 2, Hôpital de Hautepierre, Hôpitaux Universitaires de Strasbourg, 1 avenue Molière 67200, Strasbourg, France
| | - Francis Schneider
- Service de Médecine-Intensive-Réanimation, Hôpital de Hautepierre, Hôpitaux Universitaires de Strasbourg, Strasbourg, France
| | - Yves Hansmann
- Service de Maladies Infectieuses, NHC, CHU de Strasbourg, Strasbourg, France
| | - Nicolas Lefebvre
- Service de Maladies Infectieuses, NHC, CHU de Strasbourg, Strasbourg, France
| | - Julie Denis
- CHU de Strasbourg, Laboratoire de Parasitologie Et de Mycologie Médicale, Plateau Technique de Microbiologie, 1 rue Koeberlé, 67000, Strasbourg, France
| | - Marcela Sabou
- CHU de Strasbourg, Laboratoire de Parasitologie Et de Mycologie Médicale, Plateau Technique de Microbiologie, 1 rue Koeberlé, 67000, Strasbourg, France.,Université de Strasbourg, Institut de Parasitologie Et de Pathologie Tropicale, DIHP-UR 7292, Fédération de Médecine Translationnelle, 3 rue Koeberlé, 67000, Strasbourg, France
| | - François Lafitte
- Radiology Department, Rothschild Foundation in Paris, Paris, France
| | - François Cotton
- Service de Radiologie, Centre Hospitalier Lyon-Sud, Hospices Civils de Lyon, Pierre-Bénite, Lyon, France.,Univ Lyon, INSA-Lyon, Université Claude Bernard Lyon 1, UJM-Saint Etienne, CNRS, Inserm, CREATIS UMR 5220, U1206, Pierre-Bénite, F-69495, Lyon, France
| | - Marie-Paule Boncoeur-Martel
- INSERM, U1094, Neuroépidémiologie Tropicale, Limoges, France.,Univ. Limoges, U1094, Neuroépidémiologie Tropicale, Institut D'Epidémiologie Et de Neurologie Tropicale, GEIST, Limoges, France.,IRD, Unité Associée, Neuroépidémiologie Tropicale, Limoges, France.,Service de Neuroradiologie, CHU Limoges, Limoges, France
| | - Thomas Tourdias
- CHU de Bordeaux, Neuro imagerie diagnostique et thérapeutique, 33000, Bordeaux, France.,Univ. Bordeaux, INSERM U1215, Neurocentre Magendie, 33000, Bordeaux, France
| | - Jean-Pierre Pruvo
- Inserm U 1172, CHU de Lille, University of Lille, Lille, France.,Department of Neuroradiology, CHU de Lille, University of Lille, Lille, France
| | | | - Raoul Herbrecht
- Department of Hematology, Institut de Cancérologie Strasbourg.Europe (ICANS) and Université de Strasbourg, Inserm UMR-S1113/IRFAC, Strasbourg, France
| | - Stéphane Kremer
- Service d'imagerie 2, Hôpital de Hautepierre, Hôpitaux Universitaires de Strasbourg, 1 avenue Molière 67200, Strasbourg, France. .,Engineering Science, Computer Science and Imaging Laboratory (ICube), Integrative Multimodal Imaging in Healthcare, UMR 7357, University of Strasbourg-CNRS, Strasbourg, France.
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Cottier JP, Herbreteau D, Boulouis G, Cotton F. Éditorial 48e congrès annuel de la SFNR. J Neuroradiol 2021; 48:215. [PMID: 34090552 DOI: 10.1016/j.neurad.2021.05.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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19
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Serru M, Marechal B, Kober T, Ribier L, Sembely Taveau C, Sirinelli D, Cottier JP, Morel B. Improving diagnosis accuracy of brain volume abnormalities during childhood with an automated MP2RAGE-based MRI brain segmentation. J Neuroradiol 2021; 48:259-265. [DOI: 10.1016/j.neurad.2019.06.005] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2019] [Revised: 06/04/2019] [Accepted: 06/07/2019] [Indexed: 11/30/2022]
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20
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Trinh TT, Cohen C, Boullaud L, Cottier JP, Bakhos D. Sheep as a large animal model for cochlear implantation. Braz J Otorhinolaryngol 2021; 88 Suppl 1:S24-S32. [PMID: 33839060 PMCID: PMC9734264 DOI: 10.1016/j.bjorl.2021.02.014] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2020] [Revised: 01/15/2021] [Accepted: 02/28/2021] [Indexed: 12/16/2022] Open
Abstract
INTRODUCTION In surgical training, large animal models are more suitable as their anatomy is more similar to humans. In otology, there have been relatively few studies about large animal models for surgical training. OBJECTIVE In this study, we aimed to do a neuroradiologic evaluation and surgical insertion of a cochlear implant electrode array on a sheep head model. METHODS Twenty cadaveric sheep heads were studied. A computed tomography scan and neuroradiologic evaluation was performed on each head, obtaining measurements of the inner ear for each sheep. Sheep measurements were compared to those from temporal bone computed tomography scans from 20 female humans. Surgical procedures were first trained with 13 of the sheep temporal bones, after which cochlear implantation was performed on the remaining 7 temporal bones. The position of the inserted electrode array insertion was confirmed by computed tomography scan after the procedure. RESULTS Neuroradiologic evaluation showed that, relative to the 20 female humans, the mean ratio for sheep was 0.60 for volume of cochlea, 0.70 for height of cochlea, 0.73 for length of cochlea; ratios for other metrics were >0.80. For the surgical training, the round window was found in all 20 sheep temporal bones. Computed tomography scans confirmed that electrode insertions were fully complete; the mean value of electrode array insertion was 18.3 mm. CONCLUSION The neuroradiologic and surgical training data suggest that the sheep is a realistic animal model to train cochlear implant surgery and collection of perilymph samples, but less so for surgical training of mastoidectomy due to pneumatization of the mastoid.
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Affiliation(s)
- Thuy-Tran Trinh
- CHRU de Tours, Service d'ORL et Chirurgie Cervico-Faciale, France.
| | - C Cohen
- CHRU de Tours, Service de Neuroradiologie, France
| | - L Boullaud
- CHRU de Tours, Service d'ORL et Chirurgie Cervico-Faciale, France
| | - J P Cottier
- CHRU de Tours, Service de Neuroradiologie, France; Université François Rabelais de Tours, France; Inserm U1253, Tours, France
| | - David Bakhos
- CHRU de Tours, Service d'ORL et Chirurgie Cervico-Faciale, France; Université François Rabelais de Tours, France; Inserm U1253, Tours, France
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21
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Seners P, Ben Hassen W, Lapergue B, Arquizan C, Heldner MR, Henon H, Perrin C, Strambo D, Cottier JP, Sablot D, Girard Buttaz I, Tamazyan R, Preterre C, Agius P, Laksiri N, Mechtouff L, Béjot Y, Duong DL, Mounier-Vehier F, Mione G, Rosso C, Lucas L, Papassin J, Aignatoaie A, Triquenot A, Carrera E, Niclot P, Obadia A, Lyoubi A, Garnier P, Crainic N, Wolff V, Tracol C, Philippeau F, Lamy C, Soize S, Baron JC, Turc G. Prediction of Early Neurological Deterioration in Individuals With Minor Stroke and Large Vessel Occlusion Intended for Intravenous Thrombolysis Alone. JAMA Neurol 2021; 78:321-328. [PMID: 33427887 DOI: 10.1001/jamaneurol.2020.4557] [Citation(s) in RCA: 56] [Impact Index Per Article: 18.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
Importance The best reperfusion strategy in patients with acute minor stroke and large vessel occlusion (LVO) is unknown. Accurately predicting early neurological deterioration of presumed ischemic origin (ENDi) following intravenous thrombolysis (IVT) in this population may help to select candidates for immediate transfer for additional thrombectomy. Objective To develop and validate an easily applicable predictive score of ENDi following IVT in patients with minor stroke and LVO. Design, Setting, and Participants This multicentric retrospective cohort included 729 consecutive patients with minor stroke (National Institutes of Health Stroke Scale [NIHSS] score of 5 or less) and LVO (basilar artery, internal carotid artery, first [M1] or second [M2] segment of middle cerebral artery) intended for IVT alone in 45 French stroke centers, ie, including those who eventually received rescue thrombectomy because of ENDi. For external validation, another cohort of 347 patients with similar inclusion criteria was collected from 9 additional centers. Data were collected from January 2018 to September 2019. Main Outcomes and Measures ENDi, defined as 4 or more points' deterioration on NIHSS score within the first 24 hours without parenchymal hemorrhage on follow-up imaging or another identified cause. Results Of the 729 patients in the derivation cohort, 335 (46.0%) were male, and the mean (SD) age was 70 (15) years; of the 347 patients in the validation cohort, 190 (54.8%) were male, and the mean (SD) age was 69 (15) years. In the derivation cohort, the median (interquartile range) NIHSS score was 3 (1-4), and the occlusion site was the internal carotid artery in 97 patients (13.3%), M1 in 207 (28.4%), M2 in 395 (54.2%), and basilar artery in 30 (4.1%). ENDi occurred in 88 patients (12.1%; 95% CI, 9.7-14.4) and was strongly associated with poorer 3-month outcomes, even in patients who underwent rescue thrombectomy. In multivariable analysis, a more proximal occlusion site and a longer thrombus were independently associated with ENDi. A 4-point score derived from these variables-1 point for thrombus length and 3 points for occlusion site-showed good discriminative power for ENDi (C statistic = 0.76; 95% CI, 0.70-0.82) and was successfully validated in the validation cohort (ENDi rate, 11.0% [38 of 347]; C statistic = 0.78; 95% CI, 0.70-0.86). In both cohorts, ENDi probability was approximately 3%, 7%, 20%, and 35% for scores of 0, 1, 2 and 3 to 4, respectively. Conclusions and Relevance The substantial ENDi rates observed in these cohorts highlights the current debate regarding whether to directly transfer patients with IVT-treated minor stroke and LVO for additional thrombectomy. Based on the strong associations observed, an easily applicable score for ENDi risk prediction that may assist decision-making was derived and externally validated.
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Affiliation(s)
- Pierre Seners
- Neurology Department, GHU Paris psychiatrie et neurosciences, Institut de Psychiatrie et Neurosciences de Paris, INSERM U1266, Université de Paris, FHU Neurovasc, Paris, France
| | - Wagih Ben Hassen
- Radiology Department, GHU Paris psychiatrie et neurosciences, Institut de Psychiatrie et Neurosciences de Paris, INSERM U1266, Université de Paris, FHU Neurovasc, Paris, France
| | | | | | - Mirjam R Heldner
- Neurology Department, Inselspital, University Hospital, University of Bern, Bern, Switzerland
| | - Hilde Henon
- Neurology Department, CHU Lille, Université de Lille, INSERM U1171, Lille, France
| | - Claire Perrin
- Neurology Department, GHU Paris psychiatrie et neurosciences, Institut de Psychiatrie et Neurosciences de Paris, INSERM U1266, Université de Paris, FHU Neurovasc, Paris, France
| | - Davide Strambo
- Stroke Center, Neurology Service, CHU Vaudois, Lausanne University, Lausanne, Switzerland
| | | | - Denis Sablot
- Neurology Department, Perpignan Hospital, Perpignan, France
| | | | - Ruben Tamazyan
- Neurology Department, Saint Joseph Hospital, Paris, France
| | - Cécile Preterre
- Neurology Department, Nantes University Hospital, Nantes, France
| | - Pierre Agius
- Neurology Department, Nantes University Hospital, Nantes, France.,Neurology Department, St Nazaire Hospital, Saint-Nazaire, France
| | - Nadia Laksiri
- Neurology Department, La Timone University Hospital, Marseille, France
| | - Laura Mechtouff
- Department of Stroke Medicine, Hospices Civils de Lyon, Lyon, France
| | - Yannick Béjot
- Neurology Department, Dijon University Hospital, Dijon, France
| | - Duc-Long Duong
- Neurology Department, Versailles University Hospital, Versailles, France
| | | | - Gioia Mione
- Neurology Department, Nancy University Hospital, Nancy, France
| | - Charlotte Rosso
- Sorbonne Université, Institut du Cerveau et de la Moelle épinière, ICM, INSERM U 1127, CNRS UMR 7225, AP-HP, Urgences Cérébro-Vasculaires, ICM Infrastructure Stroke Network, Hôpital Pitié-Salpêtrière, Paris, France
| | - Ludovic Lucas
- Stroke Unit, Bordeaux University Hospital, Bordeaux, France
| | - Jérémie Papassin
- Stroke Unit, Grenoble University Hospital, Grenoble, France.,Neurology Department, Centre Hospitalier Metropole-Savoie, Chambery, France
| | - Andreea Aignatoaie
- Neurology Department, Centre Hospitalier Régional d'Orléans, Orléans, France
| | | | - Emmanuel Carrera
- Neurology Department, Geneve University Hospital, Geneve, Switzerland
| | | | - Alexandre Obadia
- Neurology Department, Fondation Adolphe de Rothschild, Paris, France
| | - Aïcha Lyoubi
- Neurology Department, Delafontaine Hospital, Saint-Denis, France
| | - Pierre Garnier
- Stroke Unit, Saint-Etienne University Hospital, Saint-Etienne, France
| | - Nicolae Crainic
- Neurology Department, Brest University Hospital, Brest, France
| | - Valérie Wolff
- Neurology Department, Strasbourg University Hospital, Strasbourg, France
| | - Clément Tracol
- Neurology Department, Rennes University Hospital, Rennes, France
| | | | - Chantal Lamy
- Neurology Department, Amiens University Hospital, Amiens, France
| | - Sébastien Soize
- Neuroradiology Department, Reims University Hospital, Reims, France
| | - Jean-Claude Baron
- Neurology Department, GHU Paris psychiatrie et neurosciences, Institut de Psychiatrie et Neurosciences de Paris, INSERM U1266, Université de Paris, FHU Neurovasc, Paris, France
| | - Guillaume Turc
- Neurology Department, GHU Paris psychiatrie et neurosciences, Institut de Psychiatrie et Neurosciences de Paris, INSERM U1266, Université de Paris, FHU Neurovasc, Paris, France
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22
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Obry S, Khanna RK, Lacasse M, Reffet K, Cottier JP, Chesnay A, Cohen C. Severe bilateral optic neuropathy and meningitis secondary to invasive maxillary sinus aspergillosis. Int J Infect Dis 2021; 104:423-425. [PMID: 33453394 DOI: 10.1016/j.ijid.2021.01.022] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2020] [Revised: 01/05/2021] [Accepted: 01/08/2021] [Indexed: 11/26/2022] Open
Affiliation(s)
- Sandra Obry
- Regional University Hospital Centre Tours: Centre Hospitalier Regional Universitaire de Tours, Department of Diagnostic Neuroradiology, 2 boulevard Tonnellé, 37000 Tours Cedex 9, France.
