Journal of Magnetic Resonance Imaging最新文献

{"title":"Editorial for \"Standardized MRI-Based Quantification of Epicardial Adipose Tissue Volume: Reproducibility and Agreement With Cardiac Computed Tomography\".","authors":"Stanislas Rapacchi, Farah Cadour","doi":"10.1002/jmri.70436","DOIUrl":"10.1002/jmri.70436","url":null,"abstract":"","PeriodicalId":16140,"journal":{"name":"Journal of Magnetic Resonance Imaging","volume":" ","pages":"1064-1065"},"PeriodicalIF":4.3,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13578518/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148421609","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Thalamic Nuclei Atrophy in Type 1 Diabetes Mellitus Across Disease Duration.","authors":"Hao Fang, Jiajing Yin, Shui Tian, Liuyan Dai, Wenxuan Heng, Xia Zhou, Ling Zhang, Mei Huang, Xinyi Qu, Yao Qin, Shanshan Lu, Mei Zhang","doi":"10.1002/jmri.70383","DOIUrl":"10.1002/jmri.70383","url":null,"abstract":"<p><strong>Background: </strong>Thalamic volume loss is one of the most consistent neuroimaging findings in type 1 diabetes mellitus (T1DM). However, the thalamus comprises multiple nuclei with distinct functions, and whether specific nuclei show differential vulnerability remains unclear.</p><p><strong>Purpose: </strong>To investigate the characteristics of intra-thalamic nuclear atrophy in T1DM and evaluate its association with disease duration.</p><p><strong>Field strength/sequence: </strong>3.0 T/T1-weighted magnetization-prepared-rapid-acquisition-of-gradient-echo (MPRAGE).</p><p><strong>Study type: </strong>Prospective.</p><p><strong>Population: </strong>Forty-two subjects with T1DM (18-68 years, 17 males/25 females) and 39 healthy controls (18-69 years, 16 males/23 females).</p><p><strong>Assessment: </strong>Multi-atlas-based segmentation was used to quantify volumes of 20 thalamic nuclei. Additionally, volumes of anatomical and functional subregions were derived based on topographic and functional nuclear classifications.</p><p><strong>Statistical tests: </strong>Group differences were assessed using general linear models. Associations between thalamic volume loss and disease duration were evaluated via partial correlations and exponential regression models to estimate duration-related atrophy rates. p value < 0.05 was considered significant.</p><p><strong>Results: </strong>Participants with T1DM showed significant bilateral reductions in total thalamic volume (left: 7.6%, Cohen's d = 0.91; right: 8.0%, Cohen's d = 0.95). The most pronounced atrophy was observed in the anterior, medial, and lateral thalamic subregions, with volume reductions of 15.8%, 8.6%, and 7.3%, respectively, particularly in cognition- and motor-related nuclei (9.4% and 9.2%, respectively). Longer disease duration was significantly associated with smaller thalamic volumes in the bilateral whole thalamus (r _left = -0.48 and r _right = -0.46), as well as in the Pul (r _left = -0.64 and r _right = -0.57), VLp (r _left = -0.39 and r _right = -0.38), and MD-Pf nuclei (r _left = -0.55 and r _right = -0.37), and in the left LGN (r = -0.43). Estimated disease-duration-related annualized atrophy rates exceeded age-related rates in several left-sided nuclei, including the MD-Pf (-0.67%), Pul (-0.69%), and LGN (-0.75%).</p><p><strong>Data conclusion: </strong>T1DM is associated with spatially heterogeneous atrophy of thalamic nuclei, with preferential involvement of the anterior, medial, and lateral subregions. Disease duration seems to accelerate neurodegenerative changes.</p><p><strong>Evidence level: </strong>2.</p><p><strong>Technical efficacy: </strong>Stage 2.</p>","PeriodicalId":16140,"journal":{"name":"Journal of Magnetic Resonance Imaging","volume":" ","pages":"1104-1114"},"PeriodicalIF":4.3,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13578573/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148271824","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Mapping Fatty Acid Composition in the Human Knee: Short-Term Repeatability at 3T.","authors":"Dimitri Martel, Anne Adlung, Baptiste Busi, Rollanda Bernadin, Yagni Shah, Thorsten Kirsch, Richard Kijowski, Guillaume Madelin, Amparo Ruiz","doi":"10.1002/jmri.70396","DOIUrl":"10.1002/jmri.70396","url":null,"abstract":"<p><strong>Background: </strong>Alterations in periarticular lipid composition are implicated in musculoskeletal diseases, yet short-term reliability of MRI-based triglyceride composition mapping in the knee is not fully established.