Journal of Neuroimaging最新文献

{"title":"Neuroimaging Training Programs, Certification Pathways, and Credentialing Issues","authors":"Syeda Maria Muzammil,&nbsp;Yasaman Pirahanchi,&nbsp;Ammar Tarabichi,&nbsp;Joseph C. Masdeu","doi":"10.1111/jon.70049","DOIUrl":"https://doi.org/10.1111/jon.70049","url":null,"abstract":"<div>\u0000 \u0000 <p>Neurologists have a unique ability to interpret neuroimaging in conjunction with clinical context and disease pathology, making their role vital in accurate interpretation. Neuroimaging education is essential for enhancing these skills, typically provided through neurology residency programs and specialized neuroimaging fellowships. Neuroimaging training experience in neurology residency programs can be quite variable. Neurology residents typically gain substantial exposure to neuroimaging techniques through the sheer volume of cases they encounter during training, often under direct guidance of subspeciality neurologists. However, curriculum implementation and proper documentation of training often lacks consistency, and opportunities for advanced neuroimaging training are limited. The number of fellowship-trained neuroimaging specialists is insufficient to meet the growing demand for neuroimaging expertise. Credentialing and certification issues related to neuroimaging training for neurologists hinder the integration of qualified neurologists into the neuroimaging field. The need for additional years of specialized training, financial burden associated with maintaining certification, opposition by radiological societies, complexities of reimbursement which vary by insurer, region, and hospital policies are some of the challenges. This article explores these issues and suggests that solutions may include the establishment of more accredited neuroimaging fellowship programs or an increase in the neuroimaging component of subspecialty training, as well as addressing credentialing and hospital privileging issues.</p>\u0000 </div>","PeriodicalId":16399,"journal":{"name":"Journal of Neuroimaging","volume":"35 4","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144740536","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":"Multimodal Quantitative MRI Atlas of the Human Brain in Healthy Young Adults","authors":"Julia Pfirrmann,&nbsp;Anne Adlung,&nbsp;Ingo Hermann,&nbsp;Claudia E. Weber,&nbsp;Anne Ebert,&nbsp;Frank G. Zöllner,&nbsp;Achim Gass,&nbsp;Philipp Eisele","doi":"10.1111/jon.70074","DOIUrl":"https://doi.org/10.1111/jon.70074","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background and Purpose</h3>\u0000 \u0000 <p>Quantitative MRI provides insights into (patho-) physiological processes of the brain macro- and microstructure. In this study, we applied a multimodal MRI approach to determine quantitative values of the brain in healthy young adults.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>3 T MRI including sodium MRI (4.0 mm nominal isotropic resolution), 3D T1-weighted magnetization-prepared rapid acquisition gradient-echo (spatial resolution = 0.9 mm × 0.9 mm × 0.9 mm), T2-fluid attenuated inversion recovery (spatial resolution = 0.4 mm × 0.4 mm × 5.0 mm), diffusion-weighted imaging (spatial resolution = 1.0 mm × 1.0 mm × 4.0 mm), PD/T2 (spatial resolution = 1.0 mm × 1.0 mm × 2.0 mm), and MR fingerprinting including T1 and T2* relaxation times (spatial resolution = 1 mm × 1 mm × 2 mm) was performed on 40 healthy young adults (28 women, mean age: 24.55 years).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Mean values for the gray matter were as follows—apparent diffusion coefficient (ADC): 0.95 ± 0.03 × 10⁻³ mm²/s, total sodium concentration (TSC): 41.99 ± 2.35 mM, T1: 1338.04 ± 46.29 ms, T2*: 63.39 ± 2.94 ms. For the white matter, mean values were as follows—ADC: 0.79 ± 0.02 × 10⁻³ mm²/s, TSC: 36.08 ± 5.62 mM, T1: 968.47 ± 48.35 ms, T2*: 53.62 ± 8.06 ms, and for the deep gray matter, mean values were as follows—ADC: 0.85 ± 0.04 × 10⁻³ mm²/s, TSC: 38.23 ± 2.91 mM, T1: 1087.24 ± 39.77 ms, T2*: 54.53 ± 7.15.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Our multimodal, quantitative MRI atlas of the human brain in healthy young adults provides meaningful in vivo insights into the brain microstructure and can be used for reference in future studies.