Σφακιανάκης Αλέξανδρος
ΩτοΡινοΛαρυγγολόγος
Αναπαύσεως 5 Άγιος Νικόλαος
Κρήτη 72100
00302841026182
00306932607174
alsfakia@gmail.com

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Δευτέρα 13 Ιουλίου 2020


Intra-Arterial Chemotherapy for Retinoblastoma in Infants <=10 kg: 74 Treated Eyes with 222 IAC Sessions [PEDIATRICS]
BACKGROUND AND PURPOSE: Intra-arterial chemotherapy for retinoblastoma has dramatically altered the natural history of the disease. The remarkable outcomes associated with a high safety profile have pushed the envelope to offer treatment for patients weighing ≤10 kg. The purpose was to determine the efficacy and safety of IAC infusions performed in infants weighing ≤10 kg with intraocular retinoblastoma. MATERIALS AND METHODS: A retrospective chart review was performed for patients diagnosed...
American Journal of Neuroradiology current issue
Mon Jul 13, 2020 18:00
Neuroradiologists and the Novel Coronavirus [LETTERS]
American Journal of Neuroradiology current issue
Mon Jul 13, 2020 18:00
Posttreatment Imaging in Patients with Head and Neck Cancer without Clinical Evidence of Recurrence: Should Surveillance Imaging Extend Beyond 6 Months? [HEAD & NECK]
BACKGROUND AND PURPOSE: Early detection of residual or recurrent disease is important for effective salvage treatment in patients with head and neck cancer. Current National Comprehensive Cancer Network guidelines do not recommend standard surveillance imaging beyond 6 months unless there are worrisome signs or symptoms on clinical examination and offer vague guidelines for imaging of high-risk patients beyond that timeframe. Our goal was to evaluate the frequency of clinically occult recurrence...
American Journal of Neuroradiology current issue
Mon Jul 13, 2020 18:00
Meta-Analysis as a Symptom: The Example of Flow Diverters [LETTERS]
American Journal of Neuroradiology current issue
Mon Jul 13, 2020 18:00
Novel Coronavirus: What Neuroradiologists Should Do [LETTERS]
American Journal of Neuroradiology current issue
Mon Jul 13, 2020 18:00
Perspectives [other]
American Journal of Neuroradiology current issue
Mon Jul 13, 2020 18:00
Prevalence and Incidence of Microhemorrhages in Adolescent Football Players [PEDIATRICS]
BACKGROUND AND PURPOSE: SWI is an advanced imaging modality that is especially useful in cerebral microhemorrhage detection. Such microhemorrhages have been identified in adult contact sport athletes, and the sequelae of these focal bleeds are thought to contribute to neurodegeneration. The purpose of this study was to utilize SWI to determine whether the prevalence and incidence of microhemorrhages in adolescent football players are significantly greater than those of adolescent noncontact athletes....
American Journal of Neuroradiology current issue
Mon Jul 13, 2020 18:00
Preserving Access: A Review of Stroke Thrombectomy during the COVID-19 Pandemic [INTERVENTIONAL]
SUMMARY: Thrombectomy for large-vessel-occlusion stroke is a highly impactful treatment. The spread of coronavirus 19 (COVID-19) across the United States and the globe impacts access to this crucial intervention through widespread societal and institutional changes. In this document, we review the implications of COVID-19 on the emergency care of large-vessel occlusion stroke, reviewing specific infection-control recommendations, available literature, existing resources, and expert consensus. As...
American Journal of Neuroradiology current issue
Mon Jul 13, 2020 18:00
Combination of Imaging Features and Clinical Biomarkers Predicts Positive Pathology and Microbiology Findings Suggestive of Spondylodiscitis in Patients Undergoing Image-Guided Percutaneous Biopsy [SPINE]
BACKGROUND AND PURPOSE: Pathology and microbiology results for suspected spondylodiscitis on MR imaging are often negative in up to 70% of cases. We aimed to predict whether MR imaging features will add diagnostic value when combined with clinical biomarkers to predict positive findings of spondylodiscitis on pathology and/or microbiology from percutaneous biopsy. MATERIALS AND METHODS: In this retrospective single-center institutional review board–approved study, patients with radiologically...
American Journal of Neuroradiology current issue
Mon Jul 13, 2020 18:00
Tandem Carotid Lesions in Acute Ischemic Stroke: Mechanisms, Therapeutic Challenges, and Future Directions [INTERVENTIONAL]
SUMMARY: Approximately 15% of patients undergoing endovascular thrombectomy for anterior circulation acute ischemic stroke have a tandem lesion, defined as a severe stenosis or occlusion of the cervical internal carotid artery ipsilateral to its intracranial occlusion. Patients with tandem lesions have worse outcomes than patients with isolated intracranial occlusions, but the optimal management of their carotid lesions during endovascular thrombectomy remains controversial. The main options commonly...
