Neuroradiology JournalPub Date : 2024-12-01Epub Date: 2023-12-25DOI: 10.1177/19714009231224419
Tokiko Abe, Koji Yamashita, Kazufumi Kikuchi, Eriko Hatai, Fumihiko Fujii, Pin Fee Chong, Yasunari Sakai, Hirotomo Saitsu, Ken Inoue, Osamu Togao, Kousei Ishigami
{"title":"Diagnostic MR imaging features of hypomyelination of early myelinating structures: A case report.","authors":"Tokiko Abe, Koji Yamashita, Kazufumi Kikuchi, Eriko Hatai, Fumihiko Fujii, Pin Fee Chong, Yasunari Sakai, Hirotomo Saitsu, Ken Inoue, Osamu Togao, Kousei Ishigami","doi":"10.1177/19714009231224419","DOIUrl":"10.1177/19714009231224419","url":null,"abstract":"<p><p>Hypomyelination of early myelinating structures (HEMS) has recently been defined as a new genetic disorder accompanied by clinical and MR imaging characteristics. However, no studies have focused on diffusion-weighted imaging (DWI) findings of HEMS. We would like to propose a \"sheep sign,\" which is formed by DWI hyperintensity in the medial medullary lamina along with alternating high-low-high (HLH) intensity stripes in the posterior limb of the internal capsule. We believe the presence of the \"sheep sign\" on DWI in combination with alternating HLH intensity stripes may be a valuable tool for diagnosing HEMS.</p>","PeriodicalId":47358,"journal":{"name":"Neuroradiology Journal","volume":" ","pages":"758-760"},"PeriodicalIF":1.3,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11531016/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139038093","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}
Neuroradiology JournalPub Date : 2024-12-01Epub Date: 2024-04-01DOI: 10.1177/19714009241242592
Anthony S Larson, Girish Bathla, Waleed Brinjikji, Giuseppe Lanzino, Elizabeth Heidi Cheek-Norgan, Marie C Aubry, John Huston, John C Benson
{"title":"A review of histopathologic and radiologic features of non-atherosclerotic pathologies of the extracranial carotid arteries.","authors":"Anthony S Larson, Girish Bathla, Waleed Brinjikji, Giuseppe Lanzino, Elizabeth Heidi Cheek-Norgan, Marie C Aubry, John Huston, John C Benson","doi":"10.1177/19714009241242592","DOIUrl":"10.1177/19714009241242592","url":null,"abstract":"<p><p>Diseases of the carotid arteries can be classified into different categories based on their origin. Atherosclerotic carotid disease remains the most encountered arterial wall pathology. However, other less-common non-atherosclerotic diseases can have detrimental clinical consequences if not appropriately recognized. The underlying histological features of each disease process may result in imaging findings that possess features that are obvious of the disease. However, some carotid disease processes may have histological characteristics that manifest as non-specific radiologic findings. The purpose of this manuscript is to review various non-atherosclerotic causes of carotid artery disease as well as their histologic-radiologic characteristics to aid in the appropriate recognition of these less-commonly encountered pathologies.</p>","PeriodicalId":47358,"journal":{"name":"Neuroradiology Journal","volume":" ","pages":"678-687"},"PeriodicalIF":1.3,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11531044/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140337168","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}
Neuroradiology JournalPub Date : 2024-12-01Epub Date: 2023-12-26DOI: 10.1177/19714009231224413
Ian T Mark, Ajay A Madhavan, David R Delone, Michael P Oien, Steven A Messina
{"title":"Direct pseudomeningocele contrast injection for spinal CSF leak localization.","authors":"Ian T Mark, Ajay A Madhavan, David R Delone, Michael P Oien, Steven A Messina","doi":"10.1177/19714009231224413","DOIUrl":"10.1177/19714009231224413","url":null,"abstract":"<p><p>CT myelography has been traditionally used to evaluate post-operative paraspinal fluid collections to discern CSF leaking into a pseudomeningocele versus a contained seroma. Rather than performing a lumbar puncture and injecting intrathecal contrast for myelography, we present the first report of direct contrast injection into a post-operative paraspinal pseudomeningocele for CSF leak confirmation and localization. This is a simple procedure that has several advantages over a conventional CT myelogram for the evaluation of post-operative paraspinal fluid collections.</p>","PeriodicalId":47358,"journal":{"name":"Neuroradiology Journal","volume":" ","pages":"761-763"},"PeriodicalIF":1.3,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11531060/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139038094","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}
