Journal of Neuroimaging最新文献

{"title":"Neurofibromatosis Type 1: An Imaging Review of Multisystem Manifestations in Children","authors":"Ernst L. Greisberger,&nbsp;Livja Mertiri,&nbsp;Valeria Ortega,&nbsp;Thierry A. G. M. Huisman","doi":"10.1111/jon.70151","DOIUrl":"https://doi.org/10.1111/jon.70151","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <p>Neurofibromatosis type 1 (NF1) is a common inherited tumor predisposition syndrome with multisystem involvement of the central and peripheral nervous systems, vasculature, skeleton, skin, and internal organs. Many clinically relevant manifestations are internal, age-dependent, progressive, or initially asymptomatic, making imaging central to diagnosis, surveillance, and treatment. This review provides a radiology-centered overview of the major imaging manifestations of NF1 and emphasizes pattern recognition, modality selection, and imaging features that should prompt closer follow-up, functional imaging, or tissue diagnosis with a focus on the pediatric population. The review covers optic pathway and non-optic gliomas, plexiform neurofibromas, malignant peripheral nerve sheath tumors, abdominal neoplasms, focal areas of signal intensity/unidentified bright objects (FASIs/UBOs), NF1-associated vasculopathy, and musculoskeletal dysplasias. MRI is the primary modality for evaluating CNS tumors, FASIs/UBOs, plexiform neurofibromas, spinal and paraspinal disease, dural ectasia, and whole-body tumor burden. Diffusion-weighted imaging and Fluordesoxyglucose (FDG)-PET/MRI provide complementary information when malignant transformation of a plexiform neurofibroma is suspected. CT, CTA, MRA, ultrasound, radiography, and catheter angiography remain important in selected settings, particularly for skeletal dysplasia, intracranial and systemic vasculopathy, renovascular hypertension, and preoperative planning. NF1 imaging requires an integrated multisystem approach rather than isolated organ-based interpretation. Careful assessment of lesion morphology, anatomic distribution, interval change, and clinical context enables clinicians to distinguish typical benign manifestations from findings suggestive of progression, malignant transformation, or clinically relevant vascular and skeletal complications.</p>\u0000 </section>\u0000 </div>","PeriodicalId":16399,"journal":{"name":"Journal of Neuroimaging","volume":"36 5","pages":""},"PeriodicalIF":2.5,"publicationDate":"2026-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149146254","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Transcranial Doppler Monitoring After Mechanical Thrombectomy: Pros and Cons","authors":"Yasaman Pirahanchi,&nbsp;Alexandra S. Reynolds","doi":"10.1111/jon.70150","DOIUrl":"10.1111/jon.70150","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <p>The acute ischemic stroke code that culminates in mechanical thrombectomy (MT) is accompanied by a significant amount of neuroimaging—CT head, CT angiogram of the head and neck, often a CT perfusion, and then the conventional angiogram performed by the neuroendovascular specialist. Immediately postprocedurally, patients who have undergone MT are at risk for reocclusion, hemorrhagic conversion of stroke, and malignant cerebral edema. While CT and MR imaging provide static images, transcranial Doppler (TCD) is becoming more commonly used to evaluate cerebral hemodynamics post-MT and screen for potential complications. Here, we outline the arguments for and against routine performance of TCD in the immediate post-MT phase of care.</p>\u0000 </section>\u0000 </div>","PeriodicalId":16399,"journal":{"name":"Journal of Neuroimaging","volume":"36 5","pages":""},"PeriodicalIF":2.5,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149110622","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Point-of-Care Ultrasound for Quantitative Assessment of Pupillary Dysfunction in Acute Internal Carotid Artery Dissection","authors":"Filippo Farina,&nbsp;Claudio Baracchini","doi":"10.1111/jon.70149","DOIUrl":"10.1111/jon.70149","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background and Purpose</h3>\u0000 \u0000 <p>Diagnosing internal carotid artery dissection (ICAD) can be challenging even for experienced clinicians, as one of its most specific signs—Horner syndrome (HS)—is often missed during routine neurological examination (NE). This study aimed to evaluate pupillary reactivity in ICAD patients using ultrasound pupillometry (UP) and compare quantitative UP findings with standard NE.