Neuroradiology最新文献

{"title":"System-specific reductions of resting-state BOLD signal entropy in disorders of consciousness.","authors":"Shanshan Chen, Haoran Chen, Nan Zhang, Yituo Wang","doi":"10.1007/s00234-026-04054-0","DOIUrl":"10.1007/s00234-026-04054-0","url":null,"abstract":"<p><strong>Objective: </strong>Disorders of consciousness (DoC) are associated with large-scale abnormalities in brain function, but system-specific alterations in regional resting-state BOLD signal entropy remain poorly understood. Here, we examined regional entropy of resting-state fMRI signals in patients with minimally conscious state (MCS) and unresponsive wakefulness syndrome (UWS).</p><p><strong>Methods: </strong>Resting-state fMRI was acquired in 23 MCS patients, 31 UWS patients, and 20 age-matched healthy controls. Regional entropy was estimated from voxel-wise BOLD signals within anatomically defined brain regions using a PCA-based framework, allowing quantification of covariance-based regional BOLD signal variability across the whole brain. Pairwise group comparisons were performed at both the ROI level and in grouped functionally relevant regional sets.</p><p><strong>Results: </strong>Relative to healthy controls, MCS patients showed reduced regional entropy mainly in sensory- and memory-related regions, whereas UWS patients showed widespread reductions across sensory, memory-related, and high-order cognitive regions. In grouped regional-set analyses, entropy in sensory and memory systems showed a graded decrease from healthy controls to MCS and from MCS to UWS. In contrast, entropy in high-order cognitive systems remained relatively preserved in MCS and was significantly reduced only in UWS, with the exception of the posterior cingulate cortex and precuneus.</p><p><strong>Conclusion: </strong>These findings demonstrate system-specific reductions in resting-state BOLD signal entropy in DoC and reveal distinct patterns of altered regional BOLD signal variability across sensory, memory-related, and high-order cognitive systems in MCS and UWS. Regional BOLD signal entropy may provide a quantitative regional description of altered brain dynamics in DoC and complement existing work on large-scale communication and network dysfunction.</p>","PeriodicalId":19422,"journal":{"name":"Neuroradiology","volume":" ","pages":"2805-2815"},"PeriodicalIF":2.8,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148150523","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":"Deep learning in acute ischemic stroke imaging: a systematic review of CT- and MRI-based segmentation, triage, and prognostic modeling.","authors":"Ismail Kunduracioglu, Suat Ince, Bilal Bayram, Serhat Kilicarslan, Erkan Veziroglu, Ishak Pacal","doi":"10.1007/s00234-026-04095-5","DOIUrl":"10.1007/s00234-026-04095-5","url":null,"abstract":"<p><strong>Background: </strong>Acute ischemic stroke is a time-critical neurological emergency in which imaging directly influences diagnosis, treatment eligibility, tissue-at-risk estimation, workflow prioritization, and outcome prediction. Deep learning has become increasingly prominent in stroke imaging; however, its clinical role differs substantially between computed tomography (CT) and magnetic resonance imaging (MRI).</p><p><strong>Objective: </strong>This PRISMA-guided systematic review evaluated peer-reviewed studies published between January 2023 and March 2026 that applied deep learning to acute ischemic stroke imaging.</p><p><strong>Methods: </strong>Searches across major biomedical, engineering, and clinical databases identified 91 eligible studies. Extracted data included imaging modality, dataset source, clinical task, model architecture, validation strategy, and reported performance metrics.</p><p><strong>Results: </strong>MRI-based studies predominantly addressed lesion segmentation and tissue characterization using DWI, ADC, FLAIR, and multimodal MRI. In this setting, U-Net-derived architectures, self-configuring frameworks, attention-based models, and selected CNN-Transformer hybrids frequently achieved strong Dice and IoU values on benchmark datasets, particularly ISLES 2015 and ISLES 2022. CT-based studies followed a different clinical direction, with greater emphasis on emergency triage, hemorrhage exclusion, large-vessel occlusion detection, stroke classification, ASPECTS-related assessment, and CTP-based core-penumbra estimation. High retrospective accuracy or AUC values in CT studies should be interpreted cautiously, since image-level classification performance does not establish reliable voxel-level lesion delineation, especially on NCCT, where early ischemic changes remain subtle and difficult to segment.