American Journal of Neuroradiology current issue
Mon Jul 13, 2020 18:00
Persistent Blood Flow inside the Woven EndoBridge Device More Than 6 Months after Intracranial Aneurysm Treatment: Frequency, Mechanisms, and Management--A Retrospective Single-Center Study [INTERVENTIONAL]
BACKGROUND AND PURPOSE: Due to its high safety and great efficacy, flow disruption with the Woven EndoBridge (WEB) device is increasingly used to treat intracranial aneurysms. We recently identified patients with intracranial aneurysm treated with the WEB who presented with residual blood flow inside the device ("contrast-in-WEB" phenomenon) more than 6 months posttreatment. This series reports the frequency and underlying mechanisms and discusses management of this phenomenon. MATERIALS AND...
American Journal of Neuroradiology current issue
Mon Jul 13, 2020 18:00
Headache and Neuroimaging: Why We Continue to Do It [ADULT BRAIN]
SUMMARY: The appropriate imaging of patients with headache presents a number of important and vexing challenges for clinicians. Despite a number of guidelines and studies demonstrating a lack of cost-effectiveness, clinicians continue to image patients with chronic nonfocal headaches, and the trend toward imaging is increasing. The reasons are complex and include the fear of missing a clinically significant lesion and litigation, habitual and standard of care practices, lack of tort reform, regulatory...
American Journal of Neuroradiology current issue
Mon Jul 13, 2020 18:00
Prevalence of Sigmoid Sinus Dehiscence and Diverticulum among Adults with Skull Base Cephaloceles [HEAD & NECK]
BACKGROUND AND PURPOSE: Cephaloceles are relatively rare conditions caused by a congenital and/or acquired skull defect. The incidence of associated venous brain anomalies with regard to cephaloceles remains to be fully elucidated. Accordingly, we sought to assess the prevalence of sigmoid sinus dehiscence and diverticula in patients with spontaneous skull base cephaloceles. MATERIALS AND METHODS: Our institutional data base was retrospectively queried from 2005 to 2018. Patients in whom spontaneous...
American Journal of Neuroradiology current issue
Mon Jul 13, 2020 18:00
Squamous Cell Carcinoma Arising from Sinonasal Inverted Papilloma [HEAD & NECK]
SUMMARY: Sinonasal inverted papillomas occasionally undergo malignant transformation into squamous cell carcinoma, which can be associated with EGFR mutations. Since biopsy can potentially under-sample the tumor, CT and MRI can provide clues as to the presence of malignant transformation. In particular, this entity tends to appear different from benign inverted papilloma on imaging, including prominent bone erosions, necrosis, low diffusivity in the solid tumor components, and absence of the cerebriform...
American Journal of Neuroradiology current issue
Mon Jul 13, 2020 18:00
In Vivo Evaluation of White Matter Abnormalities in Children with Duchenne Muscular Dystrophy Using DTI [FUNCTIONAL]
BACKGROUND AND PURPOSE: Duchenne muscular dystrophy is an X-linked disorder characterized by progressive muscle weakness and prominent nonmotor manifestations, such as a low intelligence quotient and neuropsychiatric disturbance. We investigated WM integrity in patients with Duchenne muscular dystrophy using DTI. MATERIALS AND METHODS: Fractional anisotropy and mean, axial, and radial diffusivity (DTI measures) were used to assess WM microstructural integrity along with neuropsychological...
American Journal of Neuroradiology current issue
Mon Jul 13, 2020 18:00
Implications of the Revisions and Revaluation of Office/Outpatient Evaluation and Management Codes for Neuroradiology Reimbursement [research-article]
SUMMARY: In the 2020 Final Rule, the Center for Medicare & Medicaid Services adopted a new coding structure and accepted the substantial increase in valuation for office/outpatient Evaluation and Management codes set to begin in 2021. Given budget neutrality requirements, the projected increase in reimbursement will require a reduction in the conversion factor to offset such increases. The aim is to inform neuroradiologists the impact of these proposed changes on reimbursement and the profession....
American Journal of Neuroradiology current issue
Mon Jul 13, 2020 18:00
Brain Cortical Structure and Executive Function in Children May Be Influenced by Parental Choices of Infant Diets [FUNCTIONAL]
BACKGROUND AND PURPOSE: While it is known that breastfeeding promotes healthy brain development in children, the potential effects of formulas substantially differing in composition (ie, milk-based versus soy-based) during infancy on brain development are unclear. MATERIALS AND METHODS: Seventy-one 8-year-old children who were predominantly breastfed, milk formula fed, or soy formula fed during infancy were recruited for an MR imaging examination of the brain and a Behavior Rating Inventory...