| | - Raoul Kanav Khanna
- Regional University Hospital Centre Tours: Centre Hospitalier Regional Universitaire de Tours, Department of Ophthalmology, Tours, France
| | - Marion Lacasse
- Regional University Hospital Centre Tours: Centre Hospitalier Regional Universitaire de Tours, Department of Infectious disease, Tours, France
| | - Kévin Reffet
- Regional University Hospital Centre Tours: Centre Hospitalier Regional Universitaire de Tours, Department of Otolaryngology head and neck surgery, Tours, France
| | - Jean-Philippe Cottier
- Regional University Hospital Centre Tours: Centre Hospitalier Regional Universitaire de Tours, Department of Diagnostic Neuroradiology, 2 boulevard Tonnellé, 37000 Tours Cedex 9, France.
| | - Adélaïde Chesnay
- Regional University Hospital Centre Tours: Centre Hospitalier Regional Universitaire de Tours, Department of Parasitology and Mycology, Tours, France.
| | - Clara Cohen
- Regional University Hospital Centre Tours: Centre Hospitalier Regional Universitaire de Tours, Department of Diagnostic Neuroradiology, 2 boulevard Tonnellé, 37000 Tours Cedex 9, France.
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23
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Charpentier J, Latinus M, Andersson F, Saby A, Cottier JP, Bonnet-Brilhault F, Houy-Durand E, Gomot M. Brain correlates of emotional prosodic change detection in autism spectrum disorder. Neuroimage Clin 2020; 28:102512. [PMID: 33395999 PMCID: PMC8481911 DOI: 10.1016/j.nicl.2020.102512] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/16/2020] [Revised: 11/17/2020] [Accepted: 11/20/2020] [Indexed: 11/30/2022]
Abstract
We used an oddball paradigm with vocal stimuli to record hemodynamic responses. Brain processing of vocal change relies on STG, insula and lingual area. Activity of the change processing network can be modulated by saliency and emotion. Brain processing of vocal deviancy/novelty appears typical in adults with autism.
Autism Spectrum Disorder (ASD) is currently diagnosed by the joint presence of social impairments and restrictive, repetitive patterns of behaviors. While the co-occurrence of these two categories of symptoms is at the core of the pathology, most studies investigated only one dimension to understand underlying physiopathology. In this study, we analyzed brain hemodynamic responses in neurotypical adults (CTRL) and adults with autism spectrum disorder during an oddball paradigm allowing to explore brain responses to vocal changes with different levels of saliency (deviancy or novelty) and different emotional content (neutral, angry). Change detection relies on activation of the supratemporal gyrus and insula and on deactivation of the lingual area. The activity of these brain areas involved in the processing of deviancy with vocal stimuli was modulated by saliency and emotion. No group difference between CTRL and ASD was reported for vocal stimuli processing or for deviancy/novelty processing, regardless of emotional content. Findings highlight that brain processing of voices and of neutral/ emotional vocal changes is typical in adults with ASD. Yet, at the behavioral level, persons with ASD still experience difficulties with those cues. This might indicate impairments at latter processing stages or simply show that alterations present in childhood might have repercussions at adult age.
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Affiliation(s)
| | | | | | - Agathe Saby
- Centre universitaire de pédopsychiatrie, CHRU de Tours, Tours, France
| | | | | | - Emmanuelle Houy-Durand
- UMR 1253 iBrain, Inserm, Université de Tours, Tours, France; Centre universitaire de pédopsychiatrie, CHRU de Tours, Tours, France
| | - Marie Gomot
- UMR 1253 iBrain, Inserm, Université de Tours, Tours, France.
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24
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Ifergan H, Amelot A, Ismail M, Gaudron M, Cottier JP, Narata AP. Stroke-mimics in stroke-units. Evaluation after changes imposed by randomized trials. Arq Neuropsiquiatr 2020; 78:88-95. [PMID: 32159722 DOI: 10.1590/0004-282x20190154] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/26/2019] [Accepted: 09/18/2019] [Indexed: 12/27/2022]
Abstract
BACKGROUND A larger therapeutic window for stroke treatment requires a significant change in the organization of emergency services, avoiding the increase in number of imaging exams and indirectly the time to treatment. OBJECTIVE To highlight the relation between faster clinical evaluation and stroke over-suspicion and consequently excessive imaging acquisition. To identify predictors of ischemic stroke and stroke mimics (SM), aiming for better patient selection for comprehensive neuroimaging and reperfusion therapies. METHODS Retrospective, cohort, observational, single-center study that reviewed all consecutive files of patients presenting with acute neurological symptoms who underwent CT scan or MRI from July 1, 2016 to July 1, 2017. RESULTS 736 patient files were reviewed. 385 patients (52.3%) presented with confirmed acute ischemic infarct, 93 (12.6%) had another brain lesion mimicking acute ischemia, and 258 (35.1%) had normal imaging. Acute stroke was more frequent in elderly patients with atrial fibrillation, arterial hypertension, or dysarthria or right motor impairment. Stroke mimic was associated with female patients with low vascular risk factors, low NIHSS, and patients with decreased level of consciousness or symptoms suggestive of posterior circulation. DISCUSSION 47.7% of all patients seen at the stroke unit did not have acute stroke lesions. Clinical assessment data have been used to provide indicators of acute stroke and stroke mimic patients, and symptoms corresponding to acute stroke and stroke mimic seem to be similar in the literature. CONCLUSION Considering that the number of patients admitted for stroke treatment will increase even further with a larger therapeutic window for mechanical thrombectomy and for thrombolysis, a diagnostic decision-making algorithm for stroke patients is required in order to reinforce the suspicion of stroke indicating an urgent MRI.
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Affiliation(s)
- Héloïse Ifergan
- Service de neuroradiologie diagnostique et interventionnelle, Centre Hospitalier Régional et Universitaire de Tours, France
| | - Aymeric Amelot
- Service de neurochirurgie, Centre Hospitalier Régional et Universitaire de Tours, France
| | - Mohammad Ismail
- Service de neuroradiologie diagnostique et interventionnelle, Centre Hospitalier Régional et Universitaire de Tours, France
| | - Marie Gaudron
- Service de neurologie vasculaire, Centre Hospitalier Régional et Universitaire de Tours, France
| | - Jean-Philippe Cottier
- Service de neuroradiologie diagnostique et interventionnelle, Centre Hospitalier Régional et Universitaire de Tours, France
| | - Ana Paula Narata
- Service de neuroradiologie diagnostique et interventionnelle, Centre Hospitalier Régional et Universitaire de Tours, France
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25
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Morel B, Piredda GF, Cottier JP, Tauber C, Destrieux C, Hilbert T, Sirinelli D, Thiran JP, Maréchal B, Kober T. Normal volumetric and T1 relaxation time values at 1.5 T in segmented pediatric brain MRI using a MP2RAGE acquisition. Eur Radiol 2020; 31:1505-1516. [PMID: 32885296 DOI: 10.1007/s00330-020-07194-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2020] [Revised: 07/02/2020] [Accepted: 08/13/2020] [Indexed: 10/23/2022]
Abstract
OBJECTIVES This study introduced a tailored MP2RAGE-based brain acquisition for a comprehensive assessment of the normal maturing brain. METHODS Seventy normal patients (35 girls and 35 boys) from 1 to 16 years of age were recruited within a prospective monocentric study conducted from a single University Hospital. Brain MRI examinations were performed at 1.5 T using a 20-channel head coil and an optimized 3D MP2RAGE sequence with a total acquisition time of 6:36 min. Automated 38 region segmentation was performed using the MorphoBox (template registration, bias field correction, brain extraction, and tissue classification) which underwent a major adaptation of three age-group T1-weighted templates. Volumetry and T1 relaxometry reference ranges were established using a logarithmic model and a modified Gompertz growth respectively. RESULTS Detailed automated brain segmentation and T1 mapping were successful in all patients. Using these data, an age-dependent model of normal brain maturation with respect to changes in volume and T1 relaxometry was established. After an initial rapid increase until 24 months of life, the total intracranial volume was found to converge towards 1400 mL during adolescence. The expected volumes of white matter (WM) and cortical gray matter (GM) showed a similar trend with age. After an initial major decrease, T1 relaxation times were observed to decrease progressively in all brain structures. The T1 drop in the first year of life was more pronounced in WM (from 1000-1100 to 650-700 ms) than in GM structures. CONCLUSION The 3D MP2RAGE sequence allowed to establish brain volume and T1 relaxation time normative ranges in pediatrics. KEY POINTS • The 3D MP2RAGE sequence provided a reliable quantitative assessment of brain volumes and T1 relaxation times during childhood. • An age-dependent model of normal brain maturation was established. • The normative ranges enable an objective comparison to a normal cohort, which can be useful to further understand, describe, and identify neurodevelopmental disorders in children.