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We enrolled 33 consecutive patients with acute ICAD and an age- and sex-matched healthy control group without ocular pathology. HS was assessed at admission using standard NE. UP was performed in both the affected eye (AE) and non-affected eye (NAE), measuring pupillary diameter (PD) and response time (PT) to light stimulus (LS) and ciliospinal reflex (CR). Ultrasound examinations were performed by a single operator, while all offline quantitative measurements were performed by a second investigator blinded to the neurological findings.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>UP revealed significantly smaller PDs in the AE compared with the NAE, both at rest and after direct and consensual LS (3.23 ± 0.64 mm vs. 5.12 ± 0.51 mm, <i>p</i> &lt; 0.01). The AE also showed reduced CR response in terms of mydriasis (4.03 ± 2.8% vs. 9.76 ± 3.36%, <i>p</i> &lt; 0.01) and dilation time (2.984 ± 0.278 s vs. 2.071 ± 0.223 s, <i>p</i> &lt; 0.01). Similar differences were observed between the AE and controls. Quantitative pupillary abnormalities were identified by UP in 96.9% of patients, whereas clinical HS was detected by standard NE in 39.4% (<i>p</i> &lt; 0.01).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>UP represents a promising Neuro-POCUS application for the objective, quantitative assessment of pupillary dysfunction in acute ICAD and may serve as a valuable adjunct to routine NE.</p>\u0000 </section>\u0000 </div>","PeriodicalId":16399,"journal":{"name":"Journal of Neuroimaging","volume":"36 5","pages":""},"PeriodicalIF":2.5,"publicationDate":"2026-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149075119","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Revascularization Plus Medical Therapy Versus Medical Therapy Alone for Asymptomatic Carotid Stenosis: A Meta-Analysis","authors":"Mohammed M. Al-Salihi,&nbsp;Maryam S. Al-Jebur,&nbsp;Adam Rizvi,&nbsp;Ahmed Saleh,&nbsp;Ufuk Erginoglu,&nbsp;Farhan Siddiq,&nbsp;Ali Ayyad,&nbsp;Mustafa K. Baskaya,&nbsp;Adnan I. Qureshi","doi":"10.1111/jon.70148","DOIUrl":"10.1111/jon.70148","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Management of asymptomatic carotid stenosis (ACS) remains controversial, particularly as contemporary optimal medical therapy (OMT) has evolved beyond the aspirin-based regimens used in earlier trials. We performed a meta-analysis comparing carotid revascularization plus OMT versus OMT alone in patients with ACS.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We searched five databases (PubMed, Embase, Web of Science, Scopus, and the Cochrane Central Register of Controlled Trials [CENTRAL]) from inception to November 2025. Randomized controlled trials comparing carotid revascularization (endarterectomy or stenting) plus OMT versus OMT alone were included. Primary outcomes were 30- to 44-day mortality and stroke. Other outcomes included long-term all-cause mortality, stroke, myocardial infarction, and intracerebral hemorrhage. All statistical analyses were performed in R, and risk ratios (RRs) with 95% confidence intervals (CIs) were pooled using either fixed- or random-effects models.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Six trials involving 8276 patients were included. Revascularization significantly increased 30- to 44-day mortality (RR 3.98 [95% CI, 1.53–10.35], <i>p</i> = 0.0046) and stroke risk (RR 4.53 [95% CI, 2.51–8.17], <i>p</i> &lt; 0.0001). However, long-term follow-up demonstrated significant reductions in all-cause mortality (RR 0.80 [95% CI, 0.68–0.93], <i>p</i> = 0.0053) and stroke (RR 0.66 [95% CI, 0.57–0.76], <i>p</i> &lt; 0.0001). No significant differences were observed in myocardial infarction or intracerebral hemorrhage rates.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Carotid revascularization combined with OMT was associated with increased periprocedural risks but lower long-term stroke and mortality in pooled analyses of patients with ACS. These findings should be interpreted cautiously given differences across trials and evolving OMT standards. Patient selection should balance procedural risks against potential long-term benefit, particularly among patients with high-grade stenosis, low periprocedural risk, and access to experienced centers.