NeuroradiologyPub Date : 2024-10-01Epub Date: 2024-07-03DOI: 10.1007/s00234-024-03418-8
Rahul Lakshmanan, Fariza Abu Hassan, Shashini Dissanayake, Harriet Crabtree, Aden McLaughlin, Matthew Cooper, Sharon Lee, Richard Warne, Peter Shipman
{"title":"Widespread haemorrhages in infants post-shunting (WHIPS): clinical features, risk factors and neuroimaging characteristics of a rare and under-recognised phenomenon.","authors":"Rahul Lakshmanan, Fariza Abu Hassan, Shashini Dissanayake, Harriet Crabtree, Aden McLaughlin, Matthew Cooper, Sharon Lee, Richard Warne, Peter Shipman","doi":"10.1007/s00234-024-03418-8","DOIUrl":"10.1007/s00234-024-03418-8","url":null,"abstract":"<p><strong>Purpose: </strong>Infants undergoing CSF shunting procedures face a rare complication which we propose to rename \"Widespread Haemorrhages in Infants Post-Shunting\" (WHIPS) to better capture this unique phenomenon specific to infants undergoing CSF diversion. Our objective is to analyse the risk factors for WHIPS development and provide a detailed neuroradiological description of these haemorrhages.</p><p><strong>Materials and methods: </strong>A radiology information system (RIS) was searched using the search terms \"shunt\" and/or \"catheter\" and/or \"drain\" and/or \"ventriculoperitoneal\" and/or \"VP\" between September 2008 to January 2021 for patients < 12 months of age. Clinical data was compiled for each patient meeting the inclusion criteria. Included cases were reviewed by three radiologists for the presence of WHIPS with calculation of the bifrontal ratio and documenting haemorrhage number, morphology, location and lobar distribution.</p><p><strong>Results: </strong>51 patients met inclusion criteria, 8 WHIPS patients and 43 controls. There was a statistically significant correlation between a larger post-op head circumference and WHIPS (p = 0.04). WHIPS was associated with post-haemorrhagic hydrocephalus and post-infectious hydrocephalus (p = 0.009). WHIPS were identified in the cortico-subcortical regions, periventricular white matter, and deep white matter. Haemorrhages were either punctate, ovoid or confluent. Haemorrhages ranged from single to innumerable.</p><p><strong>Conclusions: </strong>WHIPS represent a rare and under-recognised complication of CSF shunting unique to the infantile population. We postulate deep and superficial medullary venous haemorrhage as an underlying mechanism related to disordered intracranial hydrodynamics which are exacerbated in the infantile population due to underdeveloped arachnoid granulations and a compliant skull.</p>","PeriodicalId":19422,"journal":{"name":"Neuroradiology","volume":null,"pages":null},"PeriodicalIF":2.4,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11424702/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141492890","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
NeuroradiologyPub Date : 2024-10-01Epub Date: 2024-05-08DOI: 10.1007/s00234-024-03372-5
Chiara Gaudino, Andrea Cassoni, Martina Lucia Pisciotti, Resi Pucci, Angela Palma, Nicoletta Fantoni, Patrizia Pantano, Valentino Valentini
{"title":"MR-Neurography of the facial nerve in parotid tumors: intra-parotid nerve visualization and surgical correlation.","authors":"Chiara Gaudino, Andrea Cassoni, Martina Lucia Pisciotti, Resi Pucci, Angela Palma, Nicoletta Fantoni, Patrizia Pantano, Valentino Valentini","doi":"10.1007/s00234-024-03372-5","DOIUrl":"10.1007/s00234-024-03372-5","url":null,"abstract":"<p><strong>Purpose: </strong>One of the most severe complications in surgery of parotid tumors is facial palsy. Imaging of the intra-parotid facial nerve is challenging due to small dimensions. Our aim was to assess, in patients with parotid tumors, the ability of high-resolution 3D double-echo steady-state sequence with water excitation (DE3D-WE) (1) to visualize the extracranial facial nerve and its tracts, (2) to evaluate their relationship to the parotid lesion and (3) to compare MRI and surgical findings.</p><p><strong>Methods: </strong>A retrospective study was conducted including all patients with parotid tumors, who underwent MRI from April 2022 to December 2023. Two radiologists independently reviewed DE3D-WE images, assessing quality of visualization of the facial nerve bilaterally and localizing the nerve's divisions in relation to the tumor. MRI data were compared with surgical findings.