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Affiliation(s)
- Baptiste Morel
- Inserm UMR 1253, iBrain, Université de Tours, Tours, France. .,Pediatric Radiology Department, Clocheville Hospital, CHRU de Tours, 49 Boulevard Beranger, 37000, Tours, France.
| | - Gian Franco Piredda
- Advanced Clinical Imaging Technology, Siemens Healthcare AG, Lausanne, Switzerland.,Department of Radiology, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland.,LTS5, École Polytechnique FÉdÉrale de Lausanne (EPFL), Lausanne, Switzerland
| | | | - Clovis Tauber
- Inserm UMR 1253, iBrain, Université de Tours, Tours, France
| | | | - Tom Hilbert
- Advanced Clinical Imaging Technology, Siemens Healthcare AG, Lausanne, Switzerland.,Department of Radiology, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland.,LTS5, École Polytechnique FÉdÉrale de Lausanne (EPFL), Lausanne, Switzerland
| | | | - Jean-Philippe Thiran
- Department of Radiology, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland.,LTS5, École Polytechnique FÉdÉrale de Lausanne (EPFL), Lausanne, Switzerland
| | - Bénédicte Maréchal
- Advanced Clinical Imaging Technology, Siemens Healthcare AG, Lausanne, Switzerland.,Department of Radiology, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland.,LTS5, École Polytechnique FÉdÉrale de Lausanne (EPFL), Lausanne, Switzerland
| | - Tobias Kober
- Advanced Clinical Imaging Technology, Siemens Healthcare AG, Lausanne, Switzerland.,Department of Radiology, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland.,LTS5, École Polytechnique FÉdÉrale de Lausanne (EPFL), Lausanne, Switzerland
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26
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Ribeiro MJ, Vercouillie J, Arlicot N, Tauber C, Gissot V, Mondon K, Barantin L, Cottier JP, Maia S, Deloye JB, Emond P, Guilloteau D. Usefulness of PET With [ 18F]LBT-999 for the Evaluation of Presynaptic Dopaminergic Neuronal Loss in a Clinical Environment. Front Neurol 2020; 11:754. [PMID: 32973645 PMCID: PMC7472558 DOI: 10.3389/fneur.2020.00754] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2020] [Accepted: 06/18/2020] [Indexed: 11/21/2022] Open
Abstract
Purpose: The density of the neuronal dopamine transporter (DAT) is directly correlated with the presynaptic dopaminergic system injury. In a first study, we evaluated the brain distribution and kinetics of [18F]LBT-999, a DAT PET radioligand, in a group of eight healthy subjects. Taking into account the results obtained in healthy volunteers, we wanted to evaluate whether the loss of presynaptic striatal dopaminergic fibers could be estimated, under routine clinical conditions, using [18F]LBT-999 and a short PET acquisition. Materials and methods: Six patients with Parkinson's disease (PD) were compared with eight controls. Eighty-nine minutes of dynamic PET following an intravenous injection of [18F]LBT-999 were acquired. Using regions of interest for striatal nuclei, substantia nigra (SN), cerebellum, and occipital cortex, defined over each T1 3D MRI, time–activity curves (TACs) were obtained. From TACs, binding potential (BPND) using the simplified reference tissue model and distribution volume ratios (DVRs) using Logan graphical analysis were calculated. Ratios obtained for a 10-min image, acquired between 30 and 40 min post-injection, were also calculated. Cerebellum activity was used as non-specific reference region. Results: In PD patients and as expected, striatal uptake was lower than in controls which is confirmed by BPND, DVR, and ratios calculated for both striatal nuclei and SN, significantly inferior in PD patients compared with controls (p < 0.001). Conclusions: PET with [18F]LBT-999 could be an alternative to assess dopaminergic presynaptic injury in a clinical environment using a single 10 min acquisition.
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Affiliation(s)
- Maria-Joao Ribeiro
- UMR 1253, iBrain, Université de Tours, Tours, France.,CHRU, Tours, France.,Inserm CIC 1415, CHRU, Tours, France
| | - Johnny Vercouillie
- UMR 1253, iBrain, Université de Tours, Tours, France.,CHRU, Tours, France.,Inserm CIC 1415, CHRU, Tours, France
| | - Nicolas Arlicot
- UMR 1253, iBrain, Université de Tours, Tours, France.,CHRU, Tours, France.,Inserm CIC 1415, CHRU, Tours, France
| | - Clovis Tauber
- UMR 1253, iBrain, Université de Tours, Tours, France
| | - Valérie Gissot
- CHRU, Tours, France.,Inserm CIC 1415, CHRU, Tours, France
| | | | - Laurent Barantin
- UMR 1253, iBrain, Université de Tours, Tours, France.,CHRU, Tours, France
| | | | | | | | - Patrick Emond
- UMR 1253, iBrain, Université de Tours, Tours, France.,CHRU, Tours, France
| | - Denis Guilloteau
- UMR 1253, iBrain, Université de Tours, Tours, France.,CHRU, Tours, France.,Inserm CIC 1415, CHRU, Tours, France
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27
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Lecler A, Broquet V, Bailleux J, Carsin B, Adle-Biassette H, Baloglu S, Forestier G, Bonneville F, Calvier E, Chauvet D, Comby PO, Cottier JP, Cotton F, Deschamps R, Diard-Detoeuf C, Ducray F, Drissi C, Elmaleh M, Farras J, Aguilar Garcia J, Gerardin E, Grand S, Jianu DC, Kremer S, Loiseau H, Magne N, Mejdoubi M, Moulignier A, Ollivier M, Nagi S, Rodallec M, Shor N, Tourdias T, Vandendries C, Anxionnat R, Duron L, Savatovsky J. Advanced multiparametric magnetic resonance imaging of multinodular and vacuolating neuronal tumor. Eur J Neurol 2020; 27:1561-1569. [PMID: 32301260 DOI: 10.1111/ene.14264] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2020] [Accepted: 04/10/2020] [Indexed: 12/01/2022]
Abstract
BACKGROUND AND PURPOSE Multinodular and vacuolating neuronal tumor (MVNT) of the cerebrum is a rare brain lesion with suggestive imaging features. The aim of our study was to report the largest series of MVNTs so far and to evaluate the utility of advanced multiparametric magnetic resonance (MR) techniques. METHODS This multicenter retrospective study was approved by our institutional research ethics board. From July 2014 to May 2019, two radiologists read in consensus the MR examinations of patients presenting with a lesion suggestive of an MVNT. They analyzed the lesions' MR characteristics on structural images and advanced multiparametric MR imaging. RESULTS A total of 64 patients (29 women and 35 men, mean age 44.2 ± 15.1 years) from 25 centers were included. Lesions were all hyperintense on fluid-attenuated inversion recovery and T2-weighted imaging without post-contrast enhancement. The median relative apparent diffusion coefficient on diffusion-weighted imaging was 1.13 [interquartile range (IQR), 0.2]. Perfusion-weighted imaging showed no increase in perfusion, with a relative cerebral blood volume of 1.02 (IQR, 0.05) and a relative cerebral blood flow of 1.01 (IQR, 0.08). MR spectroscopy showed no abnormal peaks. Median follow-up was 2 (IQR, 1.2) years, without any changes in size. CONCLUSIONS A comprehensive characterization protocol including advanced multiparametric magnetic resonance imaging sequences showed no imaging patterns suggestive of malignancy in MVNTs. It might be useful to better characterize MVNTs.
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Affiliation(s)
- A Lecler
- Department of Neuroradiology, Fondation Ophtalmologique Adolphe de Rothschild, Paris, France
| | - V Broquet
- Department of Neuroradiology, CHU Lille, Lille, France
| | - J Bailleux
- Department of Neuroradiology, Fondation Ophtalmologique Adolphe de Rothschild, Paris, France
| | - B Carsin
- Department of Radiology, CHRU de Rennes, Rennes, France
| | - H Adle-Biassette
- Department of Pathology, Lariboisière Hospital, Paris Diderot, Paris-Cité-Sorbonne University, Paris, France
| | - S Baloglu
- Department of Radiology, University Hospital of Strasbourg, Strasbourg, France
| | - G Forestier
- Department of Neuroradiology, CHU Limoges, Limoges, France
| | - F Bonneville
- Department of Neuroradiology, Hôpital Pierre-Paul-Riquet, CHU Purpan, Toulouse, France
| | - E Calvier
- Neurology Department, Hôpital René et Guillaume-Laënnec, CHU de Nantes, Saint-Herblain, France
| | - D Chauvet
- Department of Neurosurgery, Fondation Ophtalmologique Adolphe de Rothschild, Paris, France
| | - P O Comby
- Department of Vascular and Interventional Radiology, Image-Guided Therapy Center, François-Mitterrand University Hospital, Dijon, France
| | - J P Cottier
- Department of Radiology, CHRU de Tours, Tours, France.,Brain and Imaging laboratory, UMR U930, INSERM, François-Rabelais University, Tours, France
| | - F Cotton
- Service de Radiologie, Centre Hospitalier Lyon-Sud, 69495 Pierre-Bénite, Hospices Civils de Lyon, University Claude Bernard Lyon 1, Lyon, France
| | - R Deschamps
- Department of Neurology, Fondation Ophtalmologique Adolphe de Rothschild, Paris, France
| | | | - F Ducray
- Department of Neuro-oncology, Lyon French Reference Center of Paraneoplastic Neurological Syndrome, Hospices Civils de Lyon, Lyon, France
| | - C Drissi
- Faculté de Médecine de Tunis, Institut National de Neurologie, Service de Neuroradiologie, Université de Tunis El Manar, Tunis, Tunisia
| | - M Elmaleh
- Pediatric Radiology Department, Robert Debré Hospital, Paris, France
| | - J Farras
- Jordi Radiologia C/ de la Roda, Andorra la Vella, Andorra
| | - J Aguilar Garcia
- Neurology Department, Hôpital René et Guillaume-Laënnec, CHU de Nantes, Saint-Herblain, France
| | - E Gerardin
- Department of Neuroradiology and MRI, Rouen University Hospital, Rouen, France
| | - S Grand
- Neuroradiologie diagnostique et interventionnelle et IRM Nord 'Centre Hospitalier et Universitaire de Alpes Grenoble', Grenoble, France
| | - D C Jianu
- Department of Neurology, Victor Babes University of Medecine and Pharmacy, Timisoara, Romania
| | - S Kremer
- Department of Radiology, University Hospital of Strasbourg, Strasbourg, France
| | - H Loiseau
- Service de Neurochirurgie, CHU de Bordeaux, Université de Bordeaux, Bordeaux, France
| | - N Magne
- Department of Neuroradiology and MRI, Rouen University Hospital, Rouen, France
| | - M Mejdoubi
- Department of Neuroradiology, University Hospital of Martinique, Fort-de-France, France
| | - A Moulignier
- Department of Neurology, Fondation Ophtalmologique Adolphe de Rothschild, Paris, France
| | - M Ollivier
- Service de Radiologie, Groupe Hospitalier Pellegrin, Bordeaux, France
| | - S Nagi
- Faculté de Médecine de Tunis, Institut National de Neurologie, Service de Neuroradiologie, Université de Tunis El Manar, Tunis, Tunisia.,Clinique les Berges du Lac, rue du Lac de Constance, Tunis, Tunisia
| | - M Rodallec
- Centre d'Imagerie Centre Cardiologique du Nord, CCN, Saint-Denis, France
| | - N Shor
- Department of Neuroradiology, Pitié-Salpêtrière Hospital, Paris, France
| | - T Tourdias
- Service de Neuroimagerie Diagnostique et Thérapeutique, CHU de Bordeaux et INSERM U1215, Université de Bordeaux, Bordeaux, France
| | - C Vandendries
- Department of Neuroradiology, Fondation Ophtalmologique Adolphe de Rothschild, Paris, France.,Centre d'Imagerie Médicale Paris 15ème, RMX, Paris, France
| | - R Anxionnat
- Service de Radiologie, CHU de Nancy, Nancy, France
| | - L Duron
- Department of Neuroradiology, Fondation Ophtalmologique Adolphe de Rothschild, Paris, France
| | - J Savatovsky
- Department of Neuroradiology, Fondation Ophtalmologique Adolphe de Rothschild, Paris, France.,Centre d'Imagerie Paris 13, Paris, France
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28
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Seners P, Turc G, Lion S, Cottier JP, Cho TH, Arquizan C, Bracard S, Ozsancak C, Legrand L, Naggara O, Debiais S, Berthezene Y, Costalat V, Richard S, Magni C, Nighoghossian N, Narata AP, Dargazanli C, Gory B, Mas JL, Oppenheim C, Baron JC. Relationships between brain perfusion and early recanalization after intravenous thrombolysis for acute stroke with large vessel occlusion. J Cereb Blood Flow Metab 2020; 40:667-677. [PMID: 30890074 PMCID: PMC7026851 DOI: 10.1177/0271678x19836288] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
In large vessel occlusion (LVO) stroke, it is unclear whether severity of ischemia is involved in early post-thrombolysis recanalization over and above thrombus site and length. Here we assessed the relationships between perfusion parameters and early recanalization following intravenous thrombolysis administration in LVO patients. From a multicenter registry, we identified 218 thrombolysed LVO patients referred for thrombectomy with both (i) pre-thrombolysis MRI, including diffusion-weighted imaging (DWI), T2*-imaging, MR-angiography and dynamic susceptibility-contrast perfusion-weighted imaging (PWI); and (ii) evaluation of recanalization on first angiographic run or non-invasive imaging ≤ 3 h from thrombolysis start. Infarct core volume on DWI, PWI-DWI mismatch volume and hypoperfusion intensity ratio (HIR; defined as Tmax ≥ 10 s volume/ Tmax ≥ 6 s volume, low HIR indicating milder hypoperfusion) were determined using a commercially available software. Early recanalization occurred in 34 (16%) patients, and multivariable analysis was associated with lower HIR (P = 0.006), shorter thrombus on T2*-imaging (P < 0.001) and more distal occlusion (P = 0.006). However, the relationship between HIR and early recanalization was robust only for thrombus length <14 mm. In summary, the present study disclosed an association between lower HIR and early post-thrombolysis recanalization. Early post-thrombolysis recanalization is therefore determined not only by thrombus site and length but also by severity of ischemia.