</p><p><strong>Purpose: </strong>To evaluate 1-week repeatability of proton-density fat fraction (PDFF) and triglyceride fatty-acid composition-saturated (SFA), monounsaturated (MUFA), and polyunsaturated (PUFA)-in periarticular knee tissues.</p><p><strong>Study type: </strong>Prospective.</p><p><strong>Population: </strong>Ten healthy adults (5 female, 5 male; age 32 ± 8 years; BMI 23.5 ± 2.4 kg/m²).</p><p><strong>Field strength/sequence: </strong>3T; 12-echo 3D spoiled gradient-echo acquisition for chemical shift-encoded fat quantification and a proton density-weighted SPACE sequence for segmentation (0.6 mm isotropic).</p><p><strong>Assessment: </strong>Participants underwent repeated MRI 1 week apart. Femoral and tibial bone marrow, patella, Hoffa's fat pad, prefemoral fat pad, quadriceps fat pad, posterior fat pad, and subcutaneous adipose tissue were segmented and rigidly aligned. Voxelwise spectral fitting was used to estimate PDFF and fatty acid composition, including SFA, MUFA, and PUFA components. Repeatability metrics included bias, within-subject standard deviation (wSD), within-subject coefficient of variation (wCV%), coefficient of repeatability, and intraclass correlation coefficient (ICC).</p><p><strong>Statistical tests: </strong>Paired t-tests assessed systematic differences (α = 0.05); ICCs used a two-way random-effects, absolute-agreement model (ICC(2,1)).</p><p><strong>Results: </strong>PDFF showed lowest variability across all regions (wCV: 1.5%-5.9%; ICC: 0.33-0.96). SFA demonstrated similar stability (wCV: 2.4%-12.6%; ICC: 0.19-0.87). MUFA exhibited anatomy-dependent reliability (wCV: 4.1%-21.1%; ICC: 0.17-0.97), with highest repeatability in subcutaneous adipose tissue (ICC: 0.97) and Hoffa's fat pad (ICC: 0.85). PUFA displayed the greatest variability (wCV: 3.6%-52.8%; ICC: 0.10-0.94), with the greatest instability in periarticular fat pads. No paired comparisons were significant (all p > 0.05; range p = 0.14-0.98). Regional ordering remained consistent across sessions.</p><p><strong>Data conclusion: </strong>A 12-echo chemical shift-encoded MRI protocol provides repeatable PDFF and SFA measurements over 1 week. MUFA reliability varies by tissue, while PUFA remains least stable.</p><p><strong>Evidence level: </strong>2 (Prospective cohort).</p><p><strong>Technical efficacy stage: </strong>2 (Reproducibility/feasibility evaluation).</p>","PeriodicalId":16140,"journal":{"name":"Journal of Magnetic Resonance Imaging","volume":" ","pages":"1066-1076"},"PeriodicalIF":4.3,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13578594/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148317516","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Editorial for \"Preoperative Prediction of Pituitary Adenoma Consistency Using Synthetic MRI and Virtual Magnetic Resonance Elastography\".","authors":"Mohammad Abd Alkhalik Basha, Ahmed M Abdelkhalik Basha","doi":"10.1002/jmri.70428","DOIUrl":"10.1002/jmri.70428","url":null,"abstract":"","PeriodicalId":16140,"journal":{"name":"Journal of Magnetic Resonance Imaging","volume":" ","pages":"1155-1156"},"PeriodicalIF":4.3,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13578581/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148673658","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Editorial for \"Pre-Radiotherapy Synthetic MRI-Derived Quantitative Heterogeneity and Early Recurrence in Glioblastoma\".","authors":"Nuowei Ge, Qinqin Yang","doi":"10.1002/jmri.70414","DOIUrl":"10.1002/jmri.70414","url":null,"abstract":"","PeriodicalId":16140,"journal":{"name":"Journal of Magnetic Resonance Imaging","volume":" ","pages":"1171-1172"},"PeriodicalIF":4.3,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13578517/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148295268","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Sex, Gender, and the Search for Analytic Truth.","authors":"Jitka Starekova, Mark E Schweitzer","doi":"10.1002/jmri.70399","DOIUrl":"10.1002/jmri.70399","url":null,"abstract":"","PeriodicalId":16140,"journal":{"name":"Journal of Magnetic Resonance Imaging","volume":" ","pages":"1173-1174"},"PeriodicalIF":4.3,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13578577/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148251874","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Diffusion Tensor Imaging of Knee Cartilage for Detection of Early Osteoarthritis and Prediction of Radiographic Progression.","authors":"José G Raya, Dimitri Martel, Alejandra Duarte, Jenny T Bencardino, Svetlana Krasnokutsky-Samuels, Jonathan Samuels, Richard Kijowski, Amparo Ruiz","doi":"10.1002/jmri.70562","DOIUrl":"10.1002/jmri.70562","url":null,"abstract":"<p><strong>Background: </strong>The progression of early osteoarthritis (OA) is difficult to predict radiographically. T2 mapping provides information about cartilage degeneration, but its sensitivity to early matrix injury is limited. Diffusion tensor imaging (DTI) may detect cartilage microstructural abnormalities beyond T2 mapping.