Clinical Neuroradiology最新文献

{"title":"Performance of Deep Learning Reconstruction for Detection of Early Ischemic Changes in NCCT: Comparison with ASIR-V in Acute Stroke.","authors":"Michal Pula, Adrian Korbecki, Krzysztof Winiarczyk, Arkadiusz Kacała, Kamil Litwinowicz, Michal Sobanski, Julita Nadwodna, Agata Zdanowicz-Ratajczyk, Maciej Guziński","doi":"10.1007/s00062-026-01645-5","DOIUrl":"10.1007/s00062-026-01645-5","url":null,"abstract":"<p><strong>Purpose: </strong>Evaluation of the impact of Deep Learning Image Reconstruction (DLIR) compared to Adaptive Statistical Iterative Reconstruction-Veo (ASIR-V) on image quality and early ischemic changes detection on non-contrast computed tomography (NCCT) in stroke suspected patients. A secondary objective was to determine the potential influence of reconstruction algorithm on ASPECT scoring relative to automated e-ASPECT score.</p><p><strong>Methods: </strong>Consecutive patients undergoing NCCT within 6 hours of symptom onset were retrospectively included. Images were reconstructed using ASIR-V and high-strength DLIR. Four readers with varying experience independently assessed subjective image quality, gray-white matter differentiation, diagnostic confidence, presence of ischemic lesions and ASPECTS scoring. Diagnostic performance (accuracy, sensitivity, specificity) was calculated using e-ASPECTS as reference. Evaluation time was recorded.</p><p><strong>Results: </strong>DLIR significantly improved subjective image quality and gray-white matter contrast compared with ASIR-V (odds ratios 2.96-3.96; p 0.001). Diagnostic performance for detecting early ischemic changes showed no significant difference, with similar accuracy, sensitivity and specificity. Evaluation time did not differ. A trend toward higher specificity and reduced bias for ASPECTS ≥6 was observed with DLIR, but mixed-model analysis did not confirm statistical significance.</p><p><strong>Conclusion: </strong>DLIR improves subjective image quality in acute stroke NCCT but does not significantly improve detection accuracy or ASPECTS scoring compared with ASIR-V. A tendency toward improved specificity was observed; further studies with larger cohorts are needed.</p>","PeriodicalId":10391,"journal":{"name":"Clinical Neuroradiology","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2026-04-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147637952","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Perceived Safety and Efficacy of Middle Meningeal Artery Embolization: Results from an International Survey.","authors":"Rosalie Morrish, Yu Zhou, Alexander Stebner, Salome Bosshart, Nima Kashani, Thanh Nguyen, Kazutaka Uchida, Satoru Fujiwara, Shinichi Yoshimura, Charlotte Weyland, Razvan Radu, Ondrej Volny, Pengfei Yang, Jianmin Liu, Johanna Ospel","doi":"10.1007/s00062-026-01646-4","DOIUrl":"https://doi.org/10.1007/s00062-026-01646-4","url":null,"abstract":"<p><strong>Background: </strong>Middle meningeal artery embolization (MMAE) is a promising new treatment for chronic SDH (cSDH). We conducted an international multi-disciplinary survey among physicians involved in the care of cSDH patients to understand the perceived safety profile and efficacy of MMAE in real-world clinical practice.</p><p><strong>Methods: </strong>The survey was distributed via several neurointerventional society mailing lists. We collected data on participant demographics, practice patterns, volumes and experience, perceived MMAE safety, complication tolerance, and decision-making. Data were analyzed using descriptive statistics, non-parametric tests and multi-variable regression.