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Affiliation(s)
- Pierre Seners
- Neurology Department, Sainte-Anne Hospital, Université Paris Descartes, INSERM UMR 1266, Paris, France
| | - Guillaume Turc
- Neurology Department, Sainte-Anne Hospital, Université Paris Descartes, INSERM UMR 1266, Paris, France
| | - Stéphanie Lion
- Radiology Department, Sainte-Anne Hospital, Université Paris Descartes, INSERM UMR 1266, Paris, France
| | - Jean-Philippe Cottier
- Department of Neuroradiology, Bretonneau Hospital, University of Tours, Tours, France
| | - Tae-Hee Cho
- Department of Stroke Medicine, Hospices Civils de Lyon, Université Lyon 1, CREATIS, CNRS UMR 5220-INSERM U1044, INSALyon, Lyon, France
| | | | - Serge Bracard
- Department of Diagnostic and Interventional Neuroradiology, University Hospital of Nancy, INSERM U 947, Nancy, France
| | | | - Laurence Legrand
- Radiology Department, Sainte-Anne Hospital, Université Paris Descartes, INSERM UMR 1266, Paris, France
| | - Olivier Naggara
- Radiology Department, Sainte-Anne Hospital, Université Paris Descartes, INSERM UMR 1266, Paris, France
| | - Séverine Debiais
- Department of Neurology, Bretonneau Hospital, University of Tours, Tours, France
| | - Yves Berthezene
- Neuroradiology Department, Hospices Civils de Lyon, Lyon, France
| | - Vincent Costalat
- Department of Interventional Neuroradiology, CHRU Gui de Chauliac, Montpellier, France
| | | | | | - Norbert Nighoghossian
- Department of Stroke Medicine, Hospices Civils de Lyon, Université Lyon 1, CREATIS, CNRS UMR 5220-INSERM U1044, INSALyon, Lyon, France
| | - Ana-Paula Narata
- Department of Neuroradiology, Bretonneau Hospital, University of Tours, Tours, France
| | - Cyril Dargazanli
- Department of Interventional Neuroradiology, CHRU Gui de Chauliac, Montpellier, France
| | - Benjamin Gory
- Department of Diagnostic and Interventional Neuroradiology, University Hospital of Nancy, INSERM U 947, Nancy, France
| | - Jean-Louis Mas
- Neurology Department, Sainte-Anne Hospital, Université Paris Descartes, INSERM UMR 1266, Paris, France
| | - Catherine Oppenheim
- Radiology Department, Sainte-Anne Hospital, Université Paris Descartes, INSERM UMR 1266, Paris, France
| | - Jean-Claude Baron
- Neurology Department, Sainte-Anne Hospital, Université Paris Descartes, INSERM UMR 1266, Paris, France
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29
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Janot K, Oliveira TR, Herbreteau D, Bibi R, Ifergan H, Maldonado I, Barrot V, Fromont-hankard G, Annan M, Filipiak I, Barantin L, Guibon R, Cottier JP, Narata AP. Analyse IRM de thrombi impliqués dans l’AVC ischemique. J Neuroradiol 2020. [DOI: 10.1016/j.neurad.2019.12.022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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30
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Morel B, Andersson F, Samalbide M, Binninger G, Carpentier E, Sirinelli D, Cottier JP. Impact on child and parent anxiety level of a teddy bear-scale mock magnetic resonance scanner. Pediatr Radiol 2020; 50:116-120. [PMID: 31501961 DOI: 10.1007/s00247-019-04514-1] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/10/2019] [Revised: 06/26/2019] [Accepted: 08/20/2019] [Indexed: 10/26/2022]
Abstract
BACKGROUND Pediatric magnetic resonance imaging (MRI) can be stressful. Mock MR scanners have been proven to be effective in avoiding the use of general anesthesia. OBJECTIVES We prospectively evaluated the impact of a teddy bear-scale model of a mock MR scanner on the anxiety experienced by parents and their children during MRI without general anesthesia . MATERIALS AND METHODS A 1-year prospective study before and after the installation of a mock scanner in a Pediatric Radiology Department of a university hospital. Anxiety levels were self-estimated by children ages 4 to 16 years and by the parents with a visual analogue scale (from 0, completely relaxed, to 100, extremely stressed) at three moments: in the waiting room, in the preparation room after an explanation by the MRI technologists, and at the issue of the MR acquisition images. Two groups were tested: one with a mock MR scanner, the other without. Analysis of variance (ANOVA) and Fisher exact tests were performed. Motion artifacts were studied. RESULTS Ninety-one children and their parents were included. The median age was 8 years (standard deviation [SD]=2). In the post mock period, the ambiance of the preparation room was considered by children as significantly more relaxing in 50% vs. 20% (P=0.004) and the anxiety level of children was significantly lower after the explanation, particularly in girls, but unchanged for their parents. The anxiety levels at the end of the examination were significantly lower for parents. The motion artifacts rate was lower (1.7% vs. 4.7%, P=0.04). CONCLUSION A mock scanner was an efficient tool to improve efficiency of the explanation and to decrease anxiety in children and motion artifacts in pediatric MRI.
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Affiliation(s)
- Baptiste Morel
- Pediatric Radiology Department, Clocheville University Hospital, 49 Boulevard Beranger, 37000, Tours, France. .,Faculty of Medicine, Francois Rabelais University, Tours, France. .,UMR 1253, iBrain, Université de Tours, Inserm, Tours, France.
| | | | - Muriel Samalbide
- Pediatric Radiology Department, Clocheville University Hospital, 49 Boulevard Beranger, 37000, Tours, France
| | - Gauthier Binninger
- Pediatric Radiology Department, Clocheville University Hospital, 49 Boulevard Beranger, 37000, Tours, France
| | - Elodie Carpentier
- Pediatric Radiology Department, Clocheville University Hospital, 49 Boulevard Beranger, 37000, Tours, France
| | - Dominique Sirinelli
- Pediatric Radiology Department, Clocheville University Hospital, 49 Boulevard Beranger, 37000, Tours, France.,Faculty of Medicine, Francois Rabelais University, Tours, France
| | - Jean-Philippe Cottier
- Faculty of Medicine, Francois Rabelais University, Tours, France.,UMR 1253, iBrain, Université de Tours, Inserm, Tours, France.,Neuroradiology Department, Bretonneau Hospital, Tours, France
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31
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Arlicot N, Vercouillie J, Malherbe C, Bidault R, Gissot V, Maia S, Barantin L, Cottier JP, Deloye JB, Guilloteau D, Ribeiro MJ. PET imaging of Dopamine Transporter with [18F]LBT-999: initial evaluation in healthy volunteers. Q J Nucl Med Mol Imaging 2019; 66:148-155. [PMID: 31496203 DOI: 10.23736/s1824-4785.19.03175-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
BACKGROUND To evaluate in healthy human brain the distribution, uptake, and kinetics of [18F]LBT-999, a PET ligand targeting the dopamine transporter, to assess its ability to explore dopaminergic innervation, using a shorter protocol, more convenient for patients than currently with [123I]ioflupane. METHODS After intravenous injection of [18F]LBT-999, 8 healthy subjects (53-80y) underwent a dynamic PET-scan. Venous samples were concomitantly obtained for metabolites analysis. Time activity curves (TACs) were generated for several ROIs (caudate, putamen, occipital cortex, substantia nigra and cerebellum). Cerebellum was used as reference region to calculate binding potentials (BPND). RESULTS No adverse events or detectable pharmacological effects were reported. [18F]LBT-999 PET revealed a good cerebral distribution, with an intense and symmetric uptake in both putamen and caudate (BPND of 6.75±1.17 and 6.30±1.17, respectively), without other brain abnormal tracer accumulation. Regional TACs showed a plateau from the maximal uptake, 20min pi, to the end of the acquisition for both caudate and putamen, whereas uptake in substantia nigra decreased progressively. A faster clearance and lowest BPND values were observed in both cortex and cerebellum. Ratios to the cerebellum exhibit value of about 3 in substantia nigra, close to 10 for both caudate and putamen, and remained around the value of 1 in cortex. The parent fraction of [18F]LBT-999 in plasma was 80%, 60% and 45% at 15, 30 and 45 min pi, respectively. CONCLUSIONS These findings support the usefulness of [18F]LBT-999 for a quantitative clinical evaluation of presynaptic dopaminergic innervation.
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Affiliation(s)
- Nicolas Arlicot
- CHRU de Tours, Unité de Radiopharmacie, Tours, France - .,UMR 1253, iBrain, Université de Tours, Inserm, Tours, France - .,-INSERM CIC 1415, University Hospital, Tours, France -
| | - Johnny Vercouillie
- UMR 1253, iBrain, Université de Tours, Inserm, Tours, France.,-INSERM CIC 1415, University Hospital, Tours, France
| | - Cécile Malherbe
- CHRU de Tours, Unité de Radiopharmacie, Tours, France.,UMR 1253, iBrain, Université de Tours, Inserm, Tours, France
| | - Rudy Bidault
- UMR 1253, iBrain, Université de Tours, Inserm, Tours, France
| | | | - Serge Maia
- CHRU de Tours, Unité de Radiopharmacie, Tours, France.,UMR 1253, iBrain, Université de Tours, Inserm, Tours, France
| | | | - Jean-Philippe Cottier
- UMR 1253, iBrain, Université de Tours, Inserm, Tours, France.,CHRU de Tours, Service de Neuroradiologie, Tours, France
| | | | - Denis Guilloteau
- UMR 1253, iBrain, Université de Tours, Inserm, Tours, France.,-INSERM CIC 1415, University Hospital, Tours, France.,CHRU de Tours, Service de Médecine Nucléaire in vitro, Tours, France
| | - Maria-Joao Ribeiro
- UMR 1253, iBrain, Université de Tours, Inserm, Tours, France.,-INSERM CIC 1415, University Hospital, Tours, France.,CHRU de Tours, Service de Médecine Nucléaire in vivo, Tours, France
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32
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Janot K, Oliveira TR, Fromont-Hankard G, Annan M, Filipiak I, Barantin L, Guibon R, Duffy S, Gilvarry M, Cottier JP, Narata AP. Quantitative estimation of thrombus-erythrocytes using MRI. A phantom study with clot analogs and analysis by statistic regression models. J Neurointerv Surg 2019; 12:181-185. [PMID: 31273071 DOI: 10.1136/neurintsurg-2019-014950] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2019] [Revised: 06/10/2019] [Accepted: 06/11/2019] [Indexed: 11/04/2022]
Abstract
BACKGROUND Thrombus composition has the potential to affect acute ischemic stroke (AIS) treatment. OBJECTIVE To evaluate in an in vitro test the correlation of clot composition, especially erythrocytes (red blood cells (RBCs)), with the variation of signal intensity ratio (SIR) obtained with MRI sequences used for AIS, and qualification of the susceptibility vessel sign effect using clot analogs. MATERIALS AND METHODS Nine ovine clots were fixed in a gelatin-manganese solution and studied by MRI (T2GE, T2-weighted gradient echo; SWI, susceptibility-weighted imaging; FLAIR, fluid attenuated inversion recovery). RBC concentration was estimated using regression models (SLR, single linear regression; MLR, multiple linear regression; RF, random Forest; and ANN, artificial neural networking), which combined the SIR-histology relationship of three MRI sequences. RESULTS Negative correlation was found between SIR and RBC concentration. T2GE SWI could not statistically distinguish clots with RBC content >54% and <23%. SLR was applied only to FLAIR images since T2GE and SWI demonstrated signal saturation. All four regression models showed a correlation between MRI and histology: SLR=0.981; MLR=0.986; RF=0.994, and ANN=0.971. One unknown clot was studied and agreement between SIR and histological analyses was found in all models. CONCLUSIONS We presented a method to quantify RBC concentration in clot analogs, combining SWI, T2GE, and FLAIR. This in vitro study has some limitations, so clot collection after thrombectomy with simultaneous imaging analysis is necessary to validate this model.
