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Abstractband Volume 23 · Supplement 1 · September 2013 Clinical Neuroradiology Official Journal of the German, Austrian, and Swiss Societies of Neuroradiology Abstracts zur 48. Jahrestagung der Deutschen Gesellschaft für Neuroradiologie Gemeinsame Jahrestagung der DGNR und ÖGNR 10.–12. Oktober 2013, Gürzenich, Köln www.cnr.springer.de Clinical Neuroradiology Official Journal of the German, Austrian, and Swiss Societies of Neuroradiology Editors C. Ozdoba L. Solymosi Bern, Switzerland (Editor-in-Chief, responsible) ([email protected]) Department of Neuroradiology H. Urbach University Würzburg Freiburg, Germany Josef-Schneider-Straße 11 ([email protected]) 97080 Würzburg Germany ([email protected]) Published on behalf of the German Society of Neuroradiology, M. Bendszus president: O. Jansen, Heidelberg, Germany the Austrian Society of Neuroradiology, ([email protected]) president: J. Trenkler, and the Swiss Society of Neuroradiology, T. Krings president: L. Remonda. Toronto, ON, Canada ([email protected]) Clin Neuroradiol 2013 · No. 1 © Springer-Verlag ABC jobcenter-medizin.de Clin Neuroradiol DOI 10.1007/s00062-013-0248-4 ABSTRACTS 48. Jahrestagung der Deutschen Gesellschaft für Neuroradiologie Gemeinsame Jahrestagung der DGNR und ÖGNR 10.–12. Oktober 2013 Gürzenich, Köln Kongresspräsidenten Prof. Dr. Arnd Dörfler Prim. Dr. Johannes Trenkler Erlangen Wien Dieses Supplement wurde von der Deutschen Gesellschaft für Neuroradiologie finanziert. Inhaltsverzeichnis Grußwort ............................................................................................................................................................................. 3 Vorträge ............................................................................................................................................................................... 4 Poster................................................................................................................................................................................... 44 Autorenverzeichnis ............................................................................................................................................................. 109 Abstracts 3 Liebe Kolleginnen und Kollegen, liebe Freunde der Neuroradiologie, herzlich willkommen zur neuroRAD 2013 in Köln, der 48. Jahrestagung der Deutschen Gesellschaft für Neuroradiologie (DGNR), die sich mittlerweile zur größten neuroradiologischen Tagung in Europa entwickelt hat. Die diesjährige Jahrestagung der Deutschen Gesellschaft für Neuroradiologie wird gemeinsam mit unserer Partnergesell- schaft, der Österreichischen Gesellschaft für Neuroradiologie (ÖGNR), veranstaltet. Mit ihrem charakteristischen Mix aus Fortbildung, wissenschaftlichen Präsentationen, Workshops, Satelliten-Symposien und Keynote-Vorträgen bietet Ihnen die neuroRAD 2013 ein abwechslungsreiches Programm in der inspirierenden Atmo- sphäre des Kölner Gürzenich. Weit mehr als 200 Abstracteinreichungen versprechen ein wissenschaftliches Programm auf höchstem Niveau. Ein Schwerpunktthema ist wie in den Vorjahren die Interventionelle Neuroradiologie und hier insbesondere die mechani- sche Rekanalisationstherapie des akuten Schlaganfalls. Neben technischen Aspekten und interdisziplinärer Diskussion wird hier der Fokus auf den (kommenden) randomisierten Studien liegen. Ein Update zur endovaskulären Aneurysmatherapie ergänzt diesen Themenschwerpunkt. Ein weiteres Schwerpunktthema ist die sich rasant weiterentwickelnde Medizintechnik und multimodale Bildgebung. Ein Augenmerk liegt hier auf der Wertigkeit innovativer Techniken wie der Hochfeld-MRT und hybriden Bildgebungsverfahren in unserer klinischen Entscheidungsfindung. Ergänzt wird das Programm durch die Themen entzündliche und metabolische ZNS-Erkrankungen und Epilepsie. Besonders freuen wir uns auf hochkarätige, international renommierte Referenten. Ein Highlight des Kongresses ist hier sicherlich der Vortrag von Anne G. Osborn (Salt Lake City) – weitere Keynote-Speaker sind u.a. D. Prayer (Wien), Ch. Strother (Madison), J. Byrne (Oxford) und F. Barkhof (Amsterdam). Last but not least, legen wir besonderen Wert auf qualitativ hochwertige und zugleich unterhaltsame Fortbildung für unsere MTRAs, deren Fähigkeiten erheblich zu Qualität und Mehrwert der Neuroradiologie beitragen. Auch hier können wir Ihnen ein abwechslungsreiches Programm versprechen. Die Deutsche und Österreichische Gesellschaft für Neuroradiologie freuen sich, Sie vom 10. bis 12. Oktober 2013 in Köln begrüßen zu dürfen. Arnd Dörfler Michael Knauth Johannes Trenkler Kongresspräsident der DGNR Präsident der DGNR Kongresspräsident der ÖGNR 1 3 4 Abstracts Vorträge 0009 Periinterventionelle Subarachnoidalblutungen