Neuroradiology JournalPub Date : 2024-12-01Epub Date: 2024-06-11DOI: 10.1177/19714009241260802
Marco Parillo, Daniele Vertulli, Federica Vaccarino, Carlo Augusto Mallio, Bruno Beomonte Zobel, Carlo Cosimo Quattrocchi
{"title":"The sensitivity of MIPs of 3D contrast-enhanced VIBE T1-weighted imaging for the detection of small brain metastases (≤ 5 mm) on 1.5 tesla MRI.","authors":"Marco Parillo, Daniele Vertulli, Federica Vaccarino, Carlo Augusto Mallio, Bruno Beomonte Zobel, Carlo Cosimo Quattrocchi","doi":"10.1177/19714009241260802","DOIUrl":"10.1177/19714009241260802","url":null,"abstract":"<p><strong>Objectives: </strong>To evaluate whether the use of Maximum Intensity Projection (MIP) images derived from contrast-enhanced 3D-T1-weighted volumetric interpolated breath-hold examination (VIBE) would allow more sensitive detection of small (≤5 mm) brain metastases (BM) compared with source as well as 2D-T1-weighted spin-echo (SE) images.</p><p><strong>Methods: </strong>We performed a single center retrospective study on subjects with BM who underwent 1.5 tesla brain magnetic resonance imaging. Two readers counted the number of small BM for each of the seven sets of contrast-enhanced images created: axial 2D-T1-weighted SE, 3D-T1-weighted VIBE, 2.5 mm-thick-MIP T1-weighted VIBE, and 5 mm-thick-MIP T1-weighted VIBE; sagittal 3D-T1-weighted VIBE, 2.5 mm-thick-MIP T1-weighted VIBE, and 5 mm-thick-MIP T1-weighted VIBE. Total number of lesions detected on each image type was compared. Sensitivity, the average rates of false negatives and false positives, and the mean discrepancy were evaluated.</p><p><strong>Results: </strong>A total of 403 small BM were identified in 49 patients. Significant differences were found: in the number of true positives and false negatives between the axial 2D-T1-weighted SE sequence and all other imaging techniques; in the number of false positives between the axial 2D-T1-weighted SE and the axial 3D-T1-weighted VIBE sequences. The two image types that combined offered the highest sensitivity were 2D-T1-weighted SE and axial 2.5 mm-thick-MIP T1-weighted VIBE. The axial 2D-T1-weighted SE sequence differed significantly in sensitivity from all other sequences.</p><p><strong>Conclusion: </strong>MIP images did not show a significant difference in sensitivity for the detection of small BM compared with native images.</p>","PeriodicalId":47358,"journal":{"name":"Neuroradiology Journal","volume":" ","pages":"744-750"},"PeriodicalIF":1.3,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11531042/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141301862","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":"Contrast-enhanced 3D black-blood magnetic resonance imaging for diagnosis of cerebral venous thrombosis.","authors":"Padcha Tunlayadechanont, Arin Chobaroon, Thanissara Chansakul","doi":"10.1177/19714009241260798","DOIUrl":"10.1177/19714009241260798","url":null,"abstract":"<p><strong>Purpose: </strong>Cerebral venous thrombosis (CVT) is often under-recognized on routine magnetic resonance imaging (MRI) examinations without concomitant magnetic resonance venography (MRV). Contrast-enhanced black-blood MRI (BBMRI) based on a three-dimensional T1-weighted variable-flip-angle turbo spin echo sequence, one of the sequences used routinely in our practice, has the potential for detection of thrombi in patients with CVT. The aim of this study is to evaluate the diagnostic performance and enhancement patterns of contrast-enhanced three-dimensional BBMRI for the diagnosis of CVT.</p><p><strong>Materials and methods: </strong>Contrast-enhanced BBMRI and contrast-enhanced MRV sequences of 64 patients, acquired from June 2018 to January 2021, were retrospectively reviewed by neuroradiologists for detection of CVT in each venous sinus segment. Diagnostic performance values were calculated for contrast-enhanced BBMRI based on enhancement patterns.