</p>\u0000 </section>\u0000 </div>","PeriodicalId":16399,"journal":{"name":"Journal of Neuroimaging","volume":"36 5","pages":""},"PeriodicalIF":2.5,"publicationDate":"2026-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149075094","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pitfalls in 2HG Detection With TE-Optimized MRS at 3T","authors":"Seyma Alcicek,&nbsp;Dunja Simicic,&nbsp;Lindsay Blair,&nbsp;Max Saint-Germain,&nbsp;Helge J. Zöllner,&nbsp;Christopher W. Davies-Jenkins,&nbsp;Matthias Holdhoff,&nbsp;John Laterra,&nbsp;Chetan Bettegowda,&nbsp;Karisa C. Schreck,&nbsp;Doris D. Lin,&nbsp;Peter B. Barker,&nbsp;David O. Kamson,&nbsp;Georg Oeltzschner","doi":"10.1111/jon.70146","DOIUrl":"https://doi.org/10.1111/jon.70146","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background and Purpose</h3>\u0000 \u0000 <p>In vivo MRS of 2-hydroxyglutarate (2HG) may provide diagnostic and monitoring biomarkers in isocitrate dehydrogenase (IDH)-mutated glioma. A previous meta-analysis has shown good diagnostic accuracy of TE-optimized PRESS for IDH-mutated glioma, but most studies feature IDH-wildtype glioma as a comparison. However, when considering newly identified brain lesions that may mimic glioma, full characterization of its diagnostic utility should also consider the accuracy of 2HG measurement in nontumor tissue. Therefore, we tested how well TE-optimized 2HG levels distinguish between IDH-mutated glioma and nontumor tissue—here, normal-appearing brain. We further examined the impact of different spectral modeling strategies (baseline stiffness, macromolecule inclusion, and basis set composition).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Forty-eight patients with diagnosed/suspected IDH-mutated glioma were enrolled. 3T MRS data were acquired from tumor and contralateral nontumor tissue with TE-optimized PRESS and analyzed with “LCModel” software. ROC analysis evaluated 2HG estimates’ ability to distinguish IDH-mutated glioma from nontumor tissue. Modeling interactions between 2HG and other metabolites were evaluated to identify reasons for potential false-positive 2HG detection.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>TE-optimized PRESS distinguished IDH-mutated glioma from nontumor tissue with lower sensitivity (range 0.76–0.62) and specificity (0.85–0.78) than the literature suggests for IDH-mutated versus IDH-wildtype glioma. Strong negative correlations between gamma-aminobutyric acid (GABA) and 2HG persisted across all modeling strategies and may lead to false-positive 2HG detection in nontumor tissue. We further present a cautionary example from a patient on a ketogenic diet, showing that ketone body acetone can interfere with 2HG detection.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Spectral overlap with GABA and acetone can lead to false-positive 2HG detection in nontumor tissue.</p>\u0000 </section>\u0000 </div>","PeriodicalId":16399,"journal":{"name":"Journal of Neuroimaging","volume":"36 5","pages":""},"PeriodicalIF":2.5,"publicationDate":"2026-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jon.70146","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148965661","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association of Early M2 Pulsatility Index Ratio With Outcomes After Successful Endovascular Thrombectomy","authors":"Seyed Behnam Jazayeri,&nbsp;Cattien Phan,&nbsp;Yasaman Pirahanchi,&nbsp;Ben Shifflett,&nbsp;Amirmohammad Eghbalnejadmofrad,&nbsp;Marissa D'Souza,&nbsp;Tiffany Hu,&nbsp;Sanad Batarseh,&nbsp;Behnam Sabayan,&nbsp;Jeffrey Steinberg,&nbsp;Jeffrey S. Pannell,&nbsp;David Santiago-Dieppa,&nbsp;Navaz P. Karanjia,&nbsp;Jamie LaBuzetta,&nbsp;Brian Lemkuil,&nbsp;Arthur Lam,&nbsp;Martin Krause,&nbsp;Anushirvan Minokadeh,&nbsp;Ali Mahta,&nbsp;Theresa McQuaid,&nbsp;Karen Rapp,&nbsp;Kunal Agrawal,&nbsp;Royya F. Modir,&nbsp;Thomas M. Hemmen,&nbsp;Dawn M. Meyer,&nbsp;Alexander A. Khalessi,&nbsp;Brett C. Meyer,&nbsp;Reza Bavarsad Shahripour","doi":"10.1111/jon.70144","DOIUrl":"10.1111/jon.70144","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background and Purpose</h3>\u0000 \u0000 <p>We investigated whether early transcranial Doppler (TCD) ultrasound asymmetry indices could serve as bedside predictors of hemorrhagic transformation (HT) and 90-day outcome after successful endovascular thrombectomy (EVT).