</p><p><strong>Conclusion: </strong>Across both modalities, technical progress remains ahead of clinical validation. External testing, patient-level separation, standardized reporting, scanner robustness, interpretability, and prospective workflow evaluation are still inconsistently addressed. The field now requires a shift from isolated benchmark performance toward clinically interpretable, externally validated, and prognosis-aware systems that can support real-time neuroradiology decision-making.</p>","PeriodicalId":19422,"journal":{"name":"Neuroradiology","volume":" ","pages":"3009-3040"},"PeriodicalIF":2.8,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13680298/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148339421","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":"Development of a standardized intracranial vessel model from 3D time-of-flight magnetic resonance angiography data of the SHIP cohort.","authors":"Antonia Dalmer, Stefan Siewert, Dominique Passler, Hagen Paetow, Christoph Brandt-Wunderlich, Daniel Cantré, Ebba Beller, Sönke Langner, Klaus-Peter Schmitz, Marc-André Weber, Felix Streckenbach","doi":"10.1007/s00234-026-04147-w","DOIUrl":"10.1007/s00234-026-04147-w","url":null,"abstract":"<p><strong>Purpose: </strong>A standardized, population-based three-dimensional (3D) computer-aided design (CAD) model of the intracranial arterial system was developed from time-of-flight magnetic resonance angiography (TOF-MRA) data of the Study of Health in Pomerania (SHIP) cohort, tailored for realistic simulation and experimental neurovascular applications.</p><p><strong>Methods: </strong>An averaged intracranial TOF-MRA dataset generated from 4308 individual whole-body MRI examinations of the SHIP cohort was used as the anatomical basis. Intracranial arteries were segmented using 3D Slicer with Frangi-based vessel enhancement, semi-automatic region-growing, and manual refinement to obtain continuous vascular masks. Centerlines were extracted with VMTK (Vascular Modelling Toolkit), and vessel radii were computed via distance mapping. The resulting centerline and radius data were imported into a CAD environment (Creo Parametric) to reconstruct smooth vessel centerlines, generate circular cross-sections, and create a lofted three-dimensional lumen model, which was converted into a hollow geometry with a uniform wall thickness and exported as an STL file for 3D printing.</p><p><strong>Results: </strong>The proposed workflow yielded a geometrically consistent, hollow 3D model of the central intracranial arteries, representing a population-averaged arterial anatomy with smooth vessel courses, gradual diameter transitions, and a closed, continuous wall. The CAD model could be successfully manufactured as a physical 3D-printed phantom and provides a stable, reproducible test environment for digital and in vitro investigations of neurovascular interventions under standardized anatomical conditions.</p><p><strong>Conclusions: </strong>Population-based TOF-MRA data can be transformed into a technically robust and anatomically meaningful intracranial reference model suitable for CAD-based simulation and additive manufacturing. The resulting 3D CAD geometry serves as a reusable reference for comparative studies, methodological validation, early-stage device development, and training in endovascular neurosurgery, without aiming to replace patient-specific models.</p>","PeriodicalId":19422,"journal":{"name":"Neuroradiology","volume":" ","pages":"2683-2696"},"PeriodicalIF":2.8,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13680334/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148796094","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":"Differential atrophy along the longitudinal axis of the hippocampus in Alzheimer's disease and suspected non-Alzheimer's disease pathophysiology (SNAP).","authors":"Torcato Meira, Rafaela Morais-Ribeiro, Tiago Jesus, Marcelo Dias, Ana Coelho, Tiago Gil Oliveira","doi":"10.1007/s00234-026-04061-1","DOIUrl":"10.1007/s00234-026-04061-1","url":null,"abstract":"<p><strong>Purpose: </strong>Cerebrospinal fluid (CSF) biomarkers are increasingly used to support Alzheimer's disease (AD) diagnosis: Alzheimer's Disease continuum (ADc) is defined by abnormal amyloid-beta (Aβ), while Suspected Non-AD Pathophysiology (SNAP) refers to normal Aβ with elevated tau. Given the differential properties along the hippocampal longitudinal axis, this study aimed to evaluate anterior-posterior subregional hippocampal volume differences among ADc, SNAP, and biomarker-negative participants, and their associations with CSF biomarkers and clinical presentation.