</p><p><strong>Purpose: </strong>To test whether baseline cartilage DTI metrics are associated with early knee OA and 3-year radiographic progression, and to compare their performance with T2 mapping and baseline Whole-Organ Magnetic Resonance Imaging Score (WORMS).</p><p><strong>Study type: </strong>Prospective longitudinal cohort.</p><p><strong>Population: </strong>Seventy-one participants (40 female, 31 male): 60 with unilateral symptomatic OA (one knee Kellgren-Lawrence [KL] ≥ 2, contralateral KL = 1) and 11 asymptomatic controls; 40 OA participants had 3-year follow-up radiographs.</p><p><strong>Field strength/sequence: </strong>3T, radial spin-echo diffusion (RAISED) DTI and multi-echo spin-echo T2 mapping.</p><p><strong>Assessment: </strong>KL grade, joint space width, baseline WORMS, and cartilage segmentations were obtained. Mean diffusivity (MD), fractional anisotropy, axial diffusivity, radial diffusivity (RD), and T2 were calculated in six cartilage regions. Progression was defined as joint space narrowing (JSN) > 0.7 mm or any KL grade increase.</p><p><strong>Statistical tests: </strong>ANCOVA adjusted for age, sex, and body mass index. Discrimination was assessed with the area under the receiver operating characteristic curve (AUC); predictive models were evaluated using cross-validated AUC. A two-sided p < 0.05 was considered statistically significant.</p><p><strong>Results: </strong>Baseline medial femoral condyle (MFC) MD distinguished KL = 0 from KL ≥ 1 knees (AUC 0.90), whereas a T2-based model showed lower discrimination (AUC 0.55). Among KL = 1 knees, 30% showed JSN progression and 28% KL progression. Baseline MFC MD and RD were higher in progressors, and adding MFC MD improved prediction of radiographic progression (AUC 0.80 for JSN and 0.71 for KL).</p><p><strong>Data conclusion: </strong>Baseline cartilage DTI, particularly MFC MD, showed stronger associations with early knee OA and radiographic progression than T2 mapping.</p><p><strong>Evidence level: </strong>2.</p><p><strong>Technical efficacy: </strong>Stage 3.</p>","PeriodicalId":16140,"journal":{"name":"Journal of Magnetic Resonance Imaging","volume":" ","pages":""},"PeriodicalIF":4.3,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13660440/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149109836","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pre-Radiotherapy Synthetic MRI-Derived Quantitative Heterogeneity and Early Recurrence in Glioblastoma.","authors":"Guanmin Quan, Shijia Wang, Yawu Liu, Tao Yuan","doi":"10.1002/jmri.70407","DOIUrl":"10.1002/jmri.70407","url":null,"abstract":"<p><strong>Background: </strong>Timely identification of early recurrence (≤ 6 months) may improve prognosis of glioblastoma (GBM), but conventional MRI has shown limited accuracy in this setting.</p><p><strong>Purpose: </strong>Risk-assessment models and a nomogram were constructed by integrating SyMRI metrics, clinical-pathological variables, and cMRI features, including contrast-enhanced T1-weighted imaging and fluid-attenuated inversion recovery (FLAIR) findings.</p><p><strong>Study type: </strong>Retrospective observational study.</p><p><strong>Population: </strong>Seventy-eight patients with GBM (median age, 59 years; 44 [56.4%] males).</p><p><strong>Field strength/sequence: </strong>3 T; pre- and post-contrast three-dimensional T1-weighted imaging, FLAIR, and SyMRI.</p><p><strong>Assessment: </strong>Histogram-based quantitative metrics were extracted from SyMRI maps using subregions defined on fused FLAIR and contrast-enhanced T1-weighted images. All candidate clinical-pathological variables, cMRI features, and SyMRI-derived metrics were entered directly into least absolute shrinkage and selection operator (LASSO) regression for variable selection. Risk-assessment models and a nomogram were constructed.