</p>\u0000 </section>\u0000 </div>","PeriodicalId":16399,"journal":{"name":"Journal of Neuroimaging","volume":"35 4","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-07-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jon.70074","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144705613","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":"Double Stent Retriever Mechanical Thrombectomy for Distal Medium Vessel Clots in the Middle Cerebral Artery: Initial Experience","authors":"José Carlos Méndez,&nbsp;Pedro Vega,&nbsp;Alfonso Lopez-Frías,&nbsp;Teresa Díaz,&nbsp;Josep Puig,&nbsp;Eduardo Murias,&nbsp;Jordi Blasco,&nbsp;Carlos Pérez-García,&nbsp;Víctor Maestro,&nbsp;Manuel Moreu,&nbsp;Marc Comas-Cufí,&nbsp;Antonio Cruz-Culebras,&nbsp;María Antonia Prieto,&nbsp;Isabel Bermúdez-Coronel,&nbsp;Javier Blázquez,&nbsp;Jaime Masjuán","doi":"10.1111/jon.70064","DOIUrl":"https://doi.org/10.1111/jon.70064","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background and Purpose</h3>\u0000 \u0000 <p>Mechanical thrombectomy (MT) is increasingly performed for distal medium vessel occlusions (DMVOs) of the anterior circulation in acute stroke patients. Although trials have not shown superiority over usual care, selected patients may still benefit from MT. The ideal endovascular technique is debated. We aimed to determine the safety and efficacy of double stent retriever MT (DSR-MT) for DMVOs.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We retrospective analyzed demographics, procedure characteristics, and clinical data from consecutive patients with acute primary DMVOs treated with DSR-MT at four comprehensive stroke centers. Reperfusion was defined by the extended Thrombolysis In Cerebral Infarction (eTICI) score. Clinical outcomes were measured by the National Institute of Health Stroke Scale (NIHSS) and modified Rankin scale (mRS) scores.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>We included 32 patients (median age, 78 years, interquartile range [IQR] 71–82; 16 [50%] female), of whom 26 (81.2%) had primary occlusion of the M2 segment of the middle cerebral artery and six (18.8%) had occlusion of M3. Clinical severity was moderate (median, NIHSS 13; IQR 10–15) in 24 patients (75%). First-pass effect (eTICI 2c/3) was achieved in 20 patients (62.5%). Final eTICI 2b/2c/3 was achieved in 30 patients (93.7%) and final eTICI 2c/3 in 25 (78.1%). Symptomatic intracranial hemorrhage developed in one patient (3.1%). Median NIHSS was 6 at 24 h (IQR 3–12) and 4 at discharge (IQR 1–9). At 90 days, 22 (73.3%) patients were functionally independent (mRS 0–2).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>This preliminary study found good efficacy and safety of DSR-MT for DMVOs in patients with M2 and M3 occlusions.</p>\u0000 </section>\u0000 </div>","PeriodicalId":16399,"journal":{"name":"Journal of Neuroimaging","volume":"35 4","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-07-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144666213","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":"A Radiomic Approach to Clinical MRI Refines the Thalamus-Cognition Link in Multiple Sclerosis","authors":"Korhan Buyukturkoglu,&nbsp;Lin Lu,&nbsp;Levi Davis,&nbsp;Renan E. Orellana,&nbsp;Charles C. White,&nbsp;Rongyi Sun,&nbsp;Sinem Ozcelik,&nbsp;Nina M. Isenstein,&nbsp;Kaho B. Onomichi,&nbsp;Rifat Iqbal,&nbsp;Binsheng Zhao,&nbsp;Yaakov Stern,&nbsp;Burcu Zeydan,&nbsp;Orhun H. Kantarci,&nbsp;Claire S. Riley,&nbsp;Philip L. De Jager","doi":"10.1111/jon.70069","DOIUrl":"https://doi.org/10.1111/jon.70069","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background and Purpose</h3>\u0000 \u0000 <p>Radiomics extracts imaging features that may not be detectable through conventional volumetric analyses. Given their role in multiple sclerosis (MS), we applied radiomics to thalamic nuclei and examined their associations with cognitive performance.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A total of 601 individuals were included (342 people with MS [PwMS] from two cohorts and 259 healthy controls [HC]). Radiomic features (RF) and volumes were extracted from the whole thalamus, five thalamic nuclei, and the putamen segmented on three-dimensional T1-weighted images. Cognitive performance was assessed using the Symbol Digit Modalities Test (SDMT) and Paced Auditory Serial Addition Test (PASAT) in PwMS and the Digit Symbol Substitution Test (DSST) in HC. In the first MS cohort, multivariate linear regression in a discovery set (<i>N</i> = 103) identified thalamus-derived RF associated with SDMT, which were retested in a replication set (<i>N</i> = 63). Their associations with PASAT in a second MS cohort (<i>N</i> = 176) and DSST in HC were also evaluated. We then tested whether the same RFs, when extracted from the putamen, was associated with SDMT. Least Absolute Shrinkage and Selection Operator (LASSO) models assessed the combined predictive value of RF and volumes.