American Journal of Neuroradiology current issue
Mon Jul 13, 2020 18:00
CT Scanning in Suspected Stroke or Head Trauma: Is it Worth Going the Extra Mile and Including the Chest to Screen for COVID-19 Infection? [ADULT BRAIN]
BACKGROUND AND PURPOSE: Chest CT may be used as a tool for rapid coronavirus disease 2019 (COVID-19) detection. Our aim was to investigate the value of additional chest CT for detection of coronavirus 19 (COVID-19) in patients who undergo head CT for suspected stroke or head trauma in a COVID-19-endemic region. MATERIALS AND METHODS: Our study included 27 patients (mean age, 74 years; range, 54–90 years; 20 men) who underwent head CT for suspected stroke (n = 21) or head trauma (n = 6),...
American Journal of Neuroradiology current issue
Mon Jul 13, 2020 18:00
James T. Goodrich, MD, PhD [article-commentary]
American Journal of Neuroradiology current issue
Mon Jul 13, 2020 18:00
Cerebrovascular Disease in COVID-19 [ADULT BRAIN]
SUMMARY: Coronavirus disease 19 (COVID-19) is a pandemic originating in Wuhan, China, in December 2019. Early reports suggest that there are neurologic manifestations of COVID-19, including acute cerebrovascular disease. We report a case of COVID-19 with acute ischemic stroke. To our knowledge, this is the first reported case of COVID-19-related cerebral infarcts that includes brain imaging at multiple time points and CT angiography. There is a growing body of published evidence that complications...
American Journal of Neuroradiology current issue
Mon Jul 13, 2020 18:00
A Hemodynamic Mechanism Correlating with the Initiation of MCA Bifurcation Aneurysms [INTERVENTIONAL]
BACKGROUND AND PURPOSE: Previous studies have reported that MCA bifurcation aneurysms usually emerge on inclined bifurcations; however, the reason is unclear. We designed this study to explore hemodynamic mechanisms that correlate with the initiation of MCA bifurcation aneurysms. MATERIALS AND METHODS: Fifty-four patients with unilateral MCA bifurcation aneurysms and 54 control patients were enrolled in this study after propensity score matching, and their clinical and CTA data were collected....
American Journal of Neuroradiology current issue
Mon Jul 13, 2020 18:00
Hemorrhagic Posterior Reversible Encephalopathy Syndrome as a Manifestation of COVID-19 Infection [ADULT BRAIN]
SUMMARY: We describe 2 hospitalized patients with confirmed coronavirus 19 (COVID-19) infection in whom brain imaging showed hemorrhagic posterior reversible encephalopathy syndrome, and we discuss the possible reasons for these findings and their relationship to the infection.
American Journal of Neuroradiology current issue
Mon Jul 13, 2020 18:00
Residual Flow Inside the Woven EndoBridge Device at Follow-Up: Potential Predictors of the Bicetre Occlusion Scale Score 1 Phenomenon [INTERVENTIONAL]
BACKGROUND AND PURPOSE: The Woven EndoBridge (WEB) device is an established technique for the treatment of intracranial aneurysms. Occasionally, persistent opacification inside the WEB lumen can be observed at follow-up (previously described as Bicêtre Occlusion Scale Score 1). We evaluated potential risk factors of this phenomenon, hypothesizing that initial deviation of the WEB device from the aneurysm axis, size of the aneurysmal neck surface, or inappropriate WEB sizing correlates with Bicêtre...
American Journal of Neuroradiology current issue
Mon Jul 13, 2020 18:00
Surprise Diagnosis of COVID-19 following Neuroimaging Evaluation for Unrelated Reasons during the Pandemic in Hot Spots [ADULT BRAIN]
SUMMARY: During the height of the recent outbreak of coronavirus 19 (COVID-19) in New York City, almost all the hospital emergency departments were inundated with patients with COVID-19, who presented with typical fever, cough, and dyspnea. A small number of patients also presented with either unrelated conditions (such as trauma) or other emergencies, and some of which are now known to be associated with COVID-19 (such as stroke). We report such a scenario in 17 patients who were admitted and...