</p><p><strong>Statistical tests: </strong>Multivariable logistic regression, multicollinearity assessment using variance inflation factors, receiver operating characteristic curve analysis with DeLong test, stratified 10-fold cross-validation, leave-one-out cross-validation, nested 5-fold cross-validation, calibration curves, and decision curve analysis. A two-sided p < 0.05 was considered statistically significant.</p><p><strong>Results: </strong>Multivariate analysis identified reduced T2 entropy (< 2.113) in enhancement-corresponding regions (odds ratio [OR] = 0.08), thick linear or nodular residual cavity wall enhancement (OR = 5.28), corpus callosum involvement (OR = 5.08), and O6-methylguanine-DNA methyltransferase (MGMT) promoter methylation (OR = 0.19) as variables associated with early recurrence. The integrated model achieved the highest performance (AUC = 0.864). Nested cross-validation showed moderate internal validation performance, with an AUC of 0.724 (0.722-0.726).</p><p><strong>Data conclusion: </strong>Histogram-based pre-radiotherapy SyMRI metrics, particularly T2 entropy, were associated with early GBM recurrence. The integrated model achieved the highest apparent performance; nested internal validation showed moderate performance. External validation in larger multicenter cohorts is required before clinical implementation.</p><p><strong>Evidence level: </strong>3.</p><p><strong>Technical efficacy: </strong>Stage 2.</p>","PeriodicalId":16140,"journal":{"name":"Journal of Magnetic Resonance Imaging","volume":" ","pages":"1157-1170"},"PeriodicalIF":4.3,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13578582/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148264745","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"An Expanded T2-FLAIR Mismatch Phenotype in IDH-Mutant Astrocytomas.","authors":"Tiantian Hua, Xiaokang Zhang, Junjie Li, Ying Jin, Jun Qiu, Yuwei Liu, Dan Cheng, Yunyun Duan, Xing Liu, Zhizheng Zhuo, Song Lin, Yaou Liu","doi":"10.1002/jmri.70404","DOIUrl":"10.1002/jmri.70404","url":null,"abstract":"<p><strong>Background: </strong>The T2-FLAIR mismatch (T2FM) sign is a highly specific imaging biomarker for isocitrate dehydrogenase (IDH)-mutant astrocytomas; however, its strict definition limits clinical applicability.</p><p><strong>Purpose: </strong>To determine whether an expanded T2FM (eT2FM) phenotype could improve identification of IDH-mutant astrocytomas and capture prognostic and biological information.</p><p><strong>Study type: </strong>Retrospective.</p><p><strong>Population: </strong>349 patients (50.14% male; mean age, 41.08 ± 10.40 years) with IDH-mutant astrocytomas.</p><p><strong>Field strength/sequence: </strong>3 T, T1-weighted gradient-echo- or spin-echo-based images, and T2-weighted, T2 fluid-attenuated inversion recovery (FLAIR), and contrast-enhanced T1-weighted images mainly acquired using spin-echo-based techniques.</p><p><strong>Assessment: </strong>The eT2FM phenotype was defined by incorporating spatially heterogeneous T2 FLAIR signals beyond the classic T2FM sign. Survival differences were compared between eT2FM and non-eT2FM tumors. Survival associations were evaluated. Metabolomic profiling was explored.</p><p><strong>Statistical tests: </strong>Kaplan-Meier analysis, weighted log-rank test, Cox regression, and metabolomic analyses. Significance was set at p < 0.05.</p><p><strong>Results: </strong>The eT2FM phenotype was identified in 116 of 349 patients (33.24%; mean age, 39.08 ± 9.51 years), exceeding classic T2FM (50/349, 14.33%; mean age, 36.40 ± 9.10 years). Kaplan-Meier analysis showed more favorable overall survival for eT2FM than non-eT2FM tumors, with restricted mean survival time (RMST) up to 36 months of 35.18 and 32.08 months, respectively (absolute difference, 3.10 months). Similar findings were observed in the external validation cohort, in which eT2FM phenotype was identified in 48 of 146 patients (32.88%; mean age, 37.77 ± 11.05 years). Kaplan-Meier analysis also showed more favorable overall survival for eT2FM than non-eT2FM tumors, with RMSTs of 36.00 and 33.81 months, respectively (absolute difference, 2.19 months). The eT2FM phenotype was associated with better prognosis in univariable Cox analysis (HR, 0.265; 95% CI, 0.120-0.585), but not independently in multivariable analysis (HR, 2.014; 95% CI, 0.380-10.673; p = 0.41). Exploratory metabolomics identified 1078 differentially abundant features between groups.</p><p><strong>Data conclusion: </strong>The eT2FM phenotype extends the clinical utility of classic T2FM sign and delineates a subgroup of IDH-mutant astrocytomas with favorable clinicopathologic features.