</p><p><strong>Results: </strong>Five-hundred-seventy-seven physicians completed the survey between November 20th, 2024 and May 1st, 2025 (median age 42.0 years, 489 [84.7%] male, comprised of endovascular neurosurgeons [185/577, 32.1%], interventional neuroradiologists [181/577, 31.4%]). The recent positive MMAE trials led to cSDH management, particularly in among endovascular neurosurgeons (adjusted odds ratio 2.56 [95% CI 1.51-4.35] compared to interventional neuroradioligists [reference]), and less so among other specialties. There were region-specific differences in rates of practice change and a negative association of physician age and practice change (adjusted odds ratio 0.72 [95% CI 0.53-0.99]). Most participants would now consider MMAE in patients with a new cSDH diagnosis with high perceived recurrence risk (192/424 [45.3%]), while 101/424 (23.8%) would consider MMAE for all cSDH patients. The highest acceptable risk for major complications was 4.0% (median, IQR, 2-5%), although this differed between regions and specialties.</p><p><strong>Conclusion: </strong>Recent trials on MMAE for cSDH treatment have changed practice patterns of cSDH management globally. MMAE is now considered a viable option by most physicians even for patients with first-time cSDH. Most would tolerate a maximum of 4% major complications, although rates of practice change and acceptable risk thresholds vary by region and specialty.</p>","PeriodicalId":10391,"journal":{"name":"Clinical Neuroradiology","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2026-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147589949","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Sex-Related Differences in Outcomes of Endovascular Treatment of Distal Medium Vessel Occlusion Strokes.","authors":"Hamza Adel Salim, Vivek Yedavalli, Dhairya Lakhani, Fathi Milhem, Basel Musmar, Nimer Adeeb, Davide Simonato, Yan-Lin Li, Orabi Hajjeh, Muhammed Amir Essibayi, Nils Henninger, Sri Hari Sundararajan, Anna Luisa Kühn, Jane Khalife, Sherief Ghozy, Luca Scarcia, Leonard Ll Yeo, Benjamin Yq Tan, Robert W Regenhardt, Jeremy J Heit, Aymeric Rouchaud, Jens Fiehler, Sunil Sheth, Ajit S Puri, Christian Dyzmann, Marco Colasurdo, Leonardo Renieri, João Pedro Filipe, Pablo Harker, Răzvan Alexandru Radu, Mohamad Abdalkader, Piers Klein, Takahiro Ota, Ashkan Mowla, Kareem El Naamani, Pascal Jabbour, Arundhati Biswas, Frédéric Clarençon, James E Siegler, Thanh N Nguyen, Ricardo Varela, Amanda Baker, David Altschul, Nestor R Gonzalez, Markus A Möhlenbruch, Vincent Costalat, Benjamin Gory, Christian Paul Stracke, Constantin Hecker, Gaultier Marnat, Hamza Shaikh, Christoph J Griessenauer, David S Liebeskind, Alessandro Pedicelli, Andrea M Alexandre, Tobias D Faizy, Illario Tancredi, Erwah Kalsoum, Boris Lubicz, Aman B Patel, Maurizio Fuschi, Max Wintermark, Adrien Guenego, Adam A Dmytriw","doi":"10.1007/s00062-026-01632-w","DOIUrl":"https://doi.org/10.1007/s00062-026-01632-w","url":null,"abstract":"<p><strong>Background: </strong>Sex-related differences in outcomes after mechanical thrombectomy (MT) for distal medium vessel occlusion (DMVO) stroke remain uncertain. While unadjusted differences have been reported in stroke populations, it is unclear whether biological sex independently influences outcomes after accounting for major prognostic factors.</p><p><strong>Methods: </strong>We performed a retrospective, multicenter analysis of the MAD-MT registry. Patients with acute DMVO who underwent MT were included. Propensity score matching (PSM) was employed. The primary outcome was functional independence (modified Rankin Scale [mRS] score 0-2) at 90 days. Secondary outcomes included excellent outcome (mRS 0-1), day 1 NIHSS shift, and reperfusion success. Safety outcomes included mortality and symptomatic intracerebral hemorrhage.</p><p><strong>Results: </strong>Before matching, 1147 females and 1062 males were included. After 1:1 PSM (748 patients in each group), the groups were balanced in baseline characteristics. The median age was 75 years in both groups. At 90 days, 51% of females and 54% of males achieved mRS 0-2 (P = 0.38). NIHSS shift from baseline to day 1 was similar (median -2 in both groups), and successful reperfusion (Thrombolysis in Cerebral Infarction 2b-3) was achieved in 86% of females and 89% of males (P = 0.18). Mortality was 18.4% in females and 15.5% in males (P = 0.11). Symptomatic intracerebral hemorrhage occurred in 8.3% of females and 7.7% of males (P = 0.67).