</p><p><strong>Results: </strong>Of 749 venous segments from 64 patients analyzed, CVT was demonstrated in 41 venous segments from 12 patients on contrast-enhanced MRV (CE MRV). Thick wall enhancement and total enhancement patterns were dominantly demonstrated in thrombosed segments. Compared with contrast-enhanced MRV, contrast-enhanced BBMRI had a patient-based sensitivity and specificity of 100% and 98.1%, respectively, and a segment-based sensitivity and specificity of 87.8% and 96.2%, respectively. The positive predictive value of contrast-enhanced BBMRI in detecting CVT was 92.3% (patient-based) and 57.1% (segment-based), and the negative predictive value was 100% (patient-based) and 99.3% (segment-based).</p><p><strong>Conclusion: </strong>Contrast-enhanced BBMRI has high diagnostic performance in detection and diagnosis of CVT. This sequence may be useful to recognize CVT when dedicated CE MRV was not performed in patients with nonspecific neurological symptoms.</p>","PeriodicalId":47358,"journal":{"name":"Neuroradiology Journal","volume":" ","pages":"738-743"},"PeriodicalIF":1.3,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11531047/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141296929","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}
Neuroradiology JournalPub Date : 2024-12-01Epub Date: 2023-12-22DOI: 10.1177/19714009231224421
Zibo Zhou, Jinlu Yu
{"title":"Embolization of cerebellar pial arteriovenous fistula presented with congestive edema of the brainstem and cervical cord.","authors":"Zibo Zhou, Jinlu Yu","doi":"10.1177/19714009231224421","DOIUrl":"10.1177/19714009231224421","url":null,"abstract":"<p><p>Cerebellar pial arteriovenous fistula (PAVF) in adults presenting with congestive edema of the brainstem and cervical cord has rarely been reported. Here, we report such a case. A 59-year-old man presented with progressive weakness and numbness of the limbs and hiccups for 6 months. On physical examination, his limbs had grade III muscle strength, and he was unable to stand or walk. He also had occasional incontinence and retention. There was a positive Babinski sign in both lower limbs. Below the neck, he had hypoesthesia of the skin. Magnetic resonance imaging (MRI) showed edema of the brainstem and upper cervical cord. Digital subtraction angiography (DSA) confirmed there was a cerebellar nongalenic-type PAVF lesion; the feeding arteries were the branches of the posterior inferior cerebellar artery (PICA); and the draining vein was a single cortical vein that ultimately entered the venous systems of the brainstem and upper cervical cord. Casting Onyx-18 via the PICA obliterated the PAVF. Postoperatively, the patient recovered gradually. Two and a half months later, he could walk using a crutch and had no incontinence. Six-month follow-up MRI and DSA revealed recession of the edema of the brainstem and cervical cord and no recurrence of this PAVF. One year later, he was nearly normal. In conclusion and extremely rarely, cerebellar nongalenic-type PAVF can present with congestive edema of the brainstem and high cervical cord. This treatment by Onyx-18 embolization can resolve PAVF.</p>","PeriodicalId":47358,"journal":{"name":"Neuroradiology Journal","volume":" ","pages":"764-771"},"PeriodicalIF":1.3,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11531025/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138886232","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}
Neuroradiology JournalPub Date : 2024-12-01Epub Date: 2023-05-21DOI: 10.1177/19714009231177412
Marco Catalano, Luca Crimi, Giuseppe Belfiore, Daniele Grippaldi, Emanuele David, Corrado Spatola, Concetto Cristaudo, Pietro Valerio Foti, Stefano Palmucci, Antonio Basile
{"title":"Congenital and acquired anomalies of the basilar artery: A pictorial essay.","authors":"Marco Catalano, Luca Crimi, Giuseppe Belfiore, Daniele Grippaldi, Emanuele David, Corrado Spatola, Concetto Cristaudo, Pietro Valerio Foti, Stefano Palmucci, Antonio Basile","doi":"10.1177/19714009231177412","DOIUrl":"10.1177/19714009231177412","url":null,"abstract":"<p><strong>Introduction: </strong>The basilar artery is one of the two cases in our body where an arterial vessel is formed by the union of two others - the vertebral arteries. It provides vascular supply to essential structures for the main vital functions; the posterior cerebral arteries originate from it as terminal branches, and form part of the anastomotic circle of Willis.