American Journal of Neuroradiology current issue
Mon Jul 13, 2020 18:00
Comparison of Intraoperative Sonography and Histopathologic Evaluation of Tumor Thickness and Depth of Invasion in Oral Tongue Cancer: A Pilot Study [HEAD & NECK]
BACKGROUND AND PURPOSE: For primary squamous cell carcinoma of the oral tongue, accurate assessment of tumor thickness and depth of invasion is critical for staging and operative management. Currently, typical imaging modalities used for preoperative staging are CT and MR imaging. Intraoperatively, CT or MR imaging cannot provide real-time guidance, and assessment by manual palpation is limited in precision. We investigated whether intraoperative sonography is a feasible technique for assessment...
American Journal of Neuroradiology current issue
Mon Jul 13, 2020 18:00
Brain Imaging Use and Findings in COVID-19: A Single Academic Center Experience in the Epicenter of Disease in the United States [ADULT BRAIN]
SUMMARY: Coronavirus disease 2019 (COVID-19) is a serious public health crisis and can have neurologic manifestations. This is a retrospective observational case series performed March 1–31, 2020, at New York University Langone Medical Center campuses. Clinical and imaging data were extracted, reviewed, and analyzed. Two hundred forty-two patients with COVID-19 underwent CT or MRI of the brain within 2 weeks after the positive result of viral testing (mean age, 68.7 ± 16.5 years; 150 men/92 women...
American Journal of Neuroradiology current issue
Mon Jul 13, 2020 18:00
Variable Refocusing Flip Angle Single-Shot Imaging for Sedation-Free Fast Brain MRI [PEDIATRICS]
BACKGROUND AND PURPOSE: Conventional single-shot FSE commonly used for fast MRI may be suboptimal for brain evaluation due to poor image contrast, SNR, or image blurring. We investigated the clinical performance of variable refocusing flip angle single-shot FSE, a variation of single-shot FSE with lower radiofrequency energy deposition and potentially faster acquisition time, as an alternative approach to fast brain MR imaging. MATERIALS AND METHODS: We retrospectively compared half-Fourier...
American Journal of Neuroradiology current issue
Mon Jul 13, 2020 18:00
COVID-19-Associated Miller Fisher Syndrome: MRI Findings [HEAD & NECK]
SUMMARY: Miller Fisher syndrome, also known as Miller Fisher variant of Guillain-Barré syndrome, is an acute peripheral neuropathy that can develop after exposure to various viral, bacterial, and fungal pathogens. It is characterized by a triad of ophthalmoplegia, ataxia, and areflexia. Miller Fisher syndrome has recently been described in the clinical setting of the novel coronavirus disease 2019 (COVID-19) without accompanying imaging. In this case, we report the first presumptive case of COVID-19–associated...
American Journal of Neuroradiology current issue
Mon Jul 13, 2020 18:00
Value of Advanced MR Imaging Techniques in Mild Traumatic Brain Injury [article-commentary]
American Journal of Neuroradiology current issue
Mon Jul 13, 2020 18:00
Ventricular Volume Is More Strongly Associated with Clinical Improvement Than the Evans Index after Shunting in Idiopathic Normal Pressure Hydrocephalus [ADULT BRAIN]
BACKGROUND AND PURPOSE: Ventricular enlargement in idiopathic normal pressure hydrocephalus is often estimated using the Evans index. However, the sensitivity of the Evans index to estimate changes in ventricular size postoperatively has been questioned. Here, we evaluated the postoperative change in ventricle size in relation to shunt response in patients with idiopathic normal pressure hydrocephalus, by comparing ventricular volume and the Evans index. MATERIALS AND METHODS: Fifty-seven...
American Journal of Neuroradiology current issue
Mon Jul 13, 2020 18:00
Automatic Machine Learning to Differentiate Pediatric Posterior Fossa Tumors on Routine MR Imaging [FUNCTIONAL]
BACKGROUND AND PURPOSE: Differentiating the types of pediatric posterior fossa tumors on routine imaging may help in preoperative evaluation and guide surgical resection planning. However, qualitative radiologic MR imaging review has limited performance. This study aimed to compare different machine learning approaches to classify pediatric posterior fossa tumors on routine MR imaging. MATERIALS AND METHODS: This retrospective study included preoperative MR imaging of 288 patients with pediatric...
American Journal of Neuroradiology current issue
Mon Jul 13, 2020 18:00
Distinguishing Extravascular from Intravascular Ferumoxytol Pools within the Brain: Proof of Concept in Patients with Treated Glioblastoma [ADULT BRAIN]
BACKGROUND AND PURPOSE: Glioblastoma-associated macrophages are a major constituent of the immune response to therapy and are known to engulf the iron-based MR imaging contrast agent, ferumoxytol. Current ferumoxytol MR imaging techniques for localizing macrophages are confounded by contaminating intravascular signal. The aim of this study was to assess the utility of a newly developed MR imaging technique, segregation and extravascular localization of ferumoxytol imaging, for differentiating extravascular-from-intravascular...
