Clinical Neuroradiology最新文献

{"title":"From Anatomy to Outcome: Linking Glioma Location Patterns to Survival Using Non-Negative Matrix Factorization.","authors":"Marianne Schell, Joel Kohler, Martha Folty-Dumitru, Haidar Alzaid, Irada Pflüger, Katharina Schregel, Tim Hilgenfeld, Julius Kernbach, Sandro Krieg, Felix Sahm, Wolfgang Wick, Martin Bendszus, Jessica Jesser","doi":"10.1007/s00062-026-01642-8","DOIUrl":"10.1007/s00062-026-01642-8","url":null,"abstract":"<p><strong>Purpose: </strong>The anatomical distribution of IDH-wildtype gliomas may encode prognostic information not captured by conventional clinical or molecular markers. The purpose of this study was to determine whether continuous, data-driven spatial patterns of tumor involvement provide prognostic value beyond established clinical and molecular factors.</p><p><strong>Methods: </strong>We applied non-negative matrix factorization (NMF) to preoperative tumor segmentations from 429 patients with IDH-wildtype gliomas to identify coherent spatial components of tumor involvement. Six reproducible spatial signatures were extracted and integrated into multivariate Cox proportional hazards models. Models additionally included tumor volume, age, sex, O6-methylguanine-DNA methyltransferase (MGMT) promotor methylation status, Eastern Cooperative Oncology Group (ECOG) performance status, and extent of resection.</p><p><strong>Results: </strong>All six spatial patterns demonstrated significant association with overall survival (p ≤ 0.005). Notably, involvement of the left parietal-occipital regions was linked to the poorest outcomes, while temporal patterns showed weaker associations with survival. Incorporating spatial patterns into the prognostic model improved its discriminatory power and altered the influence of tumor volume, indicating an interaction between tumor location and tumor burden.</p><p><strong>Conclusion: </strong>Continuous spatial phenotyping of IDH-wildtype gliomas using NMF captures prognostically relevant information not reflected by conventional markers. Integration of spatial patterns into prognostic models enhances risk stratification and supports the incorporation of detailed spatial analyses into radiologic workflows.</p>","PeriodicalId":49298,"journal":{"name":"Clinical Neuroradiology","volume":" ","pages":"921-930"},"PeriodicalIF":3.2,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13521997/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147534048","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":"Continuation or Withdrawal of Life-sustaining Therapies After Acute Anoxic Events in Childhood and Adolescence : Can Early MRI Predict Particularly Severe Outcomes?","authors":"Katharina Staudt, Martin Staudt, Irina Mader, Melanie Hessenauer, Ingeborg Kraegeloh-Mann, Samuel Groeschel","doi":"10.1007/s00062-026-01657-1","DOIUrl":"10.1007/s00062-026-01657-1","url":null,"abstract":"<p><strong>Purpose: </strong>Withholding or withdrawing life-sustaining therapies is often discussed when children or adolescents suffer severe anoxic events. Previous studies have demonstrated that early MRI can identify patients with major neurological sequelae, but not whether, within a cohort with major neurological sequelae, early MRI can predict particularly severe outcomes. This was the purpose of the present study.</p><p><strong>Methods: </strong>We retrospectively assessed MRI (analyzing 14 brain regions for signal abnormalities on diffusion, T1, T2 and FLAIR) of 38 patients who had suffered acute anoxic events between 8 months and 17 years of age and had required inpatient neurorehabilitation, looking for differences between patients with \"particularly severe outcomes\" (the 22/38 patients who were still unable to interact with their environment 22 weeks after the event) and patients with \"less severe outcomes\" (the 16/38 patients who had regained this ability within 22 weeks).