</p><p><strong>Methods: </strong>Data from 1242 participants in the Alzheimer's Disease Neuroimaging Initiative were analyzed. Biomarker-negative participants (n = 234) had normal CSF Aβ42 (≥ 192 pg/ml), total tau (< 93 pg/ml), and phosphorylated tau at threonine 181 (< 23 pg/ml). ADc individuals (n = 784) had abnormal Aβ42, and SNAP (n = 224) showed normal Aβ42 with elevated tau. T1-weighted MRI scans were used to segment the hippocampus into anterior, intermediate, and posterior subregions. Controlling for age, sex, and multiple comparisons, groups were compared using one-way ANOVA, and Pearson correlation coefficients were calculated to assess the relationships between volumetric variables and age, CSF biomarkers, or neuropsychological scores.</p><p><strong>Results: </strong>ADc individuals showed significantly lower total and subregional hippocampal volumes compared with SNAP and biomarker-negative participants (P < 0.001). Normalized volumes to total ipsilateral hippocampal volume revealed greater posterior atrophy (P < 0.001) and relatively higher anterior volume (P < 0.01) in ADc. SNAP and biomarker-negative participants showed stronger correlations between hippocampal volumes and age. Several subregional hippocampal volumes correlated with CSF biomarkers, cognitive performance, neuropsychiatric symptoms, and functional impairment.</p><p><strong>Conclusion: </strong>This study reveals distinct patterns of hippocampal atrophy in ADc and SNAP, enhancing our understanding of their differential pathophysiology and associated clinical features.</p>","PeriodicalId":19422,"journal":{"name":"Neuroradiology","volume":" ","pages":"2947-2961"},"PeriodicalIF":2.8,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13680517/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148176210","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":"An MRI-based radiomics model for precision subtyping of hereditary spastic paraplegia: discriminating SPG4 from SPG5.","authors":"Zhuoting Huang, Fan Zhang, Longjun Yuan, Yuxian Wan, Xinyu Yan, Xiang Lin, Jianping Hu, Ying Liu","doi":"10.1007/s00234-026-04064-y","DOIUrl":"10.1007/s00234-026-04064-y","url":null,"abstract":"<p><strong>Background: </strong>Differentiating spastic paraplegia type 4 (SPG4) from type 5 (SPG5) is clinically relevant with differing therapeutic strategies, yet genetic testing remains limited necessitate alternative approaches. This study aimed to develop and validate an interpretable radiomics model based on spinal cord MRI for distinguishing SPG4 from SPG5.</p><p><strong>Methods: </strong>In this prospective study, SPG4 (N = 40) and SPG5 (N = 30) were randomly assigned to training (n = 56) and test (n = 14) sets. Radiomic features were extracted from the whole spinal cord (WSC) and cervical spinal cord functional subregions (SCFS) on three-dimensional T1- and T2-weighted images. Predictive models were constructed using four machine learning algorithms and evaluated by receiver operating characteristic curve (ROC) analysis. Model robustness was assessed by permutation testing, and interpretability was provided through SHapley Additive exPlanations (SHAP).</p><p><strong>Results: </strong>Radiomics models based on the WSC consistently outperformed those based on SCFS. The optimal WSC model, constructed with a linear support vector classifier on combined T1- and T2-weighted sequences, achieved an AUC of 1.00 in the test set. SHAP analysis identified five consensus features contributed significantly to discrimination between SPG4 and SPG5. All five features also showed significant differences between the two groups (p < 0.001), with the most influential feature (T1_original_shape_SurfaceVolumeRatio) correlating with disease severity as measured by the Spastic Paraplegia Rating Scale (r = 0.434, p < 0.01).