</p><p><strong>Conclusions: </strong>After adjustment for age, baseline disability, and vascular risk factors, biological sex was not independently associated with functional or safety outcomes following mechanical thrombectomy for DMVO stroke.</p>","PeriodicalId":10391,"journal":{"name":"Clinical Neuroradiology","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2026-03-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147431323","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Diagnostic Accuracy of Machine Learning Models in Predicting Functional Outcome of Thrombectomy for Acute Posterior Circulation Artery Occlusion: a Systematic Review and Meta-Analysis.","authors":"Luciano Falcão, Karina de Lima Andrade Pereira, Kenzo Ogasawara Donato, João Victor Pereira Gonzalez, Victor Arthur Ohannesian, Anderson Matheus Pereira da Silva, João Vitor Andrade Fernandes, Rafael Hummes Müller, Ocílio Ribeiro Gonçalves, Davi J F Solla, Hasan T Ozgur, Ahmet Günkan","doi":"10.1007/s00062-026-01637-5","DOIUrl":"https://doi.org/10.1007/s00062-026-01637-5","url":null,"abstract":"<p><strong>Background: </strong>Mechanical thrombectomy (MT) is the standard treatment for acute posterior circulation artery occlusion (PCAO), but predicting outcomes remains challenging. Existing prognostic models combine clinical, imaging, and procedural variables but show inconsistent performance. Our objective is to evaluate the diagnostic accuracy of Machine Learning (ML) models in predicting favorable functional outcomes of thrombectomy for acute PCAO.</p><p><strong>Methods: </strong>We conducted a systematic review and bivariate diagnostic meta-analysis of PubMed, Embase, and Web of Science. Eligible studies evaluated ML predicting favorable outcomes (Modified Rankin Scale of 0 to 3 at hospital discharge or at 90 days) after MT for PCAO. Pooled sensitivity, specificity, and area under the summary receiver operating characteristic curve (AUC) were calculated with a bivariate random-effects model.</p><p><strong>Results: </strong>Five studies including 1739 patients met inclusion criteria. Pooled sensitivity was 78% (95% CI: 59-89%; I² = 89.29%) and specificity was 80% (95% CI: 74-85%; I² = 46.06%) for a favorable outcome. The Summary Receiver Operating Characteristic (SROC) curve yielded an AUC of 83% (95% CI: 80-86%). Subgroup analyses revealed that studies including patients with successful reperfusion (mTICI ≥ 2b) had significantly lower sensitivity and specificity. Random forest-based models achieved greater specificity, and multicenter studies demonstrated inferior specificity compared to single-center designs.</p><p><strong>Conclusions: </strong>ML models demonstrate good diagnostic accuracy in predicting functional outcomes after thrombectomy for acute PCAO. Integration of these models into clinical practice may support individualized decision-making and resource allocation, although prospective validation and improved reporting are needed before routine implementation.</p>","PeriodicalId":10391,"journal":{"name":"Clinical Neuroradiology","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2026-03-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147389494","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Letter to the Editor.","authors":"Johannes Gerber","doi":"10.1007/s00062-026-01634-8","DOIUrl":"10.1007/s00062-026-01634-8","url":null,"abstract":"","PeriodicalId":10391,"journal":{"name":"Clinical Neuroradiology","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2026-03-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147364108","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluation of Carotid Plaque Vulnerability Using Dual-energy Computed Tomography Angiography: a Prospective Observational Study.","authors":"Sakyo Hirai, Takuya Watanabe, Satoru Takahashi, Hiroto Hada, Hikaru Wakabayashi, Mariko Ishikawa, Kosuke Umeda, Hirotaka Sagawa, Shoko Fujii, Kyohei Fujita, Jun Oyama, Kazutaka Sumita","doi":"10.1007/s00062-026-01629-5","DOIUrl":"https://doi.org/10.1007/s00062-026-01629-5","url":null,"abstract":"<p><strong>Purpose: </strong>This study aimed to assess the utility of dual-energy computed tomography (DECT) for evaluating carotid plaque vulnerability.