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Grading Right-to-Left Shunt With Transforaminal Doppler: A Valid Approach in Patients With Cryptogenic Stroke
IF 2.3 4区 医学
Journal of Neuroimaging Pub Date : 2025-02-06 DOI: 10.1111/jon.70023
Beatriz Martínez García, Juan Luis Chico García, Daniel Pérez Gil, Patricia Garay Albízuri, Ana Llanes Ferrer, Gabriel García Alcántara, Gloria Cabañas Engenios, María Consuelo Matute Lozano, Alicia De Felipe Mimbrera, Rocío Vera Lechuga, Antonio Cruz Culebras, Irene Carrión Sánchez, Covadonga Fernández-Golfín, Jaime Masjuan, Sebastián García Madrona
{"title":"Grading Right-to-Left Shunt With Transforaminal Doppler: A Valid Approach in Patients With Cryptogenic Stroke","authors":"Beatriz Martínez García,&nbsp;Juan Luis Chico García,&nbsp;Daniel Pérez Gil,&nbsp;Patricia Garay Albízuri,&nbsp;Ana Llanes Ferrer,&nbsp;Gabriel García Alcántara,&nbsp;Gloria Cabañas Engenios,&nbsp;María Consuelo Matute Lozano,&nbsp;Alicia De Felipe Mimbrera,&nbsp;Rocío Vera Lechuga,&nbsp;Antonio Cruz Culebras,&nbsp;Irene Carrión Sánchez,&nbsp;Covadonga Fernández-Golfín,&nbsp;Jaime Masjuan,&nbsp;Sebastián García Madrona","doi":"10.1111/jon.70023","DOIUrl":"https://doi.org/10.1111/jon.70023","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background and Purpose</h3>\u0000 \u0000 <p>Right-to-left shunt (RLS), usually related to a patent foramen ovale (PFO), is an important cause of cryptogenic stroke (CS) in young patients. Transcranial Doppler (TCD) with an agitated saline bubble study is a highly sensitive modality for RLS diagnosis using a transtemporal approach (TTD). However, a minority of patients have insufficient temporal bone windows. We aimed to evaluate the accuracy of transforaminal TCD (TFD) for RLS diagnosis.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We included patients with CS or transient ischemic attack who were tested in the standard protocol for RLS between March 2022 and February 2023. We evaluated the concordance of RLS grades between TFD and transesophageal echocardiogram (TEE) using the weighted kappa index. We also compared TTD and TFD approaches.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Forty patients were included (66.7% men; median age 49 years). Medium or large RLS were found in 28 patients (70%) with TTD and in 27 patients with TFD (67.5%). Through TEE, 19 (82.6%) medium or large PFO were confirmed, and a high agreement rate of 0.684 (<i>p</i> = 0.0003) was observed for grading RLS. Moreover, the agreement rate of RLS grade between TTD and TFD was 0.73 (<i>p</i> &lt; 0.0001).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>TFD is a valid approach for RLS diagnosis, with substantial concordance with TEE in grading RLS. Our study found a good grade of agreement between TFD and TEE. Therefore, the value of TCD goes beyond quantifying RLS and could assist in identifying the patients with the largest RLS, who would gain the greatest benefit from PFO closure.</p>\u0000 </section>\u0000 </div>","PeriodicalId":16399,"journal":{"name":"Journal of Neuroimaging","volume":"35 1","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-02-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143248885","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}
引用次数: 0
Factors Associated With Silent Brain Infarcts After Middle Cerebral Artery Stenting or Balloon Angioplasty
IF 2.3 4区 医学
Journal of Neuroimaging Pub Date : 2025-02-03 DOI: 10.1111/jon.70018
Kyubong Lee, Jeong Yoon Song, Hyunsun Oh, Taewoo Kim, Jun Young Chang, Dong-Wha Kang, Sun U. Kwon, Seon Moon Hwang, Joon Ho Choi, Boseong Kwon, Yunsun Song, Deok Hee Lee, Bum Joon Kim