</p><p><strong>Conclusions: </strong>Spinal cord radiomics enables accurate and interpretable differentiation between SPG4 and SPG5, providing a non-invasive adjunct to genetic testing. This approach offers objective imaging biomarkers that may support precision diagnosis, improve patient stratification in hereditary spastic paraplegia.</p>","PeriodicalId":19422,"journal":{"name":"Neuroradiology","volume":" ","pages":"2963-2972"},"PeriodicalIF":2.8,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148199651","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":"Association between posterior cerebral artery involvement and arterial wall enhancement in moyamoya disease: a cross-sectional study with vessel wall imaging.","authors":"Takeshi Funaki, Hideo Chihara, Tomoki Sasagasako, Masakazu Okawa, Yohei Mineharu, Yasutaka Fushimi, Sachi Okuchi, Kentaro Ueno, John Grinstead, Sinyeob Ahn, Alto Stemmer, Taichi Ikedo, Hiroyuki Ikeda, Yoshiki Arakawa","doi":"10.1007/s00234-026-04037-1","DOIUrl":"10.1007/s00234-026-04037-1","url":null,"abstract":"<p><strong>Purpose: </strong>Early detection and activity assessment of posterior cerebral artery (PCA) involvement in moyamoya disease (MMD) are challenging. We aimed to assess the cross-sectional association between PCA involvement and PCA wall enhancement on vessel wall MRI (DANTE T1-SPACE).</p><p><strong>Methods: </strong>We analyzed consecutive patients with MMD who underwent both non-contrast-enhanced and contrast-enhanced DANTE T1-SPACE. Positive wall enhancement was defined as location-appropriate arterial wall enhancement with an enhancement ratio ≥ 1.5. PCA involvement was graded 0-2 on MRA obtained during the same period.</p><p><strong>Results: </strong>Of 368 hemispheres from 184 patients, 56 (15.2%) showed PCA involvement and 17 (4.6%) showed PCA wall enhancement. PCA involvement was present in 94.1% of enhancement-positive hemispheres versus 11.4% of enhancement-negative hemispheres (p < 0.001). The difference was consistent across age, Suzuki stage, and RNF213 genotype strata. Enhancement most often involved the P2A segment. Topographical correspondence between enhancement and the stenoocclusive lesion was excellent (overall percent agreement, 94.1%). PCA wall enhancement was observed in 0.3%, 61.5%, and 18.6% of hemispheres with grade 0, 1, and 2 PCA involvement, respectively. Positive enhancement was more frequent in grade 1 PCA involvement than in grade 2 (adjusted p = 0.02).</p><p><strong>Conclusions: </strong>Statistical and topographical findings suggest a strong cross-sectional association between PCA involvement and PCA wall enhancement. The enhancement may be associated with disease activity and may facilitate detection of early-stage PCA involvement with high specificity; these hypotheses require confirmation in longitudinal cohorts.</p>","PeriodicalId":19422,"journal":{"name":"Neuroradiology","volume":" ","pages":"2613-2621"},"PeriodicalIF":2.8,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147948727","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":"Hyperdense middle cerebral artery sign is not associated with functional outcome following mechanical thrombectomy.","authors":"Tomislav Herega, Ivan Perić, David Ozretić, Marko Radoš","doi":"10.1007/s00234-026-04129-y","DOIUrl":"10.1007/s00234-026-04129-y","url":null,"abstract":"<p><strong>Purpose: </strong>Arterial hyperdensity on non-contrast CT is a well-recognized indicator of acute thromboembolism within the intracranial arteries. However, its association with functional outcome following mechanical thrombectomy remains inconclusive. This study aimed to evaluate the association between the hyperdense middle cerebral artery sign (HMCAS) and functional outcome in a homogeneous cohort of patients treated with mechanical thrombectomy for occlusion of the M1 segment of the middle cerebral artery (MCA).  METHODS: We conducted a retrospective analysis of a tertiary stroke center prospectively maintained database to identify patients who underwent mechanical thrombectomy for M1 segment occlusion between January 1, 2021, and December 31, 2023. Demographic data, comorbidities, imaging scores, procedural parameters, and clinical parameters were collected.  