</p><p><strong>Methods: </strong>This prospective observational study included consecutive patients who underwent DECT for preoperative evaluation of carotid plaques before elective carotid artery stenting between June 2023 and May 2025. DECT parameters-including effective atomic number (Z), electron density (Rho), virtual non-contrast CT value (VNC), fat fraction (FF), and iodine concentration (IC)-were measured. Relative signal intensity (rSI) was calculated on T1-weighted magnetic resonance images as the ratio of plaque to adjacent sternocleidomastoid muscle signal.</p><p><strong>Results: </strong>A total of 46 carotid plaques, asymptomatic (n = 27) and symptomatic (n = 19), were analyzed. Both Rho and VNC were significantly lower in symptomatic compared to asymptomatic lesions (Rho, 29.6 [IQR, 26.5-33.6] vs 37.4 [IQR, 30.4-42.7], p < 0.05; VNC, 25.0 [IQR, 19.5-30.9] vs 31.2 [IQR, 21.9-41.4], p < 0.05), and FF was significantly higher in symptomatic compared to asymptomatic ones (21.5 [IQR, 17.4-23.3] vs 15.1 [IQR, 11.6-20.1], p < 0.05). No significant correlation was observed between the rSI and any of the DECT parameters. Multivariate logistic regression analysis showed that FF was significantly associated with symptomatic lesions in a model including rSI and VNC (OR, 1.39 [95% CI, 1.03-1.99], p < 0.05). Receiver operating characteristic analysis showed that adding FF to rSI improved discrimination of symptomatic plaques compared with rSI alone (AUC, 0.792 vs 0.560, p < 0.05).</p><p><strong>Conclusion: </strong>In this exploratory study, DECT-derived FF was associated with symptomatic carotid plaques and may provide complementary information beyond MRI-based plaque assessment in patients with moderate-to-severe carotid artery stenosis.</p>","PeriodicalId":10391,"journal":{"name":"Clinical Neuroradiology","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2026-03-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147343914","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Safety and Efficacy of Intracranial Stenting in Acute Stroke Patients Using a Pharmacological Treatment Protocol Including Low-Dose Intra-arterial Eptifibatide-A Single-center Retrospective Analysis.","authors":"Itamar Gothelf, Gal Ben Arie, Farouq Alguyan, Adi Shiloh, Dar Margalit, Liraz Henkin, Lior Abulaf, Ksenia Shabad, Asaf Honig, Anat Horev","doi":"10.1007/s00062-025-01565-w","DOIUrl":"10.1007/s00062-025-01565-w","url":null,"abstract":"<p><strong>Purpose: </strong>Emergent intracranial stenting (EICS) has demonstrated efficacy in managing intracranial stenosis in patients undergoing mechanical thrombectomy (MT) for acute ischemic stroke. However, an optimal pharmacological regimen balancing thrombosis prevention and hemorrhagic risk following stent deployment remains undefined. This study aimed to assess the safety and efficacy of prophylactic low-dose intra-arterial Eptifibatide following EICS.</p><p><strong>Methods: </strong>This single-center retrospective study included 57 consecutive patients who underwent EICS following MT due to an underlying intracranial stenosis. Patients received intravenous heparin and Aspirin pre-stenting, followed by prophylactic low-dose intra-arterial Eptifibatide post-stenting. Univariate and multivariable logistic regression analyses were conducted to identify factors associated with 90-day functional outcomes, categorized as favorable (modified Rankin Scale [mRS] 0-2) and non-favorable (mRS 3-6).