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Patients with successful reperfusion (thrombolysis in cerebral infarction [TICI] ≥2b) after M1-segment EVT who underwent bilateral TCD within 8 h post-EVT were included. Ipsilateral-to-contralateral ratios for mean flow velocity (MFV) and pulsatility index (PI) were calculated for M1 (segment of the middle cerebral artery) and M2 (segment of the middle cerebral artery) segments. Multivariate logistic regression identified independent predictors of HT and poor 90-day outcome.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Among seventy patients (mean age 69.9 ± 6.7 years; 58.5% male), TCD was performed 5.3 ± 1.6 h after EVT. HT occurred in 45 patients (64.2%). Independent predictors of HT were younger age (<i>p</i> = 0.012), higher baseline NIHSS (<i>p</i> = 0.025), lower M2 PI ratio (<i>p</i> &lt; 0.0001), and higher M2 MFV ratio (<i>p</i> = 0.010). Parenchymatous hemorrhage was predicted only by lower M2 PI ratio (<i>p</i> &lt; 0.001). Poor 90-day outcome occurred in 35.7% and was associated with older age (<i>p</i> = 0.027), atrial fibrillation (<i>p</i> = 0.002), lower M2 PI ratio (<i>p</i> = 0.004), and higher M1 MFV ratio (<i>p</i> = 0.043). An M2 PI ratio ≤0.79 was associated with poor 90-day outcome with 89% specificity and 80% sensitivity (area under the curve [AUC] 0.91).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Early M2 PI ratio was associated with PH-type HT and poor 90-day outcome; however, given the small sample size, wide confidence intervals, and lack of external validation, these findings remain hypothesis-generating rather than ready-to-use prognostic tools. Larger studies are needed to confirm these preliminary observations.</p>\u0000 </section>\u0000 </div>","PeriodicalId":16399,"journal":{"name":"Journal of Neuroimaging","volume":"36 4","pages":""},"PeriodicalIF":2.5,"publicationDate":"2026-08-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148808746","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Portable Ultra-Low-Field MRI in Outpatient Neurology: An Examination of Clinical Performance and Patient Experience","authors":"Laszlo Mechtler,&nbsp;Sameer Ahmad Ansari,&nbsp;Jamal Derakhshan,&nbsp;Edmond Knopp,&nbsp;Nandor Pinter,&nbsp;Mohamad Asaad Nasri,&nbsp;Gincy Samuel","doi":"10.1111/jon.70143","DOIUrl":"https://doi.org/10.1111/jon.70143","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background and Purpose</h3>\u0000 \u0000 <p>Brain magnetic resonance imaging (MRI) is an essential component for outpatient neurological evaluation, though access to timely imaging at the point of care is not feasible for most outpatient neurology practices. Portable ultra-low-field MRI systems offer a potential solution, but studies describing their clinical performance in routine outpatient neurology practice remain limited. This study evaluated clinical concordance and patient experience of portable MRI (pMRI) compared to standard-of-care MRI (sMRI) in independent neurology practices.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>In this prospective, multicenter study, adults presenting to outpatient neurology clinics and requiring clinically indicated brain MRI completed imaging with both pMRI (0.064 T) and sMRI (91% 3 T, 9% 1.5 T) in the neurology clinic. All examinations were independently reviewed by board-certified neuroradiologists in a blinded, randomized fashion without access to clinical history. The primary endpoint was patient-level concordance between modalities for the presence or absence of abnormal findings. Discordant cases underwent post hoc unblinded paired review with clinical history to assess clinical significance. Secondary endpoints included patient-reported experience, assessed using a structured questionnaire evaluating noise, comfort, claustrophobia, anxiety, and overall experience on 10-point Likert scales, as well as modality preference.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Among 125 participants imaged for common outpatient indications, including headache (40%), cognitive impairment or dementia (16%), multiple sclerosis follow-up (16%), and tumor surveillance (16%), portable and sMRI demonstrated 92% concordance on blinded review. Following clinically informed post hoc review, concordance increased to 98%. pMRI was rated more favorably across all patient experience domains (<i>p</i> &lt; 0.001), and participants preferred pMRI (61%) over sMRI (14%) by a 4:1 ratio.