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Twenty-eight RF–region of interest (ROI) pairs were associated with SDMT in the replication set (false discovery rate [FDR] &lt; 0.05). Of these, 24 were also associated with PASAT (FDR ≤ 0.03), and 2 with DSST. Only ventral nuclei volume showed replicated associations among volumetrics. Only four putamen-derived pairs were associated with SDMT (FDR = 0.04). LASSO results confirmed RF outperformed volumes.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>RF extracted from the thalamus is strongly associated with cognitive performance in PwMS, outperforming volumetric measures and supporting their potential as sensitive imaging biomarkers.</p>\u0000 </section>\u0000 </div>","PeriodicalId":16399,"journal":{"name":"Journal of Neuroimaging","volume":"35 4","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-07-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144666214","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":"Association of Carotid Plaque Calcification Attenuation With Intraplaque Hemorrhage Volume: 3D-Segmentation Analysis","authors":"Jeremy Rubin,&nbsp;Quy Cao,&nbsp;Yu Sakai,&nbsp;Nathan Arnett,&nbsp;Huy Q. Phi,&nbsp;Andrew C. Hu,&nbsp;Brett L. Cucchiara,&nbsp;Daniel Bos,&nbsp;Luca Saba,&nbsp;Elias Johannson,&nbsp;Jarcy Zee,&nbsp;Jae W. Song","doi":"10.1111/jon.70071","DOIUrl":"https://doi.org/10.1111/jon.70071","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background and Purpose</h3>\u0000 \u0000 <p>Despite the high prevalence of plaque calcifications in carotid atherosclerosis, the association between morphologic and attenuation features of calcifications and intraplaque hemorrhage (IPH) remains unclear.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Calcific carotid plaques were identified on neck computed tomography angiographies (CTAs) from patients meeting criteria for embolic stroke of undetermined source. Plaque calcifications were manually segmented using 3D-Slicer to quantify features, including volume and attenuation (Hounsfield Units [HU]). IPH volume (IPHvol) was quantified using a semi-automated software. A linear mixed regression model evaluated associations between calcification features and IPHvol, adjusting for sex, age, and cardiovascular risk factors. An interaction term between calcification volume and attenuation was included after dichotomizing attenuation (&gt;924HU) and volume (&gt;30 millimeter [mm]³) as high versus low on the basis of median values.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>From 70 patients (median age 68 years, 50% female), 116 calcific plaques containing 269 plaque calcifications were analyzed. Adjusting for age, cardiovascular risk factors, and plaque calcification features, being female showed lower IPHvols compared to males (mean ratio 0.34, <i>p</i> = 0.002). A significant interaction between calcification volume and attenuation emerged (<i>p</i> = 0.042). Among plaques with low plaque calcification volumes, plaques with low-attenuation (&lt;924HU) calcifications showed 5.53 times higher IPHvols than plaques with high-attenuation calcifications (<i>p</i> = 0.003). Among plaques with high-attenuation calcifications, plaques with high volumes of these calcifications showed 4.40 times higher IPHvols compared to low-volumes of high-attenuation calcifications (<i>p</i> = 0.011).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Plaque calcification attenuation characteristics are associated with IPHvols. Understanding calcification patterns that correlate with IPH could enable clinicians to infer plaque instability from readily visible calcifications on CTA.