Neuroradiology Journal最新文献

{"title":"Outcome of acute ischemic stroke with absent opacification of the cervical internal carotid artery at CT-angiography after endovascular treatment.","authors":"Alessio Comai, Chiara Casalboni, Vincenzo Vingiani, Matteo Bonatti, Enrica Franchini, Elisa Dall'Ora, Ghislain Noumsi Guensom, Fabio Lombardo, Ferro Federica, Benedetto Petralia","doi":"10.1177/19714009251313504","DOIUrl":"10.1177/19714009251313504","url":null,"abstract":"<p><p><b>Purpose:</b> Occlusion of the distal internal carotid artery can simulate a proximal occlusion of its cervical tract on CT angiography in patients with acute ischemic stroke, that is, pseudo-occlusion. As true and false carotid occlusions can present similarly on non-invasive imaging in patients undergoing endovascular treatment for stroke, our study aimed to evaluate clinical and technical differences of these conditions and the possible consequences of a misdiagnosis. <b>Methods:</b> We retrospectively reviewed consecutive patients who underwent mechanical thrombectomy for acute ischemic stroke at a single center between July 2015 and May 2022 and included patients with absent opacification of the cervical carotid artery on CT-angiography. Digital subtraction angiography (DSA) imaging and procedural data were evaluated to define the actual localization of the occlusion. We compared imaging and clinical data between patients with true and false carotid occlusion, including collateral circulation at CTA, revascularization grade, and clinical outcome at 3 months. <b>Results:</b> A total of 116 patients were included, 63 (54%) of whom had true occlusion of cervical internal carotid artery. Compared to the pseudo-occlusion group, collateral circulation at CTA was moderate to good in 75% of cases (vs 32%; <i>p</i> < 0.0001) and the mean ASPECT score at 24 h was 7 versus 2 (<i>p</i> < 0.0001). Modified Rankin scale 0-2 at 90 days was more frequent in patients with true occlusion than those with pseudo-occlusion (48 vs 11%; <i>p</i> = 0.0002). <b>Conclusion:</b> Pseudo-occlusion of the cervical internal carotid artery in patients with acute ischemic stroke appears to be associated with worst prognosis and poorer collateral circulation in comparison with tandem occlusion.</p>","PeriodicalId":47358,"journal":{"name":"Neuroradiology Journal","volume":" ","pages":"623-628"},"PeriodicalIF":0.8,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11760076/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143034603","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Unusual anatomic variation: The posterior inferior cerebellar artery arising from the middle meningeal artery.","authors":"Emilio Lozupone, Simona Scalise, Pietro Trombatore, Alfredo Pauciulo, Vita Direnzo, Francesco Signorelli, Leonardo Barbarini, Adriana Paladini","doi":"10.1177/19714009251313508","DOIUrl":"10.1177/19714009251313508","url":null,"abstract":"<p><p>An adult patient was admitted to our emergency department for a first episode of generalized tonic-clonic seizure. Computed tomography scan and magnetic resonance imaging showed a temporal intracranial hemorrhage and parenchymal edema caused by a dural arteriovenous fistula (DAVF), whose angioarchitecture was better understood through the DSA which showed as intriguing and rare vascular anomaly the origin of the posterior inferior cerebellar artery (PICA) from the middle meningeal artery (MMA). The endovascular treatment of the DAVF was then successfully performed.This case describes the first case of a PICA arising from the MMA in the literature and highlights as an accurate knowledge of vascular anatomy and its variations is essential for the endovascular treatment of the cerebrovascular diseases.