</p><p><strong>Results: </strong>Among 57 patients who underwent EICS, 93.0% (n = 53) received a balloon-mounted coronary stent. Successful recanalization (TICI 2b/3) was achieved in 93.0% of cases. Intracranial hemorrhage was detected in 8.8% within 24 h post-procedure. The median mRS score at 90 days was 3.5 (IQR 1-6), with 40.4% of patients achieving favorable functional outcomes (mRS 0-2). Advanced age was independently associated with a non-favorable functional prognosis (OR = 1.06, 95% CI: 1.00-1.11, P = 0.034).</p><p><strong>Conclusions: </strong>In cases of MT requiring EICS, the administration of low-dose intra-arterial Eptifibatide immediately post-stenting, in addition to post-procedure dual anti-platelet therapy, demonstrated high recanalization rates with a favorable safety profile.</p>","PeriodicalId":10391,"journal":{"name":"Clinical Neuroradiology","volume":" ","pages":"143-152"},"PeriodicalIF":2.6,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145023011","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Vertebral Artery Dominance Patterns in Embolic Basilar Artery Occlusion: Insights Toward Embolus Trajectory.","authors":"Daryl Goldman, Emery Monnig, Amol Mehta, Christopher P Kellner, J Mocco, Johanna Fifi, Reade De Leacy, Hazem Shoirah, Shahram Majidi, Mehrdad Emami, Michael Travis Caton, Tomoyoshi Shigematsu","doi":"10.1007/s00062-025-01566-9","DOIUrl":"10.1007/s00062-025-01566-9","url":null,"abstract":"<p><strong>Purpose: </strong>Embolic basilar artery occlusion (eBAO) is less common than embolic anterior circulation stroke. The anatomic basis for this discrepancy is not understood. Vertebral artery dominance (VAD) correlates with blood flow to the basilar artery. We hypothesized that left VAD is less common in eBAO, as the right vertebral artery is the more proximal to the heart in typical aortic arch anatomy.</p><p><strong>Methods: </strong>This retrospective single-center, case-control study identified cases of eBAO. Right, left, and co-dominant (RVAD, LVAD, and CVAD) prevalence was calculated in standardized fashion by CTA. To estimate the VAD prevalence in asymptomatic patients, a systematic review and metanalysis was performed. The pooled estimate of VAD prevalence in the asymptomatic group was compared to the eBAO cohort using χ² test.</p><p><strong>Results: </strong>In total, 72 eBAO were identified in the institutional cohort, and prevalence of LVAD, RVAD, and CVAD was 23.6%, 33.3%, and 43.1% respectively. Systematic review included eight studies and 1813 asymptomatic patients. Mean VAD prevalence in the asymptomatic population was LVAD 47.0% (39.0-55.1%), RVAD 26.9% (22.7-31.5%), and CVAD 25.9% (18.8-34.7%). VAD proportions differed significantly in the eBAO group (p < 0.001), with lower proportion of LVAD (OR 0.37, CI 0.20-0.67, p < 0.001), higher proportion of CVAD (OR 1.89, CI 1.13-3.13, p = 0.01) but no difference in RVAD (1.39, CI 0.81-2.35, p = 0.22).</p><p><strong>Conclusion: </strong>LVAD is significantly less common in patients with eBAO compared to asymptomatic patients. Non-LVAD anatomy (RVAD and CVAD) may represent a novel anatomic risk factor for eBAO. This finding could influence techniques for endovascular thrombectomy.</p>","PeriodicalId":10391,"journal":{"name":"Clinical Neuroradiology","volume":" ","pages":"153-160"},"PeriodicalIF":2.6,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145032753","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evolution of MRI Parameters from the Subacute to Chronic Phase After Human Traumatic Cervical Spinal Cord Injury: a Prospective, Observational Study. Part 2: Diffusion Tensor Imaging Characteristics.","authors":"Andreas Grillhösl, Iris Leister, Florian Högel, Ludwig Sanktjohanser, Matthias Vogel, Orpheus Mach, Doris Maier, Lukas Grassner","doi":"10.1007/s00062-025-01579-4","DOIUrl":"10.1007/s00062-025-01579-4","url":null,"abstract":"<p><strong>Purpose: </strong>Imaging modalities, particularly magnetic resonance imaging (MRI), have become the gold standard for assessing lesion characteristics of traumatic spinal cord injuries (SCI). Diffusion tensor imaging (DTI), an advanced MRI technique, offers insights into microstructural changes in white matter tracts. While previous studies focused on either acute or chronic SCI, few have examined longitudinal changes during the transition from acute to chronic stages of injury. This study addresses this gap by analyzing the evolution of DTI metrics over the first year following cervical SCI.