Background: There are controversies concerning the natural history of arteriovenous malformations (AVMs) in literature and it is not clear which AVMs should be treated and which should be just observed. Objective crit...Background: There are controversies concerning the natural history of arteriovenous malformations (AVMs) in literature and it is not clear which AVMs should be treated and which should be just observed. Objective criteria beyond growth in serial MRIs or angiographies are needed. The use of black blood MRI is currently under investigation for evaluating the rupture risk of cerebral aneurysms, however its use for assessment of AVMs has yet to be evaluated. We therefore conducted a feasibility study on the application of black blood MRI (bbMRI) in AVMs to assess rupture risk. Methods: Retrospective study of 10 patients with intracranial AVMs and 4 patients with arteriovenous fistulas who received a black blood MRI before treatment. Results: AVM niduses (9/10) show contrast enhancement irrespective of rupture or size. All arteriovenous fistulas (4/4) were contrast enhancing irrespective of rupture. Conclusion: High flow malformations are in a permanent stage of inflammation which does not seem to allow conclusions on their rupture risk at the current stage. BbMRI is a feasible method of identifying inflammation in AVMs and arteriovenous fistulas. However, future prospective studies are needed to evaluate whether bbMRI contrast enhancement correlates with rupture risk.展开更多
Neuro-oncology,with its various conservative,surgical,and interventional disciplines,is ideally suited to teach basic knowledge,skills,and attitudes important to medical practice in general.However,training is less ab...Neuro-oncology,with its various conservative,surgical,and interventional disciplines,is ideally suited to teach basic knowledge,skills,and attitudes important to medical practice in general.However,training is less about teaching specific treatment protocols and more about fostering skills for interdisciplinary collaboration,development of treatment recommendations,communication skills,and an ethical stance.To adequately teach this content,new and innovative formats are needed to test and learn high levels of student interaction,communication,and collaboration.New teaching concepts such as inverted teaching formats as well as the use of modern media technology can be helpful to improve networking between disciplines and to improve the quality of medical education.展开更多
Background: Inflammatory responses are implicated as crucial patho-mechanisms of vascular brain malformations. Inflammation is suggested to be a key contributor to aneurysm rupture; however it is unclear whether infla...Background: Inflammatory responses are implicated as crucial patho-mechanisms of vascular brain malformations. Inflammation is suggested to be a key contributor to aneurysm rupture; however it is unclear whether inflammation contributes similarly to bleeding of cerebral cavernous malformations (CCMs). Black blood MRI is a sequence which identifies inflammation in blood vessel walls and in the present study is used to detect inflammatory response in CCMs. Methods: Fifteen patients with 17 CCMs treated in our department in 2017 were retrospectively analysed. All patients received black blood MRIs and the results were analysed in correlation with, size and bleeding of CCMs. Results: Size and bleeding status of CCMs did not correlate with contrast enhancement in the CCM wall. One of 3 patients with bleeding displayed contrast enhancement in black blood MRI, whereas the others had non enhancing lesions. Because of the small number of cases a statistical analysis was not performed. Conclusion: In this limited cohort, inflammatory reactions in CCMs could not be detected by black blood MRI suggesting that the level of inflammation is minimal in these lesions and those different patho-mechanisms play a more important role in the rupture of CCMs.展开更多
文摘Background: There are controversies concerning the natural history of arteriovenous malformations (AVMs) in literature and it is not clear which AVMs should be treated and which should be just observed. Objective criteria beyond growth in serial MRIs or angiographies are needed. The use of black blood MRI is currently under investigation for evaluating the rupture risk of cerebral aneurysms, however its use for assessment of AVMs has yet to be evaluated. We therefore conducted a feasibility study on the application of black blood MRI (bbMRI) in AVMs to assess rupture risk. Methods: Retrospective study of 10 patients with intracranial AVMs and 4 patients with arteriovenous fistulas who received a black blood MRI before treatment. Results: AVM niduses (9/10) show contrast enhancement irrespective of rupture or size. All arteriovenous fistulas (4/4) were contrast enhancing irrespective of rupture. Conclusion: High flow malformations are in a permanent stage of inflammation which does not seem to allow conclusions on their rupture risk at the current stage. BbMRI is a feasible method of identifying inflammation in AVMs and arteriovenous fistulas. However, future prospective studies are needed to evaluate whether bbMRI contrast enhancement correlates with rupture risk.
基金Science and Digital Society within the framework of the"Fellowship for Innovations in Digital University Teaching"(GZ:5508/78-15-25)the Deutsche Forschungsgemsinschaft(DFG,German Research Foundation)Clinician Scientist Program OrganAge(funding number 413668513)+1 种基金the Interdisciplinary Center of Clinical Research of the Medical Faculty Jenathe Foundation"Else-Kröner-Fresenius-Stiftung"within the Else Kröner Research School for Physicians"AntiAge".
文摘Neuro-oncology,with its various conservative,surgical,and interventional disciplines,is ideally suited to teach basic knowledge,skills,and attitudes important to medical practice in general.However,training is less about teaching specific treatment protocols and more about fostering skills for interdisciplinary collaboration,development of treatment recommendations,communication skills,and an ethical stance.To adequately teach this content,new and innovative formats are needed to test and learn high levels of student interaction,communication,and collaboration.New teaching concepts such as inverted teaching formats as well as the use of modern media technology can be helpful to improve networking between disciplines and to improve the quality of medical education.
文摘Background: Inflammatory responses are implicated as crucial patho-mechanisms of vascular brain malformations. Inflammation is suggested to be a key contributor to aneurysm rupture; however it is unclear whether inflammation contributes similarly to bleeding of cerebral cavernous malformations (CCMs). Black blood MRI is a sequence which identifies inflammation in blood vessel walls and in the present study is used to detect inflammatory response in CCMs. Methods: Fifteen patients with 17 CCMs treated in our department in 2017 were retrospectively analysed. All patients received black blood MRIs and the results were analysed in correlation with, size and bleeding of CCMs. Results: Size and bleeding status of CCMs did not correlate with contrast enhancement in the CCM wall. One of 3 patients with bleeding displayed contrast enhancement in black blood MRI, whereas the others had non enhancing lesions. Because of the small number of cases a statistical analysis was not performed. Conclusion: In this limited cohort, inflammatory reactions in CCMs could not be detected by black blood MRI suggesting that the level of inflammation is minimal in these lesions and those different patho-mechanisms play a more important role in the rupture of CCMs.