</p><p><strong>Imaging findings: </strong>Congenital and acquired anomalies of the basilar trunk are described. We provide a schematic and detailed representation of normal anatomical variants - mainly represented by the fenestrated basilar artery or the persistence of carotid-basilar anastomosis; course anomalies are also illustrated, with reference to neuro-vascular conflicts and dolichoectasia. Among congenital anomalies, this pictorial review also shows the variants of the basilar origin, such as in the case of basilar trunk arising from only one of the two vertebral arteries, and the calibre changes - which are represented by aneurysm and hypoplasia. The latter appears to be a risk factor for posterior circulation stroke, when associated with a bilateral posterior foetal variant.Among the acquired forms, this pictorial essay describes some clinical cases of dissections, non-congenital aneurysms, thrombosis and tumour with vascular encasing or compression of basilar artery.</p><p><strong>Conclusion: </strong>CT angiography and MRI allow us to study the posterior intracranial circulation in detail, providing useful pre-treatment information. Therefore, knowledge of congenital or acquired anomalies of the basilar artery is essential for radiologists, neuroradiologists and neurosurgeons.</p>","PeriodicalId":47358,"journal":{"name":"Neuroradiology Journal","volume":" ","pages":"661-677"},"PeriodicalIF":1.3,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11531057/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9496018","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":"Ruptured thrombosed vertebral artery dissecting aneurysm treated with staged flow diverter after prediction of the rupture point by vessel wall MRI.","authors":"So Matsukawa, Akira Ishii, Yasutaka Fushimi, Yukinori Terada, Hiroki Natsuhara, Takayuki Kikuchi, Masakazu Okawa, Yukihiro Yamao, Yu Abekura, Natsuhi Sasaki, Hirofumi Tsuji, Ryo Akiyama, Susumu Miyamoto, Yoshiki Arakawa","doi":"10.1177/19714009231224420","DOIUrl":"10.1177/19714009231224420","url":null,"abstract":"<p><p>The safety and feasibility of using staged flow diverter (FD) for ruptured cerebral aneurysms, in which coil embolization is performed in the acute phase and FD is deployed in the subacute phase, has recently been reported. This strategy requires assuming the rupture point and performing coil embolization. Although vessel wall magnetic resonance imaging (VW-MRI) has been reported to be useful in predicting the rupture point of aneurysms, its use with staged FD has not yet been reported. We report the first case of staged FD with preoperative contrast-enhanced VW-MRI to predict the rupture point for partially thrombosed vertebral artery dissecting large aneurysm involving posterior inferior cerebellar artery (PICA) origin. This approach achieved a very good outcome, not only completely occluding the aneurysm, but also reconstructing the parent artery while maintaining the patency of the PICA.</p>","PeriodicalId":47358,"journal":{"name":"Neuroradiology Journal","volume":" ","pages":"772-775"},"PeriodicalIF":1.3,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11531014/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139040738","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}
Neuroradiology JournalPub Date : 2024-12-01Epub Date: 2024-05-04DOI: 10.1177/19714009241252625
Gabriela Amaral Ribas, Lara Hemerly de Mori, Tomás de Andrade Lourenção Freddi, Luciane Dos Santos Oliveira, Simone Rachid de Souza, Diogo Goulart Corrêa
{"title":"Primary central nervous system lymphoma: Imaging features and differential diagnosis.","authors":"Gabriela Amaral Ribas, Lara Hemerly de Mori, Tomás de Andrade Lourenção Freddi, Luciane Dos Santos Oliveira, Simone Rachid de Souza, Diogo Goulart Corrêa","doi":"10.1177/19714009241252625","DOIUrl":"10.1177/19714009241252625","url":null,"abstract":"<p><p>Primary central nervous system lymphoma (PCNSL) represents 5% of malignant primary brain tumors. The clinical presentation typically includes focal neurological symptoms, increased intracranial pressure, seizures, and psychiatric symptoms. Although histological examination remains the gold standard for diagnostic confirmation, non-invasive imaging plays a crucial role for the diagnosis. In immunocompetent individuals, PCNSL usually appears as a single, well-defined, supratentorial lesion with a predilection for periventricular areas, iso- or hypointense on T1- and T2-weighted magnetic resonance imaging, with restricted diffusion, slightly increased perfusion, and homogenous gadolinium-enhancement. Differential diagnoses include high-grade glioma and pseudotumoral demyelinating disease. In immunocompromised patients, PCNSL may present as multiple lesions, with a higher