während mechanischer Rekanalisierungen mit Stentretrievern *U. Yilmaz1, S. Walter2, H. Körner1, P. Papanagiotou3, C. Roth3, A. Simgen1, S. Behnke2, A. Ragoschke-Schumm2, K. Fassbender2, W. Reith1 1Universitätsklinikum des Saarlandes, Klinik für diagnos- tische und interventionelle Neuroradiologie, Homburg, Deutschland 2Universitätsklinikum des Saarlandes, Klinik für Neurolo- gie, Homburg, Deutschland 3Klinikum Bremen Mitte, Klinik für diagnostische und interventionelle Neuroradiologie, Bremen, Deutschland Fragestellung: Die mechanische Rekanalisierung mit Stentretrievern hat sich in den letzten Jahren zu einer viel- versprechenden Methode mit den höchsten Rekanalisie- rungsraten der zur Verfügung stehenden Prozeduren beim Abb. 1 ischämischen Schlaganfall entwickelt. Allerdings werden in postinterventionellen CCT-Kontrollen in bis zu 16 % der 0018 Fälle Subarachnoidalblutungen gefunden, ohne dass angio- Limitierte 2- und 3-Schicht Perfusions-CT im Vergleich graphisch Perforationen nachweisbar waren. Über den Ein- zur Ganzhirn-Perfusion in der Indikationsstellung zur fluss dieser Blutungen auf den klinischen Verlauf ist wenig Thrombolyse im erweiterten Zeitfenster bei akuter bekannt. zerebraler Ischämie Methoden: Es wurden die postinterventionellen CCTs von *T. Engelhorn1, M. Knott1, S. Kloska1, T. Struffert1, 217 konsekutiven Patienten analysiert, die aufgrund akuter S. Schwab2, M. Köhrmann2, A. Dörfler1 Verschlüsse intrakranieller Arterien endovaskulär mit Stent- retrievern in unserer Klinik behandelt wurden. 1Universitätsklinikum Erlangen, Abteilung für Neuroradio- Ergebnisse: Subarachnoidalblutungen wurden in postinter- logie, Erlangen, Deutschland ventionellen CCTs von 5,5 % der Patienten nachgewiesen. 7 2Universitätsklinikum Erlangen, Neurologische Klinik, Fälle wurden in die weitere Analyse eingeschlossen und mit Erlangen, Deutschland einer Kontrollgruppe verglichen. Die Analyse der angiogra- phischen Daten zeigte keine signifikanten Unterschiede in Fragestellung: Ausgewählte Patienten mit zerebraler Isch- den Längen der Prozeduren oder der Anzahl der durchge- ämie können auch noch im erweiterten Zeitfenster jenseits führten Rekanalisierungsmanöver. Auch das neurologische von 4,5 h von einer i. v. Thrombolyse profitieren. Vorausset- Outcome bis zur Entlassung wies keine signifikanten Unter- zung ist ein positives MRT- oder CT-Mismatch (PM). Viele schiede auf. Sekundäre symptomatische Blutungen traten der aktuell betriebenen 4- bis 64-Zeilen CT-Geräte bieten jeweils in einem Fall in beiden Gruppen auf. Lediglich die aber nur die Möglichkeit einer limitierten 2- bzw. 3-Schicht Rate asymptomatischer Blutungen in den ersten 24 h nach Perfusionsuntersuchung. Ziel dieser Studie war daher der der Prozedur war in der Gruppe mit periinterventionellen Vergleich der 2- und 3-Schicht- mit der Ganzhirn-Bildge- SABs signifikant erhöht (57 vs. 0%, P = 0,018). bung zur Indikationsstellung einer Thrombolyse im erwei- Schlussfolgerungen: Periinterventionelle Subarachnoidal- terten Zeitfenster. blutungen, die ohne angiographischen Nachweis von Per- Methoden: Retrospektiv wurden 125 Patienten mit einem forationen während mechanischer Rekanalisierungen mit supratentoriellen Perfusionsdefizit ausgewählt, die im Stentretrievern auftreten, zeigten in dieser retrospektiven erweiterten Zeitfenster ein Schlaganfall-MRT erhalten hat- Fall-Kontroll-Studie keinen signifikanten Einfluss auf das ten. Aus dem PWI-Datensatz wurden 2 bzw. 3 Schichten neurologische Outcome der betroffenen Patienten. so ausgewählt, wie sie typischerweise in der limitierten CT- Perfusion akquiriert werden. Ausgewertet wurden dann auf allen Schichten Infarktvolumen (DWI) und Volumen der 1 3 Abstracts 5 Penumbra (PWI, Time-to-Peak). Ein PM bestand, wenn das Volumen der Penumbra > 20 % größer als das infarzierte Volumen war. Die Ergebnisse der Ganzhirn- wurden mit denen der 2- und 3-Schicht-Bildgebung verglichen. Ergebnisse: Die Ganzhirn-Bildgebung zeigte bei allen Patienten ein Perfusionsdefizit und bei 70,4 % ein PM. Die 2- bzw. 3-Schicht-Bildgebung zeigte bei 72 % bzw. 76 % der Patienten ein Perfusionsdefizit und bei 52 % bzw. 54 % ein PM (Sensitivität = 73,9 % bzw. 76,1 %; P > 0,23). Gegenüber der 2- und 3-Schicht- zeigte die Ganzhirn-Bildgebung bei signifikant mehr Patienten ein Perfusionsdefizit und ein PM (P < 0,01). Schlussfolgerung: Im Vergleich zur Ganzhirn-Perfusions- bildgebung ist davon auszugehen, dass bei Verwendung von CT-Geräten mit limitierter Perfusions-Schichtzahl bei bis zu 30 % der Schlaganfallpatienten im erweiterten Zeitfenster die Ischämie und bei über 25 % der Patienten das PM nicht erkannt wird. Abb. 1 Korrelation der Medianwerte des CBF aller 13 Schweine. Die horizontalen und vertikalen Balken zeigen die
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