American Journal of Neuroradiology current issue
Mon Jul 13, 2020 18:00
Changes of Neurotransmitters in Youth with Internet and Smartphone Addiction: A Comparison with Healthy Controls and Changes after Cognitive Behavioral Therapy [FUNCTIONAL]
BACKGROUND AND PURPOSE: Neurotransmitter changes in youth addicted to the Internet and smartphone were compared with normal controls and in subjects after cognitive behavioral therapy. In addition, the correlations between neurotransmitters and affective factors were investigated. MATERIALS AND METHODS: Nineteen young people with Internet and smartphone addiction and 19 sex- and age-matched healthy controls (male/female ratio, 9:10; mean age, 15.47 ± 3.06 years) were included. Twelve teenagers...
American Journal of Neuroradiology current issue
Mon Jul 13, 2020 18:00
High Spatiotemporal Resolution 4D Flow MRI of Intracranial Aneurysms at 7T in 10 Minutes [ADULT BRAIN]
BACKGROUND AND PURPOSE: Patients with intracranial aneurysms may benefit from 4D flow MR imaging because the derived wall shear stress is considered a useful marker for risk assessment and growth of aneurysms. However, long scan times limit the clinical implementation of 4D flow MR imaging. Therefore, this study aimed to investigate whether highly accelerated, high resolution, 4D flow MR imaging at 7T provides reliable quantitative blood flow values in intracranial arteries and aneurysms. MATERIALS...
American Journal of Neuroradiology current issue
Mon Jul 13, 2020 18:00
Spine MRI in Spontaneous Intracranial Hypotension for CSF Leak Detection: Nonsuperiority of Intrathecal Gadolinium to Heavily T2-Weighted Fat-Saturated Sequences [SPINE]
BACKGROUND AND PURPOSE: Spine MR imaging plays a pivotal role in the diagnostic work-up of spontaneous intracranial hypotension. The aim of this study was to compare the diagnostic accuracy of unenhanced spine MR imaging and intrathecal gadolinium-enhanced spine MR imaging for identification and localization of CSF leaks in patients with spontaneous intracranial hypotension. MATERIALS AND METHODS: A retrospective study of patients with spontaneous intracranial hypotension examined from February...
American Journal of Neuroradiology current issue
Mon Jul 13, 2020 18:00
Cervicofacial Venous Malformations Are Associated with Intracranial Developmental Venous Anomalies and Dural Venous Sinus Abnormalities [EXTRACRANIAL VASCULAR]
BACKGROUND AND PURPOSE: Prior studies have suggested an association between the presence of cervicofacial venous malformations and intracranial developmental venous anomalies. We reviewed our institutional cohort of patients with cervicofacial venous malformations and examined the spectrum of intracranial venous anomalies, including developmental venous anomalies, cavernous malformations, and dural venous sinus abnormalities. MATERIALS AND METHODS: Consecutive patients who presented to our...
American Journal of Neuroradiology current issue
Mon Jul 13, 2020 18:00
Norman Leeds, MD [article-commentary]
American Journal of Neuroradiology current issue
Mon Jul 13, 2020 18:00
Heterogeneous Continuum of Cerebral and Cervicofacial Venous Malformations [article-commentary]
American Journal of Neuroradiology current issue
Mon Jul 13, 2020 18:00
Celebrating 35 Years of the AJNR: July 1985 edition [other]
American Journal of Neuroradiology current issue
Mon Jul 13, 2020 18:00
Tailored antiplatelet agent medication in clopidogrel hyporesponsive patients before stent-assisted coiling: single-center experience
Abstract Purpose In patients requiring stent procedures, resistance or hyperresponsiveness to antiplatelet medications is often observed. This study aims to evaluate the efficacy and safety of tailoring medications in these patients. Methods This retrospective study included 223 patients who underwent endovascular treatment for intracranial aneurysm...
Neuroradiology
Mon Jul 13, 2020 03:00
Exploring contrast-enhanced MRI findings of the clinically non-inflamed symptomatic pediatric wrist
Abstract Background Knowledge of the synovial and tenosynovial appearance of the clinically non-arthritic symptomatic juvenile wrist using contrast-enhanced magnetic resonance imaging (MRI) is sparse. Objectives To analyze contrast-enhanced MRI findings of the clinically non-inflamed symptomatic pediatric wrist, focusing on the enhancing synovial and...
Pediatric Radiology
Mon Jul 13, 2020 03:00

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