{"title":"Factors Associated With Silent Brain Infarcts After Middle Cerebral Artery Stenting or Balloon Angioplasty","authors":"Kyubong Lee,&nbsp;Jeong Yoon Song,&nbsp;Hyunsun Oh,&nbsp;Taewoo Kim,&nbsp;Jun Young Chang,&nbsp;Dong-Wha Kang,&nbsp;Sun U. Kwon,&nbsp;Seon Moon Hwang,&nbsp;Joon Ho Choi,&nbsp;Boseong Kwon,&nbsp;Yunsun Song,&nbsp;Deok Hee Lee,&nbsp;Bum Joon Kim","doi":"10.1111/jon.70018","DOIUrl":"https://doi.org/10.1111/jon.70018","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background and Purpose</h3>\u0000 \u0000 <p>Silent brain infarcts (SBIs), which manifest as dot-like lesions on diffusion-weighted imaging (DWI) after endovascular procedures, are associated with an increased risk of stroke, dementia, and cognitive decline. We aimed to identify the factors associated with SBIs following middle cerebral artery (MCA) stenting or balloon angioplasty.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We retrospectively reviewed patients who underwent MCA stenting or balloon angioplasty, including those with symptomatic, atherosclerotic MCA stenosis of ≥50%. DWI scans were conducted before and after the procedure, and newly detected DWI lesions were classified as SBIs. We investigated the factors associated with the development of SBIs, and for patients with SBIs, we conducted a detailed analysis based on lesion location (cortex and perforator territory vs. cortex only vs. perforator territory only).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Among 120 patients, 64 (53.3%) exhibited SBIs postprocedure. Factors significantly associated with SBIs included smaller stenosis diameter (odd ratio [95% confidence interval] = 0.03 [0.002–0.35], <i>p</i> = 0.006), longer stenosis length (1.24 [1.02–1.51], <i>p</i> = 0.033), higher MCA tortuosity (1.20 [1.07–1.34], <i>p</i> = 0.002), and diffuse involvement of MCA stenosis (3.99 [1.17–13.62], <i>p</i> = 0.027). Among the patients who exhibited SBIs, D-dimer (<i>p</i> = 0.002), C-reactive protein (<i>p</i> = 0.026), and hemoglobin A1c (<i>p</i> = 0.025) differed according to detailed mechanism.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Stenosis diameter, stenosis length, and MCA tortuosity were significantly associated with the development of SBIs following MCA stenting.</p>\u0000 </section>\u0000 </div>","PeriodicalId":16399,"journal":{"name":"Journal of Neuroimaging","volume":"35 1","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-02-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143111317","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}
引用次数: 0
Resting-State Functional MRI Regional Homogeneity Correlates With Motor Scores in Parkinson's Disease
IF 2.3 4区 医学
Journal of Neuroimaging Pub Date : 2025-02-03 DOI: 10.1111/jon.70020
Wei Dai, Zhe Li, Hao Lin, Yaoyun Kuang, Hengxu Mao, Tingting Gan, Jiaqi Wang, Pingyi Xu, Hongyan Li
{"title":"Resting-State Functional MRI Regional Homogeneity Correlates With Motor Scores in Parkinson's Disease","authors":"Wei Dai,&nbsp;Zhe Li,&nbsp;Hao Lin,&nbsp;Yaoyun Kuang,&nbsp;Hengxu Mao,&nbsp;Tingting Gan,&nbsp;Jiaqi Wang,&nbsp;Pingyi Xu,&nbsp;Hongyan Li","doi":"10.1111/jon.70020","DOIUrl":"https://doi.org/10.1111/jon.70020","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background and Purpose</h3>\u0000 \u0000 <p>This study investigated the neural mechanisms underlying Parkinson's disease (PD) subtypes—tremor dominant (TD) and postural instability gait difficulty (PIGD)—by analyzing regional homogeneity (ReHo) values from resting-state functional MRI.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Fifty-nine PD patients (29 TD patients, 30 PIGD patients) and 30 healthy controls (HCs) were enrolled. ReHo values were analyzed via analysis of variance and a two-sample <i>t</i>-test, with age and sex as covariates. Correlations between ReHo values and clinical motor symptoms were also examined.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Distinct ReHo patterns were observed in patients with the PD subtypes and HCs. TD patients presented decreased ReHo in the cerebellar–thalamic–cortical circuit, whereas PIGD patients presented lower ReHo in the striatum and supplementary motor area (SMA). TD patients had higher ReHo in the bilateral dorsolateral superior frontal gyrus and SMA but lower ReHo in the bilateral medial orbital part of the superior frontal gyrus and other regions on the left than PIGD patients. Specific brain area ReHo values were correlated with tremor scores, PIGD scores, and rigidity scores.