</p><p><strong>Results: </strong>Forty consecutive patients were included (M:F = 22:18; mean age 56.3 ± 17.4 years). DE3D-WE could excellently visualize the nerve main trunk and the temporofacial division in all cases. The cervicofacial branch was visible in 99% of cases and visibility was good. Distal divisions were displayed in 34% of cases with a higher visibility on the tumor side (p < 0.05). Interrater agreement was high (weighted kappa 0.94 ± 0.01 [95% CI 0.92-0.97]). Compared to surgery accuracy of MRI in localizing the nerve was 100% for the main trunk, 96% for the temporofacial and 89% for the cervicofacial branches.</p><p><strong>Conclusions: </strong>Facial nerve MR-neurography represents a reliable tool. DE3D-WE can play an important role in surgical planning of patients with parotid tumors, reducing the risk of nerve injury.</p>","PeriodicalId":19422,"journal":{"name":"Neuroradiology","volume":null,"pages":null},"PeriodicalIF":2.4,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140876967","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Isolated cerebellar stroke in a paediatric patient with typical haemolytic uraemic syndrome: a case report and literature review.","authors":"Manuela Lo Bianco, Sergio Rinella, Felice D'Arco, Evangelia Ioannidou, Marios Kaliakatsos","doi":"10.1007/s00234-024-03407-x","DOIUrl":"10.1007/s00234-024-03407-x","url":null,"abstract":"<p><p>Haemolytic Uraemic Syndrome (HUS) is a rare medical condition characterised by microangiopathic haemolytic anaemia, thrombocytopenia, and acute kidney injury. Neurological complications are documented but rarely involve the cerebellum. We present a unique case of a 23-month-old male with HUS triggered by Escherichia coli-O157 (E.coli-O157) infection leading to an isolated cerebellar stroke.The patient initially presented with fever, bloody stools, and seizures. Confirmation of E.coli-O157 infection was obtained, and MRI revealed an isolated cerebellar stroke. Treatment included supportive care, anticoagulation for a right atrial thrombus, with gradual improvement observed.This case highlights the unusual occurrence of isolated cerebellar stroke in HUS patients, emphasising the importance of promptly recognizing manifestations of the central nervous system and the necessity for a multidisciplinary approach. Finally, a comprehensive literature review was conducted to identify cases of HUS patients with cerebellar involvement.</p>","PeriodicalId":19422,"journal":{"name":"Neuroradiology","volume":null,"pages":null},"PeriodicalIF":2.4,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11424696/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141458384","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Fully automated segmentation and volumetric measurement of ocular adnexal lymphoma by deep learning-based self-configuring nnU-net on multi-sequence MRI: a multi-center study.","authors":"Guorong Wang, Bingbing Yang, Xiaoxia Qu, Jian Guo, Yongheng Luo, Xiaoquan Xu, Feiyun Wu, Xiaoxue Fan, Yang Hou, Song Tian, Sicong Huang, Junfang Xian","doi":"10.1007/s00234-024-03429-5","DOIUrl":"10.1007/s00234-024-03429-5","url":null,"abstract":"<p><strong>Purpose: </strong>To evaluate nnU-net's performance in automatically segmenting and volumetrically measuring ocular adnexal lymphoma (OAL) on multi-sequence MRI.</p><p><strong>Methods: </strong>We collected T1-weighted (T1), T2-weighted and T1-weighted contrast-enhanced images with/without fat saturation (T2_FS/T2_nFS, T1c_FS/T1c_nFS) of OAL from four institutions. Two radiologists manually annotated lesions as the ground truth using ITK-SNAP. A deep learning framework, nnU-net, was developed and trained using two models. Model 1 was trained on T1, T2, and T1c, while Model 2 was trained exclusively on T1 and T2. A 5-fold cross-validation was utilized in the training process. Segmentation performance was evaluated using the Dice similarity coefficient (DSC), sensitivity, and positive prediction value (PPV). Volumetric assessment was performed using Bland-Altman plots and Lin's concordance correlation coefficient (CCC).