</p><p><strong>Results: </strong>Prediction of \"particularly severe outcome\" was optimal using diffusion MRI obtained on days 4-5 after the event (available in 11 patients, 7 with particularly severe outcomes), when all patients with diffusion restrictions in any of the following regions-putamen (4/7), caudate nucleus (4/7), globus pallidus (6/7), or substantia nigra (4/7)-later showed particularly severe outcomes. In contrast, identification of \"less severe outcome\" was optimal using MRI obtained between days 6-9 after the event, when absence of diffusion restrictions in the cerebral white matter always predicted \"less severe outcome\".</p><p><strong>Conclusion: </strong>Early MRI can identify patients with particularly severe outcomes-and thus can contribute to discussions about the continuation or withdrawal of life-sustaining therapies in the acute phase after anoxic events.</p>","PeriodicalId":49298,"journal":{"name":"Clinical Neuroradiology","volume":" ","pages":"1083-1092"},"PeriodicalIF":3.2,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13522002/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147845121","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 Clinical Neuroradiology: Sustained Growth and Increasing International Recognition.","authors":"Martin Bendszus","doi":"10.1007/s00062-026-01714-9","DOIUrl":"10.1007/s00062-026-01714-9","url":null,"abstract":"","PeriodicalId":49298,"journal":{"name":"Clinical Neuroradiology","volume":" ","pages":"803-804"},"PeriodicalIF":3.2,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13521959/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148800582","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":"Insights into the Mechanisms Underlying the Lower Rupture Risk of Paraclinoid Aneurysms: a Comparative Analysis with Other Aneurysm Locations.","authors":"Xiaodong Zhai, Jiewen Geng, Sishi Xiang, Peng Hu, Chuan He, Guilin Li, Jingwei Li, Liming Zhang, Wei Yang, Hongqi Zhang","doi":"10.1007/s00062-026-01641-9","DOIUrl":"10.1007/s00062-026-01641-9","url":null,"abstract":"<p><strong>Background: </strong>Paraclinoid aneurysms exhibit a markedly lower rupture risk compared to intracranial aneurysms (IAs) located in other regions. We aimed to identify the hemodynamic and morphological factors underlying this reduced rupture propensity.</p><p><strong>Methods: </strong>We analyzed data from 538 unruptured IAs (179 paraclinoid) in the Chinese Intracranial Aneurysm Project (CIAP). Hemodynamic parameters were analyzed using computational fluid dynamics (CFD), and morphological features were quantified using computer-assisted semiautomated measurement (CASAM). Univariate and multivariate logistic regression analyses identified differences between paraclinoid and IAs in other locations.</p><p><strong>Results: </strong>Paraclinoid aneurysms were independently associated with younger age (OR = 1.031, P = 0.024), female sex (OR = 0.474, P = 0.011), and less frequent use of lipid-lowering medications (OR = 3.156, P < 0.001). Hemodynamically, they exhibited lower combined hemodynamic parameter (CHP; OR = 1.055, P = 0.011), normalized pressure (NP; OR = 1.469, P < 0.001), and low shear area (LSA) ratio (OR = 1.065, P < 0.001). Morphologically, they had smaller maximum diameter (OR = 1.203, P < 0.001), lower non-sphericity index (NSI; OR = 1.099, P = 0.002), larger parent artery diameter (OR = 0.157, P < 0.001), and less frequent bifurcation involvement (OR = 9.361, P < 0.001).</p><p><strong>Conclusions: </strong>Paraclinoid aneurysms exhibit lower NP, LSA, and CHP, along with smaller maximum diameter, lower NSI, and a sidewall configuration. Collectively, these features are associated with a stable hemodynamic and morphological environment that underlies their lower rupture risk. Future prospective studies with a large cohort are needed to confirm these findings.</p>","PeriodicalId":49298,"journal":{"name":"Clinical Neuroradiology","volume":" ","pages":"911-919"},"PeriodicalIF":3.2,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147516141","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":"Rethinking the Role of CT Perfusion in IVT Decision-Making in Acute Ischemic Stroke.","authors":"Matija Zupan, Senta Frol, René Chapot","doi":"10.1007/s00062-026-01643-7","DOIUrl":"10.1007/s00062-026-01643-7","url":null,"abstract":"","PeriodicalId":49298,"journal":{"name":"Clinical Neuroradiology","volume":" ","pages":"1119-1123"},"PeriodicalIF":3.2,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147505273","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":"Granulomatous