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Different motor subtypes of PD patients and HCs showed distinct ReHo patterns. ReHo correlation with clinical traits suggests its value as a biomarker for subtype-specific diagnostic strategies.</p>\u0000 </section>\u0000 </div>","PeriodicalId":16399,"journal":{"name":"Journal of Neuroimaging","volume":"35 1","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-02-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143111318","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}
引用次数: 0
Automation of Ultrasonographic Optic Nerve Sheath Diameter Measurement: A Scoping Review
IF 2.3 4区 医学
Journal of Neuroimaging Pub Date : 2025-01-24 DOI: 10.1111/jon.70017
César E. Escamilla-Ocañas, Noelia C. Morales-Cardona, Hersh Sagreiya, Alireza Akhbardeh, Mohammad I. Hirzallah
{"title":"Automation of Ultrasonographic Optic Nerve Sheath Diameter Measurement: A Scoping Review","authors":"César E. Escamilla-Ocañas,&nbsp;Noelia C. Morales-Cardona,&nbsp;Hersh Sagreiya,&nbsp;Alireza Akhbardeh,&nbsp;Mohammad I. Hirzallah","doi":"10.1111/jon.70017","DOIUrl":"10.1111/jon.70017","url":null,"abstract":"<div>\u0000 \u0000 <p>Intracranial pressure (ICP) monitoring is a cornerstone of neurocritical care in managing severe brain injury. However, current invasive ICP monitoring methods carry significant risks, including infection and intracranial hemorrhage, and are contraindicated in certain clinical situations. Additionally, these methods are not universally available. Optic nerve sheath diameter (ONSD) measurement presents a promising noninvasive alternative for ICP monitoring, though its clinical adoption has been limited due to its operator dependence and inconsistencies in imaging acquisition and measurement techniques. Automating both ONSD image acquisition and measurement could enhance accuracy and reliability, thereby improving its utility as a noninvasive ICP estimation tool. A range of image analysis and machine learning (ML) techniques have been applied to address these challenges. In this paper, we provide a narrative review of the current literature on ONSD automation, examining the strengths and limitations of classical image analysis and ML models in improving ONSD-based ICP assessment.</p>\u0000 </div>","PeriodicalId":16399,"journal":{"name":"Journal of Neuroimaging","volume":"35 1","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-01-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143033355","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}
引用次数: 0
Reliability of Central Vein Sign Imaging With 3T FLAIR* in a Multicenter Study 多中心研究中3T FLAIR*中心静脉征象成像的可靠性
IF 2.3 4区 医学
Journal of Neuroimaging Pub Date : 2025-01-21 DOI: 10.1111/jon.70011
Melissa Lynne Martin, Quy Cao, Elaina Luskin, Brian Renner, Lynn Daboul, Carly M. O'Donnell, Paulo Rodrigues, John Derbyshire, Christina J. Azevedo, Amit Bar-Or, Eduardo Caverzasi, Peter Calabresi, Bruce A. C. Cree, Léorah Freeman, Roland G. Henry, Erin E. Longbrake, Jiwon Oh, Nico Papinutto, Daniel Pelletier, Vesna Prchkovska, Marc Ramos, Rohini D. Samudralwar, Matthew K. Schindler, Elias S. Sotirchos, Nancy L. Sicotte, Andrew J. Solomon, Daniel S. Reich, Daniel Ontaneda, Russell T. Shinohara, Pascal Sati