</p>\u0000 </section>\u0000 </div>","PeriodicalId":16399,"journal":{"name":"Journal of Neuroimaging","volume":"35 4","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-07-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144615056","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":"Blood-Brain Barrier Dysfunction in Adults With Heart Failure","authors":"Bhaswati Roy,&nbsp;Xingfeng Shao,&nbsp;Kamlesh J. Jobanputra,&nbsp;Gregg C. Fonarow,&nbsp;Danny J. J. Wang,&nbsp;Mary Woo,&nbsp;Rajesh Kumar","doi":"10.1111/jon.70068","DOIUrl":"https://doi.org/10.1111/jon.70068","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background and Purpose</h3>\u0000 \u0000 <p>Heart failure (HF) patients show brain tissue injury in sites that mediate autonomic, cognitive, and mood dysfunctions that are linked with increased morbidity and mortality. The pathological mechanisms that may contribute to brain tissue injury in HF are unclear, but may include blood brain barrier (BBB) dysfunction.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We performed diffusion-weighted pseudo-continuous arterial spin labeling (DW-pCASL) in 27 HF and 59 controls to examine BBB, using a 3.0-Tesla MRI scanner, and assessed anxiety, depressive symptoms, and cognition. Using DW-pCASL data, arterial transit time (ATT, an index of large artery integrity) and water exchange rates across the BBB (Kw, an index of BBB function) maps were generated, normalized, smoothed, and compared between HF and controls, and correlated with cognition and mood.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Significantly increased mood deficits and reduced cognition appeared in HF over controls. Multiple brain areas, which are involved in mediating cognition and mood, showed altered Kw and ATT values in HF over controls. Increased Kw emerged in the insula, hippocampus, and cerebellum. ATT values decreased in the prefrontal cortices, cingulate, and cerebellum, and increased in a few sites in HF patients. Kw values from regions that are involved in mood and cognition functions showed significant associations with anxiety, depression, and cognition.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>HF patients show impaired BBB function and altered large artery integrity. BBB alterations may introduce neural damage to autonomic, mood, and cognitive regulatory areas, contributing to abnormal functions found in HF. The findings suggest a need to repair BBB function to rescue brain tissue and functions in this condition.</p>\u0000 </section>\u0000 </div>","PeriodicalId":16399,"journal":{"name":"Journal of Neuroimaging","volume":"35 4","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-07-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144550968","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":"Middle Longitudinal Fascicle Maldevelopment on Free Water Corrected MR Diffusion Underlies Language Impairment in Autism","authors":"Doudou Cao,&nbsp;Litong Ni,&nbsp;Qi Qi,&nbsp;Lan Zhou,&nbsp;Wei Zhang,&nbsp;Yi Wang,&nbsp;Li Zhu,&nbsp;Guolin Ma,&nbsp;Fan Zhang,&nbsp;Shijun Li","doi":"10.1111/jon.70067","DOIUrl":"https://doi.org/10.1111/jon.70067","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background and Purpose</h3>\u0000 \u0000 <p>The middle longitudinal fascicle (MdLF), a recently characterized white matter tract within the ventral language network, remains understudied in autism spectrum disorder (ASD). We hypothesized that altered microstructural development of the MdLF contributes to language impairment in children with ASD.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Free water corrected diffusion magnetic resonance imaging (MRI) tractography was employed to reconstruct the MdLF in 57 children with ASD (5.79±0.99 years) and 37 matched typically developing (TD) controls (5.99±1.38 years), aged 4–9 years. Language impairment was assessed using the Autism Behavior Checklist language subscale. General linear models and partial correlations (covarying age) were applied to investigate age-related differences of diffusion metrics and the correlation of diffusion metrics with language impairment in ASD.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Significant age-by-group interactions emerged for bilateral MdLF fractional anisotropy tissue (FA_t) (TD: left/right β = 0.614/0.511, <i>p</i> &lt; 0.01; ASD: <i>p</i> &gt; 0.05) and axial diffusivity tissue (AD_t) (ASD: left/right β = −0.458/−0.348, <i>p</i> &lt; 0.05; TD: <i>p</i> &gt; 0.05). In ASD, FA_t (<i>r</i> = −0.441, <i>p</i> &lt; 0.001) and AD_t (<i>r</i> = −0.28, <i>p</i> = 0.037) were negatively correlated with language impairment, while radial diffusivity tissue showed a positive correlation (<i>r</i> = 0.355, <i>p</i> = 0.007) in the right MdLF. There were no significant between-group differences found in diffusion metrics.