Diseases of the CNS: Aetiology, Neuroradiological Features and Clinical Findings.","authors":"Stefan Weidauer, Randolf Klingebiel","doi":"10.1007/s00062-026-01672-2","DOIUrl":"10.1007/s00062-026-01672-2","url":null,"abstract":"<p><p>Granulomatous disorders of the central nervous system (CNS) encompass a highly heterogeneous group of diseases with autoinflammatory, autoimmune, infectious, proliferative-neoplastic, foreign body-related, or drug-induced aetiologies. Neuroimaging plays a pivotal role, particularly with respect to early diagnosis. Therefore, knowledge of specific imaging patterns is crucial in order to narrow down the broad differential diagnosis. Although imaging cannot replace histology, its importance in initiating therapy as early as possible is indisputable. This is particularly true since many granulomatous diseases respond to treatment, usually with immunosuppressants and/or anti-infectives. This review highlights representative disease entities across the major aetiological categories and discusses key neuroradiological features and clinical symptoms together with relevant differential diagnostic considerations.</p>","PeriodicalId":49298,"journal":{"name":"Clinical Neuroradiology","volume":" ","pages":"855-877"},"PeriodicalIF":3.2,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13522057/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148145290","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":"Association Between Occluded Vessel Diameter and Clinical Outcomes of Mechanical Thrombectomy for M2 Occlusion.","authors":"Yasunori Yokochi, Hiroyuki Ikeda, Masanori Kinosada, Hidenobu Hata, Natsuki Akaike, Takaaki Kitano, Mai Tanimura, Takuya Osuki, Ryosuke Kaneko, Minami Uezato, Yoshitaka Kurosaki, Masaki Chin","doi":"10.1007/s00062-026-01639-3","DOIUrl":"10.1007/s00062-026-01639-3","url":null,"abstract":"<p><strong>Background: </strong>The association between occluded vessel diameter measured using pre-recanalization digital subtraction angiograms and clinical outcomes in patients with acute ischemic stroke undergoing mechanical thrombectomy for M2 occlusion remains unclear.</p><p><strong>Methods: </strong>Consecutive patients with acute ischemic stroke undergoing mechanical thrombectomy for M2 occlusion at our institution between January 2020 and December 2024 were retrospectively analyzed. Based on pre-recanalization digital subtraction angiograms, patients were classified as having large M2 occlusion (LM2O, ≥ 1.7 mm) or small M2 occlusion (SM2O, < 1.7 mm). Favorable 90-day outcome, defined as modified Rankin Scale 0-2 or recovery to pre-stroke level, were compared between the two groups.</p><p><strong>Results: </strong>There were 56 (58.3%) LM2O patients and 40 (41.7%) SM2O patients. Median occluded vessel diameter was 1.85 mm (IQR 1.78-2.11) for LM2O and 1.52 mm (IQR 1.43-1.62) for SM2O. LM2O patients were more likely to have dominant M2 occlusion (67.9% vs. 40.0%, P = 0.012), favorable outcome (62.5% vs. 25.0%; OR 6.67, 95% CI 2.59-17.15; P < 0.001), and first-pass effect (48.2% vs. 17.5%; OR 4.39, 95% CI 1.66-11.57; P = 0.002). In multivariable analysis, occluded vessel diameter ≥ 1.7 mm was independently associated with favorable outcome (OR 10.50, 95% CI 3.17-35.0; P < 0.001). Patients with a catheter-to-vessel ratio < 1.0 experienced higher first-pass effect more frequently than those with a catheter-to-vessel ratio ≥ 1.0 (46.8% vs. 24.5%; P = 0.032).</p><p><strong>Conclusions: </strong>Occluded M2 vessel diameter ≥ 1.7 mm may be associated with favorable 90-day outcome in patients with acute ischemic stroke undergoing mechanical thrombectomy for M2 occlusion.</p>","PeriodicalId":49298,"journal":{"name":"Clinical Neuroradiology","volume":" ","pages":"887-897"},"PeriodicalIF":3.2,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147460647","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":"Incidence of Fish-mouthing and Wall Malapposition of Different Flow Diverters in the Treatment of Cerebral Aneurysms: Device-specific Findings in a Retrospective Single-center Analysis.","authors":"Maximilian Rothe, Martin Renz, Maria Berndt-Mück, Dennis Hedderich, Dominik Sepp, Bernhard Meyer, Chiara Negwer, Jannis Bodden, Jan Kirschke, Tobias Boeckh-Behrens, Christian Maegerlein","doi":"10.1007/s00062-026-01651-7","DOIUrl":"10.1007/s00062-026-01651-7","url":null,"abstract":"<p><strong>Purpose: </strong>Flow diverter (FD) braid stability is crucial for optimal wall apposition, thereby reducing the risk of device-related complications following intracranial aneurysm treatment. We compared wall apposition characteristics across different FD designs to evaluate inter-device differences.