</p><p><strong>Results: </strong>A total of 147 patients from one center were selected as training set and 33 patients from three centers were regarded as test set. For both Model 1 and 2, nnU-net demonstrated outstanding segmentation performance on T2_FS with DSC of 0.80-0.82, PPV of 84.5-86.1%, and sensitivity of 77.6-81.2%, respectively. Model 2 failed to detect 19 cases of T1c, whereas the DSC, PPV, and sensitivity for T1_nFS were 0.59, 91.2%, and 51.4%, respectively. Bland-Altman plots revealed minor tumor volume differences with 0.22-1.24 cm<sup>3</sup> between nnU-net prediction and ground truth on T2_FS. The CCC were 0.96 and 0.93 in Model 1 and 2 for T2_FS images, respectively.</p><p><strong>Conclusion: </strong>The nnU-net offered excellent performance in automated segmentation and volumetric assessment in MRI of OAL, particularly on T2_FS images.</p>","PeriodicalId":19422,"journal":{"name":"Neuroradiology","volume":null,"pages":null},"PeriodicalIF":2.4,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11424727/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141627250","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Thyroid hemiatrophy associated with papillary thyroid carcinoma.","authors":"Takuya Seko, Hiroki Kato, Tomohiro Ando, Kazuhiro Kobayashi, Hirofumi Shibata, Takenori Ogawa, Masaya Kawaguchi, Yoshifumi Noda, Fuminori Hyodo, Masayuki Matsuo","doi":"10.1007/s00234-024-03442-8","DOIUrl":"10.1007/s00234-024-03442-8","url":null,"abstract":"<p><strong>Purpose: </strong>The present study aimed to investigate CT imaging features, pathological findings, and prognosis in patients with thyroid hemiatrophy (THA) associated with papillary thyroid carcinoma (PTC).</p><p><strong>Methods: </strong>This retrospective study included 225 patients with histopathologically proven PTC treated by surgical resection who underwent preoperative CT scanning. On CT images, THA was defined as thyroid parenchymal hemiatrophy on the ipsilateral side of PTC. CT findings, overall survival, and disease-free survival were compared between patients with and without THA. Pathological findings were also assessed in PTCs with and without THA.</p><p><strong>Results: </strong>THA was observed in 35 of 225 (16%) patients with PTC. Atrophic thyroid parenchyma was observed in the right lobe of 20 patients (57%) and in the left lobe of the remaining 15 patients (43%). With respect to the solid components within PTCs, contrast-enhanced CT attenuation (114.2 ± 18.2 vs. 126.7 ± 31.3 HU; p < 0.05) and CT attenuation change for contrast-enhanced CT minus unenhanced CT (60.2 ± 18.1 vs. 72.3 ± 31.0 HU; p < 0.05) were significantly lower in PTCs with THA than in those without THA. Histopathologically, almost all PTCs with THA (97%) had keloid-like collagen, which is broad bundles of hypocellular collagen with bright eosinophilic hyalinization, typically observed in keloid. However, no significant differences were observed in the prognosis between the two groups.</p><p><strong>Conclusion: </strong>THA was occasionally observed in patients with PTC. Weak contrast-enhancement was distinct characteristic of PTC patients with THA, which is probably caused by keloid-like collagen.</p>","PeriodicalId":19422,"journal":{"name":"Neuroradiology","volume":null,"pages":null},"PeriodicalIF":2.4,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141971541","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"A Comparative Study of AI-Based Automated and Manual Postprocessing of Head and Neck CT Angiography: An Independent External Validation with Multi-Vendor and Multi-Center Data.","authors":"Kunhua Li, Yang Yang, Shengwen Niu, Yongwei Yang, Bitong Tian, Xinyue Huan, Dajing Guo","doi":"10.1007/s00234-024-03379-y","DOIUrl":"10.1007/s00234-024-03379-y","url":null,"abstract":"<p><strong>Purpose: </strong>To externally validate the performance of automated postprocessing (AP) on head and neck CT Angiography (CTA) and compare it with manual postprocessing (MP).</p><p><strong>Methods: </strong>This retrospective study included head and neck CTA-exams of patients from three tertiary hospitals acquired on CT scanners from five manufacturers. AP was performed by CerebralDoc. The image quality was assessed using Likert scales, and the qualitative and quantitative diagnostic performance of arterial stenosis and aneurysm, postprocessing time, and scanning radiation dose were also evaluated.