Key developments in neuroradiology

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Marco Leonardi, professor of Neuroradiology, Bologna University, Bellaria Hospital, Bologna, Italy, and president of the XIX Symposium Neuroradiologicum which was held in Bologna, 4–9 October 2010, spoke to NeuroNews.

What are the most recent important developments in neuroradiology as a specialty?

 

In my opinion, the use of flow diverting stents in the endovascular treatment of brain aneurysms is an important development. This is a new approach to the endovascular treatment of intracranial aneurysms and it uses a high density mesh stent to induce sac thrombosis. These devices have been designed for the treatment of complex shaped and large size aneurysms. I have published in this area in 2008, and Byrne JV et al published the early experience in the treatment of intra-cranial aneurysms by endovascular flow diversion: a multicentre prospective study. PLoS ONE 2010 5:e12492. They reported that outcomes of the new treatment approach provide data on procedural difficulties in deployment. The authors suggest that the use of anti-thrombosis prophylaxis appears to reduce the resulting clinical sequelae, but at the cost of morbidity due to extracranial bleeding. They caution that delayed morbidity appears to be a consequence of the new approach and warrants care in selecting patients for treatment and future larger studies.

 

What are your current research interests?

 

My current research centres around endovascular treatment of brain aneurysms, arteriovenous malformations and stroke. I am also interested in the treatment of spine pathology, mainly discal hernias. I am also looking at questions in advanced MRI techniques in the study of brain tumours, comatose patients and psychological disorders.

 

What are the key challenges facing neuroradiology in Europe today?

 

Education and training of young neuroradiologists is particularly difficult because we have never obtained the approval for a specific specialisation course. This exists only in Portugal.

 

What were three of the most interesting research findings that came out of the XIX symposium Neuroradiologicum?

 

In my view, the three most interesting research areas that were discussed were 1) the possibility to treat brain stroke as the heart infarct 2) the diagnostic possibilities of MRI in characterising brain tumours and 3) the possibilities of functional MRI in the study of brain functions and physiology.

 

What key message do you have for your fellow neuroradiologists?

 

Be a clinician, work as a physician and have a strong contact with the patients. Do not accept the role of radiographer-photographer. Respect your patient as if he/her is a close relative. Describe your experiences and read and write scientific papers.

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