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Affiliation(s)
- Kevin Janot
- Neuroradiology, Regional University Hospital Centre Tours, Tours, France
| | - Tiago Ribeiro Oliveira
- Center for Engineering, Modeling and Applied Social Sciences, Federal University of the ABC, Sao Bernardo do Campo, Brazil
| | | | - Mariam Annan
- Neurology, Regional University Hospital Centre Tours, Tours, France
| | - Isabelle Filipiak
- Inserm U1253 'Imaging and Brain: iBrain'', Regional University Hospital Centre Tours, Tours, France
| | - Laurent Barantin
- Inserm U1253 'Imaging and Brain: iBrain'', Regional University Hospital Centre Tours, Tours, France
| | - Roseline Guibon
- Pathology, Regional University Hospital Centre Tours, Tours, France
| | - Sharon Duffy
- Cerenovus, Galway Neuro Technology Centre, Galway, Ireland
| | | | | | - Ana Paula Narata
- Neuroradiology, Regional University Hospital Centre Tours, Tours, France
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33
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Layly J, Marmouset F, Chassagnon G, Bertrand P, Sirinelli D, Cottier JP, Morel B. Can We Reduce Frame Rate to 15 Images per Second in Pediatric Videofluoroscopic Swallow Studies? Dysphagia 2019; 35:296-300. [DOI: 10.1007/s00455-019-10027-8] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2019] [Revised: 04/30/2019] [Accepted: 05/31/2019] [Indexed: 12/21/2022]
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34
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Seners P, Roca P, Legrand L, Turc G, Cottier JP, Cho TH, Arquizan C, Bracard S, Ozsancak C, Ben Hassen W, Naggara O, Lion S, Debiais S, Berthezene Y, Costalat V, Richard S, Magni C, Mas JL, Baron JC, Oppenheim C. Better Collaterals Are Independently Associated With Post-Thrombolysis Recanalization Before Thrombectomy. Stroke 2019; 50:867-872. [DOI: 10.1161/strokeaha.118.022815] [Citation(s) in RCA: 28] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Background and Purpose—
In acute stroke patients with large vessel occlusion, the goal of intravenous thrombolysis (IVT) is to achieve early recanalization (ER). Apart from occlusion site and thrombus length, predictors of early post-IVT recanalization are poorly known. Better collaterals might also facilitate ER, for instance, by improving delivery of the thrombolytic agent to both ends of the thrombus. In this proof-of-concept study, we tested the hypothesis that good collaterals independently predict post-IVT recanalization before thrombectomy.
Methods—
Patients from the registries of 6 French stroke centers with the following criteria were included: (1) acute stroke with large vessel occlusion treated with IVT and referred for thrombectomy between May 2015 and March 2017; (2) pre-IVT brain magnetic resonance imaging, including diffusion-weighted imaging, T2*, MR angiography, and dynamic susceptibility contrast perfusion-weighted imaging; and (3) ER evaluated ≤3 hours from IVT start on either first angiographic run or noninvasive imaging. A collateral flow map derived from perfusion-weighted imaging source data was automatically generated, replicating a previously validated method. Thrombus length was measured on T2*-based susceptibility vessel sign.
Results—
Of 224 eligible patients, 37 (16%) experienced ER. ER occurred in 10 of 83 (12%), 17 of 116 (15%), and 10 of 25 (40%) patients with poor/moderate, good, and excellent collaterals, respectively. In multivariable analysis, better collaterals were independently associated with ER (
P
=0.029), together with shorter thrombus (
P
<0.001) and more distal occlusion site (
P
=0.010).
Conclusions—
In our sample of patients with stroke imaged with perfusion-weighted imaging before IVT and intended for thrombectomy, better collaterals were independently associated with post-IVT recanalization, supporting our hypothesis. These findings strengthen the idea that advanced imaging may play a key role for personalized medicine in identifying patients with large vessel occlusion most likely to benefit from IVT in the thrombectomy era.
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Affiliation(s)
- Pierre Seners
- From the Department of Neurology (P.S., G.T., J.-L.M., J.-C.B.), Sainte-Anne Hospital, INSERM U894, University Paris Descartes, France
| | - Pauline Roca
- Department of Radiology (P.R., L.L., W.B.H., O.N., S.L., C. Oppenheim), Sainte-Anne Hospital, INSERM U894, University Paris Descartes, France
| | - Laurence Legrand
- Department of Radiology (P.R., L.L., W.B.H., O.N., S.L., C. Oppenheim), Sainte-Anne Hospital, INSERM U894, University Paris Descartes, France
| | - Guillaume Turc
- From the Department of Neurology (P.S., G.T., J.-L.M., J.-C.B.), Sainte-Anne Hospital, INSERM U894, University Paris Descartes, France
| | - Jean-Philippe Cottier
- Department of Neuroradiology (J.-P.C.), Bretonneau Hospital, University of Tours, France
| | - Tae-Hee Cho
- Department of Stroke Medicine (T.-H.C.), Hospices Civils de Lyon, Université Lyon 1, CREATIS, CNRS UMR 5220-INSERM U1044, France
| | - Caroline Arquizan
- Department of Neurology (C.A.), CHRU Gui de Chauliac, Montpellier, France
| | - Serge Bracard
- Department of Diagnostic and Interventional Neuroradiology, University Hospital of Nancy, INSERM U947, France (S.B.)
| | - Canan Ozsancak
- Department of Neurology (C. Ozsancak), Orleans Hospital, France
| | - Wagih Ben Hassen
- Department of Radiology (P.R., L.L., W.B.H., O.N., S.L., C. Oppenheim), Sainte-Anne Hospital, INSERM U894, University Paris Descartes, France
| | - Olivier Naggara
- Department of Radiology (P.R., L.L., W.B.H., O.N., S.L., C. Oppenheim), Sainte-Anne Hospital, INSERM U894, University Paris Descartes, France
| | - Stéphanie Lion
- Department of Radiology (P.R., L.L., W.B.H., O.N., S.L., C. Oppenheim), Sainte-Anne Hospital, INSERM U894, University Paris Descartes, France
| | - Séverine Debiais
- Department of Neurology (S.D.), Bretonneau Hospital, University of Tours, France
| | - Yves Berthezene
- Department of Neuroradiology (Y.B.), Hospices Civils de Lyon, Université Lyon 1, CREATIS, CNRS UMR 5220-INSERM U1044, France
| | - Vincent Costalat
- Department of Interventional Neuroradiology (V.C.), CHRU Gui de Chauliac, Montpellier, France
| | - Sébastien Richard
- Department of Neurology, University Hospital of Nancy, France (S.R.)
| | | | - Jean-Louis Mas
- From the Department of Neurology (P.S., G.T., J.-L.M., J.-C.B.), Sainte-Anne Hospital, INSERM U894, University Paris Descartes, France
| | - Jean-Claude Baron
- From the Department of Neurology (P.S., G.T., J.-L.M., J.-C.B.), Sainte-Anne Hospital, INSERM U894, University Paris Descartes, France
| | - Catherine Oppenheim
- Department of Radiology (P.R., L.L., W.B.H., O.N., S.L., C. Oppenheim), Sainte-Anne Hospital, INSERM U894, University Paris Descartes, France
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35
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Seners P, Delepierre J, Turc G, Henon H, Piotin M, Arquizan C, Cho TH, Lapergue B, Cottier JP, Richard S, Legrand L, Bricout N, Mazighi M, Dargazanli C, Nighoghossian N, Consoli A, Debiais S, Bracard S, Naggara O, Leclerc X, Obadia M, Costalat V, Berthezène Y, Tisserand M, Narata AP, Gory B, Mas JL, Oppenheim C, Baron JC. Thrombus Length Predicts Lack of Post-Thrombolysis Early Recanalization in Minor Stroke With Large Vessel Occlusion. Stroke 2019; 50:761-764. [DOI: 10.1161/strokeaha.118.023455] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Affiliation(s)
- Pierre Seners
- From the Department of Neurology, INSERM U894 (P.S., J.D., G.T., J.-L.M., J.-C.B.), Sainte-Anne Hospital, Paris, France
| | - Julie Delepierre
- From the Department of Neurology, INSERM U894 (P.S., J.D., G.T., J.-L.M., J.-C.B.), Sainte-Anne Hospital, Paris, France
| | - Guillaume Turc
- From the Department of Neurology, INSERM U894 (P.S., J.D., G.T., J.-L.M., J.-C.B.), Sainte-Anne Hospital, Paris, France
| | - Hilde Henon
- Stroke Unit (H.H.), Roger Salengro Hospital, Lille, France
| | - Michel Piotin
- Department of Neuroradiology Paris Descartes University (M.P., M.M.), Fondation Rothschild, Paris, France
| | - Caroline Arquizan
- Department of Neurology (C.A.), CHRU Gui de Chauliac, Montpellier, France
| | - Tae-Hee Cho
- Stroke Unit (T.-H.C., N.N.), Hospices Civils de Lyon, France
| | | | | | | | - Laurence Legrand
- Department of Neuroradiology, INSERM U894 (L.L., O.N., C.O.), Sainte-Anne Hospital, Paris, France
| | - Nicolas Bricout
- Department of Neuroradiology (N.B., X.L.), Roger Salengro Hospital, Lille, France
| | - Mikaël Mazighi
- Department of Neuroradiology Paris Descartes University (M.P., M.M.), Fondation Rothschild, Paris, France
- Department of Neurology, Lariboisière Hospital, Paris, France (M.M.)
| | - Cyril Dargazanli
- Department of Neuroradiology (C.D., V.C.), CHRU Gui de Chauliac, Montpellier, France
| | | | - Arturo Consoli
- Department of Neuroradiology (A.C., M.T.), Foch Hospital, Suresnes, France
| | - Séverine Debiais
- Department of Neurology (S.D.), Bretonneau Hospital, Tours, France
| | - Serge Bracard
- Department of Neuroradiology (S.B., B.G.), Nancy University Hospital, France
| | - Olivier Naggara
- Department of Neuroradiology, INSERM U894 (L.L., O.N., C.O.), Sainte-Anne Hospital, Paris, France
| | - Xavier Leclerc
- Department of Neuroradiology (N.B., X.L.), Roger Salengro Hospital, Lille, France
| | - Michael Obadia
- Department of Neurology (M.O.), Fondation Rothschild, Paris, France
| | - Vincent Costalat
- Department of Neuroradiology (C.D., V.C.), CHRU Gui de Chauliac, Montpellier, France
| | - Yves Berthezène
- Department of Neuroradiology (Y.B.), Hospices Civils de Lyon, France
| | - Marie Tisserand
- Department of Neuroradiology (A.C., M.T.), Foch Hospital, Suresnes, France
| | - Ana-Paula Narata
- Department of Neuroradiology (J.-P.C., A.-P.N.), Bretonneau Hospital, Tours, France
| | - Benjamin Gory
- Department of Neuroradiology (S.B., B.G.), Nancy University Hospital, France
| | - Jean-Louis Mas
- From the Department of Neurology, INSERM U894 (P.S., J.D., G.T., J.-L.M., J.-C.B.), Sainte-Anne Hospital, Paris, France
| | - Catherine Oppenheim
- Department of Neuroradiology, INSERM U894 (L.L., O.N., C.O.), Sainte-Anne Hospital, Paris, France
| | - Jean-Claude Baron
- From the Department of Neurology, INSERM U894 (P.S., J.D., G.T., J.-L.M., J.-C.B.), Sainte-Anne Hospital, Paris, France
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Seners P, Turc G, Naggara O, Henon H, Piotin M, Arquizan C, Cho TH, Narata AP, Lapergue B, Richard S, Legrand L, Bricout N, Blanc R, Dargazanli C, Gory B, Debiais S, Tisserand M, Bracard S, Leclerc X, Obadia M, Costalat V, Berner LP, Cottier JP, Consoli A, Ducrocq X, Mas JL, Oppenheim C, Baron JC, Abrivard M, Alamowitch S, Ben Hassen W, Berthezene Y, Blanc-Lasserre K, Boulin A, Boulouis G, Bouly S, Bourdain F, Calvet D, Charron V, Chbicheb M, Condette-Auliac S, Corabianu O, Cordonnier C, Coskun O, De Broucker T, Decroix JP, Di Maria F, Evrard S, Fissellier M, Girard I, Lalu T, Le Coz P, Le Guen M, Ille O, Leys D, Magni C, Manchon E, Mazighi M, Mounier-Vehier F, Moynier M, Muresan IP, Nighoghossian N, Ong E, Ozsancak C, Philippeau F, Pico F, Rodesch G, Rosolacci T, Sabben C, Sablot D, Tassan P, Tchikviladze M, Turjman F, Vallet AE, Wang A, Zins M, Zuber M. Post-Thrombolysis Recanalization in Stroke Referrals for Thrombectomy. Stroke 2018; 49:2975–2982. [DOI: 10.1161/strokeaha.118.022335] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
Background and Purpose—
Whether all acute stroke patients with large vessel occlusion need to undergo intravenous thrombolysis before mechanical thrombectomy (MT) is debated as (1) the incidence of post-thrombolysis early recanalization (ER) is still unclear; (2) thrombolysis may be harmful in patients unlikely to recanalize; and, conversely, (3) transfer for MT may be unnecessary in patients highly likely to recanalize. Here, we determined the incidence and predictors of post-thrombolysis ER in patients referred for MT and derive ER prediction scores for trial design.