</p><p><strong>Methods: </strong>This prospective longitudinal study involved 52 patients with traumatic cervical SCI. MRI and neurological examinations using the International Standards for Neurological Classification of Spinal Cord Injury (ISNCSCI) were performed 1 month, 3 months, and 1 year post-injury. Linear mixed model analyses assessed DTI measures over time.</p><p><strong>Results: </strong>Fractional anisotropy (FA) values gradually decreased in the reference area at the cranio-cervical junction (C0-C4; p < 0.001), indicating ongoing tissue degeneration up to one year after injury, independent of initial clinical severity. FA values at the lesion site correlated moderately with the total motor score 1 month post-SCI (R = 0.37, p = 0.033). Mean diffusivity (MD) increased significantly over time (p < 0.001), suggesting progressive microstructural changes. Axial diffusivity (AD) decreased until 3 months after injury (p < 0.001), then returned to its initial values by 1 year, reflecting dynamic pathophysiological events.</p><p><strong>Conclusion: </strong>This study highlights the potential of DTI for monitoring microstructural changes after SCI. Longitudinal imaging offers insights into evolving pathology, supports prognostic modeling, and may aid treatment monitoring and outcome prediction.</p>","PeriodicalId":10391,"journal":{"name":"Clinical Neuroradiology","volume":" ","pages":"217-225"},"PeriodicalIF":2.6,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145353997","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Midsagittal Midbrain Area and Midbrain-to-Pons-Ratio Cannot Distinguish Overlap Syndromes Between Amyotrophic Lateral Sclerosis and Progressive Supranuclear Palsy.","authors":"Daniel Cantré, Jochem König, Caroline Makowsky, Martin Dyrba, Johannes Prudlo","doi":"10.1007/s00062-025-01564-x","DOIUrl":"10.1007/s00062-025-01564-x","url":null,"abstract":"<p><strong>Purpose: </strong>When amyotrophic lateral sclerosis (ALS), a TDP-43 proteinopathy, and progressive supranuclear palsy (PSP), a tauopathy, are associated with frontotemporal dementia (ALS-FTD or PSP-FTD), clinical differentiation can be challenging. There are no established imaging biomarkers to differentiate ALS-FTD from PSP-FTD.</p><p><strong>Methods: </strong>We evaluated the midsagittal midbrain area (MBA) and the midbrain-to-pons-(MB/P)-ratios in T1 MPRAGE MRI of 36 PSP cases (n = 14 PSP-FTD), 77 ALS cases (n = 10 ALS-FTD), and 72 healthy controls (HC).</p><p><strong>Results: </strong>In ALS, both parameters were indistinguishable from HC. Patients with ALS-FTD had low MBA-values and MB/P-ratios not significantly different from cases of PSP. While ROC-analyses provided an excellent diagnostic accuracy of both parameters for differentiating PSP from HC (AUC_MBA = 0.974) as well as PSP from ALS (AUC_MBA = 0.982), midbrain morphometry provided poor diagnostic accuracy for distinguishing ALS-FTD from PSP-FTD (AUC_MBA = 0,614).</p><p><strong>Conclusion: </strong>The MBA and the MB/P-ratio are morphometric parameters that have proven reliable in atypical Parkinsonian syndromes. Both can distinguish between PSP and ALS in their typical clinical forms. However, they cannot differentiate between PSP-FTD and ALS-FTD.</p>","PeriodicalId":10391,"journal":{"name":"Clinical Neuroradiology","volume":" ","pages":"161-168"},"PeriodicalIF":2.6,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13009060/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145039257","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}