{"title":"Reliability of Central Vein Sign Imaging With 3T FLAIR* in a Multicenter Study","authors":"Melissa Lynne Martin,&nbsp;Quy Cao,&nbsp;Elaina Luskin,&nbsp;Brian Renner,&nbsp;Lynn Daboul,&nbsp;Carly M. O'Donnell,&nbsp;Paulo Rodrigues,&nbsp;John Derbyshire,&nbsp;Christina J. Azevedo,&nbsp;Amit Bar-Or,&nbsp;Eduardo Caverzasi,&nbsp;Peter Calabresi,&nbsp;Bruce A. C. Cree,&nbsp;Léorah Freeman,&nbsp;Roland G. Henry,&nbsp;Erin E. Longbrake,&nbsp;Jiwon Oh,&nbsp;Nico Papinutto,&nbsp;Daniel Pelletier,&nbsp;Vesna Prchkovska,&nbsp;Marc Ramos,&nbsp;Rohini D. Samudralwar,&nbsp;Matthew K. Schindler,&nbsp;Elias S. Sotirchos,&nbsp;Nancy L. Sicotte,&nbsp;Andrew J. Solomon,&nbsp;Daniel S. Reich,&nbsp;Daniel Ontaneda,&nbsp;Russell T. Shinohara,&nbsp;Pascal Sati","doi":"10.1111/jon.70011","DOIUrl":"10.1111/jon.70011","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background and Purpose</h3>\u0000 \u0000 <p>The central vein sign (CVS) is a diagnostic imaging biomarker for multiple sclerosis (MS). FLAIR* is a combined MRI contrast that provides high conspicuity for CVS at 3 Tesla (3T), enabling its sensitive and accurate detection in clinical settings. This study evaluated whether CVS conspicuity of 3T FLAIR* is reliable across imaging sites and MRI vendors and whether gadolinium (Gd) contrast increases CVS conspicuity.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A cross-sectional, multicenter study recruited adults referred for possible diagnosis of MS at 10 sites. FLAIR* contrast was generated using high-resolution T2*-weighted (acquired pre- and post-injection of Gd) and T2-weighted fluid-attenuated inversion recovery (T2-FLAIR) brain images at 3T from two MRI vendors. Lesions and veins were segmented to compute lesion-to-vein contrast-to-noise ratio (CNR<sub>lesion-to-vein</sub>), a quantitative measure of CVS conspicuity. CNR<sub>lesion-to-vein</sub> measures for pre- and post-Gd FLAIR* were compared across sites and vendors.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Eighty-seven participants from nine sites were included in the analysis. There was no significant difference in mean CNR<sub>lesion-to-vein</sub> between sites for pre-Gd (<i>p</i>-value = 0.07) or post-Gd (<i>p</i>-value = 0.27) FLAIR*. There were also no significant differences between vendors for pre-Gd (<i>p</i>-value = 0.10) or post-Gd (<i>p</i>-value = 0.31) FLAIR*. Patient-level pairwise differences in CNR<sub>lesion-to-vein</sub> between pre-Gd and post-Gd FLAIR* revealed a significant increase for post-Gd FLAIR* (<i>p</i>-value &lt; 0.001).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>CVS conspicuity on 3T FLAIR* is consistent across imaging sites and MRI vendors. Moreover, Gd-based contrast agent significantly improved CVS conspicuity on 3T FLAIR*. These findings support the implementation of FLAIR* in clinical settings for MS.</p>\u0000 </section>\u0000 </div>","PeriodicalId":16399,"journal":{"name":"Journal of Neuroimaging","volume":"35 1","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-01-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143006945","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}
引用次数: 0
Larger Perfusion Mismatch Volume Is Associated With Longer Hospital Length of Stay in Medium Vessel Occlusion Stroke 灌注错配量越大,中等血管闭塞卒中患者住院时间越长。
IF 2.3 4区 医学
Journal of Neuroimaging Pub Date : 2025-01-21 DOI: 10.1111/jon.70015
Janet Mei, Hamza Adel Salim, Dhairya A. Lakhani, Aneri Balar, Vaibhav Vagal, Manisha Koneru, Dylan Wolman, Risheng Xu, Victor Urrutia, Elisabeth Breese Marsh, Benjamin Pulli, Meisam Hoseinyazdi, Licia Luna, Francis Deng, Nathan Z. Hyson, Mona Bahouth, Adam A. Dmytriw, Adrien Guenego, Gregory W Albers, Hanzhang Lu, Kambiz Nael, Argye E. Hillis, Raf Llinas, Max Wintermark, Tobias D. Faizy, Jeremy J. Heit, Vivek Yedavalli
{"title":"Larger Perfusion Mismatch Volume Is Associated With Longer Hospital Length of Stay in Medium Vessel Occlusion Stroke","authors":"Janet Mei,&nbsp;Hamza Adel Salim,&nbsp;Dhairya A. Lakhani,&nbsp;Aneri Balar,&nbsp;Vaibhav Vagal,&nbsp;Manisha Koneru,&nbsp;Dylan Wolman,&nbsp;Risheng Xu,&nbsp;Victor Urrutia,&nbsp;Elisabeth Breese Marsh,&nbsp;Benjamin Pulli,&nbsp;Meisam Hoseinyazdi,&nbsp;Licia Luna,&nbsp;Francis Deng,&nbsp;Nathan Z. Hyson,&nbsp;Mona Bahouth,&nbsp;Adam A. Dmytriw,&nbsp;Adrien Guenego,&nbsp;Gregory W Albers,&nbsp;Hanzhang Lu,&nbsp;Kambiz Nael,&nbsp;Argye E. Hillis,&nbsp;Raf Llinas,&nbsp;Max Wintermark,&nbsp;Tobias D. Faizy,&nbsp;Jeremy J. Heit,&nbsp;Vivek Yedavalli","doi":"10.1111/jon.70015","DOIUrl":"10.1111/jon.70015","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background and purpose</h3>\u0000 \u0000 <p>Prolonged length of stay (LOS) following a stroke is associated with unfavorable clinical outcomes. Factors predicting LOS in medium vessel occlusion (MeVO), impacting up to 40% of acute ischemic stroke (AIS) cases, remain underexplored. This study aims to investigate the predictors of LOS in AIS-MeVO.