RESULTS: A total of 220 patients were included in the study. The prevalence of HMCAS did not differ significantly between patients with favorable and unfavorable functional outcomes. Patients with favorable outcomes were significantly younger, had a lower prevalence of arterial hypertension, lower NIHSS scores, better collateral status, and a shorter median symptom onset-to-recanalization time. In multivariable binary logistic regression analysis, HMCAS was not associated with functional outcome (OR 1.41, 95% CI 0.66-3.05, p = 0.377). Lower NIHSS scores and well-developed leptomeningeal collaterals were the strongest predictors of a favorable functional outcome.  CONCLUSION: HMCAS is not associated with functional outcome in patients undergoing mechanical thrombectomy for acute ischemic stroke caused by M1 segment occlusion. Other clinical and collateral factors are the principal determinants of functional outcome.</p>","PeriodicalId":19422,"journal":{"name":"Neuroradiology","volume":" ","pages":"2567-2576"},"PeriodicalIF":2.8,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148664240","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":"Multimodal MRI assessment of cerebral small vessel disease-related brain injury in the context of unilateral severe carotid artery stenosis.","authors":"Jiawen Gao, Min Wang, Yingying Qiao, Haotian Zhao, Jinyuan Weng, Ning Zheng, Shuo Shao","doi":"10.1007/s00234-026-04111-8","DOIUrl":"10.1007/s00234-026-04111-8","url":null,"abstract":"<p><strong>Purpose: </strong>To investigate the transhemispheric effects of unilateral severe carotid artery stenosis (CAS) on brain structure and hemodynamics, and their association with cerebral small vessel disease (CSVD) markers.</p><p><strong>Methods: </strong>Fifty-one patients with unilateral severe CAS and 48 matched healthy controls underwent multimodal MRI. Quantified metrics included cortical thickness, white matter hyperintensity (WMH) volume, free water fraction in white matter (FW-WM), peak width of skeletonized mean diffusivity (PSMD), and lateralization index for cerebral blood flow (LI-CBF). Group comparisons, interhemispheric comparisons, partial correlation analyses, and multivariable linear regression models were performed.</p><p><strong>Results: </strong>Compared with controls, CAS patients exhibited reduced cortical thickness (2.32 ± 0.08 vs. 2.36 ± 0.08 mm, P = 0.015), elevated PSMD (median 2.56 × 10⁻⁴ vs. 2.35 × 10⁻⁴, P = 0.006), increased WMH volume (median 4.65 vs. 2.37 cm³, P < 0.001), higher FW-WM (0.21 ± 0.03 vs. 0.17 ± 0.02, P < 0.001), and pronounced CBF lateralization (P < 0.001). Ipsilateral FW-WM was significantly higher than contralateral FW-WM (P < 0.001). Both FW-WM (β'=0.347, P = 0.019) and PSMD (β'=0.426, P = 0.002) were independently associated with global WMH volume. Age and anterior cerebral artery LI-CBF independently predicted FW-WM and PSMD. Ipsilateral WMH volume (β'=-0.264, P = 0.044) and age (β'=-0.371, P = 0.005) were independently associated with MoCA scores.</p><p><strong>Conclusion: </strong>Unilateral severe CAS induces structural and hemodynamic alterations overlapping with CSVD features. Hemodynamic disturbance is associated with diffuse white matter injury, which may contribute to WMH formation. Multimodal MRI metrics provide imaging evidence linking macrovascular stenosis to CSVD.</p>","PeriodicalId":19422,"journal":{"name":"Neuroradiology","volume":" ","pages":"2661-2671"},"PeriodicalIF":2.8,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148423032","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":"Machine learning versus conventional grading systems for prognostication in aneurysmal subarachnoid hemorrhage: a systematic review and meta-analysis.","authors":"Donald Ogolo, Obioma Akwada, Enyereibe Ajare, Brenda Opara, Francis Campbell, Okwunodulu Okwuoma, Wilfred Mezue, Samuel Ohaegbulam","doi":"10.1007/s00234-026-04115-4","DOIUrl":"10.1007/s00234-026-04115-4","url":null,"abstract":"<p><strong>Background: </strong>Accurate prognostication after aneurysmal subarachnoid hemorrhage (aSAH) remains challenging. Conventional clinical and radiological grading systems, including the World Federation of Neurosurgical Societies (WFNS), Hunt-Hess, and Fisher scales, are widely used but have limited discriminative capacity. This study aimed to systematically compare machine learning (ML)-based prognostic models with conventional grading systems for predicting functional outcomes and mortality after aSAH, and to evaluate factors influencing ML performance.