Methods—
Registries from 4 MT-capable centers gathering patients referred for MT and thrombolyzed either on site (mothership) or in a non MT-capable center (drip-and-ship) after magnetic resonance– or computed tomography–based imaging between 2015 and 2017. ER was identified on either first angiographic run or noninvasive imaging. In the magnetic resonance imaging subsample, thrombus length was determined on T2*-based susceptibility vessel sign. Independent predictors of no-ER were identified using multivariable logistic regression models, and scores were developed according to the magnitude of regression coefficients. Similar registries from 4 additional MT-capable centers were used as validation cohort.
Results—
In the derivation cohort (N=633), ER incidence was ≈20%. In patients with susceptibility vessel sign (n=498), no-ER was independently predicted by long thrombus, proximal occlusion, and mothership paradigm. A 6-point score derived from these variables showed strong discriminative power for no-ER (C statistic, 0.854) and was replicated in the validation cohort (n=353; C statistic, 0.888). A second score derived from the whole sample (including negative T2* or computed tomography–based imaging) also showed good discriminative power and was similarly validated. Highest grades on both scores predicted no-ER with >90% specificity, whereas low grades did not reliably predict ER.
Conclusions—
The substantial ER rate underlines the benefits derived from thrombolysis in bridging populations. Both prediction scores afforded high specificity for no-ER, but not for ER, which has implications for trial design.
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Affiliation(s)
- Pierre Seners
- From the Neurology Department (P.S., G.T., J.-L.M., J.-C.B.), INSERM U894, Sainte-Anne Hospital, Université Paris Descartes, Paris, France
| | - Guillaume Turc
- From the Neurology Department (P.S., G.T., J.-L.M., J.-C.B.), INSERM U894, Sainte-Anne Hospital, Université Paris Descartes, Paris, France
| | - Olivier Naggara
- Radiology Department (O.N., L.L., C.O.), INSERM U894, Sainte-Anne Hospital, Université Paris Descartes, Paris, France
| | - Hilde Henon
- Stroke Unit, Neurology Department (H.H.), Roger Salengro Hospital, Lille, France
| | - Michel Piotin
- Interventional Neuroradiology Department (M.P., R.B.), Fondation Adolphe de Rothschild, Paris, France
| | - Caroline Arquizan
- Neurology Department (C.A.), CHRU Gui de Chauliac, Montpellier, France
| | - Tae-Hee Cho
- Stroke Medicine Department (T.-H.C.), Hospices Civils de Lyon, France
| | - Ana-Paula Narata
- Neuroradiology Department (A.-P.N., J.-P.C.), Bretonneau Hospital, Tours, France
| | | | | | - Laurence Legrand
- Radiology Department (O.N., L.L., C.O.), INSERM U894, Sainte-Anne Hospital, Université Paris Descartes, Paris, France
| | - Nicolas Bricout
- Neuroradiology Department (N.B., X.L.), Roger Salengro Hospital, Lille, France
- Neuroradiology Department, CHU Lille, France (N.B., X.L.)
| | - Raphaël Blanc
- Interventional Neuroradiology Department (M.P., R.B.), Fondation Adolphe de Rothschild, Paris, France
| | - Cyril Dargazanli
- Neuroradiology Department (C.D., V.C.), CHRU Gui de Chauliac, Montpellier, France
| | - Benjamin Gory
- Stroke Medicine Department (T.-H.C.), Hospices Civils de Lyon, France
- Neuroradiology Department (B.G., S.B.), University Hospital of Nancy, France
| | | | - Marie Tisserand
- Neuroradiology Department (A.C., M.T.), Foch Hospital, Suresnes, France
| | - Serge Bracard
- Stroke Medicine Department (T.-H.C.), Hospices Civils de Lyon, France
- Neuroradiology Department (B.G., S.B.), University Hospital of Nancy, France
| | - Xavier Leclerc
- Neuroradiology Department (N.B., X.L.), Roger Salengro Hospital, Lille, France
- Neurology Department (C.A.), CHRU Gui de Chauliac, Montpellier, France
| | - Michael Obadia
- Neurology Department (M.O.), Fondation Adolphe de Rothschild, Paris, France
| | - Vincent Costalat
- Neuroradiology Department (C.D., V.C.), CHRU Gui de Chauliac, Montpellier, France
| | - Lise-Prune Berner
- Neuroradiology Department (L.-P.B.), Hospices Civils de Lyon, France
| | | | - Arturo Consoli
- Neuroradiology Department (A.C., M.T.), Foch Hospital, Suresnes, France
| | - Xavier Ducrocq
- Neurology Department, Metz-Thionville Hospital, France (X.D.)
| | - Jean-Louis Mas
- From the Neurology Department (P.S., G.T., J.-L.M., J.-C.B.), INSERM U894, Sainte-Anne Hospital, Université Paris Descartes, Paris, France
| | - Catherine Oppenheim
- From the Neurology Department (P.S., G.T., J.-L.M., J.-C.B.), INSERM U894, Sainte-Anne Hospital, Université Paris Descartes, Paris, France
- Radiology Department (O.N., L.L., C.O.), INSERM U894, Sainte-Anne Hospital, Université Paris Descartes, Paris, France
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Narata AP, Janot K, Bibi R, Herbreteau D, Perrault C, Marzo A, Cottier JP. Reversible Brain Edema Associated with Flow Diverter Stent Procedures: A Retrospective Single- Center Study to Evaluate Frequency, Clinical Evolution, and Possible Mechanism. World Neurosurg 2018; 122:e569-e576. [PMID: 30394357 DOI: 10.1016/j.wneu.2018.10.103] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2018] [Revised: 10/14/2018] [Accepted: 10/16/2018] [Indexed: 10/28/2022]
Abstract
BACKGROUND Hemorrhage and ischemia after flow diverter stent (FDS) procedures for intracranial aneurysms are the most common complications and have been extensively described. Temporary brain edema (TBE) is an unknown complication that could be associated with particular FDS procedures. OBJECTIVE To estimate the frequency, clinical presentation, imaging findings, and possible mechanisms associating TBE with FDS. METHODS Unruptured aneurysms treated with FDS implantation performed in our service from June 2015 to March 2018 were reviewed. Medical antecedents, endovascular procedure, clinical assessments before and after treatment, aneurysm characteristics, and image records were collected. Artery diameters of patients in whom TEB developed were also calculated to investigate any correlation between TBE and anatomic descriptors. RESULTS A total of 179 FDS procedures in 176 patients were reviewed. Six patients (3.4%) presented with symptomatic TBE, and all TBE patients had undergone FDS implantation from the middle cerebral artery (MCA) to the internal carotid artery (ICA). A Pearson product-moment correlation coefficient (PPCC) found smaller MCA diameters and MCA/ICA ratios in these 6 patients (respectively PPCC = -0.619, P < 0.04; PPCC = -0.647, P < 0.03). Hemorrhagic and ischemic complications were less frequent than TBE (2.3% and 1.1% vs. 3.4%). CONCLUSIONS TBE was more frequent than ischemic or hemorrhagic complications after FDS in this study. TBE seemed to be associated with a particular FDS positioning in small arteries, inducing flow changes and disruption of the blood-brain barrier.
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Affiliation(s)
- Ana Paula Narata
- Department of Radiology and Neuroradiology, University Hospital of Tours, France.
| | - Kevin Janot
- Department of Radiology and Neuroradiology, University Hospital of Tours, France
| | - Richard Bibi
- Department of Radiology and Neuroradiology, University Hospital of Tours, France
| | - Denis Herbreteau
- Department of Radiology and Neuroradiology, University Hospital of Tours, France
| | - Cecile Perrault
- Mechanical Engineering Department, University of Sheffield, United Kingdom
| | - Alberto Marzo
- Mechanical Engineering Department, University of Sheffield, United Kingdom
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Desmidt T, Andersson F, Brizard B, Dujardin PA, Cottier JP, Patat F, Réméniéras JP, Gissot V, El-Hage W, Camus V. Ultrasound Measures of Brain Pulsatility Correlate with Subcortical Brain Volumes in Healthy Young Adults. Ultrasound Med Biol 2018; 44:2307-2313. [PMID: 30131259 DOI: 10.1016/j.ultrasmedbio.2018.06.016] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/11/2018] [Revised: 06/20/2018] [Accepted: 06/25/2018] [Indexed: 06/08/2023]
Abstract
Increasing evidence suggests that brain pulsatility is involved in the pathophysiology of various neurological and psychiatric disorders. However, it remains unclear whether high brain pulsatility is damaging to or protective of the brain in normal conditions, and this could depend on the age of the individual and the methods used to measure brain pulsatility. The goal of our study was to investigate associations between subcortical volumes and brain pulsatility as assessed with ultrasound in healthy young adults using both a conventional method (transcranial Doppler pulsatility index [TCD-PI]) and the innovative method of tissue pulsatility imaging (TPI), which allows a high level of detection of small brain movements (micrometers). Twenty-five females aged 18-55 with no history of significant medical disorder underwent magnetic resonance imaging and ultrasound assessment. The volumes of six subcortical regions known to be particularly sensitive to change in cerebral blood flow were measured and compared with brain pulsatility as assessed with TCD-PI and TPI. TCD-PI and TPI measures positively correlated with all subcortical regions, with the caudate nucleus having the strongest association. Linear regressions found that TCD-PI and TPI measures of brain pulsatility explained 16% to 67% of the variance of the subcortical volumes. Our results suggest that a greater pulsatility as assessed with ultrasound in healthy young adults may constitute a protective factor for brain structure. Ultrasound measures of brain pulsatility may be appropriate to provide costless, non-invasive, portable and highly sensitive markers of cerebral blood flow pulsatility related to brain structure.
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Affiliation(s)
- Thomas Desmidt
- CHRU de Tours, Pôle de Psychiatrie, Tours, France; UMR 1253, iBrain, Université de Tours, Inserm, Tours, France.
| | | | - Bruno Brizard
- UMR 1253, iBrain, Université de Tours, Inserm, Tours, France
| | | | - Jean-Philippe Cottier
- CHRU de Tours, Pôle de Psychiatrie, Tours, France; UMR 1253, iBrain, Université de Tours, Inserm, Tours, France
| | - Frédéric Patat
- UMR 1253, iBrain, Université de Tours, Inserm, Tours, France; CIC 1415, Centre d'Investigation Clinique, Inserm, CHRU de Tours, Tours, France
| | | | - Valérie Gissot
- CIC 1415, Centre d'Investigation Clinique, Inserm, CHRU de Tours, Tours, France
| | - Wissam El-Hage
- CHRU de Tours, Pôle de Psychiatrie, Tours, France; UMR 1253, iBrain, Université de Tours, Inserm, Tours, France; CIC 1415, Centre d'Investigation Clinique, Inserm, CHRU de Tours, Tours, France
| | - Vincent Camus
- CHRU de Tours, Pôle de Psychiatrie, Tours, France; UMR 1253, iBrain, Université de Tours, Inserm, Tours, France
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Angel L, Bouazzaoui B, Isingrini M, Fay S, Taconnat L, Vanneste S, Ledoux M, Gissot V, Hommet C, Andersson F, Barantin L, Cottier JP, Pasco J, Desmidt T, Patat F, Camus V, Remenieras JP. Brain tissue pulsatility mediates cognitive and electrophysiological changes in normal aging: Evidence from ultrasound tissue pulsatility imaging (TPI). Brain Cogn 2018; 123:74-80. [DOI: 10.1016/j.bandc.2018.02.001] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2017] [Revised: 01/19/2018] [Accepted: 02/01/2018] [Indexed: 11/15/2022]
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40
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Desmidt T, Andersson F, Brizard B, Cottier JP, Patat F, Gissot V, Belzung C, El-Hage W, Camus V. Cerebral blood flow velocity positively correlates with brain volumes in long-term remitted depression. Prog Neuropsychopharmacol Biol Psychiatry 2018; 81:243-249. [PMID: 28939189 DOI: 10.1016/j.pnpbp.2017.09.018] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/31/2017] [Revised: 09/10/2017] [Accepted: 09/18/2017] [Indexed: 02/03/2023]
Abstract
BACKGROUND Mechanisms involved in brain changes observed in major depression have been poorly investigated in clinical populations. Changes in cerebral blood flow (CBF) have been found in depressed patients and constitute a potential mechanism by which brain volume varies in depression. We have tested the association of cerebral blood flow velocity (CBFV) as assessed with Transcranial Doppler (TCD) and cerebral blood flow (CBF) as assessed with Arterial Spin Labeling Magnetic Resonance Imaging (ASL-MRI) with Total Brain Volume (TBV) and the volume of seven subcortical regions, in currently depressed and long-term remitted patients. In addition, we have evaluated other potential confounders for the association depression/brain volume, including dimensional symptoms of depression, cardiovascular risk factors (CVRF) and antidepressants. METHODS Seventy-five individuals were recruited, divided in 3 equal groups (currently depressed, remitted individuals and healthy controls) and were submitted to clinical assessment, MRI and Transcranial Doppler. RESULTS CBFV was positively correlated with TBV, Hippocampus and Thalamus volume, but only in remitted patients, who tend to have larger brains compared to both currently depressed and controls. CVRF were negatively associated with brain volumes in the 3 groups and antidepressant use was associated with larger Thalamus. We found no association between brain volumes and CBF as assessed with ASL-MRI, anhedonia, anxiety or psychomotor retardation. DISCUSSION Greater CBFV may be a physiological mechanism by which brain is enlarged in remitted patients. Future studies should consider CBFV, CVRF and antidepressants as possible confounders for the association depression/brain volumes, especially in remitted patients.