</p><p><strong>Methods: </strong>Retrospective single-center analysis of 104 patients with 127 aneurysms treated with 121 FD (35 Derivo Embolization Devices (DED; Acandis, Pforzheim, Germany), 50 p64 (Phenox Wallaby, Bochum, Germany), 24 p48 (Phenox), 11 Silk (Balt, Montmorency, France), and 1 Pipeline (Medtronic, Dublin, Ireland)) between February 2013 and June 2023. The analysis focused on fish-mouthing-like deformities (≥ 10% focal diameter reduction at device ends) and the need for mechanical wall apposition maneuvers, as well as aneurysm occlusion, thrombus-associated events, and neurological outcomes.</p><p><strong>Results: </strong>Fish-mouthing-like deformities occurred more frequently with DED (50.0%) than with other FD-types (27.2%; p = 0.021), mainly due to \"pre\"-fish-mouthing (31.3% vs. 14.8%; p = 0.047). Mechanical wall apposition maneuvers were more often required in DED cases (60.0% vs. 25.6%; p < 0.001), particularly for proximal malapposition. Aneurysm occlusion rates were comparable at final FU (84.2% vs. 88.6%; p = 0.563). Thrombus-associated events occurred more frequently with DED (29.4% vs. 11.3%; p = 0.008), though neurological outcomes did not differ significantly (6.0% vs. 2.6%; p = 0.148). Mean FU time was 26.0 ± 21.0 months.</p><p><strong>Conclusion: </strong>DED required more frequent intraprocedural wall apposition maneuvers and showed higher rates of fish-mouthing-like deformities compared with other FD-types. However, long-term aneurysm occlusion and neurological outcomes were comparable. These findings suggest that while DED deployment may require greater technical expertise, its safety and efficacy should be further evaluated in larger, multicenter studies.</p>","PeriodicalId":49298,"journal":{"name":"Clinical Neuroradiology","volume":" ","pages":"963-975"},"PeriodicalIF":3.2,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13522061/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147693078","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":"Intra-Arterial Thrombolytic vs. Mechanical Thrombectomy in Distal Medium Middle Cerebral Artery Acute Ischemic Stroke: A Preliminary Multinational Multicenter Propensity Score-Matched Study.","authors":"Hamza Adel Salim, Benjamin Pulli, Vivek Yedavalli, Takahiro Ota, Dhairya Lakhani, Orabi Hajjeh, Basel Musmar, Nimer Adeeb, Fathi Milhem, Tobias D Faizy, Kareem El Naamani, Nils Henninger, Sri Hari Sundararajan, Anna Luisa Kühn, Jane Khalife, Sherief Ghozy, Luca Scarcia, Leonard L L Yeo, Benjamin Y Q Tan, Robert W Regenhardt, Jeremy J Heit, Nicole M Cancelliere, Aymeric Rouchaud, Jens Fiehler, Sunil Sheth, Ajit S Puri, Christian Dyzmann, Marco Colasurdo, Leonardo Renieri, João Pedro Filipe, Pablo Harker, Răzvan Alexandru Radu, Mohamad Abdalkader, Piers Klein, Thomas R Marotta, Julian Spears, Ashkan Mowla, Pascal Jabbour, Arundhati Biswas, Frédéric Clarençon, James E Siegler, Thanh N Nguyen, Ricardo Varela, Amanda Baker, Muhammed Amir Essibayi, David Altschul, Nestor R Gonzalez, Markus A Möhlenbruch, Vincent Costalat, Benjamin Gory, Christian Paul Stracke, Constantin Hecker, Gaultier Marnat, Hamza Shaikh, Christoph J Griessenauer, David S Liebeskind, Alessandro Pedicelli, Andrea M Alexandre, Illario Tancredi, Erwah Kalsoum, Boris Lubicz, Aman B Patel, Vitor Mendes Pereira, Max Wintermark, Adrien Guenego, Adam A Dmytriw","doi":"10.1007/s00062-026-01644-6","DOIUrl":"10.1007/s00062-026-01644-6","url":null,"abstract":"<p><strong>Background: </strong>Optimal treatment for acute ischemic stroke due to distal medium-vessel occlusion (DMVO) in the middle cerebral artery (MCA) remains uncertain. While mechanical thrombectomy (MT) may pose higher risks in DMVO, intra-arterial thrombolysis (IAT)-with or without intravenous thrombolysis (IVT)-could be a safer alternative.