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We conducted a retrospective analysis of prospectively maintained stroke databases, comprising AIS cases with MeVO in the anterior circulation, assessed by adequate CT perfusion (CTP). Baseline and clinical data were obtained from electronic health records. Alberta Stroke Program Early CT Scores (ASPECTS) were calculated from non-contrast head CT. The perfusion mismatch volume (time to maximum &gt; 6 s minus relative cerebral blood flow &lt;30%) volume was reported from CTP. Multiple regression was employed to examine the relationship between baseline parameters and hospital LOS.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A total of 133 patients (median age 71 [interquartile range 63–80] years, 59.4% females) were included in the study cohort. The perfusion mismatch volume significantly positively correlated with LOS (<i>r</i> = 0.264, <i>p</i> = 0.004). After adjusting for age, sex, hypertension, diabetes, prior stroke or transient ischemic attack, admission NIHSS, ASPECTS, Tan score, intravenous thrombolysis, mechanical thrombectomy (MT), and hemorrhagic transformation, a larger mismatch volume remained independently associated with longer hospital stays (<i>β</i> = 0.209, 95% confidence interval [CI] 0.006–0.412, <i>p</i> = 0.045). Additional significant determinants of longer hospital stay included admission NIHSS (<i>β</i> = 0.250, 95% CI: 0.060–0.440, <i>p</i> = 0.010) and MT (<i>β</i> = 0.208, 95% CI: 0.006–0.410, <i>p</i> = 0.044). Among patients who underwent MT (<i>n</i> = 83), multiple regression analysis incorporating both perfusion mismatch volume and admission NIHSS revealed that perfusion mismatch volume remained independently associated with LOS (<i>β</i> = 0.248, 95% CI: 0.019–0.471, <i>p</i> = 0.033), while admission NIHSS did not retain significance (<i>β</i> = 0.208, 95% CI: 0.019–0.433, <i>p</i> = 0.071).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>In our cohort of AIS patients with MeVO in the anterior circulation, and particularly in those who underwent MT, the perfusion mismatch volume serves as an independent predictor of LOS. These findings offer critical valuable insights in clinical assessments and decision-making protocols of MT in AIS-MeVO.</p>\u0000 </section>\u0000 </div>","PeriodicalId":16399,"journal":{"name":"Journal of Neuroimaging","volume":"35 1","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-01-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143006919","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}
引用次数: 0
High-Field-Blinded Assessment of Portable Ultra-Low-Field Brain MRI for Multiple Sclerosis 便携式超低场脑MRI对多发性硬化症的高场盲法评估。
IF 2.3 4区 医学
Journal of Neuroimaging Pub Date : 2025-01-15 DOI: 10.1111/jon.70005
Serhat V. Okar, Govind Nair, Karan D. Kawatra, Ashley A. Thommana, Corinne A. Donnay, María I. Gaitán, Joel M. Stein, Daniel S. Reich
{"title":"High-Field-Blinded Assessment of Portable Ultra-Low-Field Brain MRI for Multiple Sclerosis","authors":"Serhat V. Okar,&nbsp;Govind Nair,&nbsp;Karan D. Kawatra,&nbsp;Ashley A. Thommana,&nbsp;Corinne A. Donnay,&nbsp;María I. Gaitán,&nbsp;Joel M. Stein,&nbsp;Daniel S. Reich","doi":"10.1111/jon.70005","DOIUrl":"10.1111/jon.70005","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background and Purpose</h3>\u0000 \u0000 <p>MRI is crucial for multiple sclerosis (MS), but the relative value of portable ultra-low field MRI (pULF-MRI), a technology that holds promise for extending access to MRI, is unknown. We assessed white matter lesion (WML) detection on pULF-MRI compared to high-field MRI (HF-MRI), focusing on blinded assessments, assessor self-training, and multiplanar acquisitions.