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Affiliation(s)
- Thomas Desmidt
- CHRU de Tours, Tours, France; INSERM U930 Imagerie et Cerveau, Université François-Rabelais de Tours, Tours, France.
| | - Frédéric Andersson
- INSERM U930 Imagerie et Cerveau, Université François-Rabelais de Tours, Tours, France
| | - Bruno Brizard
- INSERM U930 Imagerie et Cerveau, Université François-Rabelais de Tours, Tours, France
| | - Jean-Philippe Cottier
- CHRU de Tours, Tours, France; INSERM U930 Imagerie et Cerveau, Université François-Rabelais de Tours, Tours, France
| | - Frédéric Patat
- INSERM U930 Imagerie et Cerveau, Université François-Rabelais de Tours, Tours, France; INSERM CIC 1415, Université François-Rabelais de Tours, Tours, France
| | - Valérie Gissot
- INSERM CIC 1415, Université François-Rabelais de Tours, Tours, France
| | - Catherine Belzung
- INSERM U930 Imagerie et Cerveau, Université François-Rabelais de Tours, Tours, France
| | - Wissam El-Hage
- CHRU de Tours, Tours, France; INSERM U930 Imagerie et Cerveau, Université François-Rabelais de Tours, Tours, France; INSERM CIC 1415, Université François-Rabelais de Tours, Tours, France
| | - Vincent Camus
- CHRU de Tours, Tours, France; INSERM U930 Imagerie et Cerveau, Université François-Rabelais de Tours, Tours, France
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Giraud N, Ripault-Cesbron H, Cottier JP, Dardaine-Giraud V. [Metronidazole-induced encephalopathy (MIE)]. Presse Med 2017; 46:1225-1226. [PMID: 29129417 DOI: 10.1016/j.lpm.2017.06.018] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/18/2017] [Accepted: 06/27/2017] [Indexed: 11/28/2022] Open
Affiliation(s)
- Nicolas Giraud
- CHRU de Tours, soins de suite et réadaptation gériatrique, 2, allée Gaston-Pagès, 37100 Tours, France
| | - Héliette Ripault-Cesbron
- CHRU de Tours, soins de suite et réadaptation gériatrique, 2, allée Gaston-Pagès, 37100 Tours, France
| | - Jean-Philippe Cottier
- CHRU de Tours, service de neuroradiologie, 2, boulevard Tonnellé, 37044 Tours cedex 9, France
| | - Véronique Dardaine-Giraud
- CHRU de Tours, soins de suite et réadaptation gériatrique, 2, allée Gaston-Pagès, 37100 Tours, France.
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42
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Rochetams BB, Marechal B, Cottier JP, Gaillot K, Sembely-Taveau C, Sirinelli D, Morel B. T1-weighted dynamic contrast-enhanced brain magnetic resonance imaging: A preliminary study with low infusion rate in pediatric patients. Neuroradiol J 2017; 30:429-436. [PMID: 28556691 DOI: 10.1177/1971400917709626] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Background The aim of this preliminary study is to evaluate the results of T1-weighted dynamic contrast-enhanced (DCE) magnetic resonance imaging (MRI) in pediatric patients at 1.5T, with a low peripheral intravenous gadoteric acid injection rate of 1 ml/s. Materials and methods Children with neurological symptoms were examined prospectively with conventional MRI and T1-weighted DCE MRI. An magnetic resonance perfusion analysis method was used to obtain time-concentration curves (persistent pattern, type-I; plateau pattern, type-II; washout pattern, type-III) and to calculate pharmacokinetic parameters. A total of two radiologists manually defined regions of interest (ROIs) in the part of the lesion exhibiting the greatest contrast enhancement and in the surrounding normal or contralateral tissue. Lesion/surrounding tissue or contralateral tissue pharmacokinetic parameter ratios were calculated. Tumors were categorized by grade (I-IV) using the World Health Organization (WHO) Grade. Mann-Whitney testing and receiver-operating characteristic (ROC) curves were performed. Results A total of nine boys and nine girls (mean age 10.5 years) were included. Lesions consisted of 10 brain tumors, 3 inflammatory lesions, 3 arteriovenous malformations and 2 strokes. We obtained analyzable concentration-time curves for all patients (6 type-I, 9 type-II, 3 type-III). Ktrans between tumor tissue and surrounding or contralateral tissue was significantly different ( p = 0.034). Ktrans ratios were significantly different between grade I tumors and grade IV tumors ( p = 0.027) and a Ktrans ratio value superior to 0.63 appeared to be discriminant to determine a grade IV of malignancy. Conclusions Our results confirm the feasibility of pediatric T1-weighted DCE MRI at 1.5T with a low injection rate, which could be of great value in differentiating brain tumor grades.
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Affiliation(s)
| | - Bénédicte Marechal
- 2 Advanced Clinical Imaging Technology, Siemens Healthcare HC CEMEA SUI DI PI, Lausanne, Switzerland.,3 Department of Radiology, University Hospital (CHUV), Lausanne, Switzerland
| | - Jean-Philippe Cottier
- 4 Department of Neuroradiology, Bretonneau Hospital, CHRU, Tours, France.,5 Francois Rabelais University, Faculty of Medicine, Tours, France
| | - Kathleen Gaillot
- 4 Department of Neuroradiology, Bretonneau Hospital, CHRU, Tours, France.,5 Francois Rabelais University, Faculty of Medicine, Tours, France
| | | | - Dominique Sirinelli
- 1 Department of Pediatric Radiology, Clocheville Hospital, CHRU, Tours, France.,5 Francois Rabelais University, Faculty of Medicine, Tours, France
| | - Baptiste Morel
- 1 Department of Pediatric Radiology, Clocheville Hospital, CHRU, Tours, France.,5 Francois Rabelais University, Faculty of Medicine, Tours, France
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43
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Lecler A, Obadia M, Savatovsky J, Picard H, Charbonneau F, Menjot de Champfleur N, Naggara O, Carsin B, Amor-Sahli M, Cottier JP, Bensoussan J, Auffray-Calvier E, Varoquaux A, De Gaalon S, Calazel C, Nasr N, Volle G, Jianu DC, Gout O, Bonneville F, Sadik JC. TIPIC Syndrome: Beyond the Myth of Carotidynia, a New Distinct Unclassified Entity. AJNR Am J Neuroradiol 2017; 38:1391-1398. [PMID: 28495942 DOI: 10.3174/ajnr.a5214] [Citation(s) in RCA: 58] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2016] [Accepted: 03/05/2017] [Indexed: 01/03/2023]
Abstract
BACKGROUND AND PURPOSE The differential diagnosis of acute cervical pain includes nonvascular and vascular causes such as carotid dissection, carotid occlusion, or vasculitis. However, some patients present with unclassified vascular and perivascular changes on imaging previously reported as carotidynia. The aim of our study was to improve the description of this as yet unclassified clinico-radiologic entity. MATERIALS AND METHODS From January 2009 through April 2016, 47 patients from 10 centers presenting with acute neck pain or tenderness and at least 1 cervical image showing unclassified carotid abnormalities were included. We conducted a systematic, retrospective study of their medical charts and diagnostic and follow-up imaging. Two neuroradiologists independently analyzed the blinded image datasets. RESULTS The median patient age was 48 years. All patients presented with acute neck pain, and 8 presented with transient neurologic symptoms. Imaging showed an eccentric pericarotidian infiltration in all patients. An intimal soft plaque was noted in 16 patients, and a mild luminal narrowing was noted in 16 patients. Interreader reproducibility was excellent. All patients had complete pain resolution within a median of 13 days. At 3-month follow-up, imaging showed complete disappearance of vascular abnormalities in 8 patients, and a marked decrease in all others. CONCLUSIONS Our study improved the description of an unclassified, clinico-radiologic entity, which could be described by the proposed acronym: TransIent Perivascular Inflammation of the Carotid artery (TIPIC) syndrome.
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Affiliation(s)
- A Lecler
- From the Departments of Radiology (A.L., J.S., F.C., J.C.S.)
| | | | - J Savatovsky
- From the Departments of Radiology (A.L., J.S., F.C., J.C.S.)
| | - H Picard
- Clinical Research Unit (H.P.), Fondation Ophtalmologique Adolphe de Rothschild, Paris, France
| | - F Charbonneau
- From the Departments of Radiology (A.L., J.S., F.C., J.C.S.)
| | - N Menjot de Champfleur
- Department of Neuroradiology (N.M.d.C.), Montpellier University Hospital Center, Gui de Chauliac Hospital, Montpellier, France
| | - O Naggara
- Department of Neuroradiology (O.N.), Centre Hospitalier Sainte-Anne, Paris, France
| | - B Carsin
- Department of Radiology (B.C.), Centre Hospitalier Régional Universitaire de Rennes, Rennes, France
| | - M Amor-Sahli
- Department of Neuroradiology (M.A.-S.), Pitié-Salpêtrière Hospital, Paris, France.,Centre D'imagerie Médicale Tourville (M.A.-S.), Paris, France
| | - J P Cottier
- Department of Radiology (J.P.C.), Centre Hospitalier Régional Universitaire de Tours, Tours, France.,Brain and Imaging Laboratory Unite Mixte de Recherche U930 (J.P.C.), Institut National de la Santé et de la Recherche Médicale, François-Rabelais University, Tours, France
| | - J Bensoussan
- Department of Radiology (J.B.), Hotel-Dieu Hospital, Paris, France
| | | | - A Varoquaux
- Department of Radiology (A.V.), Conception Hospital, Aix-Marseille University, Marseille, France
| | - S De Gaalon
- Neurology Department (S.D.G.), Hôpital René et Guillaume-Laënnec, Centre Hospitalier Universitaire de Nantes, Saint-Herblain, France
| | - C Calazel
- Departments of Neuroradiology (C.C., F.B.)
| | - N Nasr
- Neurology (N.N.), Hôpital Pierre-Paul-Riquet, Centre Hospitalier Universitaire Purpan, Toulouse, France
| | - G Volle
- Neurology (M.O., G.V., O.G.)
| | - D C Jianu
- Department of Neurology (D.C.J.), Victor Babes University of Medicine and Pharmacy, Timisoara, Romania
| | - O Gout
- Neurology (M.O., G.V., O.G.)
| | | | - J C Sadik
- From the Departments of Radiology (A.L., J.S., F.C., J.C.S.)