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>The MdLF exhibits aberrant developmental trajectories in preschool children with ASD, and its microstructural integrity is linked to language impairment. These findings underscore the MdLF's role in ASD-related language deficits and highlight the importance of early neurodevelopmental assessment.</p>\u0000 </section>\u0000 </div>","PeriodicalId":16399,"journal":{"name":"Journal of Neuroimaging","volume":"35 4","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-07-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144551010","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":"Contact Aspiration Alone or Combined With Stent Retriever Thrombectomy for Middle Cerebral Artery Large Vessel Occlusion","authors":"Pedro Navia,&nbsp;Andres Fernandez-Prieto,&nbsp;Alberto Alvarez-Muelas,&nbsp;Ángel Calleja,&nbsp;Joaquin Ortega,&nbsp;Carlos Domínguez,&nbsp;Antonio Sagredo,&nbsp;Amado Rodríguez-Benítez,&nbsp;Juan García-Villanego,&nbsp;Alberto Martínez-Calvo,&nbsp;Daniel Cubillo-Prieto,&nbsp;Carmen de la Rosa,&nbsp;Antonio Mosqueira,&nbsp;Rebeca Bermejo-Garcés,&nbsp;Juan Chaviano,&nbsp;Isabel Bermúdez-Coronel,&nbsp;Carlos Pérez-García,&nbsp;Carlos Manuel Rodriguez-Paz,&nbsp;Carlos Hidalgo-Barranco,&nbsp;Javier Maynar,&nbsp;Jose Luis Caniego,&nbsp;Juan David Molina-Nuevo,&nbsp;Víctor Maestro,&nbsp;Juan Manuel Sanchís-García,&nbsp;Oscar Balboa,&nbsp;Mario Martínez-Galdamez,&nbsp;Eñaut Garmendia,&nbsp;Marc Comas-Cufí,&nbsp;Josep Puig,&nbsp;Joaquín Zamarro","doi":"10.1111/jon.70065","DOIUrl":"https://doi.org/10.1111/jon.70065","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background and Purpose</h3>\u0000 \u0000 <p>The effectiveness of a large-bore aspiration catheter for contact aspiration (CA) thrombectomy is compared to the combined use of an aspiration catheter and a stent retriever (CA+SR) for large vessel occlusion (LVO). We assessed the efficacy and safety of CA alone versus CA+SR as first-line treatment for middle cerebral artery (MCA) LVO in daily practice.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We retrospectively analyzed data from the SARA-3 registry of patients with MCA occlusion (M1 and M2 segments), dividing them into two groups: first-line CA alone and combined CA+SR. Demographic, clinical, angiographic, and clinical outcomes (National Institute of Health Stroke Scale score at 24 h and modified Rankin Scale [mRS] score at 3 months) were compared.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Of 551 patients, 348 (63.8%) received CA alone and 203 (36.8%) received CA+SR. The groin-to-reperfusion time was significantly shorter in the CA-alone group than in the combined CA+SR group (median, 26 vs. 40 min, <i>p</i> &lt; 0.001). The CA group demonstrated higher first-pass modified Thrombolysis In Cerebral Infarction (mTICI) 3 recanalization rates (47% vs. 37%; adjusted odds ratio [OR] 1.5 [confidence interval 1–2.1], <i>p</i> = 0.042), a higher final mTICI 3 rate (65% vs. 56%; OR 1.5 [1–2.2], <i>p</i> = 0.037), and fewer new territory embolisms (0.9% vs. 3.9%; OR 0.2 [0–0.8], <i>p</i> = 0.028) compared to the CA+SR group. The CA-alone group had better functional outcomes at 3 months (mRS ≤ 2, 77% vs. 63%; OR 1.9 [1.3–3], <i>p</i> = 0.003).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>CA alone outperformed CA+SR as a first-line treatment for MCA LVO, yielding higher first-pass and final recanalization rates, lower new territory embolism risk, shorter procedure times, and better functional outcomes at 3 months.</p>\u0000 </section>\u0000 </div>","PeriodicalId":16399,"journal":{"name":"Journal of Neuroimaging","volume":"35 4","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jon.70065","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144536927","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":"Conventional and Advanced Imaging Features of CNS Intravascular Lymphoma","authors":"Sunpob Cheewadhanaraks,&nbsp;Otto Rapalino","doi":"10.1111/jon.70061","DOIUrl":"https://doi.org/10.1111/jon.70061","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background and Purpose</h3>\u0000 \u0000 <p>Intravascular lymphoma (IVL) is a rare and aggressive lymphoma subtype that poses diagnostic challenges due to its nonspecific clinical presentation. This study aimed to evaluate the imaging findings of this disease in the CNS and to assess the diagnostic potential of advanced imaging techniques, including dynamic susceptibility contrast (DSC) perfusion, magnetic resonance spectroscopy (MRS), and fluorine-18 fluorodeoxyglucose (FDG) PET.