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Fifty-five adults with MS underwent pULF-MRI following their HF-MRI. Two neuroradiologists independently assessed pULF-MRI images in an evaluation process, including initial assessment blinded to HF-MRI, self-training with reference to HF-MRI and evaluation of 20 cases with additional T2-fluid-attenuated inversion recovery in an additional plane. A third rater conducted cross-referenced analysis with HF-MRI data to determine true-positive lesions, false-positive areas, and case-level sensitivity and positive predictive value.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The mean age of participants was 50 years (standard deviation: 11; 74% women). Initially, Rater 2 marked more false-positive areas than Rater 1 (<i>p</i> = 0.003). After self-training, both raters embraced a conservative approach, with Rater 2 marking fewer false-positive areas (<i>p</i> = 0.01). Both raters maintained 100% case-level sensitivity and positive predictive value for detecting at least one WML, particularly in periventricular areas. Multiplanar acquisitions reduced both false-positive areas and true-positive lesions. True-positive lesions and false-positive areas had similar contrast-to-noise ratios in the juxtacortical region (<i>p</i> = 0.73) but not in periventricular, deep parenchymal regions (<i>p</i> = 0.004, <i>p</i> = 0.01).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>With adequate training, radiological interpretation of pULF-MRI has high sensitivity and positive predictive value for MS lesions but should be approached conservatively. These results suggest utility for patient triage, potentially reducing diagnostic delay, and screening high-risk individuals.</p>\u0000 </section>\u0000 </div>","PeriodicalId":16399,"journal":{"name":"Journal of Neuroimaging","volume":"35 1","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-01-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11735652/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143006898","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}
引用次数: 0
Factors Associated With Prolonged Venous Transit in Large Vessel Occlusion Acute Ischemic Strokes 大血管闭塞性急性缺血性脑卒中患者静脉流经时间延长的相关因素
IF 2.3 4区 医学
Journal of Neuroimaging Pub Date : 2025-01-14 DOI: 10.1111/jon.70006
Hamza Adel Salim, Dhairya A. Lakhani, Aneri B. Balar, Janet Mei, Licia Luna, Mona Shahriari, Nathan Z. Hyson, Francis Deng, Adam A. Dmytriw, Adrien Guenego, Victor C. Urrutia, Elisabeth B. Marsh, Hanzhang Lu, Risheng Xu, Rich Leigh, Gaurang Shah, Sijin Wen, Gregory W. Albers, Argye E. Hillis, Rafael Llinas, Kambiz Nael, Max Wintermark, Jeremy J. Heit, Tobias D. Faizy, Vivek S. Yedavalli
{"title":"Factors Associated With Prolonged Venous Transit in Large Vessel Occlusion Acute Ischemic Strokes","authors":"Hamza Adel Salim,&nbsp;Dhairya A. Lakhani,&nbsp;Aneri B. Balar,&nbsp;Janet Mei,&nbsp;Licia Luna,&nbsp;Mona Shahriari,&nbsp;Nathan Z. Hyson,&nbsp;Francis Deng,&nbsp;Adam A. Dmytriw,&nbsp;Adrien Guenego,&nbsp;Victor C. Urrutia,&nbsp;Elisabeth B. Marsh,&nbsp;Hanzhang Lu,&nbsp;Risheng Xu,&nbsp;Rich Leigh,&nbsp;Gaurang Shah,&nbsp;Sijin Wen,&nbsp;Gregory W. Albers,&nbsp;Argye E. Hillis,&nbsp;Rafael Llinas,&nbsp;Kambiz Nael,&nbsp;Max Wintermark,&nbsp;Jeremy J. Heit,&nbsp;Tobias D. Faizy,&nbsp;Vivek S. Yedavalli","doi":"10.1111/jon.70006","DOIUrl":"10.1111/jon.70006","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background and Purpose</h3>\u0000 \u0000 <p>Prolonged venous transit (PVT), derived from computed tomography perfusion (CTP) time-to-maximum (<i>T</i><sub>max</sub>) maps, reflects compromised venous outflow (VO) in acute ischemic stroke due to large vessel occlusion (AIS-LVO). Poor VO is associated with worse clinical outcomes, but pre-treatment markers predictive of PVT are not well described.