likelihood of hemorrhage and necrosis and less restricted diffusion than immunocompetent individuals. Differential diagnoses include neurotoxoplasmosis, progressive multifocal leukoencephalopathy, and cerebral abscess. Atypical forms of lymphoma are characterized by extra-axial lymphoma, lymphomatosis cerebri, and intravascular lymphoma. Extra-axial lymphoma presents as single or multiple extra-axial dural lesions with diffuse leptomeningeal contrast-enhancement. Lymphomatosis cerebri appears as an infiltrative and symmetric lesion, primarily affecting deep white matter and basal ganglia, appearing hyperintense on T2-weighted imaging, without significant contrast-enhancement or perfusion changes. Intravascular lymphoma presents as multiple rounded or oval-shaped \"infarct-like\" lesions, located cortically or subcortically. This study aims to highlight the imaging characteristics of PCNSL, focusing on magnetic resonance imaging and its differential diagnosis.</p>","PeriodicalId":47358,"journal":{"name":"Neuroradiology Journal","volume":" ","pages":"705-722"},"PeriodicalIF":1.3,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11531061/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140862691","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}
Ehab Harahsheh, Nan Zhang, Omer Elshaighi, Parth Parikh, Daniel Gomez, Emilie Weinberg, Joseph M Hoxworth, Tanya J Rath, Oana M Dumitrascu
{"title":"Retina and optic nerve diffusion restriction in acute central retinal artery occlusion: A case-control study.","authors":"Ehab Harahsheh, Nan Zhang, Omer Elshaighi, Parth Parikh, Daniel Gomez, Emilie Weinberg, Joseph M Hoxworth, Tanya J Rath, Oana M Dumitrascu","doi":"10.1177/19714009241303102","DOIUrl":"10.1177/19714009241303102","url":null,"abstract":"<p><strong>Objective: </strong>To determine the frequency and accuracy of diffusion restriction (DR) of the retina and/or optic nerve (ON) detection on standard brain magnetic resonance diffusion-weighted imaging (DWI-MRI) in patients presenting with acute non-arteritic central retinal artery occlusion (CRAO).</p><p><strong>Methods: </strong>This is a retrospective case-control study that includes all consecutive patients presenting to our tertiary academic center from 2013-2021 with acute non-arteritic CRAO (cases) or acute ischemic stroke syndrome (controls, age and gender-matched) that had brain MRI performed within 14 days from symptom onset. Two neurology residents (junior and senior), a vascular neurologist, and two neuroradiologists, blinded to the site of CRAO, independently reviewed the brain MRIs to assess for the presence of retina and ON DR. The consensus agreement between the two neuroradiologists was used to perform sensitivity and specificity analyses and calculate inter-rater reliability (prevalence-adjusted bias-adjusted kappa coefficient).</p><p><strong>Results: </strong>A total of 128 patients with acute non-arteritic CRAO (mean (SD) age 69 (14) years; 50% female; median time from CRAO to DW-MRI 2 days (IQR 1-5)) and 128 age and gender-matched controls with acute cerebral ischemia were included. After the neuroradiologist consensus, DR was correctly identified in the retina or ON in 51/128 (39.8%) CRAO cases, retina alone 27.3%, ON alone 24.2%, and both retina and ON 11.7%, with almost perfect neuroradiologists' inter-rater reliability for retina (K = 0.91) and ON (K = 0.83). Among controls, the retina DR was identified in 1/128 (0.8%) and ON DR in 5/128 (3.9%). The sensitivity, specificity, positive predictive value, and negative predictive value were 28.1%, 99.2%, 97.3%, and 58.0% for retina DR, and 27.3%, 96.1%, 87.5%, and 56.9% for ON DR.</p><p><strong>Conclusions: </strong>Though experienced neuroradiologists identified retina and ON DR with excellent inter-rater reliability, these are infrequent findings in real world CRAO practice, with excellent specificity but limited sensitivity. Prospective studies with larger cohort of patients, optimization of standardized orbit DWI-MRI protocols are needed to facilitate a more accurate and reliable identification of retina and ON DR in acute CRAO.</p>","PeriodicalId":47358,"journal":{"name":"Neuroradiology Journal","volume":" ","pages":"19714009241303102"},"PeriodicalIF":1.3,"publicationDate":"2024-11-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11607724/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142755643","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}