</p>","PeriodicalId":47358,"journal":{"name":"Neuroradiology Journal","volume":" ","pages":"633-636"},"PeriodicalIF":0.8,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11707755/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142956537","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Enhancing recanalization success: Thrombectomy plus stent angioplasty by coaxial balloon technique for acute ischemic stroke with tandem occlusions.","authors":"Pao-Sheng Yen, Victor C Kok, Yu-Hui Lin, Yu Tzu Wu, Li-Ying Ko","doi":"10.1177/19714009241303137","DOIUrl":"10.1177/19714009241303137","url":null,"abstract":"<p><p>Recanalizing acute ischemic stroke with carotid tandem occlusion (CTO) is technically challenging because distal embolic migration during revascularization can significantly influence outcomes. In this study, we aimed to introduce our coaxial balloon technique using a balloon-guiding catheter (BCG), angioplasty catheter, and aspiration catheter sequentially to prevent thrombus migration to a new vascular territory. We used this technique for six patients with CTO. Technical success with good revascularization of the CTO was achieved in all six patients (100%) without neurological complications, including one and five cases of modified Thrombolysis in Cerebral Infarction 2b and 3, respectively. The median duration of the procedure was 61 (interquartile range, 52-90) min. The mean National Institutes of Health Stroke Scale score at discharge was 3.5 (2-8), with favorable clinical outcomes at 90 days for three of six patients (50%). The coaxial balloon technique for CTO is safe and effective for revascularization in patients with acute ischemic stroke. Thrombectomy before proximal stenting was associated with shorter reperfusion times and better clinical outcomes. Therefore, this approach is recommended for tandem occlusions requiring stent angioplasty.</p>","PeriodicalId":47358,"journal":{"name":"Neuroradiology Journal","volume":" ","pages":"647-654"},"PeriodicalIF":0.8,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11584997/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142693098","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Photon-counting CT imaging of a patient with coiled and untreated intracranial saccular aneurysms.","authors":"Adrienn Tóth, Jennifer Y Cho, Evan Wilson, Jim O'Doherty, Maria Vittoria Spampinato","doi":"10.1177/19714009251313514","DOIUrl":"10.1177/19714009251313514","url":null,"abstract":"<p><p>We describe a novel application of photon-counting detector CT (PCD-CT) in neurovascular imaging by harnessing the improved spatial resolution, attenuation of electronic noise, and reduction of metal artifacts. The presented case offers the unique challenge of high-quality imaging for the assessment of treated and untreated intracranial saccular aneurysms, in the setting of metal artifacts from embolization coils. Our goal was to explore optimized reconstruction parameters for ultra-high-resolution imaging (UHR) using a dedicated, sharp neurovascular kernel (Hv72) and the highest strength of quantum iterative reconstruction (QIR-4) for detailed characterization of the vasculature. Virtual monoenergetic images (VMIs) and iterative metal artifact reduction (IMAR) were employed to investigate metal artifact reduction techniques. PCD-CT has the promising potential to enhance patient care in the follow-up of patients with treated aneurysms requiring more complex imaging parameters and image post-processing due to intracranial artifacts.</p>","PeriodicalId":47358,"journal":{"name":"Neuroradiology Journal","volume":" ","pages":"637-640"},"PeriodicalIF":0.8,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11780625/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143068603","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of workflow times on successful reperfusion after endovascular treatment in the late time window.","authors":"Ibrahim Alhabli, Faysal Benali, Michael D Hill, Sean Murphy, Danilo Toni, Michel Patrik, Ilaria Casetta, Sarah Power, Valentina Saia, Giovanni Pracucci, Salvatore Mangiafico, Karl Boyle, Stefania Nannoni, Enrico Fainardi, John Thornton, Beom Joon Kim, Bijoy K Menon, Mohammed A Almekhlafi, Fouzi Bala","doi":"10.1177/19714009251313512","DOIUrl":"10.1177/19714009251313512","url":null,"abstract":"<p><p>Background and PurposeSuccessful and complete reperfusion should be the aim of every endovascular thrombectomy (EVT) procedure. However, the effect of time delays on successful reperfusion in late window stroke patients presenting 6-to-24 h from onset has not been investigated.Materials and MethodsWe pooled individual patient-level data from seven trials and registries for anterior circulation stroke patients treated with EVT between 6 and 24 h from onset. We explored the impact