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>In outpatient neurology practices, pMRI images demonstrated high clinical concordance with sMRI for identifying the presence or absence of structural brain abnormalities and were strongly preferred by patients. These findings support the use of pMRI as a practical point-of-care imaging tool for neurology patients, enabling timely access to structural neuroimaging during the clinical encounter.</p>\u0000 </section>\u0000 </div>","PeriodicalId":16399,"journal":{"name":"Journal of Neuroimaging","volume":"36 4","pages":""},"PeriodicalIF":2.5,"publicationDate":"2026-08-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jon.70143","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148784484","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Transcranial Ultrasound in the Helicopter Emergency Medical Services—A Feasibility Study","authors":"Ingrid N. Rognes,&nbsp;Pål C. W. Morberg,&nbsp;Henriette S. Jæger,&nbsp;Marius Rehn,&nbsp;Kristine Stø,&nbsp;Lars Alteheld,&nbsp;Else Charlotte Sandset,&nbsp;Maren R. Hov,&nbsp;Karianne Larsen","doi":"10.1111/jon.70145","DOIUrl":"https://doi.org/10.1111/jon.70145","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background and Purpose</h3>\u0000 \u0000 <p>Transcranial color-coded Doppler (TCCD) is a noninvasive, widely available diagnostic method that may identify large vessel occlusion (LVO) in acute stroke patients. This study aimed to explore whether helicopter emergency medical services (HEMS) physicians could use TCCD in a prehospital setting to identify the proximal segment of the middle cerebral artery (M1-MCA).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>In a feasibility study following brief training, three HEMS physicians and a single-reference examiner performed transtemporal TCCD examinations of four healthy volunteers, on ground and in flight a cruising helicopter. One color and one pulsed-wave Doppler image of M1-MCA were stored per examination, and time was recorded. TCCD images were retrospectively assessed by two raters for M1-MCA identification success and image quality, using a 5-point Likert scale.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Participants performed a total of 32 bilateral M1-MCA examinations. The HEMS physicians identified M1-MCA in 83% of color Doppler examinations, with median (interquartile range [IQR]) time of 83 (63–130) s. Substantial inter-examiner variability was observed. The single-reference examiner identified M1-MCA in 88% of color Doppler examinations using 58 (49–101) s. Median (IQR) Likert scores for successful images were high: HEMS physicians 4.5 (4.5–5.0) and single-reference examiner 5.0 (4.5–5.0), with no significant difference between on-ground and in-flight examinations.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Following brief training, HEMS physicians were able to perform TCCD field examinations of M1-MCA in healthy volunteers, with identification rates and image quality comparable to a single-reference examiner. Substantial inter-examiner variability was observed, highlighting the importance of tailored training and competency assessment. Research is required to evaluate TCCD use by HEMS physicians under real-world prehospital conditions.</p>\u0000 </section>\u0000 </div>","PeriodicalId":16399,"journal":{"name":"Journal of Neuroimaging","volume":"36 4","pages":""},"PeriodicalIF":2.5,"publicationDate":"2026-08-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jon.70145","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148784386","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Preclinical Evaluation of a Zotarolimus-Eluting Stent for Intracranial Application: A 30-Day Procedural Feasibility and Clinical Observation Canine Study","authors":"Ibrahim A. Bhatti,&nbsp;Fareed Jumah,&nbsp;Hatem Tolba,&nbsp;Hunter Brooks,&nbsp;Syed A. Gillani,&nbsp;Ravi Nunna,&nbsp;Inamullah Khan,&nbsp;Austin Rolfes,&nbsp;Bharathi Jagadeesan,&nbsp;Ameer E. Hassan,&nbsp;Adnan I. Qureshi,&nbsp;Farhan Siddiq","doi":"10.1111/jon.70141","DOIUrl":"10.1111/jon.70141","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background and Purpose</h3>\u0000 \u0000 <p>Zotarolimus-eluting stents (ZES) are increasingly used off-label for intracranial atherosclerotic disease (ICAD), yet foundational preclinical data evaluating procedural delivery and short-term vascular safety in cerebral anatomy is sparse. We evaluated the procedural feasibility and 30-day clinical safety of the Onyx Frontier ZES in a canine intracranial model.