</p><p><strong>Level of evidence: 4: </strong></p><p><strong>Technical efficacy: </strong>Stage 4.</p>","PeriodicalId":16140,"journal":{"name":"Journal of Magnetic Resonance Imaging","volume":" ","pages":"1130-1142"},"PeriodicalIF":4.3,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13578547/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148283747","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Altered Neurofluid Dynamics Markers in Middle-Aged and Older Women With Insomnia: A Multiparametric MR Neuroimaging Study.","authors":"Ruisi Wang, Kun Wang, Qiwei Guo, Chentat Leong, Xinglin Zeng, Jinzhe Zeng, Lin Hua, Dingwen Hu, Jason Ellis, Jubin Abutalebi, Shijun Qiu, Andriy Myachykov","doi":"10.1002/jmri.70417","DOIUrl":"10.1002/jmri.70417","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Despite known brain alterations in insomnia-particularly prevalent in older females-how it affects sleep-dependent glymphatic clearance remains understudied due to in vivo human measurement challenges.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Purpose: &lt;/strong&gt;To investigate altered neurofluid dynamics in women with insomnia using indirect neuroimaging markers.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Study type: &lt;/strong&gt;Prospective.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Population: &lt;/strong&gt;46 healthy controls (HC; 56.3 ± 5.5 years) and 28 females with insomnia disorder (ID; 58.2 ± 4.9 years).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Field strength/sequence: &lt;/strong&gt;3.0 T, 3D T1-weighted magnetization-prepared rapid acquisition gradient echo, resting-state fMRI using gradient-echo echo-planar imaging, and multi-shell diffusion MRI using spin-echo-planar sequence.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Assessment: &lt;/strong&gt;(1) Blood oxygen level dependent cerebral spinal fluid (BOLD-CSF) coupling measuring temporal coordination between neurovascular and CSF oscillations, (2) diffusion tensor image analysis along the perivascular space (DTI-ALPS) quantifying directional diffusivity in periventricular white matter, (3) choroid plexus (ChP) volume reflecting morphology of primary CSF-producing structures, and (4) nucleus basalis of Meynert (NBM) volume evaluating cholinergic system integrity potentially relevant to vascular regulation; (5) all participants completed self-reported sleep measures, including the Pittsburgh Sleep Quality Index (PSQI), Insomnia Severity Index (ISI), and Fatigue Severity Scale (FSS), and also underwent cognitive function testing.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Statistical tests: &lt;/strong&gt;Analysis of covariance evaluated between-group differences controlling for demographic and clinical covariates. Relationships with cognitive and sleep scores were assessed using partial correlations, stratified by group only when significant interaction effects were detected. Multiple comparisons were false discovery rate corrected (p &lt; 0.05). Classification model performance was evaluated using the area under the receiver operating characteristic curve (AUC). Model comparisons were performed using DeLong's tests (ΔAUC) and stepwise likelihood ratio tests (LRT) to assess classification gain and the independent incremental contribution of each biomarker; all tests were two-sided with α = 0.05.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Compared to controls, insomnia patients showed significantly reduced BOLD-CSF coupling (-0.18 ± 0.20 vs. -0.32 ± 0.17), indicating altered temporal coordination between neurovascular and CSF dynamics. ChP volume was significantly enlarged in the insomnia group (1.72% ± 0.42% vs. 1.55% ± 0.39% of total intracranial volume), potentially reflecting compensatory CSF production upregulation, inflammatory changes, or vascular remodeling. NBM volume was significantly reduced in insomnia patients (201.75 ± 17.66 vs. 217.47 ± 21.04 mm&lt;sup&gt;3&lt;/sup&gt;), suggesting cholinergic system alterations. In contrast, the DTI-ALPS index did not differ b","PeriodicalId":16140,"journal":{"name":"Journal of Magnetic Resonance Imaging","volume":" ","pages":"1115-1129"},"PeriodicalIF":4.3,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13578570/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148535933","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}