of delays across multiple interval times, including onset to hospital arrival; hospital arrival to arterial puncture; imaging to arterial puncture; and onset to arterial puncture. Our primary outcome was successful reperfusion, defined as a modified thrombolysis in cerebral infarction (mTICI) score of 2b-3. Logistic regression analyses were performed to assess the association between each of the interval times and successful reperfusion.ResultsWe included 608 patients. The median age was 70 years (IQR 58-79), and 307 (50.5%) were females. Successful reperfusion was achieved in 494 (81.2%) patients. Patients with successful reperfusion had lower NIHSS scores (median 15 [IQR11-19] vs 17 [11-21], <i>p</i> = .02) and significantly shorter hospital arrival to arterial puncture time (90 min [60-150] vs 110 min [84.5-150], <i>p</i> = .01) than unsuccessful reperfusion. The odds of successful reperfusion decreased by 15% for every one-hour delay in arrival-to-puncture time (adjusted odds ratio 0.85, 95% CI: 0.75-0.95). Other workflow times did not impact the rate of successful reperfusion.ConclusionFaster hospital arrival to arterial puncture time is associated with higher odds of successful reperfusion in late window stroke patients.</p>","PeriodicalId":47358,"journal":{"name":"Neuroradiology Journal","volume":" ","pages":"616-622"},"PeriodicalIF":0.8,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11729390/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142980172","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Usefulness of amide proton transfer images in the diagnosis of malignant glioma comparison of APT images and 11C-methionine-positron emission tomography.","authors":"Masami Shirota, Masayuki Nitta, Taiichi Saitou, Syunsuke Tsuduki, Ayako Yoshida, Yoshihiro Muragaki, Takakazu Kawamata","doi":"10.1177/19714009251345107","DOIUrl":"10.1177/19714009251345107","url":null,"abstract":"<p><p>IntroductionAmide proton transfer (APT) imaging is one of the imaging methods in Magnetic Resonance Imaging (MRI). It is a molecular imaging technique that visualizes contrast based on the concentration or exchange rate of amide groups of amino acids, which increases in tumors. Methionine-positron emission tomography (MET-PET), on the other hand, has been found to be useful in the imaging diagnosis of glioma because of its clear contrast in the accumulation of tumor cells. In this study, we compared APT and MET-PET on the basis of pathological diagnostic results and backwardly examined whether APT is useful for the imaging diagnosis of glioma.MethodForty-six patients with malignant glioma (World Health Organization 2016 (WHO2016) Grade: GII/III/IV) and suspected pseudoprogression who underwent APT and MET-PET were included in the study. For APT, APT signals were measured in the tumor region of interest, and for MET-PET, 370 MBq was administered to measure the tumor-to-normal tissue ratio (TNR).ResultIn the correlation verification, the actual APT and TNR were correlated with 2.22 ± 1.01 and 2.58 ± 1.5, respectively (r = 0.6, <i>p</i> < 0.001). The accuracy of the differentiation between GII/III/IV (32 patients) and suspected pseudoprogression (14 patients) by actual APT measurements was verified with a sensitivity of 91% and specificity of 100% at a cutoff value of 1.81. In the validation of malignancy diagnosis, the measured APT value of GII (6 cases) was 2.18 ± 0.43 and the TNR was 3.53 ± 2.12, the measured APT value of GIII (11 cases) was 2.67 ± 0.69 and TNR was 2.81 ± 0.72, and the measured APT value of GIV (15 cases) was 2.99 ± 0.61 and the TNR was 3.44 ± 1.28. The APT measured value and TNR differed significantly in malignancy diagnoses, with higher grades having higher values. Genetic diagnosis validation revealed that the oligodendroglioma group (GII/III: 10 cases) had an APT of 2.37 ± 0.66 and a TNR of 3.52 ± 1.41, while the astrocytoma group (GII/III: 7 cases) had an APT of 2.67 ± 0.45 and a TNR of 2.41 ± 0.87.ConclusionAPT may be comparable to MET-PET in differentiating suspected pseudoprogression and in diagnosing malignancy. Patients with an actual APT of 1.81 or higher should be considered for a treatment plan, whereas follow-up may be an option for those with an APT of 1.81. Although the TNR tends to be higher in the oligodendroglioma group (GII/III), APT, which is not affected by the blood-brain barrier, has less variability in actual measurements and is useful for the imaging diagnosis of glioma.