</p><p><strong>Methods: </strong>A systematic review and meta-analysis were conducted according to PRISMA 2020 guidelines. PubMed, Embase, Scopus, Web of Science, and the Cochrane Library were searched for studies published between 2010 and 2025. Eligible studies evaluated ML-based models for outcome prediction in adult aSAH patients and reported performance of conventional grading systems. Prognostic discrimination was pooled using random-effects meta-analysis of the area under the receiver operating characteristic curve (AUC), with predefined subgroup analyses.</p><p><strong>Results: </strong>Fourteen studies including 6,247 patients were analyzed. ML models demonstrated good to excellent discrimination, with AUCs ranging from 0.81 to 0.97. The pooled ML AUC for predicting unfavourable neurological outcome was 0.86 (95% CI 0.83-0.89; p < 0.0001), with substantial heterogeneity (I² = 96.1%). ML models outperformed conventional grading systems in most studies and showed comparable performance in the remainder. Subgroup analyses confirmed statistically significant prognostic accuracy across clinical-only, imaging-based, and multimodal ML models.</p><p><strong>Conclusion: </strong>Machine learning-based prognostic models demonstrate statistically significant and clinically meaningful performance for outcome prediction after aSAH, exceeding conventional grading systems and supporting their role as complementary risk stratification tools.</p>","PeriodicalId":19422,"journal":{"name":"Neuroradiology","volume":" ","pages":"2755-2767"},"PeriodicalIF":2.8,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148579273","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":"Reduced choroid plexus volume aggravates the glymphatic system burden in patients with patent foramen ovale-related migraine with aura.","authors":"Liqiang Sun, Kaige Cui, Jing Hu, Yu Zhai, Jiping Yang","doi":"10.1007/s00234-026-04094-6","DOIUrl":"10.1007/s00234-026-04094-6","url":null,"abstract":"<p><strong>Objective: </strong>The choroid plexus (ChP) produces cerebrospinal fluid (CSF) and serves as a crucial component of the glymphatic system. This study investigated the characteristics of choroid plexus volume (CPV) changes in patients with patent foramen ovale-related migraine with aura (PFO-M), analyzed its correlation with migraine severity (including both visual analogue scale [VAS] and monthly migraine frequency [MMF]), and elucidated the mechanism of chronic long-term injury on ChP as well as the therapeutic significance of PFO closure.</p><p><strong>Methods: </strong>A prospective study was conducted to enroll 76 patients with PFO-related migraine with aura (PFO group) and 50 healthy controls (HC group) who were treated in our hospital from September 2023 to September 2025. 3.0T magnetic resonance imaging (MRI) was used to measure the lateral ventricular CPV of all subjects, and both VAS and MMF were adopted to evaluate the migraine severity of patients. Intergroup differences in CPV were calculated, and the correlations between CPV and migraine severity indicators (VAS and MMF) in the PFO-M group was analyzed. 26 patients underwent follow-up MRI at 6 months postoperatively to measure CPV and reassess the VAS and MMF, and pre- and post-closure changes in these metrics were compared.</p><p><strong>Results: </strong>(1) The CPV in the PFO-M group was significantly smaller than that in the HC group (1709.76 ± 468.23 mm³ vs. 2443.68 ± 797.48 mm³, t=-5.875, P < 0.001). (2) A significant negative correlation was observed between CPV and VAS (r=-0.788, P < 0.001) and MMF (r=-0.769, P < 0.001) in the PFO-M group. (3) Migraine severity in the PFO-M group at 6 months postoperatively was significantly lower compared with pre-closure levels (VAS: 1.04 ± 1.54 vs. 6.12 ± 1.84, t = 10.718, P < 0.001; MMF: 0.92 ± 1.32 vs. 5.08 ± 1.76, t = 10.316, P < 0.001). (4) There was no statistically significant difference in CPV of the PFO-M group between pre- and 6 months post-closure (1658.23 ± 421.99 mm³ vs. 1666.54 ± 486.86 mm³, t = 0.225, P = 0.823).</p><p><strong>Conclusion: </strong>Patients with PFO-related migraine with aura show reduced choroid plexus volume correlated with migraine severity. PFO closure improves migraine symptoms, without significant changes in choroid plexus volume at 6 months, suggesting longer follow-up is needed.</p>","PeriodicalId":19422,"journal":{"name":"Neuroradiology","volume":" ","pages":"3041-3048"},"PeriodicalIF":2.8,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148345774","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}