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>In a prospective study, 12 healthy canines on dual antiplatelet therapy underwent basilar artery implantation of a 2.0 × 8.0 mm Onyx Frontier ZES. Vertebral artery tortuosity was angiographically graded as Type I (mild), II (moderate), or III (severe). Endpoints focused on procedural success and 30-day clinical safety, monitored via angiography, serial neurological examinations, and clinical pathology.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Technical success was 100% (12/12) despite challenging anatomy (mean basilar artery diameter: 1.39 mm). Tortuosity distribution was 33.3% Type I, 58.3% Type II, and 8.3% Type III. Post-deployment angiographic narrowing consistent with transient vasospasm was observed in 7/12 animals, without flow limitation; with only one requiring intra-arterial verapamil for resolution. One instance (8.3%) of self-limiting contrast extravasation occurred at the distal basilar artery without long-term sequelae. At 30 days, there was 0% mortality and no procedure-related neurological adverse events. Serial clinical pathology panels demonstrated an absence of systemic organ toxicity or sustained systemic inflammation.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Implantation of the Onyx Frontier ZES is highly feasible in sub-2 mm, tortuous intracranial vessels. The platform demonstrated an excellent 30-day clinical safety profile, providing essential procedural and early clinical data to support future integrated regulatory evaluations for ICAD.</p>\u0000 </section>\u0000 </div>","PeriodicalId":16399,"journal":{"name":"Journal of Neuroimaging","volume":"36 4","pages":""},"PeriodicalIF":2.5,"publicationDate":"2026-08-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148706733","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Facial Nerve Thinning Correlates With Motor Function in Adults With Spinal Muscular Atrophy","authors":"Felipe Franco da Graça,&nbsp;Guilherme Soares de Oliveira Wertheimer,&nbsp;Thiago Junqueira Ribeiro de Rezende,&nbsp;Cristina Iwabe,&nbsp;Rodrigo de Holanda Mendonça,&nbsp;Edmar Zanoteli,&nbsp;Marcondes Cavalcante França-Jr","doi":"10.1111/jon.70142","DOIUrl":"https://doi.org/10.1111/jon.70142","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background and Purpose</h3>\u0000 \u0000 <p>Spinal muscular atrophy (SMA) leads to progressive lower motor neuron loss. While neurophysiological techniques such as CMAP and MUNIX indirectly estimate motor unit number, few imaging-based biomarkers exist. We aimed to assess whether MRI-derived facial nerve diameters distinguish adult SMA patients from controls and correlate with clinical status.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We conducted a cross-sectional study including 22 adult SMA patients (Types II/III) and 14 age and sex-matched healthy controls at a single center. All participants underwent 3T brain MRI with bFFE sequences. Diameters of facial nerves were measured bilaterally at their brainstem root entry zones. Clinical assessments included ambulation status, facial weakness, Hammersmith Functional Motor Scale Expanded (HFMSE), and Motor Function Measure (MFM-32).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>There were four patients with SMA Type II and 18 with type III. Median age was 31.5 years. Facial nerve diameters were significantly reduced in patients compared with controls (right: median 1.15 vs. 1.40 mm; left: 1.14 vs. 1.35 mm). Within patients, ambulant individuals showed larger facial diameters than non-ambulant ones. Patients with clinical facial weakness had markedly smaller diameters. Diameters correlated with MFM (<i>ρ</i> up to 0.65) and HFMSE (<i>ρ</i> up to 0.68), while the facial-to-trigeminal ratio correlated even more strongly (<i>ρ</i> up to 0.73). No associations were found with disease duration.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>In this exploratory study, facial nerve diameter and the facial-to-trigeminal ratio showed promising associations with motor function in adult SMA, including in patients without overt facial weakness. These easily measurable MRI parameters warrant further investigation as potential biomarkers of motor neuron involvement.</p>\u0000 </section>\u0000 </div>","PeriodicalId":16399,"journal":{"name":"Journal of Neuroimaging","volume":"36 4","pages":""},"PeriodicalIF":2.5,"publicationDate":"2026-07-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148616823","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}