</p>","PeriodicalId":47358,"journal":{"name":"Neuroradiology Journal","volume":" ","pages":"19714009251345107"},"PeriodicalIF":0.8,"publicationDate":"2025-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12460284/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145139042","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effective atomic number and electron density from dual-energy CT for differentiating malignant gliomas: Validation using the World Health Organization 2021 brain tumor classification.","authors":"Masami Shirota, Masayuki Nitta, Ayako Yoshida, Syunichi Kouriyama, Taiichi Saitou, Syunsuke Tsuduki, Yoshihiro Muragaki, Takakazu Kawamata","doi":"10.1177/19714009251373068","DOIUrl":"10.1177/19714009251373068","url":null,"abstract":"<p><p>Based on the World Health Organization (WHO) 2021 brain tumor pathology classification, we evaluated the usefulness of dual-energy CT (DECT) for differentiating malignancy grades in malignant gliomas and examined its correlation with amide proton transfer (APT). A prospective observational study was conducted on 49 patients: 16 with glioblastoma (GBM, grade 4), 13 with astrocytoma (A3, grade 3), 10 with oligodendroglioma (O3, grade 3), and 10 with oligodendroglioma (O2, grade 2). Effective atomic number (Zeff) and electron density (ED) from DECT were analyzed for tumor grade differentiation and correlation with APT. High-grade gliomas, which are influenced by vascular endothelial growth factor (VEGF) and microvascular proliferation, showed significant differences and correlations in post-contrast Zeff. A correlation between Zeff and MIB-1 suggests its potential as an indicator of cell proliferation. Additionally, correlations between Zeff and APT, as well as between ED and APT, indicate that DECT may be useful for grading malignant gliomas.</p>","PeriodicalId":47358,"journal":{"name":"Neuroradiology Journal","volume":" ","pages":"19714009251373068"},"PeriodicalIF":0.8,"publicationDate":"2025-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12460291/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145139081","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Outcome of intraoperative heparinization during stent-assisted coiling for unruptured aneurysms.","authors":"Takashi Fujii, Shuta Maehara, Yoshimasa Fukui, Kousei Maruyama, Kosuke Takigawa, Noriaki Tashiro, Hidetoshi Matsukawa, Yoshiya Hashiguchi, Masanobu Yasumoto, Masahiro Yasaka, Hiroshi Aikawa, Yoshinori Go, Kiyoshi Kazekawa","doi":"10.1177/19714009251377750","DOIUrl":"10.1177/19714009251377750","url":null,"abstract":"<p><p>In this study, we aimed to compare the treatment outcomes of patients with unruptured aneurysms treated using stent-assisted coil embolization with and without systemic heparinization to examine the intraoperative systemic heparinization efficacy. We included 106 consecutive patients enrolled at Fukuoka Neurosurgical Hospital, Japan, between November 2021 and March 2023. The patients were divided into two groups: the systemic heparinization and nonsystemic heparinization groups. Head magnetic resonance imaging (MRI) performed on postoperative day 1 showed that the number of ischemic foci <2 mm was higher in the nonsystemic heparinization group than in the systemic heparinization group, although the difference was not statistically significant (2 [0-6] vs 1 [0-3], <i>P</i> = .0583). No significant between-group difference was observed concerning the incidence of ischemic and hemorrhagic complications. There was no significant between-group difference regarding the modified Rankin scale (mRS) score; however, the systemic heparinization group had a higher proportion of patients with poor outcomes than did the nonsystemic heparinization group, with one (2.4%) patient with an mRS score of 5 and one (2.4%) patient with an mRS score of 6. In conclusion, intraoperative systemic heparinization during stent-assisted coil embolization of unruptured cerebral aneurysms may suppress diffusion-weighted imaging high-signal spots on head MRI performed on postoperative day 1. Moreover, systemic heparinization may worsen the outcomes of hemorrhagic complications.