</p><p><strong>Results: </strong>A total of 250 patients were included. Among these, 55 patients exhibited significant stenosis (≥ 50%), and 33 patients had aneurysms, diagnosed using original CTA datasets and corresponding multiplanar reconstructions as the reference. While the scores of the V4 segment and the edge of the M1 segment on volume rendering (VR), as well as the C4 segment on maximum intensity projection (MIP), were significantly lower with AP compared to MP across vendors (all P < 0.05), most scores in AP demonstrated image quality that was either superior to or comparable with that of MP. Furthermore, the diagnostic performance of AP was either superior to or comparable with that of MP. Moreover, AP also exhibited advantages in terms of postprocessing time and radiation dose when compared to MP (P < 0.001).</p><p><strong>Conclusion: </strong>The AP of CerebralDoc presents clear advantages over MP and holds significant clinical value. However, further optimization is required in the image quality of the V4 and M1 segments on VR as well as the C4 segment on MIP.</p>","PeriodicalId":19422,"journal":{"name":"Neuroradiology","volume":null,"pages":null},"PeriodicalIF":2.4,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140945574","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
NeuroradiologyPub Date : 2024-10-01Epub Date: 2024-07-05DOI: 10.1007/s00234-024-03417-9
Usha D Nagaraj, Jonathan R Dillman, Jean A Tkach, Joshua S Greer, James L Leach
{"title":"Evaluation of 3D T1-weighted spoiled gradient echo MR image quality using artificial intelligence image reconstruction techniques in the pediatric brain.","authors":"Usha D Nagaraj, Jonathan R Dillman, Jean A Tkach, Joshua S Greer, James L Leach","doi":"10.1007/s00234-024-03417-9","DOIUrl":"10.1007/s00234-024-03417-9","url":null,"abstract":"<p><strong>Purpose: </strong>To assess image quality and diagnostic confidence of 3D T1-weighted spoiled gradient echo (SPGR) MRI using artificial intelligence (AI) reconstruction.</p><p><strong>Materials and methods: </strong>This prospective, IRB-approved study enrolled 50 pediatric patients (mean age = 11.8 ± 3.1 years) undergoing clinical brain MRI. In addition to standard of care (SOC) compressed SENSE (CS = 2.5), 3D T1-weighted SPGR images were obtained with higher CS acceleration factors (5 and 8) to evaluate the ability of AI reconstruction to improve image quality and reduce scan time. Images were reviewed independently on dedicated research PACS workstations by two neuroradiologists. Quantitative analysis of signal intensities to calculate apparent grey and white matter signal to noise (aSNR) and grey-white matter apparent contrast to noise ratios (aCNR) was performed.</p><p><strong>Results: </strong>AI improved overall image quality compared to standard CS reconstruction in 35% (35/100) of evaluations in CS = 2.5 (average scan time = 221 ± 6.9 s), 100% (46/46) of CS = 5 (average scan time = 113.3 ± 4.6 s) and 94% (47/50) of CS = 8 (average scan time = 74.1 ± 0.01 s). Quantitative analysis revealed significantly higher grey matter aSNR, white matter aSNR and grey-white matter aCNR with AI reconstruction compared to standard reconstruction for CS 5 and 8 (all p-values < 0.001), however not for CS 2.5.</p><p><strong>Conclusions: </strong>AI reconstruction improved overall image quality and gray-white matter qualitative and quantitative aSNR and aCNR in highly accelerated (CS = 5 and 8) 3D T1W SPGR images in the majority of pediatric patients.</p>","PeriodicalId":19422,"journal":{"name":"Neuroradiology","volume":null,"pages":null},"PeriodicalIF":2.4,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11424660/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141534969","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
NeuroradiologyPub Date : 2024-10-01Epub Date: 2024-06-17DOI: 10.1007/s00234-024-03400-4
Griffin Young, Vivian S Nguyen, Quentin Howlett-Prieto, Amanda Frisosky Abuaf, Timothy J Carroll, Keigo Kawaji, Adil Javed