</p><p><strong>Purpose: </strong>To compare functional outcomes and safety profiles of IAT versus MT in acute ischemic stroke caused by MCA DMVO (M2-M4 segments).</p><p><strong>Methods: </strong>We performed a retrospective, propensity score-matched study across 37 centers (Asia, Europe, North America) using the MAD-MT registry. Patients with MCA DMVO (M2-M4) treated with IAT or MT (with/without IVT) were included. Propensity score matching adjusted for confounders. The primary outcome was excellent functional outcome (modified Rankin Scale [mRS] 0-1 at 90 days).</p><p><strong>Results: </strong>After matching, 184 patients were analyzed (19 IAT, 165 MT). Baseline characteristics were balanced. At 90 days, excellent functional outcomes occurred in 38% (IAT) versus 21% (MT) (P = 0.20). Functional independence (mRS 0-2) rates were 50% (IAT) versus 40% (MT) (P = 0.42). Mortality was comparable (13% vs. 17%). Successful reperfusion (modified Thrombolysis in Cerebral Infarction [mTICI] 2b-3) was higher with MT (90% vs. 68%; P = 0.02), but symptomatic intracranial hemorrhage occurred only with MT (6.7% vs. 0%; P = 0.60).</p><p><strong>Conclusion: </strong>For MCA DMVO, IAT showed similar functional outcomes and numerically fewer safety events than MT despite lower recanalization rates. These findings should be interpreted cautiously, given the small IAT sample size and require validation in larger prospective studies.</p>","PeriodicalId":49298,"journal":{"name":"Clinical Neuroradiology","volume":" ","pages":"983-995"},"PeriodicalIF":3.2,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13522062/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147730394","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":"Expert Panel Consensus Guidelines of the German Society of Neuroradiology on the Use of Magnetic Resonance Imaging in the Diagnosis and Monitoring of Multiple Sclerosis.","authors":"Mike P Wattjes, Carsten Lukas, Sönke Langner, Hagen H Kitzler, Michael Scheel, Andreas J Bartsch, Benedikt Wiestler","doi":"10.1007/s00062-026-01670-4","DOIUrl":"10.1007/s00062-026-01670-4","url":null,"abstract":"<p><p>The recently published 2024 revisions of the McDonald criteria unified and expanded the diagnosis of MS towards a \"biological diagnosis\" and incorporated new MR imaging (bio)markers. Most prominently, they now incorporate imaging of the optic nerve as the fifth topography for dissemination in space (DIS), as well as the central vein sign (CVS) and paramagnetic rim lesions (PRLs), to facilitate an earlier diagnosis of MS. In addition, certain new MRI measures, such as slowly expanding lesions (SELs) and particularly PRLs, are increasingly used in clinical trials and may enter routine clinical practice in the near future. These developments, along with the 2024 MAGNIMS-NAIMS-CMSC consensus recommendations, suggest a different role for MRI in managing patients with MS and expansion of the MRI acquisition protocols, reading, and interpretation. Here, an imaging expert panel of the German Society of Neuroradiology (DGNR) established consensus recommendations on the role of MRI in the management of patients with suspected or definite MS, endorsed by the German Society of Neurology (DGN). These recommendations incorporate these new developments into the context of the German healthcare system. We suggest minor modifications to the acquisition protocol outlined in the 2024 McDonald criteria and the MAGNIMS-NAIMS-CMSC consensus recommendations. For patients with inconclusive imaging findings and in specific diagnostic situations, we recommend changes to MRI acquisition protocols that incorporate susceptibility-weighted imaging (SWI) sequences to demonstrate CVS and PRLs, as well as optic nerve imaging. Additionally, we provide recommendations on the use of MRI for treatment monitoring, including progressive MS patients.</p>","PeriodicalId":49298,"journal":{"name":"Clinical Neuroradiology","volume":" ","pages":"831-854"},"PeriodicalIF":3.2,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13522060/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148036990","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}