</p>","PeriodicalId":47358,"journal":{"name":"Neuroradiology Journal","volume":" ","pages":"19714009251377750"},"PeriodicalIF":0.8,"publicationDate":"2025-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12432005/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145041942","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The efficacy of mechanical thrombectomy via right brachial approach for hyperacute right anterior circulation infarction.","authors":"Naoyuki Noda","doi":"10.1177/19714009251373063","DOIUrl":"10.1177/19714009251373063","url":null,"abstract":"<p><p>BackgroundMechanical thrombectomy (MT) is a well-established treatment for acute large-vessel occlusion. While the transfemoral approach (TFA) is the standard, it can be challenging in elderly patients with tortuous vasculature. The transbrachial approach (TBA) offers a shorter and more direct route but is associated with more puncture site complications. This study investigates the effectiveness and feasibility of TBA for right anterior circulation strokes.MethodsA total of 23 patients who underwent MT via TBA between September 2023 and January 2025 were retrospectively analyzed and compared with 23 patients treated via TFA from March 2021 to April 2023. Patient characteristics, procedural times, recanalization rates, and complications were evaluated.ResultsThe TBA group showed a shorter median puncture-to-guiding (PtoG) time (13 vs 16 min) and puncture-to-recanalization (PtoR) time (37 vs 52 min) compared to the TFA group. Successful recanalization (TICI ≥2b) was achieved in 95.7% of TBA cases versus 87.0% in TFA. One minor puncture site complication occurred in the TBA group. In rare instances, catheter kinking at the subclavian-CCA junction was observed. Sheathless technique was employed in most TBA cases to minimize puncture complications.ConclusionTBA is a feasible alternative for MT in right anterior circulation strokes, providing improved procedural efficiency. While associated with a higher rate of puncture complications, TBA offers a practical solution in cases where TFA or TRA may be technically challenging.</p>","PeriodicalId":47358,"journal":{"name":"Neuroradiology Journal","volume":" ","pages":"19714009251373063"},"PeriodicalIF":0.8,"publicationDate":"2025-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12413397/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145006701","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Bilateral thalamic infarction in a young adult: The artery of Percheron conundrum.","authors":"Giovanni Failla, Francesco Tiralongo, Salvatore Dominici, Pina Crimì, Corrado Inì, Daniele Grippaldi, Renato Farina, Emanuele David, Pietro Valerio Foti, Stefano Palmucci, Antonio Basile","doi":"10.1177/19714009251371269","DOIUrl":"https://doi.org/10.1177/19714009251371269","url":null,"abstract":"<p><p>Artery of Percheron (AOP) infarction is a rare form of ischemic stroke resulting from the occlusion of a single arterial trunk that supplies both sides of the paramedian thalamus and the midbrain. Its occlusion can lead to bilateral and symmetrical infarctions of the paramedian thalami, and occasionally, the midbrain. Due to its atypical presentation, this condition is often diagnosed late. We report a case of a 39-year-old male with no significant medical history who arrived at the emergency department with drowsiness and confusion. During the physical examination, the patient was drowsy but responsive, with poor speech. Motor deficits in all four limbs were not apparent. Vital signs, routine blood tests, and an initial CT scan were unremarkable. The diagnosis was confirmed the following day through a subsequent CT scan and brain MRI. This case emphasizes the diagnostic challenge posed by AOP infarction and highlights the importance of considering this condition even when initial CT imaging appears normal.</p>","PeriodicalId":47358,"journal":{"name":"Neuroradiology Journal","volume":" ","pages":"19714009251371269"},"PeriodicalIF":0.8,"publicationDate":"2025-08-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12397086/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144973617","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}