Intraventricular CSF pulsation artifact on fast fluid-attenuated inversion-recovery MR images: analysis of 100 consecutive normal studies.

BACKGROUND AND PURPOSE: CSF pulsation artifact is a pitfall of fast fluid-attenuated inversion-recovery (FLAIR) brain MR imaging. We studied ventricular CSF pulsation artifact (VCSFA) on axial FLAIR images and its relationship to age and ventricular size. METHODS: Fast FLAIR axial images were obtained on a 1.5-T unit (8000/150/2 [TR/TE/excitations], inversion time = 2200, field of view = 24 cm, matrix = 189 × 256, and 5-mm interleaved sections). Two observers rated VCSFA (hyperintensity on FLAIR images) in the lateral, third, and fourth ventricles by using a three-point ordinal scale in 100 consecutive subjects (ages 20–86 years) with normal brain MR studies. Left-to-right third ventricular width was also measured. RESULTS: Seventy-two subjects had VCSFA in at least one ventricular cavity. The fourth ventricle was the most common site of VCSFA (n = 58), followed by the third ventricle (n = 47) and the lateral ventricles (n = 13). VCSFA was usually severe in the third and fourth ventricles and less severe in the lateral ventricles. Fourth ventricular VCSFA was significantly associated with third ventricular VCSFA. Increasing third ventricular size and, to a lesser extent, increasing age was significantly associated with VCSFA. Ghost pulsation of VCSFA occurred across the brain parenchyma in the phase-encoding direction. VCSFA seen in the fourth ventricle on axial FLAIR images disappeared on sagittal FLAIR images in one subject. CONCLUSION: VCSFA on axial FLAIR images represents inflow artifact caused by inversion delay and ghosting effects. VCSFA might obscure or mimic intraventricular lesions, especially in the third and fourth ventricles. Although common in adults of all ages, VCSFA is associated with advancing age and increasing ventricular size. Thus, altered CSF flow dynamics that occur with ventriculomegaly and aging contribute to VCSFA on axial FLAIR MR images

Society of Vascular and Interventional Neurology (SVIN) Stroke Interventional Laboratory Consensus (SILC) Criteria: A 7M Management Approach to Developing a Stroke Interventional Laboratory in the Era of Stroke Thrombectomy for Large Vessel Occlusions

Brain attack care is rapidly evolving with cutting-edge stroke interventions similar to the growth of heart attack care with cardiac interventions in the last two decades. As the field of stroke intervention is growing exponentially globally, there is clearly an unmet need to standardize stroke interventional laboratories for safe, effective, and timely stroke care. Towards this goal, the Society of Vascular and Interventional Neurology (SVIN) Writing Committee has developed the Stroke Interventional Laboratory Consensus (SILC) criteria using a 7M management approach for the development and standardization of each stroke interventional laboratory within stroke centers. The SILC criteria include: (1) manpower: personnel including roles of medical and administrative directors, attending physicians, fellows, physician extenders, and all the key stakeholders in the stroke chain of survival; (2) machines: resources needed in terms of physical facilities, and angiography equipment; (3) materials: medical device inventory, medications, and angiography supplies; (4) methods: standardized protocols for stroke workflow optimization; (5) metrics (volume): existing credentialing criteria for facilities and stroke interventionalists; (6) metrics (quality): benchmarks for quality assurance; (7) metrics (safety): radiation and procedural safety practices

血管和介入神经病学学会(SVIN)卒中介入实验室共识(SILC)标准:在大血管闭塞性卒中机械血栓切除时代用于建立卒中介入实验室的7 M管理方法

与过去20年里心肌梗死介入治疗的发展相似,卒中介入治疗正在迅速发展.随着卒中介入治疗在全球范围内呈指数级增长,在对卒中介入实验室进行标准化以便于安全、有效和及时治疗方面显然存在未能满足的需求.为了实现这一目标,血管和介入神经病学学会(Society of Vascular and Interventional Neurology, SVIN)写作委员会采用7M管理方法制定了卒中介入实验室共识(Stroke Interventional Laboratory Consensus, SILC)标准,用于卒中中心内各卒中介入实验室的建设和标准化.SILC标准包括:(1)人力:包括医疗和行政主管、主治医师、住院医师、后备人员以及卒中生存链内的所有相关人员;(2)设备:硬件设施和血管造影设备;(3)材料:医疗器械库存、药品和血管造影用品;(4)方法:用于优化卒中诊治流程的标准化方案;(5)数量指标:针对单位和介入医师的现有认证标准;(6)质量指标:用作质量保证的基准;(7)安全指标:辐射和操作安全实践标准

机械血栓切除术综合性卒中中心的要求和卒中血管内治疗医疗体系:血管和介入神经病学学会(SVIN)卒中血管内治疗标准委员会的推荐意见

最近,5项具有里程碑意义的多中心、前瞻性、随机、开放标签、盲法终点的临床试验证实,在伴有颅内大血管闭塞的急性缺血性卒中(acute ischemic stroke, AIS)患者中,应用机械血栓切除术进行血管内治疗具有显著的临床获益.血管和介入神经病学学会(Society of Vascular and Interventional, SVIN)任命了一个专业写作委员会来总结这些新证据,并就如何应用这些数据指导AIS患者的急诊血管内治疗提出了推荐意见

Mechanical Thrombectomy-Ready Comprehensive Stroke Center Requirements and Endovascular Stroke Systems of Care: Recommendations from the Endovascular Stroke Standards Committee of the Society of Vascular and Interventional Neurology (SVIN)

Five landmark multicenter, prospective, randomized, open-label, blinded end point clinical trials have recently demonstrated significant clinical benefit of endovascular therapy with mechanical thrombectomy in acute ischemic stroke (AIS) patients presenting with proximal intracranial large vessel occlusions. The Society of Vascular and Interventional Neurology (SVIN) appointed an expert writing committee to summarize this new evidence and make recommendations on how these data should guide emergency endovascular therapy for AIS patients