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We conducted a retrospective analysis of 189 patients with anterior circulation AIS-LVO who underwent baseline CT evaluation, including non-contrast CT, CT angiography, and CTP. PVT was assessed on <i>T</i><sub>max</sub> maps; PVT+ was defined as <i>T</i><sub>max</sub> ≥ 10 s within the posterior superior sagittal sinus or torcula. Baseline clinical data were collected. Multivariable logistic regression identified independent associations between pre-treatment markers and PVT.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>PVT+ was identified in 65 patients (34%). In multivariable analysis, higher admission National Institutes of Health Stroke Scale (NIHSS) scores (adjusted odds ratio [aOR], 1.05 per point; 95% confidence interval [CI], 1.01–1.11; <i>P</i>  =  0.028) and male sex (aOR, 1.98; 95% CI, 1.03–3.89; <i>P</i>  =  0.043) were independently associated with PVT+.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Higher admission NIHSS scores and male sex are independently associated with PVT in anterior circulation AIS-LVO, suggesting that readily available clinical markers may help identify patients with poor VO profiles.</p>\u0000 </section>\u0000 </div>","PeriodicalId":16399,"journal":{"name":"Journal of Neuroimaging","volume":"35 1","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-01-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142983123","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}
引用次数: 0
Poststroke Translocator Protein Expression Dynamics and Correlations to Chronic Infarction: A [123I]-CLINDE-SPECT Study
IF 2.3 4区 医学
Journal of Neuroimaging Pub Date : 2025-01-13 DOI: 10.1111/jon.70002
Per Jensen, Brice Ozenne, Per Meden, Ling Feng, Gerda Thomsen, Lars Knudsen, Henrik Steglich-Arnholm, Kirsten Møller, Carsten Thomsen, Claus Svarer, Vincent Beliveau, Jens Mikkelsen, Gitte Knudsen, Lars H Pinborg
{"title":"Poststroke Translocator Protein Expression Dynamics and Correlations to Chronic Infarction: A [123I]-CLINDE-SPECT Study","authors":"Per Jensen,&nbsp;Brice Ozenne,&nbsp;Per Meden,&nbsp;Ling Feng,&nbsp;Gerda Thomsen,&nbsp;Lars Knudsen,&nbsp;Henrik Steglich-Arnholm,&nbsp;Kirsten Møller,&nbsp;Carsten Thomsen,&nbsp;Claus Svarer,&nbsp;Vincent Beliveau,&nbsp;Jens Mikkelsen,&nbsp;Gitte Knudsen,&nbsp;Lars H Pinborg","doi":"10.1111/jon.70002","DOIUrl":"10.1111/jon.70002","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background and Purpose</h3>\u0000 \u0000 <p>This study aims to investigate the longitudinal changes in translocator protein (TSPO) following stroke in different brain regions and potential associations with chronic brain infarction.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Twelve patients underwent SPECT using the TSPO tracer 6-Chloro-2-(4ʹ-123I-Iodophenyl)-3-(<i>N</i>,<i>N</i>-Diethyl)-Imidazo[1,2-a]Pyridine-3-Acetamide, as well as structural MRI, at 10, 41, and 128 days (median) after ischemic infarction in the middle cerebral artery. TSPO expression was measured in lesional (MRI lesion and SPECT lesion), connected (pons and ipsilesional thalamus), and nonconnected (ipsilesional cerebellum and contralesional occipital cortex) regions. Correlations were explored between the volume of chronic infarction and TSPO expression in nonconnected regions of interest (ROIs) at 128 days</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Throughout the study period, TSPO levels decreased by 24%–33% in lesional ROIs, while levels increased in connected ROIs by 35%–69% and in nonconnected ROIs by 53%–77%. At 128 days poststroke, TSPO expression in ipsilesional cerebellum positively correlated with chronic infarction volume (<i>p</i> = 0.001, <i>r</i><sup>2</sup> = 0.78).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>This study expands the current knowledge of spatial and temporal TSPO expression in humans by quantifying TSPO changes in lesional, connected, and nonconnected brain regions at three time points after cerebral infarction as well as correlating late-stage TSPO upregulation and chronic infarction volume.</p>\u0000 \u0000 <p>[Correction added on January 29, 2025, after first online publication: The p and r2 values in the results section of the abstract have been corrected in this version].</p>\u0000 </section>\u0000 </div>","PeriodicalId":16399,"journal":{"name":"Journal of Neuroimaging","volume":"35 1","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-01-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11726615/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143056051","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}