{"title":"T1 mapping from routine 3D T1-weighted inversion recovery sequences in clinical practice: comparison against reference inversion recovery fast field echo T1 scans and feasibility in multiple sclerosis.","authors":"Griffin Young, Vivian S Nguyen, Quentin Howlett-Prieto, Amanda Frisosky Abuaf, Timothy J Carroll, Keigo Kawaji, Adil Javed","doi":"10.1007/s00234-024-03400-4","DOIUrl":"10.1007/s00234-024-03400-4","url":null,"abstract":"<p><strong>Background and purpose: </strong>Quantitative T1 mapping can be an essential tool for assessing tissue injury in multiple sclerosis (MS). We introduce T1-REQUIRE, a method that converts a single high-resolution anatomical 3D T1-weighted Turbo Field Echo (3DT1TFE) scan into a parametric T1 map that could be used for quantitative assessment of tissue damage. We present the accuracy and feasibility of this method in MS.</p><p><strong>Methods: </strong>14 subjects with relapsing-remitting MS and 10 healthy subjects were examined. T1 maps were generated from 3DT1TFE images using T1-REQUIRE, which estimates T1 values using MR signal equations and internal tissue reference T1 values. Estimated T1 of lesions, white, and gray matter regions were compared with reference Inversion-Recovery Fast Field Echo T1 values and analyzed via correlation and Bland-Altman (BA) statistics.</p><p><strong>Results: </strong>159 T1-weighted (T1W) hypointense MS lesions and 288 gray matter regions were examined. T1 values for MS lesions showed a Pearson's correlation of r = 0.81 (p < 0.000), R<sup>2</sup> = 0.65, and Bias = 4.18%. BA statistics showed a mean difference of -53.95 ms and limits of agreement (LOA) of -344.20 and 236.30 ms. Non-lesional normal-appearing white matter had a correlation coefficient of r = 0.82 (p < 0.000), R<sup>2</sup> = 0.67, Bias = 8.78%, mean difference of 73.87 ms, and LOA of -55.67 and 203.41 ms.</p><p><strong>Conclusions: </strong>We demonstrate the feasibility of retroactively derived high-resolution T1 maps from routinely acquired anatomical images, which could be used to quantify tissue pathology in MS. The results of this study will set the stage for testing this method in larger clinical studies for examining MS disease activity and progression.</p>","PeriodicalId":19422,"journal":{"name":"Neuroradiology","volume":null,"pages":null},"PeriodicalIF":2.4,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141331524","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
NeuroradiologyPub Date : 2024-10-01Epub Date: 2024-06-17DOI: 10.1007/s00234-024-03388-x
Elham Rahimian, Felice D'Arco, Sniya Sudhakar, Majid R Tahsini, Neda Azin, Mahdis Morovvati, Parvaneh Karimzadeh, Mohammad Aidin Farahvash
{"title":"The full spectrum of MRI findings in 18 patients with Canavan disease: new insights into the areas of selective susceptibility.","authors":"Elham Rahimian, Felice D'Arco, Sniya Sudhakar, Majid R Tahsini, Neda Azin, Mahdis Morovvati, Parvaneh Karimzadeh, Mohammad Aidin Farahvash","doi":"10.1007/s00234-024-03388-x","DOIUrl":"10.1007/s00234-024-03388-x","url":null,"abstract":"<p><strong>Introduction: </strong>Canavan disease (CD) is a rare autosomal recessive neurodegenerative disorder caused by a deficiency of aspartoacylase A, an enzyme that degrades N-acetylaspartate (NAA). The disease is characterized by progressive white matter degeneration, leading to intellectual disability, seizures, and death. This retrospective study aims to describe the full spectrum of magnetic resonance imaging (MRI) findings in a large case series of CD patients.</p><p><strong>Materials and methods: </strong>MRI findings in 18 patients with confirmed CD were investigated, and the full spectrum of brain abnormalities was compared with the existing literature to provide new insights regarding the brain MRI findings in these patients. All the cases were proven based on genetic study or NAA evaluation in urine or brain.</p><p><strong>Results: </strong>Imaging analysis showed involvement of the deep and subcortical white matter as well as the globus pallidus in all cases, with sparing of the putamen, caudate, and claustrum. The study provides updates on the imaging characteristics of CD and validates some underreported findings such as the involvement of the lateral thalamus with sparing of the pulvinar, involvement of the internal capsules and corpus callosum, and cystic formation during disease progression.</p><p><strong>Conclusion: </strong>To our knowledge, this is one of the largest case series of patients with CD which includes a detailed description of the brain MRI findings. The study confirmed many of the previously reported MRI findings but also identified abnormalities that were previously rarely or not described. We speculate that areas of ongoing myelination are particularly vulnerable to changes in CD.</p>","PeriodicalId":19422,"journal":{"name":"Neuroradiology","volume":null,"pages":null},"PeriodicalIF":2.4,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141331525","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}