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Twenty-one pathologically confirmed cases of IVL with CNS involvement were evaluated. Two cases underwent DSC perfusion, three underwent MRS, and three underwent FDG PET.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Ninety percent of patients had intracranial imaging findings. The most common imaging pattern on brain MRI was infarct-like lesions (68%), followed by mass-like enhancement and nonspecific white matter changes (11% each). The remaining findings included enhancing lesions without mass effect and a central pontine T2/fluid-attenuated inversion recovery hyperintensity, each observed in one patient. T2* imaging abnormalities were found in 60% of cases. Vascular irregularity on noninvasive angiographic imaging was observed in 30% of cases. Spinal intradural involvement was found in four cases (19%), including three cases with nerve root enhancement and one case with spinal cord infarction. MRS showed variable choline/creatine ratios elevation in two out of three cases. No cases showed apparent cerebral blood volume elevation on DSC perfusion or increased uptake on FDG PET.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Several imaging findings can be observed in CNS IVL, with infarct-like lesions being the most common. Awareness of these imaging features is crucial for the accurate diagnosis of this challenging entity.</p>\u0000 </section>\u0000 </div>","PeriodicalId":16399,"journal":{"name":"Journal of Neuroimaging","volume":"35 4","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144536925","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":"Tandem Cervical Internal Carotid Artery Hyperdensity Implies Stent Reocclusion on Post Thrombectomy Computed Tomography.","authors":"Alex Mortimer, Wedad Mohamed, Richard Flood, Sandeep Buddha","doi":"10.1111/jon.70077","DOIUrl":"https://doi.org/10.1111/jon.70077","url":null,"abstract":"<p><strong>Background and purpose: </strong>Acute tandem internal carotid artery (ICA) reocclusion after stenting as part of endovascular stroke treatment is recognized as a complication in a significant minority of patients, and this can be associated with neurological deterioration and worse functional outcomes. Non-contrast CT (NCCT) forms the basis of initial follow-up imaging in this setting. We aimed to assess the sensitivity and specificity of asymmetrical hyperdensity within the superior cervical ICA (HD-CICA) on cranial NCCT for tandem ICA reocclusion.</p><p><strong>Methods: </strong>This was a retrospective review of a prospectively acquired database (of cases performed January 2022-December 2024 inclusive) at a regional thrombectomy center. The frequency of HD-CICA on 12-24 h NCCT was compared to contemporaneous vascular imaging (CT angiography or carotid Doppler ultrasound) in patients with patent and reoccluded ICAs.</p><p><strong>Results: </strong>A total of 148 patients underwent thrombectomy with ICA stenting for tandem occlusion. Stent occlusion was associated with lower rates of early neurological improvement and reperfusion and higher rates of neurological deterioration. A total of 99 patients were acutely investigated for stent patency, and HD-CICA was assessable in 92. The frequency of HD-CICA with stent occlusion was 18/19 (94.7%) versus 0/73 (0%) in patent stents (p < 0.0001). HD-CICA was both a sensitive (18/19, 94.7%, 95% confidence interval: 74.0%-99.9%) and specific sign (73/73, 100%, 95% confidence interval: 95.1%-100%), with high positive and negative predictive value for stent reocclusion.</p><p><strong>Conclusion: </strong>HD-CICA on acute follow-up cranial NCCT is a reliable acute marker of tandem carotid reocclusion.</p>","PeriodicalId":16399,"journal":{"name":"Journal of Neuroimaging","volume":"35 4","pages":"e70077"},"PeriodicalIF":2.3,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144957646","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}