引用次数: 0
Utilizing Quantitative Analysis of CSF Volume from Clinical T1-Weighted MRI to Predict Thrombectomy Outcomes 利用临床t1加权MRI对脑脊液体积的定量分析预测取栓结果。
IF 2.3 4区 医学
Journal of Neuroimaging Pub Date : 2025-01-13 DOI: 10.1111/jon.70013
Mohammad I. Kawas, Ahmad Shamulzai, Kyle M. Atcheson, Alex C. Horn, Renate Ma, Carol Kittel, Brian Curry, Megan Lipford, Jeongchul Kim, Kiran K. Solingapuram Sai, Stacey Q. Wolfe, Christopher T. Whitlow
{"title":"Utilizing Quantitative Analysis of CSF Volume from Clinical T1-Weighted MRI to Predict Thrombectomy Outcomes","authors":"Mohammad I. Kawas,&nbsp;Ahmad Shamulzai,&nbsp;Kyle M. Atcheson,&nbsp;Alex C. Horn,&nbsp;Renate Ma,&nbsp;Carol Kittel,&nbsp;Brian Curry,&nbsp;Megan Lipford,&nbsp;Jeongchul Kim,&nbsp;Kiran K. Solingapuram Sai,&nbsp;Stacey Q. Wolfe,&nbsp;Christopher T. Whitlow","doi":"10.1111/jon.70013","DOIUrl":"10.1111/jon.70013","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background and Purpose</h3>\u0000 \u0000 <p>Endovascular thrombectomy (EVT) is the standard for acute ischemic stroke from large vessel occlusion, but post-EVT functional independence varies. Brain atrophy, linked to higher cerebrospinal fluid volume (CSFV), may affect outcomes. Baseline CSFV could predict EVT benefit by assessing brain health. We aimed to quantify total CSFV from clinical T1-weighted (w) magnetic resonance imaging (MRI) to assess global brain atrophy and its association with functional outcomes following successful EVT.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We performed a retrospective analysis of patients achieving thrombolysis-in-cerebral-infarction ≥2b revascularization via prospectively maintained single-institution stroke thrombectomy registry (<i>n</i> = 432) between 2015 and 2021. We included 214 patients (mean age 67.5 ± 14.6, 49% female) with acceptable quality MRI within 14 days of EVT and available modified Rankin-scale (mRS) at 90 days post EVT. Clinical T1w images were transformed into high-resolution images using the convolutional neural-network SynthSR. FreeSurfer software was then used to estimate total cranial CSFV. To correct for head size, percentage of CSFV to intracranial volume was used.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Baseline CSFV% significantly predicted 90-day mRS in an ordinal regression model adjusted for baseline mRS (<i>p </i>&lt; 0.001). Further modeling was performed to account for age, sex, 24-h National-Institutes-Health-Stroke-Scale (NIHSS), smoking history, prior stroke, hypertension, congestive heart failure, hemoglobin-A1c, atrial fibrillation, and Alberta-Stroke-Program-Early-CT-Score (ASPECTS). Total CSFV% remained an independent predictor of 90-day mRS (<i>p</i> = 0.012). CSFV% did not significantly predict the occurrence of any type of hemorrhagic transformation in a logistic regression model.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Increased CSFV% correlates with poorer functional outcomes post EVT. Total CSFV% may serve as a useful imaging biomarker for clinicians determining patient prognostication prior to EVT.</p>\u0000 </section>\u0000 </div>","PeriodicalId":16399,"journal":{"name":"Journal of Neuroimaging","volume":"35 1","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-01-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142971273","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}
引用次数: 0
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