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Lemaignen A, Ghout I, Dinh A, Gras G, Fantin B, Zarrouk V, Carlier R, Loret JE, Denes E, Greder A, Lescure FX, Boutoille D, Tattevin P, Issartel B, Cottier JP, Bernard L. Characteristics of and risk factors for severe neurological deficit in patients with pyogenic vertebral osteomyelitis: A case-control study. Medicine (Baltimore) 2017; 96:e6387. [PMID: 28538361 PMCID: PMC5457841 DOI: 10.1097/md.0000000000006387] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
Severe neurological deficit (SND) is a rare but major complication of pyogenic vertebral osteomyelitis (PVO). We aimed to determine the risk factors and the variables associated with clinical improvement for SND during PVO.This case-control study included patients without PVO-associated SND enrolled in a prospective randomized antibiotic duration study, and patients with PVO-associated SND managed in 8 French referral centers. Risk factors for SND were determined by logistic regression.Ninety-seven patients with PVO-associated SND cases, and 297 controls were included. Risk factors for SND were epidural abscess [adjusted odds ratio, aOR 8.9 (3.8-21)], cervical [aOR 8.2 (2.8-24)], and/or thoracic involvement [aOR 14.8 (5.6-39)], Staphylococcus aureus PVO [aOR 2.5 (1.1-5.3)], and C-reactive protein (CRP) >150 mg/L [aOR 4.1 (1.9-9)]. Among the 81 patients with PVO-associated SND who were evaluated at 3 months, 62% had a favorable outcome, defined as a modified Rankin score ≤ 3. No factor was found significantly associated with good outcome, whereas high Charlson index [adjusted Hazard Ratio (aHR) 0.3 (0.1-0.9)], low American Spinal Injury Association (ASIA) impairment scale at diagnosis [aHR 0.4 (0.2-0.9)], and thoracic spinal cord compression [aHR 0.2 (0.08-0.5)] were associated with poor outcome. Duration of antibiotic treatment was not associated with functional outcome.SND is more common in cervical, thoracic, and S. aureus PVO, in the presence of epidural abscess, and when CRP >150 mg/L. Although neurological deterioration occurs in 30% of patients in early follow-up, the functional outcome is quite favorable in most cases after 3 months. The precise impact of optimal surgery and/or corticosteroids therapy must be specified by further studies.
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Affiliation(s)
- Adrien Lemaignen
- Department of Infectious Diseases, University Hospital of Tours, Francois Rabelais University, Tours
| | - Idir Ghout
- Clinical Research Unit, University Hospital A. Paré, APHP, Boulogne
| | - Aurélien Dinh
- Infectious Diseases Unit, University Hospital R. Poincaré, APHP, Versailles Saint Quentin University, Garches
| | - Guillaume Gras
- Department of Infectious Diseases, University Hospital of Tours, Francois Rabelais University, Tours
| | - Bruno Fantin
- Department of Internal Medicine, University Hospital Beaujon, APHP, Clichy
| | - Virginie Zarrouk
- Department of Internal Medicine, University Hospital Beaujon, APHP, Clichy
| | - Robert Carlier
- Radiology Department, Neuro-musculoskeletal Pole, University Hospital R Poincaré, APHP, Versailles University, Paris-Saclay UMR 1179, Garches
| | | | - Eric Denes
- Department of Infectious Diseases, University Hospital of Limoges, Limoges
| | - Alix Greder
- Department of Infectious Diseases, Mignot Hospital, Versailles
| | | | - David Boutoille
- Department of Infectious Diseases, Hotel-Dieu University Hospital, Nantes
| | - Pierre Tattevin
- Infectious Diseases and Intensive Care Unit, Pontchaillou University Hospital, Rennes
| | | | - Jean-Philippe Cottier
- Department of Neuroradiology, University Hospital of Tours, Francois Rabelais University, Tours, France
| | - Louis Bernard
- Department of Infectious Diseases, University Hospital of Tours, Francois Rabelais University, Tours
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Benhamou M, Lemaignen A, Ghout I, Saint-Hilaire A, Dinh A, Cottier JP, Bernard L. [Is MRI useful in the follow-up of pyogenic vertebral osteomyelitis?]. Presse Med 2017; 46:468-471. [PMID: 28457622 DOI: 10.1016/j.lpm.2017.03.020] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/03/2016] [Revised: 01/26/2017] [Accepted: 03/07/2017] [Indexed: 10/19/2022] Open
Affiliation(s)
- Michael Benhamou
- CHRU de Tours, hôpital Bretonneau, service de neuro-radiologie diagnostique et interventionnelle, 37044 Tours cedex 9, France
| | - Adrien Lemaignen
- CHRU de Tours, hôpital Bretonneau, service de médecine interne et maladies infectieuses, 37044 Tous cedex 9, France.
| | - Idir Ghout
- Assistance publique-Hôpitaux de Paris (AP-HP), hôpital Ambroise-Paré, unité de recherche clinique, 92100 Boulogne-Billancourt, France
| | - Aymeric Saint-Hilaire
- CHRU de Tours, hôpital Bretonneau, service de neuro-radiologie diagnostique et interventionnelle, 37044 Tours cedex 9, France
| | - Aurélien Dinh
- Assistance publique-Hôpitaux de Paris (AP-HP), hôpital Raymond-Poincaré, service de maladies infectieuses et tropicales, 92380 Garches, France
| | - Jean-Philippe Cottier
- CHRU de Tours, hôpital Bretonneau, service de neuro-radiologie diagnostique et interventionnelle, 37044 Tours cedex 9, France
| | - Louis Bernard
- CHRU de Tours, hôpital Bretonneau, service de médecine interne et maladies infectieuses, 37044 Tous cedex 9, France
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46
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Saab I, Gaillot K, Cottier JP. Étude de corrélation clinico-radiologique des céphalées chez les femmes enceintes ou en post-partum. J Neuroradiol 2017. [DOI: 10.1016/j.neurad.2017.01.049] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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47
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Janot K, Filipiak I, Guibon R, Frmon-Hankard G, Cottier JP, Narata AP. Analyse IRM de caillots sanguins responsables d’AVC ischémiques aigus. J Neuroradiol 2017. [DOI: 10.1016/j.neurad.2017.01.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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48
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Marzolf G, Sabou M, Lannes B, Cotton F, Meyronet D, Galanaud D, Cottier JP, Grand S, Desal H, Kreutz J, Schenck M, Meyer N, Schneider F, Dietemann JL, Koob M, Herbrecht R, Kremer S. Magnetic Resonance Imaging of Cerebral Aspergillosis: Imaging and Pathological Correlations. PLoS One 2016; 11:e0152475. [PMID: 27097323 PMCID: PMC4838310 DOI: 10.1371/journal.pone.0152475] [Citation(s) in RCA: 53] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2015] [Accepted: 03/15/2016] [Indexed: 11/21/2022] Open
Abstract
Cerebral aspergillosis is associated with a significant morbidity and mortality rate. The imaging data present different patterns and no full consensus exists on typical imaging characteristics of the cerebral lesions. We reviewed MRI findings in 21 patients with cerebral aspergillosis and correlated them to the immune status of the patients and to neuropathological findings when tissue was available. The lesions were characterized by their number, topography, and MRI signal. Dissemination to the brain resulted from direct spread from paranasal sinuses in 8 patients, 6 of them being immunocompetent. Hematogenous dissemination was observed in 13 patients, all were immunosuppressed. In this later group we identified a total of 329 parenchymal abscesses involving the whole brain with a predilection for the corticomedullary junction. More than half the patients had a corpus callosum lesion. Hemorrhagic lesions accounted for 13% and contrast enhancement was observed in 61% of the lesions. Patients with hematogenous dissemination were younger (p = 0.003), had more intracranial lesions (p = 0.0004) and had a higher 12-week mortality rate (p = 0.046) than patients with direct spread from paranasal sinuses. Analysis of 12 aneurysms allowed us to highlight two distinct situations. In case of direct spread from the paranasal sinuses, aneurysms are saccular and located on the proximal artery portions, while the hematogenous dissemination in immunocompromised patients is more frequently associated with distal and fusiform aneurysms. MRI is the exam of choice for cerebral aspergillosis. Number and type of lesions are different according to the mode of dissemination of the infection.
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Affiliation(s)
- Guillaume Marzolf
- Département de Neuroradiologie, Hôpitaux Universitaires de Strasbourg, Strasbourg, France
- * E-mail:
| | - Marcela Sabou
- Laboratoire de Parasitologie et de Mycologie Médicale, Hôpitaux Universitaires de Strasbourg, Strasbourg, France
| | - Béatrice Lannes
- Service de Pathologie, Hôpitaux Universitaires de Strasbourg, Strasbourg, France
| | - François Cotton
- Département de Neuroradiologie, Centre Hospitalier Lyon Sud, Hospices Civils de Lyon, Lyon, France
| | - David Meyronet
- Département de Neuropathologie, Hospices Civils de Lyon, Lyon, France
| | - Damien Galanaud
- Département de Neuroradiologie, Hôpital de la Pitié Salpêtrière, Hôpitaux de Paris, Paris, France
| | - Jean-Philippe Cottier
- Département de Neuroradiologie, Centre Hospitalier Universitaire de Tours, Tours, France
| | - Sylvie Grand
- Département de Neuroradiologie, Centre Hospitalier Universitaire de Grenoble, Grenoble, France
| | - Hubert Desal
- Département de Neuroradiologie, Hôpital Nord Laennec, Centre Hospitalier Universitaire de Nantes, Nantes, France
| | - Julie Kreutz
- Département de Radiologie, Centre Hospitalier Universitaire de Liège, Liège, Belgium
| | - Maleka Schenck
- Service de Réanimation Médicale, Hôpitaux Universitaires de Strasbourg, Strasbourg, France
| | - Nicolas Meyer
- Laboratoire de Biostatistique, Faculté de Médecine de Strasbourg, Strasbourg, France
| | - Francis Schneider
- Service de Réanimation Médicale, Hôpitaux Universitaires de Strasbourg, Strasbourg, France
| | - Jean-Louis Dietemann
- Département de Neuroradiologie, Hôpitaux Universitaires de Strasbourg, Strasbourg, France
| | - Meriam Koob
- Département de Neuroradiologie, Hôpitaux Universitaires de Strasbourg, Strasbourg, France
| | - Raoul Herbrecht
- Département d'Oncologie et d’Hématologie, Hôpitaux Universitaires de Strasbourg, Strasbourg, France
| | - Stéphane Kremer
- Département de Neuroradiologie, Hôpitaux Universitaires de Strasbourg, Strasbourg, France
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Dejobert M, Cazals X, Annan M, Debiais S, Lauvin MA, Cottier JP. Susceptibility-Diffusion Mismatch in Hyperacute Stroke: Correlation with Perfusion-Diffusion Mismatch and Clinical Outcome. J Stroke Cerebrovasc Dis 2016; 25:1760-1766. [PMID: 27151417 DOI: 10.1016/j.jstrokecerebrovasdis.2016.02.025] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2015] [Revised: 01/18/2016] [Accepted: 02/19/2016] [Indexed: 11/27/2022] Open
Abstract
BACKGROUND A prominent vein (PV) on susceptibility-weighted imaging (SWI) was recently proposed to be a marker of the penumbra. We aimed to compare the utility of SWI and perfusion-weighted imaging (PWI) sequences for the evaluation of the penumbra in hyperacute middle cerebral artery (MCA) stroke, and to determine whether SWI-DWI mismatch is a neuroimaging marker of clinical outcome. METHODS A total of 149 consecutive patients with MCA stroke were prospectively enrolled. Magnetic resonance imaging (MRI) was performed within 6 hours of the onset of stroke. The ASPECTS values on diffusion-weighted imaging (DWI), PWI (delayed mean transit time), and SWI (visualization of PVs) were calculated by 2 independent raters. Correlation between PWI-ASPECTS and SWI-ASPECTS was calculated with the Pearson coefficient. Reliability of the PV rating system was calculated by an intraclass correlation coefficient (ICC). Favorable outcome was defined as a modified Rankin Scale score of 0-2 at 3 months for the 88 patients who received thrombolytic therapy. RESULTS The ASPECTS-SWI and ASPECTS-PWI scores showed a good correlation (Pearson coefficient of .69, P <.001). The reproducibility between the findings of the junior and the senior radiologists was excellent with an ICC of .89 (confidence interval of 95% (IC95): .85-.92, P <.001). However, neither SWI-DWI mismatch nor PWI-SWI mismatch was associated with clinical outcome. CONCLUSION SWI and PWI were complementary but not commutable for the assessment of the penumbra. Susceptibility-diffusion mismatch was not found in this study to have predictive value for stroke outcome.
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Affiliation(s)
- Maelle Dejobert
- Department of Diagnostic and Interventional Neuroradiology, Bretonneau University Hospital, Tours, France.
| | - Xavier Cazals
- Department of Diagnostic and Interventional Neuroradiology, Bretonneau University Hospital, Tours, France
| | - Mariam Annan
- Department of Neurology, Bretonneau University Hospital, Tours, France
| | - Séverine Debiais
- Department of Neurology, Bretonneau University Hospital, Tours, France
| | - Marie-Agnes Lauvin
- Department of Diagnostic and Interventional Neuroradiology, Bretonneau University Hospital, Tours, France
| | - Jean-Philippe Cottier
- Department of Diagnostic and Interventional Neuroradiology, Bretonneau University Hospital, Tours, France
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50
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Janot K, Filipiak I, Barantin L, Cottier JP, Narata AP. Apport de l’IRM dans la détection et la caractérisation de caillots sanguins in vitro. J Neuroradiol 2016. [DOI: 10.1016/j.neurad.2016.01.101] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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